Predicting Complicated Grief Symptoms in Employed Women with a History of Miscarriage Based on Integrative Self-Knowledge: The Mediating Role of Distress Tolerance and Guilt

Document Type : Original Article

Authors

1 Master of Science in Health Psychology, Department of Psychology, Qom Branch, Islamic Azad University, Qom, Iran

2 Master of Science in Health Psychology, Department of Psychology, Qom Branch, Islamic Azad University, Qom, Iran.

10.22111/ijop.2026.55478.1083

Abstract

The present study aimed to predict complicated grief symptoms in employed women with a history of miscarriage based on integrative self-knowledge through the mediating roles of distress tolerance and guilt. This applied research employed a descriptive-correlational design. The statistical population included all employed women with previous miscarriage experiences in Qom City during the winter of 2025, from whom 270 participants were selected through purposive sampling. The research instruments comprised the Hogan Grief Reaction Checklist (Hogan et al., 2001), the Integrative Self-Knowledge Scale (Ghorbani et al., 2003), the Distress Tolerance Scale (Simons & Gaher, 2005), and the Guilt Inventory (Kugler & Jones, 1992). Data were analyzed using path analysis with SPSS-23 and AMOS-23. The results showed that complicated grief symptoms in employed women with miscarriage experiences were significantly predicted by integrative self-knowledge through the mediating effects of distress tolerance (β=–0.192, p<.001) and guilt (β=–0.231, p<.001). Overall, complicated grief was directly predicted by integrative self-knowledge, distress tolerance, and guilt, while integrative self-knowledge also exerted indirect effects on grief intensity through these mediators. These findings underscore the importance of interventions aimed at enhancing integrative self-knowledge and distress tolerance to promote psychological adjustment in this population. Consequently, psychological counseling programs should emphasize training in distress tolerance skills and guilt reduction, alongside strengthening identity coherence, to facilitate adaptive grief processing and prevent the persistence of complicated grief symptoms.

Keywords

References

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Iranian Journal of Organizational psychology
Volume 3, Issue 2
September 2026
Pages 51-58

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