Science.gov

Sample records for measuring complicated grief

  1. Complicated Grief

    MedlinePlus

    ... In: Diagnostic and Statistical Manual of Mental Disorders DSM-5. 5th ed. Arlington, Va.: American Psychiatric Association; ... al. Complicated grief and related bereavement issues for DSM-5. Depression and Anxiety. 2011;28:103. Coping ...

  2. An Item Response Theory Analysis of a Measure of Complicated Grief

    ERIC Educational Resources Information Center

    Boelen, Paul A.; Hoijtink, Herbert

    2009-01-01

    Item response theory modeling was applied to the data of 1,321 bereaved individuals who completed the Dutch version of the Inventory of Complicated Grief-Revised (ICG-R)--a 29-item self-report measure of complicated grief (CG). The authors aimed to examine the information that each of the ICG-R items contributes to the measurement of overall CG…

  3. Brief Measure for Screening Complicated Grief: Reliability and Discriminant Validity

    PubMed Central

    Ito, Masaya; Nakajima, Satomi; Fujisawa, Daisuke; Miyashita, Mitsunori; Kim, Yoshiharu; Shear, M. Katherine; Ghesquiere, Angela; Wall, Melanie M.

    2012-01-01

    Background Complicated grief, which is often under-recognized and under-treated, can lead to substantial impairment in functioning. The Brief Grief Questionnaire (BGQ) is a 5-item self-report or interview instrument for screening complicated grief. Although investigations with help-seeking samples suggest that the BGQ is valid and reliable, it has not been validated in a broader population. Methodology/Principal Findings A questionnaire was mailed to a randomly selected sample (n = 5000) residing in one of 4 areas of Japan. The BCQ was examined for responders who were bereaved more than 6 months and less than 10 years (n = 915). Non-specific psychological distress was assessed with the K6 screening scale. Multiple group confirmatory factor analysis supported a uni-dimensional factor structure and the invariance of parameters across gender and age. Cronbach's alpha was sufficiently high (alpha = .75) to confirm internal consistency. Average Variance Extracted (0.39) was higher than the shared covariance (0.14) between BGQ and K6, suggesting discriminant validity. Conclusions The results of this study support the reliability and validity of the BGQ in the Japanese population. Future studies should examine predictive validity by using structured interviews or more detailed scales for complicated grief. PMID:22348057

  4. Bereavement and Complicated Grief

    PubMed Central

    Ghesquiere, Angela; Glickman, Kim

    2013-01-01

    Bereavement is a common experience in adults age 60 and older. Loss of a loved one usually leads to acute grief characterized by yearning and longing, decreased interest in ongoing activities, and frequent thoughts of the deceased. For most, acute grief naturally evolves into a state of integrated grief, where the bereaved is able to reengage with everyday activities and find interest or pleasure. About 7% of bereaved older adults, however, will develop the mental health condition of Complicated Grief (CG). In CG, the movement from acute to integrated grief is derailed, and grief symptoms remain severe and impairing. This article reviews recent publications on the diagnosis of CG, risk factors for the condition, and evidenced-based treatments for CG. Greater attention to complicated grief detection and treatment in older adults is needed. PMID:24068457

  5. Suicide bereavement and complicated grief

    PubMed Central

    Tal Young, Ilanit; Iglewicz, Alana; Glorioso, Danielle; Lanouette, Nicole; Seay, Kathryn; Ilapakurti, Manjusha; Zisook, Sidney

    2012-01-01

    Losing a loved to suicide is one is one of life's most painful experiences. The feelings of loss, sadness, and loneliness experienced after any death of a loved one are often magnified in suicide survivors by feelings of quilt, confusion, rejection, shame, anger, and the effects of stigma and trauma. Furthermore, survivors of suicide loss are at higher risk of developing major depression, post-traumatic stress disorder, and suicidal behaviors, as well as a prolonged form of grief called complicated grief. Added to the burden is the substantial stigma, which can keep survivors away from much needed support and healing resources. Thus, survivors may require unique supportive measures and targeted treatment to cope with their loss. After a brief description of the epidemiology and circumstances of suicide, we review the current state of research on suicide bereavement, complicated grief in suicide survivors, and grief treatment for survivors of suicide. PMID:22754290

  6. Suicide bereavement and complicated grief.

    PubMed

    Tal Young, Ilanit; Iglewicz, Alana; Glorioso, Danielle; Lanouette, Nicole; Seay, Kathryn; Ilapakurti, Manjusha; Zisook, Sidney

    2012-06-01

    Losing a loved to suicide is one is one of life's most painful experiences. The feelings of loss, sadness, and loneliness experienced after any death of a loved one are often magnified in suicide survivors by feelings of quilt, confusion, rejection, shame, anger, and the effects of stigma and trauma. Furthermore, survivors of suicide loss are at higher risk of developing major depression, post-traumatic stress disorder, and suicidal behaviors, as well as a prolonged form of grief called complicated grief. Added to the burden is the substantial stigma, which can keep survivors away from much needed support and healing resources. Thus, survivors may require unique supportive measures and targeted treatment to cope with their loss. After a brief description of the epidemiology and circumstances of suicide, we review the current state of research on suicide bereavement, complicated grief in suicide survivors, and grief treatment for survivors of suicide.

  7. Treating Complicated Grief

    PubMed Central

    Simon, Naomi M.

    2015-01-01

    IMPORTANCE The death of a loved one is one of life’s greatest, universal stressors to which most bereaved individuals successfully adapt without clinical intervention. For a minority of bereaved individuals, grief is complicated by superimposed problems and healing does not occur. The resulting syndrome of complicated grief causes substantial distress and functional impairment even years after a loss, yet knowing when and how to intervene can be a challenge. OBJECTIVE To discuss the differential diagnosis, risk factors for and management of complicated grief based on available evidence and clinical observations. EVIDENCE REVIEW MEDLINE was searched from January 1990 to October 2012. Additional citations were procured from references of select research and review articles. Available treatment studies targeting complicated grief were included. RESULTS A strong research literature led to inclusion of complicated grief in the Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition) (termed persistent complex bereavement disorder as a subtype of other specified trauma and stressor-related disorders), although it is a condition for which more research is formally recommended, and there is still ongoing discussion about the optimal name and diagnostic criteria for the disorder. Reliable screening instruments are available, and the estimated prevalence rate is 7% of bereaved people. Randomized controlled data support the efficacy of a targeted psychotherapy including elements that foster resolution of complicating problems and facilitate the natural healing process. Preliminary studies suggest antidepressant medications may be helpful. CONCLUSION AND RELEVANCE Individuals with complicated grief have greater risk of adverse health outcomes, should be diagnosed and assessed for suicide risk and comorbid conditions such as depression and posttraumatic stress disorder, and should be considered for treatment. PMID:23917292

  8. Complicated grief in late life

    PubMed Central

    Miller, Mark D.

    2012-01-01

    Complicated grief (CG) is a syndrome that affects 10% to 20% of grievers regardless of age, although proportionally more will face the death of loved ones in late life, CG is characterized by preoccupying and disabling symptoms that can persist for decades such as an inability to accept the death, intense yearning or avoidance, frequent reveries, deep sadness, crying, somatic distress, social withdrawal, and suicidal ideation. This syndrome is distinct from major depression and post-traumatic stress disorder, but CG maybe comorbid with each. This communication will focus on the impact of CG in late life (over age 60) and will include a case vignette for illustrating complicated grief therapy. PMID:22754292

  9. Complicated grief after perinatal loss.

    PubMed

    Kersting, Anette; Wagner, Birgit

    2012-06-01

    The loss of an infant through stillbirth, miscarriage, or neonatal death is recognized as a traumatic life event. Predictors of development of complicated grief after prenatal loss include lack of social support, pre-existing relationship difficulties, or absence of surviving children, as well as ambivalent attitudes or heightened perception of the reality of the pregnancy. Risk of complicated grief was found to be especially high after termination of a pregnancy due to fetal abnormality. Studies have revealed that men and women show different patterns of grief, potentially exacerbating decline in a relationship. Although it is clear that prenatal loss has a large psychological impact, it is concluded that there is a substantial lack of randomized controlled studies in this field of research.

  10. Diagnostic criteria for complicated grief disorder.

    PubMed

    Horowitz, M J; Siegel, B; Holen, A; Bonanno, G A; Milbrath, C; Stinson, C H

    1997-07-01

    Some prolonged and turbulent grief reactions include symptoms that differ from the DSM-IV criteria for major depressive disorder. The authors investigated a new diagnosis that would include these symptoms. They developed observer-based definitions of 30 symptoms noted clinically in previous longitudinal interviews of bereaved persons and then designed a plan to investigate whether any combination of these would serve as criteria for a possible new diagnosis of complicated grief disorder. Using a structured diagnostic interview, they assessed 70 subjects whose spouses had died. Latent class model analyses and signal detection procedures were used to calibrate the data against global clinical ratings and self-report measures of grief-specific distress. Complicated grief disorder was found to be characterized by a smaller set of the assessed symptoms. Subjects elected by an algorithm for these symptoms patterns did not significantly overlap with subjects who received a diagnosis of major depressive disorder. A new diagnosis of complicated grief disorder may be indicated. Its criteria would include the current experience (more than a year after a loss) of intense intrusive thoughts, pangs of severe emotion, distressing yearnings, feeling excessively alone and empty, excessively avoiding tasks reminiscent of the deceased, unusual sleep disturbances, and maladaptive levels of loss of interest in personal activities.

  11. Music therapy as grief therapy for adults with mental illness and complicated grief: a pilot study.

    PubMed

    Iliya, Yasmine A

    2015-01-01

    This randomized, controlled, mixed-methods pilot study examined the effectiveness and experiences of grief-specific music therapy, in addition to standard care, with adults (N=10) who have complicated grief (CG) and mental illness, as compared to standard care alone. The study tested Worden's (2009) theories of grief therapy as well as a new grief-specific music therapy intervention, based on Shear, Frank, Houck, and Reynolds' (2005) imaginal dialogue intervention and Austin's (2008) method of vocal psychotherapy. Results demonstrated that participants in the experimental group had a greater decrease of grief symptoms, as measured by the ICG-R, as compared with the control group.

  12. Complicated grief in older adults: a randomized controlled trial of complicated grief group therapy.

    PubMed

    Supiano, Katherine P; Luptak, Marilyn

    2014-10-01

    This study compared the efficacy of complicated grief therapy (CGT; Shear, K. [2003]. Complicated grief: A guidebook for therapists [Liberty Version]. New York State Office of Mental Heath; Shear, K., Frank, E., Houck, P. R., & Reynolds, C. F. 3rd [2005]. Treatment of complicated grief: A randomized controlled trial. The Journal of the American Medical Association, 293, 2601-2608) administered as group therapy (CGGT) with standard group therapy (treatment as usual [TAU]) in older adults presenting with complicated grief (CG). The design was a 2×4, prospective, randomized controlled clinical trial. The independent variable was group type, with 1 group receiving experimental methods based on the work of Shear et al. (Shear, K., Frank, E., Houck, P. R., & Reynolds, C. F. 3rd. [2005]. Treatment of complicated grief: a randomized controlled trial. The Journal of the American Medical Association, 293, 2601-2608), CGGT versus. TAU. The dependent variable was treatment response. CGGT participants demonstrated higher treatment response than TAU participants. Although participants in both groups showed improvement in CG measures, CGGT participants realized significantly greater improvement. More importantly, when CG was measured on Prolonged Grief Disorder Scale, nearly half of CGGT participants realized clinically significant improvement. All CGGT completers had Brief Grief Questionnaire scores upon follow-up that, had they scored at that level at pretest, would have disqualified them for study enrollment. The high level of clinical significance suggests that CGGT participants were effectively treated for CG. This study offers evidence that CGGT holds promise for treatment of CG in older adults and merits inquiry in other populations. © The Author 2013. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  13. Divergent Gene Expression Responses to Complicated Grief and Non-complicated Grief

    PubMed Central

    Irwin, Michael R.; Arevalo, Jesusa M. G.; Cole, Steven W.

    2014-01-01

    The “widowhood effect” (i.e., morbidity/mortality in recently bereaved spouses) may be related to changes in immune function, but little is known about the impact of bereavement on gene transcription in immune cells. This study examined how Complicated Grief and Non-complicated Grief responses to bereavement differentially affect leukocyte gene expression. Genome-wide transcriptional profiling and bioinformatic analyses were completed on 63 older adults. Thirty-six of them had lost their spouse/partner on average 2 years ago, and 27 were nonbereaved, married controls. Twelve of the bereaved participants met criteria for Complicated Grief. Compared to nonbereaved controls, bereavement (both Complicated Grief and Non-complicated Grief) was associated with upregulated expression of genes involved in general immunologic activation and a selective downregulation of genes involved in B lymphocyte responses. However, Complicated Grief and Non-complicated Grief differed markedly in their expression of Type I interferon-related transcripts, with Non-complicated Grief subjects showing substantial upregulation relative to nonbereaved controls and Complicated Grief subjects showing substantial downregulation. Bereavement significantly modulates immune function gene expression. The magnitude of bereavement-related distress (i.e., Complicated Grief vs. Non-complicated Grief) is linked to differential patterns of transcription factor activation and gene expression involved in innate antiviral responses. These findings provide a molecular framework for understanding the health effects of bereavement, as well as new insights into the particular gene modules that are most sensitive to the individual's psychological response to loss. PMID:24380850

  14. Grief-related panic symptoms in Complicated Grief.

    PubMed

    Bui, Eric; Horenstein, Arielle; Shah, Riva; Skritskaya, Natalia A; Mauro, Christine; Wang, Yuanjia; Duan, Naihua; Reynolds, Charles F; Zisook, Sidney; Shear, M Katherine; Simon, Naomi M

    2015-01-01

    Although Complicated Grief (CG) has been associated with comorbid Panic Disorder (PD), little is known about panic attacks in CG, and whether panic symptoms may be grief-related. The present study examines the presence and impact of grief-related panic symptoms in CG. Individuals with CG (n=146, 78% women, mean (SD) age=52.4(15.0)) were assessed for CG, DSM-IV diagnoses, work and social impairment, and with the Panic Disorder Severity Scale modified to assess symptoms "related to or triggered by reminders of your loss" and anticipatory worry. Overall, 39.7% reported at least one full or limited-symptom grief-related panic attack over the past week, and 32.2% reported some level of anticipatory worry about grief-related panic. Of interest, 17% met DSM criteria for PD. Among those without PD, 34.7% reported at least one full or limited-symptom grief-related panic attack over the past week, and this was associated with higher CG symptom severity (t=-2.23, p<0.05), and functional impairment (t=-3.31, p<0.01). Among the full sample, controlling for CG symptom severity and current PD, the presence of at least one full or limited-symptom grief-related panic attack was independently associated with increased functional impairment (B(SE)=4.86(1.7), p<0.01). Limitations include a lack of assessment of non-grief-related panic symptoms and examination of a sample of individuals seeking treatment for CG. Grief-related panic symptoms may be prevalent among individuals with CG and independently contribute to distress and functional impairment. Copyright © 2014 Elsevier B.V. All rights reserved.

  15. Emotional and physiological reactivity in Complicated Grief.

    PubMed

    LeBlanc, Nicole J; Unger, Leslie D; McNally, Richard J

    2016-04-01

    Grief is a psychobiological response to the loss of a loved one. Some grief theorists suggest that this predictable response may arise from withdrawal of psychobiological regulation previously provided by the deceased (e.g. assistance with emotion regulation). Accordingly, recovery from loss may require bereaved individuals to re-establish self-regulatory control to avoid developing Complicated Grief (CG). This model implies that adults with CG may exhibit aberrant emotional responding to environmental stimuli. The present study was designed to test this hypothesis. We recruited a sample of 23 bereaved adults with CG and 26 healthy bereaved adults to complete an emotional reactivity paradigm. Participants watched a series of emotional film clips and provided measures of their self-reported emotional response. We also assessed their heart rate, respiratory sinus arrhythmia (RSA), and skin conductance level in response to these clips. Though emotional and physiological differences between the groups were rare, the CG group exhibited attenuated RSA reactivity to some emotional film clips, suggesting blunted parasympathetic nervous system reactivity in those with the disorder. Limitations include the modest sample size and unequal group sizes. Individuals with CG do not exhibit pervasive differences in emotional and physiological reactivity compared to healthy bereaved individuals. However, we did observe evidence of blunted parasympathetic nervous system reactivity in individuals with CG, which may mediate emotional inflexibility among those who develop the disorder. Copyright © 2016 Elsevier B.V. All rights reserved.

  16. Divergent gene expression responses to complicated grief and non-complicated grief.

    PubMed

    O'Connor, Mary-Frances; Schultze-Florey, Christian R; Irwin, Michael R; Arevalo, Jesusa M G; Cole, Steven W

    2014-03-01

    The "widowhood effect" (i.e., morbidity/mortality in recently bereaved spouses) may be related to changes in immune function, but little is known about the impact of bereavement on gene transcription in immune cells. This study examined how Complicated Grief and Non-complicated Grief responses to bereavement differentially affect leukocyte gene expression. Genome-wide transcriptional profiling and bioinformatic analyses were completed on 63 older adults. Thirty-six of them had lost their spouse/partner on average 2years ago, and 27 were nonbereaved, married controls. Twelve of the bereaved participants met criteria for Complicated Grief. Compared to nonbereaved controls, bereavement (both Complicated Grief and Non-complicated Grief) was associated with upregulated expression of genes involved in general immunologic activation and a selective downregulation of genes involved in B lymphocyte responses. However, Complicated Grief and Non-complicated Grief differed markedly in their expression of Type I interferon-related transcripts, with Non-complicated Grief subjects showing substantial upregulation relative to nonbereaved controls and Complicated Grief subjects showing substantial downregulation. Bereavement significantly modulates immune function gene expression. The magnitude of bereavement-related distress (i.e., Complicated Grief vs. Non-complicated Grief) is linked to differential patterns of transcription factor activation and gene expression involved in innate antiviral responses. These findings provide a molecular framework for understanding the health effects of bereavement, as well as new insights into the particular gene modules that are most sensitive to the individual's psychological response to loss. Copyright © 2013 Elsevier Inc. All rights reserved.

  17. Complicated Grief and Suicidal Ideation in Adult Survivors of Suicide

    ERIC Educational Resources Information Center

    Mitchell, Ann M.; Kim, Yookyung; Prigerson, Holly G.; Mortimer, Mary Kay

    2005-01-01

    While the prevalence of complicated grief has been demonstrated to be elevated in survivors of suicide, the association between complicated grief and suicidal ideation among adult survivors of suicide has not been explored. The purpose of the present study is to examine the association between complicated grief and suicidal ideation in suicide…

  18. Immunological and neuroimaging biomarkers of complicated grief.

    PubMed

    O'Connor, Mary-Frances

    2012-06-01

    Complicated grief (CG) is a disorder marked by intense and persistent yearning for the deceased, in addition to other criteria. The present article reviews what is known about the immunologic and neuroimaging biomarkers of both acute grief and CG, Attachment theory and cognitive stress theory are reviewed as they pertain to bereavement, as is the biopsychosocial model of CG. Reduced immune cell function has been replicated in a variety of bereaved populations. The regional brain activation to grief cues frequently includes the dorsal anterior cingulate cortex and insula, and also the posterior cingulate cortex. Using theory to point to future research directions, we may eventually learn which biomarkers are helpful in predicting CG, and its treatment.

  19. [Complicated Grief in DSM-5 era].

    PubMed

    Carmassi, Claudia; Conversano, Ciro; Pinori, Marialisa; Bertelloni, Carlo Antonio; Dalle Luche, Riccardo; Gesi, Camilla; Dell'Osso, Liliana

    2016-01-01

    An increasing number of data has been recently focused on recognizing pathological grief reactions and on the distinction from physiological processes. Particularly, several studies have supported Complicated Grief (CG) as an independent disorder, in order to define the failure of spontaneous physiological mourning resolution. Upon these studies, the latest edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) with the name of "Persistent Complex Bereavement Disorder". This article aims at retracing the history of clinical research about the physiological and psychopathological processes related to grief and aims at presenting the main scientific studies that have described the features of the CG defining it as a distinct disorder. Similarities and distinctions among CG and Depression, Posttraumatic Stress Disorder and Adjustment Disorder were also reported.

  20. Cognition, structural brain changes and complicated grief. A population-based study.

    PubMed

    Saavedra Pérez, H C; Ikram, M A; Direk, N; Prigerson, H G; Freak-Poli, R; Verhaaren, B F J; Hofman, A; Vernooij, M; Tiemeier, H

    2015-05-01

    Several psychosocial risk factors for complicated grief have been described. However, the association of complicated grief with cognitive and biological risk factors is unclear. The present study examined whether complicated grief and normal grief are related to cognitive performance or structural brain volumes in a large population-based study. The present research comprised cross-sectional analyses embedded in the Rotterdam Study. The study included 5501 non-demented persons. Participants were classified as experiencing no grief (n = 4731), normal grief (n = 615) or complicated grief (n = 155) as assessed with the Inventory of Complicated Grief. All persons underwent cognitive testing (Mini-Mental State Examination, Letter-Digit Substitution Test, Stroop Test, Word Fluency Task, word learning test - immediate and delayed recall), and magnetic resonance imaging to measure general brain parameters (white matter, gray matter), and white matter lesions. Total brain volume was defined as the sum of gray matter plus normal white matter and white matter lesion volume. Persons with depressive disorders were excluded and analyses were adjusted for depressive symptoms. Compared with no-grief participants, participants with complicated grief had lower scores for the Letter-Digit Substitution Test [Z-score -0.16 v. 0.04, 95% confidence interval (CI) -0.36 to -0.04, p = 0.01] and Word Fluency Task (Z-score -0.15 v. 0.03, 95% CI -0.35 to -0.02, p = 0.02) and smaller total volumes of brain matter (933.53 ml v. 952.42 ml, 95% CI -37.6 to -0.10, p = 0.04). Participants with complicated grief performed poorly in cognitive tests and had a smaller total brain volume. Although the effect sizes were small, these findings suggest that there may be a neurological correlate of complicated grief, but not of normal grief, in the general population.

  1. Neuropsychological Correlates of Complicated Grief in Older Spousally Bereaved Adults

    PubMed Central

    2014-01-01

    Objectives. Across many research domains, evidence for complicated grief as a distinct psychopathology continues to grow. Previous research from neuropsychology has shown an increased attentional bias to emotionally relevant stimuli in those suffering from complicated grief. This study furthers our understanding of the characteristics that distinguish complicated grief. We expand on previous research by (a) testing older adults, (b) excluding those with comorbid major depressive disorder, (c) using participant-chosen grief-related stimuli, and (d) using a married, nonbereaved control group. Methods. We recruited 76 older adults in 3 groups: spousally bereaved with complicated grief, spousally bereaved with noncomplicated grief, and nonbereaved controls. Performance on the Wisconsin Card Sorting Task, Digit Span Backwards, and the emotional counting Stroop was examined. Results. Results indicate longer reaction time across 3 blocks of grief-related words in the complicated grief group but no difference across 3 blocks of the neutral words. The 3 groups performed comparably on the other neurocognitive tasks, indicating no cognitive differences in working memory or set shifting between groups. Furthermore, these effects of complicated grief generalize to older adults and appear independent of major depression. Discussion. Complicated grief has cognitive interference as a neuropsychological component highlighting it as distinct from noncomplicated grief. PMID:23551907

  2. Neuropsychological correlates of complicated grief in older spousally bereaved adults.

    PubMed

    O'Connor, Mary-Frances; Arizmendi, Brian J

    2014-01-01

    Across many research domains, evidence for complicated grief as a distinct psychopathology continues to grow. Previous research from neuropsychology has shown an increased attentional bias to emotionally relevant stimuli in those suffering from complicated grief. This study furthers our understanding of the characteristics that distinguish complicated grief. We expand on previous research by (a) testing older adults, (b) excluding those with comorbid major depressive disorder, (c) using participant-chosen grief-related stimuli, and (d) using a married, nonbereaved control group. We recruited 76 older adults in 3 groups: spousally bereaved with complicated grief, spousally bereaved with noncomplicated grief, and nonbereaved controls. Performance on the Wisconsin Card Sorting Task, Digit Span Backwards, and the emotional counting Stroop was examined. Results indicate longer reaction time across 3 blocks of grief-related words in the complicated grief group but no difference across 3 blocks of the neutral words. The 3 groups performed comparably on the other neurocognitive tasks, indicating no cognitive differences in working memory or set shifting between groups. Furthermore, these effects of complicated grief generalize to older adults and appear independent of major depression. Complicated grief has cognitive interference as a neuropsychological component highlighting it as distinct from noncomplicated grief.

  3. Risk factors for complicated grief in older adults.

    PubMed

    Bruinsma, Sophie M; Tiemeier, Henning W; Verkroost-van Heemst, Jolande; van der Heide, Agnes; Rietjens, Judith A C

    2015-05-01

    Older adults grieving the death of a spouse have been found to have a higher risk of complicated grief compared with younger adults. The study objective was to find out whether personal characteristics of the patient and the bereaved partner, or characteristics of the patient's illness, end-of-life care, and the nature of death are risk factors for complicated grief in older adults. We performed a nested case-control study within the Rotterdam Study. We selected 100 couples of which one person had deceased and the other person experienced "complicated grief," and 100 control couples of which one person had deceased and the other person experienced "normal grief." Complicated grief was assessed with a 17-item Inventory of Complicated Grief (ICG). Determinants were assessed using several sources of information that were available for all participants of the Rotterdam Study. Additionally, medical files of the deceased were manually screened. Logistic regression analysis was performed. Only depression at baseline was significantly associated with complicated grief. Bereaved partners with depression at baseline had a higher risk of complicated grief compared to bereaved partners without depression (OR=3.48; 95% CI=1.40-8.68). Our results suggest that complicated grief in older adults is not clearly related to the circumstances of dying of the deceased partner. Preexisting conditions such as depression seem to be more important in explaining the occurrence of complicated grief.

  4. Sudden-On-Chronic Death and Complicated Grief in Bereaved Dementia Caregivers: Two Case Studies of Complicated Grief Group Therapy.

    PubMed

    Supiano, Katherine P; Andersen, Troy C; Haynes, Lara Burns

    2015-01-01

    Caring for a person with Alzheimer's disease is challenging and often has negative health and mental health effects that, for 7-20% of caregivers, persist into bereavement in the form of complicated grief. Complicated grief is a state of prolonged and ineffective mourning. An under-recognized phenomenon in dementia care and bereavement is "sudden-on-chronic death." In these situations, the caregiver is preparing for a gradual dying process from dementia, but the care recipient dies instead from a sudden death. In this study, an application of complicated grief group therapy for bereaved dementia caregivers with complicated grief is presented, and the effect of therapy with two bereaved caregivers who experienced the sudden death of their spouses who had a diagnosis of dementia is described. The unique treatment elements of complicated grief group therapy facilitated resolution of the 'trauma-like" features of bereavement and progression to a healthy grief process.

  5. Informing the Symptom Profile of Complicated Grief

    PubMed Central

    Simon, Naomi M.; Wall, Melanie M.; Keshaviah, Aparna; Dryman, M. Taylor; LeBlanc, Nicole J.; Shear, M. Katherine

    2010-01-01

    Background Complicated Grief (CG) is under consideration as a new diagnosis in DSM5. We sought to add empirical support to the current dialogue by examining the commonly used Inventory of Complicated Grief (ICG) scale completed by 782 bereaved individuals. Methods We employed IRT analyses, factor analyses, and sensitivity and specificity analyses utilizing our full sample (n=782), and also compared confirmed CG cases (n=288) to non-cases (n=377). Confirmed CG cases were defined as individuals bereaved at least 6 months who were seeking care for CG, had an ICG ≥ 30, and received a structured clinical interview for CG by a certified clinician confirming CG as their primary illness. Non-cases were bereaved individuals who did not present with CG as a primary complaint (including those with depression, bipolar disorder, anxiety disorders and controls) and had an ICG<25. Results IRT analyses provided guidance about the most informative individual items and their association with CG severity. Factor analyses demonstrated a single factor solution when the full sample was considered, but within CG cases, six symptom clusters emerged: 1) yearning and preoccupation with the deceased, 2) anger and bitterness, 3) shock and disbelief, 4) estrangement from others, 5) hallucinations of the deceased, and 6) behavior change, including avoidance and proximity seeking. The presence of at least one symptom from three different symptom clusters optimized sensitivity (94.8%) and specificity (98.1%). Conclusions These data, derived from a diverse and predominantly clinical help seeking population, add an important perspective to existing suggestions for DSM5 criteria for CG. PMID:21284064

  6. Complicated grief associated with hurricane Katrina.

    PubMed

    Shear, M Katherine; McLaughlin, Katie A; Ghesquiere, Angela; Gruber, Michael J; Sampson, Nancy A; Kessler, Ronald C

    2011-08-01

    Although losses are important consequences of disasters, few epidemiological studies of disasters have assessed complicated grief (CG) and none assessed CG associated with losses other than death of loved one. Data come from the baseline survey of the Hurricane Katrina Community Advisory Group, a representative sample of 3,088 residents of the areas directly affected by Hurricane Katrina. A brief screen for CG was included containing four items consistent with the proposed DSM-V criteria for a diagnosis of bereavement-related adjustment disorder. Fifty-eight and half percent of respondents reported a significant hurricane-related loss: Most-severe losses were 29.0% tangible, 9.5% interpersonal, 8.1% intangible, 4.2% work/financial, and 3.7% death of loved one. Twenty-six point one percent respondents with significant loss had possible CG and 7.0% moderate-to-severe CG. Death of loved one was associated with the highest conditional probability of moderate-to-severe CG (18.5%, compared to 1.1-10.5% conditional probabilities for other losses), but accounted for only 16.5% of moderate-to-severe CG due to its comparatively low prevalence. Most moderate-to-severe CG was due to tangible (52.9%) or interpersonal (24.0%) losses. Significant predictors of CG were mostly unique to either bereavement (racial-ethnic minority status, social support) or other losses (prehurricane history of psychopathology, social competence.). Nonbereavement losses accounted for the vast majority of hurricane-related possible CG despite risk of CG being much higher in response to bereavement than to other losses. This result argues for expansion of research on CG beyond bereavement and alerts clinicians to the need to address postdisaster grief associated with a wide range of losses. © 2011 Wiley-Liss, Inc.

  7. Complicated grief associated with Hurricane Katrina

    PubMed Central

    Shear, M. Katherine; McLaughlin, Katie A.; Ghesquiere, Angela; Gruber, Michael J.; Sampson, Nancy A.; Kessler, Ronald C.

    2011-01-01

    Background Although losses are important consequences of disasters, few epidemiological studies of disasters have assessed complicated grief (CG) and none assessed CG associated with losses other than death of loved one. Methods Data come from the baseline survey of the Hurricane Katrina Community Advisory Group (CAG), a representative sample of 3,088 residents of the areas directly affected by Hurricane Katrina. A brief screen for CG was included containing four items consistent with the proposed DSM 5 criteria for a diagnosis of bereavement-related adjustment disorder. Results 58.5% of respondents reported a significant hurricane-related loss: Most-severe losses were 29.0% tangible, 9.5% interpersonal, 8.1% intangible, 4.2% work-financial, and 3.7% death of loved one. 26.1% of respondents with significant loss had possible CG and 7.0% moderate-severe CG. Death of loved one was associated with the highest conditional probability of moderate-severe CG (18.5%, compared to 1.1–10.5% conditional probabilities for other losses) but accounted for only 16.5% of moderate-severe CG due to its comparatively low prevalence. Most moderate-severe CG was due to tangible (52.9%) or interpersonal (24.0%) losses. Significant predictors of CG were mostly unique to either bereavement (racial-ethnic minority status, social support) or other losses (pre-hurricane history of psychopathology, social competence.). Conclusions Non-bereavement losses accounted for the vast majority of hurricane-related possible CG despite risk of CG being much higher in response to bereavement than to other losses. This result argues for expansion of research on CG beyond bereavement and alerts clinicians to the need to address post-disaster grief associated with a wide range of losses. PMID:21796740

  8. Dream Content in Complicated Grief: A Window into Loss-Related Cognitive Schemas Running Head: Dreams in Complicated Grief

    PubMed Central

    Germain, Anne; Shear, Katherine M.; Walsh, Colleen; Buysse, Daniel J.; Monk, Timothy H.; Reynolds, Charles F.; Frank, Ellen; Silowash, Russell

    2012-01-01

    Bereavement and its accompanying psychological response (grief) constitute potent experiences that necessitate the reorganization of cognitive-affective representations of lost significant attachment figures during both wakefulness and dreaming. The goals of this preliminary study were to explore whether the dream content of 77 adults with complicated grief (CG) differed from that of a normative sample, and to explore whether CG patients who dream of the deceased differ from CG patients who do not dream of the deceased on measures of daytime emotional distress. CG dreams were characterized by more family and familiar characters including the deceased (in women), and fewer social interactions and emotions compared to norms. Increased representations of familiar characters in CG dreams may reflect attempts to reorganize relational cognitive schemas to compensate for the loss. PMID:24524436

  9. Grief and mourning gone awry: pathway and course of complicated grief

    PubMed Central

    Shear, M. Katherine

    2012-01-01

    Complicated grief is a recently recognized condition that occurs in about 7% of bereaved people. People with this condition are caught up in rumination about the circumstances of the death, worry about its consequences, or excessive avoidance of reminders of the loss. Unable to comprehend the finality and consequences of the loss, they resort to excessive avoidance of reminders of the loss as they are tossed helplessly on waves of intense emotion. People with complicated grief need help, and clinicians need to know how to recognize the symptoms and how to provide help. This paper provides a framework to help clinicans understand bereavement, grief, and mourning. Evidence-based diagnostic criteria are provided to help clinicians recognize complicated grief, and differentiate it from depression as well as anxiety disorder. We provide an overview of risk factors and basic assumptions and principles that can guide treatment. PMID:22754284

  10. Insomnia and complicated grief symptoms in bereaved college students.

    PubMed

    Hardison, Heather Gaines; Neimeyer, Robert A; Lichstein, Kenneth L

    2005-01-01

    In this study, we extended previous research by concentrating on sleep- and grief-related symptoms in a cohort of bereaved college students, in view of the potential for each of these problems to exacerbate the other. A sample of 815 college students completed the Inventory of Complicated Grief (H. G. Prigerson & S. C. Jacobs, 2001), along with an assessment of diagnostic criteria for insomnia and associated sleep behaviors. As predicted, the rate of insomnia was significantly higher (22%) in the bereaved sample than in a nonbereaved comparison group (17%), a difference that was particularly pronounced in terms of middle insomnia. Also as hypothesized, bereaved insomniacs reported higher complicated grief scores than bereaved noninsomniacs, and several specific sleep variables (including sleep-onset insomnia related to nighttime rumination about the loss and sleep-maintenance insomnia associated with dreaming of the deceased) were significantly related to complicated grief symptomatology.

  11. Complicated spiritual grief I: relation to complicated grief symptomatology following violent death bereavement.

    PubMed

    Burke, Laurie A; Neimeyer, Robert A

    2014-01-01

    Losing a loved one to violent death has been associated with poor mental health outcomes, including posttraumatic stress disorder, depression, and complicated grief (CG), a protracted, debilitating, and sometimes life-threatening reaction to loss. In addition, recent research suggests that traumatic loss can violate mourners' basic assumptive worldviews, and can precipitate a spiritual crisis following loss, also known as complicated spiritual grief (CSG). The present cross-sectional study investigated these multidimensional outcomes in a diverse sample of 150 grievers. The authors found that (a) violently bereaved individuals reported greater CG and CSG than did individuals bereaved by natural death; (b) CG and CSG were correlated across the larger sample, and yet are theoretically different constructs; and (c) specific cause of death (natural anticipated, natural sudden, homicide, suicide, or fatal accident) differentially predicted levels of CG and CSG. Implications of these findings for a clearer understanding of spiritual coping in the wake of troubling loss are noted, as well as for intervention with mourners struggling with clinical complications.

  12. Optimizing Treatment of Complicated Grief: A Randomized Clinical Trial.

    PubMed

    Shear, M Katherine; Reynolds, Charles F; Simon, Naomi M; Zisook, Sidney; Wang, Yuanjia; Mauro, Christine; Duan, Naihua; Lebowitz, Barry; Skritskaya, Natalia

    2016-07-01

    To our knowledge, this is the first placebo-controlled randomized clinical trial to evaluate the efficacy of antidepressant pharmacotherapy, with and without complicated grief psychotherapy, in the treatment of complicated grief. To confirm the efficacy of a targeted complicated grief treatment (CGT), determine whether citalopram (CIT) enhances CGT outcome, and examine CIT efficacy without CGT. Included in the study were 395 bereaved adults who met criteria for CG recruited from March 2010 to September 2014 from academic medical centers in Boston, Massachusetts; New York, New York; Pittsburgh, Pennsylvania; and San Diego, California. Co-occurring substance abuse, psychosis, mania, and cognitive impairment were exclusionary. Study participants were randomized using site-specific permuted blocks stratified by major depression into groups prescribed CIT (n = 101), placebo (PLA; n = 99), CGT with CIT (n = 99), and CGT with PLA (n = 96). Independent evaluators conducted monthly assessments for 20 weeks. Response rates were compared under the intention-to-treat principle, including all randomized participants in a logistic regression with inverse probability weighting. All participants received protocolized pharmacotherapy optimized by flexible dosing, psychoeducation, grief monitoring, and encouragement to engage in activities. Half were also randomized to receive manualized CGT in 16 concurrent weekly sessions. Complicated grief-anchored Clinical Global Impression scale measurments every 4 weeks. Response was measured as a rating of "much improved" or "very much improved." Of the 395 study participants, 308 (78.0%) were female and 325 (82.3%) were white. Participants' response to CGT with PLA vs PLA (82.5% vs 54.8%; relative risk [RR], 1.51; 95% CI, 1.16-1.95; P = .002; number needed to treat [NNT], 3.6) suggested the efficacy of CGT, and the addition of CIT did not significantly improve CGT outcome (CGT with CIT vs CGT with PLA: 83.7% vs 82.5%; RR

  13. Child and adolescent homicide survivors. Complicated grief and altered worldviews.

    PubMed

    Vigil, Gloria J; Clements, Paul T

    2003-01-01

    The act of homicide may influence the worldviews of children and adolescents. Problematic beliefs of uncertainty, inadequacy, perceiving the world as dangerous, self-denial, and lack of control can contribute to complicated grief in children and adolescents, and can potentially disrupt their normal psychosocial growth and development. Mental health professionals' understanding of grief after the homicide of a family member enhances their ability to intervene with and support young people struggling to cope with and adapt to a sudden loss.

  14. Complicated grief and related bereavement issues for DSM-5.

    PubMed

    Shear, M Katherine; Simon, Naomi; Wall, Melanie; Zisook, Sidney; Neimeyer, Robert; Duan, Naihua; Reynolds, Charles; Lebowitz, Barry; Sung, Sharon; Ghesquiere, Angela; Gorscak, Bonnie; Clayton, Paula; Ito, Masaya; Nakajima, Satomi; Konishi, Takako; Melhem, Nadine; Meert, Kathleen; Schiff, Miriam; O'Connor, Mary-Frances; First, Michael; Sareen, Jitender; Bolton, James; Skritskaya, Natalia; Mancini, Anthony D; Keshaviah, Aparna

    2011-02-01

    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.

  15. COMPLICATED GRIEF AND RELATED BEREAVEMENT ISSUES FOR DSM-5

    PubMed Central

    Shear, M. Katherine; Simon, Naomi; Wall, Melanie; Zisook, Sidney; Neimeyer, Robert; Duan, Naihua; Reynolds, Charles; Lebowitz, Barry; Sung, Sharon; Ghesquiere, Angela; Gorscak, Bonnie; Clayton, Paula; Ito, Masaya; Nakajima, Satomi; Konishi, Takako; Melhem, Nadine; Meert, Kathleen; Schiff, Miriam; O’Connor, Mary-Frances; First, Michael; Sareen, Jitender; Bolton, James; Skritskaya, Natalia; Mancini, Anthony D.; Keshaviah, Aparna

    2010-01-01

    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 paper 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. PMID:21284063

  16. Anxiety Sensitivity in Bereaved Adults with and without Complicated Grief

    PubMed Central

    Robinaugh, Donald J.; McNally, Richard J.; LeBlanc, Nicole J.; Pentel, Kimberly Z.; Schwarz, Noah R.; Shah, Riva M.; Nadal-Vicens, Mireya F.; Moore, Cynthia W.; Marques, Luana; Bui, Eric; Simon, Naomi M.

