1
|
Wilson DM, Knox M, Banamwana G, Brown CA, Errasti-Ibarrondo B. Humor: A Grief Trigger and Also a Way to Manage or Live With Your Grief. OMEGA-JOURNAL OF DEATH AND DYING 2024; 89:514-529. [PMID: 35235471 PMCID: PMC11100260 DOI: 10.1177/00302228221075276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
In 2020-2021, a qualitative study was undertaken using an interpretive description methodology to identify what triggers grief in the first 2 years following the death of a beloved family member, and to gain other helpful insights about grief triggers from bereaved Canadian adult volunteers. In that study, a purposive sampling method was used to select 10 bereaved Canadian adult volunteers for in-depth, semi-structured interviews. This paper reports on the humor findings, as revealed to be a particularly complex grief trigger for many participants, as well as a periodic way for most to manage or live with their grief. Participant quotes and an extended discussion are included to illustrate the importance of these humor findings in relation to grief, and to inform bereaved people, bereavement service providers, and the general public about both helpful aspects and some cautionary considerations about humor.
Collapse
Affiliation(s)
- Donna M. Wilson
- Faculty of Nursing, University of Alberta, Edmonton, AB, Canada
| | - Michelle Knox
- Faculty of of Medicine & Dentistry, University of Alberta, Edmonton, AB, Canada
| | | | - Cary A. Brown
- Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada
| | | |
Collapse
|
2
|
Lechner-Meichsner F, Comtesse H, Olk M. Prevalence, comorbidities, and factors associated with prolonged grief disorder, posttraumatic stress disorder and complex posttraumatic stress disorder in refugees: a systematic review. Confl Health 2024; 18:32. [PMID: 38627778 PMCID: PMC11020800 DOI: 10.1186/s13031-024-00586-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 03/20/2024] [Indexed: 04/20/2024] Open
Abstract
BACKGROUND The number of refugees worldwide is at an all-time high with many being exposed to potentially traumatic events and the loss of loved ones. The 11th revision of the International Statistical Classification of Diseases and Related Health Problems now includes prolonged grief disorder and complex posttraumatic stress disorder and revised criteria for posttraumatic stress disorder. An overview of these stress-related disorders among people who have become refugees is therefore needed. Consequently, we conducted a systematic review to determine prevalence rates, comorbidities, and associated factors for each of the disorders. METHOD We systematically searched PubMed, Web of Science, and PsycArticles to identify studies that reported prevalence rates, predictors or associated factors, and/or comorbid mental disorders for either (1) prolonged grief disorder, (2) posttraumatic stress disorder, or (3) complex posttraumatic stress disorder among refugees. The selection process followed the PRISMA guidelines. RESULTS A total of 36 studies met the inclusion criteria. Most of the studies were of high quality. There was substantial variation in prevalence rates by disorder, with prolonged grief ranging from 6 to 54%, posttraumatic stress disorder ranging from 0.4 to 80%, and complex posttraumatic stress disorder ranging from 3 to 74.6%. Pooled prevalence for posttraumatic stress disorder was estimated at 29.8% in treatment seeking samples and 9.92% in population samples. For complex posttraumatic stress disorder, it was estimated at 57.4% in treatment seeking samples and 7.8% in population samples. Posttraumatic stress disorder was among the most frequent comorbidities for prolonged grief disorder while depressive symptoms were the most frequently occurring co-morbidity across all three disorders. Sociodemographic variables, trauma exposure, and loss characteristics were associated with higher symptom severity. Postmigration living difficulties played an important role in prolonged grief and complex posttraumatic stress disorder. CONCLUSION The review revealed substantial differences in prevalence rates between the three studied disorders but underscored a very high prevalence of ICD-11 stress-related disorders among refugees. The identified associated factors point to subgroups that may be particularly at risk and establishes a foundational basis for targeted interventions and potential policy changes. Future research should incorporate longitudinal investigations and emphasize culturally sensitive assessments.
Collapse
Affiliation(s)
- Franziska Lechner-Meichsner
- Department of Psychology, Clinical Psychology and Psychotherapy, Goethe University Frankfurt, Varrentrappstraße 40-42, 60486, Frankfurt am Main, Germany.
- Clinical Psychology, Utrecht University, Heidelberglaan 1, Utrecht, 3584 CS, Netherlands.
| | - Hannah Comtesse
- Clinical and Biological Psychology, Catholic University Eichstaett-Ingolstadt, Ostenstraße 26, 85072, Eichstätt, Germany
| | - Marie Olk
- Department of Psychology, Clinical Psychology and Psychotherapy, Goethe University Frankfurt, Varrentrappstraße 40-42, 60486, Frankfurt am Main, Germany
| |
Collapse
|
3
|
Sarkar S, Gupta P, Sahu A, Anwar N, Sharan P. A qualitative phenomenological exploration of prolonged grief in New Delhi, India. Transcult Psychiatry 2023; 60:929-941. [PMID: 37993997 DOI: 10.1177/13634615231213838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2023]
Abstract
Prolonged grief disorder (PGD) is a condition characterized by difficulty in coping effectively with the loss of loved ones. The proposed diagnostic criteria for PGD have been based predominantly on research from developed Western nations. The cultural variations associated with experience and expression of grief and associated mourning rituals have not been considered comprehensively. The current study aimed to understand the experience of prolonged grief in India through a qualitative enquiry with mental health professionals (focus group discussions) and affected individuals (key informant interviews). Several novel findings diverging from the current understanding of manifestation and narratives of PGD emerged from the study, including differences in the social contexts of bereavement and culture-specific magico-religious beliefs and idioms of distress. The findings point to limitations of existing diagnostic systems for PGD. The results of this study suggest that the assumption of content equivalence for psychiatric disorders across cultures may not be justified and that there is a need to develop culturally sensitive diagnostic criteria and assessment scales for PGD.
Collapse
Affiliation(s)
- Siddharth Sarkar
- National Drug Dependence Treatment Centre, All India Institute of Medical Sciences, New Delhi, India
| | - Prashant Gupta
- Department of Psychiatry, All India Institute of Medical Sciences, New Delhi, India
| | - Anamika Sahu
- Department of Psychiatry, All India Institute of Medical Sciences, New Delhi, India
| | - Nazneen Anwar
- World Health Organization - South East Asia Regional Office, New Delhi, India
| | - Pratap Sharan
- Department of Psychiatry, All India Institute of Medical Sciences, New Delhi, India
| |
Collapse
|
4
|
Ismail A, Dekel R. Continuing bonds of bereaved Muslims mothers with their young dead child. DEATH STUDIES 2023; 48:676-687. [PMID: 37878660 DOI: 10.1080/07481187.2023.2258486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2023]
Abstract
Based on continuing bonds theory, this research examined the experience and manifestations of continuing bonds of bereaved Muslim mothers with their children who died in home accidents. This qualitative phenomenological study is based on interviews with 15 bereaved mothers (aged 28-46 years) whose children (aged 1-6 years) died 2-7 years before the interviews. Analysis revealed three themes: efforts to continue the physical bonds, challenges in the continuing bonds in cases of traumatic death, and belief in afterlife as the main element of the continuing bonds. The traumatic circumstances of the death challenged the ability to maintain the bond based on positive memories without it being overwhelmed by the traumatic memories of the last moments of the child's life. Religious beliefs played an important role in the characteristics of the bond. Maintaining the bond requires professionals to provide a therapeutic environment where bereaved mothers feel safe talking about it.
