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COMMENTARY: Religion in Coping With Bereavement:Confidence of Convictions or Scientific Scrutiny?Margaret S. StroebePublished online: 16 Nov 2009.

To cite this article: Margaret S. Stroebe (2004) COMMENTARY: Religion in Coping With Bereavement: Confidence ofConvictions or Scientific Scrutiny?, The International Journal for the Psychology of Religion, 14:1, 23-36, DOI: 10.1207/s15327582ijpr1401_2

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COMMENTARY

Religion in Coping With Bereavement:Confidence of Convictions or

Scientific Scrutiny?

Margaret S. StroebeResearch Institute for Psychology & Health

Department of Clinical PsychologyUtrecht University

Principles are identified on which a balanced, objective evaluation of the role of reli-gious beliefs in adaptation to bereavement must be judged. Subjective impressions byreligious persons that their faith has helped them through bereavement are notenough. Examining the precise mechanisms through which religion uniquely affectsbereavement is essential, and this must be based on adequately controlled, empiricalinvestigation. Researchers must be open to negative as well as positive effects of reli-gion and to the possibility that certain aspects (e.g., continued attachment) may not beunique to religious coping. Some secular belief systems may function in similarly(mal)adaptive ways. Suggestions on how to go about researching coping mechanismsare given, and scientific research criteria for the study of the impact of religious in-volvement on bereavement outcome are presented.

Benore and Park (this issue) address one of the most fundamental concerns in thescientific study of bereavement: How do people use their belief systems to come toterms with the death of a significant person in their lives? They focus on religiousbeliefs and spiritual meaning, but the interest can be stated even more broadly, for ittouches on what is arguably the essential element—namely, the “meaning of loss”

THE INTERNATIONAL JOURNAL FOR THE PSYCHOLOGY OF RELIGION, 14(1), 23–36Copyright © 2004, Lawrence Erlbaum Associates, Inc.

Requests for reprints should be sent to Margaret S. Stroebe, Research Institute for Psychology &Health, Department of Clinical Psychology, Utrecht University, P.O. Box 80140, 3508 TC Utrecht, TheNetherlands 43403. E-mail: m.stroebe@fss.uu.nl

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(cf. Neimeyer, 2001). Meaning is, of course, an extremely elusive concept even todefine, and attempts to actually measure its impact have frequently been con-founded with outcome variables. For example, if the “meaning of loss” is “I havelost the one person who was all to me,” it can be expected that this will be associatedwith difficult adjustment to bereavement, perhaps characterized by idealization ofthe deceased spouse and associated despair about ever finding another person aswonderful. In such a case, correlates have been identified, but because the assess-ment of the meaning of loss (the appraisal that he was everything to me) is so over-lapping with the measure of adjustment (outcome in terms of despair at the loss ofeverything), few conclusions about the role of meaning in adjustment can be drawn.

In studying spirituality/religiousness, it is possible to define specific aspects ofmeaning in the process of coming to terms with the death of a loved one that do notoverlap conceptually with outcome measures. Thus, quite apart from the inherentintrinsic interest in relating religion to loss reactions, such research can provideimportant inroads into understanding the role of meaning systems—and underly-ing mechanisms—in the course of adjustment to bereavement. However, the sci-entific study of the role of religious beliefs in bereavement is full of pitfalls. Thereare problems in inferring causality (that it is really religious beliefs that impact onbereavement outcome). There are methodological difficulties in conducting re-search on this topic, and there are shortcomings in the available studies.Baumeister (2002), in introducing an important collection of papers and commen-taries on Religion and Psychology, emphasized that “it is essential that religion bestudied in a balanced, open-minded, objective fashion rather than being left to thepro-religious and antireligious zealots who are seeking to support predeterminedconclusions” (p. 165). The purpose of this article is, therefore, to put another scien-tific viewpoint alongside that of Benore and Park (this issue), focusing on the ex-amination of scientific evidence and on the principles and process of conductingempirical research.

BALANCED INVESTIGATION

To fulfill the scientific standards called for by Baumeister (2002), certain principlesneed to be followed when reviewing the state of knowledge about the role of reli-gion in bereavement.