    2014-01-01

    Complicated grief (CG) is a bereavement specific syndrome chiefly characterized by symptoms of persistent separation distress. Physiological reactivity to reminders of the loss and repeated acute pangs or waves of severe anxiety and psychological pain are prominent features of CG. Fear of this grief-related physiological arousal may contribute to CG by increasing the distress associated with grief reactions and increasing the likelihood of maladaptive coping strategies and grief-related avoidance. Here, we examined anxiety sensitivity (i.e., the fear of anxiety-related sensations; AS) in two studies of bereaved adults with and without CG. In both studies, bereaved adults with CG exhibited elevated AS relative to those without CG. In Study 2, AS was positively associated with CG symptom severity among those with CG. These findings are consistent with the possibility that AS contributes to the development or maintenance of CG symptoms. PMID:25075646

  17. Symptoms of Major Depression and Complicated Grief

    MedlinePlus

    ... Depression It’s common for people to have sadness, pain, anger, bouts of crying, and a depressed mood after a loved one dies. It’s important to know about normal grief responses so that you can know if the bereaved ...

  18. Complicated grief therapy as a new treatment approach

    PubMed Central

    Wetherell, Julie Loebach

    2012-01-01

    Complicated grief therapy (CGT) is a relatively new psychotherapy model designed to address symptoms of complicated grief. Drawn from attachment theory and with roots in both interpersonal therapy (IPT) and cognitive-behavioral therapy, CGT includes techniques similar to prolonged exposure (repeatedly telling the story of the death and in vivo exposure activities). The treatment also involves focusing on personal goals and relationships. CGT has been demonstrated to be effective in a trial in which participants with complicated grief were randomly assigned to CGT or IPT; individuals receiving CGT responded more quickly and were more likely to respond overall (51 % vs 28%). This article briefly summarizes the conceptual underpinnings of CGT, discusses the empirical evidence for its efficacy, describes its techniques, and presents a case example of a client treated in a 16-session manualized CGT protocol. The article concludes with a description of future research directions for CGT. PMID:22754288

  19. Korean Version of Inventory of Complicated Grief Scale: Psychometric Properties in Korean Adolescents

    PubMed Central

    2016-01-01

    We aimed to validate the Inventory of Complicated Grief (ICG)-Korean version among 1,138 Korean adolescents, representing a response rate of 57% of 1,997 students. Participants completed a set of questionnaires including demographic variables (age, sex, years of education, experience of grief), the ICG, the Children's Depression Inventory (CDI) and the Lifetime Incidence of Traumatic Events-Child (LITE-C). Exploratory factor analysis was performed to determine whether the ICG items indicated complicated grief in Korean adolescents. The internal consistency of the ICG-Korean version was Cronbach's α=0.87. The test-retest reliability for a randomly selected sample of 314 participants in 2 weeks was r=0.75 (P<0.001). Concurrent validity was assessed using a correlation between the ICG total scores and the CDI total scores (r=0.75, P<0.001). The criterion-related validity based on the comparison of ICG total scores between adolescents without complicated grief (1.2±3.7) and adolescent with complicated grief (3.2±6.6) groups was relatively high (t=5.71, P<0.001). The data acquired from the 1,138 students was acceptable for a factor analysis (Kaiser-Meyer-Olkin Measure of Sampling Adequacy=0.911; Bartlett's Test of Sphericity, χ2=13,144.7, P<0.001). After omission of 3 items, the value of Cronbach's α increased from 0.87 for the 19-item ICG-Korean version to 0.93 for the 16-item ICG-Korean version. These results suggest that the ICG is a useful tool in assessing for complicated grief in Korean adolescents. However, the 16-item version of the ICG appeared to be more valid compared to the 19-item version of the ICG. We suggest that the 16-item version of the ICG be used to screen for complicated grief in Korean adolescents. PMID:26770046

  20. Korean Version of Inventory of Complicated Grief Scale: Psychometric Properties in Korean Adolescents.

    PubMed

    Han, Doug Hyun; Lee, Jung Jae; Moon, Duk-Soo; Cha, Myoung-Jin; Kim, Min A; Min, Seonyeong; Yang, Ji Hoon; Lee, Eun Jeong; Yoo, Seo Koo; Chung, Un-Sun

    2016-01-01

    We aimed to validate the Inventory of Complicated Grief (ICG)-Korean version among 1,138 Korean adolescents, representing a response rate of 57% of 1,997 students. Participants completed a set of questionnaires including demographic variables (age, sex, years of education, experience of grief), the ICG, the Children's Depression Inventory (CDI) and the Lifetime Incidence of Traumatic Events-Child (LITE-C). Exploratory factor analysis was performed to determine whether the ICG items indicated complicated grief in Korean adolescents. The internal consistency of the ICG-Korean version was Cronbach's α=0.87. The test-retest reliability for a randomly selected sample of 314 participants in 2 weeks was r=0.75 (P<0.001). Concurrent validity was assessed using a correlation between the ICG total scores and the CDI total scores (r=0.75, P<0.001). The criterion-related validity based on the comparison of ICG total scores between adolescents without complicated grief (1.2 ± 3.7) and adolescent with complicated grief (3.2 ± 6.6) groups was relatively high (t=5.71, P<0.001). The data acquired from the 1,138 students was acceptable for a factor analysis (Kaiser-Meyer-Olkin Measure of Sampling Adequacy=0.911; Bartlett's Test of Sphericity, χ(2)=13,144.7, P<0.001). After omission of 3 items, the value of Cronbach's α increased from 0.87 for the 19-item ICG-Korean version to 0.93 for the 16-item ICG-Korean version. These results suggest that the ICG is a useful tool in assessing for complicated grief in Korean adolescents. However, the 16-item version of the ICG appeared to be more valid compared to the 19-item version of the ICG. We suggest that the 16-item version of the ICG be used to screen for complicated grief in Korean adolescents.

  1. Complicated grief in those bereaved by violent death: the effects of post-traumatic stress disorder on complicated grief.

    PubMed

    Nakajima, Satomi; Ito, Masaya; Shirai, Akemi; Konishi, Takako

    2012-06-01

    Violent death, such as homicide, accident, and suicide, is sudden, unexpected, and caused by intentional power, The prevalence of complicated grief among those bereaved by violent death is 12.5% to 78.0%. The factors affecting this prevalence rate are considered to be comorbid mental disorders, lack of readiness for the death, difficulty in making sense of the death, high level of negative appraisal about the self and others, and various social stressors. Post-traumatic stress disorder is, in particular, considered to contribute to the development of complicated grief by suppressing function of the medial prefrontal cortex and the anterior cingulate cortex, which works at facilitating the normal mourning process. An understanding of the mechanism and biological basis of complicated grief by violent death will be helpful in developing effective preventive intervention and treatment.

  2. Complicated Grief and Associated Risk Factors Among Parents Following a Child’s Death in the Pediatric Intensive Care Unit

    PubMed Central

    Meert, Kathleen L.; Donaldson, Amy E.; Newth, Christopher J. L.; Harrison, Rick; Berger, John; Zimmerman, Jerry; Anand, K. J. S.; Carcillo, Joseph; Dean, J. Michael; Willson, Douglas F.; Nicholson, Carol; Shear, Katherine

    2012-01-01

    Objective To investigate the extent of complicated grief symptoms and associated risk factors among parents whose child died in a pediatric intensive care unit. Design Cross-sectional survey conducted by mail and telephone. Setting Seven children’s hospitals affiliated with the Collaborative Pediatric Critical Care Research Network from January 1, 2006, to June 30, 2008. Participants Two hundred sixty-one parents from 872 families whose child died in a pediatric intensive care unit 6 months earlier. Main Exposure Assessment of potential risk factors, including demographic and clinical variables, and parent psychosocial characteristics, such as attachment style, caregiving style, grief avoidance, and social support. Main Outcome Measure Parent report of complicated grief symptoms using the Inventory of Complicated Grief. Total scale range is from 0 to 76; scores of 30 or higher suggest complicated grief. Results Mean(SD)Inventory of Complicated Grief scores among parents were 33.7 (14.1). Fifty-nine percent of parents (95% confidence interval, 53%–65%) had scores of 30 or higher. Variables independently associated with higher symptom scores in multivariable analysis included being the biological mother or female guardian, trauma as the cause of death, greater attachment-related anxiety and attachment-related avoidance, and greater grief avoidance. Conclusions Parents who responded to our survey experienced a high level of complicated grief symptoms 6 months after their child’s death in the pediatric intensive care unit. However, our estimate of the extent of complicated grief symptoms may be biased because of a high number of nonresponders. Better understanding of complicated grief and its risk factors among parents will allow those most vulnerable to receive professional bereavement support. PMID:21041597

  3. Group Composition and Group Therapy for Complicated Grief

    ERIC Educational Resources Information Center

    Piper, William E.; Ogrodniczuk, John S.; Joyce, Anthony S.; Weideman, Rene; Rosie, John S.

    2007-01-01

    This prospective study investigated the impact of group composition on the outcome of 2 forms of time-limited, short-term group therapy (interpretive, supportive) with 110 outpatients from 18 therapy groups, who presented with complicated grief. The composition variable was based on the patient's level of quality of object relations. The higher…

  4. Group Composition and Group Therapy for Complicated Grief

    ERIC Educational Resources Information Center

    Piper, William E.; Ogrodniczuk, John S.; Joyce, Anthony S.; Weideman, Rene; Rosie, John S.

    2007-01-01

    This prospective study investigated the impact of group composition on the outcome of 2 forms of time-limited, short-term group therapy (interpretive, supportive) with 110 outpatients from 18 therapy groups, who presented with complicated grief. The composition variable was based on the patient's level of quality of object relations. The higher…

  5. Predictors of Complicated Grief: A Systematic Review of Empirical Studies

    ERIC Educational Resources Information Center

    Lobb, Elizabeth A.; Kristjanson, Linda J.; Aoun, Samar M.; Monterosso, Leanne; Halkett, Georgia K. B.; Davies, Anna

    2010-01-01

    A systematic review of the literature on predictors of complicated grief (CG) was undertaken with the aim of clarifying the current knowledge and to inform future planning and work in CG following bereavement. Predictors of CG prior to the death include previous loss, exposure to trauma, a previous psychiatric history, attachment style, and the…

  6. Facets of Pejorative Self-Processing in Complicated Grief

    ERIC Educational Resources Information Center

    Golden, Ann-Marie J.; Dalgleish, Tim

    2012-01-01

    Objective: Complicated grief (CG) has been proposed as a psychiatric response to bereavement distinct from established mood and anxiety disorder diagnoses. Little is known about the nature of cognitive-affective processing in CG, nor any similarities or differences compared with the processing profiles associated with other emotional disorders.…

  7. Treatment of Complicated Grief Using Virtual Reality: A Case Report

    ERIC Educational Resources Information Center

    Botella, C.; Osma, J.; Palacios, A. Garcia; Guillen, V.; Banos, R.

    2008-01-01

    This is the first work exploring the application of new technologies, concretely virtual reality, to facilitate emotional processing in the treatment of Complicated Grief. Our research team has designed a virtual reality environment (EMMA's World) to foster the expression and processing of emotions. In this study the authors present a description…

  8. Phenomenology and Correlates of Complicated Grief in Children and Adolescents

    ERIC Educational Resources Information Center

    Melhem, Nadine M.; Moritz, Grace; Walker, Monica; Shear, M. Katherine; Brent, David

    2007-01-01

    Objective: To describe the phenomenology of complicated grief (CG) in parentally bereaved children and adolescents and to examine its correlates. Method: This is a preliminary report from an ongoing 5-year, population-based, longitudinal study of the impact of parental loss on family members. Analyses of cross-sectional data at intake are…

  9. Predictors of Complicated Grief: A Systematic Review of Empirical Studies

    ERIC Educational Resources Information Center

    Lobb, Elizabeth A.; Kristjanson, Linda J.; Aoun, Samar M.; Monterosso, Leanne; Halkett, Georgia K. B.; Davies, Anna

    2010-01-01

    A systematic review of the literature on predictors of complicated grief (CG) was undertaken with the aim of clarifying the current knowledge and to inform future planning and work in CG following bereavement. Predictors of CG prior to the death include previous loss, exposure to trauma, a previous psychiatric history, attachment style, and the…

  10. Treatment of Complicated Grief Using Virtual Reality: A Case Report

    ERIC Educational Resources Information Center

    Botella, C.; Osma, J.; Palacios, A. Garcia; Guillen, V.; Banos, R.

    2008-01-01

    This is the first work exploring the application of new technologies, concretely virtual reality, to facilitate emotional processing in the treatment of Complicated Grief. Our research team has designed a virtual reality environment (EMMA's World) to foster the expression and processing of emotions. In this study the authors present a description…

  11. Facets of Pejorative Self-Processing in Complicated Grief

    ERIC Educational Resources Information Center

    Golden, Ann-Marie J.; Dalgleish, Tim

    2012-01-01

    Objective: Complicated grief (CG) has been proposed as a psychiatric response to bereavement distinct from established mood and anxiety disorder diagnoses. Little is known about the nature of cognitive-affective processing in CG, nor any similarities or differences compared with the processing profiles associated with other emotional disorders.…

  12. [Bereavement and complicated grief: towards a definition of Prolonged Grief Disorder for DSM-5].

    PubMed

    Lombardo, Luigi; Lai, Carlo; Luciani, Massimiliano; Morelli, Emanuela; Buttinelli, Elena; Aceto, Paola; Lai, Silvia; D'Onofrio, Marianna; Galli, Federico; Bellizzi, Fernando; Penco, Italo

    2014-01-01

    Mourning is a natural response to a loss and a condition which most people experience several times during their lives. Most individuals adjust adequately to the loss of a relative, neverthless, a small but noteworthy proportion of bereaved individuals experience a syndrome of prolonged psychological distress in relation to bereavement. Prolonged distress and disability in connection with bereavement has been termed Complicated Grief (CG) or Prolonged Grief Disorder (PGD). The purpose of this paper is to analyze the literature on loss and mourning making a review of the main studies published between 1993 and 2013, identified through a search conducted on Medline/PubMed, in order to describe the epidemiological and clinical aspects of "normal" grief and "complicated" grief, pointing out the path of the clinical definition of PGD and proposed diagnostic criteria for inclusion in the next edition of the Diagnostic and Statistic Manual of Mental Disorders, Fifth edition (DSM-5). The two main diagnostic systems proposed by Horowitz and Prigerson are also compared.

  13. Complicated grief after suicide bereavement and other causes of death.

    PubMed

    Tal, Ilanit; Mauro, Christine; Reynolds, Charles F; Shear, M Katherine; Simon, Naomi; Lebowitz, Barry; Skritskaya, Natalia; Wang, Yuanjia; Qiu, Xin; Iglewicz, Alana; Glorioso, Danielle; Avanzino, Julie; Wetherell, Julie Loebach; Karp, Jordan F; Robinaugh, Don; Zisook, Sidney

    2016-11-28

    The authors compared baseline demographic characteristics, clinical features, and grief-related thoughts, feelings, and behaviors of individuals bereaved by suicide, accident/homicide and natural causes participating in a complicated grief (CG) treatment clinical trial. Severity of CG and depression and current depression diagnosis did not vary by loss type. After adjusting for baseline demographic features, time since death and relationship to the deceased, those with CG after suicide had the highest rates of lifetime depression, preloss passive suicidal ideation, self-blaming thoughts, and impaired work and social adjustment. Even among this treatment-seeking sample of research participants with CG, suicide survivors may face unique challenges.

  14. The Grief Evaluation Measure (GEM): An Initial Validation Study

    ERIC Educational Resources Information Center

    Jordan, John R.; Baker, John; Matteis, Margherite; Rosenthal, Saul; Ware, Eugenia S.

    2005-01-01

    This article describes the development of the Grief Evaluation Measure (GEM), a new instrument designed to screen for the development of a complicated mourning response in a bereaved adult. The GEM provides a quantitative and qualitative assessment of risk factors, including the mourner's loss and medical history, coping resources before and after…

  15. The Grief Evaluation Measure (GEM): An Initial Validation Study

    ERIC Educational Resources Information Center

    Jordan, John R.; Baker, John; Matteis, Margherite; Rosenthal, Saul; Ware, Eugenia S.

    2005-01-01

    This article describes the development of the Grief Evaluation Measure (GEM), a new instrument designed to screen for the development of a complicated mourning response in a bereaved adult. The GEM provides a quantitative and qualitative assessment of risk factors, including the mourner's loss and medical history, coping resources before and after…

  16. Assessment of Emotional Experience and Emotional Recognition in Complicated Grief

    PubMed Central

    Fernández-Alcántara, Manuel; Cruz-Quintana, Francisco; Pérez-Marfil, M. N.; Catena-Martínez, Andrés; Pérez-García, Miguel; Turnbull, Oliver H.

    2016-01-01

    There is substantial evidence of bias in the processing of emotion in people with complicated grief (CG). Previous studies have tended to assess the expression of emotion in CG, but other aspects of emotion (mainly emotion recognition, and the subjective aspects of emotion) have not been addressed, despite their importance for practicing clinicians. A quasi-experimental design with two matched groups (Complicated Grief, N = 24 and Non-Complicated Grief, N = 20) was carried out. The Facial Expression of Emotion Test (emotion recognition), a set of pictures from the International Affective Picture System (subjective experience of emotion) and the Symptom Checklist 90 Revised (psychopathology) were employed. The CG group showed lower scores on the dimension of valence for specific conditions on the IAPS, related to the subjective experience of emotion. In addition, they presented higher values of psychopathology. In contrast, statistically significant results were not found for the recognition of emotion. In conclusion, from a neuropsychological point of view, the subjective aspects of emotion and psychopathology seem central in explaining the experience of those with CG. These results are clinically significant for psychotherapists and psychoanalysts working in the field of grief and loss. PMID:26903928

  17. Internet-Based Exposure and Behavioral Activation for Complicated Grief and Rumination: A Randomized Controlled Trial.

    PubMed

    Eisma, Maarten C; Boelen, Paul A; van den Bout, Jan; Stroebe, Wolfgang; Schut, Henk A W; Lancee, Jaap; Stroebe, Margaret S

    2015-11-01

    This study examined the effectiveness and feasibility of therapist-guided Internet-delivered exposure (EX) and behavioral activation (BA) for complicated grief and rumination. Forty-seven bereaved individuals with elevated levels of complicated grief and grief rumination were randomly assigned to three conditions: EX (N=18), BA (N=17), or a waiting-list (N=12). Treatment groups received 6 homework assignments over 6 to 8weeks. Intention-to-treat analyses showed that EX reduced complicated grief, posttraumatic stress, depression, grief rumination, and brooding levels relative to the control group at posttreatment (d=0.7-1.2). BA lowered complicated grief, posttraumatic stress, and grief rumination levels at posttreatment (d=0.8-0.9). At 3-month follow-up, effects of EX were maintained on complicated grief and grief rumination (d=0.6-1.2), and for BA on complicated grief, posttraumatic stress, and grief rumination (d=0.8-0.9). EX reduced depression more strongly than BA (d=0.6). Completers analyses corroborated results for EX, and partially those for BA, but no group differences were detected. BA suffered from high dropout (59%), relative to EX (33%) and the waiting-list (17%). Feasibility appeared higher for EX than BA. Results supported potential applicability of online exposure but not behavioral activation to decrease complicated grief and rumination. Copyright © 2015. Published by Elsevier Ltd.

  18. Treatment for complicated grief: state of the science and ways forward.

    PubMed

    Doering, Bettina K; Eisma, Maarten C

    2016-09-01

    There is increasing recognition that a minority of bereaved persons experiences persistent and disabling grief symptoms, also termed complicated grief. We review currently proposed criteria for complicated grief in the Diagnostic and Statistical Manual of Mental Disorders (DSM 5) and the International Statistical Classification of Diseases and Related Health Problems (ICD-11), highlight controversies with regard to establishing complicated grief as a psychiatric disorder, summarize recent complicated grief treatment research within a cognitive behavioral treatment framework, and establish a novel and systematic research agenda for complicated grief treatment. Clinicians should be wary of overdiagnosis and misdiagnosis of complicated grief. Recent changes to definitions of complicated grief may threaten generalizability and clinical application of research findings. Universal treatment, treatment for at-risk groups and preventive complicated grief treatment appear ineffective. Although medication is often prescribed to bereaved persons, evidence for its effectiveness is equivocal. Face-to-face and internet-based cognitive behavioral therapy techniques appear most effective in targeting complicated grief. However, little is known about what, how, and for whom treatment works best. In light of these findings, we recommend systematic investigation of: what works best in complicated grief treatment, by conducting well designed, stepped effectiveness trials and treatment component dismantling studies; how it works, by conducting investigations on therapeutic theories and examining mediators of therapeutic change; and for whom it works, by examining potential moderators of treatment effects.

  19. [Clinical case: Complicated grief in primary care. Care plan].

    PubMed

    Ruymán Brito-Brito, Pedro; Rodríguez-Ramos, Mercedes; Pérez-García-Talavera, Carlos

    2009-01-01

    This is the case of a 61-year-old patient woman that visits her nurse in Primary Health Care to get the control of blood pressure and glycemia. In the last two years has suffered the loss of her husband and of two brothers beside having lived through other vital stressful events that have taken her to a situation of complicated grief. The care plan is realized using the M. Gordon assessment system and standardized languages NANDA, NOC and NIC. The principal aims were the improvement of the depression level and the improvement in the affliction resolution. As suggested interventions were proposed to facilitate the grief and the derivation to a mental health unit. A follow-up of the patient was realized in nursing consultation at Primary health care to weekly intervals, in the beginning, and monthly, later. The evaluation of the care plan reflects an improvement in the criteria of Prigerson's complicated grief; an increase of the recreative activities; the retreat of the mourning that still she was guarding; as well as an improvement in the control of the blood pressure numbers. The attention of nurses before a case of complicated grief turns out to be complex. Nevertheless the suitable accomplishment of certain interventions orientated to facilitating the grief, with a follow-up in consultation, shows the efficiency. The difficulty in the boarding of the psychosocial problems meets increased at the moment of are necessary the nursing diagnostics adapted for every individual case. The work in group between nurses could improves the consensus.

  20. Grief and its complications in individuals with intellectual disability.

    PubMed

    Brickell, Claire; Munir, Kerim

    2008-01-01

    Bereavement and loss have significant impact on the lives of individuals with intellectual disability (ID). Although there is a growing impetus to define the symptoms of grief that predict long-term functional impairment, little is known about maladaptive grieving among individuals with ID. We examine the literature concerning the phenomenology of traumatic grief (TG) in the general population, along with what is known about the manifestations of grief in individuals with ID. We then apply modern theories of grief and grief resolution to individuals with ID in order to highlight potential areas of vulnerability in this population and to lay the groundwork for interventions that will facilitate their adaptation to loss. We provide a theoretical framework for the proposition that individuals (including children and adults) with ID are more susceptible to TG, based on an increased risk of secondary loss, barriers to communicating about the loss, and difficulty finding meaning in the loss. We conclude that individuals with ID should be considered as potential candidates for targeted bereavement interventions. Further research is required, however, in order to develop population-appropriate measurement scales for testing these hypotheses.

  1. Grief and its Complications in Individuals with Intellectual Disability

    PubMed Central

    Brickell, Claire; Munir, Kerim

    2011-01-01

    Bereavement and loss have significant impact on the lives of individuals with intellectual disability (ID). Although there is a growing impetus to define the symptoms of grief that predict long-term functional impairment, little is known about maladaptive grieving among individuals with ID. We examine the literature concerning the phenomenology of traumatic grief (TG) in the general population, along with what is known about the manifestations of grief in individuals with ID. We then apply modern theories of grief and grief resolution to individuals with ID in order to highlight potential areas of vulnerability in this population and to lay the groundwork for interventions that will facilitate their adaptation to loss. We provide a theoretical framework for the proposition that individuals (including children and adults) with ID are more susceptible to TG, based on an increased risk of secondary loss, barriers to communicating about the loss, and difficulty finding meaning in the loss. We conclude that individuals with ID should be considered as potential candidates for targeted bereavement interventions. Further research is required, however, in order to develop population-appropriate measurement scales for testing these hypotheses. PMID:18306095

  2. Continuing Bonds, Risk Factors for Complicated Grief, and Adjustment to Bereavement

    ERIC Educational Resources Information Center

    Field, Nigel P.; Filanosky, Charles

    2010-01-01

    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…

  3. Continuing Bonds, Risk Factors for Complicated Grief, and Adjustment to Bereavement

    ERIC Educational Resources Information Center

    Field, Nigel P.; Filanosky, Charles

    2010-01-01

    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…

  4. "Posthumous disillusionment" as a type of complicated grief.

    PubMed

    Stalfa, Frank J

    2010-01-01

    This article develops a theoretical concept that delineates the experience of disillusionment toward a deceased loved-one during the grieving process. Through clinical anecdote, film and autobiography, possible therapeutic initiatives are identified which may provide pastoral and clinical approaches to assist those whose grief is complicated by distressing and unexpected revelations requiring a reevaluation of their relationship with the loved-one who has died.

  5. Outcomes of bereavement care among widowed older adults with complicated grief and depression.

    PubMed

    Ghesquiere, Angela; Shear, M Katherine; Duan, Naihua

    2013-10-01

    Bereavement is common among older adults and may result in major depression or complicated grief (CG). Little is known about the effectiveness of physician care for these conditions. We examined whether, among older adults with CG and/or major depression, using physician support was associated with reductions in grief, depression, or anxiety severity. Outcomes were compared to group and religious support. We analyzed data from the Changing Lives of Older Couples (CLOC) Study, a prospective cohort study of married couples in the Detroit area. Spousal death was tracked over 5 years, and follow-up interviews conducted with widowed participants at 6 months (wave 1) and 18 months (wave 2) post loss. Analyses were limited to those with CG or depression with support-seeking data (weighted n = 89). Yes/no items asked whether participants had seen each provider for help with grief up until wave 1. A 19-item grief severity measure was developed by CLOC researchers. The 20-item Center for Epidemiologic Studies Depression scale measured depression severity. The Symptom Checklist 90-Revised assessed anxiety severity. Regressions indicated that seeking support from a family doctor at wave 1 was not associated with changes in anxiety, depression, or grief severity at wave 2 (P > .05). However, support group use was associated with reductions in grief severity (β = -8.46, P < .05), and religious leader support-seeking associated with reductions in depression severity (β = -10.12, P < .01). Findings imply that physician care for grief may not be effective, and support group referral may be helpful. Physicians may benefit from training in recognizing and appropriate referring for bereavement-related distress.

  6. Outcomes of Bereavement Care Among Widowed Older Adults With Complicated Grief and Depression

    PubMed Central

    Ghesquiere, Angela; Shear, M. Katherine; Duan, Naihua

    2014-01-01

    Bereavement is common among older adults and may result in major depression or complicated grief (CG). Little is known about the effectiveness of physician care for these conditions. We examined whether, among older adults with CG and/or major depression, using physician support was associated with reductions in grief, depression, or anxiety severity. Outcomes were compared to group and religious support. We analyzed data from the Changing Lives of Older Couples (CLOC) Study, a prospective cohort study of married couples in the Detroit area. Spousal death was tracked over 5 years, and follow-up interviews conducted with widowed participants at 6 months (wave 1) and 18 months (wave 2) post loss. Analyses were limited to those with CG or depression with support-seeking data (weighted n = 89). Yes/no items asked whether participants had seen each provider for help with grief up until wave 1. A 19-item grief severity measure was developed by CLOC researchers. The 20-item Center for Epidemiologic Studies Depression scale measured depression severity. The Symptom Checklist 90–Revised assessed anxiety severity. Regressions indicated that seeking support from a family doctor at wave 1 was not associated with changes in anxiety, depression, or grief severity at wave 2 (P > .05). However, support group use was associated with reductions in grief severity (β = −8.46, P < .05), and religious leader support-seeking associated with reductions in depression severity (β = −10.12, P < .01). Findings imply that physician care for grief may not be effective, and support group referral may be helpful. Physicians may benefit from training in recognizing and appropriate referring for bereavement-related distress. PMID:23799667

  7. Continuing bonds, risk factors for complicated grief, and adjustment to bereavement.

    PubMed

    Field, Nigel P; Filanosky, Charles

    2010-01-01

    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.

  8. Grief

    MedlinePlus

    American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders . 5th ed. Arlington, VA: American Psychiatric Publishing. 2013. Powell AD. Grief, bereavement, and adjustment disorders. ...

  9. Complicated Grief & Depression in Young Adults: Personality & Relationship Quality

    PubMed Central

    Herberman Mash, Holly B.; Fullerton, Carol S.; Shear, M. Katherine; Ursano, Robert J.

    2014-01-01

    Young adults experience problematic responses to loss more often than is commonly recognized. Few empirical studies have examined the contribution of intra- and interpersonal characteristics to grief and depression in bereaved young adults. This study investigated the association of dependency and quality of the relationship with the deceased (i.e., depth and conflict) with complicated grief (CG) and depression. Participants were 157 young adults aged 17–29 who experienced loss of a family member or close friend within the past three years (M = 1.74 years). Participants completed the Inventory of Complicated Grief, Beck Depression Inventory, Depth and Conflict subscales of the Quality of Relationships Inventory, and the Dependency subscale of the Depressive Experiences Questionnaire. Relationships among dependency and interpersonal depth and conflict and CG and depression were examined through analyses of covariance. Sixteen percent of participants met criteria for CG and 34% had mild to severe depression. Dependency and depth were independently related to CG and dependency was related to depression, but the pattern of associations was somewhat different for each outcome. Greater depth was associated with CG, at both high and low levels of dependency. High levels of dependency were related to more depressive symptoms. Interpretation of the findings is limited by the relatively small sample size and cross-sectional design. CG and depression are related but distinct responses to loss. Although dependency is associated with both CG and depression following loss, relationships between the bereaved and deceased that are characterized by high levels of depth are particularly related to the development of CG symptoms. PMID:24921421

  10. A Nationwide Random Sampling Survey of Potential Complicated Grief in Japan

    ERIC Educational Resources Information Center

    Mizuno, Yasunao; Kishimoto, Junji; Asukai, Nozomu

    2012-01-01

    To investigate the prevalence of significant loss, potential complicated grief (CG), and its contributing factors, we conducted a nationwide random sampling survey of Japanese adults aged 18 or older (N = 1,343) using a self-rating Japanese-language version of the Complicated Grief Brief Screen. Among them, 37.0% experienced their most significant…

  11. Internet-Based Cognitive-Behavioral Therapy for Complicated Grief: A Randomized Controlled Trial

    ERIC Educational Resources Information Center

    Wagner, Birgit; Knaevelsrud, Christine; Maercker, Andreas

    2006-01-01

    The present study investigates the efficacy of an Internet-based cognitive-behavioral therapy program for bereaved people suffering complicated grief. The program combines established methods of psychotherapy with new technology--therapists and patients communicated exclusively by e-mail. Bereaved individuals diagnosed with complicated grief (n =…

  12. Internet-Based Cognitive-Behavioral Therapy for Complicated Grief: A Randomized Controlled Trial

    ERIC Educational Resources Information Center

    Wagner, Birgit; Knaevelsrud, Christine; Maercker, Andreas

    2006-01-01

    The present study investigates the efficacy of an Internet-based cognitive-behavioral therapy program for bereaved people suffering complicated grief. The program combines established methods of psychotherapy with new technology--therapists and patients communicated exclusively by e-mail. Bereaved individuals diagnosed with complicated grief (n =…

  13. A Nationwide Random Sampling Survey of Potential Complicated Grief in Japan

    ERIC Educational Resources Information Center

    Mizuno, Yasunao; Kishimoto, Junji; Asukai, Nozomu

    2012-01-01

    To investigate the prevalence of significant loss, potential complicated grief (CG), and its contributing factors, we conducted a nationwide random sampling survey of Japanese adults aged 18 or older (N = 1,343) using a self-rating Japanese-language version of the Complicated Grief Brief Screen. Among them, 37.0% experienced their most significant…

  14. Disrupted Prefrontal Activity during Emotion Processing in Complicated Grief: an fMRI Investigation

    PubMed Central

    Arizmendi, Brian; Kaszniak, Alfred W.; O’Connor, Mary-Frances

    2015-01-01

    Complicated Grief, marked by a persistent and intrusive grief lasting beyond the expected period of adaptation, is associated with a relative inability to disengage from idiographic loss-relevant stimuli (O’Connor & Arizmendi, 2014). In other populations, functional magnetic resonance imaging (fMRI) studies investigating the neural networks associated with this bias consistently implicate the anterior cingulate cortex (ACC) during emotion regulation. In the present study, twenty-eight older adults were categorized into three groups based on grief severity: Complicated Grief (n=8), Non-Complicated Grief (n=9), and Nonbereaved, married controls (n=11). Using a block design, all participants completed 8 blocks (20 stimuli per block) of the ecStroop task during fMRI data acquisition. Differences in neural activity during grief-related (as opposed to neutral) stimuli across groups were examined. Those with Complicated Grief showed an absence of increased rostral ACC (rACC) and fronto-cortical recruitment relative to Nonbereaved controls. Activity in the orbitofrontal cortex (x=6, y=54, z=−10) was significantly elevated in the Non-Complicated Grief group when compared to Nonbereaved controls. Post hoc analysis evidenced activity in the dorsal ACC in the Complicated Grief and Nonbereaved groups late in the task. These findings, supported by behavioral data, suggest a relative inability to recruit the regions necessary for successful completion of this emotional task in those with Complicated Grief. This deficit was not observed in recruitment of the orbitofrontal cortex and the rACC during processing of idiographic semantic stimuli in Non-Complicated Grief. PMID:26434802

  15. Disrupted prefrontal activity during emotion processing in complicated grief: An fMRI investigation.

    PubMed

    Arizmendi, Brian; Kaszniak, Alfred W; O'Connor, Mary-Frances

    2016-01-01

    Complicated Grief, marked by a persistent and intrusive grief lasting beyond the expected period of adaptation, is associated with a relative inability to disengage from idiographic loss-relevant stimuli (O'Connor and Arizmendi, 2014). In other populations, functional magnetic resonance imaging (fMRI) studies investigating the neural networks associated with this bias consistently implicate the anterior cingulate cortex (ACC) during emotion regulation. In the present study, twenty-eight older adults were categorized into three groups based on grief severity: Complicated Grief (n=8), Non-Complicated Grief (n=9), and Nonbereaved, married controls (n=11). Using a block design, all participants completed 8 blocks (20 stimuli per block) of the ecStroop task during fMRI data acquisition. Differences in neural activity during grief-related (as opposed to neutral) stimuli across groups were examined. Those with Complicated Grief showed an absence of increased rostral ACC (rACC) and fronto-cortical recruitment relative to Nonbereaved controls. Activity in the orbitofrontal cortex (x=6, y=54, z=-10) was significantly elevated in the Non-Complicated Grief group when compared to Nonbereaved controls. Post hoc analysis evidenced activity in the dorsal ACC in the Complicated Grief and Nonbereaved groups late in the task. These findings, supported by behavioral data, suggest a relative inability to recruit the regions necessary for successful completion of this emotional task in those with Complicated Grief. This deficit was not observed in recruitment of the orbitofrontal cortex and the rACC during processing of idiographic semantic stimuli in Non-Complicated Grief. Copyright © 2015 Elsevier Inc. All rights reserved.

  16. Exploring Outcomes Related to Anxiety and Depression in Completers of a Randomized Controlled Trial of Complicated Grief Treatment.

    PubMed

    Glickman, Kim; Shear, M Katherine; Wall, Melanie

    2016-01-01

    The present study examines a more fine-grained analysis of anxiety-related and depression-related outcomes amongst a sample of treatment completers who were assigned to complicated grief treatment (CGT) (n = 35) or interpersonal psychotherapy (IPT) (n = 34) in a previously reported randomized controlled trial. We examined effects of antidepressant use and measures of anxiety and depression, focusing especially on guilt related to the death or deceased and grief-related avoidance in order to further understand the differential effectiveness of CGT and IPT amongst participants who received the full course of treatment. Analyses showed that CGT produced greater reductions in anxiety and depressive symptoms including negative thoughts about the future and grief-related avoidance. CGT's advantage over IPT in lowering depression was most pronounced amongst those not taking antidepressants. Our results further elucidate CGT effects and support the idea that CG and major depressive disorder are distinct conditions. Targeted treatment for complicated grief (CG) produces benefits in associated mood and anxiety symptoms and CG symptoms. Amongst patients with CG, interpersonal psychotherapy seems relatively ineffective in ameliorating depressive symptoms. Grief-related depressive symptoms may not respond to standard treatments unless CG symptoms are also addressed. Reducing grief-related symptoms, such as anxieties about the future, guilt related to the death or deceased and avoidance of reminders of the loss may be important aspects in reducing CG. Copyright © 2014 John Wiley & Sons, Ltd.

  17. An initial assessment of the psychometric properties of the Complicated Grief Questionnaire for People with Intellectual Disabilities (CGQ-ID).

    PubMed

    Guerin, Suzanne; Dodd, Philip; Tyrell, Janette; McEvoy, John; Buckley, Sarah; Hillery, John

    2009-01-01

    Given the research evidence that people with intellectual disability (ID) do grieve following bereavement, the present study aimed to describe and gather preliminary psychometric data for a version of the Inventory of Complicated Grief [Prigerson, H. G., Maciejewski, P. K., Reynolds, C. F., Bierhals, A. J., Newsom, J. T., Fasiczka, A., et al. (1995). Inventory of Complicated Grief: A scale to measure maladaptive symptoms of loss. Psychiatry Research, 59, 65-79] adapted for use with this population. Carers completed the Complicated Grief Questionnaire for People with ID (CGQ-ID) for 76 individuals with ID, half of whom had experienced a parental bereavement within the last 2 years. The final scale and subscales (Separation Distress and Traumatic Grief) showed very good internal and inter-rater reliability and distinguished between the two groups. While the findings suggest that the CGQ-ID is suitable for identifying complicated grief-type symptoms among adults with ID, further research must be conducted to ascertain whether the findings can be replicated.

  18. A Study of Complicated Grief Symptoms in People with Intellectual Disabilities

    ERIC Educational Resources Information Center

    Dodd, P.; Guerin, S.; McEvoy, J.; Buckley, S.; Tyrrell, J.; Hillery, J.

    2008-01-01

    Introduction: Previous studies have shown a significant association between familial bereavement and the onset of challenging behaviours and psychopathology in people with intellectual disabilities (ID). However, little work has been done to accurately describe the specific symptoms of grief, in particular symptoms of complicated grief in this…

  19. A Study of Complicated Grief Symptoms in People with Intellectual Disabilities

    ERIC Educational Resources Information Center

    Dodd, P.; Guerin, S.; McEvoy, J.; Buckley, S.; Tyrrell, J.; Hillery, J.

    2008-01-01

    Introduction: Previous studies have shown a significant association between familial bereavement and the onset of challenging behaviours and psychopathology in people with intellectual disabilities (ID). However, little work has been done to accurately describe the specific symptoms of grief, in particular symptoms of complicated grief in this…

  20. Effects of psychoeducation on helpful support for complicated grief: a preliminary randomized controlled single-blind study.

    PubMed

    Nam, I S

    2016-01-01

    Complicated grief is a distinct psychological response of individuals facing the loss of a loved one and can lead to many types of adverse health outcomes. Although social support may be beneficial, few studies have examined the beneficial effects of helpful support on complicated grief following bereavement. A randomized controlled trial was conducted. Bereaved participants and supporters were randomized to psychoeducation on complicated grief and helpful social support or psychoeducation on complicated grief. The primary outcome was the Inventory of Complicated Grief. The results showed that psychoeducation of supporters of bereaved individuals has significant beneficial effects. Particularly, symptoms of complicated grief were decreased in bereaved individuals with supporters that received psychoeducation. The results highlight the potential of psychoeducation to facilitate helpful social support and reduce complicated grief.

  1. Avoidance processes mediate the relationship between rumination and symptoms of complicated grief and depression following loss.

    PubMed

    Eisma, Maarten C; Stroebe, Margaret S; Schut, Henk A W; Stroebe, Wolfgang; Boelen, Paul A; van den Bout, Jan

    2013-11-01

    Ruminative coping has been associated with negative outcomes in bereavement. Rather than assuming it to be a problematic confrontation process, researchers have recently suggested rumination to be maladaptive through its links with avoidance processes. The main aim of this study was to examine, for the first time, whether the relationship between ruminative coping and symptoms of complicated grief and depression is mediated by avoidance processes (suppression, memory/experiential avoidance, behavioral avoidance, loss-reality avoidance). A sample of 282 adults (88% female, 12% male), bereaved on average 18 months previously, filled out three questionnaires at 6-month intervals. We assessed symptom levels, grief rumination, and trait rumination at baseline; avoidance processes after 6 months; and symptom levels after 12 months. When controlling for initial symptom levels, experiential avoidance mediated the link between grief rumination and complicated grief, and experiential avoidance and behavioral avoidance mediated the link between grief rumination and depression. Post hoc analyses showed suppression may also mediate the link between grief rumination and symptoms of complicated grief, but not depression. Loss-reality avoidance was no significant mediator of these relationships. This study provides initial evidence that rumination during bereavement increases and perpetuates symptoms of psychopathology, because it is linked with specific avoidance processes. Bereaved individuals with problematic grief and (chronic) rumination may benefit from therapy focused on countering avoidance tendencies. PsycINFO Database Record (c) 2013 APA, all rights reserved.

