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J. Behav. Ther. & Exp. Psychiat. 42 (2011) 26e31

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Journal of Behavior Therapy andExperimental Psychiatry

journal homepage: www.elsevier .com/locate/ jbtep

Autobiographical memory following cognitive behaviour therapy forcomplicated grief

Fiona Maccallum, Richard A. Bryant*

University of New South Wales, Sydney, Australia

a r t i c l e i n f o

Article history:Received 27 September 2009Received in revised form28 August 2010Accepted 31 August 2010

Keywords:Autobiographical memoryGriefCognitive behaviour therapy

* Corresponding author. School of Psychology, UniSydney, N.S.W. 2052, Australia. Tel.: þ61 2 9385 3640

E-mail address: r.bryant@unsw.edu.au (R.A. Bryan

0005-7916/$ e see front matter � 2010 Elsevier Ltd.doi:10.1016/j.jbtep.2010.08.006

a b s t r a c t

A deficit in the ability to retrieve specific autobiographical memories has been linked to a number ofnegative consequences, including poor problem solving skills, reduced ability to imagine the future, andthe onset of symptoms following trauma. This study investigated the impact of cognitive behaviourtherapy (CBT) on memory retrieval specificity in patients with Complicated Grief (CG). Twenty indi-viduals with CG who were seeking treatment were administered an autobiographical memory task(AMT) before and after completing a 10-week CBT program. Pre-treatment retrieval specificity did notpredict treatment outcome. However, there was a significant correlation between symptom reductionand increased specific retrieval to positive cues following treatment. These results suggest that over-general retrieval in CG can be modified by CBT, and may point to one means by which CBT can alleviateCG symptoms.

� 2010 Elsevier Ltd. All rights reserved.

1. Introduction

Complicated Grief (CG; alternatively know as Prolonged GriefDisorder) is a chronic and disabling bereavement related conditionthat impacts between 10% and 15% of bereaved individuals(Prigerson, Vanderwerker, & Maciejewski, 2008). The essentialfeature of CG is an intense and prolonged yearning for the deceasedcontinuing 6 months beyond the loss. Other symptoms includedifficulty accepting the loss, emotional numbing, bitterness, a lossof meaning and sense of purpose, a difficulty re-engaging in life,confusion about one’s role in life or a diminished sense of self, andavoidance of reminders (Prigerson et al., 2009, 2008). Althoughrelated to depression and PTSD, the condition is associated withunique negative consequences for the individual (Boelen &Prigerson, 2007; Prigerson et al., 2008).

There is increasing evidence that the treatment of choice for CGis cognitive behaviour therapy (CBT). Three trials have now indi-cated that CBT that incorporates psycho-education, exposure, andcognitive restructuring is an efficacious intervention for CG (Boelen,de Keijser, van den Hout, & van den Bout, 2007; Shear, Frank, Houck,& Reynolds, 2005; Wagner, Knavelesrud, & Maercker, 2006).Despite the promise shown by CBT, a significant proportion ofpatients do not benefit from this therapy. Accordingly, there is an

versity of New South Wales,; fax: þ61 2 9385 3641.t).

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important need to understand the factors associated with allevia-tion of CG with CBT.

People with CG display impaired retrieval of specific memories(Golden, Dalgleish, & Mackintosh, 2007; Maccallum & Bryant,2010). This finding is consistent with a sizable body of evidencethat individuals with depression and post-traumatic stress disorder(PTSD) have difficulty recalling specific autobiographical memories(for review see Moore & Zoellner, 2007; Williams et al., 2007). Thefinding that CG is associated with overgeneral retrieval is signifi-cant because this form of retrieval has been linked to impairedsocial problem solving (Evans, Williams, O’Loughlin, & Howells,1992; Goddard, Dritschel, & Burton, 1996), difficulties imaginingthe future in a specific way (Williams et al., 1996) and poorerresponse to treatment (Brittlebank, Scott,Williams, & Ferrier,1993).Findings that memory specificity does not typically improve whendepression remits (Brittlebank et al., 1993; Peeters, Wessel,Merckelbach, & Boon-Vermeeren, 2002; Raes, Hermans, Williams,& Eelen, 2006), and that overgeneral memory may representa risk factor for developing symptomatology following stressfulexperiences (Bryant, Sutherland, & Guthrie, 2007; Mackinger,Loschin, & Leibetseder, 2000) have lead to the proposition thatovergeneral retrieval may represent a trait that increases one’svulnerability to emotional disturbance (Williams, 1996). However,there is also growing evidence showing that retrieval specificity ismodifiable (e.g., Barnard, Watkins, & Ramponi, 2006; Raes,Williams, & Hermans, 2009; Watkins & Teasdale, 2001; Watkins,Teasdale, & Williams, 2000; Williams et al., 2006).

