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A Systematic Mapping of Suicide Bereavement and Postvention Research and

a Proposed Strategic Research Agenda

Article  in  Crisis The Journal of Crisis Intervention and Suicide Prevention · December 2017
DOI: 10.1027/0227-5910/a000498

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 Research Trends
${protocol}://econtent.hogrefe.com/doi/pdf/10.1027/0227-5910/a000498 - Karl Andriessen <karl.andriessen@gmail.com> - Tuesday, August 14, 2018 8:27:19 PM - IP Address:128.250.0.123

A Systematic Mapping of Suicide

­Bereavement and Postvention
­Research and a Proposed Strategic
Research Agenda
Myfanwy Maple1, Tania Pearce1, Rebecca Sanford2, Julie Cerel3,
Dolores Angela Castelli Dransart4, and Karl Andriessen5
1
School of Health, University of New England, Armidale, NSW, Australia
2
School of Social Work and Human Service, Thompson Rivers University, Kamploops, BC, Canada
3
College of Social Work, University of Kentucky, Lexington, KY, USA
4
School of Social Work Fribourg, HES-SO University of Applied Sciences and Art Western Switzerland, Fribourg, Switzerland
5
School of Psychiatry, University of New South Wales, Sydney, Australia

Abstract. Background: Suicide may have disruptive and/or devastating effects on family, friends, and the broader community. Of late, increased
interest from suicide researchers has given rise to an upsurge in research productivity addressing suicide bereavement and postvention. At this
critical juncture, the establishment of an agenda will help guide the direction of future scholarly research in this field. Aims: To conduct an ex-
haustive systematic mapping review and bibliometric analysis of peer-reviewed suicide bereavement and postvention research published over
the past 50 years. Method: A comprehensive and strategic search of electronic databases and web-based search engines for original research
studies was conducted resulting in the identification of 443 articles. Results: Since 1965, the global research activities in the field of suicide
bereavement and postvention is approximately 8.86 papers per year. There remains a lack of evaluation studies on the effects of interventions/
programs with the majority of papers being explanatory in nature. Several areas of study within this field remain neglected. Limitations: While
the search strategy was rigorous, potential limitations exist due to nonstandardized nomenclature and English language only inclusion, which
inherently favors research from high-income countries. Conclusion: Suggested topics for a research agenda are proposed from the current
limitations in the field.

Keywords: bereavement, grief, postvention, suicide, systematic review

Suicide bereavement and postvention research has in-
creased in the past two decades. Prior bibliography reviews
have pointed out (a) how most of these studies that have
been published in the suicidology literature have been in
two major journals (Crisis and Suicide and Life-Threatening
Behavior) and the majority of articles originated from An-
glo-Saxon, Western countries (Andriessen, 2014), and (b)
how frequency of citation is most for review papers, papers
on characteristics of suicide bereavement, and psycholog-
ical autopsies (Andriessen, Krysinska, & Stack, 2015). As
yet, there has been no comprehensive systematic review
of both suicidology and nonsuicidology journals to un-
derstand the research productivity, knowledge gaps, and
trends and patterns in the field of suicide bereavement and
postvention to guide a future research agenda. Therefore,
the objective of this paper was to perform a systematic bib-
liometric review to identify and quantify published litera-
ture in the suicide bereavement and postvention domain
published in peer-reviewed journals over a 50-year period
from January 1965 to January 2015. The study addresses
the following questions about research in suicide bereave-
ment and postvention:
1. What are the dominant themes investigated in the are-
as?
2. Which research designs are most commonly used and
what types of knowledge have been generated in the
area?
3. What is the distribution and rate of research output in
the area per year?
4. What age and population groups are studied?
5. What is the geographic distribution of the research be-
ing undertaken?

