PAST PERSONAL HISTORY OF DYSPHORIA, SOCIAL SUPPORT, AND PSYCHOLOGICALDISTRESS FOLLOWING CONJUGAL BEREAVEMENT

OBJECTIVE: This study describes the course and risk factors of psychol ogical distress following bereavement, controlling for factors often o mitted from studies of grief: psychiatric history, social support, and coping choices of the bereaved. PARTICIPANTS: Spouses of patients hos pitalized for serious illness or elective surgery were systematically screened and followed longitudinally through the recovery or death of the hospitalized patient. Of 440 respondents, 154 were bereaved within 2 months. DESIGN AND SETTING: Spouses were interviewed in their homes by trained interviewers at intake and 2, 6, 13, and 25 months postint ake. MEASUREMENTS: Dependent variables were measured with the CES-D (d epressive symptoms) and the PERI (general anxiety and hopelessness/hel plessness) scales. Independent variables were measured with the SADS-L (past personal history of dysphoria) and the Lazarus' Ways of Coping scale as well as sociodemographic measures. MAIN RESULTS: Lifetime pre valence of a brief period of dysphoric mood among spouses before the p atient's illness was 22%; past personal history of dysphoric mood was related to female sex, smaller networks, and more depression and anxie ty during the hospitalization of their spouses. Newly widowed persons with a past history of dysphoria perceived their networks to be relati vely nonsupportive, but devoted similar amounts of coping effort to se eking social support and reported similar amounts of social interactio n compared with persons with no history of dysphoria. Persons with a p ast history of dysphoria reported elevated levels of depressive sympto ms, general anxiety, and hopelessness/helplessness through 25 months p ostbereavement, yet their recovery trajectory was similar to those wit hout a past history of dysphoria. CONCLUSIONS: It was concluded that a past history of subsyndromal symptomatology in conjunction with a str essful life event such as bereavement increases one's vulnerability to excess psychological distress.