Comprehensive Assessment of the Evidence

The evidence for the importance of religion in coping with bereavement is not un-equivocal. In line with lay expectations, and with research on the benefits of reli-gion in coping with life events in general (see Folkman & Moskovitz, in press;

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George, Ellison, & Larson, 2002; Pargament, 1997), some investigators have in-deed reported positive associations between religious variables (including beliefs)and bereavement outcome (e.g., Bohannon, 1991; Clayton, Halikas, & Robins,1973; Glick, Weiss, & Parkes, 1974; Gray, 1987; Heyman & Gianturco, 1973;Levy, Martinowski, & Derby, 1994; Nolen-Hoeksema & Larson, 1999; Sherkat &Reed, 1992; Walsh, King, Jones, Tookman, & Blizard, 2002). Other studies, how-ever, show either no or weak differences between more versus less religious per-sons (cf. Austin & Lennings, 1993; Burks, Lund, Gregg, & Bluhm, 1988; Higgins,2002; Lund, Caserta, & Dimond, 1986; Schut, 1992; W. Stroebe, Stroebe, &Domittner, 1987),1 or even worse, adjustment among the more religious bereaved(e.g., Amir & Sharon, 1982; Rosik, 1989).

More specific studies investigating processes whereby religion affects adjust-ment reveal different associations too. For example, McIntosh, Silver, andWortman (1993) studied religious participation and (subjective evaluations of) theimportance of religion among bereaved parents. High scores on these religiousvariables were positively related to well-being and negatively with distress, but in-directly—namely, through the coping mechanisms that these parents adopted. Bycontrast, in a study of partners of men who had died from AIDS, Richards andFolkman (1997) reported a positive relationship between experiencing spiritualphenomena and (high) depression, anxiety, and physical health symptoms. How-ever—and this makes matters even more intricate—these men used more adaptivecoping strategies, indicating that they were making active and deliberate efforts tocope with their loss.

In view of such complex patterns of results, Benore and Park’s (this issue) strat-egy to focus on the belief in the afterlife (BA) and continued attachment (CA) as-pects, adopting a framework that enables analysis in terms of scientific constructs(coping, appraisal, etc.), makes a great deal of sense. The problem is, as their ac-count shows, there is even less sound evidence on these aspects, although theyhave overlooked some research—for example, the program of Field and collabora-tors, who have also recently developed a scale for measuring CA (see, e.g., Field,Gal-Oz, & Bonanno, 2003; Field & Horowitz, 1998; Field, Nichols, Holen, &Horowitz, 1999). There are also major shortcomings in the studies that are cited byBenore and Park (this issue; I discuss scientific criteria following), and further-more, Benore and Park base their arguments on a wide variety of nonscientificsources (including the popular literature and anecdotal information). Interestingthough the latter sources are, they are not acceptable as evidence for the impact ofBA and CA on adjustment to bereavement.

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1One also has to assume that studies finding no effects are underrepresented in the published litera-ture, because such findings are not very newsworthy.

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Examination of Potential Negative as Well as PositiveEffects of Religion

Can we confine investigation to establishing positive associations between religionand bereavement outcome? Even from the brief outline mentioned previously, itbecomes evident that fair appraisal needs to include three possibilities, not just theassumption that is Benore and Park’s (this issue) starting position and focusthroughout, that (a) religious beliefs are beneficial in coping with bereavement. Wealso need to understand the ways in which it may (b) not be helpful or in which itmay (c) even be harmful. Pargament, Koenig, and Perez (2000) have endorsed suchan approach. For example, they specified several ways that religious coping may beineffective in dealing with stressful situations in general, such as punishing God re-appraisals, demonic reappraisals, spiritual or interpersonal religious discontent,and pleading for direct intercession.

It is not difficult to surmise that religion (BA and CA) might impact both posi-tively and negatively on bereavement reactions. On the one hand, as a belief sys-tem a religion may offer potential condolence—for example, in the knowledgethat there will be reunion with the deceased in heaven (BA) or in the form of en-abling prayer for the good of the deceased, which is one way of continuing at-tachment (CA) to the deceased. Both BA and CA would have positive effects insuch cases. On the other hand, it is equally plausible that these same aspectscould work negatively. For example, if BA brings with it the knowledge of re-union in heaven, this could prevent remarriage and confine the bereaved personto the role of widow(er), precluding important new social interactions that wouldnormally be associated with increased well-being and readjustment. Likewise,CA could work negatively if it were associated with very strong dependency (asin the introductory example on the meaning of loss) and much yearning and pin-ing for the deceased person.

