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Sadino JM, Donaldson ZR. Prairie voles as a model for adaptive reward remodeling following loss of a bonded partner. Ann N Y Acad Sci 2024; 1535:20-30. [PMID: 38594916 DOI: 10.1111/nyas.15134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/11/2024]
Abstract
Loss of a loved one is a painful event that substantially elevates the risk for physical and mental illness and impaired daily function. Socially monogamous prairie voles are laboratory-amenable rodents that form life-long pair bonds and exhibit distress upon partner separation, mirroring phenotypes seen in humans. These attributes make voles an excellent model for studying the biology of loss. In this review, we highlight parallels between humans and prairie voles, focusing on reward system engagement during pair bonding and loss. As yearning is a unique feature that differentiates loss from other negative mental states, we posit a model in which the homeostatic reward mechanisms that help to maintain bonds are disrupted upon loss, resulting in yearning and other negative impacts. Finally, we synthesize studies in humans and voles that delineate the remodeling of reward systems during loss adaptation. The stalling of these processes likely contributes to prolonged grief disorder, a diagnosis recently added to the Diagnostic and Statistical Manual for Psychiatry.
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Affiliation(s)
- Julie M Sadino
- Department of Molecular, Cellular, and Developmental Biology, University of Colorado Boulder, Boulder, Colorado, USA
| | - Zoe R Donaldson
- Department of Molecular, Cellular, and Developmental Biology, University of Colorado Boulder, Boulder, Colorado, USA
- Department of Psychology & Neuroscience, University of Colorado Boulder, Boulder, Colorado, USA
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2
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Khalafi kasalani S, Karami M, Dargahi S. Investigating the mediating influence of distress tolerance on the relationship between existential thinking, sense of coherence, and the severity of mourning among families who lost a loved one to COVID-19: A cross-sectional study. Health Sci Rep 2023; 6:e1518. [PMID: 37662534 PMCID: PMC10469043 DOI: 10.1002/hsr2.1518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 07/10/2023] [Accepted: 08/09/2023] [Indexed: 09/05/2023] Open
Abstract
Background and Aims The objective of the current study was to examine how distress tolerance functions as a mediator in the relationship between existential thinking, sense of coherence, and the severity of mourning experienced by families who have lost a loved one to COVID-19. Methods The present study employed a descriptive correlational research design, targeting family members of those who passed away due to COVID-19 in the city of Mianeh in 2022. A sample of 160 individuals was selected for statistical analysis. The research instruments used in this study consisted of Flensberg's sense of coherence questionnaire (2006), Simmons and Gaher's emotional distress tolerance questionnaire (2005), Sugbart and Scott's grief experience questionnaire (1989), and Branton Scherer's existential thinking questionnaire (2006). The collected data were analyzed using path analysis, as well as SPSS and Amos software. Results The findings of the study revealed a significant correlation coefficient between existential thinking (r = 0.465), sense of coherence (r = 0.401), and distress tolerance (r = 0.521) with the severity of mourning experienced by families who lost a loved one to COVID-19. Moreover, the results indicated a positive and significant relationship (p > 0.01) between distress tolerance and sense of coherence (r = 0.126), as well as between distress tolerance and existential thinking (r = 0.059) among the bereaved families. However, the bootstrap test results suggested that distress tolerance did not mediate the relationship between sense of coherence and the severity of mourning in the families of COVID-19 victims. Conclusion Consistent with prior research, the current study's findings indicated that both existential thinking and sense of coherence had a direct impact on the severity of mourning experienced by families who lost a loved one to COVID-19. Additionally, the results revealed that the influence of existential thinking on the severity of mourning was mediated indirectly by increasing distress tolerance.
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Affiliation(s)
| | - Mina Karami
- Department of Medical SciencesIslamic Azad UniversityTehranIran
| | - Shahriar Dargahi
- Department of Family Health, Social Determinants of Health Research CenterArdabil University of Medical SciencesArdabilIran
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Attwood C, Benkwitz A, Holland M. "We are the forgotten grievers": Bereaved family members' experiences of support and mental ill-health following a road traffic collision. DEATH STUDIES 2022:1-8. [PMID: 36583725 DOI: 10.1080/07481187.2022.2160032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
Road traffic collisions (RTCs) are a global public health concern; however, research on the impact of bereavement on families remains limited. A critical realist approach was adopted to explore experiences of families suffering bereavement following RTCs, using interviews with 14 participants in the United Kingdom (UK) who have lost a family member. Three key themes were identified: (1) worsening mental health following bereavement, (2) negative impact of an RTC-related bereavement upon family members, (3) limited support following an RTC. Findings highlighted the requirement for appropriate support for bereaved families, and outlined significant flaws within the UK legal system, sentencing, and treatment of families.
