Death Studies, 29: 435458, 2005 Copyright # Taylor & Francis Inc.

ISSN: 0748-1187 print/1091-7683 online DOI: 10.1080/07481180590932544

GETTING UNSTUCK: THE ROLES OF HOPE, FINDING MEANING, AND RUMINATION IN THE ADJUSTMENT TO BEREAVEMENT AMONG COLLEGE STUDENTS
SCOTT T. MICHAEL VA Puget Sound Health Care System, Seattle, Washington, USA C. R. SNYDER University of Kansas, Lawrence, Kansas, USA

The relationships between hope, bereavement-related rumination, and finding meaning (making sense and benefit finding) were examined in 158 college students who experienced the death of a loved one within the latter half of their lives. Greater rumination was related significantly to lessened psychological well-being, and it mediated the relationship between being able to make sense of the death and superior well-being. Finding benefits in bereavement was associated with positive adjustment for those who recently experienced the death of a loved one, whereas it was related to negative adjustment for those who experienced the death longer ago. Higher hope predicted greater well-being, but it was not related to rumination or finding meaning.

At some point in the lives of virtually all people, the painful experience of coping with the death of a loved one must be faced. Ruminating about the deceased loved one and the impact the death has had on ones life is a common reaction for many. The purpose and outcome, however, of such rumination vary greatly for each individual. Some engage in a purposeful cognitive processing aimed at finding some sense of resolution to grief, whereas
Received 17 September; accepted 25 January 2005. Portions of this study were presented in a poster at the national conference of the Association for the Advancement of Behavior Therapy, Reno, NV, 2002. This material is based upon work supported in part by the Office of Academic Affiliations, VA Special MIRECC Fellowship Program in Advanced Psychiatry and Psychology, Department of Veteran Affairs. Address correspondence to Scott T. Michael, Ph.D., VA Puget Sound Health Care System, 1660 South Columbian Way (116-MHC), Seattle, WA 98108. E-mail: Scott. Michael@med.va.gov

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others are plagued by intrusive, painful rumination that continues unabated, perhaps for decades (Nolen-Hoeksema & Larson, 1999; Tait & Silver, 1989). What factors allow some to become unstuck from the grieving process and move on, whereas others stay stuck in the morass of grief and pain? Rumination, Cognitive Processing, and Bereavement Some bereavement research has demonstrated that persistent cognitive focusing on thoughts and feelings related to grief is beneficial (Bower, Kemeny, Taylor, & Fahey, 1998); conversely other studies suggest that such persistent focusing is maladaptive (NolenHoeksema, Parker, & Larson, 1994). This seeming contradiction is resolved by looking at different theoretical conceptualizations of cognitive processing and rumination. Cognitive processing models of trauma adaptation (e.g., Creamer, Burgess, & Pattison, 1992; Foa, Steketee, & Rothbaum, 1989; Janoff-Bulman, 1992) differ to some extent but share the thesis that painful=traumatic events present a challenge to ones perception of the world and self. Accordingly, adaptive coping is seen as the ability to integrate these experiences into these world and self views, either by assimilating the event into ones existing worldview, or shifting the worldview to fit the new, event-related challenging information. Recent research has supported the applicability of such models to bereavement adjustment (Bower et al., 1998; Stein, Folkman, Trabasso, & Richards, 1997). Furthermore, contemporary narrative theory holds that the self-concept functions to maintain a sense of coherent self that can be substantially challenged as a result of the death of someone important to us (Neimeyer, in press). Alternatively, rumination models indicate that persistent focusing on cognition and affect related to negative life events, such as death, leads to a lessened sense of adaptation to the event and poorer well-being. Morrow and Nolen-Hoeksema (1990) have defined rumination as, cognitions and behaviors that repetitively focus the . . . individuals attention on his or her [depressive] symptoms and the possible causes and consequences of those symptoms (p. 519). They view rumination as passive and maladaptive in the sense that the person continually focuses on negative emotions and what these emotions mean without getting any closer to finding a solution that lessens these feelings. In a prospective

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study involving bereaved participants recruited from hospices prior to their loved ones death, Nolen-Hoeksema and her colleagues (1994; Nolen-Hoeksema & Larson, 1999) found that rumination at 1-month post-loss significantly predicted depressive symptoms at all post-loss assessments over 18 months. For the purposes of this article, rumination will be defined as repetitive thought focused on negative emotions and what these emotions mean without getting any closer to finding a solution that lessens these feelings. Alternatively, cognitive processing will be defined as productive repetitive thought focused on resolution of discrepancies between cognitive models of the world pre-death and new information derived from the experience of the death. The question arises then as to what constitutes productive bereavement-related cognitive processing. What is the outcome of repetitive cognitive focus and what may distinguish those who process in a goal-directed way from those who ruminate for prolonged periods without relief? Some theorize that one of the most important outcomes of trauma-related cognitive processing in general ( Janoff-Bulman, 1992; Taylor, 1983), and bereavementrelated cognitive processing more specifically (Bower et al., 1998; Stein et al., 1997), is finding meaning in the experience. Constructing meaning may be a primary outcome of cognitive processing and instrumental in the subsequent decrease in cognitive activity devoted to processing the experience. Indeed, studies with bereaved samples (Bower et al., 1998) and traumatized samples (Silver, Boon, & Stones, 1983) show that cognitive processing is related to a sense of having constructed meaning out of the experience and that ongoing processing without finding meaning is predictive of poor outcomes. It appears that an active search for meaning after such an event is adaptive if it produces a satisfactory answer to that search; however, if one is unable to find meaning in the event, persisting in a search is likely to become ruminative in character: the cognition is intrusive, disruptive, and painful without being productive and is likely to center on how bad it feels to feel this way. Finding meaning in the death of a loved one is a highly individual process; however, researchers have developed strong theoretical models, supported by empirical research, seeking to explain common processes in meaning reconstruction. Neimeyer and Anderson (2002) differentiate between the context and the