Collapse
Affiliation(s)
- Akhlas Ismail
- The Louis and Gabi Weisfeld School of Social Work, Bar-Ilan University, Ramat Gan, Israel
| | - Rachel Dekel
- The Louis and Gabi Weisfeld School of Social Work, Bar-Ilan University, Ramat Gan, Israel
| |
Collapse
|
5
|
Hennemann S, Killikelly C, Hyland P, Maercker A, Witthöft M. Somatic symptom distress and ICD-11 prolonged grief in a large intercultural sample. Eur J Psychotraumatol 2023; 14:2254584. [PMID: 37767693 PMCID: PMC10540649 DOI: 10.1080/20008066.2023.2254584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Accepted: 07/12/2023] [Indexed: 09/29/2023] Open
Abstract
Background: Grief is a multi-faceted experience including emotional, social, and physical reactions. Research in ICD-11 prolonged grief disorder (PGD) in different cultural contexts has revealed different or potentially missing grief symptoms that may be relevant.Objective: This study thus aimed to explore the prevalence of somatic symptom distress and its associations with grief and negative affect in a culturally diverse sample of bereaved individuals with symptoms of PGD.Methods: Based on cross-sectional survey data from the Measurement and Assessment of Grief (MAGIC) project, this study included 1337 participants (mean age 23.79 yrs, 76.1% female) from three regions (USA: 62.3%, Turkey/Iran: 24.2%, Cyprus/Greece: 13.5%), who experienced a loss of a significant other. Associations between somatic symptom distress (Somatic Symptom Scale, SSS-8), symptoms of PGD (International Prolonged Grief Disorder Scale, IPGDS-33), anxiety (Generalized Anxiety Disorder Questionnaire, GAD-7), depression (Patient Health Questionnaire, PHQ-9) as well as demographic and loss related characteristics were investigated. Three hundred and thirteen participants (23.4%) scored above the proposed cut-off for clinically severe PGD.Results: 'High' or 'very high' levels of somatic symptom distress were more frequent in a possible PGD group (58.2%), than in a non-PGD group (22.4%), p < .001, as divided per cut-off in the IPGDS. In a multiple regression analysis, PGD symptoms were significantly but weakly associated with somatic symptom distress (β = 0.08, p < .001) beyond demographics, loss-related variables, and negative affect. Negative affect (anxiety and depression) mediated the relationship of PGD symptoms with somatic symptom distress and the indirect effect explained 58% of the variance.Conclusions: High levels of somatic symptom distress can be observed in a substantial proportion of bereaved across cultures. Our findings suggest that PGD is related to somatic symptom distress partly and indirectly through facets of negative affect.
Collapse
Affiliation(s)
- Severin Hennemann
- Department of Clinical Psychology, Psychotherapy and Experimental Psychopathology, Johannes Gutenberg University Mainz, Mainz, Germany
| | - Clare Killikelly
- Department of Psychology, University of Zurich, Zurich, Switzerland
| | - Philip Hyland
- Department of Psychology, Maynooth University, Kildare, Ireland
| | - Andreas Maercker
- Department of Psychology, University of Zurich, Zurich, Switzerland
| | - Michael Witthöft
- Department of Clinical Psychology, Psychotherapy and Experimental Psychopathology, Johannes Gutenberg University Mainz, Mainz, Germany
| |
Collapse
|
6
|
Thomas FC, Divirgilio R, Jayawickreme N, Sivayokan S, McShane K, Jayawickreme E. Coping with the long-term impact of civil strife: A grief-centered analysis of Tamil Sri Lankan communities affected by ethnopolitical conflict. Appl Psychol Health Well Being 2023. [PMID: 37712290 DOI: 10.1111/aphw.12491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 08/15/2023] [Indexed: 09/16/2023]
Abstract
Limited research has examined coping mechanisms in response to chronic war-related stressors, as opposed to war-exposure trauma. The current study sought to investigate the types of losses experienced by communities affected by the Sri Lankan conflict, how participants responded to their losses, and what coping mechanisms they employed. Data consisted of interviews from two independent investigations conducted following the end of the conflict in Northern Sri Lanka (total N = 103). Interview transcripts were analyzed using a directed content analysis approach. Participants most frequently described experiencing material loss and loss of loved ones. Relatedly, participants commonly reported experiencing ambiguous loss, that is, living with the uncertainty of their loved one's death. These losses were particularly pronounced by gender, with women experiencing higher rates of loss. Common coping strategies included support-seeking, including informal support from social networks and religion, and formal mental health services. Additionally, participants described a range of longer term coping strategies from establishing a future-oriented cognitive style to a sense of helplessness and resignation. The findings shed light on how conflict-affected groups cope with profound loss. We provide recommendations for how such findings can inform grief-related clinical interventions.
Collapse
Affiliation(s)
- Fiona C Thomas
- Department of Psychology, Faculty of Arts, Toronto Metropolitan University, Toronto, Ontario, Canada
| | - Richard Divirgilio
- Department of Psychology, School of Liberal Arts, Manhattan College, Bronx, New York, USA
| | - Nuwan Jayawickreme
- Department of Psychology, School of Liberal Arts, Manhattan College, Bronx, New York, USA
| | | | - Kelly McShane
- Department of Psychology, Faculty of Arts, Toronto Metropolitan University, Toronto, Ontario, Canada
- Human Resource Management and Organizational Behaviour, Ted Rogers School of Management, Toronto, Ontario, Canada
| | - Eranda Jayawickreme
- Department of Psychology and Program for Leadership and Character, Wake Forest University, Winston-Salem, North Carolina, USA
| |
Collapse
|
7
|
Lee SA, Bottomley JS. Personality and Grief-Related Panic Attacks: Analysis of Neuroticism, Worry, and Anxiety Sensitivity. OMEGA-JOURNAL OF DEATH AND DYING 2023; 86:849-861. [PMID: 33554746 DOI: 10.1177/0030222821992192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Grief-related panic attacks (GRPAs) are a relatively common yet debilitating psychological reaction to loss, the mechanisms of which remain poorly understood among scholars. The purpose of this study was to identify the personality traits that underlie GRPAs in a sample of 314 bereaved adults. The results indicate that GRPAs were relatively common (55.4%) and that anxiety sensitivity uniquely predicted both frequency and impairment associated with these kinds of attacks, while taking into account the effects of neuroticism, trait worry, grief, and gender. Findings suggest that anxiety sensitivity may be a risk factor for GRPAs and magnified grief for some mourners. Clinical implications and future directions are discussed.