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Affiliation(s)
- C Attwood
- Faculty of Arts, Society and Professional Studies, Newman University, Birmingham, UK
| | - A Benkwitz
- Faculty of Arts, Society and Professional Studies, Newman University, Birmingham, UK
| | - M Holland
- Faculty of Arts, Society and Professional Studies, Newman University, Birmingham, UK
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Sandalic D, Arora M, Pozzato I, Simpson G, Middleton J, Craig A. A Narrative Review of Research on Adjustment to Spinal Cord Injury and Mental Health: Gaps, Future Directions, and Practice Recommendations. Psychol Res Behav Manag 2022; 15:1997-2010. [PMID: 35957761 PMCID: PMC9363004 DOI: 10.2147/prbm.s259712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Accepted: 07/31/2022] [Indexed: 11/23/2022] Open
Abstract
Spinal cord injury (SCI) results in autonomic, motor, and sensory impairments that can compromise mental health. Guidelines directing the management of mental health following SCI presently address clinical anxiety, depression, post-traumatic stress, substance use disorders, and suicide. However, evidence suggests that perhaps as many as 70% of individuals with SCI do not develop a clinically diagnosable mental health disorder. Therefore, the authors contend that understanding non-clinical cognitive and psychological aspects of adjustment post-SCI is paramount and that the application of this knowledge to the formulation of adjustment-enhancing interventions is crucial. To assist with this endeavour, we examine existing mental health guidelines targeting SCI, and present a narrative review of research on the under-represented topics of adjustment, coping, grief, and resilience. We include mild cognitive impairment, which reflects a common factor that can compromise adjustment. Loss and stress trigger processes of adjustment, coping, grief, and resilience. SCI involves loss and stress triggering these processes, arguably without exception. Our study applied a narrative review methodology searching Google Scholar and PsychInfo databases for terms adjustment, coping, grief, resilience, and cognitive impairment. Qualitative studies and quantitative studies were selected to capture bottom-up and top-down perspectives. Reference lists of retrieved papers were searched as appropriate. Reviewed literature suggested that existing guidelines concerning mental health following SCI neglect positive processes of adjustment and suggest this neglect contributes to a deficits-based view of mental health following SCI. Research into “positive” or adjustment-enhancing processes is mostly cross-sectional, heterogenous, and poorly positioned to inform future guideline-development. Researchers should achieve consensus over the operationalisation of essential processes and overcome a fixation with “outcomes” to better inform management of mental health after SCI.
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Affiliation(s)
- Danielle Sandalic
- Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
- John Walsh Centre for Rehabilitation Research, Royal North Shore Hospital, Sydney, New South Wales, Australia
| | - Mohit Arora
- Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
- John Walsh Centre for Rehabilitation Research, Royal North Shore Hospital, Sydney, New South Wales, Australia
| | - Ilaria Pozzato
- Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
- John Walsh Centre for Rehabilitation Research, Royal North Shore Hospital, Sydney, New South Wales, Australia
| | - Grahame Simpson
- Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
- John Walsh Centre for Rehabilitation Research, Royal North Shore Hospital, Sydney, New South Wales, Australia
| | - James Middleton
- Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
- John Walsh Centre for Rehabilitation Research, Royal North Shore Hospital, Sydney, New South Wales, Australia
| | - Ashley Craig
- Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
- John Walsh Centre for Rehabilitation Research, Royal North Shore Hospital, Sydney, New South Wales, Australia
- Correspondence: Ashley Craig, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia, Email
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Depression and Complicated Grief, and Associated Factors, of Bereaved Family Members of Patients Who Died of Malignant Pleural Mesothelioma in Japan. J Clin Med 2022; 11:jcm11123380. [PMID: 35743451 PMCID: PMC9225633 DOI: 10.3390/jcm11123380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 06/01/2022] [Accepted: 06/10/2022] [Indexed: 12/10/2022] Open
Abstract
OBJECTIVES we investigated the prevalence and associated factors of depression and complicated grief (CG) among bereaved family members of malignant pleural mesothelioma (MPM) patients in Japan. METHODS Bereaved family members of MPM patients (n = 72) were surveyed. The Japanese version of the Patient Health Questionnaire-9 (PHQ-9) and the Japanese version of the Brief Grief Questionnaire (BGQ) were used to assess depression and complicated grief (CG), respectively. Socio-economic factors, anger toward asbestos, care satisfaction, achievement of good death, and quality of end-of-life care were assessed in relation to depression and CG. RESULTS In the family members of MPM patients, the frequencies of depression and CG were 19.4% and 15.3%, respectively. The bereaved family members who were not compensated by the asbestos-related health-damage relief system (p = 0.018) and who felt the financial impacts of the patient's MPM on the family (p = 0.006) had a higher likelihood of depression. The bereaved family members who were not satisfied with the care given when the patient became critical (p = 0.034), who were not compensated by the asbestos-related health-damage relief system (p = 0.020), who felt the financial impact of the patient's MPM on the family (p = 0.016), and whose deceased relative underwent surgery (p = 0.030) had a higher likelihood of CG. CONCLUSIONS For bereaved family members of MPM patients, routine screening for depression and CG and the provision of grief care are suggested. In addition, for family members of MPM patients, financial support, including the promotion of the asbestos-related health-damage relief system, and improved care for patients who undergo surgery and when patients become critical, are recommended.
