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The Stage Theory of Grief
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To the Editor: Dr Maciejewski and colleagues1 present the first empirical investigation of the stage model of grief. While the study adds important information, I disagree that their data represent "normal patterns of grief processing over time."
First, the authors excluded participants who met criteria for complicated grief, but they did not account for other neuropsychiatric entities such as major depression, dementia, or personality disorders. Each of these could affect normal bereavement. In this case, "average" is a better descriptor than "normal."
Second, "normal" exists within the context of culture. Normal grief processing for a Catholic New Englander might be different from that for a Tibetan Buddhist or a devout Southern Baptist. These are empirical questions, but this study did not account for the participant's country of origin, religious affiliation, religiosity, or spirituality.
Third, as the authors point out, patterns of acceptance, anger, and disbelief may be dependent on the . . . [Full Text of this Article]
Joseph S. Weiner, MD, PhD
weiner@lij.edu Department of Psychiatry Long Island Jewish Medical Center New Hyde Park, NY
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