Guilt‐ and shame‐proneness and the grief of perinatal bereavement

“Despite different grieving styles of parents potentially triggering conflict and affecting the couple relationship [15], a recent study found that most parents thought the stillbirth had strengthened their relationship [16].”

“Consistent with studies of pregnancy loss [12,14], we found guilt and self-blame to be prominent themes related to grief after termination for fetal anomaly.”

“…groups offer practical help to both men and women (Boivin, 2003), strategies for coping (Sadler, 1987), a reduction in psychological distress (Barr, 2004; Fukui, Kugaya, & Okamura, 2001), and, even in child survivors of suicide, diminished anxiety and depressive symptoms (Pfeffer, Jiang,…”

“Specific to perinatal death, when ompared to mothers, fathers consistently report fewer rief symptoms and less anxiety (Barr, 2004), however, auma symptomatology in the aftermath of a baby’s death a risk identified in the literature for both genders adenhorst and Hughes, 2007).”

“This may reflect the high-levels of guilt often perceived by mothers after stillbirth [52].”

“…validated scenario-based instruments or adjective lists and that did not constrain 332 OMEGA—Journal of Death and Dying 71(4) the participants to report on a very limited time period may be more sensitive measures of the prevalence of guilt and shame (Barr, 2004, 2012; Barr & Cacciatore, 2007).”

“Previous academic research on pregnancy loss has tended to be based on quantitative studies using standardized measures (Barr, 2004; Cuisinier, Keijpers, Hoogduin, de Graauw, & Janssen, 1993; Hughes & Riches, 2003; Säflund & Wredling, 2006; Serrano & Lima, 2006; Stirtzinger, Robinson, Stewart, &…”

“N IH -PA Author M anuscript N IH -PA Author M anuscript N IH -PA Author M anuscript • Personality - Personality traits can modify, or influence grief during perinatal bereavement when there is a predisposition to shame, guilt (Barr 2004), or jealousy and envy (Barr & Cacciatore 2007).”

“These may in turn relate to different personalities (Barr, 2004), biographical experiences and/or family structures.”

“In support of this claim, previous research has shown that personality guilt- and shame-proneness explain a substantial proportion of the variance in maternal grief following perinatal bereavement (Barr, 2004).”

“Shame, on the other hand, entails a blow to one’s self-esteem and identity, often in a social context and less able to be repaired (Barr, 2004; Duncan & Cacciatore, 2015).”

“Guilt- and-shame-proneness actuate prolonged maternal grief (Barr, 2004).”

“The fact that dysfunctional personality traits and mental ill health have been shown to correlate with maternal grief (Barr, 2004; Lasker & Toedter, 2000; Robinson & Marwit, 2006) presupposes the possibility of an important relationship between dispositional fear of death and maternal grief.”

“…between guilt and postnatal depression may be found even if guilt is not an important part of the casual pathway to postnatal depression (Barr, 2004, 2010, 2011a, 2011b, 2012, 2015; Dunford & Granger, 2017; Fontaine et al., 2001; Harder et al., 1992; Hook & Andrews, 2005; MacDonald &…”

“Mothers typically experienced higher levels of and more enduring depression, yearning, anxiety, guilt, shame, and trauma symptomatology (Barr, 2004; Samuellson, Radestad, & Segesten, 2001; Lang et al., 2001; Varney Sidmore, 2000; Vance & Najman, 1995; Bohannon, 1990).”

“Trait guilt—an individual’s personality threshold and the regulation of emotional and behavioral responses to guilt—is an enduring and dynamic aspect of long-term major mood disorders (Ghatavi, nicolson, MacDonald, Osher, & Levitt, 2002). According to Kaufman (1996), shame, a form of inner torment, specifically is “ce…”

“Several studies have sought to answer the question of who is more likely to suffer negative emotional consequences from pregnancy loss through identification of personality traits and interpersonal resources (Barr, 2004; Engelhard, van den out, & Kindt, 2006; Franche, 2001; Janssen, Cuisinier, de Graauw, & Hoogduin, 1…”

“Further, a perinatal loss can leave a woman feeling as though something she did caused the death of her child, as though her own body has betrayed her, that she is “unfit” to be a mother, or that there is something wrong with her womanhood, all contributing to self-blame and guilt (Barr, 2004; Cote-Arsenault & Mahlang…”

“Parental guilt can be associated with reduced self-esteem, self-blame and feelings of worthlessness which in turn can manifest as symptoms of depression or anxiety [17].”