© 2017 Hogrefe Publishing Crisis (2018), 39(4), 275–282

https://doi.org/10.1027/0227-5910/a000498
 276 M. Maple et al., Review of Suicide Bereavement and Postvention Research

Method Search Protocol

${protocol}://econtent.hogrefe.com/doi/pdf/10.1027/0227-5910/a000498 - Karl Andriessen <karl.andriessen@gmail.com> - Tuesday, August 14, 2018 8:27:19 PM - IP Address:128.250.0.123

Study Design Articles were included if they met all of the following cri-
teria:
1. Original quantitative, qualitative, or mixed-method re-
As the objective of the study was to provide a comprehen-
search (from any field or discipline) with a focus on sui-
sive map of the primary research published over the past
cide bereavement and postvention.
50 years, the authors chose a systematic mapping review
2. Were published between 1965 and 2015 in peer-­
design. Systematic mapping reviews are a form of protocol
reviewed English language journals.
driven methodology used “to systematically and transpar-
ently describe the extent of research in the field, to identi-
Articles were excluded if they met at least one of the fol-
fy gaps in the research base, and to provide direct links to
lowing criteria:
the evidence base” (Clapton, Rutter, & Sharif, 2009, p. 11).
1. Nonprimary empirical research (e.g., reviews, abstracts,
Coupled with this approach, a bibliometric analysis pro-
editorials, letters, unpublished reports, dissertations,
vided a measure of research output (Archambault, Vigno-
and gray literature).
la-Gagne, Côté, Larivière, & Gingrasb, 2006). In accord-
2. Studies where the terms suicide bereavement/grief and
ance with the study objectives of mapping the published
postvention are mentioned but not discussed and/or ex-
literature no critical appraisal or meta-analysis of papers
plored in the content of the paper.
was conducted. In providing for rigor and transparency, the
3. Articles that covered topics such as euthanasia or assist-
study followed the Preferred Reporting Items for Systemat-
ed suicide or nonsuicidal self-harm.
ic Reviews and Meta-Analyses (PRISMA) guidelines for the
reporting of systematic reviews (Moher et al., 2015).

In all, 14 individual search strings across 10 electronic databases (PubMed, CINAHL, EBSCO, Gale,
Figure 1. PRISMA flow diagram summarizing systematic
Informit, ProQuest, Science Direct, Scopus, Taylor & Francis, Web of Science) and Google Scholar were search used to identify published literature on suicide be-
searched to retrieve relevant papers. The search strings included combinations of the following truncated reavement and postvention.
major terms: (suicid*); (bereave* OR grie* OR loss OR mourn*); (expos* OR interven* OR research*);
(surviv* OR postvention). To maximize the retrieval of relevant records, both thesaurus subject headings
(where available) and text word searching were also used in combination with each other.

26,079 records identified through 359 additional records identified through

Identification

searches of Google Scholar

peer-reviewed databases

19,233 excluded because:

Not about suicide bereavement/postvention
Papers on euthanasia, non-suicidal self-
Screening

26,438 records screened harm

by title only

5,604 duplicates removed

1,601 title and abstracts

screened by 2 authors 866 excluded because:
Nonprimary research
Nil reference to suicide bereavement
Eligibility

/postvention

735 full-text articles screened for 206 full-text articles excluded:

eligibility by 4 authors
529 articles included in review
Included
6 non-English language
63 nil reference to suicide
bereavement/postvention
19 articles on traumatic bereavement
26 ineligible outcome (conceptual papers)
2 full-text unobtainable
90 ineligible publication type (non-primary
research)

Quantitative (n = 304) Case Studies/Reports (n = 86)

Qualitative (n = 106)
Mixed Methods (n = 33)

