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Creegan M, O'Connell M, Griffin E, O'Connell S. Exploring posttraumatic growth in individuals bereaved by suicide: A secondary data analysis of a national survey. DEATH STUDIES 2024:1-9. [PMID: 38990548 DOI: 10.1080/07481187.2024.2376823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/12/2024]
Abstract
This article explores the concept of posttraumatic growth (PTG) in individuals bereaved by suicide. The present study employs an exploratory approach to examine secondary data from a national survey. A sample of 2369 (n = 2369) responses were examined. Various instruments were utilized to assess grief experiences, social support, and personal growth. Descriptive statistics, correlational analysis and a hierarchical regression model were used to examine the relationship between the variables in this study. Hierarchical regression analysis revealed six independent predictors of PTG: social and formal support, time since loss, grief experiences, gender and multiple losses. The study highlighted the potential for growth in the aftermath of suicide bereavement, emphasizing the critical role of social support and the importance of time in promoting PTG. Despite some limitations, the present findings provide novel insight into the underlying mechanisms of PTG in suicide-bereaved individuals.
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Affiliation(s)
- Mark Creegan
- School of Psychology, University College Dublin, Dublin, Ireland
| | | | - Eve Griffin
- National Suicide Research Foundation, University College Cork, Cork, Ireland
| | - Selena O'Connell
- School of Public Health, College of Medicine and Health, University College Cork, Cork, Ireland
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2
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Durif-Bruckert C, Cuvillier B, Vieux M, Chalancon B, Villeval P, Leaune E. Psychiatric trainees as second victims after exposure to patient suicide: a French qualitative study. Front Psychiatry 2023; 14:1308021. [PMID: 38173704 PMCID: PMC10764017 DOI: 10.3389/fpsyt.2023.1308021] [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] [Received: 10/05/2023] [Accepted: 11/28/2023] [Indexed: 01/05/2024] Open
Abstract
Background The exposure to patient suicide (PS) has been identified as one of the most frequent and troubling professional experience for psychiatric trainees. Further studies are needed to better understand how residents cope with these experiences and the association between perceived support and the impacts of PS. Method In this qualitative study, we aimed to assess the impact of exposure to PS during psychiatric residency on trainees' professional career and practical experience. A total of 19 French psychiatric residents participated in 4 focus-groups performed between November 2017 and May 2019. Results A total of 4 thematic clusters were identified through a five-step content analysis, namely: (a) reactions to the exposure; (b) coping strategies; (c) professional impact; and (d) prevention and postvention proposals. All participants described the critical impact of the support provided after PS, especially by their senior staff. Those who felt supported by their superior reported less negative impact, both in emotional and professional dimensions. Participants also shared proposals to improve the prevention and postvention issues related to the exposure to PS. Conclusion We performed the first qualitative study based on focus groups on the impact of PS on psychiatric residents, which allowed for an in-depth understanding of the participants' lived experiences of the exposure to PS. The narratives inform the need and means to implement prevention and postvention strategies designed to buffer the negative impact of the exposure to PS in psychiatric trainees.
