A Loss by Suicide: The Relationship Between Meaning-Making,Post-Traumatic Growth,and Complicated Grief

Abstract

Meaning making has been found useful in processing grief, yet individuals who have experienced a loss by suicide may have difficulty with post-loss adjustment due to the traumatic nature of their loss. Through quantitative study, this article acts as an initial exploratory study and examines the relationship between meaning-making, post-traumatic growth, and complicated grief symptoms in 81 college students from a large university in the United States who have experienced the loss of a loved one to suicide. The results of this study indicated that meaning-making serves as a mediator in the relationship with post-traumatic growth and complicated grief. This finding sheds light on the importance of meaning-making as a possible avenue of interventions for clinical use in bereavement from loss by suicide to treat grief symptoms and lead to post-traumatic growth.

Keywords

complicated grief post-traumatic growth meaning-making suicide bereavement suicide loss

Get full access to this article

View all access options for this article.

References

Agerbo

(2005). Midlife suicide risk, partner’s psychiatric illness, spouse and child bereavement by suicide of other modes of death: A gender specific study. Journal of Epidemical Community Health , 59(3), 407–412. https://doi.org/10.1136/jech.2004.024950

Baron

R. M.

Kenny

D. A.

(1986). The moderator–mediator variable distinction in social psychological research: Conceptual, strategic, and statistical considerations. Journal of Personality and Social Psychology, 51(6), 1173–1182. https://doi.org/10.1037/0022-3514.51.6.1173

Berman

A. L.

(2022). Risk factors observed in the last 30 days of life among student suicides: Distinguishing characteristics of college and university student suicides. Journal of American College Health, 70(5), 1275–1279.

Bogensperger

Lueger-Schuster

(2014). Losing a child: Finding meaning in bereavement. European Journal of Psychotraumatology, 5(1), 1–9. https://doi.org/10.3402/ejpt.v5.22910

Bottomley

J. S.

Smigelsky

M. A.

Bellet

B. W.

Flynn

Price

Neimeyer

R. A.

(2019). Distinguishing the meaning making processes of survivors of suicide loss: An expansion of the meaning of loss codebook. Death Studies, 43(2), 92–102. https://doi.org/10.1080/07481187.2018.1456011

Bray

(2013). Bereavement and transformation: A psycho-spiritual and post-traumatic growth perspective. Journal of Religion & Health, 52(3), 890–903. https://doi.org/10.1007/s10943-011-9539-8

Calhoun

L. G.

Tedeschi

R. G.

Cann

Hanks

E. A.

(2010). Positive outcomes following bereavement: Paths to posttraumatic growth. Psychologica Belgica, 50(1–2), 125–143. https://doi.org/10.5334/pb-50-1-2-125

Centers for Disease Control and Prevention (CDC) . (2020). 10 Leading causes of death, United States. [Web-based Injury Statistics Query and Reporting System (WISQARS)]. https://webappa.cdc.gov/cgi-bin/broker.exe

Cerel

Brown

M. M.

Maple

Singleton

van de Venne

Moore

Flaherty

(2019). How many people are exposed to suicide? Not six. Suicide and Life-Threatening Behavior, 49(2), 529–534. https://doi.org/10.1111/sltb.12450

10.

Corrigan

P. W.

Sheehan

Al-Khouja

M. A.

Lewy

Major

D. R.

Mad

Webeer

(2017). Insight into the stigma of suicide loss survivors: Factor analyses of family stereotypes, prejudices, and discriminations. Archives of Suicide Research, 22(1), 57–66.

11.

Currier

J. M.

Holland

J. M.

Neimeyer

R. A.

(2006). Sense- making, grief, and the experience of violent loss: Toward a meditational model. Death Studies, 30(1), 403–428. https://doi.org/10.1080/07481180600614351

12.

Currier

J. M.

Holland

J. M.

Neimeyer

R. A.

(2012). Prolonged grief symptoms and growth in the first 2 years of bereavement: Evidence for a nonlinear association. Traumatology, 18(3), 65–71. https://doi.org/10.1177/1534765612438948

13.

Delgado

Wester

(2020). Using photovoice to promote meaning-making in a suicide loss support group. Journal of Mental Health Counseling, 42(3), 189–205. https://doi.org/10.17744/mehc.42.3.01

14.

Dransart

D. A. C.

(2013). From sense-making to meaning- making: Understanding and supporting survivors of suicide. British Journal of Social Work, 43, 317–335. https://doi.org/10.1093/bjsw/bct026

15.

