Protocol - Reactions to Loss

Description

The Reactions to Loss Scale (RTL) is a self-administered questionnaire to assess reactions to death and non-death losses. Each item is scored on a Likert-style scale from 1 (Never) to 6 (Always) to indicate how the participant reacted to the loss. The protocol includes three subscales for positive reappraisal (21 items), avoidance (20 items), and loss of control (29 items).

Specific Instructions

Investigators conducting research on grief and loss should adequately prepare respondents because this questionnaire could be triggering for people who have experienced a traumatic loss. Participants are first asked to identify the most significant loss that they have experienced in the last 12 months.

Items 10 and 55 did not fit in any of the subscales and could be excluded.

Availability

Available

Download PDF

Protocol

Reactions to Loss Scale

Following this most significant event or loss, I reacted in the following ways:

Never
1

Rarely
2

Some-times
3

Often
4

Very Often
5

Always
6

1. Cried about the loss

2. Listened to music to cope with the loss

3. I felt my emotions were out of control after the loss

4. Kept thoughts and feelings about the loss to myself

5. I found myself feeling positive about my life before the loss.

6. I tried to forget the whole thing

7. Overate because of the loss

8. I became a more tolerant person following the loss

9. Had trouble eating because of the loss

10. Took prescription medication because of the loss

11. Engaged in increased physical activity after the loss

12. Talked to a counselor about the loss

13. I worried more about ordinary things

14. Thought about suicide because of the loss

15. Wrote in a journal about the loss

16. Engaged in religious, spiritual, or personally meaningful activities to make sense of the loss

17. Used alcohol or drugs to cope with the loss

18. I tried hard not to think about the loss

19. I am better able to empathize with others after the loss

20. Missed classes because of the loss

21. Engaged in more distracting activities such as watching T.V. because of the loss

22. Change in amount of sexual activity following the loss

23. I found myself feeling more self-confident

24. I made a promise to myself that things would be different next time

25. Withdrew from friends and family because of the loss

26. Slept more or less because of the loss

27. Engaged in decreased physical activity after the loss

28. I was able to control my feelings about the loss so that they did not interfere with my life

29. I started to see some positives in my life after the loss

30. I had a hard time trusting others after this loss

31. I felt hopeless about anything improving in my life

32. I began to feel stronger because of dealing with the loss

33. I rediscovered what is important in life

34. I had a very difficult time overcoming my feelings of guilt about the loss

35. I felt a lot of anger and resentment after the loss

36. I continued to be optimistic about my future even after the loss

37. This loss has made me question my future; it looks bleak

38. I refused to believe this had happened

39. This loss has caused me to question my beliefs

40. My relationships with others have been strengthened through dealing with this loss

41. Blamed self for the loss

42. Talking about the loss only made me feel worse about it

43. Talking about the loss helped me feel better

44. Had trouble concentrating on my studies because of the loss

45. Blamed others for the loss

46. Felt lack of control because of the loss

47. I experienced deeper love for some people in my life

48. I could not stop thinking about the loss

49. Felt this loss would have a big effect on my future

50. I tried to understand my reaction to this loss

51. I thought about how things would be if this had not happened

52. I wished this was all over and behind me

53. I found my life to be even more interesting following the loss

54. I tried to go on as if nothing had happened

55. Accept the loss since nothing can be done

56. Changed or grew as a person in a good way

57. Found new faith

58. Criticized or lectured myself

59. I found myself meeting the challenges created by the loss

60. I hoped for a miracle

61. I wished I could change how I was feeling

62. Felt guilt about the loss

63. The loss caused me to think about other losses in my life

64. I tried to keep my feelings from interfering too much with what I had to do

65. I found I could still laugh even after the loss

66. I wished that this had never happened

67. Re-lived the loss

68. Engaged in more care-taking behaviors of others after the loss

69. I felt more inadequate than ever after the loss

70. I was inspired to do something creative

71. Increased desire to help others in need after the loss

72. Engaged in behaviors to "make-up" for my role in the loss

Scoring:

A score for each subscale can be computed as either a total score or an average for the individual items. Higher scores indicate greater reactions for each subscale.

