Anthony Papa

A Randomized Open Trial Assessing the Feasibility of Behavioral Activation for Pathological Grief Responding

This study investigated the feasibility of using behavioral activation to treat enduring postbereavement mental health difficulties using a two-arm, multiple baseline design comparing an immediate start group to a delayed start group at baseline, 12-, 24-, and 36-weeks postrandomization. Participants received 12-14 sessions of behavioral activation within a 12-week intervention period starting immediately after the first assessment or after 12weeks for the delayed start group. Prolonged grief, posttraumatic stress, and depression symptoms were assessed as outcomes. Compared with no treatment, behavioral activation was associated with large reductions in prolonged, complicated, or traumatic grief; posttraumatic stress disorder; and depression symptoms in the intent-to-treat analyses. Seventy percent of the completer sample at posttreatment and 75 percent at follow-up responded to treatment with 45 percent at posttreatment and 40 percent at follow-up being classified as evidencing high-end state functioning at 12-week follow-up.

Identity continuity and loss after death, divorce, and job loss

Abstract This paper examined the relationship of constructs identified by identity continuity and attachment theories of grief to adjustment to loss from the framework of identity theory. Connections between loss salience, identity construal, and balance of identity construal on grief intensity via their association with post-loss identity disruption were examined across three types of self-relevant losses; death of a family member, job loss, or divorce. We hypothesized that lower salience, higher endorsement of identity attributes represented by relational and individualistic self-construals, and an overall balance across identity attributes would be related to decreased grief severity across all types of loss. Results supported hypotheses with the exception that the hypothesized ameliorative effect of increases in relational self-construal was only seen in the bereaved group.