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narrative process of meaning reconstruction. The context of meaning is the content of the meanings found in the loss and may be divided into three major categories: sense-making, benefit finding, and identity reconstruction. Sense-making meaning is the attempt to answer why the death happened. It involves explaining the event in terms of ones worldview, or the adaptation of a new worldview that can encompass the death and its implications ( Janoff-Bulman, 1992, 1999; Tait & Silver, 1989). Benefit finding is a perception that the experience has worth or value to ones life; that one has grown or in other ways gained as a result of an otherwise negative event (Affleck & Tennen, 1996; Taylor, 1983; Tedeschi & Calhoun, 1996). In the hospice study mentioned earlier (Davis, Nolen-Hoeksema, & Larson, 1998), making sense and benefit finding were associated with decreased levels of distress at 6 months post-loss; however, after the first year, making sense was not a significant predictor of adjustment, whereas benefit finding retained its predictive power. These findings suggest that making sense of the death is adaptive within the first year following the death and that benefit finding is adaptive following this year. Finally, identity reconstruction involves the shifts in ones personal biography, or the story of ones life, that happen as a result of the experience. In bereavement, reconstruction of ones identity entails building a new sense of self as a result of the death, as well as ones roles in life now that the important other is gone. Neimeyer and Anderson (2002) also described the importance of the narrative process of finding meaning. In essence, this is the process of how one tells the story of the loss. Humans tend to construct narratives that explain important, and sometimes painful, events such as death. These narratives are an individuals attempt to organize the experience in a coherent framework. Bereavementrelated rumination may derail this process. As one begins to build a narrative of what happened, unproductive repetitive thought focusing on the negative aspects of the experience is likely to mire the individual in despair and hopelessness, leading to what Neimeyer (in press) would term narrative disorganization, or the inability to integrate this new, discrepant information (I am a widow=orphan, etc.) into ones life story. This is supported further by the hospice study (Nolen-Hoeksema & Larson, 1999), wherein ruminative coping predicted the inability to make sense of the loss at all follow-up assessments. Thus, the results support the

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contention that rumination is a non-productive mode of thought that disrupts healthy adaptation in the grieving process. Hope, Finding Meaning, and Bereavement Researchers have studied the relationship between a variety of individual differences measures, coping, and adjustment. The construct closest in theory to hope, optimism (Carver & Scheier, 1999), has been shown to predict the use of constructive coping strategies and positive adjustment (e.g., Carver et al., 1993). The relationship between optimism and adjustment is mediated by coping optimists choose active and adaptive coping strategies that lead to subsequent positive adjustment, whereas pessimists avoid and disengage from stressors, thereby experiencing elevations in negative affect. Hope also has been shown to be associated with adaptive coping and positive adjustment (for reviews, see Snyder, 2002, and Snyder, Cheavens, & Michael, 1999). The construct of hope, proposed by Snyder (1994), is a model of goal-directed thinking. It is made up of two components, pathways thoughts (the perceived capacity to plan for meeting goals) and agency thoughts (perceived goal-directed determination). Pathways thinking is the perception that one can create plans for reaching important goals, and agency thinking is the sense of determination to put these plans into action. Hopeful people have strong pathways thoughts, meaning that they are able to successfully generate effective plans for reaching their goals. They also have strong agency thinking, meaning they have a sense of motivation to initiate and continue using these plans. Hope has a strong association with meaning in life measures (r s .70 to .72; Feldman & Snyder, in press). Theoretically, there is a natural relationship between meaning and hope (Snyder, 1994). Hope is a goal-directed thought process. Meaning is, in essence, the source of important life goals, and it determines the value of these goals to the individual. Hope is the active cognitive process of moving toward those goals. Hope also may have a unique role in finding benefits in painful=traumatic life events. From a study of women diagnosed with fibromyalgia, Affleck and Tennen (1996) reported that hope was a stronger predictor of finding benefits than dispositional optimism. Furthermore, they found that pathways thinking plays an important role in the use of

