© 2019 MICHELLE J. BOWES ALL RIGHTS RESERVED PSYCHOLOGICAL ADJUSTMENT, RELATIONSHIP SATISFACTION, AND COMMUNICATION IN BEREAVED PARENTS USING THE BOWEN FAMILY SYSTEMS THEORY A Dissertation Presented to The Graduate Faculty of The University of Akron In Partial Fulfillment of the Requirements for the Degree Doctor of Philosophy Michelle J. Bowes August, 2019 PSYCHOLOGICAL ADJUSTMENT, RELATIONSHIP SATISFACTION, AND COMMUNICATION IN BEREAVED PARENTS USING THE BOWEN FAMILY SYSTEMS THEORY Michelle J. Bowes Dissertation Approved: Accepted: ______________________________ ______________________________ Advisor/Committee Chair Interim Director of the School of Counseling Karin Jordan, Ph.D. Varunee Faii SangganjanavanicH, Ph.D. ______________________________ ______________________________ Committee Member Acting Dean of the College of Health Heather A. Katafiasz, Ph.D. Professions Elizabeth A. Kennedy, Ph.D. ______________________________ ______________________________ Committee Member Executive Dean of the Graduate School Harvey L. Sterns, Ph.D. Chad Midha, Ph.D. ______________________________ ______________________________ Committee Member Date David H. Tefteller, Ph.D. ______________________________ Committee Member Wondimu M. Ahmed, Ph.D. ii ABSTRACT This quantitative study investigated the role of communication on grief reaction, guilt, and relationship satisfaction in bereaved couples after the death of a child to gain a better understanding of the relationship between these variables. It also explored parental gender and time since death. Fifty-four couples were recruited through newsletters, support groups, and forums. Participants were directed to Qualtrics to fill out the following instruments: demographic questionnaire, the Attitudes towards Emotional Expression Scale to measure communication, the Revised Grief Experience Inventory to measure grief reaction, the Guilt subscale of the Grief Experience Questionnaire to measure guilt, and the Marital Satisfaction Inventory-Revised to measure relationship satisfaction. Bowen family systems theory (BFST) was used as the guiding theoretical lens. There were three parametric measures used in this study: independent two-sample t-test, the Actor Partner Interdependence Model (APIM), and hierarchical regression. For the independent t-test, all the variables showed sufficient evidence at the 5% significance level of a significant difference in the average total scores. For communication males scored significantly higher than females and for grief reaction, guilt, and relationship satisfaction females scored significantly higher than males. The APIM found a statistically significant actor effect for a woman’s communication on her own grief reaction. For the hierarchical regression, the regression results indicated that this overall model did significantly predict female grief reaction. Time since death proved a iii significant predictor of female grief reaction. A discussion of the findings, limitations of the study, research and clinical implications, and direction for future research are addressed. iv ACKNOWLEDGEMENTS I am indebted to many people for their guidance and support that has led to the completion of this dissertation. First and foremost, I would like to express my sincere appreciation to the bereaved parents who participated in this study by sharing their time and experiences. I wish to recognize the assistance given from many support group facilitators, both in person and online, along with several newsletters who continued to get the word out about this study and persisted to being committed to bringing it to the attention of their members, so they could decide if they wanted to participate. In particular, Compassionate Friend and The Mothers Enduring Neonatal Death (M.E.N.D) were invaluable. I am awestricken at the resilience of these parents and appreciate them for taking the emotional energy needed to provide information that will be helpful to other grieving parents. I want to extend a special thank you to all of the people who encouraged and supported me throughout this process. This dissertation would not have been possible without it. First, I would like to thank my family and friends who have been there through this long process. Secondly, I would like to thank my advisor and committee chair, Dr. Karin Jordan, and my former advisor the late Dr. Patricia Parr. I feel privileged to have worked with both of you. Finally, I would like to thank the following committee members for their guidance and input: Dr. Karin Jordan, Dr. Heather Katafiasz, Dr. Rikki Patton, Dr. Cynthia Reynolds, Dr. Harvey Sterns, Dr David Tefteller, and Dr. Wondimu Ahmed. In particular I want to thank Dr. Ahmed and Dr. Patton for their statistical expertise, Dr. Tefteller for stepping in to replace a committee v member when dysfunctional departmental politics came into play, also providing calmness and focus, Dr. Reynolds for her patience, Dr. Sterns for his content expertise, and Dr. Katafiasz for her theoretical expertise. vi DEDICATION This dissertation is dedicated to my family and friends, especially my husband and best friend, Christopher. Christopher, you are one of the main reasons why I persisted throughout this process despite all of the obstacles. Your unconditional love and support have shaped my entire life. You challenge me to be a better person. I would not be me without you. I would like to acknowledge my mother Gloria, for being a role model and showing me what resilience looks like. I would like to recognize my mother- in-law, Carol, for her love, support, and assistance along with my step father-in-law, Bernie. I would like to thank my friends who provided their own dissertation support group composed of Dr. Joanne Holbert, Dr. Dee Dee Hewit-Hewit, and Samantha Posey. Thank you for keeping me sane, motivated, and grounded. Finally, I would like to thank Dr. Karin Jordan and the late Dr. Patricia Parr. Your mentorship, encouragement, guidance, and professionalism made all the difference. What I learned throughout tHis process impacted much more than this dissertation. vii TABLE OF CONTENTS LIST OF TABLES……………………………………………………………………...xvii LIST OF FIGURES………………………………………………………………….......xx CHAPTER I. INTRODUCTION .......................................................................................................... 1 THE PROBLEM ..................................................................................................... 2 GRIEF MODELS ................................................................................................... 4 STRESS AND ILLNESS ........................................................................................ 5 CRUCIAL FAMILY ADAPTATION CHALLENGES ......................................... 6 FRAMEWORK ...................................................................................................... 7 THEORETICAL FRAMEWORK .......................................................................... 7 STATEMENT OF THE PROBLEM ...................................................................... 9 GENERAL RESEARCH QUESTIONS AND HYPOTHESES ............................ 9 PURPOSE OF THE STUDY ................................................................................ 12 PARENTAL ADAPTATION ............................................................................... 12 GRIEF REACTION .................................................................................. 12 GRIEF REACTION AND GENDER DIFFERENCES ........................... 13 PARENTAL ADAPTATION ............................................................................... 14 GUILT AND GENDER DIFFERENCES ................................................ 14 COMMUNICATION ............................................................................................ 14 RELATIONSHIP SATISFACTION .................................................................... 15 viii SOCIAL SUPPORT .............................................................................................. 15 ASSUMPTIONS UNDERLYING THE STUDY ................................................. 16 DEFINITIONS OF IMPORTANT TERMS .......................................................... 16 CHAPTER SUMMARY ........................................................................................ 21 OVERVIEW OF THE REMAINDER OF THE PRESENT STUDY ................... 22 II. REVIEW OF THE LITERATURE ............................................................................. 23 KAMM’S (1999) STUDY: AN OVERVIEW ...................................................... 24 DISSERTATION DIFFERENCES ...................................................................... 24 TRADITIONAL COUPLE OR FAMILY ............................................................ 27 CONTEMPORARY COUPLES ........................................................................... 28 DEATH AND DYING THEORIES OVERVIEW ............................................... 29 TRADITIONAL MODELS ...................................................................... 30 GRIEF WORK .......................................................................................... 30 PHASES OF GRIEF ................................................................................. 31 STAGES OF GRIEF ................................................................................. 31 TASKS OF GRIEF ................................................................................... 32 BIOGRAPHICAL MODEL.....................................................................