Attention to Nonreligious Belief Systems

BA is a fundamentally religious conviction, but, in my view, CA is not. In this, Isuggest an alternative viewpoint to that of Benore and Park (this issue), who defineCA as “beliefs in a sustained relationship with the deceased after his or her death,”describe the construct as being “unique from nonreligious constructs,” and exam-ine it exclusively in relationship to religious beliefs. Their understanding of CA’sexclusiveness to religion becomes evident in statements such as, “A second reli-gious belief relevant to coping with bereavement is the concept of continued attach-ment.” The latter statement also makes clear that the issue here is whether CA isuseful in the coping process and not whether attachments are ultimately continuedor relinquished.

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Scientific analysis requires openness to the possibility that there may be nonre-ligious ways of continuing attachment with a deceased person in the grieving pro-cess, and that these ways may work in positive as well as negative ways.Examination of the manifestations of CA listed by Benore and Park (this issue)shows that CA may not have anything to do with BA or other religious beliefs. It ispossible and comparatively easy for some persons to go about the various manifes-tations of CA in a secular manner. Telling stories, revering, creating living memo-rials, enacting rituals, naming of children, keeping linking-objects, sensing theongoing presence, using as role model or for guidance, comparing beliefs and call-ing up wisdom, all these phenomena and manifestations of CA can be accom-plished without the basis of a religious belief system. Klass and Walter (2001)have also detailed ways that bonds between the bereaved and their deceased lovedones can continue in nontraditional and largely secular contemporary Western so-ciety that values individual autonomy, youth, and progress.

Is CA equally beneficial for all, whether used secularly or religiously? Benoreand Park (this issue) focus on positive appraisal through CA and its potential adap-tive function. However, there may be systematic individual differences in the pres-ence and in the usefulness of CA in the grieving process. This can be illustrated bytaking a secular, scientific perspective—namely, that of attachment theory (e.g.,Bowlby, 1969, 1973, 1980; for recent reviews, see Cassidy & Shaver, 1999;Mikulincer & Shaver, in press). Recently, a number of investigators have de-scribed the links between the well-established styles of attachment (secure vs. in-secure types) and different ways of continuing attachment with a deceased personduring the grieving process (Parkes, 2001; Shaver & Tancredy, 2001; M. Stroebe,Stroebe, & Schut, 2003). These patterns are reflected in the presence or absence ofcomplications in the grieving process.

There is quite some evidence that securely attached individuals deal with trau-matic or stressful experiences such as bereavement in a more adaptive manner thanthe insecurely attached, tending to exhibit normal or healthy grieving and experi-encing and expressing their emotions to a moderate degree. Characteristically, se-cure individuals are able to stay emotionally close to others, to be comfortabledepending on them and being depended on by them. It is easy to surmise that suchpeople will be able to retain attachment to a deceased person and to use a continuedconnection to the deceased to work toward acceptance of loss. The deceased is stillthere for guidance, reminiscence, and the various manifestations of CA listed byBenore and Park (this issue).

CA would not be expected to serve such an adaptive function for the insecurelyattached—for example, for those who have a style that is described as inse-cure-preoccupied (also known as dependent, anxious, or ambivalent). Typically,such persons want to be completely emotionally intimate with others and find thatothers are reluctant to get as close as they would like. They are prone to lasting,chronic grief. They are highly emotional and expressive about their loss, but in a

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ruminative manner that is not constructive. For these people, the CA would be lesslikely to help toward adjustment, because it is characterized by persistent yearn-ing, longing, and regrets, rather than by a gradual move toward relocating the de-ceased. For these bereaved persons, at least in more extreme cases, someintervention may even be needed to bring about a greater degree of detachment.

The conclusion suggested by these individual difference patterns is that CAmay function in a detrimental manner for some bereaved people, irrespective ofwhether they are religious.

Identification of Religious and/or Secular Mechanisms

Sometimes it is unclear whether religious methods are really distinct from secularmethods of coping. Take, for example, Pargament, Kennell, Hathaway,Grevengoed, Newman, & Jones’ (1988; see also Pargament et al., 2000) categori-zation into three styles of religious coping—namely, self-directing (usingGod-given resources in coping with problems); deferring (passively deferring re-sponsibility for problem solving to God); and the collaborative approach (workingwith God as a partner in problem solving). It is not hard to imagine that there may beparallel, secular ways of coping through self-directing, deferring, or collaborating,not with God, but perhaps with a therapist or family member (or any “other” for thatmatter). This points to a further difficulty: There may be confounding between reli-gious and nonreligious coping. As Folkman and Moskovitz (in press) pointed out,religious methods of gaining control, for example, could reflect a basic, nonreli-gious desire for control.

