Bereavement is common among older adults and may result in major

Bereavement is common among older adults and may result in major depressive disorder or complicated grief (CG). or depressive disorder with support-seeking data (weighted n = 89). Yes/no items asked whether participants had seen each supplier for help with grief up until wave 1. A 19-item grief severity measure was developed by CLOC experts. The 20-item Center for Epidemiologic Studies Depression scale measured depressive disorder severity. The Symptom Checklist 90-Revised assessed stress severity. Regressions indicated that seeking support from a family doctor at wave 1 was not associated with changes in stress depressive disorder or Pantoprazole (Protonix) grief severity at wave 2 (> .05). However support group use was associated with reductions in grief severity (β = ?8.46 < .05) and religious leader support-seeking associated with reductions in depressive disorder severity (β = ?10.12 < .01). Findings imply that physician care for grief may not be effective and support group referral may be helpful. Physicians may benefit from training in realizing and appropriate referring for bereavement-related distress. (to those who experienced either CG or depressive disorder at wave 1 and who also experienced data available on support seeking (weighted n = 89). High attrition between the 18- and 48-month interviews prevented examination of outcomes at 48 months. The Columbia University or college Morningside Institutional Review Table reviewed these proposed analysis and concluded that they were exempt from further review. Steps The CLOC data were collected prior to the acknowledgement of CG as a clinical entity. Therefore to identify a CG-positive subsample we selected items around the CLOC questionnaire that roughly corresponded to our proposed CG criteria set.5 The identification of the CG-positive group is explained elsewhere (A. Ghesquiere N. Duan and M. K. Shear “Prevalence and correlates of Complicated Grief in the Changing Lives of Older Couples (CLOC) Study ” unpublished data). The CLOC data set already contained a variable for whether depressive disorder was present or absent at each wave based on items assessing DSM-III criteria. End result steps were symptom severity for grief depressive disorder and stress 18 months after the loss. SFRP1 A continuous grief severity measure was developed by CLOC experts and explained elsewhere (α = .88).22 In its structure and much of its content Pantoprazole (Protonix) this measure resembles the Inventory of Complicated Grief often used to assess Pantoprazole (Protonix) CG.23 Depression severity was measured using a subset of 9 items from your 20-item Center for Epidemiologic Studies-Depression (CES-D) level (α = .75).24 Anxiety severity was assessed using the anxiety subscale of the Symptom Checklist 90-Revised (α = .86).25 26 The independent variables were family doctor support group and religious leader bereavement support seeking. Three yes/no items asked whether participants had seen each of these supplier types for help with feelings of grief loneliness or missing their spouse. This item captured any use between the death and the wave 1 interview. We controlled for variables Pantoprazole (Protonix) found in previous analyses to be associated with grief depressive disorder or stress outcomes postloss.27 28 Control variables included race gender education income (because income distribution was skewed the natural log of income was used) and single items on religious participation and importance of religious beliefs. Additionally as there is reason to expect that social network characteristics can influence help seeking 29 we estimated and controlled for several social network variables (a single close Pantoprazole (Protonix) network size item positive emotional support from friends and relatives (2 items; α = .71) positive emotional support from children (2 items; α = .70) and instrumental support (3 items; α = .64)). Anxious attachment style32 33 has been associated with increased likelihood of mental health support seeking34; an attachment anxiety composite made up of 4 items was included (α = .80). Finally we controlled for wave 1 (6 months postloss) anxiety depression and grief severity. Statistical Analyses All analyses were conducted using Stata statistical software version 12. Descriptive analyses examined the range and central tendency of all variables. Independent-samples tests compared the average change in depression severity anxiety severity and grief severity between waves by each type of support sought. Separate multiple regression analyses were conducted using the procedure in Stata. Because many participants reported using more than one service regression analyses controlled.