Figure 1. PRISMA flow diagram summarizing systematic search used to identify published
literature on suicide bereavement and postvention.
Crisis (2018), 39(4), 275–282 © 2017 Hogrefe Publishing
 M. Maple et al., Review of Suicide Bereavement and Postvention Research
Identification of Studies
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A systematic and explicit search of web-based search en-
gines and 10 databases chosen for their coverage of health,
social, and psychology research was conducted over a
2-week period ending mid-February 2015. Figure 1 de-
scribes the search, selection, and screening process. The
majority of papers were excluded through title review as
they did not meet the inclusion criteria (n = 19,233) or were
duplicates (n = 5,604). The searching of multiple databases
assisted in the maximum number of papers being retrieved.
The search terms consisted of a combination of major and
qualifying keywords. Due to a lack of standardized nomen-
clature in the field of suicidology, the search terms were
deliberately broad in context and selected by the authors;
however, only where suicide bereavement and postvention
were the focus was the paper included (i.e., where the find-
ings were not related to these core concepts the paper was
deemed ineligible, n = 26, or where traumatic bereavement
was the focus and suicide was used as a comparison, n = 19).
Data Extraction
For analysis of the 735 full-text records, a customized
data-coding spreadsheet and a code book detailing both
the coding process and formatting rules of data entry to
ensure uniformity by the four reviewers were devised. To
ensure a high standard of data extraction, a pilot test of
the coding workbook was undertaken prior to the formal
review. The records were exported from Endnote into an
Excel coding spreadsheet and details recorded against the
following categories: aims as stated in the study, geograph-
ic location of the study, sample size, population targeted
(coded according to the relationship status shared between
those sampled and those who had died by suicide, e.g., kin,
nonkin, or combination), age group, study design, key re-
sults, and limitations. A measure of the level of focus on
the topic of suicide bereavement and postvention was also
recorded. The citations were divided into random batches
of approximately 183 records and distributed among the
four members of the review team. Each team member was
responsible for accessing a full-text copy of the records as-
signed to them. Any disputed records were reviewed by a
team member who had not reviewed the paper previously.
Following this stage of the review, 206 citations failed to
meet the inclusion and exclusion criteria and were discard-
ed (see Figure 1). Although we contacted the author, one
record remained unobtainable. Finally, 529 studies were
included in the analysis. As the primary purpose of the
review was to map the published literature, methodologi-
cal rigor of the included studies was not assessed. Two of
the authors conducted the data synthesis and bibliometric
© 2017 Hogrefe Publishing
277
analysis of the included records the results of which were
then checked by a third reviewer.
Data extraction of each paper was conducted using the
full-text as a visual reference. Papers were categorized ac-
cording to their primary focus of inquiry and SPSS version
22 was used to analyze the data. The full list of papers re-
trieved is available via the IASP website.
Results
Methodological Design
Methodologies reported in the included papers were cat-
egorized into four design types. Of the 529 articles iden-
tified, 304 constituted of quantitative research paradigm,
(68.6%), with the remainder adopting a mixed-method
(n = 33, 7.44%) or qualitative (n = 106, 23.9%) approach,
while 86 papers referred to case studies/reports. These 86
records were defined by papers that either used the term
case study, case report, case consultation, case example, case
history, case profiles, case illustration etc. in the title or ab-
stract or discussed an episode or postvention event rather
than reporting research per se.
Of the 443 papers reporting original data, the content
was primarily explanatory (n = 265, 59.8%) research on
correlational relationships between variables, followed
by descriptive (n = 154, 34.7%) studies, which examined
trends but did not explain possible relationships between
variables. Very few studies reported on the efficacy of
control/interventions (n = 24, 5.4%). Each are discussed
here, finishing with a discussion of the case reports/case
studies, and other studies (n = 19) that have alternate
methodologies.
Explanatory Studies
We identified 265 studies as contributing to explanatory
knowledge. Of these, the majority used quantitative design
(n = 247, 93.2%) followed by mixed-method approach in
12 papers (4.5%). Qualitative methods were used in 2.2%
(n = 6) of explanatory papers. Investigation of risk factors
associated with exposure to suicide accounted for just un-
der half (n = 121, 45.6%) of explanatory articles included
in the review. Studies comparing the bereavement and
grief process following suicide death with the bereave-
ment experienced by other causes such as death by natural
causes, accident, or homicide (n = 71) made up 26.7% of
explanatory article.
Descriptive Studies
Of the 154 papers categorized as descriptive, qualitative
methodologies were reported in 98 papers (63.6%), while
Crisis (2018), 39(4), 275–282
 278 M. Maple et al., Review of Suicide Bereavement and Postvention Research

