An examination of mental disorders associated with spousal suicide bereavement: a longitudinal population-based study

dc.contributor.authorSpiwak, Rae
dc.contributor.examiningcommitteeChartier, Mariette (Community Health Sciences) Sareen, Jitender (Psychiatry) Bolton, James (Psychiatry) Katz, Laurence (Psychiatry) Wade, Terrance (Brock University)en_US
dc.contributor.supervisorElias, Brenda (Community Health Sciences)en_US
dc.date.accessioned2017-09-07T15:58:44Z
dc.date.available2017-09-07T15:58:44Z
dc.date.issued2012en_US
dc.degree.disciplineCommunity Health Sciencesen_US
dc.degree.levelDoctor of Philosophy (Ph.D.)en_US
dc.description.abstractSuicide bereavement is a significant public health problem, with an estimated 48 to 500 million individuals bereaved by suicide every year. Accurate measurements of suicide bereavement related health is an essential component to understanding this public health problem and organizing appropriate resources for prevention and intervention. Spousal suicide bereavement is thought to be associated with poor health outcomes due to its substantial impact on the surviving partner. There are limited theoretical frameworks to better understand the relationship between suicide bereavement and associated health, therefore to address these limitations we proposed an integrative risk framework that is testable using administrative data. The overall goal of this research was to determine if spouses bereaved by suicide have greater rates of mental disorders as compared to spouses bereaved by other sudden deaths. To achieve this goal, 7 manuscripts were written in the areas of theory, methodology, policy, and four related studies using longitudinal population-based administrative data to examine rates of mental disorders among spouses bereaved by suicide, sudden natural death, and unintentional injury. These cohorts were examined both individually as compared to matched non-bereaved spousal samples and then comparatively where suicide bereaved spouses were compared to spouses bereaved by sudden natural death and unintentional injury death using advanced statistical modeling. The overall findings of this research demonstrate that while spousal bereavement seems to be a time of poor mental health, when comparing bereavement cohorts, suicide bereaved spouses appear to be doing more poorly overall. The findings from this body of research support the need for future studies in numerous areas. First, research is needed to examine the impact of the deceased’s pre-death health on the surviving spouse to determine if caregiver stress helps explain the elevated pre-bereavement rates of mental disorders found. Second, the role of guilt and stigma in suicide bereavement and its impact on help seeking is an additional area for future work to determine if reported rates are potential underestimates due to these factors. All of these factors will ultimately inform targeted interventions for spouses bereaved by suicide.en_US
dc.description.noteOctober 2017en_US
dc.identifier.citationSpiwak R, Elias B, Bolton JM, Martens PJ, Sareen J. Suicide policy in Canada: lessons from history. Can J Public Health. 2012;103(5):e338-341.en_US
dc.identifier.urihttp://hdl.handle.net/1993/32491
dc.language.isoengen_US
dc.publisherCanadian Journal of Public Healthen_US
dc.rightsopen accessen_US
dc.subjectMental healthen_US
dc.subjectSuicideen_US
dc.subjectEpidemiologyen_US
dc.subjectBereavementen_US
dc.titleAn examination of mental disorders associated with spousal suicide bereavement: a longitudinal population-based studyen_US
dc.typedoctoral thesisen_US
local.subject.manitobayesen_US
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