F. Maccallum, R.A. Bryant / J. Behav. Ther. & Exp. Psychiat. 42 (2011) 26e31 27

A number of studies have investigated whether overgeneralmemory is amenable to change through psychological therapy.Williams, Teasdale, Segal, and Soulsby (2000) found that mindful-ness-based cognitive therapy significantly reduced categoricalretrieval in a sample of participants with remitted depression.Serrano, Latorre, Gatz, and Montanes (2004) utilized a therapywhich encouraged the retrieval of specific positivememories acrosslife stages in an elderly depressed sample. They reported greatersymptom resolution and increased specificity to positive cues in theexperimental group (see also McBride, Atkinson, Quilty, & Bagby,2006). Sutherland and Bryant (2007) found that improvement inPTSD symptoms following cognitive behaviour therapy was signif-icantly associated with improved retrieval of specific memories inresponse to positive cues. Raes et al. (2009) found that depressedpatients instructed in recalling specific memories showed concur-rent decreases in rumination and improved outcomes.

There is overwhelming evidence that overgeneral retrieval isassociated with a range of detrimental factors, including rumina-tion, impaired problem solving, and deficits in imagining a future.These potential problems might be particularly relevant forbereaved individuals because of their need to retrieve positivememories and manage future challenges without the deceased.Accordingly, it is useful to know if successful treatment of CG islinked to more specific retrieval of personal memories. The currentstudy investigated the relationship between overgeneral retrievaland treatment outcome in CG following CBT. It was predicted thatsymptom improvement would be associated with increasedretrieval specificity.

2. Method

2.1. Participants

Participants were 20 treatment-seeking individuals who metdiagnostic criteria for CG (3males, 17 females). Clinical assessmentswere conducted by Masters Level clinical psychologists. Exclusioncriteria included a history of psychosis, organic brain injury,substance dependence and the need for an interpreter.

2.2. Measures

2.2.1. Diagnostic interviewsComplicated Grief Assessment (CGA; Zhang, El-Jawahri, &

Prigerson, 2006) is a clinician administered semi-structured inter-view for assessing CG. The CGA interview is based on the self-reportInventory of Complicated Grief (Prigerson et al., 1995) and providesa diagnosis and severity index of CG. The interview assesses for thepresence of separation distress (Criterion A), a difficulty acceptingthe death, emotional numbness, bitterness, difficulty re-engagingin life and a sense of purposelessness and meaninglessness(Criterion B). A diagnosis of CG is given if 6 months has passed sincethe death, Criterion A and B have been met for at least 6 months,and there is evidence of functional impairment (Criterion C).

Clinical Administered PTSD Scale e 2 (CAPS-2; Blake et al., 1995).The CAPS-2 is a structured clinical interview that indexes the 17symptoms described by the DSM-IV PTSD criteria. Each symptom israted on a five-point scale in terms of severity and frequency of thesymptoms in the past month. This measure was used to assess forPTSD related to the death.

2.2.2. Beck Depression Inventory-II (BDI-II; Beck, Steer, & Brown,1996)

The BDI-II was used to obtain a continuous measure ofdepressive symptomatology. This 21-item self-report measure hasdemonstrated good reliability and validity (Beck et al., 1996).

2.2.3. Wechsler Adult Intelligence Scale III e Letter NumberSequencing task (Wechsler, 1997)

The Letter Number Sequencing (LNS) subtest was included toindex the role of working memory capacity on retrieval. In this taskthe participant is read a combination of numbers and letters and isrequired to recall the numbers first in ascending order and then theletters in alphabetical order.

2.2.4. National Adult Reading Test (NART; Nelson, 1991)The NART was administered as a measure of verbal intelligence.

This measure requires participants to read aloud a list of 50 irreg-ularly spelled words of increasing difficulty. The number of wordspronounced correctly is used as the final score. The NART hasdemonstrated good reliability and construct validity (Crawford,Parker, Allan, Jack, & Morrison, 1991) and correlates well withother measures of intelligence (Bright, Jaldow, & Kopelman, 2002;Nelson, 1991).