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benefit reminding (an effortful use of benefit finding as an active coping strategy). When the pathways component of hope was partialled out, the relationship between benefit finding and benefit reminding no longer was significant. This suggests that the planning routes to goals underlies the use of positive reframing as an active coping strategy. Thus, hope may play an important role in cognitively processing and finding meaning in the loss of a loved one. In theory, hope should be associated with the benefit finding construal of meaning, as it is a positive reframing strategy. This is one possible route whereby hope aids becoming unstuck from the grieving process. Another route may come via the role of hope in facilitating the return to life activities and roles, termed restorationorientation coping by Stroebe & Schut (1999) in their dual-process model of bereavement. Hopeful individuals are likely to focus on the goals that are necessary to rejoining with life and moving on after the loss. These individuals may be more successful in the identity reconstruction process (Neimeyer & Anderson, 2002). By thinking hopefully, the bereaved person focuses on goal-oriented thoughts, and thus will not be mired down in ruminations about the negative aspects of bereavement. Alternatively, ruminating individuals become overly focused on the negative aspects of bereavement (Nolen-Hoeksema, 2001) and have difficulties focusing on restoration-orientation activities. In this study, we examine a model of hope, cognitive processing, and adjustment to bereavement. There are five hypotheses in this study. First, the sense-making construal of meaning will most strongly predict psychological well-being in the acute period, whereas the benefit-finding construal will predict well-being in the later period. Second, bereavement-related rumination will be associated with lower levels of making sense and benefit finding. Third, higher hope will be a stronger predictor of lessened rumination than self-esteem. It is important to establish that hope is unique in this model and not just a proxy for a positive frame of mind or positive self-regard, thus self-esteem will be measured as a control or comparison variable. Fourth, higher hope will predict benefit finding above and beyond the variance related to selfesteem. Fifth, hope will predict psychological well-being above and beyond the variance accounted for by rumination. If hopeful thinking is an important aspect of moving on with ones life, hope

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should predict well-being above and beyond the variance accounted for by bereavement-related rumination. Method Participants One-hundred and fifty-eight undergraduate students (49 men, 109 women) participated in exchange for credit toward partial fulfillment of a requirement in their introductory psychology course. Nearly 90% were Caucasian. The mean age was 19.19 (SD 2.28; range 1837). The participants were drawn from a mass testing session using a screening instrument for the following inclusion criteria: (a) experienced death of someone; (b) deceased was not a child of participants; (c) death occurred in latter half of participants life; and (d) self-rated distress, 1 (not very) to 7 (very much so), at time of death was 5 or above. These inclusion criteria were developed in order to have a sample of individuals who experienced the death of a person who had great significance to them. Individuals who reported the death of a child were excluded as the death of a child may be a qualitatively different experience than the death of others and this difference could lead to skewed results (distress, lack of meaning, low hope, etc.). Only one potential participant was excluded from the study, reporting the death of a child. Procedure Participants completed questionnaires in small groups. All questionnaires except the Posttraumatic Growth Inventory (PTGI) and the Rumination Index Questionnaire (RIQ) were presented in random order; the latter two were presented last in order to avoid the possible sensitizing effects that focusing attention on death may have had on the other scales. Measures
TRAIT HOPE SCALE

The trait Hope Scale (Snyder et al., 1991) is a 12-item selfreport measure designed to tap the construct of hope. It contains

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two subscalesPathways and Agencythat consist of four items each. There also are four filler items. The trait Hope Scale has demonstrated acceptable internal consistency (Cronbachs a ranging between .74 to .84) and has undergone extensive construct validation (Snyder, 2002; Snyder et al., 1991).
PSYCHOLOGICAL WELL-BEING

A number of measures of psychological well-being were selected in order to tap a broad array of information pertaining to wellbeing. The Center for Epidemiologic Studies Depression Scale (CES-D; Radloff, 1977, 1991) is a self-report measure of depression that is designed for use with a nonclinical population. The CES-D has acceptable reliability for patient populations (a :90), normal adult populations (a :85), and college populations (a :87; Radloff, 1991). The Spielberger State Anxiety Scale (STAI; Spielberger, Gorsuch, & Lushene, 1970) is a measure of current anxiety levels and has demonstrated acceptable reliability (as :86 to .95 for high school student, college student, working adult, and military recruit populations). The Positive and Negative Affect Scale (PANAS; Watson, Clark, & Tellegen, 1988) offers scores for both positive and negative affect, which factor analytic analyses have shown to be separate but related constructs. Research has demonstrated strong internal consistency (Cronbachs as ranging between .86 to .90 for positive affect, and .84 to .87 for negative affect); moreover, research has supported construct validation for the PANAS.
SELF-ESTEEM

In order to evaluate whether hope has unique predictive utility above a general measure of a positive psychological frame of mind, the Rosenberg Self-Esteem Scale (RSES; Rosenberg, 1965) was administered. The RSES has been psychometrically validated and used extensively in research as a measure of self-esteem.
POSTTRAUMATIC GROWTH

