Abstract
Widowhood researchers have been increasingly interested in the construct of resilience and identifying factors which contribute to adaptive responses to conjugal loss. Available measures of general resilience were validated on nonwidowed samples and broadly lack face validity for use with widowed people. This article reports the development and validation of a resilience scale specific to widowhood, the Widowhood Resilience Scale. Initially, qualitative responses from 744 widowed people were analyzed and cross-referenced with existing literature on resilience to develop 49 items. The 49 items were tested on a sample of 1,188 widowed people, resulting in a 6-factor, 25-item scale.
In the Social Readjustment Rating Scale, Holmes and Rahe (1967) famously listed death of spouse as the most stressful life event, suggesting that conjugal loss significantly increases the likelihood of stress-related health issues. Since then, there have been a number of studies documenting the increased risk of emotional and physical consequences of grief such as an increased risk for depression (Sasson & Umberson, 2014), anxiety (Onrust & Cuijpers, 2006), and even increased mortality rates in the first year after bereavement in older adults (Williams, 2005).
Although conjugal loss is understandably associated with deep sadness and with a temporary increase in stress and associated health issues (Kowalski & Bondmass, 2008; Onrust & Cuijpers, 2006), research suggests that most people do not experience significant prolonged psychological consequences after the death of a spouse or partner (Pitzer & Bergeman, 2013; Sasson & Umberson, 2014). This lack of prolonged psychological disturbances among grievers is likely an indication of resilience. For example, resilient grievers differ from individuals who experience prolonged grief on a variety of factors including less attachment anxiety and greater healthy dependency (Mancini, Sinan, & Bonanno, 2015). Resilient widowed people may experience mild perturbations in well-being and ability to concentrate (Bisconti, Bergeman, & Boker, 2006) yet continue to function well in day-to-day life.
Resilience after the loss of a partner or spouse is especially important to understand because the bereaved are simultaneously dealing with a loss of resources and an increase in demands, all without the person who was likely their primary support and confidant. In samples of widowed people, resilience is consistently associated with markers of psychological well-being including higher life satisfaction (Rossi, Bisconti, & Bergeman, 2007), lower distress (O’Rourke, 2004), better financial satisfaction and marital/cohabitation peace after remarriage (West, Grable, Mattia, Leitz, & Rehl, 2019), and greater emotional complexity (Pitzer & Bergeman, 2013).
The Construct of Resilience
Early research in psychological resilience focused on ego resiliency or personal characteristics of individuals who were deemed resilient (Block, 1969). For example, Masten and Garmezy (1985) discussed autonomy and self-esteem as examples of intrinsic characteristics that contribute to positive adaptation in the face of adversity. More recently, researchers have proposed that resilience not be limited to static personality characteristics (Bonanno, Moskowitz, Papa, & Folkman, 2005) or be conceptualized as a goal to be achieved but should instead be conceptualized as an ongoing dynamic process (Chmitorz et al., 2018). This concept of resilience allows individuals to improve their resilience through learning particular skills and practicing behaviors positively associated with resilience. In addition, using this definition allows for more than one right path to become more resilient. For the purposes of this study, we decided to adopt the definition of resilience provided by Luthar, Cicchetti, and Becker (2000) which is “the dynamic process encompassing positive adaptation within the context of significant adversity” (p. 543).
Factors That Contribute to Resilience
One of the themes that recurs across multiple studies is the significance of relationships and social support to resilient adaptation (Lowe & McClement, 2011). For example, Bisconti et al. (2006) identified that emotional support is associated with resilience after conjugal loss. In addition, O’Rourke (2004) reports that engagement and resilience are positively related, and other studies have demonstrated that personal relationships are significantly associated with engagement (Mo & Singh, 2008). Engaging in relationships and accessing social support allow an opportunity for bereaved spouses to adapt to a new identity in environments that promote feelings of safety.
Adapting to a new identity is a difficult and important process for resilience after a spouse dies. Effective identity management has been found to contribute to resilience in widowed populations (Bennett, Gibbons, & Mackenzie-Smith, 2010; Lowe & McClement, 2011) as well as nonwidowed populations (Clauss-Ehlers, Yang, & Chen, 2008; Pearce & Morrison, 2011). A strong individuated sense of self preceding conjugal loss may protect against ensuing identity instability (Friborg, Barlaug, Martinussen, Rosenvinge, & Hjemdal, 2005). In addition, self-regulation in managing thoughts and emotional responses and the regulation of positive emotions has also been related to resilience (Lund, Utz, Caserta, & de Vries, 2009).