  2. The special case of complicated grief in women at high risk for breast cancer.

    PubMed

    Wellisch, David K; Cohen, Marie M

    2010-03-01

    Exploration of complicated grief focusing on the relationship of post-traumatic stress disorder (PTSD) and complicated grief in a population of women at high risk for developing breast cancer. Special reference is made to women who have experienced a material death. We reflected on the clinical attributes of the Revlon UCLA High Risk Clinic population in terms of their own perceived risk of developing breast cancer. For part of our population, their perceived risk was coupled with their reactions to the loss of their mothers to breast cancer. We compared and contrasted this pattern of reactions to those described by Licihtenthal et al. (2004) in their developmental review of complicated grief as a distinct disorder. We concluded that our population of women differed from Lichtenthal et al.'s (2004) model for complicated grief. Lichtenthal's group postulated that the key element of complicated grief involves the protracted nature of separation anxiety and distress and excludes PTSD. In our populations, the daughter with complicated grief experiences a combination of separation anxiety and a type of PTSD involving anxiety over the perceived certainty of her own future diagnosis of breast cancer. It was noteworthy that Lichtenthal's model population was composed of individuals caring for terminally ill spouses. Significantly, the spousal caretakers did not have an ongoing genetic link to their partners whereas our population is genetically linked. We postulate that this accounts for the unique presentation of complicated grief and ptsd in our population. We submit that this combination of complicated grief and PTSD requires a cognitive reframing of their perceived inevitability of developing breast cancer and desensitization techniques to help high risk women pursue preventative health care rather than avoiding it.

  3. Complicated grief after death of a relative in the intensive care unit.

    PubMed

    Kentish-Barnes, Nancy; Chaize, Marine; Seegers, Valérie; Legriel, Stéphane; Cariou, Alain; Jaber, Samir; Lefrant, Jean-Yves; Floccard, Bernard; Renault, Anne; Vinatier, Isabelle; Mathonnet, Armelle; Reuter, Danielle; Guisset, Olivier; Cohen-Solal, Zoé; Cracco, Christophe; Seguin, Amélie; Durand-Gasselin, Jacques; Éon, Béatrice; Thirion, Marina; Rigaud, Jean-Philippe; Philippon-Jouve, Bénédicte; Argaud, Laurent; Chouquer, Renaud; Adda, Mélanie; Dedrie, Céline; Georges, Hugues; Lebas, Eddy; Rolin, Nathalie; Bollaert, Pierre-Edouard; Lecuyer, Lucien; Viquesnel, Gérard; Léone, Marc; Chalumeau-Lemoine, Ludivine; Garrouste, Maïté; Schlemmer, Benoit; Chevret, Sylvie; Falissard, Bruno; Azoulay, Élie

    2015-05-01

    An increased proportion of deaths occur in the intensive care unit (ICU). We performed this prospective study in 41 ICUs to determine the prevalence and determinants of complicated grief after death of a loved one in the ICU. Relatives of 475 adult patients were followed up. Complicated grief was assessed at 6 and 12 months using the Inventory of Complicated Grief (cut-off score >25). Relatives also completed the Hospital Anxiety and Depression Scale at 3 months, and the Revised Impact of Event Scale for post-traumatic stress disorder symptoms at 3, 6 and 12 months. We used a mixed multivariate logistic regression model to identify determinants of complicated grief after 6 months. Among the 475 patients, 282 (59.4%) had a relative evaluated at 6 months. Complicated grief symptoms were identified in 147 (52%) relatives. Independent determinants of complicated grief symptoms were either not amenable to changes (relative of female sex, relative living alone and intensivist board certification before 2009) or potential targets for improvements (refusal of treatment by the patient, patient died while intubated, relatives present at the time of death, relatives did not say goodbye to the patient, and poor communication between physicians and relatives). End-of-life practices, communication and loneliness in bereaved relatives may be amenable to improvements. Copyright ©ERS 2015.

  4. Parental control, partner dependency, and complicated grief among widowed adults in the community.

    PubMed

    Johnson, Jeffrey G; Zhang, Baohui; Greer, Joseph A; Prigerson, Holly G

    2007-01-01

    Data from the Yale Bereavement Study, a community-based longitudinal study, were used to investigate the association of 192 widowed individuals' recollections of parenting affection and control during childhood with dependency on the deceased spouse and the development of severe grief symptoms following bereavement. The hypothesis that dependency on the deceased spouse mediates the association of parental affection and control during childhood with the development of severe grief following bereavement was investigated. Findings indicated that a high level of perceived parental control during childhood was associated with elevated levels of dependency on the deceased spouse and with symptoms of complicated grief. Dependency on the deceased spouse mediated the association of perceived parental control with the development of complicated grief following bereavement.

  5. Randomised controlled trial of a cognitive narrative intervention for complicated grief in widowhood.

    PubMed

    Barbosa, Virginia; Sá, Mónica; Carlos Rocha, José

    2014-01-01

    The implementation of bereavement interventions is frequently requested, and its effectiveness has been controversial. The aim of this study is to evaluate the effectiveness of a cognitive narrative intervention for complicated grief (CG) for controlling post-traumatic and depressive issues. The study is a randomised controlled trial and uses the Socio Demographic Questionnaire (SDQ), the Inventory of Complicated Grief (ICG), the Beck Depression Inventory (BDI) and the Impact of Events Scale-Revised (IES-R). There were three phases in the study: (1) The SDQ and CG evaluations were applied to bereaved elders (n = 82). The bereaved elders with the 40 highest ICG values (≥25) were randomly allocated into two groups: the intervention group (n = 20) and control group (n = 20); (2) participants were evaluated using the BDI and IES-R and the IG gave informed consent to participate in an intervention with four weekly 60-min sessions addressing recall, emotional and cognitive subjectivation, metaphorisation and projecting. (3) Two months later, the ICG, BDI and IES-R assessments were repeated. Outcome measures showed a statistically significant reduction of CG, depressive and traumatic symptoms compared to the controls. Very high effect sizes for the ICG, BDI and IES-R reflect the effectiveness of the intervention along the longitudinal profile. These results reinforce the importance of brief interventions that combine a reduced number of sessions with lower costs, which is reflected in an increased adherence to the programme along with high effectiveness.

  6. Death by request in Switzerland: posttraumatic stress disorder and complicated grief after witnessing assisted suicide.

    PubMed

    Wagner, B; Müller, J; Maercker, A

    2012-10-01

    Despite continuing political, legal and moral debate on the subject, assisted suicide is permitted in only a few countries worldwide. However, few studies have examined the impact that witnessing assisted suicide has on the mental health of family members or close friends. A cross-sectional survey of 85 family members or close friends who were present at an assisted suicide was conducted in December 2007. Full or partial Post-Traumatic Distress Disorder (PTSD; Impact of Event Scale-Revised), depression and anxiety symptoms (Brief Symptom Inventory) and complicated grief (Inventory of Complicated Grief) were assessed at 14 to 24 months post-loss. Of the 85 participants, 13% met the criteria for full PTSD (cut-off≥35), 6.5% met the criteria for subthreshold PTSD (cut-off≥25), and 4.9% met the criteria for complicated grief. The prevalence of depression was 16%; the prevalence of anxiety was 6%. A higher prevalence of PTSD and depression was found in the present sample than has been reported for the Swiss population in general. However, the prevalence of complicated grief in the sample was comparable to that reported for the general Swiss population. Therefore, although there seemed to be no complications in the grief process, about 20% of respondents experienced full or subthreshold PTSD related to the loss of a close person through assisted suicide. Copyright © 2010 Elsevier Masson SAS. All rights reserved.

  7. Complicated grief and bereavement in young adults following close friend and sibling loss.

    PubMed

    Herberman Mash, Holly B; Fullerton, Carol S; Ursano, Robert J

    2013-12-01

    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. 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). 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. 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. © 2013 Wiley Periodicals, Inc.

  8. Factorial structure of complicated grief: associations with loss-related traumatic events and psychosocial impacts of mass conflict amongst West Papuan refugees.

    PubMed

    Tay, Alvin Kuowei; Rees, Susan; Chen, Jack; Kareth, Moses; Silove, Derrick

    2016-03-01

    Definitions of complicated grief vary across diagnostic systems, being represented as persistent complex bereavement (PCB) in DSM-5 and prolonged grief disorder (PGD) in the proposed revision of the ICD system. A past study in a high-income country has identified a six-factor structure for complicated grief, but there are no data testing this or any other model across cultures. The present study reports findings from a survey amongst West Papuan refugees (n = 230, response rate = 92 %) residing in Port Moresby, Papua New Guinea. We applied culturally adapted measures of conflict-related traumatic event (TEs) (drawing specifically on domains of conflict and loss), symptoms of complicated grief adapted and modified to the culture, and a multidimensional psychosocial index of the broader effects of conflict and displacement. Confirmatory factor analysis yielded a single higher order construct of complicated grief comprising six factors of yearning/preoccupation; shock/disbelief; anger/negative appraisal; behavioural change; estrangement from others/impairment; and a novel dimension of confusion/diminished identity. In contrast, our analysis failed to support DSM or ICD models of PCB or PGD. A Multiple Indicators Multiple Causes (MIMIC) model revealed that traumatic loss and the sense of injustice each were associated with the unitary construct of complicated grief and its subdomains of yearning/preoccupation; shock/disbelief; anger/negative appraisal (exclusive to injustice); and estrangement from others/social impairment (exclusive to TE domain of conflict and loss). Conflict and loss associated with feelings of injustice may be especially pathogenic in generating the anger/negative appraisal component of complicated grief amongst refugees.

  9. Follow-Up Study of Complicated Grief among Parents Eighteen Months after a Child's Death in the Pediatric Intensive Care Unit

    PubMed Central

    Shear, Katherine; Newth, Christopher J.L.; Harrison, Rick; Berger, John; Zimmerman, Jerry; Anand, K.J.S.; Carcillo, Joseph; Donaldson, Amy E.; Dean, J. Michael; Willson, Douglas F.; Nicholson, Carol

    2011-01-01

    Abstract Objective We previously demonstrated that parents whose children die in a pediatric intensive care unit (PICU) have a high level of complicated grief symptoms 6 months after the death. In this study, we investigate the change in the extent of complicated grief symptoms among these parents between 6 and 18 months postdeath and identify factors predicting improvement. Methods One hundred thirty-eight parents of 106 children completed surveys at 6 and 18 months. Surveys included the Inventory of Complicated Grief (ICG), measures of grief avoidance, attachment, caregiving and social support, and demographics. Multivariable analysis was performed using generalized estimating equations to identify characteristics independently associated with improvement in ICG score. Results ICG scores were 33.4 ± 13.6 at 6 months and 28.0 ± 13.5 at 18 months, representing an improvement in ICG score of 5.4 + 8.0 (95% confidence interval [CI] 4.1–6.8, p < 0.001). Variables independently associated with greater improvement in ICG score included traumatic death and greater grief avoidance. Variables independently associated with less improvement included being the biological parent and having more responsive caregiving. Parents with one or two surviving children had more improvement in ICG score than those with no surviving children whereas parents with three or more surviving children had less improvement. Conclusion Complicated grief symptoms decrease among parents between 6 and 18 months after their child's death in the PICU; however, high symptom levels persists for some. Better understanding of the trajectory of complicated grief will allow parents at risk for persistent distress to receive professional support. PMID:21281122

  10. Predictors of Complicated Grief among Adolescents Exposed to a Peer's Suicide

    ERIC Educational Resources Information Center

    Melhem, Nadine M.; Day, Nancy; Shear, M. Katherine; Day, Richard; Reynolds, Charles F.; Brent, David

    2004-01-01

    The purpose of this article is to examine the predictors of complicated grief, depression, and post traumatic stress disorder (PTSD) among adolescents exposed to the suicide of a peer. One hundred and forty six peers of adolescent suicide victims were interviewed at 6, 12-18, and 36 months following the suicide. The roles of previous psychiatric…

  11. The Daily Life of Complicated Grief Patients--What Gets Missed, What Gets Added?

    ERIC Educational Resources Information Center

    Monk, Timothy H.; Houck, Patricia R.; Shear, M. Katherine

    2006-01-01

    Many patients with complicated grief suffer severe symptoms for several years after the loss, interfering with daily life. We sought to determine which elements of a patient's daily routine were likely to be missed or added. Sixty-four patients completed a diary each evening for 2 weeks. The diary asked whether each of 13 daily life activities…

  12. Treatment of Complicated Grief: A Comparison between Cognitive-Behavioral Therapy and Supportive Counseling

    ERIC Educational Resources Information Center

    Boelen, Paul A.; de Keijser, Jos; van den Hout, Marcel A.; van den Bout, Jan

    2007-01-01

    Few studies have examined treatments for complicated grief--a debilitating condition that can develop after the loss of a loved one. This study compared the effectiveness of cognitive-behavioral therapy with a nonspecific treatment with supportive counseling (SC). Using a minimization method, 54 mourners with clinically significant levels of…

  13. Confirming the Distinctiveness of Complicated Grief from Depression and Anxiety among Adolescents

    ERIC Educational Resources Information Center

    Dillen, Let; Fontaine, Johnny R. J.; Verhofstadt-Deneve, Leni

    2009-01-01

    Studies in adult populations have shown that symptoms of complicated grief (CG) constitute a form of bereavement-related distress distinct from symptoms of depression and anxiety. The purpose of this article is to replicate these findings in two samples of bereaved adolescents by investigating the latent structure of symptoms of CG, anxiety, and…

  14. Confirming the Distinctiveness of Complicated Grief from Depression and Anxiety among Adolescents

    ERIC Educational Resources Information Center

    Dillen, Let; Fontaine, Johnny R. J.; Verhofstadt-Deneve, Leni

    2009-01-01

    Studies in adult populations have shown that symptoms of complicated grief (CG) constitute a form of bereavement-related distress distinct from symptoms of depression and anxiety. The purpose of this article is to replicate these findings in two samples of bereaved adolescents by investigating the latent structure of symptoms of CG, anxiety, and…

  15. Treatment of Complicated Grief: A Comparison between Cognitive-Behavioral Therapy and Supportive Counseling

    ERIC Educational Resources Information Center

    Boelen, Paul A.; de Keijser, Jos; van den Hout, Marcel A.; van den Bout, Jan

    2007-01-01

    Few studies have examined treatments for complicated grief--a debilitating condition that can develop after the loss of a loved one. This study compared the effectiveness of cognitive-behavioral therapy with a nonspecific treatment with supportive counseling (SC). Using a minimization method, 54 mourners with clinically significant levels of…

  16. Complicated grief and associated risk factors among parents following a child's death in the pediatric intensive care unit.

    PubMed

    Meert, Kathleen L; Donaldson, Amy E; Newth, Christopher J L; Harrison, Rick; Berger, John; Zimmerman, Jerry; Anand, K J S; Carcillo, Joseph; Dean, J Michael; Willson, Douglas F; Nicholson, Carol; Shear, Katherine

    2010-11-01

    To investigate the extent of complicated grief symptoms and associated risk factors among parents whose child died in a pediatric intensive care unit. Cross-sectional survey conducted by mail and telephone. Seven children's hospitals affiliated with the Collaborative Pediatric Critical Care Research Network from January 1, 2006, to June 30, 2008. Two hundred sixty-one parents from 872 families whose child died in a pediatric intensive care unit 6 months earlier. Assessment of potential risk factors, including demographic and clinical variables, and parent psychosocial characteristics, such as attachment style, caregiving style, grief avoidance, and social support. Parent report of complicated grief symptoms using the Inventory of Complicated Grief. Total scale range is from 0 to 76; scores of 30 or higher suggest complicated grief. Mean (SD) Inventory of Complicated Grief scores among parents were 33.7 (14.1). Fifty-nine percent of parents (95% confidence interval, 53%-65%) had scores of 30 or higher. Variables independently associated with higher symptom scores in multivariable analysis included being the biological mother or female guardian, trauma as the cause of death, greater attachment-related anxiety and attachment-related avoidance, and greater grief avoidance. Parents who responded to our survey experienced a high level of complicated grief symptoms 6 months after their child's death in the pediatric intensive care unit. However, our estimate of the extent of complicated grief symptoms may be biased because of a high number of nonresponders. Better understanding of complicated grief and its risk factors among parents will allow those most vulnerable to receive professional bereavement support.

  17. The younger sibling of PTSD: similarities and differences between complicated grief and posttraumatic stress disorder

    PubMed Central

    Maercker, Andreas; Znoj, Hansjörg

    2010-01-01

    Just as traumatic experiences may lead to posttraumatic stress disorder (PTSD) in some individuals, grief may also be a serious health concern for individuals who have experienced bereavement. At present, neither the DSM-IV nor the ICD-10 recognizes any form of grief as a mental disorder. The aim of this review is to summarize recent advances in definition, assessment, prevention, and treatment of complicated grief disorder (CGD) and to compare CGD with PTSD. Four areas are identified to be of importance to clinicians and researchers: (a) the recently proposed consensus criteria of CGD for DSM-V and ICD-11, (b) available assessment instruments, (c) recent prevention and treatment techniques and related effectiveness studies, and (d) emerging disorder models and research on risks and protective factors. This review focuses on the similarities and differences between CGD and PTSD and highlights how a PTSD-related understanding aids the investigation and clinical management of CGD. PMID:22893801

  18. Social acknowledgement as a predictor of post-traumatic stress and complicated grief after witnessing assisted suicide.

    PubMed

    Wagner, Birgit; Keller, Valerie; Knaevelsrud, Christine; Maercker, Andreas

    2012-07-01

    In Switzerland, right-to-die organizations such as Exit Deutsche Schweiz offer suicide assistance to their members. However, there is limited knowledge of the impact that witnessing assisted suicide has on the post-traumatic stress severity or the grief process of family members. Low perceived social acknowledgement may affect mental health. A cross-sectional survey of 85 family members who were present at an assisted suicide was conducted in December 2007. The Inventory of Complicated Grief and the Impact of Event Scale were used to assess symptoms of post-traumatic stress disorder (PTSD) and complicated grief (CG) at 14 to 24 months post-loss. Further, the Social Acknowledgement Questionnaire was used to examine the impact that the social environment's acknowledgement of the end-of-life decision had on respondents' mental health. As expected, social acknowledgement as a survivor was related to PTSD symptoms and CG. In particular, perceived general disapproval was strongly correlated with all outcome measures, whereas recognition was not significantly related to PTSD or CG (intrusion and avoidance). Family members of patients who use assisted suicide may hesitate to disclose the manner of death, and the community and societal environment may express strong views concerning the end-of-life decision. This can lead to increased levels of PTSD and CG.

  19. The Role of Defense Mechanisms, Personality and Demographical Factors on Complicated Grief following Death of a loved one by Cancer.

    PubMed

    Rahimian Boogar, Isaac; Talepasand, Siavash

    2015-04-01

    Identification of the risk factors and psychological correlates of prolonged grief disorder is vital for health promotions in relatives of persons who died of cancer. The aim of this research was to investigate the role of defense mechanisms, character dimension of personality and demographic factors on complicated grief following a loss of a family member to cancer. A number of 226 persons who had lost a family member to cancer in a cancer institute at Tehran University of Medical Science were selected through compliance sampling and completed the Inventory of complicated Grief-Revised (ICG-R), the Defense Styles Questionnaire (DSQ), the Character dimension of Temperament and Character Inventory (TCI), and the Demographical questionnaire. Data were analyzed by stepwise multiple regression analysis, using the PASW version 18. Findings revealed that neurotic defense style had a significant positive predictive role in the complicated grief; and cooperativeness, age of the deceased person, self-transcendence and mature defense style had a significant negative predictive role in complicated grief (p<0.001). R2 was 0.73 for the final model (p<.001). The results revealed that two character dimensions (low cooperativeness and self-transcendence), high neurotic defense style and young age of the deceased person were involved in the psychopathological course of the complicated and prolonged grief. It was concluded that personality characteristics of the grieving persons and demographics of the deceased person should be addressed in designing tailored interventions for complicated grief.

  20. The Role of Defense Mechanisms, Personality and Demographical Factors on Complicated Grief following Death of a loved one by Cancer

    PubMed Central

    Rahimian Boogar, Isaac; Talepasand, Siavash

    2015-01-01

    Objective: Identification of the risk factors and psychological correlates of prolonged grief disorder is vital for health promotions in relatives of persons who died of cancer. The aim of this research was to investigate the role of defense mechanisms, character dimension of personality and demographic factors on complicated grief following a loss of a family member to cancer. Method: A number of 226 persons who had lost a family member to cancer in a cancer institute at Tehran University of Medical Science were selected through compliance sampling and completed the Inventory of complicated Grief-Revised (ICG-R), the Defense Styles Questionnaire (DSQ), the Character dimension of Temperament and Character Inventory (TCI), and the Demographical questionnaire. Data were analyzed by stepwise multiple regression analysis, using the PASW version 18. Results: Findings revealed that neurotic defense style had a significant positive predictive role in the complicated grief; and cooperativeness, age of the deceased person, self-transcendence and mature defense style had a significant negative predictive role in complicated grief (p<0.001). R2 was 0.73 for the final model (p<.001). Conclusion: The results revealed that two character dimensions (low cooperativeness and self-transcendence), high neurotic defense style and young age of the deceased person were involved in the psychopathological course of the complicated and prolonged grief. It was concluded that personality characteristics of the grieving persons and demographics of the deceased person should be addressed in designing tailored interventions for complicated grief. PMID:26884783

  1. Cohesion and outcome in short-term psychodynamic groups for complicated grief.

    PubMed

    Kipnes, Dianne R; Piper, William E; Joyce, Anthony S

    2002-10-01

    This study used two measures of cohesion for the process analysis of 12 short-term, time-limited groups for complicated grief. The measures had similar theoretical definitions but differed in terms of rater source (member vs. observer), measurement score (mean of items vs. global rating), and rating unit (individual vs. group). We examined the relationship between the measures, assessed the development of cohesion over the life of the group, and evaluated each measure's relationship to outcome. A principal components analysis with each measure yielded one cohesion component, which supported a unidimensional model; however, the two cohesion components were independent of each other, which supported a multidimensional model. Repeated measures analyses indicated that observer-rated cohesion developed in a quadratic manner (v pattern) across sessions, while member-rated cohesion developed in a linear manner. The object focus (the group, other members, the therapist) of the members' ratings determined whether cohesion increased or decreased across sessions. No significant relationships between cohesion and outcome were identified. Implications of the findings for the understanding of group cohesion are considered.

  2. The transformation of the meaning of death in complicated grief group therapy for survivors of suicide: A treatment process analysis using the meaning of loss codebook.

    PubMed

    Supiano, Katherine P; Haynes, Lara Burns; Pond, Vicki

    2017-04-20

    We examined the therapeutic process of grief change in survivors of suicide participating in complicated grief group therapy (CGGT) using the meaning of loss codebook (MLC). Complicated grief group therapy is a multimodal group psychotherapy designed to restore normal grieving in persons with complicated grief. Using video data, we evaluated transition points in psychotherapy associated with meaning reconstruction: retelling the narrative of the death, having an imaginal conversation with the deceased, and memory integration. The MLC codes captured most of the voiced statements of participants, provided a valuable lens for articulating the therapeutic process, and affirmed that CGGT facilitated effective grief.

  3. Understanding and Treating Complicated Grief: What Can We Learn from Posttraumatic Stress Disorder?

    PubMed Central

    Ehlers, Anke

    2013-01-01

    The paper outlines possible parallels between the phenomenology and treatment of complicated grief and PTSD. In particular, it explores how treatment procedures used in Cognitive Therapy for PTSD (Ehlers & Clark, 2000) may be adapted for the treatment of complicated grief. Stimulus Discrimination may be helpful in breaking the link between everyday triggers and “felt presence” memories of the deceased. Memory Updating procedures may help the patient accept that the deceased is no longer alive and no longer suffering. Reclaiming your Life procedures may help the patient access autobiographical memories that are not linked to the deceased and counteract beliefs about the value of life without the deceased. The paper further addresses the necessity of specifying the idiosyncratic beliefs that prevent coming to terms with the death, of understanding the relationship between beliefs and coping strategies, and of distinguishing memories from rumination. PMID:23814410

  4. The Influence of Anxiety Sensitivity on a Wish to Die in Complicated Grief.

    PubMed

    Baker, Amanda W; Goetter, Elizabeth M; Bui, Eric; Shah, Riva; Charney, Meredith E; Mauro, Christine; Shear, M Katherine; Simon, Naomi M

    2016-04-01

    Individuals with complicated grief are at elevated risk of suicidal thoughts. Anxiety sensitivity has recently emerged as a risk factor of suicide. This study aimed to investigate a possible association between anxiety sensitivity and a wish to die in individuals with complicated grief. Participants were evaluated for participation in a treatment study and completed an ancillary questionnaire-based study. Participants were 51 bereaved adults evaluated (age: mean, 54 [SD, 13.6] years; 78% [n = 40] women). Logistic regression was used to examine the relationship between anxiety sensitivity and a wish to die. Overall, anxiety sensitivity was associated with a wish to die at the level of a medium effect size, although it did not reach statistical significance. The anxiety sensitivity social concerns subscale was significantly associated with a wish to die. These findings add to a growing literature implicating anxiety sensitivity in reporting a wish to die.

  5. Complicated Grief Treatment for older adults: The critical role of a supportive person.

    PubMed

    Nam, Ilsung

    2016-10-30

    In the wake of the increased interest in treatment for complicated grief (CG) symptoms, research has reported the promising effect of CG treatment (CGT) on CG symptoms. This study compared CGT with supportive counseling (SC) in terms of improvement in CG symptoms. A randomized trial design was used to compare the effectiveness of CGT with that of SC in treating CG symptoms, depressive symptoms, and social impairments. The primary outcome was the Inventory of Complicated Grief. Relative to SC, CGT resulted in improved CG symptoms and depressive symptoms. Among those receiving CGT, participants with a supportive person in their sessions showed more beneficial results in CG and depressive symptoms than those without a supportive person did. This suggests that CGT is superior to SC in reducing CG symptoms and depressive symptoms, and in improving work and social functions during bereavement. Moreover, having a supportive person plays a critical role in the effectiveness of CGT sessions.

  6. Complicated grief and manic comorbidity in the aftermath of the loss of a son.

    PubMed

    Carmassi, Claudia; Shear, M Katherine; Socci, Chiara; Corsi, Martina; Dell'osso, Liliana; First, Michael B

    2013-09-01

    Based on the recommendations of the sub-workgroup on trauma and dissociative disorders, the American Psychiatric Association (APA) removed the "bereavement exclusion" from the criteria for major depression in DSM-5. In addition, proposed DSM-5 research criteria for persistent complex bereavement disorder (PCBD) were included in the new manual in a section for conditions and criteria needing further research. We describe a case that warranted such a diagnosis. The patient was a 52- year-old woman who was admitted to the inpatient unit of our clinic on the birthday of her son who had died 18 months earlier. She was diagnosed with a manic episode with psychotic symptoms according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR) criteria and was treated accordingly. Three months after discharge, she made a suicide attempt and was admitted and re-assessed. During this admission, she completed the Inventory of Complicated Grief (ICG), the Mood-Spectrum Rating Scale (MOODS-SR), and the Trauma and Loss Spectrum questionnaire (TALS-SR). She endorsed symptoms of intense yearning for her son, feelings of shock and disbelief, anger and bitterness related to his death, estrangement from others, auditory, tactile and visual hallucinations of the deceased, and intense emotional reactivity to memories of her son. These symptoms were sufficiently prolonged and severe to meet criteria for complicated grief. While complicated grief appeared to be the primary diagnosis for this patient, when she was diagnosed using only DSMIV-TR criteria, her treatment failed to address herprimary problem. This case draws attention to the occurrence of manic-like symptoms as well as depression-like manifestations following bereavement and highlights the importance of including the syndrome of complicated grief in the diagnostic nomenclature.

  7. The Grief and Meaning Reconstruction Inventory (GMRI): Initial Validation of a New Measure.

    PubMed

    Gillies, James M; Neimeyer, Robert A; Milman, Evgenia

    2015-01-01

    Although increasing numbers of grief theorists, researchers, and therapists have begun to focus on the quest for meaning in lives disrupted by loss, no convenient and psychometrically validated measure of meanings made specifically in bereavement has been available to guide their efforts. To construct such a measure, the authors began with a systematic content analysis of sense-making, benefit finding, and identity reconstruction themes gleaned from the narrative responses of a sample of 162 adults who were diverse in their age, ethnicity, relationship to the decedent, cause of death, and severity of their grief response. These were then formulated into a set of 65 candidate items in a Likert scale format representing the level of the respondent's endorsement of the item in the past week. Subsequent administration to a second sample of 300 bereaved respondents permitted factor analysis of this pilot version of the Grief and Meaning Reconstruction Inventory (GMRI), and reduced the items to 29, which loaded on 5 distinct factors, labeled Continuing Bonds, Personal Growth, Sense of Peace, Emptiness and Meaninglessness, and Valuing Life. Both the overall GMRI and its constituent factors showed good internal consistency and strong convergent validity in the form of negative correlations with established measures of bereavement-related negative emotions, symptoms of complicated grief, and more general psychological distress and mental health symptomatology, and positive correlations with grief related personal growth. The authors close by noting several specific research and clinical applications of the measure, which could play a useful role in testing and refining contemporary models of meaning made in the wake of loss.

  8. COMPLICATED GRIEF SYMPTOMS IN CAREGIVERS OF PERSONS WITH LUNG CANCER: THE ROLE OF FAMILY CONFLICT, INTRAPSYCHIC STRAINS, AND HOSPICE UTILIZATION*

    PubMed Central

    KRAMER, BETTY J.; KAVANAUGH, MELINDA; TRENTHAM-DIETZ, AMY; WALSH, MATTHEW; YONKER, JAMES A.

    2012-01-01

    Guided by a stress process conceptual model, this study examines social and psychological determinants of complicated grief symptoms focusing on family conflict, intrapsychic strains, and the potential moderating effect of care quality and hospice utilization. Relying on data from 152 spouse and adult child lung cancer caregiver survey respondents, drawn from an ancillary study of the Assessment of Cancer CarE and SatiSfaction (ACCESS) in Wisconsin, hierarchical multiple regression analysis was used to examine determinants of complicated grief. After controlling for contextual factors and time since death, complicated grief symptoms were higher among care-givers with less education, among families with lower prior conflict but higher conflict at the end-of-life, who had family members who had difficulty accepting the illness, and who were caring for patients with greater fear of death. Additionally, hospice utilization moderated the effect of fear of death on complicated grief. Findings suggest that family conflict, intrapsychic strains, and hospice utilization may help to explain the variability found in complicated grief symptoms among bereaved caregivers. Implications for enhancing complicated grief assessment tools and preventative interventions across the continuum of cancer care are highlighted. PMID:21495532

  9. African American homicide bereavement: aspects of social support that predict complicated grief, PTSD, and depression.

    PubMed

    Burke, Laurie A; Neimeyer, Robert A; McDevitt-Murphy, Meghan E

    2010-01-01

    Psychological adaptation following homicide loss is challenged not only by the violent nature of the death itself but also by the bereaved's relationships with would-be supporters. Recruiting a sample of 54 African-American homicidally bereaved individuals, we examined perceived and actual support, the size of the support network, family versus non-family support, and number of negative relationships to gauge the role of social support in bereavement outcomes such as complicated grief, PTSD, and depression. Results of quantitative assessments revealed that size of available network, quantity of negative relationships, and levels of grief-specific support were correlated with bereavement outcome. Clinical implications and suggestions for future research on the role of social support in adaptation of African Americans to traumatic loss are discussed.

  10. THE STRUCTURED CLINICAL INTERVIEW FOR COMPLICATED GRIEF: RELIABILITY, VALIDITY, AND EXPLORATORY FACTOR ANALYSIS.

    PubMed

    Bui, Eric; Mauro, Christine; Robinaugh, Donald J; Skritskaya, Natalia A; Wang, Yuanjia; Gribbin, Colleen; Ghesquiere, Angela; Horenstein, Arielle; Duan, Naihua; Reynolds, Charles; Zisook, Sidney; Simon, Naomi M; Shear, M Katherine

    2015-07-01

    Complicated grief (CG) has been recently included in the DSM-5, under the term "persistent complex bereavement disorder," as a condition requiring further study. To our knowledge, no psychometric data on any structured clinical interview for CG (SCI-CG) is available to date. In this manuscript, we introduce the SCI-CG, a 31-item "SCID-like" clinician-administered instrument to assess the presence of CG symptoms. Participants were 281 treatment-seeking adults with CG (77.9% [n = 219] women, mean age = 52.4, standard deviation [SD] = 17.8) who were assessed with the SCI-CG and measures of depression, posttraumatic stress, anxiety, functional impairment. The SCI-CG exhibited satisfactory internal consistency (α = .78), good test-retest reliability (interclass correlation [ICC] 0.68, 95% CI [0.60-0.75]), and excellent interrater reliability (ICC = 0.95, 95% CI [0.89-0.98]). Exploratory factor analyses revealed that a five-factor structure, explaining 50.3% of the total variance, was the best fit for the data. The clinician-rated SCI-CG demonstrates good internal consistency, reliability, and convergent validity in treatment-seeking individuals with CG and therefore can be a useful tool to assess CG. Although diagnostic criteria for CG have yet to be adequately validated, the SCI-CG may facilitate this process. The SCI-CG can now be used as a validated instrument in research and clinical practice. © 2015 Wiley Periodicals, Inc.

  11. Attachment, continuing bonds, and complicated grief following violent loss: testing a moderated model.

    PubMed

    Currier, Joseph M; Irish, Jennifer E F; Neimeyer, Robert A; Foster, Joshua D

    2015-01-01

    There is increasing consensus that mourners' general attachment security and ongoing sense of connectedness to the deceased figure prominently in adjustment to bereavement. However, the interplay between these variables has not been investigated thoroughly. We therefore studied 195 young adults who were bereaved by violent causes (homicide, suicide, and fatal accidents) in the previous 2 years, measuring their attachment-related insecurities (anxiety and avoidance), their specific ongoing attachment or "continuing bond" (CB) to the deceased, and their complicated grief (CG) symptomatology over the loss of this relationship. Analyses indicated that CBs were concurrently linked with greater CG symptomatology. However, other results also suggested that attachment could moderate the adaptiveness of maintaining a sense of connection to the deceased loved one. Specifically, CBs were less predictive of CG symptomatology for individuals with high anxiety and low avoidance, and most predictive of intense grieving for bereaved people whose attachment styles were more highly avoidant and minimally anxious. These findings suggest the relevance of evaluating the appropriateness of clinical techniques that emphasize or deemphasize the CB for mourners who differ in their styles of attachment. Such studies could potentially promote a better match of interventions to clients whose styles of coping are congruent with these procedures.

  12. Measuring Grief Following Miscarriage: Psychometric Properties of the Chinese Version of the Perinatal Grief Scale

    ERIC Educational Resources Information Center

    Lai, Beatrice P. Y.; Chung, Tony K. H.; Lee, Dominic T. S.; Kong, Grace W. S.; Lok, Ingrid H.

    2013-01-01

    Grief following miscarriage is a complex psychological response. This study was conducted to examine the psychometric properties of the Chinese version of the Perinatal Grief Scale (PGS). A total of 280 Chinese women completed the PGS immediately following a diagnosis of miscarriage (baseline) and were reassessed at 12 months follow-up. The factor…

  13. Measuring Grief Following Miscarriage: Psychometric Properties of the Chinese Version of the Perinatal Grief Scale

    ERIC Educational Resources Information Center

    Lai, Beatrice P. Y.; Chung, Tony K. H.; Lee, Dominic T. S.; Kong, Grace W. S.; Lok, Ingrid H.

    2013-01-01

    Grief following miscarriage is a complex psychological response. This study was conducted to examine the psychometric properties of the Chinese version of the Perinatal Grief Scale (PGS). A total of 280 Chinese women completed the PGS immediately following a diagnosis of miscarriage (baseline) and were reassessed at 12 months follow-up. The factor…

  14. Pharmacological approaches to the treatment of complicated grief: rationale and a brief review of the literature

    PubMed Central

    Bui, Eric; Nadal-Vicens, Mireya; M. Simon, Naomi

    2012-01-01

    Complicated grief (CG) is a common and often under-acknowledged cause of profound impairment experienced after the loss of a loved one. Although both clinical and basic research suggests that pharmacological agents might be of use in the treatment of CG, research on pharmacological approaches to this condition is still scarce. Three open-label trials and one randomized trial on bereavement-related depression suggest that tricyclic antidepressants may be effective, although they may be more efficacious for depressive symptoms than for grief-specific symptoms. Four open-label trials (total number of participants, 50) of selective serotonin reuptake inhibitors (SSRIs) have yielded results, providing very preliminary support that they might be effective in the treatment of CG, both as a standalone treatment and in conjunction with psychotherapeutic interventions. These more recent studies have shown an effect on both depression and grief-specific scales. Furthermore, therapeutic interventions for CG may be more effective in conjunction with SSRI administration. Given the small number of pharmacological studies to date, there is a need for randomized trials to test the potential efficacy of pharmacological agents in the treatment of CG. PMID:22754287

  15. Complicated grief and depression in young adults: personality and relationship quality.

    PubMed

    Mash, Holly B Herberman; Fullerton, Carol S; Shear, M Katherine; Ursano, Robert J

    2014-07-01

    Young adults experience problematic responses to loss more often than is commonly recognized. Few empirical studies have examined the contribution of intrapersonal and interpersonal characteristics to grief and depression in bereaved young adults. This study investigated the association of dependency and quality of the relationship with the deceased (i.e., depth and conflict) with complicated grief (CG) and depression. Participants were 157 young adults aged 17 to 29 years who experienced loss of a family member or close friend within the past 3 years (mean = 1.74 years). Participants completed the Inventory of Complicated Grief, Beck Depression Inventory, Depth and Conflict subscales of the Quality of Relationships Inventory, and the Dependency subscale of the Depressive Experiences Questionnaire. Relationships among dependency and interpersonal depth and conflict and CG and depression were examined through analyses of covariance. Sixteen percent of participants met criteria for CG and 34% had mild to severe depression. Dependency and depth were independently related to CG and dependency was related to depression, but the pattern of associations was somewhat different for each outcome. Greater depth was associated with CG, at both high and low levels of dependency. High levels of dependency were related to more depressive symptoms. Interpretation of the findings is limited by the relatively small sample size and cross-sectional design. CG and depression are related but distinct responses to loss. Although dependency is associated with both CG and depression after loss, relationships between the bereaved and deceased that are characterized by high levels of depth are particularly related to the development of CG symptoms.

  16. Adult separation anxiety disorder in complicated grief: an exploratory study on frequency and correlates.

    PubMed

    Gesi, Camilla; Carmassi, Claudia; Shear, Katherine M; Schwartz, Theresa; Ghesquiere, Angela; Khaler, Julie; Dell'Osso, Liliana

    2017-01-01

    Complicated grief (CG) has been the subject of increasing attention in the past decades but its relationship with separation anxiety disorder (SEPAD) is still controversial. The aim of the current study was to explore the prevalence and clinical significance of adult SEPAD in a sample of help-seeking individuals with CG. 151 adults with CG, enrolled in a randomized controlled trial comparing the effectiveness of (CG) treatment to that of interpersonal therapy, were assessed by means of the Inventory of Complicated Grief (ICG), the Structured Clinical Interview for DSM-IV, the Hamilton Rating Scale for Depression (HAM-D), the Work and Social Adjustment Scale (WSAS), the Adult Separation Anxiety Questionnaire (ASA-27), the Grief Related Avoidance Questionnaire (GRAQ), the Peritraumatic Dissociative Experiences Questionnaire (PDEQ), and the Impact of Events Scale (IES). 104 (68.9%) individuals with CG were considered to have SEPAD (ASA-27 score ≥22). Individuals with SEPAD were more likely to have reported a CG related to the loss of another close relative or friend (than a parent, spouse/partner or a child) (p=.02), as well as greater scores on the ICG (p=<.001), PDEQ (p=.004), GRAQ (p<.001), intrusion (p<.001) and avoidance (p=<.001) IES subscales, HAM-D (p<.001) and WSAS (p=.006). ASA-27 total scores correlated with ICG (p<.0001), PDEQ (p<.001) GRAQ (p<.0001) scores and both the IES intrusion (p<.0001) and IES avoidance (p<.0001) subscale scores. People with SEPAD had higher rates of lifetime post-traumatic stress disorder (PTSD) (p=.04) and panic disorder (PD) (p=.01). SEPAD is highly prevalent among patients with CG and is associated with greater symptom severity and impairment and greater comorbidity with PTSD and PD. Further studies will help to confirm and generalize our results and to determine whether adult SEPAD responds to CG treatment and/or moderates CG treatment response. Copyright © 2016 Elsevier Inc. All rights reserved.

