The Association of Grief with Mental Health and the Role of Loneliness During the COVID-19 Pandemic

Authors

  • Laia Benítez-Manzanas Department of Clinical Psychology and Psychobiology, Universitat de Barcelona https://orcid.org/0000-0001-7729-894X
  • Guillem Feixas Universitat de Barcelona, España https://orcid.org/0000-0002-6288-6009
  • Aina Gabarrell-Pascuet 3Research and Development Unit, Parc Sanitari Sant Joan de Déu, Barcelona, and Centre for Biomedical Research on Mental Health (CIBERSAM), Spain. https://orcid.org/0000-0002-2236-1435
  • Joan Domènech-Abella Research and Development Unit, Parc Sanitari Sant Joan de Déu, Barcelona, and Centre for Biomedical Research on Mental Health (CIBERSAM), Spain. https://orcid.org/0000-0001-7605-3887
  • Philippe Mortier Health Services Research Unit, IMIM (Hospital del Mar Medical Research Institute), Barcelona, & Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain. https://orcid.org/0000-0003-2113-6241
  • Gemma Vilagut Health Services Research Unit, IMIM (Hospital del Mar Medical Research Institute), Barcelona, & Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain. https://orcid.org/0000-0002-3714-226X
  • Josep Maria Haro Research and Development Unit, Parc Sanitari Sant Joan de Déu, Barcelona, Centre for Biomedical Research on Mental Health (CIBERSAM), and Department of Medicine, Universitat de Barcelona, Spain. https://orcid.org/0000-0002-3984-277X
  • Jordi Alonso Health Services Research Unit, IMIM (Hospital del Mar Medical Research Institute), Barcelona, & Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain. https://orcid.org/0000-0001-8627-9636

DOI:

https://doi.org/10.5944/ap.19.1.36886

Keywords:

dysfunctional grief, bereavement, anxiety, depression, SARS-CoV-2, social isolation

Abstract

Previous research found that bereavement is associated with several pathological responses affecting both physical and mental health. During the COVID-19 pandemic and the socially disruptive measures implemented, losses of close contacts have occurred under exceptional circumstances, and it is reasonable to expect that many bereaved people would be unable to overcome their loss adaptively, resulting in dysfunctional grief leading to mental health alterations. Loneliness, which has increased during the pandemic, has been identified as a significant risk factor for mental health that is common when people grieve. In this study, we aimed to gauge the effects of bereavement on mental health in the context of the COVID-19 pandemic and to explore the mediating role of loneliness on the relationship between grief and mental health alterations by surveying a representative sample of 2000 Spanish adults interviewed by phone during the pandemic (February-March 2021). Logistic regressions were performed to examine the effects of grief levels on depression, anxiety, panic attacks, post-traumatic stress disorder, substance abuse, and suicidal thoughts and behaviors. Our results confirmed that how the loss of a loved one is processed is associated with the development of mental health conditions. Dysfunctional grief was significantly associated with all mental health conditions, particularly depression (OR = 14.28) and anxiety (OR = 11.61). As predicted, loneliness accounted for a substantial percentage (8-30%) of the impact of grief on mental health outcomes.

Downloads

Download data is not yet available.

References

American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.). Author.

Ballester, L., Alayo, I., Vilagut, G., Almenara, J., Cebrià, A. I., Echeburúa, E., Gabilondo, A., Gili, M., Lagares, C., Piqueras, J. A., Roca, M., Soto-Sanz, V., Blasco, M. J., Castellví, P., Forero, C. G., Bruffaerts, R., Mortier, P., Auerbach, R. P., Nock, M. K., … Alonso, J. (2019). Accuracy of Online Survey Assessment of Mental Disorders and Suicidal Thoughts and Behaviors in Spanish university students. Results of the WHO World Mental Health-International College Student initiative. PLoS ONE, 14(9), 1–21. https://doi.org/10.1371/journal.pone.0221529

Bertuccio, R. F. & Runion, M. C. (2020). Considering Grief in Mental Health Outcomes of COVID-19. Psychological Trauma: Theory, Research, Practice, and Policy, 12, S87–S89. https://doi.org/10.1037/tra0000723

