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. 2022 Jan;29(1):299-312.
doi: 10.1002/cpp.2635. Epub 2021 Jul 20.

Rumination, worry and negative and positive affect in prolonged grief: A daily diary study

Maarten C Eisma  1 , Minita Franzen  1 , Mabel Paauw  1 , Anke Bleeker  1 , Marije Aan Het Rot  1
Affiliations

Rumination, worry and negative and positive affect in prolonged grief: A daily diary study

Maarten C Eisma et al. Clin Psychol Psychother. 2022 Jan.

Abstract

After bereavement, a significant minority experiences severe, persistent, and disabling grief, termed prolonged grief or complicated grief. Prolonged grief treatments may be enhanced by improving understanding of malleable risk factors in post-loss psychological adaptation. Repetitive negative thought (e.g., rumination, worry) constitutes such a risk factor. Rumination and worry are both theorized to be maladaptive through interrelations with affect, yet this assumption has not been systematically investigated in the bereaved. We aimed to fill this gap in knowledge with a baseline survey and 10-day daily diary investigation among a bereaved sample. Survey between-subject analyses (N = 113) demonstrated that trait rumination and worry, trait negative affect and prolonged grief symptoms are positively related to each other and negatively related with trait positive affect. Within-subject multilevel analyses of diaries (N = 62) demonstrated that trait rumination and trait worry relate positively to daily negative affect and negatively to daily positive affect. Daily rumination and worry showed similar relationships with daily negative and positive affect. A stronger relationship emerged between daily rumination and daily negative affect in people with higher prolonged grief symptom levels. Findings consistently support interrelations between repetitive negative thought, affect, and prolonged grief symptoms. Rumination appears particularly detrimental in people with severe grief reactions. Results align with research demonstrating the effectiveness of targeting repetitive negative thought in prolonged grief treatments. Additionally, our study demonstrates the potential feasibility and usefulness of using daily diaries to study behaviours of relevance to post-loss adaptation in everyday life.

Keywords: affect; complicated grief; coping; emotion regulation; rumination; worry.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

FIGURE 1
FIGURE 1
Flow diagram of the number of participants (values in bold) through the study
FIGURE 2
FIGURE 2
Daily negative affect as a function of low (−1 SD) and high (+1 SD) daily rumination in individuals low (−1 SD) and high (+1 SD) on PG symptoms. Note: There was a significant moderation effect of PG symptoms (p = .019; d = 0.21), with a slightly stronger association between daily rumination with daily negative affect for individuals with high (β = .43, p < .0001) versus low PG symptoms (β = .42, p < .0001). PG, prolonged grief
See this image and copyright information in PMC

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