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Shepherd BF, Brochu PM, Stripling AM. Hidden grief is complicated: identity concealment as a minority stressor and relational-cultural barrier among bereaved sexual and gender minoritized elders. PSYCHOLOGY & SEXUALITY 2021. [DOI: 10.1080/19419899.2021.1970618] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Benjamin F. Shepherd
- Department of Clinical and School Psychology, Nova Southeastern University, Fort Lauderdale, FL
| | - Paula M. Brochu
- Department of Clinical and School Psychology, Nova Southeastern University, Fort Lauderdale, FL
| | - Ashley M. Stripling
- Department of Clinical and School Psychology, Nova Southeastern University, Fort Lauderdale, FL
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Farella Guzzo M, Gobbi G. Parental Death During Adolescence: A Review of the Literature. OMEGA-JOURNAL OF DEATH AND DYING 2021:302228211033661. [PMID: 34324402 DOI: 10.1177/00302228211033661] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
While extensive research exists on parental loss in childhood and the related psychological interventions, little has been done in the adolescent population. Adolescence is a particular phase of life characterized by a singular psychological, emotional, neurological, and endocrinological development, paralleled by the process of self-affirmation and an opening toward social relationships. This complex neuropsychological phase should thus be understood independently from children and adults. The objective of this work was to review the literature studying the impacts of parental loss in adolescents. The current review identified a wide range of behavioral and emotional responses to parental death in adolescence, including depression, suicidal ideations, anxiety, insomnia, addiction and impaired function at school and home. The role of peers, school life, and family and social environment are important for the recovery from loss. More studies are required to better understand the different psychological trajectories in adolescence after parental death and tailor mental health interventions accordingly.
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Affiliation(s)
| | - Gabriella Gobbi
- Department of Psychiatry, McGill University, Montreal, Quebec, Canada.,Department of Psychiatry, McGill University Health Center, Montreal, Quebec, Canada
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Záhorcová L, Enright R, Halama P. The Effectiveness of a Forgiveness Intervention on Mental Health in Bereaved Parents-A Pilot Study. OMEGA-JOURNAL OF DEATH AND DYING 2021; 87:614-631. [PMID: 34152878 DOI: 10.1177/00302228211024479] [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: 11/17/2022]
Abstract
The aim of this pilot study was to test the effectiveness of an educational forgiveness intervention on mental health in grieving parents. 21 grieving parents were randomly assigned to the experimental group (in which the educational forgiveness intervention occurred) and to the control group (in which a psycho-education grief intervention with a humanistic approach took place). Participants in both groups completed 12 individual hourly sessions for three months. The results showed that participants in the experimental group achieved statistically greater improvement in forgiveness towards others, self-forgiveness, and a greater decrease in depression in the post-test and follow-up test; a greater decrease in anxiety and anger in the post-test; as well as higher improvement in the post-traumatic growth in the follow-up test, four months after the end of the intervention. We highlight the potential benefits of using a forgiveness intervention with bereaved parents.
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Affiliation(s)
- Lucia Záhorcová
- Department of Psychology, Trnava University in Trnava, Trnava, Slovakia
| | - Robert Enright
- Department of Educational Psychology, University of Wisconsin-Madison, Madison.,International Forgiveness Institute, Inc., Madison, Wisconsin
| | - Peter Halama
- Department of Psychology, Trnava University in Trnava, Trnava, Slovakia
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9
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Jordan TR, Wotring AJ, McAfee CA, Polavarapu M, Cegelka D, Wagner-Greene VR, Hamdan Z. The COVID-19 pandemic has changed dying and grief: Will there be a surge of complicated grief? DEATH STUDIES 2021; 46:84-90. [PMID: 34027825 DOI: 10.1080/07481187.2021.1929571] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Worldwide, more than 3 million people have died from COVID-19. Each decedent represents a person who was loved, will be missed, and whose death elicited grief. COVID-19 has changed the way we die and grieve. Many people have died without family members and friends present and many of the bereft have grieved and mourned alone. Individuals and communities have experienced multiple losses within a short time while suffering from concomitant stress, anxiety, and depression. More deaths and more grief will continue in the foreseeable future. Preventive education is needed to prepare for and manage the likely increase in complicated grief.