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Affiliation(s)
| | | | - Maxime Vieux
- Center for Suicide Prevention, Centre Hospitalier le Vinatier, Bron, France
- Groupe d’Etude et de Prévention duSuicide, Saint-Benoit, France
| | - Benoit Chalancon
- Center for Suicide Prevention, Centre Hospitalier le Vinatier, Bron, France
- Groupe d’Etude et de Prévention duSuicide, Saint-Benoit, France
| | | | - Edouard Leaune
- Center for Suicide Prevention, Centre Hospitalier le Vinatier, Bron, France
- Groupe d’Etude et de Prévention duSuicide, Saint-Benoit, France
- RESHAPE, Inserm U1290, Université Claude Bernard Lyon 1, Lyon, France
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3
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Graziano RC, Brown WJ, Strasshofer DR, Yetter MA, Berfield JB, Haven SE, Bruce SE. Posttraumatic stress symptoms, posttraumatic growth, and personality factors: A network analysis. J Affect Disord 2023; 338:207-219. [PMID: 37290526 DOI: 10.1016/j.jad.2023.06.011] [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: 12/27/2021] [Revised: 02/13/2023] [Accepted: 06/04/2023] [Indexed: 06/10/2023]
Abstract
BACKGROUND After experiencing a traumatic event, two possible outcomes are experiencing positive changes, such as posttraumatic growth (PTG), and/or experiencing distress in the form of posttraumatic stress symptoms (PTSS). These constructs are not mutually exclusive; those who experience PTSS may concurrently or at a later date likewise undergo PTG. Pretrauma factors, such as personality as measured by the Big Five Inventory (BFI), can interact with both PTSS and PTG. METHODS The present study utilized Network theory to examine the interactions between PTSS, PTG, and personality in 1310 participants. Three networks were computed (PTSS, PTSS/BFI, PTSS/PTG/BFI). RESULTS Within the PTSS network, strong negative emotions emerged as the strongest influence on the network. Again, in the PTSS and BFI network, strong negative emotions exerted the strongest overall influence in addition to bridging the PTSS and personality domains. In the network with all variables of interest, the PTG domain of new possibilities was the strongest overall influence on the network. Specific relationships between constructs were identified. LIMITATIONS Limitations of this study include the cross-sectional design and utilization of a sub-threshold PTSD, non-treatment seeking sample. CONCLUSIONS Overall, nuanced relationships between variables of interest were identified, informing personalized treatment and furthers our understanding of both positive and negative responses to trauma. As the primary influence across two networks, the experience of strong negative emotions appears to be central to the subjective experience of PTSD. This may indicate a need to modify present treatments for PTSD, which conceptualize PTSD as a primarily fear-based disorder.
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Affiliation(s)
| | - Wilson J Brown
- Psychology Department, Penn State Behrend, Erie, PA, United States of America
| | | | - Marissa A Yetter
- Department of Psychological Sciences, University of Missouri-St. Louis, St. Louis, MO, United States of America
| | - Jillian B Berfield
- Department of Psychological Sciences, University of Missouri-St. Louis, St. Louis, MO, United States of America
| | - Sophie E Haven
- Department of Psychological Sciences, University of Missouri-St. Louis, St. Louis, MO, United States of America
| | - Steven E Bruce
- Department of Psychological Sciences, University of Missouri-St. Louis, St. Louis, MO, United States of America.
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4
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Ramos-Vera C, O'Diana AG, Vallejos-Saldarriaga J, Saintila J. Validation of the Post-Traumatic Growth Inventory in Adolescents Who Lost a Family Member in the Past 4 years: Effects of Time After the Death Event and Gender. OMEGA-JOURNAL OF DEATH AND DYING 2023:302228231166833. [PMID: 37012212 DOI: 10.1177/00302228231166833] [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: 04/05/2023]
Abstract
Post-traumatic growth is the psychological capacity to perceive positive changes facing high-stress or potentially traumatic events and may be especially useful in lessening their effects in adolescents' lives. Present study aimed to evaluate the psychometric properties of the Post-Traumatic Growth Inventory (PTGI) in 662 Peruvian adolescents who suffered the death of an immediate family member over the last 4 years. Firstly, an exploratory graphical analysis (EGA) was conducted to determine the best parsimonious structure of the instrument and confirmed with its respective factor models. The results report adequate fit indices in the EGA Bifactor model. Furthermore, another structural model is included, which reports significant latent effects of the time elapsed since the relative's death and gender (male) on PTGI general factor. Likewise, gender measure was significantly related to items 3, 7, and 11, which is linked to personal growth.
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5
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Van der Hallen R, Godor BP. COVID-19 pandemic-related posttraumatic growth in a small cohort of university students: A 1-year longitudinal study. Psychiatry Res 2022; 312:114541. [PMID: 35429912 PMCID: PMC8979838 DOI: 10.1016/j.psychres.2022.114541] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Revised: 03/23/2022] [Accepted: 04/01/2022] [Indexed: 01/18/2023]
Abstract
The COVID-19 pandemic has affected all areas of life, with severe potential consequences for people's mental health. Posttraumatic growth (PTG), a positive psychological change that may develop following a traumatic event, in light of the COVID-19 pandemic has only received little attention. The current study aimed to investigate (1) the prevalence of PTG within the context of the COVID-19 pandemic and (2) which psychological aspects predict COVID-19 pandemic-related PTG using a 1-year longitudinal design. A sample of 70 participants completed a survey on COVID-19, posttraumatic stress, emotional well-being, coping styles, determinates of resilience, and PTG at both T1, May 2020, and T2, May 2021. Results reveal moderate levels of PTG for about one in five participants at both T1 and T2 (21% and 23%, respectively). Moreover, PTG at T1 and T2 were moderate to strongly, positively correlated, r = 0.62. Posttraumatic stress and social support were found to positively predict PTG at T1, while positive affect and social skills were found to positively predict PTG at both T1 and T2, βs = 0.22-.52. Implications of the current findings and suggestions for future research are discussed.
