Bottomley Jamison S, Neimeyer Robert A
National Crime Victims Research and Treatment Center, Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, 67 President Street, Charleston, SC 29425, USA.
Portland Institute for Loss and Transition, Portland, OR 97223, USA.
Behav Sci (Basel). 2025 May 14;15(5):671. doi: 10.3390/bs15050671.
Adults bereaved by the suicide or overdose death of someone close to them are vulnerable to adverse mental health outcomes, but little is known about how these individuals utilize avoidance- and approach-based coping strategies, how these strategies relate to outcomes, and what accounts for these associations. Informed by contemporary theories of bereavement, we utilize prospective data from suicide- and overdose-bereaved adults ( = 212) who completed two waves of online data collection approximately two years following the death (T1 and T2; six months apart) to examine the mediating role of meaning making in the relationship between coping strategies and grief-related mental health outcomes, such as prolonged grief (PG), posttraumatic stress (PTS), and depression. Path analysis with mediation was used to investigate the relations between coping strategies at T1, meaning making at T2, and mental health outcomes at T2. The results indicated direct effects of avoidant coping at T1 in predicting higher PG and PTS symptoms at T2, while approach-based coping at T1 indirectly predicted an improvement in all three T2 outcomes due to increased meaning making. These results suggest that avoidance-based strategies directly and indirectly contribute to poorer outcomes and impaired meaning making processes, while approach-based strategies lead to increased meaning making and adaptation to loss among suicide and overdose loss survivors. The clinical implications and future directions for research are discussed.
因亲近之人自杀或服药过量死亡而痛失亲人的成年人容易出现不良心理健康后果，但对于这些人如何运用基于回避和接近的应对策略、这些策略与后果之间的关系以及造成这些关联的原因，我们却知之甚少。基于当代丧亲理论，我们利用来自因自杀和服药过量痛失亲人的成年人（n = 212）的前瞻性数据，这些成年人在亲人死亡约两年后（T1和T2；相隔六个月）完成了两波在线数据收集，以检验意义建构在应对策略与悲伤相关心理健康后果（如持续性悲伤（PG）、创伤后应激（PTS）和抑郁）之间关系中的中介作用。采用带有中介效应的路径分析来研究T1时的应对策略、T2时的意义建构与T2时的心理健康后果之间的关系。结果表明，T1时的回避应对直接预测了T2时更高的PG和PTS症状，而T1时基于接近的应对由于意义建构增加而间接预测了所有三个T2结果的改善。这些结果表明，基于回避的策略直接和间接地导致了更差的结果和受损的意义建构过程，而基于接近的策略则导致自杀和服药过量丧亲幸存者的意义建构增加和对丧失的适应。本文还讨论了临床意义和未来的研究方向。