Other physical and emotional well-being factors influence resilience such as physical activity (Penedo & Dahn, 2005), a healthy diet (Cartwright et al., 2003), and spirituality (Naef, Ward, Mahrer-Imhof, & Grande, 2013). In addition, self-care is a key factor for resilience in older adults dealing with conjugal loss (Naef et al., 2013). This is especially important since mortality rates in older adults are increased for more than 2 years after the death of a spouse, and depression and spousal bereavement are both associated with increased cardiovascular disease (Williams, 2005).
In addition but related to inter- and intrapersonal factors, and health and wellness factors, some teachable behaviors and skills can help construct resilience as well. For example, goal setting had a positive effect on resilience in older widowed adults (Naef et al., 2013) as well as nonwidowed populations (Leary & DeRosier, 2012). Finding and returning to a consistent structure in daily life (Muller & Thompson, 2003) is also associated with improved resilience in widowed people.
Although certain commonalities exist between resilient responses in widowed and nonwidowed populations, resilience in widowhood also has certain unique characteristics. For example, acceptance of the loss (Mancini, Prati, & Bonanno, 2011) and continued connection with the deceased (Bennett et al., 2010) are factors that are unique and specific to those who have experienced conjugal loss.
Assessing Resilience After Conjugal Loss
As with the inconsistency in the operational definitions of resilience, there has been equal inconsistency and confusion in the measurement of this construct. This lack of consensus has made it difficult to compare research and has hampered the incorporation of resilience assessment in clinical settings. For instance, Powers, Bisconti, and Bergeman (2014) found like Bonanno et al. (2002) that depression post-loss improves for widowed people in most cases, in a resilient manner. They found, however, that life satisfaction continued to decrease significantly until the 1-year mark and then only marginally increased over the second year. Which of these, absence of depressive symptoms or life satisfaction most accurately, assess resilience as it relates to widowed people? Without a clearly operationalized definition of resilience postconjugal loss and a validated means of assessment, it is difficult to say which is more valid and create consistency for comparison purposes.
In addition to operationalization inconsistencies, most currently available measures of resilience were validated on nonwidowed samples and broadly lack face validity for use with widowed people (Graber, Pichon, & Carabine, 2015). For instance, some studies (e.g., Rossi et al., 2007) have used versions of the Dispositional Resilience Scale (DRS; Bartone, Ursano, Wright, & Ingraham, 1989), a scale initially validated on a sample of city bus drivers (Bartone, 1989) that has been since used to explore stress and resilience in other vocational settings, such as the military (Bartone et al., 2008), and in disaster workers (Bartone et al., 1989). Other resilience scales used in widowhood resilience studies (e.g. Ong, Bergeman, Bisconti, & Wallace, 2006) such as the psychoanalytically informed Ego Resilience Scale (Block & Kremen, 1996) include face valid items for assessing resilience in widows but exclusively assess static dispositional traits.
Such static assessments lack significant clinical utility as they do not assess the dynamic processes involved in resilient responses to conjugal loss. This also limits the usefulness as an aspirational or goal-setting tool and can be demotivating if used for self-assessment because the bereaved person has little or no control over, or hope to improve their own resilience score when it is based on static personality traits. Finally, because these assessments are not specific to the context of spousal loss or grief, they do not measure one’s ability to integrate the loss into their life, their cognitive structures, or their identity, which are important to adapting to the death of a spouse (Enez, 2018; Hasson, Peri, Rotschild, & Tuval, 2017).
One currently available assessment, the Inventory of Daily Widowed Life (IDWL; Caserta & Lund, 2007), does measure coping processes following conjugal loss but does not explicitly assess resilience. Informed by Stroebe and Schut (1999) dual-process model of coping with bereavement, the scale assesses the balance (or oscillation) between loss-oriented and restoration-oriented coping. Stroebe and Schut’s model describes this oscillation (as well as the oscillation between negative and positive affect (Stroebe & Schut, 2010) as critically important to coping with conjugal loss. In practice, however, the IDWL may lack ecological validity as numerical ratings of oscillation, loss-oriented coping, and restoration-oriented coping are not easily translated to applied contexts.
