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Maccallum, Fiona Louise Psychology Faculty of Science UNSW. "Autobiographical memory in complicated grief." Publisher:University of New South Wales. Psychology, 2008. http://handle.unsw.edu.au/1959.4/43510.
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Complicated Grief (CG) has been identified as a potential consequence of bereavement that is associated with unique and debilitating outcomes. This thesis investigated autobiographical memory in CG. This program of research focused on the specificity and content of autobiographical memories in the context of CG. Study 1 investigated memory retrieval specificity using a cue word paradigm. Bereaved individuals with CG displayed an overgeneral retrieval style (OGM) compared to bereaved individuals without CG. Study 2 found that CG participants were also less specific in imagining future events in response to positive cues. Further, there was a significant independent relationship between memory retrieval specificity and the specificity of future imaginings. Study 3 investigated the relationship between overgeneral memory and social problem solving. CG participants performed more poorly on this task; however, there was no independent relationship with memory retrieval style. Study 4 investigated the impact of treatment on OGM. Results indicated that as symptoms of CG reduced following treatment, individuals retrieved more specific memories to positive cues. Studies 5-7 examined proposed relationships between self construct and autobiographical remembering in CG, as outlined in Conway and Pleydell-Pearce??s (2000) self memory system model. In Study 5, individuals with CG were more likely than bereaved controls to view their self-identity as being related to the deceased. Study 6 investigated the relationship between self-discrepancy, personal goals and memory content. CG individuals were more likely to recall loss-related memories, and there was a relationship between personal goals and memory content. Study 7 extended examination of these factors to future-related thinking. Finally, the program recognised the importance of investigating the impact of the cognitive strategies that individuals may adopt to manage painful memories. Using an experimental Stroop procedure as a measure of thought accessibility, Study 8 investigated thought suppression in CG. The results suggested that CG individuals experienced greater interference from death-related cues. In summary, these studies highlighted some of the key memory processes that may be involved in the maintenance, and potentially the resolution, of CG.
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Findlay, Jules. "Fragmentation : materialising mourning from complicated grief." Thesis, Royal College of Art, 2018. http://researchonline.rca.ac.uk/3465/.
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This research by project is asking whether the affect of embodied materiality can be materialised from complicated grief, in an investigation into the relationship between the affect of grief and the creative, embodied encounters with paper materials. In some types of traumatic loss, complicated grief can subsume the bereaved in a way like no other. Mourning can be a very difficult process. The research integrates creative practice, working with fibre-based materials, with the scholarly and cultural exploration of the literature and theory of mourning as a specific psychological state of mind. It is an exploration of the experience of mourning a complicated grief, through the sustained process of an embodied encounter with the materiality of making paper. Paper becomes the metaphor to discuss research questions that connect the maternal with affect in maternal grief, that paper can be the Symbolic and the body that inputs Cartesian culture is feminised using affect of the embodied encounter with materials. This research is not into art therapy, nor into art as illustrative of psychology. I use a hybrid approach to methodology, involving auto-ethnography and subjective experience as a medium through which to reflect on the relationship between materiality and affect. The substrate uses play; judgment is suspended, whilst the substrate is being handmade to create individual materiality. Culture and social theory, which enabled the methods of auto-ethnography and creative practice research to emerge, is the paradigm of postmodern and post positivist accounts of new relations between ‘subjectivity’ and ‘objectivity’. Moving forward from Glaser and Strauss’s thinking on grounded theory, display, together with reflective practice, is compatible with the emergence of feminist thinking on the significance of subjectivity and affect. The submission comprises a written dissertation, which reflects on the six years of creative practice, making new sense of the conventional silence surrounding complex mourning. The practice itself, connotes affect through the materialities of paper.
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Hawkes, Percy. "Complicated Grief and Melancholia| Identity-Questioning Issues." Thesis, Pacifica Graduate Institute, 2016. http://pqdtopen.proquest.com/#viewpdf?dispub=10076222.
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Through hermeneutic and heuristic research this thesis looks at melancholia or complicated grief with the contributing factor of identity questioning. From a depth psychological perspective, normal grief is differentiated from melancholia or complicated grief, which involves the unconscious. This exploration employs the theory of Allan Hugh Cole Jr., whose work on melancholia draws on that of Donald Capps, Erik Erikson, and Sigmund Freud. A disposition to melancholia, particularly in men, comes from the first abandonment by a primary parent, resulting in identity loss and resistance to resolution of grief. Factors such as trauma, sexual orientation, religion, or marginalized race can have exacerbating effect on melancholia and were found to have treatment implications. Ritual, art, play, humor, and dreams can be identity-conferring and restorative resources. The author proposes that melancholia with identity issues should be understood as a psychological problem that is distinct from, although it can prolong and complicate, grief.
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Robinaugh, Donald J., Christine Mauro, Eric Bui, Lauren Stone, Riva Shah, Yuanjia Wang, Natalia A. Skritskaya, et al. "Yearning and Its Measurement in Complicated Grief." TAYLOR & FRANCIS INC, 2016. http://hdl.handle.net/10150/620910.
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Persistent intense yearning for the deceased is a core clinical feature of complicated grief (CG) that distinguishes it from other mental disorders that develop following loss. The Yearning in Situations of Loss Scale (YSL) is a recently developed assessment of yearning. To assess the psychometric properties of the YSL in those with CG, we administered the YSL, Inventory of Complicated Grief, and Quick Inventory of Depression Symptomatology to 303 treatment-seeking bereaved adults with CG. Our results suggest the YSL is a reliable assessment with acceptable convergent and discriminant validity as a measure of yearning in those with CG.
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Golden, Ann-Marie Jelena. "Complicated grief (CG) : emotional and cognitive factors." Thesis, Open University, 2007. https://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.446278.
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McSpedden, Margaret. "Perinatal grief: complicated or what? an analysis of the symptoms of perinatal grief in two samples of bereaved mothers in Australia." Thesis, The University of Sydney, 2013. http://hdl.handle.net/2123/12217.
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Background: Perinatal grief, which affects parents whose babies die during pregnancy or within a year after birth, has been shown to lead to severe morbidity and, in some cases, mortality. Despite the assertion that all these parents are susceptible to developing complicated grief because of the nature of their loss, there has been little evidence to support this. However, some variables which may predict the likelihood of these bereaved mothers having unremitting, intense grief have previously been identified, including: maternal age, education, marital status, occupational status, other losses and the presence of living children. Objective: The present studies assessed perinatal grief and the impact of these variables on the risk of developing complicated grief using self-reported data in two separate samples of perinatally bereaved mothers (N = 121) and (N = 146) up to five years after their loss. In Study 2 other psychopathological symptoms, including: depression, anxiety, stress and post-traumatic stress were also assessed. Results: Contrary to expectations, findings indicated that the proportion of these mothers who experienced complicated grief, 12.5% in Study 1 and 18% in Study 2, was similar to other populations of grievers. In both studies those variables that had been suggested as indicative of higher risk for developing psychopathology were not supported except for the absence/presence of other children. Conclusion: Perinatally bereaved mothers report clinically significant symptoms of complicated grief as well as other psychopathology such as depression, anxiety, stress and post-traumatic stress at levels similar to other populations of grievers. The symptomology of these mothers should be routinely monitored to assess need for referral for treatment when indicated. Limitations, such as the convenience samples of participants and strengths, such as, quantitative design of the study, are addressed and implications are outlined.
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Drenth, Cornelia Maria. "Complicated grief in the South African context : a therapeutic intervention programme / Cornelia Maria (Nelia) Drenth." Thesis, North-West University, 2008. http://hdl.handle.net/10394/2623.
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Smith, Lucinda. "The application of mindfulness to complicated grief : an exploration of the effectiveness of using mindfulness based interventions in treating clients with complicated grief." Thesis, University of Southampton, 2007. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.440947.
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Robinaugh, Donald John. "Examining Cognitive Impairments in Bereaved Adults With and Without Complicated Grief." Thesis, Harvard University, 2015. http://nrs.harvard.edu/urn-3:HUL.InstRepos:23845061.
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Grief is a syndrome of cognitions, emotions, and behaviors that commonly arise together following the death of a loved one. It includes intense pangs of emotional pain, yearning for the deceased, emotional numbness, subjective difficulty imagining the future without the deceased, and preoccupation with thoughts related to the death and the deceased. In the initial months following loss, the majority of bereaved adults will experience some or even many elements of this syndrome. For most, the frequency and severity of these elements diminishes over time. However, for some, grief persists for years after the loss; a condition known as complicated grief (CG). These distinct grief trajectories raise a critically important question for grief research: why does grief persist in some individuals, but not others?
In this dissertation, I aimed to take an initial step toward answering this question. I first review recent advances in our understanding of the nature of CG and discuss the implications of these advances for research examining the etiology of CG. Most notably, I review how vulnerability factors that render bereaved adults susceptible to experiencing specific elements of the CG syndrome may contribute to the development or maintenance of CG. I then present three studies in which I examined cognitive impairments that may act as vulnerability factors for the core cognitive elements of CG and, thereby, may contribute to the broader CG syndrome.
In Paper 1, I examined the ability to resist distracter information and the ability to resist proactive interference; two types of cognitive inhibition that, if impaired, may render bereaved adults vulnerable to experiencing intrusive grief-related cognitions and, thus, the broader CG syndrome. Contrary to my hypotheses, I found no evidence that bereaved adults with CG exhibit deficits in either type of cognitive inhibition for either emotional or non-emotional information relative to a bereaved comparison group without CG. In Paper 2, I examined another type of cognitive control: the ability to shift between mental representations. Contrary to my hypotheses, bereaved adults with CG did not exhibit deficits in cognitive set shifting for either emotional or non-emotional information. In Paper 3, I examined the ability to engage in episodic simulation of novel future events. Consistent with my hypotheses, bereaved adults with CG produced event simulations with fewer episodic details, less perceptual richness, less emotion/thought content, and less episodic richness than did the bereaved comparison group.
Together, these studies provide a small step toward identifying cognitive vulnerabilities that may contribute to the development or maintenance of CG. Papers 1 and 2 suggest that general deficits in cognitive control are unlikely to feature prominently in the etiology of CG. Accordingly, in future studies, it will be important for researchers to examine alternative factors that may contribute to the preoccupying grief-related cognitions observed in CG, including cognitive control for more specific types of information than were assessed in this study (e.g., attachment- or grief-related information) and higher-order cognitive variables such as perceived explicability of the loss. Paper 3 providers further evidence that prospection is impaired in bereaved adults with CG and identifies impaired constructive episodic simulation of novel future events as a potential cognitive vulnerability that may contribute to the etiology of the broader CG syndrome.Psychology
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Anderson, Scott Robert. "Examination of Complicated Grief, Posttraumatic Stress, and Other Psychological Reactions among Student Survivors of the April 16th Shootings at Virginia Tech." Diss., Virginia Tech, 2013. http://hdl.handle.net/10919/37503.