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Affiliation(s)
- Ruth Van der Hallen
- Department of Psychology, Education & Child Studies, Erasmus University Rotterdam, Rotterdam 3062 PA, The Netherlands.
| | - Brian P Godor
- Department of Psychology, Education & Child Studies, Erasmus University Rotterdam, Rotterdam 3062 PA, The Netherlands
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6
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Fisher JE, Rice AJ, Zuleta RF, Cozza SJ. Bereavement during the COVID-19 Pandemic: Impact on Coping Strategies and Mental Health. Psychiatry 2022; 85:354-372. [PMID: 35404761 DOI: 10.1080/00332747.2022.2051141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
The COVID-19 coronavirus has caused 5.4 million deaths worldwide, including over 800,000 deaths in the United States (as of December 2021). In addition to these staggering statistics, an even greater number of individuals have died from other causes during the COVID-19 pandemic. As a result, a large portion of the global population has faced bereavement during the COVID-19 pandemic and resulting quarantine. The often rapid and unexpected nature of COVID-19 deaths and the presence of pandemic-related stressors and living restrictions make it more difficult for individuals bereaved during the pandemic to implement effective strategies for coping with the loss compared to non-pandemic periods. Quarantine-related constraints (e.g., social distancing, availability of and access to resources) impede coping strategies that have been found to be adaptive after a loss, such as supportive (e.g., seeking emotional and instrumental support) and active (e.g., problem-focused and cognitive reframing) coping, and they augment avoidant strategies (e.g., substance use, denial, and isolation) that have been found to be maladaptive. Poorer mental health outcomes (including prolonged grief disorder; PGD) have been associated with less healthy coping. This article reviews research findings regarding bereavement during the COVID-19 pandemic, discusses the effects of pandemic-related stressors on bereavement coping strategies, and proposes how different types of coping during the pandemic may account for the poorer mental health outcomes described in recent reports. Interventions for promoting adaptive coping strategies and minimizing maladaptive coping strategies are also outlined.
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7
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Fu M, Huang N, Hall BJ, Shi Q, Shahid M, Guo J. Does the attribution of responsibilities modify the relationship between coping styles and mental health? A survey of Chinese adults during the COVID-19 pandemic. J Health Psychol 2021; 27:2211-2226. [PMID: 34180295 DOI: 10.1177/13591053211025596] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The COVID-19 pandemic is associated with Posttraumatic Stress Symptoms (PTSS) and self-reported Posttraumatic Growth (PTG) in the general population. This study used linear regressions for analyses, based on an online survey conducted during the COVID-19 lockdown among 2441 Chinese adults in February 2020. The results showed negative coping and attributing responsibilities to individuals were associated with more PTSS, while both positive and negative coping, as well as attributing responsibilities to individuals were related to more PTG. Moreover, attribution of responsibilities modified the association between coping and PTSS, but not PTG. These findings shed light on mental health interventions in a pandemic context.
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Affiliation(s)
| | - Ning Huang
- Huazhong University of Science and Technology, P.R. China
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Ruocco KA, Patton CS, Burditt K, Carroll B, Mabe M. TAPS Suicide Postvention Model TM: A comprehensive framework of healing and growth. DEATH STUDIES 2021; 46:1897-1908. [PMID: 33407006 DOI: 10.1080/07481187.2020.1866241] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
The TAPS Suicide Postvention ModelTM is a three-phase approach to suicide grief that offers a framework for survivors and providers in the aftermath of a suicide. This framework proposes guidance on how to build a foundation for an adaptive grief journey and creates a research-informed, proactive, intentional pathway to posttraumatic growth. The Model follows the Tragedy Assistance Program for Survivors' peer-based model of care and has supported more than 16,000 military suicide loss survivors over the past decade. The Model is applicable to anyone grieving a suicide loss or coping with any associated trauma.
