The dissertation of Kelley, IHM, MS_________________ entitled ...

The dissertation of _____________Donna Kelley, IHM, M.S._________________ entitled
_______________The Impact of Social Support, Spirituality and Extraversion___________
______________________on Grief Symptoms in Women Religious:___________________
____________________________A Longitudinal Examination_______________________
submitted to the Department of Psychology in partial fulfillment of the requirements
for the Degree of Doctor of Psychology in the College of Arts and Sciences has
been read and approved by the Committee:

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Running head: GRIEF SYMPTOMS IN WOMEN RELIGIOUS
Grief in Women Religious
The Impact of Social Support, Spirituality and Extraversion
on Grief Symptoms in Women Religious:
A Longitudinal Examination
A Dissertation Presented to the Faculty of the
Graduate School of Loyola College in Partial Fulfillment of the
Requirements for the Degree of
Doctor of Psychology
by
Donna Kelley, IHM, M.S.
2006

ABSTRACT
Grief in Women Religious
Research indicates that the bereavement process can be influenced by social
support, spirituality and personality factors (Sanders, 1999). The purpose of this study
was to assess the impact that social support, spirituality and extraversion have on grief
symptoms in Roman Catholic women religious. The participants in the present study
totaled 82 active and contemplative women religious who had experienced the death of a
family member or friend within seven months of the initial data collection. In addition,
48 of the participants belonged to five active congregations and 34 of the participants
belonged to 17 contemplative monasteries. The study was passive observational and
longitudinal, with two times of measurement that were three months apart. The variables
examined were type of religious life (active/contemplative), grief symptoms, social
support, spirituality, and extraversion.
Results indicate no significant association between social support and grief
symptoms over time. Further results show that for women religious overall spirituality
was not a significant predictor of grief over time.
Multiple regressions were conducted separately for the two groups
(active/contemplative). Results indicate that spirituality was a significant predictor of
time 2 residualized grief for the active group only. Moreover, for both groups, neither
time 1 social support nor the interaction between spirituality and social support were
predictive of grief over time. Additionally, no significant interaction
between religious lifestyle and extraversion was found.
i

Grief in Women Religious
Multiple regression analyses found a significant main effect for religious
lifestyles. Specifically, active women religious reported higher grief scores than did
contemplatives. Post hoc analyses indicate significant differences in closeness to the
deceased among the two groups.
This study suggests that spirituality for bereaved active women religious has more
of an impact on grief than it does for bereaved contemplatives. Furthermore, active
women religious appear closer to the deceased and experience more grief than do
contemplatives. Nevertheless, closeness to the deceased affects grief symptoms more for
the contemplative group man it does for the active group. Differences in the active and
contemplative lifestyles appear to play a role in the grief process. Therefore, future
research is needed to address these factors.
ii

COMMITTEE IN CHARGE OF CANDIDACY:
David Powers, Ph.D., Chairperson
Carolyn Barry, Ph.D.
Deborah Haskins, Ph.D.
iii
Grief in Women Religious

DEDICATION
Grief in Women Religious
To Bettyann, my sister, and Reverend Thomas Kelley, OSFS, USN, my uncle, the
faith and love you shared are among my most treasured blessings. Thank you for
enriching my life with your goodness. You are missed!
iv

ACKNOWLEDGEMENTS
Grief in Women Religious
The author would like to extend a special thank you to David Powers, Ph.D., my
chairperson, for his help in completing this project. His continued support,
encouragement, guidance and knowledge made this work possible and successful.
Without his kindness and patience during the challenging times and his endless
repetitions and explanations, this project would not have been completed. He has been a
blessing during the past four years. It has been an honor to work with him and learn from
him. In addition, the author would like to thank Carolyn Barry, Ph.D. for her interest,
assistance and attention to detail throughout this study. She has been a gentle force and
an invaluable consultant. The author would also like to express thanks to Deborah
Haskins, Ph.D. for her support, encouragement, and assistance with this project. Her
enthusiastic spirit and interest in this research was contagious and made working with her
enjoyable.
In addition, the author would like to thank the Sisters, Servants of the Immaculate
Heart of Mary for their prayerful support and for making it possible to pursue this work.
Furthermore, the author would like to thank her parents for their continued support,
encouragement and belief in her. In a special way, the author would like to offer thanks
to her mother for her meticulous work in data entry. Her generous time commitment
hastened a tedious process and made it memorable. Finally, the author would like to
thank three special friends, Sisters Vicky, Barbara and Cindy for patiently traveling with
her in pursuit of participants for this study. To each of you and the many others not
mentioned by name, the author offers prayers of gratitude.
v

TABLE 1.
TABLE 2.
TABLE 3.
TABLE 4.
TABLE 5.
TABLE 6.
TABLE 7.
TABLE 8.
LIST OF TABLES
Summary of Demographic Information for Participants
Summary of Time Since Death and Relation to Deceased
Summary of Descriptive Statistics for Variables of Interest
Grief in Women Religious
Intercorrelations between Time 1 and Time 2 Grief Symptoms and Time 1
and Time 2 Social Support Satisfaction and Time 1 and Time 2
Spirituality
Stepwise Regression Analysis for Extraversion Variables predicting Grief
Symptoms in Active and Contemplative Women Religious
Summary of Descriptive Statistics for Lifestyle-Extraversion Interaction
Page
Stepwise Regression Analysis Among Active Women Religious for Variables
Predicting Grief at Time 2
Stepwise Regression Analysis Among Contemplative Women Religious for
Variables Predicting Residualized Grief at Time 2
vi
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ABSTRACT
TABLE OF CONTENTS
COMMITTEE IN CHARGE OF CANDIDACY
DEDICATION
ACKNOWLEDGMENTS
LIST OF TABLES
CHAPTER I - Introduction
Review of the Literature
Overview of Grief
Social Support and Grief
Personality and Grief
Spirituality
Application to Women Religious
History of Religious Life
Women Religious and Personality
Women Religious and Grief
Statement of the Problem
Statement of Hypotheses
Grief in Women Religious
CHAPTER II-Method 18
Participants 18
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Grief in Women Religious
Measures 18
Procedures
Texas Revised Inventory of Grief
Social Support Questionnaire
Revised NEO Personality Inventory - Extraversion Domain
Spiritual Well-Being Scale
Design and Analyses
CHAPTER III-Results
CHAPTER IV-Discussion
Limitations
Implications for Future Research
REFERENCES
APPENDIXES
APPENDIX A. Human Subject Review Letter of Consent for Study
APPENDIX B. Texas Revised Inventory of Grief
APPENDIX C. Social Support Questionnaire
APPENDIX D. Revised NEO Personality Inventory
APPENDIX E. Spiritual Well-Being Scale
APPENDIX F. Spiritual Well-Being Scale -Modified
APPENDIX G. Cover Letter
APPENDIX H. Demographic Questionnaire
viii
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APPENDIX I. Consent Form
APPENDIX J. Contact Information
APPENDIX K. Thank You Letter Time 1
APPENDIX L. Thank You Letter Time 2
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Grief in Women Religious
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CHAPTER 1
Introduction
Grief in Women Religious 1
Research suggests that grief is a normal response to loss. Grief scholars have
examined numerous populations; however, the present author has found no studies that
concentrate on the loss experienced by Catholic women religious, individuals who
profess the vows of chastity, obedience and poverty. In the Roman Catholic Church there
are two forms of religious life for women: contemplative and active. Contemplative
women religious choose to live these vows in solitude and prayer within the confines of
their monasteries. In contrast, active women religious choose a lifestyle that is
committed to an apostolic work within the church. It is important for psychologists to
understand this particular vocation because religious life may result in distinct treatment
needs. Little is known, however, of how the death of a loved one affects women living
these exceptional lifestyles. Therefore, research in this area is needed in order to identify
variables that impact the grief process in this population.
The literature indicates that a variety of intrapersonal and interpersonal factors are
related to grief. Two intrapersonal areas of special concern for this study were
spirituality and the personality factor of extraversion. An interpersonal factor that this
study examined was social support. These issues were additionally addressed
longitudinally in the context of Catholic women living the active and contemplative
religious lifestyles.

Overview of Grief
Review of the Literature
Grief in Women Religious 2
Research shows that grief following the death of a loved one is a normal reaction
and one which varies across individuals (Malkinson, 2001). Strobe, Hansson, Stroebe,
and Schut (2001) define grief as an emotional reaction to the loss of a loved one through
death. The outward expression of grief is considered mourning (Ringdal, Jordhoy,
Ringdal, & Kaasa, 2001). Grief and mourning are the outcome of bereavement, the
situation of an individual having lost a loved one by death (Ringdal et al., 2001).
Although grief is a normal response to the loss of a loved one, the length of the
process may not be the same for everyone (Herkert, 2000). Some researchers suggest
that grief reactions intensify immediately following the loss and decrease over time
(Malkinson, 2001). However, other research indicates that for the duration of the
bereaved's life, feelings of grief commonly reoccur around significant dates associated
with the deceased such as birthdays, holidays, or the anniversary of the death (Rosenblatt,
1996). Walsh, King, Jones, Tookman, and Blizard (2002) found that bereaved people
frequently reach a level of functioning that is close to typical for them between four to six
months after the death. Ringdal et al. (2001) report a significant decline in grief
symptoms from 1 month to 13 months after the death of a family member. In the first
three months of the loss, there was a slight increase in grief reactions; however, it was not
statistically significant. For these individuals, the major decrease in grief reactions
occurred within three to sixth months after the loss.
In contrast to these findings, Malkinson (2001) reports that normal grief work is
not expected to be completed within a 12-month period. Results of a longitudinal study

Grief in Women Religious 3
performed by Thompson, Gallagher-Thompson, Futterman, Gilewski, and Peterson
(1991) also found that grief resolution may not be completed within the first year of the
loss. This study found that grief can continue for 30 months after the death of a spouse.
Furthermore, Parkes and Weiss (1983) suggest that depression may subside over the first
12 months of bereavement, but distress surrounding loss issues continues for a number of
years.
Several studies found that each loss is unique and that the bereaved lives the loss
uniquely by getting in touch fully with their sorrow (Kenel, 1994; Solari-Twadell,
Bunkers, Wang, & Snyder, 1995) and coping with their feelings (Cowan, 1983). DeVries
(1997) reports that adjustment to the death of a loved one takes place on multiple levels.
During this period of mourning, the bereaved person searches to find meaning in the
death as well as a new self-meaning (Rosenblatt et al., 1991). Failure to admit the
finality of the loss may leave the individual enveloped in depression and anger (Kenel,
1994). The resolution of grief, however, can enhance an individual's personal richness
and depth and lead to new inner strength (Solari-Twadell et al., 1995), which makes it
possible for love and creativity to intensify (Laakso & Paunonen-Ilmonen, 2002).
Research suggests that social support appears to have a positive effect on grief resolution
and increases personal growth.
Social Support and Grief
Social support is a source of nurturance that can positively or negatively impact
an individual's well-being (Laakso & Paunonen-Ilmonen, 2002). Through social support,
individuals develop healthy coping strategies and come to view crises with new insight
(Schaefer & Moos, 2001). By facilitating a clearer understanding of the stressful

Grief in Women Religious 4
situation, social support reduces the effects of stress, supplies techniques to help make
sense of a loss within the first several months of the death, and is a valuable way to cope
with hardships (Krause, 1986; Nolen-Hoeksema & Larson, 1999).
Social support functions as a coping resource that improves the individual's
interpersonal support system and stimulates new interests, which may soothe the effects
of the loss (Norris & Murrell, 1990; Sanders, 1999). Furthermore, social support serves
as a diversion from depression, pushes the bereaved to face their grief (Rosenblatt, 1993),
and can include emotional support and/or material support (Laakso & Paunonen-
Ilmonen, 2002; Nolen-Hoeksema & Larson, 1999; Vachon & Stylianos, 1988).
Emotional support involves family, friends and colleagues who provide the
bereaved person with the space and opportunity to talk about their loss (Nolen-Hoeksema
& Larson, 1999). These individuals also supply emotional support through listening,
touch, and expressions of sympathy and love (Kaunonen, Tarkka, Hautamaki, &
Paunonen, 2000; Ringler & Hayden, 2000). This may be offered through phone calls,
cards, prayer or other visible manifestations of interest and concern (Webner, 1999).
Moreover, the bereaved may find support from association with individuals who have
experienced the same type of loss (Lehman et al, 1986; Rosenblatt, 1993). Herth (1990)
found that the frequency of visits by family and friends were related positively to the
level of grief resolution and level of hope in 75 bereaved spouses. Furthermore, other
factors found to correlate significantly with grief resolution are situations where the
bereaved feels connected to their social support network, engages in quality
communication, and conveys feelings honestly (Vachon & Stylianos, 1988).

Grief in Women Religious 5
Material or concrete support consists of deeds such as performing tasks or
providing time that may alleviate the bereaved person's current difficulties (Kaunonen et
al., 2000; Nolen-Hoeksema & Larson, 1999). Aiken (2001) reports that valued forms of
material support, when provided with empathy, are offering transportation or assistance
with practical matters. This may include assisting with funeral arrangements, sorting
through paper work, preparing meals or helping with household tasks (Nolen-Hoksema &
Larson, 1999). It also may involve answering questions surrounding legal and financial
issues (Nolen-Hoeksema & Larson, 1999).
Several studies indicate that social support has a positive effect on bereavement.
One such study by Ulmer, Range and Smith (1991) found that a high purpose in life was
associated with an enhanced recovery from bereavement. The results of this study
suggest that this may be due to a more expanded social support system or a greater
capacity to utilize social support in addition to a greater life satisfaction. W. Stroebe and
M. Stroebe (1996) conducted a longitudinal study of 60 recently widowed and 60 married
men and women. Their results show that individuals with perceived high social support
availability reported less depression and fewer somatic symptoms. In contrast,
individuals with perceived low social support availability reported more depression and
more somatic symptoms.
Contrary to previous findings, research by Gamino and Sewell (1998) found that
social support did not show a negative relationship with mourning. These results indicate
that what facilitates grief resolution is an involved coping style that actively intertwines
the world, self and others. This implies that active behavior rather than passive behavior
during bereavement may lead to a reduction in grief symptoms over time.

Grief in Women Religious 6
Research also suggests that the quality of the social support rather than the
quantity of social support has a positive impact on the grief process (Nolen-Hoeksema &
Larson, 1999). In the case of bereaved women religious who live in community, the
availability of social support may be of importance. This lifestyle provides a unique
environment that includes living with women of various personalities, temperaments,
ages and experiences. In addition, women religious also live closely with those who
share similar goals and values. This may mean that grieving women religious will find a
considerable amount of positive support from their community during a period of
bereavement. Alternatively, the close proximity in which women religious live with one
another may make social support more of a challenge due to a lack of privacy and the
conflicts that occur from daily life. Furthermore, since active women religious have
more of an opportunity to engage in social relationships than do contemplative women
religious, the effects of social support may be more evident among this group.
Personality and Grief
The intensity, quality and resolution of grief appear to be associated with the
personality of the bereaved (Aiken, 2001). Furthermore, research indicates that
personality characteristics (e.g. anxiety, conscientiousness, sociability), as measured
through health and personality questionnaires, affect the ability to cope positively or
negatively with grief (Sanders, 1999; Vachon, Rogers, et al., 1982). Results of a study
performed by Meuser, Davies, and Marwit (1995) suggest that personality style can be a
risk factor for complicated grief. Additionally, Vachon and Stylianos (1988) discuss
personality factors such as anxiety, self-esteem and dependency that may determine the
manner in which individuals attempt to elicit social support during bereavement. These

Grief in Women Religious 7
findings indicate that personality factors may impact the bereavement process. One
component of personality that has not yet been well examined in regard to grief but may
have an impact is extraversion/introversion.
Research by McCrae and Costa (1987) has measured extraversion and
introversion as opposite ends of a single continuum. According to these studies
extraverted people are more sociable, friendly, talkative, high-spirited and demonstrative.
On the other hand, the researchers describe introverts as reserved, independent, even
paced and individuals who value their privacy. Morris (1979) claims that although
extraverts are behaviorally vivacious, they are emotionally reserved. Conversely,
introverts are behaviorally reserved, but they are aware of deep and various emotions.
Therefore, while introverts may not visibly express their emotions, they are more in touch
with their emotions than are extraverts (Morris, 1979).
Several studies that investigated various facets of life events included extraversion
as one of the components. In one such study, Zautra, Finch, and Reich (1991) examined
predictors of daily positive, negative, and ill-health events over time. Among the
bereaved participants with unsupportive social networks, this study found a relation
between extraversion and less physical problems but more undesirable events. In an
additional study, Grace and O'Brien (2003) investigated the role that life events, presence
of a significant other, and personality factors have on depression. Their findings show
that of the 104 elderly participants, the individuals with multiple experiences of
bereavement also suffered from early-onset depression and received lower extraversion
scores on a personality instrument than did the control group. Hotard, McFatter,
McWhirter, and Stegall (1989) examined the interaction of extraversion, neuroticism and

Grief in Women Religious 8
social support on subjective well-being. Results show that neurotic introverted
individuals and introverted people with negative social support reported lower subjective
well-being than either the extraverted or neurotic extraverted participants. According to
the researchers, these findings may indicate that under adverse circumstances, introverted
individuals may experience an increased sensitivity, which may be associated with their
reports of lower subjective well-being. These findings may suggest that during times of
bereavement, extraverted women religious may rely more on social support than do
introverted women religious. In addition, the active religious life permits more
interaction and communication with people than does the contemplative religious life.
Therefore, while both forms of religious life will include extraverted and introverted
members, it would seem likely that more extraverted women would be found in the active
religious life than in the contemplative religious life. Furthermore, during periods of
bereavement, the limitations imposed on social support by the structure of the
contemplative lifestyle may hinder the grief process for extraverted contemplative
women religious. Research also suggests that spirituality may influence bereavement.
Spirituality
Spirituality is multidimensional and defined in many different ways (Miller,
1999). Paloutzian and Ellison (1991) suggest the term spiritual well-being to portray a
clearer meaning of spirituality. As indicated by these researchers, when individuals refer
to spirituality, they typically imply a relationship with God/ higher power or a
contentment and purpose in life. Additionally, according to Miller (1999), spirituality is
an attribute of a person and deals with individual subjective experiences. He further
reports that spirituality does not necessarily involve religion. The author explains that

Grief in Women Religious 9
spirituality also can focus on an indefinable substance that provides meaning in the
individual's life. In recent years, bereavement scholars have attempted to integrate grief
studies and spirituality by reflecting on clinical and/or individual experiences. Studies
found that, for individuals who believe in God, grief may produce a spiritual crisis that
leaves the bereaved depressed, helpless, and hopeless, and it also may raise faith
questions that are incongruent with the individual's spiritual roots (Massey, 2000). This
spiritual turning point reflects a rupture in the person's present relationship with God and
consequently, the bereaved may experience loneliness and desolation (Massey, 2000).
Consolation, however, may be obtained by sensing the presence of the deceased in a
religious experience such as private prayer, ritual, or prayer services (Klass, 1993). On
these occasions the mourners may feel God's presence which brings comfort and peace;
however, many will likely still feel the sadness and emptiness associated with grief
(Bullitt-Jonas, 1994).
Balk's (1999) examination of case studies indicates that bereavement also affects
spirituality by challenging innate beliefs about life. This may shake faith systems and
lead to a period of inner turmoil as the bereaved searches for new meaning. In order to
change the anguish into optimism and be transformed by God, the person must enter into
the grief process, face the pain and make sense of the loss (Balk, 1999; Webner, 1999).
In this way, spiritual change can occur and the individual may become compassionate
(Balk, 1999; Chen, 1997). Therefore, this research may suggest that during times of loss,
grief may impact spirituality.
Additional research indicates that spirituality is related to the bereavement
process. Results of one qualitative study performed by Golsworthy and Coyle (1999)

Grief in Women Religious 10
indicate that the experience of grief may appear to shake the faith of the bereaved
because it is associated with questions and doubts. In spite of their confusion, the
individuals in this study felt God's presence in their lives. Their spirituality as evidenced
by a sense of a personal and trusting link to God supported them through their grief.
However, the bereaved also felt shame and self-criticism because they thought that their
faith should help them cope more effectively with their grief.
Furthermore, Marrone's (1999) examination of empirical research and clinical
insights suggests that the loss of a loved one may challenge religious beliefs and raise
questions about the meaning of life. As a result, the bereaved may experience a spiritual
crisis; however, through active coping rather than passive coping this spiritual struggle
may lead to the resolution of grief. Therefore, spirituality may help the bereaved work
through the mourning process (Marrone, 1999).
During periods of severe pain or sadness, some individuals seek comfort from a
religious or spiritual explanation for their loss (Sanders, 1999). Religious faith can
cushion the detrimental consequences of a crisis and help the bereaved view the mundane
with new insight and wisdom (Ellison, 1991). Research suggests that religious people
tend to use more adaptive strategies and are less distressed than are nonreligious
individuals (Nolen-Hoeksema & Larson, 1999). Results of Fry's (2001) study of 188
bereaved widows and widowers indicate that aspects of religious beliefs and spirituality
are predictors of psychological well-being and coping with the death of a loved one.
Scholars conceptualize the terms religious beliefs and spirituality as different
constructs. Specifically, religious beliefs are innate convictions about how an individual
relates to the sacred or divine and are often manifested outwardly (Miller, 1999).

Grief in Women Religious 11
Spirituality, on the other hand, is a person's search to understand the meaning of life and
to make life meaningful (Batten & Oltjenbruns, 1999). Spirituality pervades all aspects
of an individual's life (Golsworthy & Coyle, 2001) and involves forgiveness, compassion
and feeling connected to a community (Mahoney & Graci, 1999). It is a perception of
existence that can be fostered and nurtured (Gamino, Sewell, & Easterling, 2000). While
religious beliefs, people's convictions of transcendence and deity, appear to help the
bereaved cope with their loss, the search for meaning surrounding loss may cause the
individual to raise questions about these beliefs (Davis & Nolen-Hoeksema, 2001; Miller,
2000). Therefore, spirituality, an individual's pursuit to find meaning in life, may impact
the grief process.
The relation between spirituality and bereavement is a particularly relevant issue
to address in the context of grieving women religious. Spirituality is the core of women
religious' lives and encompasses all aspects of their existence. Thus, spirituality should
be a major source of strength and comfort for bereaved women religious. For
contemplative women religious whose primary focus is a life dedicated to prayer and
whose main social support comes from their community, spirituality may have more of
an initial impact on the grief process than it will have on the grief process for active
women religious who have more of a social support network. Little research, however, is
available to address these issues.
Application to Women Religious
History of religious life. Religious life in the Roman Catholic Church has been in
existence for nearly 2000 years (Schneiders, 2001). During the second century, the
tradition of women living as consecrated virgins began, and over time this practice was

Grief in Women Religious 12
replaced by the vows of chastity, poverty and obedience (Cita-Malard, 1964). In the fifth
century, the first women monasteries were established by Scholastica under the guidance
of her brother Benedict. In these monasteries, the women followed the Benedictine rule
that structured how they lived, worked, and prayed together. In 1283, as a safeguard for
nuns against the barbarian invasion, Pope Boniface VIII erected enclosure. It was not
until the 16 th century, however, that the Council of Trent enforced the rules of solemn
vows and enclosure on all women who live in community (Cita-Malard, 1964). The
institution of contemplative religious life as it is lived out in the Roman Catholic Church
began at this time. Contemplative women religious not only profess the vows of chastity,
poverty, and obedience they also choose to live a life of solitude and prayer within the
confines of their monasteries.
Active religious life also came into existence in the 16 th century as a result of the
needs of the times (Cita-Malard, 1964). Active women religious also profess the vows of
chastity, poverty, and obedience as well as commit themselves to an apostolic work in the
church. At this time, women religious were permitted to assume a less rigid rule of
enclosure and work as teachers or in hospitals (Cita-Malard, 1964). Throughout the
centuries, religious congregations were established to meet the needs of the times and of
the Catholic Church. Typically, a congregation was established by one or two founders
who decided on the purpose, way of life, and who wrote a rule for the group.
Women religious are called to serve the Church within a community, and they
enter religious life to live out the gospel message according to the specific spirit and
values of a congregation (Donavan, 1989). The two basic forms of religious life for
women are the active and the contemplative lifestyles. Schneiders (2000) explains that

Grief in Women Religious 13
contemplatives distinguish themselves by prayer which is the unique visible expression
of their lifestyle. Contemplative women religious live a life of solitude, prayer and
withdrawal from the world. Rarely will events or circumstances interrupt the structure of
community exercises or common prayer. These women choose to spend their life within
one monastery and usually are not transferred to another house.
In contrast, ministry is the distinct characteristic of the active religious lifestyle
(Schneider, 2000). In this type of life, women religious strive to balance a life of prayer
(private and common), commitment to their congregation, and a job related to the service
of the Catholic Church. Active women religious choose to serve God's people where
they are most needed, and consequently, their ministry may necessitate the need for them
to move to new geographical areas.
Women religious and personality. Although little research can be found on the
personality types of women who seek admission into religious life, one may surmise that
since active religious life provides opportunities to develop numerous interpersonal
relationships more extraverted women will seek entrance into these congregations than
will introverted women. Conversely, more introverted women would be expected to seek
admittance into contemplative religious congregations as this lifestyle lends itself to
solitude and little contact with strangers or other people in general. Interestingly,
Donavan (1989) suggests that naive women who seek interpersonal relationships and
protection may look for these things in a contemplative congregation. The majority of
religious congregations, however, utilize psychological assessments to evaluate applicant
suitability for religious life (Batsis, 1993).

Grief in Women Religious 14
Women religious and grief. Grief is a life crisis and crises can impact social
relationships and initiate spiritual change (Balk, 1999). Women religious are not
excluded from this grief process. When these women lose a loved one, their grief is
unique to them as individuals and may be influenced by their religious life. These
women choose to live a countercultural lifestyle. As a result, the potency of their grief
may go unnoticed or be misconstrued because people do not understand their way of life
or the depth of their love for others. Bowlby (1980) discusses several factors that may
predict complicated grief including unresolved previous losses, the inability to develop
meaningful relationships, living alone, unhelpful social interaction, persistent anger, self-
reproach, and depression. In addition, Sanders (1999) cautions that postponing grief or
acting as though the loss did not occur may be symptoms of abnormal grief. These issues
may be of particular relevance for bereaved women religious because of their highly
spiritual life and their bond with members of their congregation.
Furthermore, Doka (1987) indicates that grief may be intensified in nontraditional
relationships and add confusion to the bereavement process. This may be especially true
for contemplative religious whose lifestyle may not permit them to leave their enclosure
to care for a family member or visit a dying friend. Consequently, the bereaved women
religious may feel isolated, lonely and depressed. As research suggests (Kaltreider,
Becker, & Horowitz, 1984; Parkes, 1998), women may be more sensitive than men to the
loss of a parent, which may lead to psychological problems; women religious should be
no exception. The death of parents may leave a woman religious with a feeling of
"homelessness" and a sibling's death may break a tie to a family unit. Without a family
of her own, the bond with her nuclear family may be intense and the finality of the loss

Grief in Women Religious 15
may be tremendous. The grief of a woman religious also may be complicated because
her life of selfless service may inhibit her from admitting or expressing the pain and
emptiness caused by death.
For active and contemplative women religious who live in community the
availability of positive social support should ease the grieving process. These women
have available to them community members who are willing to listen, to help in practical
matters and to share with individuals who have experienced similar losses. Ideally,
members of the woman religious' local convent will support her through the grieving
process with their physical and spiritual presence. Moreover, active women religious
have the liberty to engage in social relationships with other religious outside of their local
community as well as lay friends and colleagues. These relationships may provide active
women religious with additional support during the bereavement process.
The grief process also may be affected by the woman religious' personality. An
extraverted grieving woman religious may tend to seek social support outside of her local
house, look for distractions from her pain, and express more visible grieving emotions.
Contrary to this, an introverted woman religious may be more satisfied with the social
support received from her local community, be more in touch with her emotions, be less
expressive of these emotions, and seek more time alone than an extraverted woman
religious.
A woman religious would be expected to turn to God and her faith for comfort
and support during times of grief. Religious beliefs may bring a sense of solace that her
loved one is in heaven and that one day she will be reunited with the deceased. The
support of the funeral liturgy, prayer services and rituals that envelop the days following

Grief in Women Religious 16
a death may be a source of strength for the bereaved woman religious. This does not
mean, however, that the woman religious will not feel the pain associated with the loss of
the loved one. It does mean that her faith may influence this grief process in a significant
manner. For contemplative women religious whose life is dedicated to prayer and
solitude, the resolution of grief may primarily involve a focus on spirituality. This may
be a natural consequence of enclosure and limited social contacts. Conversely, for active
women religious who are immersed in an apostolic ministry, the resolution of grief may
initially focus on social support. The availability of social support from a variety of
sources may make this a feasible preference. However, over time the active women
religious may turn more towards their faith and relationship with God for comfort. This
refocus on spirituality may consequently flow from their primary commitment to God.
Furthermore, research suggests that spirituality may not only help the bereaved work
through the grief process, but also lead to a stronger interior life (Marrone, 1999; Massey,
2000).
Statement of the Problem
Grief is an inescapable fact of life. The significance of the grieving process can
be seen both in research, self-help literature and support groups available to the bereaved.
Research on grief suggests that bereavement is an intensely emotional period that lasts
for an indeterminate length of time. Women religious experience many losses that affect
their life in a profound way. Among these losses are the deaths of parents, siblings,
relatives, community members and intimate friends. Little research, however, can be
found that addresses the issues of loss within a religious community. Women religious

Grief in Women Religious 17
attempt to deal with these outcomes while they continue to serve God's people and live in
community.
Present research suggests that social support and spirituality are important factors
in bringing the grieving process to a healthy resolution. Research also indicates that
personality factors may affect the grief process. The purpose of this study was to
determine the impact that social support, spirituality and the personality factor of
extraversion have on grief symptoms in active and contemplative women religious. The
relations among these variables were examined over a 3 month time period.
Statement of Hypotheses
1. There is a relation between social support and grief symptoms such that the social
support of women religious is related negatively to grief symptoms over time.
2. There is a relation between spirituality and grief symptoms such that the
spirituality of women religious is related negatively to grief symptoms over time.
3. There is a significant interaction between women religious lifestyles and
personality factors in relation to grief symptoms, such that extraversion is related
negatively to grief symptoms over time in active women religious and related
positively to grief symptoms in contemplative women religious over time.
4. There is a difference between women religious lifestyles in relative contribution
of time 1 spirituality and social support in predicting time 2 grief symptoms, such
that social support and spirituality will be more predictive of grief among active
women religious and spirituality alone will be predictive of grief among
contemplative women religious.

Participants
Chapter II
Method
Grief in Women Religious 18
The participants in this study were 82 Roman Catholic women religious
who had experienced the death of a family member or friend within the past seven
months. In addition, 58% (n = 48) of the participants belonged to five active
congregations and 42% (n = 34) were members of 17 contemplative monasteries.
Furthermore, the participants were drawn from the New England, Mid-Atlantic,
Southern, and Midwestern states. The entire population spoke English and 89% of the
participants describe themselves as White/European American. In this study, the median
age for the active participants was 63 and the median age for the contemplative
participants was 61. This is comparable to the 1999 statistics for women religious in the
United States which reports a median age of 68 for active women religious and a median
age of 65 for contemplative women religious (Froehle et al., 2000).
Moreover, the participants represented a range of educational levels. See Table 1
for summary of demographic information. Approval to use human subjects was obtained
from the Human Subject committee of Loyola College in Maryland (see Appendix A).
Measures
Grief. Symptoms of grief were measured with Part II titled, "Present Feelings,"
of the Texas Revised Inventory of Grief (TRIG; Faschingbauer, Zisook, & De Vaul,
1987; see Appendix B). Faschingbauer et al. designed this measure to evaluate grief "as
a present emotion of longing, as an adjustment to a past life event, as a medical
psychology outcome, and as a personal experience" (1987, p. 111). The items of this

Table 1
Summary of Demographic Information for Participants
Age
Active
Contemplative
Years in Lifestyle
Active
Contemplative
Ethnicity
White/European
American
Native American
Black/Latino
White/Native
American
Education
H.S. Diploma
Bachelors
Masters
Doctoral
Other/Missing
Minimum
40
46
40
.75
22
.75
Maximum
81
M
62.79
Grief in Women Religious 19
SD
9.98
N
82
%
81 63.73 9.32 48 58.5
79
63
61.47
42.03
10.85
12.73
34
78
63 44.13 10.32 46
58
39.01
15.22
32
82
73
7
41.5
89
8.5
1 1.2
1
82
12
1.2
14.6
12 14.6
49
59.8
2 2.4
Note. Other/Missing = some college credits; three participants did not report number of
years in religious life.
7
8.5

Grief in Women Religious 20
measure were developed by Faschingbauer and colleagues based on their clinical
experience as well as literature for normal and atypical grief (Stroebe et al., 2001).
The TRIG consists of 26 items that assess feelings and actions surrounding the death of a
loved one. The introductory section of the TRIG assesses the individual's relationship
with the deceased, perceived closeness with the deceased, and length of time since the
death occurred. This inventory also consists of two primary scales, which are composed
of simple statements. Part I, titled "Past Behavior," consists of eight items that assess
behavior occurring shortly after the death (e.g., "I found it hard to sleep after this person
died"). The participants respond on a 5-point Likert scale ranging from "Completely
True" to "Completely False." On this section, the items are reverse scored and the scores
range from 8 to 40 (Longman, 1993).
Part II, titled "Present Feelings," consists of 13 items that assess feelings at the
time of the data collection (e.g., "I still get upset when I think about the person who
died;" Ginzburg, Geron, & Solomon, 2002). Part II is the primary measure used to assess
change in grief symptoms over a period of time (Stroebe et al., 2001). On this scale, the
participants also respond on a 5-point Likert scale ranging from "Completely True" to
"Completely False," such that the scores on Part II can range from 13 to 65 (Longman,
1993). In addition, the items are reverse scored. For this study, the mean
score for Part II used to assess grief symptoms over time.
Part III, titled "Related Facts," consists of five basic statements that assess
information associated with the death of the individual (Longman, 1993). For this
section, the participants respond either true or false. The TRIG concludes with an open-
ended question that asks participants to add other thoughts or feelings. For the purposes

Grief in Women Religious 21
of this study, no specific hypothesis will utilize the qualitative data gathered from the
TRIG.
Research shows the TRIG to have a moderate level of reliability with coefficient
alphas of .77 for Part I and .86 for Part II (Stroebe, Stroebe, & Hansson, 1993).
Furthermore, in a study of 260 adults, the coefficient alpha for Part II was .77
(Faschingbauer et al., 1987). In a longitudinal study performed by Longman (1993),
grief symptoms were assessed in male and female adults at three months to two years
postloss and than three months later. The Cronbach's alpha in that study ranged from .78
to .93 for different sections of the TRIG at different times of measurement. In the present
study, for Part II, the coefficient alphas for time 1 and time 2 were .85 and .83.
Some modifications were made on the TRIG to reflect the present study's
population and time frame. Specifically, in the inventory items, husband and wife were
removed and time since the person died was revised to range from ''within the past
month" to "within the past 4 to 7 months," Furthermore, in Part III, on item four, "each
year" was changed to read "each month." However, no items in Part II were altered,
which is the primary scale used to assess changes in symptoms of grief and was the only
section used in this study.
Social support. Social Support was measured using the Social Support
Questionnaire (SSQ; Sarason, Levine, Basham, & Sarason, 1983). The SSQ measures
the participant's availability for and his or her satisfaction with social support (see
Appendix C). Sarason et al. (1983) derived their definition of social support from
Bowlby's Theory of Attachment, basing it on the accessibility of individuals on whom
they can depend, who care for them and who support them. The SSQ consists of 27

Grief in Women Religious 22
items that ask the subject to list who they can turn to in particular situations and then to
rate their satisfaction with the support that they receive from these people on a 6-point
Likert scale ranging from "very satisfied" to "very dissatisfied" (Heitzmann & Kaplan,
1988). The items are reverse scored. The SSQ is scored by first adding the total number
of people listed (maximum number is 243). This total is the SSQ Number Score (SSQN;
Sarason et al., 1983). The Total Satisfaction score for all 27 items (Max = 162) is also
computed. This score is the SSQ Satisfaction score (SSQS; Bowling, 1997). By dividing
the sum of the SSQN and SSQS scores by 27, the total number of items, the overall N
and S scores are obtained (Sarason et al., 1983).
Reliability for the SSQ in a college student sample was assessed by Sarason et al.
(1983). Results show an alpha coefficient of .97 and an alpha coefficient for satisfaction
scores of .94. Similarly, in the present study, the coefficient alphas for time 1 and time 2
were .94 and .95 respectively.
Construct validity for the SSQ was tested in a study of 227 male and female
college students who were given the SSQ, the Multiple Affect Adjective Check List
(MAACL), and the Lack of Protection Scale (LP; Heitzmann & Kaplan, 1988).
Significant negative correlations of -.22 and -.43 were reported between the SSQ-N and
the SSQ-S and the MAACL that assesses emotional discomfort. Additionally, a negative
correlation (-.22 and -.32) was found between the LP and the SSQ. A subsample of 28
men and 38 women from this study was administered Extraversion and Neuroticism
scales. The Extraversion measure for women was correlated positively (r = .35) with the
SSQ-N, and was correlated negatively (r = -.37) with the Neuroticism scale for women.

Grief in Women Religious 23
For the purpose of the present study, three items that did not apply to this
population were eliminated. Specifically, items 4, 10, and 15 were not included in the
participants' total scores as they addressed issues not related to the religious lifestyle such
as marriage.
Personality. Extraversion was measured using the Revised NEO Personality
Inventory (NEO PI-R; Costa & McCrae, 1992). The NEO PI-R measures five major
dimensions of personality: Neuroticism, Extroversion, Openness, Agreeableness, and
Conscientiousness. The self-report form of the NEO PI-R consists of 240 items.
Participants are asked to respond on a 5-point Likert scale ranging from "strongly
disagree" to "strongly agree." Each of the five domains contains six subscales that
measure a variety of facets of that specific domain. For the purpose of this study, only
the 48 items from Form S that measure extraversion was used (see Appendix D).
Numerous studies have been performed to evaluate the reliability of the NEO PI-
R. Two research designs that include coefficient alphas for the Extraversion scale will be
reviewed. Costa, McCrae, and Dye (1991) and Costa and McCrae (1992) report internal
consistencies for the individual facet scales of the NEO PI-R. In a study of 1,539
participants, the coefficient alphas for the individual facet scales ranged from .56 to .81.
Additionally, on the 48-item Extraversion scale the coefficient alphas ranged from .63 to
.77.
McCrae and Costa (1983) report retest reliability for the NEO PI-R in a study of
31 men and women. The values for the facet scales ranged from .66 to .92. In this same
study, the reliability value for the Extraversion scale was .91. Furthermore, in a sample
of 208 college students, the test-retest reliability coefficient for Extraversion was reported

Grief in Women Religious 24
as .79 (p < .001; Costa & McCrae, 1992). In the present study, a coefficient alpha of .91
was found for the NEO-E.
Spirituality. Spirituality was measured using the Spiritual Well-Being Scale
(SWB; Paloutzian & Ellison, 1982). The SWB scale gives a global assessment of the
subjective spiritual quality of life (see Appendix E). Paloutzian and Ellison (1991) state
that the term "spiritual well-being" reflects people's meaning of spirituality as "either
their relationship with God or what they understand to be their spiritual being, or their
sense of satisfaction with life or purpose in life" (p.2). The SWB total score presents a
general measure of an individual's spiritual well-being. Additionally, the SWB contains
two subscales. The Religious Well-Being score (RWB) provides an assessment of an
individual's relationship with God and the individual's perceived satisfaction with God.
The Existential Well-Being (EWB) score assesses an individual's satisfaction with and
purpose in life (Paloutzian & Ellison, 1991).
The SWB is a 20-item self-administered instrument Responses are given on a 6-
point Likert scale ranging from "strongly agree" to "strongly disagree." RWB is assessed
by the ten even-numbered statements that contain the word "God" and the ten remaining
odd numbered items assess EWB (Paloutzian & Ellison, 1991). In an attempt to control
for response bias, about half of the items are worded in a negative fashion. The
statements are scored from 1 to 6. For positive items, a higher number represents greater
well-being, and the negatively worded items are reverse scored. The sum of all 20 items
assesses overall spiritual well-being (Paloutzian & Ellison, 1991).
Bufford, Paloutzian, and Ellison (1991) found high reliability for the SWB in four
test-retest studies. The reliability coefficients ranged from .88 to .98 for RWB, .73 to .98

Grief in Women Religious 25
for EWB, and .82 to .99 for SWB. In addition, the index of internal consistency
coefficient alpha, also showed high reliability across seven samples. These results ranged
from .82 to .92 for RWB, .78 to .86 for EWB, and .89 to .94 for SWB. Similarly, in the
present study, the coefficient alphas for the SWB at time 1 and time 2 were .92 and .90
respectively.
Additionally, Bufford et al. (1991) found that the SWB is a valid gauge for overall
well-being. The three scales are correlated positively with purpose in life and are
correlated negatively with loneliness (Ellison, 1983). A ceiling effect has been reported
by the authors in some religious samples (Hill & Hood, 1999). This measure, however, is
sensitive at the low end and research suggests that it may be a useful instrument to assess
those experiencing spiritual distress or lack of well-being (Hill & Hood, 1999).
A pilot study was performed in March 2003 to determine if the SWB scale would
be an effective measure to use with women religious. Twenty members of two women
religious congregations living in Maryland and Pennsylvania took part in this study.
None of these women participated in this present study. It was hypothesized that scores
on the modified version of the scale (see Appendix E) would show significantly more
variability than would scores on the original version of the scale. The modified scale
ranged from 0 to 100 instead of 0 to 5. The reason, for the modification, was concern
that the range of 0 to 5 would not show enough variability in such a highly spiritual
group. Findings show a mean of 1841.90 and a standard deviation of 143.61 for the
modified version. For the original version, a mean of 108.35 and standard deviation of
10.69 was found. The maximum score on the original scale is 120, and the maximum
score on the modified scale was 2000. Three women religious reported the maximum

Grief in Women Religious 26
score on both the original and modified scales. There was no ceiling effect with either
the original measure or the modified measure. This indicates no significant difference
between the two versions of the scales; therefore, it was decided the original scale would
be used. These results are similar to those of O'Kane (19%) who used the original SWB
in a study of women religious. Furthermore, at time 1 and time 2, this present study
found significant correlations between the TRIG (r = .80, p < .05), the SSQ (r = .79, p <
.05), and the SWB (r = .70, p < .05).
Procedure
Data collection began subsequent to receiving approval from the author's
dissertation committee and the Human Subject committee of Loyola College in
Maryland. A second time of measurement occurred three months after the first data
collection. A list of 12 active women religious congregations and 16 contemplative
monasteries of women were obtained from the Official Catholic Directory (2003). All
congregations and monasteries obtained from this source were located within the eastern
region of the United States. General leadership members of nine active congregations
were contacted by phone and a personal interview date was requested. One individual in
lieu of a personal interview suggested that e-mail messages be sent to the 17 presidents of
the congregation situated throughout the United States. Furthermore, due to scheduling
conflicts, two other persons requested that a letter be sent explaining the procedures for
this study. Phone messages were left with general leadership members of three other
active congregations, but no response was obtained. Several e-mail messages were sent
to one of the individuals, but a request for a meeting was not obtained. Therefore, a total
of 12 active congregations were contacted.

Grief in Women Religious 27
The superior and/or contact person of 16 contemplative communities were
contacted by phone, mail, e-mail or through personal interviews. Due to the small
number of participants, names of four additional monasteries were verbally given to the
researcher by colleagues and these monasteries were either visited or contacted by phone.
Furthermore, 58 monasteries, throughout the United States and Ireland, were located on
the internet and they were contacted by e-mail. Therefore, 79 contemplative monasteries
were contacted and 48 of them responded. These monasteries were located across the
United States.
The names and addresses of women religious who had lost a parent, sibling or
close friend within the last three months were either mailed to the researcher or the
women were personally contacted by their leadership personnel to assess their
willingness to participate in this study. Subsequently, the names and contact information
of the women willing to participate were either forwarded to the researcher or the
participant personally contacted the researcher by e-mail or phone.
A packet of materials was mailed to the active and contemplative women
religious as distance made it unfeasible to visit each convent. For each eligible
contemplative woman religious who resided in the monastery that was visited, a packet of
materials was left at the monastery for her. Before the packets were mailed or
distributed, identification numbers for coding purposes were placed on each of them.
The packets included a cover letter, a consent form, a demographic questionnaire, the
Texas Revised Inventory of Grief (Faschingbauer, 1981; see Appendix B), the Social
Support Questionnaire (Sarason et al., 1983; see Appendix C), the NEO PI-E (Costa &
McCrae, 1992; see Appendix D) and the Spiritual Well-Being Scale (Paloutzian &

Grief in Women Religious 28
Ellison, 1982; see Appendix E). The measures were arranged in a counterbalanced
order.
The cover letter described the purpose and procedure of the study (see Appendix
F). It also provided information on confidentiality, voluntary participation, risks and
benefits involved in participation, and the person to contact if a question arose. The
cover letter also indicated that a doctoral psychology student at Loyola College in
Maryland conducted the study. Additionally, the cover letter informed the participants
that there was a 3-month follow-up study to assess the impact of social support and
spirituality on the grief process in women religious. The demographic questionnaire
included questions regarding age, years in religious life, level of education, ethnicity, and
type of work (see Appendix G). Voluntary consent to participate in the study was shown
by returning the consent form (see Appendix H).
In order to perform the follow-up study and to maintain confidentiality,
participants were asked to provide the researcher with contact information on a separate
sheet of paper (see Appendix I). The number of packets distributed totaled 114 (Active =
62; Contemplative = 52), and the number of responses to time 1 totaled 93 (Active = 53;
Contemplative = 40). Upon return of the questionnaires, thank you letters were mailed to
each participant with a reminder of the follow-up study (see Appendix J). Moreover,
postcard or e-mail reminders were mailed to those who did not respond. Three months
after the participant returned the first packet of questionnaires, packets containing the
Texas Revised Inventory of Grief, the Social Support Questionnaire, the Spiritual Well-
Being Scale, a consent form and a cover letter were mailed again to the participants. The
cover letter restated the purpose and procedure of the study. In addition, it again

Grief in Women Religious 29
explained confidentiality, voluntary participation, the risks and benefits involved in
participation, and the person to contact if a question arises. Voluntary consent to
participate in the study was indicated by the return of the consent form. The number of
replies to time 2 totaled 79 (Active = 44; Contemplative = 35). After the follow-up
packets were returned, a thank you letter (see Appendix K) and a copy of the article,
Grief’s Journey, published by the Hospice of Baltimore (2002) were mailed to the
participants. Additionally, postcard or e-mail reminders were sent to those participants
who did not respond. The participants who requested the results were mailed a summary
of the findings.
For time 1, due to the length of time that elapsed between mailing and returning
the packets of questionnaires, the time since death was extended, from the original plan
of three months, to include those individuals who experienced a loss within the past
seven months. Of the 93 respondents, 11 individuals were eliminated because the time
since death was reported as greater than seven months. See Table 2 for summary of time
since death and relation to the deceased.
Design and Analyses
This study was passive observational and longitudinal. The variables investigated
were as follows: type of religious life (active/contemplative), symptoms of grief, social
support, extroversion and spirituality. The criterion variable was grief over time which
was looked at by examining time 2 grief after controlling for time 1 grief. The predictor
variables were grief at time 1, social support, spirituality, women religious lifestyle and
extraversion. A multiple regression was used to test the relation between these variables.

Table 2
Summary of Time Since Death and Relation to Deceased
Variable
Time
One month
Two months
Three months
Active
Grief in Women Religious 30
Contemplative
10 10
15 8
16 4
4-7 months 7 12
Relation**
Parent
Sibling
18 4
Community 0 14
Member
Total
Friend
Other
13
5
12
48
Note. Time = Time since death as reported in Time 1. Relation = Relation to the
deceased. **χ 2 for Relation = 35.00, p

CHAPTER III
Results
Grief in Women Religious 31
Descriptive Statistics for all variables of interest are presented in Table 3. In
order to examine grief over time, a residualized grief score was calculated, representing
grief at time 2 after controlling for grief at time 1.
Hypothesis 1 was that there is a relation between social support and grief such
that the social support of women religious is negatively related to grief symptoms over
time. This was tested using the Pearson correlation coefficient. Social support was not
related to grief symptoms over time. Time 1 social support was not significantly related
to grief symptoms at time 2 regardless of whether grief at time 1 was controlled (see
Table 4).
Hypothesis 2 was that there is a relation between spirituality and grief such that
the spirituality of women religious is negatively related to grief symptoms over time (see
Table 4). This was tested using the Pearson correlation coefficient. Time 1 spirituality
was not related to grief symptoms at time 2 regardless of whether grief at time 1 was
controlled.
Hypothesis 3 was that there is a significant interaction between women religious
lifestyles and personality factors in relation to grief symptoms, such that extraversion is
negatively related to grief symptoms over time in active women religious and positively
related to grief symptoms in contemplative women religious over time. This was tested
using multiple regression (see Table 5). The overall effect of lifestyle was significant.
The mean scores for active and contemplative groups on time 2 grief and time 2

Table 3
Summary of Descriptive Statistics for Variables of Interest
Variables
TRIG1*
Overall
Active
Contemplative
TRIG2**
N
81
47
34
M
35.29
SD
9.22
Grief in Women Religious 32
Skew
.30
37.09 7.90 .52
32.80
10.40
Overall 68 32.51 8.69 -.17
Active 39 35.51 6.77 .17
Contemplative
TRIG2R**
29
.53
28.48 9.43 .29
Overall 67 .01 5.29 .24
Active 38 2.14 4.70 -.62
Contemplative
SSQ1
Overall
Active
29
73
45
-2.78 4.75 1.73
132.40 11.67 -.99
134.06 10.08 -1.05
Contemplative 28 129.73 13.63 -.74
Table 3 continued on next page

Table 3 cont
SWB1
Overall
Active
Contemplative
SSQ2
Overall
Active
Contemplative
SWB2
Overall
Active
Contemplative
NEO-E*
Overall
Active
Contemplative
82
48
34
62
34
28
73
42
31
77
46
31
108.91 11.41 -1.50
108.64
109.29
10.98
12.16
Grief in Women Religions 33
-1.91
-1.13
132.41 11.78 -.84
133.19
131.45
10.91
12.89
-.88
-.78
109.45 10.68 -1.69
109.31
109.65
11.14
10.21
-2.10
-1.01
105.85 20.83 -.27
109.77
100.02
20.99
19.49
Note. TRIG1 = Time 1 TRIG Part II Present; TRIG2 = Time 2 TRIG Part II Present; TRIG2R =
Time 2 TRIG with Time 1 Residualized; SSQ1 = Time 1 Social Support Adjusted Satisfaction;
SWB1 = Time 1 Spiritual Well-Being; SSQ2 = Time 2 Social Support Adjusted Satisfaction;
SWB2 = Time2 Spiritual Well-Being; NEO-E = Extraversion. *p

Table 4
Grief in Women Religious 34
Intercorrelations between Time 1 and Time 2 Grief Symptoms and Time 1 and Time 2
Social Support Satisfaction and Time 1 and Time 2 Spirituality
Grief 1
Grief2
Grief R
SSQ1
SSQ2
SWB1
81
67
67
73
62
82
N
Grief 2
.80**
Grief R
.001
SSQ1
-.05
SSQ2
-.26*
SWB1
-.20
SWB2
-.26*
.61** .04 -.19 -.17 -.33**
.18 .04 -.03 -.18
.79**
.33**
.40**
.30*
.49**
.70**
Note. Grief 1 = Time 1 TRIG Part II Present; Grief 2 = Time 2 TRIG Part II Present;
Grief R = Time 2 TRIG with Time 1 Residualized; SSQ1 = Time 1 Social Support
Adjusted Satisfaction; SSQ 2 = Time 2 Social Support Adjusted Satisfaction; SWB 1 =
Time 1 Spirituality; SWB 2 = Time 2 Spirituality.
*p

Table 5
Grief in Women Religious 35
Stepwise Regression Analysis for Extroversion Variables Predicting Grief Symptoms in
Active and Contemplative Women Religious
Step l
Variable
Centered
Ext
Step 2
Centered
Ext
Centered
Lifestyle
Step3
Centered
Ext
Centered
Lifestyle
Interaction
Lifestyle-
Ext
B
.01

Grief in Women Religious 36
residualized grief are shown in Table 3. The difference for both of these measures was
that active women religious reported higher levels of grief than did contemplative women
religious. The main effect of lifestyle was significant, as mentioned above, but the main
effect of extraversion was not significant. In addition, although no interaction between
lifestyle and extraversion was found, the scores approached significance. In order to
examine the nature of this interaction, Table 6 shows mean residualized grief scores for
active and contemplative participants who scored either above or below the sample mean
for extraversion. The differences in the means were consistent with the hypothesis,
although not significant.
Hypothesis 4 was that there is a difference between women religious lifestyles in
relative contribution of time 1 spirituality and social support in predicting time 2 grief
symptoms, after controlling for time 1 grief, such that social support and spirituality is
more predictive of grief among active women religious and spirituality alone is predictive
of grief among contemplative women religious. This was tested using a hierarchical
regression. Due to limited power as a result of a small sample size, analyses were
conducted separately for the two groups rather than conducting a regression with a 3-way
interaction (see Table 7 and Table 8). Among active women religious spiritual well-
being was a significant predictor of time 2 residualized grief (see Table 7), but neither
social support nor the interaction between spirituality and social support were predictive
of grief. Specifically, time 1 spirituality was negatively predictive of time 2 grief. For
contemplative women religious, spirituality was not a significant predictor of time 2
residualized grief (see Table 8). Additionally, neither social support nor the interaction

Table 6
Grief in Women Religious 37
Summary of Descriptive Statistics for Lifestyle-Extroversion Interaction
Extraversion
High
Low
Lifestyle
Active Contemplative
M= 1.72, SD = (4.80)
n = 26
M= 2.58, SD = (4.97)
n= 20
M = -1.14, SD= (6.31)
n=12
M= -3.54, SD = (2.61)
n= 19
Note. M= Mean score for Time 2 TRIG with Time 1 Residualized; SD = Standard
Deviation for Time 2 TRIG with Time 1 Residualized.

Table 7
Grief in Women Religious 38
Stepwise Regression Analysis Among Active Women Religions for Variables Predicting
Residualized Grief at Time 2
Step 1
Variable
Centered
SWB1
Step 2
Centered
SWB1
Centered
SSQ1
Steps
Centered
SWB1
Centered
SSQ1
Interaction
Centered
SSQ1 &
SWB1
B
-.25
-.24
-.04
-.26
-.03
-.003
Note. *p

Table 8
Grief in Women Religious 39
Stepwise Regression Analysis Among Contemplative Women Religious for Variables
Predicting Residualized Grief at Time 2
Step 1
Variable
Centered
SWB1
Step 2
Centered
SWB1
Centered
SSQ1
Step3
Centered
SWB1
Centered
SSQ1
Interaction
Centered
SSQ1 &
SWB1
B
.23
.30
-.08
.14
.02
-.02
SEB
.22
.27
.17
.35
.21
.02
β
.22
.30
-.13
.14
.02
-.22
t
1.06
1.12
-.48
.39
.07
-.74
Sig.
.30
.28
.64
.70
.94
.47
R 2
.05
.06
.09
^R 2
.05
.03
.06

Grief in Women Religious 40
between spirituality and social support, at time 1, were predictive of grief at time 2.
Furthermore, post hoc examination of closeness to the deceased was conducted,
due to concern that closeness may act as a confound in the analyses. Closeness was
measured on a Likert scale ranging from one to five with one being the highest degree of
closeness, and it was reverse scored. The active women religious were significantly
closer to the deceased (M = 2.31, SD =1.10) than were the contemplative women
religious (M= 2.88, SD = 1.18; t = -2.25, p < .05). Furthermore, closeness was
significantly correlated with time 1 and time 2 grief for the contemplative women
religious (r = -.64, p < .01; r = -.73, p < .01) but not for the active women religious.
However, closeness was not significantly related to residualized time 2 grief for either
group.
In addition, post hoc examination of relation to the deceased was conducted due
to concern that relation to the deceased may act as a confound in the study. Results
indicate a significant difference between active women religious and contemplative
women religious (χ 2 = 35.00, p < .001). Active women religious reported a higher loss of
parents and siblings, whereas contemplative women religious reported the loss of more
community members.

CHAPTER IV
Discussion
Grief in Women Religious 41
This study examined the impact that social support, spirituality and extraversion
have on grief symptoms in active and contemplative women religious. Overall, their
perceived social support remained relatively stable over time, as indicated by the means
and standard deviations. For women religious in this study, social support did not affect
grief symptoms over time. This finding is inconsistent with the existing research on
social support and grief, which indicates that social support appears to have a positive
impact on grief resolution (Krause, 1986; Nolen-Hoeksema, 1999; Norris & Murrell,
1990; Sanders, 1999). The results of the present study may be due to the short span of
time between the experience of loss and testing. Previous research examined these
variables over longer periods of time such as one to seven years post loss (Lehman &
Wortman, 1986; Nolen-Hoeksema, 1999; Laakos & Paunonen-Ilmonen, 2002). It is
possible that for social support to influence grief symptoms, a longer tune frame is
needed then the present study explored.
In addition, the lack of impact of social support on grief symptoms among the
participants in this study may be due to the nature of their social support network. In this
study, women religious reported that family members, community members, lay friends
and members of the clergy were people who they count on for support. Previous research
suggests that the quality and the ability to utilize social support are negatively associated
with bereavement (Nolen-Hoeksema & Larson, 1999; Ulmer et al., 1991; Vachon &
Stylianos, 1988). Although women religious, on self-reported measures may be satisfied
with their overall social support, during times of bereavement, they may not be living

Grief in Women Religious 42
with or even have regular contact with other individuals who also are grieving for the
deceased. Moreover, they do not have a spouse or children and the emotional ties that
spring from relationships of this nature. Research indicates that nontraditional
relationships may lead to additional problems during the grieving process (Doka, 1987).
Moreover, during times of bereavement, the structure of religious life may inhibit
women religious from utilizing their social support system to its full effectiveness. The
mean and standard deviation scores of social support, for the active and contemplative
women noted in Table 3, are lower than those of college students in the original study (M
= 145.26, Sarason et al., 1983). Religious life demands a willingness to embrace self-
sacrifice, live by countercultural values, and follow specific rules. For contemplative
religious, this may mean restricted contact with their support system. This may
demonstrate itself through limited contacts by phone, visits, or an in depth sharing of
feelings. For active women religious, this may be the consequence of living apart from
their religious community, the responsibilities and time restraints of their ministry, or the
obligations they have to their communities. Research indicates that the structure of an
organization can hinder the positive impact of social support and stresses that the effects
of social support depends on the degree of contact between individuals (Vachon &
Stylianos, 1988).
Furthermore, when active and contemplative women religious were examined as
one group, spirituality at time 1 did not predict grief symptoms at time 2. In contrast,
when the results were examined separately by group (active and contemplative),
spirituality at time 1 for the active women religious did impact grief at time 2. The
present study's finding that spirituality did not impact grief symptoms over time, when

Grief in Women Religious 43
women religious were tested as one group, is inconsistent with research on spirituality
and grief, which indicates that spirituality impacts grief resolution (Golsworthy & Coyle,
1999; Marrone, 1999). While spirituality is an important focus for active women
religious, their lives also entail a ministerial dimension. Their ministry requires them to
engage in personal contact with others and to spend less time in silence and structured
prayer (Schneiders, 2000). The fast-paced feature of the active religious life is similar to
the lifestyle of lay people. For these reasons, it appears that spirituality may impact the
grief of active women religious as previous research suggests (Golsworthy & Coyle,
1999; Marrone, 1999). In addition, active women religious may also use high perceived
spirituality as a shield to refrain from addressing the pain associated with their loss. This
would be consistent with research that suggests that while faith supports individuals
through the grief process, it can also lead to feelings of embarrassment and guilt when
individuals criticize themselves for not coping more effectively with their loss
(Golsworthy & Coyle, 1999). In contrast to the active group, results indicate that for the
contemplative group spirituality at time 1 did not impact grief at time 2. This finding is
consistent with a longitudinal study of bereaved adults using the TRIG and a spirituality
scale which did not find a significant relation between spirituality and grief (Longman,
1993). Additional research in this area is needed.
Moreover, the difference found between active and contemplative women
religious may also suggest a relation between religious lifestyles and coping styles. The
lifestyle of active women religious may provide more overt opportunities for coping such
as personal therapy, support groups, or frequent contact with other individuals who have
lost loved ones; whereas, in the contemplative life, due to its structure, these

Grief in Women Religious 44
opportunities may not be as accessible. Research indicates that the relation between
spirituality and grief may be due to active coping styles rather than passive coping styles
(Marrone, 1999). This assumption may be an interesting aspect to examine in future
research. In addition, spirituality may be assessed from multiple domains including
spiritual coping, search for meaning, religious values, strength of beliefs, perception of
the transcendent (God, the divine), and spiritual experiences (Fetzer Institute, 1999). For
clinicians who work with bereaved women religious, it is important to understand and
address these various facets of spirituality.
Given that the results for this population, when tested in one group, are contrary
to previous findings, it is important to consider the possibility of measurement issues. As
previously reported, in the present study, the coefficient alphas for the measures used at
time 1 and time 2 were comparable to those found in past research. In addition, at time 1
and time 2 all of the participants scored within the moderate to high range of spirituality.
At time 1, 12 of the 82 participants received the maximum score and at time 2, 11 of the
73 women received the maximum score. Therefore, although a pilot study was
conducted in order to minimize potential ceiling effects with the SWB measure, there
may still have been such a problem with this sample. Furthermore, at time 1 and time 2,
this present study found significant correlations between social support and spirituality.
This finding is consistent with other research that found a negative correlation with the
SWB scale and loneliness (Ellison, 1983). Although this present study does not present
data to address these differences, it may be important to examine these factors in future
research.

Grief in Women Religious 45
Although findings do not support that the impact of extroversion on grief depends
on a particular religious lifestyle, the results came close to significance. Findings appear
to indicate that active women religious with high extraversion also reported lower grief
symptoms. Furthermore, contemplative women religious with high extraversion also
reported higher grief symptoms. Statistical power may be a consideration here; if a larger
number of participants had been obtained, a significant finding may have been reported.
Although extensive attempts were made, it was difficult to find eligible and willing
contemplative participants.
In addition, results show a relation between religious lifestyle and grief
symptoms. Specifically, the active participants reported significantly higher grief
symptoms than did the contemplative participants. One projected reason for this
difference may be the degree of closeness to the deceased. As stated above, a larger
number of active women religious endorsed more grief symptoms and greater closeness
to the deceased than did the contemplative women religious. Closeness, however, was
significantly related to grief in the contemplative group and not in the active group.
Although, over both groups, individuals who were closer to the deceased may have
endorsed more grief symptoms, the degree of closeness to the deceased for contemplative
women religious had more of an effect on their grief than for the active women religious.
The between-group difference may stem from the physically and emotionally close
community environment that the contemplative life entails. If a community of
contemplative women religious live with the same people over the course of years, the
bond that develops between these people may become extremely close. Therefore, the

Grief in Women Religious 46
impact that the loss of a member has on a bereaved contemplative woman religious may
be significantly greater than if they had lived in a different type of community.
Furthermore, when a contemplative woman religious experiences the death of
someone close to her, the physical separation from family and friends that the
contemplative life requires and the reduced number of outlets that this lifestyles permits
may intensify her grief symptoms. These restrictions may hinder contemplative women
religious from displaying sufficient outward expressions of grief, participating actively in
bereavement rituals, or connecting adequately with family or friends who are also
grieving. In addition, the type of death (e.g., sudden, slow, tragedy) may have an impact
on the level of grief symptoms endorsed by both active and contemplative women
religious. Moreover, if an individual cared for the deceased during their last illness, this
may also have influenced the degree of grief symptoms reported.
Limitations of the Study. There are several limitations of this study. First, the size
of the sample, especially the small number of contemplative women religious, reduced
the power of the study. There are approximately 69,963 women religious (active and
contemplative) in the United States (Kenedy, 2005). Therefore, education on the
importance of grief research in this population may persuade greater participation in
future research. In addition, while the SSQ and SWB are reliable and valid measures in
the general population, they may not be the best measures to use with this population.
Several participants reported that the SSQ was confusing, repetitive, and time consuming.
Therefore, the participants may have inaccurately reported their responses. Moreover, as
discussed earlier, there was a ceiling effect with the SWB in this population despite pre-

Grief in Women Religious 47
emptive pilot study designed to check for this concern. This may suggest a need to
develop measures that are more sensitive to this population.
Furthermore, closeness and relation to the deceased were not factored into the
analyses. As previously discussed the active women religious were significantly closer to
the deceased and also reported the loss of more immediate family members than did the
contemplative group who reported more losses of community members. Therefore,
control of these variables may be important factors to consider in future research with this
population. An additional, limitation of this study is that the sample consisted mainly of
European Americans. According to Mary Bendyna, RSM, Executive Director of the
Center for Applied Research in the Apostolate, there is no data on the background of
women religious in the United States (M. Bendyna, personal communication, September
19, 2004). Therefore, it is difficult to know if the proportional race and ethnicity reported
in this sample is representative of women religious. It may be interesting for future
research to explore the existence of cultural differences in the grief process of women
religious and generally beneficial to have richer demographic information on this
population.
Implications for Future Research. More research on grief in women religious is
needed to examine the impact of spirituality and social support on grief symptoms in
active and contemplative women religious. In this regard, future research may benefit
from using other social support and spirituality measures that are more appropriate for
this population. Furthermore, the present findings suggest that future research also may
benefit from examining the variables in separate groups (active and contemplative) rather
than together. In this study, the main effect of lifestyle was found to be significant. This

Grief in Women Religious 48
may indicate that if social support and spirituality were examined separately for each
lifestyle with larger samples, results may have found these variables to be significant
predictors of grief. Therefore, attempts to gather a larger sample size is important for
future research. For that reason, it is essential that contemplative women religious be
encouraged to participate in this type of research. This may necessitate educational
programs, seminars, and/or journal articles that address the relevance of examining grief
related issues in women religious. Furthermore, the restricted and secluded nature of the
contemplative life makes group research such as this extremely difficult.
An additional factor that may be interesting to examine in future research with
women religious is neuroticism. McCrae and Costa (2003) describe neuroticism as the
likeliness of a person to experience unpleasant emotions that lead to disturbing thoughts
and actions. According to these researchers, individuals who are high in neuroticism are
likely to be high in traits such as anxiety, anger, depression, self-consciousness,
impulsivity and vulnerability. Furthermore, high neuroticism leads to problematic
interpersonal relationships and difficulties coping with negative events (McCrae &
Cossta, 2003). In addition, Kenel (1983) indicates a relation between depression, anger
and grief. Therefore, neuroticism may influence the grief process and be an important
factor to investigate in future research with bereaved women religious.
Moreover, future research may consider addressing a longer length of time since the
loss occurred, closeness to the deceased, coping styles, the role of personal growth during
bereavement and the limited emotional contact that contemplative women religious may
encounter. From this type of research, mental health care providers may identity key
factors that may result in unique treatment needs for women religious. Therefore, women

Grief in Women Religious 49
religious may benefit psychologically and spiritually, from research on grief, which will
lead to healthier and more productive lives.
In addition, as women religious in the United States continue to examine their
lifestyle and adapt to changes in society, it is important to study differences in the grief
process of this distinct population due to their belief system and the nature of their
environment. It may be interesting to further explore the relative contribution of
spirituality and particular components of lifestyle on grief resolution in this specific
group of women. Research findings may help women religious better understand
bereavement, identity variables that create supportive local communities and clarify the
role of spirituality in the grief process.

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bereavement research: Consequences, coping, and care (pp. 145-167).
Washington, DC: American Psychological Association.
Schneider, S. M. (2000). Finding the treasure (Vol. 1). New York: Paulist Press.
Schneider, S. M. (2001). Selling all (Vol. 2). New York: Paulist Press.
Solari-Twadell, P. A., Bunkers, S. S., Wang, C., & Snyder, D. (1995). The pinwheel
model of bereavement. Image-The Journal of Nursing Scholarship, 27(4), 323-
326.
Stroebe, M. S., Hansson, R. O., Stroebe, W., & Schut, H. (Eds.). (2001). Handbook of
bereavement: Consequences, coping, and care. Washington, DC: American
Psychological Association.
Stroebe, W., & Stroebe, M. (1996). The role of loneliness and social support in
adjustment to loss: A test of attachment versus stress theory. Journal of
Personality and Social Psychology, 70(6), 1241-1249.
Stroebe, M. S., Stroebe, W., & Hansson, R. O. (Eds.). (1993). Handbook of bereavement.
Theory, research, and intervention. New York: Cambridge University Press.

Grief in Women Religious 58
Thompson, L. W., Gallagher-Thompson, D., Futterman, A. G., Gilewski, M. S., &
Peterson, J. (1991). The effects of late-life spousal bereavement over a 30-month
interval. Psychology and Aging, 6(3), 434-441.
Ulmer, A., Range, L. M., & Smith, P. C. (1991). Purpose in life: A moderator of recovery
from bereavement. Omega, 23(4), 279-289.
Vachon, M. L. S., Rogers, J., Lyall, A., Lancee, W. J., Sheldon, A. R, & Freeman, S. J.
(1982). Predictors and correlates of adaptation to conjugal bereavement
American Journal of Psychiatry, 139(8), 998-1002.
Vachon, M. L. S., & Sylianos, V. S. (1988). The role of social support in bereavement.
Journal of Social Issues, 44(3), 175-190.
Walsh, K., King, M., Jones, L., Tookman, A., & Blizard, R. (2002). Spiritual beliefs may
affect outcome of bereavement: Prospective study. British Medical Journal,
324(7353), 1551-1555.
Webner, M L. (1999). Wilderness: A journey through grief. Spiritual Life, Sum, 110-
117.
Zautra, A. J., Finch, J. F., & Reich, J. W. (1991). Predicting the everyday life events of
older adults. Journal of Personality, 59(3), 507-508.

APPENDIX A
Human Subject Review Letter of Consent for Study
Grief in Women Religious 59

Grief in Women Religious 60
LOYOLA COLLEGE IN MARYLAND
Office of Grant Services, 4501 North Charles Street, Baltimore, Maryland 21210
REVIEW OF PROTOCOL FOR RESEARCH INVOLVING HUMAN SUBJECTS
Log Number: 1842 Date Received: 5/3/2004
Principal Investigator: Donna Kelley Home Phone: 410 337-1462
7601 Osler Drive Campus Phone:
Towson, MD 21286
Co-Investigators:
Proposal Title: The Impact of Social Support, Spirituality and Extroversion on Grief Symptoms
in Women Religious
Faculty Sponsor: David Powers Faculty Phone: 2093
Primary Reviewer: Nancy Dufau Project Period: 5/1/2004 to 1/17/2006
Secondary Reviewer: Requires Renewal Yes, if checked
Project Submitted as: Exempt: Yes Under Category: 3 Expedited: No
Primary and Secondary Reviewers:
Please sign and return to the Office of Grant Services, Humanities Center, Room 165.
RECOMMENDATION:
This proposal or amendment is approved as is.
Additional information is required in order to evaluate this
application/amendment. See comments below.
This proposal is not exempt, it qualifies for approval under the expedited review
process. Applicant should revise and resubmit the protocol in accord with the
attached evaluation or should request a full committee review.
COMMENTS:________________________________________________________________
________________________________________________________________
________________________________________________________________
Decision to PI:
Hard Copy to PI:
Clarification Requested:
Clarification Rec'd:
Amendment Rec'd:
Amendment Decision:
Notes: You may wish to change the
wording in the cover letter to state
"your participation is voluntary",
In the last line of the second
paragraph.
THE COLLEGE'S GENERAL
REQUIREMENTS FOR THE PROTECTION
OF HUMAN SUBJECTS APPLY TO ALL
RESEARCH, WHETHER OR NOT IT HAS
BEEN DECLARED EXEMPT.

APPENDIX B
Texas Revised Inventory of Grief
Grief in Women Religious 61

Inventory Items:
TRIG
Grief in Women Religious 62
If more than one person has died, please complete a separate form for each person.
The person who died was my (check only one):
Father______ Friend______
Mother______ Other (Specify)__________
Brother______
Sister______
Looking back, I would guess that my relationship with this person was
(check only one):
_____ Closer than any relationship I've ever had before or since.
_____ Closer than most relationships I've had with other people.
_____About as close as most of my relationships with others.
_____ Not as close as most of my relationships.
_____ Not very close at all.
How old was the person when they died? __________
This person died (check only one):
_____ within the past one 1 month
_____ within the past 2 months
_____ within the past 3 months
_____ within the past 4-7 months
The person's death was
_____ Expected _____ Unexpected _____ Slow _____ Sudden
ID#_______________

PART I: PAST BEHAVIOR
Grief in Women Religious 63
Think back to the time this person died and answer all of these items about your feelings
and actions at that time by checking whether each item is Completely True, Mostly True,
Both True and False, Mostly False, or Completely False as it applied to you after this
person died. Check the best answer.
1. After this person died I found it hard to get along with certain people.
____Completely True ____Mostly True ____Both True and False
____Mostly False ____Completely False
2. I found it hard to work well after this person died.
____Completely True ____Mostly True ____Both True and False
____Mostly False ____Completely False
3. After this person's death I lost interest in my family, friends, and outside activities.
____Completely True ____Mostly True ____Both True and False
____Mostly False ____Completely False
4. I felt a need to do things that the deceased had wanted to do.
____Completely True ____Mostly True ____Both True and False
____Mostly False ____Completely False
5. I was unusually irritable after this person died.
____Completely True ____Mostly True ____Both True and False
____Mostly False ____Completely False
6. I couldn’t keep up with my normal activities for the first 3 months after this person
died.
____Completely True ____Mostly True ____Both True and False
____Mostly False ____Completely False
7. I was angry that the person who died left me.
____Completely True ____Mostly True ____Both True and False
____Mostly False ____Completely False
8. I found it hard to sleep after this person died.
____Completely True ____Mostly True ____Both True and False
____Mostly False ____Completely False

PART II: PRESENT EMOTIONAL FEELINGS
Grief in Women Religious 64
Now answer all of the following items by checking how you presently feel about this
person's death. Do not look back at Part I.
1. I still cry when I think of the person who died.
____Completely True ____Mostly True ____Both True and False
____Mostly False ____Completely False
2. I still get upset when I think about the person who died.
____Completely True ____Mostly True ____Both True and False
____Mostly False ____Completely False
3. I cannot accept this person's death.
____Completely True ____Mostly True ____Both True and False
____Mostly False ____Completely False
4. Sometimes I very much miss the person who died.
____Completely True ____Mostly True ____Both True and False
____Mostly False ____Completely False
5. Even now it's painful to recall memories of the person who died.
____Completely True ____Mostly True ____Both True and False
____Mostly False ____Completely False
6. I am preoccupied with thoughts (often think) about the person who died.
____Completely True ____Mostly True ____Both True and False
____Mostly False ____Completely False
7. I hide my tears when I think about the person who died.
____Completely True ____Mostly True ____Both True and False
____Mostly False ____Completely False
8. No one will ever take the place in my life of the person who died
____Completely True ____Mostly True ____Both True and False
____Mostly False ____Completely False
9. I can't avoid thinking about the person who died
____Completely True ____Mostly True ____Both True and False
____Mostly False ____Completely False
10. I feel it's unfair that this person died.
____Completely True ____Mostly True ____Both True and False
____Mostly False ____Completely False

Grief in Women Religious 65
11. Things and people around me still remind me of the person who died.
____Completely True ____Mostly True ____Both True and False
____Mostly False ____Completely False
12. I am unable to accept the death of the person who died.
____Completely True ____Mostly True ____Both True and False
____Mostly False ____Completely False
13 . At times I still feel the need to cry for the person who died.
____Completely True ____Mostly True ____Both True and False
____Mostly False ____Completely False
PART III: RELATED FACTS
Please answer the following items by circling either True or False.
1.
2.
3.
4.
5.
I attended the funeral of the person who died.
I feel that I have really grieved for the person who died.
I feel that I am now functioning about as well as I was
before the death.
I seem to get upset each month at about the same time as the
person died.
Sometimes I feel that I have the same illness as the person
who died.
True
True
True
True
True
Thank you for answering all of these questions. We are also very interested in
False
False
False
False
False
your special thoughts and comments. Please use the rest of this side to tell us about
any thoughts and feelings that you have.

APPENDIX C
Social Support Questionnaire
Grief in Women Religious 66

INSTRUCTIONS:
SSQ
Grief in Women Religious 67
The following questions ask about people in your environment who provide you with
help or support. Each question has two parts. For the first part, list all the people you
know, excluding yourself, who you can count on for help or support in the manner
described. Give the person's initials and their relationship to you (see example). Do
not list more than one person next to each of the numbers beneath the question.
For the second part, circle how satisfied you are with the overall support you have.
If you have no support for a question, check the words "No one," but still rate your level
of satisfaction. Do not list more than nine persons per question.
Please answer all questions as best you can. All your responses will be kept confidential.
EXAMPLE:
Who do you know whom you can trust with information that could get you in trouble?
No one
1) T.N. (brother)
2) T.M. (friend)
3) R.S. (friend)
How satisfied?
6 - very 5 - fairly
satisfied satisfied
4 - a little
satisfied
4) T.N. (father)
5) L.M. (employer)
6) B.D. (community member)
3 - a little
dissatisfied
7)
8)
9)
2 - fairly
dissatisfied
1. Whom can you really count on to listen to you when you need to talk?
No one 1)
2)
3)
4)
5)
6)
7)
8)
9)
1 - very
dissatisfied
ID#_______
How satisfied?
6 - very 5 - fairly 4 - a little 3 - a little 2 - fairly 1 - very
satisfied satisfied satisfied dissatisfied dissatisfied dissatisfied
2. Whom could you really count on to help you if a person whom you thought was a good friend
insulted you and told you that he/she didn't want to see you again?
No one 1)
4)
7)
2)
3)
How satisfied?
5)
6)
8)
9)
6 - very
satisfied
5 - fairly
satisfied
4 – a little
satisfied
3 - a little
dissatisfied
2 - fairly
dissatisfied
1 - very
dissatisfied

3. Whose lives do you feel that you are an important part of?
No one 1)
2)
3)
How satisfied?
4)
5)
6)
7)
8)
9)
6 - very
satisfied
5 - fairly
satisfied
4 - a little
satisfied
3 - a little
dissatisfied
2 - fairly
dissatisfied
Grief in Women Religious 68
1 - very
dissatisfied
4. Whom do you feel would help you if you were married and had just separated from your
spouse?
No one 1)
2)
3)
How satisfied?
6 - very
satisfied
5 - fairly
satisfied
4)
5)
6)
4 - a little
satisfied
3- a little
dissatisfied
7)
8)
9)
2 - fairly
dissatisfied
1 - very
dissatisfied
5. Whom could you really count on to help you out in a crisis situation, even though they would
have to go out of their way to do so?
No one 1) 4) 7)
2) 5) 8)
3) 6) 9)
How satisfied?
6 - very
satisfied
5 - fairly
satisfied
4 - a little
satisfied
3 - a little
dissatisfied
2 - fairly
dissatisfied
1 - very
dissatisfied
6. Whom can you talk with frankly, without having to watch what you say?
No one 1) 4) 7)
2) 5) 8)
3)
How satisfied?
6) 9)
6 - very 5 - fairly 4 - a little 3 - a little 2 - fairly 1 - very
satisfied satisfied satisfied dissatisfied dissatisfied dissatisfied
7. Who helps you feel that you truly have something positive to contribute to others?
No one 1)
2)
3)
4)
5)
6)
7)
8)
9)
How satisfied?
6 - very
satisfied
5 - fairly
satisfied
4 - a little
satisfied
3 - a little
dissatisfied
2 - fairly
dissatisfied
1 - very
dissatisfied

Grief in Women Religious 69
8. Whom can you really count on to distract you from your worries when you feel under stress?
No one
How satisfied?
6 - very
satisfied
l)
2)
3)
5 - fairly
satisfied
4)
5)
6)
4 - a little
satisfied
3 - a little
dissatisfied
7)
8)
9)
2 - fairly
dissatisfied
1 - very
dissatisfied
9. Whom can you really count on to be dependable when you need help?
No one 1)
2)
3)
How satisfied?
4)
5)
6)
7)
8)
9)
6 - very 5 - fairly 4 - a little 3 - a little 2 - fairly 1 - very
satisfied satisfied satisfied dissatisfied dissatisfied dissatisfied
10. Whom could you really count on to help you out if you had just been fired from your job or
expelled from school?
No one 1) 4)
7)
2) 5)
8)
3) 6)
9)
How satisfied?
6 - very
satisfied
5 - fairly
satisfied
4 - a little
satisfied
3 - a little
dissatisfied
11. With whom can you totally be yourself?
No one 1) 4)
2) 5)
3)
How satisfied?
6)
6 - very 5 - fairly 4 - a little 3 - a little
satisfied satisfied satisfied dissatisfied
12. Whom do you feel really appreciates you as a person?
No one 1) 4)
2)
3)
5)
6)
How satisfied?
6 - very
satisfied
5 - fairly
satisfied
4 - a little
satisfied
3 - a little
dissatisfied
2 - fairly
dissatisfied
7)
8)
9)
2 - fairly
dissatisfied
7)
8)
9)
2 - fairly
dissatisfied
1 - very
dissatisfied
1 - very
dissatisfied
1 - very
dissatisfied

Grief in Women Religious 70
13. Whom can you really count on to give you useful suggestions that help you to avoid making
mistakes?
No one 1)
2)
3)
How satisfied?
6 - very 5 - fairly
satisfied satisfied
4)
5)
6)
4 - a little
satisfied
3 - a little
dissatisfied
7)
8)
9)
2 - fairly
dissatisfied
1 - very
dissatisfied
14. Whom can you count on to listen openly and uncritically to your innermost feelings?
No one 1)
4)
7)
2)
5)
8)
3)
6)
9)
How satisfied?
6 - very 5 - fairly
satisfied satisfied
4 - a little
satisfied
3 - a little
dissatisfied
2 - fairly
dissatisfied
15. Who will comfort you when you need it by holding you in their arms?
No one 1)
4)
7)
2)
5)
8)
3)
How satisfied?
6)
9)
6 - very
satisfied
5 - fairly
satisfied
4 - a little
satisfied
3 - a little
dissatisfied
2 - fairly
dissatisfied
1 - very
dissatisfied
1 - very
dissatisfied
16. Whom do you feel would help if a good friend of yours had been in a car accident and was
hospitalized in serious condition?
No one 1)
4)
7)
2)
5)
8)
3)
How satisfied?
6)
9)
6 - very
satisfied
5 - fairly
satisfied
4 - a little
satisfied
3 - a little
dissatisfied
2 - fairly
dissatisfied
1 - very
dissatisfied
17. Whom can you really count on to help you feel more relaxed when you are under pressure or
tense?
No one 1)
2)
3)
How satisfied?
4)
5)
6)
7)
8)
9)
6 - very
satisfied
5 - fairly
satisfied
4 - a little
satisfied
3 - a little
dissatisfied
2 - fairly
dissatisfied
1 - very
dissatisfied

Grief in Women Religious 71
18. Whom do you feel would help if a family member very close to you died?
No one 1)
2)
3)
How satisfied?
4)
5)
6)
7)
8)
9)
6 - very
satisfied
5 - fairly
satisfied
4 - a little
satisfied
3 - a little
dissatisfied
2 - fairly
dissatisfied
19. Who accepts you totally, including both your worst and your best points?
No one 1) 4)
7)
2) 5)
8)
3) 6)
9)
How satisfied?
6 - very
satisfied
5 - fairly
satisfied
4 - a little
satisfied
3-a little
dissatisfied
2 - fairly
dissatisfied
1 - very
dissatisfied
1 - very
dissatisfied
20. Whom can you really count on to care about you, regardless of what is happening to you?
No one
How satisfied?
6 - very
satisfied
1)
2)
3)
5 - fairly
satisfied
4)
5)
6)
4 - a little
satisfied
3 - a little
dissatisfied
7)
8)
9)
2 - fairly
dissatisfied
1 - very
dissatisfied
21. Whom can you really count on to listen to you when you are very angry at someone else?
No one
How satisfied?
6 - very
satisfied
1)
2)
3)
5 - fairly
satisfied
4)
5)
6)
4 - a little
satisfied
3 - a little
dissatisfied
7)
8)
9)
2 - fairly
dissatisfied
1- very
dissatisfied
22. Whom can you really count on to tell you, in a thoughtful manner, when you need to improve
in some way?
No one
How satisfied?
6 - very
satisfied
1)
2)
3)
5 - fairly
satisfied
4)
5)
6)
4 - a little
satisfied
3 - a little
dissatisfied
7)
8)
9)
2 - fairly
dissatisfied
1 - very
dissatisfied

Grief in Women Religious 72
23. Whom can you really count on to help you feel better when you are feeling generally down-
in-the-dumps?
No one
How satisfied?
6 - very
satisfied
1)
2)
3)
5 - fairly
satisfied
4)
5)
6)
4 - a little
satisfied
3 - a little
dissatisfied
24. Whom do you feel truly loves you deeply?
No one 1) 4)
2) 5)
3) 6)
How satisfied?
6 - very
satisfied
5 - fairly
satisfied
4 - a little
satisfied
3 - a little
dissatisfied
7)
8)
9)
2 - fairly
dissatisfied
7)
8)
9)
2 - fairly
dissatisfied
25. Whom can you count on to console you when you are very upset?
No one 1) 4)
7)
2) 5)
8)
3) 6)
9)
How satisfied?
6 - very 5 - fairly
satisfied satisfied
4 - a little
satisfied
3 - a little
dissatisfied
2 - fairly
dissatisfied
1 - very
dissatisfied
1 - very
dissatisfied
1 - very
dissatisfied
26. Whom can you really count on to support you in major decisions you make?
No one 1) 4)
7)
2) 5)
8)
3) 6)
9)
How satisfied?
6 - very 5 - fairly
satisfied satisfied
4 - a little
satisfied
3 - a little
dissatisfied
2 - fairly
dissatisfied
1 - very
dissatisfied
27. Whom can you really count on to help you feel better when you are very irritable, ready to
get angry at almost anything?
No one 1) 4)
7)
2) 5)
8)
3) 6)
9)
How satisfied?
6 - very
satisfied
5 - fairly
satisfied
4 - a little
satisfied
3 - a little
dissatisfied
2 - fairly
dissatisfied
1 - very
dissatisfied

APPENDIX D
NEO-E
Grief in Women Religious 73

NEO-E
Grief in Women Religious 74
ID#_______
Please read each item carefully and circle the one answer that best corresponds to your
agreement or disagreement.
Circle "SD" if the statement is definitely false or if you strongly disagree.
Circle "D" if the statement is definitely false or if you disagree.
Circle "N" if the statement is about equally true or false, if you cannot decide, or if you
are neutral on the statement
Circle "A" if the statement is mostly true or if you agree.
Circle "SA" if the statement is definitely true or if you strongly agree.
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
I really like most people I meet.
I shy away from crowds of people.
I am dominant, forceful, and
assertive.
I have a leisurely style in work and
play.
I often crave excitement
I have never literally jumped for joy.
I don't get much pleasure from
chatting with people.
I like to have a lot of people around
me.
I sometimes fail to assert myself as
much as I should.
When I do things, I do them
vigorously.
SD
SD
SD
SD
SD
SD
SD
SD
SD
SD
D
D
D
D
D
D
D
D
D
D
N
N
N
N
N
N
N
N
N
N
A
A
A
A
A
A
A
A
A
A
SA
SA
SA
SA
SA
SA
SA
SA
SA
SA

11. I wouldn't enjoy vacationing in Las
Vegas.
12. I have sometimes experienced
intense joy or ecstasy.
13. I'm known as a warm and friendly
person.
14. I usually prefer to do things alone.
15. I have often been a leader of groups I
have belonged to.
16. My work is likely to be slow but
steady.
17. I have sometimes done things just for
"kicks" or "thrills."
18. I am not a cheerful optimist
19. Many people think of me as
somewhat cold and distant
20. I really feel the need for other people
if I am by myself for long.
21. In meetings, I usually let others do
the talking.
22. I often feel as if I am bursting with
energy.
23. I tend to avoid movies that are
shocking or scary.
24. Sometimes I bubble with happiness.
25. I really enjoy talking to people.
26. I prefer jobs that let me work alone
without being bothered by other
people.
SD
SD
SD
SD
SD
SD
SD
SD
SD
SD
SD
SD
SD
D
D
D
D
D
D
D
D
D
D
D
D
D
Grief in Women Religious 75
N
N
N
N
N
N
N
N
N
N
N
N
N
A
A
A
A
A
A
A
A
A
A
A
A
A
SA
SA
SA
SA
SA
SA
SA
SA
SA
SA
SA
SA
SA
SD D N A SA
SD D N A SA
SD
D
N
A
SA

27. Other people often look to me to
make decisions.
28. I am not as quick and lively as other
people.
29. I like to be where the action is.
30. I don't consider myself especially
"light-hearted."
31. I find it easy to smile and be
outgoing with strangers.
32. I'd rather vacation at a popular beach
than an isolated cabin in the woods.
33. I would rather go my own way than
be a leader of others.
34. I usually seem to be in a hurry.
35. I love the excitement of roller
coasters.
36. I am a cheerful, high-spirited person.
37. I have strong emotional attachments
to my friends.
38. Social gatherings are usually boring
to me.
39. In conversations, I tend to do most
of the talking.
40. My life is fast-paced.
41. I'm attracted to bright colors and
flashy styles.
42. I rarely use words like "fantastic!" or
"sensational!" to describe my
experiences.
SD
SD
SD
SD
SD
SD
SD
SD
SD
SD
SD
SD
SD
SD
SD
SD
Grief in Women Religious 76
D
D
D
D
D
D
D
D
D
D
D
D
D
D
D
D
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
A
A
A
A
A
A
A
A
A
A
A
A
A
A
A
A
SA
SA
SA
SA
SA
SA
SA
SA
SA
SA
SA
SA
SA
SA
SA
SA

43. I take a personal interest in the
people I work with.
44. I enjoy parties with lots of people.
45. I don't find it easy to take charge of
a situation.
46. I am a very active person.
47. I like being part of the crowd at
sporting events.
48. I laugh easily.
SD
D
Grief in Women Religious 77
N
A
SA
SD D N A SA
SD
D
N
A
SA
SD D N A SA
SD
SD
D
D
N
N
A
A
SA
SA

APPENDIX E
Spiritual Well-Being Scale
Grief in Women Religious 78

SWB Scale
Grief in Women Religious 79
For each of the following statements circle the choice that best indicates the extent of your agreement or
disagreement as it describes your personal experience.
SA = Strongly Agree
MA = Mostly Agree
A =Agree
D= Disagree
MD = Moderately Disagree
SD = Strongly Disagree
1. I don't find much satisfaction in private prayer with God. SA MA A D MD SD
2. I don't know who I am, where I came from,
or where I am going.
SA MA A D MD SD
3. I believe that God loves me and cares about me.
4. I feel that life is a positive experience.
5. I believe that God is impersonal and not interested in
my daily situations.
6. I feel unsettled about my future.
7. I have a personally meaningful relationship with God.
8. I feel very fulfilled and satisfied with life.
9. I don't get much personal strength and support
from my God.
10. I feel a sense of well-being about the direction
my life is headed in.
11. I believe that God is concerned about my problems.
12. I don't enjoy much life.
13. I don't have a personally satisfying relationship with God. SA MA A D MD SD
14. I feel good about my future.
15. My relationship with God helps me not to feel lonely.
16. I feel that life is full of conflict and unhappiness.
SA
SA
SA
SA
SA
SA
SA
SA
SA
MA
MA
MA
MA
MA
MA
MA
MA
MA
A
A
A
A
A
A
A
A
A
D
D
D
D
D
D
D
D
D
MD
MD
MD
MD
MD
MD
MD
MD
MD
SA MA A D MD
17. I feel most fulfilled when I'm in close communion with God. SA MA A D MD SD
18. Life doesn't have much meaning.
19. My relation with God contributes to my sense of well-being.
SA
SA
SA
MA
MA
MA
A
A
A
D
D
D
MD
MD
MD
SA MA A D MD
20. I believe there is some real purpose for my life. SA MA A D MD SD
SWB Scale Copyright c 1982 by Craig W. Ellison and Raymond F. Paloutzian. All rights reserved. Not to be
duplicated unless express written permission is granted by the authors or by Life Advance, inc., 81 Front ST., Nyack,
NY 10960.
SD
SD
SD
SD
SD
SD
SD
SD
SD
SD
SD
SD
SD
SD

APPENDIX F
Spiritual Well-Being Scale - Modified
Grief in Women Religious 80

Grief in Women Religious 81
SWB Scale
For each of the following statements use the scale below to indicate the extent of
your agreement or disagreement as it describes your personal experience. Use the
best fitting number from 0 to 100.
1. I don't find much satisfaction in private prayer with God. ____
2. I don't know who I am, where I came from, or where I am going.
____
3. I believe that God loves me and cares about me. ____
4. I feel that life is a positive experience.
____
5. I believe that God is impersonal and not interested in my daily
situations.
____
6. I feel unsettled about my future. ____
7. I have a personally meaningful relationship with God.
____
8. I feel very fulfilled and satisfied with life. ____
9. I don't get much personal strength and support from my God. ____
10. I feel a sense of well-being about the direction my life is headed in.
11. I believe that God is concerned about my problems.
____
____
12. I don't enjoy much life. ____
13. I don't have a personally satisfying relationship with God.
____
14. I feel good about my future. ____
15. My relationship with god helps me not to feel lonely.
____
16. I feel that life is full of conflict and unhappiness. ____
17. I feel most fulfilled when I'm in close communion with God.
____
18. Life doesn't have much meaning. ____
19. My relation with God contributes to my sense of well-being. ____
20. I believe there is some real purpose for my life. ____

APPENDIX G
Cover Letter
Grief in Women Religious 82

Dear Sister,
Cover Letter
Grief in Women Religious 83
I am a member of the Sisters, Servants of the Immaculate Heart of Mary in
Immaculata, Pennsylvania and I am currently pursuing studies in the Doctor of
Psychology program at Loyola College in Maryland. For my dissertation project, I am
researching grief among women religious who have lost a loved one through death.
Although grief studies have been reported in numerous areas, few have concentrated on
the loss experienced by women religious. I am asking your help in this project that is
designed to make a contribution toward understanding the spiritual and psychological
well-being of women religious as they journey through grief. Please know that you play
a significant part in this study.
Enclosed you will find a packet of questionnaires. I am asking you to please take
time (about one hour) to respond to these inventories by recording your answers on the
lines provided on the inventories. Please answer the questions with the response that best
reflects your experience. There may be some questions that will not apply to you. When
you have completed the four inventories please mail them to me in the enclosed self-
addressed envelope. Your answers will be completely confidential as indicated in the
consent form. Your responses will not be shown or given to anyone else, only I will see
them and your name will not be on them. Also, the overall results will be reported as
group data rather than individually. Your participation is voluntary and you may
withdraw at any time for any reason.
Since the grief process continues over time, there will be a three month follow-up
study to assess your grief symptoms. At that time you will be contacted by mail and
asked for your willingness to complete a similar but briefer follow-up packet. On the
enclosed form, please include a mailing address for where you may be contacted three
months from now. Sister, thank you for generously giving your time to this project.
Please return these inventories within two weeks of your receiving them. I am
counting on each person's full response for a representative sample of grieving women
religious. If you have a question at any time during this study, please feel tree to contact
me at dmkelley@loyola.edu or call me at 410-337-1462. You may also contact my
dissertation chair, Dr. David Powers, at dpowers@loyola.edu or by phone at 410-617-
2093.
Thank you for your willingness to take part in this study. Please know that I am
grateful for your interest, help and participation.
Sincerely,
Sister Donna Kelley, IHM

APPENDIX H
Demographic Questionnaire
Grief in Women Religious 84

Background Information
Grief in Women Religious 85
Please respond to each item by writing your answer on the line provided.
1. Age:________
2. Years professed:_________
3. Years in religious life since entrance:__________
4. Title of Congregation:___________________________________________________
5. Classify your community according to lifestyle:
_______Active Religious Life _______Contemplative Religious Life
6. Current ministry (If retired, please note):___________________________________
7. Highest level of education:______________________
8. Primary language:_______________________
9. How many people close to you have died in the past three months?___________
10. How do you describe yourself?
Caucasian __ Black/African American ___ Hispanic ___
Native American___ Other (Please note):______________________

APPENDIX I
Consent Form
Grief in Women Religious 86

Information and Consent Form
Grief in Women Religious 87
This research project examines different aspects of grief. These surveys should take
about one hour of your time at most, and all your responses are confidential. Your
responses will not be shown or given to anyone else, only the person who is given these
surveys to you will see them and your name will not be on them. Overall results will be
reported as group data, rather than individually.
Your participation is completely voluntary, and if you feel uncomfortable you may
discontinue at any time for any reason.
If you are interested in hearing about the results of the study, write your name and phone
number on a separate piece of paper (NOT on the survey) and the researcher will get in
touch with you when the study is completed. This is the beginning of a study that will
continue for several years, so there may be some delay in responding until all results are
completed. If you have any questions feel free to contact Donna Kelley, IHM at
dmkelley@loyola.edu or 410-337-1462 or David Powers, Ph.D. at dpowers@loyola.edu
or 410-617-2093.
Thank you very much for your consideration. If you are interested in participating,
please sign the following statement
I have read the information provided and agree to participate in the survey. I
understand that my participation is voluntary and that I may stop participating at
anytime.
________________________________________
Participant Date
________________________________________
Researcher Date

APPENDIX J
Contact Information for Follow-Up Study
Grief in Women Religious 88

Contact Information for Three Month Follow-up Study
Grief in Women Religious 89
Please complete the following information by projecting where you may be
contacted in three (3) months. Please print your answers on the lines provided.
Name:_________________________________________
Convent (Where you will be living in 3 months):
________________________________________________
Address (Where you will be living in 3 months):
_________________________________________________
_________________________________________________

APPENDIX K
Thank you Letter Time 1
Grief in Women Religious 90

September 2004
Dear Sister,
Grief in Women Religious 91
Thank you very much for completing the surveys and returning them to me. Each of
your responses is noteworthy and of value for this grief study. Your help and willingness
to participate in this process are deeply appreciated. I am most grateful to you for
generously giving of your time.
I am delighted with the favorable and affirming responses received from sisters across the
eastern and western regions of the United States. These responses support my belief that
grief research in women religious is necessary. I am encouraged by you to continue my
work on this project. Please know that you play a significant part in the success of this
study.
As mentioned in my first communication with you, there will be a follow-up study.
Shortly, I will be mailing this second packet of surveys, which will be smaller than the
first. I realize that your time is precious and again I express my gratitude.
Please know that you continue to be remembered in prayer during this time of loss.
Sincerely,
Sister Donna Kelley, IHM

APPENDIX L
Thank you Letter Time 2
Grief in Women Religious 92

March 2005
Dear Sister,
Grief in Women Religious 93
Thank you very much for your participation in the grief study. Your help and willingness
to share in this process are deeply appreciated. I am most grateful to you for generously
giving of your time.
I am encouraged by the favorable and affirming responses received from sisters across
the United States. Without the generosity of women like you, my data collection would
not have been possible. You have played a significant part in the success of this study.
Once again I express my gratitude for your help with this research. If you have requested
the results of the study, they will be sent to you within the next several months after the
project is fully completed. Thank you for your patience.
There is enclosed an article on grief that the Hospice of Baltimore publishes which you
may find insightful. Please know of my prayers as you continue to journey through this
grief process.
Gratefully,
Sister Donna Kelley, IHM