Collapse
Affiliation(s)
- Sherman A Lee
- Department of Psychology, Christopher Newport University, Newport News, VA, USA
| | | |
Collapse
|
8
|
Tateo L. Cultural mediation of grief: the role of esthetic experience. CULTURE & PSYCHOLOGY 2022. [DOI: 10.1177/1354067x221145901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
In Global North’s psychology, some existential experiences such as the loss of beloved persons are understood as purely individual problems. In a society of functioning individuals, the person is responsible for her own condition and for consuming the healthcare services provided to overcome the “problem” as soon as possible to go back to the fully functional role in the society. This vision raises several questions about turning “experiences” into “pathologies.” Historically, mankind made sense of death, loss, and grief as both a personal and collective experiences, mediated by heterogeneous cultural forms. I elaborate theoretically the concept of cultural mediation of grief, focusing on the esthetic and temporal dimensions of such mediation, as it is visible in art, rituals and everyday discourses. The idea is that such mediation is always present, and that psychology must be able to recognize it also in apparently secularized societies.
Collapse
Affiliation(s)
- Luca Tateo
- Department of Special Needs Education, University of Oslo, Oslo, Norway
| |
Collapse
|
9
|
Claudius M, Shino EN, Job S, Hofmann D, Thalmayer AG. Still Standing Inside: A Local Idiom Related to Trauma among Namibian Speakers of Khoekhoegowab. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14323. [PMID: 36361207 PMCID: PMC9657148 DOI: 10.3390/ijerph192114323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 10/18/2022] [Accepted: 10/26/2022] [Indexed: 06/16/2023]
Abstract
Euro-centric psychiatric conceptualizations often ignore the interplay of local with universal factors in psychological suffering. Emic, locally focused perspectives can enrich etic knowledge to provide culturally sensitive care and to better elucidate the role of culture in mental illness. This study explored the idiom Tsûsa ǃNaeǃkhais xa hâǃnâ/mâǃnâ/ǂgâǃnâhe hâ (a terrible event has entered a person and remains standing inside), which was understood to relate to experiences of trauma and post-traumatic stress, among speakers of Khoekhoegowab, a southern-African click language. Semi-structured interviews were conducted with 16 participants from six urban and rural communities in Namibia. Questions probed perceptions of the idiom in terms of etiology, course, and risk and resilience factors from a socio-ecological framework. Five key themes were identified using thematic analysis: origin in a shocking event; intrusive recurrence of memories, "it keeps on coming back"; the close interplay between mental and physical suffering; the importance of active engagement in healing through prayer and acceptance; and the role of the community in both alleviating and amplifying distress. Our findings highlight local norms and strategies for adaptive coping, and the benefits of exploring local idioms to elucidate the braiding together of universal and cultural elements in psychological distress.
Collapse
Affiliation(s)
- Milena Claudius
- Institute of Psychology, University of Bern, 3012 Bern, Switzerland
- Department of Psychology and Professional Counseling, Webster University Geneva, 1293 Bellevue, Switzerland
| | - Elizabeth N. Shino
- Department of Psychology and Social Work, Faculty of Health Sciences & Veterinary Medicine, University of Namibia, Windhoek 10026, Namibia
| | - Sylvanus Job
- Department of Humanities and Arts, Faculty of Education & Human Sciences, University of Namibia, Windhoek 10026, Namibia
| | - Daniel Hofmann
- Department of Psychology, University of Zurich, 8050 Zurich, Switzerland
| | - Amber Gayle Thalmayer
- Department of Psychology, University of Zurich, 8050 Zurich, Switzerland
- Institute of Psychology, University of Lausanne, 1015 Lausanne, Switzerland
| |
Collapse
|
10
|
DeGroot JM, Carmack HJ. Accidental and Purposeful Triggers of Post-Relationship Grief. JOURNAL OF LOSS & TRAUMA 2022. [DOI: 10.1080/15325024.2022.2108614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
Affiliation(s)
- Jocelyn M. DeGroot
- Applied Communication Studies, Southern Illinois University Edwardsville, Edwardsville, IL, USA
| | | |
Collapse
|
11
|
Hinton DE. Auditory Hallucination Among Traumatized Cambodian Refugees: PTSD Association and Biocultural Shaping. Cult Med Psychiatry 2021; 45:727-750. [PMID: 33386575 DOI: 10.1007/s11013-020-09701-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/01/2020] [Indexed: 11/29/2022]
Abstract
At a psychiatric refugee clinic for survivors of the Khmer Rouge genocide, a survey revealed that 42% (38/90) had auditory hallucinations (AHs) in the last month. Of those with AHs, 87% (33/38) had PTSD, whereas of those without AHs, 31% (16/52) had PTSD, giving a chi square of 27.8, p < .001, odds ratio 14.8 (4.8-45). Most AHs were of a "ghost summoning" (khmaoch hao), considered an exhortation to go with a ghost (e.g., hearing "Please come with me, younger sister"), experienced by 73% percent of patients with AHs. The voices were always exterior and usually loud and clear. AHs were heard most often during hypnagogia (i.e., upon falling asleep or awakening), experienced by 72% of patients with AHs, whereas 42% of patients with AHs experienced AHs when fully awake. AHs were almost always attributed to a ghost, giving rise to great fear: of having the "soul" called away or of being frightened to death. AH episodes almost always triggered trauma recall. AHs caused patients to undertake certain actions to address acute episodes and to prevent further ones. To illustrate these processes, cases are provided. AH appears to be a key part of the Cambodian bioculturally shaped trauma subjectivity.
Collapse
Affiliation(s)
- Devon E Hinton
- Massachusetts General Hospital, Harvard Medical School, Center for Anxiety and Traumatic Stress Disorders, One Bowdoin Square, 6th Floor, Boston, MA, 02114, USA.
| |
Collapse
|
12
|
Causes and Risk Factor of Post-Traumatic Stress Disorder in Adult Asylum Seekers and Refugees. PSYCHIATRY INTERNATIONAL 2021. [DOI: 10.3390/psychiatryint2040032] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Objectives: To assess the causes and risk factors of post-traumatic stress disorder (PTSD) in adult asylum seekers and refugees. To explore whether the causes and risk factors of PTSD between male and female adult refugees/asylum seekers are different. Study design: Systematic review of current literature. Data Sources: PubMed, Web of Science, Scopus and Google Scholar up until February 2019. Method: A structured, systematic search was conducted of the relevant databases. Papers were excluded if they failed to meet the inclusion and exclusion criteria. Afterwards, a qualitative assessment was performed on the selected papers. Results: 12 Studies were included for the final analysis. All papers were either case studies/reports or cross-sectional studies. Traumatic events experienced by refugees/asylum seekers are the most frequently reported pre-migration causes of PTSD development, while acculturative stress is the most common post-migration stressor. There were mixed reports regarding the causes of PTSD between both genders of refugees/asylum seekers. Conclusions: This review’s findings have potential clinical application in terms of helping clinicians to risk stratify refugees/asylum seekers for PTSD development and thus aid in embarking on earlier intervention measures. However, more rigorous research similar to this study is needed for it to be implemented into clinical practice.
