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Huh, Hyu Jung, Kyung Hee Kim, Hee-Kyung Lee, and Jeong-Ho Chae. "Attachment Style, Complicated Grief and Post-Traumatic Growth in Traumatic Loss: The Role of Intrusive and Deliberate Rumination." Psychiatry Investigation 17, no. 7 (2020): 636–44. http://dx.doi.org/10.30773/pi.2019.0291.
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Objective The present study examines the effects of attachment styles on the grief response and the indirect effect of rumination in parents who lost a child in the Sewol Ferry accident.Methods Bereaved parents (n=81) completed self-report questionnaires evaluating their attachment style (Experience in Close Relationship-Short form), traumatic loss related rumination (Event-Related Rumination Inventory), degree of complicated grief (Inventory of Complicated Grief), and post-traumatic growth (Post-Traumatic Growth Inventory). Data were analyzed using correlation analysis, structural equation modeling, and bootstrapping.Results The indirect effect of event-related intrusive rumination was significant in the relationship between attachment avoidance and complicated grief. The path from attachment avoidance to post-traumatic growth via deliberate rumination was not significant. With respect toattachment anxiety and post-traumatic growth, the indirect effect of deliberate rumination was significant. But the indirect effect of intrusive rumination was not significant in the relationships among attachment anxiety, complicated grief, and post-traumatic growth.Conclusion Individuals with attachment anxiety could obtain post-traumatic growth via deliberate rumination. By contrast, attachment avoidance was associated with the risk of maladaptive grief. Grief interventions should account for individual differences in attachment styles through interventions that manage intrusive rumination and strengthen deliberate rumination.
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Tang, Suqin, and Amy Y. M. Chow. "Subjective and objective traumatic death: distinct roles in developing complicated grief and depression among older adults in Hong Kong." International Psychogeriatrics 29, no. 3 (2016): 409–17. http://dx.doi.org/10.1017/s1041610216001873.
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ABSTRACTBackground:Symptoms of complicated grief are associated with a traumatic death. However, the subjective experience of whether or not the death was considered traumatic has not been substantially explored. This study first examined the difference between objective and subjective traumatic death, and then investigated their respective impacts on complicated grief and depressive symptoms following bereavement among older adults in Hong Kong.Methods:Participants were 187 Hong Kong adults aged 65 years or above who had lost a family member within the past five years. Demographic information, the Inventory of Complicated Grief (ICG), the Geriatric Depression Scale (GDS), and the anxiety subscale of the Hospital Anxiety and Depression Scale (HADS) were utilized.Results:The subjective traumatic level of the death did not differ between the objective traumatic and non-traumatic death as defined by nature of death (t = −1.554, p = 0.122). Higher subjective traumatic levels and younger age of the deceased, were positively related to complicated grief symptoms, F (10, 161) = 14.222, p < 0.001, R2 = 0.469. Higher subjective traumatic levels and older age of the bereaved were positively associated with symptoms of depression, F (10, 160) = 2.855, p = 0.003, R2 = 0.151. However, objective traumatic death was found to have no relation to either complicated grief or depressive symptoms.Conclusions:Subjective and objective traumatic death may be two distinct concepts, and the subjective experience of the death as a trauma may be a more important factor that contributes to complicated grief and depressive symptoms.
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Ruddle, Jean Anne, B. Rudi Coetzer, and Frances L. Vaughan. "Grief after Brain Injury: A Validation of the Brain Injury Grief Inventory (BIGI)." Illness, Crisis & Loss 13, no. 3 (2005): 235–47. http://dx.doi.org/10.1177/105413730501300304.
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The objective of this article is to determine whether a new questionnaire (the BIGI) is a valid and reliable measure of grief in a brain injured population. Design: Within group, questionnaire based prospective study of individuals with traumatic brain injury (TBI). The BIGI was compared with other questionnaires to determine the construct validity and repeated to assess test re-test reliability. Results: The loss scale of the BIGI had a higher internal consistency than the adjustment scale. Test re-test reliability for both variables was good. Younger individuals appeared to be more likely to show a positive adjustment to a TBI than older individuals. Women reported higher scores for loss than men. On the adjustment scale, married individuals achieved lower scores than single persons. Conclusions: The BIGI scales of loss and adjustment were associated with a number of the other measures. The loss scale had a higher internal consistency than the adjustment scale. The clinical utility of the scale is discussed and further research suggested.
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Morgos, Dorothy, J. William Worden, and Leila Gupta. "Psychosocial Effects of War Experiences among Displaced Children in Southern Darfur." OMEGA - Journal of Death and Dying 56, no. 3 (2008): 229–53. http://dx.doi.org/10.2190/om.56.3.b.
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This study focused on assessing the psychosocial effects of the long standing, high intensity, and guerrilla-style of warfare among displaced children in Southern Darfur. The goal was to better understand the etiology, prognosis, and treatment implications for traumatic reactions, depression, and grief symptoms in this population. Three hundred thirty-one children aged 6–17 from three IDP Camps were selected using a quota sampling approach and were administered a Demographic Questionnaire, Child Post Traumatic Stress Reaction Index, Child Depression Inventory, and the Expanded Grief Inventory. Forty-three percent were girls and 57% were boys. The mean age of the children was 12 years. Results found that children were exposed to a very large number of war experiences with no significant differences between genders for types of exposure, including rape, but with older children (13–17 years) facing a larger number of exposures than younger children (6–12 years). Out of the 16 possible war experiences, the mean number was 8.94 ( SD = 3.27). Seventy-five percent of the children met the DSM-IV criteria for PTSD, and 38% exhibited clinical symptoms of depression. The percentage of children endorsing significant levels of grief symptoms was 20%. Increased exposure to war experiences led to higher levels of: 1) traumatic reactions; 2) depression; and 3) grief symptoms. Of the 16 war experiences, abduction, hiding to protect oneself, being raped, and being forced to kill or hurt family members were most predictive of traumatic reactions. Being raped, seeing others raped, the death of a parent/s, being forced to fight, and having to hide to protect oneself were the strongest predictors of depressive symptoms. War experiences such as abduction, death of one's parent/s, being forced to fight, and having to hide to protect oneself were the most associated with the child's experience of grief. In addition to Total Grief, Traumatic Grief, Existential Grief, and Continuing Bonds were measured in these children. Although trauma, depression, and grief often exist as co-morbid disorders, the mechanisms and pathways of these is less understood. In this study we used Structural Equation Modeling to better understand the complex interaction and trajectories of these three symptoms evolving from war exposure and loss. This study is the first of its kind to assess the psychosocial effects of war experiences among children currently living in war zone areas within Sudan. It identifies some of the most prevalent war-related atrocities and their varying impact on the children's psychological well-being and overall adjustment. Implications for planning mental health interventions are discussed.