  17. The Structured Clinical Interview for Complicated Grief: Reliability, Validity, and Exploratory Factor Analysis

    PubMed Central

    Bui, Eric; Mauro, Christine; Robinaugh, Donald J.; Skritskaya, Natalia A.; Wang, Yuanjia; Gribbin, Colleen; Ghesquiere, Angela; Horenstein, Arielle; Duan, Naihua; Reynolds, Charles; Zisook, Sidney; Simon, Naomi M.; Shear, M. Katherine

    2015-01-01

    Background Complicated grief (CG) has been recently included in the DSM-5, under the term “Persistent Complex Bereavement Disorder”, as a condition requiring further study. To our knowledge, no psychometric data on any structured clinical interview of CG is available to date. In this manuscript, we introduce the Structured Clinical Interview for CG (SCI-CG) a 31-item “SCID-like” clinician-administered instrument to assess the presence of CG symptoms. Methods Participants were 281 treatment-seeking adults with CG (77.9% (n=219) women, mean age = 52.4, SD = 17.8) who were assessed with the SCI-CG and measures of depression, posttraumatic stress, anxiety, functional impairment. Results The SCI-CG exhibited satisfactory internal consistency (α = .78), good test-retest reliability (Inter-class correlation [ICC] 0.68, 95% CI [0.60, 0.75]), and excellent inter-rater reliability (ICC=0.95, 95% CI [0.89, 0.98]). Exploratory factor analyses revealed that a five-factor structure, explaining 50.3% of the total variance, was the best fit for the data. Conclusions The clinician-rated SCI-CG demonstrates good internal consistency, reliability, and convergent validity in treatment-seeking individuals with CG and therefore can be a useful tool to assess CG. Although diagnostic criteria for CG have yet to be adequately validated, the SCI-CG may facilitate this process. The SCI-CG can now be used as a validated instrument in research and clinical practice. PMID:26061724

  18. A nationwide random sampling survey of potential complicated grief in Japan.

    PubMed

    Mizuno, Yasunao; Kishimoto, Junji; Asukai, Nozomu

    2012-01-01

    To investigate the prevalence of significant loss, potential complicated grief (CG), and its contributing factors, we conducted a nationwide random sampling survey of Japanese adults aged 18 or older (N = 1,343) using a self-rating Japanese-language version of the Complicated Grief Brief Screen. Among them, 37.0% experienced their most significant loss by expected non-violent death, 17.9% by unexpected non-violent death, and 5.5% by violent death. The mean length of time since the loss was 11.9 years (SD = 11.6). The percentage of individuals with potential CG (5 or higher score on the scale) was 2.5% among those who experienced significant loss. The individuals with potential CG showed lower mental health scores than those without. Through regression analysis, we found the significant effects of gender difference, time since the loss, and the interaction of the mode of death, gender of the bereaved, and the kinship relationship to the deceased on the CG score. Women who had lost a child by sudden or violent death showed significantly higher CG scores, but men did not. By comparison, those (particularly men) who had lost a partner by expected or sudden nonviolent death showed significantly higher CG scores. The implications of the findings are discussed.

  19. Predictors of Complicated Grief after a Natural Disaster: A Population Study Two Years after the 2004 South-East Asian Tsunami

    ERIC Educational Resources Information Center

    Kristensen, Pal; Weisaeth, Lars; Heir, Trond

    2010-01-01

    The authors examined predictors of complicated grief (CG) in Norwegians 2 years after bereavement in the 2004 South-East Asian tsunami. A cross-sectional postal survey retrospectively covering disaster experiences and assessing CG according to the Inventory of Complicated Grief yielded 130 respondents (35 directly disaster-exposed and 95 not…

  20. Predictors of Complicated Grief after a Natural Disaster: A Population Study Two Years after the 2004 South-East Asian Tsunami

    ERIC Educational Resources Information Center

    Kristensen, Pal; Weisaeth, Lars; Heir, Trond

    2010-01-01

    The authors examined predictors of complicated grief (CG) in Norwegians 2 years after bereavement in the 2004 South-East Asian tsunami. A cross-sectional postal survey retrospectively covering disaster experiences and assessing CG according to the Inventory of Complicated Grief yielded 130 respondents (35 directly disaster-exposed and 95 not…

  1. The impact of losing a child on the clinical presentation of complicated grief.

    PubMed

    Zetumer, Samuel; Young, Ilanit; Shear, M Katherine; Skritskaya, Natalia; Lebowitz, Barry; Simon, Naomi; Reynolds, Charles; Mauro, Christine; Zisook, Sidney

    2015-01-01

    It is unclear whether bereaved parents with Complicated Grief (CG) struggle with their grief differently than others with CG. This study addressed this question by comparing CG severity, CG-related symptoms, thoughts and behaviors, and comorbid psychiatric diagnoses of bereaved parents with CG to the diagnoses and symptoms of others with CG. Baseline data from 345 participants enrolled in the Healing Emotions After Loss (HEAL) study, a multi-site CG treatment study, were used to compare parents with CG (n=75) to others with CG (n=275). Data from the parent group was then used to compare parents with CG who had lost a younger child (n=24) to parents with CG who had lost an older child (n=34). Demographic and loss-related data were also gathered and used to control for confounders between groups. Parents with CG demonstrated slightly higher levels of CG (p=0.025), caregiver self-blame (p=0.007), and suicidality (p=0.025) than non-parents with CG. Parents who had lost younger children were more likely to have had a wish to be dead since the loss than parents who had lost older children (p=0.041). All data were gathered from a treatment research study, limiting the generalizability of these results. No corrections were made for multiple comparisons. The comparison of parents who lost younger children to parents who lost older children was limited by a small sample size. Even in the context of CG, the relationship to the deceased may have a bearing on the degree and severity of grief symptoms and associated features. Bereaved parents with CG reported more intense CG, self-blame, and suicidality than other bereaved groups with CG, though this finding requires confirmation. The heightened levels of suicidal ideation experienced by parents with CG, especially after losing a younger child, suggest the value of routinely screening for suicidal thoughts and behaviors in this group. Published by Elsevier B.V.

  2. The impact of losing a child on the clinical presentation of complicated grief

    PubMed Central

    Zetumer, Samuel; Young, Ilanit; Shear, M. Katherine; Skritskaya, Natalia; Lebowitz, Barry; Simon, Naomi; Reynolds, Charles; Mauro, Christine; Zisook, Sidney

    2014-01-01

    Background It is unclear whether bereaved parents with Complicated Grief (CG) struggle with their grief differently than others with CG. This study addressed this question by comparing CG severity, CG-related symptoms, thoughts and behaviors, and comorbid psychiatric diagnoses of bereaved parents with CG to the diagnoses and symptoms of others with CG. Methods Baseline data from 345 participants enrolled in the Healing Emotions After Loss (HEAL) study, a multi-site CG treatment study, were used to compare parents with CG (n = 75) to others with CG (n = 275). Data from the parent group was then used to compare parents with CG who had lost a younger child (n = 24) to parents with CG who had lost an older child (n = 34). Demographic and loss-related data were also gathered and used to control for confounders between groups. Results Parents with CG demonstrated slightly higher levels of CG (p = .025), caregiver self-blame (p = .007), and suicidality (p = .025) than non-parents with CG. Parents who had lost younger children were more likely to have had a wish to be dead since the loss than parents who had lost older children (p = .041). Limitations All data were gathered from a treatment research study, limiting the of these results. No corrections were made for multiple comparisons. The comparison of parents who lost younger children to parents who lost older children was limited by a small sample size. Conclusions Even in the context of CG, the relationship to the deceased may have a bearing on the degree and severity of grief symptoms and associated features. Bereaved parents with CG reported more intense CG, self-blame, and suicidality than other bereaved groups with CG, though this finding requires confirmation. The heightened levels of suicidal ideation experienced by parents with CG, especially after losing a younger child, suggest the value of routinely screening for suicidal thoughts and behaviors in this group. PMID:25217759

  3. Measuring Migratory Grief and Loss Associated with the Experience of Immigration

    ERIC Educational Resources Information Center

    Casado, Banghwa Lee; Hong, Michin; Harrington, Donna

    2010-01-01

    Objectives: The Migratory Grief and Loss Questionnaire (MGLQ) was designed to measure the grief experience associated with immigration. This article reports the development and psychometric properties of a Chinese-version of MGLQ. Methods: An exploratory factor analysis (EFA) using maximum likelihood extraction with varimax rotation was conducted…

  4. Measuring Migratory Grief and Loss Associated with the Experience of Immigration

    ERIC Educational Resources Information Center

    Casado, Banghwa Lee; Hong, Michin; Harrington, Donna

    2010-01-01

    Objectives: The Migratory Grief and Loss Questionnaire (MGLQ) was designed to measure the grief experience associated with immigration. This article reports the development and psychometric properties of a Chinese-version of MGLQ. Methods: An exploratory factor analysis (EFA) using maximum likelihood extraction with varimax rotation was conducted…

  5. Examination of Proposed Criteria for Complicated Grief in People Confronted with Violent or Non-Violent Loss

    ERIC Educational Resources Information Center

    Boelen, Paul A.; van den Bout, Jan

    2007-01-01

    In the late 1990s, a panel of experts proposed criteria for complicated grief (CG) and found these to have satisfactory operating characteristics. The present study aimed to replicate that finding in 4 groups of mourners divided by cause of loss and time from loss. Data were available from 1,052 bereaved individuals. All had completed the revised…

  6. An Initial Assessment of the Psychometric Properties of the Complicated Grief Questionnaire for People with Intellectual Disabilities (CGQ-ID)

    ERIC Educational Resources Information Center

    Guerin, Suzanne; Dodd, Philip; Tyrell, Janette; McEvoy, John; Buckley, Sarah; Hillery, John

    2009-01-01

    Given the research evidence that people with intellectual disability (ID) do grieve following bereavement, the present study aimed to describe and gather preliminary psychometric data for a version of the Inventory of Complicated Grief [Prigerson, H. G., Maciejewski, P. K., Reynolds, C. F., Bierhals, A. J., Newsom, J. T., Fasiczka, A., et al.…

  7. Initial Validation of a Comprehensive Assessment Instrument for Bereavement-Related Grief Symptoms and Risk of Complications: The Indicator of Bereavement Adaptation—Cruse Scotland (IBACS)

    PubMed Central

    Schut, Henk; Stroebe, Margaret S.; Wilson, Stewart; Birrell, John

    2016-01-01

    Objective This study assessed the validity of the Indicator of Bereavement Adaptation Cruse Scotland (IBACS). Designed for use in clinical and non-clinical settings, the IBACS measures severity of grief symptoms and risk of developing complications. Method N = 196 (44 male, 152 female) help-seeking, bereaved Scottish adults participated at two timepoints: T1 (baseline) and T2 (after 18 months). Four validated assessment instruments were administered: CORE-R, ICG-R, IES-R, SCL-90-R. Discriminative ability was assessed using ROC curve analysis. Concurrent validity was tested through correlation analysis at T1. Predictive validity was assessed using correlation analyses and ROC curve analysis. Optimal IBACS cutoff values were obtained by calculating a maximal Youden index J in ROC curve analysis. Clinical implications were compared across instruments. Results ROC curve analysis results (AUC = .84, p < .01, 95% CI between .77 and .90) indicated the IBACS is a good diagnostic instrument for assessing complicated grief. Positive correlations (p < .01, 2-tailed) with all four instruments at T1 demonstrated the IBACS' concurrent validity, strongest with complicated grief measures (r = .82). Predictive validity was shown to be fair in T2 ROC curve analysis results (n = 67, AUC = .78, 95% CI between .65 and .92; p < .01). Predictive validity was also supported by stable positive correlations between IBACS and other instruments at T2. Clinical indications were found not to differ across instruments. Conclusions The IBACS offers effective grief symptom and risk assessment for use by non-clinicians. Indications are sufficient to support intake assessment for a stepped model of bereavement intervention. PMID:27741246

  8. Initial Validation of a Comprehensive Assessment Instrument for Bereavement-Related Grief Symptoms and Risk of Complications: The Indicator of Bereavement Adaptation-Cruse Scotland (IBACS).

    PubMed

    Newsom, Catherine; Schut, Henk; Stroebe, Margaret S; Wilson, Stewart; Birrell, John

    2016-01-01

    This study assessed the validity of the Indicator of Bereavement Adaptation Cruse Scotland (IBACS). Designed for use in clinical and non-clinical settings, the IBACS measures severity of grief symptoms and risk of developing complications. N = 196 (44 male, 152 female) help-seeking, bereaved Scottish adults participated at two timepoints: T1 (baseline) and T2 (after 18 months). Four validated assessment instruments were administered: CORE-R, ICG-R, IES-R, SCL-90-R. Discriminative ability was assessed using ROC curve analysis. Concurrent validity was tested through correlation analysis at T1. Predictive validity was assessed using correlation analyses and ROC curve analysis. Optimal IBACS cutoff values were obtained by calculating a maximal Youden index J in ROC curve analysis. Clinical implications were compared across instruments. ROC curve analysis results (AUC = .84, p < .01, 95% CI between .77 and .90) indicated the IBACS is a good diagnostic instrument for assessing complicated grief. Positive correlations (p < .01, 2-tailed) with all four instruments at T1 demonstrated the IBACS' concurrent validity, strongest with complicated grief measures (r = .82). Predictive validity was shown to be fair in T2 ROC curve analysis results (n = 67, AUC = .78, 95% CI between .65 and .92; p < .01). Predictive validity was also supported by stable positive correlations between IBACS and other instruments at T2. Clinical indications were found not to differ across instruments. The IBACS offers effective grief symptom and risk assessment for use by non-clinicians. Indications are sufficient to support intake assessment for a stepped model of bereavement intervention.

  9. Relationships among affect, work, and outcome in group therapy for patients with complicated grief.

    PubMed

    Piper, William E; Ogrodniczuk, John S; Joyce, Anthony S; McCallum, Mary; Rosie, John S

    2002-01-01

    This study examined the relationships among patient affect (experienced and expressed), work, and outcome in two forms of time-limited, short-term group therapy for complicated grief. Work was defined as the degree to which the patient pursued the primary objectives of the two forms of therapy. Substantial evidence of direct relationships between the experience and expression of positive affect and favorable outcome was found. A direct relationship between work and favorable outcome was also found. Additive and interaction effects indicated that the combination of these two types of predictor variables (positive affect, work) had a stronger relationship to favorable outcome than either variable alone. Some evidence was found for an inverse relationship between the experience and expression of negative affect and favorable outcome. The findings were consistent with a social-functional theory of the impact of affect on others during bereavement. Clinical implications of the findings are considered.

  10. Factors Related to Complicated Grief among Bereaved Individuals after the Wenchuan Earthquake in China

    PubMed Central

    Hu, Xiao-Lin; Li, Xiao-Lin; Dou, Xin-Man; Li, Rong

    2015-01-01

    Background: The Wenchuan earthquake in China caused shock and grief worldwide. Sudden bereavement caused by the earthquake led to physical disorders as well as psychological disturbances in the bereaved individuals. The bereaved had a high risk for complicated grief (CG), which may have led to significant distress and impairment in their health. However, there was few available studies on CG among disaster-bereaved individuals in China after the disaster. The aim of this study was to identify factors (demographic characteristics and disaster-related variables) associated with symptoms of CG among the bereaved 18 months after the Wenchuan earthquake. Methods: This study was conducted with a cross-sectional design and a convenience sample of 271 bereaved individuals from three of the hardest hit areas. Data were collected by questionnaires and the instruments used in the study were: General questionnaire and Inventory of CG (ICG). Multivariate linear regression analysis was used to identify factors associated with symptoms of CG. Results: The mean score on ICG was 52.77 (standard deviation: 10.00). Being female and loss of a child were related to higher level of CG while having another child after the disaster and receiving psychological counseling experience were associated with lower level of CG. Forty-nine percent of the variance of CG was explained by these identified factors. Conclusions: Eighteen months after the Wenchuan earthquake, the symptoms of CG among the bereaved were higher than the previous studies with bereaved individuals. This study uncovers a vulnerable population of the bereaved at high risk for CG. Early assessments, targeted interventions, and policy support tailored for the disaster-bereaved individuals are necessary to identify and alleviate symptoms of CG and to improve their well-being. PMID:26021497

  11. Validation of the Italian version Inventory of Complicated Grief (ICG): a study comparing CG patients versus bipolar disorder, PTSD and healthy controls.

    PubMed

    Carmassi, Claudia; Shear, M Katherine; Massimetti, Gabriele; Wall, Melanie; Mauro, Christine; Gemignani, Sara; Conversano, Ciro; Dell'Osso, Liliana

    2014-07-01

    A minority (9%-20%) of bereaved individuals experience symptoms of persistent intense grief associated with significant distress and impairment. This recently identified distinct post-loss syndrome has been variously named complicated grief, prolonged grief disorder, traumatic grief and persistent complex bereavement disorder. The Inventory of Complicated Grief (ICG) is a self-report instrument used to reliably identify this syndrome. We undertook a study to: 1) validate the Italian version of the ICG; 2) examine its performance in a clinical of bereaved individuals with complicated grief, post-traumatic stress disorder, bipolar disorder and healthy controls. Study participants included 171 bereaved individuals clinically diagnosed with complicated grief (n=64); post-traumatic stress disorder (n=72); bipolar disorder (n=35) and 58 bereaved healthy controls. Assessments included the Structured Clinical Interview for DSM-IV Axis I disorders (SCID-I/P) and the Italian version of the ICG. The mean total ICG score was significantly different among the study groups [F(3.228)=94.19, p<.001]. Post-hoc Games-Howell comparisons indicated significantly higher scores in complicated grief patients with respect to the other three groups and significantly lower scores in healthy controls compared to all other participants. The scale demonstrated a high level of internal consistency: Cronbach's alpha value for the whole sample was 0.947. Factor analyses demonstrated a single-factor solution. This study provides evidence of the validation of the Italian version of the ICG, tested in a large and well-characterized clinical help-seeking population. These data further support the existence of a unique grief-related syndrome different from bipolar and post-traumatic stress disorders. Copyright © 2014 Elsevier Inc. All rights reserved.

  12. "I was just trying to stick it out until I realized that I couldn't": a phenomenological investigation of support seeking among older adults with complicated grief.

    PubMed

    Ghesquiere, Angela

    Complicated Grief (CG) is a prolonged, impairing mental health condition affecting about 7% of the bereaved. CG may be especially prevalent in older adults. Though evidence-based treatments for CG have been developed, little is known about support-seeking in older adults with CG. This study used the descriptive phenomenological approach to explore the CG support-seeking process. In-depth interviews were conducted with 8 CG-positive older adults who had completed participation in a randomized clinical trial of CG treatment. Five primary themes arose: observing that grief was causing a great deal of distress and impairment; grief not meeting expectations of what grief "should be"; an important influence of social relationships on support-seeking; lack of effectiveness of grief support groups and/or care from mental health professionals prior to study enrollment; and strong reactions to the label of CG. Themes may hep inform efforts to engage older adults with CG in effective care.

  13. Should prolonged grief be reclassified as a mental disorder in DSM-5?: reconsidering the empirical and conceptual arguments for complicated grief disorder.

    PubMed

    Wakefield, Jerome C

    2012-06-01

    The proposed changes to DSM-5 will create new categories of mental disorder (referred to here generically as Prolonged Grief Disorder'' [PGD]) to diagnose individuals experiencing prolonged intense grief reactions to the loss of a loved one. Individuals could be diagnosed even if they have no depressive or anxiety symptoms but only symptoms typical of grief (e.g., yearning, avoidance of reminders, disbelief, feelings of emptiness). The main challenge for such proposals is to establish that the proposed diagnostic criteria validly discriminate a genuine psychiatric disorder of grief from intense normal grief. With this test in mind, I evaluate the soundness of four empirical arguments and one conceptual argument that have been put forward to support such proposals: (1) PGD has discriminant validity because distinctive, pathognomonic symptoms distinguish it from normal grief; (2) PGD has discriminant validity because it identifies grief symptoms that are of greater absolute severity than in normal grief; (3) PGD has predictive validity because it implies a chronic, interminable process of grieving, thus a derailment of the normal process of grief resolution; (4) PGD has predictive validity because it predicts negative mental and physical health outcomes unlikely in normal grief; and (5) PGD has conceptual validity because grief is analogous to a wound or, alternatively, lengthy grief is analogous to a wound that does not heal. Upon close examination, each of these arguments turns out to have serious empirical or conceptual deficiencies. I conclude that the proposed diagnostic criteria for PGD fail to discriminate disorder from intense normal grief and are likely to yield massive false-positive diagnoses. Consequently, the proposal to add pathological grief categories to DSM-5 should be withdrawn pending further research to identify more valid criteria for diagnosing PGD.

  14. Coping flexibility and complicated grief: a comparison of American and Chinese samples.

    PubMed

    Burton, Charles L; Yan, Oscar H; Pat-Horenczyk, Ruth; Chan, Ide S F; Ho, Samuel; Bonanno, George A

    2012-01-01

    The ability to process a death and the ability to remain optimistic and look beyond the loss are both thought to be effective means of coping with loss and other aversive events. Recently, these seemingly contrary dimensions have been integrated into the idea of coping flexibility. In this study, we assessed the ability of married and bereaved individuals in the United States and Hong Kong to use both coping approaches as operationalized by the trauma-focused and forward-focused coping scales of a previously validated questionnaire. We also calculated a single flexibility score. Bereaved participants reported greater trauma-focused coping ability than did married participants. However, bereaved participants meeting criteria for complicated grief (CG) reported less forward-focused coping than both asymptomatic bereaved and married participants. The CG group also showed less overall coping flexibility than the asymptomatic bereaved and married groups. Country was not a factor. Findings suggest that deficits in coping flexibility are indicative of pathology in bereaved individuals, and that this relationship extends across cultures. Limitations of the study and directions for future research are discussed. © 2011 Wiley-Liss, Inc.

  15. Peri-loss Dissociation, Symptom Severity and Treatment Response in Complicated Grief

    PubMed Central

    Bui, Eric; Simon, Naomi M.; Robinaugh, Donald J.; LeBlanc, Nicole J.; Wang, Yuanjia; Skritskaya, Natalia A.; Mauro, Christine; Shear, M. Katherine

    2014-01-01

    Background Complicated grief (CG) is a bereavement-specific syndrome characterized by traumatic and separation distress lasting over 6 months. Little is known about the role of dissociation experienced during or immediately after the loss of a loved one (i.e. Peri-Loss Dissociation (PLD)) in CG. The present study aimed to examine the psychometric properties of the PLD-adapted peritraumatic dissociative experiences questionnaire and its association with symptom severity, treatment response, and drop-out rate. Methods PLD data collected as part of a randomized controlled trial of two loss-focused psychotherapy approaches for CG was examined. Treatment-seeking individuals with primary CG (n=193) were assessed for PLD at the initial visit, 95 of whom were randomized and completed at least one treatment session. Results The PLD-adapted peritraumatic dissociative experiences questionnaire was found to be internally consistent (alpha = 0.91) with good convergent and divergent validity. After controlling for age, gender, time since loss and current comorbid psychiatric diagnosis, self-reported PLD was associated with greater CG symptom severity (p<0.01). However, contrary to our hypotheses, after controlling for age, baseline symptoms severity, psychiatric comorbidity and treatment arm, PLD was predictive of better treatment response (p<0.05) and lower study discontinuation (p<0.01). Conclusions PLD may be useful in identifying individuals at risk for CG and those who might respond to psychotherapy. Additional research should investigate the relationship of PLD with treatment outcome for different treatment approaches, and whether PLD prospectively predicts the development of CG. PMID:23212730

  16. The effectiveness of family-based cognitive-behavior grief therapy to prevent complicated grief in relatives of suicide victims: the mediating role of suicide ideation.

    PubMed

    de Groot, Marieke; Neeleman, Jan; van der Meer, Klaas; Burger, Huibert

    2010-10-01

    Grief interventions are more effective for high risk individuals. The presence of suicide ideation following suicide bereavement was examined to determine whether it indicates a high risk status. Using data from a randomized controlled trial (n = 122) on the effectiveness of cognitive-behavior therapy, the effect of suicide ideation on the effectiveness of grief therapy on the bereavement outcome at 13 months post loss was examined. Results show that suicide ideators more often have a history of mental disorder and suicidal behavior than non-ideators, and suicide ideation indicates a high risk for adverse bereavement outcome. Grief therapy likely reduces the risk of maladaptive grief reactions among suicide ideators. Therefore, suicide ideators may benefit from grief therapy following a loss through suicide.

  17. Dream Content in Complicated Grief: A Window into Loss-Related Cognitive Schemas

    ERIC Educational Resources Information Center

    Germain, Anne; Shear, Katherine M.; Walsh, Colleen; Buysse, Daniel J.; Monk, Timothy H.; Reynolds, Charles F., III; Frank, Ellen; Silowash, Russell

    2013-01-01

    Bereavement and its accompanying psychological response (grief) constitute potent experiences that necessitate the reorganization of cognitive-affective representations of lost significant attachment figures during both wakefulness and dreaming. The goals of this preliminary study were to explore whether the dream content of 77 adults with…

  18. Dream Content in Complicated Grief: A Window into Loss-Related Cognitive Schemas

    ERIC Educational Resources Information Center

    Germain, Anne; Shear, Katherine M.; Walsh, Colleen; Buysse, Daniel J.; Monk, Timothy H.; Reynolds, Charles F., III; Frank, Ellen; Silowash, Russell

    2013-01-01

    Bereavement and its accompanying psychological response (grief) constitute potent experiences that necessitate the reorganization of cognitive-affective representations of lost significant attachment figures during both wakefulness and dreaming. The goals of this preliminary study were to explore whether the dream content of 77 adults with…

  19. Predictors of complicated grief after a natural disaster: a population study two years after the 2004 South-East Asian tsunami.

    PubMed

    Kristensen, Pål; Weisaeth, Lars; Heir, Trond

    2010-02-01

    The authors examined predictors of complicated grief (CG) in Norwegians 2 years after bereavement in the 2004 South-East Asian tsunami. A cross-sectional postal survey retrospectively covering disaster experiences and assessing CG according to the Inventory of Complicated Grief yielded 130 respondents (35 directly disaster-exposed and 95 not directly exposed), with 47.7% screening CG positive. They identified positive associations between CG and being female, losing a child or spouse, and time to death confirmation, and negative associations with previous losses, being employed, and receiving social support. Direct exposure did not increase CG risk. Support service providers should be aware of this high prevalence of severe, persistent grief.

  20. Measuring grief and loss after spinal cord injury: Development, validation and psychometric characteristics of the SCI-QOL Grief and Loss item bank and short form

    PubMed Central

    Kalpakjian, Claire Z.; Tulsky, David S.; Kisala, Pamela A.; Bombardier, Charles H.

    2015-01-01

    Objective To develop an item response theory (IRT) calibrated Grief and Loss item bank as part of the Spinal Cord Injury – Quality of Life (SCI-QOL) measurement system. Design A literature review guided framework development of grief/loss. New items were created from focus groups. Items were revised based on expert review and patient feedback and were then field tested. Analyses included confirmatory factor analysis (CFA), graded response IRT modeling and evaluation of differential item functioning (DIF). Setting We tested a 20-item pool at several rehabilitation centers across the United States, including the University of Michigan, Kessler Foundation, Rehabilitation Institute of Chicago, the University of Washington, Craig Hospital and the James J. Peters/Bronx Department of Veterans Affairs hospital. Participants A total of 717 individuals with SCI answered the grief and loss questions. Results The final calibrated item bank resulted in 17 retained items. A unidimensional model was observed (CFI = 0.976; RMSEA = 0.078) and measurement precision was good (theta range between −1.48 to 2.48). Ten items were flagged for DIF, however, after examination of effect sizes found this to be negligible with little practical impact on score estimates. Conclusions This study indicates that the SCI-QOL Grief and Loss item bank represents a psychometrically robust measurement tool. Short form items are also suggested and computer adaptive tests are available. PMID:26010969

  1. Measuring grief and loss after spinal cord injury: Development, validation and psychometric characteristics of the SCI-QOL Grief and Loss item bank and short form.

    PubMed

    Kalpakjian, Claire Z; Tulsky, David S; Kisala, Pamela A; Bombardier, Charles H

    2015-05-01

    To develop an item response theory (IRT) calibrated Grief and Loss item bank as part of the Spinal Cord Injury--Quality of Life (SCI-QOL) measurement system. A literature review guided framework development of grief/loss. New items were created from focus groups. Items were revised based on expert review and patient feedback and were then field tested. Analyses included confirmatory factor analysis (CFA), graded response IRT modeling and evaluation of differential item functioning (DIF). We tested a 20-item pool at several rehabilitation centers across the United States, including the University of Michigan, Kessler Foundation, Rehabilitation Institute of Chicago, the University of Washington, Craig Hospital and the James J. Peters/Bronx Department of Veterans Affairs hospital. A total of 717 individuals with SCI answered the grief and loss questions. The final calibrated item bank resulted in 17 retained items. A unidimensional model was observed (CFI=0.976; RMSEA=0.078) and measurement precision was good (theta range between -1.48 to 2.48). Ten items were flagged for DIF, however, after examination of effect sizes found this to be negligible with little practical impact on score estimates. This study indicates that the SCI-QOL Grief and Loss item bank represents a psychometrically robust measurement tool. Short form items are also suggested and computer adaptive tests are available.

  2. The Process of Change in Complicated Grief Group Therapy for Bereaved Dementia Caregivers: an Evaluation Using the Meaning of Loss Codebook.

    PubMed

    Supiano, Katherine P; Haynes, Lara Burns; Pond, Vicki

    2017-01-04

    Caring for a person with dementia is challenging and has adverse health and mental health effects that, for 9-25% of caregivers persist into bereavement in the form of complicated grief (CG). For those bereaved dementia caregivers unable to satisfactorily process grief, specialized Complicated Grief Group Therapy (CGGT) can restore a healthy grief process. We investigated the progression of therapeutic change in CGGT participants (N = 16 in three treatment groups), using an adapted version of Meaning of Loss Codebook (MLC; Gillies et al., 2014, 2015) that captured both negatively and positively valenced meaning of death themes in CGGT participants. We evaluated MLC coded video segments of group therapy sessions focusing on inflection points in grief transitions including retelling of the death story, voiced interpretation of imaginal conversations with the deceased care recipient and self-statements of change. Participants demonstrated positive gains in 16 thematic areas, most notably in moving on with life, in summoning pleasant memories, and in ascribing bad memories to disease rather than the decedent. Our hypothesis that meaning of loss themes would transition from negatively to positively valenced interpretations of the death over the course of treatment was supported, and will contribute to refinement of CGGT treatment.

  3. The Effectiveness of Family-Based Cognitive-Behavior Grief Therapy to Prevent Complicated Grief in Relatives of Suicide Victims: The Mediating Role of Suicide Ideation

    ERIC Educational Resources Information Center

    de Groot, Marieke; Neeleman, Jan; van der Meer, Klaas; Burger, Huibert

    2010-01-01

    Grief interventions are more effective for high risk individuals. The presence of suicide ideation following suicide bereavement was examined to determine whether it indicates a high risk status. Using data from a randomized controlled trial (n = 122) on the effectiveness of cognitive-behavior therapy, the effect of suicide ideation on the…

  4. The Effectiveness of Family-Based Cognitive-Behavior Grief Therapy to Prevent Complicated Grief in Relatives of Suicide Victims: The Mediating Role of Suicide Ideation

    ERIC Educational Resources Information Center

    de Groot, Marieke; Neeleman, Jan; van der Meer, Klaas; Burger, Huibert

    2010-01-01

    Grief interventions are more effective for high risk individuals. The presence of suicide ideation following suicide bereavement was examined to determine whether it indicates a high risk status. Using data from a randomized controlled trial (n = 122) on the effectiveness of cognitive-behavior therapy, the effect of suicide ideation on the…

  5. Grief interventions for people bereaved by suicide: A systematic review

    PubMed Central

    Steinig, Jana; Nagl, Michaela; Kersting, Anette

    2017-01-01

    Background Adaption to the loss of a loved one due to suicide can be complicated by feelings of guilt, shame, responsibility, rejection, and stigmatization. Therefore people bereaved by suicide have an increased risk for developing complicated grief which is related to negative physical and mental disorders and an increased risk for suicidal behavior. Grief interventions are needed for this vulnerable population. The aim of this systematic review was to provide an overview of the current state of evidence concerning the effectiveness of interventions that focus on grief for people bereaved by suicide. Methods We conducted a systematic literature search using PubMed, Web of Science, and PsycINFO for articles published up until November 2016. Relevant papers were identified and methodological quality was assessed by independent raters. A narrative synthesis was conducted. Results Seven intervention studies met the inclusion criteria. Two interventions were based on cognitive-behavioral approaches, four consisted of bereavement groups, and one utilized writing therapy. As five of the seven interventions were effective in reducing grief intensity on at least one outcome measure, there is some evidence that they are beneficial. Bereavement groups tend to be effective in lowering the intensity of uncomplicated grief, as are writing interventions in lowering suicide-specific aspects of grief. Cognitive-behavioral programs were helpful for a subpopulation of people who had high levels of suicidal ideation. Limitation On average, methodological quality was low so the evidence for benefits is not robust. The stability of treatment effects could not be determined as follow-up assessments are rare. Generalizability is limited due to homogeneous enrollments of mainly female, white, middle-aged individuals. Conclusions People bereaved by suicide are especially vulnerable to developing complicated grief. Therefore, grief therapies should be adapted to and evaluated in this

  6. Grief interventions for people bereaved by suicide: A systematic review.

    PubMed

    Linde, Katja; Treml, Julia; Steinig, Jana; Nagl, Michaela; Kersting, Anette

    2017-01-01

    Adaption to the loss of a loved one due to suicide can be complicated by feelings of guilt, shame, responsibility, rejection, and stigmatization. Therefore people bereaved by suicide have an increased risk for developing complicated grief which is related to negative physical and mental disorders and an increased risk for suicidal behavior. Grief interventions are needed for this vulnerable population. The aim of this systematic review was to provide an overview of the current state of evidence concerning the effectiveness of interventions that focus on grief for people bereaved by suicide. We conducted a systematic literature search using PubMed, Web of Science, and PsycINFO for articles published up until November 2016. Relevant papers were identified and methodological quality was assessed by independent raters. A narrative synthesis was conducted. Seven intervention studies met the inclusion criteria. Two interventions were based on cognitive-behavioral approaches, four consisted of bereavement groups, and one utilized writing therapy. As five of the seven interventions were effective in reducing grief intensity on at least one outcome measure, there is some evidence that they are beneficial. Bereavement groups tend to be effective in lowering the intensity of uncomplicated grief, as are writing interventions in lowering suicide-specific aspects of grief. Cognitive-behavioral programs were helpful for a subpopulation of people who had high levels of suicidal ideation. On average, methodological quality was low so the evidence for benefits is not robust. The stability of treatment effects could not be determined as follow-up assessments are rare. Generalizability is limited due to homogeneous enrollments of mainly female, white, middle-aged individuals. People bereaved by suicide are especially vulnerable to developing complicated grief. Therefore, grief therapies should be adapted to and evaluated in this population. Prevention of complicated grief may be

  7. Do we need to change our understanding of anticipatory grief in caregivers? A systematic review of caregiver studies during end-of-life caregiving and bereavement.

    PubMed

    Nielsen, Mette Kjaergaard; Neergaard, Mette Asbjoern; Jensen, Anders Bonde; Bro, Flemming; Guldin, Mai-Britt

    2016-03-01

    Caregivers of terminally ill patients may experience anticipatory grief or low levels of preparedness for the patient's impending death. Both concepts are related to a forewarning of the impending loss. Anticipatory grief has been suggested to be grief work before the loss, which would improve bereavement outcome, but recent studies indicate a negative impact. Hence, this review systematically investigates key issues relating to anticipatory grief and preparedness for the death; definitions, measurement tools, and potential effects on caregiver outcome. We used a systematic approach (PRISMA statement). Databases were searched for publications during 1990-2015. Studies on adult caregivers of terminally ill adult patients were included if anticipatory grief or preparedness was assessed by a measurement tool. Anticipatory grief was captured in the definition "pre-loss grief." High levels of grief and low levels of preparedness during caregiving were associated with poor bereavement outcome such as complicated grief. The assumptions that grief work before the loss would alleviate bereavement outcome was not confirmed. Thus, the concept of anticipatory grief is questioned. High preparedness was associated with improved caregiver outcome. Additional support should be given to caregivers with pre-loss grief and low preparedness. Copyright © 2016 Elsevier Ltd. All rights reserved.

  8. Prevalence and psychological correlates of complicated grief among bereaved adults 2.5-3.5 years after September 11th attacks.

    PubMed

    Neria, Yuval; Gross, Raz; Litz, Brett; Maguen, Shira; Insel, Beverly; Seirmarco, Gretchen; Rosenfeld, Helena; Suh, Eun Jung; Kishon, Ronit; Cook, Joan; Marshall, Randall D

    2007-06-01

    A Web-based survey of adults who experienced loss during the September 11, 2001, terrorist attacks was conducted to examine the prevalence and correlates of complicated grief (CG) 2.5-3.5 years after the attacks. Forty-three percent of a study group of 704 bereaved adults across the United States screened positive for CG. In multivariate analyses, CG was associated with female gender, loss of a child, death of deceased at the World Trade Center, and live exposure to coverage of the attacks on television. Posttraumatic stress disorder, major depression, anxiety, suicidal ideation, and increase in post-9/11 smoking were common among participants with CG. A majority of the participants with CG reported receiving grief counseling and psychiatric medication after 9/11. Clinical and policy implications are discussed.

  9. Understanding Grief and Loss

    MedlinePlus

    ... Loss > Understanding Grief and Loss Request Permissions Understanding Grief and Loss Approved by the Cancer.Net Editorial ... of grief and mourning after a loss. Common grief reactions Reactions to loss, called grief reactions, vary ...

  10. The heterogeneity of long-term grief reactions.

    PubMed

    Lotterman, Jenny H; Bonanno, George A; Galatzer-Levy, Isaac

    2014-01-01

    Individuals experience the loss of a spouse in varied ways. There is growing recognition of major depressive disorder and complicated grief as distinct post-bereavement disorders. However, most studies focusing on these different courses of functioning have not examined pre-loss functioning. We used data from a prospective population based study to examine depression and grief among conjugally bereaved older adults. We compared latent trajectories of grief and depression symptoms based on data from pre-loss and 6, 18, and 48 months post-loss, and examined a number of pre- and post-loss predictor variables. The chronic grief and chronic depression trajectories did not differ in grief symptoms at any post-loss time point. However, a number of pre- and post-loss variables uniquely differentiated these two distinct trajectories. Measures used in the current study were based on self-report and compared only two trajectories. Additionally, the sample was restricted to older adults (M age=72) and thus our findings may not generalize to younger populations. These two distinct trajectories--chronic grief and chronic depression--may appear similar when examining grief symptoms alone, though it is apparent that they have different long-term courses of functioning. It is important to understand pre-loss functioning as well as variables associated with each group in order to appropriately target treatment. Copyright © 2014 Elsevier B.V. All rights reserved.

  11. Dreams of the Dead among Cambodian Refugees: Frequency, Phenomenology, and Relationship to Complicated Grief and Posttraumatic Stress Disorder

    ERIC Educational Resources Information Center

    Hinton, Devon E.; Field, Nigel P.; Nickerson, Angela; Bryant, Richard A.; Simon, Naomi

    2013-01-01

    The authors investigated the importance of dreams of the deceased in the experiencing of prolonged grief (PG) and posttraumatic stress disorder (PTSD) among Cambodian refugees who survived the Pol Pot genocide (1975-1979). Such dreams were frequent in the last month (52% of those surveyed), and most often involved a relative who died in the Pol…

  12. Dreams of the Dead among Cambodian Refugees: Frequency, Phenomenology, and Relationship to Complicated Grief and Posttraumatic Stress Disorder

    ERIC Educational Resources Information Center

    Hinton, Devon E.; Field, Nigel P.; Nickerson, Angela; Bryant, Richard A.; Simon, Naomi

    2013-01-01

    The authors investigated the importance of dreams of the deceased in the experiencing of prolonged grief (PG) and posttraumatic stress disorder (PTSD) among Cambodian refugees who survived the Pol Pot genocide (1975-1979). Such dreams were frequent in the last month (52% of those surveyed), and most often involved a relative who died in the Pol…

  13. Coping Style Use Predicts Posttraumatic Stress and Complicated Grief Symptom Severity Among College Students Reporting a Traumatic Loss

    ERIC Educational Resources Information Center

    Schnider, Kimberly R.; Elhai, Jon D.; Gray, Matt J.

    2007-01-01

    Problem-focused coping, and active and avoidant emotional coping were examined as correlates of grief and posttraumatic stress disorder (PTSD) severity among 123 college students reporting the unexpected death of an immediate family member, romantic partner, or very close friend. The authors administered to participants, via the Internet, 5…

  14. "Every time that month comes, I remember": using cognitive interviews to adapt grief measures for use with bereaved adolescents in South Africa.

