Psychological Flexibility and Resilience in Parentally Bereaved College Students

Abstract

Losing a parent prior to age 18 years can have life-long implications. The challenges of emerging adulthood may be even more difficult for parentally bereaved college students, and studying their coping responses is crucial for designing campus services and therapy interventions. This study examined the relationships between bereavement-related distress, experiential avoidance (EA), values, and resilience. Findings indicated that EA and low importance of values were correlated with bereavement difficulties, with EA accounting for 26% of the variance in the bereavement distress measure. In addition, reports of behaving consistently with values accounted for 20% of the variance in the resiliency measure. Contrary to hypotheses and previous literature, there were no significant relationships between the measures of EA and values. The results, limitations, and directions for future research are discussed.

Keywords

college students bereavement experiential avoidance values resilience

Parental Bereavement

Nearly every human will be bereaved by the death of a loved one in his or her lifetime (Brown & Goodman, 2005; Stroebe, Hansson, Stroebe, & Schut, 2001). The bereavement period can affect an individual’s overall functioning in a variety of ways, including the experience of diverse feelings (e.g., sadness and relief), intrusive thoughts, or an inability to concentrate (Boelen, van den Hout, & de Keijser, 2003; Howarth, 2011). Grief, which involves the cognitive, emotional, and physiological struggles that accompany bereavement (Brown & Goodman, 2005; Stroebe et al., 2001), can result in increased psychological distress and decreased physical health and help seeking. Consequently, bereaved individuals (i.e., those who have experienced the death of a loved one) evidence higher rates of premature mortality than nonbereaved individuals (Stroebe, Schut, & Stroebe, 2007). Therefore, contextual (Bonanno & Mancini, 2008) and personal (Mancini & Bonanno, 2009) factors shape the sequela of loss.

Approximately 3% of individuals under the age of 18 years experience the death of a parent (Christ, Siegel, & Christ, 2002). Losing a parent during a crucial time of development can have life-long implications. Bereaved adolescents report less secure peer attachment, lower work performance, more poorly developed career plans, and diminished educational aspirations as compared with peers who have not experienced the death of a parent (Brent, Melhem, Masten, Porta, & Payne, 2012).

Type, or cause, of parental death can affect bereaved youths’ outcomes. Individuals whose parent(s) died either by accident or by suicide have higher risks of developing depression than nonbereaved individuals and those whose parents died of natural causes (Brent, Melhem, Donohoe, & Walker, 2009). Furthermore, nearly 2 years after the passing of their parents, individuals who experienced parental suicide were more likely to engage in alcohol or substance abuse, whereas individuals whose parents passed away due to an accident reported higher levels of anxiety, complicated grief, and functional impairment (Brent et al., 2009). Experiencing the death of a parent prior to age 18 years can significantly impact individuals’ later approach to pursuing important, valued life directions (Brent et al., 2012). Thus, future outcomes may be affected as bereaved youth enter college and identify as emerging adults.

Parentally Bereaved College Students

Emerging adults are typically optimistic, 18-to 25-year-old individuals, who are focused on exploring and establishing their interests regarding romantic relationships, education, careers, and world viewpoints (Arnett, 2000, 2004). Their quests for self-conceptualization involve self-focus and instability; they do not yet meet the defining characteristics of adulthood, although they are more mature than adolescents (Arnett, 2004; Scheer, Unger, & Brown, 1994). College involves many challenging experiences for emerging adults, such as developing new personal and professional relationships, meeting academic requirements and family expectations, and ultimately establishing independence and competence. Given these pressures, students may experience severe levels of psychological distress (Beiter et al., 2015).

Throughout this period of growth, many emerging adults receive help from their parents in making decisions and navigating difficult situations (Carlson, 2014). For example, over 50% of undergraduate students have parents who assist them with tuition and other costs associated with college life (e.g., cafeteria food and recreational activities). The average amount of money parents pay ranges from $5,000 to $30,000 annually (Padilla-Walker, Nelson, & Carroll, 2012). In addition to financial assistance, parents might help emerging adults navigate difficult decision-making situations by giving advice or by providing networking opportunities. If a parent is deceased, however, these resources are depleted. Therefore, the lack of these parental resources may significantly impact emerging adults’ college experiences.

How a student copes with the death of a parent is influenced by the student’s developmental stage (Roy, 1986; Servaty-Seib & Taub, 2010), perception of the bereavement experience (Boelen et al., 2003; Lin, Sandler, Ayers, Wolchik, & Luecken, 2004), and support from the college environment for students experiencing grief (Balk, 1996; Servaty-Seib & Taub, 2010). Although college student bereavement is prevalent, universities struggle to provide a supportive coping environment. This affects students’ skills acquisition, which—in turn—may limit their academic successes (Balk, 2001; Silverman, 1987).

Individual factors strongly contribute to overall mental health, with the strongest predictor being coping abilities (Byrd & McKinney, 2012). When individuals are bereaved, they may lack confidence in their abilities to maintain relationships and daily routines throughout the grieving process (Cupit & Servaty-Seib, 2013; Cousins, 2011; Eppler, 2008). In addition, the death of a parent can undermine one’s sense of self (Neimeyer, Prigerson, & Davies, 2002), likely contributing further to diminished adaptive coping (Wolchik, Tein, Sandler, & Ayers, 2006).

Currently, there is little research that examines coping abilities in an emerging adult college student population. Conducting research applicable to current evidence-based treatment models is equally important. Therefore, this project examines coping, in part, through the lens of an evidenced based third-wave behavior therapy, acceptance and commitment therapy (ACT; Hayes, Strosahl, & Wilson, 2012).

