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Adams L, Athey A, Brooks K, Lazarus K, DeVinney A, Leaf PJ. When Death Hits You in Your Face, You Have to Listen": A Qualitative Investigation of Peer Bereavement Support Volunteers in Black American Communities. OMEGA-JOURNAL OF DEATH AND DYING 2023:302228231161816. [PMID: 36857204 PMCID: PMC10471771 DOI: 10.1177/00302228231161816] [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] [Indexed: 03/02/2023]
Abstract
Efforts to support grief in Black American communities are often under-recognized despite their potential to address negative mental health outcomes in this population. The aim of the current study was to qualitatively assess the community-level influence of bereavement support programs on predominantly Black communities in Baltimore, Maryland. Five focus groups (n = 23) were conducted with volunteers from a non-profit bereavement organization. Participants were queried about how their training may be sustainably applied as a community resource in Baltimore City. Thematic analysis from focus groups revealed three main themes: (1) enhancing feelings of belongingness fosters a sense of community cohesion, (2) use of bereavement support tools as a source of personal healing, and (3) applications of bereavement support in the community. Implications of our study support the widespread influence of peer-led bereavement support training to reduce the reverberating impact of personal and collective grief in Black American communities.
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Affiliation(s)
- Leslie Adams
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Alison Athey
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | | | - Kimberly Lazarus
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Aubrey DeVinney
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Phillip J. Leaf
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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Singer J, McLean E, Kahler J, Papa A. An evaluation of common risk factors for prolonged grief disorder using the international classification of diseases-11 criteria. Aging Ment Health 2022; 26:2202-2207. [PMID: 34738488 DOI: 10.1080/13607863.2021.1998359] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
OBJECTIVES Inclusion of Prolonged Grief Disorder (PGD) in the ICD-11 warrants examination of risk factors using diagnostic criteria as there is a paucity of research that has examined risk factors of PGD using the diagnostic criteria. This study examines if the identified risk factors for prolonged grief predict PGD using the diagnostic criteria across three samples. METHODS A cross-sectional survey design was used to assess risk factors and PG-13 in three distinct samples of bereaved adults. The PG-13 was either parsed dichotomously using the ICD-11 diagnostic criteria to indicate presence of PGD or summed to index general grief severity.Results: When using ICD-11 diagnostic criteria, only female gender and high levels of pre-loss contact were identified in separate samples as increasing risk of diagnosis. The most replicable results across samples were found when using the summed PG-13 symptom scores. When using the PG-13 total score, younger age and more pre-loss contact with the deceased were associated with higher symptom levels, which replicated in all three studies.Conclusions: This study provided evidence that the extant literature using summed scores to explore risk factors might not generalize to the ICD-11 diagnostic criteria.
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Affiliation(s)
- Jonathan Singer
- Department of Psychological Sciences, Texas Tech University, Lubbock, TX, USA
| | - Elisabeth McLean
- Clinical Psychology, University of Hawai'i at Manoa College of Arts and Humanities, Honolulu, HI, USA
| | - Julie Kahler
- Portland VA Medical Center, Health Services Research and Development, Portland, OR, USA
| | - Anthony Papa
- Clinical Psychology, University of Hawai'i at Manoa College of Arts and Humanities, Honolulu, HI, USA
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Cesur G, Durak-Batıgün A. A Turkish adaptation of the grief cognitions questionnaire: Factor analysis, reliability and validity. CURRENT PSYCHOLOGY 2021. [DOI: 10.1007/s12144-018-9983-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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User acceptability of the diagnosis of prolonged grief disorder: How do professionals think about inclusion in ICD-11? J Affect Disord 2018; 229:306-313. [PMID: 29329064 DOI: 10.1016/j.jad.2017.12.095] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2017] [Revised: 11/23/2017] [Accepted: 12/31/2017] [Indexed: 11/20/2022]
Abstract
BACKGROUND For the next edition of the International Statistical Classification of Diseases (ICD-11) it is proposed to include prolonged grief disorder as a new diagnosis. The diagnosis describes persistent intensive and disabling grief reactions to bereavement (WHO, 2016b). The aim of the present survey was to determine the extent to which the diagnosis is accepted by practitioners in the healthcare and psychosocial field. METHODS A total of 2088 German-speaking professionals in the fields of psychotherapy, psychology, counselling, medicine and palliative care completed the online survey. RESULTS 42.4% of the participants felt that the advantages of including the diagnosis outweigh the disadvantages, 32.9% came to the conclusion that there are more disadvantages. The remaining 24.7% stated that advantages and disadvantages are balanced. The proposed classification as separate diagnosis was supported by 24.8%, while 60.0% preferred alternatives (e.g. as subtype of adjustment disorder). Furthermore, a time criterion of at least 12 months was voted for considerably more frequently (49.2%) than the proposed 6 months (11.3%). Objections were predominantly expressed with regard to pathologization of normal grief and to the difficulty of adequate crosscultural application of the diagnosis. LIMITATIONS Results are limited to predominantly German health-care professionals. The items did not undergo psychometric analyses. CONCLUSIONS The disagreement about the diagnosis found in specialist literature is also reflected in the responses by the participants. The present results provide stimulation for future questions and validation studies carried out as part of the ICD revision.