Collapse
|
13
|
Wilson DM, Underwood L, Errasti-Ibarrondo B. A scoping research literature review to map the evidence on grief triggers. Soc Sci Med 2021; 282:114109. [PMID: 34157614 DOI: 10.1016/j.socscimed.2021.114109] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 05/31/2021] [Accepted: 06/02/2021] [Indexed: 11/18/2022]
Abstract
Grief is understandably severe in the first days, if not weeks or months, following the death of a beloved person. Unless the mourner develops complicated grief, which is prolonged severe and impactful grief, the initial acute grief lessens in severity over time, although waves of significant grief will still occur with grief triggers. A scoping research literature review was undertaken in early 2021 to determine how often grief triggers occur, what the most common grief triggers are, the impact of triggered grief, and what can be done (by those not diagnosed with complicated grief) to manage grief triggers and mitigate the effect of them. Nine academic library databases were searched for English-language research reports using the keywords "grief trigger(s)" and "research": CINAHL, Directory of Open Access (online) Journals, Humanities Index, JSTOR, Medline (Ovid), Periodicals Index Online, PsychArticles, Scopus, and Web of Science. Six research papers relevant for review were published in the last two decades, with some evidence gained on how often grief triggers occur, what constitutes a grief trigger, and the impact of grief triggers. Major gaps in evidence were revealed, despite grief triggers being identified as a major consideration for grief in general and for grief recovery specifically.
Collapse
Affiliation(s)
- Donna M Wilson
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, T6G1C9, Canada.
| | - Leah Underwood
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, T6G1C9, Canada
| | | |
Collapse
|
14
|
Blum K, McLaughlin T, Modestino EJ, Baron D, Bowirrat A, Brewer R, Steinberg B, Roy AK, Febo M, Badgaiyan RD, Gold MS. Epigenetic Repair of Terrifying Lucid Dreams by Enhanced Brain Reward Functional Connectivity and Induction of Dopaminergic Homeostatic Signaling. ACTA ACUST UNITED AC 2021; 10. [PMID: 34707968 DOI: 10.2174/2211556010666210215153513] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
During Lucid Dreams, the dreamer is aware, experiences the dream as if fully awake, and may control the dream content. The dreamer can start, stop, and restart dreaming, depending on the nature and pleasantness of the dream. For patients with Reward Deficiency Syndrome (RDS) behaviors, like Attention Deficit Hyperactivity Disorder (ADHD), Tourette's- Syndrome, and Posttraumatic Stress Disorder (PTSD), the dream content may be pleasant, unpleasant, or terrifying. A sample of psychiatric center patients identified as having RDS reported the effectiveness of a neuronutrient, dopamine agonist, KB200Z, in combating terrifying, lucid dreaming. These reports motivated the study of eight clinical cases with known histories of substance abuse, childhood abuse, and PTSD. The administration of KB200Z, associated with eliminating unpleasant or terrifying lucid dreams in 87.5% of the cases. Subsequently, other published cases have further established the possibility of the long-term elimination of terrifying dreams in PTSD and ADHD patients. Induction of dopamine homeostasis may mitigate the effects of neurogenetic and epigenetic changes in neuroplasticity, identified in the pathogenesis of PTSD and ADHD. The article explores how relief of terrifying lucid dreams may benefit from modulation of dopaminergic signaling activated by the administration of a neuronutrient. Recently, precision formulations of the KB220 neuronutrient guided by Genetic Addiction Risk Score (GARS) test results have been used to repair inheritable deficiencies within the brain reward circuitry. The proposition is that improved dopamine transmodulational signaling may stimulate positive cognitive recall and subsequently attenuate the harmful epigenetic insults from trauma.
Collapse
Affiliation(s)
- Kenneth Blum
- Western University Health Sciences, Pomona, CA., USA.,Department Psychiatry, Wright University, Boonshoff School of Medicine, Dayton, OH., USA.,Division of Neuroscience & Addiction Research Therapy, Pathway Healthcare, Birmingham, AL., USA.,Division of Nutrigenomics, Geneus Genomic Testing Center, Geneus Health, LLC., San Antonio, TX., USA.,Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
| | | | | | - David Baron
- Department Psychiatry, Wright University, Boonshoff School of Medicine, Dayton, OH., USA
| | - Abdalla Bowirrat
- Department of Neuroscience and Genetics, Interdisciplinary Center Herzliya, Israel
| | - Raymond Brewer
- Division of Nutrigenomics, Geneus Genomic Testing Center, Geneus Health, LLC., San Antonio, TX., USA
| | | | - A Kenison Roy
- Department of Psychiatry, School of Medicine, University of Tulane, New Orleans, LA., USA
| | - Marcello Febo
- Department of Psychiatry, McKnight Brain Institute, University of Florida, School of Medicine, Gainesville, FL.USA
| | - Rajendra D Badgaiyan
- Department of Psychiatry, Ichan School of Medicine, Mount Sinai Hospital, New York, NY.& Department of Psychiatry, South Texas Veteran Health Care System, Audie L. Murphy Memorial VA Hospital, San Antonio, TX, Long School of Medicine, University of Texas Medical Center, San Antonio, TX, USA
| | - Marks S Gold
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Mo. USA
| |
Collapse
|
15
|
Abu-Raiya H, Jamal H. The links between religious coping and subjective well-being among Israeli-Muslims who lost a beloved person through death. DEATH STUDIES 2021; 45:296-304. [PMID: 31192770 DOI: 10.1080/07481187.2019.1626951] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/09/2023]
Abstract
This study examined the relationships between religious coping and indices of subjective well-being among 132 Israeli-Muslims who lost a beloved person through death. Participants provided demographic and death-related information, and completed measures of religious coping, satisfaction with life, positive/negative affect. Positive correlations were observed between positive religious coping and both satisfaction with life and positive affect, and between negative religious coping and negative affect. Further, the type of death (expected vs. sudden) was found to be a significant moderator between religious coping and subjective well-being. The theoretical and practical implications of the findings are discussed.
Collapse
Affiliation(s)
- Hisham Abu-Raiya
- Bob Shapell School of Social Work, Tel Aviv University, Tel Aviv, Israel
| | - Haneen Jamal
- Bob Shapell School of Social Work, Tel Aviv University, Tel Aviv, Israel
| |
Collapse
|
16
|
Hemer SR. Shock, anger and bad deaths in Lihir: A reanalysis of grieving in Papua New Guinea. DEATH STUDIES 2020; 45:40-50. [PMID: 33246396 DOI: 10.1080/07481187.2020.1851884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
This paper explores a revelatory moment in fieldwork-the death of a close friend and research participant who died suddenly in suspicious circumstances. Her mourning period challenged my understandings of grief in Lihir. In a previous article I argued that grief in Lihir is resilient and focused on remembering and forgetting, rather than emotions. However this particular mourning period was an emotionally charged space and time. I explore what made this death and grief distinctive, arguing that the nature of her death provoked shock and anger. This paper contributes to an ongoing discussion about how sudden or violent deaths might impact grieving both in the local context, and globally.
