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Protocol - Reactions to Loss

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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

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                                          

1

2

3

4

5

6

2. Listened to music to cope with the loss         

1

2

3

4

5

6

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

1

2

3

4

5

6

4. Kept thoughts and feelings about the loss to myself 

1

2

3

4

5

6

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

1

2

3

4

5

6

6. I tried to forget the whole thing

1

2

3

4

5

6

7. Overate because of the loss

1

2

3

4

5

6

8. I became a more tolerant person following the loss

1

2

3

4

5

6

9. Had trouble eating because of the loss  

1

2

3

4

5

6

10. Took prescription medication because of the loss

1

2

3

4

5

6

11. Engaged in increased physical activity after the loss 

1

2

3

4

5

6

12. Talked to a counselor about the loss    

1

2

3

4

5

6

13. I worried more about ordinary things

1

2

3

4

5

6

14. Thought about suicide because of the loss        

1

2

3

4

5

6

15. Wrote in a journal about the loss

1

2

3

4

5

6

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

1

2

3

4

5

6

17. Used alcohol or drugs to cope with the loss       

1

2

3

4

5

6

18. I tried hard not to think about the loss   

1

2

3

4

5

6

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

1

2

3

4

5

6

20. Missed classes because of the loss

1

2

3

4

5

6

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

1

2

3

4

5

6

22. Change in amount of sexual activity following the loss 

1

2

3

4

5

6

23. I found myself feeling more self-confident        

1

2

3

4

5

6

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

1

2

3

4

5

6

25. Withdrew from friends and family because of the loss   

1

2

3

4

5

6

26. Slept more or less because of the loss

1

2

3

4

5

6

27. Engaged in decreased physical activity after the loss

1

2

3

4

5

6

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

1

2

3

4

5

6

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

1

2

3

4

5

6

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

1

2

3

4

5

6

31. I felt hopeless about anything improving in my life

1

2

3

4

5

6

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

1

2

3

4

5

6

33. I rediscovered what is important in life

1

2

3

4

5

6

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

1

2

3

4

5

6

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

1

2

3

4

5

6

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

1

2

3

4

5

6

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

1

2

3

4

5

6

38. I refused to believe this had happened

1

2

3

4

5

6

39. This loss has caused me to question my beliefs

1

2

3

4

5

6

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

1

2

3

4

5

6

41. Blamed self for the loss

1

2

3

4

5

6

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

1

2

3

4

5

6

43. Talking about the loss helped me feel better        

1

2

3

4

5

6

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

1

2

3

4

5

6

45. Blamed others for the loss

1

2

3

4

5

6

46. Felt lack of control because of the loss

1

2

3

4

5

6

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

1

2

3

4

5

6

48. I could not stop thinking about the loss

1

2

3

4

5

6

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

1

2

3

4

5

6

50. I tried to understand my reaction to this loss

1

2

3

4

5

6

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

1

2

3

4

5

6

52. I wished this was all over and behind me            

1

2

3

4

5

6

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

1

2

3

4

5

6

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

1

2

3

4

5

6

55. Accept the loss since nothing can be done         

1

2

3

4

5

6

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

1

2

3

4

5

6

57. Found new faith

1

2

3

4

5

6

58. Criticized or lectured myself

1

2

3

4

5

6

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

1

2

3

4

5

6

60. I hoped for a miracle

1

2

3

4

5

6

61. I wished I could change how I was feeling

1

2

3

4

5

6

62. Felt guilt about the loss

1

2

3

4

5

6

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

1

2

3

4

5

6

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

1

2

3

4

5

6

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

1

2

3

4

5

6

66. I wished that this had never happened

1

2

3

4

5

6

67. Re-lived the loss

1

2

3

4

5

6

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

1

2

3

4

5

6

69. I felt more inadequate than ever after the loss      

1

2

3

4

5

6

70. I was inspired to do something creative           

1

2

3

4

5

6

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

1

2

3

4

5

6

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

1

2

3

4

5

6


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 CategoryRequired
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
StandardNameIDSource
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 IDVariable DescriptiondbGaP Mapping
PX870501_Reactions_Loss_Accept_Nothing_Done
PX870501550000 "Accept the loss since nothing can be done more 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 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 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 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 N/A
PX870501_Reactions_Loss_Missed_Classes
PX870501200000 "Missed classes because of the loss more 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 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 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 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 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.