Psychosomatic Medicine, Vol 56, Issue 6 557-563, Copyright © 1994 by American Psychosomatic Society

ORIGINAL ARTICLES

Conscious and unconscious coping with loss

S Jacobs, S Kasl, C Schaefer and A Ostfeld
Yale University Department of Psychiatry and Laboratory of Epidemiology and Public Health, New Haven, Connecticut 06510-9068.

Sixty-seven persons were identified 1 to 2 months after the death or life-threatening illness of their spouse and followed for 25 months. Intake measures included a) a revised Ways of Coping Scale, a structured assessment of ego defenses, sociodemographic information, and other baseline variables. Fifty-six completed follow-up. Outcome measures included deaths, hospitalization, self-rated health, depressive symptoms, symptoms of anxiety, and separation distress. In our analyses, bereavement was used as a covariate and found to be unrelated to outcome. Low self-ratings on coping by making a change and problem-focused planning predicted higher scores on separation distress at 13 months (p < or = .05). Participants who used less problem-focused planning were at risk for higher depression scores 13 months after the stressful event (p < or = .05). Low ego-defensive work and high neurotic ego-defensive ratings predicted high depression scores at 13 months (p < or = .05). At 25 months, coping by self-blame was inversely related to scores on separation distress (p < or = .05). Coping variables predicted neither scores on anxiety symptom scales nor the outcomes of hospitalization or death over the 25-month study period. These observations counter some prevailing clinical assumptions about coping with a loss and emphasize the value of empirical studies of coping as a mediator of outcome during the stress of a loss.

This article has been cited by other articles:

				H. G. Prigerson and S. C. Jacobs Caring for Bereaved Patients: "All the Doctors Just Suddenly Go" JAMA, September 19, 2001; 286(11): 1369 - 1376. [Abstract] [Full Text] [PDF]