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Boelen, Paul A., and Jan van den Bout. "Gender Differences in Traumatic Grief Symptom Severity after the Loss of a Spouse." OMEGA - Journal of Death and Dying 46, no. 3 (2003): 183–98. http://dx.doi.org/10.2190/6c8g-c0xr-f0q4-vr3x.
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Gender differences in bereavement outcome have received much attention in bereavement research in the past decades. While many studies have focused on depressive symptomatology and/or normal grief reactions, little attention has been paid to gender differences in symptoms of pathological or traumatic grief (TG). In addition, few studies have investigated gender differences beyond the acute grieving period. In the present study, cross-sectional data were used to explore gender differences in the temporal course of TG symptomatology. Data were derived from 270 spousally bereaved individuals who filled in the Inventory of Traumatic Grief on the Internet. Analyses of variance were conducted to explore differences in TG symptoms over time and between widows and widowers. No differences were found between men and women on the TG symptoms or the TG summary score, on any of the observational time points. With regard to the temporal course of TG symptomatology, indications were found that symptoms of separation distress are likely to subside over the passage of time, while symptoms of traumatic distress are unlikely to do so.
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Wagner, B., J. Müller, and A. Maercker. "Death by request in Switzerland: Posttraumatic stress disorder and complicated grief after witnessing assisted suicide." European Psychiatry 27, no. 7 (2012): 542–46. http://dx.doi.org/10.1016/j.eurpsy.2010.12.003.
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AbstractBackgroundDespite continuing political, legal and moral debate on the subject, assisted suicide is permitted in only a few countries worldwide. However, few studies have examined the impact that witnessing assisted suicide has on the mental health of family members or close friends.MethodsA cross-sectional survey of 85 family members or close friends who were present at an assisted suicide was conducted in December 2007. Full or partial Post-Traumatic Distress Disorder (PTSD; Impact of Event Scale–Revised), depression and anxiety symptoms (Brief Symptom Inventory) and complicated grief (Inventory of Complicated Grief) were assessed at 14 to 24 months post-loss.ResultsOf the 85 participants, 13% met the criteria for full PTSD (cut-off≥35), 6.5% met the criteria for subthreshold PTSD (cut-off≥25), and 4.9% met the criteria for complicated grief. The prevalence of depression was 16%; the prevalence of anxiety was 6%.ConclusionA higher prevalence of PTSD and depression was found in the present sample than has been reported for the Swiss population in general. However, the prevalence of complicated grief in the sample was comparable to that reported for the general Swiss population. Therefore, although there seemed to be no complications in the grief process, about 20% of respondents experienced full or subthreshold PTSD related to the loss of a close person through assisted suicide.
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McClatchy, Irene Searles, M. Elizabeth Vonk, and Gregory Palardy. "The Prevalence of Childhood Traumatic Grief—A Comparison of Violent/Sudden and Expected Loss." OMEGA - Journal of Death and Dying 59, no. 4 (2009): 305–23. http://dx.doi.org/10.2190/om.59.4.b.
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The purpose of this study was to examine the prevalence of childhood traumatic grief (CTG) and posttraumatic stress disorder (PTSD) symptoms in parentally bereaved children and compare scores between those who had lost a parent to a sudden/violent death and those who had lost a parent to an expected death. Asample of 158 parentally bereaved children ages 7–16 completed the Extended Grief Inventory (EGI); 127 of those also completed the UCLA PTSD Index. A large number of children were experiencing CTG symptoms at moderate and severe levels. There was no significant difference in EGI or UCLA PTSD Index scores between the two types of losses. Findings are discussed in relation to trauma theory, research on parentally bereaved children and implications for practice.
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Soares, J., S. L. Azevedo Pinto, A. C. Pinheiro, S. Pacheco, and R. Curral. "Therapeutic Approach to Complicated Grief–An Example of Group Psychotherapy in Psychiatric Patients." European Psychiatry 41, S1 (2017): s772—s773. http://dx.doi.org/10.1016/j.eurpsy.2017.01.1458.
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Introduction.Complicated Grief (CG) affects 7–10% of the grieving individuals in the general population. However, the incidence is much higher in psychiatric patients, reaching 70% in most samples. These individuals present many risk factors for such condition, demanding a particular attention and treatment approach. Most studies have shown that pharmacological treatment may help relieving depressive and anxiety symptoms, although they do not promote a consistent improvement of the grieving scenario. Several meta-analyses have recognized different psychological interventions as effective in dealing with the loss, decreasing psychological suffering and promoting adaptation. It is accepted that the benefits of the intervention overcome any possible harm.Objectives.To evaluate the impact of a group intervention (12 sessions) in pharmacologically stabilized psychiatric patients presenting with CG.Methods.Patient selection was performed through a clinical interview and the fulfilment of the following psychometric tests: Complicated Grief Inventory; the Impact of Events Scale; Beck Depression Inventory; Social Support Scale. These assessment tools were also used to evaluate the impact of the intervention performed.Results.After the psychotherapeutic intervention, there were significant differences in the levels of depressive and post-traumatic stress symptoms.Conclusion.Group intervention in CG has proven effective in this population, specially regarding depression and post-traumatic stress levels.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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BOELEN, PAUL A., JAN VAN DEN BOUT, JOS DE KEIJSER, and HERBERT HOIJTINK. "RELIABILITY AND VALIDITY OF THE DUTCH VERSION OF THE INVENTORY OF TRAUMATIC GRIEF (ITG)." Death Studies 27, no. 3 (2003): 227–47. http://dx.doi.org/10.1080/07481180302889.
