The Correlates of Grief after Death of Pet

ABSTRACT

The correlates of degree of grief after death of dogs and cats were determined. With both animals, retrospectively reported grief was associated with present death depression and positive attitude toward pets. Grief after the death of a dog was associated with living alone at the time of death, higher death depression, and female gender. Grief after the death of a cat was associated with higher death depression, female gender, and was inversely correlated with the person's age at the time of the pet's death. These psychological and psychosocial variables were more associated with pet grief than behavioral variables such as amount of time spent with the pet.     

Attachment styles impact on pet visitation effectiveness

Abstract

This paper describes a field study on the effects of attachment styles on the subjective well-being of institutionalized older persons after participating in a pet visitation program. We compared how attachment style (i.e., secure, anxious ambivalent, dismissive avoidant, and fearful avoidant) moderated the impact of a dog visitation program in 52 elderly residents of an assisted-living facility. Controlling for pre-visitation mood, the results revealed that the secure style related to increases in positive mood after interacting with the dogs. The anxious ambivalent style related to increases in positive mood and decreases in ratings of depression. Most importantly, the fearful avoidant style related to increases in depression after interacting with the dogs. The results highlight the notion that not all participants benefit from taking part in pet visitation programs. Theoretically, this study presents preliminary evidence for the relevance of attachment styles in understanding human–pet interactions.     

There for You: Attending Pet Euthanasia and Whether this Relates to Complicated Grief and Post-Traumatic Stress Disorder

ABSTRACT

Recognizing the deep relationship between grief and the loss of a companion animal, veterinarians and mental health practitioners often find themselves consoling pet owners both prior to and in the aftermath of pet euthanasia. Yet how does euthanasia influence this bereavement process? To explore this we examined, using a survey, the correlations between pet euthanasia, Complicated Grief (CG), and Post-Traumatic Stress Disorder (PTSD) amongst a diverse range of pet owners from the state of Hawaii. Participants (n = 236) completed a 37-item questionnaire, the Inventory of Complicated Grief Revised Short Form (ICG-R-SF), and the PTSD Checklist (PCL). Of the participants, 3.4% and 4.7% met the criteria for CG and PTSD, respectively. This paper explores and subdivides respondents into those who attended their companion animal’s euthanasia and those who did not. Our results indicate that physically attending a companion animal’s euthanasia is not correlated with CG or PTSD. As the experience of pet loss itself may be more indicative of psychological distress than whether or not the owner was present at the moment of euthanasia, veterinary staff need not dissuade pet owners from sharing their pet’s final moments.     

Human Grief Resulting from the Death of a Pet

Abstract

This study investigated antecedents of the human grief response which was associated with the death of a pet cat or dog. The sample included 207 voluntary subjects who experienced this type of loss within a one-year time period prior to participating in the study. Data for the predictor variables were obtained from two validated instruments and a questionnaire developed by the author. Data for grief outcome were obtained from another validated instrument on three clinical and three validity scales. The results indicated that level of attachment to the deceased pet, perceived understanding from others and other stressful events combined to have significant predictive ability in grief outcome. Other analyses indicated qualitative differences in grief outcome according to gender of owner and the presence of children and/or more than one other adult in the household. No significant difference was found between single and multiple pet ownership in grief outcome.     

Pet Loss: Understanding Disenfranchised Grief,Memorial Use,and Posttraumatic Growth

