Finding Positive Meaning After Loss: The Mediating Role of Reflection for Bereaved Individuals

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1 Journal of Loss and Trauma, 15: , 2010 Copyright # Taylor & Francis Group, LLC ISSN: print= online DOI: / Finding Positive Meaning After Loss: The Mediating Role of Reflection for Bereaved Individuals GÜLER BOYRAZ Psychology Department, Tennessee State University, Nashville, Tennessee, USA SHARON G. HORNE and THOMAS V. SAYGER y Department of Counseling, Educational Psychology, and Research, University of Memphis, Memphis, Tennessee, USA This study examined the mediating effect of reflection on the relationship between search for meaning, positive affect, negative affect, and positive meaning-finding among 380 bereaved individuals. Using structural equation modeling, reflection was found to mediate the relationship between search for meaning, affect (positive and negative), and positive meaning-finding. The hypothesized model accounted for 32% of the variance in reflection and 34% of the variance in positive meaning-finding. Implications of the findings, including strategies to increase reflection and positive affect following the loss of a loved one, are discussed. Losing a loved one can be a life-altering experience and often challenges assumptions that the world is a benevolent and meaningful place (e.g., Janoff-Bulman, 1992). Although experiencing the death of a loved one can create intense distress and even lead to the development of posttraumatic stress disorder (e.g., Murphy, Johnson, Chung, & Beaton, 2003), it can also spur personal transformations for some bereaved individuals (e.g., Gillies & Neimeyer, 2006; Janoff-Bulman & Berg, 1998; Schaefer & Moos, 2001). The experience of loss may initiate a meaning reconstruction process through which an individual tries to minimize the discrepancy between y Deceased. Received 29 May 2009; accepted 17 July Address correspondence to Güler Boyraz, Psychology Department, Tennessee State University, 3500 John A. Merritt Blvd., Nashville, TN , USA. gboyraz@gmail.com 242

2 Finding Positive Meaning After Loss 243 previous positive assumptions about the world and the new reality that is encountered by the death of a loved one (e.g., Davis, Nolen-Hoeksama, & Larson, 1998; Gillies & Neimeyer, 2006; Janoff-Bulman & Berg, 1998). Such a meaning reconstruction process may lead to benefit-finding for some bereaved individuals (e.g., Gillies & Neimeyer, 2006; Neimeyer, 2000). Positive meaning-finding (also referred to as benefit-finding) after loss involves determining the value and meaning of the event in one s life and may include personal gains in strength and confidence, a deeper insight into the meaning of life, and improved relationships (e.g., Davis et al., 1998; Janoff-Bulman & Frantz, 1997), as well as posttraumatic growth (Tedeschi & Calhoun, 1995, 1996). Posttraumatic growth, an aspect of positive meaningfinding, refers to positive personal growth changes such as increased spirituality and appreciation of life, improved relationships, and finding new possibilities in life. Therefore, positive meaning-finding may be associated with positive cognitive reconstruction of a loss or traumatic event, a personal growth-enhancing transformation, or even other benefits. Indeed, empirical studies suggest that bereaved individuals find positive meaning from their experiences in a variety of ways (e.g., Davis et al., 1998; Wheeler, 2001). For example, in a study with bereaved individuals, Davis et al. (1998) found that positive meaning-finding involves several categories, such as positive reappraisals of the death in a constructive way (e.g., death as the end of a loved one s suffering), personal growth, and receiving social support from others. This study explores whether engagement in a search for meaning and positive and negative affect predict positive meaning-finding in bereaved individuals, as well as whether reflection acts as a mediator of the relationships between search for meaning, affect, and positive meaning-finding. SEARCH FOR MEANING AND POSITIVE MEANING-FINDING Victor Frankl (1963) long ago asserted that suffering may trigger a search for meaning. Frankl (1969, 1986) emphasized people s capacity for selftranscendence and will to find meaning (i.e., motivation to find meaning and purpose in life) and suggested that individuals may discover meaning in life through suffering. Consistent with Frankl s (1963, 1969) work, Steger, Frazier, Oishi, and Kaler (2006) defined a search for meaning as the drive and orientation toward finding meaning in one s life (p. 85). They suggest that engagement in a search for meaning is not necessarily related to the absence of meaning or meaninglessness; those who report having meaning in their lives may search for a deeper or more satisfying understanding of their lives. Therefore, experiencing positive meaning from bereavement may not be an end point in the search for meaning, and bereaved individuals may experience both engagement in a search for meaning and a positive meaning-finding process simultaneously.