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Boelen, Paul A., and Geert E. Smid. "The Traumatic Grief Inventory Self-Report Version (TGI-SR): Introduction and Preliminary Psychometric Evaluation." Journal of Loss and Trauma 22, no. 3 (2017): 196–212. http://dx.doi.org/10.1080/15325024.2017.1284488.
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Kentish-Barnes, Nancy, Marine Chaize, Valérie Seegers, et al. "Complicated grief after death of a relative in the intensive care unit." European Respiratory Journal 45, no. 5 (2015): 1341–52. http://dx.doi.org/10.1183/09031936.00160014.
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An increased proportion of deaths occur in the intensive care unit (ICU).We performed this prospective study in 41 ICUs to determine the prevalence and determinants of complicated grief after death of a loved one in the ICU. Relatives of 475 adult patients were followed up. Complicated grief was assessed at 6 and 12 months using the Inventory of Complicated Grief (cut-off score >25). Relatives also completed the Hospital Anxiety and Depression Scale at 3 months, and the Revised Impact of Event Scale for post-traumatic stress disorder symptoms at 3, 6 and 12 months. We used a mixed multivariate logistic regression model to identify determinants of complicated grief after 6 months.Among the 475 patients, 282 (59.4%) had a relative evaluated at 6 months. Complicated grief symptoms were identified in 147 (52%) relatives. Independent determinants of complicated grief symptoms were either not amenable to changes (relative of female sex, relative living alone and intensivist board certification before 2009) or potential targets for improvements (refusal of treatment by the patient, patient died while intubated, relatives present at the time of death, relatives did not say goodbye to the patient, and poor communication between physicians and relatives).End-of-life practices, communication and loneliness in bereaved relatives may be amenable to improvements.
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Kempson, Diane A. "Effects of Intentional Touch on Complicated Grief of Bereaved Mothers." OMEGA - Journal of Death and Dying 42, no. 4 (2001): 341–53. http://dx.doi.org/10.2190/t1u8-jwau-3rxu-ly1l.
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Loss of one's child represents one of the most traumatic events a human may endure. Few effective interventions have been documented. The purpose of this research was to determine the effect of touch therapy on grieving mothers. Bereavement responses of mothers who had lost a child in the previous 6–60 months ( n 31, intervention group; n 34, comparison group) were evaluated for significant differences between intervention (touch therapy) and comparison groups, measured by the Grief Experience Inventory (GEI). Analysis of the nine clinical scales of the GEI demonstrated statistically significant differences for the intervention group on the following scales: despair ( F 8.290, p .006), depersonalization ( F 4.904, p .031), and somatization ( F 6.833, p .012). Significance of findings as they relate to treatment of complicated grief is discussed.
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Wagner, Birgit, Valerie Keller, Christine Knaevelsrud, and Andreas Maercker. "Social acknowledgement as a predictor of post-traumatic stress and complicated grief after witnessing assisted suicide." International Journal of Social Psychiatry 58, no. 4 (2011): 381–85. http://dx.doi.org/10.1177/0020764011400791.
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Background: In Switzerland, right-to-die organizations such as Exit Deutsche Schweiz offer suicide assistance to their members. However, there is limited knowledge of the impact that witnessing assisted suicide has on the post-traumatic stress severity or the grief process of family members. Low perceived social acknowledgement may affect mental health. Methods: A cross-sectional survey of 85 family members who were present at an assisted suicide was conducted in December 2007. The Inventory of Complicated Grief and the Impact of Event Scale were used to assess symptoms of post-traumatic stress disorder (PTSD) and complicated grief (CG) at 14 to 24 months post-loss. Further, the Social Acknowledgement Questionnaire was used to examine the impact that the social environment’s acknowledgement of the end-of-life decision had on respondents’ mental health. Results: As expected, social acknowledgement as a survivor was related to PTSD symptoms and CG. In particular, perceived general disapproval was strongly correlated with all outcome measures, whereas recognition was not significantly related to PTSD or CG (intrusion and avoidance). Conclusion: Family members of patients who use assisted suicide may hesitate to disclose the manner of death, and the community and societal environment may express strong views concerning the end-of-life decision. This can lead to increased levels of PTSD and CG.
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Boelen, Paul A., A. A. A. Manik J. Djelantik, Jos de Keijser, Lonneke I. M. Lenferink, and Geert E. Smid. "Further validation of the Traumatic Grief Inventory-Self Report (TGI-SR): A measure of persistent complex bereavement disorder and prolonged grief disorder." Death Studies 43, no. 6 (2018): 351–64. http://dx.doi.org/10.1080/07481187.2018.1480546.
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Pinheiro, M., N. Carvalho, D. Mendes, and J. Rocha. "A Prospective Intervention in Patients with Complicated Grief." European Psychiatry 41, S1 (2017): s781. http://dx.doi.org/10.1016/j.eurpsy.2017.01.1487.
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IntroductionMost reactions to grief are adaptive. However, there is the possibility that some individuals present a complicated grief disorder, where there is a pathological intensification of symptoms lasting more than 6 months, deserving special treatment.Objectives/aimsEvaluate the effectiveness of two types of intervention in complicated grief: group intervention (GI) and cognitive-narrative (CN) therapy.MethodsPatients in a complicated grief process were selected (n = 70), and distributed in three groups: cognitive–narrative therapy group (CNTG), group intervention group (GIG) and a control group (CG). Inclusion criteria: adults, with a reference to mourning situation, with personal meaning, for over six months and results in ICG ≥30points (cutoff). The Inventory of Complicated Grief (ICG), the Center for epidemiologic studies depression scale (CES-D) and the trauma questionnaire (ICD-11) were used. Follow-up was performed 3 months after the end of each intervention. Data analysis was performed using the statistical package from social sciences (SPSS 20).ResultsWith respect to complicated grief symptoms (CGx) and depression symptoms (Dx) there were statistically significant differences between the CNTG and the CG, but not with the GIG. There was no statistically significant effect in post-traumatic symptoms (PTx), even though both interventions had a slight decrease. When the CNTG and the GIG were directly compared, there was only a statistically significant difference between PTx.ConclusionsIn our single center cohort, CNTG was a more effective intervention in complicated grief patients for CGx and Dx reduction. For PTx, no intervention was superior. Larger multi-center studies are needed to validate these results.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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Langenberg, Simone M. C. H., Marlies E. W. J. Peters, Winette T. A. van der Graaf, Anke N. Machteld Wymenga, Judith B. Prins, and Carla M. L. van Herpen. "How did partners experience cancer patients' participation in a phase I study? An observational study after a patient's death." Palliative and Supportive Care 14, no. 3 (2015): 241–49. http://dx.doi.org/10.1017/s1478951515000887.