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Affiliation(s)
- Timothy R Jordan
- School of Population Health, University of Toledo, Toledo, Ohio, Toledo
| | - Amy J Wotring
- Department of Applied Sciences, Indiana State University, Terre Haute, Indiana, USA
| | - Colette A McAfee
- School of Nursing and Health Sciences, Westminster College, Salt Lake City, Utah, USA
| | | | - Derek Cegelka
- Department of Kinesiology and Health Science, Stephen F. Austin State University, Nacogdoches, Texas, USA
| | - Victoria R Wagner-Greene
- Department of Kinesiology and Health Science, Stephen F. Austin State University, Nacogdoches, Texas, USA
| | - Zena Hamdan
- Department of Health Administration, Capella University, Minneapolis, Minnesota, USA
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10
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Pinto S, Soares J, Silva A, Curral R, Coelho R. COVID-19 Suicide Survivors-A Hidden Grieving Population. Front Psychiatry 2020; 11:626807. [PMID: 33408658 PMCID: PMC7779552 DOI: 10.3389/fpsyt.2020.626807] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Accepted: 12/01/2020] [Indexed: 12/29/2022] Open
Abstract
Present time has been dominated by the COVID-19 pandemic. People are grieving several non-death related situations: the loss of a job, of a status, of a role, of their life. Restrictive measures and uncertainty about the future makes individuals vulnerable to feelings of hopelessness and helplessness. Mental health support has been hindered and teams are reinventing themselves to reach people in need. Nevertheless, decompensation of previous psychiatric disorders, increasing levels of depression and anxiety, economical handicaps and fear of the infection, are prompting several cases of COVID-19 related suicides worldwide. Every suicide affects between 5 and 80 individuals, which are known as suicide survivors. Suicide grief is particularly challenging, with rates of complicated grief as high as 40%. Suicide survivors are at increased risk of developing depression, anxiety disorders and of suicidal behaviors. Moreover, feelings of guilt and shame, as well as social stigma, are major obstacles for them to reach form help. This article aims to review the existing literature on COVID-19 related suicides, complicated grief in suicide survivors and highlight modifiable risk factors for both conditions, as well as propose some public health measures to reduce the impact of the pandemic context on self-inflicted harm and its consequences on families, friends and the community. Obstacles to access to mental health support need to be overcome through the use of technology. Technicians should actively approach populations more vulnerable to develop suicidal ideation. Social media have the obligation to provide accurate an non-sensationalistic information. Families and friends should maintain social proximity, despite the need for physical distancing. When a suicide death occurs, police forces and health staff should be prepared to share the news with the family using an empathic and humane approach and providing psychological support. Funerals, memorials and other services should be held as much as possible. Closer contacts should be signalized and closely followed in order to detect the need for specific interventions. Help seeking behaviors should be promoted. Additionally, people should be educated on suicide and its impacts, in order to reduce stigma.
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Affiliation(s)
- Sara Pinto
- Psychiatry Service, Centro Hospitalar Universitário São João, Oporto, Portugal
- Department of Clinical Neurosciences and Mental Health, Faculty of Medicine of the University of Oporto, Oporto, Portugal
| | - Joana Soares
- Psychology Service, Centro Hospitalar Universitário São João, Oporto, Portugal
| | - Alzira Silva
- Psychiatry Service, Centro Hospitalar Universitário São João, Oporto, Portugal
- Department of Clinical Neurosciences and Mental Health, Faculty of Medicine of the University of Oporto, Oporto, Portugal
| | - Rosário Curral
- Psychiatry Service, Centro Hospitalar Universitário São João, Oporto, Portugal
- Department of Clinical Neurosciences and Mental Health, Faculty of Medicine of the University of Oporto, Oporto, Portugal
| | - Rui Coelho
- Psychiatry Service, Centro Hospitalar Universitário São João, Oporto, Portugal
- Department of Clinical Neurosciences and Mental Health, Faculty of Medicine of the University of Oporto, Oporto, Portugal
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11
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Ego State Therapy for the Treatment of Grief and Loss After Death. ADDICTIVE DISORDERS & THEIR TREATMENT 2020. [DOI: 10.1097/adt.0000000000000215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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12