The Posttraumatic Growth Inventory (PTGI; Tedeschi & Calhoun, 1996) was used to assess levels of posttraumatic growth. The wording of the items was changed. The scale usually asks the respondent to rate the degree of change, for each item, that has occurred, as a result of my crisis. These anchors were changed

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to as a result of the death in order to be more specific to the crisis experienced by all of the participants in this study. Tedeschi (personal communication, October 24, 2000) says the PTGI has been adapted to specific traumas in this way before and it is an acceptable variation that has not been found to affect the psychometric properties of the measure. The PTGI has good internal reliability (a .90 for full scale; as of .67 to .85 for subscales), and it has met other criteria of construct validity (Tedeschi & Calhoun, 1996).
RUMINATION AND FINDING MEANING

For the purposes of this study, a measure of bereavementrelated rumination and meaning finding was developed based upon the research of Silver and her colleagues (Holman & Silver, 1998; Silver et al., 1983; Tait & Silver, 1989) and Davis et al. (1998). This measure was designed to tap (a) intrusive ideation related to the death and (b) the search for meaning in both the sense-making construal and benefit-finding construal. The first seven items were adapted from the Silver et al. studies and, as in those studies, were aggregated (RIQ1). These items tap repetitive thought about the death and the degree to which these thoughts were intrusive and distressing. The other two items, taken verbatim from the Davis et al. study, were analyzed individually to measure the two construals of meaning (Do you feel that you have been able to make sense of the death? and Sometimes people who lose a loved one find some positive aspect in the experience. For example, some people feel they learn something about themselves or others. Have you found anything positive in this experience?). In order to test hypotheses related to time since death, the sample was divided into those who experienced the death within the last year (n 34) and those that experienced the death 13 or more months since the date of the study (n 124). An a priori decision was made to dichotomize the sample in order to separately test acute and prolonged grieving processes. Other studies (e.g., Davis et al., 1998) have found differences in meaning-finding processes between such acute (1 year) and prolonged (18 months) periods. In the following sections, these groups will be referred to as acute period and prolonged period.
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Interested readers please contact Scott T. Michael for a copy of questions.

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Results Descriptive Statistics and Internal Reliability The mean time since the death was 38.56 months (SD 32.41). The mean distress at the time of death was 6.36 (SD .69) on a 7-point scale. The relationships of those who died to the research participants were two mothers, nine fathers, three brothers, two sisters, 56 friends, 65 grandparents, and 21 other relatives (e.g., cousins, aunts, etc.). (For further descriptive statistics, please contact Scott T. Michael). The Cronbachs a was calculated for each measure, and is as follows: Hope (.80), CES-D (.91), STAI (.93), Positive Affect [PANAS] (.86), Negative Affect [PANAS] (.87), RSES (.91), PTGI (.91), and RIQ (.84). Correlational and Regression Analyses To control for Type I error, we used a Bonferroni correction of .006 (.05=8 total number of correlations including meaning variables, rumination, and psychological well-being measures) for significance.
FINDING MEANING AND BEREAVEMENT-RELATED RUMINATION

To test hypotheses related to time since the death, we used the acute period and prolonged period subsamples. In the acute group, making sense of the death (MS) was significantly negatively correlated with rumination (r .66, p < .001). In the prolonged group, MS continued to be negatively correlated with rumination (r .29, p .001). A Fishers z0 transformation (Cohen & Cohen, 1983) was calculated to test whether two correlations from different samples are significantly different. These two correlations were significantly different, z0 .4938, p .006, indicating that MS had a significantly stronger correlation with rumination within the first year following the death than it did for those who had experienced the death over a year ago. Benefit Finding (BF) was negatively correlated with rumination in the acute group (r .37, p .02). Contrary to predictions, BF was positively correlated with rumination (r .17, p .03) for those in the prolonged sample. Neither of the BF and RIQ correlations was significant at the Bonferroni-corrected level, but these

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correlations are worth noting. The PTGI was positively correlated with rumination in the prolonged sample (r .31, p < .001), which supports the relationship of the BF item and rumination in that sample. Thus, finding benefits in the death was inversely related with rumination for those within the first year post-death but was positively related with rumination after the first year.
FINDING MEANING AND PSYCHOLOGICAL WELL-BEING

Within 12 months post-death. Regression analyses were run using BF and MS as the two predictors and the psychological well-being measures as criterion variables. For each set of analyses, one analysis entered BF first into the model and MS second. This order was reversed for the other analysis. These results may be found in Table 1. As these results indicate, BF is a significant predictor of depressive symptoms (CES-D) and state anxiety (STAI) when entered in to the model after MS. Alternatively, MS does not predict any of the psychological well-being indicators when it is entered in second. Therefore, BF is a unique predictor of less depressive symptoms and anxiety in the first year following the death. These associations are in the hypothesized direction (i.e., BF and MS are inversely related to distress), albeit, benefit finding was not hypothesized to have stronger associations with

