title: Resilience and vulnerability: prolonged grief in the bereaved spouses of marital partners who died of AIDS.
abstract: Spousal bereavement is closely linked to prolonged grief, that is, significant adjustment symptoms that last for more than six months after the loss. This article focused on potential risk and protective factors that may influence bereavement outcomes. Participants in this study were surviving spouses of individuals who died of acquired immune deficiency syndrome (AIDS). These participants were themselves living with human immunodeficiency syndrome. In this cross-sectional study, 120 bereaved participants completed measures of grief, quality of dying and death of the deceased, negative conceptions of death resulting from AIDS, death attitudes, and personal resilience. The results showed that one-third (35.0%) of the bereaved participants reported grief levels above the prolonged grief cut-off scores, and can be categorized as the "prolonged grief" group. Although quality of dying and death was not associated with the intensity of grief, negative conceptions of death from AIDS, fear of death and resilience independently predicted grief symptoms in the regression models. Our findings provide insight into the grief process for the surviving spouse of AIDS victims in rural China. Since resilience is malleable, developing resilience interventions to enhance adjustment to bereavement may be a promising direction in grief counselling and therapies.
authors.affiliation: a Department of Applied Social Sciences , City University of Hong Kong , Hong Kong , People's Republic of China.
authors.forename: Nancy Xiaonan
authors.initials: NX
authors.lastname: Yu
authors.affiliation: b Center on Behavioral Health and Department of Social Work and Social Administration , The University of Hong Kong , Hong Kong , People's Republic of China.
authors.forename: Cecilia L W
authors.initials: CL
authors.lastname: Chan
authors.affiliation: c Institute of Psychology , Chinese Academy of Sciences , Beijing , People's Republic of China.
authors.forename: Jianxin
authors.initials: J
authors.lastname: Zhang
authors.affiliation: d Department of Psychiatry , University of Texas Southwestern Medical Center , Dallas , TX , USA.
authors.forename: Sunita M
authors.initials: SM
authors.lastname: Stewart
mesh_terms: D000328:Adult; D001293:Attitude to Death; D001601:Bereavement; D002681:China / Q000453:epidemiology; D003430:Cross-Sectional Studies; D003863:Depression / Q000453:epidemiology; D005260:Female; D006117:Grief; D015658:HIV Infections / Q000401:mortality* / Q000523:psychology; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008393:Marriage; D008875:Middle Aged; D055500:Resilience, Psychological; D012424:Rural Population; D018454:Spouses / Q000523:psychology*; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology
keywords: AIDS; HIV; Prolonged grief; conceptions of death; death attitudes; quality of dying and death; resilience