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AbstractObjective:It can be assumed that patients' participation in a phase I study will have an important impact on their partners' life. However, evaluation of partners' experiences while patients are undergoing experimental treatment and of their well-being after the patient's death is lacking. We aimed to explore partners' experience of patients' participation in phase I studies and to investigate their well-being after a patient's death.Method:This was an observational study conducted after the patient's death. Partners of deceased patients who had participated in a phase I study completed a questionnaire designed by us for experience evaluation and the Beck Depression Inventory for Primary Care, the Hospital Anxiety and Depression Scale, the Inventory of Traumatic Grief, and the RAND-36 Health Survey.Results:The median age of the 58 participating partners was 58 years (range: 51–65), and 67% was female. Partners reported negative effects on patients' quality of life, but only 5% of partners regretted patients' participation. Approximately two years after the patients' death, 19% of partners scored for depression, 36% for psychological distress, and 46% for complicated grief, and partners generally scored significantly lower on social and mental functioning compared to normative comparators.Significance of Results:Although partners reported negative consequences on patients' quality of life, most did not regret patients' participation in the phase I studies. Prevalence of depression, psychological distress, and complicated grief seemed important problems after a patient's death, and these must be considered when shaping further support for partners of patients participating in phase I trials.
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Powell, Steve, Willi Butollo, and Maria Hagl. "Missing or Killed." European Psychologist 15, no. 3 (2010): 185–92. http://dx.doi.org/10.1027/1016-9040/a000018.
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Many people go missing during war and acts of terrorism. Do their families suffer an additional or different kind of mental health burden than families of people who are known to have been killed? Two groups of respondents, each comprising 56 women living in Bosnia and Herzegovina, were included in the study. These were women whose husbands were either confirmed as having been killed during the 1992–1995 war or who were at the time of the study officially still listed as missing as a result of the war. These two groups filled in questionnaires on war events, postwar stressors, and mental health status. The results showed that the group with unconfirmed losses had higher levels of traumatic grief (measured on a version of the UCLA Grief Inventory) as well as severe depression (measured on the General Health Questionnaire), even when traumatic events and stressors were controlled for. This study represents one of the first empirical confirmations that, at least in a war context, suffering the unconfirmed loss of a family member has specific negative mental health consequences compared to suffering a confirmed loss. In particular the high levels of severe depression including suicidal ideation in this group give cause for concern.
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Kalantari, Mehrdad, William Yule, Atle Dyregrov, Hamidtaher Neshatdoost, and S. J. Ahmadi. "Efficacy of Writing for Recovery on Traumatic Grief Symptoms of Afghani Refugee Bereaved Adolescents: A Randomized Control Trial." OMEGA - Journal of Death and Dying 65, no. 2 (2012): 139–50. http://dx.doi.org/10.2190/om.65.2.d.
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Effective evidence-based intervention for traumatic bereavement is one of the current major research issues in the field of Post Traumatic Stress Disorder (PTSD) in children and adolescents. The “Writing for Recovery” group intervention is a new treatment approach developed by the Children and War Foundation for traumatized and bereaved children and adolescents after disasters. The purpose of this project was an empirical examination of this intervention with 12- to 18-year-old war bereaved Afghani refugees. Eighty-eight war bereaved Afghani refugees were screened using the Traumatic Grief Inventory for Children (TGIC). From those with the highest total score, 61 were randomly assigned to either an experimental ( n = 29) or control group ( n = 32). The experimental group received six sessions of group training on 3 consecutive days in their school. The difference of TGIC scores between the experimental group in pretest and posttest was significant ( p = 0.001). Results of analysis of covariance also showed a significant effect of Writing for Recovery on the experimental group ( p < 0.001). It is concluded that “Writing for Recovery” is an effective group intervention for bereaved children and adolescents after disasters.
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Carmassi, C., C. Socci, M. Corsi, et al. "Adult separation anxiety in patients with complicated grief: relationship with post traumatic stress versus mood spectrum symptomatology." European Psychiatry 26, S2 (2011): 142. http://dx.doi.org/10.1016/s0924-9338(11)71853-3.
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IntroductionAround 9–20% of bereaved individuals experience symptoms of complicated grief (CG) associated with significant distress and impairment. Increasing research has been focused on identifying the distinctive set of psychiatric symptoms that characterize this condition with respect to major depression, corroborating the need to include this syndrome in the forthcoming DSM-V as a distinctive diagnosis. Vulnerability to CG has been rooted in attachment disturbances and authors reported that symptoms of separation anxiety in childhood should be considered as predictors of CG onset in adulthood.ObjectivesTo date no study explored symptoms of adult separation anxiety among patients with CG with respect to healthy control subjects (HC).AimsTo explore adult separation anxiety and mood spectrum symptoms in patients with CG with respect to HC.Methods53 patients with CG and 50 control subjects were recruited, Department of Psychiatry, University of Pisa. Assessments: SCID-I/P, the Inventory of Complicated Grief (ICG), the Adult Separation Anxiety Questionnaire (ASA-27), the Work and Social Adjustment Scale (WSAS), the Impact of Event Scale (IES) and the Mood Spectrum-Self Report (MOODS-SR) lifetime version.ResultsPatients with CG reported significantly higher scores on the MOODS-SR, ASA_27, IES and WSAS with respect to controls. The scores on the ASA_27 were more strongly associated with IES scores with respect to other scales.ConclusionsOur results suggest a correlation between adult separation anxiety and CG onset after the loss of a loved one in adulthood, with a possible correlation to a post-traumatic stress symptomatology. Further studies are needed.