The growing body of literature exploring pet loss suggests that many bereaved pet owners experience disenfranchised grief. Disenfranchised grief occurs when a loss is unacknowledged and the bereaved are unable to express their grief. When grief is considered illegitimate, the bereaved may experience a variety of adverse psychological outcomes, including increased distress and reduced quality of life. Additionally, when grief is inhibited, the individual may be less likely to experience positive changes such as posttraumatic growth. Few studies have considered the relationship between disenfranchisement and posttraumatic growth following the loss of a companion animal. This study investigated the relationship between disenfranchised grief, memorialization, and posttraumatic growth in bereaved pet owners. Grief severity was assessed as a moderator. Using an online survey, respondents (n?=?133) completed standardized measures, including the Pet Bereavement Questionnaire, the Loss of Social Support subscale from the Grief Experience Questionnaire, and the Posttraumatic Growth Inventory-Short Form (PTGI-SF). As hypothesized, there was a significant interaction between disenfranchised grief, grief severity, and posttraumatic growth, suggesting that disenfranchised grief inhibits posttraumatic growth when grief severity is high. Contrary to the hypothesis, there was no relationship between memorial quantity or type and posttraumatic growth. Overall, this study shows that disenfranchised grief can inhibit posttraumatic growth following the loss of a pet, highlighting the complicated relationship between posttraumatic growth, grief intensity, and disenfranchised grief.     

Texas-Revised Inventory of Grief: Validierung der deutschen Version TRIG-D

The loss of a loved person has often yearlong consequences for the bereaved. The Texas-Revised Inventory of Grief was developed by Faschingbauer and coworkers to measure the grief-specific distress. Up to now, no German translation of this instrument existed. An adapted German version of the TRIG is presented and results of a validation study with parents who lost a child are reported. The TRIG-D shows good internal consistency (Cronbach’s a =.87) Correlations of grief-intensity of the TRIG-D with stress-related symptoms and depression were high. These predictors explained 55% of the total variance of grief intensity. The TRIG-D measures reliably the intensity of grief related distress; however, there exist no cut-off-values for complicated grief.     

Prolonged Grief Disorder: Psychometric Validation of Criteria Proposed for DSM-V and ICD-11

Background

Bereavement is a universal experience, and its association with excess morbidity and mortality is well established. Nevertheless, grief becomes a serious health concern for a relative few. For such individuals, intense grief persists, is distressing and disabling, and may meet criteria as a distinct mental disorder. At present, grief is not recognized as a mental disorder in the DSM-IV or ICD-10. The goal of this study was to determine the psychometric validity of criteria for prolonged grief disorder (PGD) to enhance the detection and potential treatment of bereaved individuals at heightened risk of persistent distress and dysfunction.

Methods and Findings

A total of 291 bereaved respondents were interviewed three times, grouped as 0–6, 6–12, and 12–24 mo post-loss. Item response theory (IRT) analyses derived the most informative, unbiased PGD symptoms. Combinatoric analyses identified the most sensitive and specific PGD algorithm that was then tested to evaluate its psychometric validity. Criteria require reactions to a significant loss that involve the experience of yearning (e.g., physical or emotional suffering as a result of the desired, but unfulfilled, reunion with the deceased) and at least five of the following nine symptoms experienced at least daily or to a disabling degree: feeling emotionally numb, stunned, or that life is meaningless; experiencing mistrust; bitterness over the loss; difficulty accepting the loss; identity confusion; avoidance of the reality of the loss; or difficulty moving on with life. Symptoms must be present at sufficiently high levels at least six mo from the death and be associated with functional impairment.

Conclusions

The criteria set for PGD appear able to identify bereaved persons at heightened risk for enduring distress and dysfunction. The results support the psychometric validity of the criteria for PGD that we propose for inclusion in DSM-V and ICD-11. Please see later in the article for Editors'' Summary     

Pet Loss and Representations of Death,Attachment, Depression,and Euthanasia

Studies that have examined pet loss hypothesize that attachment, representations of death, and the belief in an afterlife for animals may influence owners’ bereavement and depressive outcomes. The following instruments were administered to 159 Italian participants recruited through snowball sampling: the Lexington Attachment to Pets Scale (LAPS), the Pet Bereavement Questionnaire (PBQ), the Testoni Death Representation Scale (TDRS), and Beck’s Depression Inventory II (BDI-II). Questions concerning pet euthanasia-related issues and the relationship between owners and veterinarians were also submitted to the participants. A path model was conducted, showing that the representation of death and the attachment to a pet had a direct effect on pet grief, which in turn had a direct effect on depression. The results show a positive correlation between the LAPS and PBQ factors, particularly with the PBQ factor Grief. The LAPS factors positively correlated with the TDRS representation of Death as a Passage and negatively correlated with the TDRS representation of Death as Annihilation. The LAPS People Substituting factor positively correlated with the total score and the Cognitive-Affective factor of the BDI-II. The PBQ factors positively correlated with the BDI-II, whereas only the TDRS Death as Annihilation factor positively correlated with the BDI-II. Belief in a transcendent dimension was associated with higher scores on the PBQ Guilt factor and the TDRS factors of Death as a Passage and Death as Change, whereas these beliefs were associated with lower scores on the TDRS factor Death as Annihilation.