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Abstract
This study investigates clinical expressions of prolonged grief in samples of 32 Chinese and 33 Swiss bereaved parents, according to the proposed International Classification of Diseases, 11th Revision model of prolonged grief disorder (PGD). Sex differences and predictors (cultural attitudes, sense of coherence, and posttraumatic growth) of PGD were analyzed. In result, after controlling for sociodemographic and loss-related sample differences, both samples showed similar PGD symptom profiles, with Swiss parents exhibiting more severe grief-related preoccupation and Chinese parents exhibiting some accessory symptoms and functional impairment to a greater extent. Multivariate analyses revealed for the Chinese sample primary predictions of PGD by life satisfaction, general health and one's world view (social cynicism) and for the Swiss sample by female sex, sense of coherence, and life satisfaction. The findings substantiate the basic appropriateness of the International Classification of Diseases, 11th Revision PGD in distinct cultural groups and may contribute to a better understanding of grief expression and its potential predictors across different cultures.
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Goodkin K, Lee D, Frasca A, Molina R, Zheng W, O'Mellan S, Farhat D, Khamis I. Complicated Bereavement: A Commentary on its State of Evolution. OMEGA-JOURNAL OF DEATH AND DYING 2016. [DOI: 10.2190/1mgy-u3rb-vypp-q8gm] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
We have reviewed the articles submitted by Walter (2006), Neimeyer (2005–2006, this issue), Stroebe and Schut (2005–2006, this issue), and Prigerson and Maciejewski (2005–2006, thiss issue). Walter (2005–2006, this issue) assumes a social constructivist perspective of complicated grief. His article focuses on a number of issues that we believe to be extrinsic to the primary issue of the definition of complicated grief. We do not view the movement toward a new diagnosis of complicated grief as a normalization of grief as a construct of psychiatry (“psychiatric medicine” is a redundant term), an operational requirement of “bereavement agencies,” a concept through which society can discipline the bereaved, a label applied to those who actively resist cultural grieving norms, a product of societal obsession with risk, or a result of “negotiating participants in the bereavement field.” We also do not assume that complicated grief is a “psychological disorder” but, rather, a type of psychopathology (without reference to professional discipline).
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Affiliation(s)
| | - Diana Lee
- University of Miami School of Medicine, Florida
| | | | | | - Wenli Zheng
- University of Miami School of Medicine, Florida
| | | | | | - Imad Khamis
- University of Miami School of Medicine, Florida
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Hogan NS, Worden JW, Schmidt LA. Considerations in Conceptualizing Complicated Grief. OMEGA-JOURNAL OF DEATH AND DYING 2016. [DOI: 10.2190/8565-3t0t-6jud-4xkh] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Breen LJ, O'Connor M. The Fundamental Paradox in the Grief Literature: A Critical Reflection. OMEGA-JOURNAL OF DEATH AND DYING 2016; 55:199-218. [DOI: 10.2190/om.55.3.c] [Citation(s) in RCA: 73] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
A key theme in the bereavement literature is the recognition that every grief experience is unique and dependent on many variables, such as the circumstances of the death, characteristics of the bereaved individual, their relationship with the deceased, the provision and availability of support, and a myriad of sociocultural factors. Concurrently, there are corresponding efforts to define “normal” grief and delineate it from “complicated” grief experiences. The discord between these two potentially opposing statements remains a paradox evident within the three major tensions within the thanatological literature—the dominance of grief theories, the medicalization of grief, and the efficacy of grief interventions. Three recommendations for moving beyond the paradox are discussed—the provision of improved grief education for service providers, the bereaved, and the wider community; the conduct of research that emphasizes the context of grief and is relevant to service provision; and the examination of current grief interventions.