Experiential Avoidance and Coping Styles

Experiential avoidance (EA) involves deliberate attempts to avoid or change internal stimuli (e.g., thoughts, feelings, and bodily sensations) and external situations that make them more likely to occur, even when doing so has known negative consequences (Hayes, Wilson, Gifford, Follette, & Strosahl, 1996). In the short term, EA can be adaptive in the grieving process (Shear, 2010). It may be necessary, for example, to file paperwork that allows for a semester withdrawal. Here, EA is the preferred alternative to being stymied by grief and receiving all failing grades at the end of the semester. In this way, EA can be compared with what Bonanno and Mancini (2008) refer to as pragmatic coping, which is associated with resilience. However, EA as a long-term strategy to cope with bereavement is likely problematic, as it can hinder and prolong grief (Shear, 2010). For instance, if a student is unwilling to experience pain and avoids sadness and all situations which might increase sadness, or reminders of the deceased parent (e.g., home, school, and doctors’ offices), then severe pathology can readily develop. Similarly, pragmatic coping has been associated with negative characteristics such as rigidity, narcissism, and poor health (Mancini & Bonanno, 2009).

Mancini and Bonanno (2009) note that a critical variable in loss outcome appears to be flexible adaptation. Depending on how it is used and how long it is used, EA can be helpful or maladaptive. Its maladaptive form tends to result in a vicious cycle. An individual attempts to change the content of personal thoughts and feelings, or how often those thoughts and feelings occur (e.g., thought suppression; Gold & Wegner, 1995; Hayes et al., 1996). This avoidance strategy paradoxically leads to an increase in frequency of avoided stimuli (Gross, 1998; Kashdan, Barrios, Forsyth, & Steger, 2006; Wegner, Schneider, Carter, & White, 1987), which the individual again attempts to avoid or change (Hayes & Gifford, 1997). As a result, individuals who are high in EA are more likely to report negative life events, negative life appraisals, and negative affective experiences (Kashdan et al., 2006).

EA in adult populations is most often measured with a 7-item self-report assessment called the acceptance and action questionnaire-II (Bond et al., 2011). This measure is scored on a Likert-like scale from 1 (never true) to 7 (always true) and includes items such as, “My painful memories prevent me from having a fulfilling life,” and “I'm afraid of my feelings.” The items are summed, and higher scores indicate higher EA. The measure is intended to capture cognitive fusion, which is the idea that someone takes his or her thoughts literally and responds to them as truth, as well as inability in taking action when feeling overwhelmed by thoughts or feelings—at the expense of values. The measure has been utilized in many studies and has adequate psychometric properties (mean alpha = .84, Bond et al., 2011).

Those who interpret their grief reactions negatively are more likely to experience distress and discomfort, ultimately engaging in maladaptive avoidance strategies in efforts to avoid the negative feelings associated with their losses (Boelen et al., 2003; Eisma et al., 2013; Stroebe et al., 2007). Bereaved college students who utilize avoidant emotion coping (which is a subset of EA) are significantly more likely to experience complex grief and decreased levels of overall college adjustment (Cousins, 2011; Schnider, Elhai, & Gray, 2007). In addition, avoidant coping styles are predictive of severity of posttraumatic stress disorder symptoms (Schnider et al., 2007).

Avoidant coping styles are a subset of a plethora of ways in which people respond to stressors. Coping styles can be conceptualized as situation specific, dispositional, or as some combination of both (Lazarus & Folkman, 1991). While a thorough review of the coping literature is beyond the scope of this article (for review, see Lazarus & Folkman, 1991), a few key coping styles as they are relevant to parental loss will be briefly discussed. These include active or approach, support seeking, and avoidant coping (Lazarus & Folkman, 1991).

An individual might approach and address problems associated with the loss of a parent in a direct way, indicating an active style of coping. Active coping strategies are responses designed to directly address the nature of the stressor itself, or how one thinks about and relates to it (Holahan & Moos, 1987). For example, an individual may journal about their distress or write letters to the parent(s) who passed away. Whether behavioral or emotional, active coping strategies are associated with more adaptive outcomes in response to stressful life events (Folkman & Lazarus, 1985; Holahan & Moos, 1987).

Another individual may utilize their support group to address bereavement concerns. This support-seeking coping style involves using social resources for support from family, peers, and other environmental resources to help deal with distress, and it is associated with positive outcomes (Costa, Hall, & Stewart, 2007; Feenstra, Banyard, Rines, & Hopkins, 2001). In contrast to these two, an avoidant coping style includes minimizing or completely ignoring an event that occurred in efforts to deal with the impact of the event (Feenstra et al., 2001). As was mentioned in reference to EA, avoidant coping might be helpful in the short term, but denying or minimizing the death of a parent might ultimately lead to more psychological distress (Lawrence, Jeglic, Matthews, & Pepper, 2005; Sigman & Wilson, 1998). This maladaptive avoidance style may be interpreted as a means of regulating thoughts and feelings, where individuals have the choice to either regulate their private events or respond with acceptance, which in turn increases psychological flexibility (Twohig, 2012).

Psychological flexibility refers to an individual being purposefully aware of the present moment and using moment to moment awareness of internal and external stimuli to either persist in or change behavior based on personal values (Hayes, Luoma, Bond, Masuda, & Lillis, 2006). This concept overlaps with what Mancini and Bonanno (2009) refer to as resilient individuals’ ability to flexibly adapt. Kashdan and Rottenberg (2010) draw comparisons between psychological flexibility and ego resiliency, ability to balance and shift time perspective, and adaptive psychological functioning. These descriptions of psychological flexibility overlap a great deal with the values-directed behavior therapy that is conducted in ACT (Wilson & Murrell, 2004). Exposure to previously avoided stimuli is conducted not solely to decrease arousal but also to increase a wide range of behaviors that are congruent with values. Although there are many definitions of values, this article uses the definition consistent with ACT, outlined in the section later.

Values and Resilience

Values are defined as verbally constructed consequences that may change over time and have no endpoint. Valuing is an active behavior, which establishes intrinsic reinforcement in an appetitive fashion, primarily free from external choice or control (Wilson & Dufrene, 2009). At times, choosing to behave in accordance with one’s values involves feeling uncomfortable or experiencing suffering in the short term (e.g., attending the funeral of a loved one to remain consistent with valuing family).