26.6% (n = 41) used quantitative research design. Mixed 17.4%. In the 2000s, 39 case study/report design papers
methods accounted for 9.7% (n = 15) of descriptive stud- on suicide bereavement and postvention were published
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ies. A review of the study focus of these papers indicated
experiences of suicide bereavement (n = 68, 44.1%) was
the dominating theme of all the descriptive research in-
cluded in this review. Other key topics included papers
on the impact of suicide on health professionals (n = 28,
18.1%), descriptions of postvention support groups, on-
line services, and accounts of how schools manage be-
reaved students following a death by suicide. Research
participation and the barriers that exist in recruitment of
participants was the subject of 13 (8.44%) papers, with
less focus being paid to the suicide bereaved experiences
of minority groups (n = 5, 3.2%), attitudes and stigmatiza-
tion toward suicide bereavement (n = 4, 2.5%), and com-
parative studies (n = 2, 1.2%).
Control/Intervention Studies
Although control/intervention studies are important
in building evidence-based knowledge (Jenson, 2005,
p.  133), only 5% (n = 24) of the 443 records included in
this review were of this kind; 66.6% (n = 16) were quan-
titative and 25% were carried out with mixed methods.
Only two papers used a qualitative approach (8.3%). While
some of the programs and interventions were designed
to measure the effectiveness of group interventions that
catered purposely to target groups such as adolescents
(n = 3), parents (n = 2), children (n = 2), spousal survivors as ethical issues related to research participation support
(n = 2), others tested specific interventions such as cogni- provided by groups and by schools following suicide death.
tive-based therapy (n = 3).
Running head: REVIEW OF SUICIDE BEREAVEMENT
Case Studies/Reports
Overall, case study/report research in the field of suicide
bereavement and postvention has been published at a
rate of 2.1 papers per year. In the 1990s case study/report
output doubled, with 37.2% of papers being produced
compared with the previous period where the output was
representing an increase to 45.3%. Content analysis of
principal case study/report themes reveals a preoccupa-
tion by researchers with the effects of suicide bereave-
ment (26.7%, n = 23), descriptions of school postvention
programs (19.7%, n = 17) and support services (19.7%,
n = 17), and the impact of client suicide on health profes-
sionals (12.7%, n = 11).
Research Over the Decades
Reports on the experiences of witnessing suicide first ap-
peared in the 1970s. In the following decade, the study fo-
cus of research ranged from investigation into the attitudes
toward and stigmatization of suicide bereavement (n = 2),
the impact of suicide on health professionals (n = 1), to com-
parative studies exploring the effects of suicide bereave-
ment against other types of death including accidental and
natural (n = 8). It was also during this same period that the
first substantial increase in research output was observed
with 22 papers produced. During the 1990s, scholarly con-
tribution to the field of suicide bereavement escalated, with
a fourfold increase in research output compared with the
previous period. While the study focus of papers remained
constant, five new research topics were introduced such
More importantly, it was in the 1990s that research into
the effectiveness of intervention
& POSTVENTION programs first emerged.
RESEARCH 15
Over the following 10 years, although research output in
this field doubled, only one new topic of interest was intro-
duced, that is, epidemiological-based studies aiming at es-
timating the number of survivors affected by suicide.
During the first decade of the 21st century, when youth
suicide became a significant issue for several countries,