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Carmassi, C., C. Socci, I. Pergentini, et al. "Mood spectrum symptoms and adult separation anxiety in patients with post-traumatic stress disorder and/or Complicated Grief." European Psychiatry 26, S2 (2011): 1064. http://dx.doi.org/10.1016/s0924-9338(11)72769-9.
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IntroductionComplicated grief (CG) is currently under consideration for inclusion in DSM-V and a major issue is whether it can be differentiated from major depression (MDD) and post-traumatic stress disorder (PTSD).ObjectivesThere is evidence on the role of childhood but not separation anxiety as a significant risk factor for CG, and no study compared CG and PTSD patients with respect to these features.AimsTo compare adult separation anxiety in patients with PTSD versus CG or both conditions. Further, to investigate the possible impact of mood spectrum symptoms in the same samples.MethodsA total sample of 116 patients (66 PTSD, 22 CG and 28 with CG+PTSD) was recruited. Assessments included: the SCID-I/P, the Inventory of Complicated Grief (ICG), the Adult Separation Anxiety Questionnaire (ASA-27), the Work and Social Adjustment Scale (WSAS) and the Mood Spectrum-Self Report (MOODS-SR) lifetime version.ResultsCG was strongly associated with female gender (8:1). MDD comorbidity was more common among patients with CG while bipolar disorder was highest among those with PTSD+CG. Patients with both CG and PTSD reported significantly higher ASA_27 (p = 0.008) scores than patients with either CG or PTSD alone. Patients with both diagnoses or PTSD alone reported significantly (p = 0.02) higher scores on the manic component of the MOODS-SR. No significant differences were reported in the WSAS scores.ConclusionsOur results support differences between CG and PTSD, important to consideration of including CG as a new disorder in DSM-V.
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Buck, Harleah G., Paula Cairns, Nnadozie Emechebe, et al. "Accelerated Resolution Therapy: Randomized Controlled Trial of a Complicated Grief Intervention." American Journal of Hospice and Palliative Medicine® 37, no. 10 (2020): 791–99. http://dx.doi.org/10.1177/1049909119900641.
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Background and Objectives: Complicated grief (CG) is severe, prolonged (>12 months) grieving. Complicated grief disproportionately affects older adults and is associated with negative physical/psychological effects. Although treatment options exist, those which do are time-intensive. We report on a randomized clinical trial (RCT) which examined whether accelerated resolution therapy (ART), a novel mind-body therapy, is effective in treating CG, post-traumatic stress disorder (PTSD), and depression among hospice informal caregivers. Research Design and Methods: Prospective 2 group, wait-listed RCT. All participants were scheduled to receive 4 ART sessions. Inclusion: ≥60 years, inventory of CG >25, and PTSD checklist for Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition >33 or Psychiatric Diagnostic Screen Questionnaire PTSD subscale >5. Exclusion: Major psychiatric disorder, other current psychotherapy treatment. Depression was measured by the Center for Epidemiologic Studies Depression. Results: Mean (standard deviation [SD]) age of 54 participants was 68.7 (7.2) years, 85% female, and 93% white. Participants assigned to ART reported significantly greater mean (SD) CG reduction (−22.8 [10.3]) versus Wait-list participants (−4.3 [6.0]). Within-participant effect sizes (ESs) for change from baseline to 8-week post-treatment were CG (ES = 1.96 (95% confidence interval [CI]: 1.45-2.47; P < .0001), PTSD (ES = 2.40 [95% CI: 1.79-3.00]; P < .0001), depression (ES = 1.63 [95% CI: 1.18-2.08; P < .0001). Treatment effects did not substantially differ by baseline symptom levels. Discussion and Implications: Results suggests that ART presents an effective and less time-intensive intervention for CG in older adults. However, it should undergo further effectiveness testing in a larger, more diverse clinical trial with a focus on determining physiological or behavioral mechanisms of action.
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Williams, Joah L., Jasmine R. Eddinger, Edward K. Rynearson, and Alyssa A. Rheingold. "Prevalence and Correlates of Suicidal Ideation in a Treatment-Seeking Sample of Violent Loss Survivors." Crisis 39, no. 5 (2018): 377–85. http://dx.doi.org/10.1027/0227-5910/a000520.
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Abstract. Background: Family members grieving the traumatic death of a loved one, as in cases of homicide, suicide, and fatal accidents, are at risk for a number of trauma and bereavement-related mental health problems, including posttraumatic stress disorder (PTSD), depression, prolonged grief disorder, and suicidal ideation (SI). Aims: The purpose of this study was to examine the prevalence and correlates of SI among a sample of 130 treatment-seeking traumatically bereaved family members. Method: Adults seeking treatment at two clinics on the US West Coast were assessed for SI, clinical outcomes, and death-related characteristics. Results: Overall, 42% of traumatically bereaved family members endorsed some form of active or passive SI on the Beck Depression Inventory suicide item. The type of loss experienced (i.e., homicide, suicide, fatal accident) was not associated with SI. Although individuals with SI reported more severe symptoms across all clinical outcomes, avoidance (OR = 2.22) and depression (OR = 1.16) were uniquely associated with SI even after adjusting for PTSD-related intrusions and hyperarousal. Limitations: Results should be interpreted in light of limitations associated with cross-sectional data and a single-item outcome of SI. Conclusion: Routine screening for SI should be standard practice for providers working with traumatically bereaved families.
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Zasiekina, Larysa, Shelia Kennison, Serhii Zasiekin, and Khrystyna Khvorost. "Psycholinguistic Markers of Autobiographical and Traumatic Memory." East European Journal of Psycholinguistics 6, no. 2 (2019): 119–33. http://dx.doi.org/10.29038/eejpl.2019.6.2.zas.