Collapse
Affiliation(s)
- Susan R Hemer
- Department of Anthropology and Development Studies, University of Adelaide, South Australia, Australia
| |
Collapse
|
17
|
Abstract
The loss of a loved one causes the world and the place of the bereaved survivor in it to change irreversibly. A key aspect of the grieving process is the integration of the loss in the bereaved survivor's life story, identity change, and a new future orientation through meaning attribution. Meaning attribution can have favourable or unfavourable effects on the grieving process and hence determines the extent to which a loss disrupts the bereaved survivor's functioning. A framework of meaning attribution after loss is presented, comprising 17 determinants that fall into five categories: event-related, cultural, social, individual and relational determinants. Each determinant may lead to both positive and negative meanings, thereby facilitating or complicating the grieving process. The framework of meaning attribution highlights the importance of an integrated network for mental health care, spiritual care, and end-of-life care in the prevention and treatment of traumatic grief. It also emphasizes the support from relatives, collective rituals, cultural views, legal settlements, and other societal factors that may foster or impede adaptation to loss. The framework of meaning attribution informs research across a range of research themes, including specialist care for traumatic grief, a culturally sensitive care network for traumatic grief, and improving care for ambiguous loss in a global context.
Collapse
Affiliation(s)
- Geert E Smid
- ARQ National Psychotrauma Centre, Diemen, The Netherlands.,University of Humanistic Studies, Utrecht, The Netherlands
| |
Collapse
|
18
|
Hinton DE, Reis R, de Jong J. Ghost Encounters Among Traumatized Cambodian Refugees: Severity, Relationship to PTSD, and Phenomenology. Cult Med Psychiatry 2020; 44:333-359. [PMID: 31701326 DOI: 10.1007/s11013-019-09661-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Ghost encounters were found to be a key part of the trauma ontology among Cambodian refugees at a psychiatric clinic, a key idiom of distress. Fifty-four percent of patients had been bothered by ghost encounters in the last month. The severity of being bothered by ghosts in the last month was highly correlated to PTSD severity (r = .8), and among patients bothered by ghosts in the last month, 85.2% had PTSD, versus among those not so bothered, 15.4%, odds ratio of 31.8 (95% confidence level 11.3-89.3), Chi square = 55.0, p < .001. Ghost visitations occurred in multiple experiential modalities that could be classified into three states of consciousness: full sleep (viz., in dream), hypnagogia, that is, upon falling asleep or awakening (viz., in sleep paralysis [SP] and in non-SP hallucinations), and full waking (viz., in hallucinations, visual aura, somatic sensations [chills or goosebumps], and leg cramps). These ghost visitations gave rise to multiple concerns-for example, of being frightened to death or of having the soul called away-as part of an elaborate cosmology. Several heuristic models are presented including a biocultural model of the interaction of trauma and ghost visitation. An extended case illustrates the article's findings.
Collapse
Affiliation(s)
- Devon E Hinton
- Center for Anxiety and Traumatic Stress Disorders, Massachusetts General Hospital, Harvard Medical School, One Bowdoin Square, 6th Floor, Boston, MA, 02114, USA.
| | - Ria Reis
- Leiden University Medical Center, Leiden, The Netherlands
- Amsterdam Institute for Social Science Research, University of Amsterdam, Amsterdam, The Netherlands
- The Children's Institute, School of Child and Adolescent Health, University of Cape Town, Cape Town, South Africa
| | - Joop de Jong
- Center for Anxiety and Related Disorders, Boston University, Boston, USA
| |
Collapse
|
19
|
Kokou-Kpolou CK, Moukouta CS, Masson J, Bernoussi A, Cénat JM, Bacqué MF. Correlates of grief-related disorders and mental health outcomes among adult refugees exposed to trauma and bereavement: A systematic review and future research directions. J Affect Disord 2020; 267:171-184. [PMID: 32217217 DOI: 10.1016/j.jad.2020.02.026] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Revised: 01/02/2020] [Accepted: 02/08/2020] [Indexed: 10/25/2022]
Abstract
BACKGROUND With conflict driving millions of refugees away from their homes worldwide, there has been an increase in interest in the field of refugee trauma. However, while trauma and bereavement interlink, prior studies have focused on trauma and its related disorders (PTSD) and predictive factors. This paper reviewed up-to-date literature on the prevalence rates of prolonged grief disorder (PGD), its comorbidities, and associated risk factors among adult refugees. METHOD We systematically reviewed the literature using five databases (PsycINFO, PsycARTICLES, Psychology and Behavioral Sciences Collection, Academic Search Elite, and PubMed). The process of study selection was designed according to PRISMA guidelines. RESULTS The initial search generated 126 articles, of which 12 met the inclusion criteria. The pooled prevalence of PGD was 33.2% (95% CI: 15.2-54.2%). Being an older refugee, traumatic and multiple losses implying the death of first-degree relatives appeared to be consistent risk factors for PGD, combined PTSD/PGD, depression, idioms of distress, and functional impairment. PGD, PTSD, and PTSD/PGD intersect on PTSD-intrusions and painful memories. LIMITATIONS All included studies adopted a cross-sectional design, thus limiting the understanding of causal pathways. CONCLUSIONS Our findings showed that the high prevalence of PGD and related comorbidities were influenced by the load of traumatic circumstances surrounding the death(s). The findings shed light on the current proposed grief-related diagnostic criteria . Psychopathological and transcultural aspects are discussed, and we provide concrete recommendations for improvements to future research in this field.
Collapse
Affiliation(s)
| | | | - Joanic Masson
- Department of Psychology, University of Picardy Jules Verne, Amiens, France
| | - Amal Bernoussi
- Department of Psychology, University of Picardy Jules Verne, Amiens, France
| | | | | |
Collapse
|
20
|
Liu TH, Field NP. Continuing bonds and dreams following violent loss among Cambodian survivors of the Pol Pot era. DEATH STUDIES 2019; 46:297-306. [PMID: 31822206 DOI: 10.1080/07481187.2019.1699202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
In non-Western societies, two-way communication between the bereaved and deceased is important in distinguishing adaptive versus maladaptive continuing bonds (CBs). We examined CBs expressed in dreams among Cambodian survivors during the Pol Pot era. Participants completed measures addressing dreams of the deceased, complicated grief (CG), and post-traumatic stress disorder (PTSD) symptoms. Participants who reported distressing dreams were more likely to have witnessed violent deaths of loved ones during the Pol Pot era and reported more severe CG and PTSD symptoms relative to those reporting other types of dreams. Distressing visitation dreams were shown to mediate the effect of violent loss on CG but not on PTSD.