Attitudes 0 0 2 4 1 4

Contagion 0 0 0 2 5 2

Control 0 0 0 7 7 10

0 0 0 0 1 2
Epidem.
Exposure 1 2 4 25 53 42

Media 0 0 0 0 0 2

Minorities 0 0 0 0 0 5

Postvention 0 0 0 6 10 13

Professionals 0 0 1 5 19 15

0 0 0 1 1 2
Programs
0 0 2 1 2 4
Psychometrics
Research Part. 0 0 0 2 3 8

S.B. Comparison 0 0 8 21 22 22

0 1 5 12 38 38
S.B. Experiences
0 1 20 1 2 30 5 10 0 10 20 30 0 20 40 60 0 20 40
1960-1969 1970-1979 1980-1989 1990-1999 2000-2009 2010-2015

Figure 2. Publications by decade.

Figure 2. Publications by decade.
Crisis (2018), 39(4), 275–282 © 2017 Hogrefe Publishing

180
 0 1 5 12 38 38
S.B. Experiences
0 1 20 1 2 30 5 10 0 10 20 30 0 20 40 60 0 20 40
1960-1969 1970-1979 1980-1989 1990-1999 2000-2009 2010-2015

Figure 2. Publications
M. Maple et al., Review by decade.Bereavement and Postvention Research
of Suicide 279

180 Figure 3. Time trend analysis of research

160 output.
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140
120
100
80
60
40
A20
SYSTEMATIC REVIEW OF SUICIDE BEREAVEMENT AND POSTVENTION RESEARCH 16
0
1960 – 1979 1980 - 1989 1990 - 1999 2000 - 2009 2010 - 2015

Figure 3. Time trend analysis of research

Adults 0 0
output. 7 34 78 83

Children & Young 0 1 5 30 34 32

People

Mixed 0 1 8 16 40 44

Not Stated/Unclear 1 1 2 6 10 10

0 1 20 1 20 5 10 0 10 20 30 40 0 50 0 50 100
1960-1969 1970-1979 1980-1989 1990-1999 2000-2009 2010-1015

Figure 4.
Figure 4.Distribution
Distributionofofage
agegroup
groupsamples.
samples.

additional interest on the impact of exposure to suicide people as an exclusive group was low. As presented in Fig-
Other
death was reflected in an increase
Professionals 3% in the number of papers ure 4, over the span of 50 years, papers using adult sam-
(n = 53) being11%
published on that topic. Overall, the rate ples constituted nearly half of all of the papers published
of research productivity was greater during the few years (n = 202, 45.5%) with 24.6% of articles using mixed age
between 2010 and 2015 (n = 169) than the number pro- samples. However, over a 25-year period beginning in
duced during the whole of the previous decade where only the 1990s there was a substantial increase in attention to
162 papers were published. Two new topicsKin of interest dur- the effects of suicide bereavement on youth, those under
48%
ing the years 2010–2015Mixed included research on the reac- the age of 25, with 96 papers being published during that
tions and perceptions of those bereaved by suicide toward
Kin/Nonkin time. While the effects of suicide on first-degree relatives
22%
media reporting, and ethnographic research on cultural remained a concern, there also appeared to be a recent in-
minority and Aboriginal groups and suicide bereavement. crease in focus on the effects of suicide on nonkin in the
Nonkin
A detailed overview of the 16% study focus of included re- broader community across the age groups.
cords by decade may be seen in Figure 2.

Productivity Over Time
Figure 5. Population group samples.
In assessing research productivity over time, a time trend
analysis of the included papers in this review (Figure 3) in-
dicate an upward movement in research output over the
past 50 years, especially those published during the past
two decades.
Samples
Age Groups
While interest in field of suicide bereavement and postven-
tion took hold in the late 1960s, the interest in studying su-
icide bereavement and postvention in children and young
Population Groups
As indicated in Figure 5, nearly half of the publications in-
cluded in the study (n = 212, 48%) samples consisted of
first degree relatives or other close family members to the
person who had died by suicide. Another 16% (n = 71) of
papers investigated the impact of suicide on non-kin popu-
lations whilst a further 22% (n = 99) used samples drawn
from a mixture of relatives, friends and peers bereaved by
suicide. In fifty cases (11%) researchers investigated the
impact of suicide on frontline professionals such as mental
health clinicians, school counselors, teachers, clergy, mili-
tary veterans and students. Of these, 16 papers considered
the attitudes and reactions of medical practitioners and
therapists to the suicide of their patients.

