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Little is known about widowhood's effects on externalizing expressions of distress, like substance use, among sexual minorities. Our study is the first to address this issue using a large national sample of LGB individuals living in the United States. Using the 2010 Aging with Pride: National Health, Aging, and Sexuality/Gender Study ( n  = 2,258), we ran logistic regression models predicting current smoking, past 30-day binge drinking, and past year drug use. Widowhood predicted higher odds of drug use. These results were found for currently partnered individuals, suggesting that widowhood's effects are not completely offset by current partnership. In contrast, widowhood did not predict smoking or binge drinking. All results held for women and men. Results suggest that LGB widowhood's effects on substance use vary by current partner status and substance type. These findings contrast with those of studies examining widowhood's effects on internalized expressions of distress, which consistently find detrimental effects., Competing Interests: Declaration of Conflicting InterestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

We explore the phenomenon of organ donation between rivals in time of war when a significant gift such as organ donation is given not just to a "stranger" but to a stranger who may be considered an enemy. This is a case study of a unique organ donation event that occurred in Israel during Operation Guardian of the Walls in May 2021. It involved a Palestinian boy killed by a Jewish policeman and a Jewish man killed by Palestinian youths. Both victims, lacking organ donor cards, had their organs donated by their families with the awareness that recipients could come from the "opposing" group. We ask: (1) How do families from rival groups construct meaning in their decision to donate organs? (2) How do they construct meaning in their experience of loss? The findings reveal that bereaved families imbue their actions with political and religious significance, framing the organ donations as a "universal gift" guided by religious commandments to save lives. While these acts initially transcend cultural and national boundaries, a lack of recognition and gratitude afterward can lead to disillusionment, reinforcing "us" versus "them" boundaries. This study underscores the intricate dynamics in organ donations during political conflict and the pivotal role of religious authorities in shaping perceptions and meaning. Moreover, it highlights the potential for organ donations to foster reconciliation and coexistence amidst conflict, provided mutual recognition in cases where compassion and understanding of loss are prioritized., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

This study identifies the stigma experienced by 12 bereaved parents 2 and 5 years after losing a child in the Sewol ferry disaster in South Korea. Using thematic analysis, we categorized the experience of stigma into two components based on Corrigan and Kosyluk's social cognitive model of stigma: public stigma and self-stigma, and each was analyzed into three types of stigma: stereotype, prejudice, and discrimination. We identified four additional factors related to stigma mitigation. The potential implications for characterizing the experiences of bereaved parents, particularly those facing stigma, are discussed in light of these findings in the longitudinal perspective., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Different parents grieve differently. However, research directed at understanding the important contextual or individual factors that influence the path each bereaved parent takes is lacking. In this qualitative analysis we seek to understand the array of bereaved parent experiences more completely. By deeply diving into one parent dyad using interpretive phenomenology analysis and situating that story within the conventional content analysis of 13 other bereaved parents of adolescents and young adults (AYAs) who died from advanced cancer, we illustrate the roles of religion/spirituality, maintaining a connection, and fulfilling parental roles as elements of grief processing. Clinicians and investigators should consider similar individualized approaches to understanding and supporting the grief experiences of bereaved parents before and after the death of a child., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

The COVID-19 pandemic has reshaped the way Americans deal with death and dying. Social distancing restrictions prevented or delayed end of life services for families who lost loved ones to COVID-19. Alternatively, some took to the internet to express their grief through online memorialization. Using content analysis, this study analyzes 200 randomly selected online memorials from the COVID Memorial website, a website created to share the stories of those lost to COVID-19 on social media. Our findings offer insight into memorial author demographics, how memorial authors framed and understood death due to COVID-19, and the COVID-19 pandemic through online memorialization. Two major themes emerged during data analysis, "references to COVID-19 death" and "COVID-specific directives to readers." The  former, details how memorial authors framed and understood the death of a loved one to COVID-19. The latter details "advice" or "directives" authors gave to readers about social distancing guidelines and other guidelines meant to prevent the spread of COVID-19., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Background: Grieving is a natural process, and many people adjust with support from family and friends. Around 40% of people would benefit from additional input. Online bereavement support interventions may increase access to support. Evidence regarding their acceptability and effectiveness is emerging but needs to be synthesised., Aim: To synthesise evidence on the feasibility, acceptability, effectiveness, impacts and implementation of online interventions to improve wellbeing, coping and quality of life after bereavement., Design: A rapid review of evidence regarding online bereavement support. We appraised study quality using AMSTAR 2 and the Mixed Methods Appraisal Tool., Data Sources: English language articles published 1 January 2010 to 4 January 2024, using Ovid MEDLINE, Ovid Embase and APA PsycINFO. Eligible articles examined formal and informal online interventions to improve bereavement outcomes., Results: We screened 2050 articles by title and abstract. Four systematic reviews and 35 individual studies were included. Online bereavement support was feasible, acceptable and effective in reducing grief intensity, stress-related outcomes and depression. Where reported, participant retention was typically >70%. Positive impacts included: access to a supportive community at any time, reduced isolation; opportunities to process feelings; normalisation of loss responses; access to coping advice and opportunities for meaning-making and remembrance. Negative impacts included upset due to insensitive comments from others via unmoderated online forums., Conclusion: Online interventions can widen access to acceptable, effective bereavement support and improve outcomes for bereaved people. National policies and clinical guidelines relating to bereavement support need to be updated to take account of online formats., Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