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Iglewicz A, Shear MK, Reynolds CF, Simon N, Lebowitz B, Zisook S. Complicated grief therapy for clinicians: An evidence-based protocol for mental health practice. Depress Anxiety 2020; 37:90-98. [PMID: 31622522 DOI: 10.1002/da.22965] [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: 02/25/2019] [Revised: 07/07/2019] [Accepted: 08/20/2019] [Indexed: 11/07/2022] Open
Abstract
In the United States alone, about 10 million persons are newly bereaved each year. Most do not require professional intervention or treatment, but many can benefit from targeted support. However, a significant minority of bereaved persons experience intense, prolonged and disabling grief symptoms associated with considerable morbidity and mortality (aka, "Complicated Grief"). Individuals with Complicated Grief require more formal interventions. In this article, we describe a compassionate and evidence-based approach to bereavement-care that can be provided in varied mental health settings. For individuals struggling with acute grief, clinicians can help by providing recognition and acceptance of the grief, eliciting and compassionately listening to their narratives of their relationship with the deceased and the death, and regularly "checking in" regarding their grief experiences. For bereaved persons who are experiencing Complicated Grief, we recommend an evidence-based approach to bereavement-care, complicated grief therapy (CGT), that involves helping the individual accept and cope with the loss while simultaneously assisting them with adaptation to life without the deceased. We describe ways of implementing CGT's seven core themes: (1) understanding and accepting grief, (2) managing painful emotions, (3) planning for a meaningful future, (4) strengthening ongoing relationships, (5) telling the story of the death, (6) learning to live with reminders, and (7) establishing an enduring connection with memories of the person who died. This work can be done in a variety of settings, taking into consideration the needs of the patient, the limitations of the setting, and the skills and experiences of each clinician.
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Affiliation(s)
- Alana Iglewicz
- Veterans Affairs San Diego Healthcare System, La Jolla, California.,Department of Psychiatry, University of California San Diego, La Jolla, California
| | - M Katherine Shear
- Columbia University School of Social Work and College of Physicians and Surgeons, Columbia University, New York, New York
| | - Charles F Reynolds
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Naomi Simon
- Department of Psychiatry, NYU Langone Health, NYU School of Medicine, New York, New York
| | - Barry Lebowitz
- Department of Psychiatry, University of California San Diego, La Jolla, California
| | - Sidney Zisook
- Department of Psychiatry, University of California San Diego, La Jolla, California
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13
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Palmer WW, Yuen FK. Ears to Listen, Hearts to Understand: Bereavement Adaptation and Its Relationship to Kinship and Gender. JOURNAL OF LOSS & TRAUMA 2019. [DOI: 10.1080/15325024.2019.1675017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
| | - Francis K. Yuen
- Division of Social Work, California State University, Sacramento, CA, USA
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14
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Liu JJW, Taillefer SE, Tassone A, Vickers K. The importance of bereavement cognitions on grief symptoms: Applications of cognitive processing therapy. DEATH STUDIES 2019; 45:552-562. [PMID: 31588857 DOI: 10.1080/07481187.2019.1671537] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
The experience of bereavement and trauma share some overlapping features, such as changes in the cognitive processing of information. This article explored the extent to which cognitive processes during bereavement influence coping outcomes in relation to grief in a sample of university students who had been previously bereaved (N = 104). First, we examined differences in bereavement outcomes based on whether cognitive processes associated with the bereavement were accommodated (n = 55), over-accommodated (n = 25), or assimilated (n = 24). Results indicate that grief-related outcomes significantly differed as a result of cognitive processes. We then compared the degree to which these cognitive processes accounted for grief outcomes in individuals with high and low grief symptoms. In individuals with low grief levels, both depressive symptoms and grief cognitions significantly accounted for grief levels. However, in individuals with high grief levels, only cognitive processes significantly accounted for levels of grief. Results from this study underscore the importance of examining cognitive processes during bereavement. Future research should further examine the underlying mechanisms that contextualize both the bereavement and cognitive processes surrounding the loss. Finally, results from this study highlight the associated cognitive processing of information as a potential topic for targeted treatment in bereavement.