3 244 G. Boyraz et al. Empirical examinations suggest that positive appraisals about the death of a loved one are more common than negative appraisals (e.g., Capps & Bonanno, 2000; Stein, Folkman, Trabasso, & Richards, 1997), and the loss of a loved one is often associated with positive meaning-finding despite the grief and distress it brings (e.g., Davis et al., 1998; Wheeler, 2001). For example, Wheeler (2001) conducted a qualitative study to investigate the search for meaning among 176 bereaved parents. In addition to focusing on the painful aspects of their experience (e.g., guilt, regret, and frustration), parents reported significant benefits (e.g., increased awareness of the importance of relationships, increased appreciation of life, and deeper religious and spiritual understanding) as a result of their struggle. Clearly, engagement in a search for meaning following the loss of a loved one may result in positive meaning-finding. REFLECTION Although it is clear that engagement in a search for meaning is important for positive meaning-finding in the aftermath of a major life crisis, the processes that foster the relationship between engagement in a search for meaning and positive meaning-finding haven t been fully understood. Several researchers (e.g., Janoff-Bulman, 1992; Tedeschi & Calhoun, 1995) suggest that one of the processes that may minimize the discrepancy between preloss and postloss assumptions is reevaluation and reinterpretation of the event. Calhoun and Tedeschi (2006) emphasized the role of constructive cognitive processing in the posttraumatic growth process and suggested that deliberate, reflective rumination in the aftermath of a major life crisis helps a person rebuild what has been shattered by the loss or trauma. Therefore, although cognitive processing of a loss may be an important mediator between search for meaning and positive meaning-finding, only those people who process their experience constructively may construe positive change from their bereavement experience. On the other hand, those who exclusively focus on the negative aspects of the event may have difficulty deriving benefits from their experience. Empirical research suggests that particular personality domains (i.e., openness) may predispose individuals to use intellectual self-reflection (Trapnell & Campbell, 1999), and people who are inclined to use intellectual reflection are more likely to find benefits from their bereavement experience compared to those who tend to use neurotic rumination, which is primarily focused on the negative aspects of an experience (Boyraz, Horne, & Sayger, 2009). These findings suggest that intellectual self-reflection may be an important element for fostering positive meaning-finding for bereaved individuals who engage in a search for meaning in the aftermath of the loss of their loved one. In this study, we used the term reflection to refer to a tendency to engage in intellectual reflection that is motivated by the curiosity or epistemic interest in the self (Trapnell & Campbell, 1999, p. 297). This study explored