Positive Reappraisal: items 2, 5, 8, 11, 16, 19, 23, 29, 32, 33, 36, 40, 43, 47, 53, 56, 57, 59, 68, 70, 71

Avoidance: items 4, 6, 13, 18, 24, 30, 35, 38, 41, 42, 45, 51, 52, 54, 58, 61, 62, 64, 66, 72

Loss of Control: items 1, 3, 7, 9, 12, 14, 15, 17, 20, 21, 22, 25, 26, 27, 31, 34, 37, 39, 44, 46, 48, 49, 50, 60, 63, 67, 69, 28, 65

Personnel and Training Required

Investigators conducting research on grief and loss should be trained in clinical skills to introduce, prepare, and debrief respondents following the questionnaire.

Equipment Needs

None

Requirements

Requirement Category	Required
Major equipment	No
Specialized training	No
Specialized requirements for biospecimen collection	No
Average time of greater than 15 minutes in an unaffected individual	Yes

Mode of Administration

Self-administered questionnaire

Lifestage

Adult

Participants

Adults, ages 18 years and older

Selection Rationale

The Reactions to Loss Scale (RTL) is valid, reliable, and includes measures of both positive and negative affect.

Language

English

Standards

Standard	Name	ID	Source

Derived Variables

None

Process and Review

Not applicable

Protocol Name from Source

Reactions to Loss Scale (RTL)

Source

Cooley, E., Toray, T., & Roscoe, L. (2010). Reactions to Loss Scale: Assessing grief in college students. Omega, 61(1), 25-51.

General References

Cooley, E., Toray, T., & Roscoe, L. (2013). Assessing effective coping with bereavement in college students: The Reactions to Loss Scale. Omega, 68(3), 241-257.

Olwit, C., Mugaba, M., Osingada, C. P., & Nabirye, R. C. (2018). Existence, triggers, and coping with chronic sorrow: A qualitative study of caretakers of children with sickle cell disease in a National Referral Hospital in Kampala, Uganda. BMC Psychology, 6(1), 50.

Sirrine, E. H., Kliner, O., & Gollery, T. J. (2021). College student experiences of grief and loss amid the COVID-19 global pandemic. OMEGA - Journal of Death and Dying, 00302228211027461.

Smid, G. E., Groen, S., de la Rie, S. M., Kooper, S., & Boelen, P. A. (2018). Toward cultural assessment of grief and grief-related psychopathology. Psychiatric Services, 69(10), 1050-1052.