    PubMed

    Taylor, Tory M; Thurman, Tonya R; Nogela, Lineo

    2016-07-01

    To assess standard grief measures through cognitive interviews with bereaved adolescents in Free State, South Africa, and make recommendations designed to improve the measurement of grief in this and similar populations. Twenty-one parentally bereaved adolescents participated in semi-structured cognitive interviews about the Core Bereavement Items (CBI) questionnaire, Grief Cognitions Questionnaire for Children (GCQ-C), or Intrusive Griefs Thoughts Scale (IGTS). Interviewees offered valuable insights for improving grief measurement with this population (e.g., consensus that not thinking frequently about a deceased loved one was shameful, aversion to terms including "died"). Participants were better able to apply response options denoting specific frequencies (e.g., "once or twice a week") versus general ones (e.g., "a little bit of the time"). Questions intended to gauge grief commonly elicited responses reflecting the impact of loss on adolescents' basic survival instead of psychological wellbeing. The need for psychological support is high among orphans and vulnerable children. Tools for measuring psychological outcomes can provide evidence of programme effects and guide decision making about investment. Grief measures used with adolescents in South Africa should account for the issues raised by cognitive interviewees in the study, including question and response option complexity, linguistic preferences, and cultural norms.

  15. Death and Grief

    MedlinePlus

    ... A Week of Healthy Breakfasts Shyness Death and Grief KidsHealth > For Teens > Death and Grief Print A ... Yourself en español Muerte y duelo What Is Grief? Grief is the reaction we have in response ...

  16. Grief: Coping with the Reminders After a Loss

    MedlinePlus

    ... but also allow yourself to experience joy and happiness. As you celebrate special times, you might find ... life, consult a grief counselor or other mental health provider. Unresolved or complicated grief can lead to ...

  17. Distinguishing Symptoms of Grief and Depression in a Cohort of Advanced Cancer Patients

    PubMed Central

    Jacobsen, Juliet C.; Zhang, Baohui; Block, Susan D.; Maciejewski, Paul K.; Prigerson, Holly G.

    2010-01-01

    Several studies have shown that the symptoms of grief are different from symptoms of depression among bereaved family members. This study is an attempt to replicate this finding among advanced cancer patients and examine clinical correlates of patient grief and depression. Analyses were conducted on data from interviews with 123 advanced cancer patients. Grief was measured using symptoms from the patient version of the Inventory of Complicated Grief-Revised (ICG-R) and symptoms of depression were assessed using the Structured Clinical Interview for DSM-IV (SCID). A factor analysis revealed that symptoms of patient grief formed a coherent factor that was distinct from a depression factor. Patient grief “caseness” (defined as being in the top 10% of the distribution of grief scores), but not MDD, was uniquely associated with the wish to die (OR 10.13 [0.1.08-95.06]). Both depression and grief were significantly associated with mental health service use (OR 16.07 [1.68, 153.77] vs. 4.82 CI=[1.09, 21.41]) and negative religious coping (OR 1.36 [1.06, 1.73] vs. 1.25 [1.05, 1.49]); neither was associated with terminal illness acknowledgement. PMID:20953316

  18. Dreams of the dead among Cambodian refugees: frequency, phenomenology, and relationship to complicated grief and posttraumatic stress disorder.

    PubMed

    Hinton, Devon E; Field, Nigel P; Nickerson, Angela; Bryant, Richard A; Simon, Naomi

    2013-09-01

    The authors investigated the importance of dreams of the deceased in the experiencing of prolonged grief (PG) and posttraumatic stress disorder (PTSD) among Cambodian refugees who survived the Pol Pot genocide (1975-1979). Such dreams were frequent in the last month (52% of those surveyed), and most often involved a relative who died in the Pol Pot period. Past month frequency was correlated with PG severity (r = .59) and PTSD severity (r = .52). The dreams were almost always deeply upsetting because the dreams indicated the deceased to be in a difficult spiritual state. Dreams of the deceased as a central component of PG and PTSD among Cambodian refugees is discussed.

  19. Preloss grief in family caregivers during end-of-life cancer care: A nationwide population-based cohort study.

    PubMed

    Nielsen, Mette Kjaergaard; Neergaard, Mette Asbjoern; Jensen, Anders Bonde; Vedsted, Peter; Bro, Flemming; Guldin, Mai-Britt

    2017-03-07

    Severe grief symptoms in family caregivers during end-of-life cancer trajectories are associated with complicated grief and depression after the loss. Nevertheless, severe grief symptoms during end-of-life caregiving in caregivers to cancer patients have been scarcely studied. We aimed to explore associations between severe preloss grief symptoms in caregivers and modifiable factors such as depressive symptoms, caregiver burden, preparedness for death, and end-of-life communication. We conducted a population-based prospective study of caregivers to 9512 patients registered with drug reimbursement due to terminal illness, and 3635 caregivers responded. Of these, 2865 caregivers to cancer patients completed a preloss grief scale (Prolonged Grief 13, preloss version). Associations with factors measured during end-of-life caregiving were analyzed using logistic regression. Severe preloss grief symptoms were reported by 432 caregivers (15.2%). These symptoms were associated with depressive symptoms (adjusted odds ratio [OR] = 12.4; 95% CI, 9.5-16.3), high caregiver burden (adjusted OR = 8.3; 95% CI, 6.3-11.1), low preparedness for death (adjusted OR = 3.3; 95% CI, 2.5-4.4), low level of communication about dying (adjusted OR = 3.2; 95% CI, 2.2-4.4), and "too much" prognostic information (adjusted OR = 2.8; 95%, 1.7-4.6). Severe preloss grief symptoms were significantly associated with distress, low preparedness, and little communication during caregiving. Thus, severe preloss grief symptoms may be a key indicator for complications in caregivers of cancer patients in an end-of-life trajectory. Targeted interventions are needed to support family caregivers with severe preloss grief symptoms. Development of preloss grief assessment tools and interventions should be a priority target in future research. Copyright © 2017 John Wiley & Sons, Ltd.

  20. Normal grief and complicated bereavement among traumatized Cambodian refugees: cultural context and the central role of dreams of the dead.

    PubMed

    Hinton, Devon E; Peou, Sonith; Joshi, Siddharth; Nickerson, Angela; Simon, Naomi M

    2013-09-01

    This article profiles bereavement among traumatized Cambodian refugees and explores the validity of a model of how grief and post-traumatic stress disorder (PTSD) interact in this group to form a unique bereavement ontology, a model in which dreams of the dead play a crucial role. Several studies were conducted at a psychiatric clinic treating Cambodian refugees who survived the Pol Pot genocide. Key findings included that Pol Pot deaths were made even more deeply disturbing owing to cultural ideas about "bad death" and the consequences of not performing mortuary rites; that pained recall of the dead in the last month was common (76 % of patients) and usually caused great emotional and somatic distress; that severity of pained recall of the dead was strongly associated with PTSD severity (r = .62); that pained recall was very often triggered by dreaming about the dead, usually of someone who died in the Pol Pot period; and that Cambodians have a complex system of interpretation of dreams of the deceased that frequently causes those dreams to give rise to great distress. Cases are provided that further illustrate the centrality of dreams of the dead in the Cambodian experiencing of grief and PTSD. The article shows that not assessing dreams and concerns about the spiritual status of the deceased in the evaluation of bereavement results in "category truncation," i.e., a lack of content validity, a form of category fallacy.

  1. Normal Grief and Complicated Bereavement among Traumatized Cambodian Refugees: Cultural Context and the Central Role of Dreams of the Dead

    PubMed Central

    Hinton, Devon E.; Peou, Sonith; Joshi, Siddharth; Nickerson, Angela; Simon, Naomi

    2013-01-01

    This article profiles bereavement among traumatized Cambodian refugees and explores the validity of a model of how grief and PTSD interact in this group to form a unique bereavement ontology, a model in which dreams of the dead play a crucial role. Several studies were conducted at a psychiatric clinic treating Cambodian refugees who survived the Pol Pot genocide. Key findings included that Pol Pot deaths were made even more deeply disturbing owing to cultural ideas about “bad death” and the consequences of not performing mortuary rites; that pained recall of the dead in the last month was common (76% of patients) and usually caused great emotional and somatic distress; that severity of pained recall of the dead was strongly associated with PTSD severity (r = .62); that pained recall was very often triggered by dreaming about the dead, usually of someone who died in the Pol Pot period; and that Cambodians have a complex system of interpretation of dreams of the deceased that frequently causes those dreams to give rise to great distress. Cases are provided that further illustrate the centrality of dreams of the dead in the Cambodian experiencing of grief and PTSD. The article shows that not assessing dreams and concerns about the spiritual status of the deceased in the evaluation of bereavement results in “category truncation,” i.e., a lack of content validity, a form of category fallacy. PMID:23868080

  2. “I Was Just Trying To Stick It Out Until I Realized That I Couldn't”: A Phenomenological Investigation of Support Seeking Among Older Adults With Complicated Grief*

    PubMed Central

    Ghesquiere, Angela

    2014-01-01

    Complicated Grief (CG) is a prolonged, impairing mental health condition affecting about 7% of the bereaved. CG may be especially prevalent in older adults. Though evidence-based treatments for CG have been developed, little is known about support-seeking in older adults with CG. This study used the descriptive phenomenological approach to explore the CG support-seeking process. In-depth interviews were conducted with 8 CG-positive older adults who had completed participation in a randomized clinical trial of CG treatment. Five primary themes arose: observing that grief was causing a great deal of distress and impairment; grief not meeting expectations of what grief “should be”; an important influence of social relationships on support-seeking; lack of effectiveness of grief support groups and/or care from mental health professionals prior to study enrollment; and strong reactions to the label of CG. Themes may hep inform efforts to engage older adults with CG in effective care. PMID:24547662

  3. What is "normal" in grief?

    PubMed

    Arizmendi, Brian J; O'Connor, Mary-Frances

    2015-05-01

    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. Copyright © 2015 Australian College of Critical Care Nurses Ltd. Published by Elsevier Ltd. All rights reserved.

  4. Grief in the context of HIV: recommendations for practice.

    PubMed

    Mallinson, R Kevin

    2013-01-01

    Grief is a universal human response to loss. While the symptoms of grief are distressing and uncomfortable, they usually diminish over time without therapy. For persons grieving an HIV-related death, however, a variety of unique factors may interfere with the healthy resolution of symptoms. When the grief process becomes complicated, a person may experience serious alterations in physical health and/or disruptions in daily functioning. To assess grief, nurses need to apply interpersonal skills and therapeutic communication techniques in a compassionate manner; currently, no one screening instrument is optimal for evaluating grief in the clinical setting. The person experiencing grief or complicated grief may be referred for support services or counseling, pharmacologic interventions, or cognitive behavioral therapy. This report summarizes evidence from the literature and clinical practice to support recommendations for the practice of nurses caring for persons with HIV-associated grief; recommended strategies are illustrated through an exemplar case study.

  5. Grief reactions in dementia carers: a systematic review.

    PubMed

    Chan, Diana; Livingston, Gill; Jones, Louise; Sampson, Elizabeth L

    2013-01-01

    Supporting dementia carers is an identified target of the UK government, yet we know little about such family carers' grief before and after the death of the person with dementia for whom they care. We systematically review the existing literature on characteristics, prevalence, predictors and associations of grief in dementia carers before and after death. We searched electronic databases and found 31 publications meeting predetermined criteria. Grief in dementia carers, which may be normal or complicated, is a complex reaction to losses occurring before and after death. Carers experience anticipatory grief as multiple losses for themselves (companionship, personal freedom and control) and the person with dementia. Anticipation and ambiguity about the future, anger, frustration and guilt are core features. Anticipatory grief is greatest in moderate to severe stage dementia and spouse carers, especially when the person with dementia is institutionalised. There was poor quality evidence about the prevalence of grief; studies reported anticipatory grief between 47% and 71%, and complicated grief after death is estimated around 20%. Carer depression increases with anticipatory grief. Being a spouse carer and being depressed are the strongest predictors of complicated and normal grief after death. Grief in dementia carers can be expected; however, those at risk of distressing anticipatory and complicated grief may be identified and targeted for intervention when necessary. Higher quality research from a wider range of samples and countries is needed to explore this complex and emergent topic. Copyright © 2012 John Wiley & Sons, Ltd.

  6. Effectiveness of psychosocial interventions in reducing grief experienced by family carers of people with dementia: a systematic review.

    PubMed

    Wilson, Sally; Toye, Christine; Aoun, Samar; Slatyer, Susan; Moyle, Wendy; Beattie, Elizabeth

    2017-03-01

    Family carers of people living and dying with dementia experience grief. The prevalence, predictors and associated factors of grief in this population have been identified, and psychosocial interventions to decrease grief symptoms have been implemented. However, the effect of psychosocial interventions on family carers' grief, loss or bereavement has not been examined. To synthesize the existing evidence regarding the impact of psychosocial interventions to assist adjustment to grief, pre- and post-bereavement, for family carers of people with dementia. Family carers of older persons with dementia (>65 years). Psychosocial interventions in health and social care facilities, and community settings designed to assist family carers adjust to grief during the dementia trajectory and/or following death. No treatment, standard care or treatment as usual, or an alternative intervention. Experimental and epidemiological study designs. Grief in family carers including anticipatory, complicated and prolonged grief disorder measured with validated instruments. A three-step strategy sought to identify both published and unpublished studies from 1995. Assessed by two independent reviewers using standardized critical appraisal tools from the Joanna Briggs Institute Meta Analysis of Statistics Assessment and Review Instrument (JBI-MAStARI). The standardized data extraction tool from JBI-MAStARI was used by two reviewers independently. Statistical pooling of results was not possible due to the heterogeneity of the interventions and the outcome measures. Data were extracted from three studies. Study designs were a randomized controlled trial; a pre-test, multiple post-test quasi-experimental; and a single group, repeated measures. The interventions were multi-component, had durations of nine to 26 weeks and were delivered while care recipients were alive. All studies were undertaken in the United States. There were 327 family carers, of which 197 received a psychosocial

  7. Grief counseling.

    PubMed Central

    Borins, M.

    1995-01-01

    Patients grieve the loss of loved ones, jobs, marriages, or even functioning. They seek comfort, understanding, respect, and especially hope. The "work of grief" progresses through stages. Mixed with the sadness can be feelings of anger, fear, and guilt. Psychotherapy can relieve self-destructive anger and guilt, advance the recovery phase, and stimulate psychological strength and personality growth. PMID:7647626

  8. Parental Grief Responses and Personal Growth Following the Death of a Child

    ERIC Educational Resources Information Center

    Riley, Linda P.; LaMontagne, Lynda L.; Hepworth, Joseph T.; Murphy, Barbara A.

    2007-01-01

    Conceptualizing parental grief as a psychosocial transition, this cross-sectional study of bereaved mothers (N = 35) examined the relationship of dispositional factors, grief reactions, and personal growth. More optimistic mothers reported less intense grief reactions and less distress indicative of complicated grief. Additionally, mothers who…

  9. Childhood Traumatic Grief

    MedlinePlus

    ... Educators Resources for Kids and Teens Childhood Traumatic Grief What is Childhood Traumatic Grief? Children grieve in their own way following the ... child may have a condition called Childhood Traumatic Grief (CTG). Thinking about the person who died—even ...

  10. Dealing with Your Grief

    MedlinePlus

    ... grief > Dealing with your grief Dealing with your grief E-mail to a friend Please fill in ... can do to help you feel better. Order bereavement materials Order our resources for grieving families , including ...

  11. Grief and loss for patients before and after heart transplant.

    PubMed

    Poole, Jennifer; Ward, Jennifer; DeLuca, Enza; Shildrick, Margrit; Abbey, Susan; Mauthner, Oliver; Ross, Heather

    2016-01-01

    The purpose of the study was to examine the loss and grief experiences of patients waiting for and living with new hearts. There is much scholarship on loss and grief. Less attention has been paid to these issues in clinical transplantation, and even less on the patient experience. Part of a qualitative inquiry oriented to the work of Merleau-Ponty, a secondary analysis was carried out on audiovisual data from interviews with thirty participants. Patients experience loss and three forms of grief. Pre-transplant patients waiting for transplant experience loss and anticipatory grief related to their own death and the future death of their donor. Transplanted patients experience long-lasting complicated grief with respect to the donor and disenfranchised grief which may not be sanctioned. Loss as well as anticipatory, complicated and disenfranchised grief may have been inadvertently disregarded or downplayed. More research and attention is needed. Copyright © 2016 Elsevier Inc. All rights reserved.

  12. Potential Use of Ayahuasca in Grief Therapy.

    PubMed

    González, Débora; Carvalho, María; Cantillo, Jordi; Aixalá, Marc; Farré, Magí

    2017-01-01

    The death of a loved one is ultimately a universal experience. However, conventional interventions employed for people suffering with uncomplicated grief have gathered little empirical support. The present study aimed to explore the potential effects of ayahuasca on grief. We compared 30 people who had taken ayahuasca with 30 people who had attended peer-support groups, measuring level of grief and experiential avoidance. We also examined themes in participant responses to an open-ended question regarding their experiences with ayahuasca. The ayahuasca group presented a lower level of grief in the Present Feelings Scale of Texas Revised Inventory of Grief, showing benefits in some psychological and interpersonal dimensions. Qualitative responses described experiences of emotional release, biographical memories, and experiences of contact with the deceased. Additionally, some benefits were identified regarding the ayahuasca experiences. These results provide preliminary data about the potential of ayahuasca as a therapeutic tool in treatments for grief.

  13. Acute versus chronic grief: the case of pregnancy loss.

    PubMed

    Lasker, J N; Toedter, L J

    1991-10-01

    Conceptual and measurement problems in identifying those at risk of chronic grief are reviewed, and results are presented of a longitudinal study of people who have experienced pregnancy loss. Coping resources, particularly prior mental health and social support, were the best predictors of low scores on subscales of the Perinatal Grief Scale that indicate chronic grief reactions. Results also offer some evidence of delayed grief responses, especially among men and those who experienced early losses.

  14. The effect of bereavement groups on grief, anxiety, and depression - a controlled, prospective intervention study.

    PubMed

    Näppä, Ulla; Lundgren, Ann-Britt; Axelsson, Bertil

    2016-07-12

    Bereavement groups are believed to be beneficial as preventive interventions to reduce the development of complicated grief for people at risk after the death of a significant other. This study aimed to investigate whether measurable effects on grief, anxiety, and depression could be detected in those participating in bereavement groups compared to non-participating controls. Questionnaires covering the Texas Revised Inventory of Grief (TRIG), the Hospital Anxiety and Depression Scale (HADS), and background questions were handed out pre-intervention, five weeks and one year post-intervention to bereaved caregivers invited to bereavement groups. The results were analysed with non-parametric methods. A total of 124 individuals answered the questionnaires, and were divided into three categories: participants, non-participants unable to participate, and non-participants not wanting to participate in bereavement groups. At the one-year follow up, participants and those unable to participate reported higher levels of grief and were more anxious than those not wanting to participate. Depression did not differ between the groups. Participation in bereavement groups did not produce any effects on grief, anxiety, or depression in comparison to non-participants who were unable to participate. Non-participants who did not want to participate reported lower levels of grief and anxiety than the other two groups.

  15. The Continuing Process of Parental Grief

    ERIC Educational Resources Information Center

    Arnold, Joan; Gemma, Penelope Buschman

    2008-01-01

    The death of a child is an incomprehensible and devastating loss. Grief for parents is lifelong, becoming the connection between parent and child. To extend and deepen current understanding of parental grief, a new survey instrument was developed, combining quantitative and qualitative measures. The qualitative findings from this combined…

  16. The Continuing Process of Parental Grief

    ERIC Educational Resources Information Center

    Arnold, Joan; Gemma, Penelope Buschman

    2008-01-01

    The death of a child is an incomprehensible and devastating loss. Grief for parents is lifelong, becoming the connection between parent and child. To extend and deepen current understanding of parental grief, a new survey instrument was developed, combining quantitative and qualitative measures. The qualitative findings from this combined…

  17. Prevalence and predictors of parental grief and depression after the death of a child from cancer.

    PubMed

    McCarthy, Maria C; Clarke, Naomi E; Ting, Cheng Lin; Conroy, Rowena; Anderson, Vicki A; Heath, John A

    2010-11-01

    To investigate patterns of grief and depression in a sample of parents whose child had died of cancer, and to examine factors related to burden of illness and end-of-life care as potential predictors of parental grief and depression outcomes. Fifty-eight parents completed standardized self-report questionnaires measuring prolonged grief disorder (Inventory of Complicated Grief-Revised [ICG-R]) and depression (Beck Depression Inventory-Second Edition [BDI-II]) and participated in structured interviews designed to elicit their perceptions of their child's end-of-life care and burden of illness. The majority of participants were mothers (84%) and the mean length of time since child death was 4.5 (standard deviation [SD] = 2.4) years (range, 1.0-9.8 years). Rates of prolonged grief disorder (PGD) were similar to those reported in other bereaved populations (10.3%); however, 41% of parents met diagnostic criteria for grief-related separation distress. Twenty-two percent of parents reported clinically significant depressive symptoms. Time since death and parental perception of the oncologist's care predicted parental grief symptoms but not depressive symptoms. Perceptions of the child's quality of life during the last month, preparedness for the child's death, and economic hardship also predicted grief and depression outcomes. A minority of parents met criteria for PGD and depression, however, almost half the sample was experiencing significant separation distress associated with persistent longing and yearning for their child. Time since death is a significant predictor of parental psychological distress. This study also highlights the importance of end-of-life factors in parents' long-term adjustment and the need for optimal palliative care to ensure the best possible outcomes for parents.

  18. The MM-CGI Cerebral Palsy: modification and pretesting of an instrument to measure anticipatory grief in parents whose child has cerebral palsy.

    PubMed

    Al-Gamal, Ekhlas; Long, Tony

    2014-07-01

    To establish the potential of a modified version of the MM-CGI Childhood Cancer to assess anticipatory grief in parents of children with cerebral palsy, to amend the existing scale for use with the specific patient group, to test the psychometric properties of the modified version (MM-CGI Cerebral Palsy) and to review the clinical potential of the new scale. Parents of children with cerebral palsy may experience reactions similar to parents of children with other enduring or life-limiting conditions, and anticipatory grief may be one such psychological reaction. While the burden of caring is sometimes balanced by positive perceptions of the child, which enhance coping ability, for many parents the outcome is damage to their physical and mental health and impaired family functioning. A cross-sectional, descriptive, correlational design. The MM-CGI Cerebral Palsy was administered in structured interviews with 204 parents. Standardised measures of caregivers' depression, stress and perceived social support were also administered. Mothers and fathers were recruited from healthcare centres and schools for special education. Cronbach's alpha was used to assess internal consistency, and Pearson's product-moment correlation was used to assess construct validity. The subscales were each found to measure a single dimension of anticipatory grief, and significant correlations were established with existing instruments. The instrument demonstrated excellent internal consistency reliability and good construct validity. The MM-CGI Cerebral Palsy could be useful for diagnosing anticipatory grief among parents of children with cerebral palsy. This preliminary work moves the programme on to testing in intervention studies. In the absence of an existing measure for the assessment of anticipatory grief, specifically in parents of children with cerebral palsy, the MM-CGI Cerebral Palsy could prove to be an effective assessment tool for clinicians and researchers. © 2013 John Wiley

  19. Children and grief

    MedlinePlus

    ... medlineplus.gov/ency/patientinstructions/000749.htm Children and grief To use the sharing features on this page, ... your own child, learn the normal responses to grief that children have and the signs when your ...

  20. An Investigation of the Relationship of Personality, Coping, and Grief Intensity among Bereaved Mothers

    ERIC Educational Resources Information Center

    Robinson, Tristan; Marwit, Samuel J.

    2006-01-01

    A mediational model of grief intensity (Meuser & Marwit, 2000) was examined in a population at risk for complicated grief. Coping strategies (emotion-oriented, task-oriented, and avoidance-oriented coping) were hypothesized to mediate the influence of personality factors (neuroticism and extraversion) on grief. Bereaved mothers (N =138)…

  1. Culinary Grief Therapy: Cooking for One Series.

    PubMed

    Nickrand, Heather L; Brock, Cara M

    2017-02-01

    Although loss of loved ones is a universal experience, individuals who experience this loss grieve in different ways. Complicated grief involves the development of trauma symptoms, such as flashbacks, anxiety, and fear associated with daily activities after a death that disrupts the healthy grieving process. Daily activities such as eating, meal planning, grocery shopping, managing finances, and household maintenance can become painful and isolating for those experiencing complicated grief. Cognitive behavioral therapy is used to address irrational beliefs, feelings of depression or anger, and avoidance or numbing behaviors with a goal of leading the individual to adapting to a life, which no longer includes the lost loved one. As part of the bereavement counseling program in a hospice, a need was identified in individuals who had lost loved ones and were having difficulty with adjusting to meal planning, grocery shopping, and cooking for one. To address this need for grief counseling centered on meal planning, grocery shopping, meal preparations, and eating meals alone, "Culinary Grief Therapy: Cooking for One Series" was developed with a local Culinary Arts Program. Partnering with a local community college culinary arts program, the Cooking for One Series provides an interactive venue for cognitive behavioral therapy centered on meal planning and meal times. Along with demonstrations and hands-on experiences, participants are engaged in bereavement counseling with hospice staff. Initial reactions to Culinary Grief Therapy have been positive. Many attendees have participated in multiple workshops, and the number of participants grows for each offering. Culinary Grief Therapy is a novel approach to the needs of those experiencing the loss of a loved one and may reduce or prevent complicated grief associated with meal planning, grocery shopping, and cooking for one.

  2. “Prolonged grief disorder” and “persistent complex bereavement disorder”, but not “complicated grief”, are one and the same diagnostic entity: an analysis of data from the Yale Bereavement Study

    PubMed Central

    Maciejewski, Paul K.; Maercker, Andreas; Boelen, Paul A.; Prigerson, Holly G.

    2016-01-01

    There exists a general consensus that prolonged grief disorder (PGD), or some variant of PGD, represents a distinct mental disorder worthy of diagnosis and treatment. Nevertheless, confusion remains over whether different names and proposed symptom criteria for this disorder identify the same or different diagnostic entities. This study aimed to determine whether PGD, complicated grief (CG), and persistent complex bereavement disorder (PCBD) as described by the DSM‐5 are substantively or merely semantically different diagnostic entities. Data were derived from the Yale Bereavement Study, a longitudinal community‐based study of bereaved individuals funded by the US National Institute of Mental Health, designed explicitly to evaluate diagnostic criteria for disordered grief. The results suggested that the difference between PGD and PCBD is only semantic. The level of agreement between the original PGD test, a new version of the PGD test proposed for ICD‐11 and the PCBD test was high (pairwise kappa coefficients = 0.80‐0.84). Their estimates of rate of disorder in this community sample were similarly low (∼10%). Their levels of diagnostic specificity were comparably high (95.0‐98.3%). Their predictive validity was comparable. In contrast, the test for CG had only moderate agreement with those for PGD and PCBD; its estimate of rate of disorder was three‐fold higher (∼30%); its diagnostic specificity was poorer, and it had no predictive validity. We conclude that PGD, PCBD and proposed ICD‐11, but not CG, symptom‐diagnostic tests identify a single diagnostic entity. Ultimately, brief symptom‐diagnostic tests, such as the one proposed here for ICD‐11, may have the greatest clinical utility. PMID:27717273

  3. Dementia Grief: A Theoretical Model of a Unique Grief Experience

    PubMed Central

    Blandin, Kesstan; Pepin, Renee

    2016-01-01

    Previous literature reveals a high prevalence of grief in dementia caregivers before physical death of the person with dementia that is associated with stress, burden, and depression. To date, theoretical models and therapeutic interventions with grief in caregivers have not adequately considered the grief process, but instead have focused on grief as a symptom that manifests within the process of caregiving. The Dementia Grief Model explicates the unique process of pre-death grief in dementia caregivers. In this paper we introduce the Dementia Grief Model, describe the unique characteristics dementia grief, and present the psychological states associated with the process of dementia grief. The model explicates an iterative grief process involving three states – separation, liminality, and re-emergence – each with a dynamic mechanism that facilitates or hinders movement through the dementia grief process. Finally, we offer potential applied research questions informed by the model. PMID:25883036

  4. Abnormal Grief: Should We Consider a More Patient-Centered Approach?

    PubMed

    Moayedoddin, Babak; Markowitz, John C

    2015-01-01

    Grief, the psychological reaction to the loss of a significant other, varies complexly in its cause, experience, evolution, and prognosis. Although most bereaved individuals experience a normal grieving process, some develop complicated grief (CG) or major depressive disorder (MDD). The DSM-5, which controversially altered the nosology, recognizes grief-related major depression (GRMD) as a diagnostic subtype if a patient meets MDD criteria two weeks post bereavement. The (DSM-5) tries to distinguish between grief and MDD, but remains a symptom-based, centered approach to grief that is not patient centered. This article reviews grief in its normal and abnormal dimensions. Using an illustrative clinical case in which interpersonal psychotherapy (IPT) was employed, we discuss the need for a more patient-centered approach to treating abnormal grief, considering the patient's personal history, perceptions, experiences of bereavement, and interpersonal environment. Clinical studies need to better identify subgroups of individuals susceptible to abnormal grief and to evaluate their response to early interventions.

  5. Assisting the bereaved: A systematic review of the evidence for grief counselling.

    PubMed

    Waller, Amy; Turon, Heidi; Mansfield, Elise; Clark, Katherine; Hobden, Bree; Sanson-Fisher, Rob

    2016-02-01

    Supporting people after bereavement is a priority area for many health services. Investment in bereavement care must be supported by a rigorous evidence-base. To examine the (1) relative proportion of descriptive, measurement and intervention research in grief counselling and (2) quality and effectiveness of intervention studies. Systematic review of studies published in the area of grief counselling. MEDLINE, Embase, Cochrane Library and PsycINFO databases were searched for studies published between 2000 and 2013. Eligible papers were categorised into descriptive, measurement, review, commentaries and intervention studies. Intervention studies were assessed against the Cochrane Effective Practice and Organisation of Care methodological criteria, and papers meeting criteria were assessed for quality. The impact of interventions on grief, psychological morbidity and quality of life was examined. A total of 126 data-based papers, including 47 descriptive, 3 measurement and 76 grief counselling intervention studies were included. Only 59% (n = 45) of intervention studies met Effective Practice and Organisation of Care design criteria. Overall, study quality was poor, with the majority of interventions showing a risk of bias in several key areas. The three studies that met all criteria showed mixed effectiveness. Grief counselling interventions require a strong rationale for design, and a systematic approach to development and evaluation. Descriptive research efforts should inform this process, focusing on homogeneity in sample, identification of risk factors for complicated grief and the impact of extraneous factors on intervention effects. Interventions should include comparisons to usual care, as well as replication to confirm positive findings. © The Author(s) 2015.

  6. Effects of Mental Health Support on the Grief of Bereaved People Caused by Sewol Ferry Accident.

    PubMed

    Han, Hyesung; Noh, Jin Won; Huh, Hyu Jung; Huh, Seung; Joo, Ji Young; Hong, Jin Hyuk; Chae, Jeong Ho

    2017-07-01

    Few studies have assessed the overall effects of multi-centered, complicated mental health support on the grief process. This study investigated the broader influence of mental health support provided practically to the bereaved family on the severity of complicated grief. Ninety-three bereaved family members of the Sewol ferry accident were recruited. Severity of complicated grief, post-traumatic stress disorder (PTSD) and depressive disorder was assessed through self-reporting questionnaire, inventory of complicated grief (ICG), PTSD Check List-5 (PCL-5) and Patient Health Questionnaire-9 (PHQ-9). We also included demographic, socioeconomic, health-related variables, and Functional Social Support Questionnaire (FSSQ), which affect the ICG score. Participants were divided into 4 groups based on the experience of psychotherapy or psychiatry clinic service before the accident and mental health support after the disaster. In univariate analysis, these 4 groups showed a significant difference in the mean ICG score (P = 0.020). Participants who received mental health support only after the Sewol ferry accident (group 2) showed a lower mean ICG score than those who received neither psychotherapy or psychiatry clinic service before the disaster nor mental health support after the accident (group 4). There was no significant correlation between the ICG score and other variables except for subjective health status measured 1 month after the disaster (P = 0.005). There was no significant difference in PCL-5 (P = 0.140) and PHQ-9 scores (P = 0.603) among groups, respectively. In conclusion, mental health support significantly reduced the severity of grief only in those participants who had not received any psychotherapy or psychiatry clinic service before the accident. © 2017 The Korean Academy of Medical Sciences.

  7. Grief Processing and Deliberate Grief Avoidance: A Prospective Comparison of Bereaved Spouses and Parents in the United States and the People's Republic of China

    ERIC Educational Resources Information Center

    Bonanno, George A.; Papa, Anthony; Lalande, Kathleen; Zhang, Nanping; Noll, Jennie G.

    2005-01-01

    In this study, the authors measured grief processing and deliberate grief avoidance and examined their relationship to adjustment at 4 and 18 months of bereavement for 2 types of losses (spouse, child) in 2 cultures (People's Republic of China, United States). Three hypotheses were compared: the traditional grief work assumption, a conditional…

  8. Death and Grief

    MedlinePlus

    ... response to a death or loss. Grief can affect our body, mind, emotions, and spirit. People might notice or show grief in several ways: Physical reactions: These might be things like changes in appetite or sleep, an upset stomach, tight chest, crying, tense muscles, ...

  9. Understanding Grief & Loss.

    ERIC Educational Resources Information Center

    Parker, Judith

    1995-01-01

    Although death is the one certainty in life, death or the grieving process is rarely discussed. Grief includes physical, emotional, spiritual, and psychological reactions to loss, and is not limited to feelings about death. Grief can be the response to loss of home or country, separation or displacement, and changes resulting from new life stages.…

  10. The narrative dynamics of grief after homicide.

    PubMed

    Rynearson, Edward K

    2012-01-01

    The homicidal death of a loved one is horrific. Dying from homicide can be more sudden, frightening, and stigmatizing than natural dying and may be followed by a sub-type of prolonged grief complicated by vivid narrative reenactment of the dying, intense feelings of remorse, and nihilistic despair. After a literature review of grief after homicide, the author clarifies the salient narrative themes of homicidal dying and their specific effects on trauma and separation distress. A preliminary model is then developed and illustrated in a therapy case outlining a technique (imaginative exposure) to diminish the disabling fixation of reenactment imagery, remorse, and despair.

  11. What causes grief in dementia caregivers?

    PubMed

    Warchol-Biedermann, Katarzyna; Mojs, Ewa; Gregersen, Rikke; Maibom, Kirsten; Millán-Calenti, José C; Maseda, Ana

    2014-01-01

    Alzheimer's disease (AD) is the most prevalent neurodegenerative disease in the world. Most AD patients become dependent on their relatives, i.e. family caregivers. Providing care to a person with AD influences caregiver's life and leads to feelings of grief, which often precede caregiver depression. The purpose of the article was to evaluate the Meuser and Marwit Caregiver Grief Inventory (MM-CGI-50) for use in Polish family caregivers and to find out determinants of grief of family caregivers of AD individuals living in Poland. A sample of 151 spouse and adult child caregivers of community-dwelling AD patients (95 females and 56 males) was interviewed to determine the influence of such factors as caregiver's age, gender, family relation to the care recipient (CR) and caregiving-related changes in caregiver's working time, leisure time and material status to find out the impact of caregiving role on intensity of caregiver grief. Caregiver grief was measured by means of MM-CGI-50. Additionally, carers were administered a questionnaire including patient's and caregiver's demographics. Also, CR's dementia assessment was informant-based and determined with investigator-administered clinical dementia rating (CDR) scale. Of all analyzed factors, only caregiver's informant dementia rating significantly influenced caregiver grief. To conclude, the effect of caregiver's age, gender, family relation to the CR and caregiving-related changes in caregiver's working time; leisure time and material status could not be found. To add, MM-CGI-50 can be effectively used to assess grief in Polish family caregivers of AD patients. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  12. End of Life: Suicide Grief

    MedlinePlus

    ... suicide, overwhelming emotions can leave you reeling. Your grief might be heart wrenching. At the same time, ... you or leaving you with a legacy of grief — or angry with yourself or others for missing ...

  13. Depressive disorder and grief following spontaneous abortion.

    PubMed

    Kulathilaka, Susil; Hanwella, Raveen; de Silva, Varuni A

    2016-04-12

    Abortion is associated with moderate to high risk of psychological problems such as depression, use of alcohol or marijuana, anxiety, depression and suicidal behaviours. The increased risk of depression after spontaneous abortion in Asian populations has not been clearly established. Only a few studies have explored the relationship between grief and depression after abortion. A study was conducted to assess the prevalence and risk factors of depressive disorder and complicated grief among women 6-10 weeks after spontaneous abortion and compare the risk of depression with pregnant women attending an antenatal clinic. Spontaneous abortion group consisted of women diagnosed with spontaneous abortion by a Consultant Obstetrician. Women with confirmed or suspected induced abortion were excluded. The comparison group consisted of randomly selected pregnant, females attending the antenatal clinics of the two hospitals. Diagnosis of depressive disorder was made according to ICD-10 clinical criteria based on a structured clinical interview. This assessment was conducted in both groups. The severity of depressive symptoms were assessed using the Patients Health Questionnaire (PHQ-9). Grief was assessed using the Perinatal Grief Scale which was administered to the women who had experienced spontaneous abortion. The sample consisted of 137 women in each group. The spontaneous abortion group (mean age 30.39 years (SD = 6.38) were significantly older than the comparison group (mean age 28.79 years (SD = 6.26)). There were more females with ≥10 years of education in the spontaneous abortion group (n = 54; SD = 39.4) compared to the comparison group (n = 37; SD = 27.0). The prevalence of depression in the spontaneous abortion group was 18.6 % (95 CI, 11.51-25.77). The prevalence of depression in the comparison group was 9.5 % (95 CI, 4.52-14.46). Of the 64 women fulfilling criteria for grief, 17 (26.6 %) also fulfilled criteria for a depressive episode. The relative risk of

  14. Grief and Traumatic Grief in Children in the Context of Mass Trauma.

    PubMed

    Dyregrov, Atle; Salloum, Alison; Kristensen, Pål; Dyregrov, Kari

    2015-06-01

    Children who have had someone close die as a result of a mass trauma event such as war, armed conflict, acts of terror, political violence, torture, mass accidents, and natural disasters are at risk for biopsychosocial problems. Research on how to classify when grief becomes complicated or traumatic in children is scarce, and while functioning level may provide a good indication, assessing functioning may be difficult in mass trauma environments where routines and structure are often lacking. There are promising trauma- and grief-focused interventions for children post-mass trauma, which are mostly provided in school settings. However, more advanced multi-method interventions are needed that address grief and trauma in the context of the child's overall mental health, parent/caregiver role in assisting the child, family system issues, ways to provide safe caring environments amidst chaos and change, and interventions that take into account local consumer perspectives, including the voices of children.

  15. Grief among Family Members of Nursing Home Residents with Advanced Dementia

    PubMed Central

    Givens, Jane L.; Prigerson, Holly G.; Kiely, Dan K.; Shaffer, Michele L.; Mitchell, Susan L.

    2011-01-01

    Objectives To describe pre-loss and post-loss grief symptoms among family members of nursing home (NH) residents with advanced dementia, and to identify predictors of greater post-loss grief symptoms. Design Prospective cohort study. Setting 22 NHs in the greater Boston area. Participants 123 family members of NH residents who died with advanced dementia. Measurements Pre-loss grief was measured at baseline, and post-loss grief was measured 2 and 7 months post-loss using the Prolonged Grief Disorder scale. Independent variables included resident and family member sociodemographic characteristics, resident comfort, acute illness, acute care prior to death, family member depression, and family member understanding of dementia and of resident’s prognosis. Results Levels of pre-loss and post-loss grief were relatively stable from baseline to 7 months post-loss. Feelings of separation and yearning were the most prominent grief symptoms. After multivariable adjustment, greater pre-loss grief and the family member having lived with the resident prior to NH admission were the only factors independently associated with greater post-loss grief 7 months after resident death. Conclusions The pattern of grieving for some family members of NH residents with advanced dementia is prolonged and begins before resident death. Identification of family members at risk for post-loss grief during the pre-loss period may help guide interventions aimed at lessening post-loss grief. PMID:21606897

  16. The Course of Grief in Children Bereaved by Sudden Parental Death

    PubMed Central

    Melhem, Nadine M.; Porta, Giovanna; Shamseddeen, Wael; Payne, Monica Walker; Brent, David A.