Given the lack of validated measures for assessing resilience in widows, many researchers have turned to alternative means of assessment. Bonanno et al. (2002) operationalize resilience as low preconjugal loss depression with low depression following the loss as well. In another widowhood study, Pitzer and Bergeman (2013) defined resilience as high emotional complexity as assessed by a mental health inventory. Although interesting, these measures do not explore the processes by which people are resilient nor do they consider facets of resilience apart from mood. Other researchers such as Bennett (2010) assess resilience through qualitative, semistructured interviews. Although these assessments may attain greater construct validity, they suffer from the shortcomings of all qualitative assessments: namely, subjectivity, lack of replicability, and poor generalizability and ecological validity.
The development of a validated measure of widowhood resilience could help clarify the nature of resilience in widowed people, to identify individual and subpopulation variations, to delineate idiographic strengths and weaknesses, as well as to make possible meaningful comparisons within the research literature. In addition, a measure of widowhood resilience should reflect the conceptualizations and aspirations of those who are widowed. Although some items in existing scales of resilience are appropriate for representing resilient behaviors in other contexts such as after a natural disaster, those same behaviors such as actively replacing losses in one’s life, may actually be counterproductive when the individual is coping with the loss of their partner or spouse. The items in a self-assessment scale can establish desirable behaviors; if those behaviors do not feel attainable or authentic to the individual using the scale, the assessment could have the inadvertent effect of creating self-judgment and discouragement as well as possibility of decreased support from friends and family who perceive the person as grieving incorrectly.
This study is the first to report on the development and validation of a measure of domain-specific resilience to conjugal loss. There are likely general attributes of resilience that are transferable yet there is growing interest in determining which protective factors are particularly important and adaptive to a particular stressor. Understanding the domain-specific attributes of resilience that are most relevant to positive adaptation to conjugal loss may inform the development of effective interventions for those experiencing prolonged grief, maximizing the benefits to a specific group with specific needs which Graber et al. (2015) notes is essential for effective interventions. At present, we report on the development and validation of such a scale, the Widowhood Resilience Scale (WRS).
Method
Item Development
The goal of this project was to capture the concept of resilience that is consistent with how resilience is defined by widowed people. An additional goal of the project was to develop a scale to be used by widowed people for ongoing self-assessment and goal setting. To understand resilience from a widowed person’s perspective, an inductive process was used to analyze qualitative responses. Responses were collected from 744 widowed people using Survey Monkey. Participants were recruited through email and social media by Soaring Spirits International (SSI). In keeping with SSI’s policy of inclusiveness, individuals qualified for the survey if they “had lost the person with whom they thought they would spend the rest of their life.” SSI is a nonprofit organization that offers peer-based support to widowed people through several programs including three annual conferences, online support, and regional groups. Research was done in partnership with the founder and executive director of SSI.
In this initial stage of this study participants primarily identified as female (N = 684), with 57 identifying as male, and 3 identifying as transgender. The average age of participants was 53.26 (SD = 11.13), they were between the ages of 23 and 81 years and were an average of 7.86 years postloss (SD = 3.93). Participants primarily identified as white (N = 695), followed by Hispanic (N = 36), Black or African-American (N = 18), Asian (N = 13), American Indian or Alaska Native (N = 12), and Native Hawaiian or other Pacific Islander (N = 4). Participants were all widowed as defined by SSI. Before losing their partner, 688 participants were legally married, 22 were engaged, 32 were in a committed relationship, and 2 were divorced from their deceased spouse. At the time of the survey, 32 participants reported being remarried, 89 reported being in a committed relationship, and 623 reported not being in a relationship or remarried.
Participants were asked to complete the following open-ended about resilience: “I feel resilient/strong when I . . . ” and “Think of a widow or widower you admire. What is it about the way they’ve handled things that you would like to be able to do?” The questions were optional items at the end of a longer survey. There were 591 responses about their own resilience and 506 responses about what resilient behaviors they admired in other widowed people.