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The diagnosis of Complicated Grief (CG) is being proposed for inclusion in DSMâ 5. As such, it has been the focus of several studies purporting to build evidence of its validity and its conceptual and statistical distinction from Posttraumatic Stress Disorder (PTSD) and depression (Bonanno et al., 2007; Golden & Dalgleish, 2010; Prigerson et al., 1995b). However, previous research has focused predominantly on bereavement caused by non-violent means (e.g., prolonged terminal illness). This study attempts to explore the nature of CG among a sample of students who survived a mass shooting. Exploratory and confirmatory factor analytic procedures were used to examine and confirm the factor structure of CG as reported in previous studies (e.g., Boelen & van den Bout, 2005; Dillen, Fontaine, & Verhofstadt-Denève, 2008). A refined CG scale was then used as a criterion to demonstrate how different types of traumatic exposure contribute to symptoms of CG and/or posttraumatic stress (PTS). It was hypothesized that exposure items related to bereavement would be more related to CG than to PTS, whereas direct exposure to the shootings would be more closely related to PTS than to CG. Results of exploratory and confirmatory factor analyses supported CG as a unitary construct distinct from PTS and from anxiety/depression. Logistic regression results demonstrated that bereavement status was significantly predicted by CG but not PTS: Participants who scored 1 standard deviation above the mean on the CG scale were 14.64 times more likely to have been bereaved than were those who scored at the mean. SEM analyses were used to provide an additional test of this hypothesis. The final model had acceptable fit as assessed by RMSEA = .046, CI = .043â .049, SRMR = .048, and CFI = .990; however, the Satorra-Bentler Scaled Ï 2 = 1507.82, df = 589, p < .001, did not support the model. Overall, results of SEM suggested that interpersonal loss (i.e., whether a friend was killed, injured, or escaped from the shootings) predicted CG but not PTS, whereas perceived threat predicted both CG and PTS.Ph. D.
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Allen, Jessica Y. "Bereavement Outcomes among Spousal Hospice Caregivers: The Role of Rumination, Feelings of Relief, and Perceived Suffering." Scholar Commons, 2012. http://scholarcommons.usf.edu/etd/4276.
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Background: The death of a spouse is among the most distressing life events faced by older adults and frequently follows long periods of providing extensive care and support. Although many spouses are resilient following loss, a number of bereaved spousal caregivers have poor psychological well-being and may benefit from clinical services. However, it can be difficult to determine who may most benefit from bereavement services and why some individuals are at greater risk for poor bereavement; thus, there is a need for greater understanding of the process of bereavement. Therefore, the purpose of this dissertation was to investigate a number of theoretically relevant factors within the context of bereavement after caregiving as possible predictors of psychological well-being following loss. Specifically, former caregivers' perceptions of loved ones' end-of-life suffering, rumination, and feelings of relief were investigated as possible predictors of caregivers symptoms of depression, grief, and complicated grief following loss.
Method: Participants included 61 former spousal caregivers of hospice patients 50 years of age or older who lost a spouse in the last 6-18 months. Individuals completed an interview that included retrospective recall of perceptions of loved ones' physical, emotional, and existential suffering, current frequency of thoughts about loved ones' suffering, stress-reactive rumination, and feelings of relief following the death. Participants also completed measures assessing current symptoms of depression, present feelings of grief, and complicated grief. Descriptive information about care recipients was obtained via retrospective review of hospice electronic medical records following participant interview. Several regression analyses were conducted to investigate the relationship of possible predictor variables to bereavement outcomes and interactions among predictor variables.
Results: Findings revealed important relationships between rumination, feelings of relief, and former caregivers' psychological well-being follow loss. Higher rumination and less feelings of relief were associated with worse bereavement outcomes. In addition, interaction analyses revealed that rumination and feelings of relief moderated the relationship between participants' perceptions of their spouses' emotional end-of-life suffering and psychological distress. Other descriptive predictors of depression, grief, and complicated grief were identified.
Discussion: Participants were highly distressed former caregivers who were highly engaged in caregiving duties prior to loss. About 40% reported no feelings of relief following the loss, and over one-fourth of participants still had frequent ruminations about their loved ones' suffering. High stress-reactive rumination was an important predictor of bereaved spouses' psychological distress. Clinical interventions, such as cognitive behavioral therapy, could focus on identifying, redirecting, and reducing distressing thoughts or the negative feelings associated with them, such as ruminations associated with loved ones' end-of-life suffering. Future longitudinal research should examine the relationships between rumination, feelings of relief, perceived suffering, and bereavement outcomes in order to identify patterns that may inform clinical interventions.
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McConnell, Mairead H., and Mairead H. McConnell. "Wanting What is Already Gone: Functional Imaging Differentiating Reward Components in Bereavement." Thesis, The University of Arizona, 2017. http://hdl.handle.net/10150/625269.
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Complicated grief, or persistent complex bereavement disorder, is a condition that affects approximately 10% of bereaved individuals and is marked by intense longing and yearning for the deceased. Little is known about the neurocognitive mechanisms contributing to this syndrome, but previous research suggests that reward pathways in the brain may play a role. The present study was designed with this theory in mind, aiming to understand reward processing in those experiencing complicated and non-complicated grief as well as to differentiate the "wanting" and "liking" phases of reward processing in bereavement. Twenty-five older adults were categorized based on grief severity into one of three groups: complicated grief (CG), non-complicated grief (NCG) and non-bereaved married controls (NB). Neural activation was examined using fMRI while participants viewed a countdown on the screen (anticipation) followed by a photo of their (living or deceased) spouse. There was no significantly differential activation between the three groups for the spouse v. stranger photo contrast, nor for anticipation period v. spouse photo. However, these two contrasts were also run separately in the three groups. Each group produced significant activation, in similar and distinct regions, primarily associated with emotion and visual processing. In addition, post-hoc analyses were conducted using self-reported yearning scores as a regressor across all bereaved participants, which revealed that greater symptoms of yearning predicted greater activation in the subgenual anterior cingulate cortex (sgACC). This region of the brain has been previously linked to depression and suggests that symptoms of yearning may present an opportune place to intervene to improve outcomes in CG.
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Masferrer, Boix Laura. "Bereavement and addiction: complicated grief symptoms, psychopathology and associated variables in a substance use disorder sample." Doctoral thesis, Universitat de Girona, 2017. http://hdl.handle.net/10803/461359.
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The loss of a loved one is a universal experience to which the majority of people adjust adequately. A substantial minority do not allow the natural process and, despite the passing of time, they continue to live with great discomfort developing symptomatology of Complicated Grief (CG). The principal aim of this research was to describe the presence of symptoms of Complicated Grief as well as psychopathology and other significant variables among a Substance Use Disorder (SUD) sample. The sample was formed by 196 bereaved SUD patients and the control group was made up of 100 bereaved non-addicted participants. The presence of symptoms of CG among the bereaved SUD sample was 34.2€ in comparison with only 5% from de control group. The specific factors associated with symptomatology of CG were: loss of a sibling, reported traumatic death, and stated lower level of social support. Participants with CG symptoms reported higher frequency of clinical syndromesLa pèrdua d’un ésser estimat és una experiència universal que la majoria de les persones s’hi adapten adequadament. Una minoria però, no segueix el procés natural i, malgrat el pas del temps, segueix vivint amb molta incomoditat desenvolupant la simptomatologia de Dol Complicat (DC). L’objectiu principal d’aquesta investigació és descriure la presència de símptomes de Dolor Complicat, així com la psicopatologia i altres variables significatives entre una mostra del Trastorn d’Ús de Substàncies (TUS). La mostra estava formada per 196 pacients TUS i el grup de control estava format per 100 participants. La presència de símptomes de DC entre la mostra clínica va ser del 34,2%, en comparació amb només el 5% del grup de control. Els factors específics associats amb la simptomatologia de DC van ser: la pèrdua d’un germà, mort traumàtica i la percepció de nivell baix de suport social. Els participants amb símptomes de DC van presentar una major freqüència de síndromes clínics
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Shuter, Patricia Elizabeth. "A longitudinal study of grieving in family caregivers of people with dementia." Thesis, Queensland University of Technology, 2012. https://eprints.qut.edu.au/60967/1/Patricia_Shuter_Thesis.pdf.
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A longitudinal study of grieving in family caregivers of people with dementia Recent research into dementia has identified the long term impact that the role of care giving for a relative with dementia has on family members This is largely due to the cognitive decline that characterises dementia and the losses that can be directly attributed to this. These losses include loss of memories, relationships and intimacy, and are often ambiguous so that the grief that accompanies them is commonly not recognised or acknowledged.
The role and impact of pre-death or anticipatory grief has not previously been widely considered as a factor influencing health and well-being of family caregivers.
Studies of grief in caregivers of a relative with dementia have concluded that grief is one of the greatest barriers to care giving and is a primary determinant of caregiver well-being. The accumulation of losses, in conjunction with experiences unique to dementia care giving, place family caregivers at risk of complicated grief. This occurs when integration of the death does not take place following bereavement and has been associated with a range of negative health outcomes.
The aim of this research was to determine the influence of grief, in addition to other factors representing both positive and negative aspects of the role, on the health related quality of life of family caregivers of people with dementia, prior to and following the death of their relative with dementia.
An exploratory research project underpinned by a conceptual framework of caregivers’ adaptation in the context of subjective appraisal of the strains and gains in their role was undertaken. The research comprised three studies. Study 1 was a scoping study that involved a series of semi-structured interviews with thirteen participants who were family caregivers of people with severe dementia or whose relative with dementia had died in the previous twelve months. The results of this study in conjunction with factors identified in the literature informed data collection for the further studies.
Study 2 was a cross sectional survey of fifty caregivers recruited when their relative was in the moderate to severe stage of dementia. This study provided the baseline data for Study 3, a prospective cohort follow up study. Study 3 consisted of seventeen participants followed up at two time points after the death of their relative with dementia: six weeks and then six months following the death of the relative with dementia.
The scoping study indicated that differences in appraisal of the care giving role and encounters with health professionals were related to levels of grief of caregivers prior to and following the death of the relative with dementia. This was supported in the baseline and follow up studies. In the baseline study, after adjusting for all variables in multivariate regression models, subjective appraisal of burden was found to make a significant contribution (p<.05) to mental health related quality of life. The two dependent variables, anticipatory grief and mental health related quality of life, were significantly (p<.01) correlated at a bivariate level. In the follow up study, linear mixed modelling and multiple regression analysis of data found that subjective appraisal of burden and resilience were significantly associated (p<.05 and p<.01, respectively) with mental health related quality of life over time. In addition, bereavement and complicated grief were significantly associated (p<.05) with mental health following the death of the relative. In this study social support and satisfaction with end of life care were found to be statistically associated (p<.05) with physical health related quality of life over time.
The strong relationship between grief of caregivers and their health related quality of life over the entire care giving trajectory and period following the death of their relative highlights the urgent need for further research and interventions in this area. Overall results indicate that addressing the risk and protective factors including subjective appraisal of their care giving role, resilience, social support and satisfaction with end of life care of their relative, has the potential to both ameliorate negative health outcomes and to promote improved health for these caregivers. This research provides important information for development of targeted and appropriate interventions that aim to promote resilience and reduce the personal burden on caregivers of people with dementia.
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Fulbrook, Thomas Brian. "Bereavement and Parents Who Have Experienced the Sudden Death of a Child." ScholarWorks, 2015. https://scholarworks.waldenu.edu/dissertations/1847.