Dvregrov

K. M.

Dieserud

Hjelmeland

H. M.

Straiton

Rasmussen

M. L.

Knizek

B. L.

Leenaars

A. A.

(2011). Meaning-making through psychological autopsy interviews: The value of participating in qualitative research for those bereaved by suicide. Death Studies, 35(8), 685–710. https://doi.org/10.1080/07481187.2011.553310

16.

Feigelman

Cerel

McIntosh

J. L.

Brent

Gutin

(2018). Suicide exposures and bereavement among American adults: Evidence from the 2016 general social survey. Journal of Affective Disorders, 227, 1–6. https://doi.org/10.1016/j.jad.2017.09.056

17.

Hagstrom

A. S.

(2017). Suicide stigma” renegotiated: Storytelling, social support and resistance in an internet-based community for the young suicide-bereaved. Qualitative Social Work, 16(6), 775–792. https://doi.org/10.1177/1473325016644039

18.

Hibberd

(2013). Meaning reconstruction in bereavement: Sense and significance. Death Studies, 37(7), 670–692. https://doi.org/10.1080/07481187.2012.692453

19.

Holland

J. M.

Currier

Coleman

R. A.

Neimeyer

R. A.

(2010). The integration of stressful life experiences scale (ISLES): Development and initial validation of a new measure. International Journal of Stress Management, 17(4), 325–352. https://doi.org/10.1037/a0020892

20.

Janoff-Bulman

(1989). Assumptive worlds and the stress of traumatic events: Applications of the schema construct. Social Cognition, 7(2), 113-136. https://doi.org/10.1521/soco.1989.7.2.113

21.

Johnsen

Afgun

(2020). Complicated grief and post-traumatic growth in traumatically bereaved siblings and close friends. Journal of Loss & Trauma. Advanced online publication. https://doi.org/10.1080/15325024.2020.1762972

22.

Kheibari

Sanford

Cerel

Frey

(2016). Personal experience with stigma in adults bereaved by suicide and suicide attempt survivors: A qualitative study. In American Association of Suicidology. April, 2016. https://doi.org/10.13140/rg.2.2.23214.82248

23.

Kristiansen

C. B.

Jesper

N. K.

Hjorth

Andersen

Prina

A. M.

(2019). The association of time since spousal loss and depression in widowhood: A systematic review and meta-analysis. Social Psychiatry and Psychiatric Epidemiology, 54, 781–792. https://doi.org/10.1007/s00127-019-01680-3

24.

Levi-Belz

(2019). With a little help from my friends: A follow-up study on the contribution of interpersonal characteristics to posttraumatic growth among suicide-loss survivors. Psychological Trauma: Theory, Research, Practice, and Policy, 11(8), 895–904.

25.

Lichtenthal

W. G.

Neimeyer

R. A.

Currier

J. M.

Roberts

Jordan

(2013). Cause of death and the quest for meaning after the loss of a child. Death Studies, 37(4): 311–342.

26.

Liu

C. H.

Stevens

Wong

S. H. M.

Yasui

Chen

J. A.

(2019). The prevalence and predictors of mental health diagnoses and suicide among U.S. college students: Implications for addressing disparities in service use. Depression & Anxiety, 36(1), 8–17.

27.

Mayton

H. N.

Wester

(2019). Understanding the experiences of survivors of a loss by suicide: A photovoice study. Journal of Creativity in Mental Health, 14(1), 10–22. https://doi.org/10.1080/15401383.2018.1491814

28.

McDaniel

M. B.

Daly

Pacheco

C. L.

Crist

J. D.

(2022). Experiences with suicide loss: A qualitative study. Clinical Nursing Research, 31(8), 1491–1499.

29.

Michael

S. T.

Snyder

C. R.

(2005). Getting unstuck: The roles of hope, finding meaning, and rumination in the adjustment to bereavement among college students. Death Studies, 29, 435–458.

30.

Milman

Neimeyer

R. A.

Fitzpatrick

MacKinnon

C. J.

Muis

K. R.

Cohen

S. R.

(2017). Prolonged grief symptomatology following violent loss: The mediating role of meaning. European Journal of Psychotraumatology, 8(2), 564. https://doi.org/10.1080/20008198.2018.1503522

31.

National Institute of Mental Health (2019). Suicide. NIMH. https://www.nimh.nih.gov/health/statistics/suicide.html

32.

Neimeyer

(2005). Lessons of loss: A guide to coping (2nd ed.). Routledge.

33.

Neimeyer

R. A.

(2006). Complicated grief and the quest for meaning: A constructivist contribution. Omega-Journal of Death and Dying, 52, 37–52. https://doi.org/10.2190/eql1-ln3v-knyr-18tf

34.