It becomes clear that we need to learn more about the precise pathways throughwhich religion influences bereavement outcome, and we need to define methods ofreligious coping with bereavement that are distinct from secular ones. As Benoreand Park (this issue) note, the cognitive stress perspective of Lazarus and Folkman(1984) enables a systematic investigation of mechanisms underlying the relation-ship between religious involvement and health. Folkman (2001) has recentlyadapted this approach to include positive meaning as part of the appraisal processand to apply specifically to the bereavement stressor. Folkman and Moskovitz (inpress) noted that religion plays an important role in the entire stress process, fromappraisal and coping with immediate demands (e.g., finding strength) to ways thatpeople respond psychologically and physically in the long term.

How do we link this theory to empirical examination? One useful inroad tostudy the diverse aspects associated with bereavement would be to follow the cate-gorization of George et al. (2002). These investigators identified four types of reli-gious, psychosocial mechanisms in the research literature that can be integratedwithin the stress-coping perspective. These were health practices, social support,psychosocial resources such as self-esteem and self-efficacy, and belief structures

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such as sense of coherence. (BA and CA would probably be placed in this last cate-gory, although they may also serve as social support and/or a boost to self-esteem.)However, this is only a beginning: George et al. reported mixed and inconsistentevidence for these mediators so far, and further dimensions are thinkable (e.g.,even psychophysiological benefits of meditating and prayer).

A further useful lead toward understanding the role of religious coping strate-gies in bereavement outcome would be to employ the recently developed measureof religious coping (Pargament, Koenig, & Perez, 2000) that specifies key reli-gious functions that affect (positively as well as negatively) the outcomes of majorlife stressors (search for meaning in coping, coping to gain control, coping to gaincomfort, coping to gain intimacy with others/social cohesiveness, coping toachieve a life transition). This would help us move from the general interest in thebenefits of believing in an afterlife or having CAs to examining, empirically, howprecisely BA or CA might actually operate in the coping process to bring about(mal)adjustment to bereavement. Furthermore, there are diverse measures that arenow available for use in empirical research on a broad range of psychological as-pects of religion (for a compendium, see Hill & Hood, 1999).

Further empirical research of mediators and strategies specifically in the be-reavement context is essential: Understanding the mechanisms is fundamental toexplaining relationships between religion and bereavement outcome. Recent con-ceptual developments in the general field of the psychology of religion, which canbe used to guide future research on the role of religion in bereavement, have beendiscussed in a recent review by Emmons and Paloutzian (2003).

SCIENTIFIC RESEARCH CRITERIA

Statements about the role of religion in coping with bereavement must also be madeon the basis of sound, empirical evidence. Thus, we need to ask whether the conclu-sions drawn by investigators about the positive (or negative) effects of religion arereally justified and valid. Closer inspection reveals shortcomings both in the empir-ical studies that claim to find positive effects and in those that do not. The mainproblems in research on the impact of religion in bereavement are summarized andillustrated next (for more general discussion of methodological issues in bereave-ment research, see M. Stroebe, Stroebe, & Schut, in press).

Subjective Versus Objective Evaluation of Outcome

In some of the studies reporting a positive relationship between religion and be-reavement outcome, evaluation has been based—sometimes exclusively—onsubjective assessment by the bereaved themselves (e.g., Frantz, Trolley, & Johll,

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1996; Glick et al., 1974; Heyman & Gianturco, 1973). Religion is often per-ceived by the religious person him- or herself as serving as a great comfort andguide through bereavement (e.g., Frantz et al., 1996). Subjective assessment thatreligion is helpful in bereavement is not enough to establish that religious beliefsare efficacious in the grieving process. Subjective evaluation may be completelyunrelated to “objective” outcome (e.g., in terms of mental and/or physicallong-term effects). To establish religion’s impact, a control group needs to be in-cluded and comparison made of adjustment over time—for example, betweenthose holding religious beliefs with those who do not. To make this clear: Asimilar strategy would be necessary in establishing the efficacy of counseling ortherapy for the bereaved. Subjective impressions that such intervention helpstells us nothing about the actual benefits of a program (e.g., because of demandcharacteristics, bereaved people generally adjust over time and may wrongly at-tribute this improvement to the intervention, dropouts may have found the pro-gram harmful, etc.). What we need in this case too is a control group of bereavedpeople who have not undergone the therapy or counseling, and before and after(and follow-up) measures of adjustment and well-being (cf. Schut, Stroebe, vanden Bout, & Terheggen, 2001).