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In studies, grief due to the loss of a child is recognized as a complex process, one whose trajectory is influenced by a variety of factors. One factor, the age of the child at the time of death, may be an important influence in the trajectory of grief. The purpose of this interpretive phenomenological study was to explore the experiences of loss for 15 bereaved mothers and fathers whose children suddenly died between the ages of 2 and 12 years. This age range was selected to explore bereavement in parents of young and preteen children because they may feel a greater sense of daily care and responsibility for the safety of their children in comparison to bereaved mothers and fathers of older children or adults. The psychosocial transition theory was used to develop the research questions, which framed the exploration of the experiences and adaptive responses of the parent participants. There were 15 recorded semistructured interviews from which the data were collected. The transcribed data were validated with member checking. Data analysis was completed using open and hierarchical coding to identify meanings and recurrent themes in the participant narratives. Recurrent themes included that grieving was emotional and physical for these parents, and that grief made it difficult for them to do everyday tasks or care for surviving children. Mothers and fathers identified viewing their world as less safe and experienced a reevaluation or complete abandonment of their spiritual beliefs. Implications for positive social change include increasing social awareness in the general public about grief due to child death and challenging unrealistic expectations of grief trajectory. Furthermore, the findings of this study may be used by mental health professionals to create interventions specific to this type of loss.
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Weiskittle, Rachel E. "The Efficacy of a Group Visual Art Bereavement Intervention with Older Adults." VCU Scholars Compass, 2019. https://scholarscompass.vcu.edu/etd/5940.
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Research on expressive art interventions for bereavement has burgeoned in recent years. Studies have supported their effectiveness in facilitating participants’ adjustment to loss (e.g., Rosner, Kruse, & Hagl, 2010; Uttley, 2015) and have revealed the frequency with which they are clinically implemented (Thompson & Neimeyer, 2014). Clinicians and recipients of expressive art interventions advocate for their helpfulness in grief processing (e.g., Gamino, 2015). Publications have highlighted particular visual art modules that facilitate adaptive adjustment to loss by providing avenues for self-expression, meaning making and continuing bonds with the deceased (Neimeyer, 2016), but few studies have quantitatively investigated whether they improve bereavement outcomes. Efficacy of treatment modalities are especially warranted for bereaved subgroups at elevated risk for developing symptoms of complicated grief, such as socioeconomically vulnerable older adults, as they are among those most likely to benefit from intervention but face the most barriers to accessible treatment (Ghesquiere, 2013; Newson et al., 2011). This longitudinal study investigated the feasibility and efficacy of a 4-week grief support group with visual art modalities for bereaved older adults residing in government subsidized independent living facilitates in the community. Measured outcomes included meaning made from the loss, continued bonds with the deceased, perceived social support, personal growth, and negative bereavement experiences such as symptoms of complicated grief and depression. Findings from this study support the feasibility and acceptability of implementing an art-based grief support group for socioeconomically vulnerable older adults. Significant improvement was found in meaning made from the loss, personal growth, and negative grief symptoms. Depressive symptoms significantly decreased immediately following completion of the group, but these levels returned closer to baseline levels at one-month follow up. Participants who screened positively for complicated grief at baseline reported greater improvement in their negative grief symptoms and depression, consistent with the extant literature that the bereft in highest distress receive the most benefit from grief intervention. As complicated grief is more prevalent in the older adult population than other age groups, further investigation on the efficacy and effectiveness of targeted bereavement support is warranted.
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Eriksson, Ida, and Johanna Jarl. "Komplicerad sorg : en studie om upplevelsen av gruppsykoterapeutisk sorgbehandling." Thesis, Örebro universitet, Akademin för juridik, psykologi och socialt arbete, 2010. http://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-11634.
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I studien undersöks individers upplevelse av gruppsykoterapeutisk behandling för komplicerad sorg. Genom halvstrukturerade djupintervjuer och kvalitativa enkätfrågor erhålls beskrivningar från olika livsvärldar utifrån individers olika perspektiv. En tolkningsram har tagits fram innehållande tidigare forskning samt teoretiska utgångspunkter vilken utgör verktyg för analys av erhållna resultat. I resultatavsnittet framhålls den oerhörda och ibland avgörande betydelse behandlingen haft för individernas välbefinnande. Det framkommer också tre aspekter som varit avgörande för det positiva resultatet av behandlingen nämligen relationen till terapeuten, den metod som använts samt gemenskapen i gruppen. Vidare undersöktes gemenskapens betydelse på en djupare nivå. Det resultat som framkom var att förståelse från de andra i gruppen, att individerna insåg att de inte vara unika om sin situation samt att en medvetenhet och insikt uppstod i tankeprocesser och det interpersonella beteendet var det som hade störst betydelse i gemenskapen. Denna upptäckt presenteras som en tentativ modell som kan ligga till grund för framtida forskning. Slutligen diskuteras resultat och analys i relation till syfte och tolkningsram samt presenteras slutsatser och ytterligare förslag till framtida forskning.The study examines individuals' experience of group psychotherapy for complicated grief treatment. Through semi-structured interviews and qualitative survey questions have descriptions of the various life worlds of individuals from different perspectives been obtained. Previous research and theories are presented which constitute tools for analysis of the obtained results. The results present the tremendous and sometimes vital significance the treatment had on individuals' wellbeing. It also presents three aspects that were decisive for the positive outcome of the treatment. These were the relationship to the therapist, the method used and the community in the group. The meaning of community was further examined on a deeper level. The obtained result of this question shows that understanding from the other group members, the fact that the individuals' realized that they’re not unique about their situation and that awareness and insight in thoughts and interpersonal behavior arose were of greatest meaning. This discovery is presented as a tentative model that could provide a basis for future research. The results are discussed and analyzed in relation to the purpose of the study and previous research. Finally, conclusions and further suggestions for future research are presented.
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Alexandersson, Pelle. "Psykometrisk prövning av PG-13; ett självskattningsinstrument för ihållande sorg." Thesis, Stockholms universitet, Psykologiska institutionen, 2010. http://urn.kb.se/resolve?urn=urn:nbn:se:su:diva-43566.
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Frågan om ”normal” respektive ”patologisk” sorg har under en lång tid varit ett omdiskuterat ämne inom psykologin och psykiatrin. En grupp forskare har tagit fram kriterier på ett syndrom som fått benämningen ihållande sorg (”prolonged grief”). Studier har visat på att ihållande sorg är ett distinkt syndrom separat från depression, posttraumatisk stressyndrom och generaliserat ångestsyndrom. Ihållande sorg föreslås ingå som en diagnos i de kommande versionerna av de diagnostiska manualerna DSM och ICD. Syftet med denna studie var att översätta självskattningsinstrumentet Prolonged Grief Disorder (PG-13) till svenska, och undersöka dess reliabilitet och validitet genom bland annat en explorativ och konfirmatorisk faktoranalys. Studien genomfördes på ett annonsrekryterat heterogent sample (n=162 varav 90 % var kvinnor) vad gäller typ av dödsfall och relation till den avlidne. Respondenterna besvarade en webb- eller pappersenkät som bestod av 75 items. PG-13 bedöms ha en hög reliabilitet, god begrepps- och samtidig validitet samt en måttlig diskriminativ validitet.
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Bourgeois, Marc Louis. "Les deuils pathologiques : traduction et validation de l'Inventaire de "deuil compliqué" (Inventory of complicated grief, de H.G. Prigerson et al., 1995-1996) chez 107 patients psychiatriques hospitalisés et 100 témoins de la population générale : comparaison avec l'échelle T.R.I.G. (Texas revised inventory of grief, Faschingbauer et al., 1983)." Bordeaux 2, 2002. http://www.theses.fr/2002BOR20947.
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Dans la partie I sont résumées les conceptions et interprétations de l'expérience et du comportement de deuil, avec les modèles psychopathologiques proposés au cours du XXème siècle. Les études descriptives, naturalistes, longitudinales, épidémiologiques, dans la population générale, ont précisé la clinique du deuil, en particulier le modèle du "deuil non compliqué" (DSM-III, DSM-IV, CIM 10). Les réactions de deuil évoluent normalement en 4 stades (choc, angoisse de séparation et comportement de recherche, travail de deuil et dépression spontanément résolutive, enfin phase de récupération), ayant chacun ses caractéristiques. À l'opposé, des "deuils pathologiques", psychiatriques, anormaux, etc. . . . Ont été définis, en particulier le modèle du "deuil compliqué", caractérisé par la chronicisation et des complications psychosociales et organiques. L'ICG (Inventory of complicated grief, Prigerson et al. , 1995, 1996), échelle de psychopathologie quantitative, spécifique du deuil, permet de faire la distinction entre les symptômes témoignant d'une "détresse de séparation" et d'une "détresse traumatique", et les réactions de dépression et d'anxiété liées au deuil. Elle permet de repèrer, dans une approche dimensionnelle, les endeuillés à risque accru de pathologies psychiques et organiques (cancers, cardiopathies, etc. . . . ) d'où son intérêt majeur en psychologie de la santé. 20 % de l'ensemble des deuils seraient compliqués, ce qui représente un important problème de santé publique. Dans la partie II sont résumées les controverses sur les méthodes d'étude du deuil, qualitatives et/ou quantitatives, et plus particulièrement les échelles quantitatives se voulant spécifiques du deuil, spécialement les TRIG, CBI et ICG. La partie III présente l'étude empirique personnelle ayant porté sur un échantillon de 108 patients hospitalisés librement en psychiatrie, et 100 personnes de la population générale. On a confirmé l'excellente validité de critère et sa validité convergente (avec le TRIG). Il repère de façon spécifique l'expérience de deuil et son caractère pathologique, quand les scores ICG se situent au-delà d'un certain seuil (22-30/79), et surtout quand l'évolution ne se fait pas vers une régression des scores et des symptômes du deuil. Le travail confirme l'utilité d'un instrument validé, permettant enfin des études empiriques valables. La prévention et la prise en charge des deuils pathologiques, compliqués et/ou traumatiques, pourront ainsi être évalués quant à leurs modalités et leur efficacité. Après la partie IV, synthèse et conclusion générale, sont reproduits en annexe les 8 articles consacrés à l'étude du deuil, en population générale et en population psychiatrique, publiés par l'auteur dans la littératurePart one of this thesis presents various conceptualization and interpretations of the experience as well as behavior of bereavement and grief using 20th century models of psychopathology. Recent descriptive naturalistic, longitudinal and epidemiological studies of the general population helped define the clinical aspects of "normative grief", and in particular the model of "non complicated bereavement (DSM-III, DSM-IV, CIM 10). Grief normally evolves according to four stages (shock, separation anxiety and research behaviour, working through one's grief and spontaneously resolving depression, and finally a stage of recuperation), with each stage having its own characteristics. Conversely, abnormal, psychiatric, or pathological grief has been defined, and in particular the model of "complicated grief" which is characterized by chronicity as well as by psychosocial and somatic complications. The ICG (Inventory of complicated grief, Prigerson et al. , 1995-1996) is a quantitative instrument specific to grief which allows for distinguishing separation distress and traumatic distress on the one hand, and the grief reactions of depression and anxiety on the other. Using a dimensional approach, the ICG helps identify bereaved persons at high risk for psychological and somatic disorders (cancer, heart disease, etc. . . ), and its therefore of major interest in a health psychology. As twenty percent of all bereaved subjects will present with complicated grief, this represents an important public health concern. Part 2 of this thesis reviews the controversys relative to the different qualitative and/or quantitative approaches to bereavement and grief, and in particular the quantitative grief scales such as the TRIG, CBI and ICG. The 3rd part presents an individual empirical study based on a sample of 108 psychiatric inpatients compared to 100 subjects from the general population. The results of the investigation confirme the excellent construct validity, criterion validity and convergent validity of the ICG, compared to the TRIG
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Braz, Mariana Sarkis. "Prevenção de luto complicado em cuidados paliativos: percepções dos profissionais de saúde acerca de suas contribuições nesse processo." Pontifícia Universidade Católica de São Paulo, 2013. https://tede2.pucsp.br/handle/handle/15305.