Previous research has demonstrated the importance of valuing behavior for well-being and decision making in the college population (e.g., Feather, 1988; Mitchell, Kimball, Thorton, & Young-Demarco, 2008; Talbot, 1990). Overall, emerging adults who have an internalized set of values tend to be more well adjusted and successful in college (Nelson & Padilla-Walker, 2013). Additionally, undergraduates who identified values in several different domains (e.g., relationships and education) are less likely to engage in EA and report less psychological distress than those who identified fewer value domains (Adcock, Murrell, & Woods, 2007; VanDyke, Rogers, & Wilson, 2006). Further, Hernandez (2013) found that psychological flexibility predicted values purity (intrinsically chosen values) and success in living consistently with values in an undergraduate sample. Psychological flexibility mediated the relationship between values purity and success in valued living.

Taken together, these results suggest valuing behavior plays an important role in college students’ well-being. Results further indicate that students behave consistently with their values while experiencing all of their internal and external stimuli, regardless of whether those thoughts, feelings, bodily sensations, and the like are positive or negative in valence. This is similar to the findings of McCracken and Yang (2006) that indicated a significant, negative correlation between EA and consistency with valued living in individuals with chronic pain. This ability to do things that matter—no matter what—could be seen as resilience.

Resilience refers to the process of experiencing substantial hardships and positively adapting to one’s environment in response to those hardships (Luthar, Cicchetti, & Becker, 2000). Bonanno (2004) defines resilient people as having two main characteristics after a loss or other trauma: (a) maintaining stable, healthy physical, and psychological functioning and (b) exhibiting signs of vitality, or doing well, not just lacking symptoms. Congruently, a common ACT technique is to ask clients if an activity feels vital even if it is also painful (such as attending a parent’s funeral).

Bonanno (2004) originally proposed that personality factors like hardiness and self-enhancement, as well as positive emotions and repressive coping, were associated with resilience after a loss. More updated research by Bonanno Westphal, and Mancini, 2011 has revealed that resilience after potential traumatic events is likely the result of a complex, multiply-intertwined, and multidirectional mix of factors including, demographic variables (gender and SES), coping, stress level, positive emotions, worldviews, and social support. Additionally, a review article (Clark, Pynoos, & Goebel, 1993) reviewed that expression of feelings in writing, effective communication with and support by remaining family members, the family seeking professional treatment, and a mix of avoidant and active coping led to resilience in parentally bereaved children and adolescents. The authors of this article are unaware of any examination of resilience in parentally bereaved emerging adults, and the relationships among resilience, values, and EA in parentally bereaved college students had yet to be examined.

Present Study

Since many college students are, in some way, dependent upon their parents for financial support (Carlson, 2014), guidance, and assistance with adult identity formation (Nelson & Padilla-Walker, 2013), losing a parent before college can be life altering. Furthermore, psychological difficulties and distress might be exacerbated due to the features that characterize emerging adults within a college setting (e.g., relationship instability). One coping method students might engage in is avoidance. Although some individuals might use EA as an effective form of coping with bereavement (Shear, 2010), EA is also related to complex grief (Schnider et al., 2007), college maladjustment (Cousins, 2011), and overall greater distress and discomfort (Boelen et al., 2003). Still, some bereaved college students may display high levels of valuing and resilience. It is thought that these students most likely engage in acceptance and utilize their emerging adulthood to experience growth, reframe their priorities, and pursue a meaningful life (Cupit & Servaty-Seib, 2013). In the present study, the relationships among bereavement-related distress, EA, values, and resiliency in parentally bereaved college students were explored. Given previous findings, several hypotheses were made. First, it was hypothesized that EA would predict bereavement difficulties. Second, it was hypothesized that the importance placed on values would correlate with lower levels of bereavement difficulties and EA. Third, it was hypothesized that behaving consistently with one’s values would predict higher resiliency and lower EA.

Methods

Participants

The participants in this study were adult undergraduates at a large university in the south central region of the United States. For participants to be included in this study, they needed to be currently enrolled in the university and have experienced the death of a parent before age 18 years. Given the specificity of requisites, a sample of 63 participants (N = 63) were recruited, consented, and retained to participate in this study. The majority of individuals in this sample were female (76.2%; N = 48) and Caucasian (52.4%; N = 33). The average age of participants was 22 years old (SD = 4.8; Range = 18–43 years). More participants reported having deceased fathers than deceased mothers. Demographics are presented in Table 1.
Table 1.
Descriptive Statistics for Parentally Bereaved College Students (N = 63).

Frequency Percent Mean SD

Sex

Male 15 23.8

Female 48 76.2

Ethnicity

African American or Black 15 23.8

American Indian or Native Alaskan 1 1.6

Caucasian or White 33 52.4

Asian or Pacific Islander 1 1.6

Biracial 5 7.9

Hispanic or Latino 6 9.5

Other 2 3.2

Education classification

Freshman 15 23.8

Sophomore 11 17.5

Junior 12 19

Senior 25 39.7

Deceased parent gender

Male (Father) 36 57.1

Female (Mother) 24 38.1

Both 2 3.2

Participant age 63 – 22.0 4.8

Age of parent at death 58 – 47.2 11.8

Age of child at death 60 – 14.3 6.5

Siblings

Yes 55 87.2

No 8 12.7

Number of siblings in family 55 – 2.2 1.8

Measures

Demographic questionnaire

The demographic questionnaire asked participants to provide information related to age, gender, ethnicity, classification in school (e.g., freshman), number of siblings, age of participant at time of parental death, and age of parent at death.

Valued living questionnaire (Wilson & Groom, 2002)

The valued living questionnaire (VLQ) is a 20-item self-report measure that assesses an individual’s valued living in 10 domains. These domains include the following: family, marriage or couples or intimate relations, parenting, friendship, work, education, recreation, spirituality, citizenship, and physical self-care. The first 10 items examine the amount an individual values each domain on a 10-point scale ranging from 1 (not at all important) to 10 (extremely important). The second set of 10 items assesses how consistently an individual lives with their values within each of the 10 domains from 1 (not at all consistent) to 10 (extremely consistent). Responses from both importance and consistency are typically used to derive a weighted value composite by multiplying the two responses and computing the mean of the products. The VLQ is inversely correlated with psychological distress as measured by the general pathology scale of the Butcher treatment planning inventory (r = −.27, p < .005), and it demonstrates divergent validity with the gold-standard measure of EA (the acceptance and action questionnaire-II; r = −.13). Further, it significantly, positively correlates with measures of vitality and mental health. More specifically, the VLQ composite scores correlate with the vitality (r = .37, p < . 001), lack of interference by emotional problems (r = .22, p < .001), lack of interference by physical problems (r = .15, p < .05), social functioning (r = .13, p < .05), and mental health subscales (r = .23, p < .001) of the short form health inventory-36 (Wilson, Sandoz, Kitchens, & Roberts, 2010).

