Doctorate in Clinical Psychology: Main Research Portfolio

: 1) Critical Review of the Literature: A systematic review of the psychosocial outcomes of sibling bereavement in childhood and early adulthood; 2) Service Improvement Project: Improving the process for referrals for psychological input: how recovery team employees make decisions to refer; 3) Main Research Project: Guilt and shame in perinatal death: a comparison of childless women and women who have children.

Abstract

In 2014, approximately 1% of births in England and Wales resulted in perinatal death, defined as stillbirth at more than 24 weeks of gestation or neonatal death of a baby within 28 days of birth. Of women who experience perinatal death, 15-25% have clinically significant mental health symptoms a year later which can be conceptualised as complicated grief. Shame and guilt-proneness are associated with prolonged grief in women who have experienced perinatal death, yet it is not known whether shame and guilt are triggered by perinatal death, or the risk factors for increased shame and guilt. This cross-sectional study explored whether state shame and guilt are associated with longterm grief even when controlled for depression. It also considered whether childlessness before perinatal death predicts feelings of state shame, and having living children predicts state guilt. Three groups of women recruited online through social media and support groups completed a survey online or by telephone containing measures of shame and guiltproneness, state shame and guilt, and grief. Groups comprised: women who had experienced perinatal death 13-36 months previously divided between participants with surviving children pre-bereavement (n=40) and participants with no children prebereavement (n=55); and a control group who had given birth to a surviving baby 13-36 months previously (n=96). Bereaved groups reported significantly higher levels of state shame and guilt than the control group despite comparable levels of shame and guilt-proneness across groups. There were no significant differences between state shame, state guilt or grief within bereaved groups. A Pearson product-moment correlation indicated that state shame explained a significant proportion of variance in grief when controlled for depression (17%). Understanding the role of shame when working clinically with women who have experienced perinatal death and developing interventions to reduce shame and guilt is an important area of research.

Date of Award	30 Sept 2017
Original language	English
Awarding Institution	University of Bath
Supervisor	Megan Wilkinson-Tough (Supervisor), Sarah Halligan (Supervisor) & James Gregory (Supervisor)