Blasco, M. J., Castellví, P., Almenara, J., Lagares, C., Roca, M., Sesé, A., Piqueras, J. A., Soto-Sanz, V., Rodríguez-Marín, J., Echeburúa, E., Gabilondo, A., Cebrià, A. I., Miranda-Mendizábal, A., Vilagut, G., Bruffaerts, R., Auerbach, R. P., Kessler, R. C., Alonso, J., Barbaglia, G., … Vives, M. (2016). Predictive Models for Suicidal Thoughts and Behaviors among Spanish University Students: Rationale and Methods of the UNIVERSAL (University & Mental Health) Project. BMC Psychiatry, 16(1), 1–13. https://doi.org/10.1186/s12888-016-0820-y

Boelen, P. (2010). Intolerance of Uncertainty and Emotional Distress Following the Death of a Loved one. Anxiety, Stress and Coping, 23(4), 471–478. https://doi.org/10.1080/10615800903494135

Breen, L. J., Lee, S. A., & Neimeyer, R. A. (2021). Psychological Risk Factors of Functional Impairment after COVID-19 Deaths. Journal of Pain and Symptom Management, 61(4), e1–e4. https://doi.org/10.1016/j.jpainsymman.2021.01.006

Breen, R., Karlson, K. B., & Holm, A. (2013). Total, Direct, and Indirect Effects in Logit and Probit Models. Sociological Methods and Research, 42(2), 164–191. https://doi.org/10.1177/0049124113494572

Camacho, D. (2013). Grief: The Emotional Response to Loss. EduPsykhé, 12(2), 129–149.

Diez-Quevedo, C., Rangil, T., Sanchez-Planell, L., Kroenke, K., & Spitzer, R. L. (2001). Validation and Utility of the Patient Health Questionnaire in Diagnosing Mental Disorders in 1003 general Hospital Spanish Inpatients. Psychosomatic Medicine, 63(4), 679–686. https://doi.org/10.1097/00006842-200107000-00021

Díez Martínez, S., Martín Moros, J. M., Altisent Trota, R., Aznar Tejero, P., Cebrián Martín, C., Imaz Pérez, F. J., & del Castillo Pardo, M. (1991). Brief Questionnaires for the Early Detection of Alcoholism in Primary Health Care. Atencion Primaria / Sociedad Española de Medicina de Familia y Comunitaria, 8(5), 367–370.

Djelantik, A. A. A. M. J., Smid, G. E., Mroz, A., Kleber, R. J., & Boelen, P. A. (2020). The Prevalence of Prolonged Grief Disorder in Bereaved Individuals following Unnatural Losses: Systematic Review and meta Regression Analysis. Journal of Affective Disorders, 265, 146–156. https://doi.org/10.1016/j.jad.2020.01.034

Fernández, Ó. & González-González, M. (2020). The Dead with No Wake, Grieving with No Closure: Illness and Death in the Days of Coronavirus in Spain. Journal of Religion and Health, 0123456789. https://doi.org/10.1007/s10943-020-01078-5

Flamenbaum, R. & Holden, R. R. (2007). Psychache as a Mediator in the Relationship between Perfectionism and Suicidality. Journal of Counseling Psychology, 54(1), 51–61. https://doi.org/10.1037/0022-0167.54.1.51

Fried, E. I., Bockting, C., Arjadi, R., Borsboom, D., Amshoff, M., Cramer, A. O. J., Epskamp, S., Tuerlinckx, F., Carr, D., & Stroebe, M. (2015). From Loss to Loneliness: The Relationship between Bereavement and Depressive Symptoms. Journal of Abnormal Psychology, 124(2), 256–265. https://doi.org/10.1037/abn0000028

Frumkin, M. R., Robinaugh, D. J., LeBlanc, N. J., Ahmad, Z., Bui, E., Nock, M. K., Simon, N. M., & McNally, R. J. (2021). The Pain of Grief: Exploring the Concept of Psychological Pain and its Relation to Complicated Grief, Depression, and Risk for Suicide in Bereaved Adults. Journal of Clinical Psychology, 77(1), 254–267. https://doi.org/10.1002/jclp.23024

Furr, S. R., Johnson, W. D., & Goodall, C. S. (2015). Grief and Recovery: The Prevalence of Grief and Loss in Substance Abuse Treatment. Journal of Addictions and Offender Counseling, 36(1), 43–56. https://doi.org/10.1002/j.2161-1874.2015.00034.x

