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A Content Analysis of the Treatment Narratives of Patients With Complicated Grief

Wilsey, Stephanie A. (2006) A Content Analysis of the Treatment Narratives of Patients With Complicated Grief. Doctoral Dissertation, University of Pittsburgh. (Unpublished)

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A CONTENT ANALYSIS OF THE TREATMENT NARRATIVES OF PATIENTS WITH COMPLICATED GRIEFStephanie A. Wilsey, Ph.D.University of Pittsburgh, 2006This dissertation explores the verbal content of revisiting exercises told by patients diagnosed with Complicated Grief during a therapy session. A revisiting exercise is a complete narrative account of a primary loss, from the time that the patient discovered or heard of the loss until the funeral and aftermath. Twenty-two patients receiving treatment for Complicated Grief each provided his or her last revisiting exercise from treatment. Narratives were analyzed via qualitative content analysis. Pearson Product Moment Correlations and Spearman's Correlation Coefficient for Ranked Data were also used to examine the relationship between narrative content and patient's grief, depression, and trauma symptoms. Results revealed four major thematic categories within the narratives: Emotions, Cognitions, Social Support, and Focus on Death. Overall emotional content tended to be negative, with an emphasis on angry and sad feelings. While patients spoke longer about unsupportive social networks, most patients reported a mix of supportive and unsupportive friends and family. Important cognitive categories included self-evaluations, blame, and asking why the loss occurred. Finally, for most patients, the appearance of the corpse became fixated in their minds and they had trouble getting past their dual aversion and fascination with this image. Correlations between themes and symptoms scores did not occur in the expected direction and were not consistently significant. Correlations were useful, however, in generating hypotheses for further qualitative analyses. For example, the present study indicated that the integration of narrative themes should be explored in future research. The study indicated that patients wove positive and negative themes together but primarily focused on themes that troubled them, such as unsupportive family and the corpse's appearance. Although patients were told to tell the story of the death, for most, additional themes such as the support or lack of support from others were integral to the stories. Exploring a subsample of patients revealed how and where in the narratives patients described particular themes. In addition, the subsample exploration revealed that anger was the unifying theme in the narratives, particularly in narratives from early treatment sessions. Implications for Complicated Grief research and treatment are presented, as well as implications for grief narrative research.


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Item Type: University of Pittsburgh ETD
Status: Unpublished
CreatorsEmailPitt UsernameORCID
Wilsey, Stephanie
ETD Committee:
TitleMemberEmail AddressPitt UsernameORCID
Committee ChairElman, Nancyelman@pitt.eduELMAN
Committee CoChairShear, M
Committee MemberPingel, Louispingel@pitt.eduPINGEL
Committee MemberPorter, Maureenmporter@pitt.eduMPORTER
Date: 18 April 2006
Date Type: Completion
Defense Date: 28 March 2006
Approval Date: 18 April 2006
Submission Date: 12 April 2006
Access Restriction: No restriction; Release the ETD for access worldwide immediately.
Institution: University of Pittsburgh
Schools and Programs: School of Education > Psychology in Education
Degree: PhD - Doctor of Philosophy
Thesis Type: Doctoral Dissertation
Refereed: Yes
Uncontrolled Keywords: Complicated Grief; grief; narratives
Other ID:, etd-04122006-184120
Date Deposited: 10 Nov 2011 19:36
Last Modified: 15 Nov 2016 13:39


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