Trajectories of insomnia following bereavement.

BACKGROUND: Insomnia symptoms are common following bereavement and may exacerbate severe and protracted grief reactions, such as prolonged grief disorder (PGD). However, typical trajectories of insomnia symptoms and risk factors for having a more chronic insomnia trajectory following bereavement are yet unknown. METHOD: In the current investigation, 220 recently bereaved (≤6 months post-loss) participants, completed questionnaires assessing sociodemographic and loss-related characteristics, rumination, experiential avoidance and symptoms of (prolonged) grief and depression, on three time-points (6 months apart). We applied growth mixture models to investigate the typical trajectories of insomnia symptoms following bereavement. RESULTS: Three insomnia trajectory classes emerged, characterized by a resilient (47 %), recovering (43 %), and a chronic trajectory (10 %). Baseline depression symptoms best predicted the type of insomnia trajectory. At one-year follow-up, 9 %, 27 %, and 60 % of participants met the criteria for probable PGD within the resilient, recovering and chronic trajectory, respectively. A parallel process model showed that temporal changes in insomnia symptoms were strongly related to changes in prolonged grief symptoms. CONCLUSION: The results suggest, that targeting insomnia symptoms in the treatment of PGD, particularly with comorbid depression, may be a viable option.

Cross-Lagged Analyses of Prolonged Grief and Depression Symptoms With Insomnia Symptoms.

Prolonged grief disorder, characterized by severe, persistent and disabling grief, has recently been added to the DSM-5-TR and ICD-11. Treatment for prolonged grief symptoms shows limited effectiveness. It has been suggested that prolonged grief symptoms exacerbate insomnia symptoms, whereas insomnia symptoms, in turn, may fuel prolonged grief symptoms. To help clarify if treating sleep disturbances may be a viable treatment option for prolonged grief disorder, we examined the proposed reciprocal relationship between symptoms of prolonged grief and insomnia. On three time points across 6-month intervals, 343 bereaved adults (88% female) completed questionnaires to assess prolonged grief, depression, and insomnia symptoms. We applied random intercept cross-lagged panel models (RICLPMs) to assess reciprocal within-person effects between prolonged grief and insomnia symptoms and, as a secondary aim, between depression and insomnia symptoms. Changes in insomnia symptoms predicted changes in prolonged grief symptoms but not vice versa. Additionally, changes in depression and insomnia symptoms showed a reciprocal relationship. Our results suggest that targeting insomnia symptoms after bereavement is a viable option for improving current treatments for prolonged grief disorder.

Examining socioeconomic disparities in changes in adolescent mental health before and during different phases of the coronavirus disease 2019 pandemic.

This study examined socioeconomic disparities in changes in adolescent mental health between fall 2019 (pre-COVID-19), spring 2020 (initial coronavirus disease 2019 (COVID-19) phase), and fall 2020 (prevailing COVID-19 phase). Using data from 1429 adolescents (Mage  = 17.9) from tertiary vocational schools in the Netherlands with n = 386 participating in all three waves, linear and latent basis growth curve models were assessed and multigroup analyses conducted. Results showed a small but significant decrease in life satisfaction and small but significant increases in emotional problems, peer relationship problems, conduct problems, and hyperactivity-inattention problems. For emotional problems and peer relationship problems, increases between pre-COVID-19 and the initial COVID-19 phase were more pronounced than increases between the initial and prevailing COVID-19 phase. In contrast, linear decreases were found for life satisfaction and linear increases for conduct problems and hyperactivity-inattention problems over the course of the study. Mental health patterns were largely comparable for adolescents from families with varying socioeconomic status.

Reciprocal Relations of Worry, Rumination, and Psychopathology Symptoms After Loss: A Prospective Cohort Study.

Bereavement can precipitate symptoms of depression, prolonged grief disorder, and posttraumatic stress disorder. Targeting repetitive negative thought (i.e., worry, rumination) in treatment may help reduce post-loss psychopathology. Yet, evidence on longitudinal associations of depressive rumination and worry with post-loss psychopathology symptoms has been mixed and the directions of effects are still unclear. Recently bereaved adults (78% female) completed questionnaires assessing depressive rumination (brooding), worry, and depression, prolonged grief and posttraumatic stress symptoms 11 times in 1.5 month intervals. We applied random-intercept cross-lagged panel models (RICLPMs) to examine reciprocal within-person associations between worry and psychopathology symptoms, between rumination and these symptoms, and between worry and rumination. Main findings were that worry showed reciprocal relationships with psychopathology symptoms (although worry did not consistently predict prolonged grief symptoms). Depressive rumination was predicted by psychopathology symptoms, but not vice versa. Worry showed reciprocal relations with depressive rumination. Findings suggest that worry may be part of a downward spiral, enhancing psychopathology symptoms following loss, whereas depressive rumination is solely a consequence of such symptoms.