Inclusion of Control Groups

Emerging from the previously mentioned points: Even results of studies that haveused more objective health measures to assess bereavement outcome can be diffi-cult to interpret if nonbereaved controls are not included (W. Stroebe & Schut,2001). Some forms of religious orientation (e.g., intrinsic religious orientation) arepositively associated with mental health in the general religious population(Batson, Schoenrade, & Ventis, 1993). So positive associations of religion withhealth in bereaved individuals may simply reflect this general association in thepopulation. What we would need to demonstrate, to show that having intrinsic reli-gious beliefs impacts positively on health in bereavement, is that the intrinsicallyreligious are relatively healthier than the nonintrinsically religious bereaved com-pared with their respective nonbereaved controls (of intrinsically vs.nonintrinsically religious nonbereaved persons).

Confounding Variables

Perhaps this is one of the least-acknowledged yet most critical problems: It is typi-cally overlooked that there may be differential selection into (non)religious groups.There can clearly be no random assignment (which is nevertheless a fundamentaldesign requirement) to the religious versus nonreligious groups that are typically

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compared in research (or, for that matter, in popular wisdom). This is critical be-cause—just as the intrinsically religious may be healthier in general than thenonintrinsically religious—the religious bereaved may differ from the nonreli-gious bereaved on a variety of dimensions associated with health outcome, possiblyneuroticism, control beliefs, and other personality-related factors. For example, inthe Lund study (see, e.g., Lund, Caserta, & Dimond, 1993), religious activity ap-peared to have a positive association with more favorable outcomes to bereave-ment, but there was further evidence that pointed to social activity in general, ratherthan the religious nature per se of the activity, as the positive influence on bereave-ment adjustment.

What this means is, then, that control has to be made for confounding, extrane-ous variables such as certain personality variables, social support, or social inte-gration, because—given that these variables are known to be associated with (ill)health (see, e.g., W. Stroebe & Stroebe, 1996)—systematic, parallel differences onthese dimensions could provide alternative explanations for differences betweenreligious and nonreligious groups. For example, Sherkat and Reed (1992) found aninverse relationship between frequent church attendance (but not personal prayer)and depression, but when they controlled for level of social support, this associa-tion became insignificant. Some studies are attempting to control for confoundssystematically (see, e.g., Batson et al., 1993).

Operationalization of Spirituality/Religion

For the sake of simplicity, discussion in this article has focused on religion, reli-gious beliefs, or the specific BA and CA constructs. And yet it is evident thatstudies vary greatly in their conceptualizations and in their measurement of reli-giousness and spirituality, from simple comparisons between religious and non-religious according to church affiliation (Catholic, Anglican, Jewish, Muslim,etc.) to employment of scales measuring religious behaviors and/or attitudes in afine-grained manner (e.g., intrinsic vs. extrinsic religiosity, extent of church-go-ing, use of prayer, dimensions of religious coping, etc.). Overall group compari-sons such as those between the religious and nonreligious may cover too wide arange of beliefs—some of which may be beneficial, others debilitating—for theimpact of religion to be identified (see also Potential Misinterpretations ofNonsignificance following). Yet the more detailed measures of religious-ness/spirituality used in some studies have frequently been inadequately vali-dated. Scales used in studies with negative results may simply have failed to tapthe dimensions sensitively enough. Equally, studies reporting positive effectsmay have failed to tap certain aspects of religion that could have a negative im-pact (cf. the BA and CA illustrations given previously). What this means is thatwe need to specify the dimensions of religion (and aspect of adjustment to be-

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reavement—see following) to decide precisely in what ways religion is a forcefor health—or sickness—in bereavement (cf. Batson et al., 1993; Pargament etal., 2000).

