CHICAGO The most common reaction to the death of a loved one from natural causes is not depression as has been thought but rather yearning or pining, a study said on Tuesday.
The study found that the most characteristic feature of bereavement after a death by natural causes "is more about yearning and pining and missing the person -- a hunger for having them come back," said senior author Holly Prigerson, director of Dana-Farber's Center for Psycho-Oncology and Palliative Care Research.
"The focus on depression is misguided," she said in an interview. Yearning "really dominates the psychological picture, (with a feeling) that a part of you is missing and that without this essential piece you won't be happy."
She said the previous belief was that depression dominated bad feelings, but the new study showed that yearning peaks after four months and that depression, which can be a product of that sadness, peaks much later.
The study, which was published in this week's Journal of the American Medical Association, was written by experts at the Yale University School of Medicine, New Haven, Connecticut, Boston's Dana-Farber Cancer Institute and elsewhere. It was based on interviews over two years with 233 people who had lost a loved one, most often a spouse, due to death from natural causes.
The study confirmed the overall sequence of the "stage theory" of grief that was popularized by Dr. Elisabeth Kubler-Ross in the 1960s -- disbelief, yearning, anger, depression and acceptance, researchers said.
"But, equally important, the data provide a benchmark for how grief changes over time," said Prigerson, a bereavement expert.
As a result, she said, those who help treat grief need to focus first on yearning.
The report said sudden deaths to due to trauma or other reasons -- which account for about 6 percent of all U.S. deaths -- may produce higher degrees of disbelief and anger and less acceptance than found in the study.
Regardless of how the data are analyzed, the study concluded, all of the negative responses are in decline by about six months after a loss. If it goes beyond six months the bereaved survivor may have to be referred for treatment.