Remembering the romantic past: Autobiographical memory functions and romantic relationship quality.

Do the reasons why we think about our memories and share them with others have implications for our romantic relationship quality? In the present series of studies (total N = 1,102), we aimed to answer this question by examining whether the self (e.g., creating a stable self-image), social (e.g., connecting with others) and directive (e.g., guiding future behavior) functions of regular memories (Study 1, Study 2) and relationship memories (Study 2, Study 3) were related to intimacy and satisfaction in the current relationship. We further investigated these links when relationship memories were shared with the romantic partner (Study 3). Results showed no association between the self-reported uses of memory for regular events and relationship quality. In contrast, the social function served by the relationship events was positively associated, and the directive function was negatively associated with intimacy and relationship satisfaction. When the memories were to be shared with the partner, only social function was related, positively, to the relationship satisfaction. Findings were discussed in terms of the importance of considering the self-reported reasons for recalling an event and understanding of the contextual factors in remembering.

Marriage as a training ground: Examining change in self-control and forgiveness over the first 4 years of marriage.

Do partners' levels of self-control and forgiveness change over the course of marriage? Based on the idea that marriage may function as a training ground for these vital relationship abilities, we hypothesized that people increase their levels of self-control and forgiveness over time and that these developments take place simultaneously. We tested these predictions among 199 newlywed couples in the first 4 years of marriage, using a dyadic latent growth curves analysis. Confirming our hypotheses, results showed significant increases in self-control and forgiveness as well as a positive concurrent correlation between these variables. However, the developments of self-control and forgiveness were unrelated. So, while people become more self-controlled and forgiving over the course of a marriage, these developments do not coincide.

Buffering Internalization of HIV Stigma: Implications for Treatment Adherence and Depression.

BACKGROUND: One mechanism through which social stigma of HIV affects health outcomes for people living with HIV (PLWH) is through internalization of stigma. However, this transformation of social stigma in the community into internalized stigma may not be of the same magnitude for all PLWH. We examined the moderating effects of 3 personality traits-fear of negative social evaluation, attachment-related anxiety, and dispositional resilience-in transforming perceived stigma in the community into internalized stigma. Furthermore, we investigated downstream effects of these moderated associations on depressive symptoms and antiretroviral treatment (ART) adherence. SETTING/METHODS: In study 1, data from 203 PLWH in the Southeast United States were analyzed controlling for age, sex, education, race, and time on ART. In study 2, data from 453 women in a multisite study were analyzed controlling for age, education, race, time on ART, and substance use. RESULTS: In both studies, fear of negative evaluation and attachment-related anxiety moderated the effect of perceived HIV stigma in the community on internalized HIV stigma: People higher on those moderating variables had stronger associations between perceived stigma in the community and internalized stigma. In study 2, resilience was assessed and also moderated the effect of perceived HIV stigma in the community on internalized stigma. In moderated mediation models, fear of negative evaluation, attachment-related anxiety, and resilience moderated the indirect effect of perceived HIV stigma in the community on ART adherence and depression through internalized stigma. CONCLUSIONS: Interventions to assuage internalization of HIV stigma should focus on bolstering attachment-related security, social competence, and resilience.

On the Association Between Mindfulness and Romantic Relationship Satisfaction: the Role of Partner Acceptance.

In three studies, it was investigated whether trait mindfulness is positively associated with partner acceptance, defined as the ability and willingness to accept the partner's imperfections, and whether partner acceptance explains the association between trait mindfulness and relationship satisfaction. Trait mindfulness, partner acceptance and relationship satisfaction were assessed in two MTurk samples (n 1 = 190; n 2 = 140) and a sample of participants of a mindfulness-based stress reduction course (n 3 = 118) and their partners (53 complete couples), using self-report measures. In all three samples, trait mindfulness was related to partner acceptance and in two out of three studies trait mindfulness was directly positively related to relationship satisfaction. Also, the results provided initial support for the mediating role of partner acceptance in the association between mindfulness and relationship satisfaction. Dyadic data further suggested that the benefits of mindfulness and partner acceptance on relationship satisfaction extend from the individual to the partner through increased partner acceptance. Together, the results provide initial support for the hypothesis that partner acceptance may be an important mechanism through which mindfulness promotes relationship satisfaction in both partners of a romantic couple.