García-Campayo, J., Zamorano, E., Ruíz, M. A., Pardo, A., Freire, O., Pérez-Páramo, M., López-Gómez, V., & Rejas, J. (2009). Cultural Adaptation into Spanish of the Generalized Anxiety Disorder Scale - 7 (GAD-7) Scale. European Psychiatry, 24(S1), 1–1. https://doi.org/10.1016/s0924-9338(09)70771-0

García-Nieto, R., Blasco-Fontecilla, H., Paz Yepes, M., & Baca-García, E. (2013). Traducción y validación de la Self-Injurious Thoughts and Behaviors Interview en población española con conducta suicida [Translation and Validation of the “Self-Injurious Thoughts and Behaviors Interview” in a Spanish Population with Suicidal Behaviour]. Revista de Psiquiatria y Salud Mental, 6(3), 101–108. https://doi.org/10.1016/j.rpsm.2012.07.001

Hagengimana, A., Hinton, D., Bird, B., Pollack, M., & Pitman, R. K. (2003). Somatic Panic-Attack Equivalents in a Community Sample of Rwandan Widows who Survived the 1994 Genocide. Psychiatry Research, 117(1), 1–9. https://doi.org/10.1016/S0165-1781(02)00301-3

Hansson, R. O. & Stroebe, M. S. (2003). Grief, Older Adulthood. In T. P. Gullotta, M. Bloom (eds.), The Encyclopedia of Primary Prevention and Health Promotion (pp. 515–521). Kluwer.

Heeke, C., Kampisiou, C., Niemeyer, H., & Knaevelsrud, C. (2017). A Systematic Review and Meta-analysis of Correlates of Prolonged Grief Disorder in Adults Exposed to Violent Loss. European Journal of Psychotraumatology, 8(sup6), 1583524. https://doi.org/10.1080/20008198.2019.1583524

Hinkin, C. H., Castellon, S. A., Dickson-Fuhrman, E., Daum, G., Jaffe, J., & Jarvik, L. (2001). Screening for Drug and Alcohol Abuse among Older Adults using a Modified Version of the CAGE. American Journal on Addictions, 10(4), 319–326. https://doi.org/10.1111/j.1521-0391.2001.tb00521.x

Hobson, C. J., Kamen, J., Szostek, J., Nethercut, C. M., Tiedmann, J. W., & Wojnarowicz, S. (1998). Stressful Life Events: A Revision and Update of the Social Readjustment Rating Scale. International Journal of Stress Management, 5(1), 1–23. https://doi.org/10.1023/A:1022978019315

Hoffart, A., Johnson, S. U., & Ebrahimi, O. V. (2020). Loneliness and Social Distancing during the COVID-19 Pandemic: Risk Factors and Associations with Psychopathology. Frontiers in Psychiatry, 11, 1–9. https://doi.org/10.3389/fpsyt.2020.589127

Holden, R. R., Mehta, K., Cunningham, E. J., & McLeod, L. D. (2001). Development and Preliminary Validation of a Scale of Psychache. Canadian Journal of Behavioural Science / Revue Canadienne Des Sciences Du Comportement, 33(4), 224–232. https://doi.org/10.1037/h0087144

Holmes, T. H. & Rahe, R. H. (1967). The Social Readjustment Rating Scale. Journal of Psychosomatic Research, 11(2), 213–218. https://doi.org/10.1016/0022-3999(67)90010-4

Hughes, M. E., Waite, L. J., Hawkley, L. C., & Cacioppo, J. T. (2004). A Short Scale for Measuring Loneliness in Large Surveys: Results from two Population-Based Studies. Research on Aging, 26(6), 655–672. https://doi.org/10.1177/0164027504268574

Jacobs, S., Hansen, F., Kasl, S., Ostfeld, A., Berkman, L., & Kim, K. (1990). Anxiety Disorders during Acute Bereavement: Risk and Risk Factors. Journal of Clinical Psychiatry, 51(7), 269–274.

