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A Cognitive Attachment Model of prolonged grief: Integrating attachments, memory, and identity
Abstract
Prolonged grief (PG), otherwise known as complicated grief, has attracted much attention in recent years as a potentially debilitating condition that affects approximately 10% of bereaved people. We propose a model of PG that integrates processes of attachment, self-identity, and autobiographical memory. The paper commences with a discussion of the PG construct and reviews current evidence regarding the distinctiveness of PG from other bereavement related-outcomes. We then review the evidence regarding the dysfunctional attachments, appraisals, and coping styles that people with PG display. Recent evidence pertaining to the patterns of autobiographical memory in PG is described in the context of the self-memory system. This system provides a unifying framework to understand the roles of personal memories, identity, attachments, and coping responses in PG. The proposed model places emphasis on how one's sense of identity influences yearning, memories of the deceased, appraisals, and coping strategies, to maintain a focus on the loss. The model is discussed in relation to existing models of PG. The potential for shaping treatment strategies to shift perceptions of the self is then outlined. Finally, we outline future directions to test propositions stemming from the model and enhance our understanding of the mechanisms underlying PG.
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“PGD can, with its core symptoms of separation distress, be defined as an attachment related disorder (Maccallum and Bryant, 2013; WHO, 2022).”
From Group-based compassion-focused therapy for prolonged grief symptoms in adults – Results from a randomized controlled trial (2022) · cites this paper as Maccallum and Bryant, 2013
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“Further, longitudinal studies indicate that maladaptive cognitive appraisals, including rumination, mediate longerterm prolonged grief symptomatology 88,116 .”
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Kealy, D., Hernandez, C. A. S., Piper, W. E., Joyce, A. S., Weideman, R., & Ogrodniczuk, J. S. (2017) · Psychiatry · doi:10.1080/00332747.2016.1220231 · Cited by 10
LeBlanc, N. J., Simon, N. M., Reynolds, C. F., Shear, M. K., Skritskaya, N. A., & Zisook, S. (2019) · Elsevier eBooks · doi:10.1016/b978-0-12-813333-0.00020-2 · Cited by 10
Mann-Feder, V. R. (2019) · doi:10.1093/oso/9780190630485.003.0002 · Cited by 10
Metadata
- Authors
- Maccallum, F., & Bryant, R. A.
- Affiliations
- UNSW Sydney (AU)
- Corresponding author
- Maccallum, Fiona
- Venue
- Clinical Psychology Review
- Publisher
- Elsevier BV
- Published
- 2013-08
- Volume
- 33
- Issue
- 6
- Pages
- 713-727
- ISSN
- 0272-7358 (ISSN-L)
- OpenAlex
- W1997669167
- Cited by
- 214
- References
- 137
- Citations by year
- 2026: 24 · 2025: 23 · 2024: 16 · 2023: 20 · 2022: 12 · 2021: 26 · 2020: 20 · 2019: 11 · 2018: 9 · 2017: 22 · 2016: 11 · 2015: 11 · 2014: 9
- FWCI
- 1.53
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Clinical Psychology Review (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Grief, Bereavement, and Mental Health
- Social Sciences › Psychology › Developmental and Educational Psychology › Identity, Memory, and Therapy
- Social Sciences › Anthropology › Death, Funerary Practices, and Mourning
- Keywords
- prolonged grief disorder, complicated grief, bereavement, attachment, self-identity, autobiographical memory, coping strategies, longing, appraisal, grief therapy
- MeSH terms
- Adaptation, Psychological, Bereavement, Death, Grief, Humans, Memory, Models, Psychological, Object Attachment
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