© 2017 Hogrefe Publishing Crisis (2018), 39(4), 275–282

Figure 4. Distribution of age group samples.
280 M. Maple et al., Review of Suicide Bereavement and Postvention Research
Other
Professionals 3%
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11%
Kin
48%
Mixed
Kin/Nonkin
22%
Nonkin
16%
Figure 5. Population group samples.
Geographic Spread
Figure 5. Population group samples.
Sample populations of the 443 papers included in the re-
view originated from 34 countries (acknowledging our
sampling inclusion criteria of English-language papers).
Starting in 1996, and increasing recently, papers drew
upon population samples from multicountry sites (12
quantitative and two qualitative) indicating an increasing
interest in engaging in collaborative research partnerships.
Applying the World Bank (Fantom & Serajuddin, 2016)
classification of countries by high and low income, an
analysis of the five most common study locations (for both
single and multicountry sample sites) indicates that since
1965, 76% of papers have been conducted in five high-in-
come countries, that is, the United States (n = 211), Aus-
tralia (n = 30), United Kingdom (n = 25), Sweden (n = 26),
and Canada (n = 23). Paradoxically, a review of the re-
search output in the five countries where the suicide rates
per population are substantially higher when compared
with the mentioned five high-income countries was vir-
tually nonexistent with only one paper from South Korea
(Lee, Kim, & Shim, 2013) being published in the past 50
years.
Overall, high-income countries constituted a majority of
the research output with 93.2% (n = 413) of papers being
published. Upper medium-income countries such as Chi-
na, South Africa, and Thailand produced 2.4% (n = 11) of
research, while lower-income countries (Cambodia, India,
Nicaragua, and Uganda) were represented in 1.1% of arti-
cles. A further 3.1% (n = 14) of papers were made up of re-
search from either high-income countries (United States,
Crisis (2018), 39(4), 275–282
Australia, and the United Kingdom) or low-income coun-
tries (Nicaragua and Cambodia) or a combination of both.
Discussion
The aims of this paper were to map the research published
on the topic of suicide bereavement and postvention, to
determine where and what has been published, to identify
gaps in the published research, in order to provide a pro-
spective map of areas of need for future research. A total of
443 studies were included in the analysis. Since 1965, the
global research activity in the field of suicide bereavement
and postvention is approximately 8.86 papers per year.
While there has been growing interest in research in this
area, studies have primarily been research on correlational
relationships between variables (n = 265, 59.8%) and de-
scriptive (n = 154, 34.7%) studies.
There are significant gaps in the published literature
that require the attention of future research. These are list-
ed here for researchers to consider when designing future
postvention and bereavement research:
•• Reaction to suicide death beyond kinship and those who seek
help. Currently there is a significant reliance on samples
dominated by kin and those who are already proactively
seeking assistance and/or support following a death by
suicide. This limits research on nonkin and those who
do not seek help. Two recent systematic reviews clear-
ly demonstrate this in relation to kin (Pitman, Osborn,
King, & Erlangsen, 2014) and nonkin (Maple, Cerel,
Sanford, Pearce, & Jordan, 2017) to determine the risk
that has been attributed to those exposed to suicide.
This risk, now well established, requires methodologi-
cal creativity to further explore this in individuals who
are not actively seeking support (Maple, Cerel, Jordan,
& McKay, 2014).
•• Underrepresentation of minority groups and lower-income
samples. While a limitation of this paper is the Eng-
lish-language inclusion criteria, a significant issue that
requires urgent attention is the paucity of research being
conducted with minority groups (Aboriginal; culturally
and linguistically diverse groups; gay, lesbian, bisexual,
transgender, and/or intersex people; people with disa-
bility, etc.) and from lower-income countries. Given the
proportionally higher suicide rates among these groups
and subsequent higher exposure to suicide along with
marginalization from support services, the postvention
needs of these groups require urgent attention.
