12 - The mortality of bereavement: A review

Summary

Increasingly in recent years researchers have focused on positive aspects of the experience of bereavement, emphasizing that it is a “growth experience,” that people are “resilient,” and that the illness metaphor should be abandoned in describing the consequences of grief. The chapters in this volume by Silverman and Worden, McCrae and Costa, and Shuchter and Zisook, to name only a few, underline this message. Yet the reason that so much research has focused on bereavement is because the loss of a loved one is associated with extreme mental and physical suffering, not for everyone, and not always lastingly, but for a significant minority. Even more disturbing are the statistics for mortality. Not only do some bereaved individuals fall ill following the loss of a loved one, but they also die.

Given that fatal consequences occur for some bereaved, it is important to identify those who are vulnerable and to understand why they and not others succumb. A decade ago we reviewed the research on mortality (M. Stroebe, Stroebe, Gergen, & Gergen, 1981) and concluded that there was some evidence that bereavement results in excess mortality. However, the surveyed research suffered from many methodological shortcomings. In the meantime, much research has been done and much has been written about the bereavement-mortality relationship. The goals of this chapter, therefore, are to review the scientific evidence that is now available, examine subgroup differences that suggest high-risk categories, and review and evaluate theoretical explanations that could account for the bereavement-mortality relationship.