The COVID-19 pandemic has killed millions across the world in only two years. Government health restrictions aimed at preventing transmission have impacted typical mourning practices such as funeral gatherings and in-person grief support services. This research examines the potential impacts that the pandemic may have had on people's ability to grieve. We employed a mixed methods study design to ask those who have lost a loved one during this time to reflect on their mourning practices with an anonymous survey. Our results present themes of complicated grief, the uncertainty of who to blame for frustrations, and common needs requested by the bereaved to help them mourn during these unprecedented times. These findings may help inform grief support and bereavement services during current and future mass death and pandemic health concerns., Competing Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2023.)

To translate and culturally adapt the Perinatal Bereavement Care Competence Scale (PBCCS) scale into Turkish (T- PBCCS) and determine its psychometric properties. This reliability and validity study was conducted with 150 midwives between April and September 2024. The 150 active midwives completed the information form and the T-PBCCS forms. Exploratory factor analysis revealed a six-factor structure consistent with the theoretical framework, explaining 70.07% of the total variance. Confirmatory factor analysis showed a good fit for the six-factor model. The Cronbach's a value of the scale was .92 and the test-retest reliability coefficient was .99. Some statements in the original structure of the scale were excluded from the scale because they could not be adequately validated in Turkish culture. The results of the statistical analyses of the Perinatal Bereavement Care Competence Scale adapted to Turkish culture showed that it gave valid and reliable results in Turkish culture., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

This qualitative study explores the bereavement experiences of 12 surviving siblings in India, focusing on familial, societal, and cultural influences. Six themes emerged: "The Demanding Familial Role," "Isolation That Accompanies the Grief," "Damaging Impact of Society," "Positive Role of Friends and Family," "Support Systems," and "Continuing Bonds." Participants often felt the burden of supporting their parents, leading to personal grief suppression and isolation, exacerbated by societal stigmas. Conversely, empathetic friends, supportive extended family, and professional resources like therapy provided crucial coping mechanisms. Continuing bonds with the deceased offered comfort and connection. The study highlights the need for comprehensive support systems tailored to cultural and societal contexts. It emphasizes the importance of public awareness and education to foster a supportive response to bereavement. Further research with larger, more diverse samples is recommended., Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Background: Grief has previously been described in pathological terms, characterized by several stages. In the past three decades, new perspectives on grief as a reaction to the loss of a significant other have emerged. It shows that grief is an individual process based on circumstances surrounding the death and the bereaved person's life situation, rather than being predetermined., Objective: The aim of the study was to show how grief is perceived by people who have lost a significant other, and it focuses on bereavement support, how the death affects the bereaved person's living conditions, how the bereaved person deals with grief, and if grief is expressed differently depending on whether it was an expected death (ED) or an unexpected death (UED)., Design: A cross-sectional design was used with data collected anonymously using an online survey with semi-structured answers and options for participants to add their own comments, and it was analyzed descriptively., Result: Support in grief was mainly given by family and friends, and the perceived need was primarily for emotional support or emotional support combined with practical support, and to a greater extent for UEDs and women. For some bereaved persons, health caregivers and religious institutions provided support outside their own network. Grief can affect how people socialize with others and change social relationships. People can deal with grief in social as well as religious ways in the company of friends, through everyday conversations, spending time in nature, and having a spiritual outlook on life, and with the help of pets., Conclusion: The results can contribute to an increased understanding of grief after the loss of a significant other and how grief affects the bereaved person's life depending on whether it is an ED or a UED. There was a difference between the genders, with women perceiving a need for and receiving different forms of support and to a greater extent than men., Competing Interests: The authors declare that there is no conflict of interest., (© The Author(s), 2024.)

Background: Festivals play an important role in improving death and grief literacy, enabling members of the public to engage with these often-sensitive topics. Good Grief Weston festival was co-designed and delivered with the community in Weston-super-Mare, a coastal town in South-West England with high levels of socioeconomic disadvantage but rich community assets. It was held in person over 8 days in May 2023., Objectives: To evaluate the reach and impact of Good Grief Weston festival and gather data to inform future festivals., Design: Mixed methods evaluation (survey and focus groups)., Methods: Online and paper surveys assessing participants' characteristics and experiences were administrated during and after the festival. Survey participants who indicated their willingness to participate were invited to attend a focus group. Focus groups were recorded, transcribed and analysed using thematic analysis. Data were collected by trained community co-researchers., Results: Approximately 3000 people attended the festival. Of 204 completed surveys, 64.5% were from women, age range ⩽15 to ⩾75 years; 88.2% identified as White; 14.9% deaf, disabled/with a chronic condition; 18.9% neurodivergent; 9.0% gay, bisexual or queer. Festival participants were entertained (70.9%), inspired (68.5%), felt part of a like-minded community (54.3%), talked to someone new (49.2%), learnt about grief/bereavement (34.3%), shared or expressed experiences (30.3%) and found out about local support (19.7%). 71.3% reported that they felt more confident talking about grief after attending. Median experience rating was 5 (IQR 0; possible range 1 = poor to 5 = excellent). In free-text comments, participants expressed appreciation for the festival and described benefits in attending. Two focus groups were conducted ( n  = 8 participants, all women), lasting c.1.5 h. Focus groups added rich descriptions of the festival's value, and data to inform the next festival., Conclusion: Findings suggest festivals of this nature can play a central role in a public health approach., (© The Author(s), 2024.)