2.2.5. Autobiographical Memory Task (AMT)This task was adapted from Williams and Broadbent’s (1986)

Autobiographical Memory Task (AMT). Participants were pre-sentedwith 5 positive (i.e., happy, love, confident, helpful, interesting)and 5 negative cue words (i.e., blame, sad, stress, argue, fear) andasked to recall a specific autobiographical memory for each word. Aspecific memory was defined as a memory for “an event that mayhave lasted just a fewseconds,minutes or even hours, but not longerthan a day”. Examples of acceptable and unacceptable responseswere given and participants completed 2 practice trials to ensurethat they understood the task. At the pre-treatment administration,participants were presented with one of four alternate word lists. Adifferent list fromthis groupwasgiven at post-treatment. Cuewordswerematched for valence, frequencyof use, and intensity (Bradley&Lang, 1999). Order of presentation was randomized except thatpositive and negative cuewordswere alternated. The valance of thefirst word was counterbalanced across participants. Participantswere given 60 s to respond to each cue.

Memory responses were audio-recorded and coded for speci-ficity according to the criteria outlined in Williams and Dritschel(1992). A memory was coded as ‘specific’ if it referred to a partic-ular event that took place on a specific day. A memory was cate-gorized as ‘categoric’ if it described a series of repeated events or‘extended’ if it described an event that lasted more than one day. Asecond independent rater coded 20% of memory responses forspecificity. Memory content was coded into three categories ‘loss’,‘person’ or ‘other’. The ‘loss’ category included memories of eventsthat were associated with the individual’s death or memoriesrelating to an aspect of the grief experience, such as the deceasedperson’s absence at an event. The ‘person’ category referred tomemories of the person that were neither death nor grief-related.All remaining memories were coded as “other”. A second inde-pendent rater coded 20% of memory responses. The mean kappareliability coefficient was 0.89 for specificity and 0.91 for content.

2.3. Procedure

Participants initially underwent a clinical assessment involvingCGA, CAPS-2, and BDI-II. One week later participants returned tocomplete the autobiographical memory task, the LNS and the NART.

Participants then completed a 10-week group-based CBTprogram that included an additional 4 individual sessions. Therapyinvolved psycho-education, cognitive restructuring, communi-cating with the deceased exercise that facilitated emotionalexpression, discussion of positive memories of the deceased, goalsetting, and pleasant event scheduling (see Shear et al., 2005). Oneweek after the completion of treatment an independent clinical

Table 1Participant characteristics at pre- and post-treatment assessments.

Pre N ¼ 20 Post-treatmentN ¼ 20

Age 52.30 (11.69)Relationship

of the deceasedPartner 30%Child 30%Parent 40%

Years since death 3.36 (2.48)CGA Mean 32.45 (4.17) 21.85 (8.22)

Range 25e40 9e35BDI Mean 32.1 (11.05) 22.76 (11.72)a

Range 17e52 1e44CAPS Mean 51.80 (19.72) 30.65 (20.57)

Range 26e95 0e87LNS 10.10 (1.44) 10.75 (1.91)NART 34.85 (7.20)

Note: Standard deviations appear in parentheses.a BDI-II scores were unavailable for 3 participants at post-treatment.

Table 2Mean memory specificity before and after treatment.

Time 1 Time 2

SpecificPositive 2.65 (1.34) 3.25 (1.33)Negative 2.75 (1.33) 3.90 (1.17)

CategoricPositive 1.45 (1.09) 1.05 (1.05)Negative 1.45 (1.15) 0.85 (1.81)

ExtendedPositive 0.40 (0.50) 0.65 (0.81)Negative 0.30 (0.57) 0.20 (0.41)

Note: Standard deviations appear in parentheses. Time 1 ¼ Pre-treatment assess-ment, Time 2 ¼ Post-treatment assessment.

F. Maccallum, R.A. Bryant / J. Behav. Ther. & Exp. Psychiat. 42 (2011) 26e3128

psychologistwhowas blind to responses from the initial assessmentre-administered the CGA, CAPS-2 and BDI-II.1 Participants returned1 week later to complete the AMT and the LNS. This session wasconducted by a researcher who was blind to treatment response.