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Affiliation(s)
- Jenny J W Liu
- Department of Psychology, Ryerson University, Toronto, Canada
| | - Stephanie E Taillefer
- Operational Stress Injury Clinic, Nova Scotia Health Authority, Dartmouth, Nova Scotia, Canada
| | - Adrianna Tassone
- Department of Psychology, Wilfrid Laurier University, Waterloo, Canada
| | - Kristin Vickers
- Department of Psychology, Ryerson University, Toronto, Canada
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15
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Scocco P, Zerbinati L, Preti A, Ferrari A, Totaro S. Mindfulness-based weekend retreats for people bereaved by suicide (Panta Rhei): A pilot feasibility study. Psychol Psychother 2019; 92:39-56. [PMID: 29512287 DOI: 10.1111/papt.12175] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2017] [Revised: 01/26/2018] [Indexed: 11/26/2022]
Abstract
OBJECTIVES This study investigates whether a programme of mindfulness-based weekend retreats (Panta Rhei) is able to improve mood states, mindfulness qualities, and self-compassion in family members and friends of suicide victims (suicide survivors). DESIGN Longitudinal prospective study. METHODS Sixty-one suicide survivors participated in a mindful-self-compassion retreat. The Five-Facet Mindfulness Questionnaire, the Profile of Mood States (POMS), and the Self-Compassion Scale were administered 4-6 days before and after the retreat. RESULTS A significant reduction in all dimensions of the POMS (except Vigor-Activity) and lower levels of overidentification were observed after the retreat. CONCLUSIONS Although further research is warranted, this study highlights the potential beneficial effect of brief mindfulness-based weekend retreats on the well-being of suicide survivors. PRACTITIONER POINTS Mindfulness-based weekend retreats seem to be effective in alleviating the psychological distress of suicide survivors in the short term. The benefit may depend on standard mindfulness practices and on more tailored interventions aimed at promoting acceptance of loss, forgiveness and rage management, and thus reducing rumination. Since there is no established treatment for this population, this type of intervention, which seems feasible and well accepted by participants, paves the way for future research in this area.
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Affiliation(s)
- Paolo Scocco
- Mental Health Center, ULSS 6 Euganea, Padova, Italy
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Abstract
OBJECTIVES This article describes the development and program evaluation of an 8-session outpatient geriatric mental health clinic bereavement group for United States military veterans who experienced the death of a loved one. METHODS Group materials were developed based on a review of literature, with a focus on the dual process model of coping with bereavement and complicated grief treatment. Data are presented from 19 veterans who attended at least 4 of the 8 sessions across the five offerings of this group between 2013 and 2015. RESULTS Self-report measures of complicated grief and depressive symptoms decreased significantly from the first to the final session. Veterans indicated that the group met their treatment goals and that they would recommend it to others. Adaptations made to the group over time based on feedback from members and facilitators are discussed. CONCLUSIONS Preliminary evidence suggests that the group described in this manuscript is effective for bereaved older, male veterans. Future research would be helpful including larger samples and controlled studies. CLINICAL IMPLICATIONS Most bereaved individuals do not require formal mental health treatment. However, for individuals with distressing symptoms, time-limited group therapy may be an effective treatment.
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Affiliation(s)
| | - Michele J Karel
- b Office of Mental Health and Suicide Prevention , Department of Veterans Affairs Central Office , Washington , DC , USA
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A Two-Tiered Strategy for Preventing Complications of Bereavement in the First Thirteen Months Post-Loss: A Pilot Study Using Peer Supports with Professional Therapist Back-up. Am J Geriatr Psychiatry 2018; 26:350-357. [PMID: 28988634 PMCID: PMC5929124 DOI: 10.1016/j.jagp.2017.05.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2017] [Revised: 05/16/2017] [Accepted: 05/18/2017] [Indexed: 11/24/2022]
Abstract
This feasibility and acceptance pilot study for preventing complications of bereavement within the first year post loss recruited 20 adult grievers within 9 months of becoming bereft and assigned consenting subjects to peer supporters trained by a non-profit bereavement support organization for weekly or bi-weekly telephone-based peer support until month 13 post-loss. Subjects who met DSM-5 criteria for major depressive disorder or showed an Inventory of Complicated Grief (ICG) score exceeding 19, 6 months or more post loss, were assigned to 12 to 16 weeks of interpersonal psychotherapy (IPT) with an experienced therapist. Eight and six subjects completed the protocol assigned to peer support and IPT, respectively, with pre/post Patient Health Questionnaire-9 scores of 5.38 (2.45) versus 3.25 (4.13) (p = 0.266) and 16.67 (7.17) versus 8.40 (5.73) (p =0.063); and pre/post ICG scores of 12.50 (4.72) versus 5.00 (2.51) (p = 0.016) and 35.17 (5.12) versus 8.4 (5.73) (p = 0.063). Implications of this two-tiered model of early intervention for preventing complications of grief are discussed.