Karlson, K. B. & Holm, A. (2011). Decomposing Primary and Secondary Effects: A New Decomposition Method. Research in Social Stratification and Mobility, 29(2), 221–237. https://doi.org/10.1016/j.rssm.2010.12.005

Karlson, K. B., Holm, A., & Breen, R. (2012). Comparing Regression Coefficients Between Same-sample Nested Models Using Logit and Probit: A New Method. Sociological Methodology, 42(1), 286–313. https://doi.org/10.1177/0081175012444861

Kessler, R. C., Santiago, P. N., Colpe, L. J., Dempsey, C. L., First, M. B., Heeringa, S. G., Stein, M. B., Fullerton, C. S., Gruber, M. J., Naifeh, J. A., Nock, M. K., Sampson, N. A., Schoenbaum, M., Zaslavsky, A. M., & Ursano, R. J. (2013). Clinical reappraisal of the Composite International Diagnostic Interview Screening Scales (CIDI-SC) in the Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS). International Journal of Methods in Psychiatric Research, 22(4), 303–321. https://doi.org/10.1002/mpr.1398

Kessler, R. C. & Üstün, B. B. (2004). The World Mental Health (WMH) Survey Initiative version of the World Health Organization (WHO) Composite International Diagnostic Interview (CIDI). International Journal of Methods in Psychiatric Research, 13(2), 93–117. https://doi.org/10.1002/mpr.168

Keyes, K. M., Pratt, C., Galea, S., McLaughlin, K. A., Koenen, K. C., & Shear, M. K. (2014). The Burden of Loss: Unexpected Death of a Loved one and Psychiatric Disorders across the Life Course in a National Study. American Journal of Psychiatry, 171(8), 864–871. https://doi.org/10.1176/appi.ajp.2014.13081132

Kocalevent, R. D., Berg, L., Beutel, M. E., Hinz, A., Zenger, M., Härter, M., Nater, U., & Brähler, E. (2018). Social Support in the General Population: Standardization of the Oslo Social Support Scale (OSSS-3). BMC Psychology, 6(1), 4–11. https://doi.org/10.1186/s40359-018-0249-9

Latham, A. E. & Prigerson, H. G. (2004). Suicidality and Bereavement: Complicated Grief as Psychiatric Disorder Presenting Greatest Risk for Suicidality. Suicide and Life-Threatening Behavior, 34(4), 350–362. https://doi.org/10.1521/suli.34.4.350.53737

Lee, S. A. & Neimeyer, R. A. (2020). Pandemic Grief Scale: A Screening Tool for Dysfunctional Grief due to a COVID-19 loss. Death Studies, 0(0), 1–11. https://doi.org/10.1080/07481187.2020.1853885

Li, L. Z. & Wang, S. (2020). Prevalence and Predictors of General Psychiatric Disorders and Loneliness during COVID-19 in the United Kingdom. Psychiatry Research, 291, Article 113267. https://doi.org/10.1016/j.psychres.2020.113267

López-Maya, L., Lina-Manjarrez, F., Navarro-Henze, S., & López, L. M. L. (2012). Adicciones en anestesiólogos. ¿Por qué se han incrementado? ¿Debemos preocuparnos? Revista Mexicana de Anestesiologia, 35(2), 95–106.

Lund, D. (1989). Conclusions about Bereavement in Later Life and Implications for Interventions and Future Research. In D. Lund (ed.), Older Bereaved Spouses: Research with Practical Applications (pp. 217–231). Taylor & Francis/Hemisphere.

Marques, L., Bui, E., Leblanc, N., Porter, E., Robinaugh, D., Dryman, M. T., Nadal-Vicens, M., Worthington, J., & Simon, N. (2013). Complicated Grief Symptoms in Anxiety Disorders: Prevalence and associated impairment. Depression and Anxiety, 30(12), 1211–1216. https://doi.org/10.1002/da.22093

Mayland, C. R., Harding, A. J. E., Preston, N., & Payne, S. (2020). Supporting Adults Bereaved Through COVID-19: A Rapid Review of the Impact of Previous Pandemics on Grief and Bereavement. Journal of Pain and Symptom Management, 60(2), e33–e39. https://doi.org/10.1016/j.jpainsymman.2020.05.012

Mdege, N. D., & Lang, J. (2011). Screening Instruments for Detecting Illicit Drug Use/Abuse that could be Useful in General Hospital Wards: A Systematic Review. Addictive Behaviors, 36(12), 1111–1119. https://doi.org/10.1016/j.addbeh.2011.07.007

MINDCOVID. (2020). Mind Covid | Impacto de la pandemia en la salud mental. https://www.mindcovid.org/

Mortier, P., Vilagut, G., Ferrer, M., Serra, C., de Dios Molina, J., López-Fresneña, N., Puig, T., Pelayo-Terán, J. M., Pijoan, J. I., Emparanza, J. I., Espuga, M., Plana, N., González-Pinto, A., Ortí-Lucas, R. M., de Salázar, A. M., Rius, C., Aragonès, E., del Cura-González, I., Aragón-Peña, A., … Zurbano, S. L. (2021). Thirty-day Suicidal Thoughts and Behaviors among Hospital Workers during the First Wave of the Spain COVID-19 outbreak. Depression and Anxiety, 38(5), 528–544. https://doi.org/10.1002/da.23129

