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Grief, Bereavement, and Coping With Loss (PDQ®)

Patient Version
Last Modified: 09/23/2011

Factors that Affect Complicated Grief

Key Points for This Section


Researchers study grief reactions to try to find out what might increase the chance that complicated grief will occur.

Studies have looked at how the following factors affect the grief response:

Whether the death is expected or unexpected.

It may seem that any sudden, unexpected loss might lead to more difficult grief. However, studies have found that bereaved people with high self-esteem and/or a feeling that they have control over life are likely to have a normal grief reaction even after an unexpected loss. Bereaved people with low self-esteem and/or a sense that life cannot be controlled are more likely to have complicated grief after an unexpected loss. This includes more depression and physical problems.

The personality of the bereaved.

Studies have found that people with certain personality traits are more likely to have long-lasting depression after a loss. These include people who are very dependent on the loved one (such as a spouse), and people who deal with distress by thinking about it all the time.

The religious beliefs of the bereaved.

Some studies have shown that religion helps people cope better with grief. Other studies have shown it does not help or causes more distress. Religion seems to help people who go to church often. The positive effect on grief may be because church-goers have more social support.

Whether the bereaved is male or female.

In general, men have more problems than women do after a spouse’s death. Men tend to have worse depression and more health problems than women do after the loss. Some researchers think this may be because men have less social support after a loss.

The age of the bereaved.

In general, younger bereaved people have more problems after a loss than older bereaved people do. They have more severe health problems, grief symptoms, and other mental and physical symptoms. Younger bereaved people, however, may recover more quickly than older bereaved people do, because they have more resources and social support.

The amount of social support the bereaved has.

Lack of social support increases the chance of having problems coping with a loss. Social support includes the person's family, friends, neighbors, and community members who can give psychological, physical, and financial help. After the death of a close family member, many people have a number of related losses. The death of a spouse, for example, may cause a loss of income and changes in lifestyle and day-to-day living. These are all related to social support.



Glossary Terms

bereavement (beh-REEV-ment)
A state of sadness, grief, and mourning after the loss of a loved one.
cope (kope)
To adjust to new situations and overcome problems.
depression (dee-PREH-shun)
A mental condition marked by ongoing feelings of sadness, despair, loss of energy, and difficulty dealing with normal daily life. Other symptoms of depression include feelings of worthlessness and hopelessness, loss of pleasure in activities, changes in eating or sleeping habits, and thoughts of death or suicide. Depression can affect anyone, and can be successfully treated. Depression affects 15-25% of cancer patients.
distress (dih-STRESS)
Extreme mental or physical pain or suffering.
grief (greef)
The normal response to a major loss, such as the death of a loved one. Grief may also be felt by a person with a serious, long-term illness or with a terminal illness. It may include feelings of great sadness, anger, guilt, and despair. Physical problems, such as not being able to sleep and changes in appetite, may also be part of grief.
psychological (SY-koh-LAH-jih-kul)
Having to do with how the mind works and how thoughts and feelings affect behavior.
recover (ree-KUH-ver)
To become well and healthy again.
religion (reh-LIH-jun)
A set of beliefs and practices that center on questions about the meaning of life and may involve the worship of a supreme being.
self-esteem (self-eh-STEEM)
A feeling of self-worth, self-confidence, and self-respect.
social support (SOH-shul suh-PORT)
A network of family, friends, neighbors, and community members that is available in times of need to give psychological, physical, and financial help.
symptom (SIMP-tum)
An indication that a person has a condition or disease. Some examples of symptoms are headache, fever, fatigue, nausea, vomiting, and pain.