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Palliative care seek quality of life based primarily on prevention and relief of suffering of patients who have life threatening diseases, encompassing the areas of physical, psychosocial and spiritual. Furthermore, extending the post-mortem patient, it offers support the family support in the grieving process. The theme provides discussions of education for death and dying process for health care professionals who are educated mostly geared towards the enhancement of technical knowledge at the expense of a humanist education, which removes the theme of death as the focus of learning. This qualitative study aimed to understand and analyze the training of professionals in relation to dying patient and their perception regarding their contributions to the prevention of complicated grief care unit. The Attachment Theory grounded this research theoretically, providing support for the analysis. Health professionals who integrate palliative care teams voluntarily participated in this research . A questionnaire was used to obtain academic and professional data, besides courses taken. A semi-structured interview allowed us to understand the following topics: the choice of working in palliative care, the strategies used (by oneself and by the care unit) on a daily basis to deal with the issue of the dying process and the perception of its contribution to the prevention of complicated grief of patient and family. The results confirmed that the training of professionals in relation to the dying process is scarce. Moreover, it was observed that health professionals working in palliative care have attachment behaviors, identified as natural in this context, and that ends up to make it harder to realize that those are important contributions to prevent grief from becoming complicated in the care unit
Os cuidados paliativos buscam qualidade de vida baseada principalmente na prevenção e no alívio do sofrimento de pacientes que possuem doenças ameaçadoras de vida, englobando as esferas de ordem física, psicossocial e espiritual. Além disso, estende-se ao pós-morte do paciente, oferecendo suporte e apoio à família no processo de luto. O tema proporciona discussões acerca de educação para morte e processo de morrer para os profissionais de saúde, que têm uma formação em sua maioria voltada para a valorização do saber técnico em detrimento de uma formação humanista, o que afasta o tema da morte como foco de aprendizado. Esta pesquisa qualitativa teve como objetivo compreender e analisar a formação dos profissionais em relação ao processo de morrer do paciente e as percepções daqueles em relação às suas contribuições para a prevenção de luto complicado da unidade de cuidado. A Teoria do Apego fundamentou teoricamente esta pesquisa, oferecendo respaldo para a análise. Participaram voluntariamente desta pesquisa profissionais de saúde, que integram formalmente equipes de cuidados paliativos. Foi utilizado um questionário auto-aplicativo para obtenção de dados acadêmicos, profissionais e de cursos realizados e uma entrevista semiestruturada, que permitiu compreender os seguintes tópicos: a escolha de trabalhar em cuidados paliativos; as estratégias utilizadas (para si mesmo e para com a unidade de cuidado) no dia a dia para lidar com a questão do processo de morrer e a percepção sobre a sua contribuição para a prevenção de um luto complicado de paciente e família. Os resultados confirmaram que a formação dos profissionais em relação ao processo de morrer é escassa. Ademais, observou-se que os profissionais de saúde que trabalham em cuidados paliativos possuem comportamentos de apego, os quais são identificados como naturais nesse contexto, o que acaba por dificultar a percepção de que são importantes contribuições para a prevenção de luto complicado da unidade de cuidado
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Clarke, Rochelle S. "Uncovering Meanings of Death, Trauma, and Loss as Experienced by Hospice Bereavement Coordinators: A Phenomenological Study." NSUWorks, 2015. http://nsuworks.nova.edu/shss_dft_etd/12.
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This study examined the experiences of Hospice Bereavement Coordinators (HBCs) and Hospice Chaplains working with grief narratives from patient-family units exhibiting signs of anticipatory or complicated grief. While a significant amount of research has been conducted on Hospice employees, no qualitative studies have examined the interpretation of meaning from employees whose primary role focused on the psychosocial-spiritual aspects of clients exhibiting anticipatory or complicated grief. The researcher identified shared meaning of death, trauma, and loss from six participants in the context of a high stress and high loss environment. This study‘s findings revealed ten central themes: Death is an earthly transition to immortality; Death is an intense progression; Trauma is an interpretive response to a bad experience; Trauma highlights quality of life; Loss is an adaptation to change; Loss highlights self-awareness about mortality; Cases impact views of death, trauma, and loss; Influences of spirituality; Stressful aspects of working in hospice settings; and Methods of coping.
Through this study, the researcher captured five elements of the shared phenomena: the conflicting nature of anticipatory or complicated grief with the participant‘s interpretation of death; the acknowledgement of loss as the next stage for survivors of the deceased; the instability patient-family units exhibiting anticipatory or complicated grief faced; the role of faith; and the proactive efforts of participants to create a balance between work and their personal life. These meanings contributed to the continued need for future qualitative studies whereby the lived experiences of Hospice employees could be expressed to assist with the development of structured training programs specific to the requirements outlined by the nature of their work.
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Sani, Livia. "Consequences and psychological support after a perinatal loss : an eighteen-month mixed longitudinal study of twenty-nine bereaved parents." Thesis, Strasbourg, 2019. http://www.theses.fr/2019STRAG041.
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Cette recherche vise à évaluer le risque de développement d’un trouble du deuil compliqué et l’apport d’un soutien psychologique (personnel, de groupe et sur internet) à la suite d’une perte périnatale. 29 parents français ont été rencontrés au total cinq fois : une première fois, puis 3, 6, 12 et 18 mois après la première réunion. Une méthodologie mixte a été utilisée, s'appuyant sur des entretiens qualitatifs (évalués avec l'Interpretative Phenomanological Analysis et le programme Alceste) et à l’aide de deux questionnaires (l'Inventory of Complicated Grief et le General Health Questionnaire-28).21 femmes (72%) et 8 hommes (28%) sont les parents rencontrés avec une moyenne d’âge de 31,4 ans. Le délai maximal entre le décès de l’enfant et la première réunion était d’environ 10 mois, le délai minimum était quant à lui de 22 jours. 44% des décès étaient dus à des problèmes médicaux et 35% à une interruption médicale de grossesse. Seulement 22% des enfants étaient mort-nés (maximum 96 jours) et 79% étaient décédés in utero.Notre recherche a confirmé que la perte périnatale est un événement difficile et risqué pour les parents. Ce n’est que 18 mois après la perte de l’enfant que les parents ont rejoint le niveau du deuil non compliqué. La participation à des groupes de parole s’est révélée utile, tandis que les groupes sur internet peuvent mener au développement de troubles psychopathologiques. Le rôle social et les contraintes culturelles liées au genre influencent la façon dont s’exprime le chagrin des parents. Au niveau du soutien émotionnel, la proximité et l’aide du partenaire et de la famille sont très importantes. Se souvenir et commémorer l'enfant malgré le temps qui passe et les grossesses ultérieures est fondamental pour aller de l’avantThis research aims to evaluate the risk of complicated grief disorder (CG) and the contribution of psychological support (professional, or personal and group, and online) following a perinatal loss. 29 bereaved French parents were met for a total of five meetings : the first one, 3, 6, 12 and 18 months after the first meeting. A mixed methodology was used, drawing on qualitative interviews (evaluated through the Interpretative Phenomenological Analysis and the Alceste programm) and two questionnaires (Inventory of Complicated Grief and General Health Questionnaire 28).The parents were 21 women (72%) and 8 men (28%), with a mean age of 31.4 years old. The maximum time between the child’s death and the first meeting is about 10 months, while the minimum is 22 days. 44% of deaths occurred due to medical problems and 35% to a Late Termination of Pregnancy. Only 22% of children lived (up to a maximum of 96 days) and 79% died in utero. Our research confirmed that perinatal loss is a difficult and risky event. Only more than 18 months a half after the loss, the parents reached the uncomplicated grief threshold. Participation in support groups has proved useful while online groups can influence the development of psychopathological disorders. The social role and cultural impositions of gender influence the expression of grief. Regarding the emotional support, the closeness and help of the partner and family are very important. Remembering and commemorating the child despite the passing of time and subsequent pregnancies are fundamental to move forward
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Bergh, Johannesson Kerstin. "Traumatic Exposure, Bereavement and Recovery among Survivors and Close Relatives after Disasters." Doctoral thesis, Uppsala : Acta Universitatis Upsaliensis : Univ.-bibl. [distributör], 2010. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-120200.
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Manda, Charles Bester. "Re-Authroing narratives of trauma survivors in kwazulu-natal spiritual perspective." Thesis, University of Pretoria, 2013. http://hdl.handle.net/2263/40211.
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In his thesis, Re-authoring life narratives of trauma survivors in KwaZulu-Natal: Spiritual perspective, the researcher investigates a holistic understanding of the effects of trauma on surviving individuals and communities historically affected by political violence in KwaZulu-Natal, South Africa. Traditionally, the exploration of the impact of trauma on survivors in South Africa has been focused mainly on the bio-psycho-social aspects. The Bio-psycho-social approach recognises that trauma affects people on several dimensions- biological, social and psychological. However, Nevid (et al 2006:19) and Kaminer (et al 2012) acknowledge that these bio-psychosocial factors are incomplete for us to understand the effects of trauma on the individual and call for consideration of all possible pathways and account for multiple factors, influences, and interactions.
Using qualitative and narrative approach, personal life narratives were listened to with the aim of looking in depth at the effects of traumatic experiences on the research participants, and specifically investigate whether, and how trauma affected their spirituality. The findings show that the research participants sustained psychological, moral and spiritual injuries during and after traumatic experiences. The results concur with Buckenham’s (1999:7-8) argument that trauma wreaks its toll in the life of a person emotionally, psychologically, spiritually, in our relationships with ourselves, others and with God. The study also established that regardless of religious affiliation, research participants turned to spiritual resources for answers, healing and recovery in traumatic situations.
Therefore, the study recommends the integration of the spiritual perspective to reach a holistic model of understanding and treating traumatized individuals and communities. Although the study is localised in the South African context, the results have a much wider relevance in understanding the role of ‘posttraumatic spirituality’ in the re-authoring of life narratives shattered by trauma.Thesis (PhD)--University of Pretoria, 2013.
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Glickman, Kim Lisa. "Complicated Grief Treatment: What Makes It Work?" Thesis, 2013. https://doi.org/10.7916/D8Z89BSB.
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This dissertation is an exploration of the putative mediators of complicated grief treatment (CGT) in an effort to gain a better understanding of the mechanisms by which the treatment exerts its effects. This three-paper dissertation utilizes data from an NIMH-funded randomized controlled trial of CGT (Shear et al., 2005), which showed that CGT is more effective than Interpersonal Psychotherapy (IPT) in reducing symptoms of complicated grief (CG). The first paper examines a broad range of ancillary outcomes including symptoms of anxiety, depression, complicated grief and sleep disturbance due to bad dreams. Antidepressant use is examined as a possible moderator since half the sample was taking antidepressants and those taking antidepressants had a marginally better response rate in CGT than those not taking them (59% vs. 42% in CGT and 40% vs. 19% in IPT). CGT was more effective than IPT in reducing cognitive symptoms of anxiety, depression as measured by the Hamilton Rating Scale for Depression (HRSD), somatic symptoms of depression, guilt/self-blame, negative thoughts about the future, avoidance and poor sleep due to bad dreams. The difference in treatment effect on the HRSD for CGT over IPT was more pronounced for participants not taking antidepressants where CGT reduced depression but IPT did not. Paper two examines possible mediators specific to the model of CGT including: guilt/self-blame specific to the death or deceased; negative thoughts about the future; avoidance of reminders of the loss; anxiety and depression (intense negative emotions). Antidepressants are also examined as a potential moderator to explore whether their use affects the mediating role of the identified variables. All of these variables emerged as either full or partial mediators of CGT. Antidepressant use had no effect on the mediating role of these variables. Paper three examines whether alliance (measured at week 4) predicts subsequent change in grief symptoms (controlling for early symptom change) and if so, whether it accounts for the difference in treatment effect between CGT and IPT (mediation). Working alliance emerged as a mediator of CGT, accounting for 28% of the treatment effect found between CGT/IPT and grief symptoms. Discussion sections for each paper summarize study findings, limitations and implications for future research.
