title: Gender differences in the effects of bereavement-related psychological distress in health outcomes.
abstract: BACKGROUND
  This study examined whether traumatic grief, depressive and anxiety symptoms formed three distinct factors for widows and widowers. In addition, we examined whether high symptom levels of traumatic grief, depression and anxiety predicted different mental and physical health outcomes for widows and widowers.
  
  
  METHODS
  Ninety-two future widows and 58 future widowers were interviewed at the time of their spouse's hospital admission and then at 6 weeks, 6, 13 and 25 month follow-ups. Principal axis factor analyses tested the distinctiveness of traumatic grief, depressive and anxiety symptoms, by gender. Repeated measures ANOVA tested for gender differences and changes over time in mean symptom levels of traumatic grief, depression and anxiety. Linear and logistic regression models estimated the effects of high symptom levels of traumatic grief, depression and anxiety at 6 months on health outcomes at 13 and 25 months post-intake by gender.
  
  
  RESULTS
  Three distinct symptom clusters (i.e. traumatic grief, depressive and anxiety symptoms) were found to emerge for both widows and widowers. Widows had higher mean levels of traumatic grief, depressive and anxiety symptoms. High symptom levels of traumatic grief measured at 6 months predicted a physical health event (e.g. cancer, heart attack) at 25 months post-intake for widows. High symptom levels of anxiety measured at 6 months predicted suicidal ideation at 25 months for widowers.
  
  
  CONCLUSIONS
  The results suggest that there are gender differences in the levels of psychological symptoms resulting from bereavement and in their effects on subsequent mental and physical health for widows and widowers.
authors.affiliation: Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA.
authors.forename: J H
authors.initials: JH
authors.lastname: Chen
authors.forename: A J
authors.initials: AJ
authors.lastname: Bierhals
authors.forename: H G
authors.initials: HG
authors.lastname: Prigerson
authors.forename: S V
authors.initials: SV
authors.lastname: Kasl
authors.forename: C M
authors.initials: CM
authors.lastname: Mazure
authors.forename: S
authors.initials: S
authors.lastname: Jacobs
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D001008:Anxiety Disorders / Q000175:diagnosis* / Q000523:psychology; D001601:Bereavement; D003866:Depressive Disorder / Q000175:diagnosis* / Q000523:psychology; D005260:Female; D005500:Follow-Up Studies; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D012737:Sex Factors; D013997:Time Factors