Enya Jeffs
30013282
A longitudinal, quantitative investigation on levels of traumatic/complicated grief and
bereavement outcome after viewing or not viewing the body of the deceased.
Background and Rationale
This quantitative study aims to investigate bereavement outcomes and levels of
traumatic/complicated grief over two years, after viewing or not viewing the body of the
deceased after a sudden death. Moreover, this investigation will explore the area of debate
investigating whether viewing or not viewing the deceased is a risk or protective factor for
bereavement outcome. The investigation of existing academic literature regarding viewing
the body of the deceased and bereavement has been undertaken to exhibit an extensive
background and rationale for this proposal.
Chapple and Ziebland’s (2010) study on viewing the body after death is an influential source
in the psychological area of grief and bereavement and provides extensive academic
background on viewing the body of the deceased, and how this influences bereavement
outcome both immediately and at a later stage. Interviews with eighty bereaved individuals
found that two regretted viewing the deceased and eight chose not to view, therefore
displaying a strong indication that viewing the deceased is a protective factor for
bereavement (Chapple & Ziebland, 2010). Furthermore, the participants identified that
viewing the deceased retains their social identity, and helps the acceptance of the death,
therefore further reinforcing the positive influence of viewing the deceased. (Chapple &
Ziebland, 2010). Similar research by Howarth (2010) on viewing the deceased after a
traumatic death supports Chapple and Ziebland. Both of these articles identify that viewing
the deceased may increase distress, anxiety, and levels of traumatic grief in the short term, but
that it reduced distress and influenced a more positive, accepting bereavement outcome in the
long term and therefore encouraging a better psychological recovery. Both pieces of literature
apply to this current research proposal and provide convincing support for the hypothesis of
this investigation. However, both literature may lack temporal validity and generalisability to
this research proposal due to their age, the small participant samples used, and
methodological differences.
Research by Omerov et al (2014) and Mowll, Lobb and Wearing (2016) also strongly
supports that viewing the deceased can have a positive impact on the bereavement process,
and further reinforces the work of Chapple and Ziebland (2010) and Howarth (2010).
Equivalently, Omerov et al (2014) investigate viewing the body after a suicide, and Mowll et
al (2016) identify the experience of viewing or not viewing the body after a sudden or
unexpected death. After a violent death by suicide, the relatives are informed on what to
expect and sometimes advised not to view the deceased body (Omerov et al, 2014), and those
bereaving after an unexpected death may also be advised not to view it (Mowll et al, 2016).
However, many bereaved individuals have reported regret and ongoing psychological
difficulties from not viewing the deceased body after being advised not to (Omerov et al,
2014; Mowll et al, 2016). Mowll et al (2014) identified that a majority of the bereaved
wanted to spend time with the deceased after a sudden death to comprehend and come to a
sense of reality, therefore sustaining the idea that viewing the deceased is important and that
it creates a more positive bereavement experience than those who did not view. The literature
by both Mowll et al (2014) and Omerov et al (2016) demonstrate a focus on viewing the
, Enya Jeffs
30013282
deceased after a sudden or unexpected death, which Omerov et al (2016) exhibit a focus on
suicide. This circumstance of death is the same circumstance being explored within this
investigation, and therefore has higher internal validity and is more relevant than the work of
Chapple and Ziebland (2010) and Howarth (2010) which focus on traumatic deaths.
Additionally, the articles by Omerov et al (2016) and Mowll et al (2014) are more recent and
therefore demonstrate higher temporal validity and generalisability. Despite this however,
Mowll et al (2014) utilises an in-depth interviewing methodology, the same as Chapple and
Ziebland (2010) and Howarth (2010), which contrasts the methodology used in this
investigation. Conversely, Omerov et al (2016) employ a quantitative survey data collection
method which is similar to the methodology of this investigation, and therefore their findings
are more applicable and generalisable as a rationale.
Fiegelman, Jordan and Gorman (2009) take a slightly alternative stance and exhibit a focus
on differences in death circumstance and time since the loss on bereavement outcome.