•• Intervention/control studies and translation across con-
texts. Rigorous evaluation of existing postvention servic-
es, along with adaptation of those showing promise to a
variety of locations, is required to determine for whom
© 2017 Hogrefe Publishing
 M. Maple et al., Review of Suicide Bereavement and Postvention Research
support is needed, when the optimum time for support
is, and the length of time that such support is required in
${protocol}://econtent.hogrefe.com/doi/pdf/10.1027/0227-5910/a000498 - Karl Andriessen <karl.andriessen@gmail.com> - Tuesday, August 14, 2018 8:27:19 PM - IP Address:128.250.0.123
order to understand the full utility of postvention across
groups and cultural contexts.
•• Ongoing barriers to suicide bereavement and postvention
research. These have been documented elsewhere and
include lack of nomenclature and robust methodologi-
cal design (Andriessen & Krysinska, 2012) and ethical
issues (Moore, Maple, Mitchell, & Cerel, 2013) that
need to be conscientiously addressed in future research.
Strengths and Limitations cess by those impacted by suicide. This provides support
This systematic review was undertaken using a rigorous
and methodical screening and recording process. The
quality of the data extraction process was ensured by the
involvement of multiple reviewers coding papers and the
inclusion of a second review round where records were re-
checked for accuracy and completeness by other reviewers
on the team. A variety of databases covering multiple sub-
ject areas and journals from a range of disciplinary fields
were searched using strategies that were highly sensitive
to the point where data saturation was achieved and the
maximum number of records identified. At this stage of
searching, no limitations were placed on study outcomes
to ensure the retrieval of a broad range of suicide bereave-
ment- and postvention-relates studies. The findings of this
review have allowed for the identification and confirma-
tion of critical gaps in knowledge in this emerging field of
research. This provides a systematic background for the
research currently underway that was simultaneously un-
dertaken and published elsewhere (Andriessen, Castelli
Dransart, Cerel, & Maple, 2017).
While steps were taken to minimize any limitations, the
authors acknowledge that the review may have been im-
pacted by several methodological weaknesses. Although
the search strategies were highly sensitive, some papers
may have been missed due to a lack of standardized termi-
nology in the field of suicide bereavement and postvention.
The search strategy was restricted to English-language
journals, which skewed the results toward predominate-
ly high-income and higher-income countries such as the
United States, Australia, and the United Kingdom. In turn,
this will also have impacted on the outcome of the biblio-
metric analysis where analysis of the geographic spread of
research output was limited only to studies included in this
review. The databases used to search for relevant papers
may also have contributed to a publication bias where the
focus is on research from developed countries. Further, not
all electronic databases retrieve results as far back as 1960
and manual searches were not conducted. These limita-
© 2017 Hogrefe Publishing
281
tions could not be overcome within the resources available
to the research team.
A significant challenge in undertaking this task was the
lack of standardization in terminology and definitions used
across the literature. This issue has also been noted in the
broader field of suicidology (Silverman, 2016). The utility
of set nomenclature not only assists with searching the lit-
erature, but also with assessing the topic under investiga-
tion. A newly proposed continuum of survivorship (Cerel,
McIntosh, Neimeyer, Maple, & Marshall, 2014) should go
some way in addressing this challenge in the future.
Many studies in the review were limited by small sample
sizes due to poor participation rates in the research pro-
to the ongoing issue of how to improve participation rates
in research by those bereaved by suicide. Only five of the
443 papers explored the barriers and the drivers that ei-
ther prevent or encourage research participation by those
bereaved by suicide.
A biased trend toward the production of research origi-
nating in high-income countries is a common issue identi-
fied by review research. Ongoing debates on the cause of
