• Jason M Holland and Robert A Neimeyer.
• Center for Health Care Evaluation, VA Palo Alto Health Care System and Stanford University Medical Centerm, Menlo Park, CA 94025, USA. jmhollnd@gmail.com
• Omega (Westport). 2010 Jan 1; 61 (2): 103-20.

AbstractDespite its popularity, few attempts have been made to empirically test the stage theory of grief. The most prominent of these attempts was conducted by Maciejewski, Zhang, Block, and Prigerson (2007), who found that different states of grieving may peak in a sequence that is consistent with stage theory. The present study aimed to provide a conceptual replication and extension of these findings by examining the association between time since loss and five grief Indicators (focusing on disbelief, anger, yearning, depression, and acceptance), among an ethnically diverse sample of young adults who had been bereaved by natural (n=441) and violent (n=173) causes. We also examined the potential salience of meaning-making and assessed the extent to which participants had made sense of their losses. In general, limited support was found for stage theory, alongside some evidence of an "anniversary reaction" marked by heightened distress and reduced acceptance for participants approaching the second anniversary of the death. Overall, sense-making emerged as a much stronger predictor of grief Indicators than time since loss, highlighting the relevance of a meaning-oriented perspective.

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