Background: Grieving individuals demonstrate attentional bias towards reminders of the deceased vs. neutral stimuli. We sought to assess bias towards reminders of the deceased vs. a living-attachment figure and to evaluate similarities and differences in the neural correlates of deceased and living-related attention. We also sought to identify grief process variables associated with deceased-related attentional bias.
Methods: Twenty-five subjects grieving the death of a first-degree relative or partner within 14-months performed an emotional Stroop task, using words related to a deceased or a living attachment figure, and a standard Stroop task, to identify general selective attention, during functional magnetic resonance imaging (fMRI). Subjects rated word-sadness, complicated grief (CG) symptoms, depression severity, attachment style, emotional pain, nonacceptance, yearning and intrusions.
Results: We identified an attentional bias to deceased vs. living-related words, independent of age, depression severity/history, loss-type, word-sadness, medication use and time since loss. Attentional bias correlated with CG severity and intrusive thinking. A conjunction analysis identified joint activation in fusiform gyrus, posterior cingulate and temporal parietal junction across living and deceased-related attention vs. general selective attention. Insecure-avoidant attachment style correlated with decreased engagement of this network in deceased-related attention.
Conclusions: We have demonstrated an attentional bias to reminders of the deceased vs. a living attachment in grieving. Overlapping neural circuits related to living and deceased related attention suggests that the bereaved employ similar processes in attending to the deceased as they do in attending to the living. Deceased-related attentional bias appears to be linked primarily to intrusive thinking about the loss.