Neimeyer, R. A. & Burke, L. A. (2017). Spiritual Distress and Depression in Bereavement: A Meaning-Oriented Contribution. Journal of Rational - Emotive and Cognitive - Behavior Therapy, 35(1), 38–59. https://doi.org/10.1007/s10942-017-0262-6

Newman, M. G., Zuellig, A. R., Kachin, K. E., Constantino, M. J., Przeworski, A., Erickson, T., & Cashman-McGrath, L. (2002). Preliminary Reliability and Validity of the Generalized Anxiety Disorder Questionnaire-IV: A Revised Self-Report Diagnostic Measure of Generalized Anxiety Disorder. Behavior Therapy, 33(2), 215–233. https://doi.org/10.1016/S0005-7894(02)80026-0

Palgi, Y., Shrira, A., Ring, L., Bodner, E., Avidor, S., Bergman, Y., Cohen-Fridel, S., Keisari, S., & Hoffman, Y. (2020). The loneliness pandemic: Loneliness and other concomitants of depression, anxiety and their comorbidity during the COVID-19 outbreak. Journal of Affective Disorders, 275, 109–111. https://doi.org/10.1016/j.jad.2020.06.036

Parisi, A., Sharma, A., Howard, M. O., & Blank Wilson, A. (2019). The Relationship between Substance Misuse and Complicated Grief: A Systematic Review. Journal of Substance Abuse Treatment, 103, 43–57. https://doi.org/10.1016/j.jsat.2019.05.012

Parkes, C. M. (1996). Bereavement: Studies of Grief in Adult Life (3rd ed.). Routledge.

Parro-Jiménez, E., Morán, N., Gesteira, C., Sanz, J., & García-Vera, M. P. (2021). Complicated Grief: A Systematic Review of Prevalence, Diagnosis, Risk and Protective Factors in the Adult Population of Spain. Anales de Psicologia, 37(2), 189–201. https://doi.org/10.6018/analesps.443271

Pfefferbaum, B. & North, C. S. (2020). Mental Health and the Covid-19 Pandemic. New England Journal of Medicine, 1–3. https://doi.org/10.1056/NEJMp2008017

Pinedo, R., Vicario-Molina, I., González Ortega, E., & Palacios Picos, A. (2021). Factors Related to Mental Health During the COVID-19 Lockdown in Spain. Frontiers in Psychology, 12, 1–12. https://doi.org/10.3389/fpsyg.2021.715792

Pini, S., Gesi, C., Abelli, M., Muti, M., Lari, L., Cardini, A., Manicavasagar, V., Mauri, M., Cassano, G. B., & Shear, K. M. (2012). The Relationship between Adult Separation Anxiety Disorder and Complicated Grief in a Cohort of 454 Outpatients with Mood and Anxiety Disorders. Journal of Affective Disorders, 143(1–3), 64–68. https://doi.org/10.1016/j.jad.2012.05.026

Posner, K., Brown, G. K., Stanley, B., Brent, D. A., Yershova, K. V., Oquendo, M. A., Currier, G. W., Melvin, G. A., Greenhill, L., Shen, S., & Mann, J. J. (2011). The Columbia–Suicide Severity Rating Scale: Initial Validity and Internal Consistency Findings from Three Multisite Studies with Adolescents and Adults. American Journal of Psychiatry, 168(12), 1266–1277. https://doi.org/10.1176/appi.ajp.2011.10111704

Prigerson, H. G., Horowitz, M. J., Jacobs, S. C., Parkes, C. M., Aslan, M., Goodkin, K., Raphael, B., Marwit, S. J., Wortman, C., Neimeyer, R. A., Bonanno, G., Block, S. D., Kissane, D., Boelen, P., Maercker, A., Litz, B. T., Johnson, J. G., First, M. B., & Maciejewski, P. K. (2009). Prolonged Grief Disorder: Psychometric Validation of Criteria Proposed for DSM-Vand ICD-11. PLoS Medicine, 6(8), Article e100012. https://doi.org/10.1371/journal.pmed.1000121