4 Finding Positive Meaning After Loss 245 reflection as a potential mediator between search for meaning and positive meaning-finding among individuals who had lost a loved one. POSITIVE AND NEGATIVE AFFECT Tedeschi and Calhoun (2004) emphasized the role of an individual s personality in his or her response to stressful events and suggested that individuals who have the capacity to cope successfully with the emotional pain they are experiencing may be more likely to find benefits from their experience. According to Calhoun and Tedeschi (2006), several personality characteristics such as dispositional positive affectivity may relate to an individual s ability to endure distress and process his or her experience constructively. Distress and positive affect can co-occur (see Folkman & Moskowitz, 2000, for a review), and positive emotions during major life crises buffer resilient people against depression and foster the development of psychological resources in the aftermath of crises (e.g., Fredrickson, Tugade, Waugh, & Larkin, 2003). In addition to fostering adaptation to stressful situations, positive affect may also help bereaved individuals find benefits from their experience through fostering constructive cognitive processes that are central to the meaning construction process. Fredrickson s (2001) broaden and build theory of positive emotions suggests that positive emotions expand people s thought and behavioral repertoire during stressful events and foster the development of new resources. Empirical research suggests that positive affect fosters adjustment to stressful events and facilitates creativity and flexibility in thinking and the processing of self-relevant information (see Folkman & Moskowitz, 2000, for a review). In addition, positive affect has been found to be significantly correlated with meaning in life (e.g., King, Hicks, Krull, & Del Gaiso, 2006). Therefore, we hypothesized that positive affect may foster positive meaning-finding in bereaved individuals through the processing of self-relevant information (reflection). Although search for meaning and positive affect may lead to positive meaning-finding through a constructive self-reflection process, a long-term, unresolved search for meaning that is associated with increased negative affect may not lead to positive meaning-finding (e.g., Kernan & Lepore, 2009). In their longitudinal study with breast cancer patients, Kernan and Lepore (2009) found that more than half of their participants were able to reconstruct meaning of their diagnosis at early or later stages. On the other hand, higher engagement in a search for meaning was not significantly related to positive meaning-finding; ongoing, unresolved search for meaning was significantly related to an increase in negative affect. Having the resources to manage distress following the loss of a loved one may be important for finding benefits from loss. In contrast, a search for meaning that is accompanied by negative affect may prevent bereaved individuals from

5 246 G. Boyraz et al. FIGURE 1 Hypothesized model. receiving positive benefits from their loss. We hypothesized that negative affect may reduce the likelihood that individuals will experience positive meaning-finding from their loss because they will be less likely to engage in intellectual self-reflection. The purpose of this study was to investigate the role of reflection as a mediator of the relationship between search for meaning, positive affect, negative affect, and positive meaning-finding. The hypothesized partially mediated model is derived from theory and previous empirical work (e.g., Fredrickson, 2001; Gillies & Neimeyer, 2006; Janoff-Bulman, 1992; Tedeschi & Calhoun, 1995) and is illustrated in Figure 1. According to the hypothesized partially mediated model, it was expected that (a) both search for meaning and positive affect would be positively associated with reflection, (b) negative affect would be negatively associated with reflection, (c) reflection would be positively associated with positive meaning-finding, and (d) reflection would partially mediate the relationship between exogenous variables (search for meaning, positive affect, negative affect) and positive meaning-finding. METHOD Participants Data for this study were collected from 380 bereaved individuals in a Webbased survey design. Participants were recruited from several online grief support groups and Web sites related to bereavement. The age of the participants ranged from 18 to 76 years (M ¼ 45.16, SD ¼ 12.31). Most of the participants were female (87.4%); 44 were male (11.6%), and 4 did not report their gender. The majority of the participants (87.1%) were Caucasian, with 4.2% Hispanic=Latino, 2.4% biracial or multiracial, 1.6% African American, 1.3% Asian American, and.07% Native American; some participants (2.4%)