this problem point to the partiality of westernized databas-
es toward research content generated from high-income
economies, editorial bias, and the readership and citation
limitations that come with health-related journals from
non-English countries. Additionally, a paucity of studies
from low- and middle-income countries may also be at-
tributed to an ongoing lack of health research funding in
developing countries (Muula, 2008).
Conclusion
With the rise in suicide bereavement and postvention re-
search and in the absence of an all-inclusive systematic
mapping review and bibliometric analysis of empirical
research in this field, this paper aimed to understand the
trends and patterns of research productivity in the field
of suicide bereavement and postvention. The review of
the studies in the field of suicide bereavement/postven-
tion reveals that the research productivity has increased
significantly over the past 50 years. The quality of post-
vention studies has been attributed to a number of issues,
including design and methodological flaws, gender bias,
lack of cultural diversity and definitional issues (Maple et
al., 2014). This study will be of value to the broader sui-
cide bereavement and postvention research community
through the formulation of a clear direction for research.
Ultimately this should also be beneficial to new research-
ers entering the field, as they carve out new areas for explo-
ration, as well as for established researchers collaborating,
Crisis (2018), 39(4), 275–282
 282
applying for research funding and contributing to local,
national and international policy discussions on suicide
${protocol}://econtent.hogrefe.com/doi/pdf/10.1027/0227-5910/a000498 - Karl Andriessen <karl.andriessen@gmail.com> - Tuesday, August 14, 2018 8:27:19 PM - IP Address:128.250.0.123
bereavement and postvention.
Acknowledgments
An earlier version of this paper was read as a presentation
at the XXVIII IASP World Congress, June 16–20, 2015, in
Montreal, Canada. This work was undertaken as a task-
force of the IASP Special Interest Group on Suicide Be-
reavement and Postvention.
The authors have no conflict of interest to report.
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Myfanwy Maple, BSW, PhD, is Professor of Social Work in the School of
Health at the University of New England, New South Wales, Australia.
Her research focuses on suicide exposure and bereavement, suicide
attempt survivors and trauma, and qualitative methods.
Tania Pearce is a social worker, research assistant, and PhD student
in the School of Health at the University of New England (UNE), New
South Wales, Australia. Her research interests include health program
evaluation and translation of knowledge into practice.
Rebecca L. Sanford, PhD, MSSA, is a lecturer in the School of Social
Work and Human Service at Thompson Rivers University, Canada. She
is a clinical social worker and researcher focused on the suicide be-
reavement trajectory, disenfranchised grief and ambiguous loss, and
the development and dissemination of interventions for the bereaved.
Dr. Cerel is a licensed clinical psychologist and professor in the Col-
lege of Social Work at the University of Kentucky, USA. Her research
has focused on suicide exposure and bereavement, suicide attempt
survivors, and suicide prevention. She currently serves as President of
the American Association of Suicidology. She is the author of over 50
academic publications and co-author of Seeking Hope: Stories of the
Suicide Bereaved.
Dolores Angela Castelli Dransart, PhD, is a social worker and professor
at the School of Social Work Fribourg, University of Applied Sciences
and Arts Western Switzerland. Her teaching and research interests
include the various impacts of suicide and suicidality on families and
professionals, postvention, assisted suicide, end-of-life decisions, ag-
ing, and identity transitions.
Karl Andriessen, MSuicidology, is a PhD researcher at the School of
Psychiatry, University of New South Wales, Sydney, Australia, support-
ed by a research grant of the Anika Foundation for Adolescent Depres-
sion and Suicide. He has published widely on suicide prevention and
postvention, including the 2017 volume: Postvention in Action: The In-
ternational Handbook of Suicide Bereavement Support.
Myfanwy Maple
School of Health
University of New England
Armidale, NSW
Australia
mmaple2@une.edu.au
© 2017 Hogrefe Publishing