Depression and PTSD
George A. Bonanno and Anthony D. Mancini
Coping with the death of a close friend or relation can be one of the most highly stressful experiences a person might endure (Holmes & Rahe, 1967). Losses that result from violence and other types of potentially traumatic circumstances appear to be even more difficult for bereaved survivors (Bonanno & Kaltman, 1999). Although many bereaved individuals will recover from such losses within 1 to 2 years and most even sooner, a small but significant subset will experience unremitting distress and depression and in some cases the symptoms of post-traumatic stress disorder (PTSD) for years after the loss (Bonanno & Kaltman, 2001).
Bereaved persons exhibiting chronic grief reactions would be obvious candidates for clinical intervention (Jordan & Neimeyer, 2003; Mancini, Pressman, & Bonanno, in press; Schut, Stroebe, van den Bout, & Terheggen, 2001). Unfortunately, however, despite the voluminous literature on therapeutic techniques and interventions for bereavement, the research evidence suggests the rather sobering conclusion that existing clinical interventions for bereavement have been generally inefficacious (Allumbaugh & Hoyt, 1999; Kato & Mann, 1999; Neimeyer, 2000). For example, two recent meta-analytic studies compared randomly assigned grief treatment and control groups. In contrast to the generally robust effect sizes typically observed for psychotherapeutic outcomes, grief-specific therapies produce only small and relatively