“Prior studies on moral emotions and grief have failed to distinguish between shame and guilt, or have relied on trait measures of shame- and guilt-proneness (Barr, 2004; Barr and Cacciatore, 2007–2008).”

“Other research (Barr, 2004; Boye et al., 2002; Ferguson et al., 2002) also showed that guilt might be related to psychological problems under hard life conditions.”

“Thus, they may be reluctant to share their feelings of guilt with others, preferring to remain alone with them [76].”

“…PM 214 The Journal of Perinatal Education | Fall 2017, Volume 26, Number 4 JPE26-4_PTR_A6_208-218.indd 214 9/30/17 12:55 PM Fathers’ Worries During Pregnancy | Pilkington and Rominov 215 (Barr, 2004) and perinatal loss services tend to focus on supporting women, and neglect men’s emotional needs.”

“…(Malatesta, 1990; Pettigrew & Dawson, 1979; Yalom, 1980), which can be the maladaptive source of psychological symptoms and psychopathology (Barr, 2004; Barr & Cacciatore, 2008; Bybee & Quiles, 1998; Firestone, 1994; Gilbert & Andrews, 1998; Harder, 1995; Tangney, Burggraf, & Wagner, 1995;…”

“This is concerning as a previous mental illness can contribute to increased intensity of grief following a perinatal death [33].”

“Previous studies have reported that negative self-conscious emotions, including shame and guilt, are commonly experienced by bereaved parents and disturb the normal progression of grieving (Barr, 2004, 2012).”

“For example, the existence of guilt, shame or feeling responsible for the pregnancy loss might have reinforced the reclusion of the topic exclusively to the close family or friends, or in some cases, only among the couple who experience miscarriage [33, 34].”

“…of the loss (e.g., sudden and unexpected vs more preparation time) (Kersting and Wagner 2012), underlying cognitive processes (e.g., guilt, blame) (Barr 2004; Frost and Condon 1996), amount of support from their partner, friends and family (Kersting and Wagner 2012; Samuelsson et al. 2001),…”

“This may explain why chronic guilt proneness (Barr, 2004) and trait self-criticism (Franche, 2001) are positive predictors of women’s and men’s grief symptomatology after the death of a baby during pregnancy or soon after birth.”

“…0.72 0.79 0.672 正式问卷 16 0.33 0.19 0.47 内疚测量方式 自编问卷 38 0.36 0.27 0.46 0.19 0.665 个体内疚 25 0.33 0.22 0.44 内疚类型 群体内疚 29 0.38 0.28 0.48 0.38 0.538 非受害方 13 0.3 0.14 0.46 受害方 33 0.38 0.28 0.47 亲社会行为对象 未指明对象 8 0.36 0.17 0.55 0.61 0.736 西方 14 0.37 0.22 0.52 文化背景 东方 40 0.35 0.26 0.44 0.04 0.836 补偿 19…”

“Over time and many discussions, it became apparent that taking the blame implied that we had some control over the situation and thereby made her death easier to accept (Barr, 2004).”

“Selfblame is linked to higher anxiety and depression and to greater post-traumatic symptomatology (Cacciatore, Froen, & Killian, 2013; Jind, 2003), while guilt as a general concept is associated with more intense expressions of grief (Barr, 2004, 2012; Barr & Cacciatore, 2007).”

“Parents who have lost a child through stillbirth or neonatal death frequently experience guilt, regardless of the circumstances of their loss [7,8].”

“…severe psychological symptoms than women, men were more prone to survivor guilt, anger, frustration and emotional withdrawal (Avelin et al., 2013; Barr, 2004, 2012; Burden et al., 2016), and sometimes take these irritable feelings out on their wives, or turn to alcohol consumption (Bhat & Byatt,…”

“34 One of the common characteristics associated with shame and guilt is the desire to hide or withdraw from social situations, in part to avoid situations that may elicit further guilt.”

“Peter Barr [2] investigated 158 parents identified from hospital records at one month and 13 months following stillbirth or neonatal death (overall response rate 44%).”

“However, one study 45 showed that guilt and shame proneness were associated with longer and more intense grief following perinatal bereavement in both women and men.”

“Women who experience child death face psychological devastation (Shifa et al., 2018), guilt and social stigma (Barr, 2004).”

“Recent studies have corroborated that one of the most important risk factors for ordinary grief to become chronic and turn into psychopathology is guilt (Barr, 2004; Keser, Ar-Karci, et al., 2022; Li et al., 2019).”

“A study that assessed shame and guilt proneness personality types to enduring grief symptoms did find a relationship between shame proneness to enduring grief into 13 months after the loss of a child (Barr, 2004).”