This study aims to validate the Korean version of the Revised Prolonged Grief Disorder scale (PG-13-R-K) by exploring the psychometric properties of the revised Prolonged Grief Disorder scale in bereaved South Korean adults. A total of 694 bereaved individuals who had experienced the loss of a close person for a duration ranging from 12 to 24 months were included in this study and randomly divided into two separate datasets to conduct factor analyses. The results of both EFA and CFA revealed a single-factor structure for the PG-13-R-K. Moreover, the results of reliability and validity tests showed adequate internal consistency and concurrent validity. These findings suggest that the PG-13-R-K is a reliable and valid tool for assessing PGD symptoms among bereaved Korean adults. The limitations and implications of this study are thoroughly examined and discussed., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Despite rising rates of drug-related deaths (DRDs), the consequences of DRDs for bereaved family members are scarcely investigated. This study aimed to estimate the prevalence of prolonged grief (PG) symptoms in bereaved family members after DRDs, identify predictors of PG and examine whether symptom levels decrease with time. A cross-sectional design based on survey data from parents ( n = 93), siblings ( n = 78), children ( n = 24) and other family members ( n = 39) was conducted ( n = 234). Descriptive analyses, a multivariate linear regression, and ANOVA were performed. 60 family members (26%) suffered from high levels of PG symptoms after DRDs (parents 31.2%, siblings 21.8%, children 20.9%). The strongest associations were found between a high level of symptoms and 'months since the loss', 'suicidal thoughts' and 'withdrawal from others'. The ANOVA analyses showed that time does not always 'heal all wounds', and the bereaved who lost one to 2 years ago had the highest level of PG symptoms., Competing Interests: Declaration of Conflicting InterestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Bereavement is commonly experienced by students in higher education and is associated with negative health and academic consequences. We conducted a systematic review of the literature to identify how grief affects students in higher education and the types of support they seek and/or find beneficial. A search of Health Collection, Medline, CINAHL Plus, Web of Science, Taylor and Francis online, ProQuest, and Open Grey resulted in 30 articles that met inclusion criteria. A narrative synthesis resulted in 11 themes focused on the university experience following bereavement (six themes) and supports following bereavement (five themes). Our review highlights how grief symptoms can have a negative impact on bereaved students' academic and social experiences. These difficulties are exacerbated by barriers to accessing grief supports, and unhelpful responses from staff and peers. Students' grief is often disenfranchised and so students learn to avoid grief related emotions, communications, and support-seeking., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

This paper outlines a new approach to using participants' self-identified temporal triggers to center data collection around meaningful time periods as it pertains to coping with loss and trauma. We describe the utility of ecological momentary assessment and wearable technology as tools for time-informed data collection; and provide a study protocol for a recent study in which we paired these approaches to gather data from adult respondents who had lost a loved one. Data collection included two phases: a baseline phase and a target date phase. The target date phase was centered around the participant's self-identified temporal trigger. Several lmitations to this mode of data collection are disucsed. The overall approach is client centered and more accurately captures the lived experiences of individuals coping with loss and trauma. Data of this kind will begin to highlight the psychological and physiological impacts of anniversary dates among survivors of trauma and loss., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

This study aimed to shed light on the initial-stage bereavement experiences of an individual bereaved by suicide, at three months from the loss of his spouse to suicide. A semi-structured in-depth interview was conducted with the individual, a man in his thirties. The data were analyzed using qualitative assimilation analysis, based on the Assimilation Model and the Assimilation of Problematic Experiences Scale (APES). The APES ratings of the interview revealed that the individual's bereavement was associated with the earlier stages of APES (all scoring under 3.5). In addition, the swift and frequent fluctuations in the APES ratings gave indications that the bereavement was unstable and complicated. It is suggested that mental health professionals could use APES to evaluate suicide bereavement and take note of the APES evaluations in clinical interventions., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Adverse life events are associated with the often-terrifying REM sleep parasomnia of sleep paralysis (SP), but the impact of bereavement on SP has not been specifically examined. This exploratory, mixed-methods study ( N = 168) includes qualitative data from 55 participants who described factors they believed led to their SP. Of these, almost half with a traumatic loss listed death-related precipitants. In unadjusted (bivariate) negative binomial regression models, traumatic death, time since death, religiosity, and age estimated increased SP frequency in the prior month, prior year, or both. In multivariable models, traumatic death, time since death, and age estimated increased frequency in the prior month, prior year, or both. Unexpectedly, in all models, as compared to death ≥9 years earlier, prior month SP was greater with death 1-6 years earlier, but not <1 year earlier. Discussion includes the possible role of social constraints in traumatic grief trajectories and care provider recommendations., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