6 Finding Positive Meaning After Loss 247 reported their ethnicity as other, and one participant did not report ethnicity. Most of the participants (51.6%) reported their education as some college or less, 28.2% had a college degree, and 20.2% had a graduate degree. Approximately 45% of the participants reported their relationship status as married, and 25% reported that they were widowed. Slightly more than half of the participants (50.3%) reported that their loved one passed away within the preceding year, 22.6% within 2 years, 7.6% within 3 years, 5.3% within 4 years, 2.9% within 5 years, and 11.3% more than 5 years ago. Most of the participants (82.6%) described their relationship to the deceased as a family member, 10.3% as a relative, 4.5% as a close friend, and 2.6% as other (e.g., fiancé, boyfriend, or girlfriend). In terms of cause of death, 43.2% of the participants reported that their loved one passed away as a result of a natural, anticipated cause (e.g., lengthy illness); 26.6% indicated that their loved one passed away as a result of a natural, sudden cause (e.g., heart attack); 17.6% indicated the death was due to an accidental cause; 6.6% reported homicide; 3.7% reported suicide, and 2.3% indicated other causes (e.g., fire, drug overdose). Less than half of the participants (39.5%) reported that they sought professional psychological help following the loss of their loved one. Instruments The Meaning in Life Questionnaire (MLQ; Steger et al., 2006) is a 10-item self-report instrument that has two subscales: Presence of Meaning and Search for Meaning. Only the Search for Meaning subscale, which measures the motivation and orientation toward finding meaning in life, was used in the present study. Participants were asked to respond to the items on a 7-point scale ranging from 1 (absolutely untrue) to 7 (absolutely true). Steger et al. (2006) reported Cronbach alpha values ranging from.84 to.91 and a 1-month test-retest reliability of.73 for the Search for Meaning subscale. Their results also provided satisfactory evidence for the convergent and discriminant validity of this scale. The reliability analysis for the present study revealed an internal consistency value of.88. The Positive and Negative Affect Schedule (PANAS; Watson, Clark, & Tellegen, 1988) is a widely used instrument that includes 20 self-report items to measure positive affect (PA) and negative affect (NA). The PA subscale is composed of 10 mood descriptors such as strong and excited. The NA subscale includes 10 mood descriptors such as irritable and distressed. Participants are asked to rate items on a scale from 1 (very slightly or not at all) to 5 (extremely) based on how strongly they experience the emotion. The results of a factor analysis have shown that PA and NA are not the opposites of each other but are highly distinct dimensions of mood. Watson et al. (1988) suggest that the scales of the PANAS can be used both as measures of current mood and trait measures of affect. The PA and NA subscales of the PANAS were used to measure dispositional positive and negative affect for

7 248 G. Boyraz et al. this study. The reliability and validity of the PANAS have been supported in many studies with college students and other populations. A reliability analysis for the present study revealed a value of.92 for Positive Affect and.90 for Negative Affect. The Rumination-Reflection Questionnaire (RRQ; Trapnell & Campbell, 1999) is a 24-item self-report inventory that measures two types of self-focus: neurotic and inquisitive=intellectual self-focus. These items are rated on a 5-point Likert scale ranging from 1 (strongly disagree) to 5 (strongly agree). A factor analysis revealed two independent factors with a minimal correlation between them (r ¼.22). These factors are rumination, assessing neurotic self-focused attention, and reflection, assessing intellectual self-focused attention. Only the Reflection subscale of the RRQ was used in this study. Trapnell and Campbell (1999) reported a Cronbach alpha value of.91 for Reflection. The reliability analyses for the current study revealed a Cronbach alpha value of.91 for the subscale. The Positive Meaning Scale was adapted from the Positive Meaning Scale of Tugade and Fredrickson (2004). In order to assess the degree to which individuals find positive meaning from their stressful experiences, Tugade and Fredrickson (2004) developed the Positive Meaning Scale, which is composed of four items from the Coping Responses Inventory (CRI; Moos, 1988) and two additional items that they developed. The two items that Tugade and Fredrickson created are as follows: (a) To what extent do you feel that you might find benefit in this situation in the long term? and (b) How likely is it that there is something to learn from the experience? For the purpose of this study, these two items were modified and combined with two other items that were developed by the first author. The following four items comprised the Positive Meaning Scale for this study: (a) Did anything good come out of dealing with this loss? (b) Do you think you might find benefit from this situation in the long term? (c) Do you think it is likely that there is something to learn from this experience? and (d) Do you think it is likely that this experience could change your life in a positive way? A 5-point rating scale ranging from 0 (not applicable) to 4 (definitely yes) was used for the current scale. We conducted a factor analysis of these four items using principal component analysis. The scree plot and the magnitude of factor loadings were examined to determine the number of factors to be rotated. The results suggested the unidimensionality of the scale. As a result, a one-factor solution was submitted to an oblique rotation. The rotated solution revealed a single factor that accounted for 59.2% of the item variance. The internal consistency coefficient for the positive meaning-finding scale was.88. Procedure Prior to data collection, human subjects approval was obtained from the institutional review board of the university where the research was conducted.

