Looking back and moving forward: dimensions of coping flexibility divergently predict long-term bereavement outcomes

Anxiety Stress Coping. 2023 May;36(3):275-290. doi: 10.1080/10615806.2022.2099545. Epub 2022 Jul 19.

Abstract

Background and objectives: Bereavement is a serious public health concern. Some people suffer prolonged and debilitating functional impairment after the death of a loved one. Evidence suggests that flexibility in coping approaches predicts resilience after stressful life events, but its long-term effects after the unique experience of bereavement are unknown. Which strategies of coping flexibility predict better-or worse-adjustment over time for bereaved people and at what times?

Design and methods: The present study used path analyses to investigate longitudinal effects of forward-focus and loss-focus coping strategies on symptoms of persistent complex bereavement disorder (PCBD), depression, and posttraumatic stress disorder in a spousally bereaved adult sample (N = 248) at three time-points after the loss (∼3 months, ∼14 months, and ∼25 months).

Results: Forward-focus coping demonstrated adaptive utility overall, with sooner effects on PCBD than on depression. By contrast, loss-focus coping demonstrated a delayed-onset, maladaptive pattern.

Conclusions: The findings contribute to the coping flexibility literature by suggesting that the adaptiveness or maladaptiveness of different coping strategies may depend on the context that requires coping. In particular, forward-focus coping may be substantially more advantageous than loss-focus coping in the context of bereavement. Implications, limitations, and future research directions are discussed.

Keywords: Coping flexibility; PCBD; PTSD; bereavement; coping strategies; depression.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adaptation, Psychological
  • Adult
  • Bereavement*
  • Depression / diagnosis
  • Grief
  • Humans
  • Stress Disorders, Post-Traumatic* / diagnosis