The Stigma of Suicide Scale (SOSS) is a measure of public attitudes toward suicide decedents, which makes it unique from other scales that measure more general attitudes toward suicide. The aim of this study was to further replicate and extend the reliability and factor structure of the SOSS (both long- and short form) in a sample of individuals directly impacted by suicide. This study also sought to identify factors that impact suicide attitudes unique to this sample. The sample included 312 participants who had personal experience with suicide. Results provided support for the oblique three-factor structure of the SOSS (stigma, isolation/depression, and glorification/normalization), with a superior model fit for the 16-item short form version. Correlates of suicide attitudes among individuals exposed to suicide included perceived relationship closeness to a suicide decedent, experience with both loss and attempt, and the sex of the suicide decedent., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Ethical bonds transformation is a cultural phenomenon in Taiwanese bereaved families. When the death event occurs, the absent status of the deceased invokes spontaneous change in whole family to cope with the irreparable loss. In the present study, 283 bereaved individuals were recruited to develop the ethical bonds transformation scale. Exploratory factor analysis has generated two factors: ethical bonds and symbolic bonds. Partial correlation has shown that ethical bonds was positively correlated with post-grief growth and negatively correlated with most of the grief related symptoms, indicating that ethical bonds might be a protective factor in the family grief process., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Attachment insecurity, including attachment anxiety and attachment avoidance, is proposed as a key factor disrupting adaptive recovery following bereavement, resulting in complicated grief. However, findings are inconsistent across studies. This review aimed to synthesise existing research on attachment patterns in adults experiencing complicated grief to better understand this relationship. 22 cross-sectional and longitudinal studies (5149 participants), published between 2003 and 2020, met inclusion criteria. Higher levels of attachment anxiety were consistently associated with symptoms of complicated grief. Higher levels of attachment avoidance were associated with symptoms of complicated grief, although this relationship was less consistent. The review has implications for clinical practice as bereaved adults with insecure attachment histories may be particularly vulnerable to experiencing complicated grief. The research is limited by the reliance on mainly cross-sectional studies. Future research should focus on longitudinal studies, and studies that explore men's experiences, and of individuals living in non-Western countries., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

The fear of contracting the disease, introduction of practices such as quarantine, social isolation, and curfew to prevent its transmission, and effects of experiencing a loss due to this disease are experienced differently by different people. The empirical phenomenological approach will be used to describe, explain, and analyze the experiences of the family members of individuals who lost their lives due to COVID-19. This study was created in accordance with COREQ Statement Checklist. The themes obtained from the interviews are "death in isolation", "changing cultural-religious practices that cannot be performed", "not being able to say goodbye".This transformed grieving process caused by the pandemic may create unique psychosocial needs among family members. To meet these needs, planning and organizing complex grief therapy, speech therapies, expressive supportive counseling, and grief recovery programs is recommended., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

This article explores the ways in which bereaved mothers framed experiences of continuing bonds with their stillborn child and aims to enrich an understanding of maternal sense-making. Four interviews were carried out with bereaved mothers and approached using Interpretative Phenomenological Analysis, so as to offer deeper insight into their individual experiences. Themes which arose from the analysis include: "Continuing bonds and the female body;" "Conflicted bonding with the shape-shifting baby;" and "Experiencing connection in the life beyond loss." These findings point to a tension between restorative meaning-making and detachment in maternal sense-making following stillbirth and have implications for clinicians working with bereaved mothers., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Grief and bereavement impact nearly every individual at some point of their lives, often having short or long-term physical and psychosocial impacts. Yet, these issues are rarely the focus of discussion, intensive therapy programs, or policy initiatives (Corr, 2002; Doka, 2002). This research explores the impacts of a closed group art and narrative therapy program in Ontario for individuals experiencing a grief or bereavement process following the loss of a loved one. It explores the grief experiences of art therapy participants during their time in the program, the nature, extent, and impacts of social and community connections that were made, how the program influenced grief over time, and the overall effectiveness of the program. This study suggests that art and narrative therapy hold great therapeutic potential as a tool to help individuals going through a grief or bereavement process., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

To date, several theoretical models have been proposed to explain how the expected and natural grief processes turns into psychiatric disorders. Nevertheless, there is a paucity of empirical research examining the basic assumption of psychoanalytic theory regarding pre-death conflict and bereavement related guilt. Accordingly, the current study aimed to investigate the mediator role of bereavement related guilt in the relationship between the pre-death conflict and maladaptive grief process. The sample consisted of 447 bereaved adults who lost a loved one due to death in the last 5 years. The Unfinished Business in Bereavement (UBBS), Bereavement Guilt Scale (BGS), Beck Depression Inventory (BDI), and Prolonged Grief Disorder Scale (PG-13) scales were administered. The results indicated that the UBBS scores were positively correlated with both BDI and PG-13 scores, and BGS scores mediated these relationships. Obtained findings were discussed in relation to psychoanalytic theory and existing studies in the grief literature., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