3. Results

3.1. Participant characteristics

Table 1 presents participant characteristics for age, relationshipto the deceased, years since death, and pre- and post-treatmentCGA, BDI-II and CAPS-2 scores. As expected, symptoms of CGdecreased significantly from pre (M ¼ 32.45; SD ¼ 4.17) to post-treatment (M ¼ 21.85; SD ¼ 8.22), t(19) ¼ 5.67, p < 0.001. At thepost-treatment assessment, 11 of the 20 participants no longer metdiagnostic criteria for CG. There were also significant decreases inscores on the BDI-II from pre- (M ¼ 32.10; SD ¼ 11.05) to post-treatment (M ¼ 22.76; SD ¼ 11.72), t(16) ¼ 2.39, p < 0.03, and theCAPS-2 (M ¼ 51.80; SD ¼ 19.72) to post-treatment (M ¼ 30.65;SD ¼ 20.57), t(19) ¼ 5.95, p < 0.001.

3.2. Memory patterns over time

Table 2 presents the mean number of specific, categoric andextendedmemories at pre- (Time 1) and post-treatment (Time 2). A2 (Time) � 2 (Cue Valence) ANOVA on specific memories indicateda main effect for Time (F(1, 19) ¼ 11.91, p < 0.004); Overall,participants recalled more specific memories at post-treatmentthan pre-treatment assessment. Separate 2 (Time) � 2 (CueValence) ANOVAs of categoric and extendedmemories indicated nosignificant overall effects. A 3 (Memory Content) � 2 (CueValence) � 2 (Time) repeated measures ANOVA revealed a maineffect for Memory Content, (F(2,38) ¼ 30. 70 p < 0.001) anda significant 2 way interaction for Cue Valence � Content, (F(2,38) ¼ 3.75., p < 0.04) (see Table 3). Overall, participants recalledmore Other than Loss or Person memories; however this patternvaried for positive and negative cues. Whereas the differencebetween Loss and Other memories was not significant for negativecues, it was significant for positive cues [t(19) ¼ �8.51 p < 0.001].That is, in response to negative cues participants tended to recalla greater proportion of Loss related memories than in response topositive cues. There were no significant differences in memorycontent from pre- to post-treatment.

1 Note: Three participants did not complete the BDI-II post-treatment. For thisreason degrees of freedom vary in subsequent analyses using this measure.

3.3. Memory specificity and treatment outcome

Hierarchical multiple regression analyses were conducted toexamine the degree to which treatment outcome (post-treatmentCGA score) was predicted by pre-treatment specific or categoricmemory retrieval. Due to the small sample size, only a limitednumber of predictors were included in these analyses. On Step 1,pre-treatment CG scores were entered and on Step 2, pre-treatmentspecificity (or categoric) scores were entered. All equations werenon-significant (Specificity: R2 ¼ 0.06, adjusted R2 ¼ �0.05,p< 0.59, Categoric R2 ¼ 0.07, adjusted R2¼�0.03, p< 0.51). NeitherTime 1 severity of CG symptoms nor memory specificity (or cate-goricness) were significant predictors of outcome in this sample.

3.4. Memory specificity and symptom change

To examine the relationship between change in memory spec-ificity and change in symptom levels standardized residual gainscores were calculated. Residual gain scores are a well validatedmeasure of change (Mintz, Luborsky, & Christoph, 1979; Steketee &Chambless, 1992). These scores are the standardized residuals ofthe regression of pre-treatment measures on post-treatmentmeasures, and thus represent the change in symptoms (memories)that is not expected on the basis of pre-treatment scores alone.Overall, there was a significant negative correlation betweenchange in CGA and memory specificity to positive cues (r ¼ �0.61,p < 0.005). Reductions in CG symptoms were correlated withincreases in specificity to positive cues. The correlation betweenchange in CG and negative cues was non-significant (r ¼ 0.03).2

To examine the extent to which this relationship was impactedby concurrent changes in depression, post-traumatic stress, andworking memory (as indexed by the LNS) residual gain scores werecalculated for each of these variables. Partial correlations betweenCGA and positive and negative cue specificity residual gain scorescontrolling for change in these variables were calculated (adjustedalpha p < .012). The correlation between change in positivememory specificity and change in CG was marginally reduced(r ¼ �0.57, p < .05). Partial Correlation coefficients for specificnegative retrieval (r ¼ �0.01) remained non-significant.