8 In order to recruit participants, first we conducted a comprehensive online search to determine potential sources of data collection. After reviewing Web sites and online support groups related to loss, bereavement, and grief, we selected and contacted the managers of the sites that were aimed at providing support, information, and resources to individuals who had experienced the death of a loved one. We requested that the managers provide information about our study to their online communities and included the link to our study. In addition, we contacted owners of several online grief support groups that were focused on a particular type of bereavement (e.g., spouse loss, parent loss, sibling loss) or bereavement in general (i.e., death of a loved one). Participants from these groups were invited to participate in the study. After indicating their informed consent on the title page, participants were asked to complete a brief demographic questionnaire and the instruments included in the study. Data Analysis We used structural equation modeling (SEM) to test the hypothesized model. Following recommendations to test a measurement model prior to testing a structural model (Anderson & Gerbing, 1988; Weston & Gore, 2006), we first conducted a confirmatory factor analysis to test a measurement model and then tested our hypothesized structural model. Subsequently, we compared our hypothesized partially mediated model against fully mediated models to determine the best-fitting model. The maximum-likelihood method with AMOS 7.0 (Arbuckle, 2006) was used to test both the measurement and structural models. In order to examine the significance of indirect effects, the bootstrap procedure recommended by Shrout and Bolger (2002) was utilized. The bias-corrected bootstrap estimation method has been found to have higher power to detect mediation effects compared to alternative methods of testing mediation (MacKinnon, Lockwood, & Williams, 2004); therefore, we used this procedure and created bootstrap samples to examine the significance of indirect effects. RESULTS The results of preliminary analyses indicated that there were no significant mean differences between male and female participants in terms of their positive meaning-finding scores, t(372) ¼.069, ns; likewise, there was no significant relationship between age and positive meaning-finding (r ¼ 03, ns). Measurement Model Finding Positive Meaning After Loss 249 Prior to testing the measurement model, we created three item parcels for each latent variable except for search for meaning and positive

9 250 G. Boyraz et al. meaning-finding, which were estimated from the individual item scores of the instruments measuring these constructs. In order to create item parcels for positive affect, negative affect, and reflection latent variables, we followed the procedures recommended by Russell, Kahn, Spoth, and Altmaier (1998). First, we factor analyzed the items of each instrument using exploratory factor analysis via the maximum-likelihood method. We fit a one-factor model for each instrument. Next, we rank ordered the items of each scale based on the magnitude of their factor loadings. Then we assigned these items to the parcels in order to create three item parcels for each latent variable. Items were assigned to the parcels so as to equalize the average loadings of each parcel on its particular factor. The measurement model included five latent variables and 18 observed indicators. All exogenous latent variables (i.e., search for meaning, positive affect, and negative affect) had significant correlations with the mediator variable, reflection (rs ¼.25,.48, and.29, respectively) and the dependent variable, positive meaning-finding (rs ¼.14,.58, and.34, respectively). Likewise, the correlation between the mediator variable (i.e., reflection) and positive meaning-finding was significant (r ¼.44). Data for all observed variables met the assumption of normality (see Weston & Gore, 2006, for recommended guidelines). We used the results of a chi-square test and three other fit indices to determine the goodness of fit of the measurement model. A model is considered to have an acceptable fit if the comparative fit index (CFI) value is greater than or equal to.95 and the root-mean-square error of approximation (RMSEA) and standardized root-mean-square residual (SRMR) values are less than or equal to.10 for sample sizes smaller than 500 (Weston & Gore, 2006). The results of the confirmatory factor analysis for the measurement model revealed a good fit for the data: v 2 (125, N ¼ 380) ¼ , p <.001, CFI ¼.96, IFI ¼.96, SRMR ¼.054, RMSEA ¼.063. The magnitude of the factor loadings (standardized) of the observed indicators on their latent variables ranged from.69 to.91. In addition, the factor loadings of all observed variables on their latent variables were significant (p <.001), suggesting that latent variables were properly measured by their observed indicators. Structural Model for Testing Mediated Effects We used the same fit indices in order to determine whether the structural model had a good fit with the data. First, we tested our hypothesized partially mediated model to examine the hypothesized relationships among the variables of the study. The structural model fit the data well, v 2 (125, N ¼ 380) ¼ , p <.001, CFI ¼.96, IFI ¼.96, SRMR ¼.054, RMSEA ¼.063. Further, all hypothesized direct effects were significant. Examination of the results of the bootstrap analysis indicated that all hypothesized indirect paths were statistically significant. As hypothesized, search for meaning (b ¼ ¼.06;

