Trauma and Stressor Related Disorders and Disasters
Kyani K. Uchimura, B.A.
Undergraduate Student
University of Hawai’i at Manoa
Honolulu, Hawaii
Brianna J. Preiser, B.S.
Graduate Student
University of Hawai’i at Manoa
Honolulu, Hawaii
Lauren E. Bradley, B.A.
Undergraduate Student
University of Hawai’i at Manoa
Honolulu, Hawaii
Anthony Papa, Ph.D.
Associate Professor
University of Hawai’i at Manoa
Honolulu, Hawaii
Worry is a type of repetitive thought about the future that may occur following the death of a loved one. Worry can cause poor adjustment to bereavement since it is a form of cognitive and behavioral avoidance which may be magnified in response to increases in secondary stressors following a loss (e.g. financial, social, and familial problems). As grief is already painful to endure on its own, the co-occurrence of stressful life events such as a global pandemic can create additional stress that exacerbate the burden on grievers. Pre-pandemic research theorized that secondary stressors following a loss are modifiable determinants of worry (Eisma et al., 2017). Thus, working to alleviate pandemic-related secondary stressors (PSS) may therefore be a crucial aspect of grief work for bereaved individuals during the pandemic.
This study had two aims: (1) to determine if worry is a predictor of maladaptive grief responses, and (2) if PSS will act as a moderator in the relationship between worry and maladaptive grief responses. We asked participants about general PSS and the unique stress of pandemic-related loneliness (PL). Study participants included 523 adults who lost a loved one within 1 to 12 months of completing the survey. Participants completed measures of demographics, worry, PSS, PL, depression, PTSD, and prolonged grief symptoms.
Results showed that 55% of participants were female and the average age was 39 years old (SD=11.79). In Model 1, included known predictors of grief were gender, age, relationship to the deceased, level of dependence on the deceased, cause of death, expectedness of the loss, time since loss, and past and current diagnoses of PTSD, depression, and or anxiety. All predictors were significant in expected directions (R2 =.42, F (13,483) = 28.85, p < .001).
Adding worry to Model 1 increased the explained variance to 54%, F(14, 482) = 42.42, p < .001. This indicated that worry was a significant predictor of grief over and above other established predictors (Model 2).
After adding PSS and PSS*Worry to Model 2, R2 = .66, F(8,513) = 127.64, p < .001, the interaction term was significant (b = -.065, p < .05). The simple slope for low PSS was significant (b = .12, p < .01) but not for high PSS (b = -.01, p =.91) indicating that increases in worry only affected grief when PSS was low. Those with high PSS had consistently high grief regardless of the worry levels.
The interactions term for PL (b = -.05, p < .05) was also significant after adding PL and PL*Worry to Model 2, R2 = .65, F(8,513) = 121.187, p < .001. The simple slope for low PL was significant (b = .12, p < .01) while the slope for high PL was not (b = .03, p =.49). Like PSS, Worry only had an effect on grief when PL was low. When PL was high, grief was high, regardless of the level of worry.
As previous studies have suggested, our results indicated that targeting worry in treatment for grief responses is important to promote adaptation to bereavement (Eisma et al., 2020; Wenn et al., 2019). Our study further suggested that grief treatment for a loss that occurred during the pandemic should consider addressing pandemic-related stress and loneliness to reduce worry and maladaptive grief symptoms during a time where there is an increased likelihood of variables that can impede grief resolution.