Potential Misinterpretations of Nonsignificance

It is possible that no difference in the means between religious and nonreligiousgroups are found on outcome variables (e.g., distress, well-being), but that thiscamouflages two opposing trends that would only become evident in further statis-tical analyses of patterns of variance. As illustrated in the example on reunitingwith the deceased in the after-life, religion may be helpful for some people, but det-rimental for others. It could even be surmised that the prospect of reuniting wouldlead some people to lose the will to live. Likewise, the sense of the presence of thedeceased may be construed as a support, as a guard against adversity, or it could beconstrued as a constraint, inhibiting reintegration.

There is also the possibility that religious beliefs themselves may be affected bythe experience of bereavement (which could in turn exacerbate or ameliorate thebereavement reaction). Although some bereaved persons may experiencestrengthening of their beliefs, others may find them shattered (e.g., because spiri-tual powers have failed to keep the loved one alive). To my knowledge, such oppo-site effects have not been taken into account in analyzing and interpretingempirical results.

There is still another possible interpretation, if no differences are found be-tween religious and nonreligious bereaved persons. It could be that religion helpsthe religious, whereas the nonreligious adopt alternative, beneficial coping strate-gies (e.g., other belief/meaning systems, other social support systems) in dealingwith their bereavement. Careful examination of alternative or “compensatory”strategies among religious and nonreligious samples is called for.

Selection of Outcome Measures

Studies have been limited in the range not only of religious/spiritual aspects, butalso in assessment of ways that these beliefs will affect bereavement. Mostly,the impact on distress, or on other features of mental or physical health, has beenstudied. Yet religious beliefs could be expected to impact on many other things.For example, do religious beliefs assist social (re)integration; do they ameliorategrief symptomatology, separation anxiety levels, acceptance of loss, or auton-omy? Conclusions about the impact of religious beliefs on bereavement adjust-ment need to be made on the basis of a broader range of outcome measures thanhas so far been investigated.

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Specification of Sample Characteristics

As noted previously, studies (including those reviewed by Benore & Park in this is-sue) range across a wide variety of religious groups and belief systems, each ofwhich is likely to have a different, perhaps unique, impact on bereavement out-come. Religious coping among, for example, Catholics, Protestants, Non-Chris-tians, Humanists, Muslims, Jews, Mormons, and New Age adherents would needseparate consideration. A benevolent God may be more helpful than a wrathful one.Differences in funeral practices between these groups (even between burial andcremation) may make a difference, too.

On a different level, some death circumstances may be more positively influ-enced by religious coping than others. For example, the circumstances of deathfollowing HIV infection may dictate more need for and use of religious copingthan following other types of loss (cf. Jenkins, 1995).

CONCLUSIONS

It is highly plausible that religion helps some persons to come to terms with their be-reavement. Death-specific religious beliefs are likely to be “vital determinants ofadjustment to bereavement,” as Benore and Park (this issue) claim. This would becompatible with findings from other areas of research: There is a growing body ofevidence that religion helps people to cope with a variety of life circumstances in avariety of ways and that it affects mental and physical health. However, researcherscannot simply draw inferences from this broader literature or follow common wis-dom, or even rely on subjective assessment by bereaved persons themselves, andassume a causal role of religion in adjustment to bereavement. We need to work to-ward further specification of the determinants and mechanisms through which reli-gion is (un)helpful in adjustment to bereavement. We need to be aware that it worksfor some but not other subgroups of bereaved persons, and we need to rememberthat secular ways of coping may be equally (un)helpful. We must identify what isunique about religious coping with bereavement: What is religion’s distinc-tive—adaptive and maladaptive—contribution to human adaptation to bereave-ment? To achieve this, scientific principles and criteria such as those outlined inthis article need to be followed.

REFERENCES

Amir, Y., & Sharon, I. (1982). Factors in the adjustment of war widows in Israel. In C. D. Spielberger, I.G. Sarason, & N. A. Milgram (Eds.), Stress and anxiety (Vol. 8, pp. 225–234). Washington, DC:Hemisphere.

RELIGION IN COPING WITH BEREAVEMENT 33

Dow

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Austin, D., & Lennings, C. (1993). Grief and religious belief: Does belief moderate depression? DeathStudies, 17, 487–496.

Batson, C. D., Schoenrade, P., & Ventis, W. L. (1993). Religion and the individual. New York: OxfordUniversity Press.

Baumeister, R. (2002). Religion and psychology: Introduction to the special issue. Psychological In-quiry, 13, 165–167.