4. Discussion

This study found that as symptoms of CG reduced after CBT,memory specificity in response to positive cue words increased.

2 Correlations between CGA and categoric and extended recall residual gainscores were non-significant (adjusted alpha p < .008). Similarly, correlationalanalysis indicated no association between change in symptoms and change inmemory content.

Table 3Mean proportion of loss, person and other memories before and after treatment.

Time 1 Time 2

LossPositive 0.10 (0.14) 0.12 (0.16)Negative 0.39 (0.29) 0.29 (0.25)

PersonPositive 0.14 (0.21) 0.19 (0.27)Negative 0.04 (0.08) 0.05 (0.12)

OtherPositive 0.75 (0.25) 0.69 (0.31)Negative 0.56 (0.30) 0.79 (1.02)

Note: Standard deviations appear in parentheses. Time 1 ¼ Pre-treatment assess-ment, Time 2 ¼ Post-treatment assessment.

F. Maccallum, R.A. Bryant / J. Behav. Ther. & Exp. Psychiat. 42 (2011) 26e31 29

This finding is consistent with studies showing an increase inspecificity of autobiographical retrieval in remitted depression(McBride et al., 2006; Williams et al., 2000) and PTSD (Sutherland& Bryant, 2007) following cognitive based psychological inter-ventions. The result is also consistent with studies showing thatovergeneral memory is directly modifiable in clinical (Raes et al.,2009; Serrano et al., 2004) and nonclinical samples of depressedand dysphoric individuals (Barnard et al., 2006; Watkins &Teasdale, 2001; Watkins et al., 2000; Williams et al., 2006).

Interestingly, although there was an overall increase in memoryspecificity from pre- to post-treatment, only increases in positivememory specificity were associated with a reduction in griefsymptoms: changes in negative memory specificity were notcorrelated with outcome. The CARFAX model proposes that threefactors may contribute to the occurrence of overgeneral memory:(a) functional avoidance of painful memories and emotions, (b) thetendency to ruminate, which leads people to focus on categoriclevel memories and general themes, and (c) executive processinglimitations that preclude adequate retrieval resources to locatea specific memory (Williams, 2006). Dalgleish et al. (2007) reportedthat reduced executive functioning played a key role in overgeneralretrieval in depression. It is possible that as our participants’symptoms of grief reduced over time, their executive controlcapacity increased allowing for more effective retrieval. Providingsome support for this proposition, the relationship between changein positive memory specificity and change in CG symptoms wasmarginally reduced after controlling for changes in symptoms ofdepression, PTSD and working memory. It is also well understoodthat CG is characterized by ruminative focus on the loss (Boelen,van den Hout, & van den Bout, 2006; Prigerson et al., 2008;Stroebe et al., 2007) and so it is possible that increased memoryspecificity resulted from reduced rumination following successfultreatment. However, neither of these explanations can adequatelyaccount for the increase in specificity to negative cues, which wasunrelated to symptom change. The degree to which functionalavoidance is relevant to memory retrieval in CG has yet to bedetermined. Whereas self-reported avoidance behaviour has beenassociated with worse outcomes in bereavement (Boelen, van denBout, & van den Hout, 2003; Boelen, van den Bout, & van denHout, 2006), grief reactions have also been linked with approachtendencies toward memories of the deceased (Boelen, van denHout, et al., 2006; Prigerson et al., 2008; Raphael &Martinek,1997).

Future studies will be needed to determine the reliability of thedifferential pattern of findings for positive and negative cues in CG.However, there is some evidence to suggest that the ability to recallspecific negative memories may not be a good indicator of level offunctioning per se. Golden et al. (2007) found that whereas indi-viduals with CG displayed the overgeneral retrieval effect on theAMT, on a task requiring them to recall specific memories about thedeceased’s life they were more specific in response to negative cues.

