Bereavement, Post-Traumatic Growth, and the Role of Cognitive Processes: Study of Bereaved Parents and Spouses in Baluchistan, Pakistan

By Agha, Syed Aziz Uddin; Haque, Anis-Ul | Pakistan Journal of Psychological Research, January 1, 2020 | Go to article overview

Bereavement, Post-Traumatic Growth, and the Role of Cognitive Processes: Study of Bereaved Parents and Spouses in Baluchistan, Pakistan


Agha, Syed Aziz Uddin, Haque, Anis-Ul, Pakistan Journal of Psychological Research


The death of a child or life partner leaves the bereaved parents and spouses in various levels of grief and distress. Chow (2010) in his study argued that for some individuals, death of a loved one implies loss of goals and future while Gerrish, Dyck, and Marsh (2009) reported that early response to death varies from person to person and these early responses may range from delightedness, satisfaction, and relief, to depression and traumatization. This variance in early response indicates that the following process of bereavement is likely to be equally different and the ultimate outcome of bereavement mostly depends upon what precedes it.

Traditionally bereavement outcomes are studied in pathological contexts. As noted by Brunoni, Nunes, Pinheiro, Lotufo, and Benseñor (2014), death of loved ones results in despair and feelings of loneliness. In reaction to grief, certain symptoms appear which are commonly associated with some mental disorder and therefore, it is debated whether such symptoms need to be treated when they appear to constitute a mental disorder. Sveen, Pohlkampl, Kreicbergs, Maarten and Eisma (2019) have reported that bereaved individuals may be more vulnerable to developing prolonged grief.

This debate has stayed for long in psychiatry and exclusion criteria of bereavement in the fifth edition of Diagnostic and Statistical Manual of Mental Disorders (American Psychiatric Association, 2013) for diagnosis of major depressive disorder seems a reflection of that debate and controversy. According to Naef, Ward, Mahrer-Imhof, and Grande (2013) new knowledge about bereavement indicates that grief is an individualized, pervasive and a common experience that needs to be incorporated into the life perspectives and meanings.

In contrast to pathological outcomes, recently there has been a focus on possible positive and adaptive outcomes of traumatic and adversarial events including bereavement. Tedeschi and Calhoun (as cited in Joseph & Linley, 2007) reported that the notion of possible positive outcome as a result of adversarial events has been existent in literature for long. They further added that growth can occur as a result of various adversarial events. According to Kállay (2015):

The potential to grow in the aftermath of crisis has been recorded for very long time and the chances that it could really happen exist. Nevertheless, it should not be taken at its face value, and more importantly, its possibility should not determine research to consider that every situation should determine growth in everybody (p. 8).

Tedeschi and Calhoun (as cited in Joseph, 2009) coined the term post-traumatic growth to refer to positive outcomes. Post-traumatic growth is the experience of adaptive change that happens as a result of coping with adverse life events (Tedeschi & Calhoun, 2004). Posttraumatic growth, according to its profounders, implies experiencing positive and adaptive changes after the death of a loved one in three broad areas that include relationship with others, views about one's self and others, and philosophy of life. These broad areas are further elaborated and operationalized in specific areas including personal strength, changed sense about relationships with others, spirituality, and appreciation of life. Post-traumatic growth denotes positive psychological change after a traumatic experience that is an improvement over the state before the trauma (Khanna & Greyson, 2015).

Calhoun, Cann, Tedeschi, and McMillan (2000) described posttraumatic growth as an experience of important adaptive outcomes resulting from coping with adverse events in life. They argued that focus on systematic study of post-traumatic growth has appeared recently, however, it has been recognized long before. Taku et al. (2007) have mentioned that the possible occurrence of positive changes as a result of coping with adverse experiences has drawn attention since the 1990s. It is important to emphasize that bereavement experience does not inherently entail experience of post-traumatic growth rather occurrence of post-traumatic growth experience depends upon how the individual handles the bereavement experience. …

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