Objective

This study describe the course and risk factors of psychological distress following bereavement, controlling for factors often omitted from studies of grief: psychiatric history, social support, and coping choices of the bereaved.

Participants

Spouses of patients hospitalized for serious illness or elective surgery were systematically screened and followed longitudinally through the recovery or death of the hospitalized patient. Of 440 respondents, 154 were bereaved within 2 months.

Design and setting

Spouses were interviewed in their homes by trained interviewers at intake and 2, 6, 13, and 25 months postintake.

Measurements

Dependent variables were measured with the CES-D (depressive symptoms) and the PERI (general anxiety and hopelessness/helplessness) scales. Independent variables were measured with the SADS-L (past personal history of dysphoria) and the Lazarus' Ways of Coping scale as well as sociodemographic measures.

Main results

Lifetime prevalence of a brief period of dysphoric mood among spouses before the patient's illness was 22%; past personal history of dysphoric mood was related to female sex, smaller networks, and more depression and anxiety during the hospitalization of their spouses. Newly widowed persons with a past history of dysphoria perceived their networks to be relatively nonsupportive, but devoted similar amounts of coping effort to seeking social support and reported similar amounts of social interaction compared with persons with no history of dysphoria. Persons with a past history of dysphoria reported elevated levels of depressive symptoms, general anxiety, and hopelessness/helplessness through 25 months postbereavement, yet their recovery trajectory was similar to those without a past history of dysphoria.

Conclusions

It was concluded that a past history of subsyndromal symptomatology in conjunction with a stressful life event such as bereavement increases one's vulnerability to excess psychological distress.