TABLE 1 Regression Analyses for Meaning and Well-Being Within the First Year Post-Death Step predictor Benefit finding Measure CES-D STAI PANAS NA PA b 3.96 4.73 1.76 .54 F 11.96 14.42 5.30 .39 Making sense b 1.63 .64 .58 1.92 F 1.33 .17 .36 3.43 Step predictor Making sense b 3.40 3.21 1.42 1.57 F 8.04 5.37 3.23 3.60 Benefit finding b 2.99 4.35 1.40 .59 F 4.50 7.73 2.20 .33

Note. df (1, 32) for Step 1, df (2, 31) for Step 2. bs are for full models with both predictors. Fs are F Change values. CES-D Center for Epidemiologic Depression Scale; STAI Spielberger State Anxiety Inventory; PANAS Positive and Negative Affect Scale; NA Negative Affect Scale; PA Positive Affect Scale. p < .05. p < .006.

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psychological well-being than making sense for those in the acute aftermath of a death. Over 1 year post-death. A similar data-analysis strategy was used (see Table 2). BF was a significant positive predictor of depressive symptoms above and beyond the variance attributed to MS when this variable was entered first. The direction of the relationships was contrary to that which was hypothesized, as indicated by the beta weights. BF was associated with poorer psychological well-being for those who experienced the death over a year or more ago, especially with regard to depressive symptoms. On the other hand, MS continued to be associated with better adjustment to the death. When MS was entered into the model after BF, it was a unique predictor of depressive symptoms and negative affect. In order to test whether MS is a more powerful predictor of psychological well-being in the initial phase following the death than in the later phase, we calculated a Fishers z0 transformation for the one measure that was significant for both samples (CES-D). The Fishers z0 transformation (z0 .43, p .06) was not significantly different; however, the difference was in the predicted direction. This indicates that MS has a stronger, albeit non-significant, inverse relationship with depressive symptoms
TABLE 2 Regression Analyses for Meaning and Well-Being After the First Year Post-Death Step predictor Benefit finding Measure CES-D STAI PANAS NA PA b 1.45 .47 .37 .51 F 3.90 .32 .51 1.00 Making sense b F Step predictor Making sense b 1.40 .97 1.14 .19 F 4.43 1.63 6.27 .18 Benefit finding b 1.81 .70 .63 .57 F 6.13 .68 1.53 1.21

1.72 6.68 1.09 1.98 1.26 7.29 .29 .39

Note. df (1, 122) for Step 1, df (2, 121) for Step 2; df (1, 121) for Step 1, df (2, 120) for Step 2. bs are for full models with both predictors Fs are F Change values CES-D Center for Epidemiologic Depression Scale; STAI Spielberger State Anxiety Inventory; PANAS Positive and Negative Affect Scale; NA Negative Affect Scale; PA Positive Positive Affect Scale. p < .05 p < .006.

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within the first year following the death than it does after this first year. This analysis was not performed for benefit finding due to the change in valence of the correlations between the variable and the well-being indicators for those in the different groups.
RUMINATION, MEANING, AND PSYCHOLOGICAL WELL-BEING

Rumination was consistently associated with poorer subjective well-being. Rumination had significant positive correlations with the CES-D (r .47), STAI (r .42), and Negative Affect (r .52) scales; it also was significantly negatively correlated with Positive Affect (r .28). Hope and rumination were not significantly associated (r .05, p .55). In order to examine the relationships between rumination, the two construals of meaning, and psychological adjustment to bereavement, we calculated a series of regression analyses. The overall sample was used for the MS, RIQ , and well-being analyses. Because of the findings that the associations between BF, RIQ , and the well-being measures change valence for the acute and prolonged subsamples, these analyses were run separately for each subsample. For both meaning variables, only the variables that had significant zero-order correlations with the two meaning variables were used in the partial correlation analyses. Making sense. MS was significantly correlated ( ps < .006) with the CES-D (r .28), STAI (r .22), and NA (r .25). It was not correlated significantly at this level with PA (r .14, p .04). As discussed previously, rumination was correlated significantly with all of the measures of psychological well-being. Prior research tested mediational models between cognitive processing, meaning, and health (Bower et al., 1998). An analysis of a potential mediational model between MS, rumination, and psychological well-being was performed. The psychological well-being measures chosen as the dependent variables were those that had significant correlations with MS (CES-D, STAI, and NA). According to the Baron and Kenny (1986) approach, mediation in this model could be tested by running three regression analyses for each distress variable. The first analysis regressed rumination on MS (this analysis is the same for each test of mediation for each distress variable, so it was only performed

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TABLE 3 Mediation Regressions for Making Sense, Rumination, and Psychological Distress Making sense Measure CES-D STAI NA b 2.10 1.84 1.25 t 3.63 2.75 3.22 R2 .08 .05 .06 bRIQ .77 .80 .59 Rumination and making sense t 5.61 4.94 6.63 bMS .83 .52 .27 t 1.44 .77 .73 R2cha .01 .003 .003

