Date of Award
Dissertation - Restricted
Doctor of Philosophy (PhD)
Educational Policy and Leadership
The pattern of change in mental health status over 24 months of bereavement was studied using a cohort sequential design with 118 widows and widowers who experienced the death of a spouse within the past 18 months. In order to identify the patern of change in spousal bereavement, observed mean score changes in mental health were calculated for the three time frames when data were collected starting at 3 months and concluding at 24 months. Results indicated a consistent pattern of improvement in overall mental health starting at 3 months, peaking at 15 months, slightly declining over the next 6 months, followed by an upward trend again at 24 months. The overall pattern of change in mental health status was similar to the psychotherapy dosage model in which time and other factors (e.g., psychotherapy, group participation, and personal resources) contribute to the natural course of recovery. The improvement in bereaved individuals followed a pattern similar to that observed in the psychotherapy phase model; dramatic change in the domain of well-being followed by symptom alleviation. Unlike, the psychotherapy model, the functioning domain remained within a normal range throughout the 24 months of bereavement. Comparisons between the: pattern of change for complicated and uncomplicated grievers indicated significant differences in overall mental health, wellbeing, symptoms, and functioning throughout the first 18 months. Using criteria for clinically significant change, 73.7% of participants exhibited improvement by 24 months post-bereavement, an additional 14.91% met the criteria for reliable change, and 11.39% did not improve. Hierarchical multiple regression analysis indicated that additional stressors, social support, and age accounted for 42% of the variance in mental health status. Differences in the pattern of change in mental health were illustrated for these variables. A discriminant function analysis indicated that decreased levels of social support and spiritual support, increased stressors, younger age, and presence of dependent children accurately predicted improved and nonimproved mental health status. The implications of these findings are discussed in terms of clinical interventions, theoretical formulations, and future research on patterns of bereavement.