Rumination and Avoidance as Predictors of Prolonged Grief, Depression, and Posttraumatic Stress in Female Widowed Survivors of War
Abstract
This study examined independent contributions of rumination and experiential avoidance in predicting symptoms of psychological distress among female widowed survivors of war. A decade after the war in Kosovo, 100 widowed survivors of war completed measures of rumination, experiential avoidance, depression, posttraumatic stress, and prolonged grief. Results showed that both rumination and experiential avoidance significantly predicted the symptom severity of prolonged grief, depression, and posttraumatic stress. Furthermore, rumination accounted for additional variance above and beyond experiential avoidance and vice versa. Finally, the interaction of rumination and experiential avoidance did not provide significant explanatory power over and above the individual main effects. These findings suggest that rumination and experiential avoidance may be significant factors in understanding and treating psychological distress following exposure to potentially traumatic events and loss due to violence.
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Prolonged grief disorder is associated with avoidance of emotions and thoughts associated with the deceased, suppression of unwanted emotions or thoughts, avoidance of external reminders that trigger negative emotions, and impaired emotional flexibility.
“The disorder tends to be associated with avoidance of emotions and thoughts associated with the deceased 117,118 , suppression of unwanted emotions or thoughts 117,119 , avoidance of external reminders that trigger negative emotions 120 , and impaired emotional flexibility 121 .”
The trait tendency to engage in ruminative self-focus is concurrently and longitudinally moderately positively associated with complicated grief symptoms.
“The trait tendency to engage in ruminative self-focus is concurrently and longitudinally moderately positively associated with CG symptoms (Eisma, Stroebe, et al., 2014; Eisma et al., 2013; Morina, 2011; Tang, Eisma, Li, &Chow, 2019)”
From Emotion Regulatory Strategies in Complicated Grief: A Systematic Review (2021) · cites this paper as Morina, 2011
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References 65 · Cited by 81
- Authors
- Morina, N.
- Venue
- Journal of Nervous & Mental Disease
- Published
- 2011-12
- Volume
- 199
- Issue
- 12
- Pages
- 921-927
- ISSN
- 0022-3018 (ISSN-L)
- OpenAlex
- W2019919813
- Cited by
- 81
- References
- 65
- Citations by year
- 2026: 6 · 2025: 3 · 2024: 4 · 2023: 3 · 2022: 7 · 2021: 7 · 2020: 12 · 2019: 4 · 2018: 7 · 2017: 10 · 2016: 3 · 2015: 6 · 2014: 5 · 2013: 3
- FWCI
- 3.10
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Journal of Nervous and Mental Disease (publishedVersion)
- PubMed (publishedVersion)
- UvA-DARE (University of Amsterdam) (publishedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Grief, Bereavement, and Mental Health
- Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Keywords
- rumination, experiential avoidance, prolonged grief disorder, depression, post-traumatic stress, widowhood, war survivors, women survivors, Kosovo War, psychological distress, bereavement, potentially traumatic events
- MeSH terms
- Adult, Avoidance Learning, Depressive Disorder, Female, Grief, Humans, Middle Aged, Population Surveillance, Predictive Value of Tests, Stress Disorders, Post-Traumatic, Warfare, Yugoslavia, Survivors, Widowhood
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