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It is frequently claimed that grief is the price one has to pay for love. Indeed, the way people come to terms with the loss of a relationship through death has much to do with the nature of the foregoing bond between the deceased and surviving person. Furthermore, just as current relationships with others (e.g., friends, parents, colleagues, siblings, neighbors, partners) influence virtually all aspects of everyday existence, so can the deaths of significant persons have profound impact on many domains of one's life. Thus, it becomes important to determine precisely how and in what respect death of a loved one affects people and to identify subgroups for whom the impact is extreme. These issues are addressed in the first part of this entry. In the second part, theoretical approaches to understanding the identified manifestations of bereavement are outlined. Because bereavement has fundamentally to do with human relationships—not the forming or maintaining, but with the ending of a relationship—it stands to reason that a relationship theory could have much to offer in terms of scientific understanding and generation of theory-guided empirical research. One such theory, Attachment Theory, focuses on reactions to separation from a significant person and can be applied to the situation of separation when an attachment figure dies. Thus, particular attention is given to this theoretical approach. Finally, the impact of other human relationships in assisting the bereaved, both informally (through social support) and professionally (counseling and therapy), is summarized.

First, three basic terms need to be defined in the ways they are used in the contemporary scientific literature. Bereavement is the objective situation of a person who has recently experienced the loss of someone significant through that person's death. Grief refers to the primarily emotional (affective) reaction to bereavement. It incorporates diverse psychological (cognitive, social-behavioral) and physical (physiological-somatic) manifestations. Grief is generally distinguished from mourning, which involves the public display, social expressions, or acts expressive of grief that are shaped by (religious) beliefs and practices of a given society or cultural group (e.g., mourning rituals). Some researchers and practitioners (e.g., those adhering to the psychoanalytic tradition) use the terms grief and mourning interchangeably.

Health Consequences of Bereavement

Mortality

The popular expression that she or he died of a broken heart has been subject to considerable empirical examination. Researchers have conducted well-controlled longitudinal investigations comparing bereaved and nonbereaved counterparts to establish whether bereavement is associated with higher rates of mortality. Most have focused on spousal loss. Excess risk of mortality among bereaved samples has been reported quite consistently for the early months of bereavement, with some investigators reporting persisting elevated risk beyond 6 months. Subgroup differences have been identified. Widowers appear to be relatively more vulnerable than widows. Death of a child, a highly impactful type of loss, has been shown to have a greater mortality effect on mothers than on fathers. Mortality excesses among the bereaved are due to various causes, with suicide being a significant risk. In one large-scale study conducted in Finland, mortality in a group of bereaved persons was found to be very high for accidental and violent causes, moderate for chronic ischemic heart disease and lung cancer, and lower for other causes.

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