Collapse
Affiliation(s)
- Tsung-Hsing Liu
- Department of Education, National Kaohsiung Normal University, Kaohsiung, Taiwan
| | - Nigel P Field
- Pacific Graduate School of Psychology at Palo Alto University, Palo Alto, CA, USA
| |
Collapse
|
21
|
Steil R, Gutermann J, Harrison O, Starck A, Schwartzkopff L, Schouler-Ocak M, Stangier U. Prevalence of prolonged grief disorder in a sample of female refugees. BMC Psychiatry 2019; 19:148. [PMID: 31088419 PMCID: PMC6518607 DOI: 10.1186/s12888-019-2136-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Accepted: 04/30/2019] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Prolonged Grief Disorder (PGD) is a distinct syndrome that follows bereavement. It is different from other mental disorders and is characterized by symptoms such as yearning for the bereaved, or intense emotional pain or distress. Violent loss is one major risk factor for the development of PGD. OBJECTIVES PGD has been studied in different populations, mostly in small samples, with only a few of them being representative. Although research highlighted that traumatic experiences paired with challenges related to migration make refugees particularly vulnerable to PGD, PGD has only rarely been studied in refugees. Thus, this article a) examines the prevalence of PGD in female refugees in Germany according to the criteria proposed by Prigerson and colleagues in 2009, and b) associates PGD with other common psychopathology (e.g. anxiety, depression, somatization and trauma). METHOD A total of 106 female refugees were assessed for bereavement and PGD. Of these 106 individuals, 85 were interviewed using the Prolonged Grief Disorder Scale (PG-13). Symptoms of anxiety and depression were assessed by the Hopkins Symptom Checklist-25 (HSCL-25), somatization was assessed by the Somatization Subscale of the Symptom-Checklist-90 (SCL-90), and the number of witnessed and experienced trauma was assessed by the Posttraumatic Diagnostic Scale (PDS/HTQ). RESULTS Ninety of the 106 participants had experienced bereavement, and among those, 9.41% met criteria for PGD. The most frequent PGD symptoms were bitterness, longing or yearning for the bereaved, and lack of acceptance of the loss. Furthermore, grief symptoms were significantly associated with symptoms of depression, anxiety, somatization, and the number of experienced traumatic events. CONCLUSION The PGD prevalence rate found corresponds with previous studies, demonstrating that prevalence rates for PGD are especially high in refugees. High prevalence rates of bereavement as well as PGD highlight the need for assessment and specifically tailored treatment of PGD in refugees. PGD goes along with significant psychopathology, which further emphasizes the need for treatment.
Collapse
Affiliation(s)
- Regina Steil
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology, Goethe University Frankfurt, Varrentrappstr. 40-42, 60486, Frankfurt on Main, Hesse, Germany.
| | - Jana Gutermann
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology, Goethe University Frankfurt, Varrentrappstr. 40-42, 60486, Frankfurt on Main, Hesse, Germany
| | - Octavia Harrison
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology, Goethe University Frankfurt, Varrentrappstr. 40-42, 60486, Frankfurt on Main, Hesse, Germany
| | - Annabelle Starck
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology, Goethe University Frankfurt, Varrentrappstr. 40-42, 60486, Frankfurt on Main, Hesse, Germany
| | - Laura Schwartzkopff
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology, Goethe University Frankfurt, Varrentrappstr. 40-42, 60486, Frankfurt on Main, Hesse, Germany
| | - Meryam Schouler-Ocak
- Department of Psychiatry, Institute of Medicine, University Clinic of Charité at St. Hedwig Hospital, Berlin, Germany
| | - Ulrich Stangier
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology, Goethe University Frankfurt, Varrentrappstr. 40-42, 60486, Frankfurt on Main, Hesse, Germany
| |
Collapse
|
22
|
Killikelly C, Bauer S, Maercker A. The Assessment of Grief in Refugees and Post-conflict Survivors: A Narrative Review of Etic and Emic Research. Front Psychol 2018; 9:1957. [PMID: 30405474 PMCID: PMC6204364 DOI: 10.3389/fpsyg.2018.01957] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2018] [Accepted: 09/21/2018] [Indexed: 12/29/2022] Open
Abstract
Background: Prolonged grief disorder (PGD) is a new mental health disorder that will be recognized by the World Health Organization’s disorder classification, the ICD-11, in 2018. Current assessment measures of PGD are largely based on North American and European conceptualizations of grief (etic i.e., from the perspective of the observer). However, research is emerging from communities outside of the Global North, in particular, conflict-exposed communities, exploring local models (emic i.e., from within the cultural group), assessment measures and symptoms of grief. Several reviews have found that refugees have higher rates of mental illness, defined by etic standards as depression, post-traumatic stress disorder (PTSD), anxiety disorders and psychotic symptoms. Yet, presently there are no reviews documenting the assessment of PGD in refugees and post conflict survivors. Method: This narrative review will provide an overview of studies that assess grief in refugees to (1) identify current assessment measures of grief in refugees (i.e., type and frequency of questionnaires used, whether Global North-based, etic, or locally developed, emic, and the level of cultural adaptation) and (2) to document the variety and rate of grief symptoms identified with Global North standard measures and/or local measures (i.e., the endorsement of standard symptom items and the identification of culturally specific symptoms of grief). Results: This review revealed 24 studies that assessed disordered grief in refugee or post conflict samples. Studies were heterogeneous in their assessment methods; the majority (n = 17) used an etic approach, four used a combined etic/emic approach, and three used a predominantly emic approach. The rate of disordered grief was high depending on cultural adaptation approach (31–76%) and when standard etic measures were used the disordered grief rate was 32%. Conclusion: These findings will help to guide future studies to provide accurate assessment of grief in refugee and post conflict populations and has implications for improving cultural knowledge in clinical practice.
Collapse
Affiliation(s)
- Clare Killikelly
- Division Psychopathology and Clinical Intervention, Department of Psychology, University of Zürich, Zürich, Switzerland
| | - Susanna Bauer
- Division Psychopathology and Clinical Intervention, Department of Psychology, University of Zürich, Zürich, Switzerland
| | - Andreas Maercker
- Division Psychopathology and Clinical Intervention, Department of Psychology, University of Zürich, Zürich, Switzerland
| |
Collapse
|
23
|
Migraine-Like Visual Auras Among Traumatized Cambodians with PTSD: Fear of Ghost Attack and Other Disasters. Cult Med Psychiatry 2018; 42:244-277. [PMID: 29019040 DOI: 10.1007/s11013-017-9554-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
This article profiles visual auras among traumatized Cambodian refugees attending a psychiatric clinic. Thirty-six percent (54/150) had experienced an aura in the previous 4 weeks, almost always phosphenes (48% [26/54]) or a scintillating scotoma (74% [40/54]). Aura and PTSD were highly associated: patients with visual aura in the last month had greater PTSD severity, 3.6 (SD = 1.8) versus 1.9 (SD = 1.6), t = 10.2 (df = 85), p < 0.001, and patients with PTSD had a higher rate of visual aura in the last month, 69% (22/32) versus 13% (7/55), odds ratio 15.1 (5.1-44.9), p < 0.001. Patients often had a visual aura triggered by rising up to the upright from a lying or sitting position, i.e., orthostasis, with the most common sequence being an aura triggered upon orthostasis during a migraine, experienced by 60% of those with aura. The visual aura was often catastrophically interpreted: as the dangerous assault of a supernatural being, most commonly the ghost of someone who died in the Pol Pot period. Aura often triggered flashback. Illustrative cases are provided. The article suggests the existence of local biocultural ontologies of trauma as evinced by the centrality of visual auras among Cambodian refugees.