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Abstract
In this paper, I propose that the politicization of grief falls into 3 categories of what I have termed different types of Mourning Sickness. In Mourning Sickness Type I, the politicization of grief functions to discipline the individual mourner's body into a productive, functioning, and contributing member of a capitalistic society. Moreover, I argue that the individualist ethos that pathologizes grief neuters the rage that can come with mourning and turns the gaze away from social injustices such as poverty, imprisonment, and opportunity gaps that are caused by state neglect. In Mourning Sickness Type II, I suggest that the politicization of grief is about consciously manipulating individual and collective grief in the service of nationalism and military power. The manipulation of grief on this level includes the explicit links made between loss and grief and justification for war, aggression, and violence, but also includes the distinctions made between whose lives are deemed grievable and whose lives are considered worthless and unmournable. Both Mourning Sickness Types I and II are of the pathological variety urgently requiring academic and public critique. In the last type of Mourning Sickness, I suggest that grief is also politicized when it is activated as a motivator toward a social justice agenda that includes peace, reconciliation, nonviolence, and positive social change on behalf of individuals, communities, and nations.
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Artra IP. Transparent Assessment: Discovering Authentic Meanings Made by Combat Veterans. JOURNAL OF CONSTRUCTIVIST PSYCHOLOGY 2014. [DOI: 10.1080/10720537.2014.904704] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Herberman Mash HB, Fullerton CS, Ursano RJ. Complicated grief and bereavement in young adults following close friend and sibling loss. Depress Anxiety 2013; 30:1202-10. [PMID: 23401012 DOI: 10.1002/da.22068] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2012] [Revised: 01/04/2013] [Accepted: 01/12/2013] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND This study examined the association between types of loss (i.e., sibling or close friend) and relationship quality (i.e., depth and conflict) with complicated grief, depression, somatic symptoms, and world assumptions in bereaved young adults. METHODS Participants were 107 young adults aged 17-29 years who were either bereaved or had never experienced a loss. Among bereaved participants, 66 lost a close friend and seven lost a sibling within the past 3 years (M = 1.63 years). RESULTS Nineteen percent of the young adults met criteria for complicated grief and 31% had mild to severe depression. Participants with a deceased sibling reported greater depth in the relationship as compared to those who lost a friend. They were also more likely to have complicated grief (57% versus 15%) and report significantly higher levels of grief, depression, and somatic symptoms. Those who lost a sibling reported a lower sense of meaningfulness and benevolence of the world and self-worth as compared with those who lost a close friend or had not experienced a loss. CONCLUSIONS Complicated grief and depression are common among bereaved young adults. Sibling loss is particularly distressing to young adults, due in part to the high level of relationship depth, and is associated with increased psychological and physical symptoms postloss.