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Wardecker BM, Kaplow JB, Layne CM, Edelstein RS. Caregivers' positive emotional expression and children's psychological functioning after parental loss. JOURNAL OF CHILD AND FAMILY STUDIES 2017; 26:3490-3501. [PMID: 29170615 PMCID: PMC5695886 DOI: 10.1007/s10826-017-0835-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
The death of a loved one, particularly a parent, has been identified as not only the most common, but also the most distressing form of adversity youth may experience in their lifetime. Surviving caregivers' communication with their children may play a critical role in shaping bereaved children's psychological functioning. However, few studies have examined the specific content (e.g., word usage) of caregivers' verbal communication as a predictor of psychological functioning in bereaved youth. In a sample of 39 parentally-bereaved children and their surviving caregivers, we investigated whether the frequency of caregivers' use of positive emotion words (e.g., "love", "happy", "hope") during a reminiscing task about the deceased was associated with children's psychological functioning and coping. In a cross-sectional analysis, we specifically examined whether these associations were moderated by the amount of time passed since children lost their parents. The Linguistic Inquiry and Word Count Program (LIWC) was used to code and evaluate the percentage of positive emotion words caregivers used during the discussion. When caregivers used more positive emotion words, children were less likely to experience depression, anxiety, and avoidant coping. Those associations were present for children who had experienced parental loss at least 105 days prior to the study. Our findings have implications for how caregivers can support their children and help to alleviate psychological distress in the aftermath of parental loss.
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Affiliation(s)
- Britney M Wardecker
- Center for Healthy Aging, Department of Biobehavioral Health, The Pennsylvania State University, 428 Biobehavioral Health Building, University Park, PA 16802;
| | - Julie B Kaplow
- Department of Psychiatry, University of Texas Health Science Center, 1941 East Rd., Houston, TX 77054;
| | - Christopher M Layne
- National Center for Child Traumatic Stress, 11150 W. Olympic Blvd., Los Angeles, CA 90064;
| | - Robin S Edelstein
- Department of Psychology, University of Michigan, 530 Church St., Ann Arbor, MI 48104;
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Thompson MR, Whiteman AD, Loucks KD, Daudt HML. Complicated Grief in Canada: Exploring the Client and Professional Landscape. JOURNAL OF LOSS & TRAUMA 2017. [DOI: 10.1080/15325024.2017.1358574] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
| | | | - Karen D. Loucks
- Bereavement Services, Victoria Hospice, British Columbia, Canada
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Chambers RA, Wallingford SC. On Mourning and Recovery: Integrating Stages of Grief and Change Toward a Neuroscience-Based Model of Attachment Adaptation in Addiction Treatment. Psychodyn Psychiatry 2017; 45:451-473. [PMID: 29244621 PMCID: PMC6383361 DOI: 10.1521/pdps.2017.45.4.451] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Interpersonal attachment and drug addiction share many attributes across their behavioral and neurobiological domains. Understanding the overlapping brain circuitry of attachment formation and addiction illuminates a deeper understanding of the pathogenesis of trauma-related mental illnesses and comorbid substance use disorders, and the extent to which ending an addiction is complicated by being a sort of mourning process. Attention to the process of addiction recovery-as a form of grieving-in which Kubler-Ross's stages of grief and Prochaska's stages of change are ultimately describing complementary viewpoints on a general process of neural network and attachment remodeling, could lead to more effective and integrative psychotherapy and medication strategies.
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Affiliation(s)
- R. Andrew Chambers
- Director, Addiction Psychiatry Training Program & Lab for Translational Neuroscience of Dual Diagnosis, Associate Professor, Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN
| | - Sue C. Wallingford
- Chair, Division of Transpersonal Counseling and Psychology, Associate Professor, Graduate School of Counseling & Psychology, Naropa University, Boulder, CO
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Complicated Grief Treatment: An Evidence-Based Approach to Grief Therapy. JOURNAL OF RATIONAL-EMOTIVE AND COGNITIVE-BEHAVIOR THERAPY 2016. [DOI: 10.1007/s10942-016-0242-2] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Lai C, Luciani M, Galli F, Morelli E, Moriconi F, Penco I, Aceto P, Lombardo L. Persistent complex bereavement disorder in caregivers of terminally ill patients undergoing supportive-expressive treatment: a pilot study. J Ment Health 2016; 26:111-118. [DOI: 10.3109/09638237.2016.1167855] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Carlo Lai
- Dynamic and Clinical Psychology, Sapienza University of Rome, Rome, Italy,
| | - Massimiliano Luciani
- Psychiatry and Psychology Institute, Catholic University of Sacred Heart, Rome, Italy,
| | | | | | - Federica Moriconi
- Dynamic and Clinical Psychology, Sapienza University of Rome, Rome, Italy,
| | | | - Paola Aceto
- Department of Anaesthesiology and Intensive Care, Catholic University of Sacred Heart, Rome, Italy
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Lovell GP, Smith T, Kannis-Dymand L. Surrogate End-of-Life Care Decision Makers' Postbereavement Grief and Guilt Responses. DEATH STUDIES 2015; 39:647-653. [PMID: 26020736 DOI: 10.1080/07481187.2015.1047062] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
This article examined differences in familial/friend surrogate decision makers' (N = 93) postbereavement grief and guilt associated with decisions to either prioritize comfort or longevity in determining end-of-life care for decisionally incapacitated adult palliative loved ones. Results demonstrated that participants prioritizing the longevity of loved ones experienced significantly and meaningfully higher levels of grief, complicated grief, and trauma related guilt than those who prioritized comfort.
