This work was concerned with individuals who suffered the loss of someone important. Some persons seem to continue to be affected by bereavement, which results in a problematic grief outcome. The question that was central to the current investigation was: To what extent does the attachment that someone has formed in early childhood to its primary caregiver(s) influence the outcome of bereavement processes later in life? 

Death of a family member is considered to be an event with a large impact. Through this thesis I have aimed to account for the risk-factors that influence the coping with demise. The assessment of risk-indicators has its practical value in that it offers a direction for monitoring and preventive actions. The earlier we can determine whether the bereaved is at risk, the more time and opportunity there is to intervene, when necessary, and to eventually adapt the situation before it deteriorates. When we are able to adequately predict the situation after the loss from factors that can, in principle, already be assessed prior to the loss, this provides an even broader scope for preventive measures. 

The first step in prevention is thus the recognition of specific risk-groups of bereaved as well as specific individual characteristics that are indicative of dysfunction. In this thesis I sought to identify these risk-factors. However, the objective here was especially to examine the causal links between loss of a beloved person, pathological grief outcome and childhood experience. 

How do previous experiences with the loss of a loved one influence the bereavement process? This scientific subquestion I have addressed in an effort to introduce a background information of risk-factors stemming from earlier life events, which may have taken place in childhood. In assessing the affect of prior losses on grief reactions, one needs to look at the particular type and timing of these experiences. It seems that this encounter with death may either facilitate a good outcome for later loss or create a bereavement overload. If the antecedent demise is resolved positively than it could prepare the person for additional loss. However, a negative resolution of previous experiences with bereavement may further complicate the response to the new loss. 

The processes of adaptation to later losses appear also related to the security-anxiety dimension of early attachments. Individuals whose earlier relationships are secure tend, after a period of mourning, to be able to resume normal lives and find new attachment bonds. On the other hand, individuals whose previous relations were anxious are more likely to manifest pathological variations of the grieving process, which may result in finding it more difficult to establish intimate connections with others later on.  To what extent does the successful formation of a secure attachment of a child to its primary caregiver(s) in early childhood ensure a more successful grief outcome later in life? In view of attachment behavior being potentially active throughout life, I have made an attempt to answer this scientific subquestion. According to Bowlby (1973/1980), secure attachment enables the bereaved to cope well with his loss, since he has established an internal working model whereby he is a competent person who can effectively adjust to adversity.

Finally, I have concluded that the type of attachment that someone forms in early childhood has an enormous effect on the way this person reacts to bereavement, which in turn determines the outcome of grief. Bowlby (1980) distinguished three disturbed attachment patterns that he related to pathological grief outcome. Anxious attachment and compulsive care-giving may result in chronic grief when facing the loss of a loved one. Compulsive self-reliance, however, is likely to cause a prolonged absence of conscious morning. 
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