10 Finding Positive Meaning After Loss 251 p <.001) and positive affect (b ¼ ¼.09; p <.001) had significant positive indirect effects on positive meaning-finding. The indirect effect of negative affect on positive meaning-finding through reflection was negative (b ¼ ¼.04; p <.01). Following Martens s (2005) recommendations, we compared our hypothesized partially mediated model against alternative, fully mediated models. First, we constrained the path from search for meaning to positive meaning-finding to zero to examine whether the relationship between search for meaning and positive meaning-finding was partially or fully mediated by reflection. The result of the chi-square difference test was significant, Dv 2 (1) ¼ 4.607, p <.05, suggesting that constraining the path from search for meaning to positive meaning-finding significantly reduced the model fit. Therefore, we retained the path from search for meaning to positive meaning-finding. Next, we constrained the path from positive affect to positive meaning-finding to zero to examine whether the relationship between positive affect and positive meaning-finding was partially or fully mediated. The result of the chi-square difference test indicated a significant difference between the original hypothesized partially mediated model and the alternative model, Dv 2 (1) ¼ , p <.05, suggesting that the path from positive affect to positive meaning-finding should be retained. Finally, we constrained the path from negative affect to positive meaning-finding to zero to determine whether the relationship between negative affect and positive meaning-finding was fully or partially mediated. The result of the chi-square difference test indicated that constraining the path from negative affect to positive meaning-finding to zero significantly reduced the fit of the model, Dv 2 (1) ¼ , p <.05. Therefore, the FIGURE 2 Parameter estimates of the hypothesized model testing whether reflection mediates the relationship between search for meaning, positive affect, negative affect, and positive meaning-finding..

11 TABLE 1 Bootstrap Analysis of the Magnitude and Statistical Significance of the Direct and Indirect Effects. Independent variable Mediator variables Dependent variable b standardized indirect effect B mean SE of indirect effect a mean a 95% CI a (lower, upper) Search for meaning! Reflection ,.247 Positive affect! Reflection ,.439 Negative affect! Reflection ,.044 Search for meaning! Positive meaning-finding ,.168 Positive affect! Positive meaning-finding ,.391 Negative affect! Positive meaning-finding ,.097 Reflection! Positive meaning-finding ,.392 Search for meaning! Reflection! Positive meaning-finding ¼ ,.079 Positive affect! Reflection! Positive meaning-finding ¼ ,.150 Negative affect! Reflection! Positive meaning-finding ¼ ,.012 a These values are based on unstandardized beta coefficients. CI ¼ confidence interval. p <.05; p <.01; p <