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Affiliation(s)
- Geoff P Lovell
- a School of Social Sciences , University of the Sunshine Coast , Maroochydore , Australia
| | - Trish Smith
- a School of Social Sciences , University of the Sunshine Coast , Maroochydore , Australia
| | - Lee Kannis-Dymand
- a School of Social Sciences , University of the Sunshine Coast , Maroochydore , Australia
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Schenck LK, Eberle KM, Rings JA. Insecure Attachment Styles and Complicated Grief Severity. OMEGA-JOURNAL OF DEATH AND DYING 2015. [DOI: 10.1177/0030222815576124] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
A growing body of evidence supports links between attachment style, complicated grief (CG), and coping mechanisms in bereavement. In general, adults with insecure attachment styles are at an increased risk for developing CG when faced with the death of a loved one. However, much remains unknown regarding this complex interaction. This article provides a comprehensive synthesis of this literature base, offering future directions for attachment-informed CG research, clinical assessment, and treatment. The clear risk posed by an insecure attachment style on CG highlights the need for a proper and thorough assessment of attachment style as part of standard practice in grief-related treatment as well as the importance of meeting the unique clinical needs of the bereaved in consideration of one's attachment style. Further emphasis also should be placed on the mediating impacts of sociocultural variables, any of which could help to mitigate one's return to a level of preloss functioning.
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Affiliation(s)
- Laura K. Schenck
- Department of Applied Psychology and Counselor Education, University of Northern Colorado, Greeley, CO, USA
| | - Kiersten M. Eberle
- Department of Applied Psychology and Counselor Education, University of Northern Colorado, Greeley, CO, USA
| | - Jeffrey A. Rings
- Department of Applied Psychology and Counselor Education, University of Northern Colorado, Greeley, CO, USA
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Arizmendi BJ, O'Connor MF. What is "normal" in grief? Aust Crit Care 2015; 28:58-62; quiz 63. [PMID: 25716103 DOI: 10.1016/j.aucc.2015.01.005] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2014] [Revised: 12/24/2014] [Accepted: 01/26/2015] [Indexed: 10/24/2022] Open
Abstract
Research conducted over the past two decades has revealed that grief, a common phenomenon experienced by many people following the loss of a loved one, is rarely experienced as a steady progression from high acuity (intensity) to eventual resolution. Instead of this single "traditional" path, four distinct trajectories are supported by empirical data: resilience, chronic grief, depressed-improved, and chronic depression. Furthermore, a small subset of individuals never fully integrate the loss into their life, and continue to experience severe disruption in daily life many years after the loss event, a phenomenon known as Complicated Grief (CG). Continued empirical research will help further our understanding of the normative grief process and CG as a disorder. This information is crucial for informing clinicians of best practices when attending to those suffering from loss.
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Affiliation(s)
- Brian J Arizmendi
- Department of Psychology, University of Arizona, 1503 E. University Boulevard, Room 430, Tucson, AZ 85721, United States
| | - Mary-Frances O'Connor
- Department of Psychology, University of Arizona, 1503 E. University Boulevard, Room 430, Tucson, AZ 85721, United States.
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Zisook S, Iglewicz A, Avanzino J, Maglione J, Glorioso D, Zetumer S, Seay K, Vahia I, Young I, Lebowitz B, Pies R, Reynolds C, Simon N, Shear MK. Bereavement: course, consequences, and care. Curr Psychiatry Rep 2014; 16:482. [PMID: 25135781 DOI: 10.1007/s11920-014-0482-8] [Citation(s) in RCA: 68] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
This paper discusses each of several potential consequences of bereavement. First, we describe ordinary grief, followed by a discussion of grief gone awry, or complicated grief (CG). Then, we cover other potential adverse outcomes of bereavement, each of which may contribute to, but are not identical with, CG: general medical comorbidity, mood disorders, post-traumatic stress disorder, anxiety, and substance use.
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Affiliation(s)
- Sidney Zisook
- Department of Psychiatry, University of California, 3350 La Jolla Village Dr, San Diego, CA, 92161-116A, USA,
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