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"The influence of context on complicated grief." Thesis, 2008. http://hdl.handle.net/10210/1618.
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D.Litt. et Phil.Internationally, significant efforts have been made to understand complicated grief. However, the topic is not well covered in the South African psychological literature and much work remains to be done with regard to gaining insight into factors that contribute towards its development. To this end, the aim of the study was to explore the influence of context on bereavement to the extent that grief becomes complicated. The stance adopted is that bereavement and grief are experiences that cannot be dissociated from the context in which it occurs. From this point of view, bereavement and grief were construed as both personal and social experiences. Drawing on ecosystemic theory, this study focused on micro and macro contexts. As such, emphasis was on socio-environmental contexts, the family context and the personal context. Literature was surveyed so as to highlight the extent to which these contexts either heighten the risk of maladaptive reactions or served the purpose of ameliorating the impact of bereavement and grief. The literature review was also extended to incorporate an understanding of earlier linear stage and phase theories of grief. Similarly, contemporary conceptual models, which represent more complex multifaceted and integrative approaches, were included. While earlier theorists tended to attribute maladaptive grief to intra-individual pathology, contemporary approaches consider maladaptive grief responses as a function of the individuals’ inability to maintain a balance between the different dimensions of their post-bereavement lives. Methodologically, this study employed an exploratory research approach. Semi-structured interviews based on predetermined guide questions, were conducted with thirteen participants ranging in age from 25 to 45 years. Emphasis was placed on the loss of an attachment relationship, which included the death of a child, sibling, parent, spouse or live-in partner. Both natural and unnatural deaths were focused on. In an effort to control for gender as an external variable, all the participants were females. Responses to the predetermined guide questions were translated into categories. The frequency of responses within each category was calculated and presented as percentages. Categories in relation to the influence of the socio-environmental context on complicated grief translated into living environment risks and community support. Cognizance was also taken of how macro societal institutions and processes such as socio-economic factors, the political climate and societal attitudes, manifesting in medical attitudes shape the social and personal contexts in which bereavement is experienced and complicated grief is expressed. The influence of these macro institutions and processes filter through to the living environments and communities in which death occurred. Similarly, categories in relation to the influence of family context on complicated grief translated into family patterns of interaction and relationships, family emotional integration and family support. Categories reflecting the influence of the personal context on complicated grief were represented by making meaning of the death, the mode of death and the belief systems of the participants. The belief systems were addressed in terms of the participants’ religious and cultural beliefs. Being exploratory in nature, the study did not provide definitive answers with regard to the influence of context on complicated grief. However, it was possible to establish potential relationships between various dimensions of context and complicated grief. The study also highlighted the need for a theory of complicated grief, which embrace contextual influences. This is likely to lend support for situating the locus of complicated grief in the social context in which it occurs. The findings of this research support the idea that complicated grief is being influenced by the social context in which it occurs.
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Bullock, Ashley Brown. "The Expression and Regulation of Sadness in Complicated Grief." Thesis, 2012. https://doi.org/10.7916/D8T72VTR.
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The current study examined the role of context sensitive emotional responding in normal and pathological adjustment to loss among conjugally bereaved persons later in bereavement. We specifically focused on investigating how participants with complicated grief (CG) emotionally responded in comparison to a non-pathological bereaved group. We comprehensively measured the emotional responding behaviors (i.e., facial displays of emotion and head movements) of participants as they watched an evocatively sad or neutral film and also examined their emotion experience via self-report. We anticipated that CG participants would show and report less emotional context-sensitivity (i.e., less sadness and more negative emotions other than sadness) than non-pathological bereaved participants in the sad condition. Our findings demonstrate differences in both the emotional expression and emotional experience of the CG group compared with the non-pathological bereaved group in the context of a sad film. Our findings both support and extend our predictions. While overall participants more commonly expressed the prototypical sadness expressions in the sad condition than the neutral condition, a number of notable interaction effects emerged. Specifically, non-pathological bereaved participants were significantly more likely to express sadness expressions that involved the orbicular oculi muscles (i.e., AU 6 or the "cheek raiser"), the outer muscles that orbit the eyes, than CG participants in the sad condition. Research evidences how the orbicular oculi muscles are associated with "genuine" or more intense expressions of happiness and the current study suggests that the orbicular oculi muscles also distinguish between sadness expressions. In addition, while both groups were more likely to report feeling greater sadness in the sad condition than the neutral condition, CG participants were more likely to feel disgust and anger than non-pathological bereaved participants in the sad condition, pointing to unique pattern of context insensitive emotional responding. We found that CG is "complicated" in part due to its high co-morbidity rates with Major Depressive Disorder (MDD) and Post-traumatic Stress Disorder (PTSD). While controlling for the effects of MDD and PTSD did not significantly change our results, the high co-morbidity rate of CG with MDD (74%) and PTSD (68%) begs us to consider the pan-diagnostic nature of chronic grief-related pathology. In sum, the current study highlights grief-related pathology as a distinct clinical problem and points to how emotion context-insensitivity importantly plays a role in the maintenance of grief-related problems.
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McCutcheon, Kelly A. "Predictors of complicated and uncomplicated grief after the death of a companion animal /." 2004. http://gateway.proquest.com/openurl?url_ver=Z39.88-2004&res_dat=xri:pqdiss&rft_val_fmt=info:ofi/fmt:kev:mtx:dissertation&rft_dat=xri:pqdiss:NR11599.
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Thesis (Ph.D.)--York University, 2004. Graduate Programme in Psychology.Typescript. Includes bibliographical references (leaves 182-196). Also available on the Internet. MODE OF ACCESS via web browser by entering the following URL: http://gateway.proquest.com/openurl?url_ver=Z39.88-2004&res_dat=xri:pqdiss&rft_val_fmt=info:ofi/fmt:kev:mtx:dissertation&rft_dat=xri:pqdiss:NR11599
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Beverung, Lauren Mock. "Conditions leading to unresolved attachment status for loss and the role of complicated grief." Thesis, 2012. http://hdl.handle.net/2152/ETD-UT-2012-05-5175.
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A central goal of this study is to better understand why some mothers become unresolved with respect to experiences of loss whereas others do not. Adults are considered to be unresolved with respect to loss if they display signs of mental disorganization while discussing an attachment-related loss due to death – for example, talking in the present tense about a deceased person as if the person is still alive (Main, Goldwyn, & Hesse, 2002). Studies have accumulated documenting the negative consequences of being unresolved. Researchers have linked unresolved attachment to frightened/frightening maternal behavior (Jacobvitz, Leon, & Hazen, 2006), drug/alcohol abuse (Riggs & Jacobvitz, 2002), and other Axis I and II disorders (Ward, Lee, & Polan, 2006; Fonagy et al., 1996); as well as anxiety, anger, (Busch, Cowan, & Cowan, 2008) and controlling behavior (Creasey, 2002) in romantic relationships. Less is known about the conditions under which a person becomes unresolved. This study will be one of the first to examine the comprehensive effects of several risk factors known to influence a person’s ability to resolve a loss including kinship, cause of death, and suddenness as well as primary attachment pattern. Other factors included in this study are social support and lifestyle changes.
Although attachment theory provides a thorough explanation for an individual’s inability to resolve a loss, it is only one of many theoretical explanations of this phenomenon (Rando, 1993). One theory that is conceptually similar to unresolved loss is the theory of complicated grief, the process of painful searching and yearning for a deceased person (Prigerson et al., 1995b). Like those who study unresolved loss, complicated grief researchers are still seeking to understand what factors can predict whether an individual will experience prolonged symptoms of grief (van der Houwen et al., 2010). Also similar to unresolved loss, complicated grief involves irregular patterns of mental processes following a loss; however, complicated grief seems to be a conscious process, whereas unresolved loss has non-conscious components. Hence, this dissertation also examined whether complicated grief was related to unresolved loss and, if so, whether the origins for complicated grief were similar to unresolved loss.text
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Fowler, Kenneth E. "The relationship between self reported trauma, complicated grief, and depression among college students." 2006. http://etd.lib.fsu.edu/theses/available/etd-07102006-140024.
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Thesis (Ph. D.)--Florida State University, 2006.Advisor: Charles R. Figley, Florida State University, College of Human Sciences, Dept. of Family and Child Sciences. Title and description from dissertation home page (viewed Jan. 2, 2007). Document formatted into pages; contains vii, 69 pages. Includes bibliographical references.
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Brooker, Monica. "The Role of Relatedness and Expressive Flexibility In the Prediction of Complicated Grief." Thesis, 2013. https://doi.org/10.7916/D8MK6C9B.
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The current study explores the association between expressive flexibility, attachment, interpersonal dependency, and complicated grief among a sample of middle-aged bereaved adults. A relatedness framework, which encompasses specific and more generalized relational interpersonal behaviors, was utilized to broaden the frame of inquiry. This study represents one of the first systematic efforts to examine conjointly attachment and dependency behaviors in a middle-aged bereaved population. It is also one of the first empirical explorations of the association between dependency and expressive flexibility. The Experiences in Close Relationships - Revised questionnaire (ECR-R; Fraley, Waller, and Brennan, 2000) was employed to derive anxious and avoidant attachment schemas. Adaptive and maladaptive interpersonal dependence were measured utilizing the Relationship Profile Test (RPT; Bornstein and Languirand, 2003). Participants were asked to express, suppress, or behave normally to evocative images. Observer ratings of participants' responses were used to measure expressive enhancement and suppression ability. Results indicated a significant association between expressive flexibility factors, attachment, and complicated grief, and more notably a relationship between dependency and complicated grief. Results also revealed adaptive dependence (i.e., healthy dependency) as the strongest predictor of complicated grief, above and beyond attachment related anxiety and avoidance. The data also suggested that expressive enhancement ability moderates the relationship between healthy dependency and complicated grief, such that the interaction between low expressive enhancement ability and low healthy dependence predict significantly increase the likelihood of complicated grief. Taken together, the findings of this study suggest the importance of including expressive flexibility and dependency factors in understanding complicated grief. The clinical implications of these findings are also discussed.
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Cohen, Nicole L. "Grief and trauma : an empirical investigation of the construct overlap and the psychological and physical functioning of bereaved individuals with and without complicated grief /." 2005. http://wwwlib.umi.com/cr/yorku/fullcit?pNR11561.
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Thesis (Ph.D.)--York University, 2005. Graduate Programme in Psychology.Typescript. Includes bibliographical references (leaves 137-151). Also available on the Internet. MODE OF ACCESS via web browser by entering the following URL: http://wwwlib.umi.com/cr/yorku/fullcit?pNR11561
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Liu, Hsi, and 劉. 曦. "The Correlative Study of Forgiveness, Complicated Grief, and Recovery Degree of Survivors of Traffic Accidents." Thesis, 2013. http://ndltd.ncl.edu.tw/handle/pb5976.