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This study examines psycholinguistic structure of autobiographical and traumatic narratives representing positive emotional and stressful traumatic life events. The research applied the cross sectional, between subjects design utilizing the independent variables of external agent they, space and time and dependent variable of word number in traumatic narratives for multiple regression analysis. The approval letter to recruit the participants through SONA system in 2015–2016 academic year was obtained from Institutional Review Board of Oklahoma State University (USA). 64 undergraduates of nonclinical setting, females (n=37), males (n=27), mean age was 19.43 (SD=1.37) were recruited. PTSD-8: A Short PTSD Inventory assesses PTSD, the Linguistic Inquiry and Word Count (LIWC) analyzes traumatic and autobiographical narratives in terms of linguistic units and psychological meaningful categories. The results indicate that there are significant differences between pronoun they as external agent of proposition and psychological categories of negative emotions and anxiety in traumatic and autobiographical narratives. The frequency of these categories is higher in traumatic narratives compared with autobiographical narratives. External agent they, category of time and space taken together significantly contribute to word number in traumatic narrative. There is a negative correlation between focus on the past and word count, and positive correlation between social category and word count in traumatic narrative in nonclinical sample. To sum up, propositional structure of traumatic memory of individuals without PTSD is represented by external agent and context (place and time) taken together. Considering time as a significant negative predictor of creating traumatic narrative, temporal processing without overestimation of time is an important factor of avoiding PTSD. The principal theoretical implication of this study is that traumatic memory might be examined through psycholinguistic markers represented by propositional structures and psychological meaningful categories of traumatic narratives in individuals from nonclinical and clinical settings.
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Habler, Betty. "Grief Experience Inventory." Measurement and Evaluation in Counseling and Development 21, no. 2 (1988): 91–93. http://dx.doi.org/10.1080/07481756.1988.12022887.
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Harkness, Kate L., M. Katherine Shear, Ellen Frank, and Rebecca A. Silberman. "Traumatic Grief Treatment." Journal of Clinical Psychiatry 63, no. 12 (2002): 1113–20. http://dx.doi.org/10.4088/jcp.v63n1205.
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COHEN, JUDITH A., ANTHONY P. MANNARINO, TAMRA GREENBERG, SUSAN PADLO, and CARRIE SHIPLEY. "Childhood Traumatic Grief." Trauma, Violence, & Abuse 3, no. 4 (2002): 307–27. http://dx.doi.org/10.1177/1524838002237332.
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Aldrich, Holly, and Diya Kallivayalil. "Traumatic Grief After Homicide." Illness, Crisis & Loss 24, no. 1 (2015): 15–33. http://dx.doi.org/10.1177/1054137315587630.
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Solano, Joao Paulo Consentino. "Traumatic and complicated grief?" Ciência & Saúde Coletiva 16, no. 10 (2011): 4337–38. http://dx.doi.org/10.1590/s1413-81232011001100029.
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Beechem, Michael H., Jone Prewitt, and Joe Scholar. "Loss-Grief Addiction Model." Journal of Drug Education 26, no. 2 (1996): 183–98. http://dx.doi.org/10.2190/0gxh-9q2y-9nug-uq24.
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This group study features a loss-grief inventory in the treatment of ninety-eight substance abusers in a public outpatient treatment facility. The inventory serves as both assessment and treatment tools. That is, the inventory helps the counselor and the client to identify unresolved loss-grief issues which may contribute to the addiction; it also serves as a treatment tool to assist the client through the grieving process. In identifying losses, the client has three time categories from which to choose: 1) pre-addiction losses; 2) losses associated with the addiction; and 3) losses associated with entering treatment. An additional feature of the inventory illustrates a simplified procedure to compute the client's unresolved loss-grief level through use of a 5-point Likert scale.
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Andriessen, Karl, Dusan Hadzi-Pavlovic, Brian Draper, Michael Dudley, and Philip B. Mitchell. "The adolescent grief inventory: Development of a novel grief measurement." Journal of Affective Disorders 240 (November 2018): 203–11. http://dx.doi.org/10.1016/j.jad.2018.07.012.
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Martin, Terry L., and Wen-Chi Wang. "A Pilot Study of the Development of a Tool to Measure Instrumental and Intuitive Styles of Grieving." OMEGA - Journal of Death and Dying 53, no. 4 (2006): 263–76. http://dx.doi.org/10.2190/y888-0t65-7t87-8136.
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Recently, 2 patterns of grieving (intuitive and instrumental) were identified as 2 extremes on a continuum. One of these patterns (instrumental) challenged the grief work hypothesis and traditional views of grieving. This study sought to validate an instrument to identify these 2 patterns. Sixty-three volunteer participants were randomly assigned to two groups, each receiving both the Grief Experience Inventory and the Grief Pattern Inventory. It was hypothesized that: 1) the Grief Pattern Inventory would determine the intuitive and instrument patterns of grief; and 2) these 2 patterns would be correlated with the subscales on Grief Experience Inventory to further highlight the differences between the 2 patterns. The analyzed results were found to support both of the hypotheses.
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Shear, M. Katherine, Allan Zuckoff, and Ellen Frank. "The Syndrome of Traumatic Grief." CNS Spectrums 6, no. 4 (2011): 339–46. http://dx.doi.org/10.1017/s1092852900022057.
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ABSTRACTTraumatic grief is a common and debilitating syndrome whose clinical presentation is well recognized but whose diagnostic criteria have only recently been delineated. Though it shares features with major depressive disorder, adjustment disorder, and posttraumatic stress disorder, none of these subsume the criteria set for traumatic grief, and the diagnostic overlap is limited in community samples. Furthermore, diagnosis of traumatic grief appears to have prognostic value for clinical course and treatment response among bereaved individuals. In the absence of empirically supported treatments of pathological grief, a new, manualized treatment for traumatic grief symptoms has been developed and is currently undergoing testing in a randomized controlled trial. The conceptual basis for Traumatic Grief Treatment (TGT) is presented, the structure of the treatment is outlined, and the primary clinical strategies employed are described.
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Prigerson, Holly G., Lee Wolfson, M. Katherine Shear, et al. "Case Histories of Traumatic Grief." OMEGA - Journal of Death and Dying 35, no. 1 (1997): 9–24. http://dx.doi.org/10.2190/tdyg-mrb4-h5h8-hhr7.
