Spousal Bereavement: Factors Associated with Depression and Life Satisfaction

Background/Purpose: The loss of a spouse is associated with negative psychological and physical health outcomes including higher depressive symptoms, loneliness, lower life satisfaction, increased psychological distress, hospitalizations, and anxiety. There are many negative consequences associated with widowhood, but these can be mitigated by positive factors such as social support, engagement, religion, and economic resources. This study explores the extent to which these mitigating factors are related to two indicators of psychological adaptation post widowhood -- depression and life satisfaction.

Methods: The study employed a secondary analysis of data collected for the Americans’ Changing Lives Study (ACL), a longitudinal, multistage, stratified area probability sample of persons living in the continental United States. Wave 1 interviews were conducted in 1986 among 3,617 individuals, with African Americans and individuals aged 60 and older over-sampled at twice the rate of White and younger individuals. Subsequent waves were conducted with survivors in 1989, 1994, 2001/2, and 2011. For the purposes of this study, the analytic sample included 827 individuals who were either continuously married, continuously widowed, or changed from married to widowed from wave 4 (2001/2002) to wave 5 (2011). Two multivariable regression models were estimated. The first model used OLS regression to test social support (including children and friends), economic resources, perceived importance of religion, and marital status with depression, while controlling for age, gender, race and education. The second model used ordinal logistic regression to test the same set of independent and control variables with increasing levels of life satisfaction.

Results: Social support from friends (some (b= -1.45, p<0.01), quite a bit (b= -2.02, p<0.001), or a great deal (b= -1.79, p<0.001) was associated with lower depressive symptoms, whereas social support from children was not significantly associated with depressive symptoms. Additionally, increasing income categories was associated with decreasing depressive symptoms (ranging from b= -1.21, p<0.01 to b= -2.35, p<0.001). Those who felt quite a bit (OR=3.04, p<0.05) or a great deal of love (OR=4.61, p<0.01) from their children had increased odds of a higher score on life satisfaction, whereas other factors (support from friends, economic stability, and perceived importance of religion) were not significantly associated with life satisfaction. Changes in marital status from married to widowed (from wave 4 to wave 5) was associated with both higher depressive symptoms (b=1.10, p< 0.001) and lower life satisfaction (OR=0.38, p<0.001) compared to individuals who were continuously married.

Conclusions and Implications: Results highlight the importance of social support and economic stability among the widowed population, especially those who are recently widowed. Consistent with previous studies on bereavement, factors associated with one aspect of psychological adaptation may not be associated with all aspects of psychological adaptation. Social workers working with widowed individuals should pay attention to economic resources and needs, and strengthening family and friend relationships, rather than focusing only on grief or depression. Future research with the widowed population needs to continue to include multiple measures, such as depression and life satisfaction to understand the complex nature of psychological adaptation in widowhood.