Title: The Role of Relatedness and Expressive Flexibility In the Prediction of Complicated Grief
Description: The current study explores the association between expressive flexibility, attachment, interpersonal dependency, and complicated grief among a sample of middle-aged bereaved adults. A relatedness framework, which encompasses specific and more generalized relational interpersonal behaviors, was utilized to broaden the frame of inquiry. This study represents one of the first systematic efforts to examine conjointly attachment and dependency behaviors in a middle-aged bereaved population. It is also one of the first empirical explorations of the association between dependency and expressive flexibility. The Experiences in Close Relationships - Revised questionnaire (ECR-R; Fraley, Waller, and Brennan, 2000) was employed to derive anxious and avoidant attachment schemas. Adaptive and maladaptive interpersonal dependence were measured utilizing the Relationship Profile Test (RPT; Bornstein and Languirand, 2003). Participants were asked to express, suppress, or behave normally to evocative images.

Observer ratings of participants' responses were used to measure expressive enhancement and suppression ability. Results indicated a significant association between expressive flexibility factors, attachment, and complicated grief, and more notably a relationship between dependency and complicated grief. Results also revealed adaptive dependence (i.e., healthy dependency) as the strongest predictor of complicated grief, above and beyond attachment related anxiety and avoidance. The data also suggested that expressive enhancement ability moderates the relationship between healthy dependency and complicated grief, such that the interaction between low expressive enhancement ability and low healthy dependence predict significantly increase the likelihood of complicated grief. Taken together, the findings of this study suggest the importance of including expressive flexibility and dependency factors in understanding complicated grief. The clinical implications of these findings are also discussed.