Collapse
|
24
|
Kokou-Kpolou K, Mbassa Menick D, Moukouta CS, Baugnet L, Kpelly DE. A Cross-Cultural Approach to Complicated Grief Reactions Among Togo–Western African Immigrants in Europe. JOURNAL OF CROSS-CULTURAL PSYCHOLOGY 2017. [DOI: 10.1177/0022022117721972] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Many researchers have noted that bereavement is a major stress factor associated with the etiopathogeny of psychological disorders among immigrants, but until now, the grief reactions of these ethnic minorities have not been analyzed. This study aims to examine the impact of the migration trajectory (immigration status and duration) as well as the use of ritual support to cope with grief reactions in the context of migration. Fifty-four migrants and 20 refugees ( N = 74) in France and Belgium were surveyed regarding their experience of mourning a family member. The results showed that complicated grief is associated with the status and duration of immigration. A majority of refugees reported a deterioration of their social life when the duration of their immigration exceeded 10 years. Feeling guilty, dazed or stunned, loneliness, bitterness, numbness, and emptiness made up the spectrum of severe and persistent guilt reactions. Those who took part in bereavement rituals suffered less from feelings of guilt and despondency. Eldest siblings presented a very high rate of complicated grief. These findings were discussed using a psycho-cultural approach; they demonstrated that in the context of migration, grief reactions develop around the principle of debt, based on the parent–child relationship inextricably associated with a feeling of belonging to the ethnic group and collective memory.
Collapse
Affiliation(s)
| | | | | | - Lucy Baugnet
- University of Picardie Jules Verne, Amiens, France
| | | |
Collapse
|
25
|
Joe KK, Mapatano MA, Manyonga T, Mwadianvita CK, Valérien M, Stanis W, Kavulu M, Espérance K. Normal grief and its correlates in Lubumbashi, an urban city in the Democratic Republic of Congo. Pan Afr Med J 2016; 24:24. [PMID: 27583088 PMCID: PMC4992397 DOI: 10.11604/pamj.2016.24.24.5533] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2014] [Accepted: 04/10/2016] [Indexed: 11/11/2022] Open
Abstract
Introduction Grief is a universal experience faced at one time or another by most people during their lives. Response to grief and bereavement losses can lead to psychiatric disorders such as mood disorders, post traumatic responses, insomnia loss of appetite, anxiety, and depression. The aim of our study is to value in our community the physical and psychological complications of a normal grief. Methods We conducted a cross-sectional study from March 2012 to September 2012 in Lubumbashi, Democratic Republic of Congo. Two questionnaires, the Hamilton Anxiety Scale and the Beck Depression Inventory scale were used as screening tool. A snow ball sampling method was performed and the questionnaires were administered only to those who consented to participate in the study. Results A total of 78 subjects were included in the study of which 87.2% were aged between 14-50 years old. The majority of the subjects were female 65.4%, and about a quarter (28%) was unemployed. The main correlates of the grief reported in the present study were being treated as witchcraft or accused to be responsible of a death (68%), being rejected by family and not being allowed to inherit (32%). Being homeless was reported in 26%. The main psychological symptoms reported were psychological distress after 1 year (65%) and related physical health problems after the death (72%). Depression and mild anxiety were the most reported disorders, with respectively 92.3% and 74.4% of the subjects. Conclusion Grief in Lubumbashi is associated with a large number of psychological, social and health problems. Health problems such as gastric is, high blood pressure were often reported. Being accused of witchcraft remains the main social impact. Depression and anxiety were the most psychological problem associated with grief.
Collapse
Affiliation(s)
- Katabwa Kabongo Joe
- Department of Internal Medicine, Psychiatry Unit, University of Lubumbashi, Democratic Republic of Congo
| | - Mala Ali Mapatano
- Department of Public Health, University of Kinshasa (UNIKIN), Democratic Republic of Congo
| | - Tshibangu Manyonga
- Department of Psychology, Excellence Centre, University of Lubumbashi, Democratic Republic of Congo
| | | | - Mutombo Valérien
- Department of Neurology, University of Mbuji Mayi, Democratic Republic of Congo
| | - Wembonyama Stanis
- Department of Paediatrics, University of Lubumbashi, Democratic Republic of Congo
| | - Mukendi Kavulu
- Neurology Unit, Mons Regional Hospital Complex and University Catholique de Louvain (UCL), Belgium, Department of Paediatrics, University of Lubumbashi, Democratic Republic of Congo
| | | |
Collapse
|
26
|
|
27
|
Abstract
After catastrophic events in which people's survival has been threatened, as happened during the Khmer Rouge regime in Cambodia 1975-1979, some continue to suffer from painful mental symptoms. Surveys carried out in Cambodia based on Western diagnostic categories have found a high prevalence of posttraumatic stress disorder (PTSD), depression, and anxiety symptoms in the population. This study explored Cambodian approaches to healing trauma, examining the ways in which Cambodians appeal to elements of Buddhism in their efforts to calm their minds, situating this mode of coping in the context of broader Khmer Buddhist practice and understandings. Western psychology may have much to learn from local, contextualised methods of dealing with the aftermath of trauma, including Khmer understandings of distress and approaches to relief. Methods of assessment and treatment of distress cannot be transposed wholesale from one cultural setting to another but require considerable cultural adaptation. This kind of cultural interchange may give rise to innovative, hybrid discourses and methods that may have much to offer in the support of victims of organised violence.
Collapse
|
28
|
McLaughlin T, Blum K, Oscar-Berman M, Febo M, Demetrovics Z, Agan G, Fratantonio J, Gold MS. Using the Neuroadaptagen KB200z™ to Ameliorate Terrifying, Lucid Nightmares in RDS Patients: the Role of Enhanced, Brain-Reward, Functional Connectivity and Dopaminergic Homeostasis. JOURNAL OF REWARD DEFICIENCY SYNDROME 2015; 1:24-35. [PMID: 26065033 PMCID: PMC4459746 DOI: 10.17756/jrds.2015-006] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Lucid Dreams are a form of dream life, during which the dreamer may be aware that he/she is dreaming, can stop/re-start the dreams, depending on the pleasantness or unpleasant nature of the dream, and experiences the dream as if he/she were fully awake. Depending on their content, they may be pleasant, un-pleasant or terrifying, at least in the context of patients, who also exhibit characteristics of Reward Deficiency Syndrome (RDS) and Posttraumatic Stress Disorder (PTSD). CASE SERIES We present eight clinical cases, with known substance abuse, childhood abuse and diagnosed PTSD/RDS. The administration of a putative dopamine agonist, KB200Z™, was associated with the elimination of unpleasant and/or terrifying, lucid dreams in 87.5% of the cases presented, whereas one very heavy cocaine abuser showed a minimal response. These results required the continuous use of this nutraceutical. The lucid dreams themselves were distinguishable from typical, PTSD nightmares insofar as their content did not appear to reflect a symbolic rendition of an originally-experienced, historical trauma. Each of the cases was diagnosed with a form of RDS, i.e., ADHD, ADD, and/or Tourette's syndrome. They all also suffered from some form of Post-Traumatic-Stress-Disorder (PTSD) and other psychiatric diagnoses as well. CONCLUSION The reduction or elimination of terrifying Lucid Dreams seemed to be dependent on KB220Z, whereby voluntary stopping of the agent results in reinstatement of the terrifying non-pleasant nature of the dreams. Following more required research on a much larger population we anticipate confirmation of these seemingly interesting observations. If these results in a small number of patients are indeed confirmed we may have found a frontline solution to a very perplexing and complicated symptom known as lucid dreams.