12 Finding Positive Meaning After Loss 253 hypothesized partially mediated model was selected as the best-fitting model. According to the final model, reflection partially mediated the relationship between exogenous variables (i.e., search for meaning, positive affect, and negative affect) and positive meaning-finding. The parameter estimates of the hypothesized partially mediated model are presented in Figure 2. The results of the bootstrap procedure are presented in Table 1. The hypothesized model accounted for 32% of the variance in reflection and 34% of the variance in positive meaning-finding. DISCUSSION Victor Frankl (1963) emphasized people s capacity for self-transcendence and suggested that suffering can motivate people s search for meaning and enable them to find reasons to live. The purpose of this study was to determine whether reflection mediated the relationship between search for meaning, positive affect, negative affect, and positive meaning-finding among bereaved individuals. The results supported our hypothesis that search for meaning may have direct and indirect associations with positive meaning-finding through reflection. This finding supports previous theoretical assertions (e.g., Gillies & Neimeyer, 2006) that engagement in a search for meaning in the aftermath of the loss of a loved one may result in positive meaning-finding. Further, the present findings extend the existing literature by suggesting that reflection is an important process that mediates the relationship between search for meaning and positive meaning-finding. It was hypothesized that reflection would mediate the relationship between positive affect, negative affect, and positive meaning-finding. As expected, reflection partially mediated the relationship between positive affect, negative affect, and positive meaning-finding. Participants who endorsed dispositional positive affectivity reported higher levels of inquisitive self-reflection, which, in turn, predicted positive meaning-finding. Negative affect exerted both direct and indirect effects on positive meaning-finding through decreased reflection. These results support Fredrickson s (2001) broaden and build theory of positive emotions, which suggests that positive emotions foster adjustment to stressful experiences through expanding the range of one s thoughts and actions and providing cognitive flexibility. On the other hand, negative affect may prevent people from developing new resources by narrowing their thought processes and behavioral responses. Given the fact that positive affect appears to play an important role in positive meaning-finding in the aftermath of the loss of a loved one, it is important to help bereaved individuals increase their capacity for positive affect and to the extent possible decrease negative affect in order to foster their meaning reconstruction process. Empirical literature suggests that a multimodal psychotherapy approach that combines cognitive behavior

13 254 G. Boyraz et al. therapy and hypnosis is effective in reducing negative affect and increasing positive affect during radiotherapy among breast cancer patients (Schnur et al., 2009). Further, in a longitudinal study, Moskowitz, Folkman, Collette, and Vittinghoff (1996) found that positive reappraisal was significantly associated with positive affect during AIDS-related care-giving and bereavement. This finding may also suggest that the relationship between positive affect and positive meaning-finding may be bidirectional; therefore, helping bereaved individuals reframe their loss experiences in a positive way may result in an increase in positive affect. The results of this study suggest that reflection is one of the key processes contributing to positive meaning-finding by mediating the relationship between search for meaning, affect, and positive meaning-finding. Helping individuals increase engagement in intellectual reflection, which may be fostered through therapy, can be beneficial in monitoring affect and assisting with the search for meaning process. Neimeyer (1999, 2000) recommended narrative exercises, self-help techniques, and therapist-initiated homework assignments to foster self-reflection and the meaning reconstruction process for bereaved individuals. In addition, several logotherapy techniques (e.g., Frankl, 1969, 1978, 1986), such as Socratic dialogue or techniques to modify attitudes, can help clients remove obstacles to meaning fulfillment and foster the process of discovery of meaning. It has also been recommended that the constructive cognitive processing of loss or trauma can be fostered by self-disclosure in a supportive environment (Tedeschi & Calhoun, 2004). Although the research examining the effectiveness of group therapy in the meaning-making process of bereaved individuals is limited, coping-focused group therapy has been found to be effective in decreasing depression and grief (Smith, Tarakeshwar, Hansen, Kochman, & Sikkema, 2009). There is also evidence that therapeutic writing can foster personal growth following a difficult life experience (Ullrich & Lutgendorf, 2002); it has been found to be associated with a decrease in psychological symptoms compared to other forms of nonverbal emotional expression methods (i.e., drawing), especially when clients experience high levels of initial distress (Chan & Horneffer, 2006). It is important to be aware of the fact that not all bereaved individuals engage in a search for meaning. As Gillies and Neimeyer (2006) suggested, some bereaved individuals might explain their loss experience within existing meaning structures and therefore may not become involved in a search for meaning process. Therefore, disturbing the meaning structures of clients who may not be engaged in exploring existential questions may be harmful rather than helpful. The present study has a number of limitations that should be taken into consideration when interpreting these findings. Correlational design does not permit causal inferences. All instruments were self-report; therefore, results may be impacted by mono-method bias. Most of the participants were