Bohannon, J. R. (1991). Religiosity related to grief levels of bereaved mothers and fathers. Omega, 23,153–159.

Bowlby, J. (1969). Attachment and loss: Vol. 1: Attachment. London: Hogarth.Bowlby, J. (1973). Attachment and loss: Vol. 2: Separation. London: Hogarth.Bowlby, J. (1980). Attachment and loss: Vol. 3. Loss: Sadness and depression. New York: Basic Books.Burks, V., Lund, D., Gregg, C., & Bluhm, H. (1988). Bereavement and remarriage for older adults.

Death Studies, 12, 51–60.Cassidy, J., & Shaver, P. R. (1999). Handbook of attachment: Theory, research, and clinical applica-

tions. New York: Guilford.Clayton, P., Halikas, J., & Robins, E. (1973). Anticipatory grief and widowhood. British Journal of Psy-

chiatry, 122, 47–51.Emmons, R. A., & Paloutzian, R. F. (2003). The psychology of religion. Annual Review of Psychology,

54, 377–402.Field, N., Gal-Oz, E., & Bonanno, G. (2003). Continuing bonds and adjustment at 5 years after the death

of a spouse. Journal of Consulting and Clinical Psychology, 71, 110–117.Field, N., & Horowitz, M. (1998). Applying an empty-chair monologue paradigm to examine unre-

solved grief. Psychiatry, 61, 279–287.Field, N., Nichols, C., Holen, A., & Horowitz, M. (1999). The relation of continuing attachment to ad-

justment in conjugal bereavement. Journal of Consulting and Clinical Psychology, 67, 212–218.Folkman, S. (2001). Revised coping theory and the process of bereavement. In M. Stroebe, R. O.

Hanson, H. Schut, & W. Stroebe (Eds.), Handbook of bereavement research: Consequences, copingand care (pp. 563–584). Washington, DC: American Psychological Association.

Folkman, S., & Moskovitz, J. (in press). Coping: Pitfalls and promise. Annual Review of Psychology.Frantz, T., Trolley, B., & Johll, M. (1996). Religious aspects of bereavement. Pastoral Psychology, 44,

151–163.George, L., Ellison, C., & Larson, D. (2002). Explaining the relationships between religious involve-

ment and health. Psychological Inquiry, 13, 190–200.Glick, I., Weiss, R. S., & Parkes, C. M. (1974). The first year of bereavement. New York: Wiley.Gray, R. (1987). Adolescent response to the death of a parent. Journal of Youth and Adolescence, 16,

511–525.Heyman, D., & Gianturco, D. (1973). Long-term adaptation by the elderly to bereavement. Journal of

Gerontology, 28, 359–362.Higgins, M. (2002). Parental bereavement and religious factors. Omega, 45, 187–207.Hill, P. C., & Hood, R. W. (1999). Measures of religiosity. Birmingham, AL: Religious Education Press.Jenkins, R. (1995). Religion and HIV: Implications for research and intervention. Journal of Social Is-

sues, 51, 131–144.Klass, D., & Walter, T. (2001). Processes of grieving: How bonds are continued. In M. Stroebe, R. O.

Hansson, W. Stroebe, & H. Schut (Eds.). Handbook of bereavement research: Consequences, cop-ing, and care (pp. 431–448). Washington, DC: American Psychological Association.

Lazarus, R. S., & Folkman, S. (1984). Stress, appraisal and coping. New York: Springer.Levy, L., Martinowski, K. S., & Derby, E. (1994). Differences in patterns of adaptation in conjugal be-

reavement: Their sources and potential significance. Omega, 29, 207–218.Lund, D., Caserta, M., & Dimond, M. (1986). Gender differences through two years of bereavement

among the elderly. The Gerontologist, 26, 314–320.

34 STROEBE

Dow

nloa

ded

by [

Uni

vers

ity o

f Y

ork]

at 1

0:52

08

Oct

ober

201

4

Lund, D., Caserta, M., & Dimond, M. (1993). The course of spousal bereavement in later life. In M.Stroebe, W. Stroebe, & R. O. Hansson (Eds.), Handbook of bereavement: Theory, research and in-tervention (pp. 240–254). New York: Cambridge University Press.

McIntosh, D., Silver, R., & Wortman, C. (1993). Religion’s role in adjustment to a negative lifeevent: Coping with the loss of a child. Journal of Personality and Social Psychology, 65,812–821.