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碩士國立臺北護理健康大學
生死教育與輔導研究所
101
The research aims to investigate the relationship among complicated grief, Recovery Degree and forgiveness of survivors who lost their family in traffic accident in Taiwan, and try to realize the state of their grief. The researcher cooperated with Taipei association for victims support to collect data by mailing questionnaires to survivors. The questionnaire includes Inventory of Complicated Grief (ICG), Recovery degree Scale and Enright Forgiveness Inventory (EFI). The statistical analysis based on 71 effective questionnaires. Research conclusions are as follows: 1.The forgiveness of survivor can predict their Recovery degree, and if put forgiveness as intervening variables between complicated and Recovery degree, the explanatory power is improved significantly. 2.Female score is higher than male in ICG, and lower in Recovery degree Scale. 3.The survivors who get married have higher ICG score and lower Recovery degree score. The survivors who lost spouses have higher ICG score and lower Recovery degree score. 4.The survivors who have religious beliefs have higher ICG score than those have no religious beliefs. 5.The survivors who lost their family members 5-10 years ago have lower ICG score. 6.The survivors who think they have enough support forces have lower ICG score, higer Recovery degree score, and higher EFI score. 7.The survivors who satisfy with the result of litigation have higher EFI score. Finally, based on the research, the researcher offers concrete suggestion for references.
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Slater, Stephanie S. "Subjective distress among homicidally bereaved siblings as measured by the Impact of Event Scale (IES-R): are event and loss related distress distinguishable among siblings bereaved by homicide?" Thesis, 2016. http://hdl.handle.net/1828/7571.
Full textAbstract:
Trauma and grief often co-occur, however the degree to which these two constructs overlap or are distinguishable is still poorly understood. Homicidally bereaved individuals are exposed to both trauma and loss-related stressors. Previously collected data were used to explore the relationship between trauma and grief components in homicide bereavement distress, and whether homicide bereavement distress was distinguishable from that of other adverse life events. The overarching research question for this study was: Are event and loss related distress distinguishable among siblings bereaved by homicide,1 as measured on the Impact of Event Scale-Revised (IES-R)? Data from 67 individuals who lost a sibling to murder while growing up (Murder Group) were compared to data from 80 comparison individuals who grew up with a sibling (Comparison Group), but who had no experience of homicide bereavement. A cross-sectional, iterative survey design using group comparisons was used. Participants in the Murder Group reported significantly higher levels of current subjective distress compared with the Comparison Group. Among the siblings bereaved by the homicide loss of a sibling, event- and loss-related subjective distresses were highly and significantly correlated. In addition, both decreased significantly over time (years), and at similar rates. Preliminary findings from exploratory analyses of the IES-R provide insight into the avoidance, intrusion, and hyperarousal components of subjective distress following homicide loss. Findings will inform understanding of the overlap, and distinguishing features, of concurrent trauma and grief. Implications for theory and empirical research are noted, and recommendations for future research and counselling practice are discussed.Graduate
2017-09-13
simpson9@uvic.ca
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Tolstikova, Katerina. "Complicated grief following a significant loss : trauma symptomatology, search for meaning, self-reference, and death anxiety /." 2003. http://wwwlib.umi.com/cr/yorku/fullcit?pMQ86319.
Full textAbstract:
Thesis (M.A.)--York University, 2003. Graduate Programme in Psychology.Typescript. Includes bibliographical references (leaves 93-101). Also available on the Internet. MODE OF ACCESS via web browser by entering the following URL: http://wwwlib.umi.com/cr/yorku/fullcit?pMQ86319
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Ghesquiere, Angela Rosabelle. "Patterns and Outcomes of Bereavement Support-Seeking Among Older Adults with Complicated Grief and Bereavement-Related Depression." Thesis, 2012. https://doi.org/10.7916/D8Q246BQ.
Full textAbstract:
The dissertation aims to enhance knowledge about bereavement support-seeking among older adults with Complicated Grief (CG) and/or depression and to examine the outcomes of support received. This three-paper dissertation uses data from two studies of bereaved older adults: the Changing Lives of Older Couples (CLOC) Study and the Complicated Grief Treatment in Older Adults (CGTOA) Study. The dissertation draws upon Pescosolido and colleagues' Network Episode Model to frame the exploration of support-seeking. Paper 1 is based on qualitative interviews with eight older adults with CG who completed participation in a National Institute of Mental Health (NIMH) funded randomized clinical trial of CG treatment, the CGTOA study, and seeks to better understand the bereavement support- seeking process. Several primary themes arose, including observing that grief was causing a great deal of emotional distress and role impairment, grief not meeting their own or others' expectations of what grief "should be," influences of social relationships on support-seeking, and a lack of effectiveness of support groups and/or care from mental health professionals. Papers 2 and 3 use secondary analyses of longitudinal surveys from the CLOC Study, a representative community sample of widowed older adults. Paper 2 describes support sought for grief at 6, 18, and 48 months post-widowhood, including religious leader, support group, and family doctor support, and examines the influence of social network variables, the presence of CG and depression, and other demographic (gender, education, age, race, income, and home ownership) and clinical variables (health satisfaction, anxiety severity, attachment anxiety, attachment avoidance) on support sought. Approximately 20% of the sample sought multiple types of support concurrently. Social network, clinical and demographic variables also varied across types of support sought. For example, the presence of CG was associated with a greater likelihood of seeking support, and low instrumental support increased the odds of going to family doctors for support with grief. There were also significant associations between types of support sought. Paper 3 determined whether utilization of bereavement supports at 6 months post-loss was associated with reductions in emotional distress (grief, depression, or anxiety) at 18 months in widows with CG or depression in the CLOC sample. Using a self-help or support group reduced grief symptoms, but did not significantly alter depression or anxiety symptoms. Seeking support from a religious leader decreased depression, but not grief or anxiety. Seeking support from a family doctor did not impact anxiety, depression or grief. Discussion sections for each paper and a conclusion section for the entire dissertation summarize study findings, identify limitations, and detail implications for practice, research, and policy.
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Sawyer, Jacob Scott. "Grieving Without God: Comparing Posttraumatic Growth, Complicated Grief, and Psychological Distress in Believers and Atheists During Bereavement." Thesis, 2017. https://doi.org/10.7916/D8280M19.
Full textAbstract:
The purpose of this dissertation was to examine coping and outcomes of grief for atheist individuals during bereavement. The landscape of grief research has significantly changed since the days of Freud, and widely accepted stage theory models of grief have not held up to empirical review (Wortman & Silver, 1989). Emerging research examines factors that may lead to positive changes as a result of loss or trauma, known as posttraumatic growth. However, atheist individuals continue to be an understudied group in the psychological and bereavement literature, while people with religious beliefs continue to receive the most focus (Brewster, Robinson, Sandil, Esposito, & Geiger, 2014; D’Andrea & Sprenger, 2007). This study explored how cognitive (e.g., assumptions about the world), existential (e.g., meaning), and behavioral (active and emotional) coping methods are associated with posttraumatic growth, complicated grief, and psychological distress in a believer and atheist sample after the death of a close friend or family member. Specifically, posttraumatic growth, complicated grief, and psychological distress were regressed onto the three types of coping (cognitive, existential, and behavioral) using a hierarchical regression analysis. The first analysis controlled for demographic variables and the second analysis consisted of matched groups on demographic variables that were found to be associated with grief outcomes in prior research (e.g., Bonanno et al., 2008; Bonanno, Galea, Bucciarelli, & Vlahov, 2007). Exploratory bivariate correlations were conducted to assess interrelations between the variables of interest. Additionally, MANOVA was used to assess differences in demographic variables between the believer and atheist sample. Significant cognitive, existential, and behavioral coping methods were found to be associated with posttraumatic growth, complicated grief, and psychological distress. Furthermore, the endorsement of a belief in God(s) was significantly and positively associated with posttraumatic growth, but also significantly and positively associated with complicated grief and psychological distress. Results from this study can be used to identify appropriate clinical strategies for counselors working with grieving atheists, and will deepen the breadth of literature on bereavement and coping within diverse populations. Limitations and directions for future research are also discussed.
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Douglas, Ryan Patrick. "An examination of the relationship between attachment and loss : the role of meaning-making." Thesis, 2014. http://hdl.handle.net/2152/26134.
Full textAbstract:
This dissertation examined the relationship between attachment insecurity and complicated grief by testing a path model of variables that were hypothesized to mediate this relationship. Three meaning-making variables were tested as potential mediators: benefit-finding, sense-making, and positive reappraisal. First, a series of principal components analyses were performed to determine the factor structure of these meaning-making variables. After these constructs were identified, a series of hierarchical regression analyses were conducted to determine the unique contribution of each of the primary variables in predicting either complicated grief or one of the meaning-making variables. As hypothesized, some of the attachment and meaning-making variables were highly associated with complicated grief. Attachment insecurity variables were also associated with some of the meaning-making variables suggesting that attachment may have some influence on how individuals use meaning-making strategies in the midst of a loss. These variables were then entered into a path analysis that accounted for other relevant risk factors. It was found that, contrary to the main hypothesis, the meaning-making variables did not appear to mediate the relationship between attachment insecurity and complicated grief. Multiple regression was used to determine the relative impact of meaning-making and attachment variables on complicated grief because these variables have not been previously included in one statistical model. The results suggested that both meaning-making and attachment insecurity variables can play an important role as risk factors for complicated grief and that these relationships are still present after accounting for the closeness that an individual reported towards the deceased. It was concluded that both sets of variables, attachment and meaning-making, should be included in models of the development of complicated grief and that both may have clinical implications in terms of how to approach counseling for individuals struggling with complicated grief. More research on this topic is needed to look at similar research questions within specific populations. It was also suggested that in the future, researchers need to find better ways to measure meaning-making constructs because the current findings suggest that meaning-making may be even more multifaceted than has been suggested in previous literature.text
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Russell, Erica Lee. "Evaluation of a bereavement training programme for volunteers at a Community Centre." Thesis, 2006. http://hdl.handle.net/10539/1808.
Full textAbstract:
Student Number : 0204770E -
MEd research report -
School of Education -
Faculty of HumanitiesThe present study investigates a bereavement training programme with a group of volunteer lay counsellors. In South Africa, the number of orphans resulting from an increase in parental deaths from natural causes, such as AIDS and nonnatural causes, for example violence, is increasing rapidly. The increasing number of bereaved children is creating a demand for professional support services that cannot be met by the present number of trained professionals. To address this imbalance, the training of lay counsellors is proposed. It is thus relevant to train those who are willing to help with the necessary knowledge and skills in a bereavement training programme. The present study involves ten volunteers from a Community Centre. Qualitative research methods are employed to analyse the data that is gained from the preand post-training responses to the interviews and Case Examples. Content analysis is used to elucidate the themes that emerge from the collected data. The results of the present study indicate that perceptual and developmental changes have occurred within the volunteers following the training programme, however, it is evident that further training is necessary because of the limited ability that the volunteers demonstrate in practically transferring the knowledge to new cases. In terms of this finding it is clear that factors such as language, age, educational level and personal experiences of death are important criteria to consider in the selection of volunteers for a bereavement training programme. Furthermore, traditional African perspectives of death, cultural differences and HIV/AIDS awareness need to be incorporated into future bereavement training programmes. In terms of the outcomes of the study, a positive outcome is the revision of the Bereavement Programme for children, taking cognisance of cultural sensitiveness, to make it more applicable within the local context. The results of the study also highlight the limitations and implications of the present research, which are discussed and recommendations for future research are made.