This raises the possibility that memory specificity to negative cuesmay vary according to content, rather than symptom reduction. Wedid not find an overall difference in the content of retrievedmemories from pre- to post-treatment; however, in the currentstudy no limits were set on the content of participants’ recall and thenumber of responses in several content categories was low,impacting on our ability to undertake the specific comparisonsneeded to examine this possibility. Future research could investigatethis issue by instructing participants to recall memories fromparticular content categories, such as loss versus nonloss. It is alsopossible that memory specificity for negative cues was enhanced forall participants as a result of their recent involvement in a 10-weekCBT program. This treatment involved in-depth discussion of specificdistressing life events as a means of identifying maladaptive inter-pretations and behaviors, and so may have increased the generalaccessibility of such specific negative memories assessed at post-treatment, irrespective of treatment response. Future studies wouldbenefit from assessing memory specificity and content with a longerpost-treatment interval. This would overcome any recency effectsfrom treatment. Future research would also benefit from exploringthe extent to which memories recalled to positive and negative cuesare experienced as emotionally positive or negative, respectively. Ingrief, it is possible that the memory of a positive experience maytrigger distress if it is associated with the loss; whereas, a negativepast event may also elicit positive emotions if it relates to a timewhen the deceased was alive.

An alternative explanation for the current pattern of results isprovided by Conway and Pleydell-Pearce’s (2000) self memorysystem model (see also Conway, Singer, & Tagini, 2004). Accordingto this model, a reduction of symptoms would be associated witha change in a person’s “working self”, where the “working self”represents the goals and motivations that are currently importantto an individual. A reduction in grief symptomswould be associatedwith a change from a working self that is dominated by loss andyearning to one that is no longer loss focused, but has beenmodified to include new roles and a more optimistic attitudetowards the future. Conway and Pleydell-Pearce (2000) argue thatthere is a reciprocal relationship between an individual’s workingself and their autobiographical memory database, and thatmemories consistent with the working self have increased acces-sibility. Support for this proposition comes from a number ofstudies showing a link between memory content and personalgoals (Maccallum & Bryant, 2010; McNally, Lasko, Macklin, &Pitman, 1995; Moberly & MacLeod, 2006). Thus as an individual’sworking self shifts from themes of loss and yearning and to a morepositive and hopeful outlook, it would be expected that therewould be a corresponding increase in the accessibility of specificpositive memories.

This study found that while there was a significant relationshipbetween outcome and change in positive memory specificity, therelationship between outcome and change in categoric andextended recall was non-significant. This may reflect a relative lackof power due to the small sample size of the current study or thecomparatively low frequency of responses in these categories.However, there is also evidence that retrieving categoric memoriesversus fewer specific memories may be linked with differentemotional consequences (Raes et al., 2006), and so it is possible thatchanges in specific recall occur independent of changes in categoric(or extended) recall. Future research would benefit from examiningthis issue using a larger sample size.

It is recognized that the conclusions that can be drawn from thisstudy are limited by the correlational design. It is not possible todeterminewhether a reduction in grief symptoms across treatmentled to increased accessibility of specific positive experiences, orwhether an increase in the retrieval of specific positive memories

F. Maccallum, R.A. Bryant / J. Behav. Ther. & Exp. Psychiat. 42 (2011) 26e3130

led to a reduction in grief symptoms, perhaps by assisting in affectregulation, generating a sense of hopefulness or a more positiveself-identity. Alternatively, it is possible that changes in positivememory specificity and grief symptoms occurred independentlyacross treatment. The relationship betweenmemory specificity andsymptom change in CG could be further investigated in futurestudies by applyingmemory specificity training procedures, such asthose described in Raes et al. (2009), or by indexing memoryspecificity and symptom change at more time points across treat-ment. To better understand the specific role CBT techniques mayhave played in increasing memory specificity it will also beimportant for future studies to include an untreated CG groupassessed over time.

In contrast to previous studies of depressed patients(Brittlebank et al., 1993;Mackinger et al., 2002; Peeters et al., 2002),this study found no association between memory specificity at pre-treatment and treatment response. This lack of association isconsistent with the findings of Sutherland and Bryant (2007) andBrewin, Reynolds, and Tata (1999), who similarly found no rela-tionship between OGM and treatment in PTSD and depression,respectively. However, due to the small sample size used in thisstudy, the result may reflect a lack of power to detect an effect.Future studies utilising larger sample sizes will be need to addressthis issue.

Notwithstanding the limitations that have been outlined, thisstudy represents the first examination of autobiographical memoryin CG before and after treatment. The study provides preliminaryevidence that enhanced retrieval of specific positive memories isassociated with remission in CG symptoms. Further study of themechanisms underpinning these retrieval patterns may shed lighton recovery from complicated grief.

Acknowledgments

This research was supported by a National Health and MedicalResearch Council Program Grant (300403).

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