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Affiliation(s)
- Holly B Herberman Mash
- Center for the Study of Traumatic Stress, Department of Psychiatry, Uniformed Services University of the Health Sciences, Bethesda, Maryland
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Shear MK, Simon N, Wall M, Zisook S, Neimeyer R, Duan N, Reynolds C, Lebowitz B, Sung S, Ghesquiere A, Gorscak B, Clayton P, Ito M, Nakajima S, Konishi T, Melhem N, Meert K, Schiff M, O'Connor MF, First M, Sareen J, Bolton J, Skritskaya N, Mancini AD, Keshaviah A. Complicated grief and related bereavement issues for DSM-5. Depress Anxiety 2011; 28:103-17. [PMID: 21284063 PMCID: PMC3075805 DOI: 10.1002/da.20780] [Citation(s) in RCA: 532] [Impact Index Per Article: 40.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Bereavement is a severe stressor that typically incites painful and debilitating symptoms of acute grief that commonly progresses to restoration of a satisfactory, if changed, life. Normally, grief does not need clinical intervention. However, sometimes acute grief can gain a foothold and become a chronic debilitating condition called complicated grief. Moreover, the stress caused by bereavement, like other stressors, can increase the likelihood of onset or worsening of other physical or mental disorders. Hence, some bereaved people need to be diagnosed and treated. A clinician evaluating a bereaved person is at risk for both over-and under-diagnosis, either pathologizing a normal condition or neglecting to treat an impairing disorder. The authors of DSM IV focused primarily on the problem of over-diagnosis, and omitted complicated grief because of insufficient evidence. We revisit bereavement considerations in light of new research findings. This article focuses primarily on a discussion of possible inclusion of a new diagnosis and dimensional assessment of complicated grief. We also discuss modifications in the bereavement V code and refinement of bereavement exclusions in major depression and other disorders.
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Hibberd R, Elwood LS, Galovski TE. Risk and Protective Factors for Posttraumatic Stress Disorder, Prolonged Grief, and Depression in Survivors of the Violent Death of a Loved One. JOURNAL OF LOSS & TRAUMA 2010. [DOI: 10.1080/15325024.2010.507660] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Kristensen P, Weisaeth L, Heir T. Psychiatric disorders among disaster bereaved: an interview study of individuals directly or not directly exposed to the 2004 tsunami. Depress Anxiety 2010; 26:1127-33. [PMID: 19998267 DOI: 10.1002/da.20625] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Few studies have explored the long-term mental health consequences of disaster losses in bereaved, either exposed to the disaster themselves or not. This study examined the prevalence and predictors of mental disorders and psychological distress in bereaved individuals either directly or not directly exposed to the 2004 tsunami disaster. METHOD A cross-sectional study of 111 bereaved Norwegians (32 directly and 79 not directly exposed) was conducted 2 years postdisaster. We used a face-to-face structured clinical interview to diagnose current posttraumatic stress disorder (PTSD) and depression (major depressive disorder, MDD) and a self-report scale to measure prolonged grief disorder (PGD). RESULTS The prevalence of psychiatric disorders was twice as high among individuals directly exposed to the disaster compared to individuals who were not directly exposed (46.9 vs. 22.8 per 100). The prevalence of disorders among the directly exposed was PTSD (34.4%), MDD (25%), and PGD (23.3%), whereas the prevalence among the not directly exposed was PGD (14.3%), MDD (10.1%), and PTSD (5.2%). The co-occurrence of disorders was higher among the directly exposed (21.9 vs. 5.2%). Low education and loss of a child predicted PGD, whereas direct exposure to the disaster predicted PTSD. All three disorders were independently associated with functional impairment. CONCLUSIONS The dual burden of direct trauma and loss can inflict a complex set of long-term reactions and mental health problems in bereaved individuals. The relationship between PGD and impaired functioning actualizes the incorporation of PGD in future diagnostic manuals of psychiatric disorders.
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Affiliation(s)
- Pål Kristensen
- Norwegian Centre for Violence and Traumatic Stress Studies, 0407 Oslo, Norway.
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Breen LJ, O'Connor M. Acts of resistance: breaking the silence of grief following traffic crash fatalities. DEATH STUDIES 2010; 34:30-53. [PMID: 24479174 DOI: 10.1080/07481180903372384] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Theoretical arguments and empirical evidence demonstrate the limited utility of a narrow construction of "normal" grief. Sudden and violent death, the young age of the deceased, and perceptions of death preventability are associated with grief reactions that extend beyond an expected grief response. Interviews were conducted with 21 adults bereaved through the death of a family member in a traffic crash. We present their attempts to resist notions of "working through" grief and "recovery" from it and consider how the participants' constructions of an alternative discourse, or normative narrative, possess the potential to challenge a prevailing grief discourse.