The morbidity and mortality rates of COVID-19 pandemic are increasing, and many families have lost their loved ones. This study explored the experiences of families living in Iran who lost a loved one to COVID-19. The researchers apply a descriptive phenomenological approach and draw on in-depth interviews with 18 family members who had lost at least one family member because of COVID-19. Data were analyzed using Colaizzi's method. After reviewing and comparing the consistency of the codes, crisis in crisis, circumstances of death and its consequences, and lack of preservation of patient dignity were extracted as main categories. Neglecting grieving families and related issues can lead to delays and difficulties in the process of recovery and intensification of their psychosocial pressures. Acquiring more knowledge about different impacts of COVID-19 will be helpful for providing timely and better rehabilitation., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Background: Suicide is a major public health issue that increases the risk of suicide for those bereaved by suicide themselves. There is a lack of evaluation of the effectiveness and acceptability of suicide postvention services supporting those bereaved by suicide. Aims: This review aimed to assess evaluations of postvention services supporting those bereaved by suicide and the acceptability of methods of postvention. Methods: Searches of peer-reviewed literature identified 36 studies for inclusion. 22 studies evaluated specific postvention services, 14 evaluated models of postvention. Results: Using the Mixed Methods Appraisal Tool, mixed-methods and qualitative postvention evaluation and acceptability research produce high-quality studies. Studies rated as low quality reflect poor reporting, rather than ineffective services. Conclusion: Further evaluation of community-based postvention services within the UK is needed. This would evidence that services in the UK are effective in supporting those bereaved by suicide. Evaluation would benefit services in accessing funding, improve service development and provide holistic support., Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Brief contact interventions are an efficient and cost-effective way of providing support to individuals. Whether they are an effective bereavement intervention is not clear. This systematic review included articles from 2014 to 2021.711 studies were identified, with 15 meeting inclusion criteria. The brief contact interventions included informational and emotional supports. Narrative synthesis identified that participants valued brief contact interventions, however some did not find them helpful. Exposure to a brief contact intervention was typically associated with improvements in wellbeing. Studies with comparison groups typically found significant but modest improvements in grief, depression symptoms and wellbeing associated with the intervention. However, one intervention was associated with significant deterioration of depression symptoms. Existing brief contact interventions for bereavement appear feasible, generally acceptable to the target population and are associated with improvements in wellbeing. Further development and evaluation to account for why improvements occur, and to identify any unintended impacts, is required., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

The COVID-19 pandemic has resulted in many people experiencing bereavement in challenging circumstances. In April 2020 at a large London Trust, a "Bereavement Welfare Hub" was established to offer support and advice by telephone to relatives and carers of all adults who died as inpatients. Data from BWH call records regarding 809 adults who died at the Trust in March, April and May 2020 were collated. A random selection of 149 call records were examined using thematic analysis. Six themes which influenced the bereavement experiences and grief status of call recipients were identified. These included family and community support, care up to the point of death, communication, care after death and death rituals and customs. Several factors positively and negatively influenced the experiences of people bereaved during the first wave of COVID-19. From these findings, recommendations have been made which have the potential to improve the bereavement experience, particularly during the pandemic era., Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Grief responses range from minimal changes in functioning to debilitating, prolonged, complicated grief. The objective of the current study was to clarify the relationship between maladaptive personality characteristics, coping and situational factors associated with symptoms of complicated grief and health difficulties among bereaved individuals who had lost a loved one within the past six months to two years ( N = 304; 59% male; M age = 33.49, SD = 9.98, range 20-81). Situational risk factors, coping (self-distancing, denial, substance use, positive reframing, acceptance, religion, self-blame, behavioral disengagement, venting and humor) and maladaptive personality traits significantly predicted either symptoms of complicated grief or health difficulties. Coping strategies partially mediated the relationship between maladaptive personality traits and symptoms of complicated grief and health difficulties. Overall, these findings highlight the importance of maladaptive personality traits and coping strategies in the conceptualization of complicated grief and should be a greater focus of clinical intervention., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Continuing bond manifesting as unexplainable experiences reflects bereaved´s attempts to restore connection with the deceased. As an experience unaligned with a person's overall schemas of meaning unexplainable experiences are a source of anxiety that individuals aim to alleviate by attribution thinking. This study describes how bereaved aim to explain unexplainable experiences related to the death of their loved ones. The study analysed 408 narratives of 181 bereaved individuals. Bereaved individuals (1) described the meaning of their experience to be receaving information, emotions or support by the experience and communicating about crossing the boundary between life and death. As (2) reflections on the cause of their experiences bereaved individuals described certain and uncertain explanations of the phenomenon, ruling out explanations and the compatibility or incompatibility of the experience with their prior worldviews. The process of attribution thinking must be perceived as meaningful regardless of the outcome of the bereaved person's reflection., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

This study examines adult children's loss of a parent through final conversations and communal coping. By looking at survivors' experiences through the lens of the opportunity model for presence (OMP) during the end-of-life (EOL) process, a model that provides a path of engagement leading to a good or bad death and consequent bereavement processes, we quantitatively test the relationships between two communication constructs before and after death of a parent. While final conversations as one construct did not lead to appraisal or action coping, results illustrate that final conversation topics of identity, instrumental, love, and everyday talk, were significantly related to shared appraisal. Instrumental talk and love were significantly related to joint action. Joint action and shared appraisal together led to participants engaging in all three types of coping. Final conversations as a whole, was important for bereavement outcomes, whereas communal coping's role in these relationships was convoluted., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