Although overall valued living composite scores are often utilized (Wilson & Murrell, 2004); given the findings of VanDyke et al. (2006), Adcock et al. (2007), and Hernandez (2013) as well as the results of McCracken and Yang (2006), it was determined that examining the subscales of importance and consistency separately would be more appropriate for this study. The importance scores across domains were summed for each participant, and then the summary scores were dichotomized based on a cutoff score. Participants with a summary score of 91.49 or below were assigned a score of 1 for “low valuing,” and participants with a sum of 91.50 or higher were assigned a 2 for “high valuing.” Consistency scores were summed across domains and left as a continuous variable. The Cronbach’s alpha in this sample was .81.

The avoidance and fusion questionnaire for youth (Greco, Murrell, & Coyne, 2005)

The avoidance and fusion questionnaire for youth (AFQ-Y) is a 17-item self-report measure, which examines EA, psychological inflexibility, and cognitive fusion. Participants respond to this questionnaire by rating how true for themselves they find an item to be on a scale of 0 (not at all true) to 4 (very true). A total score is then calculated, with higher scores indicative of higher levels of psychological inflexibility. The AFQ-Y, which was originally developed and normed with a child and adolescent population, has also demonstrated good internal consistency in undergraduate samples (α = .84–.92; Fergus et al., 2012; Schmalz & Murrell, 2010). The AFQ-Y correlates positively with depression (r = .59), stress (r = .55), and anxiety (r = .53; Schmalz & Murrell, 2010). The Cronbach’s alpha for this sample was .82.

The Connor-Davidson Resiliency Scale (Connor & Davidson, 2003)

The Connor-Davidson Resiliency Scale (CD-RISC) is a 25-item self-report measure, which assesses an individual’s coping ability in response to stress. Each item is rated on a 5-point scale ranging from 0 (not true at all) to 4 (true nearly all the time), with higher scores indicating greater resilience. The CD-RISC demonstrates high internal consistency (α = .89) across both clinical and community samples and is negatively correlated with stress scores (Connor & Davidson, 2003). The Cronbach’s alpha in this sample was .89.

Bereavement experience questionnaire (Guarnaccia & Hayslip, 1998)

The bereavement experience questionnaire (BEQ-24) is a short version of the longer 67-item BEQ developed by Demi and Schroeder (1987). The BEQ-24 has three subscales that assess existential loss, anger or blame or guilt, and preoccupying thoughts of the deceased person. This measure has 24 items ranging from 0 (never) to 4 (almost always), with higher scores indicating more grief and bereavement experience. The BEQ-24 demonstrates high-internal consistency (α = .91) in undergraduate samples (Guarnaccia & Hayslip, 1998). The Cronbach’s alpha for this sample was .90.

Procedure

Participants were recruited from the university’s online human research system (Sona) and were screened via a structured questionnaire to confirm whether they had a deceased parent or parent figure. After screening, participants met in person with the researchers where consent to participate in the study was collected. The study was approved by the university institutional review board which follows U.S. federal guidelines on ethical research procedures. All measures were completed in person via pencil and paper methods. Participants who completed the study received extra credit for an undergraduate psychology course.

Results

Prior to hypothesis testing, assumptions for correlations and regressions were run. The dichotomized variables were planned nonparametric tests. A few of the demographic variables were nonnormal and those were left untransformed. Next, a series of bivariate correlations were run to examine relationships among the demographic variables and key variables of interest. There were two significant correlations. Whether participants attended the funerals of their parents was significantly correlated with bereavement difficulties or not, with attendance being associated with higher rates of anger, blame, and preoccupying thoughts and the like, r(61) = .369, p = .004. In addition, there was a positive relationship between substance use and resiliency, r(61) = .256, p = .044. These were used as covariates in all future analyses.

To test Hypothesis 1, a hierarchical regression was used to test whether EA significantly predicted bereavement difficulties (i.e., higher levels of existential loss, anger or blame or guilt, and preoccupying thoughts of the parent who passed away). The predictor variable was the total score on the AFQ-Y, and the criterion variable was the mean total score on the BEQ. Funeral attendance was entered at Step 1 to control for the relationship between funeral attendance and bereavement adjustment. Funeral attendance accounted for approximately 12% of the variance in bereavement adjustment. The results indicated the overall model for EA, after removing the effects of funeral attendance, was significant, F(1, 59) = 19.20, p < .001. EA significantly predicted bereavement difficulties, β = .52, t(61) = 5.04, p < .001. The total score for EA accounted for 26% of the total variance in bereavement difficulties, Adjusted R²= .26, p < .001. Results from this regression can be seen in Table 2.
Table 2.
Simple Regression Analysis for Experiential Avoidance Predicting Bereavement Difficulties in Parentally Bereaved College Students (N = 63).

B SE(B) β t p Adjusted R²

AFQ-Y .022 .004 .52 5.04 <.001 .26

AFQ-Y = avoidance and fusion questionnaire for youth.

To test Hypothesis 2, the importance of values would be correlated with both bereavement difficulties and EA, 2 two-tailed Spearman’s rho correlation analyses were conducted. The newly created high–low VLQ importance variable was correlated with the BEQ mean total score and the AFQ-Y total score. Funeral attendance was statistically controlled in the bereavement adjustment analysis. This hypothesis was partially supported. There was not a significant correlation between the EA measure and the importance score. However, results indicated a small but significant correlation in the expected direction for the first part of the hypothesis, ρ(61) = −.392, p = .001.