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Affiliation(s)
- Lauren J Breen
- Social Justice Research Centre, Edith Cowan University, Joondalup, Western Australia, Australia.
| | - Moira O'Connor
- Western Australian Centre for Cancer and Palliative Care, Curtin University of Technology, Perth, Western Australia, Australia
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Field NP, Filanosky C. Continuing bonds, risk factors for complicated grief, and adjustment to bereavement. DEATH STUDIES 2010; 34:1-29. [PMID: 24479173 DOI: 10.1080/07481180903372269] [Citation(s) in RCA: 105] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
This study examined type of continuing bonds (CB) expression in relation to risk factors for complicated grief and measures of bereavement-related adjustment. Externalized CB expressions involving illusions and hallucinations with the deceased were distinguished from internalized CB expressions involving use of the deceased as an autonomy promoting secure base. 502 bereaved participants completed over the internet a CB measure assessing externalized and internalized CB along with various known risk-factor measures that included cause of death (i.e., violent vs. non-violent death), responsibility for the death, and attachment style as well as measures of psychological adjustment that included complicated grief symptoms, perceived physical health, and personal growth. As predicted, externalized CB was positively associated with violent death and responsibility for the death, whereas internalized CB was negatively associated with these risk factors as well as uniquely positively linked to personal growth. The implications of the findings for the role of CB in adjustment are discussed.
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Affiliation(s)
- Nigel P Field
- Program in Clinical Psychology, Palo Alto University, Palo Alto, California 94304, USA.
| | - Charles Filanosky
- Mental Health Integrated Clinic, VA Medical Center, San Francisco, California, USA
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Simon NM, Shear KM, Thompson EH, Zalta AK, Perlman C, Reynolds CF, Frank E, Melhem NM, Silowash R. The prevalence and correlates of psychiatric comorbidity in individuals with complicated grief. Compr Psychiatry 2007; 48:395-9. [PMID: 17707245 DOI: 10.1016/j.comppsych.2007.05.002] [Citation(s) in RCA: 192] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2007] [Revised: 05/01/2007] [Accepted: 05/02/2007] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Complicated grief (CG), variously called pathological or traumatic grief, is a debilitating syndrome that is not currently included in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, (DSM-IV) nomenclature. One issue that remains under debate is whether this condition can be clearly distinguished from other psychiatric disorders, such as major depression and posttraumatic stress disorder, with which CG frequently coexists. METHODS Using a structured clinical interview for CG and the Structured Clinical Interview for DSM-IV, trained experienced raters conducted careful diagnostic assessments of individuals seeking treatment of bereavement-related distress. All study participants met criteria for a current CG syndrome. Liberal criteria were used to diagnose DSM-IV disorders, making no attempt to decide if symptoms could be explained by grief. RESULTS Of 206 who met the criteria for CG, 25% had no evidence of a current DSM-IV Axis I disorder. When present, psychiatric comorbidity was associated with significantly greater severity of grief; however, even after adjustment for the presence of comorbidity, severity of CG symptoms was associated with greater work and social impairment. LIMITATIONS It is likely that our study underestimated the rate of CG without comorbidity because fewer DSM diagnoses would have been made if a judgment about grief had been taken into consideration. CONCLUSIONS Our data provide further support for the need to identify CG as a psychiatric disorder.
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Affiliation(s)
- Naomi M Simon
- Massachusetts General Hospital and Harvard Medical School, MA, USA.
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Hafen M, Rush BR, Reisbig AMJ, McDaniel KZ, White MB. The role of family therapists in veterinary medicine: opportunities for clinical services, education, and research. JOURNAL OF MARITAL AND FAMILY THERAPY 2007; 33:165-76. [PMID: 17437457 DOI: 10.1111/j.1752-0606.2007.00014.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
Marriage and family therapists (MFTs) are applying their specific skill set in a variety of arenas. A new area for collaboration is veterinary medicine. The veterinary medical profession is emphasizing the importance of non-biomedical skills such as communication skills, acknowledging that human clientele are likely to view their pets as family members, and discussing veterinarian personal well-being. Each of these trends has clear application for intervention by MFTs. A discussion of how MFTs may be uniquely positioned to assist veterinary medicine is presented. An example of collaboration between MFT and veterinary medicine at Kansas State University is highlighted. Recommendations are made for development of effective educational relationships and possible private sector collaborations.
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