Note. df (1, 156) for single predictor; df (2, 155) for two predictors; bRIQ Rumination beta weight; bMS Making Sense beta weight; R2cha Making Sense entered in step 2. CES-D Center for Epidemiologic Depression Scale; STAI Spielberger State Anxiety Inventory; NA Negative Affect Scale. p < .006.

once; b 1.65, p < .004, R2 .16). The second analysis regressed the target distress variable on MS, and the third analysis regressed the same distress variable on both rumination and MS. The results for these analyses may be found in Table 3. As these results indicate, rumination mediates the relationship between MS and each of the indicators of psychological distress. This meets the criterion for mediation set by Baron and Kenny. The changes in effect size (R2 changes) from the model with MS as the single predictor to the model with MS as the second predictor after rumination also may be found in Table 3. These changes reflect the relative degree of mediation. In other words, sizeable decreases in the amount of variance explained by the target variable indicate greater mediation on the part of rumination. As Table 3 reflects, in each case, rumination mediated the relationships between MS and psychological distress to a fair degree. Benefit finding within 12 months post-death. Within this sample, BF was only significantly correlated with the CES-D (r .52) and the STAI (r .56) at the .006 level. In order to examine the possibility of a mediational relationship between BF and the RIQ for these variables, the Baron and Kenny (1986) mediation criteria were used again. BF did significantly predict RIQ scores, b 1.43, p < .03. With the CES-D as a criterion variable, rumination was a significant predictor, b .78, p .02; however, it was no longer a significant predictor when BF was added to the model, b .47, p .14. BF, on the other

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hand, was a significant predictor of depressive symptoms in this model, b 3.30, p .01. The amount of variance explained by rumination was moderate, R2 .16, when it was a single predictor; however, this decreased, R2 change .05, when rumination was entered into the model after BF. Rumination also was a significant predictor of STAI scores, b .76, p .04, until BF was added to the model, b .36, p .30. Again, BF was a significant predictor of anxiety in the full model, b 4.12, p .004. The variance explained, again, dropped from the first model (rumination as single predictor) to the second (rumination entered after BF), R2 .12 and R2 change .02, respectively. Thus, within the first year following the death, BF mediated the relationships between rumination and depressive symptoms and anxiety. Benefit finding over 1 year post-death. After the first year, the relationships between benefit finding, rumination, and psychological well-being are weaker than those for the individuals who were within the first year post-death. BF was not significantly correlated with any psychological well-being variable at the .006 significance level. Hope and Adjustment to Bereavement It was theorized that hope would be related to bereavement resolution in two ways. One, it will be related to cognitive processing such that it will predict low levels of rumination and high levels of finding meaning (specifically benefit finding). Two, hope will have an unique relationship with psychological adjustment above that of rumination.
HOPE AND RUMINATION

Initially, bivariate correlations were calculated. Hope was not related to the RIQ (r .048, p .547). Because of the fact that hope had no relation with bereavement-related rumination, this set of analyses was not carried forward.
HOPE AND BENEFIT FINDING

The first-order analysis was to calculate bivariate correlations among hope and positive reframing, as tapped by the posttraumatic growth inventory (PTGI) and the benefit finding (BF) item. Hope was not significantly related to either the PTGI (r .11,

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p .17) or the BF item (r .09, p .28). In line with the analysis plan, this set of analyses was not carried forward. The analyses with self-esteem as a control variable are not relevant as hope was not correlated with the positive reframing measures. In the present study, hope did not play a role in death-related rumination nor finding meaning.
HOPE, RUMINATION, AND PSYCHOLOGICAL WELL-BEING

Initially, bivariate correlations between hope and the psychological well-being measures were calculated. A Bonferroni-correction was used to control for Type I error. Thus, for four analyses, a p value of .01 (.05=4 .01) was required for significance. Hope was significantly related to all four variables: CESD (r .22, p .006); STAI (r .30, p < .001); negative affect (r .25, p .002); and positive affect (r .45, p < .001). A series of linear regression analyses were conducted with the psychological wellbeing measures as criterion variables and with hope and rumination as predictor variables. In each analysis, using a step-wise approach, rumination was entered first in to the model and then hope was entered. The results may be found in Table 4. As these results indicate, hope significantly predicts psychological wellbeing above and beyond the variance accounted for by rumination for all variables. The results support the hypothesis that hope is independently related to psychological well-being. It appears that
TABLE 4 Regression Analyses for Rumination, Hope, and Psychological Well-Being Rumination Measure CES-D STAI PANAS NA PA b .85 .85 .62 .34 F 44.84 32.55 56.89 12.82 R2 .22 .17 .28 .08 b .28 .46 .21 .43 Hope F change 7.98 16.45 11.16 40.92 R2 change .04 .08 .05 .19

Note. df (1, 156) for Step 1, df (2, 155) for Step 2, Rumination as a single predictor. CES-D Center for Epidemiologic Depression Scale; STAI Spielberger State Anxiety Inventory; PANAS Positive and Negative Affect Scale; NA Negative Affect Scale; PA Positive Affect Scale. p < .008.