To test the third hypothesis that behavioral consistency with values would predict higher resiliency and lower EA, a hierarchical regression was conducted. The predictor variable was the computed VLQ consistency summary score, and the criterion variables were the CD-RISC total score and the AFQ-Y total score. Substance use was entered at the first step given its correlation with resiliency. Results demonstrated no significant relationship between living consistently with values and avoidance. Therefore, a regression was then conducted for resiliency alone, controlling for substance use as it was entered as the first predictor. Substance use accounted for 5% of the variance in resiliency. The overall model investigating consistently living with values was significant in the expected direction, F(1, 61) = 8.578, p < .001. Higher values consistency significantly predicted higher resiliency, β = .409, t(61) = 3.49, p < .001. The consistency score for values accounted for 20% of the total variance in resiliency, Adjusted R²= .199, p < .001. Results from this regression can be seen in Table 3.
Table 3.
Simple Regression Analysis for Value-Consistent Living Predicting Resiliency in Parentally Bereaved College Students (N = 63).

B SE(B) β t p Adjusted R²

VLQ-consistent .268 .08 .419 3.60 <.001 .16

VLQ = valued living questionnaire.

Discussion

Although death is a natural and universal human experience, the death of a loved one can still bring about intense suffering, as well as increased risk for psychological and physical problems (Stroebe et al., 2007). Given these consequences, studying the factors which relate to effective coping and adaption after parental bereavement seems critical. In fact, understanding the underlying processes that influence effective outcomes is important for promoting resiliency and psychological flexibility in bereaved individuals (Sandler, Wolchik, & Ayers, 2008). Thus, the relationships among bereavement-related distress, EA, values, and resiliency in parentally bereaved college students were explored.

Results demonstrated that, as expected, individuals who reported higher levels of EA endorsed higher levels of difficulty with their bereavement. This relationship remained significant even after controlling for funeral attendance. This finding is consistent with previous research that indicates avoidance is associated with complicated grief (e.g., Boelen & van de Bout, 2008). Over-utilizing EA can impede processing grief (Shear, 2010). Avoidance of unpleasant experiences can cause interference with a person’s understanding of their loss, thereby decreasing active adjustment and ultimately contributing to loss-related psychopathology (Boelen & van de Bout, 2008; Boelen, van den Hout, & van den Bout, 2006). For instance, individuals who are more experientially avoidant are more likely to endorse catastrophic misrepresentations of grief reactions (Boelen, Van de Bout, & van de Hout, 2010). Some studies have found that such misinterpretations actually account for larger portions of variance in adjustment than avoidance (Boelen et al., 2010). The current study, however, did not explore that factor.

The relationships among values and bereavement adjustment were explored. Bereaved college students who assigned high levels of importance to values had fewer bereavement difficulties. Although this particular relationship had not previously been explored, this finding is consistent with research that demonstrates undergraduates with internalized value sets have generally positive outcomes and less psychological distress (i.e., depression and anxiety; Hernandez, 2013; VanDyke et al., 2006). Furthermore, this is congruent with the Nelson and Padilla-Walker (2013) study, in which emerging adults who were better adjusted to college had higher internalized value sets and lower levels of depression, anxiety, drinking, drug use, and violent video game usage. These findings suggest that valuing behavior in college students who experience adversity might lead to more healthy and adaptive outcomes. Bereaved students who lived more consistently with their values also reported more resiliency in the face of hardships than those who lived inconsistently with their values. These findings are consistent with previous studies which have investigated behavioral consistency with values (e.g., McCracken & Yang, 2006; Wilson et al., 2010).

Neither importance placed on valuing nor behavioral consistency with values was predictive of EA. This null finding is inconsistent with several previous studies (Adcock et al., 2007; McCracken & Yang, 2006; VanDyke et al., 2006; Wilson et al., 2010) and thus was unexpected. One possible explanation is that, while efforts were made to examine these constructs in a similar manner to previous studies, the exact measures were somewhat inconsistent across previous works. More specifically, this was the only study that used the AFQ-Y as the measure of EA. The McCracken and Yang (2006) study used a measure of pain-specific EA, and the others used the avoidance and action questionnaire. Additionally, in the Wilson et al. (2010) study, unlike the others, the VLQ composite score was used rather than separate scores for Importance, Consistency, or both. An alternative explanation for this inconsistency is that there is something specific to a parentally bereaved sample that affected this relationship, and this should also be further explored. Other future directions, as well as limitations, are discussed later.

Limitations and Future Directions

Limitations of this research include small sample size (N = 63), the lack of diversity in the sample, and having cross-sectional data. One particular compounded factor was that we had only self-report measures, and for many participants, the parents’ death was not a recent event (time since the death of the parent had a mean of 7.9 years but a range of 21.6 years). Although effects of bereavement may last a lifetime, reports of functioning may have differed for participants based on length of time since parental death, which is uncertain from self-report.

Future research might benefit from incorporating more diversity in the sample in the areas of gender, ethnicity, and religion. Religion and spirituality were frequently named value domains. Therefore, including more individuals with varying belief systems might promote a more comprehensive understanding of value-consistent living. This data could be used to see for whom these domains are most valuable for (e.g., theist or nontheist persons). With regard to the study being cross-sectional, future research may care to follow-up with measures to assess bereavement and resiliency throughout the college experience. This might provide more insight into the contribution of value-consistent living in resiliency and EA in bereavement difficulties.

Another important consideration for future research is investigation of how the characteristics of emerging adulthood impact bereavement outcomes. Although the majority of participants in this study are classifiable by age as emerging adults, we did not specifically measure features of this developmental period which might have contributed to our findings. Emerging adulthood is a complex culturally based developmental period characterized by particular features (i.e., exploration, instability, self-focus, feeling-in-between, and possibilities; Arnett, 2004), and understanding the interplay between emerging adulthood features and bereavement or grief might help researchers understand why some bereaved college students are more resilient than others. For instance, perhaps emerging adult college students who feel as if their possibilities in life are limited due to losing their parent might have prolonged grief experiences. This limitation seems particularly important to explore when considering two of Mancini and Bonanno’s (2009) hypothesized predictors of resilience. Worldview interruption and identity continuity and complexity could be greatly affected by loss of a parent at a young age.