Protocol ID

870501

Variables

Export Variables

Variable Name	Variable ID	Variable Description	dbGaP Mapping
PX870501_Reactions_Loss_Accept_Nothing_Done
	PX870501550000	"Accept the loss since nothing can be done more " show less	N/A
PX870501_Reactions_Loss_Better_Empathize_With_Others
	PX870501190000	"I am better able to empathize with others more after the loss" show less	N/A
PX870501_Reactions_Loss_Blamed_Others
	PX870501450000	"Blamed others for the loss"	N/A
PX870501_Reactions_Loss_Blamed_Self
	PX870501410000	"Blamed self for the loss"	N/A
PX870501_Reactions_Loss_Caused_think_Other_Losses
	PX870501630000	"The loss caused me to think about other more losses in my life" show less	N/A
PX870501_Reactions_Loss_Change_Grew_Person_Good
	PX870501560000	"Changed or grew as a person in a good way "	N/A
PX870501_Reactions_Loss_Change_Sexual_Activities
	PX870501220000	"Change in amount of sexual activity more following the loss " show less	N/A
PX870501_Reactions_Loss_Control_Feelings_Not_Interfere_With_Life
	PX870501280000	"I was able to control my feelings about the more loss so that they did not interfere with my life " show less	N/A
PX870501_Reactions_Loss_Could_Not_Stop_Thinking
	PX870501480000	"I could not stop thinking about the loss"	N/A
PX870501_Reactions_Loss_Cried
	PX870501010000	"Cried about the loss more " show less	N/A
PX870501_Reactions_Loss_Criticized_Lectured_Myself
	PX870501580000	"Criticized or lectured myself"	N/A
PX870501_Reactions_Loss_Difficult_Time_Overcoming_Feeling_Guilt
	PX870501340000	"I had a very difficult time overcoming my more feelings of guilt about the loss " show less	N/A
PX870501_Reactions_Loss_Emotions_Out_Control
	PX870501030000	"I felt my emotions were out of control more after the loss" show less	N/A
PX870501_Reactions_Loss_Engaged_Behaviors_Makeup_Role
	PX870501720000	"Engaged in behaviors to "make-up" for my more role in the loss" show less	N/A
PX870501_Reactions_Loss_Engaged_Care_Behaviors
	PX870501680000	"Engaged in more care-taking behaviors of more others after the loss " show less	N/A
PX870501_Reactions_Loss_Engaged_Decreased_Physical_Activity
	PX870501270000	"Engaged in decreased physical activity more after the loss" show less	N/A
PX870501_Reactions_Loss_Engaged_Distracting_Activities
	PX870501210000	"Engaged in more distracting activities such more as watching T.V. because of the loss" show less	N/A
PX870501_Reactions_Loss_Experienced_Deeper_Love
	PX870501470000	"I experienced deeper love for some people more in my life " show less	N/A
PX870501_Reactions_Loss_Feeling_Positive_Life_Before
	PX870501050000	"I found myself feeling positive about my more life before the loss." show less	N/A
PX870501_Reactions_Loss_Feeling_Self_Confident
	PX870501230000	"I found myself feeling more self-confident more " show less	N/A
PX870501_Reactions_Loss_Feel_Stronger
	PX870501320000	"I began to feel stronger because of dealing more with the loss " show less	N/A
PX870501_Reactions_Loss_Felt_Anger_Resentment
	PX870501350000	"I felt a lot of anger and resentment after more the loss " show less	N/A
PX870501_Reactions_Loss_Felt_Guilt
	PX870501620000	"Felt guilt about the loss"	N/A
PX870501_Reactions_Loss_Felt_Hopeless_Anything_Improving
	PX870501310000	"I felt hopeless about anything improving in more my life" show less	N/A
PX870501_Reactions_Loss_Felt_More_Inadequate_After
	PX870501690000	"I felt more inadequate than ever after the more loss " show less	N/A
PX870501_Reactions_Loss_Felt_Would_Have_Big_Effect_Future
	PX870501490000	"Felt this loss would have a big effect on more my future" show less	N/A
PX870501_Reactions_Loss_Found_Could_Laugh_After
	PX870501650000	"I found I could still laugh even after the more loss " show less	N/A
PX870501_Reactions_Loss_Found_Life_Interesting
	PX870501530000	"I found my life to be even more interesting more following the loss " show less	N/A
PX870501_Reactions_Loss_Found_Myself_Meeting_Challenges_Created
	PX870501590000	"I found myself meeting the challenges more created by the loss" show less	N/A
PX870501_Reactions_Loss_Found_New_Faith
	PX870501570000	"Found new faith"	N/A
PX870501_Reactions_Loss_Hard_Time_Trusting_others
	PX870501300000	"I had a hard time trusting others after more this loss " show less	N/A
PX870501_Reactions_Loss_Hoped_Miracle
	PX870501600000	"I hoped for a miracle"	N/A
PX870501_Reactions_Loss_Increased_Desire_help_Others
	PX870501710000	"Increased desire to help others in need more after the loss " show less	N/A
PX870501_Reactions_Loss_Inspired_Something_Creative
	PX870501700000	"I was inspired to do something creative more " show less	N/A
PX870501_Reactions_Loss_Kept_Thought_myself
	PX870501040000	"Kept thoughts and feelings about the loss more to myself" show less	N/A
PX870501_Reactions_Loss_Lack_Control
	PX870501460000	"Felt lack of control because of the loss"	N/A
PX870501_Reactions_Loss_Listened_Music_Cope
	PX870501020000	"Listened to music to cope with the loss more " show less	N/A
PX870501_Reactions_Loss_Missed_Classes
	PX870501200000	"Missed classes because of the loss more " show less	N/A