The results indicated that the sensitivity of the veterinarian and a veterinarian who helps owners make conscious and informed decisions for their pet and choose the right time to perform euthanasia are important variables in the management of pet loss. However, these factors are not sufficient and psychological support should be improved to help owners better cope with grief.     

Pet Loss and Grief: Identifying At-risk Pet Owners during the Euthanasia Process

Pet owners often experience complex and profound grief reactions when their animals are euthanized. Veterinary staff are increasingly being called upon to be aware of and to respond to the grief reactions of pet owners at this critical time. The objectives of this study were to identify pet owners who are most at risk of grief and to suggest veterinary interventions during the euthanasia process. A convenience sample of 409 pet owners whose animals had been euthanized in the past year took part in a survey. Variables of interest included pet and pet-owner demographics, pet-death characteristics, attachment to pet, and bereavement reactions. Stepwise multiple regression analyses were conducted to identify factors related to the three grief reaction subtypes: sorrow, anger, and guilt. Results indicated that attachment to pets was a strong predictor of feelings of grief/sorrow (p < 0.001) and anger (p < 0.001). Sudden death was also related to feelings of anger (p < 0.05). Cancer diagnosis was negatively related to feelings of anger (p < 0.05) and guilt (p < 0.01). The findings from this study provide additional insight into the complexity of grief following pet euthanasia. For veterinary staff, anticipating the needs of pet owners and supporting them through the grief process is an integral role. Understanding which pet owners are at greatest risk of grief is an important initial step, followed by empathic communications, sensitive interactions, and the provision of grief support.     

Separation Anxiety,Attachment and Inter-Personal Representations: Disentangling the Role of Oxytocin in the Perinatal Period

In this paper, we aimed to assess cross-sectionally and longitudinally associations between disturbances in maternal early attachment experiences, symptoms of separation anxiety and depression and oxytocin plasma levels. We examined a mediational model that tested the hypothesis that anxious attachment style arising from the mothers’ early bonding experiences with her own parents was associated with high levels of separation anxiety which, via its impact on depression, was associated with reduced levels of oxytocin in the postnatal period. Data is reported on a structured sample of 127 women recruited during pregnancy from a general hospital antenatal clinic and an initial follow up cohort of 57 women who were re-assessed at 3-months post-partum. We found an association between lower oxytocin level in the post partum period and symptoms of separation anxiety and depression during pregnancy, as well as maternal negative interpersonal representations, upbringing attributes and anxious attachment style. Further meditational analysis revealed that the unique association between anxious attachment and depression is mediated by separation anxiety and that depressed mood mediated the relationship between separation anxiety and oxytocin. In conjunction with evidence from the literature suggesting that lower oxytocin level is associated with bonding difficulties, our findings have significant implications for understanding the biological processes underpinning adverse attachment experiences, negative affect state, and mother-to-infant bonding difficulties.     

Young Adults' Attachment to Pet Dogs: Findings from Open-Ended Methods

ABSTRACT

Turning to someone in times of emotional distress (safe haven) is one key feature of an attachment bond. Aspects of pet dogs as sources of safe haven were examined with open-ended methods for two samples of young adults who were college students (total n = 566, mean age = 19.24 years). Based on ranked nominations, relative to other features of pet dogs as attachment figures, safe haven was the least salient. Nonetheless, although participants were less likely to turn to pet dogs than to mothers, friends, and romantic partners in times of distress, they were more likely to turn to pets than to fathers and brothers and just as likely to turn to sisters. Differences between pet dogs and some humans as sources of safe haven were smallest for participants with high levels of involvement in the care of their dogs and participants who regarded their dogs as strongly meeting needs for relatedness. It is concluded that characteristics of both the dog and the owner predispose young adults to regard their dogs as a source of safe haven and serve as one basis for establishing attachment bonds with them.     