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hope is directly related to adjustment to bereavement and not indirectly related via cognitive processing. Discussion When someone close to us dies, we often find ourselves motivated to create some meaning in what happened. Alternatively, we feel the pull to look ahead and begin the process of moving forward in our lives. In this regard, cognitive processing may be a double-edged sword. On the one hand, avoiding any thoughts and feelings related to grief may have long-term effects in the form of ongoing intrusive and distressing thoughts and poor well-being. On the other hand, excessive cognitive processing may take on a distinctly ruminative character, with repetitive focusing on how awful it is that our loved one died and how bad it feels to grieve. Perhaps the (predominant) focus of ones repetitive thought differentiates adaptive grieving from maladaptive grieving. As discussed earlier, there may be two basic types of bereavement-related cognitive processing: (a) purposeful processing with an end goal of resolution to the grieving process; and (b) ruminative processingcharacterized by repeated focus on the negative impact of the death on various life domainsthat does not lead to progress toward grief resolution. The results from this study show a distinctly negative relationship between bereavementrelated rumination and psychological well-being, but this does not mean that those who ruminate are wholly engaging in a nonproductive form of repetitive thought. It is very common, in the early stages of grieving, for thoughts related to the loss to be painful and for the predominant focus to be the negative aspects of the loss. Indeed, other prospective research on cognitive processing of trauma has shown that early negative affect predicts later positive adjustment (Creamer et al., 1992). In time though, those who adapt are likely to focus their thought toward productive processing of the loss, whereas those who adapt poorly will continue to focus on the negative, painful aspects of the death. The question, then, is what differentiates productive repetitive thought (cognitive processing) from non-productive repetitive thought (rumination). The present study and other research suggest that the search for meaning may be an important element of cognitive processing, and that finding such meaning

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is associated with decreased cognitive processing and positive psychological well-being. This is not to say that bereaved individuals stop thinking about the deceased, or that these thoughts are not, at times, painful. Often, however, bereaved individuals describe a transformation of the quality to the cognition and affect connected to the loss. While sadness and a sense of loss may always be present, the intrusive, distressing quality of the thoughts will subside for those who adjust to the loss and refocus on their lives. The present study supports these cognitive processing models. The making sense construal of meaning was associated with decreased levels of rumination about the death and positive wellbeing. The inverse correlation between making sense and rumination was fairly robust for those who had experienced the death more recently, whereas this association was significantly less for those past the one year mark in the grieving process. This suggests that making sense of the death and cogitating about the loss are more closely linked within the first year post-death. Furthermore, making sense was more strongly (inversely) linked to bereavement-related rumination than was benefit finding. Thus, the results suggest that making sense of the death may be an important outcome of ruminating about the loss. An alternate interpretation is that the perception of having made sense of the death is inferred by bereaved persons from the fact that they are ruminating about the loss less often. The inverse of this interpretation also may be true: Those who ruminate continuously about the death may infer that they have been unable to make sense of the death. These individuals may be dispositionally ruminative copers (Morrow & NolenHoeksema, 1990). Because of the cross-sectional nature of this study, determination of causality in the link between rumination and making sense of loss is not possible. The mediational role for bereavement-related rumination in the relationship between making sense of the death and psychological well-being suggests that the impact of making sense on improving psychological well-being is via the decreased levels of rumination that occur as a result of making sense. In other words, making sense is not directly related to positive wellbeing; it is related by means of decreased rumination, which may improve well-being in bereaved persons. The relationships between the benefit finding construal of meaning, bereavement-related rumination, and well-being were

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more complicated. Contrary to the Davis et al. (1998) study, benefit finding was more strongly associated with positive well-being for those who had experienced the death more recently than for those who had experienced the death longer ago. Moreover, finding benefits in the death was a stronger predictor of well-being for those who experienced the death within the last year than was making sense. When rumination was added to the model, benefit finding mediated the relationship between rumination and depressive and anxiety symptoms. Curiously, the valence of these associations changed for those who had experienced the death over a year ago. For this group, finding benefits was positively related to ruminating about the loss and depressive symptoms. When rumination was partialled out of this model, benefit finding was no longer significantly correlated with depressive symptoms. Consequently, benefit finding appears to have been a ruminative process for those in the later stage of grieving, and this type of cognitive processing led to poorer well-being. These findings suggest that benefit finding was adaptive for bereaved participants in an earlier phase of grieving, whereas benefit finding seems to have been a ruminative process linked to poor well-being for those in the later phase. Why would benefit finding be beneficial in the acute aftermath of bereavement, but be maladaptive in a later phase? In line with the theoretical differences between purposeful cognitive processing and rumination discussed earlier, it follows that a certain proportion of bereaved people will engage in an active, purposeful processing of cognitions and affect related to the loss. For these individuals, such processing will be painful but may lead to gains as meaning is found in the event and a sense of growth develops out of the experience. Conversely, some bereaved persons will not be able to find meaning, will continue to (internally) search for it, and will dwell on the painful aspects of the loss. These individuals will continue to ruminate about the death, feel devastated about its impact on their lives, and subsequently experience poor well-being. Searching for benefits may be part of an ongoing attempt to cope with the grief and find some resolution to it. Perhaps participants in the later phase of grieving who reported finding benefits were using the benefits as an inadequate strategy in an attempt to cope with ongoing intrusive rumination and the attending distress.