Ideal Standards, Acceptance, and Relationship Satisfaction: Latitudes of Differential Effects.

We examined whether the relations of consistency between ideal standards and perceptions of a current romantic partner with partner acceptance and relationship satisfaction level off, or decelerate, above a threshold. We tested our hypothesis using a 3-year longitudinal data set collected from heterosexual newlywed couples. We used two indicators of consistency: pattern correspondence (within-person correlation between ideal standards and perceived partner ratings) and mean-level match (difference between ideal standards score and perceived partner score). Our results revealed that pattern correspondence had no relation with partner acceptance, but a positive linear/exponential association with relationship satisfaction. Mean-level match had a significant positive association with actor's acceptance and relationship satisfaction up to the point where perceived partner score equaled ideal standards score. Partner effects did not show a consistent pattern. The results suggest that the consistency between ideal standards and perceived partner attributes has a non-linear association with acceptance and relationship satisfaction, although the results were more conclusive for mean-level match.

Meaning and coping orientation of bereaved parents: Individual and dyadic processes.

The present study aimed to examine whether bereaved parents "meaning-made"-defined as results of attempts to reduce discrepancies between the meaning assigned to the death of the child and self and world-views-was influenced by their own and their partner's coping orientations. Coping orientations were conceptualized within the Dual Process Model, which entails loss coping orientation (LO; focus on the loss itself), restoration coping orientations (RO; focus on stressors that come about as an indirect consequence of the bereavement), and a flexible oscillation between both coping orientations. The sample consisted of 227 couples identified through obituary notices in local and national newspapers, who provided data at 6, 13, and 20 months after the death of their child. At all three points of measurement, both partners independently completed the Dual Coping Inventory (DCI) and a scale developed by the authors about meaning-made from the loss. Data were analyzed using a multi-level Actor-Partner Interdependence Model. Results show that the combination of parents' own LO and RO (operationalized through the interaction effect between LO and RO) have a positive effect in parents' meaning-made. Partners' LO have a negative effect in parents' meaning-made. These results highlight the importance of, in the context of parental bereavement, being flexible by using both coping orientations, and of acknowledging the interdependence between partners, namely, the interpersonal process by which partner's coping affect one's meaning-made.

The impact of bereaved parents' perceived grief similarity on relationship satisfaction.

The present research focused on bereaved parents' perceived grief similarity, and aimed to investigate the concurrent and longitudinal effects of the perceptions that the partner has less, equal, or more grief intensity than oneself on relationship satisfaction. Participants of our longitudinal study were 229 heterosexual bereaved Dutch couples who completed questionnaires 6, 13, and 20 months after the loss of their child. Average age of participants was 40.7 (SD = 9.5). Across 3 study waves, participants' perceived grief similarity and relationship satisfaction were assessed. To control for their effects, own grief level, child's gender, expectedness of loss, parent's age, parent's gender, and time were also included in the analyses. Consistent with the hypotheses, cross-sectional results revealed that bereaved parents who perceived dissimilar levels of grief (less or more grief) had lower relationship satisfaction than bereaved parents who perceived similar levels of grief. This effect remained significant controlling for the effects of possible confounding variables and actual similarity in grief between partners. We also found that perceived grief similarity at the first study wave was related to the highest level of relationship satisfaction at the second study wave. Moreover, results showed that perceived grief similarity was associated with a higher level in partner's relationship satisfaction. Results are discussed considering the comparison and similarity in grief across bereaved partners after child loss. (PsycINFO Database Record

Both trust and self-control are necessary to prevent intrusive behaviors: evidence from a longitudinal study of married couples.

Many people engage in intrusive behaviors in close relationships. Existing research links intrusive behaviors to a lack of trust and an imbalance between self- and partner-interest. The authors tested the novel hypothesis that people need self-control to regulate intrusive behaviors. Self-control enables people to forgo their self-interests (reassurance or closeness) for the sake of their partner or the relationship. Specifically, we predicted that people need both trust and self-control to refrain from intrusive behavior. One-hundred-eighty-nine couples participated in a prospective longitudinal study with three waves. Consistent with predictions, multilevel analyses revealed an interaction between trust and self-control on intrusive behaviors cross-sectionally as well as longitudinally (albeit marginally). These results provide support for our hypothesis that neither trust in the partner nor self-control is sufficient to forestall intrusive behaviors, but rather both are necessary to refrain from intruding into one's partner's privacy.