Childhood Neglect,Attachment to Companion Animals,and Stuffed Animals as Attachment Objects in Women and Men

ABSTRACT

Childhood neglect has severe, pervasive, negative outcomes that often continue into adulthood. As a potential source of support for both children and adults, companion animals (pets) can both give and receive affection and therefore may be sources of healthy attachment for people who were raised in negative situations. Toy stuffed animals, in contrast, can only receive affection but may still be useful as transitional objects, particularly for people who experienced interpersonal neglect in childhood and who are in the midst of a transition away from the family home and into college. The current study examined the relationships among childhood neglect, companion animal attachment, and attachment to toy stuffed animals. Undergraduate participants (n = 457) from a large regional university answered questionnaires online. The first hypothesis, that self-reported childhood neglect would be positively related to attachment to companion animals, was supported for women only. Neglected women were more attached to companion animals than were non-neglected women, with a medium effect size. For men, there was no significant effect. The second hypothesis was that childhood neglect would be positively related to attachment to stuffed animals; this hypothesis was not supported. The third hypothesis, that women would be more attached to both companion animals and stuffed animals than would men, was supported. Attachment to companion animals and attachment to stuffed animals were positively related. Results are discussed within a framework of attachment and transitional objects as potential aids to therapy in people who were neglected in childhood.     

Perceived Social Support Moderates the Link between Attachment Anxiety and Health Outcomes

Two literatures have explored some of the effects intimate relationships can have on physical and mental health outcomes. Research investigating health through the lens of attachment theory has demonstrated that more anxiously attached individuals in particular consistently report poorer health. Separate research on perceived social support (e.g., partner or spousal support) suggests that higher support has salutary influences on various health outcomes. Little to no research, however, has explored the interaction of attachment anxiety and perceived social support on health outcomes. The present study examined the attachment-health link and the moderating role of perceived social support in a community sample of married couples. Results revealed that more anxious persons reported poorer overall physical and mental health, more bodily pain, more medical symptoms, and impaired daily functioning, even after controlling for age, relationship length, neuroticism, and marital quality. Additionally, perceived social support interacted with attachment anxiety to influence health; more anxious individuals'' health was poorer even when perceived social support was high, whereas less anxious individuals'' health benefited from high support. Possible mechanisms underlying these findings and the importance of considering attachment anxiety in future studies of poor health in adulthood are discussed.     

Children with Avoidant or Disorganized Attachment Relate Differently to a Dog and to Humans During a Socially Stressful Situation

ABSTRACT

Human attachment representations are shaped in interaction with the primary caregiver and are generally transferred to further bonding/ social partners later in life. According to previous evidence, primary attachment representations acquired with humans do not seem to be transferred to companion animals. This was held as a major factor why such animals would effectively provide social support also to persons with insecure attachment. The aim of this study in 19 male children, 7–11 years of age and with insecure-avoidant or disorganized attachment, was to investigate differences in their social behavior and in physiological responses when socially supported by an unfamiliar therapy dog in a socially stressful situation. The Trier Social Stress Test for Children (TSST-C) was conducted to elicit stress in the children when in the presence of the dog and a female human investigator. We found that boys with disorganized attachment (n=11) communicated more intensely than avoidantly attached boys (n=8) with both the dog and humans present. Boys with a disorganized attachment had more physical contact with the dog during the TSST-C and talked more to the dog during and after the TSST-C than did boys with an insecure-avoidant attachment. While the prevailing wisdom holds that attachment representations acquired with the primary human caregiver would not transfer to companion animals, our data indicate otherwise. At least components of attachment-related interaction styles, such as degree of contact seeking in verbal and tactile interactions are also displayed in interaction with animal partners.     