Lastly, our research suggests that individuals who experience higher levels of existential loss, anger or blame or guilt, and preoccupying thoughts of the parent might benefit from interventions that attempt to address difficulties associated with EA. Those with lower levels of EA are likely to have more resilience due to their lack of attempts to control or change their unwanted experiences (Biglan, Hayes, & Pistorello, 2008). Prior to moving further with this idea, additional research that explores the role of misinterpretations of beliefs must be explored. It does appear that a treatment that targets values and one’s relationship to maladaptive, misinterpreted thoughts in addition to avoidance, like ACT, might be beneficial.

There is certainly not one correct way to experience the loss of a parent, or any loved one. It is important for clinical researchers and for university support staff to remember that behaviors that may appear avoidant or value-inconsistent may function differently for the person who has lost a dear one. In fact, absence of grief is not necessarily pathological or problematic (individual differences in grief reactions reviewed in Bonanno & Kaltman, 2001). Therefore, it is our hope that this study leads us all to be more flexible in our approach.

	Frequency	Percent	Mean	SD
Sex
Male	15	23.8
Female	48	76.2
Ethnicity
African American or Black	15	23.8
American Indian or Native Alaskan	1	1.6
Caucasian or White	33	52.4
Asian or Pacific Islander	1	1.6
Biracial	5	7.9
Hispanic or Latino	6	9.5
Other	2	3.2
Education classification
Freshman	15	23.8
Sophomore	11	17.5
Junior	12	19
Senior	25	39.7
Deceased parent gender
Male (Father)	36	57.1
Female (Mother)	24	38.1
Both	2	3.2
Participant age	63	–	22.0	4.8
Age of parent at death	58	–	47.2	11.8
Age of child at death	60	–	14.3	6.5
Siblings
Yes	55	87.2
No	8	12.7
Number of siblings in family	55	–	2.2	1.8

	B	SE(B)	β	t	p	Adjusted R²
AFQ-Y	.022	.004	.52	5.04	<.001	.26

	B	SE(B)	β	t	p	Adjusted R²
VLQ-consistent	.268	.08	.419	3.60	<.001	.16

Footnotes

Declaration of Conflicting Interests

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Funding

The author(s) received no financial support for the research, authorship, and/or publication of this article.

Author Biographies

Amy R. Murrell is an associate professor at the University of North Texas in the Department of Psychology. She has conducted research on functional contextual science since 2000, primarily investigating Acceptance and Commitment Therapy with families.

Ryeshia Jackson obtained her undergraduate degree from this department, and this paper stemmed from her honors thesis work. She is interested in working with families dealing with chronic illness and early deaths. She currently works as a Child Life Specialist.

Ethan G. Lester is currently a graduate student in this same department.

Teresa Hulsey is currently a graduate student in this same department. Her current research interests include looking at experiential avoidance as it relates to identity development, parent-child relationships, and the development and maintenance of psychopathology in emerging adults.

References

Adcock, A. C., Murrell, A., & Woods, D. (2007, May). Empirical support for the importance of valuing on psychological well-being. Paper presented at the meeting of the Association for Behavior Analysis, San Diego, CA.

Arnett

J. J.

(2000) Emerging adulthood: A theory of development from the late teens through the twenties. American Psychologist 55: 469–480.

Arnett

J. J.

(2004) Emerging adulthood: The winding road from the late teens through the twenties, New York, NY: Oxford University Press.

Balk

(2001) College student bereavement, scholarship, and the university: A call for university engagement. Death Studies 25: 67–84.

Balk

D. E.

(1996) Attachment and the reactions of bereaved college students: A longitudinal study. In: Klass

Silverman

P. R.

Nickman

(eds) Continuing bonds: New understandings of grief, Philadelphia, PA: Taylor & Francis, pp. 311–328.

Beiter

Nash

McCrady

Rhoades

Linscomb

Clarahan

Sammut

(2015) The prevalence and correlates of depression, anxiety, and stress in a sample of college students. Journal of Affective Disorders 173: 90–96.

Biglan

Hayes

S. C.

Pistorello

(2008) Acceptance and commitment: Implications for prevention science. Prevention Science 9: 139–152.

Boelen

P. A.

van den Bout

de Keijser

(2003) Traumatic grief as a distinct disorder from bereavement-related depression and anxiety: A replication study with bereavement mental health care patients. American Journal of Psychiatry 160: 1339–1342.

Boelen

P. A.

van den Bout

van den Hout

M. A.

(2010) A prospective examination of catastrophic misinterpretations and experiential avoidance in emotional distress following loss. Journal of Nervous and Mental Disease 198: 252–257.

10.

Boelen

P. A.

van den Hout

M. A.

(2008) The role of threatening misinterpretations and avoidance in emotional problems after loss. Behavioural and Cognitive Psychotherapy 36: 71–87.

11.

Boelen

P. A.

van den Hout

M. A.

van den Bout

(2006) A cognitive-behavioral conceptualization of complicated grief. Clinical Psychology: Science and Practice 13: 109–128.

12.

Bonanno

G. A.

(2004) Loss, trauma, and human resilience: Have we underestimated the human capacity to thrive after extremely aversive events? American Psychologist 59(1): 20–28.

13.

Bonanno

G. A.

Kaltman

(2001) The varieties of grief experience. Clinical Psychology Review 21: 705–734.

14.

Bonanno

G. A.

Mancini

A. D.

(2008) The human capacity to thrive in the face of potential trauma. Pediatrics 121: 369–375.

15.

Bonanno

G. A.

Westphal

Mancini

A. D.

(2011) Resilience to loss and potential trauma. Annual Review of Clinical Psychology 7: 511–535.

16.

Bond

F. W.

Hayes

S. C.

Baer

R. A.

Carpenter

K. M.

Guenole

Orcutt

H. K.

Zettle

R. D.

(2011) Preliminary psychometric properties of the acceptance and action questionnaire-II: A revised measure of psychological flexibility and experiential avoidance. Behavior Therapy 42: 676–688.

17.

Brent

Melhem

Donohoe

M. B.

Walker

(2009) The incidence and course of depression in bereaved youth 21 months after the loss of a parent to suicide, accident, or sudden natural death. The American Journal of Psychiatry 166: 786–794.

18.

