bereavement

1. BEREAVEMENT
NUR AINA BINTI AB KADIR
082012100061

2. CONTENTS
 Definitions
 Normal reaction of bereavement
 Abnormal reaction of bereavement
 Differences between bereavement &
depression

3. DEFINITIONS
 Bereavement: the fact of loss through death
 Bereavement reaction: any psychological,
physiological or behavioral response to
bereavement
 Bereavement process: un umbrella term that
refers to the emergence of bereavement
reactions over time

4. DEFINITIONS
 Grief: the feelings & associated behaviors, eg
crying, accompanying the awareness of
irrevocable loss
 Grieving process: the changing affective
state over time
 Mourning: the social expressions of grief,
including funerals, visitations, and rituals.
 Bereaved
 Deceased

5. NORMAL BEREAVEMENT
REACTIONS
 Protest
 behaviour
 Despair and detachment
 Reorganize and recovery
 accept reality, ways to keep memory

6. COMPLICATED
BEREAVEMENT
 Risk factors
 Multiple, sudden, unexpected deaths, suicide,
murder,and stigmatized deaths
 Preexisting personality in the bereaved:
insecurity, low self esteem, dependence,
difficulties coping with stress, relationship
 Depression, prior substance abuse, multiple
concurrent life stresses or other crises,
perceived lack of support

7. COMPLICATED PROCESSES
CHRONIC GRIEF
HYPERTROPHIC GRIEF
DELAYED GRIEF

8. CHRONIC GRIEF
 Most common
 Unremitting grief, highlighted by bitterness
and idealization of the dead
 Extremely close relationship between the
bereaved and the deceased
 Ambivalent, dependent, social supports are
lacking

9. COMPLICATED
BEREAVEMENT
 HYPERTROPHIC
GRIEF
 After sudden and
unexpected death
 Customary coping
strategies are
ineffective in
mitigating anxiety
 Disruption of family
stability
 Long term course
 DELAYED GRIEF
 Absent/inhibited
grief
 Prolonged denial
 Anger, guilt

10. OTHERS
 UNRESOLVED
GRIEF
 Arrests in the normal
process of grief
 Common
 Depressive
symptoms and
syndromes, chronic
mourning
 TRAUMATIC GRIEF
 Both grief & PTSD
 Grief more both
chronic &
hypertrophic
 Violence,
victimization, volition
 Fear, horror,
vulnerability,
disintegration of
cognitive
assumptions may
ensue

11. BEREAVEMENT VS
DEPRESSION

12. QUESTION.
 A 10 year-old girl is brought in for treatment by her father
following the unexpected death of her mother due to a heart
attack 6 weeks previously. The father is worried because the
child is not sleeping well, has lost 7lb because of a decreased
appetite, seems to be tired much of the time, and is
preoccupied with memories of her mother. He notes that she
cannot concentrate on her usual favourite television shows
and has lost interest in many of her previous social activities.
The patient reports that she deeply misses her mother, and
she smiles in recalling many pleasant memories of their life
together. Which of the following is the most likely diagnosis?
 A. Adjustment disorder with depressed mood
 B. Major depression
 C. Normal bereavement
 D. Dysthymic disorder
 E. Sleep disorder

13. REFERENCES
 Kaplan & Saddock’s, Synopsis of
Psychiatry, volume 2.
 Case Files Psychiatry by Toy and
Klamen,5th edition.