Neimeyer

R. A.

(Ed.), (2021). New techniques of grief therapy: Bereavement and beyond (1st ed.). Routledge. https://doi.org/10.4324/9781351069120

35.

Neimeyer

R. A.

Klass

Dennis

M. A.

(2014). A social constructionist account of grief: Loss and the narration of meaning. Death Studies, 38(1), 485–498. https://doi.org/10.1080/07481187/07481187

36.

Neimeyer

R. A.

Laurie

Mehta

Hardison

Currier

J. M.

(2008). Lessons of loss: Meaning-making in bereaved college students. New Directions for Student Services, 2008(121), 27–39.

37.

Park

C. L.

(2008). Testing the meaning making model of coping with loss. Journal of Social and Clinical Psychology , 27(2), 970–994. https://doi.org/10.1521/jscp.2008.27.9.970

38.

Prigerson

H. G.

Horowitz

M. J.

Jacobs

S. C.

Parkes

C. M.

Aslan

Goodkin

Maciejewski

P. K.

(2009). Prolonged grief disorder: Psychometric validation of criteria proposed for DSM-V and ICD-11. PLoS Medicine, 6(8), 1–12.

39.

Prigerson

H. G.

Maciejewski

P. K.

Reynolds

C. F.

Bierhals

A. J.

Newsom

J. T.

Fasiczka

Frank

Doman

Miller

(1995). Inventory of complicated grief: A scale to measure maladaptive symptoms of loss. Journal of Psychiatry Research, 59, 65–79.

40.

Pritchard

T. R.

Buckle

J. L.

(2018). Meaning-making after partner suicide: A narrative exploration using the meaning of loss codebook. Death Studies, 42(1), 35–44. https://doi.org/10.1080/07481187.2017.1334007

41.

Rogerson

P. A.

(2001). Statistical methods for geography. Sage.

42.

Rozalski

Holland

J. M.

Neimeyer

R. A.

(2017). Circumstances of death and complicated grief: Indirect associations through meaning made of loss. Journal of Loss and Trauma, 22(1), 11–23. https://doi.org/10.1080/15325024.2016.1161426

43.

Schwartz

L. E.

Howell

K. H.

Jamison

& L. E.

(2018). Effect of time since loss on grief, resilience, and depression among bereaved emerging adults. Death Studies, 42(9), 537–547. https://doi.org/10.1080/07481187.2018.1430082

44.

Sheehan

Corrigan

P. W.

Al-Khouja

M. A.

Lewy

S. A.

Major

D. R.

Mead

Weber

(2016). Behind closed doors: The stigma of suicide loss survivors. Journal of Death and Dying , 77(4), 330–349.

45.

Stein

C. H.

Petrowski

C. E.

Gonzales

S. M.

Mattei

G. M.

Hartl

J. M.

Froemming

M. W.

Greenberg

S. C.

Dulek

E. B.

Benoit

M. F.

(2018). A matter of life and death: Understanding continuing bonds and post-traumatic growth when young adults experience the loss of a close friend. Journal of Child and Family Studies, 27, 725–738.

46.

Tabachnick

B. G.

Fidell

L. S.

(2001). Using Multivariate Statistics (4th Edition). Allyn and Bacon.

47.

Tedeschi

Park

Calhoun

(Eds), (1998). Posttraumatic growth: Positive changes in the aftermath of crisis. Erlbaum.

48.

Tedeschi

R. G.

Calhoun

L. G.

(1996). The posttraumatic growth inventory: Measuring the positive legacy of trauma. Journal of Traumatic Stress, 9(3), 455–471.

49.

Tedeschi

R. G.

Calhoun

L. G.

(2004). Posttraumatic growth: Conceptual foundations and empirical evidence”. Psychological Inquiry, 15(1), 1-18. https://doi.org/10.1207/s15327965pli1501_01

50.

Yilmaz

Zara

(2016). Traumatic loss and posttraumatic growth: The effect of traumatic loss related factors on posttraumatic growth. Anadolu Psikiyatri Dergisi, 17(1), 5–11. https://doi.org/10.5455/apd.188311

51.

Zetumer

Young

Shear

M. K.

Skritskaya

Lebowitz

Simon

Zisook

(2015). The impact of losing a child on the clinical presentation of complicated grief. Journal of Affective Disorders, 170(1), 15–21.

52.

Zisook

Shear

M. K.

Reynolds

C. F.

Simon

N. M.

Mauro

Skritskaya

N. A.

Qui

(2018). Treatment of complicated grief in survivors of suicide loss: A heal report. The Journal of Clinical Psychiatry, 79(2), 467. https://doi.org/10.4088/JCP.17m11592