To analyze responses to the first question, “I feel resilient/strong when I . . . ,” three undergraduate research assistants (RAs) were recruited and trained to code all qualitative responses. The RAs were trained by one of the primary researches in open coding and taken through a practice coding session. Next, 30 responses were randomly selected and all three RAs coded the responses one at a time using line-by-line open coding. They met to refine coding categories until, after three rounds, they had an acceptable reliability (Krippendorff’s alpha > .7) resulting in 18 themes. The RAs then used those themes to code the remaining responses.
Next, two of the primary researchers used the same process to find themes in the responses to a second open-ended question, “Think of a widow or widower you admire. What is it about the way they’ve handled things that you would like to be able to do?” The authors had acceptable reliability (Krippendorff’s alpha > .7) after two rounds of coding and revising. Analysis of the second question resulted in 14 themes.
Finally, participants were asked to respond to 18 statements reflecting resilience behaviors. These items were written by based on experience working with widowed people, feedback from widowed people, and discussion with members of the SSI organization who have years of experience supporting widowed people. Participants rated each of the 18 items on a 4-point scale, with 1 representing “This is NOT true of HOW I PICTURE RESILIENCE at all” and 4 representing “This is VERY TRUE of how I picture resilience.” All 18 statements represented reported a mean of at least 2.4, demonstrating they captured at least some of how participants think of resilience.
The authors then cross-referenced the themes from the qualitative responses, the ratings of prewritten statements representing resilience, and themes identified through literature review. By cross-referencing the three sources, the authors next identified 22 domains that were highly represented in participants’ qualitative responses as well as in the literature. Together with a small group of widows and external experts, the original responses were consulted to find those that were most representative of each of the domains and the original language of the participants was retained or slightly adapted to create items to test for the scale. This allowed the researchers to keep the wording of the questions authentic to the participant group. We pretested potential items on a small sample of widowed people; with their feedback, we identified 49 items with strong face validity that also reflected the distribution of items in our qualitative domain analyses.
Scale Validation
Participants were primarily recruited online through Soaring Spirits’ International, using mailing lists and social media. The survey was also shared on other social media sites and blogs. Participants were required to be at least 18 years of age. Participants were eligible to participate if they identified as a widow or widower, which included anyone who lost the person they were planning to spend the rest of their life with. This definition is inclusive of participants who were in same-sex relationships, divorced, committed relationships, or engaged at the time of their loss.
Participants completed an informed consent and a battery of questionnaires anonymously through SurveyMonkey. A total of 1,188 participants completed the battery in full. There were 1,052 participants who identified as female, 135 identified as male, and 1 identified as transgender. The average age of participants was 50.65 years (SD = 11.55) and the average reported time since loss was less than 9 years (M = 8.83, SD = 4.06). Participants primarily identified as White (N = 1,121) followed by Hispanic (N = 45), Black or African-American (N = 23), Asian (N = 24), American Indian or Alaska Native (N = 25), and Native Hawaiian or other Pacific Islander (N = 10). Most of the participants were married to their spouse or partner at the time they were widowed (N = 1,065), while 44 were engaged, 71 were in a committed relationship but not legally married or engaged, and 8 were divorced. Participants experienced different types of losses such as sudden loss (N = 509), loss within 6 months of discovering illness or other issue (N = 177), long-term illness or issue (N = 363), or other (N = 139).
Results
Data Analysis
The 49 items of the Widowed Resilience Scale were assessed to ensure suitability of the data for factor analysis. The correlation matrix reported most correlations above .3, the Kaiser–Meyer–Olkin value was .97, which is well above the recommended threshold of .6 (Kaiser, 1974). In addition, Bartlett’s test of sphericity reported a significant value (p ≤ .001).
Next, the 49 items were analyzed using SPSS version 24. First, any items with an item-total correlation below .4 were removed. Principle axis factoring yielded seven factors with Eigen values over 1. The seven-factor solution explained a total of 59.03% of the variance with the first factor explaining 40.96%, the second factor explaining 4.29%, the third factor explaining 3.52%, the fourth factor explaining 3.40%, the fifth factor explaining 2.57%, the sixth factor explaining 2.43%, and the seventh factor explaining 2.14%. We next proceeded to extract factors using principal axis factoring (PAF) with a promax rotation to aid in interpretations of the factors. We then removed items that did not load at a minimum of 0.4 and items that cross-loaded at more than 0.3. We also removed any items loading in a single factor with collinearity of 0.7 above and only retained factors with more than one remaining item. Then the remaining 25 items were subjected again to a PAF with promax rotation which reported a six-factor solution (Table 1) with each remaining item loading strongly >.4 and substantially only on one factor. It was decided to retain six factors even though the first factor explains a substantial percentage of the variance due to construct validity considerations. The six factors have construct and face validity and each item within the factors group around a common theme. The result is the following subscales: Agency, Social Support, Living in the Present, Helping Others, Integration, and Outlook.