    2014-01-01

    Context There have been major advances in our understanding of the phenomenology and course of grief in adults. However, little is known about the course of grief in children. Objective We report on course and impact of children’s grief reactions following parental sudden death on subsequent psychiatric and functional status. Design Longitudinal study of bereaved children and families with yearly comprehensive assessments up to three years after parental death. Setting Bereaved children and their surviving parents recruited through the coroners’ records and advertisement. Participants 182 parentally bereaved children between 7 and 18 years of age whose parent died from suicide, accident, or sudden natural deaths. Main Exposure Sudden parental death. Main Outcome Measures Grief, functional impairment, incident depression. Results There were 3 distinct trajectories of grief reactions with a group, consisting of 10.4% of the sample, with increased grief reactions that showed no change 33 months post-death. Youths with prolonged grief reactions had higher rates of previous personal history of depression. Prolonged grief made unique contribution to increased levels of functional impairment even after controlling for clinical characteristics antecedent and following the death. Conversely, prolonged grief, both in youths and the surviving caregiver, predisposed to an increased hazard of incident depression. Another group (30%) showed increased grief reactions 9 months following the death, which gradually decreased over time. Despite this, grief reactions in this group were also associated with functional impairment and increased risk of incident depression. Conclusions Grief reactions abate over time for most children bereaved by sudden parental death; however, a subset show increased or prolonged grief reactions, which in turn increases the risk for functional impairment and depression. Research on interventions designed to relieve the burden of grief in bereaved

  17. Diagnostic and clinical considerations in prolonged grief disorder

    PubMed Central

    Maercker, Andreas; Lalor, John

    2012-01-01

    This review focuses on the similarities and differences between prolonged grief disorder (PGD) and post-traumatic stress disorder (PTSD). It highlights how a PTSD-related understanding aids the investigation and clinical management of PGD. Grief has long been understood as a natural response to bereavement, as serious psychological and physiological stress has been regarded as a potential outcome of extreme or traumatic stress. PTSD was first included in DSM-III in 1980. In the mid-1980s, the first systematic investigation began into whether there is an extreme or pathological form of mourning. Meanwhile, there is much research literature on complicated, traumatic, or prolonged grief This literature is reviewed in this article, with the following questions: Is it possible to distinguish normal from non-normal grief? Which clinical presentation does PGD have—and how does this compare with PTSD? Finally, diagnostic, preventive, and therapeutic approaches and existing tools are presented. PMID:22754289

  18. Parental Grief Response to Perinatal Death.

    ERIC Educational Resources Information Center

    Smith, Anne Clarke; Borgers, Sherry B.

    1989-01-01

    Examined grief responses of parents suffering perinatal loss and explored effects of gender, type of loss, time since loss, number of losses, and subsequent pregnancy on grief response. Responses to Grief Experience Inventory from 176 such parents revealed subjects suffering grief. Grief response was affected by subjects' perception that loss was…

  19. [Postoperative thromboembolic complications and preventive measures].

    PubMed

    Vegar-Brozović, Vesna; Prajdić-Predrijevac, D

    2003-01-01

    Modern surgical procedures become very extensive and aggressive in every surgical branch. Due to expressive development of anesthesia techniques with large monitoring systems support is provided to patients for broad spectrum of disorders. Therefore, we need to protect patients from imminent complications, as development of deep venous thrombosis and embolic pulmonary incidents. The main target in prophylaxis is to divide patients by risk and the type of surgical procedures during the time of "bed recovery". Today, current farmacological treatment is prone to control and prevent such events and to decrease mortality. Patients are divided in three groups: low risk (small operations with early mobilization); medium risk (surgery with risk in patients history); high risk (severe patients and long surgery, prolonged recovery). The best solutions in current medicine is to prevent most of complications, by administration of low molecular heparin (LMWH). Advantages of that treatment are: no need of intensive monitoring, long-time treatment, safe usage in "day case surgery" Beside LMWH, we still use heparin, although we tend to trial newer treatments and supports for prevention of complications. For special groups of patients recent trials examine heparinoid like drug-hyrudin, provided by chemical engeneering. That drug is metabolised in liver. Current therapy and prevention of DVT and pulmonary embolia is LMWH. It entered in every alghorythm of surgical and anaesthetic procedures and become CONDITIO SINE QUA NON.

  20. Adolescent Unresolved Grief in Response to the Death of a Mother.

    ERIC Educational Resources Information Center

    Lenhardt, Ann Marie C.; McCourt, Bernadette

    2000-01-01

    Explores developmental factors and gender differences in the grief responses of adolescents who experience maternal death. Presents factors that place adolescent daughters at increased risk for complicated grief reactions to a mother's death. Proposes that school counselors can provide bereaved students with opportunities to express and explore…

  1. Getting straight about grief.

    PubMed

    Shear, M Katherine

    2012-06-01

    Acute grief is emotionally intense, cognitively preoccupying, and disruptive, but grief is not an illness; major depression and anxiety disorders are. Grief and mourning have a purpose. They provide an intense, focused opportunity to reregulate emotion and to engage in a learning process that is aimed at reconfiguring life without the deceased—both the internal life of the mind, and ongoing life in the world. A bereaved person needs to figure out how to find meaning, purpose, joy, and satisfaction in life without someone who has previously been central to these feelings. This reconfiguration is a very natural process that tends to occur in fits and starts as bereaved people move forward and deal with everyday life. Nevertheless, a knowledgeable, empathic and supportive clinician can foster good adjustment. Successful mourning is, however, not a given. For some people, the mourning process is derailed and acute grief is inordinately painful and prolonged. For others, the stress of bereavement triggers the onset or worsening of symptoms of MDD, an anxiety disorder or another psychiatric or medical condition, suicidality or negative health behaviors. Clinicians need to be alert to all of these problematic responses to loss. In the wake of bereavement, we need to both facilitate effective mourning and diagnose and treat co-occurring conditions.

  2. Communication During Grief.

    ERIC Educational Resources Information Center

    Larson, Charles U.

    The physical and psychological difficulties which accompany grief resulting from another's death are described, and the intrapersonal and interpersonal communication behaviors exhibited by bereaved individuals are outlined. The role of intrapersonal communication--the mourner communicating with himself--and interpersonal communication--the mourner…

  3. The Calculus of Grief

    ERIC Educational Resources Information Center

    Williams, Lee Burdette

    2010-01-01

    On a college campus, educators and students live on the edge of tragedy. They walk that edge everyday, aware that the possibility of death is always one misstep away. One careless move by any of the hundreds or thousands of them walking that edge, and their whole community falls into a canyon of grief from which they will climb only after weeks,…

  4. Understanding Grief within a Cultural Context

    MedlinePlus

    ... Grief Within a Cultural Context Request Permissions Understanding Grief Within a Cultural Context Approved by the Cancer. ... son becomes the family leader. Personal differences in grief and mourning People adopt the beliefs and values ...

  5. Coping with Loss: Bereavement and Grief

    MedlinePlus

    ... with Loss: Bereavement and Grief Coping with Loss: Bereavement and Grief In our hearts, we all know that death ... suicide is particularly beneficial and advisable. Living with Grief Coping with death is vital to your mental ...

  6. Mediating processes in bereavement: the role of rumination, threatening grief interpretations, and deliberate grief avoidance.

    PubMed

    van der Houwen, Karolijne; Stroebe, Margaret; Schut, Henk; Stroebe, Wolfgang; van den Bout, Jan

    2010-11-01

    Limited research so far has examined coping processes that mediate between risk factors and bereavement outcome. Knowledge of these pathways is important, since it helps establish why some bereaved persons are more vulnerable than others and suggests possibilities for intervention. In this international longitudinal study, three potentially critical mediators, namely rumination, threatening grief interpretations and deliberate grief avoidance, were examined in relationship to previously established risk factors (e.g., expectedness of the death, attachment style) and four major outcome variables (grief, depressive symptoms, emotional loneliness and positive mood). Individuals who were recently bereaved (maximum 3 years) filled in questionnaires at three points in time. Results showed that rumination and--to a somewhat lesser extent--threatening grief interpretations played an important role in mediating the effects of various risk factors on outcomes. However, the contribution of these two mediators was dependent on the specific risk factor and outcome measure under consideration. For example, whereas the effect of neuroticism on grief was mediated by both processes (to the extent of 73%), the effect of neuroticism on positive mood was only mediated by rumination and to a smaller extent (23%). A few risk factors, such as current financial situation and spirituality, were not mediated by either coping strategy. Implications of these findings are discussed.

  7. Identifying vulnerability in grief: psychometric properties of the Adult Attitude to Grief Scale.

    PubMed

    Sim, Julius; Machin, Linda; Bartlam, Bernadette

    2014-05-01

    Grief is a reaction to a significant loss that can profoundly affect all aspects of life and capacity to function well. The consequences can vary from severe psychological distress through to physical disturbances and significant social problems. This study sought to identify a measure of vulnerability in grief, by examining the psychometric properties of the Adult Attitude to Grief (AAG) scale in a sample of 168 people seeking help in their bereavement. The factor structure of the scale, its internal consistency, its construct validity and optimum classification cutoffs were tested. Confirmatory factor analysis broadly supported the factor structure of the AAG, but identified one item that could profitably be reworded. Internal consistency of the three subscales was acceptable. Construct validity and discriminative validity were supported by correlations with allied constructs (depression and anxiety) and a significant difference between scores for clients with Prolonged Grief Disorder and those without. A correlation with counsellors' own clinical ratings of vulnerability demonstrated criterion-related validity of the AAG. Using receiver operating characteristic methods, optimum cutoff scores on the scale were identified for the classification of different levels of vulnerability. The AAG was found to be a psychometrically promising tool for identifying vulnerability in grief.

  8. The grief map

    NASA Astrophysics Data System (ADS)

    Monteiro, L. H. A.

    2014-12-01

    Grieving is a natural human reaction to a significant loss. According to a psychiatric model, this process is characterized by a typical sequence of psychological changes. Here, I propose a discrete-time dynamical system, called the grief map, in order to represent the grieving process. The corresponding bifurcation diagram, which exhibits stationary, periodic, and chaotic behavior, is related to the stages of this sorrowful journey occurring during about 12 months post-loss.

  9. [Abnormal grief reaction].

    PubMed

    Meyer, J E

    1977-01-01

    Pathological grief reactions following the death of a child are reported on the basis of five case studies. In contrast to acute grief reactions these pathological syndromes are of long standing. One parent had not truly accepted the death of the child. The denial of reality is sometimes a defence against aggression towards the deceased, because of his having left one behind. The mourning process comes to no end but remains in its initial phase. At the same time the life of the mourner stands still, as in the house and the family everything is left unchanged. Family interactions alter, particularly between the parents. For the genesis of these grief syndromes the following is of relevance: The death occurs at a time, when another child cannot replace the one who died. Mature independence had not been reached by either parent or child. Death destroyed expectations that this child would succeed in that which the parent had been unable to achieve. The parent had not seen the child after death--a gap in the continuity of experiencing which made acceptance of the irreversibility of the loss even more difficult.

  10. African Americans in bereavement: grief as a function of ethnicity.

    PubMed

    Laurie, Anna; Neimeyer, Robert A

    2008-01-01

    Few empirical studies have explored the grieving process among different ethnic groups within the United States, and very little is known about how African Americans and Caucasians may differ in their experience of loss. The purpose of this study was to examine the African-American experience of grief, with particular emphasis on issues of identity change, interpersonal dimensions of the loss, and continuing attachments with the deceased. Participants were 1,581 bereaved college students (940 Caucasians and 641 African Americans) attending classes at a large southern university. Each participant completed the Inventory of Complicated Grief-Revised, the Continuing Bonds Scale, and questions regarding the circumstances surrounding his or her loss. Results revealed that African Americans experienced more frequent bereavement by homicide, maintenance of a stronger continuing bond with the deceased, greater grief for the loss of extended kin beyond the immediate family, and a sense of support in their grief, despite their tendency to talk less with others about the loss or seek professional support for it. Overall, African Americans reported higher levels of complicated grief symptoms than Caucasians, especially when they spent less time speaking to others about their loss experience. Implications of these findings for bereavement support services for African Americans were briefly noted.

  11. How to help patients understand and conquer grief. Avoiding depression in the midst of sadness.

    PubMed

    Crow, H E

    1991-06-01

    Grief is a painful yet normal process that many patients do not fully understand or appreciate. Any person may be at risk for depression as a result of grief-inducing events. Early, organized intervention by primary care physicians can help patients return to full emotional health and maintain self-esteem. When the behavioral markers that measure the intensity of grief are named and used as a scale by which to measure progress, grief reactions can be jointly managed by patient and physician in brief counseling sessions over a reasonable period of time. I believe this is an efficient, effective, and valuable service to patients.

  12. Grief: Helping Young Children Cope

    ERIC Educational Resources Information Center

    Wood, Frances B.

    2008-01-01

    In their role as caregivers supporting the children they teach, it is important for teachers to understand the grieving process and recognize symptoms of grief. The author explains Elisabeth Kubler-Ross's five stages of grief and offers 10 classroom strategies to help young children cope with their feelings.

  13. How to Deal with Grief

    MedlinePlus

    ... 4:30 pm EST) http://www.fernside.org Grief information, resources, and support for grieving children and their families. RENEW: Center ... experienced a death or other loss, feelings of grief are part of a normal reaction. But ... and Bipolar Support Alliance (DBSA) 730 N. Franklin Street, Suite 501 ...

  14. Grief: Helping Young Children Cope

    ERIC Educational Resources Information Center

    Wood, Frances B.

    2008-01-01

    In their role as caregivers supporting the children they teach, it is important for teachers to understand the grieving process and recognize symptoms of grief. The author explains Elisabeth Kubler-Ross's five stages of grief and offers 10 classroom strategies to help young children cope with their feelings.

  15. Building metaphors and extending models of grief.

    PubMed

    VandeCreek, L

    1985-01-01

    Persons in grief turn to metaphors as they seek to understand and express their experience. Metaphors illustrated in this article include "grief is a whirlwind," "grief is the Great Depression all over again" and "grief is gray, cloudy and rainy weather." Hospice personnel can enhance their bereavement efforts by identifying and cultivating the expression of personal metaphors from patients and families. Two metaphors have gained wide cultural acceptance and lie behind contemporary scientific explorations of grief. These are "grief is recovery from illness" (Bowlby and Parkes) and "death is the last stage of growth and grief is the adjustment reaction to this growth" (Kubler-Ross). These models have developed linear perspectives of grief but have neglected to study the fluctuating intensity of symptoms. Adopting Worden's four-part typology of grief, the author illustrates how the pie graph can be used to display this important aspect of the grief experience, thus enhancing these models.

  16. Grief after second-trimester termination for fetal anomaly: a qualitative study

    PubMed Central

    Maguire, Marguerite; Light, Alexis; Kuppermann, Miriam; Dalton, Vanessa K.; Steinauer, Jody E.; Kerns, Jennifer L.

    2015-01-01

    Objectives We aimed to qualitatively evaluate factors that contribute to and alleviate grief associated with termination of a pregnancy for a fetal anomaly and how that grief changes over time. Study design We conducted a longitudinal qualitative study of decision satisfaction, grief and coping among women undergoing termination (dilation and evacuation or induction termination) for fetal anomalies and other complications. We conducted three postprocedure interviews at 1–3 weeks, 3 months and 1 year. We used a generative thematic approach to analyze themes related to grief using NVivo software program. Results Of the 19 women in the overall study, 13 women’s interviews were eligible for analysis of the grief experience. Eleven women completed all three interviews, and two completed only the first interview. Themes that contributed to grief include self-blame for the diagnosis, guilt around the termination decision, social isolation related to discomfort with abortion and grief triggered by reminders of pregnancy. Social support and time are mechanisms that serve to alleviate grief. Conclusions Pregnancy termination in this context is experienced as a significant loss similar to other types of pregnancy loss and is also associated with real and perceived stigma. Women choosing termination for fetal anomalies may benefit from tailored counseling that includes dispelling misconceptions about cause of the anomaly. In addition, efforts to decrease abortion stigma and increase social support may improve women’s experiences and lessen their grief response. Implications The nature and course of grief after second-trimester termination for fetal anomaly are, as of yet, poorly understood. With improved understanding of how women grieve over time, clinicians can better recognize the significance of their patients’ suffering and offer tools to direct their grief toward positive coping. PMID:25499590

  17. Grief after second-trimester termination for fetal anomaly: a qualitative study.

    PubMed

    Maguire, Marguerite; Light, Alexis; Kuppermann, Miriam; Dalton, Vanessa K; Steinauer, Jody E; Kerns, Jennifer L

    2015-03-01

    We aimed to qualitatively evaluate factors that contribute to and alleviate grief associated with termination of a pregnancy for a fetal anomaly and how that grief changes over time. We conducted a longitudinal qualitative study of decision satisfaction, grief and coping among women undergoing termination (dilation and evacuation or induction termination) for fetal anomalies and other complications. We conducted three post-procedure interviews at 1-3 weeks, 3 months and 1 year. We used a generative thematic approach to analyze themes related to grief using NVivo software program. Of the 19 women in the overall study, 13 women's interviews were eligible for analysis of the grief experience. Eleven women completed all three interviews, and two completed only the first interview. Themes that contributed to grief include self-blame for the diagnosis, guilt around the termination decision, social isolation related to discomfort with abortion and grief triggered by reminders of pregnancy. Social support and time are mechanisms that serve to alleviate grief. Pregnancy termination in this context is experienced as a significant loss similar to other types of pregnancy loss and is also associated with real and perceived stigma. Women choosing termination for fetal anomalies may benefit from tailored counseling that includes dispelling misconceptions about cause of the anomaly. In addition, efforts to decrease abortion stigma and increase social support may improve women's experiences and lessen their grief response. The nature and course of grief after second-trimester termination for fetal anomaly are, as of yet, poorly understood. With improved understanding of how women grieve over time, clinicians can better recognize the significance of their patients' suffering and offer tools to direct their grief toward positive coping. Copyright © 2015 Elsevier Inc. All rights reserved.

  18. Palliative Care Caregivers' Grief Mediators: A Prospective Study.

    PubMed

    Coelho, Alexandra M; Delalibera, Mayra A; Barbosa, António

    2016-05-01

    The aim of the study is to identify the mediators of complicated grief in a Portuguese sample of caregivers. Grief mediators were prospectively evaluated using a list of risk factors completed by the palliative care team members, during the predeath and bereavement period. More than 6 months after the death, we applied PG-13 to diagnose prolonged grief disorder (PGD). The sample was composed of 64 family caregivers. Factors associated with PGD were insecure and dependent relationship, unresolved family crisis, and the perceived deterioration and disfigurement of the patient. The results show relational factors are relevant, but we must consider the reciprocal influence among factors, as well as their impact on specific symptoms. © The Author(s) 2015.

  19. Designing personal grief rituals: An analysis of symbolic objects and actions.

    PubMed

    Sas, Corina; Coman, Alina

    2016-10-01

    Personal grief rituals are beneficial in dealing with complicated grief, but challenging to design, as they require symbolic objects and actions meeting clients' emotional needs. The authors reported interviews with 10 therapists with expertise in both grief therapy and grief rituals. Findings indicate three types of rituals supporting honoring, letting go, and self transformation, with the latter being particularly complex. Outcomes also point to a taxonomy of ritual objects for framing and remembering ritual experience, and for capturing and processing grief. Besides symbolic possessions, the authors identified other types of ritual objects including transformational and future-oriented ones. Symbolic actions include creative craft of ritual objects, respectful handling, disposal, and symbolic play. They conclude with theoretical implications of these findings, and a reflection on their value for tailored, creative co-design of grief rituals. In particular, several implications for designing grief rituals were identified that include accounting for the client's need, selecting (or creating) the most appropriate objects and actions from the identified types, integrating principles of both grief and art/drama therapy, exploring clients' affinity for the ancient elements as medium of disposal in letting go rituals, and the value of technology for recording and reflecting on ritual experience.

  20. [Parents' grief at the loss of a premature infant and approaches to their care].

    PubMed

    Liu, Hsiu-Mei

    2007-10-01

    The more than 3,000 deaths of premature infants due to low weight in Taiwan cause deep personal grief in their parents, for whom there is no pain greater than losing a child. This loss, nearly always sudden and unexpected, is an issue often ignored by clinic nursing staff. The purpose of this paper was to consider various grief counseling theories in order to help nurses attend to the grief counseling needs of parents who lose a premature infant. Better understanding of parents' grief responses by nursing staffs will help nurses to accept and address such. Grief processes identified include: shock and numbness, searching and yearning, disorientation and reorganization. Grief responses include: feel, physiology and sense organs, cognition and behavior. The four tasks essential to grief recovery include: to accept the reality of the loss, to work through the pain of grief, to adjust to an environment in which the deceased is missing, and to emotionally relocate the deceased and move on with life. Coaching through grief counseling theory puts forward and looks after concrete measures, and provides three suggestions for the parents who lose a premature infant. These can be used as reference by clinical staffs, help promote nursing staff understanding of this topic, help improve care for grieving parents and improve care quality.

  1. Resilience and vulnerability: prolonged grief in the bereaved spouses of marital partners who died of AIDS.

    PubMed

    Yu, Nancy Xiaonan; Chan, Cecilia L W; Zhang, Jianxin; Stewart, Sunita M

    2016-01-01

    Spousal bereavement is closely linked to prolonged grief, that is, significant adjustment symptoms that last for more than six months after the loss. This article focused on potential risk and protective factors that may influence bereavement outcomes. Participants in this study were surviving spouses of individuals who died of acquired immune deficiency syndrome (AIDS). These participants were themselves living with human immunodeficiency syndrome. In this cross-sectional study, 120 bereaved participants completed measures of grief, quality of dying and death of the deceased, negative conceptions of death resulting from AIDS, death attitudes, and personal resilience. The results showed that one-third (35.0%) of the bereaved participants reported grief levels above the prolonged grief cut-off scores, and can be categorized as the "prolonged grief" group. Although quality of dying and death was not associated with the intensity of grief, negative conceptions of death from AIDS, fear of death and resilience independently predicted grief symptoms in the regression models. Our findings provide insight into the grief process for the surviving spouse of AIDS victims in rural China. Since resilience is malleable, developing resilience interventions to enhance adjustment to bereavement may be a promising direction in grief counselling and therapies.

  2. AN INTERNET TOOL TO NORMALIZE GRIEF*

    PubMed Central

    DOMINICK, SALLY A.; IRVINE, A. BLAIR; BEAUCHAMP, NATASHA; SEELEY, JOHN R.; NOLEN-HOEKSEMA, SUSAN; DOKA, KENNETH J.; BONANNO, GEORGE A.

    2009-01-01

    This research evaluated the efficacy of a psycho-educational Internet self-help tool to educate and support recently (1–6 months) bereaved individuals. The goal of the website was to help users normalize their grief to enhance their adaptive adjustment. A randomized controlled trial evaluated the gains in social cognitive theory constructs and state anxiety. Compared to the control group (N = 34), treatment participants (N = 33) reported significant multivariate gains (eta-square = .191). Significant program effects were obtained on all three outcome measures: attitude (eta-square = .177), self-efficacy (eta-square = .106), and state anxiety (eta-square = .083). These findings suggest the potential efficacy of an Internet-based grief support tool to enhance adaptive adjustment of the bereaved. PMID:20039532

  3. Factorial Validity of the Texas Revised Inventory of Grief-Present Scale among Bereaved Older Adults

    ERIC Educational Resources Information Center

    Futterman, Andrew; Holland, Jason M.; Brown, Patrick J.; Thompson, Larry W.; Gallagher-Thompson, Dolores

    2010-01-01

    The Texas Revised Inventory of Grief-Present scale (TRIG-Present) is one of the most widely used grief measures; however, researchers have only empirically examined the validity and underlying factor structure of TRIG-Present scores in a few studies. Hence, in the present investigation, we sought to examine the factorial validity of the…

  4. Development and Validation of a Christian-Based Grief Recovery Scale

    ERIC Educational Resources Information Center

    Jen Der Pan, Peter; Deng, Liang-Yu F.; Tsai, S. L.; Chen, Ho-Yuan J.; Yuan, Sheng-Shiou Jenny

    2014-01-01

    The purpose of this study was to develop and validate a Christian-based Grief Recovery Scale (CGRS) which was used to measure Christians recovering from grief after a significant loss. Taiwanese Christian participants were recruited from churches and a comprehensive university in northern Taiwan. They were affected by both the Christian faith and…

  5. Factorial Validity of the Texas Revised Inventory of Grief-Present Scale among Bereaved Older Adults

    ERIC Educational Resources Information Center

    Futterman, Andrew; Holland, Jason M.; Brown, Patrick J.; Thompson, Larry W.; Gallagher-Thompson, Dolores

    2010-01-01

    The Texas Revised Inventory of Grief-Present scale (TRIG-Present) is one of the most widely used grief measures; however, researchers have only empirically examined the validity and underlying factor structure of TRIG-Present scores in a few studies. Hence, in the present investigation, we sought to examine the factorial validity of the…

  6. Development and Validation of a Christian-Based Grief Recovery Scale

    ERIC Educational Resources Information Center

    Jen Der Pan, Peter; Deng, Liang-Yu F.; Tsai, S. L.; Chen, Ho-Yuan J.; Yuan, Sheng-Shiou Jenny

    2014-01-01

    The purpose of this study was to develop and validate a Christian-based Grief Recovery Scale (CGRS) which was used to measure Christians recovering from grief after a significant loss. Taiwanese Christian participants were recruited from churches and a comprehensive university in northern Taiwan. They were affected by both the Christian faith and…

  7. Disenfranchised Grief and Physician Burnout.

    PubMed

    Lathrop, Deborah

    2017-07-01

    Over the span of their career, physicians experience changes to their professional role and professional identity. The process of continual adaptation in their work setting incurs losses. These losses can be ambiguous, cumulative, and may require grieving. Grief in the workplace is unsanctioned, and may contribute to physicians' experience of burnout (emotional exhaustion, depersonalization, low sense of achievement). Acknowledging loss, validating grief, and being prescient in dealing with physician burnout is essential. © 2017 Annals of Family Medicine, Inc.

  8. Anticipatory Grief: A Mere Concept?

    PubMed

    Moon, Paul J

    2016-06-01

    Anticipatory grief (AG) has been studied, debated, and written about for several decades. This type of grief is also recognized in hospice and palliative care (HPC). The question, however, is whether the reality of AG is sufficiently upheld by professionals at the point of concrete service delivery. In other words, is AG a mere concept or is everyday practice of HPC duly informed of AG as evidenced by the resulting care delivery? © The Author(s) 2015.

  9. Tlaxcalan constructions of acute grief.

    PubMed

    Fabrega, H; Nutini, H

    1994-12-01

    In rural Tlaxcala, Mexico, the sudden and unexpected death of infants and young children was a relatively common occurrence during the time when this study was conducted. Not surprisingly, the deaths constituted major social tragedies and operated as psychological traumas to the family, especially the parents. Acute grief reactions inevitably resulted and these were suffused with bodily and psychological disturbances of different types, some of which were handled in the society as illness. The article grows out of a longitudinal study about these tragedies to families of the region. Attention is given to the grief reactions of parents, with special emphasis placed on psychological and behavioral manifestations. Of particular interest is the way local, cultural symbols pertaining to the cause of the deaths, which involved the malevolent attack of blood-sucking witches, were configured in the verbalizations and behavioral reactions that comprised the grief reactions. Details of the way symbols entered into the construction of meaningful accounts of the tragedies during the ordeal of the grief reactions are discussed and analyzed. Although the manifestations of grief could be said to have clinical, psychiatric implications, it is the way these manifestations served to explain the tragedies, in the process regulating and restoring social relations, that is given principal attention. A description of one mother's grief reaction is provided as a case illustration.

  10. Themes of grief.

    PubMed

    Carter, S L

    1989-01-01

    A thematic analysis of 30 narrative accounts of bereavement revealed nine themes that included five core themes in bereavement--being stopped, hurting, missing, holding, and seeking; three meta-themes about bereavement--change, expectations, and inexpressibility; and a contextual theme--personal history. The themes were compared with three theoretical perspectives on bereavement by Freud, Kübler-Ross, and one defined as existential-phenomenological. Features of bereavement that are dissimilar or unaddressed by the theoretical perspectives were: (a) the quality of grief's changing character, including "waves" and intense pain which may be triggered years after the death; (b) holding, an individual process of preserving the fact and meaning of the loved one's existence; (c) expectations, both social and personal, as to how the bereaved should be overlaying the experience; and (d) the critical importance of personal history in affecting the quality and meaning of individual bereavement.

  11. Media exposure and prolonged grief: A study of bereaved parents and siblings after the 2011 Utøya Island terror attack.

    PubMed

    Kristensen, Pål; Dyregrov, Kari; Dyregrov, Atle; Heir, Trond

    2016-11-01

    After terror attacks, the media coverage can be a potential secondary stressor for bereaved families. In the present study, we aimed to examine the level of prolonged grief (PG), and to explore the association between media exposure and PG in parents and siblings of individuals who were killed in a terror attack. Parents and siblings (n = 103) from 42 different families bereaved by the 2011 Utøya Island mass shooting participated in a survey 18 months after the attack. The survey measured the amount of media exposure experienced by the bereaved during the first month after the attack. PG was self-reported using the Inventory of Complicated Grief (ICG). Data was analyzed with multilevel methods with mixed effects models. Of the total sample of participants, 78.6% (n = 81/103) had sum scores higher than the designated cutoff >25 on ICG, indicating a probable prolonged grief disorder (PGD). Multilevel analysis showed significantly higher level of PG among those who reported high exposure to the media coverage (>4 hours daily) the first month after the attack, among females, and among those who were in contact with their son/daughter/brother/sister by telephone during the attack. With the cross-sectional design, caution should be taken about making interpretations about causal effects. Media exposure may trigger or maintain prolonged grief reactions. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  12. Brief Eclectic Psychotherapy for Traumatic Grief (BEP-TG): toward integrated treatment of symptoms related to traumatic loss

    PubMed Central

    Smid, Geert E.; Kleber, Rolf J.; de la Rie, Simone M.; Bos, Jannetta B. A.; Gersons, Berthold P. R.; Boelen, Paul A.

    2015-01-01

    Background Traumatic events such as disasters, accidents, war, or criminal violence are often accompanied by the loss of loved ones, and may then give rise to traumatic grief. Traumatic grief refers to a clinical diagnosis of persistent complex bereavement disorder (PCBD) with comorbid (symptoms of) posttraumatic stress disorder (PTSD) and/or major depressive disorder (MDD) following confrontation with a traumatic loss. Trauma survivors, who are frequently from different cultural backgrounds, have often experienced multiple losses and ambiguous loss (missing family members or friends). Current evidence-based treatments for PTSD do not focus on traumatic grief. Objective To develop a treatment for traumatic grief combining treatment interventions for PTSD and PCBD that may accommodate cultural aspects of grief. Method To provide a rationale for treatment, we propose a cognitive stress model of traumatic grief. Based on this model and on existing evidence-based treatments for PTSD and complicated grief, we developed Brief Eclectic Psychotherapy for Traumatic Grief (BEP-TG) for the treatment of patients with traumatic grief. The treatment is presented along with a case vignette. Results Processes contributing to traumatic grief include inadequately integrating the memory of the traumatic loss, negative appraisal of the traumatic loss, sensitivity to matching triggers and new stressors, and attempting to avoid distress. BEP-TG targets these processes. The BEP-TG protocol consists of five parts with proven effectiveness in the treatment of PCBD, PTSD, and MDD: information and motivation, grief-focused exposure, memorabilia and writing assignments, finding meaning and activation, and a farewell ritual. Conclusion Tailored to fit the needs of trauma survivors, BEP-TG can be used to address traumatic grief symptoms related to multiple losses and ambiguous loss, as well as cultural aspects of bereavement through its different components. PMID:26154434

  13. [Providing grief counseling to a major depressive elderly widower: a nurse's experience].

    PubMed

    Chu, Hsiu-Ching; Chow, Philip C

    2008-10-01

    The death of a spouse is both a major loss and a tremendous life stressor for the partner left behind. Such has been shown to be particularly hard on the elderly. This article describes a nurse's experience caring for an elderly patient suffering from major depression resulting from the death of his wife. While providing nursing care to the client, the author, employing holistic nursing assessment, identified a reciprocal influence between his depressive symptoms and grief reaction. In applying the Inventory of Complicated Grief to ascertain grief reaction intensity to help the client discern between major depressive symptoms and grief reaction, the author found that the client (1) could not accept the loss of his wife, (2) had difficulty adjusting to life after his wife's death, and (3) faced a tense and distant relationship with his son. Such resulted in suicidal ideation and planning and feelings of loneliness, helplessness, hopelessness and incapability, which triggered major depression and a complicated grief reaction. Therefore, the author applied grief counseling to help the client accept the loss of his spouse, communicate his grief, overcome the difficult adjustment to life after his spouse's death, bid farewell to his wife, and establish new relationships. Such counseling gradually helped the client accept the inevitability of death and his wife's passing. To help the client establish new relationships under existing circumstances of negligible external support systems, the author encouraged the client to establish a new relationship with himself and integrate the old-age stage of life cycle naturally into his daily routine. Based on this care experience, we recommend psychiatric nurses assess cautiously the loss experience and grief reaction in elderly widowers under their care in order to provide timely grief counseling intervention to help the client pass quickly through the grieving phase and free him or her from the haze of depression.

  14. Grief, Bereavement, and Coping with Loss (PDQ)

    MedlinePlus

    ... Caregiver Questions to Ask about Advanced Cancer Research Grief, Bereavement, and Coping With Loss (PDQ®)–Patient Version Overview ... a resource to help caregivers of cancer patients. Bereavement and Grief Key Points Bereavement is the period ...

  15. When grief makes you sick: Bereavement induced systemic inflammation is a question of genotype

    PubMed Central

    Schultze-Florey, Christian R.; Martínez-Maza, Otoniel; Magpantay, Larry; Breen, Elizabeth Crabb; Irwin, Michael R.; Gündel, Harald; O’Connor, Mary-Frances

    2012-01-01

    Although bereavement is associated with increased morbidity and mortality in the surviving spouse, some widow(er)s remain healthy. Genetic variability in expression of inflammatory markers in response to stress may be the key to this observation. The present study compares bereaved vs. married/partnered older adults, investigating the impact of bereavement status, pro-inflammatory cytokine single nucleotide polymorphisms (SNPs) on circulating markers of inflammation and hypothesizing a gene by environment (GxE) effect. The study sample included 64 older adults, of which 36 were widow(er)s. Circulating levels of inflammatory markers IL-6, IL-1RA and sTNFRII were measured. Participants were genotyped for SNPs in the IL-6 gene (IL-6 – 174 and –572), the IL-1β gene (IL-1β –511), and TNF-α gene (TNF-α –308). Grief severity was assessed with the Inventory of Complicated Grief. Bereaved participants had higher circulating levels of IL-1RA and IL-6. This increase could not be explained by pro-inflammatory genotype frequency differences, or Complicated Grief diagnosis. However, a GxE effect with the IL-6 –174 SNP moderated individual vulnerability to higher circulating levels of inflammation resulting from bereavement exposure. These results suggest a possible mechanism for the increase in morbidity and mortality in the surviving spouse. Genetic variability interacts with an environmental stressor, leading to increased inflammatory markers in genetically susceptible subjects only. For these patients, clinical interventions for bereavement-related stressor reduction might be crucial for overall health. PMID:22735772

  16. When grief makes you sick: bereavement induced systemic inflammation is a question of genotype.

    PubMed

    Schultze-Florey, Christian R; Martínez-Maza, Otoniel; Magpantay, Larry; Breen, Elizabeth Crabb; Irwin, Michael R; Gündel, Harald; O'Connor, Mary-Frances

    2012-10-01

    Although bereavement is associated with increased morbidity and mortality in the surviving spouse, some widow(er)s remain healthy. Genetic variability in expression of inflammatory markers in response to stress may be the key to this observation. The present study compares bereaved vs. married/partnered older adults, investigating the impact of bereavement status, pro-inflammatory cytokine single nucleotide polymorphisms (SNPs) on circulating markers of inflammation and hypothesizing a gene by environment (GxE) effect. The study sample included 64 older adults, of which 36 were widow(er)s. Circulating levels of inflammatory markers IL-6, IL-1RA and sTNFRII were measured. Participants were genotyped for SNPs in the IL-6 gene (IL-6 -174 and -572), the IL-1β gene (IL-1β -511), and TNF-α gene (TNF-α -308). Grief severity was assessed with the Inventory of Complicated Grief. Bereaved participants had higher circulating levels of IL-1RA and IL-6. This increase could not be explained by pro-inflammatory genotype frequency differences, or Complicated Grief diagnosis. However, a GxE effect with the IL-6 -174 SNP moderated individual vulnerability to higher circulating levels of inflammation resulting from bereavement exposure. These results suggest a possible mechanism for the increase in morbidity and mortality in the surviving spouse. Genetic variability interacts with an environmental stressor, leading to increased inflammatory markers in genetically susceptible subjects only. For these patients, clinical interventions for bereavement-related stressor reduction might be crucial for overall health. Copyright © 2012 Elsevier Inc. All rights reserved.

  17. Report on Bereavement and Grief Research

    ERIC Educational Resources Information Center

    Genevro, Janice L.

    2004-01-01

    Research on bereavement and grief has burgeoned in the past 20 years, with the publication of scores of research reports, reviews, and compendia. This report therefore serves as a road map to information identified in that time period as critical to understanding advances in research on bereavement and grief, with a focus on grief and health. It…

  18. Risk Factors for Anticipatory Grief in Family Members of Terminally Ill Veterans Receiving Palliative Care Services.

    PubMed

    Burke, Laurie A; Clark, Karen A; Ali, Khatidja S; Gibson, Benjamin W; Smigelsky, Melissa A; Neimeyer, Robert A

    2015-01-01

    Anticipatory grief is the process associated with grieving the loss of loved ones in advance of their inevitable death. Because anticipatory grief has been associated with a variety of outcomes, risk factors for this condition deserve closer consideration. Fifty-seven family members of terminally ill, hospice-eligible veterans receiving palliative care services completed measures assessing psychosocial factors and conditions. Elevated anticipatory grief was found in families characterized by relational dependency, lower education, and poor grief-specific support, who also experienced discomfort with closeness and intimacy, neuroticism, spiritual crisis, and an inability to make sense of the loss. Thus, in this sample, anticipatory grief appears to be part of a cluster of factors and associated distress that call for early monitoring and possible intervention.

  19. Distinguishing grief from depression during acute recovery from spinal cord injury.

    PubMed

    Klyce, Daniel W; Bombardier, Charles H; Davis, Trevor J; Hartoonian, Narineh; Hoffman, Jeanne M; Fann, Jesse R; Kalpakjian, Claire Z

    2015-08-01

    To examine whether grief is a psychometrically sound construct that is distinct from depression in individuals who have recently sustained a spinal cord injury (SCI). Cross-sectional survey. Inpatient rehabilitation units at 3 geographically diverse, university-affiliated medical centers. Patients with SCI (N=206) were recruited (163 men [79.1%]). Most patients were non-Hispanic whites (n=175 [85.0%]). Most patients sustained a cervical SCI (n=134 [64.4%]). Various injury etiologies were represented, with the majority being accounted for by falls (n=72 [31.5%]) and vehicle-related accidents (n=69 [33.5%]). The mean time since injury was 53.5±40.5 days. Not applicable. An adapted version of the 12-item structured clinical interview for Prolonged Grief Disorder was used to assess symptoms of grief, and the Patient Health Questionnaire-9 was used to measure depression. Demographic and injury-related data were also collected. A principal component analysis (with direct oblimin rotation) of the grief measure suggested a 2-component solution. The content of items loading on the separate components suggested 2 subscales: loss (6 items; Cronbach α=.810) and trauma (6 items; Cronbach α=.823). Follow-up principal component analyses including both grief and depression measures suggested clear differentiation of grief-related loss from depression. The prevalence of clinically significant levels of grief was low (6%), and levels of depression were consistent with previous findings related to inpatient rehabilitation (23.5%). The items used to assess grief symptoms in patients participating in inpatient rehabilitation for recently sustained SCI appear to capture a psychometrically reliable construct that is distinct from that of depression. Research is needed on the predictive validity of early grief symptoms after SCI and the relation of grief to other psychological constructs over time. Copyright © 2015 American Congress of Rehabilitation Medicine. Published by Elsevier

  20. Perinatal grief and mourning.

    PubMed

    Menke, J A; McClead, R E

    1990-01-01

    The grief and mourning that parents experience following a perinatal loss is as devastating as the loss of an older loved one. The pattern of mourning can be anticipated and interventions can be implemented. With proper help, the parents can pass through this catastrophic time in their lives with a minimum of scars. If the physician stops, reaches out, listens, and supports the parents, he or she can have a dramatic effect on the lives of these parents. In the same manner in which we started this paper, we close with a quotation from another parent who suffered a loss: Daughters may die, But why? For even daughters can't live with half a heart. Three days isn't much a life. But long enough to remember thin blue lips, uneven gasps in incubators, Racking breaths that cause a pain to those who watched. Long enough to remember I never held her Or felt her softness Or counted her toes. I didn't even know the color of her eyes. Dead paled hands not quite covered by the gown she Was to go home in. Moist earth smell. One small casket. And the tears. You see, I hold in my hand but souvenirs of an occasion. A sheet of paper filled with statistics, A certificate with smudged footprints, A tiny bracelet engraved "Girl, Smith." You say that you are sorry That you know how I feel. But you can't know because I don't feel. Not yet.