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It is unclear, however, why making sense also would not function in this manner. One speculation is that the meaning finding processes for making sense and benefit finding may differ in terms of the sense of finiteness of the process. The search for making sense is more likely than benefit finding to be a finite process. Once someone has made sense of an event, this meaning-finding process may end. This is not to say that the sense one has made is never reconsidered nor revised; however, many may never revisit this type of meaning finding once a satisfactory answer has been found. The continuous nature of the making sense variable is likely to represent the extent to which sense has been made and how satisfactory this answer is. Finding benefits, on the other hand, is more likely to be an ongoing process. There may be numerous benefits found and these benefits may manifest themselves at different times or take on different permutations. In this regard, finding one benefit does not mean that the search is over. It is not about finding answers so much as it is looking for how the event has influenced ones life positively since the event occurred. And the findings from this study indicate that an ongoing consideration of these benefits is not so beneficial. It appears that it is more adaptive to find benefits and then move on with life. It was hypothesized that hope would facilitate adjustment to bereavement via two avenues. First, hopeful thinking would be related to bereavement-oriented cognitive processing. In other words, hope would be associated with lower levels of rumination about the past traumatic event and higher levels of meaning. Second, hope should be predictive of psychological well-being above and beyond the variance accounted for by rumination. The first hypothesis was not supported. Hope was not related to lower levels of bereavement-based rumination, nor higher levels of benefit finding. The second hope-related hypothesis was supported: Hope consistently predicted the well-being variables above and beyond the variance accounted for by bereavement-related rumination. Hope facilitates resolution to the grieving process via its effects on present psychological functioning. Hopeful thinking helps the bereaved individual to focus on present concerns and begin the process of moving toward important life goals in the present and future. This would be in line with the restoration-orientation of Stroebe and Schuts (1999) dual process model of coping with

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bereavement. Restoration-orientation coping involves focusing on present-based concerns that surface as a result of the death. It is a process of re-orienting to the roles and demands of a life that no longer includes the deceased loved one. Neimeyer and Anderson (2002) referred to identity reconstructiona similar process of developing new ideas and roles about oneself following the loss of a loved onea process likely to benefit from hopeful thinking. This study indicates that hope may be most beneficial in helping the bereaved to redefine themselves and build new roles in efforts to move on with ones life. Thus, hope does not appear to be related to finding meaning in the death of a loved one. Hope has a strong relation to general meaning in life, as evidenced by the Feldman and Snyder (in press) study. It appears, however, that hope is not related to a specific meaning-finding process following bereavement. A general sense of meaningfulness is not necessarily the same as finding meaning in specific experiences. Hope, it seems, may be related to the former and not the latter, at least for the individuals in this study. There are several limitations of the present study. First, the present cross-sectional design does not allow for proper tests of causality; for example, it is not possible to say whether those who engaged in high levels of processing the loss in the early phase experienced subsequent benefits of this processing. Or does finding meaning in the acute aftermath of a loss predict later low levels of rumination and positive well-being? The data in this study suggest such processes, but only a prospective design can properly support such conclusions. Second, the sample recruited for this study were predominately young college students, which may restrict the generalizability of the findings. Third, only one item was used to assess the finding meaning variables. Although the PTGI was used, the Benefit Finding item was used in most of the statistical analyses and was more strongly related to the majority of variables in the study. And fifth, the research design may have primed bereavement-related rumination. Because of ethical considerations, participants were informed prior to participating that they would be asked to focus on the death of their loved one. This may have sensitized the research participants to thoughts and images of their loved ones and led to higher levels of rumination leading up to their research session. In conclusion, the death of someone close to us often causes a period of psychological upheaval, including feeling depressed, sad,

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lonely, anxious, and sometimes angry. The death may seem utterly meaningless. Images, thoughts, and feelings about the deceased loved one frequently intrude into our awareness during this period. After this initial acute reaction, some begin the process of rebuilding their frameworks of meaning and begin to look forward again. They move through the grieving process and, subsequently, the intrusiveness of the death fades and well-being begins to improve. For others, though, resolution is elusive. Many of the thoughts and images about the deceased are upsetting and come unbidden, resulting in yet more sadness and grief. These individuals cannot find any meaning in the death and are plagued by continuing ruminations about the loss. In addition to this resolution process, one is beset by questions of what life will be like without the presence of the loved one. Hopeful thinking facilitates this process of moving on by focusing the bereaved individual on the important life goals that are a part of ones present and future life. Although we can never have this person back, we can choose to look forward and go on with life. Indeed, in our clinical experiences in working with bereaved clients, we have at times heard them assert that their deceased loved one would want them to move on with their lives. Even in death our loved ones can leave us with encouragement to hope. References
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