Brent

D. A.

Melhem

N. M.

Masten

A. S.

Porta

Payne

M. W.

(2012) Longitudinal effects of parental bereavement on adolescent developmental competence. Journal of Clinical Child & Adolescent Psychology 41: 778–791.

19.

Brown

E. J.

Goodman

R. F.

(2005) Childhood traumatic grief: An exploration of the construct in children bereaved on September 11. Journal of Clinical Child and Adolescent Psychology 34: 248–259.

20.

Byrd

McKinney

K. J.

(2012) Individual, interpersonal, and institutional level factors associated with the mental health of college students. Journal of American College Health 60: 185–193.

21.

Carlson

C. L.

(2014) Seeking self-sufficiency: Why emerging adult college students receive and implement parental advice. Emerging Adulthood 2: 257–269.

22.

Christ

G. H.

Siegel

Christ

A. E.

(2002) Adolescent grief: It never really hit me…. until it actually happened. Jama 288(10): 1269–1278.

23.

Clark

D. C.

Pynoos

R. S.

Goebel

A. E.

(1993) Mechanisms and processes of adolescent bereavement. In: Haggerty

R. J.

Sherrod

L. R.

Garmezy

Rutter

(eds) Stress, risk and resilience in children and adolescents, Cambridge, England/New York, NY: Cambridge University Press, pp. 100–146.

24.

Connor

K. M.

Davidson

J. R. T.

(2003) Development of a new resilience scale: The Connor-Davidson Resilience Scale (CD-RISC) [Electronic version]. Depression and Anxiety 18: 76–82.

25.

Costa

B. M.

Hall

Stewart

(2007) Qualitative exploration of the nature of grief-related beliefs and expectations. Omega: Journal of Death and Dying 55: 27–56.

26.

Cousins

(2011) Coping related predictors of adjustment for bereaved and non-bereaved college students. Dissertation Abstracts International 71: 5784.

27.

Cupit

I. N.

Servaty-Seib

H. L.

(2013) Bereavement and grief for U.S. college students: A call for global extension. In: Shanun-Klein

(ed.) Studies of grief and bereavement, Hauppauge, NY: Nova, pp. 153–164.

28.

Demi, A. S., & Schroeder, M. A. (1987). Bereavement experience questionnaire (Unpublished manuscript). Georgia State University, Atlanta.

29.

Eisma

M. C.

Stroebe

M. S.

Schut

H. A. W.

van den Bout

Boelen

P. A.

Stroebe

(2013) Avoidance processes mediate the relationship between rumination and symptoms of complicated grief and depression following loss. Journal of Abnormal Psychology 122: 961–970.

30.

Eppler

(2008) Exploring themes of resiliency in children after the death of a parent. Professional School Counseling 11: 189–196.

31.

Feather

N. T.

(1988) Values, valences, and course enrollment: Testing role of personal values within an expectancy-valence framework. Journal of Educational Psychology 80: 381–391.

32.

Feenstra

J. S.

Banyard

V. L.

Rines

E. N.

Hopkins

K. R.

(2001) First-year students’ adaptation to college: The role of family variables and individual coping. Journal of College Student Development 42: 106–113.

33.

Fergus

T. A.

Valentiner

D. P.

Gillen

M. J.

Hiraoka

Twohig

M. P.

Abramowitz

J. S.

McGrath

P. B.

(2012) Assessing psychological inflexibility: The psychometric properties of the avoidance and fusion questionnaire for youth in two adult samples. Psychological Assessment 24(2): 402–408.

34.

Folkman

Lazarus

(1985) If it changes it must be a process: Study of emotion and coping during three stages of a college examination. Journal of Personality and Social Psychology 48: 150–170.

35.

Gold

D. B.

Wegner

D. M.

(1995) Origins of ruminative thought: Trauma, incompleteness, nondisclosure, and suppression. Journal of Applied Social Psychology 25: 1245–1261.

36.

Greco, L. A., Murrell, A. R., & Coyne, L. W. (2005). Avoidance and fusion questionnaire for youth (Unpublished manuscript). Department of Psychology, University of Missouri, St. Louis. Retrieved from www.contextualpsychology.org.

37.

Gross

J. J.

(1998) The emerging field of emotion regulation: An integrative review. Review of General Psychology 2: 271–299.

38.

Guarnaccia

C. A.

Hayslip

B. J.

(1998) Factor structure of the Bereavement Experience Questionnaire: The BEQ-24, a revised short-form. Omega: Journal of Death and Dying 37: 303–316.

39.

Hayes

S. C.

Gifford

E. V.

(1997) The trouble with language: Experiential avoidance, rules, and the nature of verbal events. Psychological Science 8(3): 170–173.

40.

Hayes

S. C.

Luoma

J. B.

Bond

F. W.

Masuda

Lillis

(2006) Acceptance and commitment therapy: Model, processes and outcomes. Behaviour Research and Therapy 44: 1–25.

41.

Hayes

S. C.

Strosahl

K. D.

Wilson

K. G.

(2012) Acceptance and commitment therapy: The process and practice of mindful change, New York, NY: Guilford Press.

42.

Hayes

S. C.

Wilson

K. W.

Gifford

E. V.

Follette

V. M.

Strosahl

(1996) Experiential avoidance and behavioral disorders: A functional dimensional approach to diagnosis and treatment. Journal of Consulting and Clinical Psychology 64: 1152–1168.

43.

Hernandez, N. C. (2013). Values and valuing in the college population (Unpublished doctoral dissertation). University of North Texas, Texas.

44.

Holahan

C. J.

Moos

R. H.

(1987) Risk, resistance, and psychological distress: A longitudinal analysis with adults and children. Journal of Abnormal Psychology 96: 3–13.

45.

Howarth

R. A.

(2011) Concepts and controversies in grief and loss. Journal of Mental Health Counseling 33: 4–10.

46.

Kashdan

T. B.

Barrios

Forsyth

J. P.

Steger

M. F.

(2006) Experiential avoidance as a generalized psychological vulnerability: Comparisons with coping and emotion regulation strategies. Behaviour Research and Therapy 44: 1301–1320.

47.

Kashdan

T. B.

Rottenberg

(2010) Psychological flexibility as a fundamental aspect of health. Clinical Psychology Review 30(7): 865–878.

