Research Article
THE PSYCHOLOGICAL SYMPTOMS OF CONJUGAL BEREAVEMENT IN ELDERLY MEN OVER THE FIRST 13 MONTHS
G. J. A. BYRNE,
B. RAPHAEL,
Corresponding Author
G. J. A. BYRNE
Department of Psychiatry, The University of Queensland, Royal Brisbane Hospital, Herston, Australia
Department of Psychiatry, The University of Queensland, Room K12, Mental Health Centre, Royal Brisbane Hospital, Herston, Queensland 4029, Australia.Search for more papers by this authorB. RAPHAEL
Department of Psychiatry, The University of Queensland, Royal Brisbane Hospital, Herston, Australia
Search for more papers by this authorG. J. A. BYRNE,
B. RAPHAEL,
Corresponding Author
G. J. A. BYRNE
Department of Psychiatry, The University of Queensland, Royal Brisbane Hospital, Herston, Australia
Department of Psychiatry, The University of Queensland, Room K12, Mental Health Centre, Royal Brisbane Hospital, Herston, Queensland 4029, Australia.Search for more papers by this authorB. RAPHAEL
Department of Psychiatry, The University of Queensland, Royal Brisbane Hospital, Herston, Australia
Search for more papers by this authorFirst published: 04 December 1998
Citations: 83
Abstract
Objective. The purpose of this study was to investigate the psychological symptoms experienced by recently widowed older men. It was hypothesized that conjugal bereavement in this group would be characterized by a mixture of depression, anxiety and loneliness.
Design. Double cohort study.
Setting. Suburban community population of Brisbane, Australia.
Participants. Consecutive widowers (65+ years; N = 57) identified from official death records. Married men (65+ years; N = 57) identified from the electoral roll. Widowers interviewed at 6 weeks, 6 months and 13 months post-bereavement. Married men interviewed at similar intervals.
Measures. Bereavement Phenomenology Questionnaire (BPQ), a 22-item self-report measure employing a four-point response scale to rate the frequency of phenomena over the previous fortnight. Zung Self-rating Depression Scale (SDS). State component of the Spielberger State/Trait Anxiety Inventory (STAI). Revised UCLA Loneliness Scale (ULS). 28-item General Health Questionnaire (GHQ).
Results. Widowers reported more state anxiety and general psychological distress, but not more depression or loneliness, than matched married men over the first 13 months post-bereavement. Widowers also reported more sleep disturbance and thoughts of death and suicide than married men. Level of state anxiety was strongly correlated with intensity of grief, but not with age, income, education, occupational prestige, cognitive function, duration of wife's final illness or expectedness of wife's death.
Conclusions. The main hypothesis was not supported, as anxiety symptoms were the predominant clinical feature of recent conjugal bereavement among older men. The nature of these anxiety symptoms requires further investigation in recently widowed older persons. © 1997 John Wiley & Sons, Ltd.
References
- Baum, S. K. (1982) Loneliness in elderly persons: A preliminary study. Psychol. Rep. 50, 1317–1318.
- Blazer, D. G., Bachar, J. R. and Manton, K. G. (1986) Suicide in late life. Review and commentary. J. Am. Geriatr. Soc. 34, 519–525.
- Bornstein, P. E., Clayton, P. J., Halikas, J. A., Maurice, W. L. and Robins, E. (1973) The depression of widowhood after thirteen months. Brit. J. Psychiat. 122, 561–566.
- Bowlby, J. (1973) Attachment and Loss, Volume II: Separation, Anxiety and Anger. Hogarth Press and Institute of Psychoanalysis, London.
- Bowling, A. and Benjamin, B. (1985) Mortality after bereavement: A follow-up study of a sample of elderly widowed people. Biol. Soc. 2, 197–203.
- Bruce, M. L., Kim, K., Leaf, P. J. and Jacobs, S. (1990) Depressive episodes and dysphoria resulting from conjugal bereavement in a prospective community sample. Am. J. Psychiat. 147, 608–611.
- Byrne, G. J. A. and Raphael, B. (1994) A longitudinal study of bereavement phenomena in recently widowed elderly men. Psychol. Med. 24, 411–421.
- Clayton, P. J. (1975) The effect of living alone on bereavement symptoms. Am. J. Psychiat. 132, 133–137.
- Clayton, P. J. and Darvish, H. S. (1979) Course of depressive symptoms following the stress of bereavement. In Stress and Mental Disorder ( J. E. Barrett, Ed.) Raven Press: New York.
- Clayton, P. J., Halikas, J. A. and Maurice, W. L. (1971) The bereavement of the widowed. Dis. Nerv. Syst. 32, 597–604.