Psychometric Evaluation of the Lexington Attachment to Pets Scale (Laps)

Abstract

This paper reports on the development and psychometric evaluation of a scale for assessing emotional attachment of individuals to their pets. Previous attachment scales have suffered variously from low internal consistency and reliance on small or nonrepresentative samples for their development. Telephone interviews of a random, representative sample of 412 pet owners in Fayette County, Kentucky, were completed in September 1990; a 69.5 percent response rate was achieved. From a preliminary set of 42 questions, a final 23-question instrument, the Lexington Attachment to Pets Scale (LAPS), was developed, having excellent psychometric properties. The scale is suitable for use with dog and cat owners. Data on internal consistency, factor structure, and item response theory (IRT) modeling are presented, along with correlations between the LAPS and several domains of variables known to relate to pet attachment.     

Exploring Unprotected Anal Intercourse among Newly Diagnosed HIV Positive Men Who Have Sex with Men in China: An Ethnographic Study

BackgroundUnprotected anal intercourse (UAI) is a major pathway towards secondary HIV transmission among men who have sex with men (MSM). We explored the socio-cultural environment and individual beliefs and experiences conducive to UAI in the context of Southern China.MethodsWe employed an ethnographic approach utilizing a socio-ecological framework to conduct repeated in-depth interviews with thirty one newly diagnosed HIV positive MSM as well as participant observations in Shenzhen based healthcare settings, MSM venues and NGO offices.ResultsSome men (6/31) reported continuing to practice UAI after an initial diagnosis of being HIV positive. For MSM who had existing lovers or stable partners, the fear of losing partners in a context of non-serostatus disclosure was testified to be a major concern. MSM with casual partners reported that anonymous sexual encounters and moral judgments played a significant role in their sexual risk behaviors. Simultaneously, self-reported negative emotional and psychological status, perception and idiosyncratic risk interpretation, as well as substance abuse informed the intrapersonal context for UAI.ConclusionUAI among these HIV positive MSM was embedded in an intrapersonal context, related to partner type, shaped by anonymous sexual encounters, psychological status, and moral judgments. It is important that prevention and intervention for secondary HIV transmission among newly diagnosed HIV positive MSM in China take into account these contextual factors.     

Individual attachment style modulates human amygdala and striatum activation during social appraisal

Adult attachment style refers to individual personality traits that strongly influence emotional bonds and reactions to social partners. Behavioral research has shown that adult attachment style reflects profound differences in sensitivity to social signals of support or conflict, but the neural substrates underlying such differences remain unsettled. Using functional magnetic resonance imaging (fMRI), we examined how the three classic prototypes of attachment style (secure, avoidant, anxious) modulate brain responses to facial expressions conveying either positive or negative feedback about task performance (either supportive or hostile) in a social game context. Activation of striatum and ventral tegmental area was enhanced to positive feedback signaled by a smiling face, but this was reduced in participants with avoidant attachment, indicating relative impassiveness to social reward. Conversely, a left amygdala response was evoked by angry faces associated with negative feedback, and correlated positively with anxious attachment, suggesting an increased sensitivity to social punishment. Secure attachment showed mirror effects in striatum and amygdala, but no other specific correlate. These results reveal a critical role for brain systems implicated in reward and threat processing in the biological underpinnings of adult attachment style, and provide new support to psychological models that have postulated two separate affective dimensions to explain these individual differences, centered on the ventral striatum and amygdala circuits, respectively. These findings also demonstrate that brain responses to face expressions are not driven by facial features alone but determined by the personal significance of expressions in current social context. By linking fundamental psychosocial dimensions of adult attachment with brain function, our results do not only corroborate their biological bases but also help understand their impact on behavior.     