  1. A concept analysis of nurses' grief.

    PubMed

    Wisekal, Ashley E

    2015-10-01

    The psychological and personal well-being of nurses can change the way they care for patients. If nurses' grief is not properly managed, the nursing shortage will continue to grow. Consequently, a need exists for the identification of nurses' grief and effective interventions to manage grief to ensure the successful development and growth of the nursing profession. This concept analysis sought to properly define nurses' grief and the role it plays in the day-to-day requirements of nurses. A review of the literature was conducted using CINAHL®, BioMed, EBSCOhost, and MEDLINE® and the following key words. Nurses' grief must be incorporated into the nursing curriculum and addressed by employers. In particular, facility leaders should help promote a healthy work environment and address the need for proper grief management. Educators, managers, and nurses can benefit from acknowledging the current gap in managing nurses' grief.

  2. Children and Grief. ERIC Digest.

    ERIC Educational Resources Information Center

    McEntire, Nancy

    Noting that the death of a loved one brings grief to children as well as adults, this Digest draws on research to examine how children respond to death and the role of parents and teachers in helping children cope with loss. The Digest delineates children's "tasks" during mourning that are essential to their adjustment to loss, such as…

  3. Reading Guidance: Death and Grief.

    ERIC Educational Resources Information Center

    Smith, Alice Gullen

    1989-01-01

    Gives guidelines for the librarian using reading guidance (similar to bibliotherapy). Provides a nine-item annotated bibliography of novels for children and adolescents on the subject of death and grief. Appends an embryo list of categories suitable for content analysis of any file librarians might wish to keep on books suitable for use in this…

  4. Reading Guidance: Death and Grief.

    ERIC Educational Resources Information Center

    Smith, Alice Gullen

    1989-01-01

    Gives guidelines for the librarian using reading guidance (similar to bibliotherapy). Provides a nine-item annotated bibliography of novels for children and adolescents on the subject of death and grief. Appends an embryo list of categories suitable for content analysis of any file librarians might wish to keep on books suitable for use in this…

  5. Helping Teens Work Through Grief.

    ERIC Educational Resources Information Center

    Perschy, Mary Kelly

    Teens who have experienced the death of a parent, grandparent, friend, or relative often find it difficult to grieve openly. When adults whom teens trust are aware of the cycle of grief, they can provide a safe atmosphere to allow teens to experience the turmoil of the intense and conflicting emotions in order to move toward healing. This guide is…

  6. Death Education and Grief Counseling.

    ERIC Educational Resources Information Center

    Mille, Nancy A.

    This paper explores ways in which school counselors can help young people with death-related concerns. It is often assumed that school counselors have the necessary skills for working with students who experience grief, but most graduate counseling curricula do not require courses in death education; thus, many counselors feel uncomfortable in…

  7. Helping Teens Work Through Grief.

    ERIC Educational Resources Information Center

    Perschy, Mary Kelly

    Teens who have experienced the death of a parent, grandparent, friend, or relative often find it difficult to grieve openly. When adults whom teens trust are aware of the cycle of grief, they can provide a safe atmosphere to allow teens to experience the turmoil of the intense and conflicting emotions in order to move toward healing. This guide is…

  8. End of Life: Dealing with Grief and Confronting Painful Emotions

    MedlinePlus

    ... will experience that dagger in the heart called grief. Dealing with grief is a challenge like no other. How can ... challenging and devastating the raw, intense emotions of grief can be, because it's happened to me. Nearly ...

  9. Grief as pathology: The evolution of grief theory in psychology from Freud to the present.

    PubMed

    Granek, Leeat

    2010-02-01

    The emergence of grief as a topic worthy of psychological study is an early 20th century invention. Freud published his influential essay on mourning and melancholia in 1917. Since he proposed the concept of "grief work," contemporary psychologists have examined his theory empirically and have claimed that grief is a pathology that should be included within the psychological domain. How, and why, has grief theory evolved within the discipline of psychology in this way? In what ways do these changes in the understanding of grief coincide with other historical developments within the discipline? In this article, I trace the development of grief, originally conceived by Freud within a psychoanalytic and nonpathological framework, to the current conceptualization of grief within the disease model. I show how grief theory has evolved within the discipline of psychology to become (a) an object worthy of scientific study within the discipline, and subsequently, (b) a pathology to be privatized, specialized, and treated by mental health professionals.

  10. Mindfulness-based Intervention for Perinatal Grief after Stillbirth in Rural India

    PubMed Central

    Roberts, Lisa R.; Montgomery, Susanne B.

    2015-01-01

    We explored the concept of using a Mindfulness-based intervention to reduce perinatal grief among Indian women. Data were collected using mixed methods to explore concept acceptability, receptivity, modality, and feasibility of the intervention. The intervention was piloted and evaluated with measures of perinatal grief, psychosocial wellbeing, religious coping, perceived social provision of support, and mindfulness. The intervention was well received and effective in teaching skills to help women deal with high levels of grief and subsequent mental health challenges. To overcome attendance barriers modification is necessary. Partnership with a local nursing school is critical to enhance sustainability of the intervention. PMID:25898268

  11. Perinatal grief following a termination of pregnancy for foetal abnormality: the impact of coping strategies.

    PubMed

    Lafarge, Caroline; Mitchell, Kathryn; Fox, Pauline

    2013-12-01

    Pregnancy termination for foetal abnormality (TFA) can have significant psychological repercussions, but little is known about the coping strategies involved in dealing with TFA. This study examined the relationships between women's coping strategies and perinatal grief. A total of 166 women completed a survey online. Coping and perinatal grief were measured using the Brief COPE and Short Perinatal Grief Scales. Data were analysed through multiple regression analyses. Despite using mostly adaptive coping strategies, women's levels of grief were high and varied according to obstetric and termination variables. Grief was predicted by behavioural disengagement, venting, planning, religion, self-blame, being recently bereaved, being childless at the time of TFA, not having had children/being pregnant since TFA and uncertainty about the decision to terminate the pregnancy. Acceptance and positive reframing negatively predicted grief. Identifying women vulnerable to poor psychological adjustment and promoting coping strategies associated with lower levels of grief may be beneficial. This could be addressed through information provision and interventions such as Cognitive Behavioural Therapy or Acceptance and Commitment Therapy. © 2013 John Wiley & Sons, Ltd.

  12. Death of an Ex-Spouse: Lessons in Family Communication about Disenfranchised Grief

    PubMed Central

    Tullis, Jillian A.

    2017-01-01

    The death of a loved one is an emotional-laden experience, and while grief and mourning rituals are less formal today in many communities, there remain some social norms for individuals to process loss. The death of an ex-family member, such as a former spouse, is more complicated and expectations for how to respond are fraught with uncertainty. While grief has been studied and is primarily understood as an individual cognitive process, scholars in sociology and communication are considering the ways in which grief and mourning are social and take place in dialogue with others. This manuscript explores Kenneth Doka’s concept of disenfranchised grief, which is “grief that is experienced when loss cannot be openly acknowledged, socially sanctioned, or publicly mourned” through the author’s experience of the death of her ex-husband. The narrative will recount how the author learned about her ex-husband’s death (via text message), and will challenge definitions of family and family communication about death and grief, particularly the communication strategies used to cope with this unique type of loss. PMID:28338631

  13. Efficacy of an outpatient treatment for prolonged grief disorder: a randomized controlled clinical trial.

    PubMed

    Rosner, Rita; Pfoh, Gabriele; Kotoučová, Michaela; Hagl, Maria

    2014-01-01

    Abnormal forms of grief, currently referred to as complicated grief or prolonged grief disorder, have been discussed extensively in recent years. While the diagnostic criteria are still debated, there is no doubt that prolonged grief is disabling and may require treatment. To date, few interventions have demonstrated efficacy. We investigated whether outpatients suffering from prolonged grief disorder (PGD) benefit from a newly developed integrative cognitive behavioural therapy for prolonged grief (PG-CBT). A total of 51 patients were randomized into two groups, stratified by the type of death and their relationship to the deceased; 24 patients composed the treatment group and 27 patients composed the wait list control group (WG). Treatment consisted of 20-25 sessions. Main outcome was change in grief severity; secondary outcomes were reductions in general psychological distress and in comorbidity. Patients on average had 2.5 comorbid diagnoses in addition to PGD. Between group effect sizes were large for the improvement of grief symptoms in treatment completers (Cohen׳s d=1.61) and in the intent-to-treat analysis (d=1.32). Comorbid depressive symptoms also improved in PG-CBT compared to WG. The completion rate was 79% in PG-CBT and 89% in WG. The major limitations of this study were a small sample size and that PG-CBT took longer than the waiting time. PG-CBT was found to be effective with an acceptable dropout rate. Given the number of bereaved people who suffer from PGD, the results are of high clinical relevance. Copyright © 2014 Elsevier B.V. All rights reserved.

  14. Pathological grief: two Victorian case studies.

    PubMed

    Ramchandani, D

    1996-01-01

    Despite 75 years of investigation, the concept of pathological grief remains tenuous and controversial. The author turns to the stories of two nineteenth century women, one real and the other fictitious to examine the syndrome of grief gone away. He concludes that pathological grief may be best viewed on a continuum of psychopathology, the expression of which depends upon the interaction between the personality of the patient, the nature of the lost relationship, and the circumstances of its loss.

  15. Innovative moments in grief therapy: the meaning reconstruction approach and the processes of self-narrative transformation.

    PubMed

    Alves, Daniela; Fernández-Navarro, Pablo; Baptista, João; Ribeiro, Eugénia; Sousa, Inês; Gonçalves, Miguel M

    2014-01-01

    Several studies have proposed that self-narrative transformation occurs through the elaboration of "Innovative Moments" (IMs), which are alternative experiences to the problematic self-narrative. This study aimed to analyze the emergence of IMs among 6 complicated grief women undergoing grief therapy according to the meaning reconstruction approach and to examine associations of IMs to the severity of grief symptomatology, assessed by the "Inventory of Complicated Grief." Eighty-three sessions were analyzed using the "Innovative Moments Coding System" (IMCS). A generalized linear model analysis (GLM) showed a significant association between the emergence of IMs and the interaction between time and symptomatic improvement, indicating a higher rate of IM production over time in cases with better clinical outcomes. These results reinforce IMs' relevance in studying narrative change among cases with distinct clinical progressions.

  16. The Spectrum of Grief: Identification and Management

    PubMed Central

    Barnes, Daphne

    1989-01-01

    Loss is a common human experience, and grief is frequently seen in a physician's office. Grief occurs not only after a death, but also during chronic or serious illness, infertility, divorce, job changes, surgery, rape, and so forth. Some patients somatize distress, presenting with physical symptoms rather than acknowledging their grief. Bereavement increases the risk of both psychiatric and physical disease and can exacerbate pre-existing illness. In the majority, grief resolves normally, but in some the process becomes morbid. The family physician is in a unique position to identify, educate, assess, and intervene with the grieving patient and his family. PMID:21248941

  17. Autonomy and social norms in a three factor grief model predicting perinatal grief in India.

    PubMed

    Roberts, Lisa R; Lee, Jerry W

    2014-01-01

    Perinatal grief following stillbirth is a significant social and mental health burden. We examined associations among the following latent variables: autonomy, social norms, self-despair, strained coping, and acute grief-among poor, rural women in India who experienced stillbirth. A structural equation model was built and tested using quantitative data from 347 women of reproductive age in Chhattisgarh. Maternal acceptance of traditional social norms worsens self-despair and strained coping, and increases the autonomy granted to women. Greater autonomy increases acute grief. Greater despair and acute grief increase strained coping. Social and cultural factors were found to predict perinatal grief in India.

  18. Dream Work in Grief Therapy

    PubMed Central

    Noronha, Konrad Joseph

    2014-01-01

    Working with dreams is useful with grief and loss clients who present with dreams. Adlerian dream analysis is one-way of exploring dreams. It incorporates the life-style of the client. This case report demonstrates how Adlerian dream analysis was used with a client. Progress was noted in improved life-style once the client began to talk about her dream. PMID:25035561

  19. Impact of a Neonatal-Bereavement-Support DVD on Parental Grief: A Randomized Controlled Trial.

    PubMed

    Rosenbaum, Joan L; Smith, Joan R; Yan, Yan; Abram, Nancy; Jeffe, Donna B

    2015-01-01

    This study tested the effect of a neonatal-bereavement-support DVD on parental grief after their baby's death in a Neonatal Intensive Care Unit compared with standard bereavement care (controls). Following a neonatal death, the authors measured grief change from a 3- to 12-month follow-up using a mixed-effects model. Intent-to-treat analysis was not significant, but only 18 parents selectively watched the DVD. Thus, we subsequently compared DVD viewers with DVD nonviewers and controls. DVD viewers reported higher grief at 3-month interviews compared with DVD nonviewers and controls. Higher grief at 3 months was negatively correlated with social support and spiritual/religious beliefs. These findings have implications for neonatal-bereavement care.

  20. Impact of A Neonatal-Bereavement-Support DVD on Parental Grief: A Randomized Controlled Trial

    PubMed Central

    Rosenbaum, Joan L.; Smith, Joan R.; Yan, Yan; Abram, Nancy; Jeffe, Donna B.

    2014-01-01

    This study tested the effect of a neonatal-bereavement-support DVD on parental grief after their baby’s death in our Neonatal Intensive Care Unit compared with standard bereavement care (controls). Following a neonatal death, we measured grief change from 3- to 12-month follow-up using a mixed-effects model. Intent-to-treat analysis was not significant, but only 18 parents selectively watched the DVD. Thus, we subsequently compared DVD-viewers with DVD-non-viewers and controls. DVD-viewers reported higher grief at 3-month interviews compared with DVD-non-viewers and controls. Higher grief at 3 months was negatively correlated with social support and spiritual/religious beliefs. These findings have implications for neonatal-bereavement care. PMID:25530502

  1. The Grief Resolution Process in Divorce.

    ERIC Educational Resources Information Center

    Crosby, John F.; And Others

    1983-01-01

    Compares grief in divorce to the Kubler-Ross model of grief resolution in bereavement in 17 persons who wrote essays about their divorce. The results suggested a conceptual model based on three chronological stages with linear progression through the stages, characterized by circularity within each stage. (JAC)

  2. Integrating Buddhist Psychology into Grief Counseling

    ERIC Educational Resources Information Center

    Wada, Kaori; Park, Jeeseon

    2009-01-01

    The field of grief counseling has yet to see an integration of Buddhist psychology. Drawing on Buddhist psychology literature and Western models of grief, this article explores possible integrations of two approaches. To lay the foundation for this discussion, the authors introduced a brief overview of the history of Buddhism as well as a Buddhist…

  3. The Child in Grief: Implications for Teaching.

    ERIC Educational Resources Information Center

    Hare, Jan; And Others

    The purpose of this paper is to increase teachers' understanding of children's conceptualizations of death to enable them to respond to the symptoms of grief in both early and middle childhood. John Bowlby's theoretical framework of childhood mourning is elaborated, and research on teachers' facilitation of children's grief is briefly noted. The…

  4. The Grief Resolution Process in Divorce.

    ERIC Educational Resources Information Center

    Crosby, John F.; And Others

    1983-01-01

    Compares grief in divorce to the Kubler-Ross model of grief resolution in bereavement in 17 persons who wrote essays about their divorce. The results suggested a conceptual model based on three chronological stages with linear progression through the stages, characterized by circularity within each stage. (JAC)

  5. Grief Counseling: A Review of the Literature

    ERIC Educational Resources Information Center

    Daneker, Darlene; Cashwell, Craig

    2005-01-01

    Grief counseling has grown over the past two decades to become a well respected specialty within the field of counseling. This article examines books, articles, and literature developed by leading agencies in the field. Grief counseling is an interdisciplinary field focusing on the clinical aspects of working with individuals involved in dying and…

  6. Integrating Buddhist Psychology into Grief Counseling

    ERIC Educational Resources Information Center

    Wada, Kaori; Park, Jeeseon

    2009-01-01

    The field of grief counseling has yet to see an integration of Buddhist psychology. Drawing on Buddhist psychology literature and Western models of grief, this article explores possible integrations of two approaches. To lay the foundation for this discussion, the authors introduced a brief overview of the history of Buddhism as well as a Buddhist…

  7. Grief and Loss: A Social Work Perspective

    ERIC Educational Resources Information Center

    Simpson, Jennifer E.

    2013-01-01

    Despite the wealth of research that exists in the area of death, grief, and loss, the scarcity of literature examining the impact upon social work practitioners is troubling. This article initially draws upon a case study to explore this impact through the theoretical framework of disenfranchised grief. Further comment is made regarding the…

  8. The Grief Account: Dimensions of a Contemporary Bereavement Genre

    ERIC Educational Resources Information Center

    Dennis, Michael Robert

    2008-01-01

    The genre of the grief account is identified to include published narratives of surviving grief. Thematic analysis of Andrew Holleran's (2006) "Grief: A Novel," Lolly Winston's (2004) "Good Grief: A Novel," Joan Didion's (2005) "The Year of Magical Thinking," and J. Canfield and M. V. Hansen's (2003) "Chicken Soup for the Grieving Soul: Stories…

  9. Grief Counseling: An Investigation of Counselors' Training, Experience, and Competencies

    ERIC Educational Resources Information Center

    Ober, Anne M.; Granello, Darcy Haag; Wheaton, Joe E.

    2012-01-01

    Grief is prevalent in counseling, but little is known about the current status of counselors' preparation and competencies to provide effective care. This exploratory study surveyed counselors (N = 369) on grief training, personal and professional experiences with grief, and grief counseling competence. Multiple regression analyses found training…

  10. The Grief Account: Dimensions of a Contemporary Bereavement Genre

    ERIC Educational Resources Information Center

    Dennis, Michael Robert

    2008-01-01

    The genre of the grief account is identified to include published narratives of surviving grief. Thematic analysis of Andrew Holleran's (2006) "Grief: A Novel," Lolly Winston's (2004) "Good Grief: A Novel," Joan Didion's (2005) "The Year of Magical Thinking," and J. Canfield and M. V. Hansen's (2003) "Chicken Soup for the Grieving Soul: Stories…

  11. Traumatic grief as a risk factor for mental and physical morbidity.

    PubMed

    Prigerson, H G; Bierhals, A J; Kasl, S V; Reynolds, C F; Shear, M K; Day, N; Beery, L C; Newsom, J T; Jacobs, S

    1997-05-01

    The aim of this study was to confirm and extend the authors' previous work indicating that symptoms of traumatic grief are predictors of future physical and mental health outcomes. The study group consisted of 150 future widows and widowers interviewed at the time of their spouse's hospital admission and at 6-week and 6-, 13-, and 25- month follow-ups. Traumatic grief was measured with a modified version of the Grief Measurement Scale. Mental and physical health outcomes were assessed by self-report and interviewer evaluation. Survival analysis and linear and logistic regressions were used to determine the risk for adverse mental and physical health outcomes posed by traumatic grief. Survival and regression analyses indicated that the presence of traumatic grief symptoms approximately 6 months after the death of the spouse predicted such negative health outcomes as cancer, heart trouble, high blood pressure, suicidal ideation, and changes in eating habits at 13- or 25-month follow-up. The results suggest that it may not be the stress of bereavement, per se, that puts individuals at risk for long-term mental and physical health impairments and adverse health behaviors. Rather, it appears that psychiatric sequelae such as traumatic grief are of critical importance in determining which bereaved individuals will be at risk for long-term dysfunction.

  12. The effects of orff-based music therapy and social work groups on childhood grief symptoms and behaviors.

    PubMed

    Hilliard, Russell E

    2007-01-01

    This study evaluated and compared the effects of Orff-based music therapy, social work, and wait-list control groups on behavioral problems and grief symptoms of bereaved school-aged children. Social work and music therapy sessions were provided weekly for one hour over an eight-week period. Participants (N = 26) attended three different public elementary schools, and each school was randomly assigned to one of the conditions. Pre and posttest measures consisted of the Behavior Rating Index for Children (BRIC) and the Bereavement Group Questionnaire for Parents and Guardians (BP). The BRIC measured behavioral distress and the BP measured grief symptoms prior to and following participation in the assigned conditions. Statistical analyses indicated that participants in the music therapy group significantly improved in the behaviors and grief symptoms, and those in the social work group experienced a significant reduction in their behavioral problems but not their grief symptoms. Participants in the wait-list control group made no significant improvements in either their grief symptoms or behavioral problems. A reduction in behavioral distress as measured by the BRIC and a reduction in grief symptoms as measured by the BP is the most desired outcome. This study supports the use of Orff-based music therapy interventions for bereaved children in a school-based grief program. Recommendations for future research are included.

  13. Parents' Grief in the Context of Adult Child Mental Illness: A Qualitative Review

    ERIC Educational Resources Information Center

    Richardson, Meg; Cobham, Vanessa; Murray, Judith; McDermott, Brett

    2011-01-01

    Research indicates that parents and other family members often grieve their child or relative's mental illness. This grief appears resultant from a profound sense of loss, which has been described as complicated and nonfinite (e.g., Atkinson in "Am J Psychiatry" 151(8):1137-1139, 1994; Davis and Schultz in "Soc Sci Med" 46(3):369-379, 1998; Jones…

  14. Sense-Making, Grief, and the Experience of Violent Loss: Toward a Mediational Model

    ERIC Educational Resources Information Center

    Currier, Joseph M.; Holland, Jason M.; Neimeyer, Robert A.

    2006-01-01

    Bereavement following violent loss by accident, homicide or suicide increases the risk for complications in grieving. This is the first study to examine a constructivist model of grief that proposes that sense-making, or the capacity to construct an understanding of the loss experience, mediates the association between violent death and…

  15. Sense-Making, Grief, and the Experience of Violent Loss: Toward a Mediational Model

    ERIC Educational Resources Information Center

    Currier, Joseph M.; Holland, Jason M.; Neimeyer, Robert A.

    2006-01-01

    Bereavement following violent loss by accident, homicide or suicide increases the risk for complications in grieving. This is the first study to examine a constructivist model of grief that proposes that sense-making, or the capacity to construct an understanding of the loss experience, mediates the association between violent death and…

  16. Parents' Grief in the Context of Adult Child Mental Illness: A Qualitative Review

    ERIC Educational Resources Information Center

    Richardson, Meg; Cobham, Vanessa; Murray, Judith; McDermott, Brett

    2011-01-01

    Research indicates that parents and other family members often grieve their child or relative's mental illness. This grief appears resultant from a profound sense of loss, which has been described as complicated and nonfinite (e.g., Atkinson in "Am J Psychiatry" 151(8):1137-1139, 1994; Davis and Schultz in "Soc Sci Med" 46(3):369-379, 1998; Jones…

  17. The Man I Once Knew: Grief and Inflammation in Female Partners of Veterans With Traumatic Brain Injury.

    PubMed

    Saban, Karen L; Mathews, Herbert L; Collins, Eileen G; Hogan, Nancy S; Tell, Dina; Bryant, Fred B; Pape, Theresa Louise Bender; Griffin, Joan M; Janusek, Linda Witek

    2016-01-01

    Grief, although traditionally conceptualized as a bereavement-related reaction, is also experienced by significant others in response to the profound cognitive and personality changes associated with a traumatic brain injury (TBI) in a loved one. Grief associated with the death of a loved one is related to increases in proinflammatory cytokines, yet it is not clear whether this is the case for grief experienced by individuals caring for a significant other with TBI. The purpose of this cross-sectional, exploratory study was to examine grief and its association with a proinflammatory cytokine, tumor necrosis factor α (TNF-α), in wives/partners caring for veterans with TBI. Participants completed written measures of grief, perceived stress, and depressive symptoms and provided morning saliva samples for TNF-α analysis. Participants reported levels of grief comparable to those reported in studies evaluating individuals grieving the death of a loved one. Path analysis revealed that grief was not associated with TNF-α; however, participants reporting high levels of blame/anger, a subscale of the grief scale, had higher levels of TNF-α. In addition, both grief and blame/anger were related to increased perceived stress and depressive symptoms; however, path analysis demonstrated that perceived stress and depressive symptoms did not mediate the influence of blame/anger on TNF-α. These findings suggest that blame/anger associated with grief may be related to the elevations in TNF-α exhibited by individuals caring for a loved one with TBI. © The Author(s) 2015.

  18. Mourning and Grief on Facebook.

    PubMed

    Willis, Erin; Ferrucci, Patrick

    2017-01-01

    Facebook not only changed the way we communicate but also the way we mourn and express grief. The social networking site allows users to interact with deceased users' walls after death. This study utilized textual analysis to categorize Facebook posts ( N = 122) on 30 deceased users' walls according to uses and gratifications theory. Most posts were found to be motivated by entertainment, followed by integration and social interaction. Facebook users posted memories, condolences, and interacted with friends and family members in the deceased user's network. Implications and potential future research are discussed.

  19. Perinatal grief in Latino parents.

    PubMed

    Whitaker, Claudia; Kavanaugh, Karen; Klima, Carrie

    2010-01-01

    Extensive research exists that describes the meaning of perinatal loss to some parents, but the experience of loss from the perspective of Latino parents is not clearly understood. Additionally, current perinatal bereavement practices used often to facilitate memory making for parents (such as viewing or holding the baby, taking photographs, or collecting mementos) are based on research done primarily with non-Latino families. Are these common practices appropriate for this population? Because there is a paucity of research on this topic, this article describes what has been written over the past 30 years on the topic of grief and perinatal loss in Latino culture.

  20. Perinatal Grief in Latino Parents

    PubMed Central

    Whitaker, Claudia; Kavanaugh, Karen; Klima, Carrie

    2013-01-01

    Extensive research exists that describes the meaning of perinatal loss to some parents, but the experience of loss from the perspective of Latino parents is not clearly understood. Additionally, current perinatal bereavement practices used often to facilitate memory-making for parents (such as viewing or holding the baby, taking photographs, or collecting mementos) are based upon research done primarily with non-Latino families. Are these common practices appropriate for this population? Because there is a paucity of research on this topic, this article describes what has been written over the past 30 years on the topic of grief and perinatal loss in Latino culture. PMID:20975393

  1. Convergent Validity of Three Methods for Measuring Postoperative Complications

    PubMed Central

    Fritz, Bradley A.; Escallier, Krisztina E.; Abdallah, Arbi Ben; Oberhaus, Jordan; Becker, Jennifer; Geczi, Kristin; McKinnon, Sherry; Helsten, Dan L.; Sharma, Anshuman; Wildes, Troy S.; Avidan, Michael S.

    2016-01-01

    Background Anesthesiologists need tools to accurately track postoperative outcomes. The accuracy of patient report in identifying a wide variety of postoperative complications after diverse surgical procedures has not previously been investigated. Methods In this cohort study, 1,578 adult surgical patients completed a survey at least 30 days after their procedure asking if they had experienced any of 18 complications while in the hospital after surgery. Patient responses were compared to the results of an automated electronic chart review and (for a random subset of 750 patients) to a manual chart review. Results from automated chart review were also compared to those from manual chart review. Forty-two randomly selected patients were contacted by telephone to explore reasons for discrepancies between patient report and manual chart review. Results Comparisons between patient report, automated chart review, and manual chart review demonstrated poor-to-moderate positive agreement (range, 0 to 58%) and excellent negative agreement (range, 82 to 100%). Discordance between patient report and manual chart review was frequently explicable by patients reporting events that happened outside the time period of interest. Conclusions Patient report can provide information about subjective experiences or events that happen after hospital discharge, but often yields different results from chart review for specific in-hospital complications. Effective in-hospital communication with patients and thoughtful survey design may increase the quality of patient-reported complication data. PMID:27028469

  2. BEREAVEMENT BY TRAUMATIC MEANS: THE COMPLEX SYNERGY OF TRAUMA AND GRIEF

    PubMed Central

    NERIA, YUVAL; LITZ, BRETT T.

    2013-01-01

    When people lose intimates unexpectedly, in particular from malicious acts of violence, they are at risk for chronic grief reactions. The phenomenology, clinical symptoms, clinical needs, and risk factors associated with loss by traumatic means and the combined influences of loss and trauma exposure are yet to be systematically studied. We review the complex interplay between trauma and loss by traumatic means. The distinctions between normal and traumatic loss, and complicated and traumatic grief, are contrasted with the traditional conceptualization of posttraumatic stress disorder. The role of various mediators such as concurrent or life-span trauma exposure and interpersonal factors, particularly the degree of attachment to the individual or group traumatically lost, is discussed. We offer a more integrated and focused view of traumatic grief, its predictors, and future directions for the integrative study of trauma and loss outcomes. PMID:23633929

  3. Social and cultural factors associated with perinatal grief in Chhattisgarh, India.

    PubMed

    Roberts, Lisa R; Montgomery, Susanne; Lee, Jerry W; Anderson, Barbara A

    2012-06-01

    Stillbirth is a globally significant public health problem with many medical causes. There are also indirect causal pathways including social and cultural factors which are particularly salient in India's traditional society. The purpose of this study was to explore women's perceptions of stillbirth and to determine how issues of gender and power, social support, coping efforts, and religious beliefs influence perinatal grief outcomes among poor women in rural Chhattisgarh, India. Structured interviews were done face-to-face in 21 randomly selected villages among women of reproductive age (N=355) who had experienced stillbirth (n=178) and compared to those who had not (n=177), in the Christian Hospital, Mungeli catchment area. Perinatal grief was significantly higher among women with a history of stillbirth. Greater perinatal grief was associated with lack of support, maternal agreement with social norms, and younger maternal age. These predictors must be understood in light of an additional finding-distorted sex ratios, which reflect gender discrimination in the context of Indian society. The findings of this study will allow the development of a culturally appropriate health education program which should be designed to increase social support and address social norms, thereby reducing psychological distress to prevent complicated perinatal grief. Perinatal grief is a significant social burden which impacts the health women.

  4. Social and Cultural Factors Associated with Perinatal Grief in Chhattisgarh, India

    PubMed Central

    Roberts, Lisa R.; Montgomery, Susanne; Lee, Jerry W.; Anderson, Barbara A.

    2017-01-01

    Stillbirth is a globally significant public health problem with many medical causes. There are also indirect causal pathways including social and cultural factors which are particularly salient in India's traditional society. The purpose of this study was to explore women's perceptions of stillbirth and to determine how issues of gender and power, social support, coping efforts, and religious beliefs influence perinatal grief outcomes among poor women in rural Chhattisgarh, India. Structured interviews were done face-to-face in 21 randomly selected villages among women of reproductive age (N = 355) who had experienced stillbirth (n = 178) and compared to those who had not (n = 177), in the Christian Hospital, Mungeli catchment area. Perinatal grief was significantly higher among women with a history of stillbirth. Greater perinatal grief was associated with lack of support, maternal agreement with social norms, and younger maternal age. These predictors must be understood in light of an additional finding—distorted sex ratios, which reflect gender discrimination in the context of Indian society. The findings of this study will allow the development of a culturally appropriate health education program which should be designed to increase social support and address social norms, thereby reducing psychological distress to prevent complicated perinatal grief. Perinatal grief is a significant social burden which impacts the health women. PMID:21956647

  5. Parents' grief in the context of adult child mental illness: a qualitative review.

    PubMed

    Richardson, Meg; Cobham, Vanessa; Murray, Judith; McDermott, Brett

    2011-03-01

    Research indicates that parents and other family members often grieve their child or relative's mental illness. This grief appears resultant from a profound sense of loss, which has been described as complicated and nonfinite (e.g., Atkinson in Am J Psychiatry 151(8):1137-1139, 1994; Davis and Schultz in Soc Sci Med 46(3):369-379, 1998; Jones in Br J Soc Work 34:961-979, 2004; MacGregor in Soc Work 39(2):160-166, 1994; Osborne and Coyle in Couns Psychol Q 15(4):307-323, 2002; Ozgul in Aust N Z J Fam Ther 25(4):183-187, 2004; Tuck et al. in Arch Psychiatric Nurs 11(3):118-125, 1997). This paper reviews existent research in this emerging field, with a focus on parents' grief experience in relation to their adult child's mental disorder. Studies that explore parents' and family members' grief, using both qualitative and quantitative methodologies, are considered. Research evidence for the association between parents' and family members' grief and other outcomes are discussed. Findings concerning the prediction of grief in parents and family members who have a child or relative with a mental disorder will be reviewed. Finally, this paper considers methodological and theoretical issues associated with existent research and presents options for further study.

  6. The social construction of anticipatory grief.

    PubMed

    Fulton, G; Madden, C; Minichiello, V

    1996-11-01

    As medical technology prolongs life and facilitates the early diagnosis of terminal illnesses such as AIDS, the concept of anticipatory grief requires further scrutiny. The original concept of anticipatory grief has become widely accepted. This paper, however, argues that the uncritical acceptance of this concept rests primarily on the authority of the biomedical model, which has focused analysis on the predictable symptomatology of the grief process, integrating this understanding into health care. This paper provides a critical review of the concept of anticipatory grief, highlighting conceptual shifts which are required if the concept is to be relevant to the subjective experiences of people who are confronted with life-threatening illness. The paper discusses the relevance of understanding the conceptual confusion which exists in the literature between "anticipatory grief" and "forewarning of loss". It is argued that grief may be the response to a loss of meaning, and that the psychological process of adjustment to loss requires individuals to engage in the reconstitution of purpose and meaning in their lives. Distinguishing between what is being expressed for past and present losses and what responses occur when individuals focus on various aspects of their future may shed light on some of the inconsistent and contradictory findings surrounding research on anticipatory grief.

  7. Long-term Effects of the Family Bereavement Program on Multiple Indicators of Grief in Parentally Bereaved Children and Adolescents

    PubMed Central

    Sandler, Irwin N.; Ma, Yue; Tein, Jenn-Yun; Ayers, Tim S.; Wolchik, Sharlene; Kennedy, Cara L.; Millsap, Roger

    2009-01-01

    Objectives This paper reports on results from a randomized experimental trial of the effects of the Family Bereavement Program (FBP) on multiple measures of grief experienced by parentally-bereaved children and adolescents over a six year period of time. Method Participants were 244 youth (ages 8–16, mean age = 11.4 years) from 156 families that had experienced the death of a parent. The sample consisted of 53% boys; ethnicity was 67% non-Hispanic white and 33% ethnic minority. Families were randomly assigned to the FBP (N=135) or a literature control condition (N=109). Two grief measures, the Texas Revised Inventory of Grief (TRIG) and the Intrusive Grief Thoughts Scale (IGTS) were administered at four times over six years, pre-test, post-test, eleven-month and six-year follow-ups. A third measure, an adaptation of the Inventory of Traumatic Grief (ITG) was administered only at the six-year follow-up. Results The FBP showed a greater reduction as compared to controls in their level of problematic grief (IGTS) at post-test and six-year follow-up and in the percent at clinical levels of problematic grief at the post-test. The FBP also reduced scores on a dimension of the ITG, Social Detachment/Insecurity, at six-year follow-up for three subgroups; those who experienced lower levels of grief at program entry, older youth, and boys. Conclusion These are the first findings from a randomized trial with long-term follow-up of the effects of a program to reduce problematic levels of grief of parentally-bereaved youth. PMID:20350025

  8. Identity, grief and self-awareness after traumatic brain injury.

    PubMed

    Carroll, Emma; Coetzer, Rudi

    2011-06-01

    The objective of this study was to investigate perceived identity change in adults with traumatic brain injury (TBI) and explore associations between identity change, grief, depression, self-esteem and self-awareness. The participants were 29 adults with TBI who were being followed up by a community brain injury rehabilitation service. Participants were longer post-injury than those more commonly studied. Time since injury ranged from 2.25 to 40 years (mean = 11.17 years, SD = 11.4 years). Participants completed a battery of questionnaires. Significant others and clinicians completed a parallel version of one of these measures. Questionnaires included the Head Injury Semantic Differential Scale (HISDS-III), Brain Injury Grief Inventory (BIGI), Hospital Anxiety and Depression Scale - Depression, Rosenberg Self-Esteem Scale (RSES) and the Awareness Questionnaire (Self/Significant other/Clinician versions). The main findings were that participants reported significant changes in self-concept with current self being viewed negatively in comparison to pre-injury self. Perceived identity change was positively associated with depression and grief and negatively associated with self-esteem and awareness. Awareness was negatively associated with self-esteem and positively associated with depression. These findings were consistent with previous research, revealing changes in identity following TBI. Further research is needed to increase our understanding of the psychological factors involved in emotional adjustment after TBI and to inform brain injury rehabilitation interventions, including psychotherapy approaches.

  9. Predicting grief intensity after recent perinatal loss.

    PubMed

    Hutti, Marianne H; Myers, John; Hall, Lynne A; Polivka, Barbara J; White, Susan; Hill, Janice; Kloenne, Elizabeth; Hayden, Jaclyn; Grisanti, Meredith McGrew

    2017-08-02

    The Perinatal Grief Intensity Scale (PGIS) was developed for clinical use to identify and predict intense grief and need for follow-up after perinatal loss. This study evaluates the validity of the PGIS via its ability to predict future intense grief based on a PGIS score obtained early after a loss. A prospective observational study was conducted with 103 international, English-speaking women recruited at hospital discharge or via the internet who experienced a miscarriage, stillbirth, or neonatal death within the previous 8weeks. Survey data were collected at baseline using the PGIS and the Perinatal Grief Scale (PGS). Follow-up data on the PGS were obtained 3months later. Data analysis included descriptive statistics, Cronbach's alpha, receiver operating characteristic curve analysis, and confirmatory factor analysis. Cronbach's alphas were ≥0.70 for both instruments. PGIS factor analysis yielded three factors as predicted, explaining 57.7% of the variance. The optimal cutoff identified for the PGIS was 3.535. No difference was found when the ability of the PGIS to identify intense grief was compared to the PGS (p=0.754). The PGIS was not inferior to the PGS (AUC=0.78, 95% CI 0.68-0.88, p<0.001) in predicting intense grief at the follow-up. A PGIS score≥3.53 at baseline was associated with increased grief intensity at Time 2 (PGS: OR=1.97, 95% CI 1.59-2.34, p<0.001). The PGIS is comparable to the PGS, has a lower response burden, and can reliably and validly predict women who may experience future intense grief associated with perinatal loss. Copyright © 2017 Elsevier Inc. All rights reserved.

  10. Normal grief and its correlates in Lubumbashi, an urban city in the Democratic Republic of Congo

    PubMed Central

    Joe, Katabwa Kabongo; Mapatano, Mala Ali; Manyonga, Tshibangu; Mwadianvita, Costa Kazadi; Valérien, Mutombo; Stanis, Wembonyama; Kavulu, Mukendi; Espérance, Kashala

    2016-01-01

    Introduction Grief is a universal experience faced at one time or another by most people during their lives. Response to grief and bereavement losses can lead to psychiatric disorders such as mood disorders, post traumatic responses, insomnia loss of appetite, anxiety, and depression. The aim of our study is to value in our community the physical and psychological complications of a normal grief. Methods We conducted a cross-sectional study from March 2012 to September 2012 in Lubumbashi, Democratic Republic of Congo. Two questionnaires, the Hamilton Anxiety Scale and the Beck Depression Inventory scale were used as screening tool. A snow ball sampling method was performed and the questionnaires were administered only to those who consented to participate in the study. Results A total of 78 subjects were included in the study of which 87.2% were aged between 14-50 years old. The majority of the subjects were female 65.4%, and about a quarter (28%) was unemployed. The main correlates of the grief reported in the present study were being treated as witchcraft or accused to be responsible of a death (68%), being rejected by family and not being allowed to inherit (32%). Being homeless was reported in 26%. The main psychological symptoms reported were psychological distress after 1 year (65%) and related physical health problems after the death (72%). Depression and mild anxiety were the most reported disorders, with respectively 92.3% and 74.4% of the subjects. Conclusion Grief in Lubumbashi is associated with a large number of psychological, social and health problems. Health problems such as gastric is, high blood pressure were often reported. Being accused of witchcraft remains the main social impact. Depression and anxiety were the most psychological problem associated with grief. PMID:27583088

  11. Normal grief and its correlates in Lubumbashi, an urban city in the Democratic Republic of Congo.

    PubMed

    Joe, Katabwa Kabongo; Mapatano, Mala Ali; Manyonga, Tshibangu; Mwadianvita, Costa Kazadi; Valérien, Mutombo; Stanis, Wembonyama; Kavulu, Mukendi; Espérance, Kashala

    2016-01-01

    Grief is a universal experience faced at one time or another by most people during their lives. Response to grief and bereavement losses can lead to psychiatric disorders such as mood disorders, post traumatic responses, insomnia loss of appetite, anxiety, and depression. The aim of our study is to value in our community the physical and psychological complications of a normal grief. We conducted a cross-sectional study from March 2012 to September 2012 in Lubumbashi, Democratic Republic of Congo. Two questionnaires, the Hamilton Anxiety Scale and the Beck Depression Inventory scale were used as screening tool. A snow ball sampling method was performed and the questionnaires were administered only to those who consented to participate in the study. A total of 78 subjects were included in the study of which 87.2% were aged between 14-50 years old. The majority of the subjects were female 65.4%, and about a quarter (28%) was unemployed. The main correlates of the grief reported in the present study were being treated as witchcraft or accused to be responsible of a death (68%), being rejected by family and not being allowed to inherit (32%). Being homeless was reported in 26%. The main psychological symptoms reported were psychological distress after 1 year (65%) and related physical health problems after the death (72%). Depression and mild anxiety were the most reported disorders, with respectively 92.3% and 74.4% of the subjects. Grief in Lubumbashi is associated with a large number of psychological, social and health problems. Health problems such as gastric is, high blood pressure were often reported. Being accused of witchcraft remains the main social impact. Depression and anxiety were the most psychological problem associated with grief.