- Clayton, P. J., Halikas, J. A. and Maurice, W. L. (1972) The depression of widowhood. Brit. J. Psychiat. 120, 71–78.
- Cohen, J. (1988) Statistical Power Analysis for the Behavioural Sciences. Lawrence Erlbaum, Hillsdale, NJ.
- Daniel, A. (1984) The measurement of social class. Comm. Health Stud. 8, 218–222.
- Elkowitz, E. B. and Virginia, A. T. (1980) Relationship of depression to physical and psychologic complaints of the widowed elderly. J. Am. Geriatr. Soc. 28, 507–510.
- Faletti, M. V., Gibbs, J. M., Clark, M. C., Pruchno, R. A. and Berman, E. A. (1989) Longitudinal course of bereavement in older adults. In Older Bereaved Spouses ( D. A. Lund, Ed.) Hemisphere: New York.
- Folstein, M. F., Folstein, S. E. and McHugh, P. R. (1975) ‘Mini-Mental State’: A practical method for grading the cognitive state of patients for the clinician. J. Psychiatr. Res. 12, 189–198.
- Gallagher, D. E., Thompson, L. W. and Peterson, J. A. (1981) Psychosocial factors affecting adaptation to bereavement in the elderly. Int. J. Aging Hum. Dev. 14, 79–95.
- Gallagher, D. E., Breckenridge, J. N., Thompson, L. W. and Peterson, J. A. (1983) Effects of bereavement on indicators of mental health in elderly widowers. J. Gerontol. 38, 565–571.
- Gass, K. A. and Chang, A. S. (1989) Appraisals of bereavement, coping, resources, and psychosocial health dysfunction in widows and widowers. Nurs. Res. 38, 31–36.
- Gilewski, M. J., Farberow, N. L., Gallagher, D. E. and Thompson, L. W. (1991) Interaction of depression and bereavement on mental health in the elderly. Psychol. Aging 6, 67–75.
-
Goldberg, E. L.,
Comstock, G. W. and
Harlow, S. D.
(1988)
Emotional problems and widowhood.
J. Gerontol.
43,
206–208.
10.1093/geronj/43.6.S206 Google Scholar
- Goldberg, D. P. and Hillier, V. F. (1979) A scaled version of the General Health Questionnaire. Psychol. Med. 9, 139–145.
- Goldberg, D. P. and Williams, P. (1988) A User's Guide to the General Health Questionnaire. NFER-Nelson, Windsor.
- Greatorex, I. F. (1988) Proximal femoral fractures: An assessment of the outcome of health care in elderly people. Commun. Med. 10, 203–210.
- Grimby, A. (1993) Bereavement among elderly people: grief reactions, post-bereavement hallucinations and quality of life. Acta Psychiatr. Scand. 87, 72–80.
- Hays, J. C., Kasl, S. and Jacobs, S. (1994) Past personal history of dysphoria, social support, and psychological distress following conjugal bereavement. J. Am Geriatr. Soc. 42, 712–718.
- Henderson, A. S., Scott, R. and Kay, D. W. K. (1986) The elderly who live alone: Their mental health and social relationships. Aust. N. Z. J. Psychiat. 20, 202–209.
- Hickie, C. and Snowdon, J. (1992) Depression scales for the elderly: GDS, Gilleard, Zung. Clin. Gerontol. 12, 51–53.
- Himmelfarb, S. and Murrell, S. A. (1983) Reliability and validity of five mental health scales in older persons. J. Gerontol. 38, 333–339.
- Hindmarch, I. and Clyde, C. A. (1980) The effects of triazolam and nitrazepam on sleep quality, morning vigilance and psychomotor performance. Arzneimittel-Forschung., 30, 1163–1166.
- Jacobs, S., Hansen, F., Kasl, S., Ostfeld, A., Berkman, L. and Kim, K. (1990) Anxiety disorders during acute bereavement: Risk and risk factors. J. Clin. Psychiat. 51, 269–274.
- Jacobs, S. and Ostfeld, A. (1977) An epidemiological review of the mortality of bereavement. Psychosom. Med. 39, 344–357.
- Jegede, R. O. (1976) Psychometric properties of the self-rating depression scale (SDS). J. Psychol. 93, 27–30.
- Lopata, H. Z., Heinemann, G. D. and Baum, J. (1982) Loneliness: antecedents and coping strategies in the lives of widows. In Loneliness. A Sourcebook of Current Theory, Research and Therapy ( L. A. Peplau and D. Perlman, Eds.) Wiley; New York.