Factor Loadings for Widowhood Resilience Scale.
Reliability and Validity
The 25 remaining items demonstrated good reliability in this sample, reporting a Cronbach’s alpha of .94 in this study. The six subscales demonstrated high internal consistency (Table 2).
Correlation Between Widowhood Resilience Subscales.
*Correlation is significant at the .05 level (two-tailed).
**Correlation is significant at the .01 level (two-tailed).
Measures
Construct validity of the overall scale and subscales was assessed using the following measures.
Connor–Davidson Resilience Scale 25
The Connor–Davidson Resilience Scale (CD-RISC-25)© (Connor & Davidson, 2003) is a 25-item general resilience scale validated on both clinical and nonclinical samples. Scale items were inspired by research conducted by Kobasa (1979), Rutter (1985), and Lyons (1991), as well as Alexander’s (1998) account of Shackleton’s expedition to the Antarctic in 1912.
The Brief COPE
The Brief Coping Orientation to Problems Experienced (COPE; Carver, 1997) is a 28-item scale measuring a range of potential coping responses. The Brief COPE calculates 14 two-item coping dimensions including self-distraction, active coping, denial, substance use, use of emotional support, use of instrumental support, behavioral disengagement, venting, positive reframing, planning, humor, acceptance, religion, and self-blame.
The Inventory of Daily Widowed Life
IDWL (Caserta & Lund, 2007) is a 22-item scale based on the dual-process model of coping with bereavement (Stroebe & Schut, 1999). The scale measures loss-orientation coping, restoration-oriented coping, and the oscillation between these two coping processes.
The Texas Revised Inventory of Grief-Revised
The Texas Revised Inventory of Grief-Revised (Faschingbauer, 1981) is a 21-item scale developed to measure unresolved grief. The scale includes a subscale assessing behavior after the loss as well as a subscale measuring present emotional experience.
The 10-Item Personality Inventory
The 10-Item Personality Inventory (TIPI; Gosling, Rentfrow, & Swann, 2003) is a 10-item scale developed to quickly assess the Big Five personality dimensions. This personality inventory is comprised of five subscales: extraversion, agreeableness, conscientiousness, emotional stability, and openness to experience.
The University Rhode Island Change Assessment Scale
University Rhode Island Change Assessment (URICA) Scale (McConnaughy, Prochaska, & Velicer, 1983) is a 32-item scale designed to assess readiness for change. The scale was developed based on Prochaska and colleagues’ transtheoretical model and includes subscales measuring precontemplation, contemplation, action, and maintenance. As the scale was originally developed to assess readiness for change in the domain of health behaviors, the current researchers made minor adaptations to the language when necessary to better fit a bereaved population.
Construct validity was assessed using Pearson product–moment correlations. All relationships were significant at the p < .001 level in the hypothesized directions (Table 3).
Construct Validity, Widowhood Resilience Scale.
TIPI = 10-Item Personality Inventory; COPE = Coping Orientation to Problems Experienced.
**p < .001.
Discussion
Expanding the availability of measures of resilient adaptation is central to providing individualized resources to those experiencing conjugal loss. Preexisting measures are not domain specific to resilience after conjugal loss. Thus, this study examined aspects of reliability and validity of the newly developed, domain-specific WRS. The results of this study suggest that the WRS demonstrates adequate interitem reliability and is significantly correlated with a range of self-report criteria, including the Connor–Davidson Resilience Scale, the IDWL, the Texas Revised Inventory of Grief (Present), TIPI (Emotional Stability), and the Brief Cope: Active Coping subscale, which provide evidence of construct validity for the WRS. In addition, the WRS, although significantly correlated with other measures of resilience, was found to identify specific factors that are central for resilient adaptation to conjugal loss. One particular scale used in the battery, the URICA, did not appear to adequately assess stages of change for a widowed population despite modifications made to it to better fit a widowed population. We suspect the nonsignificant results of the URICA subscales were a result of the original measure being designed to specifically assess health behaviors.