  12. Early Family Deaths May Create 'Grief Gap' for Blacks

    MedlinePlus

    ... fullstory_163190.html Early Family Deaths May Create 'Grief Gap' for Blacks Compared to whites, they are ... earlier ages than whites, creating a potentially devastating "grief gap," new research suggests. Studying more than 42, ...

  13. The effectiveness of Grief-Help, a cognitive behavioural treatment for prolonged grief in children: study protocol for a randomised controlled trial

    PubMed Central

    2013-01-01

    Background There is growing recognition of a syndrome of disturbed grief referred to as prolonged grief disorder (PGD). PGD is mostly studied in adults, but clinically significant PGD symptoms have also been observed in children and adolescents. Yet, to date no effective treatment for childhood PGD exists. The aims of this study are: (1) to investigate the effectiveness of Grief-Help, a nine-session cognitive-behavioural treatment for childhood PGD, combined with five sessions of parental counselling, immediately after the treatment and at three, six and twelve months follow-up; (2) to examine tentative mediators of the effects of Grief-Help, (i.e., maladaptive cognitions and behaviours and positive parenting), and (3) to determine whether demographic variables, child personality, as well as symptoms of PGD, anxiety, and depression in parents moderate the treatment effectiveness. Methods/Design We will conduct a Randomised Controlled Trial (RCT) in which 160 children and adolescents aged 8–18 years are randomly allocated to cognitive behavioural Grief-Help or to a supportive counselling intervention; both treatments are combined with five sessions of parental counselling. We will recruit participants from clinics for mental health in the Netherlands. The primary outcome measure will be the severity of Prolonged Grief Disorder symptoms according to the Inventory of Prolonged Grief for Children (IPG-C). Secondary outcomes will include PTSD, depression and parent-rated internalizing and externalizing problems. Mediators like positive parenting and maladaptive cognitions and behaviours will be identified. We will also examine possible moderators including demographic variables (e.g. time since loss, cause of death), psychopathology symptoms in parents (PGD, anxiety and depression) and child personality. Assessments will take place in both groups at baseline, after the treatment-phase and three, six and twelve months after the post-treatment assessment. Discussion We

  14. The effectiveness of Grief-Help, a cognitive behavioural treatment for prolonged grief in children: study protocol for a randomised controlled trial.

    PubMed

    Spuij, Mariken; Prinzie, Peter; Dekovic, Maja; van den Bout, Jan; Boelen, Paul A

    2013-11-20

    There is growing recognition of a syndrome of disturbed grief referred to as prolonged grief disorder (PGD). PGD is mostly studied in adults, but clinically significant PGD symptoms have also been observed in children and adolescents. Yet, to date no effective treatment for childhood PGD exists. The aims of this study are: (1) to investigate the effectiveness of Grief-Help, a nine-session cognitive-behavioural treatment for childhood PGD, combined with five sessions of parental counselling, immediately after the treatment and at three, six and twelve months follow-up; (2) to examine tentative mediators of the effects of Grief-Help, (i.e., maladaptive cognitions and behaviours and positive parenting), and (3) to determine whether demographic variables, child personality, as well as symptoms of PGD, anxiety, and depression in parents moderate the treatment effectiveness. We will conduct a Randomised Controlled Trial (RCT) in which 160 children and adolescents aged 8-18 years are randomly allocated to cognitive behavioural Grief-Help or to a supportive counselling intervention; both treatments are combined with five sessions of parental counselling. We will recruit participants from clinics for mental health in the Netherlands. The primary outcome measure will be the severity of Prolonged Grief Disorder symptoms according to the Inventory of Prolonged Grief for Children (IPG-C). Secondary outcomes will include PTSD, depression and parent-rated internalizing and externalizing problems. Mediators like positive parenting and maladaptive cognitions and behaviours will be identified. We will also examine possible moderators including demographic variables (e.g. time since loss, cause of death), psychopathology symptoms in parents (PGD, anxiety and depression) and child personality. Assessments will take place in both groups at baseline, after the treatment-phase and three, six and twelve months after the post-treatment assessment. We aim to contribute to the improvement

  15. Grief reaction model of families who experienced acute bereavement in Japan.

    PubMed

    Tatsuno, Junko; Yamase, Hiroaki; Yamase, Yoshie

    2012-06-01

    The present study clarified the structure of factors that affect grief reactions of families who experienced acute bereavement in critical care settings in Japan. Sixty-four families who experienced acute bereavement answered a questionnaire. The questionnaire included the Miyabayashi Grief Measurement, recognition of bereavement, Multidimensional Scale of Perceived Social Support, and the Tri-Axial Coping Scale. We analyzed the causal structure regarding the relationship of stress recognition, coping, and grief reactions using structural equation modeling. The greatest influence on grief reactions of bereaved families was stress recognition. Factors that influenced stress recognition were subjective degree of sadness, acceptance of bereavement, regret for bereavement, and recognition of a peaceful death. These results show that the quality of end-of-life care in critical care settings is an important factor that affects bereaved families' stress recognition and grief reactions. Nurses and medical staff must provide end-of-life care to help family members accept the death of their loved one and reduce regrets as much as possible.

  16. Support program for women suffering grief after termination of pregnancy: A pilot study.

    PubMed

    Sriarporn, Punpilai; Turale, Sue; Lordee, Nuananong; Liamtrirat, Sawanee; Hanpra, Wasana; Kanthino, Authid

    2017-03-01

    In this study, we preliminarily examined the effects of the Informational and Emotional Support Program for Women after Pregnancy Termination in 30 Thai women. A literature review and House's theory of social support informed the program content, which consisted of the following elements: (i) an evaluation of grief; (ii) an analysis of the problems and needs of each woman; (iii) informational and emotional support tailored to individual problems and needs; (iv) telephone support; and (v) an exit phone interview. The Grief Questionnaire for Women after Pregnancy Termination was used to measure changes in the grief levels of participants. The data were analyzed using descriptive statistics and the contingency coefficient. At the completion of the study, the participants' average grief score had decreased from the prior grief score and was in the moderate to low range. These preliminary findings indicate that the support program can be effective in real-life situations in Thailand to assist women who are grieving after the termination of pregnancy. Our findings highlight the need for nursing and emotional support to be provided to help Thai women after the TOP. © 2016 John Wiley & Sons Australia, Ltd.

  17. Financial Perils in Higher Education--Good Grief!

    ERIC Educational Resources Information Center

    Shaw, Kenneth A.; Britton, Thomas C.

    The premise that institutions pass through a grief process in adjusting to declining resources and radical changes, is proposed. In addition, strategies that administrators can use to respond to institutional grief are suggested. Elisabeth Kubler-Ross's paradigm of five grief stages/reactions to serious loss are described: denial, anger,…

  18. Brief Information on Childhood Traumatic Grief for School Personnel

    ERIC Educational Resources Information Center

    National Child Traumatic Stress Network, 2008

    2008-01-01

    This information sheet summarizes material found in the "In-Depth General Information Guide to Childhood Traumatic Grief" and "In-Depth Information on Childhood Traumatic Grief for School Personnel." Childhood traumatic grief is a condition that some children develop after the death of a close friend or family member. Children who develop…

  19. Anticipatory Grief and AIDS: Strategies for Intervening with Caregivers.

    ERIC Educational Resources Information Center

    Walker, Rebecca J.; And Others

    1996-01-01

    Anticipatory grief may have beneficial effects for caregivers of people with HIV infection or AIDS. Illness duration, stigmatization, and multiple losses may impede the caregiver's ability to effectively engage in the grief process, however. Discusses the impact of these aspects of the disease on the anticipatory grief process and mourning tasks…

  20. Tweeting Prayers and Communicating Grief over Michael Jackson Online

    ERIC Educational Resources Information Center

    Sanderson, Jimmy; Cheong, Pauline Hope

    2010-01-01

    Death and bereavement are human experiences that new media helps facilitate alongside creating new social grief practices that occur online. This study investigated how people's postings and tweets facilitated the communication of grief after pop music icon Michael Jackson died. Drawing on past grief research, religion, and new media studies, a…

  1. Financial Perils in Higher Education--Good Grief!

    ERIC Educational Resources Information Center

    Shaw, Kenneth A.; Britton, Thomas C.

    The premise that institutions pass through a grief process in adjusting to declining resources and radical changes, is proposed. In addition, strategies that administrators can use to respond to institutional grief are suggested. Elisabeth Kubler-Ross's paradigm of five grief stages/reactions to serious loss are described: denial, anger,…

  2. Brief Information on Childhood Traumatic Grief for School Personnel

    ERIC Educational Resources Information Center

    National Child Traumatic Stress Network, 2008

    2008-01-01

    This information sheet summarizes material found in the "In-Depth General Information Guide to Childhood Traumatic Grief" and "In-Depth Information on Childhood Traumatic Grief for School Personnel." Childhood traumatic grief is a condition that some children develop after the death of a close friend or family member. Children who develop…

  3. Residential Grief Camps: An Initial Phenomenological Study of Staff Perspectives

    ERIC Educational Resources Information Center

    Brown, Tiffany B.; Kimball, Thomas G.

    2012-01-01

    Research has focused primarily on the impact of death on family functioning and the stages and tasks of grief, though little attention has been given to grief camps or the experiences of those who work there. This study explored the experiences of staff at a four-day overnight children's grief camp. Eight participants reported their experience of…

  4. Tweeting Prayers and Communicating Grief over Michael Jackson Online

    ERIC Educational Resources Information Center

    Sanderson, Jimmy; Cheong, Pauline Hope

    2010-01-01

    Death and bereavement are human experiences that new media helps facilitate alongside creating new social grief practices that occur online. This study investigated how people's postings and tweets facilitated the communication of grief after pop music icon Michael Jackson died. Drawing on past grief research, religion, and new media studies, a…

  5. Goodbye Therapy: Use of Imagery Techniques for Problematic Grief Intervention.

    ERIC Educational Resources Information Center

    Brown, James C.

    This document addresses the issue of problematic grief reactions, reactions which tend to be more common than are often realized and which may be a source of "existential" anxiety. It presents a treatment model which can be used with any loss-elicited grief reaction including the acute grief reaction typically encountered subsequent to the death…

  6. Guided mourning for morbid grief: a controlled study.

    PubMed

    Mawson, D; Marks, I M; Ramm, L; Stern, R S

    1981-03-01

    During 2 weeks on a waiting list 12 patients with morbid grief did not improve significantly. They were then randomly allocated either to guided mourning treatment, in which they were encouraged to face cues concerning their bereavement, or to control treatment in which they were asked to avoid such cues. Each treatment comprised six 1 1/2 hour sessions over 2 weeks. At week 4 guided mourning patients had improved significantly more than had controls on 3 measures, with a supportive trend on 4 measures. Improvement, though modest, was maintained to 10-28 weeks follow-up. Control patients did not improve significantly or show any trend to do so.

  7. Grief, Depressive Symptoms, and Physical Health Among Recently Bereaved Spouses

    PubMed Central

    Utz, Rebecca L.; Caserta, Michael; Lund, Dale

    2012-01-01

    Purpose: Widowhood is among the most distressing of all life events, resulting in both mental and physical health declines. This paper explores the dynamic relationship between physical health and psychological well-being among recently bereaved spouses. Design and Methods: Using a sample of 328 bereaved persons who participated in the “Living After Loss” study, we modeled trends in physical health, somatic symptoms, and psychological well-being over the first year and a half of widowhood. The primary focus is whether physical health at the time of widowhood modifies psychological well-being over time. Results: There were considerable somatic symptoms during the earliest months of bereavement but no major health declines over the first year and half of bereavement. Those in poor health had initially higher levels of grief and depressive symptoms, but the trajectories or changes over time were similar regardless of health status. Those with poor health at the time of widowhood had significantly higher risks of complicated grief and major depression disorder. Implications: Bereavement requires physical and emotional adjustment, but the psychological trajectory of bereavement may be somewhat universal. Bereavement support ought to include a focus on self-care and health promotion in addition to emotional support, especially because those with poor health initially may be most susceptible to prolonged and intense clinical distress. PMID:22156713

  8. Grief, depressive symptoms, and physical health among recently bereaved spouses.

    PubMed

    Utz, Rebecca L; Caserta, Michael; Lund, Dale

    2012-08-01

     Widowhood is among the most distressing of all life events, resulting in both mental and physical health declines. This paper explores the dynamic relationship between physical health and psychological well-being among recently bereaved spouses.   Using a sample of 328 bereaved persons who participated in the "Living After Loss" study, we modeled trends in physical health, somatic symptoms, and psychological well-being over the first year and a half of widowhood. The primary focus is whether physical health at the time of widowhood modifies psychological well-being over time.   There were considerable somatic symptoms during the earliest months of bereavement but no major health declines over the first year and half of bereavement. Those in poor health had initially higher levels of grief and depressive symptoms, but the trajectories or changes over time were similar regardless of health status. Those with poor health at the time of widowhood had significantly higher risks of complicated grief and major depression disorder.   Bereavement requires physical and emotional adjustment, but the psychological trajectory of bereavement may be somewhat universal. Bereavement support ought to include a focus on self-care and health promotion in addition to emotional support, especially because those with poor health initially may be most susceptible to prolonged and intense clinical distress.

  9. Grief and attitudes toward suicide in peers affected by a cluster of suicides as adolescents.

    PubMed

    Abbott, Caroline H; Zakriski, Audrey L

    2014-12-01

    Eighty-five young adults exposed to a cluster of peer suicides as adolescents completed measures of attitudes toward suicide, grief, and social support. Closeness to the peers lost to suicide was positively correlated with grief and the belief that suicide is not preventable, with grief further elevated in close individuals with high social support from friends. Overall, social support was related to healthy attitudes about suicide including preventability, yet it was also related to some stigmatizing beliefs. Compared with 67 young adults who had not been exposed to a suicide cluster, the exposed sample was more likely to think that suicide is normal but more likely to think of it as incomprehensible. © 2014 The American Association of Suicidology.

  10. Grief in children and adolescents bereaved by sudden parental death.

    PubMed

    Melhem, Nadine M; Porta, Giovanna; Shamseddeen, Wael; Walker Payne, Monica; Brent, David A

    2011-09-01

    Major advances have been made in our understanding of the phenomenology and course of grief in adults. However, little is known about the course of grief in children and adolescents. We report on the course of children's and adolescents' grief reactions after sudden parental death and the effect of those reactions on subsequent psychiatric and functional status. Longitudinal study (July 1, 2002, through January 16, 2007) of bereaved children, adolescents, and families, with yearly comprehensive assessments as long as 3 years after parental death. Bereaved children and adolescents and their surviving parents recruited through coroners' records and a newspaper advertisement. A total of 182 parentally bereaved children and adolescents aged 7 through 18 years whose parent died due to suicide, unintentional injury, or sudden natural causes. Grief, functional impairment, and incident depression. Three distinct trajectories of grief reactions were observed in the study participants. In 1 group, which consisted of 10.4% of the sample, grief reactions showed no change 33 months after death. Children and adolescents with prolonged grief reactions had higher rates of previous personal history of depression. Prolonged grief made unique contributions to increased levels of functional impairment, even after controlling for the clinical characteristics before and after the death. Conversely, prolonged grief in children, adolescents, and the surviving caregiver predisposed children and adolescents to an increased hazard of incident depression. Another group (30.8%) showed increased grief reactions 9 months after the death, which gradually decreased over time. Despite this finding, grief reactions in this group also were associated with functional impairment and increased risk of incident depression. Grief reactions abate over time for most children and adolescents bereaved by sudden parental death; however, a subset shows increased or prolonged grief reactions, which in turn

  11. Childhood Traumatic Grief: An Exploration of the Construct in Children Bereaved on September 11

    ERIC Educational Resources Information Center

    Brown, Elissa J.; Goodman, Robin F.

    2005-01-01

    This study is an exploration of the measurement and correlates of childhood traumatic grief (CTG). Eighty-three children of uniformed service personnel who died during the World Trade Center attack on September 11, 2001, were assessed using measures of demographic characteristics, trauma exposure (physical proximity, emotional proximity, and…

  12. The grief involved in change.

    PubMed

    Linney, B J

    1999-01-01

    In this era of rapid change, people need to be helped through the grieving process at work. "By acknowledging and articulating what is involved, you facilitate people's movement through it ... successful people in growing organizations need to learn to move through the process as quickly and efficiently as possible and help others do the same." Morris Shectman, in Working Without a Net says, "Contrary to the old paradigm--which held that others don't have a right to know about your personal life--the new paradigm says that it's a necessity that they know." If people are to move through the grief that is caused by undesired change, they will have to tell some of their personal feelings. "Each stage of the process--shock and denial, anger, bargaining, depression, and acceptance--is functional ... when people go through the process in a healthy manner, they'll recycle through it in a diluted fashion." Leaders in the organization can help people start the process or move through it if they get stuck at a particular stage.

  13. [Continuous cuff pressure measurement during laryngeal mask anesthesia : An obligatory measure to avoid postoperative complications].

    PubMed

    Hensel, M; Güldenpfennig, T; Schmidt, A; Krumm, M

    2016-05-01

    Inflation of laryngeal masks is often performed only with regard to the clinical impression and without any objective measurement of cuff pressure. As a result the use of laryngeal masks frequently leads to postoperative complications, such as sore throat, dysphonia, dysphagia and nerve palsy. In this study the influence of continuous measurement of cuff pressure on the incidence of postoperative sore throat was investigated in patients who underwent laryngeal mask anesthesia. In the context of a retrospective audit all patients who underwent laryngeal mask anesthesia were asked to complete a questionnaire on anesthesia. The primary endpoint of the study was the postoperative occurrence of a sore throat. For analysis the patients were divided into two groups. In the first group the cuff pressure was controlled only by clinical means and in the second group the cuff pressure was controlled using continuous manometry. The study covered a 10-month period of observation for each group. During the observation period laryngeal mask anesthesia was performed in 4169 patients. Of these 917 patients (manometry group n = 433 and control group n = 484) voluntarily completed the questionnaire. In the group without cuff pressure measurement 36 % of patients complained of sore throat postoperatively but only 12 % of the patients in the group with cuff pressure measurement (p < 0.001). Postoperative nausea and vomiting occurred in 16 % of the patients and 13 % complained of severe pain in the area of the operation. No differences between the two groups were found. While 97 % of patients in the group with continuous measurement of cuff pressure were satisfied with the anesthesia, this applied to only 79 % of patients in the control group (p = 0.006). In terms of the results of this study and with respect to data from the literature, measurement of cuff pressure should be compulsory during laryngeal mask anesthesia.

  14. Grief, consolation, and religions: a conceptual framework.

    PubMed

    Klass, Dennis

    2014-01-01

    Consolation is grief's traditional amelioration, but contemporary bereavement theory lacks a conceptual framework to include it. The article begins to develop that framework. The article argues that grief is inter-subjective, even at the biological level. Consolation and grief happen in the same inter-subjective space. Material from the histories of several religions sets the article in a cross-cultural and historical environment. The article examines consolation in interpersonal relationships, and then moves to consolation in cultural/religious resources that range from the literal image of God as an idealized parent to the abstract architecture of Brahm's Requiem. The most common consolation in the histories of religions comes within continuing bonds that are accessed in a wide variety of beliefs, rituals, and devotional objects. The article closes by briefly drawing the connection between consolation and faith.

  15. Prolonged grief disorder and depression in a German community sample.

    PubMed

    Schaal, Susanne; Richter, Anne; Elbert, Thomas

    2014-01-01

    The aims of this study were to examine rates and risk factors for prolonged grief and to investigate the association between prolonged grief and depression. The authors interviewed a heterogeneous bereaved sample of 61 Germans, 6 of whom had prolonged grief and depression, respectively. The 2 syndromes were strongly linked to one another. Risk factors for prolonged grief were being a woman and having high levels of religious beliefs and low levels of satisfaction with one's religious beliefs, emotional closeness to the deceased, and unanticipated loss. Symptoms of prolonged grief may endure years post-loss and often overlap with depression.

  16. Pediatric nurses' grief experience, burnout and job satisfaction.

    PubMed

    Adwan, Jehad Z

    2014-01-01

    Correlations among grief, burnout, and job satisfaction among highly satisfied pediatric nurses were examined using the Revised Grief Experience Inventory (RGEI), Maslach Burnout Inventory (MBI), and Index of Work Satisfaction (IWS). Results showed that grief had significant correlations; positive with burnout, negative with job satisfaction. RN's reported significantly higher emotional exhaustion if their primary patients died and higher guilt if patients died younger. Conclusions suggest a dynamic statistical interaction among nurses' grief, burnout, and job satisfaction representing a pathway to intention to leave their unit, organization, or nursing. Recommendations include implementation and evaluation of grief intervention and education programs.

  17. The grief account: dimensions of a contemporary bereavement genre.

    PubMed

    Dennis, Michael Robert

    2008-01-01

    The genre of the grief account is identified to include published narratives of surviving grief. Thematic analysis of Andrew Holleran's (2006) Grief: A Novel, Lolly Winston's (2004) Good Grief: A Novel, Joan Didion's (2005) The Year of Magical Thinking, and J. Canfield and M. V. Hansen's (2003) Chicken Soup for the Grieving Soul: Stories About Life, Death and Overcoming the Loss of a Loved One is informed by recent scholarship regarding eulogies and illness and dying narratives. Six dimensions (restorative, evaluative, interpretive, affirmative, affective, transformative) of contemporary grief accounts are recognized as sources of inspiration for the practice and experience of bereavement.

  18. Grief following pet and human loss: Closeness is key.

    PubMed

    Eckerd, Lizabeth M; Barnett, James E; Jett-Dias, Latishia

    2016-01-01

    The authors compared grief severity and its predictors in two equivalent college student samples who had experienced the death of a pet (n = 211) or a person (n = 146) within the past 2 years. The human death sample reported higher grief severity, p < .01, but effect sizes were small (ds = .28-.30). For both samples, closeness to the deceased was overwhelmingly the strongest predictor of grief severity; other predictors generally dropped out with closeness added to the model. Results highlight the importance of including closeness to deceased in grief research, and its centrality in understanding grief counseling clients.

  19. Grief Shortly after Suicide and Natural Death: A Comparative Study among Spouses and First-Degree Relatives

    ERIC Educational Resources Information Center

    de Groot, M. H.; de Keijser, J.; Neeleman, J.

    2006-01-01

    Chronic dysfunction after complicated grief is not rare and emphasizes the need to identify bereaved individuals at risk. Three months following bereavement, self-reported psychiatric and general health of 153 relatives of 74 suicides was worse than of 70 relatives of 39 natural deaths. Moreover, the felt need for professional help was higher…

  20. Grief Shortly after Suicide and Natural Death: A Comparative Study among Spouses and First-Degree Relatives

    ERIC Educational Resources Information Center

    de Groot, M. H.; de Keijser, J.; Neeleman, J.

    2006-01-01

    Chronic dysfunction after complicated grief is not rare and emphasizes the need to identify bereaved individuals at risk. Three months following bereavement, self-reported psychiatric and general health of 153 relatives of 74 suicides was worse than of 70 relatives of 39 natural deaths. Moreover, the felt need for professional help was higher…

  1. Psychometric properties of the Dutch Inventories of Prolonged Grief for Children and Adolescents.

    PubMed

    Spuij, Mariken; Prinzie, Peter; Zijderlaan, Jolanda; Stikkelbroek, Yvonne; Dillen, Let; de Roos, Carlijn; Boelen, Paul A

    2012-01-01

    A significant minority of bereaved adults develops prolonged grief disorder (PGD), a syndrome encompassing debilitating symptoms of grief distinct from depression and anxiety. Few studies have examined the phenomenology and correlates of PGD among children and adolescents. In part, this is due to the lack of a psychometrically sound questionnaire to assess PGD symptoms in these groups. Based on an adult measure of PGD, we developed two questionnaires of PGD symptoms for children and adolescents named the Inventory of Prolonged Grief for Children (IPG-C) and Inventory of Prolonged Grief for Adolescents (IPG-A), respectively. Psychometric properties of these measures were examined in three samples, including mostly parentally bereaved children (aged 8-12 years, total sample n = 169) and adolescents (aged 13-18 years, total sample n = 153). First, findings showed that items of the IPG-C and IPG-A represented one underlying dimension. Second, the internal consistency and temporal stability of both questionnaires were adequate. Third, findings supported the concurrent validity (e.g., significant correlations with measures of depression and post-traumatic stress-disorder [PTSD]), convergent and divergent validity (stronger correlations with similar questionnaires of 'traumatic grief' than with two dissimilar questionnaires of 'ongoing presence' and 'positive memories') and incremental validity (significant correlations with an index of functional impairment, even when controlling for concomitant depression and PTSD) of the IPG-C and IPG-A. This report provides further evidence of the clinical significance of PGD symptoms among children and adolescents and promising psychometric properties of questionnaires that can be used to assess these symptoms. The Inventory of Prolonged Grief for Children (IPG-C) and Inventory of Prolonged Grief for Adolescents (IPG-A) were developed to be able to assess symptoms of Prolonged Grief Disorder (PGD) among children and adolescents. In

  2. Online grief support groups: facilitators' attitudes.

    PubMed

    Lubas, Margaret; De Leo, Gianluca

    2014-01-01

    Although bereaved individuals report positive experiences from participating in online support groups, little is known from a facilitator perspective. Using a web-based survey, data was collected from a national sample of grief facilitators (N = 64). Respondents reported more favorable attitudes toward in-person groups over online and indicated a low likelihood of facilitating an online group in the next year. However, 62% of the sample (n = 37) reported willingness to refer to online groups. This attitude may reflect facilitator acknowledgment of the need to increase the presence and availability of grief services; a need that bereaved individuals' express, as shown in previous research.

  3. [Grief and crises in Norse literature].

    PubMed

    Høyersten, J G

    1993-03-30

    The significance of literature for psychiatry and vice versa is commented on, as an introduction to a study of Norse literature. This was written down mainly in Iceland in the 13th Century on the basis of oral traditions, some of which date back to the 9th century. From a psychological point of view, the Icelandic Sagas, the Royal Sagas of Snorri Sturluson and the earliest hero-poems of the Edda are of particular interest. This literature includes detailed descriptions of grief and crisis reactions, the management and rituals of grief, and the associated rituals. These patterns have a striking similarity to modern principles of crisis intervention.

  4. Perinatal loss and parental grief: the challenge of ambiguity and disenfranchised grief.

    PubMed

    Lang, Ariella; Fleiszer, Andrea R; Duhamel, Fabie; Sword, Wendy; Gilbert, Kathleen R; Corsini-Munt, Serena

    2011-01-01

    Following perinatal loss, a type of ambiguous loss, bereaved couples struggle with and experience distress due to various forms of ambiguity. Moreover, the juxtaposition of their grief with society's minimization often disenfranchises them from traditional grieving processes. The purpose of this study was to explore sources of ambiguity and disenfranchised grief related to perinatal loss. Audio-taped interviews with 13 bereaved couples at 2, 6, and 13 months following the death of their fetus or infant were analyzed. Several categories of ambiguity and disenfranchised grief emerged, pertaining to: (a) the viability of the pregnancy; (b) the physical process of pregnancy loss; (c) making arrangements for the remains; and (d) sharing the news. This study uncovers the many sources of ambiguity and disenfranchised grief that bereaved couples face in interactions with family, friends, society, and healthcare professionals. These insights may inform healthcare professionals in their attempts to ease distress related to perinatal loss.

  5. The push and pull of grief: Approach and avoidance in bereavement.

    PubMed

    Maccallum, Fiona; Sawday, Simon; Rinck, Mike; Bryant, Richard A

    2015-09-01

    Prolonged Grief (PG) is recognized as a post-bereavement syndrome that is associated with significant impairment. Although approach and avoidance tendencies have both been hypothesized to play key roles in maintaining PG symptoms, understanding of these relationships has been limited by a reliance on self-report methodology. This study applies an experimental paradigm to simultaneously investigate the relationship between PG severity and approach-avoidance behavioral tendencies. Fifty-five bereaved individuals with and without PG completed a behavioral measure of approach and avoidance responding in which they pulled or pushed a joystick in response to grief-related, positive, negative and neutral images that appeared on a computer screen. Concurrent visual feedback created the illusion that the images were either approaching or receding from the participant. Half of the participants also received a prime designed to activate their grief prior to the task. Irrespective of prime condition, PG participants pulled grief-related images more quickly than they pushed them. This difference was not observed in response to non-grief related images. Non PG participants showed no difference in their reaction times to grief-stimuli. This study was undertaken in a nonclinical setting and the majority of participants had lost a loved one due to chronic illness. Future research with treatment-seeking populations and sudden loss will be needed to explore the generalizability of the findings. The findings from this study provide preliminary evidence supporting models of PG that integrate approach and avoidance tendencies. Copyright © 2015 Elsevier Ltd. All rights reserved.

  6. Gender differences in the effect of grief reactions and burnout on emotional distress among clinical oncologists.

    PubMed

    Granek, Leeat; Krzyzanowska, Monika K; Nakash, Ora; Cohen, Michal; Ariad, Samuel; Barbera, Lisa; Levy, Rotem; Ben-David, Merav

    2016-12-01

    The current study was conducted to examine gender differences in the effect of grief reactions and burnout on emotional distress among clinical oncologists. The participants included a convenience sample of 178 oncologists from Israel (52 of whom were women) and Canada (48 of whom were women). Oncologists completed a questionnaire package that included a sociodemographic survey, the General Health Questionnaire, a burnout measure, and the Adult Oncologists Grief Questionnaire. To examine the effect of grief reactions and burnout on emotional distress while controlling for country and past depression within each gender, 2 hierarchical linear regression analyses were computed. Female oncologists reported significantly more grief responses to patient death (mean, 47.72 [standard deviation (SD), 8.71] and mean, 44.53 [SD, 9.19], respectively), more emotional distress (mean, 12.41 [SD, 4.36] and mean, 10.64 [SD, 3.99], respectively), and more burnout (mean, 2.59 [SD, 1.69] and mean, 1.84 [SD, 1.5], respectively). For both genders, higher levels of grief reactions were associated with greater emotional distress among those who reported high levels of burnout (P<.001). However, for men, the association between grief reactions and emotional distress also was documented at moderate levels of burnout (P<.001). Patient death is a regular part of clinical oncology. It is essential that oncologists be able to cope effectively with this aspect of their work. The findings of the current study highlight the need to take into account the cumulative stressors that oncologists contend with when designing supportive interventions. Gender differences in burnout, reactions to patient death, and emotional distress need to be addressed to ensure the best quality of life for oncologists and the best quality of care for their patients. Cancer 2016;122:3705-14. © 2016 American Cancer Society. © 2016 American Cancer Society.

  7. Grief, traumatic stress, and posttraumatic growth in women who have experienced pregnancy loss.

    PubMed

    Krosch, Daniel Jay; Shakespeare-Finch, Jane

    2017-07-01

    Pregnancy loss is common and can be devastating for those who experience it. However, a historical focus on negative outcomes, and grief in particular, has rendered an incomplete portrait of both the gravity of the loss, and the potential for growth in its wake. Consistent with contemporary models of growth following bereavement, this study explored the occurrence of posttraumatic growth following pregnancy loss and further assessed the role of core belief disruptions and common loss context factors across perinatal grief, posttraumatic stress symptoms, and posttraumatic growth. Women who had experienced a miscarriage or stillbirth (N = 328) were recruited through perinatal loss support groups and completed an online survey that assessed core belief disruption, perinatal grief, posttraumatic stress symptoms, posttraumatic growth, loss context factors, and demographics. Hypotheses were tested via hierarchical multiple regression. All hypotheses were supported. Specifically, (a) moderate levels of posttraumatic growth were reported; (b) core belief disruptions predicted perinatal grief, posttraumatic stress symptoms, and posttraumatic growth; and (c) perinatal grief predicted posttraumatic stress symptoms and growth. Findings suggest that pregnancy loss can be a traumatic event, that core belief disruptions play a significant role in posttrauma outcomes, and that other factors may contribute to grief, posttraumatic stress symptoms, and posttraumatic growth following pregnancy loss that warrant further research (e.g., rumination). Despite potential methodological and sampling limitations, the use of validated measures to assess posttraumatic growth in a large sample represents a robust attempt to quantify the occurrence of posttrauma change following pregnancy loss. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  8. [Family Focused Grief Therapy - A Suitable Model for the Palliative Care of Cancer Patients and their Families?].

    PubMed

    Weißflog, Gregor; Mehnert, Anja

    2015-11-01

    Loss is a universal human experience. Within the context of cancer and especially in the palliative care of oncological patients, anticipated and real losses and their management play a crucial role. A high proportion of patients and family members develop a treatment requiring psychiatric comorbidity (for both groups between 20 and 30%, mainly adjustment and anxiety disorders and depression). Approximately 15% of the bereaved persons suffer from complicated grief after the death of their relative. Within the early palliative care, the implementation of the Family Focused Grief Therapy (FFGT) has the potential to reduce psychological distress incl. mental comorbidities in patients and their relatives. Simultaneously, the incidence of the prolonged grief disorder in bereaved persons could be diminished (after the death of their relative). Thus, the FFGT can make a substantial contribution in order to improve the palliative care of cancer patients and their bereaved persons. © Georg Thieme Verlag KG Stuttgart · New York.

  9. Persistent Complex Bereavement Disorder and Culture: Early and Prolonged Grief in Nepali Widows.

    PubMed

    Kim, Jane; Tol, Wietse A; Shrestha, Abina; Kafle, Hari Maya; Rayamajhi, Rajin; Luitel, Nagendra P; Thapa, Lily; Surkan, Pamela J

    2017-01-01

    Persistent complex bereavement disorder (PCBD) in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), has not been well studied in socioculturally diverse populations. Thus, this qualitative study examined (a) how widows in Nepal understand grief, (b) whether a local construct of PCBD exists, and (c) its comparability with the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), terminology. Using an adapted Explanatory Model Interview Catalogue (EMIC) framework, semistructured interviews with 25 widows and 12 key informants, as well as three focus-group discussions (n = 20), were conducted between October 2014 and April 2015. Through an inductive grounded theory-based approach, we used the constant comparative method, iteratively coding transcripts to identify themes and patterns in the data. Also, we created two lists of grief responses, one of early reactions and another all reactions to grief, based on the frequency of mention. No single term for grief was reported. Widows reported a local construct of PCBD, which was broadly compatible with DSM-5 terminology but with important variation reflecting societal influence. Surviving torture during conflict, economic and family stressors, and discrimination were mentioned as important determinants that prolong and complicate grief. Suicidal ideation was common, with about 31% and 62% of widows reporting past-year and lifetime suicidality, respectively. Findings may not be generalizable to all Nepali widows; participants were recruited from a non-governmental organization, from Kathmandu and its neighboring districts, and were primarily of reproductive age. While PCBD symptoms proposed in DSM-5 were mentioned as relevant by study participants, some components may need adaptation for use in non-Western settings, such as Nepal.

  10. [Factors influencing grief due to bereavement among elderly widows and widowers].

    PubMed

    Terasaki, A; Nakamura, K

    1998-06-01

    To identify the factors that influence the grief of bereaved elderly people due to the death of a spouse. Subjects consisted of 172 widows and widowers (137 females, 35 males) aged 60 or older who experienced bereavement of a spouse in the last three years. Between August 1994 and October 1996, the subjects were interviewed using a semi-structured questionnaire and data was also obtained from self-report measures which were returned by mail. A questionnaire consisting of 26 items was prepared based on the theories of Parkes and Deeken. These responses were classified into 4 categories (sensory paralysis, deep attachment and protest, disintegration, reconstruction) and analysis was made by these categories. The time course of the grief was evaluated at 1 week, 49 days and 1 year after the death of the spouse and the time of survey. (1) Of the 172 subjects, general health was graded as poor or slightly poor in 33.6%, 67.4% cared for their spouse during medical treatment; and the average GDS depression score was 5.85 (SD = 3.50). (2) With respect to anticipated grief, while their spouses were under medical treatment, more than 50% of the subjects were thinking "I will do Whatever I can to cope". (3) Change in grief response over time: For "sensory paralysis", "I have done whatever I can" rated the highest at 3 points or more on a scale of 4, from immediately after the spouse's death to the present. For "deep attachment and protest", deep attachment including "always thinking of the lost one" marked higher (3.4 points immediately after death to 2.9 at present) than protest. For "disintegration", "nobody understands what I feel" rated the highest (2.6-2.9 points). For "reconstruction", the subjects gradually accepted the death as "unavoidable" and had started to adapt. (4) Factors that significantly influenced grief were the subject's health condition, whether the subject had been notified of the name of the disease or given a prognosis; whether subject provided care

  11. Treating Childhood Traumatic Grief: A Pilot Study.

    ERIC Educational Resources Information Center

    Cohen, Judith A.; Mannarino, Anthony P.; Knudsen, Kraig

    2004-01-01

    Objective: To examine the potential efficacy and specific timing of treatment response of individual child and parent trauma-focused cognitive-behavioral therapy for childhood traumatic grief (CTG), a condition in which trauma symptoms impinge on the child's ability to successfully address the normal tasks of grieving. Method: Twenty-two children…

  12. Grief and Horses: Putting the Pieces Together

    ERIC Educational Resources Information Center

    Symington, Ashley

    2012-01-01

    The effectiveness of grief counseling may be enhanced through the utilization of equine-assisted psychotherapy (EAP). An experiential, solution-focused, and natural approach, EAP provides clients with the opportunity to discover solutions to challenges that exist within themselves. Counselors and equine specialists team with horses to provide a…

  13. Treating Childhood Traumatic Grief: A Pilot Study.

    ERIC Educational Resources Information Center

    Cohen, Judith A.; Mannarino, Anthony P.; Knudsen, Kraig

    2004-01-01

    Objective: To examine the potential efficacy and specific timing of treatment response of individual child and parent trauma-focused cognitive-behavioral therapy for childhood traumatic grief (CTG), a condition in which trauma symptoms impinge on the child's ability to successfully address the normal tasks of grieving. Method: Twenty-two children…

  14. The Challenge of Grief: Counseling the Survivors.

    ERIC Educational Resources Information Center

    Strong, Winifred; Honer, Mary

    This paper focuses on the stress and struggles faced by survivors, following physical and/or emotional loss. It explains how counselors must be prepared to assist when grief strikes the nation, the classroom, or the individual. Each incident carries its own uniqueness and must be dealt with in light of the victim's personal need and their belief…

  15. Nursing 433: Uncomplicated Grief and Bereavement.

    ERIC Educational Resources Information Center

    Kane, James J.

    A description is provided of "Uncomplicated Grief and Bereavement," a course designed to provide the graduate nursing student with the assessment, diagnosis, planning, intervention, and evaluation skills required to facilitate a normal bereavement outcome among persons experiencing the loss of a significant other. The course description first…

  16. Children and Grief: When a Parent Dies.

    ERIC Educational Resources Information Center

    Worden, J. William

    The research findings on childhood grief are often inconsistent and differ among studies. This book presents major findings from the Child Bereavement Study and looks at the implications of these of these findings for intervention with bereaved children and their families. Following an introduction describing the methodology of the Child…

  17. Grief Experiences and Expectance of Suicide

    ERIC Educational Resources Information Center

    Wojtkowiak, Joanna; Wild, Verena; Egger, Jos

    2012-01-01

    Suicide is generally viewed as an unexpected cause of death. However, some suicides might be expected to a certain extent, which needs to be further studied. The relationships between expecting suicide, feeling understanding for the suicide, and later grief experiences were explored. In total, 142 bereaved participants completed the Grief…

  18. Grief Support Group Curriculum: Facilitator's Handbook.

    ERIC Educational Resources Information Center

    Lehmann, Linda; Jimerson, Shane R.; Gaasch, Ann

    This handbook is designed for facilitators of grief support groups for mourning children. The first chapter discusses the history, philosophy, and format of a specific curriculum - the Mourning Child curriculum. This curriculum, originally written in 1986 and later expanded and revised, has been used with hundreds of children. Chapter two covers…

  19. Living with Grief: Children, Adolescents, and Loss.

    ERIC Educational Resources Information Center

    Doka, Kenneth J., Ed.

    Noting that the best way to help and prepare children to cope with death and trauma is through education and understanding of the day-to-day ramifications that loss and grief have on them, this book is designed to help adults involved with children and adolescents to provide that education and understanding. Chapters in the first section of the…

  20. Grief as a Social Emotion: Theoretical Perspectives

    ERIC Educational Resources Information Center

    Jakoby, Nina R.

    2012-01-01

    The article explores a sociological perspective on grief as a social emotion. Focusing on the social bond with the deceased, the self-concept of the survivor or the power of feeling rules, general sociological theories of emotions (symbolic interactionism, structural theory, behavioral theory) have the potential to deepen the understanding of…

  1. Grief and Horses: Putting the Pieces Together

    ERIC Educational Resources Information Center

    Symington, