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<strong>The</strong> <strong>dissertation</strong> <strong>of</strong> _____________Donna <strong>Kelley</strong>, <strong>IHM</strong>, M.S._________________ <strong>entitled</strong><br />
_______________<strong>The</strong> Impact <strong>of</strong> Social Support, Spirituality and Extraversion___________<br />
______________________on Grief Symptoms in Women Religious:___________________<br />
____________________________A Longitudinal Examination_______________________<br />
submitted to the Department <strong>of</strong> Psychology in partial fulfillment <strong>of</strong> the requirements<br />
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been read and approved by the Committee:
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Running head: GRIEF SYMPTO<strong>MS</strong> IN WOMEN RELIGIOUS<br />
Grief in Women Religious<br />
<strong>The</strong> Impact <strong>of</strong> Social Support, Spirituality and Extraversion<br />
on Grief Symptoms in Women Religious:<br />
A Longitudinal Examination<br />
A Dissertation Presented to the Faculty <strong>of</strong> the<br />
Graduate School <strong>of</strong> Loyola College in Partial Fulfillment <strong>of</strong> the<br />
Requirements for the Degree <strong>of</strong><br />
Doctor <strong>of</strong> Psychology<br />
by<br />
Donna <strong>Kelley</strong>, <strong>IHM</strong>, M.S.<br />
2006
ABSTRACT<br />
Grief in Women Religious<br />
Research indicates that the bereavement process can be influenced by social<br />
support, spirituality and personality factors (Sanders, 1999). <strong>The</strong> purpose <strong>of</strong> this study<br />
was to assess the impact that social support, spirituality and extraversion have on grief<br />
symptoms in Roman Catholic women religious. <strong>The</strong> participants in the present study<br />
totaled 82 active and contemplative women religious who had experienced the death <strong>of</strong> a<br />
family member or friend within seven months <strong>of</strong> the initial data collection. In addition,<br />
48 <strong>of</strong> the participants belonged to five active congregations and 34 <strong>of</strong> the participants<br />
belonged to 17 contemplative monasteries. <strong>The</strong> study was passive observational and<br />
longitudinal, with two times <strong>of</strong> measurement that were three months apart. <strong>The</strong> variables<br />
examined were type <strong>of</strong> religious life (active/contemplative), grief symptoms, social<br />
support, spirituality, and extraversion.<br />
Results indicate no significant association between social support and grief<br />
symptoms over time. Further results show that for women religious overall spirituality<br />
was not a significant predictor <strong>of</strong> grief over time.<br />
Multiple regressions were conducted separately for the two groups<br />
(active/contemplative). Results indicate that spirituality was a significant predictor <strong>of</strong><br />
time 2 residualized grief for the active group only. Moreover, for both groups, neither<br />
time 1 social support nor the interaction between spirituality and social support were<br />
predictive <strong>of</strong> grief over time. Additionally, no significant interaction<br />
between religious lifestyle and extraversion was found.<br />
i
Grief in Women Religious<br />
Multiple regression analyses found a significant main effect for religious<br />
lifestyles. Specifically, active women religious reported higher grief scores than did<br />
contemplatives. Post hoc analyses indicate significant differences in closeness to the<br />
deceased among the two groups.<br />
This study suggests that spirituality for bereaved active women religious has more<br />
<strong>of</strong> an impact on grief than it does for bereaved contemplatives. Furthermore, active<br />
women religious appear closer to the deceased and experience more grief than do<br />
contemplatives. Nevertheless, closeness to the deceased affects grief symptoms more for<br />
the contemplative group man it does for the active group. Differences in the active and<br />
contemplative lifestyles appear to play a role in the grief process. <strong>The</strong>refore, future<br />
research is needed to address these factors.<br />
ii
COMMITTEE IN CHARGE OF CANDIDACY:<br />
David Powers, Ph.D., Chairperson<br />
Carolyn Barry, Ph.D.<br />
Deborah Haskins, Ph.D.<br />
iii<br />
Grief in Women Religious
DEDICATION<br />
Grief in Women Religious<br />
To Bettyann, my sister, and Reverend Thomas <strong>Kelley</strong>, OSFS, USN, my uncle, the<br />
faith and love you shared are among my most treasured blessings. Thank you for<br />
enriching my life with your goodness. You are missed!<br />
iv
ACKNOWLEDGEMENTS<br />
Grief in Women Religious<br />
<strong>The</strong> author would like to extend a special thank you to David Powers, Ph.D., my<br />
chairperson, for his help in completing this project. His continued support,<br />
encouragement, guidance and knowledge made this work possible and successful.<br />
Without his kindness and patience during the challenging times and his endless<br />
repetitions and explanations, this project would not have been completed. He has been a<br />
blessing during the past four years. It has been an honor to work with him and learn from<br />
him. In addition, the author would like to thank Carolyn Barry, Ph.D. for her interest,<br />
assistance and attention to detail throughout this study. She has been a gentle force and<br />
an invaluable consultant. <strong>The</strong> author would also like to express thanks to Deborah<br />
Haskins, Ph.D. for her support, encouragement, and assistance with this project. Her<br />
enthusiastic spirit and interest in this research was contagious and made working with her<br />
enjoyable.<br />
In addition, the author would like to thank the Sisters, Servants <strong>of</strong> the Immaculate<br />
Heart <strong>of</strong> Mary for their prayerful support and for making it possible to pursue this work.<br />
Furthermore, the author would like to thank her parents for their continued support,<br />
encouragement and belief in her. In a special way, the author would like to <strong>of</strong>fer thanks<br />
to her mother for her meticulous work in data entry. Her generous time commitment<br />
hastened a tedious process and made it memorable. Finally, the author would like to<br />
thank three special friends, Sisters Vicky, Barbara and Cindy for patiently traveling with<br />
her in pursuit <strong>of</strong> participants for this study. To each <strong>of</strong> you and the many others not<br />
mentioned by name, the author <strong>of</strong>fers prayers <strong>of</strong> gratitude.<br />
v
TABLE 1.<br />
TABLE 2.<br />
TABLE 3.<br />
TABLE 4.<br />
TABLE 5.<br />
TABLE 6.<br />
TABLE 7.<br />
TABLE 8.<br />
LIST OF TABLES<br />
Summary <strong>of</strong> Demographic Information for Participants<br />
Summary <strong>of</strong> Time Since Death and Relation to Deceased<br />
Summary <strong>of</strong> Descriptive Statistics for Variables <strong>of</strong> Interest<br />
Grief in Women Religious<br />
Intercorrelations between Time 1 and Time 2 Grief Symptoms and Time 1<br />
and Time 2 Social Support Satisfaction and Time 1 and Time 2<br />
Spirituality<br />
Stepwise Regression Analysis for Extraversion Variables predicting Grief<br />
Symptoms in Active and Contemplative Women Religious<br />
Summary <strong>of</strong> Descriptive Statistics for Lifestyle-Extraversion Interaction<br />
Page<br />
Stepwise Regression Analysis Among Active Women Religious for Variables<br />
Predicting Grief at Time 2<br />
Stepwise Regression Analysis Among Contemplative Women Religious for<br />
Variables Predicting Residualized Grief at Time 2<br />
vi<br />
19<br />
30<br />
32<br />
34<br />
35<br />
37<br />
38<br />
39
ABSTRACT<br />
TABLE OF CONTENTS<br />
COMMITTEE IN CHARGE OF CANDIDACY<br />
DEDICATION<br />
ACKNOWLEDGMENTS<br />
LIST OF TABLES<br />
CHAPTER I - Introduction<br />
Review <strong>of</strong> the Literature<br />
Overview <strong>of</strong> Grief<br />
Social Support and Grief<br />
Personality and Grief<br />
Spirituality<br />
Application to Women Religious<br />
History <strong>of</strong> Religious Life<br />
Women Religious and Personality<br />
Women Religious and Grief<br />
Statement <strong>of</strong> the Problem<br />
Statement <strong>of</strong> Hypotheses<br />
Grief in Women Religious<br />
CHAPTER II-Method 18<br />
Participants 18<br />
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2<br />
2<br />
3<br />
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8<br />
11<br />
11<br />
13<br />
14<br />
16<br />
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Grief in Women Religious<br />
Measures 18<br />
Procedures<br />
Texas Revised Inventory <strong>of</strong> Grief<br />
Social Support Questionnaire<br />
Revised NEO Personality Inventory - Extraversion Domain<br />
Spiritual Well-Being Scale<br />
Design and Analyses<br />
CHAPTER III-Results<br />
CHAPTER IV-Discussion<br />
Limitations<br />
Implications for Future Research<br />
REFERENCES<br />
APPENDIXES<br />
APPENDIX A. Human Subject Review Letter <strong>of</strong> Consent for Study<br />
APPENDIX B. Texas Revised Inventory <strong>of</strong> Grief<br />
APPENDIX C. Social Support Questionnaire<br />
APPENDIX D. Revised NEO Personality Inventory<br />
APPENDIX E. Spiritual Well-Being Scale<br />
APPENDIX F. Spiritual Well-Being Scale -Modified<br />
APPENDIX G. Cover Letter<br />
APPENDIX H. Demographic Questionnaire<br />
viii<br />
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APPENDIX I. Consent Form<br />
APPENDIX J. Contact Information<br />
APPENDIX K. Thank You Letter Time 1<br />
APPENDIX L. Thank You Letter Time 2<br />
ix<br />
Grief in Women Religious<br />
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CHAPTER 1<br />
Introduction<br />
Grief in Women Religious 1<br />
Research suggests that grief is a normal response to loss. Grief scholars have<br />
examined numerous populations; however, the present author has found no studies that<br />
concentrate on the loss experienced by Catholic women religious, individuals who<br />
pr<strong>of</strong>ess the vows <strong>of</strong> chastity, obedience and poverty. In the Roman Catholic Church there<br />
are two forms <strong>of</strong> religious life for women: contemplative and active. Contemplative<br />
women religious choose to live these vows in solitude and prayer within the confines <strong>of</strong><br />
their monasteries. In contrast, active women religious choose a lifestyle that is<br />
committed to an apostolic work within the church. It is important for psychologists to<br />
understand this particular vocation because religious life may result in distinct treatment<br />
needs. Little is known, however, <strong>of</strong> how the death <strong>of</strong> a loved one affects women living<br />
these exceptional lifestyles. <strong>The</strong>refore, research in this area is needed in order to identify<br />
variables that impact the grief process in this population.<br />
<strong>The</strong> literature indicates that a variety <strong>of</strong> intrapersonal and interpersonal factors are<br />
related to grief. Two intrapersonal areas <strong>of</strong> special concern for this study were<br />
spirituality and the personality factor <strong>of</strong> extraversion. An interpersonal factor that this<br />
study examined was social support. <strong>The</strong>se issues were additionally addressed<br />
longitudinally in the context <strong>of</strong> Catholic women living the active and contemplative<br />
religious lifestyles.
Overview <strong>of</strong> Grief<br />
Review <strong>of</strong> the Literature<br />
Grief in Women Religious 2<br />
Research shows that grief following the death <strong>of</strong> a loved one is a normal reaction<br />
and one which varies across individuals (Malkinson, 2001). Strobe, Hansson, Stroebe,<br />
and Schut (2001) define grief as an emotional reaction to the loss <strong>of</strong> a loved one through<br />
death. <strong>The</strong> outward expression <strong>of</strong> grief is considered mourning (Ringdal, Jordhoy,<br />
Ringdal, & Kaasa, 2001). Grief and mourning are the outcome <strong>of</strong> bereavement, the<br />
situation <strong>of</strong> an individual having lost a loved one by death (Ringdal et al., 2001).<br />
Although grief is a normal response to the loss <strong>of</strong> a loved one, the length <strong>of</strong> the<br />
process may not be the same for everyone (Herkert, 2000). Some researchers suggest<br />
that grief reactions intensify immediately following the loss and decrease over time<br />
(Malkinson, 2001). However, other research indicates that for the duration <strong>of</strong> the<br />
bereaved's life, feelings <strong>of</strong> grief commonly reoccur around significant dates associated<br />
with the deceased such as birthdays, holidays, or the anniversary <strong>of</strong> the death (Rosenblatt,<br />
1996). Walsh, King, Jones, Tookman, and Blizard (2002) found that bereaved people<br />
frequently reach a level <strong>of</strong> functioning that is close to typical for them between four to six<br />
months after the death. Ringdal et al. (2001) report a significant decline in grief<br />
symptoms from 1 month to 13 months after the death <strong>of</strong> a family member. In the first<br />
three months <strong>of</strong> the loss, there was a slight increase in grief reactions; however, it was not<br />
statistically significant. For these individuals, the major decrease in grief reactions<br />
occurred within three to sixth months after the loss.<br />
In contrast to these findings, Malkinson (2001) reports that normal grief work is<br />
not expected to be completed within a 12-month period. Results <strong>of</strong> a longitudinal study
Grief in Women Religious 3<br />
performed by Thompson, Gallagher-Thompson, Futterman, Gilewski, and Peterson<br />
(1991) also found that grief resolution may not be completed within the first year <strong>of</strong> the<br />
loss. This study found that grief can continue for 30 months after the death <strong>of</strong> a spouse.<br />
Furthermore, Parkes and Weiss (1983) suggest that depression may subside over the first<br />
12 months <strong>of</strong> bereavement, but distress surrounding loss issues continues for a number <strong>of</strong><br />
years.<br />
Several studies found that each loss is unique and that the bereaved lives the loss<br />
uniquely by getting in touch fully with their sorrow (Kenel, 1994; Solari-Twadell,<br />
Bunkers, Wang, & Snyder, 1995) and coping with their feelings (Cowan, 1983). DeVries<br />
(1997) reports that adjustment to the death <strong>of</strong> a loved one takes place on multiple levels.<br />
During this period <strong>of</strong> mourning, the bereaved person searches to find meaning in the<br />
death as well as a new self-meaning (Rosenblatt et al., 1991). Failure to admit the<br />
finality <strong>of</strong> the loss may leave the individual enveloped in depression and anger (Kenel,<br />
1994). <strong>The</strong> resolution <strong>of</strong> grief, however, can enhance an individual's personal richness<br />
and depth and lead to new inner strength (Solari-Twadell et al., 1995), which makes it<br />
possible for love and creativity to intensify (Laakso & Paunonen-Ilmonen, 2002).<br />
Research suggests that social support appears to have a positive effect on grief resolution<br />
and increases personal growth.<br />
Social Support and Grief<br />
Social support is a source <strong>of</strong> nurturance that can positively or negatively impact<br />
an individual's well-being (Laakso & Paunonen-Ilmonen, 2002). Through social support,<br />
individuals develop healthy coping strategies and come to view crises with new insight<br />
(Schaefer & Moos, 2001). By facilitating a clearer understanding <strong>of</strong> the stressful
Grief in Women Religious 4<br />
situation, social support reduces the effects <strong>of</strong> stress, supplies techniques to help make<br />
sense <strong>of</strong> a loss within the first several months <strong>of</strong> the death, and is a valuable way to cope<br />
with hardships (Krause, 1986; Nolen-Hoeksema & Larson, 1999).<br />
Social support functions as a coping resource that improves the individual's<br />
interpersonal support system and stimulates new interests, which may soothe the effects<br />
<strong>of</strong> the loss (Norris & Murrell, 1990; Sanders, 1999). Furthermore, social support serves<br />
as a diversion from depression, pushes the bereaved to face their grief (Rosenblatt, 1993),<br />
and can include emotional support and/or material support (Laakso & Paunonen-<br />
Ilmonen, 2002; Nolen-Hoeksema & Larson, 1999; Vachon & Stylianos, 1988).<br />
Emotional support involves family, friends and colleagues who provide the<br />
bereaved person with the space and opportunity to talk about their loss (Nolen-Hoeksema<br />
& Larson, 1999). <strong>The</strong>se individuals also supply emotional support through listening,<br />
touch, and expressions <strong>of</strong> sympathy and love (Kaunonen, Tarkka, Hautamaki, &<br />
Paunonen, 2000; Ringler & Hayden, 2000). This may be <strong>of</strong>fered through phone calls,<br />
cards, prayer or other visible manifestations <strong>of</strong> interest and concern (Webner, 1999).<br />
Moreover, the bereaved may find support from association with individuals who have<br />
experienced the same type <strong>of</strong> loss (Lehman et al, 1986; Rosenblatt, 1993). Herth (1990)<br />
found that the frequency <strong>of</strong> visits by family and friends were related positively to the<br />
level <strong>of</strong> grief resolution and level <strong>of</strong> hope in 75 bereaved spouses. Furthermore, other<br />
factors found to correlate significantly with grief resolution are situations where the<br />
bereaved feels connected to their social support network, engages in quality<br />
communication, and conveys feelings honestly (Vachon & Stylianos, 1988).
Grief in Women Religious 5<br />
Material or concrete support consists <strong>of</strong> deeds such as performing tasks or<br />
providing time that may alleviate the bereaved person's current difficulties (Kaunonen et<br />
al., 2000; Nolen-Hoeksema & Larson, 1999). Aiken (2001) reports that valued forms <strong>of</strong><br />
material support, when provided with empathy, are <strong>of</strong>fering transportation or assistance<br />
with practical matters. This may include assisting with funeral arrangements, sorting<br />
through paper work, preparing meals or helping with household tasks (Nolen-Hoksema &<br />
Larson, 1999). It also may involve answering questions surrounding legal and financial<br />
issues (Nolen-Hoeksema & Larson, 1999).<br />
Several studies indicate that social support has a positive effect on bereavement.<br />
One such study by Ulmer, Range and Smith (1991) found that a high purpose in life was<br />
associated with an enhanced recovery from bereavement. <strong>The</strong> results <strong>of</strong> this study<br />
suggest that this may be due to a more expanded social support system or a greater<br />
capacity to utilize social support in addition to a greater life satisfaction. W. Stroebe and<br />
M. Stroebe (1996) conducted a longitudinal study <strong>of</strong> 60 recently widowed and 60 married<br />
men and women. <strong>The</strong>ir results show that individuals with perceived high social support<br />
availability reported less depression and fewer somatic symptoms. In contrast,<br />
individuals with perceived low social support availability reported more depression and<br />
more somatic symptoms.<br />
Contrary to previous findings, research by Gamino and Sewell (1998) found that<br />
social support did not show a negative relationship with mourning. <strong>The</strong>se results indicate<br />
that what facilitates grief resolution is an involved coping style that actively intertwines<br />
the world, self and others. This implies that active behavior rather than passive behavior<br />
during bereavement may lead to a reduction in grief symptoms over time.
Grief in Women Religious 6<br />
Research also suggests that the quality <strong>of</strong> the social support rather than the<br />
quantity <strong>of</strong> social support has a positive impact on the grief process (Nolen-Hoeksema &<br />
Larson, 1999). In the case <strong>of</strong> bereaved women religious who live in community, the<br />
availability <strong>of</strong> social support may be <strong>of</strong> importance. This lifestyle provides a unique<br />
environment that includes living with women <strong>of</strong> various personalities, temperaments,<br />
ages and experiences. In addition, women religious also live closely with those who<br />
share similar goals and values. This may mean that grieving women religious will find a<br />
considerable amount <strong>of</strong> positive support from their community during a period <strong>of</strong><br />
bereavement. Alternatively, the close proximity in which women religious live with one<br />
another may make social support more <strong>of</strong> a challenge due to a lack <strong>of</strong> privacy and the<br />
conflicts that occur from daily life. Furthermore, since active women religious have<br />
more <strong>of</strong> an opportunity to engage in social relationships than do contemplative women<br />
religious, the effects <strong>of</strong> social support may be more evident among this group.<br />
Personality and Grief<br />
<strong>The</strong> intensity, quality and resolution <strong>of</strong> grief appear to be associated with the<br />
personality <strong>of</strong> the bereaved (Aiken, 2001). Furthermore, research indicates that<br />
personality characteristics (e.g. anxiety, conscientiousness, sociability), as measured<br />
through health and personality questionnaires, affect the ability to cope positively or<br />
negatively with grief (Sanders, 1999; Vachon, Rogers, et al., 1982). Results <strong>of</strong> a study<br />
performed by Meuser, Davies, and Marwit (1995) suggest that personality style can be a<br />
risk factor for complicated grief. Additionally, Vachon and Stylianos (1988) discuss<br />
personality factors such as anxiety, self-esteem and dependency that may determine the<br />
manner in which individuals attempt to elicit social support during bereavement. <strong>The</strong>se
Grief in Women Religious 7<br />
findings indicate that personality factors may impact the bereavement process. One<br />
component <strong>of</strong> personality that has not yet been well examined in regard to grief but may<br />
have an impact is extraversion/introversion.<br />
Research by McCrae and Costa (1987) has measured extraversion and<br />
introversion as opposite ends <strong>of</strong> a single continuum. According to these studies<br />
extraverted people are more sociable, friendly, talkative, high-spirited and demonstrative.<br />
On the other hand, the researchers describe introverts as reserved, independent, even<br />
paced and individuals who value their privacy. Morris (1979) claims that although<br />
extraverts are behaviorally vivacious, they are emotionally reserved. Conversely,<br />
introverts are behaviorally reserved, but they are aware <strong>of</strong> deep and various emotions.<br />
<strong>The</strong>refore, while introverts may not visibly express their emotions, they are more in touch<br />
with their emotions than are extraverts (Morris, 1979).<br />
Several studies that investigated various facets <strong>of</strong> life events included extraversion<br />
as one <strong>of</strong> the components. In one such study, Zautra, Finch, and Reich (1991) examined<br />
predictors <strong>of</strong> daily positive, negative, and ill-health events over time. Among the<br />
bereaved participants with unsupportive social networks, this study found a relation<br />
between extraversion and less physical problems but more undesirable events. In an<br />
additional study, Grace and O'Brien (2003) investigated the role that life events, presence<br />
<strong>of</strong> a significant other, and personality factors have on depression. <strong>The</strong>ir findings show<br />
that <strong>of</strong> the 104 elderly participants, the individuals with multiple experiences <strong>of</strong><br />
bereavement also suffered from early-onset depression and received lower extraversion<br />
scores on a personality instrument than did the control group. Hotard, McFatter,<br />
McWhirter, and Stegall (1989) examined the interaction <strong>of</strong> extraversion, neuroticism and
Grief in Women Religious 8<br />
social support on subjective well-being. Results show that neurotic introverted<br />
individuals and introverted people with negative social support reported lower subjective<br />
well-being than either the extraverted or neurotic extraverted participants. According to<br />
the researchers, these findings may indicate that under adverse circumstances, introverted<br />
individuals may experience an increased sensitivity, which may be associated with their<br />
reports <strong>of</strong> lower subjective well-being. <strong>The</strong>se findings may suggest that during times <strong>of</strong><br />
bereavement, extraverted women religious may rely more on social support than do<br />
introverted women religious. In addition, the active religious life permits more<br />
interaction and communication with people than does the contemplative religious life.<br />
<strong>The</strong>refore, while both forms <strong>of</strong> religious life will include extraverted and introverted<br />
members, it would seem likely that more extraverted women would be found in the active<br />
religious life than in the contemplative religious life. Furthermore, during periods <strong>of</strong><br />
bereavement, the limitations imposed on social support by the structure <strong>of</strong> the<br />
contemplative lifestyle may hinder the grief process for extraverted contemplative<br />
women religious. Research also suggests that spirituality may influence bereavement.<br />
Spirituality<br />
Spirituality is multidimensional and defined in many different ways (Miller,<br />
1999). Paloutzian and Ellison (1991) suggest the term spiritual well-being to portray a<br />
clearer meaning <strong>of</strong> spirituality. As indicated by these researchers, when individuals refer<br />
to spirituality, they typically imply a relationship with God/ higher power or a<br />
contentment and purpose in life. Additionally, according to Miller (1999), spirituality is<br />
an attribute <strong>of</strong> a person and deals with individual subjective experiences. He further<br />
reports that spirituality does not necessarily involve religion. <strong>The</strong> author explains that
Grief in Women Religious 9<br />
spirituality also can focus on an indefinable substance that provides meaning in the<br />
individual's life. In recent years, bereavement scholars have attempted to integrate grief<br />
studies and spirituality by reflecting on clinical and/or individual experiences. Studies<br />
found that, for individuals who believe in God, grief may produce a spiritual crisis that<br />
leaves the bereaved depressed, helpless, and hopeless, and it also may raise faith<br />
questions that are incongruent with the individual's spiritual roots (Massey, 2000). This<br />
spiritual turning point reflects a rupture in the person's present relationship with God and<br />
consequently, the bereaved may experience loneliness and desolation (Massey, 2000).<br />
Consolation, however, may be obtained by sensing the presence <strong>of</strong> the deceased in a<br />
religious experience such as private prayer, ritual, or prayer services (Klass, 1993). On<br />
these occasions the mourners may feel God's presence which brings comfort and peace;<br />
however, many will likely still feel the sadness and emptiness associated with grief<br />
(Bullitt-Jonas, 1994).<br />
Balk's (1999) examination <strong>of</strong> case studies indicates that bereavement also affects<br />
spirituality by challenging innate beliefs about life. This may shake faith systems and<br />
lead to a period <strong>of</strong> inner turmoil as the bereaved searches for new meaning. In order to<br />
change the anguish into optimism and be transformed by God, the person must enter into<br />
the grief process, face the pain and make sense <strong>of</strong> the loss (Balk, 1999; Webner, 1999).<br />
In this way, spiritual change can occur and the individual may become compassionate<br />
(Balk, 1999; Chen, 1997). <strong>The</strong>refore, this research may suggest that during times <strong>of</strong> loss,<br />
grief may impact spirituality.<br />
Additional research indicates that spirituality is related to the bereavement<br />
process. Results <strong>of</strong> one qualitative study performed by Golsworthy and Coyle (1999)
Grief in Women Religious 10<br />
indicate that the experience <strong>of</strong> grief may appear to shake the faith <strong>of</strong> the bereaved<br />
because it is associated with questions and doubts. In spite <strong>of</strong> their confusion, the<br />
individuals in this study felt God's presence in their lives. <strong>The</strong>ir spirituality as evidenced<br />
by a sense <strong>of</strong> a personal and trusting link to God supported them through their grief.<br />
However, the bereaved also felt shame and self-criticism because they thought that their<br />
faith should help them cope more effectively with their grief.<br />
Furthermore, Marrone's (1999) examination <strong>of</strong> empirical research and clinical<br />
insights suggests that the loss <strong>of</strong> a loved one may challenge religious beliefs and raise<br />
questions about the meaning <strong>of</strong> life. As a result, the bereaved may experience a spiritual<br />
crisis; however, through active coping rather than passive coping this spiritual struggle<br />
may lead to the resolution <strong>of</strong> grief. <strong>The</strong>refore, spirituality may help the bereaved work<br />
through the mourning process (Marrone, 1999).<br />
During periods <strong>of</strong> severe pain or sadness, some individuals seek comfort from a<br />
religious or spiritual explanation for their loss (Sanders, 1999). Religious faith can<br />
cushion the detrimental consequences <strong>of</strong> a crisis and help the bereaved view the mundane<br />
with new insight and wisdom (Ellison, 1991). Research suggests that religious people<br />
tend to use more adaptive strategies and are less distressed than are nonreligious<br />
individuals (Nolen-Hoeksema & Larson, 1999). Results <strong>of</strong> Fry's (2001) study <strong>of</strong> 188<br />
bereaved widows and widowers indicate that aspects <strong>of</strong> religious beliefs and spirituality<br />
are predictors <strong>of</strong> psychological well-being and coping with the death <strong>of</strong> a loved one.<br />
Scholars conceptualize the terms religious beliefs and spirituality as different<br />
constructs. Specifically, religious beliefs are innate convictions about how an individual<br />
relates to the sacred or divine and are <strong>of</strong>ten manifested outwardly (Miller, 1999).
Grief in Women Religious 11<br />
Spirituality, on the other hand, is a person's search to understand the meaning <strong>of</strong> life and<br />
to make life meaningful (Batten & Oltjenbruns, 1999). Spirituality pervades all aspects<br />
<strong>of</strong> an individual's life (Golsworthy & Coyle, 2001) and involves forgiveness, compassion<br />
and feeling connected to a community (Mahoney & Graci, 1999). It is a perception <strong>of</strong><br />
existence that can be fostered and nurtured (Gamino, Sewell, & Easterling, 2000). While<br />
religious beliefs, people's convictions <strong>of</strong> transcendence and deity, appear to help the<br />
bereaved cope with their loss, the search for meaning surrounding loss may cause the<br />
individual to raise questions about these beliefs (Davis & Nolen-Hoeksema, 2001; Miller,<br />
2000). <strong>The</strong>refore, spirituality, an individual's pursuit to find meaning in life, may impact<br />
the grief process.<br />
<strong>The</strong> relation between spirituality and bereavement is a particularly relevant issue<br />
to address in the context <strong>of</strong> grieving women religious. Spirituality is the core <strong>of</strong> women<br />
religious' lives and encompasses all aspects <strong>of</strong> their existence. Thus, spirituality should<br />
be a major source <strong>of</strong> strength and comfort for bereaved women religious. For<br />
contemplative women religious whose primary focus is a life dedicated to prayer and<br />
whose main social support comes from their community, spirituality may have more <strong>of</strong><br />
an initial impact on the grief process than it will have on the grief process for active<br />
women religious who have more <strong>of</strong> a social support network. Little research, however, is<br />
available to address these issues.<br />
Application to Women Religious<br />
History <strong>of</strong> religious life. Religious life in the Roman Catholic Church has been in<br />
existence for nearly 2000 years (Schneiders, 2001). During the second century, the<br />
tradition <strong>of</strong> women living as consecrated virgins began, and over time this practice was
Grief in Women Religious 12<br />
replaced by the vows <strong>of</strong> chastity, poverty and obedience (Cita-Malard, 1964). In the fifth<br />
century, the first women monasteries were established by Scholastica under the guidance<br />
<strong>of</strong> her brother Benedict. In these monasteries, the women followed the Benedictine rule<br />
that structured how they lived, worked, and prayed together. In 1283, as a safeguard for<br />
nuns against the barbarian invasion, Pope Boniface VIII erected enclosure. It was not<br />
until the 16 th century, however, that the Council <strong>of</strong> Trent enforced the rules <strong>of</strong> solemn<br />
vows and enclosure on all women who live in community (Cita-Malard, 1964). <strong>The</strong><br />
institution <strong>of</strong> contemplative religious life as it is lived out in the Roman Catholic Church<br />
began at this time. Contemplative women religious not only pr<strong>of</strong>ess the vows <strong>of</strong> chastity,<br />
poverty, and obedience they also choose to live a life <strong>of</strong> solitude and prayer within the<br />
confines <strong>of</strong> their monasteries.<br />
Active religious life also came into existence in the 16 th century as a result <strong>of</strong> the<br />
needs <strong>of</strong> the times (Cita-Malard, 1964). Active women religious also pr<strong>of</strong>ess the vows <strong>of</strong><br />
chastity, poverty, and obedience as well as commit themselves to an apostolic work in the<br />
church. At this time, women religious were permitted to assume a less rigid rule <strong>of</strong><br />
enclosure and work as teachers or in hospitals (Cita-Malard, 1964). Throughout the<br />
centuries, religious congregations were established to meet the needs <strong>of</strong> the times and <strong>of</strong><br />
the Catholic Church. Typically, a congregation was established by one or two founders<br />
who decided on the purpose, way <strong>of</strong> life, and who wrote a rule for the group.<br />
Women religious are called to serve the Church within a community, and they<br />
enter religious life to live out the gospel message according to the specific spirit and<br />
values <strong>of</strong> a congregation (Donavan, 1989). <strong>The</strong> two basic forms <strong>of</strong> religious life for<br />
women are the active and the contemplative lifestyles. Schneiders (2000) explains that
Grief in Women Religious 13<br />
contemplatives distinguish themselves by prayer which is the unique visible expression<br />
<strong>of</strong> their lifestyle. Contemplative women religious live a life <strong>of</strong> solitude, prayer and<br />
withdrawal from the world. Rarely will events or circumstances interrupt the structure <strong>of</strong><br />
community exercises or common prayer. <strong>The</strong>se women choose to spend their life within<br />
one monastery and usually are not transferred to another house.<br />
In contrast, ministry is the distinct characteristic <strong>of</strong> the active religious lifestyle<br />
(Schneider, 2000). In this type <strong>of</strong> life, women religious strive to balance a life <strong>of</strong> prayer<br />
(private and common), commitment to their congregation, and a job related to the service<br />
<strong>of</strong> the Catholic Church. Active women religious choose to serve God's people where<br />
they are most needed, and consequently, their ministry may necessitate the need for them<br />
to move to new geographical areas.<br />
Women religious and personality. Although little research can be found on the<br />
personality types <strong>of</strong> women who seek admission into religious life, one may surmise that<br />
since active religious life provides opportunities to develop numerous interpersonal<br />
relationships more extraverted women will seek entrance into these congregations than<br />
will introverted women. Conversely, more introverted women would be expected to seek<br />
admittance into contemplative religious congregations as this lifestyle lends itself to<br />
solitude and little contact with strangers or other people in general. Interestingly,<br />
Donavan (1989) suggests that naive women who seek interpersonal relationships and<br />
protection may look for these things in a contemplative congregation. <strong>The</strong> majority <strong>of</strong><br />
religious congregations, however, utilize psychological assessments to evaluate applicant<br />
suitability for religious life (Batsis, 1993).
Grief in Women Religious 14<br />
Women religious and grief. Grief is a life crisis and crises can impact social<br />
relationships and initiate spiritual change (Balk, 1999). Women religious are not<br />
excluded from this grief process. When these women lose a loved one, their grief is<br />
unique to them as individuals and may be influenced by their religious life. <strong>The</strong>se<br />
women choose to live a countercultural lifestyle. As a result, the potency <strong>of</strong> their grief<br />
may go unnoticed or be misconstrued because people do not understand their way <strong>of</strong> life<br />
or the depth <strong>of</strong> their love for others. Bowlby (1980) discusses several factors that may<br />
predict complicated grief including unresolved previous losses, the inability to develop<br />
meaningful relationships, living alone, unhelpful social interaction, persistent anger, self-<br />
reproach, and depression. In addition, Sanders (1999) cautions that postponing grief or<br />
acting as though the loss did not occur may be symptoms <strong>of</strong> abnormal grief. <strong>The</strong>se issues<br />
may be <strong>of</strong> particular relevance for bereaved women religious because <strong>of</strong> their highly<br />
spiritual life and their bond with members <strong>of</strong> their congregation.<br />
Furthermore, Doka (1987) indicates that grief may be intensified in nontraditional<br />
relationships and add confusion to the bereavement process. This may be especially true<br />
for contemplative religious whose lifestyle may not permit them to leave their enclosure<br />
to care for a family member or visit a dying friend. Consequently, the bereaved women<br />
religious may feel isolated, lonely and depressed. As research suggests (Kaltreider,<br />
Becker, & Horowitz, 1984; Parkes, 1998), women may be more sensitive than men to the<br />
loss <strong>of</strong> a parent, which may lead to psychological problems; women religious should be<br />
no exception. <strong>The</strong> death <strong>of</strong> parents may leave a woman religious with a feeling <strong>of</strong><br />
"homelessness" and a sibling's death may break a tie to a family unit. Without a family<br />
<strong>of</strong> her own, the bond with her nuclear family may be intense and the finality <strong>of</strong> the loss
Grief in Women Religious 15<br />
may be tremendous. <strong>The</strong> grief <strong>of</strong> a woman religious also may be complicated because<br />
her life <strong>of</strong> selfless service may inhibit her from admitting or expressing the pain and<br />
emptiness caused by death.<br />
For active and contemplative women religious who live in community the<br />
availability <strong>of</strong> positive social support should ease the grieving process. <strong>The</strong>se women<br />
have available to them community members who are willing to listen, to help in practical<br />
matters and to share with individuals who have experienced similar losses. Ideally,<br />
members <strong>of</strong> the woman religious' local convent will support her through the grieving<br />
process with their physical and spiritual presence. Moreover, active women religious<br />
have the liberty to engage in social relationships with other religious outside <strong>of</strong> their local<br />
community as well as lay friends and colleagues. <strong>The</strong>se relationships may provide active<br />
women religious with additional support during the bereavement process.<br />
<strong>The</strong> grief process also may be affected by the woman religious' personality. An<br />
extraverted grieving woman religious may tend to seek social support outside <strong>of</strong> her local<br />
house, look for distractions from her pain, and express more visible grieving emotions.<br />
Contrary to this, an introverted woman religious may be more satisfied with the social<br />
support received from her local community, be more in touch with her emotions, be less<br />
expressive <strong>of</strong> these emotions, and seek more time alone than an extraverted woman<br />
religious.<br />
A woman religious would be expected to turn to God and her faith for comfort<br />
and support during times <strong>of</strong> grief. Religious beliefs may bring a sense <strong>of</strong> solace that her<br />
loved one is in heaven and that one day she will be reunited with the deceased. <strong>The</strong><br />
support <strong>of</strong> the funeral liturgy, prayer services and rituals that envelop the days following
Grief in Women Religious 16<br />
a death may be a source <strong>of</strong> strength for the bereaved woman religious. This does not<br />
mean, however, that the woman religious will not feel the pain associated with the loss <strong>of</strong><br />
the loved one. It does mean that her faith may influence this grief process in a significant<br />
manner. For contemplative women religious whose life is dedicated to prayer and<br />
solitude, the resolution <strong>of</strong> grief may primarily involve a focus on spirituality. This may<br />
be a natural consequence <strong>of</strong> enclosure and limited social contacts. Conversely, for active<br />
women religious who are immersed in an apostolic ministry, the resolution <strong>of</strong> grief may<br />
initially focus on social support. <strong>The</strong> availability <strong>of</strong> social support from a variety <strong>of</strong><br />
sources may make this a feasible preference. However, over time the active women<br />
religious may turn more towards their faith and relationship with God for comfort. This<br />
refocus on spirituality may consequently flow from their primary commitment to God.<br />
Furthermore, research suggests that spirituality may not only help the bereaved work<br />
through the grief process, but also lead to a stronger interior life (Marrone, 1999; Massey,<br />
2000).<br />
Statement <strong>of</strong> the Problem<br />
Grief is an inescapable fact <strong>of</strong> life. <strong>The</strong> significance <strong>of</strong> the grieving process can<br />
be seen both in research, self-help literature and support groups available to the bereaved.<br />
Research on grief suggests that bereavement is an intensely emotional period that lasts<br />
for an indeterminate length <strong>of</strong> time. Women religious experience many losses that affect<br />
their life in a pr<strong>of</strong>ound way. Among these losses are the deaths <strong>of</strong> parents, siblings,<br />
relatives, community members and intimate friends. Little research, however, can be<br />
found that addresses the issues <strong>of</strong> loss within a religious community. Women religious
Grief in Women Religious 17<br />
attempt to deal with these outcomes while they continue to serve God's people and live in<br />
community.<br />
Present research suggests that social support and spirituality are important factors<br />
in bringing the grieving process to a healthy resolution. Research also indicates that<br />
personality factors may affect the grief process. <strong>The</strong> purpose <strong>of</strong> this study was to<br />
determine the impact that social support, spirituality and the personality factor <strong>of</strong><br />
extraversion have on grief symptoms in active and contemplative women religious. <strong>The</strong><br />
relations among these variables were examined over a 3 month time period.<br />
Statement <strong>of</strong> Hypotheses<br />
1. <strong>The</strong>re is a relation between social support and grief symptoms such that the social<br />
support <strong>of</strong> women religious is related negatively to grief symptoms over time.<br />
2. <strong>The</strong>re is a relation between spirituality and grief symptoms such that the<br />
spirituality <strong>of</strong> women religious is related negatively to grief symptoms over time.<br />
3. <strong>The</strong>re is a significant interaction between women religious lifestyles and<br />
personality factors in relation to grief symptoms, such that extraversion is related<br />
negatively to grief symptoms over time in active women religious and related<br />
positively to grief symptoms in contemplative women religious over time.<br />
4. <strong>The</strong>re is a difference between women religious lifestyles in relative contribution<br />
<strong>of</strong> time 1 spirituality and social support in predicting time 2 grief symptoms, such<br />
that social support and spirituality will be more predictive <strong>of</strong> grief among active<br />
women religious and spirituality alone will be predictive <strong>of</strong> grief among<br />
contemplative women religious.
Participants<br />
Chapter II<br />
Method<br />
Grief in Women Religious 18<br />
<strong>The</strong> participants in this study were 82 Roman Catholic women religious<br />
who had experienced the death <strong>of</strong> a family member or friend within the past seven<br />
months. In addition, 58% (n = 48) <strong>of</strong> the participants belonged to five active<br />
congregations and 42% (n = 34) were members <strong>of</strong> 17 contemplative monasteries.<br />
Furthermore, the participants were drawn from the New England, Mid-Atlantic,<br />
Southern, and Midwestern states. <strong>The</strong> entire population spoke English and 89% <strong>of</strong> the<br />
participants describe themselves as White/European American. In this study, the median<br />
age for the active participants was 63 and the median age for the contemplative<br />
participants was 61. This is comparable to the 1999 statistics for women religious in the<br />
United States which reports a median age <strong>of</strong> 68 for active women religious and a median<br />
age <strong>of</strong> 65 for contemplative women religious (Froehle et al., 2000).<br />
Moreover, the participants represented a range <strong>of</strong> educational levels. See Table 1<br />
for summary <strong>of</strong> demographic information. Approval to use human subjects was obtained<br />
from the Human Subject committee <strong>of</strong> Loyola College in Maryland (see Appendix A).<br />
Measures<br />
Grief. Symptoms <strong>of</strong> grief were measured with Part II titled, "Present Feelings,"<br />
<strong>of</strong> the Texas Revised Inventory <strong>of</strong> Grief (TRIG; Faschingbauer, Zisook, & De Vaul,<br />
1987; see Appendix B). Faschingbauer et al. designed this measure to evaluate grief "as<br />
a present emotion <strong>of</strong> longing, as an adjustment to a past life event, as a medical<br />
psychology outcome, and as a personal experience" (1987, p. 111). <strong>The</strong> items <strong>of</strong> this
Table 1<br />
Summary <strong>of</strong> Demographic Information for Participants<br />
Age<br />
Active<br />
Contemplative<br />
Years in Lifestyle<br />
Active<br />
Contemplative<br />
Ethnicity<br />
White/European<br />
American<br />
Native American<br />
Black/Latino<br />
White/Native<br />
American<br />
Education<br />
H.S. Diploma<br />
Bachelors<br />
Masters<br />
Doctoral<br />
Other/Missing<br />
Minimum<br />
40<br />
46<br />
40<br />
.75<br />
22<br />
.75<br />
Maximum<br />
81<br />
M<br />
62.79<br />
Grief in Women Religious 19<br />
SD<br />
9.98<br />
N<br />
82<br />
%<br />
81 63.73 9.32 48 58.5<br />
79<br />
63<br />
61.47<br />
42.03<br />
10.85<br />
12.73<br />
34<br />
78<br />
63 44.13 10.32 46<br />
58<br />
39.01<br />
15.22<br />
32<br />
82<br />
73<br />
7<br />
41.5<br />
89<br />
8.5<br />
1 1.2<br />
1<br />
82<br />
12<br />
1.2<br />
14.6<br />
12 14.6<br />
49<br />
59.8<br />
2 2.4<br />
Note. Other/Missing = some college credits; three participants did not report number <strong>of</strong><br />
years in religious life.<br />
7<br />
8.5
Grief in Women Religious 20<br />
measure were developed by Faschingbauer and colleagues based on their clinical<br />
experience as well as literature for normal and atypical grief (Stroebe et al., 2001).<br />
<strong>The</strong> TRIG consists <strong>of</strong> 26 items that assess feelings and actions surrounding the death <strong>of</strong> a<br />
loved one. <strong>The</strong> introductory section <strong>of</strong> the TRIG assesses the individual's relationship<br />
with the deceased, perceived closeness with the deceased, and length <strong>of</strong> time since the<br />
death occurred. This inventory also consists <strong>of</strong> two primary scales, which are composed<br />
<strong>of</strong> simple statements. Part I, titled "Past Behavior," consists <strong>of</strong> eight items that assess<br />
behavior occurring shortly after the death (e.g., "I found it hard to sleep after this person<br />
died"). <strong>The</strong> participants respond on a 5-point Likert scale ranging from "Completely<br />
True" to "Completely False." On this section, the items are reverse scored and the scores<br />
range from 8 to 40 (Longman, 1993).<br />
Part II, titled "Present Feelings," consists <strong>of</strong> 13 items that assess feelings at the<br />
time <strong>of</strong> the data collection (e.g., "I still get upset when I think about the person who<br />
died;" Ginzburg, Geron, & Solomon, 2002). Part II is the primary measure used to assess<br />
change in grief symptoms over a period <strong>of</strong> time (Stroebe et al., 2001). On this scale, the<br />
participants also respond on a 5-point Likert scale ranging from "Completely True" to<br />
"Completely False," such that the scores on Part II can range from 13 to 65 (Longman,<br />
1993). In addition, the items are reverse scored. For this study, the mean<br />
score for Part II used to assess grief symptoms over time.<br />
Part III, titled "Related Facts," consists <strong>of</strong> five basic statements that assess<br />
information associated with the death <strong>of</strong> the individual (Longman, 1993). For this<br />
section, the participants respond either true or false. <strong>The</strong> TRIG concludes with an open-<br />
ended question that asks participants to add other thoughts or feelings. For the purposes
Grief in Women Religious 21<br />
<strong>of</strong> this study, no specific hypothesis will utilize the qualitative data gathered from the<br />
TRIG.<br />
Research shows the TRIG to have a moderate level <strong>of</strong> reliability with coefficient<br />
alphas <strong>of</strong> .77 for Part I and .86 for Part II (Stroebe, Stroebe, & Hansson, 1993).<br />
Furthermore, in a study <strong>of</strong> 260 adults, the coefficient alpha for Part II was .77<br />
(Faschingbauer et al., 1987). In a longitudinal study performed by Longman (1993),<br />
grief symptoms were assessed in male and female adults at three months to two years<br />
postloss and than three months later. <strong>The</strong> Cronbach's alpha in that study ranged from .78<br />
to .93 for different sections <strong>of</strong> the TRIG at different times <strong>of</strong> measurement. In the present<br />
study, for Part II, the coefficient alphas for time 1 and time 2 were .85 and .83.<br />
Some modifications were made on the TRIG to reflect the present study's<br />
population and time frame. Specifically, in the inventory items, husband and wife were<br />
removed and time since the person died was revised to range from ''within the past<br />
month" to "within the past 4 to 7 months," Furthermore, in Part III, on item four, "each<br />
year" was changed to read "each month." However, no items in Part II were altered,<br />
which is the primary scale used to assess changes in symptoms <strong>of</strong> grief and was the only<br />
section used in this study.<br />
Social support. Social Support was measured using the Social Support<br />
Questionnaire (SSQ; Sarason, Levine, Basham, & Sarason, 1983). <strong>The</strong> SSQ measures<br />
the participant's availability for and his or her satisfaction with social support (see<br />
Appendix C). Sarason et al. (1983) derived their definition <strong>of</strong> social support from<br />
Bowlby's <strong>The</strong>ory <strong>of</strong> Attachment, basing it on the accessibility <strong>of</strong> individuals on whom<br />
they can depend, who care for them and who support them. <strong>The</strong> SSQ consists <strong>of</strong> 27
Grief in Women Religious 22<br />
items that ask the subject to list who they can turn to in particular situations and then to<br />
rate their satisfaction with the support that they receive from these people on a 6-point<br />
Likert scale ranging from "very satisfied" to "very dissatisfied" (Heitzmann & Kaplan,<br />
1988). <strong>The</strong> items are reverse scored. <strong>The</strong> SSQ is scored by first adding the total number<br />
<strong>of</strong> people listed (maximum number is 243). This total is the SSQ Number Score (SSQN;<br />
Sarason et al., 1983). <strong>The</strong> Total Satisfaction score for all 27 items (Max = 162) is also<br />
computed. This score is the SSQ Satisfaction score (SSQS; Bowling, 1997). By dividing<br />
the sum <strong>of</strong> the SSQN and SSQS scores by 27, the total number <strong>of</strong> items, the overall N<br />
and S scores are obtained (Sarason et al., 1983).<br />
Reliability for the SSQ in a college student sample was assessed by Sarason et al.<br />
(1983). Results show an alpha coefficient <strong>of</strong> .97 and an alpha coefficient for satisfaction<br />
scores <strong>of</strong> .94. Similarly, in the present study, the coefficient alphas for time 1 and time 2<br />
were .94 and .95 respectively.<br />
Construct validity for the SSQ was tested in a study <strong>of</strong> 227 male and female<br />
college students who were given the SSQ, the Multiple Affect Adjective Check List<br />
(MAACL), and the Lack <strong>of</strong> Protection Scale (LP; Heitzmann & Kaplan, 1988).<br />
Significant negative correlations <strong>of</strong> -.22 and -.43 were reported between the SSQ-N and<br />
the SSQ-S and the MAACL that assesses emotional discomfort. Additionally, a negative<br />
correlation (-.22 and -.32) was found between the LP and the SSQ. A subsample <strong>of</strong> 28<br />
men and 38 women from this study was administered Extraversion and Neuroticism<br />
scales. <strong>The</strong> Extraversion measure for women was correlated positively (r = .35) with the<br />
SSQ-N, and was correlated negatively (r = -.37) with the Neuroticism scale for women.
Grief in Women Religious 23<br />
For the purpose <strong>of</strong> the present study, three items that did not apply to this<br />
population were eliminated. Specifically, items 4, 10, and 15 were not included in the<br />
participants' total scores as they addressed issues not related to the religious lifestyle such<br />
as marriage.<br />
Personality. Extraversion was measured using the Revised NEO Personality<br />
Inventory (NEO PI-R; Costa & McCrae, 1992). <strong>The</strong> NEO PI-R measures five major<br />
dimensions <strong>of</strong> personality: Neuroticism, Extroversion, Openness, Agreeableness, and<br />
Conscientiousness. <strong>The</strong> self-report form <strong>of</strong> the NEO PI-R consists <strong>of</strong> 240 items.<br />
Participants are asked to respond on a 5-point Likert scale ranging from "strongly<br />
disagree" to "strongly agree." Each <strong>of</strong> the five domains contains six subscales that<br />
measure a variety <strong>of</strong> facets <strong>of</strong> that specific domain. For the purpose <strong>of</strong> this study, only<br />
the 48 items from Form S that measure extraversion was used (see Appendix D).<br />
Numerous studies have been performed to evaluate the reliability <strong>of</strong> the NEO PI-<br />
R. Two research designs that include coefficient alphas for the Extraversion scale will be<br />
reviewed. Costa, McCrae, and Dye (1991) and Costa and McCrae (1992) report internal<br />
consistencies for the individual facet scales <strong>of</strong> the NEO PI-R. In a study <strong>of</strong> 1,539<br />
participants, the coefficient alphas for the individual facet scales ranged from .56 to .81.<br />
Additionally, on the 48-item Extraversion scale the coefficient alphas ranged from .63 to<br />
.77.<br />
McCrae and Costa (1983) report retest reliability for the NEO PI-R in a study <strong>of</strong><br />
31 men and women. <strong>The</strong> values for the facet scales ranged from .66 to .92. In this same<br />
study, the reliability value for the Extraversion scale was .91. Furthermore, in a sample<br />
<strong>of</strong> 208 college students, the test-retest reliability coefficient for Extraversion was reported
Grief in Women Religious 24<br />
as .79 (p < .001; Costa & McCrae, 1992). In the present study, a coefficient alpha <strong>of</strong> .91<br />
was found for the NEO-E.<br />
Spirituality. Spirituality was measured using the Spiritual Well-Being Scale<br />
(SWB; Paloutzian & Ellison, 1982). <strong>The</strong> SWB scale gives a global assessment <strong>of</strong> the<br />
subjective spiritual quality <strong>of</strong> life (see Appendix E). Paloutzian and Ellison (1991) state<br />
that the term "spiritual well-being" reflects people's meaning <strong>of</strong> spirituality as "either<br />
their relationship with God or what they understand to be their spiritual being, or their<br />
sense <strong>of</strong> satisfaction with life or purpose in life" (p.2). <strong>The</strong> SWB total score presents a<br />
general measure <strong>of</strong> an individual's spiritual well-being. Additionally, the SWB contains<br />
two subscales. <strong>The</strong> Religious Well-Being score (RWB) provides an assessment <strong>of</strong> an<br />
individual's relationship with God and the individual's perceived satisfaction with God.<br />
<strong>The</strong> Existential Well-Being (EWB) score assesses an individual's satisfaction with and<br />
purpose in life (Paloutzian & Ellison, 1991).<br />
<strong>The</strong> SWB is a 20-item self-administered instrument Responses are given on a 6-<br />
point Likert scale ranging from "strongly agree" to "strongly disagree." RWB is assessed<br />
by the ten even-numbered statements that contain the word "God" and the ten remaining<br />
odd numbered items assess EWB (Paloutzian & Ellison, 1991). In an attempt to control<br />
for response bias, about half <strong>of</strong> the items are worded in a negative fashion. <strong>The</strong><br />
statements are scored from 1 to 6. For positive items, a higher number represents greater<br />
well-being, and the negatively worded items are reverse scored. <strong>The</strong> sum <strong>of</strong> all 20 items<br />
assesses overall spiritual well-being (Paloutzian & Ellison, 1991).<br />
Bufford, Paloutzian, and Ellison (1991) found high reliability for the SWB in four<br />
test-retest studies. <strong>The</strong> reliability coefficients ranged from .88 to .98 for RWB, .73 to .98
Grief in Women Religious 25<br />
for EWB, and .82 to .99 for SWB. In addition, the index <strong>of</strong> internal consistency<br />
coefficient alpha, also showed high reliability across seven samples. <strong>The</strong>se results ranged<br />
from .82 to .92 for RWB, .78 to .86 for EWB, and .89 to .94 for SWB. Similarly, in the<br />
present study, the coefficient alphas for the SWB at time 1 and time 2 were .92 and .90<br />
respectively.<br />
Additionally, Bufford et al. (1991) found that the SWB is a valid gauge for overall<br />
well-being. <strong>The</strong> three scales are correlated positively with purpose in life and are<br />
correlated negatively with loneliness (Ellison, 1983). A ceiling effect has been reported<br />
by the authors in some religious samples (Hill & Hood, 1999). This measure, however, is<br />
sensitive at the low end and research suggests that it may be a useful instrument to assess<br />
those experiencing spiritual distress or lack <strong>of</strong> well-being (Hill & Hood, 1999).<br />
A pilot study was performed in March 2003 to determine if the SWB scale would<br />
be an effective measure to use with women religious. Twenty members <strong>of</strong> two women<br />
religious congregations living in Maryland and Pennsylvania took part in this study.<br />
None <strong>of</strong> these women participated in this present study. It was hypothesized that scores<br />
on the modified version <strong>of</strong> the scale (see Appendix E) would show significantly more<br />
variability than would scores on the original version <strong>of</strong> the scale. <strong>The</strong> modified scale<br />
ranged from 0 to 100 instead <strong>of</strong> 0 to 5. <strong>The</strong> reason, for the modification, was concern<br />
that the range <strong>of</strong> 0 to 5 would not show enough variability in such a highly spiritual<br />
group. Findings show a mean <strong>of</strong> 1841.90 and a standard deviation <strong>of</strong> 143.61 for the<br />
modified version. For the original version, a mean <strong>of</strong> 108.35 and standard deviation <strong>of</strong><br />
10.69 was found. <strong>The</strong> maximum score on the original scale is 120, and the maximum<br />
score on the modified scale was 2000. Three women religious reported the maximum
Grief in Women Religious 26<br />
score on both the original and modified scales. <strong>The</strong>re was no ceiling effect with either<br />
the original measure or the modified measure. This indicates no significant difference<br />
between the two versions <strong>of</strong> the scales; therefore, it was decided the original scale would<br />
be used. <strong>The</strong>se results are similar to those <strong>of</strong> O'Kane (19%) who used the original SWB<br />
in a study <strong>of</strong> women religious. Furthermore, at time 1 and time 2, this present study<br />
found significant correlations between the TRIG (r = .80, p < .05), the SSQ (r = .79, p <<br />
.05), and the SWB (r = .70, p < .05).<br />
Procedure<br />
Data collection began subsequent to receiving approval from the author's<br />
<strong>dissertation</strong> committee and the Human Subject committee <strong>of</strong> Loyola College in<br />
Maryland. A second time <strong>of</strong> measurement occurred three months after the first data<br />
collection. A list <strong>of</strong> 12 active women religious congregations and 16 contemplative<br />
monasteries <strong>of</strong> women were obtained from the Official Catholic Directory (2003). All<br />
congregations and monasteries obtained from this source were located within the eastern<br />
region <strong>of</strong> the United States. General leadership members <strong>of</strong> nine active congregations<br />
were contacted by phone and a personal interview date was requested. One individual in<br />
lieu <strong>of</strong> a personal interview suggested that e-mail messages be sent to the 17 presidents <strong>of</strong><br />
the congregation situated throughout the United States. Furthermore, due to scheduling<br />
conflicts, two other persons requested that a letter be sent explaining the procedures for<br />
this study. Phone messages were left with general leadership members <strong>of</strong> three other<br />
active congregations, but no response was obtained. Several e-mail messages were sent<br />
to one <strong>of</strong> the individuals, but a request for a meeting was not obtained. <strong>The</strong>refore, a total<br />
<strong>of</strong> 12 active congregations were contacted.
Grief in Women Religious 27<br />
<strong>The</strong> superior and/or contact person <strong>of</strong> 16 contemplative communities were<br />
contacted by phone, mail, e-mail or through personal interviews. Due to the small<br />
number <strong>of</strong> participants, names <strong>of</strong> four additional monasteries were verbally given to the<br />
researcher by colleagues and these monasteries were either visited or contacted by phone.<br />
Furthermore, 58 monasteries, throughout the United States and Ireland, were located on<br />
the internet and they were contacted by e-mail. <strong>The</strong>refore, 79 contemplative monasteries<br />
were contacted and 48 <strong>of</strong> them responded. <strong>The</strong>se monasteries were located across the<br />
United States.<br />
<strong>The</strong> names and addresses <strong>of</strong> women religious who had lost a parent, sibling or<br />
close friend within the last three months were either mailed to the researcher or the<br />
women were personally contacted by their leadership personnel to assess their<br />
willingness to participate in this study. Subsequently, the names and contact information<br />
<strong>of</strong> the women willing to participate were either forwarded to the researcher or the<br />
participant personally contacted the researcher by e-mail or phone.<br />
A packet <strong>of</strong> materials was mailed to the active and contemplative women<br />
religious as distance made it unfeasible to visit each convent. For each eligible<br />
contemplative woman religious who resided in the monastery that was visited, a packet <strong>of</strong><br />
materials was left at the monastery for her. Before the packets were mailed or<br />
distributed, identification numbers for coding purposes were placed on each <strong>of</strong> them.<br />
<strong>The</strong> packets included a cover letter, a consent form, a demographic questionnaire, the<br />
Texas Revised Inventory <strong>of</strong> Grief (Faschingbauer, 1981; see Appendix B), the Social<br />
Support Questionnaire (Sarason et al., 1983; see Appendix C), the NEO PI-E (Costa &<br />
McCrae, 1992; see Appendix D) and the Spiritual Well-Being Scale (Paloutzian &
Grief in Women Religious 28<br />
Ellison, 1982; see Appendix E). <strong>The</strong> measures were arranged in a counterbalanced<br />
order.<br />
<strong>The</strong> cover letter described the purpose and procedure <strong>of</strong> the study (see Appendix<br />
F). It also provided information on confidentiality, voluntary participation, risks and<br />
benefits involved in participation, and the person to contact if a question arose. <strong>The</strong><br />
cover letter also indicated that a doctoral psychology student at Loyola College in<br />
Maryland conducted the study. Additionally, the cover letter informed the participants<br />
that there was a 3-month follow-up study to assess the impact <strong>of</strong> social support and<br />
spirituality on the grief process in women religious. <strong>The</strong> demographic questionnaire<br />
included questions regarding age, years in religious life, level <strong>of</strong> education, ethnicity, and<br />
type <strong>of</strong> work (see Appendix G). Voluntary consent to participate in the study was shown<br />
by returning the consent form (see Appendix H).<br />
In order to perform the follow-up study and to maintain confidentiality,<br />
participants were asked to provide the researcher with contact information on a separate<br />
sheet <strong>of</strong> paper (see Appendix I). <strong>The</strong> number <strong>of</strong> packets distributed totaled 114 (Active =<br />
62; Contemplative = 52), and the number <strong>of</strong> responses to time 1 totaled 93 (Active = 53;<br />
Contemplative = 40). Upon return <strong>of</strong> the questionnaires, thank you letters were mailed to<br />
each participant with a reminder <strong>of</strong> the follow-up study (see Appendix J). Moreover,<br />
postcard or e-mail reminders were mailed to those who did not respond. Three months<br />
after the participant returned the first packet <strong>of</strong> questionnaires, packets containing the<br />
Texas Revised Inventory <strong>of</strong> Grief, the Social Support Questionnaire, the Spiritual Well-<br />
Being Scale, a consent form and a cover letter were mailed again to the participants. <strong>The</strong><br />
cover letter restated the purpose and procedure <strong>of</strong> the study. In addition, it again
Grief in Women Religious 29<br />
explained confidentiality, voluntary participation, the risks and benefits involved in<br />
participation, and the person to contact if a question arises. Voluntary consent to<br />
participate in the study was indicated by the return <strong>of</strong> the consent form. <strong>The</strong> number <strong>of</strong><br />
replies to time 2 totaled 79 (Active = 44; Contemplative = 35). After the follow-up<br />
packets were returned, a thank you letter (see Appendix K) and a copy <strong>of</strong> the article,<br />
Grief’s Journey, published by the Hospice <strong>of</strong> Baltimore (2002) were mailed to the<br />
participants. Additionally, postcard or e-mail reminders were sent to those participants<br />
who did not respond. <strong>The</strong> participants who requested the results were mailed a summary<br />
<strong>of</strong> the findings.<br />
For time 1, due to the length <strong>of</strong> time that elapsed between mailing and returning<br />
the packets <strong>of</strong> questionnaires, the time since death was extended, from the original plan<br />
<strong>of</strong> three months, to include those individuals who experienced a loss within the past<br />
seven months. Of the 93 respondents, 11 individuals were eliminated because the time<br />
since death was reported as greater than seven months. See Table 2 for summary <strong>of</strong> time<br />
since death and relation to the deceased.<br />
Design and Analyses<br />
This study was passive observational and longitudinal. <strong>The</strong> variables investigated<br />
were as follows: type <strong>of</strong> religious life (active/contemplative), symptoms <strong>of</strong> grief, social<br />
support, extroversion and spirituality. <strong>The</strong> criterion variable was grief over time which<br />
was looked at by examining time 2 grief after controlling for time 1 grief. <strong>The</strong> predictor<br />
variables were grief at time 1, social support, spirituality, women religious lifestyle and<br />
extraversion. A multiple regression was used to test the relation between these variables.
Table 2<br />
Summary <strong>of</strong> Time Since Death and Relation to Deceased<br />
Variable<br />
Time<br />
One month<br />
Two months<br />
Three months<br />
Active<br />
Grief in Women Religious 30<br />
Contemplative<br />
10 10<br />
15 8<br />
16 4<br />
4-7 months 7 12<br />
Relation**<br />
Parent<br />
Sibling<br />
18 4<br />
Community 0 14<br />
Member<br />
Total<br />
Friend<br />
Other<br />
13<br />
5<br />
12<br />
48<br />
Note. Time = Time since death as reported in Time 1. Relation = Relation to the<br />
deceased. **χ 2 for Relation = 35.00, p
CHAPTER III<br />
Results<br />
Grief in Women Religious 31<br />
Descriptive Statistics for all variables <strong>of</strong> interest are presented in Table 3. In<br />
order to examine grief over time, a residualized grief score was calculated, representing<br />
grief at time 2 after controlling for grief at time 1.<br />
Hypothesis 1 was that there is a relation between social support and grief such<br />
that the social support <strong>of</strong> women religious is negatively related to grief symptoms over<br />
time. This was tested using the Pearson correlation coefficient. Social support was not<br />
related to grief symptoms over time. Time 1 social support was not significantly related<br />
to grief symptoms at time 2 regardless <strong>of</strong> whether grief at time 1 was controlled (see<br />
Table 4).<br />
Hypothesis 2 was that there is a relation between spirituality and grief such that<br />
the spirituality <strong>of</strong> women religious is negatively related to grief symptoms over time (see<br />
Table 4). This was tested using the Pearson correlation coefficient. Time 1 spirituality<br />
was not related to grief symptoms at time 2 regardless <strong>of</strong> whether grief at time 1 was<br />
controlled.<br />
Hypothesis 3 was that there is a significant interaction between women religious<br />
lifestyles and personality factors in relation to grief symptoms, such that extraversion is<br />
negatively related to grief symptoms over time in active women religious and positively<br />
related to grief symptoms in contemplative women religious over time. This was tested<br />
using multiple regression (see Table 5). <strong>The</strong> overall effect <strong>of</strong> lifestyle was significant.<br />
<strong>The</strong> mean scores for active and contemplative groups on time 2 grief and time 2
Table 3<br />
Summary <strong>of</strong> Descriptive Statistics for Variables <strong>of</strong> Interest<br />
Variables<br />
TRIG1*<br />
Overall<br />
Active<br />
Contemplative<br />
TRIG2**<br />
N<br />
81<br />
47<br />
34<br />
M<br />
35.29<br />
SD<br />
9.22<br />
Grief in Women Religious 32<br />
Skew<br />
.30<br />
37.09 7.90 .52<br />
32.80<br />
10.40<br />
Overall 68 32.51 8.69 -.17<br />
Active 39 35.51 6.77 .17<br />
Contemplative<br />
TRIG2R**<br />
29<br />
.53<br />
28.48 9.43 .29<br />
Overall 67 .01 5.29 .24<br />
Active 38 2.14 4.70 -.62<br />
Contemplative<br />
SSQ1<br />
Overall<br />
Active<br />
29<br />
73<br />
45<br />
-2.78 4.75 1.73<br />
132.40 11.67 -.99<br />
134.06 10.08 -1.05<br />
Contemplative 28 129.73 13.63 -.74<br />
Table 3 continued on next page
Table 3 cont<br />
SWB1<br />
Overall<br />
Active<br />
Contemplative<br />
SSQ2<br />
Overall<br />
Active<br />
Contemplative<br />
SWB2<br />
Overall<br />
Active<br />
Contemplative<br />
NEO-E*<br />
Overall<br />
Active<br />
Contemplative<br />
82<br />
48<br />
34<br />
62<br />
34<br />
28<br />
73<br />
42<br />
31<br />
77<br />
46<br />
31<br />
108.91 11.41 -1.50<br />
108.64<br />
109.29<br />
10.98<br />
12.16<br />
Grief in Women Religions 33<br />
-1.91<br />
-1.13<br />
132.41 11.78 -.84<br />
133.19<br />
131.45<br />
10.91<br />
12.89<br />
-.88<br />
-.78<br />
109.45 10.68 -1.69<br />
109.31<br />
109.65<br />
11.14<br />
10.21<br />
-2.10<br />
-1.01<br />
105.85 20.83 -.27<br />
109.77<br />
100.02<br />
20.99<br />
19.49<br />
Note. TRIG1 = Time 1 TRIG Part II Present; TRIG2 = Time 2 TRIG Part II Present; TRIG2R =<br />
Time 2 TRIG with Time 1 Residualized; SSQ1 = Time 1 Social Support Adjusted Satisfaction;<br />
SWB1 = Time 1 Spiritual Well-Being; SSQ2 = Time 2 Social Support Adjusted Satisfaction;<br />
SWB2 = Time2 Spiritual Well-Being; NEO-E = Extraversion. *p
Table 4<br />
Grief in Women Religious 34<br />
Intercorrelations between Time 1 and Time 2 Grief Symptoms and Time 1 and Time 2<br />
Social Support Satisfaction and Time 1 and Time 2 Spirituality<br />
Grief 1<br />
Grief2<br />
Grief R<br />
SSQ1<br />
SSQ2<br />
SWB1<br />
81<br />
67<br />
67<br />
73<br />
62<br />
82<br />
N<br />
Grief 2<br />
.80**<br />
Grief R<br />
.001<br />
SSQ1<br />
-.05<br />
SSQ2<br />
-.26*<br />
SWB1<br />
-.20<br />
SWB2<br />
-.26*<br />
.61** .04 -.19 -.17 -.33**<br />
.18 .04 -.03 -.18<br />
.79**<br />
.33**<br />
.40**<br />
.30*<br />
.49**<br />
.70**<br />
Note. Grief 1 = Time 1 TRIG Part II Present; Grief 2 = Time 2 TRIG Part II Present;<br />
Grief R = Time 2 TRIG with Time 1 Residualized; SSQ1 = Time 1 Social Support<br />
Adjusted Satisfaction; SSQ 2 = Time 2 Social Support Adjusted Satisfaction; SWB 1 =<br />
Time 1 Spirituality; SWB 2 = Time 2 Spirituality.<br />
*p
Table 5<br />
Grief in Women Religious 35<br />
Stepwise Regression Analysis for Extroversion Variables Predicting Grief Symptoms in<br />
Active and Contemplative Women Religious<br />
Step l<br />
Variable<br />
Centered<br />
Ext<br />
Step 2<br />
Centered<br />
Ext<br />
Centered<br />
Lifestyle<br />
Step3<br />
Centered<br />
Ext<br />
Centered<br />
Lifestyle<br />
Interaction<br />
Lifestyle-<br />
Ext<br />
B<br />
.01<br />
Grief in Women Religious 36<br />
residualized grief are shown in Table 3. <strong>The</strong> difference for both <strong>of</strong> these measures was<br />
that active women religious reported higher levels <strong>of</strong> grief than did contemplative women<br />
religious. <strong>The</strong> main effect <strong>of</strong> lifestyle was significant, as mentioned above, but the main<br />
effect <strong>of</strong> extraversion was not significant. In addition, although no interaction between<br />
lifestyle and extraversion was found, the scores approached significance. In order to<br />
examine the nature <strong>of</strong> this interaction, Table 6 shows mean residualized grief scores for<br />
active and contemplative participants who scored either above or below the sample mean<br />
for extraversion. <strong>The</strong> differences in the means were consistent with the hypothesis,<br />
although not significant.<br />
Hypothesis 4 was that there is a difference between women religious lifestyles in<br />
relative contribution <strong>of</strong> time 1 spirituality and social support in predicting time 2 grief<br />
symptoms, after controlling for time 1 grief, such that social support and spirituality is<br />
more predictive <strong>of</strong> grief among active women religious and spirituality alone is predictive<br />
<strong>of</strong> grief among contemplative women religious. This was tested using a hierarchical<br />
regression. Due to limited power as a result <strong>of</strong> a small sample size, analyses were<br />
conducted separately for the two groups rather than conducting a regression with a 3-way<br />
interaction (see Table 7 and Table 8). Among active women religious spiritual well-<br />
being was a significant predictor <strong>of</strong> time 2 residualized grief (see Table 7), but neither<br />
social support nor the interaction between spirituality and social support were predictive<br />
<strong>of</strong> grief. Specifically, time 1 spirituality was negatively predictive <strong>of</strong> time 2 grief. For<br />
contemplative women religious, spirituality was not a significant predictor <strong>of</strong> time 2<br />
residualized grief (see Table 8). Additionally, neither social support nor the interaction
Table 6<br />
Grief in Women Religious 37<br />
Summary <strong>of</strong> Descriptive Statistics for Lifestyle-Extroversion Interaction<br />
Extraversion<br />
High<br />
Low<br />
Lifestyle<br />
Active Contemplative<br />
M= 1.72, SD = (4.80)<br />
n = 26<br />
M= 2.58, SD = (4.97)<br />
n= 20<br />
M = -1.14, SD= (6.31)<br />
n=12<br />
M= -3.54, SD = (2.61)<br />
n= 19<br />
Note. M= Mean score for Time 2 TRIG with Time 1 Residualized; SD = Standard<br />
Deviation for Time 2 TRIG with Time 1 Residualized.
Table 7<br />
Grief in Women Religious 38<br />
Stepwise Regression Analysis Among Active Women Religions for Variables Predicting<br />
Residualized Grief at Time 2<br />
Step 1<br />
Variable<br />
Centered<br />
SWB1<br />
Step 2<br />
Centered<br />
SWB1<br />
Centered<br />
SSQ1<br />
Steps<br />
Centered<br />
SWB1<br />
Centered<br />
SSQ1<br />
Interaction<br />
Centered<br />
SSQ1 &<br />
SWB1<br />
B<br />
-.25<br />
-.24<br />
-.04<br />
-.26<br />
-.03<br />
-.003<br />
Note. *p
Table 8<br />
Grief in Women Religious 39<br />
Stepwise Regression Analysis Among Contemplative Women Religious for Variables<br />
Predicting Residualized Grief at Time 2<br />
Step 1<br />
Variable<br />
Centered<br />
SWB1<br />
Step 2<br />
Centered<br />
SWB1<br />
Centered<br />
SSQ1<br />
Step3<br />
Centered<br />
SWB1<br />
Centered<br />
SSQ1<br />
Interaction<br />
Centered<br />
SSQ1 &<br />
SWB1<br />
B<br />
.23<br />
.30<br />
-.08<br />
.14<br />
.02<br />
-.02<br />
SEB<br />
.22<br />
.27<br />
.17<br />
.35<br />
.21<br />
.02<br />
β<br />
.22<br />
.30<br />
-.13<br />
.14<br />
.02<br />
-.22<br />
t<br />
1.06<br />
1.12<br />
-.48<br />
.39<br />
.07<br />
-.74<br />
Sig.<br />
.30<br />
.28<br />
.64<br />
.70<br />
.94<br />
.47<br />
R 2<br />
.05<br />
.06<br />
.09<br />
^R 2<br />
.05<br />
.03<br />
.06
Grief in Women Religious 40<br />
between spirituality and social support, at time 1, were predictive <strong>of</strong> grief at time 2.<br />
Furthermore, post hoc examination <strong>of</strong> closeness to the deceased was conducted,<br />
due to concern that closeness may act as a confound in the analyses. Closeness was<br />
measured on a Likert scale ranging from one to five with one being the highest degree <strong>of</strong><br />
closeness, and it was reverse scored. <strong>The</strong> active women religious were significantly<br />
closer to the deceased (M = 2.31, SD =1.10) than were the contemplative women<br />
religious (M= 2.88, SD = 1.18; t = -2.25, p < .05). Furthermore, closeness was<br />
significantly correlated with time 1 and time 2 grief for the contemplative women<br />
religious (r = -.64, p < .01; r = -.73, p < .01) but not for the active women religious.<br />
However, closeness was not significantly related to residualized time 2 grief for either<br />
group.<br />
In addition, post hoc examination <strong>of</strong> relation to the deceased was conducted due<br />
to concern that relation to the deceased may act as a confound in the study. Results<br />
indicate a significant difference between active women religious and contemplative<br />
women religious (χ 2 = 35.00, p < .001). Active women religious reported a higher loss <strong>of</strong><br />
parents and siblings, whereas contemplative women religious reported the loss <strong>of</strong> more<br />
community members.
CHAPTER IV<br />
Discussion<br />
Grief in Women Religious 41<br />
This study examined the impact that social support, spirituality and extraversion<br />
have on grief symptoms in active and contemplative women religious. Overall, their<br />
perceived social support remained relatively stable over time, as indicated by the means<br />
and standard deviations. For women religious in this study, social support did not affect<br />
grief symptoms over time. This finding is inconsistent with the existing research on<br />
social support and grief, which indicates that social support appears to have a positive<br />
impact on grief resolution (Krause, 1986; Nolen-Hoeksema, 1999; Norris & Murrell,<br />
1990; Sanders, 1999). <strong>The</strong> results <strong>of</strong> the present study may be due to the short span <strong>of</strong><br />
time between the experience <strong>of</strong> loss and testing. Previous research examined these<br />
variables over longer periods <strong>of</strong> time such as one to seven years post loss (Lehman &<br />
Wortman, 1986; Nolen-Hoeksema, 1999; Laakos & Paunonen-Ilmonen, 2002). It is<br />
possible that for social support to influence grief symptoms, a longer tune frame is<br />
needed then the present study explored.<br />
In addition, the lack <strong>of</strong> impact <strong>of</strong> social support on grief symptoms among the<br />
participants in this study may be due to the nature <strong>of</strong> their social support network. In this<br />
study, women religious reported that family members, community members, lay friends<br />
and members <strong>of</strong> the clergy were people who they count on for support. Previous research<br />
suggests that the quality and the ability to utilize social support are negatively associated<br />
with bereavement (Nolen-Hoeksema & Larson, 1999; Ulmer et al., 1991; Vachon &<br />
Stylianos, 1988). Although women religious, on self-reported measures may be satisfied<br />
with their overall social support, during times <strong>of</strong> bereavement, they may not be living
Grief in Women Religious 42<br />
with or even have regular contact with other individuals who also are grieving for the<br />
deceased. Moreover, they do not have a spouse or children and the emotional ties that<br />
spring from relationships <strong>of</strong> this nature. Research indicates that nontraditional<br />
relationships may lead to additional problems during the grieving process (Doka, 1987).<br />
Moreover, during times <strong>of</strong> bereavement, the structure <strong>of</strong> religious life may inhibit<br />
women religious from utilizing their social support system to its full effectiveness. <strong>The</strong><br />
mean and standard deviation scores <strong>of</strong> social support, for the active and contemplative<br />
women noted in Table 3, are lower than those <strong>of</strong> college students in the original study (M<br />
= 145.26, Sarason et al., 1983). Religious life demands a willingness to embrace self-<br />
sacrifice, live by countercultural values, and follow specific rules. For contemplative<br />
religious, this may mean restricted contact with their support system. This may<br />
demonstrate itself through limited contacts by phone, visits, or an in depth sharing <strong>of</strong><br />
feelings. For active women religious, this may be the consequence <strong>of</strong> living apart from<br />
their religious community, the responsibilities and time restraints <strong>of</strong> their ministry, or the<br />
obligations they have to their communities. Research indicates that the structure <strong>of</strong> an<br />
organization can hinder the positive impact <strong>of</strong> social support and stresses that the effects<br />
<strong>of</strong> social support depends on the degree <strong>of</strong> contact between individuals (Vachon &<br />
Stylianos, 1988).<br />
Furthermore, when active and contemplative women religious were examined as<br />
one group, spirituality at time 1 did not predict grief symptoms at time 2. In contrast,<br />
when the results were examined separately by group (active and contemplative),<br />
spirituality at time 1 for the active women religious did impact grief at time 2. <strong>The</strong><br />
present study's finding that spirituality did not impact grief symptoms over time, when
Grief in Women Religious 43<br />
women religious were tested as one group, is inconsistent with research on spirituality<br />
and grief, which indicates that spirituality impacts grief resolution (Golsworthy & Coyle,<br />
1999; Marrone, 1999). While spirituality is an important focus for active women<br />
religious, their lives also entail a ministerial dimension. <strong>The</strong>ir ministry requires them to<br />
engage in personal contact with others and to spend less time in silence and structured<br />
prayer (Schneiders, 2000). <strong>The</strong> fast-paced feature <strong>of</strong> the active religious life is similar to<br />
the lifestyle <strong>of</strong> lay people. For these reasons, it appears that spirituality may impact the<br />
grief <strong>of</strong> active women religious as previous research suggests (Golsworthy & Coyle,<br />
1999; Marrone, 1999). In addition, active women religious may also use high perceived<br />
spirituality as a shield to refrain from addressing the pain associated with their loss. This<br />
would be consistent with research that suggests that while faith supports individuals<br />
through the grief process, it can also lead to feelings <strong>of</strong> embarrassment and guilt when<br />
individuals criticize themselves for not coping more effectively with their loss<br />
(Golsworthy & Coyle, 1999). In contrast to the active group, results indicate that for the<br />
contemplative group spirituality at time 1 did not impact grief at time 2. This finding is<br />
consistent with a longitudinal study <strong>of</strong> bereaved adults using the TRIG and a spirituality<br />
scale which did not find a significant relation between spirituality and grief (Longman,<br />
1993). Additional research in this area is needed.<br />
Moreover, the difference found between active and contemplative women<br />
religious may also suggest a relation between religious lifestyles and coping styles. <strong>The</strong><br />
lifestyle <strong>of</strong> active women religious may provide more overt opportunities for coping such<br />
as personal therapy, support groups, or frequent contact with other individuals who have<br />
lost loved ones; whereas, in the contemplative life, due to its structure, these
Grief in Women Religious 44<br />
opportunities may not be as accessible. Research indicates that the relation between<br />
spirituality and grief may be due to active coping styles rather than passive coping styles<br />
(Marrone, 1999). This assumption may be an interesting aspect to examine in future<br />
research. In addition, spirituality may be assessed from multiple domains including<br />
spiritual coping, search for meaning, religious values, strength <strong>of</strong> beliefs, perception <strong>of</strong><br />
the transcendent (God, the divine), and spiritual experiences (Fetzer Institute, 1999). For<br />
clinicians who work with bereaved women religious, it is important to understand and<br />
address these various facets <strong>of</strong> spirituality.<br />
Given that the results for this population, when tested in one group, are contrary<br />
to previous findings, it is important to consider the possibility <strong>of</strong> measurement issues. As<br />
previously reported, in the present study, the coefficient alphas for the measures used at<br />
time 1 and time 2 were comparable to those found in past research. In addition, at time 1<br />
and time 2 all <strong>of</strong> the participants scored within the moderate to high range <strong>of</strong> spirituality.<br />
At time 1, 12 <strong>of</strong> the 82 participants received the maximum score and at time 2, 11 <strong>of</strong> the<br />
73 women received the maximum score. <strong>The</strong>refore, although a pilot study was<br />
conducted in order to minimize potential ceiling effects with the SWB measure, there<br />
may still have been such a problem with this sample. Furthermore, at time 1 and time 2,<br />
this present study found significant correlations between social support and spirituality.<br />
This finding is consistent with other research that found a negative correlation with the<br />
SWB scale and loneliness (Ellison, 1983). Although this present study does not present<br />
data to address these differences, it may be important to examine these factors in future<br />
research.
Grief in Women Religious 45<br />
Although findings do not support that the impact <strong>of</strong> extroversion on grief depends<br />
on a particular religious lifestyle, the results came close to significance. Findings appear<br />
to indicate that active women religious with high extraversion also reported lower grief<br />
symptoms. Furthermore, contemplative women religious with high extraversion also<br />
reported higher grief symptoms. Statistical power may be a consideration here; if a larger<br />
number <strong>of</strong> participants had been obtained, a significant finding may have been reported.<br />
Although extensive attempts were made, it was difficult to find eligible and willing<br />
contemplative participants.<br />
In addition, results show a relation between religious lifestyle and grief<br />
symptoms. Specifically, the active participants reported significantly higher grief<br />
symptoms than did the contemplative participants. One projected reason for this<br />
difference may be the degree <strong>of</strong> closeness to the deceased. As stated above, a larger<br />
number <strong>of</strong> active women religious endorsed more grief symptoms and greater closeness<br />
to the deceased than did the contemplative women religious. Closeness, however, was<br />
significantly related to grief in the contemplative group and not in the active group.<br />
Although, over both groups, individuals who were closer to the deceased may have<br />
endorsed more grief symptoms, the degree <strong>of</strong> closeness to the deceased for contemplative<br />
women religious had more <strong>of</strong> an effect on their grief than for the active women religious.<br />
<strong>The</strong> between-group difference may stem from the physically and emotionally close<br />
community environment that the contemplative life entails. If a community <strong>of</strong><br />
contemplative women religious live with the same people over the course <strong>of</strong> years, the<br />
bond that develops between these people may become extremely close. <strong>The</strong>refore, the
Grief in Women Religious 46<br />
impact that the loss <strong>of</strong> a member has on a bereaved contemplative woman religious may<br />
be significantly greater than if they had lived in a different type <strong>of</strong> community.<br />
Furthermore, when a contemplative woman religious experiences the death <strong>of</strong><br />
someone close to her, the physical separation from family and friends that the<br />
contemplative life requires and the reduced number <strong>of</strong> outlets that this lifestyles permits<br />
may intensify her grief symptoms. <strong>The</strong>se restrictions may hinder contemplative women<br />
religious from displaying sufficient outward expressions <strong>of</strong> grief, participating actively in<br />
bereavement rituals, or connecting adequately with family or friends who are also<br />
grieving. In addition, the type <strong>of</strong> death (e.g., sudden, slow, tragedy) may have an impact<br />
on the level <strong>of</strong> grief symptoms endorsed by both active and contemplative women<br />
religious. Moreover, if an individual cared for the deceased during their last illness, this<br />
may also have influenced the degree <strong>of</strong> grief symptoms reported.<br />
Limitations <strong>of</strong> the Study. <strong>The</strong>re are several limitations <strong>of</strong> this study. First, the size<br />
<strong>of</strong> the sample, especially the small number <strong>of</strong> contemplative women religious, reduced<br />
the power <strong>of</strong> the study. <strong>The</strong>re are approximately 69,963 women religious (active and<br />
contemplative) in the United States (Kenedy, 2005). <strong>The</strong>refore, education on the<br />
importance <strong>of</strong> grief research in this population may persuade greater participation in<br />
future research. In addition, while the SSQ and SWB are reliable and valid measures in<br />
the general population, they may not be the best measures to use with this population.<br />
Several participants reported that the SSQ was confusing, repetitive, and time consuming.<br />
<strong>The</strong>refore, the participants may have inaccurately reported their responses. Moreover, as<br />
discussed earlier, there was a ceiling effect with the SWB in this population despite pre-
Grief in Women Religious 47<br />
emptive pilot study designed to check for this concern. This may suggest a need to<br />
develop measures that are more sensitive to this population.<br />
Furthermore, closeness and relation to the deceased were not factored into the<br />
analyses. As previously discussed the active women religious were significantly closer to<br />
the deceased and also reported the loss <strong>of</strong> more immediate family members than did the<br />
contemplative group who reported more losses <strong>of</strong> community members. <strong>The</strong>refore,<br />
control <strong>of</strong> these variables may be important factors to consider in future research with this<br />
population. An additional, limitation <strong>of</strong> this study is that the sample consisted mainly <strong>of</strong><br />
European Americans. According to Mary Bendyna, RSM, Executive Director <strong>of</strong> the<br />
Center for Applied Research in the Apostolate, there is no data on the background <strong>of</strong><br />
women religious in the United States (M. Bendyna, personal communication, September<br />
19, 2004). <strong>The</strong>refore, it is difficult to know if the proportional race and ethnicity reported<br />
in this sample is representative <strong>of</strong> women religious. It may be interesting for future<br />
research to explore the existence <strong>of</strong> cultural differences in the grief process <strong>of</strong> women<br />
religious and generally beneficial to have richer demographic information on this<br />
population.<br />
Implications for Future Research. More research on grief in women religious is<br />
needed to examine the impact <strong>of</strong> spirituality and social support on grief symptoms in<br />
active and contemplative women religious. In this regard, future research may benefit<br />
from using other social support and spirituality measures that are more appropriate for<br />
this population. Furthermore, the present findings suggest that future research also may<br />
benefit from examining the variables in separate groups (active and contemplative) rather<br />
than together. In this study, the main effect <strong>of</strong> lifestyle was found to be significant. This
Grief in Women Religious 48<br />
may indicate that if social support and spirituality were examined separately for each<br />
lifestyle with larger samples, results may have found these variables to be significant<br />
predictors <strong>of</strong> grief. <strong>The</strong>refore, attempts to gather a larger sample size is important for<br />
future research. For that reason, it is essential that contemplative women religious be<br />
encouraged to participate in this type <strong>of</strong> research. This may necessitate educational<br />
programs, seminars, and/or journal articles that address the relevance <strong>of</strong> examining grief<br />
related issues in women religious. Furthermore, the restricted and secluded nature <strong>of</strong> the<br />
contemplative life makes group research such as this extremely difficult.<br />
An additional factor that may be interesting to examine in future research with<br />
women religious is neuroticism. McCrae and Costa (2003) describe neuroticism as the<br />
likeliness <strong>of</strong> a person to experience unpleasant emotions that lead to disturbing thoughts<br />
and actions. According to these researchers, individuals who are high in neuroticism are<br />
likely to be high in traits such as anxiety, anger, depression, self-consciousness,<br />
impulsivity and vulnerability. Furthermore, high neuroticism leads to problematic<br />
interpersonal relationships and difficulties coping with negative events (McCrae &<br />
Cossta, 2003). In addition, Kenel (1983) indicates a relation between depression, anger<br />
and grief. <strong>The</strong>refore, neuroticism may influence the grief process and be an important<br />
factor to investigate in future research with bereaved women religious.<br />
Moreover, future research may consider addressing a longer length <strong>of</strong> time since the<br />
loss occurred, closeness to the deceased, coping styles, the role <strong>of</strong> personal growth during<br />
bereavement and the limited emotional contact that contemplative women religious may<br />
encounter. From this type <strong>of</strong> research, mental health care providers may identity key<br />
factors that may result in unique treatment needs for women religious. <strong>The</strong>refore, women
Grief in Women Religious 49<br />
religious may benefit psychologically and spiritually, from research on grief, which will<br />
lead to healthier and more productive lives.<br />
In addition, as women religious in the United States continue to examine their<br />
lifestyle and adapt to changes in society, it is important to study differences in the grief<br />
process <strong>of</strong> this distinct population due to their belief system and the nature <strong>of</strong> their<br />
environment. It may be interesting to further explore the relative contribution <strong>of</strong><br />
spirituality and particular components <strong>of</strong> lifestyle on grief resolution in this specific<br />
group <strong>of</strong> women. Research findings may help women religious better understand<br />
bereavement, identity variables that create supportive local communities and clarify the<br />
role <strong>of</strong> spirituality in the grief process.
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McDowell, I., & Newell, C. (1987). Measuring health: A guide to rating scales and<br />
questionnaires. New York: Oxford University Press.<br />
Meuser, T. M., Davies, R. M., & Marwit, S. J. (1995). Personality and conjugal<br />
bereavement in older widow(er)s. Omega, 30(3), 223-235.<br />
Miller, W. R. (Ed.). (1999). Integrating spirituality into treatment: Resources for<br />
practioners. Washington, DC: American Psychological Association.<br />
Morris, L. W. (1979). Extroversion and introversion: An interactional perspective.<br />
Washington, DC: Hemisphere.<br />
Nolen-Hoeksema, S., & Larson, J. (1999). Coping with loss. Mahwah, NJ: Lawrence<br />
Erlbaum.<br />
Norris, F. H., & Murrell, S. A. (1990). Social support, life events, and stress as modifiers<br />
<strong>of</strong> adjustment to bereavement by older adults. Psychology and Aging, 5(3), 429-<br />
436.
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O'Kane, J. (1996). A comparison <strong>of</strong> continuity <strong>of</strong> life issues, perceived social support,<br />
spiritual well-being and life satisfaction in two groups <strong>of</strong> female nursing home<br />
residents: Catholic sisters and middle class lay women (Unpublished doctoral<br />
<strong>dissertation</strong>, Fordham University).<br />
Paloutzian, R. F., & Ellison, C. W. (1991). Manual for the spiritual well-being scale.<br />
New York: Life Advance.<br />
Parkes, C. M. (1998). Bereavement: Studies <strong>of</strong> grief in adult life (3 rd ed.). Madison, CT:<br />
International Universities Press.<br />
Parkes, C. M., & Weiss, R. S. (1983). Recovery from bereavement. New York: Basic<br />
Books.<br />
Ringdal, G. I., Jordhoy, M. S., Ringdal, K., & Kaasa, S. (2001). <strong>The</strong> first year <strong>of</strong> grief<br />
and bereavement in close family members to individuals who have died <strong>of</strong> cancer.<br />
Palliative Medicine, 15, 91-105.<br />
Ringler, L. L., & Hayden, D. C. (2000). Adolescent bereavement and social support: Peer<br />
loss compared to other losses. Journal <strong>of</strong> Adolescent Research, 15(2), 209-230.<br />
Rosenblatt, P. (1993). Grief: <strong>The</strong> social context <strong>of</strong> private feelings. In M. S. Stroebe, W.<br />
Stroebe & R. O. Hansson (Eds.), Handbook <strong>of</strong> bereavement: <strong>The</strong>ory, research,<br />
and intervention (pp. 102-111). New York: Cambridge University Press.<br />
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Difficulties in supporting the bereaved. Omega, 23(2), 119-128.<br />
Rosenblatt, P. C. (1996). Grief that does not end. In D. Klass, P. R. Silverman, & S. L.<br />
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Grief in Women Religious 57<br />
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Sons.<br />
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support: <strong>The</strong> social support questionnaire. Journal <strong>of</strong> Personality and Social<br />
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Schaefer, J. A., & Moos, R. H. (2001). Bereavement experiences and personal growth. In<br />
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bereavement research: Consequences, coping, and care (pp. 145-167).<br />
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Schneider, S. M. (2000). Finding the treasure (Vol. 1). New York: Paulist Press.<br />
Schneider, S. M. (2001). Selling all (Vol. 2). New York: Paulist Press.<br />
Solari-Twadell, P. A., Bunkers, S. S., Wang, C., & Snyder, D. (1995). <strong>The</strong> pinwheel<br />
model <strong>of</strong> bereavement. Image-<strong>The</strong> Journal <strong>of</strong> Nursing Scholarship, 27(4), 323-<br />
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<strong>The</strong>ory, research, and intervention. New York: Cambridge University Press.
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interval. Psychology and Aging, 6(3), 434-441.<br />
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(1982). Predictors and correlates <strong>of</strong> adaptation to conjugal bereavement<br />
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Walsh, K., King, M., Jones, L., Tookman, A., & Blizard, R. (2002). Spiritual beliefs may<br />
affect outcome <strong>of</strong> bereavement: Prospective study. British Medical Journal,<br />
324(7353), 1551-1555.<br />
Webner, M L. (1999). Wilderness: A journey through grief. Spiritual Life, Sum, 110-<br />
117.<br />
Zautra, A. J., Finch, J. F., & Reich, J. W. (1991). Predicting the everyday life events <strong>of</strong><br />
older adults. Journal <strong>of</strong> Personality, 59(3), 507-508.
APPENDIX A<br />
Human Subject Review Letter <strong>of</strong> Consent for Study<br />
Grief in Women Religious 59
Grief in Women Religious 60<br />
LOYOLA COLLEGE IN MARYLAND<br />
Office <strong>of</strong> Grant Services, 4501 North Charles Street, Baltimore, Maryland 21210<br />
REVIEW OF PROTOCOL FOR RESEARCH INVOLVING HUMAN SUBJECTS<br />
Log Number: 1842 Date Received: 5/3/2004<br />
Principal Investigator: Donna <strong>Kelley</strong> Home Phone: 410 337-1462<br />
7601 Osler Drive Campus Phone:<br />
Towson, MD 21286<br />
Co-Investigators:<br />
Proposal Title: <strong>The</strong> Impact <strong>of</strong> Social Support, Spirituality and Extroversion on Grief Symptoms<br />
in Women Religious<br />
Faculty Sponsor: David Powers Faculty Phone: 2093<br />
Primary Reviewer: Nancy Dufau Project Period: 5/1/2004 to 1/17/2006<br />
Secondary Reviewer: Requires Renewal Yes, if checked<br />
Project Submitted as: Exempt: Yes Under Category: 3 Expedited: No<br />
Primary and Secondary Reviewers:<br />
Please sign and return to the Office <strong>of</strong> Grant Services, Humanities Center, Room 165.<br />
RECOMMENDATION:<br />
This proposal or amendment is approved as is.<br />
Additional information is required in order to evaluate this<br />
application/amendment. See comments below.<br />
This proposal is not exempt, it qualifies for approval under the expedited review<br />
process. Applicant should revise and resubmit the protocol in accord with the<br />
attached evaluation or should request a full committee review.<br />
COMMENTS:________________________________________________________________<br />
________________________________________________________________<br />
________________________________________________________________<br />
Decision to PI:<br />
Hard Copy to PI:<br />
Clarification Requested:<br />
Clarification Rec'd:<br />
Amendment Rec'd:<br />
Amendment Decision:<br />
Notes: You may wish to change the<br />
wording in the cover letter to state<br />
"your participation is voluntary",<br />
In the last line <strong>of</strong> the second<br />
paragraph.<br />
THE COLLEGE'S GENERAL<br />
REQUIREMENTS FOR THE PROTECTION<br />
OF HUMAN SUBJECTS APPLY TO ALL<br />
RESEARCH, WHETHER OR NOT IT HAS<br />
BEEN DECLARED EXEMPT.
APPENDIX B<br />
Texas Revised Inventory <strong>of</strong> Grief<br />
Grief in Women Religious 61
Inventory Items:<br />
TRIG<br />
Grief in Women Religious 62<br />
If more than one person has died, please complete a separate form for each person.<br />
<strong>The</strong> person who died was my (check only one):<br />
Father______ Friend______<br />
Mother______ Other (Specify)__________<br />
Brother______<br />
Sister______<br />
Looking back, I would guess that my relationship with this person was<br />
(check only one):<br />
_____ Closer than any relationship I've ever had before or since.<br />
_____ Closer than most relationships I've had with other people.<br />
_____About as close as most <strong>of</strong> my relationships with others.<br />
_____ Not as close as most <strong>of</strong> my relationships.<br />
_____ Not very close at all.<br />
How old was the person when they died? __________<br />
This person died (check only one):<br />
_____ within the past one 1 month<br />
_____ within the past 2 months<br />
_____ within the past 3 months<br />
_____ within the past 4-7 months<br />
<strong>The</strong> person's death was<br />
_____ Expected _____ Unexpected _____ Slow _____ Sudden<br />
ID#_______________
PART I: PAST BEHAVIOR<br />
Grief in Women Religious 63<br />
Think back to the time this person died and answer all <strong>of</strong> these items about your feelings<br />
and actions at that time by checking whether each item is Completely True, Mostly True,<br />
Both True and False, Mostly False, or Completely False as it applied to you after this<br />
person died. Check the best answer.<br />
1. After this person died I found it hard to get along with certain people.<br />
____Completely True ____Mostly True ____Both True and False<br />
____Mostly False ____Completely False<br />
2. I found it hard to work well after this person died.<br />
____Completely True ____Mostly True ____Both True and False<br />
____Mostly False ____Completely False<br />
3. After this person's death I lost interest in my family, friends, and outside activities.<br />
____Completely True ____Mostly True ____Both True and False<br />
____Mostly False ____Completely False<br />
4. I felt a need to do things that the deceased had wanted to do.<br />
____Completely True ____Mostly True ____Both True and False<br />
____Mostly False ____Completely False<br />
5. I was unusually irritable after this person died.<br />
____Completely True ____Mostly True ____Both True and False<br />
____Mostly False ____Completely False<br />
6. I couldn’t keep up with my normal activities for the first 3 months after this person<br />
died.<br />
____Completely True ____Mostly True ____Both True and False<br />
____Mostly False ____Completely False<br />
7. I was angry that the person who died left me.<br />
____Completely True ____Mostly True ____Both True and False<br />
____Mostly False ____Completely False<br />
8. I found it hard to sleep after this person died.<br />
____Completely True ____Mostly True ____Both True and False<br />
____Mostly False ____Completely False
PART II: PRESENT EMOTIONAL FEELINGS<br />
Grief in Women Religious 64<br />
Now answer all <strong>of</strong> the following items by checking how you presently feel about this<br />
person's death. Do not look back at Part I.<br />
1. I still cry when I think <strong>of</strong> the person who died.<br />
____Completely True ____Mostly True ____Both True and False<br />
____Mostly False ____Completely False<br />
2. I still get upset when I think about the person who died.<br />
____Completely True ____Mostly True ____Both True and False<br />
____Mostly False ____Completely False<br />
3. I cannot accept this person's death.<br />
____Completely True ____Mostly True ____Both True and False<br />
____Mostly False ____Completely False<br />
4. Sometimes I very much miss the person who died.<br />
____Completely True ____Mostly True ____Both True and False<br />
____Mostly False ____Completely False<br />
5. Even now it's painful to recall memories <strong>of</strong> the person who died.<br />
____Completely True ____Mostly True ____Both True and False<br />
____Mostly False ____Completely False<br />
6. I am preoccupied with thoughts (<strong>of</strong>ten think) about the person who died.<br />
____Completely True ____Mostly True ____Both True and False<br />
____Mostly False ____Completely False<br />
7. I hide my tears when I think about the person who died.<br />
____Completely True ____Mostly True ____Both True and False<br />
____Mostly False ____Completely False<br />
8. No one will ever take the place in my life <strong>of</strong> the person who died<br />
____Completely True ____Mostly True ____Both True and False<br />
____Mostly False ____Completely False<br />
9. I can't avoid thinking about the person who died<br />
____Completely True ____Mostly True ____Both True and False<br />
____Mostly False ____Completely False<br />
10. I feel it's unfair that this person died.<br />
____Completely True ____Mostly True ____Both True and False<br />
____Mostly False ____Completely False
Grief in Women Religious 65<br />
11. Things and people around me still remind me <strong>of</strong> the person who died.<br />
____Completely True ____Mostly True ____Both True and False<br />
____Mostly False ____Completely False<br />
12. I am unable to accept the death <strong>of</strong> the person who died.<br />
____Completely True ____Mostly True ____Both True and False<br />
____Mostly False ____Completely False<br />
13 . At times I still feel the need to cry for the person who died.<br />
____Completely True ____Mostly True ____Both True and False<br />
____Mostly False ____Completely False<br />
PART III: RELATED FACTS<br />
Please answer the following items by circling either True or False.<br />
1.<br />
2.<br />
3.<br />
4.<br />
5.<br />
I attended the funeral <strong>of</strong> the person who died.<br />
I feel that I have really grieved for the person who died.<br />
I feel that I am now functioning about as well as I was<br />
before the death.<br />
I seem to get upset each month at about the same time as the<br />
person died.<br />
Sometimes I feel that I have the same illness as the person<br />
who died.<br />
True<br />
True<br />
True<br />
True<br />
True<br />
Thank you for answering all <strong>of</strong> these questions. We are also very interested in<br />
False<br />
False<br />
False<br />
False<br />
False<br />
your special thoughts and comments. Please use the rest <strong>of</strong> this side to tell us about<br />
any thoughts and feelings that you have.
APPENDIX C<br />
Social Support Questionnaire<br />
Grief in Women Religious 66
INSTRUCTIONS:<br />
SSQ<br />
Grief in Women Religious 67<br />
<strong>The</strong> following questions ask about people in your environment who provide you with<br />
help or support. Each question has two parts. For the first part, list all the people you<br />
know, excluding yourself, who you can count on for help or support in the manner<br />
described. Give the person's initials and their relationship to you (see example). Do<br />
not list more than one person next to each <strong>of</strong> the numbers beneath the question.<br />
For the second part, circle how satisfied you are with the overall support you have.<br />
If you have no support for a question, check the words "No one," but still rate your level<br />
<strong>of</strong> satisfaction. Do not list more than nine persons per question.<br />
Please answer all questions as best you can. All your responses will be kept confidential.<br />
EXAMPLE:<br />
Who do you know whom you can trust with information that could get you in trouble?<br />
No one<br />
1) T.N. (brother)<br />
2) T.M. (friend)<br />
3) R.S. (friend)<br />
How satisfied?<br />
6 - very 5 - fairly<br />
satisfied satisfied<br />
4 - a little<br />
satisfied<br />
4) T.N. (father)<br />
5) L.M. (employer)<br />
6) B.D. (community member)<br />
3 - a little<br />
dissatisfied<br />
7)<br />
8)<br />
9)<br />
2 - fairly<br />
dissatisfied<br />
1. Whom can you really count on to listen to you when you need to talk?<br />
No one 1)<br />
2)<br />
3)<br />
4)<br />
5)<br />
6)<br />
7)<br />
8)<br />
9)<br />
1 - very<br />
dissatisfied<br />
ID#_______<br />
How satisfied?<br />
6 - very 5 - fairly 4 - a little 3 - a little 2 - fairly 1 - very<br />
satisfied satisfied satisfied dissatisfied dissatisfied dissatisfied<br />
2. Whom could you really count on to help you if a person whom you thought was a good friend<br />
insulted you and told you that he/she didn't want to see you again?<br />
No one 1)<br />
4)<br />
7)<br />
2)<br />
3)<br />
How satisfied?<br />
5)<br />
6)<br />
8)<br />
9)<br />
6 - very<br />
satisfied<br />
5 - fairly<br />
satisfied<br />
4 – a little<br />
satisfied<br />
3 - a little<br />
dissatisfied<br />
2 - fairly<br />
dissatisfied<br />
1 - very<br />
dissatisfied
3. Whose lives do you feel that you are an important part <strong>of</strong>?<br />
No one 1)<br />
2)<br />
3)<br />
How satisfied?<br />
4)<br />
5)<br />
6)<br />
7)<br />
8)<br />
9)<br />
6 - very<br />
satisfied<br />
5 - fairly<br />
satisfied<br />
4 - a little<br />
satisfied<br />
3 - a little<br />
dissatisfied<br />
2 - fairly<br />
dissatisfied<br />
Grief in Women Religious 68<br />
1 - very<br />
dissatisfied<br />
4. Whom do you feel would help you if you were married and had just separated from your<br />
spouse?<br />
No one 1)<br />
2)<br />
3)<br />
How satisfied?<br />
6 - very<br />
satisfied<br />
5 - fairly<br />
satisfied<br />
4)<br />
5)<br />
6)<br />
4 - a little<br />
satisfied<br />
3- a little<br />
dissatisfied<br />
7)<br />
8)<br />
9)<br />
2 - fairly<br />
dissatisfied<br />
1 - very<br />
dissatisfied<br />
5. Whom could you really count on to help you out in a crisis situation, even though they would<br />
have to go out <strong>of</strong> their way to do so?<br />
No one 1) 4) 7)<br />
2) 5) 8)<br />
3) 6) 9)<br />
How satisfied?<br />
6 - very<br />
satisfied<br />
5 - fairly<br />
satisfied<br />
4 - a little<br />
satisfied<br />
3 - a little<br />
dissatisfied<br />
2 - fairly<br />
dissatisfied<br />
1 - very<br />
dissatisfied<br />
6. Whom can you talk with frankly, without having to watch what you say?<br />
No one 1) 4) 7)<br />
2) 5) 8)<br />
3)<br />
How satisfied?<br />
6) 9)<br />
6 - very 5 - fairly 4 - a little 3 - a little 2 - fairly 1 - very<br />
satisfied satisfied satisfied dissatisfied dissatisfied dissatisfied<br />
7. Who helps you feel that you truly have something positive to contribute to others?<br />
No one 1)<br />
2)<br />
3)<br />
4)<br />
5)<br />
6)<br />
7)<br />
8)<br />
9)<br />
How satisfied?<br />
6 - very<br />
satisfied<br />
5 - fairly<br />
satisfied<br />
4 - a little<br />
satisfied<br />
3 - a little<br />
dissatisfied<br />
2 - fairly<br />
dissatisfied<br />
1 - very<br />
dissatisfied
Grief in Women Religious 69<br />
8. Whom can you really count on to distract you from your worries when you feel under stress?<br />
No one<br />
How satisfied?<br />
6 - very<br />
satisfied<br />
l)<br />
2)<br />
3)<br />
5 - fairly<br />
satisfied<br />
4)<br />
5)<br />
6)<br />
4 - a little<br />
satisfied<br />
3 - a little<br />
dissatisfied<br />
7)<br />
8)<br />
9)<br />
2 - fairly<br />
dissatisfied<br />
1 - very<br />
dissatisfied<br />
9. Whom can you really count on to be dependable when you need help?<br />
No one 1)<br />
2)<br />
3)<br />
How satisfied?<br />
4)<br />
5)<br />
6)<br />
7)<br />
8)<br />
9)<br />
6 - very 5 - fairly 4 - a little 3 - a little 2 - fairly 1 - very<br />
satisfied satisfied satisfied dissatisfied dissatisfied dissatisfied<br />
10. Whom could you really count on to help you out if you had just been fired from your job or<br />
expelled from school?<br />
No one 1) 4)<br />
7)<br />
2) 5)<br />
8)<br />
3) 6)<br />
9)<br />
How satisfied?<br />
6 - very<br />
satisfied<br />
5 - fairly<br />
satisfied<br />
4 - a little<br />
satisfied<br />
3 - a little<br />
dissatisfied<br />
11. With whom can you totally be yourself?<br />
No one 1) 4)<br />
2) 5)<br />
3)<br />
How satisfied?<br />
6)<br />
6 - very 5 - fairly 4 - a little 3 - a little<br />
satisfied satisfied satisfied dissatisfied<br />
12. Whom do you feel really appreciates you as a person?<br />
No one 1) 4)<br />
2)<br />
3)<br />
5)<br />
6)<br />
How satisfied?<br />
6 - very<br />
satisfied<br />
5 - fairly<br />
satisfied<br />
4 - a little<br />
satisfied<br />
3 - a little<br />
dissatisfied<br />
2 - fairly<br />
dissatisfied<br />
7)<br />
8)<br />
9)<br />
2 - fairly<br />
dissatisfied<br />
7)<br />
8)<br />
9)<br />
2 - fairly<br />
dissatisfied<br />
1 - very<br />
dissatisfied<br />
1 - very<br />
dissatisfied<br />
1 - very<br />
dissatisfied
Grief in Women Religious 70<br />
13. Whom can you really count on to give you useful suggestions that help you to avoid making<br />
mistakes?<br />
No one 1)<br />
2)<br />
3)<br />
How satisfied?<br />
6 - very 5 - fairly<br />
satisfied satisfied<br />
4)<br />
5)<br />
6)<br />
4 - a little<br />
satisfied<br />
3 - a little<br />
dissatisfied<br />
7)<br />
8)<br />
9)<br />
2 - fairly<br />
dissatisfied<br />
1 - very<br />
dissatisfied<br />
14. Whom can you count on to listen openly and uncritically to your innermost feelings?<br />
No one 1)<br />
4)<br />
7)<br />
2)<br />
5)<br />
8)<br />
3)<br />
6)<br />
9)<br />
How satisfied?<br />
6 - very 5 - fairly<br />
satisfied satisfied<br />
4 - a little<br />
satisfied<br />
3 - a little<br />
dissatisfied<br />
2 - fairly<br />
dissatisfied<br />
15. Who will comfort you when you need it by holding you in their arms?<br />
No one 1)<br />
4)<br />
7)<br />
2)<br />
5)<br />
8)<br />
3)<br />
How satisfied?<br />
6)<br />
9)<br />
6 - very<br />
satisfied<br />
5 - fairly<br />
satisfied<br />
4 - a little<br />
satisfied<br />
3 - a little<br />
dissatisfied<br />
2 - fairly<br />
dissatisfied<br />
1 - very<br />
dissatisfied<br />
1 - very<br />
dissatisfied<br />
16. Whom do you feel would help if a good friend <strong>of</strong> yours had been in a car accident and was<br />
hospitalized in serious condition?<br />
No one 1)<br />
4)<br />
7)<br />
2)<br />
5)<br />
8)<br />
3)<br />
How satisfied?<br />
6)<br />
9)<br />
6 - very<br />
satisfied<br />
5 - fairly<br />
satisfied<br />
4 - a little<br />
satisfied<br />
3 - a little<br />
dissatisfied<br />
2 - fairly<br />
dissatisfied<br />
1 - very<br />
dissatisfied<br />
17. Whom can you really count on to help you feel more relaxed when you are under pressure or<br />
tense?<br />
No one 1)<br />
2)<br />
3)<br />
How satisfied?<br />
4)<br />
5)<br />
6)<br />
7)<br />
8)<br />
9)<br />
6 - very<br />
satisfied<br />
5 - fairly<br />
satisfied<br />
4 - a little<br />
satisfied<br />
3 - a little<br />
dissatisfied<br />
2 - fairly<br />
dissatisfied<br />
1 - very<br />
dissatisfied
Grief in Women Religious 71<br />
18. Whom do you feel would help if a family member very close to you died?<br />
No one 1)<br />
2)<br />
3)<br />
How satisfied?<br />
4)<br />
5)<br />
6)<br />
7)<br />
8)<br />
9)<br />
6 - very<br />
satisfied<br />
5 - fairly<br />
satisfied<br />
4 - a little<br />
satisfied<br />
3 - a little<br />
dissatisfied<br />
2 - fairly<br />
dissatisfied<br />
19. Who accepts you totally, including both your worst and your best points?<br />
No one 1) 4)<br />
7)<br />
2) 5)<br />
8)<br />
3) 6)<br />
9)<br />
How satisfied?<br />
6 - very<br />
satisfied<br />
5 - fairly<br />
satisfied<br />
4 - a little<br />
satisfied<br />
3-a little<br />
dissatisfied<br />
2 - fairly<br />
dissatisfied<br />
1 - very<br />
dissatisfied<br />
1 - very<br />
dissatisfied<br />
20. Whom can you really count on to care about you, regardless <strong>of</strong> what is happening to you?<br />
No one<br />
How satisfied?<br />
6 - very<br />
satisfied<br />
1)<br />
2)<br />
3)<br />
5 - fairly<br />
satisfied<br />
4)<br />
5)<br />
6)<br />
4 - a little<br />
satisfied<br />
3 - a little<br />
dissatisfied<br />
7)<br />
8)<br />
9)<br />
2 - fairly<br />
dissatisfied<br />
1 - very<br />
dissatisfied<br />
21. Whom can you really count on to listen to you when you are very angry at someone else?<br />
No one<br />
How satisfied?<br />
6 - very<br />
satisfied<br />
1)<br />
2)<br />
3)<br />
5 - fairly<br />
satisfied<br />
4)<br />
5)<br />
6)<br />
4 - a little<br />
satisfied<br />
3 - a little<br />
dissatisfied<br />
7)<br />
8)<br />
9)<br />
2 - fairly<br />
dissatisfied<br />
1- very<br />
dissatisfied<br />
22. Whom can you really count on to tell you, in a thoughtful manner, when you need to improve<br />
in some way?<br />
No one<br />
How satisfied?<br />
6 - very<br />
satisfied<br />
1)<br />
2)<br />
3)<br />
5 - fairly<br />
satisfied<br />
4)<br />
5)<br />
6)<br />
4 - a little<br />
satisfied<br />
3 - a little<br />
dissatisfied<br />
7)<br />
8)<br />
9)<br />
2 - fairly<br />
dissatisfied<br />
1 - very<br />
dissatisfied
Grief in Women Religious 72<br />
23. Whom can you really count on to help you feel better when you are feeling generally down-<br />
in-the-dumps?<br />
No one<br />
How satisfied?<br />
6 - very<br />
satisfied<br />
1)<br />
2)<br />
3)<br />
5 - fairly<br />
satisfied<br />
4)<br />
5)<br />
6)<br />
4 - a little<br />
satisfied<br />
3 - a little<br />
dissatisfied<br />
24. Whom do you feel truly loves you deeply?<br />
No one 1) 4)<br />
2) 5)<br />
3) 6)<br />
How satisfied?<br />
6 - very<br />
satisfied<br />
5 - fairly<br />
satisfied<br />
4 - a little<br />
satisfied<br />
3 - a little<br />
dissatisfied<br />
7)<br />
8)<br />
9)<br />
2 - fairly<br />
dissatisfied<br />
7)<br />
8)<br />
9)<br />
2 - fairly<br />
dissatisfied<br />
25. Whom can you count on to console you when you are very upset?<br />
No one 1) 4)<br />
7)<br />
2) 5)<br />
8)<br />
3) 6)<br />
9)<br />
How satisfied?<br />
6 - very 5 - fairly<br />
satisfied satisfied<br />
4 - a little<br />
satisfied<br />
3 - a little<br />
dissatisfied<br />
2 - fairly<br />
dissatisfied<br />
1 - very<br />
dissatisfied<br />
1 - very<br />
dissatisfied<br />
1 - very<br />
dissatisfied<br />
26. Whom can you really count on to support you in major decisions you make?<br />
No one 1) 4)<br />
7)<br />
2) 5)<br />
8)<br />
3) 6)<br />
9)<br />
How satisfied?<br />
6 - very 5 - fairly<br />
satisfied satisfied<br />
4 - a little<br />
satisfied<br />
3 - a little<br />
dissatisfied<br />
2 - fairly<br />
dissatisfied<br />
1 - very<br />
dissatisfied<br />
27. Whom can you really count on to help you feel better when you are very irritable, ready to<br />
get angry at almost anything?<br />
No one 1) 4)<br />
7)<br />
2) 5)<br />
8)<br />
3) 6)<br />
9)<br />
How satisfied?<br />
6 - very<br />
satisfied<br />
5 - fairly<br />
satisfied<br />
4 - a little<br />
satisfied<br />
3 - a little<br />
dissatisfied<br />
2 - fairly<br />
dissatisfied<br />
1 - very<br />
dissatisfied
APPENDIX D<br />
NEO-E<br />
Grief in Women Religious 73
NEO-E<br />
Grief in Women Religious 74<br />
ID#_______<br />
Please read each item carefully and circle the one answer that best corresponds to your<br />
agreement or disagreement.<br />
Circle "SD" if the statement is definitely false or if you strongly disagree.<br />
Circle "D" if the statement is definitely false or if you disagree.<br />
Circle "N" if the statement is about equally true or false, if you cannot decide, or if you<br />
are neutral on the statement<br />
Circle "A" if the statement is mostly true or if you agree.<br />
Circle "SA" if the statement is definitely true or if you strongly agree.<br />
1.<br />
2.<br />
3.<br />
4.<br />
5.<br />
6.<br />
7.<br />
8.<br />
9.<br />
10.<br />
I really like most people I meet.<br />
I shy away from crowds <strong>of</strong> people.<br />
I am dominant, forceful, and<br />
assertive.<br />
I have a leisurely style in work and<br />
play.<br />
I <strong>of</strong>ten crave excitement<br />
I have never literally jumped for joy.<br />
I don't get much pleasure from<br />
chatting with people.<br />
I like to have a lot <strong>of</strong> people around<br />
me.<br />
I sometimes fail to assert myself as<br />
much as I should.<br />
When I do things, I do them<br />
vigorously.<br />
SD<br />
SD<br />
SD<br />
SD<br />
SD<br />
SD<br />
SD<br />
SD<br />
SD<br />
SD<br />
D<br />
D<br />
D<br />
D<br />
D<br />
D<br />
D<br />
D<br />
D<br />
D<br />
N<br />
N<br />
N<br />
N<br />
N<br />
N<br />
N<br />
N<br />
N<br />
N<br />
A<br />
A<br />
A<br />
A<br />
A<br />
A<br />
A<br />
A<br />
A<br />
A<br />
SA<br />
SA<br />
SA<br />
SA<br />
SA<br />
SA<br />
SA<br />
SA<br />
SA<br />
SA
11. I wouldn't enjoy vacationing in Las<br />
Vegas.<br />
12. I have sometimes experienced<br />
intense joy or ecstasy.<br />
13. I'm known as a warm and friendly<br />
person.<br />
14. I usually prefer to do things alone.<br />
15. I have <strong>of</strong>ten been a leader <strong>of</strong> groups I<br />
have belonged to.<br />
16. My work is likely to be slow but<br />
steady.<br />
17. I have sometimes done things just for<br />
"kicks" or "thrills."<br />
18. I am not a cheerful optimist<br />
19. Many people think <strong>of</strong> me as<br />
somewhat cold and distant<br />
20. I really feel the need for other people<br />
if I am by myself for long.<br />
21. In meetings, I usually let others do<br />
the talking.<br />
22. I <strong>of</strong>ten feel as if I am bursting with<br />
energy.<br />
23. I tend to avoid movies that are<br />
shocking or scary.<br />
24. Sometimes I bubble with happiness.<br />
25. I really enjoy talking to people.<br />
26. I prefer jobs that let me work alone<br />
without being bothered by other<br />
people.<br />
SD<br />
SD<br />
SD<br />
SD<br />
SD<br />
SD<br />
SD<br />
SD<br />
SD<br />
SD<br />
SD<br />
SD<br />
SD<br />
D<br />
D<br />
D<br />
D<br />
D<br />
D<br />
D<br />
D<br />
D<br />
D<br />
D<br />
D<br />
D<br />
Grief in Women Religious 75<br />
N<br />
N<br />
N<br />
N<br />
N<br />
N<br />
N<br />
N<br />
N<br />
N<br />
N<br />
N<br />
N<br />
A<br />
A<br />
A<br />
A<br />
A<br />
A<br />
A<br />
A<br />
A<br />
A<br />
A<br />
A<br />
A<br />
SA<br />
SA<br />
SA<br />
SA<br />
SA<br />
SA<br />
SA<br />
SA<br />
SA<br />
SA<br />
SA<br />
SA<br />
SA<br />
SD D N A SA<br />
SD D N A SA<br />
SD<br />
D<br />
N<br />
A<br />
SA
27. Other people <strong>of</strong>ten look to me to<br />
make decisions.<br />
28. I am not as quick and lively as other<br />
people.<br />
29. I like to be where the action is.<br />
30. I don't consider myself especially<br />
"light-hearted."<br />
31. I find it easy to smile and be<br />
outgoing with strangers.<br />
32. I'd rather vacation at a popular beach<br />
than an isolated cabin in the woods.<br />
33. I would rather go my own way than<br />
be a leader <strong>of</strong> others.<br />
34. I usually seem to be in a hurry.<br />
35. I love the excitement <strong>of</strong> roller<br />
coasters.<br />
36. I am a cheerful, high-spirited person.<br />
37. I have strong emotional attachments<br />
to my friends.<br />
38. Social gatherings are usually boring<br />
to me.<br />
39. In conversations, I tend to do most<br />
<strong>of</strong> the talking.<br />
40. My life is fast-paced.<br />
41. I'm attracted to bright colors and<br />
flashy styles.<br />
42. I rarely use words like "fantastic!" or<br />
"sensational!" to describe my<br />
experiences.<br />
SD<br />
SD<br />
SD<br />
SD<br />
SD<br />
SD<br />
SD<br />
SD<br />
SD<br />
SD<br />
SD<br />
SD<br />
SD<br />
SD<br />
SD<br />
SD<br />
Grief in Women Religious 76<br />
D<br />
D<br />
D<br />
D<br />
D<br />
D<br />
D<br />
D<br />
D<br />
D<br />
D<br />
D<br />
D<br />
D<br />
D<br />
D<br />
N<br />
N<br />
N<br />
N<br />
N<br />
N<br />
N<br />
N<br />
N<br />
N<br />
N<br />
N<br />
N<br />
N<br />
N<br />
N<br />
A<br />
A<br />
A<br />
A<br />
A<br />
A<br />
A<br />
A<br />
A<br />
A<br />
A<br />
A<br />
A<br />
A<br />
A<br />
A<br />
SA<br />
SA<br />
SA<br />
SA<br />
SA<br />
SA<br />
SA<br />
SA<br />
SA<br />
SA<br />
SA<br />
SA<br />
SA<br />
SA<br />
SA<br />
SA
43. I take a personal interest in the<br />
people I work with.<br />
44. I enjoy parties with lots <strong>of</strong> people.<br />
45. I don't find it easy to take charge <strong>of</strong><br />
a situation.<br />
46. I am a very active person.<br />
47. I like being part <strong>of</strong> the crowd at<br />
sporting events.<br />
48. I laugh easily.<br />
SD<br />
D<br />
Grief in Women Religious 77<br />
N<br />
A<br />
SA<br />
SD D N A SA<br />
SD<br />
D<br />
N<br />
A<br />
SA<br />
SD D N A SA<br />
SD<br />
SD<br />
D<br />
D<br />
N<br />
N<br />
A<br />
A<br />
SA<br />
SA
APPENDIX E<br />
Spiritual Well-Being Scale<br />
Grief in Women Religious 78
SWB Scale<br />
Grief in Women Religious 79<br />
For each <strong>of</strong> the following statements circle the choice that best indicates the extent <strong>of</strong> your agreement or<br />
disagreement as it describes your personal experience.<br />
SA = Strongly Agree<br />
MA = Mostly Agree<br />
A =Agree<br />
D= Disagree<br />
MD = Moderately Disagree<br />
SD = Strongly Disagree<br />
1. I don't find much satisfaction in private prayer with God. SA MA A D MD SD<br />
2. I don't know who I am, where I came from,<br />
or where I am going.<br />
SA MA A D MD SD<br />
3. I believe that God loves me and cares about me.<br />
4. I feel that life is a positive experience.<br />
5. I believe that God is impersonal and not interested in<br />
my daily situations.<br />
6. I feel unsettled about my future.<br />
7. I have a personally meaningful relationship with God.<br />
8. I feel very fulfilled and satisfied with life.<br />
9. I don't get much personal strength and support<br />
from my God.<br />
10. I feel a sense <strong>of</strong> well-being about the direction<br />
my life is headed in.<br />
11. I believe that God is concerned about my problems.<br />
12. I don't enjoy much life.<br />
13. I don't have a personally satisfying relationship with God. SA MA A D MD SD<br />
14. I feel good about my future.<br />
15. My relationship with God helps me not to feel lonely.<br />
16. I feel that life is full <strong>of</strong> conflict and unhappiness.<br />
SA<br />
SA<br />
SA<br />
SA<br />
SA<br />
SA<br />
SA<br />
SA<br />
SA<br />
MA<br />
MA<br />
MA<br />
MA<br />
MA<br />
MA<br />
MA<br />
MA<br />
MA<br />
A<br />
A<br />
A<br />
A<br />
A<br />
A<br />
A<br />
A<br />
A<br />
D<br />
D<br />
D<br />
D<br />
D<br />
D<br />
D<br />
D<br />
D<br />
MD<br />
MD<br />
MD<br />
MD<br />
MD<br />
MD<br />
MD<br />
MD<br />
MD<br />
SA MA A D MD<br />
17. I feel most fulfilled when I'm in close communion with God. SA MA A D MD SD<br />
18. Life doesn't have much meaning.<br />
19. My relation with God contributes to my sense <strong>of</strong> well-being.<br />
SA<br />
SA<br />
SA<br />
MA<br />
MA<br />
MA<br />
A<br />
A<br />
A<br />
D<br />
D<br />
D<br />
MD<br />
MD<br />
MD<br />
SA MA A D MD<br />
20. I believe there is some real purpose for my life. SA MA A D MD SD<br />
SWB Scale Copyright c 1982 by Craig W. Ellison and Raymond F. Paloutzian. All rights reserved. Not to be<br />
duplicated unless express written permission is granted by the authors or by Life Advance, inc., 81 Front ST., Nyack,<br />
NY 10960.<br />
SD<br />
SD<br />
SD<br />
SD<br />
SD<br />
SD<br />
SD<br />
SD<br />
SD<br />
SD<br />
SD<br />
SD<br />
SD<br />
SD
APPENDIX F<br />
Spiritual Well-Being Scale - Modified<br />
Grief in Women Religious 80
Grief in Women Religious 81<br />
SWB Scale<br />
For each <strong>of</strong> the following statements use the scale below to indicate the extent <strong>of</strong><br />
your agreement or disagreement as it describes your personal experience. Use the<br />
best fitting number from 0 to 100.<br />
1. I don't find much satisfaction in private prayer with God. ____<br />
2. I don't know who I am, where I came from, or where I am going.<br />
____<br />
3. I believe that God loves me and cares about me. ____<br />
4. I feel that life is a positive experience.<br />
____<br />
5. I believe that God is impersonal and not interested in my daily<br />
situations.<br />
____<br />
6. I feel unsettled about my future. ____<br />
7. I have a personally meaningful relationship with God.<br />
____<br />
8. I feel very fulfilled and satisfied with life. ____<br />
9. I don't get much personal strength and support from my God. ____<br />
10. I feel a sense <strong>of</strong> well-being about the direction my life is headed in.<br />
11. I believe that God is concerned about my problems.<br />
____<br />
____<br />
12. I don't enjoy much life. ____<br />
13. I don't have a personally satisfying relationship with God.<br />
____<br />
14. I feel good about my future. ____<br />
15. My relationship with god helps me not to feel lonely.<br />
____<br />
16. I feel that life is full <strong>of</strong> conflict and unhappiness. ____<br />
17. I feel most fulfilled when I'm in close communion with God.<br />
____<br />
18. Life doesn't have much meaning. ____<br />
19. My relation with God contributes to my sense <strong>of</strong> well-being. ____<br />
20. I believe there is some real purpose for my life. ____
APPENDIX G<br />
Cover Letter<br />
Grief in Women Religious 82
Dear Sister,<br />
Cover Letter<br />
Grief in Women Religious 83<br />
I am a member <strong>of</strong> the Sisters, Servants <strong>of</strong> the Immaculate Heart <strong>of</strong> Mary in<br />
Immaculata, Pennsylvania and I am currently pursuing studies in the Doctor <strong>of</strong><br />
Psychology program at Loyola College in Maryland. For my <strong>dissertation</strong> project, I am<br />
researching grief among women religious who have lost a loved one through death.<br />
Although grief studies have been reported in numerous areas, few have concentrated on<br />
the loss experienced by women religious. I am asking your help in this project that is<br />
designed to make a contribution toward understanding the spiritual and psychological<br />
well-being <strong>of</strong> women religious as they journey through grief. Please know that you play<br />
a significant part in this study.<br />
Enclosed you will find a packet <strong>of</strong> questionnaires. I am asking you to please take<br />
time (about one hour) to respond to these inventories by recording your answers on the<br />
lines provided on the inventories. Please answer the questions with the response that best<br />
reflects your experience. <strong>The</strong>re may be some questions that will not apply to you. When<br />
you have completed the four inventories please mail them to me in the enclosed self-<br />
addressed envelope. Your answers will be completely confidential as indicated in the<br />
consent form. Your responses will not be shown or given to anyone else, only I will see<br />
them and your name will not be on them. Also, the overall results will be reported as<br />
group data rather than individually. Your participation is voluntary and you may<br />
withdraw at any time for any reason.<br />
Since the grief process continues over time, there will be a three month follow-up<br />
study to assess your grief symptoms. At that time you will be contacted by mail and<br />
asked for your willingness to complete a similar but briefer follow-up packet. On the<br />
enclosed form, please include a mailing address for where you may be contacted three<br />
months from now. Sister, thank you for generously giving your time to this project.<br />
Please return these inventories within two weeks <strong>of</strong> your receiving them. I am<br />
counting on each person's full response for a representative sample <strong>of</strong> grieving women<br />
religious. If you have a question at any time during this study, please feel tree to contact<br />
me at dmkelley@loyola.edu or call me at 410-337-1462. You may also contact my<br />
<strong>dissertation</strong> chair, Dr. David Powers, at dpowers@loyola.edu or by phone at 410-617-<br />
2093.<br />
Thank you for your willingness to take part in this study. Please know that I am<br />
grateful for your interest, help and participation.<br />
Sincerely,<br />
Sister Donna <strong>Kelley</strong>, <strong>IHM</strong>
APPENDIX H<br />
Demographic Questionnaire<br />
Grief in Women Religious 84
Background Information<br />
Grief in Women Religious 85<br />
Please respond to each item by writing your answer on the line provided.<br />
1. Age:________<br />
2. Years pr<strong>of</strong>essed:_________<br />
3. Years in religious life since entrance:__________<br />
4. Title <strong>of</strong> Congregation:___________________________________________________<br />
5. Classify your community according to lifestyle:<br />
_______Active Religious Life _______Contemplative Religious Life<br />
6. Current ministry (If retired, please note):___________________________________<br />
7. Highest level <strong>of</strong> education:______________________<br />
8. Primary language:_______________________<br />
9. How many people close to you have died in the past three months?___________<br />
10. How do you describe yourself?<br />
Caucasian __ Black/African American ___ Hispanic ___<br />
Native American___ Other (Please note):______________________
APPENDIX I<br />
Consent Form<br />
Grief in Women Religious 86
Information and Consent Form<br />
Grief in Women Religious 87<br />
This research project examines different aspects <strong>of</strong> grief. <strong>The</strong>se surveys should take<br />
about one hour <strong>of</strong> your time at most, and all your responses are confidential. Your<br />
responses will not be shown or given to anyone else, only the person who is given these<br />
surveys to you will see them and your name will not be on them. Overall results will be<br />
reported as group data, rather than individually.<br />
Your participation is completely voluntary, and if you feel uncomfortable you may<br />
discontinue at any time for any reason.<br />
If you are interested in hearing about the results <strong>of</strong> the study, write your name and phone<br />
number on a separate piece <strong>of</strong> paper (NOT on the survey) and the researcher will get in<br />
touch with you when the study is completed. This is the beginning <strong>of</strong> a study that will<br />
continue for several years, so there may be some delay in responding until all results are<br />
completed. If you have any questions feel free to contact Donna <strong>Kelley</strong>, <strong>IHM</strong> at<br />
dmkelley@loyola.edu or 410-337-1462 or David Powers, Ph.D. at dpowers@loyola.edu<br />
or 410-617-2093.<br />
Thank you very much for your consideration. If you are interested in participating,<br />
please sign the following statement<br />
I have read the information provided and agree to participate in the survey. I<br />
understand that my participation is voluntary and that I may stop participating at<br />
anytime.<br />
________________________________________<br />
Participant Date<br />
________________________________________<br />
Researcher Date
APPENDIX J<br />
Contact Information for Follow-Up Study<br />
Grief in Women Religious 88
Contact Information for Three Month Follow-up Study<br />
Grief in Women Religious 89<br />
Please complete the following information by projecting where you may be<br />
contacted in three (3) months. Please print your answers on the lines provided.<br />
Name:_________________________________________<br />
Convent (Where you will be living in 3 months):<br />
________________________________________________<br />
Address (Where you will be living in 3 months):<br />
_________________________________________________<br />
_________________________________________________
APPENDIX K<br />
Thank you Letter Time 1<br />
Grief in Women Religious 90
September 2004<br />
Dear Sister,<br />
Grief in Women Religious 91<br />
Thank you very much for completing the surveys and returning them to me. Each <strong>of</strong><br />
your responses is noteworthy and <strong>of</strong> value for this grief study. Your help and willingness<br />
to participate in this process are deeply appreciated. I am most grateful to you for<br />
generously giving <strong>of</strong> your time.<br />
I am delighted with the favorable and affirming responses received from sisters across the<br />
eastern and western regions <strong>of</strong> the United States. <strong>The</strong>se responses support my belief that<br />
grief research in women religious is necessary. I am encouraged by you to continue my<br />
work on this project. Please know that you play a significant part in the success <strong>of</strong> this<br />
study.<br />
As mentioned in my first communication with you, there will be a follow-up study.<br />
Shortly, I will be mailing this second packet <strong>of</strong> surveys, which will be smaller than the<br />
first. I realize that your time is precious and again I express my gratitude.<br />
Please know that you continue to be remembered in prayer during this time <strong>of</strong> loss.<br />
Sincerely,<br />
Sister Donna <strong>Kelley</strong>, <strong>IHM</strong>
APPENDIX L<br />
Thank you Letter Time 2<br />
Grief in Women Religious 92
March 2005<br />
Dear Sister,<br />
Grief in Women Religious 93<br />
Thank you very much for your participation in the grief study. Your help and willingness<br />
to share in this process are deeply appreciated. I am most grateful to you for generously<br />
giving <strong>of</strong> your time.<br />
I am encouraged by the favorable and affirming responses received from sisters across<br />
the United States. Without the generosity <strong>of</strong> women like you, my data collection would<br />
not have been possible. You have played a significant part in the success <strong>of</strong> this study.<br />
Once again I express my gratitude for your help with this research. If you have requested<br />
the results <strong>of</strong> the study, they will be sent to you within the next several months after the<br />
project is fully completed. Thank you for your patience.<br />
<strong>The</strong>re is enclosed an article on grief that the Hospice <strong>of</strong> Baltimore publishes which you<br />
may find insightful. Please know <strong>of</strong> my prayers as you continue to journey through this<br />
grief process.<br />
Gratefully,<br />
Sister Donna <strong>Kelley</strong>, <strong>IHM</strong>