Throughout our investigations, we observed the centrality of identity to resilient adaptation postconjugal loss. Qualitative analyses of open-ended responses and the ultimate factor model leading to the WRS revolve around themes of identity maintenance and formation for the widowed person. This aligns with Luthar et al.’s (2000) conception of resilience as the positive adaptation in the context of adversity rather than bouncing back after adversity.
For instance, the Agency subscale centers on ways in which the widowed person can take on new roles and navigate life independent of their late partner. The Social Support and Helping Others subscales reflect the ways in which the self is oriented to others, either via giving or receiving. The theme of an evolving sense of self in the wake of the loss is further echoed by the remaining three subscales—Living in the Present, Integration, and Outlook—each of which assess evolving orientations to life postloss. The thematic similarities these subscales share may explain why our model appeared unidimensional by certain metrics. We believe, however, that each specific subscale of the WRS elucidates a specific facet of the evolving self that can be important to the widowed person’s adjustment. We chose to include each subscale for this reason: the descriptive, instructive power each scale possesses.
Our results point to a dynamic process of change and growth that transcends static characterological resilience or behavioral checklists. This provides support for prior research suggesting a fixation on the past being detrimental for widowed people (Bonanno, Wortman, & Nesse, 2004; Nolen-Hoeksema, McBride, & Larson, 1997). If the primary task of the widowed person is to establish a new integrative identity, a ruminative focus on making meaning of death may indeed delay that process. This contradicts the significance of meaning-making in other models of positive adaptation and well-being (Baerger & McAdams, 1999; Seligman, 2011). The irreversibility of conjugal loss and the oftentimes seeming randomness of death may suggest why searching for meaning and ruminating about the loss are indicative of less resilient response styles. Instead, we see that integration of the past with a new present is indicative of a more resilient response style.
These findings are also consistent with previous research suggesting that widowed people with a strong sense of self evidence more resilient coping (Bennett, Hughes, & Smith, 2005; Bonanno, Papa, & O’Neill, 2001). It appears that it is that sense of “Who am I now?” that is often most profoundly affected by conjugal loss. It may be that widows who derive much of their identity and sense of meaning from others may experience the most difficult adjustment to conjugal loss.
Instability of identity distinguishes widowed people from other populations coping with adversity. Resilience, as measured by other scales, frequently focuses on traumas or challenges that do not mirror this loss of identity experienced by the widowed. The necessity of developing a unique resilience scale for widowed populations is underscored by these very differences. As expected, the WRS demonstrated moderately high convergent validity with measures of resilience, emotional stability, and coping, and divergent validity with a measure of grief. Specifically, the relationship with the Connor–Davidson Resilience Scale indicates an alignment with what may be a core set of behaviors related to resilience paired with a unique set of behaviors specific to widowhood.
Conjugal bereavement is a unique experience with different processes for constructing resilience. A scale that is limited to this context needs to create a positive model for resilient behaviors. For instance, previous research has supported the idea that grieving individuals should remain connected to their deceased loved one (Bonanno et al., 2004). Some global resilience scales do not take into account how the loss must be integrated into the person’s life going forward, and how a healthy behavior for a widowed person is not to move on but to move forward with their loss to integrate their past, present, and future.
A shortcoming of this study is the lack of racial and gender diversity in the participants recruited. This largely reflects the demographic composition of the primary recruiting course, Soaring Spirits International. Future studies should explore the validity of the WRS with populations underrepresented in the current sample. In addition, further study must also determine the clinical utility of the WRS. Although most widowed people evidence resilient responding with time, the WRS may well eventually identify factors that predict poor adjustment to loss, with targeted suggestions for how to intervene. Further analyses of the construct validity of the subscales may also suggest uses for each subscale in predicting adaptation to loss.
Footnotes
Authors’ Note
Data collection for this scale was made possible by Soaring Spirits International. The authors thank Michele Neff Hernandez and the Board at Soaring Spirits for consulting on language used for scale items and authenticity at various stages in the research process. A special thank you is extended to the widowed people who participated in this project and offered valuable feedback.
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.
