Does voluntary assisted dying cause public stigma for the bereaved? A vignette-based experiment

Objective Studies in countries where assisted dying is legal show that bereaved people express concern over the potential for social disapproval and social stigma because of the manner of death. There are indications that voluntary assisted dying is judged as less acceptable if the deceased is younger. A vignette-based experiment was used to determine whether public stigma (i.e., negative emotional reactions and desired social distance) and expected grief symptoms are higher for conjugally bereaved people through voluntary assisted dying (vs. long-term illness), when the deceased is a young adult (vs. older adult). Method A 2 × 2 randomized factorial design was conducted with 164 Australian adults (130 women, 34 men, Mage = 37.69 years). Each participant was randomized online to read one of four vignettes and completed measures of anger, fear, prosocial emotions, desire for social distance, and expectations of grief symptomatology. Results A multivariate analysis of variance (MANOVA) was conducted. Death at a young age (28 years) was significantly associated with stronger negative emotional reactions of fear ( $\eta _p^2 = 0.04$ , P = 0.048) and anger ( $\eta _p^2 = 0.06$ , P = 0.010). There were no differences in outcomes associated with the mode of death, nor was there an interaction between mode of death and age group. Significance of results Concerns that voluntary assisted dying elicits public stigma appear unfounded. The fact that participants reported significantly higher anger and fear in response to bereaved people experiencing loss at a younger (vs. older) age, irrespective of cause of death, indicates that young people who lose their spouse might benefit from additional support.

Symptoms of persistent complex bereavement disorder, depression, and PTSD in a conjugally bereaved sample: a network analysis

BackgroundComplicated and persistent grief reactions afflict approximately 10% of bereaved individuals and are associated with severe disruptions of functioning. These maladaptive patterns were defined in Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) as persistent complex bereavement disorder (PCBD), but its criteria remain debated. The condition has been studied using network analysis, showing potential for an improved understanding of PCBD. However, previous studies were limited to self-report and primarily originated from a single archival dataset. To overcome these limitations, we collected structured clinical interview data from a community sample of newly conjugally bereaved individuals (N= 305).MethodsGaussian graphical models (GGM) were estimated from PCBD symptoms diagnosed at 3, 14, and 25 months after the loss. A directed acyclic graph (DAG) was generated from initial PCBD symptoms, and comorbidity networks with DSM-5 symptoms of major depressive disorder (MDD) and post-traumatic stress disorder (PTSD) were analyzed 1 year post-loss.ResultsIn the GGM, symptoms from the social/identity PCBD symptoms cluster (i.e. role confusion, meaninglessness, and loneliness) tended to be central in the network at all assessments. In the DAG, yearning activated a cascade of PCBD symptoms, suggesting how symptoms lead into psychopathological configurations. In the comorbidity networks, PCBD and depressive symptoms formed separate communities, while PTSD symptoms divided in heterogeneous clusters.ConclusionsThe network approach offered insights regarding the core symptoms of PCBD and the role of persistent yearnings. Findings are discussed regarding both clinical and theoretical implications that will serve as a step toward a more integrated understanding of PCBD.

Psychological Adjustment to Conjugal Bereavement: Do Social Networks Aid Coping following Spousal Death?

This research sought to investigate the role of social networks in coping and adjustment to spousal bereavement. A total of 198 Xhosa-speaking participants, drawn from the rural areas of the Eastern Cape Province, South Africa, took part in the study. Quantitative data analyses revealed significant correlations between perceived social support on Social Support Appraisals scale and the anxiety scores on the Beck Depression Inventory-Second Edition and the problem-solving coping strategy scale on the Coping Strategy Indicator. Regression analyses revealed that depression contributed to increased social support appraisals, while anxiety was a significant negative predictor of the participants' experience of perceived social support. The authors highlight the need for bereavement intervention programs in the rural areas to be geared toward psycho-educating the conjugally bereaved individuals, within the socio-cultural framework, to continuously evaluate their support structures and strengthen ties with social networks that render support, instrumental assistance, and advice in times of need.

Change in Depression of Spousal Caregivers of Dementia Patients Following Patient's Death

Caring for an elderly spouse with dementia places a heavy burden on spousal caregivers and often results in chronic depression. Little has been written about change in depression caregivers experience from before to after the death of the spouse with dementia. This longitudinal study examines change in depression of spousal caregivers that occurs following death of the dementia patient. Two theoretical models, the Relief and Stress Models, are discussed in terms of caregiver depression after the death of the dementia-patient care-recipient spouse. These two theoretical models were tested using longitudinal data from the National Institute on Aging sponsored Health and Retirement Study. Both male and female spousal caregivers report an increase in depression after the death of the dementia-patient care-recipient spouse. As time passed following the spouse's death, the conjugally bereaved husbands showed a decrease in depression while the conjugally bereaved wives continued to report increased depression.