PX870501_Reactions_Loss_More_Tolerant
	PX870501080000	"I became a more tolerant person following more the loss" show less	N/A
PX870501_Reactions_Loss_Optimistic_Future
	PX870501360000	"I continued to be optimistic about my more future even after the loss " show less	N/A
PX870501_Reactions_Loss_Overate
	PX870501070000	"Overate because of the loss"	N/A
PX870501_Reactions_Loss_Physical_Activity_After
	PX870501110000	"Engaged in increased physical activity more after the loss " show less	N/A
PX870501_Reactions_Loss_Promise_Myself_Things_Different_Next
	PX870501240000	"I made a promise to myself that things more would be different next time " show less	N/A
PX870501_Reactions_Loss_Question_Beliefs
	PX870501390000	"This loss has caused me to question my beliefs"	N/A
PX870501_Reactions_Loss_Question_Future_Bleak
	PX870501370000	"This loss has made me question my future; more it looks bleak " show less	N/A
PX870501_Reactions_Loss_Rediscovered_Important_Life
	PX870501330000	"I rediscovered what is important in life"	N/A
PX870501_Reactions_Loss_Refused_Believe
	PX870501380000	"I refused to believe this had happened"	N/A
PX870501_Reactions_Loss_Releationships_Strengthened
	PX870501400000	"My relationships with others have been more strengthened through dealing with this loss" show less	N/A
PX870501_Reactions_Loss_Religious_Spritual_Personally_Meaningful_Activities
	PX870501160000	"Engaged in religious, spiritual, or more personally meaningful activities to make sense of the loss" show less	N/A
PX870501_Reactions_Loss_Relived
	PX870501670000	"Re-lived the loss"	N/A
PX870501_Reactions_Loss_See_Positives_Life
	PX870501290000	"I started to see some positives in my life more after the loss " show less	N/A
PX870501_Reactions_Loss_Slept_More
	PX870501260000	"Slept more or less because of the loss"	N/A
PX870501_Reactions_Loss_talked_Counselor
	PX870501120000	"Talked to a counselor about the loss "	N/A
PX870501_Reactions_Loss_Talking_Feel_Worse
	PX870501420000	"Talking about the loss only made me feel more worse about it" show less	N/A
PX870501_Reactions_Loss_Talking_Helped_Feel_Better
	PX870501430000	"Talking about the loss helped me feel more better " show less	N/A
PX870501_Reactions_Loss_Thought_How_Things_Would_Be_If_Not_Happened
	PX870501510000	"I thought about how things would be if this more had not happened " show less	N/A
PX870501_Reactions_Loss_Thought_Suicide
	PX870501140000	"Thought about suicide because of the loss more " show less	N/A
PX870501_Reactions_Loss_Took_Prescription_Medication
	PX870501100000	"Took prescription medication because of the loss"	N/A
PX870501_Reactions_Loss_Tried_Forget
	PX870501060000	"I tried to forget the whole thing"	N/A
PX870501_Reactions_Loss_Tried_Go_Nothing_Happened
	PX870501540000	"I tried to go on as if nothing had happened more " show less	N/A
PX870501_Reactions_Loss_Tried_Keep_Feelings_Interfering
	PX870501640000	"I tried to keep my feelings from more interfering too much with what I had to do " show less	N/A
PX870501_Reactions_Loss_Tried_Not_Think_About
	PX870501180000	"I tried hard not to think about the loss "	N/A
PX870501_Reactions_Loss_Tried_Understand_Reaction
	PX870501500000	"I tried to understand my reaction to this loss"	N/A
PX870501_Reactions_Loss_Trouble_Concentrating_Studies
	PX870501440000	"Had trouble concentrating on my studies more because of the loss" show less	N/A
PX870501_Reactions_Loss_Trouble_Eating
	PX870501090000	"Had trouble eating because of the loss "	N/A
PX870501_Reactions_Loss_Used_Alcohol_Drugs_Cope
	PX870501170000	"Used alcohol or drugs to cope with the loss more " show less	N/A
PX870501_Reactions_Loss_Wished_Change_Feeling
	PX870501610000	"I wished I could change how I was feeling"	N/A
PX870501_Reactions_Loss_Wished_Never_Happened
	PX870501660000	"I wished that this had never happened"	N/A
PX870501_Reactions_Loss_Wished_Over_Behind
	PX870501520000	"I wished this was all over and behind me more " show less	N/A
PX870501_Reactions_Loss_Withdrew_From_Friends_Family
	PX870501250000	"Withdrew from friends and family because of more the loss " show less	N/A
PX870501_Reactions_Loss_Worried_Ordinary_Things
	PX870501130000	"I worried more about ordinary things"	N/A
PX870501_Reactions_Loss_Wrote_Journal
	PX870501150000	"Wrote in a journal about the loss"	N/A

SCD Psychosocial and Social Determinants of Health

Measure Name

Reactions to Loss

Release Date

February 6, 2023

Definition

A measure to assess symptoms of grief and response to loss.

Purpose

This measure assesses behavioral responses to a loss, which could be a death or non-death loss. Experiences of grief and loss and associated responses can affect mental health and physical functioning and may be important for conditions that lead to early aging such as sickle cell disease.

Keywords

sickle cell disease, SCD, psychosocial and social determinants of health, grief, loss, bereavement, depression, anxiety, grief, loss, early aging, social support

Measure Protocols

Protocol ID	Protocol Name
870501	Reactions to Loss

Publications

There are no publications listed for this protocol.