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The symptoms of traumatic grief have been shown to be distinct from those of bereavement-related depression and anxiety among elderly widows and widowers, and bare striking resemblance to symptoms of Posttraumatic Stress Disorder (PTSD). In light of the findings demonstrating that traumatic grief is associated with a heightened risk of critical mental and physical health outcomes, it is important to understand the underlying mechanisms that may put bereaved individuals at risk of developing traumatic grief. Attachment theory offers an explanation for why loss of a stabilizing relationship might be traumatic for individuals who possess insecure or unstable attachments (e.g., excessive dependency, defensive separation, compulsive caregiving) and self-regulatory deficits (e.g., identity disturbances, difficulty with affect modulation). A model illustrating hypothesized causal linkages between childhood experiences, attachment and personality traits, dissolution of a stabilizing relationship, and traumatic symptomatology is proposed. Case histories of late-life pre- and post-loss traumatic grievers are presented and discussed in terms of their compatibility with the proposed model.
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Prigerson, Holly G., M. Katherine Shear, Selby C. Jacobs, et al. "Consensus criteria for traumatic grief." British Journal of Psychiatry 174, no. 1 (1999): 67–73. http://dx.doi.org/10.1192/bjp.174.1.67.
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BackgroundStudies suggest that symptoms of traumatic grief constitute a distinct syndrome worthy of diagnosis.AimsA consensus conference aimed to develop and test a criteria set for traumatic grief.MethodThe expert panel proposed consensus criteria for traumatic grief. Receiver operator characteristic (ROC) analyses tested the performance of the proposed criteria on 306 widowed respondents at seven months post-loss.ResultsROC analyses indicated that three of four separation distress symptoms (e.g. yearning, searching, loneliness) had to be endorsed as at least ‘sometimes true’ and four of the final eight traumatic distress symptoms (e.g. numbness, disbelief, distrust, anger, sense of futility about the future) had to be endorsed as at least ‘mostly true’ to yield a sensitivity of 0.93 and a specificity of 0.93 for a diagnosis of traumatic grief.ConclusionsPreliminary analyses suggest the consensus criteria for traumatic grief have satisfactory operating characteristics, and point to directions for further refinement of the criteria set.
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Arehart-Treichel, Joan. "Youngsters Can Experience Traumatic Grief." Psychiatric News 39, no. 16 (2004): 22. http://dx.doi.org/10.1176/pn.39.16.0390022.
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Jacobs, Carolyn Mazure, Holly Prige, Selby. "DIAGNOSTIC CRITERIA FOR TRAUMATIC GRIEF." Death Studies 24, no. 3 (2000): 185–99. http://dx.doi.org/10.1080/074811800200531.
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Cohen, Judith A., and Anthony P. Mannarino. "Treatment of Childhood Traumatic Grief." Journal of Clinical Child & Adolescent Psychology 33, no. 4 (2004): 819–31. http://dx.doi.org/10.1207/s15374424jccp3304_17.
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Kersting, Anette, K. Kroker, J. Steinhard, et al. "Complicated grief after traumatic loss." European Archives of Psychiatry and Clinical Neuroscience 257, no. 8 (2007): 437–43. http://dx.doi.org/10.1007/s00406-007-0743-1.
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Unterhitzenberger, Johanna, and Rita Rosner. "Preliminary Evaluation of a Prolonged Grief Questionnaire for Adolescents." OMEGA - Journal of Death and Dying 74, no. 1 (2016): 80–95. http://dx.doi.org/10.1177/0030222815598046.
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Currently, there is no established measure to assess prolonged grief in adolescents. A new measure was designed based on the Extended Grief Inventory, the Inventory of Complicated Grief—Revised for Children, and the Inventory of Prolonged Grief for Children/Adolescents. We investigated the psychometric properties of the Prolonged Grief Questionnaire for Adolescents in a sample of 69 14- to 18-year-old parentally bereaved adolescents living in rural Rwanda. Additionally, we obtained sociodemographic information and assessed loss experiences and depressive symptoms. A principal component analysis revealed item loadings on two factors, which we named separation distress and secondary emotions. Internal consistency in this first evaluation was high (α = .94), and the criterion validity was satisfying. A sensitivity of 85.3% and a specificity of 85.9% were found. The small sample size is a major limitation. However, the Prolonged Grief Questionnaire for Adolescents may be a promising tool for assessing prolonged grief symptoms in adolescents.
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MAHONEY, DIANA. "Childhood Traumatic Grief Must Be Addressed." Clinical Psychiatry News 36, no. 1 (2008): 25. http://dx.doi.org/10.1016/s0270-6644(08)70024-9.
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MAHONEY, DIANA. "Childhood Traumatic Grief Must Be Addressed." Pediatric News 42, no. 2 (2008): 29. http://dx.doi.org/10.1016/s0031-398x(08)70066-3.
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Fox, G. C., G. E. Reid, A. Salmon, P. Mckillop-Duffy, and C. Doyle. "Criteria for traumatic grief and PTSD." British Journal of Psychiatry 174, no. 6 (1999): 560. http://dx.doi.org/10.1192/s0007125000262703.
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Pivar, Ilona L., and Holly G. Prigerson. "Traumatic Loss, Complicated Grief, and Terrorism." Journal of Aggression, Maltreatment & Trauma 9, no. 1-2 (2004): 277–88. http://dx.doi.org/10.1300/j146v09n01_34.
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Shear, M. Katherine, Ellen Frank, Edna Foa, et al. "Traumatic Grief Treatment: A Pilot Study." American Journal of Psychiatry 158, no. 9 (2001): 1506–8. http://dx.doi.org/10.1176/appi.ajp.158.9.1506.
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DeGroot, Jocelyn M., and Tennley A. Vik. "Disenfranchised Grief Following a Traumatic Birth." Journal of Loss and Trauma 22, no. 4 (2017): 346–56. http://dx.doi.org/10.1080/15325024.2017.1284519.
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Boelen, Paul A., and Jan van den Bout. "Positive Thinking in Bereavement: Is it Related to Depression, Anxiety, or Grief Symptomatology?" Psychological Reports 91, no. 3 (2002): 857–63. http://dx.doi.org/10.2466/pr0.2002.91.3.857.