During the COVID-19 pandemic, stringent measures were imposed in numerous countries, including France. These measures significantly disrupted societal practices, particularly mourning and funeral rituals. This study, conducted between June and September 2021 as part of the COVIDEUIL-France research, involved 242 participants, predominantly female (84%) with an average age of 49.64 years. The research aimed to investigate the consequences of the absence of funeral rituals and the adoption of personalized, domestic, and digital alternatives. Using online surveys and psychological tools, including the Traumatic Grief Inventory Self Report Version (TGI-SR), General Health Questionnaire-28 (GHQ-28), and Post-traumatic Growth Inventory (PTGI), the study found a significant correlation between the lack of traditional practices and grief complications. Despite 21.81% of participants compensating with personal commemorations, digital commemorations were underutilized, raising questions about their effectiveness. The study provides crucial insights, emphasizing the need to address the psychological effects of disrupted mourning practices in France., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Following late-life spousal bereavement, sensory and quasi-sensory experiences of the deceased (SED) are commonly reported. This longitudinal study examined SED among 310 older widowed adults 6-10 (T1) and 18-20 (T2) months post loss. Reports of SED in the first 6-10 months after loss were associated with higher symptom levels of prolonged grief, post-traumatic stress, and loneliness at T1. Experiencers of SED were more likely to experience symptoms of prolonged grief and post-traumatic stress above cut-off scores at T1. Importantly, only a minority of the experiencers of SED displayed these elevated levels of bereavement-related distress. In addition, employing multi-level-modeling, a similar trajectory of decreasing bereavement-related distress over time was found for both experiencers and non-experiencers of SED. We argue that SED may be one of several potential reactions to bereavement, which should not be seen as an indicator of grief complications per se., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

This qualitative study explores the perceptions of impact associated with engaging in a therapeutic recreation-based bereavement camp for families whose child has died from serious illness. Interviews were completed with 12 parents who had participated in a three-camp cycle of the program over 12-month period, including a subgroup who had also attended a reunion camp. Interviews were also conducted with program staff. Thematic analysis generated key themes relating to the perceived impact which suggest that those engaged in this program perceived positive contributions associated with participation, including perceptions of positive impact on coping with bereavement, access to support and implications for family functioning. This study highlights the areas of impact associated with engagement in a therapeutic recreation-based bereavement intervention, and the potential contribution of wider access to these programs for families whose child has died from serious illness., Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Objective: Personal memories of the death of a spouse can guide bereavement adjustment. Place of death and quality of death are end-of-life factors that are likely to influence death experiences and formation of subsequent personal memories. The current study employs narrative content-analysis to examine how place and quality of death relate to affective sequences present in older adults' final memories from the death of their spouse. Method: Based on power analyses, 53 older adults were recruited and completed a Final Memory Interview. They also reported place of spouse's death (ie, in hospital, out of hospital) and quality of death across four subscales. Final memory narratives were reliably content-analyzed (interrater agreements >.70), revealing positive and negative affective sequences, including: redemption , contamination , positive stability , and negative stability . Findings: Experiencing the death of a spouse in hospital was related to narrating final memories with contamination. In terms of quality of death, reporting a less comforting social environment at time of death was related to the presence of redemption in final memories. Reporting that one's spouse received appropriate medical care related to narrating memories that showed positive stability. Conclusions: Final memories are carried with the bereaved long after their loss. Positive final memories appear to stem from witnessing a comfortable, medically appropriate death outside of a hospital setting. End-of-life 'that is' between care and aligned with patients' values for place and treatment may be critical for spouses' formation of constructive final memories and bereavement adjustment.

The management and delivery of bereavement care and support services present practical challenges. A national-level, qualitative study was conducted to examine the current practices in Singapore. The study's purpose was to inform bereavement care practices by drawing from perspectives of service providers offering death, dying and bereavement-related services. This qualitative study was undertaken using focused group discussion (FGD) with service providers from the health, social and death-related sectors. Ten FGDs were conducted with a total of 69 participants. Thematic analysis yield two themes - identifying challenging circumstances to provide bereavement care and strategies for dealing with the gaps in service delivery. The service providers' experiential knowledge could be borrowed to strengthen the current bereavement care practices for the good of the community. The findings have informed the reconceptualization of a local bereavement care and support service model, with the public health model as the recommended underpinning conceptual framework., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

The integration of assisted dying into end-of-life care is raising reflections on bereavement. Patients and families may be faced with a choice between this option and natural death assisted by palliative care; a choice that may affect grief. Therefore, this study describes and compares grief experiences of individuals who have lost a loved one by medical assistance in dying or natural death with palliative care. A mixed design was used. Sixty bereaved individuals completed two grief questionnaires. The qualitative component consisted of 16 individual semi-structured interviews. We found no statistically significant differences between medically assisted and natural deaths, and scores did not suggest grief complications. Qualitative results are nuanced: positive and negative imprints may influence grief in both contexts. Hastened and natural deaths are death circumstances that seem to generally help ease mourning. However, they can still, in interaction with other risk factors, produce difficult experiences for some family caregivers., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