Collapse
Affiliation(s)
| | - Kenneth Blum
- Department of Psychiatry and McKnight Brain Institute, University of Florida, College of Medicine, Gainesville, FL, USA
- Department of Clinical Medicine, Malibu Beach Recovery Center, Malibu Beach, CA, USA
- Department of Addiction Medicine, Victory Nutrition International, LLC., Lederoch, PA, USA
- Community Mental Health Institute, Center for Clinical & Translational Science, University of Vermont and Department of Psychiatry, University of Vermont College of Medicine, Burlington, VT, USA
- Dominion Diagnostics, Inc. North Kingstown, RI, USA
- Center for Genomics and Applied Gene Technology, Institute of Integrative Omics and Applied Biotechnology (IIOAB), Nonakuri, Purbe Medinpur, West Bengal, India
- Center for RDS Research, Victory Nutrition, LLC, Austin, TX, USA
- Department of Nutrigenomics, RDSolutions, Inc., Salt Lake City, UT, USA
- Department of Personalized Medicine, IGENE, LLC., Austin, TX, USA
| | - Marlene Oscar-Berman
- Departments of Psychiatry, Anatomy and Neurobiology, and Boston VA and Boston University School of Medicine, MA, USA
| | - Marcelo Febo
- Department of Psychiatry and McKnight Brain Institute, University of Florida, College of Medicine, Gainesville, FL, USA
| | - Zsolt Demetrovics
- Department of Clinical Psychology and Addiction, Institute of Psychology, Eötvös Loránd University, Hungary
| | - Gozde Agan
- Divisions of Addiction Services, & Applied Clinical Research & Education, Dominion Diagnostics, LLC, North Kingstown, RI, USA
| | - James Fratantonio
- Divisions of Addiction Services, & Applied Clinical Research & Education, Dominion Diagnostics, LLC, North Kingstown, RI, USA
| | - Mark S. Gold
- Departments of Psychiatry & Behavioral Sciences at the Keck, University of Southern California, School of Medicine, CA, USA
- Director of Research, Drug Enforcement Administration (DEA) Educational Foundation, Washington, D.C, USA
| |
Collapse
|
29
|
McLaughlin T, Blum K, Oscar-Berman M, Febo M, Agan G, Fratantonio JL, Simpatico T, Gold MS. Putative dopamine agonist (KB220Z) attenuates lucid nightmares in PTSD patients: role of enhanced brain reward functional connectivity and homeostasis redeeming joy. J Behav Addict 2015; 4:106-15. [PMID: 26132915 PMCID: PMC4500891 DOI: 10.1556/2006.4.2015.008] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Lucid dreams are frequently pleasant and training techniques have been developed to teach dreamers to induce them. In addition, the induction of lucid dreams has also been used as a way to ameliorate nightmares. On the other hand, lucid dreams may be associated with psychiatric conditions, including Post-Traumatic Stress Disorder (PTSD) and Reward Deficiency Syndrome-associated diagnoses. In the latter conditions, lucid dreams can assume an unpleasant and frequently terrifying character. CASE PRESENTATIONS We present two cases of dramatic alleviation of terrifying lucid dreams in patients with PTSD. In the first case study, a 51-year-old, obese woman, diagnosed with PTSD and depression, had attempted suicide and experienced terrifying lucid nightmares linked to sexual/physical abuse from early childhood by family members including her alcoholic father. Her vivid "bad dreams" remained refractory in spite of 6 months of treatment with Dialectical Behavioral Therapy (DBT) and standard pharmaceutical agents which included prazosin, clonidie and Adderall. The second 39-year-old PTSD woman patient had also suffered from lucid nightmares. RESULTS The medication visit notes reveal changes in the frequency, intensity and nature of these dreams after the complex putative dopamine agonist KB220Z was added to the first patient's regimen. The patient reported her first experience of an extended period of happy dreams. The second PTSD patient, who had suffered from lucid nightmares, was administered KB220Z to attenuate methadone withdrawal symptoms and incidentally reported dreams full of happiness and laughter. CONCLUSIONS These cases are discussed with reference to the known effects of KB220Z including enhanced dopamine homeostasis and functional connectivity of brain reward circuitry in rodents and humans. Their understanding awaits intensive investigation involving large-population, double-blinded studies.
Collapse
Affiliation(s)
| | - Kenneth Blum
- Department of Psychiatry and McKnight Brain Institute, University of Florida, College of Medicine, Gainesville, FL, USA,Department of Personalized Medicine, IGENE, LLC, Austin, TX, USA,Division of Applied Clinical Research, Dominion Diagnostics, LLC, North Kingstown, RI, USA,* Corresponding author: Kenneth Blum, PhD; Department of Psychiatry & McKnight Brain Institute, University of Florida, College of Medicine, Box 100183 Gainesville, FL, 32610-0183, USA; Phone: +1-352-392-6680; Fax: +1-352-392-8217; E-mail:
| | - Marlene Oscar-Berman
- Departments of Psychiatry, Neurology, and Anatomy & Neurobiology, Boston University School of Medicine, and Boston VA Healthcare, Boston, MA, USA
| | - Marcelo Febo
- Department of Psychiatry and McKnight Brain Institute, University of Florida, College of Medicine, Gainesville, FL, USA
| | - Gozde Agan
- Division of Addiction Services, Dominion Diagnostics, LLC, North Kingstown, RI, USA
| | - James L. Fratantonio
- Division of Applied Clinical Research, Dominion Diagnostics, LLC, North Kingstown, RI, USA
| | - Thomas Simpatico
- Community Mental Health Institute, Center for Clinical & Translational Science, University of Vermont and Department of Psychiatry, University of Vermont College of Medicine, Burlington, VT, USA
| | - Mark S. Gold
- Department of Psychiatry and McKnight Brain Institute, University of Florida, College of Medicine, Gainesville, FL, USA,Rivermend Health, LLC, Atlanta, GA, USA
| |
Collapse
|