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Affiliation(s)
- Kim A Ruocco
- Tragedy Assistance Program for Survivors, Arlington, Virginia, USA
| | | | - Kim Burditt
- Tragedy Assistance Program for Survivors, Arlington, Virginia, USA
| | - Bonnie Carroll
- Tragedy Assistance Program for Survivors, Arlington, Virginia, USA
| | - Matt Mabe
- Tragedy Assistance Program for Survivors, Arlington, Virginia, USA
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9
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Leaune E, Lestienne L, Grandgenèvre P, Morgiève M, Vaiva G, Vieux M, Chalancon B, Laplace N, Haesebaert J, Poulet E. Development of an Online Resource for People Bereaved by Suicide: A Mixed-Method User-Centered Study Protocol. Front Psychiatry 2021; 12:770154. [PMID: 34992555 PMCID: PMC8724422 DOI: 10.3389/fpsyt.2021.770154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Accepted: 11/22/2021] [Indexed: 12/04/2022] Open
Abstract
Introduction: Suicide bereavement is known to be highly distressing and is frequently associated with mental health problems. Despite high-level of need regarding mental and physical health, people bereaved by suicide display low level of help-seeking and perceived support in the aftermath of the loss. The lack of accessibility and reliability of face-to-face counseling resources is notably reported by suicide survivors. Online resources can enhance early access to help and support for people bereaved by suicide. The primary objective of the study is to design and implement an innovative and adaptive online resource for people bereaved by suicide according to their needs and expectation regarding online solutions dedicated to suicide bereavement. Methods: The ESPOIR2S study is a mixed-method user-centered study. ESPOIR2S seeks to build the resource from the perspectives and needs of both people bereaved by suicide and professionals or volunteers working in the field of postvention. The Information System Research (ISR) Framework is used to guide the design of the study through a 3-step research cycle. The structure of the ESPOIR2S study relies on a simultaneous collection of qualitative and quantitative data which will be collected and analyzed during (a) the Relevance cycle through an online questionnaire and focus groups; (b) the Design cycle through focus groups; and (c) and the Rigor cycle through an online questionnaire and semi-structured interviews. The user-centeredness will be ensured by the active participation of people bereaved by suicide, members of associations for bereaved people and professionals of postvention. Discussion: The mixed-method and user-centered design of the ESPOIR2S study will offer an in-depth collection of the needs and expectation of suicide survivors regarding online resources. Through the implementation of an adaptive online solution, we aim to enhance the access to help and support for suicide survivors which are highly correlated with well-being and recovery.
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Affiliation(s)
- Edouard Leaune
- Centre Hospitalier Le Vinatier, Bron, France.,INSERM, U1028, CNRS, UMR5292, Lyon Neuroscience Research Center, Psychiatric Disorders: from Resistance to Response - PSYR2 Team, Lyon, France.,Groupement d'étude et de prévention du suicide, Saint-Benoît, France
| | | | - Pierre Grandgenèvre
- Groupement d'étude et de prévention du suicide, Saint-Benoît, France.,Univ. Lille, INSERM, CHU Lille, U1172 - LilNCog - Lille Neuroscience & Cognition, Lille, France
| | - Margot Morgiève
- Groupement d'étude et de prévention du suicide, Saint-Benoît, France.,Centre de Recherche Médecine, Sciences, Santé, Santé Mentale, Société (Cermes3), UMR CNRS 8211, Unité INSERM 988-EHESS-Université Paris Descartes, Paris, France
| | - Guillaume Vaiva
- Groupement d'étude et de prévention du suicide, Saint-Benoît, France.,Univ. Lille, INSERM, CHU Lille, U1172 - LilNCog - Lille Neuroscience & Cognition, Lille, France.,Centre National de Ressources & Résilience pour les Psychotraumatismes (Cn2r Lille Paris), Lille, France
| | | | | | | | - Julie Haesebaert
- EA 7425, HESPER Health Services and Performance Research-Claude Bernard Lyon 1 University, Université de Lyon, Lyon, France
| | - Emmanuel Poulet
- Centre Hospitalier Le Vinatier, Bron, France.,INSERM, U1028, CNRS, UMR5292, Lyon Neuroscience Research Center, Psychiatric Disorders: from Resistance to Response - PSYR2 Team, Lyon, France.,Groupement d'étude et de prévention du suicide, Saint-Benoît, France.,Department of Emergency Psychiatry, University Hospital Edouard Herriot, Hospices Civils de Lyon, Lyon, France
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10