48.

Lawrence

Jeglic

E. L.

Matthews

L. T.

Pepper

C. M.

(2005) Gender differences in grief reactions following the death of a parent. Omega: Journal of Death and Dying 52: 323–337.

49.

Lazarus

Folkman

(1991) The concept of coping. In: Monat

Lazarus

R. S.

(eds) Stress and coping: An anthology, 3rd ed. New York, NY: Columbia University Press, pp. 189–206.

50.

Lin

K. K.

Sandler

I. N.

Ayers

T. S.

Wolchik

S. A.

Luecken

L. J.

(2004) Resilience in parentally bereaved children and adolescents seeking preventive services. Journal of Clinical Child and Adolescent Psychology 33: 673–683.

51.

Luthar

S. S.

Cicchetti

Becker

(2000) The construct of resilience: A critical evaluation and guidelines for future work. Child Development 3: 543–562.

52.

Mancini

A. D.

Bonanno

G. A.

(2009) Predictors and parameters of resilience to loss: Toward an individual differences model. Journal of Personality 77(6): 1805–1832.

53.

McCracken

L. M.

Yang

(2006) The role of values in a contextual cognitive-behavioral approach to chronic pain. Pain 123(1–2): 137–145.

54.

Mitchell, C., Kimball, M., Thornton, A., & Young-DeMarco, L. (2008). The reciprocal relationship between college major and values: Family, careers, and society (Unpublished manuscript). Department of Sociology and Institute for Social Research, The University of Michigan, Ann Arbor, MI.

55.

Neimeyer

R. A.

Prigerson

H. G.

Davies

(2002) Mourning and meaning. American Behavioral Scientist 46: 235–251.

56.

Nelson

L. J.

Padilla-Walker

L. M.

(2013) Flourishing and floundering in emerging adult college students. Emerging Adulthood 1: 67–78.

57.

Padilla-Walker

L. M.

Nelson

L. J.

Carroll

J. S.

(2012) Affording emerging adulthood: Parental financial assistance of their college-aged children. Journal of Adult Development 19: 50–58.

58.

Roy

E. T.

(1986) Treating the grieving student. In: Talley

J. E.

Rockwell

W. J. K.

(eds) Counseling and psychotherapy with college students: A guide to treatment, New York, NY: Praeger, pp. 64–86.

59.

Sandler

I. N.

Wolchik

S. A.

Ayers

T. S.

(2008) Resilience rather than recovery: A contextual framework on adaptation following bereavement. Death Studies 32: 59–73.

60.

Scheer, S. D., Unger, D. G., & Brown, M. (1994, February). Adolescents becoming adults: Attributes for adulthood. Poster presented at the biennial meeting of the Society for Research on Adolescence, San Diego, CA.

61.

Schmalz

J. E.

Murrell

A. R.

(2010) Measuring experiential avoidance in adults: The Avoidance and Fusion Questionnaire. International Journal of Behavioral Consultation and Therapy 6: 198–213.

62.

Schnider

K. R.

Elhai

J. D.

Gray

M. J.

(2007) Coping style use predicts posttraumatic stress and complicated grief symptom severity among college students reporting a traumatic loss. Journal of Counseling Psychology 54: 344–350.

63.

Servaty-Seib

H. L.

Taub

D. J.

(2010) Bereavement and college students: The role of counseling psychology. The Counseling Psychologist 38: 947–975.

64.

Shear

M. K.

(2010) Exploring the role of experiential avoidance from the perspective of attachment theory and the dual process model. Omega: Journal of Death and Dying 61: 357–369.

65.

Sigman

Wilson

(1998) Traumatic bereavement: Post traumatic stress disorder and prolonged grief in motherless daughters. Journal of Psychological Practice 4(1): 35–50.

66.

Silverman

P. R.

(1987) The impact of parental death on college—Age women. Psychiatric Clinics of North America 10: 387–404.

67.

Stroebe

Schut

Stroebe

(2007) Health outcomes of bereavement. The Lancet 370: 1960–1973.

68.

Stroebe

M. S.

Hansson

R. O.

Stroebe

W. E.

Schut

H. E.

(2001) Handbook of bereavement research: Consequences, coping, and care, Washington, DC: American Psychological Association.

69.

Talbot

G. L.

(1990) Personality correlates and personal investment of college students who persist and achieve. Journal of Research & Development in Education 24: 53–57.

70.

Twohig

M. P.

(2012) Acceptance and commitment therapy: Introduction. Cognitive and Behavioral Practice 19(4): 499–507.

71.

VanDyke, J., Rogers, L., & Wilson, K. (2006). Valued living, experiential avoidance, and psychological well-being. Presentation at the annual meeting of the Association for Behavior Analysis, Atlanta, GA.

72.

Wegner

D. M.

Schneider

D. J.

Carter

S. R.

White

T. L.

(1987) Paradoxical effects of thought suppression. Journal of Personality and Social Psychology 53: 5–13.

73.

Wilson

K. G.

DuFrene

(2009) Mindfulness for two: An acceptance and commitment therapy approach to mindfulness in psychotherapy, Oakland, CA: New Harbinger Publications.

74.

Wilson

K. G.

Groom

(2002) The valued living questionnaire, Oxford, MS: Department of Psychology, University of Mississippi.

75.

Wilson

K. G.

Murrell

A. R.

(2004) Values work in acceptance and commitment therapy: Setting a course for behavioral treatment. In: Hayes

S. C.

Follette

V. M.

Linehan

M. M.

(eds) Mindfulness and acceptance: Expanding the cognitive-behavioral tradition, New York, NY: The Guilford Press, pp. 120–150.

76.

Wilson

K. G.

Sandoz

E. K.

Kitchens

Roberts

M. E.

(2010) The valued living questionnaire: Defining and measuring valued action within a behavioral framework. The Psychological Record 60: 249–272.

77.

Wolchik

S. A.

Tein

Sandler

I. N.

Ayers

T. S.

(2006) Stressors, quality of the child-caregiver relationship, and children’s mental health problems after parental death: The mediating role of self-system beliefs. Journal of Abnormal Child Psychology 34(2): 221–238.