Alcohol Consumption among HIV-Infected Persons in a Large Urban HIV Clinic in Kampala Uganda: A Constellation of Harmful Behaviors

IntroductionAlcohol use by persons living with HIV/AIDS (PLWHA) negatively impacts the public health benefits of antiretroviral therapy (ART). Using a standardized alcohol assessment tool, we estimate the prevalence of alcohol use, identify associated factors, and test the association of alcohol misuse with sexual risk behaviors among PLWHA in Uganda.MethodsA cross-section of PLWHA in Kampala were interviewed regarding their sexual behavior and self-reported alcohol consumption in the previous 6 months. Alcohol use was assessed using the alcohol use disorders identification test (AUDIT). Gender-stratified log binomial regression analyses were used to identify independent factors associated with alcohol misuse and to test whether alcohol misuse was associated with risky sexual behaviors.ResultsOf the 725 subjects enrolled, 235 (33%) reported any alcohol use and 135 (18.6%) reported alcohol misuse, while 38 (5.2%) drank hazardous levels of alcohol. Alcohol misuse was more likely among subjects not yet on ART (adjusted prevalence ratio [aPR] was 1.65 p=0.043 for males and 1.79, p=0.019 for females) and those with self-reported poor adherence (aPR for males=1.56, p=0.052, and for females=1.93, p=0.0189). Belonging to Pentecostal or Muslim religious denominations was protective against alcohol misuse compared to belonging to Anglican and Catholic denominations in both sexes (aPR=0.11 for men, p<0.001, and aPR=0.32 for women, p=0.003). Alcohol misuse was independently associated with reporting risky sexual behaviors (aPR=1.67; 95% CI: 1.07–2.60, p=0.023) among males, but not significant among females (aPR=1.29; 95% CI: 0.95–1.74, p=0.098). Non-disclosure of HIV positive status to sexual partner was significantly associated with risky sex in both males (aPR=1.69; p=0.014) and females (aPR 2.45; p<0.001).ConclusionAlcohol use among PLWHA was high, and was associated with self-reported medication non-adherence, non-disclosure of HIV positive status to sexual partner(s), and risky sexual behaviors among male subjects. Interventions targeting alcohol use and the associated negative behaviors should be tested in this setting.     

Health related quality of life in adult cancer survivors: Importance of social and emotional support

BackgroundAdult cancer survivors (ACS) are at increased risk for developing various comorbid conditions and having poor health-related quality of life (HRQOL) when compared to adults with no history of cancer. The effect of social and emotional support on HRQOL among ACS is not fully elucidated. The purpose of this study was to understand the role of social and emotional support on HRQOL in ACS and to examine if the association between social and emotional support and HRQOL is modified by gender, time since cancer diagnosis, or marital status.MethodsData for this study were obtained from the 2009 Behavioral Risk Factor Surveillance System. Statistical analysis was based on ACS with complete data (n = 23,939) on all variables considered. Multivariable logistic regression models were used to model the association between social and emotional support and indicators of HRQOL (i.e., general health, physical health, mental health, and activity limitation). To examine if gender, marital status, or the number of years since cancer diagnosis modify the association, separate stratified analyses were conducted.ResultsWhen compared to ACS who reported that they Rarely/Never received social and emotional support, those who reported that they Always received were 32 % less likely to report Fair/Poor General health, 23 % less likely to report frequent unhealthy days of Physical health, 73 % less likely to report frequent unhealthy days of Mental health and 38 % less likely to report frequent unhealthy days of Activity limitation. Social and emotional support was positively associated with all four domains of HRQOL among ACS who were female, unmarried, or greater than 5 years since cancer diagnosis, while this positive association was evident only with one or two domains of HRQOL among their corresponding counterparts (i.e., male, married, less than 5 years since diagnosis).ConclusionsSocial and emotional support is an important factor directly related to a better HRQOL, but it is modified by gender, marital status, and time since diagnosis. Findings from this study should inform health care providers about the importance of a support system for ACS in improving their overall quality of life.     

The Attachment of People to Companion Animals

ABSTRACT

This article examines whether the human-companion animal relation, and in particular attachment, can be explained and understood with the help of attachment theory and the “internal working model.” The (perceived) social support and responsivity of the human-animal bond and how these relate to the attachment theory are also discussed.

The research, however, found only weak relationships between owning a companion animal and attachment. Other factors that could influence the attachment of owners toward their animals are discussed.