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Rudaz M, Ledermann T, Grzywacz JG. The Role of Private Religious Practices, Spiritual Mindfulness, and Years Since Loss on Perceived Growth in Widowed Adults. JOURNAL OF RELIGION AND HEALTH 2020; 59:2819-2832. [PMID: 31993920 PMCID: PMC7384955 DOI: 10.1007/s10943-020-00986-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Private religiosity can lead to perceived growth after bereavement, but little is known about the role of mindfulness and the time since loss in widowed adults. Using data from the second panel of the Midlife in the United States study (MIDUS), this study examined adults (n = 250) who were married one time and became widowed. Results showed that spiritual mindfulness moderated the effect of private religious practices on personal growth, and that the association between spiritual mindfulness and positive reinterpretation was moderated by time since loss. A high level of spiritual mindfulness seems to benefit widowed adults' personal growth and positive reinterpretation. Additionally, the greater time since loss the more positive is the association between mindfulness and positive reinterpretation. No difference was found in means between widowed adults and a matched control group of non-widowed adults (n = 250) on personal growth and positive reinterpretation.
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Affiliation(s)
- Myriam Rudaz
- Florida State University, Tallahassee, USA.
- Psychiatric Services of Thurgovia (Academic Teaching Hospital of Medical University Salzburg), Muensterlingen, Switzerland.
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11
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Jordan JR. Lessons Learned: Forty Years of Clinical Work With Suicide Loss Survivors. Front Psychol 2020; 11:766. [PMID: 32411052 PMCID: PMC7201040 DOI: 10.3389/fpsyg.2020.00766] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Accepted: 03/30/2020] [Indexed: 11/13/2022] Open
Abstract
The author has been a grief therapist in private practice for almost 40 years. The largest percentage of his clients have been suicide loss survivors, and in this article, the author reflects on the “lessons learned” about how grief therapy with survivors is both the same as, and very different from, work with clients bereaved after other types of losses. After briefly reviewing some of the empirical literature about differences between suicide bereavement and grief after other modes of death, the author argues that perhaps the most distinguishing and difficult aspect of a suicide loss is the “perceived intentionality” of the death, and the related “perceived responsibility” for the death. The author goes on to identify a number of tasks of psychological reintegration after a suicide loss that can serve as a template for treatment goals for clinicians and clients alike. These include the cultivation of a very specific type of secure and nurturing therapeutic alliance; extensive psychoeducation about suicide, trauma, and grief; the need to help the client repair the psychological continuing bond with the deceased; and providing gentle support for the survivor in rebuilding an assumptive world that has been shattered by the suicide of a loved one. Finally, the article concludes with a discussion of the clinical implications of these differences for work with suicide loss survivors.
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12
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Lee YY, Verma S, Subramaniam M. Beyond Recovery: Exploring Growth in the Aftermath of Psychosis. Front Psychiatry 2020; 11:108. [PMID: 32174857 PMCID: PMC7054454 DOI: 10.3389/fpsyt.2020.00108] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Accepted: 02/07/2020] [Indexed: 11/15/2022] Open
Affiliation(s)
- Ying Ying Lee
- Research Division, Institute of Mental Health, Singapore, Singapore
| | - Swapna Verma
- Department of Psychosis, Institute of Mental Health, Singapore, Singapore.,Office of Education, Duke-National University of Singapore Medical School, Singapore, Singapore
| | - Mythily Subramaniam
- Research Division, Institute of Mental Health, Singapore, Singapore.,Neuroscience and Mental Health, Lee Kong Chian School of Medicine, Singapore, Singapore.,Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
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13
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Fisher JE, Zhou J, Zuleta RF, Fullerton CS, Ursano RJ, Cozza SJ. Coping Strategies and Considering the Possibility of Death in Those Bereaved by Sudden and Violent Deaths: Grief Severity, Depression, and Posttraumatic Growth. Front Psychiatry 2020; 11:749. [PMID: 32848927 PMCID: PMC7427580 DOI: 10.3389/fpsyt.2020.00749] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Accepted: 07/16/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Bereavement by sudden and violent deaths can lead to increased grief severity, depression, and reduced posttraumatic growth compared to those bereaved by natural causes. These outcomes can be affected by coping strategies and whether a survivor had been "prepared" for the death. The present study examined the effect of coping and considering the possibility of death on grief severity, depression, and posttraumatic growth in those bereaved by sudden deaths. METHODS Participants bereaved by suicide, accident, or combat deaths completed an online survey about