Mikulincer, M., & Shaver, P. R. (in press). The attachment behavioral system in adulthood: Activation,psychodynamics, and interpersonal processes. In M. P. Zanna (Ed.), Advances in experimental so-cial psychology. San Diego, CA: Academic.

Neimeyer, R. (2001). Meaning reconstruction and the experience of loss. Washington, DC: AmericanPsychological Association Press.

Nolen-Hoeksema, S., & Larson, J. (1999). Coping with loss. Mahwah, NJ: Lawrence ErlbaumAssociates, Inc.

Pargament, K. (1997). The psychology of religion and coping: Theory, research, practice. New York:Guilford.

Pargament, K., Kennell, J., Hathaway, W., Grevengoed, N., Newman, J., & Jones, W. (1988). Religionand the problem-solving process: Three styles of coping. Journal for the Scientific Study of Religion,27, 90–104.

Pargament, K., Koenig, H., & Perez, L. (2000). The many methods of religious coping: Developmentand initial validation of the RCOPE. Journal of Clinical Psychology, 56, 519–543.

Parkes, C. M. (2001). A historical overview of the scientific study of bereavement. In M.Stroebe, R. O. Hansson, W. Stroebe, & H. Schut (Eds.). Handbook of bereavement research:Consequences, coping, and care (pp. 25–45). Washington, DC: American PsychologicalAssociation.

Richards, A., & Folkman, S. (1997). Spiritual aspects of loss at the time of a partner’s death from AIDS.Death Studies, 21, 515–540.

Rosik, C. (1989). The impact of religious orientation in conjugal bereavement among older adults. Inter-national Journal of Aging and Human Development, 28, 251–260.

Schut, H. (1992). Omgaan met de dood van de levenspartner: Effecten op gezondheid en effecten vanrouwbegeleiding [Coping with conjugal bereavement: Effects on psychological functioning and ef-fects of grief counseling]. Amsterdam: Thesis Publishers.

Schut, H., Stroebe, M., van den Bout, J., & Terheggen, M. (2001). The efficacy of bereavement interven-tions: Determining who benefits. In M. Stroebe, R. O. Hansson, W. Stroebe, & H. Schut (Eds.),Handbook of bereavement research: Consequences, coping, and care (pp. 705–737). Washington,DC: American Psychological Association.

Shaver, P., & Tancredy, C. (2001). Emotion, attachment, and bereavement: A conceptual commen-tary. In M. Stroebe, R. O. Hansson, W. Stroebe, & H. Schut (Eds.), Handbook of bereavement re-search: Consequences, coping, and care (pp. 63–88). Washington, DC: American PsychologicalAssociation.

Sherkat, D., & Reed, M. (1992). The effects of religion and social support on self-esteem and depressionamong the suddenly bereaved. Social Indicators Research, 26, 259–275.

Stroebe, M., Stroebe, W., & Schut, H. (2003). Bereavement research: Methodological issues and ethicalconcerns. Palliative Medicine, 17, 235–240.

Stroebe, W., & Schut, H. (2001). Risk factors in bereavement outcome: A methodological and empiricalreview. In M. Stroebe, R. O. Hansson, W. Stroebe, & H. Schut (Eds.), Handbook of bereavement re-search: Consequences, coping, and care (pp. 349–371). Washington, DC: American PsychologicalAssociation.

Stroebe, W., & Stroebe, M. (1996). The social psychology of social support. In E. T. Higgins & A.Kruglanski (Eds.), Social psychology: Handbook of basic principles (pp. 597–621). New York:Guilford.

RELIGION IN COPING WITH BEREAVEMENT 35

Dow

nloa

ded

by [

Uni

vers

ity o

f Y

ork]

at 1

0:52

08

Oct

ober

201

4

Stroebe, W., Stroebe, M., & Domittner, G. (1987). Kummerbewältigung und Kummereffekt:Psychische und physische Reaktionen von Verwitweten [Coping with grief: Psychological andphysical reactions of the bereaved; Tech. Rep. University of Tübingen, Germany.

Walsh, K., King, M., Jones, L., Tookman, A., & Blizard, R. (2002). Spiritual beliefs may affect outcomeof bereavement: prospective study. British Medical Journal, 324, 1551.

36 STROEBE

Dow

nloa

ded

by [

Uni

vers

ity o

f Y

ork]

at 1

0:52

08

Oct

ober

201

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