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Continuing Bonds and Reconstructing Meaning
Neimeyer, Baldwin, and Gillies (2006)

Advanced Psychology Seminar

Literature Review
    Attachment Theory Perspective
        Traditional “grief work”
        More contemporary focus on changing the nature of the bond
        Conflicting findings; now focus more on who benefits from ongoing bonds (it appears that those further along in their grief do)

    Meaning Reconstruction Perspective
        Sense-making
        Benefit-finding (more important later on)
        Meaning-making and attachment: reorganizing bonds following loss according to internal working models of self and others

Methods
Purpose: assess possible interaction of continuing bonds and sense-making, benefit finding, and identity change as predictors of complicated grief symptomatology

506 participants, mean age of 21, who experienced loss of a loved one in the last 24 months

Measured using ICG, CBS, questions about meaning making, and questions about factors surrounding the loss and participants’ relationship to the decedent

Regression analysis used to see additional variance in grief outcome attributed to CBS, meaning making questions, and interaction of the two.

Results – Separation Distress
Demographics: As a whole, demographic variable did not contribute a significant portion of the variance in CG. African Americans demonstrated more separation distress than whites.

Characteristics of death and support variables: did contribute significantly to CG (R˛ = .266, p<.001); family relationships, contact with deceased in months preceding death, intimacy, counseling, presence of supportive person, and time talking about loss all had positive relationships with separation distress; time since loss did not.

Continuing Bonds coping and meaning reconstruction: significant contribution to separation distress (R˛ = .276, p<.001); amount of identity reconstruction had positive relationship; benefit finding and positive identity change were negatively related.

Interactions: Sense-making and relationship to deceased moderated the relationship between continuing bonds and separation distress.
When amount of sense made was low, strength of continuing bond made less of a difference in separation symptoms;
When deceased was immediate family member, stronger bonds were assoc with higher separation distress than were weaker ones

Results – Traumatic Distress
Demographics: only age was significant (negative relationship)

Characteristics of death and support variables: 9 of the 12 were significant (R˛ = .293, p<.001);
Neg: age of deceased, months since loss, and ability to talk with someone
Pos: immediate family, amount of contact, death through murder or suicide, history of counseling, time talking about loss

Continuing Bonds coping and meaning reconstruction: (R˛ = .243, p<.001);
Pos.-amount of identity reconstruction
Neg.-benefit finding and positive identity change

Interactions
Same as separation stress: higher levels of sense making and non-familial relationship moderated effects of continuing bond
When sense making was low, prior counseling predicted greater stress; when SM high, little effect
When sense making was low, younger age of decedent predicted greater stress; when SM high, little effect

When controlling for continuing bonds, meaning reconstruction, and interactions only the following were still significant predictors of traumatic stress:
    Amount of prior contact
    Number months since death
    Prior counseling
    African American ethnic background

Discussion
High levels of meaning making consistently predicted better grief outcomes in the first 2 years, whereas high levels of post-loss attachment predicted CG, at least during low levels of sense making.

Continuing bonds more highly related to separation, rather than traumatic distress, and sense-making related equally to both.

Thus, continuing bonds do not always mitigate the stress of bereavement, as some have thought.

It is possible that once more than 2 years has passed, reflecting on attachment to decedent may be helpful. It must be remembered, however, that time since loss was not significant; thus, finding benefit has important implications.

Intimacy with decedent and therapeutic factors appeared to increase risk of CG, but damage was reduced with sense-making. Thus, narrative strategies that promote meaning making can mitigate bereavement complications for high risk mourners.

More attention should be given to ethnicity in CG and ongoing bonds/meaning making literature.

Discussion Questions
Critically evaluate the methods used in this study. What are the limitations? What unforeseen problems might influence results?

Give an overview of ongoing bonds/attachment and meaning making theoretical formulations.

What is the primary theoretical contribution of the study?

What does the study conclude about ongoing bonds theory? Do you agree? Why or why not?

The study concluded that African Americans continued to experience higher rates of CG, even when controlling for continuing bonds and meaning making questions. Why do you think this is the case?

What implications do the results have for practice? (Remember that authors found that prior counseling and levels of intimacy predicted more CG).

What clinical implications do results have for cross-cultural practice?

What insights does this give you in terms of how you might handle a major loss, should you be faced with it?