This study examined the relationship between having an opportunity to say goodbye to a dying family member or friend in person or virtually, as well as attending their funeral services in person or virtually, and the bereaved individuals' psychological distress and complicated grief during the COVID-19 pandemic. Five hundred and nineteen US adults who had lost a family member or a friend between January 2020 and June 2021 completed an online survey for this study. Only a small proportion of participants were able to say goodbye to their dying family member or friend in person, and saying goodbye virtually was associated with higher levels of complicated grief and psychological distress. Those who physically attended a formal, in-person funeral or memorial service reported lower levels of psychological distress. The findings suggest a complicated process of saying goodbye in different formats during the pandemic., Competing Interests: Declaration of Conflicting InterestsThe author declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

The study explores resilience and posttraumatic growth in adults in Kosovo who have experienced grief, using the Resilience Portfolio Model as a guiding framework. Twelve participants shared their experiences through semi-structured interviews, aiming to capture detailed personal narratives and insights into coping with loss. Thematic analysis of the data revealed three main themes: "Reaction to Loss," "Navigating through Loss and Embracing Adaptations," and "Resilience and Posttraumatic Growth." The findings highlight the transformative experiences contributing to personal development and resilience, emphasizing the significant role of cultural dimensions in shaping resilience and posttraumatic growth. The study underscores the importance of considering cultural context in therapeutic approaches to better support individuals in their recovery and growth from experiences of loss., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Every society adheres to grieving rules that govern how people experience loss and grief. These are rarely communicated explicitly, which can lead to insecurities in dealing with one's own grief and the grief of others. This is particularly true for adolescents. Based on Doka's concept of disenfranchised grief, this study explores the grieving rules of mid-adolescents. Cross-sectional data collection took place in November and December 2022 at six secondary schools in Germany. A total of 226 adolescents predominantly aged between 14 and 16 years completed the questionnaire. The analysis of the data shows that in some respects, mid-adolescents have similar grieving rules as adults. However, they are more inclusive when it comes to losses of ex-partners, pets and people with intellectual disabilities. Possible sources of (self-)disenfranchisement are parasocial relationships and the duration of grief. Open communication about grieving rules is suggested to prevent possible disenfranchisement., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

This article explores some of the implications of the often-heard saying that, "There are no right or wrong ways to grieve." In order to do so, this article offers some reflections on the key phrases that are involved implicitly or explicitly in this advice: loss, bereavement, grief, grieving, and mourning. On that basis, this article examines a series of claims: Are there actually no right ways to grieve?; Is there no single right way to grieve?; Are there no wrong ways to grieve? These analyses are enriched by incorporating some of the new understandings of loss, grief, and mourning that have emerged in the professional literature in recent years from research and scholarship. The conclusion offers lessons that should be learned and that should not be learned from the advice that, "There are no right or wrong ways to grieve"., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Bereaved persons following a drug-related death (DRD) experience significant stress, an increased risk of health-related problems, complicated grief reactions and a risk of higher mortality. Despite the support received from professional helpers being important, research has yet to examine their perspectives to understand and meet the bereaved's needs and increase the helpers' competence. Hence, this qualitative study explored professional helpers' perspectives on essential skills and competencies when supporting bereaved following DRD. We conducted focus group interviews with 29 professional helpers from diverse health and welfare services across six Norwegian municipalities. Reflexive thematic analysis generated three main themes: Diversity of competence, Basic human competence and Balancing act between different considerations. It is crucial that municipal services explicitly define the needs of bereaved persons following a DRD and determine the necessary professional competencies and appropriate intervention levels required., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

This review examines Post-Traumatic Growth (PTG) in the aftermath of Drug-Related Deaths (DRDs) amid a public health crisis underscored by an increase in overdose fatalities. It examines grief and unique challenges confronting those bereaved by DRDs, such as stigmatization, and synthesizes existing literature to elucidate pathways toward resilience and growth. Fundamental mechanisms facilitating PTG, including reframing loss, engaging in open dialogues with support, and cultivating self-compassion and hope, are highlighted, demonstrating the transformative potential of navigating bereavement with supportive communication and personal development. The review also addresses limitations within current research, such as focusing on specific bereaved populations, which may impact the generalizability of findings. Recommendations for future research include longitudinal studies and broader demographic inclusion to understand and support individuals grieving a DRD. Advocating for holistic, growth-oriented bereavement care models, this review underscores the necessity of comprehensive approaches to facilitate healing and growth in the wake of DRDs., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Background: There is a lack of research that investigates the influence of physical activity on grief outcomes. This research aimed to examine the influence of cycling on grief outcomes in individuals who have experienced a bereavement., Method: Semi-structured interviews with 14 participants ( n = 8 males; age M = 47.5 years) who engaged in cycling behaviour and had experienced a bereavement. Reflexive thematic analysis was used to guide analysis., Results: Four key themes were generated, providing: an (1) Embodied experience of cycling, within the 2) Cycling community, helping to provide support, alongside the (3) Nature connectedness, which led to 4) Post traumatic growth, following bereavement., Conclusion: Evidence suggests that cycling can provide an opportunity for a physical challenge, an immense connection to nature and a community of support from likeminded individuals. These therapeutic qualities of cycling should be considered for future interventions and add novel findings to the area of cycling, bereavement and grief., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