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The present study sought to explore the relationship between positive thinking—operationalized as the frequency of positive automatic thoughts and dispositional optimism—and depression, anxiety, and traumatic grief symptomatology. Data were derived from 326 bereaved adults who had 3 yr. earlier experienced the loss of a first degree loved one. Analysis showed that positive thinking was inversely related to measures of depression, anxiety, and traumatic grief symptomatology. However, positive thinking did not covary with anxiety and traumatic grief when shared variance was controlled. Conversely, positive thinking remained inversely related to depression, even when anxiety and traumatic grief were controlled The findings indicate that, among bereaved individuals, low positive thinking is a cognitive feature of depression that is relatively independent of anxiety and traumatic grief symptomatology.
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CHEN, J. H., A. J. BIERHALS, H. G. PRIGERSON, S. V. KASL, C. M. MAZURE, and S. JACOBS. "Gender differences in the effects of bereavement-related psychological distress in health outcomes." Psychological Medicine 29, no. 2 (1999): 367–80. http://dx.doi.org/10.1017/s0033291798008137.
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Background. This study examined whether traumatic grief, depressive and anxiety symptoms formed three distinct factors for widows and widowers. In addition, we examined whether high symptom levels of traumatic grief, depression and anxiety predicted different mental and physical health outcomes for widows and widowers.Method. Ninety-two future widows and 58 future widowers were interviewed at the time of their spouse's hospital admission and then at 6 weeks, 6, 13 and 25 month follow-ups. Principal axis factor analyses tested the distinctiveness of traumatic grief, depressive and anxiety symptoms, by gender. Repeated measures ANOVA tested for gender differences and changes over time in mean symptom levels of traumatic grief, depression and anxiety. Linear and logistic regression models estimated the effects of high symptom levels of traumatic grief, depression and anxiety at 6 months on health outcomes at 13 and 25 months post-intake by gender.Results. Three distinct symptom clusters (i.e. traumatic grief, depressive and anxiety symptoms) were found to emerge for both widows and widowers. Widows had higher mean levels of traumatic grief, depressive and anxiety symptoms. High symptom levels of traumatic grief measured at 6 months predicted a physical health event (e.g. cancer, heart attack) at 25 months post-intake for widows. High symptom levels of anxiety measured at 6 months predicted suicidal ideation at 25 months for widowers.Conclusions. The results suggest that there are gender differences in the levels of psychological symptoms resulting from bereavement and in their effects on subsequent mental and physical health for widows and widowers.
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Meuser, Thomas M., and Samuel J. Marwit. "An Integrative Model of Personality, Coping and Appraisal for the Prediction of Grief Involvement in Adults." OMEGA - Journal of Death and Dying 40, no. 2 (2000): 375–93. http://dx.doi.org/10.2190/p6bm-qu6c-6xy9-bnum.
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This Study Contrasts Two Opposing Conceptualizations Of Personality's Effect Upon Grief: A Traditional Ego Psychology (Risk Factor) View And Lazarus And Folkman's Contextual Coping Model. The Eysenck Personality Questionnaire, the Coping Inventory for Stressful Situations, and the Revised Grief Experience Inventory were administered to 101 bereaved adults. Predictor variables included neuroticism, extraversion, threat appraisal, emotion-oriented coping, task/problem-oriented coping, and avoidance coping. Significant predictive effects for emotion oriented coping, task/problem oriented coping, and grief-related variables were found. Results support contextual coping theory, indicating that immediate coping processes may be better predictors of grief involvement than longstanding personality traits. Clinical implications are discussed.
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Martinčeková, Lucia, and John Klatt. "Mothers’ Grief, Forgiveness, and Posttraumatic Growth After the Loss of a Child." OMEGA - Journal of Death and Dying 75, no. 3 (2016): 248–65. http://dx.doi.org/10.1177/0030222816652803.
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The aim of this study was to investigate maternal grief after losing a child in relation to forgiveness and posttraumatic growth. A sample of 60 grieving mothers from Slovakia completed the following battery: The Texas Revised Inventory of Grief, a modified version of the Enright Forgiveness Inventory, and the Posttraumatic Growth Inventory. The results showed a negative association between forgiveness and grief and a strong positive association between forgiveness and posttraumatic growth, which was not moderated by the time elapsed since the loss. Semistructured interviews were conducted with 12 mothers. The data were analyzed through Consensual Qualitative Research to gain deeper understanding of forgiveness and posttraumatic growth experiences after the loss of a child. Categories and subcategories are discussed.
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Waskowic, Tracey D., and Brian M. Chartier. "Attachment and the Experience of Grief Following the Loss of a Spouse." OMEGA - Journal of Death and Dying 47, no. 1 (2003): 77–91. http://dx.doi.org/10.2190/0cmc-gyp5-n3qh-weh4.
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Numerous studies have been conducted in the areas of attachment theory and grief. There is, however, very little research that explores the possible connection between attachment and grief. The present study examines the relationship between an adult's attachment style (i.e., secure or insecure) and an individual's experience of grief after the loss of a spouse. Seventy-seven widows and widowers completed a questionnaire package consisting of the Relationship Scales Questionnaire (Griffin & Bartholomew, 1994), the Grief Experience Inventory (Sanders, Mauger, & Strong, 1985a), and the Continuing Bonds Scale (Grund, 1998). Differences between participants who were secure in attachment to their spouse and those insecure in attachment (which includes preoccupied, dismissing, and fearful) were examined on the Grief Experience Inventory and the Continuing Bonds Scale. Findings revealed differences between securely and insecurely attached widowed people on subscales of the Grief Experience Inventory. In particular, securely attached people were less angry, less socially isolated, less guilty, had less death anxiety, less somatic symptoms, less despair, less depersonalization, and ruminated less than insecurely attached people. Analysis of the Continuing Bonds subscales revealed significant differences between secure and insecure attachments such that secure people scored higher on Interchanges with the Deceased, as well as Reminiscing about the Deceased, than insecure people. Taken as a whole, the results seem to indicate that attachment style has an affect on one's grief reaction.