- Lund, D. A., Caserta, M. S. and Dimond, M. F. (1986) Gender differences through two years of bereavement among the elderly. Gerontologist 26, 314–320.
- Lund, D. A., Caserta, M. S. and Dimond, M. F. (1989) Impact of spousal bereavement on the subjective well-being of older adults. In Older Bereaved Spouses ( D. A. Lund, Ed.) Hemisphere: New York.
- Mendes de Leon, C., Kasl, S. V. and Jacobs, S. (1994) A prospective study of widowhood and changes in symptoms of depression in a community sample of the elderly. Psycholog. Med. 24, 613–624.
- Myers, G. C. (1994) World statistical trends and prospects. In Principles and Practice of Geriatric Psychiatry ( J. R. M. Copeland, M. T. Abou-Saleh and D. G. Blazer, Eds) Wiley; Chichester.
- Niemi, T. (1979) The mortality of male old-age pensioners following spouse's death. Scand. J. Soc. Med. 7, 115–117.
- Norusis, M. J. (1990) SPSS/PC + 4.0 Base Manual. SPSS, Chicago.
- Parkes, C. M. and Brown, R. (1972) Health after bereavement: A controlled study of young Boston widows and widowers. Psychosom. Med. 34, 449–461.
- Perlman, D., Gerson, A. C. and Spinner, B. (1978) Loneliness among senior citizens: An empirical report. Essence 2, 239–248.
- Raphael, B. (1983) The Anatomy of Bereavement. Basic Books, New York.
- Richards, J. G. and McCallum, J. (1979) Bereavement in the elderly. N. Z. Med. J. 89, 201–204.
- Russell, D. (1982) The measurement of loneliness. In Loneliness. A Sourcebook of Current Theory, Research and Therapy ( L. A. Peplau and D. Perlamn, Eds) Wiley: New York.
- Russell, D., Peplau, L. A. and Cutrona, C. E. (1980) The revised UCLA loneliness scale: Concurrent and discriminant validity evidence. J. Pers. Soc. Psychol. 39, 472–480.
- Siegel, J. M. and Kuykendall, D. H. (1990) Loss, widowhood, and psychological distress among the elderly. J. Consult. Clin. Psychol. 58, 519–524.
- Sorock, G. S. and Shimkin, E. E. (1988) Benzodiazepine sedatives and the risk of falling in a community-dwelling elderly cohort. Arch. Intern. Med. 148, 2441–2444.
- Spielberger, C. D., Gorsuch, R. L., Luchene, R., Vagg, P. R. and Jacobs, G. H. (1970) Manual of the State–Trait Anxiety Inventory. Consulting Psychologists Press, Palo Alto.
- Statistical Sciences (1993) S-PLUS for Windows User's Manual, Version 3.1. Statistical Sciences, Seattle.
-
Stroebe, W. and
Stroebe, M. S.
(1987)
Bereavement and Health. The Psychological and Physical Consequences of Partner Loss.
Cambridge University Press,
Cambridge.
10.1017/CBO9780511720376 Google Scholar
- Tokunaga, H. T. (1985) The effect of bereavement upon death-related attitudes and fears. Omega 16, 267–280.
- Thompson, L. W., Gallagher-Thompson, D., Futterman, A., Gilewski, M. J. and Peterson, J. (1991) The effects of late-life spousal bereavement over a 30-month period. Psychol. Aging 6, 434–441.
- Tudiver, F., Hilditch, J. and Permaul, J. A. (1991) A comparison of psychosocial characteristics of new widowers and married men. Fam. Med. 23, 501–505.
- Vachon, M. L. S., Rogers, J., Lyall, W. A., Lance, W. J. and Sheldon, A. R. (1982) Predictors and correlates of adaption to conjugal bereavement. Am. J. Psychiat. 139, 998–1002.
- Van Zandt, S., Mou, R. and Abbott, D. (1989) Mental and physical health of rural bereaved and nonbereaved elders: A longitudinal study. In Older Bereaved Spouses. ( D. A. Lund, Ed.) Hemisphere: New York.
- Zisook, S. and Shuchter, S. R. (1991) Depression through the first year after the death of a spouse. Am. J. Psychiat. 148, 1346–1352.
- Zung, W. W. K. (1965) A self-rating depression scale. Arch. Gen. Psychiat. 12, 63–70.
-
Zung, W. W. K. and
Zung, E. M.
(1986)
Use of the Zung self-rating depression scale in the elderly.
Clin. Gerontol.
5,
137–148.
10.1300/J018v05n01_07 Google Scholar