demographics (including the cause of death), coping, grief severity, depression, and posttraumatic growth. A factor analysis of the coping measure yielded factors representing three coping strategies: avoidant coping, supportive coping, and active coping. These three strategies, the causes of death and considering the possibility of death were used as predictors of either grief severity, depression, or posttraumatic growth in multivariate linear regression models. RESULTS Each coping strategy and cause of death was differentially associated with grief severity, depression, and posttraumatic growth. Specifically, supportive coping and active coping were each only associated with higher posttraumatic growth. In contrast, avoidant coping was associated with all outcomes (higher grief severity and depression and lower posttraumatic growth). In addition, accidents and suicides (compared to combat deaths) had independent effects on grief severity and posttraumatic growth. Considering the possibility of death interacted with avoidant coping and also with supportive coping to predict grief severity in combat-loss survivors. DISCUSSION Findings highlight the differential contributions of coping strategies and their complex relationships with cause of death in contributing to grief severity, depression, and posttraumatic growth. Avoidant coping contributed to negative outcomes and inhibited posttraumatic growth, suggesting its importance as a target for therapeutic intervention. Although supportive and active coping facilitated posttraumatic growth, they had less of a role in mitigating grief severity or depression in this study. Although considering the possibility of death appeared to mitigate negative outcomes among survivors of combat death, avoidance of that possibility is likely protective for the majority of family members whose loved ones return home safely.
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Affiliation(s)
- Joscelyn E Fisher
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD, United States.,Center for the Study of Traumatic Stress, Department of Psychiatry, Uniformed Services University of the Health Sciences, Bethesda, MD, United States
| | - Jing Zhou
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD, United States.,Center for the Study of Traumatic Stress, Department of Psychiatry, Uniformed Services University of the Health Sciences, Bethesda, MD, United States
| | - Rafael F Zuleta
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD, United States.,Center for the Study of Traumatic Stress, Department of Psychiatry, Uniformed Services University of the Health Sciences, Bethesda, MD, United States
| | - Carol S Fullerton
- Center for the Study of Traumatic Stress, Department of Psychiatry, Uniformed Services University of the Health Sciences, Bethesda, MD, United States
| | - Robert J Ursano
- Center for the Study of Traumatic Stress, Department of Psychiatry, Uniformed Services University of the Health Sciences, Bethesda, MD, United States
| | - Stephen J Cozza
- Center for the Study of Traumatic Stress, Department of Psychiatry, Uniformed Services University of the Health Sciences, Bethesda, MD, United States
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14
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Recipients of Suicide-Related Disclosure: The Link between Disclosure and Posttraumatic Growth for Suicide Attempt Survivors. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16203815. [PMID: 31658681 PMCID: PMC6843227 DOI: 10.3390/ijerph16203815] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Revised: 10/01/2019] [Accepted: 10/04/2019] [Indexed: 02/06/2023]
Abstract
It is important to explore factors that could help or hinder one’s wellbeing following a suicide attempt, which could yield not only negative consequences but also posttraumatic growth (PTG; positive changes following a traumatic event). The present study used a multivariate analysis of covariance (MANCOVA) to test the relationship between disclosure, PTG, and posttraumatic depreciation among suicide attempt survivors when controlling for time since attempt and to test whether these effects remained after controlling for quality of support from family and friends. Suicide attempt survivors (n = 159) completed an online survey about their experiences. Increases in disclosure to family and friends but not to healthcare providers predicted changes in PTG. The effects of family disclosure remained even after controlling for quality of support. Disclosure to healthcare providers demonstrated some statistical effects on PTG, yet in the opposite direction and only after controlling for quality of support. The control variables—time since attempt and quality of support—were the only variables that predicted a change in posttraumatic depreciation. These findings suggest there is value in disclosing one’s personal story to family regardless of whether one receives supportive responses and that social support can impact one’s PTG.
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