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Tsai, Wei I., and 蔡洧沂. "The Change Pattern and its Predicting Factors of Complicated Grief During Bereavement Stage for Family Caregivers of Terminally ill Cancer Patients." Thesis, 2014. http://ndltd.ncl.edu.tw/handle/37870309904496045855.
Full textAbstract:
碩士長庚大學
護理學系
102
The purposes of this study were to explore the changs of complicated grief during the stage of bereavement for family caregivers of terminally ill cancer patients and its influencing factors. This study used a descriptive longitudinal research design and 364 family caregivers of terminally ill cancer patients were recruited by a convenience sampling method in a medical center in Northern Taiwan. The Chinese version of the Prolonged Grief Scale was used to measure complicated grief symptoms at four time-points: 6th, 13th, 18th, 24th month after bereavement. Data was analyzed by the Generalized Estimation Equations model. There were no significant differences in the prevalence of the complicated grief at the four time-points, but intensity of complicated grief levels declined significantly over time. Multivariate logistic regression analysis indicated that caregivers with more severe depressive symptoms and a higher level of difficult perception of their relative’s dying situation had a significant higher likelihood of experiencing complicated grief. The intensity of complicated grief was greater for bereaved caregivers who were decedent patient’s spouse with more severe depressive symptoms. In contrast, the intensity of complicated grief was lower for those who also took care of other family members or friends and bereaved for a longer time. Caregivers at risk of complicated grief, especially for those who were decedent patient’s spouse with more severe depressive symptoms and those who perceived a difficult dying situation of their relative need to be assessed carefully when terminally ill cancer patients are still alive to prevent family caregivers suffering from complicated grief once they lose their beloved relative. Effective interventions should be developed and provided to at-risk bereaved caregivers to lift their suffering and avoid complicated grief over the bereavement stage.
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Provenzano, Retawnya M. "Memory and connection in maternal grief: Harriet Beecher Stowe, Emily Dickinson, and the bereaved mother." Thesis, 2017. https://doi.org/10.7912/C2T667.
Full textAbstract:
Indiana University-Purdue University Indianapolis (IUPUI)This essay explores a broad range of literary works that treat long-term grief as a natural response to the death of a child. Literary examples show gaps in the medical and social sciences’ considerations of grief, since these disciplines judge bereaved mothers’ grief as excessive or label it bereavement disorder. By contrast, authors who employ the ancient storyline of child death illuminate maternal grieving practices, which are commonly marked with a vigilance that expresses itself in wildness. Many of these authors treat grief as a forced pilgrimage, but question the possibility of returning to a previous state of psychological balance. Instead, the mothers in their stories and poems resist external pressure for closure and silence and favor lasting memory. Harriet Beecher Stowe, in Uncle Tom’s Cabin, and Emily Dickinson, in letters to bereaved mother Susan Gilbert Dickinson and in the poetry included in these letters, represent maternal child loss as compelling a movement into a new state and emphasize the lasting pain and disruption of this loss.
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Valentim, Filipa Alexandra Goulart. "A Redescoberta do Luto e Sua Psicopatologia nas Classificações Contemporâneas." Master's thesis, 2017. http://hdl.handle.net/10316/82604.
Full textAbstract:
Trabalho de Projeto do Mestrado Integrado em Medicina apresentado à Faculdade de MedicinaNeste trabalho de revisão procurámos esclarecer determinados aspetos de uma patologia que continua a levantar imensas questões na comunidade médica e cientifica: o Luto Patológico. Para tal, realizámos inicialmente uma pesquisa bibliométrica, uma vez que existe uma enorme confusão relativamente à designação desta patologia na língua inglesa. Seguidamente procurámos esclarecer qual a melhor forma de diagnosticar estes doentes e qual o tratamento indicado para os ajudar, dado que à luz das classificações atuais ainda não existe um consenso. A discórdia na nomenclatura perpetua-se pela desigualdade de terminologia utilizada pelas duas entidades DSM-V e ICD-11, que utilizam “Persistent Complex Bereavement Disorder” e ”Prolonged Grief”, respetivamente. Embora esta divergência tenha consequências nocivas em termos diagnósticos, a introdução desta patologia nas classificações mais atuais e o estabelecimento de critérios diagnósticos para a mesma (embora provisórios), trás uma nova esperança para estes doentes. Em termos terapêuticos a controvérsia é menor, tendo sido possível apurar que as técnicas cognitivo-comportamentais atingem melhores resultados nestes doentes. Neste trabalho serão descritas e discutidas as variações destas técnicas, assim como os achados da sua associação com terapêuticas farmacológicas.
In this revision article we’ve tried to clarify certain aspects of a pathological entity that continues to raise multiple questions in the medical and scientific community: Complicated Grief. Initially we executed a bibliometric survey, since there is an enormous confusion regarding the designation of this disease in the english language. We then sought to clarify how to diagnose these patients and how to treat them, given that there is still no consensus in the current classifications. The quarrel in the nomenclature is perpetuated by the difference of terminology used by the two entities DSM-V and ICD-11, which use "Persistent Complex Bereavement Disorder" and "Prolonged Grief", respectively. Although this divergence has harmful consequences in terms of diagnosis, the introduction of this disease in the most current classifications and the establishment of diagnostic criteria (although provisional), brings new hope for these patients.In terms of therapy, there is not so much controversy, as it was understandable that cognitive-behavioral techniques have better results in these patients. In this paper we will describe and discuss the variations of these techniques, as well as the effects of its association with pharmacological therapies.
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Světlíková, Zora. "Prožívání ztráty dítěte." Master's thesis, 2013. http://www.nusl.cz/ntk/nusl-330750.
Full textAbstract:
The diploma thesis "Experiencing the loss of a child" deals with the psychological aspects of adaptation to the loss of a child. Its main objective is to analyse the supporting factors that help the adaptation and to find out how such loss influences individuals and their subsequent life. The theoretical part of the thesis focuses on the issue of the loss of a close person and details the specifics of the loss of a child. Based on available literature the author explores the process of grieving and its manifestations and determines the variables that influence the adaptation to child loss. She also evaluates the impact of the child loss on the individual and the potential for intervention in the process. The empirical part determines the factors that help to cope with such loss, describes, how the loss influences the life of the individual and focuses on the needs of the bereaved parents. The data gathering consisted of ten individual in-depth interviews with women which experienced the loss of a child. These interviews were then qualitatively analysed using the IPA (Interpretative Phenomenological Analysis) method. Based on the results of the qualitative analysis we identified four main support aspects of adaptation to child loss - social support, individual activity, professional help and faith....
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Silva, Vanessa Filipa Cardoso da. "The Forgotten Grievers : a intervenção psicológica no luto fraterno : uma revisão sistemática da literatura." Master's thesis, 2019. http://hdl.handle.net/10400.14/32317.
Full textAbstract:
Introdução: Uma das premissas fundamentais dos Cuidados Paliativos é o apoio
à família. Este apoio ocorre não somente na fase de doença, mas também após a morte do
paciente, durante o processo de luto. Um dos componentes centrais do sistema familiar é
a fratria, sendo que a relação entre irmãos é considerada a relação mais significativa e
duradoura que se vive.
Todavia, verifica-se que o impacto da morte de um irmão na vida de uma
criança/adolescente tem sido pouco valorizado, e atendendo a que o Psicólogo é um
elemento das equipas de cuidados paliativos, pretende-se perceber quais os tipos de
intervenção psicológica que permitem diminuir o risco de ocorrência de perturbações
associadas ao luto, mormente o luto complicado / prolongado, nesta população.
Método: Revisão sistemática da literatura realizada entre 24 e 27 de Janeiro de
2019, recorrendo às bases de dados PubMed, Scielo, Redalyc e EBSCO (PsycArticles,
Academic Search Complete e Psychological and Behavioral Sciences).
Resultados: Foram selecionadas 10 publicações que abordavam a intervenção
psicológica junto de irmãos em luto. As intervenções recorriam às mais variadas técnicas
e estratégias, visando a promoção de um processo de luto adaptativo (e
consequentemente, diminuindo a probabilidade de complicações associadas a este
processo).
Conclusão: O papel do psicólogo é fundamental para que os irmãos sobreviventes
possam partilhar as suas experiências, medos, ansiedades, bem como validar sentimentos.
Os psicólogos, enquanto membros das equipas de cuidados paliativos, devem estar
preparados para prestar o apoio necessário aos irmãos que sobrevivem, encontrando as
formas adequadas para ir ao seu encontro e criar uma relação de ajuda que permita atenuar
o seu sofrimento, lidar com as emoções negativas e traumáticas e ajudá-los a seguir em
frente no seu processo de luto.Introduction: One of the main premises of Palliative Care is family support. This support occurs not only during the disease phase, but also after the patient’s death, during the bereavement process. One of the central components of the family system is the sibling relationship, since it is considered to be the most significant and lasting relationship one experiences. However, the impact of a sibling’s death in a child or adolescent’s life has been little valued. Given that the psychologist is an element of the Palliative Care teams, we intend to understand what types of psychological intervention can reduce the risk of disturbances associated with mourning, especially complicated / prolonged grief, in this population. Method: Systematic literature review conducted between the 24th and 27th of January 2019, using the databases PubMed, Scielo, Redalyc and EBSCO (PsycArticles, Academic Search Complete and Psychological and Behavioral Sciences). Results: 10 publications referring to psychological intervention with bereaved siblings were selected. The interventions used the most varied techniques and strategies, aiming to promote an adaptive mourning process (and consequently, diminishing the probability of bereavement complications). Conclusion: The role of the psychologist is fundamental so that surviving siblings can share their experiences, fears, anxieties, as well as to validate feelings. Psychologists, as members of palliative care teams, should be prepared do provide the necessary support to surviving siblings, by finding the appropriate ways to meet them and to create a helping relationship that alleviates their suffering, that allows them to deal with their negative and traumatic emotions, and that helps them to move forward in the grieving process.
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Quisenberry, Clinton Edward. "Murder, mayhem, and mourning: a qualitative study of the experiences, reactions, and coping mechanisms of homicide survivors." 2009. http://hdl.handle.net/1969.1/ETD-TAMU-2009-05-426.
Full textAbstract:
Previous research has greatly ignored the unique stressors that homicide
survivors experience following the murder of their loved one, indicating a general lack
of understanding of the experiences and reactions they are subjected to or the coping
mechanisms that they utilize. What little research that had been conducted has largely
been made up of anecdotal insight of psychological practitioners who had worked with
clients. A need exists to speak with the survivors themselves to chronicle their
experiences in as much detail as possible to help researchers and practitioners wrap their
mind around the totality of the loss as well as ground future research.
The participants in the study consisted of twelve persons who had immediate
family members who had been murdered. Participants were interviewed utilizing
Lincoln & Guba?s Naturalistic Inquiry paradigm. They were initially interviewed and
encouraged to discuss their loss in narrative and then were asked a series of specific
questions that may or may not have been discussed during the narrative. The collected data was analyzed utilizing the constant comparison methodology.