Fiegelman et al (2009) anticipated that the bereaved individuals who found the deceased
body would experience higher levels of grief, but then identified that those who had passed
from suicide resulted in higher levels of grief from the bereaved; finding the deceased body
did not result in the bereaved individual experiencing greater levels of bereavement
difficulties. Viewing the body before burial or cremation was a stronger predictor for stress
and grief than finding the body, contrasting their original hypothesis (Fiegelman et al, 2009).
The findings of this research are further reinforced by the previous literature which exhibits
the positive influence of viewing the deceased, and therefore supports the proposed
hypothesis of this investigation. Additionally, Fiegelman et al’s (2009) work demonstrates an
additional insight the previous literature neglected; the location in which the body of the
deceased was viewed. This additional variable of ‘location’ provides a greater background in
understanding the influence of viewing or not viewing the body of the deceased on
bereavement outcome.
Regarding the relationship between time and viewing the deceased, Chapple and Ziebland
(2010) conducted interviews with bereaved individuals asking if they viewed the body of the
deceased and their emotional reactions both immediately and at a later stage; similar to the
work of Howarth (2010). Despite some short-term difficulties after viewing the body, there
was an overall long-term positive influence of viewing the deceased on bereavement
outcome. Fiegelman et al (2009) also exhibit the importance in accounting for time
differences in bereavement outcomes. There is an upward spike in grief difficulties between
the first twelve to twenty-four months after a loss, but then there is a decrease in difficulties
between three to five years after, therefore reinforcing the positive impact that viewing the
deceased body has on long term bereavement outcome (Fiegelman et al, 2009). Research by
Omerov et al (2014) also supports this. Parents who had viewed the body of their deceased
child tended to have a higher risk of intrusive thoughts and nightmares, but the majority did
not regret it two to five years after the death (Omerov et al, 2014). Ultimately, these academic
articles strongly demonstrate the influence of time on bereavement outcomes after viewing
the body of the deceased – despite higher levels of stress, grief and anxiety short term,
viewing the deceased body has long-term positive effects on the grief and bereavement
process.
Hollander’s (2016) work on ambiguous loss and complicated grief can be used to understand
bereavement outcomes in greater depth and provides an alternative perspective. Ambiguous
30013282
A longitudinal, quantitative investigation on levels of traumatic/complicated grief and
bereavement outcome after viewing or not viewing the body of the deceased.
Background and Rationale
This quantitative study aims to investigate bereavement outcomes and levels of
traumatic/complicated grief over two years, after viewing or not viewing the body of the
deceased after a sudden death. Moreover, this investigation will explore the area of debate
investigating whether viewing or not viewing the deceased is a risk or protective factor for
bereavement outcome. The investigation of existing academic literature regarding viewing
the body of the deceased and bereavement has been undertaken to exhibit an extensive
background and rationale for this proposal.
Chapple and Ziebland’s (2010) study on viewing the body after death is an influential source
in the psychological area of grief and bereavement and provides extensive academic
background on viewing the body of the deceased, and how this influences bereavement
outcome both immediately and at a later stage. Interviews with eighty bereaved individuals
found that two regretted viewing the deceased and eight chose not to view, therefore
displaying a strong indication that viewing the deceased is a protective factor for
bereavement (Chapple & Ziebland, 2010). Furthermore, the participants identified that
viewing the deceased retains their social identity, and helps the acceptance of the death,
therefore further reinforcing the positive influence of viewing the deceased. (Chapple &
Ziebland, 2010). Similar research by Howarth (2010) on viewing the deceased after a
traumatic death supports Chapple and Ziebland. Both of these articles identify that viewing
the deceased may increase distress, anxiety, and levels of traumatic grief in the short term, but
that it reduced distress and influenced a more positive, accepting bereavement outcome in the
long term and therefore encouraging a better psychological recovery. Both pieces of literature
apply to this current research proposal and provide convincing support for the hypothesis of
this investigation. However, both literature may lack temporal validity and generalisability to
this research proposal due to their age, the small participant samples used, and
methodological differences.
Research by Omerov et al (2014) and Mowll, Lobb and Wearing (2016) also strongly
supports that viewing the deceased can have a positive impact on the bereavement process,
and further reinforces the work of Chapple and Ziebland (2010) and Howarth (2010).
