Psychological Medicine



Gender differences in the effects of bereavement-related psychological distress in health outcomes


J. H. CHEN a1, A. J. BIERHALS a1, H. G. PRIGERSON a1c1, S. V. KASL a1, C. M. MAZURE a1 and S. JACOBS a1
a1 Department of Psychiatry, Donaghue Women's Health Investigator Program at Yale and Department of Epidemiology and Public Health, Yale University School of Medicine, New Haven and Northeast Program Evaluation Center, Veterans Affairs Medical Center (182), West Haven, Connecticut; and University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA

Abstract

Background. This study examined whether traumatic grief, depressive and anxiety symptoms formed three distinct factors for widows and widowers. In addition, we examined whether high symptom levels of traumatic grief, depression and anxiety predicted different mental and physical health outcomes for widows and widowers.

Method. Ninety-two future widows and 58 future widowers were interviewed at the time of their spouse's hospital admission and then at 6 weeks, 6, 13 and 25 month follow-ups. Principal axis factor analyses tested the distinctiveness of traumatic grief, depressive and anxiety symptoms, by gender. Repeated measures ANOVA tested for gender differences and changes over time in mean symptom levels of traumatic grief, depression and anxiety. Linear and logistic regression models estimated the effects of high symptom levels of traumatic grief, depression and anxiety at 6 months on health outcomes at 13 and 25 months post-intake by gender.

Results. Three distinct symptom clusters (i.e. traumatic grief, depressive and anxiety symptoms) were found to emerge for both widows and widowers. Widows had higher mean levels of traumatic grief, depressive and anxiety symptoms. High symptom levels of traumatic grief measured at 6 months predicted a physical health event (e.g. cancer, heart attack) at 25 months post-intake for widows. High symptom levels of anxiety measured at 6 months predicted suicidal ideation at 25 months for widowers.

Conclusions. The results suggest that there are gender differences in the levels of psychological symptoms resulting from bereavement and in their effects on subsequent mental and physical health for widows and widowers.


Correspondence:
c1 Address for correspondence: Dr Holly G. Prigerson, Room 144, Connecticut Mental Health Center, 34 Park Street, New Haven, CT 06519, USA.


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