Resick, P., Chard, K., & Monson, C. (2020). Cognitive Processing Therapy for Posttraumatic Stress Disorder (PTSD). https://cptforptsd.com/wp-content/uploads/2018/05/PCL-5-Spanish-version.pdf

Ritchie, H., Ortiz-Ospina, E., Beltekian, D., Mathieu, E., Hasell, J., Macdonald, B., Giattino, C., Appel, C., Rodés-Guirao, L., & Roser, M. (2020). Coronavirus Pandemic (COVID-19). OurWorldInData.Org

Robb, C. E., de Jager, C. A., Ahmadi-Abhari, S., Giannakopoulou, P., Udeh-Momoh, C., McKeand, J., Price, G., Car, J., Majeed, A., Ward, H., & Middleton, L. (2020). Associations of Social Isolation with Anxiety and Depression During the Early COVID-19 Pandemic: A Survey of Older Adults in London, UK. Frontiers in Psychiatry, 11, 1–12. https://doi.org/10.3389/fpsyt.2020.591120

Saitz, R., Lepore, M. F., Sullivan, L. M., Amaro, H., & Samet, J. H. (1999). Alcohol Abuse and Dependence in Latinos Living in the United States: Validation of the CAGE (4M) Questions. Archives of Internal Medicine, 159(7), 718–724. https://doi.org/10.1001/archinte.159.7.718

Schaal, S., Dusingizemungu, J. P., Jacob, N., Neuner, F., & Elbert, T. (2012). Associations Between Prolonged Grief Disorder, Depression, Posttraumatic Stress Disorder, and Anxiety in Rwandan Genocide Survivors. Death Studies, 36(2), 97–117. https://doi.org/10.1080/07481187.2011.573177

Schladitz, K., Löbner, M., Stein, J., Weyerer, S., Werle, J., Wagner, M., Heser, K., Scherer, M., Stark, A., Kaduszkiewicz, H., Wiese, B., Oey, A., König, H. H., Hajek, A., & Riedel-Heller, S. G. (2021). Grief and Loss in Old Age: Exploration of the Association between Grief and Depression. Journal of Affective Disorders, 283, 285–292. https://doi.org/10.1016/j.jad.2021.02.008

Shear, M. K., Simon, N., Wall, M., Zisook, S., Neimeyer, R., Duan, N., Reynolds, C., Lebowitz, B., Sung, S., Ghesquiere, A., Gorscak, B., Clayton, P., Ito, M., Nakajima, S., Konishi, T., Melhem, N., Meert, K., Schiff, M., O’Connor, M. F., … Keshaviah, A. (2011). Complicated Grief and Related Bereavement Issues for DSM-5. Depression and Anxiety, 28(2), 103–117. https://doi.org/10.1002/da.20780

Shear, M. K. & Skritskaya, N. A. (2012). Bereavement and anxiety. Current Psychiatry Reports, 14(3), 169–175. https://doi.org/10.1007/s11920-012-0270-2

Simon, N. M., Shear, K. M., Thompson, E. H., Zalta, A. K., Perlman, C., Reynolds, C. F., Frank, E., Melhem, N. M., & Silowash, R. (2007). The prevalence and correlates of psychiatric comorbidity in individuals with complicated grief. Comprehensive Psychiatry, 48(5), 395–399. https://doi.org/10.1016/j.comppsych.2007.05.002

Simon, N. M., Shear, M. K., Reynolds, C. F., Cozza, S. J., Mauro, C., Zisook, S., Skritskaya, N., Robinaugh, D. J., Malgaroli, M., Spandorfer, J., & Lebowitz, B. (2020). Commentary on Evidence in Support of a Grief-Related Condition as a DSM Diagnosis. Depression and Anxiety, 37(1), 9–16. https://doi.org/10.1002/da.22985

StataCorp. (2015). Stata Statistical Software: Release 14. College Station, TX: StataCorp LP.