Equivalently, Omerov et al (2014) investigate viewing the body after a suicide, and Mowll et
al (2016) identify the experience of viewing or not viewing the body after a sudden or
unexpected death. After a violent death by suicide, the relatives are informed on what to
expect and sometimes advised not to view the deceased body (Omerov et al, 2014), and those
bereaving after an unexpected death may also be advised not to view it (Mowll et al, 2016).
However, many bereaved individuals have reported regret and ongoing psychological
difficulties from not viewing the deceased body after being advised not to (Omerov et al,
2014; Mowll et al, 2016). Mowll et al (2014) identified that a majority of the bereaved
wanted to spend time with the deceased after a sudden death to comprehend and come to a
sense of reality, therefore sustaining the idea that viewing the deceased is important and that
it creates a more positive bereavement experience than those who did not view. The literature
by both Mowll et al (2014) and Omerov et al (2016) demonstrate a focus on viewing the
, Enya Jeffs
30013282
deceased after a sudden or unexpected death, which Omerov et al (2016) exhibit a focus on
suicide. This circumstance of death is the same circumstance being explored within this
investigation, and therefore has higher internal validity and is more relevant than the work of
Chapple and Ziebland (2010) and Howarth (2010) which focus on traumatic deaths.
Additionally, the articles by Omerov et al (2016) and Mowll et al (2014) are more recent and
therefore demonstrate higher temporal validity and generalisability. Despite this however,
Mowll et al (2014) utilises an in-depth interviewing methodology, the same as Chapple and
Ziebland (2010) and Howarth (2010), which contrasts the methodology used in this
investigation. Conversely, Omerov et al (2016) employ a quantitative survey data collection
method which is similar to the methodology of this investigation, and therefore their findings
are more applicable and generalisable as a rationale.
Fiegelman, Jordan and Gorman (2009) take a slightly alternative stance and exhibit a focus
on differences in death circumstance and time since the loss on bereavement outcome.
Fiegelman et al (2009) anticipated that the bereaved individuals who found the deceased
body would experience higher levels of grief, but then identified that those who had passed
from suicide resulted in higher levels of grief from the bereaved; finding the deceased body
did not result in the bereaved individual experiencing greater levels of bereavement
difficulties. Viewing the body before burial or cremation was a stronger predictor for stress
and grief than finding the body, contrasting their original hypothesis (Fiegelman et al, 2009).
The findings of this research are further reinforced by the previous literature which exhibits
the positive influence of viewing the deceased, and therefore supports the proposed
hypothesis of this investigation. Additionally, Fiegelman et al’s (2009) work demonstrates an
additional insight the previous literature neglected; the location in which the body of the
deceased was viewed. This additional variable of ‘location’ provides a greater background in
understanding the influence of viewing or not viewing the body of the deceased on
bereavement outcome.
Regarding the relationship between time and viewing the deceased, Chapple and Ziebland
(2010) conducted interviews with bereaved individuals asking if they viewed the body of the
deceased and their emotional reactions both immediately and at a later stage; similar to the
work of Howarth (2010). Despite some short-term difficulties after viewing the body, there
was an overall long-term positive influence of viewing the deceased on bereavement
outcome. Fiegelman et al (2009) also exhibit the importance in accounting for time
differences in bereavement outcomes. There is an upward spike in grief difficulties between
the first twelve to twenty-four months after a loss, but then there is a decrease in difficulties
between three to five years after, therefore reinforcing the positive impact that viewing the
deceased body has on long term bereavement outcome (Fiegelman et al, 2009). Research by
Omerov et al (2014) also supports this. Parents who had viewed the body of their deceased
child tended to have a higher risk of intrusive thoughts and nightmares, but the majority did
not regret it two to five years after the death (Omerov et al, 2014). Ultimately, these academic
articles strongly demonstrate the influence of time on bereavement outcomes after viewing
the body of the deceased – despite higher levels of stress, grief and anxiety short term,
viewing the deceased body has long-term positive effects on the grief and bereavement
process.
Hollander’s (2016) work on ambiguous loss and complicated grief can be used to understand
bereavement outcomes in greater depth and provides an alternative perspective. Ambiguous
