Conscious and unconscious coping with loss.
Sixty-seven persons were identified 1 to 2 months after the death or life-threatening illness of their spouse and followed for 25 months. Intake measures included a) a revised Ways of Coping Scale, a structured assessment of ego defenses, sociodemographic information, and other baseline variables. Fifty-six completed follow-up. Outcome measures included deaths, hospitalization, self-rated health, depressive symptoms, symptoms of anxiety, and separation distress. In our analyses, bereavement was used as a covariate and found to be unrelated to outcome. Low self-ratings on coping by making a change and problem-focused planning predicted higher scores on separation distress at 13 months (p < or = .05). Participants who used less problem-focused planning were at risk for higher depression scores 13 months after the stressful event (p < or = .05). Low ego-defensive work and high neurotic ego-defensive ratings predicted high depression scores at 13 months (p < or = .05). At 25 months, coping by self-blame was inversely related to scores on separation distress (p < or = .05). Coping variables predicted neither scores on anxiety symptom scales nor the outcomes of hospitalization or death over the 25-month study period. These observations counter some prevailing clinical assumptions about coping with a loss and emphasize the value of empirical studies of coping as a mediator of outcome during the stress of a loss.
Jacobs
S
S
Yale University Department of Psychiatry and Laboratory of Epidemiology and Public Health, New Haven, Connecticut 06510-9068.
Kasl
S
S
Schaefer
C
C
Ostfeld
A
A
D000223:Adaptation, Psychological; D001010:Anxiety, Separation / Q000523:psychology; D001293:Attitude to Death; D001601:Bereavement; D003674:Defense Mechanisms; D004532:Ego; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008016:Life Change Events; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D012647:Self-Assessment; D013315:Stress, Psychological / Q000523:psychology; D011795:Surveys and Questionnaires; D014473:Unconscious, Psychology