Stroebe, M. & Schut, H. (2021). Bereavement in Times of COVID-19: A Review and Theoretical Framework. Omega (United States), 82(3), 500–522. https://doi.org/10.1177/0030222820966928

Stroebe, M., Schut, H., & Stroebe, W. (2007). Health outcomes of bereavement. Lancet, 370(9603), 1960–1973. https://doi.org/10.1016/S0140-6736(07)61816-9

Stroebe, Margaret S., Hansson, R. O., Schut, H., & Stroebe, W. (2008). Handbook of Bereavement research and practice: Advances in Theory and Intervention. American Psychological Association. https://doi.org/https://doi.org/10.1037/14498-000

Stroebe, Margaret Susan, Folkman, S., Hansson, R. O., & Schut, H. (2006). The Prediction of Bereavement Outcome: Development of an Integrative Risk Factor Framework. Social Science and Medicine, 63(9), 2440–2451. https://doi.org/10.1016/j.socscimed.2006.06.012

Troister, T. & Holden, R. R. (2010). Comparing Psychache, Depression, and Hopelessness in their Associations with Suicidality: A Test of Shneidman’s Theory of Suicide. Personality and Individual Differences, 49(7), 689–693. https://doi.org/10.1016/j.paid.2010.06.006

Üstun, T. B., Chatterji, S., Mechbal, A., Murray, C. J. L., WHS Collaborating Groups. (2005). Quality Assurance in Surveys: Standards, Guidelines, and Procedures. In Household Sample Surveys in Developing and Transition Countries, chap X. United Nations Publications.

van Tilburg, T. G., Steinmetz, S., Stolte, E., van der Roest, H., & de Vries, D. H. (2021). Loneliness and Mental Health During the COVID-19 Pandemic: A Study Among Dutch Older Adults. The Journals of Gerontology: Series B, 76(7), e249–e255. https://doi.org/10.1093/geronb/gbaa111

Vedder, A., Boerner, K., Stokes, J. E., Schut, H. A. W., Boelen, P. A., & Stroebe, M. S. (2021). A Systematic Review of Loneliness in Bereavement: Current Research and Future Directions. Current Opinion in Psychology, 43, 48–64. https://doi.org/10.1016/j.copsyc.2021.06.003

Weathers, F. W., Litz, B. T., Keane, T. M., Palmieri, P. A., Marx, B. P., Schnurr, P. P. (2013). The PTSD Checklist for DSM-5 (PCL-5). Department of Veterans Affairs. https://www.ptsd.va.gov

World Health Organization. (2022). WHO COVID-19 Dashboard. https://covid19.who.int/

World Health Organization. (2018). International Classification of Diseases for Mortality and Morbidity Statistics (11th Revision). Author.

Williams, R. (2012). Using the Margins Command to Estimate and Interpret Adjusted Predictions and Marginal Effects. Stata Journal, 12(2), 308–331. https://doi.org/10.1177/1536867x1201200209

Wu, Y., Levis, B., Riehm, K. E., Saadat, N., Levis, A. W., Azar, M., Rice, D. B., Boruff, J., Cuijpers, P., Gilbody, S., Ioannidis, J. P. A., Kloda, L. A., McMillan, D., Patten, S. B., Shrier, I., Ziegelstein, R. C., Akena, D. H., Arroll, B., Ayalon, L., … Thombs, B. D. (2020). Equivalency of the diagnostic accuracy of the PHQ-8 and PHQ-9: a systematic review and individual participant data meta-analysis – ERRATUM. Psychological Medicine, 50(16), 2816–2816. https://doi.org/10.1017/s0033291719002137

Zisook, S., Iglewicz, A., Avanzino, J., Maglione, J., Glorioso, D., Zetumer, S., Seay, K., Vahia, I., Young, I., Lebowitz, B., Pies, R., Reynolds, C., Simon, N., & Shear, M. K. (2014). Bereavement: Course, Consequences, and Care. Current Psychiatry Reports, 16(10), Article 482. https://doi.org/10.1007/s11920-014-0482-8

Zuromski, K. L., Ustun, B., Hwang, I., Keane, T. M., Marx, B. P., Stein, M. B., Ursano, R. J., & Kessler, R. C. (2019). Developing an Optimal Short-form of the PTSD Checklist for DSM-5 (PCL-5). Depression and Anxiety, 36(9), 790–800. https://doi.org/10.1002/da.22942

Downloads

Published

2022-06-30

How to Cite

Benítez-Manzanas , L., Feixas, G., Gabarrell-Pascuet, A., Domènech-Abella , J., Mortier, P., Vilagut, G., Haro, J. M., & Alonso, J. (2022). The Association of Grief with Mental Health and the Role of Loneliness During the COVID-19 Pandemic. Acción Psicológica, 19(1), 21–42. https://doi.org/10.5944/ap.19.1.36886

Issue

Section

Artículos de temática libre [Selection of articles]