Results indicate that many homicide survivors feel overwhelmed by the changes that
occur in the short and long term. None of the participants reported positive experiences
interacting with mental health practitioners but virtually everyone endorsed peer-group
support. There was also evidence that participants whose loved one was murdered by a
person of an ethnicity that differed from their own resulted in racist feelings towards the
other ethnicity. Further, there was no evidence that the process of interviewing homicide
survivors was in and of itself negatively perceived or harmful; rather some participants
reported feeling relieved that they were able to discuss their loss in totality without
having to edit themselves.
Results suggest that homicide survivors may spend an unusual amount of time
reflecting on the person that their loved one may have become had they not been
murdered. Suggestions also include how to best notify and support homicide survivors
and how practitioners may best relate with their clients.
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Van, Niekerk Anna Maria Susanna. "Opvoedkundig-sielkundige riglyne vir die terapeutiese hantering van die verlies- en treurproses." Diss., 2011. http://hdl.handle.net/10500/4914.
Full textAbstract:
Text in AfrikaansDie doel van hierdie studie was om die aard en negatiewe gevolge van die verlies- en treurproses te ondersoek, en riglyne daar te stel vir die terapeutiese hantering van die verlies- en treurproses. Aan die hand van ‘n literatuurstudie is die aard, gevolge en terapie-benaderings met betrekking tot die verlies- en treurproses bestudeer. Die Opvoedkundig-sielkundige Relasieteorie is verken, en is as raamwerk in ’n empiriese studie gebruik. Die hantering van die verlies- en treurproses is kwalitatief ondersoek. Deur terapeutiese intervensie in drie deelnemers se verlies- en treurproses, is insig verkry met die oog op die samestelling van ’n terapieprogram, sowel as vir riglyne vir die terapeut en die kliënt. Ek het wegbeweeg van navorsing wat primêr beskrywend van aard is en op diagnostiese oorwegings fokus, na raamwerke waar intervensie-strategieë en spesifieke tegnieke gebruik kan word wanneer die terapeut en die kliënt betrokke is in deurlopende psigoterapie. Die navorsingsresultate toon dat dit belangrik is om nie slegs op die verlies te fokus nie, maar ook op onopgeloste kwessies wat vantevore in die kliënt se lewe plaasgevind het. Insig en kennis van hulleself, hul verhoudings, verdedigingsmeganismes, emosies, denke en gedrag, en die invloed wat dit op hulle verlies- en treurproses het, was nodig sodat die kliënte hul ongewenste aangeleerde gedrag kon wysig, om sodoende hulleself beter te verstaan in die hantering van hulle verlies en die treurproses.
The purpose of this study was to investigate the nature and negative consequenses of, and to set guidelines for the therapeutic handling of the loss and grief process. A literature study was undertaken to determine the nature, consequences, and therapeutic techniques, with regard to the loss and grief process, based on Psychological Relations theory. By means of therapeutic intervention in the three participants’ loss and grief processes, I gained insight to compose a therapeutic programme, as well as therapeutic guidelines and intervention strategies and specific techniques that can be used when the therapist and the client are involved in continuous psychotherapy. The results of the study indicated that it is important to focus on unresolved issues that happened earlier in the client’s life. Insight in the person as a whole, is required to be able to understand themselves better in the handling of their loss and the grieving process.
Educational Studies
M. Ed. (Voorligting)
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Kardaus, Miroslav. "Ověření využitelnosti nástroje hodnocení potřeb při úmrtí a ztrátě." Master's thesis, 2015. http://www.nusl.cz/ntk/nusl-349485.
Full textAbstract:
In this study we are verifying aplicability of the tool BNAT for the target group of people with severe, multiple disability and autism in social residential facilities. Next we comment the tool. The research has been conducted by means of interviewing primary care workers. Based on the results of qualitative analysis of interviews we had commented BNAT tool and suggested adjustments, leading towards usability in residential facility conditions, considering target group. The contribution of the study is based on verifying of practicality of the tool that is mapping the needs of users in the moment of loss. The significance is foremost for workers who lead individuals with intellectual disability through the loss of the loved one.
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Pereira, Sara Maria do Nascimento Dinis. "Ambivalência e resolução da ambivalência: uma análise da interação terapêutica." Master's thesis, 2017. http://hdl.handle.net/1822/46585.
Full textAbstract:
Dissertação de mestrado em Psicologia Aplicada (área de especialização em Psicologia Clínica e da Saúde)Quando não resolvida, a ambivalência pode condicionar o sucesso terapêutico. Assim, pretendemos saber de que modo a díade terapêutica interage nos momentos de ambivalência e nos momentos de resolução da ambivalência, num caso de sucesso seguido em terapia construtivista de luto complicado. Para tal analisamos as intervenções do terapeuta antes e depois dos momentos de ambivalência e da sua resolução e as respostas da cliente, utilizando o Sistema de Codificação de Colaboração Terapêutica. Os resultados mostram que os momentos de ambivalência e os momentos de resolução de ambivalência tendem a emergir na sequência de intervenções de desafio. Mostram ainda que face aos primeiros o terapeuta tende a oferecer suporte, ao passo que face aos segundos, o terapeuta tende a persistir no desafio. Por sua vez a cliente tende a validar as intervenções do terapeuta, sugerindo que a díade trabalha a maior parte do tempo dentro da Zona de Desenvolvimento Proximal Terapêutica. Estes resultados vão de encontro aos estudos anteriores, sendo a principal diferença a elevada percentagem de invalidação face ao desafio, pouco comum nas amostras estudadas anteriormente. Especula-se que este fenómeno possa refletir a dificuldade e a culpa associadas à reconstrução da vida face à perda.
When unresolved, ambivalence may condition therapeutic success. Therefore will study how the therapeutic dyad interacts in these moments of ambivalence and in moments when ambivalence is solved, in a successful case followed in a constructivist therapy of complicated mourning. For that purpose, we analyzed the therapist´s interventions before and after the moments of ambivalence, its resolution and the client´s responses, using the Therapy Collaboration Coding System. The results suggest that moments of ambivalence and moments of solving ambivalence tend to emerge as a result of challenging interventions. When ambivalence emerges, the therapist tends to offer support, and when ambivalence is solved, the therapist tends to persist in the challenge. In turn, the client tends to validate the therapist's interventions, implying that the dyad works most of the time within the Therapeutic Proximal Development Zone. These results are generally in line with previous studies. An important difference is the high percentage of invalidation of the client towards challenging therapist interventions, uncommon in the samples studied previously. We speculated that this phenomenon may reflect the difficulty and guilt associated with rebuilding life in the face of loss.
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Sousa, Ana Rita da Rocha Oliveira de. "Ambivalência em terapia online de luto complicado." Master's thesis, 2017. http://hdl.handle.net/1822/48297.
Full textAbstract:
Dissertação de mestrado em Psicologia AplicadaDe uma perspetiva narrativa, o processo de mudança em psicoterapia envolve o desenvolvimento de significados alternativos à auto-narrativa problemática, através da emergência e expansão de Momentos de Inovação (MIs). No entanto, este processo pode ser atenuado através da reafirmação da auto-narrativa problemática conduzindo o cliente à ambivalência, levando-o a produzir Marcadores de Ambivalência (MAs). Assim, no presente estudo realizou-se um estudo de caso de terapia online de luto complicado cujos objetivos foram: a) descrever o perfil de ambivalência; b) relacionar a emergência de ambivalência e a evolução clínica da cliente; c) avaliar os MIs mais frequentemente atenuados ao longo do processo terapêutico. No presente estudo utilizou-se o Sistema de Codificação da Ambivalência (SCA) para identificar MAs e uma análise Time Series para estudar a associação entre a evolução dos MAs e a evolução da mudança sintomática. Os resultados sugerem que a emergência de MAs está significativamente associada à evolução clínica da cliente. Este estudo permitiu ainda analisar de que modo os processos de mudança e de ambivalência na terapia online são comparáveis à terapia face-a-face, sugerindo uma semelhança entre ambas as formas de terapia.
The change process in psychotherapy involves development of alternative meanings to the problematic self-narrative through the emergence and expansion of innovative moments (IMs). However, this process can be nullified through the resurgence of the problematic self-narrative, giving place to ambivalence. This resurgence is empirically tracked by the identification of ambivalence markers (AMs) by the client. Thus, the goals of this study were: a) describe the ambivalence evolution on a case of complicated grief using online therapy; b) test de association between ambivalence occurrence and the clinical evolution of the client; c) identify the IMs that are more frequently attenuated in the course of the therapeutic process in this case. Using the Ambivalence Coding System to track AMs and a time series model to analyze the cross-correlation between AMs and symptomatic evolution, we found a significant association between AMS occurrence and the client’s clinical evolution. This study allowed us to start exploring the processes of change and ambivalence in online therapy, and to compare it to the results of face to face therapy. In general we found similar processes in these two therapeutic contexts regarding the emergence and evolution of IMs and AMs in complicated grief.
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Dias, Joana Soares Pimentel de Sequeira. "Fatores de risco no desenvolvimento de um luto complicado em familiares cuidadores de doentes oncológicos." Master's thesis, 2015. http://hdl.handle.net/10400.14/20546.
Full textAbstract:
Embora o luto complicado afete aproximadamente seis milhões de cuidadores de doentes oncológicos em todo o mundo (Carr & Steel, 2013), este processo de luto em familiares cuidadores destes doentes recebeu ainda pouca atenção empírica contextualizada na nossa realidade e numa abordagem qualitativa.
Neste sentido, procurou-se compreender quais os fatores que, na perspetiva destes cuidadores informais, contribuíram para o desenvolvimento do luto complicado. Através de uma metodologia qualitativa, foram realizadas entrevistas semi-estruturadas a quatro familiares cuidadoras de doentes oncológicos que vivenciaram um luto complicado. A análise de conteúdo foi orientada pelos princípios da Grounded Theory.
Como principais resultados, salienta-se que as participantes apontaram como fatores que contribuíram para o luto complicado a introversão, a intensidade do vínculo com o(a) doente, a consciência do sofrimento do(a) doente, a dificuldade de aceitação da morte, e, a presença de patologias pessoais ou familiares concorrentes à doença paliativa ou à perda. Já o local e modo da morte, e, a conspiração de silêncio com o(a) doente não se revelaram como tendo influenciado o luto.
Na nossa perspetiva, o conhecimento deste tipo de fatores traz contributos para a compreensão dos processos de luto complicado destes cuidadores com implicações no ajustamento das práticas profissionais neste fenómeno.Although complicated grief affect about six million caregivers of oncologic patients worldwide (Carr & Steel, 2013), this grief process in family caregivers of these patients has received little empirical attention contextualized in our reality and in a qualitative approach. Therefore, we aimed to understand what factors influenced the development of a complicated grief from the perspective of these informal caregivers. Through a qualitative approach, semi-structured interviews were conducted with four family caregivers of oncologic patients that experienced a complicated grief, and were used the principles of Grounded Theory for data analysis. The main conclusions shows that participants pointed as factors that contributed for complicated grief introversion, intensity of attachment to patient, the awareness of patient’s suffering, the difficulty of accepting death and the presence of personal and family’s pathologies competitors of oncologic disease or loss. The location and way of the death, and the conspiracy of silence with the patient were those that didn’t seem to have influence in the grief process. We believe that the knowledge of such factors brings contributions to understanding complicated grief processes in these caregivers and research community and practitioners’ action that, in this way, can promote an adjusted grief process in this population.