14 Finding Positive Meaning After Loss 255 Caucasian and female, limiting the generalizability of the findings to other racial groups as well as men. Likewise, most participants were well educated, limiting the generalizability of the findings to bereaved individuals with lower education levels. Exploring these questions with more diverse samples would be beneficial. In addition, there may be several other variables such as the amount of time passed since a participant s loved one died, the type of relationship to the deceased, the cause of death, and the extent of social support (including whether the participant received therapeutic services) that may have important influences on the degree to which participants find positive meaning from their experience. Further, the participants in this study were recruited from grief support listservs or Web sites; being a member of a grief support listserv may have impacted the degree to which participants derived benefits from their experience. Future research may benefit from controlling these variables because of their potential impact on positive meaning-finding. In addition, using a longitudinal study design would permit causal inferences and provide a more comprehensive understanding of the processes that foster engagement in a search for meaning and positive meaning-finding in bereaved individuals. Despite these limitations, the present study highlights the important role of reflection in mediating the relationship between search for meaning, affect, and positive meaning-finding for bereaved individuals. Engagement in selfreflection during one s search for meaning is an important pathway to increasing personal growth and making sense of the loss of a loved one. Finally, this study reemphasizes the role of positive affect in managing distress and loss. REFERENCES Anderson, J. C., & Gerbing, D. W. (1988). Structural equation modeling in practice: A review and recommended two step approach. Psychological Bulletin, 103, Arbuckle, J. L. (2006). Amos (Version 7.0) [Computer software]. Chicago: SPSS. Boyraz, G., Horne, S. G., & Sayger, T. V. (2009). Personality factors and posttraumatic growth: Testing a mediation model of rumination and reflection among bereaved individuals. Unpublished manuscript. Calhoun, L. G., & Tedeschi, R. G. (2006). The foundations of posttraumatic growth: An expanded framework. In L. G. Calhoun & R. G. Tedeschi (Eds.), Handbook of posttraumatic growth: Research and practice (pp ). Mahwah, NJ: Erlbaum. Capps, L., & Bonanno, G. A. (2000). Narrating bereavement: Thematic and grammatical predictors of adjustment to loss. Discourse Processes, 30, Chan, K. M., & Horneffer, K. J. (2006). Emotional expression and psychological symptoms: A comparison of writing and drawing. The Arts in Psychotherapy, 33,

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17 258 G. Boyraz et al. Watson, D., Clark, L. A., & Tellegen, A. (1988). Development and validation of brief measures of positive and negative affect: The PANAS scales. Journal of Personality and Social Psychology, 54, Weston, R., & Gore, P. A. (2006). A brief guide to structural equation modeling. Counseling Psychologist, 34, Wheeler, I. (2001). Parental bereavement: The crisis of meaning. Death Studies, 25, Güler Boyraz, Ph.D., is an assistant professor of Counseling Psychology at Tennessee State University. Her research focuses on bereavement adjustment, resilience, and posttraumatic growth. Sharon G. Horne, Ph.D., is an associate professor of Counseling Psychology at The University of Memphis. Her work focuses on psychological well-being of gay, lesbian, bisexual, and transgender individuals, as well as the application of psychology in international and cross-cultural contexts. Thomas V. Sayger, Ph.D., was a professor of Counseling Psychology at The University of Memphis. His research interests were families and children, and crosscultural psychology.

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