A child's death is a traumatic experience that profoundly impacts parents' psychological, physical, and social wellbeing. The literature describes gender differences in grief response associated with child loss, yet less is known about fathers' grief in comparison that of mothers due to fathers' underrepresentation in bereavement research. There is a need for scholarly exploration to advance understanding of fathers' grief. This article presents selected findings on fathers' grief responses that emerged from a larger qualitative study, which aimed to describe fathers' lived experience of bereavement after a child's death. Profound grief emerged as one essential theme of fathers' bereavement experience. Participants described the meaning of their grief, their multidimensional grief responses, their grief triggers, and their grief intensity. Findings deepen understanding of fathers' grief associated with child loss and advance the body of parental bereavement literature., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Pregnancy can be associated with risk factors that may lead to fetal loss, which is a profoundly distressing event impacting the psychological well-being, family dynamics, and overall quality of life of women. The present study aimed to explore women's lived experiences of fetal death. Conducted in 2023, this study employed a descriptive phenomenological approach, utilizing purposeful sampling to interview 12 pregnant women with a history of fetal loss. Data analysis was conducted using the seven-step method of Colaizzi. The study identified five main themes and fifteen sub-themes capturing women's experiences of fetal death. These themes include unfulfilled dreams, transitioning from happiness to grief, varied reactions among individuals, viewing a new healthy baby as a source of renewed hope, and the enduring long-term effects of fetal loss. Fetal death emerges as a deeply painful experience fraught with challenges for affected women. As such, these women require specialized attention from healthcare professionals, particularly midwives, gynecologists, and family specialists., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

This article is a contribution to recording one dimension of the history of education in the field of death, dying, and bereavement. It offers some personal reflections on the history and current status of textbooks in our field that have been or are currently published in North America. The scope of this reflection looks back on the earliest textbooks in this field published in the 1960s and 1970s and extends to textbooks published in the early 2020s. Critical comments are offered on general trends or on textbooks that are no longer in print, but not on individual titles that are currently available for adoption and instructional use. Because I am the lead author of one such textbook, I do not choose to engage in invidious comparisons. Instead, this article includes descriptions of contemporary textbooks taken from the Amazon website., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

We investigated the effects of cause of death (COVID-19 with an underlying medical condition vs. without) and prolonged grief disorder status (PGD present or absent) on participants' reported public stigma towards the bereaved. Participants ( N = 304, 66% women; M = 39.39 years) were randomly assigned to read one of four vignettes describing a bereaved man. Participants completed stigma measures assessing negative attributions, desired social distance, and emotional reactions. Participants reported significantly stronger stigmatizing responses towards an individual with PGD (vs. without PGD) across all stigma measures. There was no significant difference in stigma based on cause of death; however, stigma was reported regardless of cause of death. There was no significant interaction between cause of death and PGD on stigma. This study supports the robust finding of public stigma being reported toward an individual with PGD, suggesting these individuals are at risk of public stigma and not receiving adequate bereavement support.age = 39.39 years) were randomly assigned to read one of four vignettes describing a bereaved man. Participants completed stigma measures assessing negative attributions, desired social distance, and emotional reactions. Participants reported significantly stronger stigmatizing responses towards an individual with PGD (vs. without PGD) across all stigma measures. There was no significant difference in stigma based on cause of death; however, stigma was reported regardless of cause of death. There was no significant interaction between cause of death and PGD on stigma. This study supports the robust finding of public stigma being reported toward an individual with PGD, suggesting these individuals are at risk of public stigma and not receiving adequate bereavement support., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

With 7.3% of children under the age of 18 experiencing the death of a parent and more who experience a loss of a loved one bereavement is a common experience in the lives of children and youth. The current study sought to evaluate the effectiveness of an 8-week, school-based grief group treatment program in reducing symptoms of grief, dysregulation, and improving social support. A total of 296 children and youth (age 11-18) participated in the grief programming provided by a local hospice agency. With a retention rate of 76% the researchers identified a significant reduction in grief symptomology, frequency of emotion dysregulation, and a significant increase in perceived social support from pre- to post-8-week school-based grief programming. A reduction in intensity of dysregulation was not significant. Implications for school personnel and parental support of children and youth experiencing loss are discussed., Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

The current study examined the role of interpersonal vulnerability, that is, self-perceived threats to one's interpersonal domain, in the mental health of bereaved parents. Israeli bereaved parents in older adulthood ( N = 105, aged 48-88, M = 64.06, SD = 9.93) were pair-matched with equivalent 105 non-bereaved parents. Participants completed questionnaires assessing interpersonal vulnerability, satisfaction with life, and depressive symptoms. The results showed higher levels of interpersonal vulnerability among bereaved parents compared to their non-bereaved counterparts. Additionally, parental bereavement and interpersonal vulnerability were associated with worse mental health. Finally, interpersonal vulnerability mediated the association of parental bereavement with worse mental health. This study reveals interpersonal vulnerability as an important vulnerability factor among a significant minority in older adulthood., Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.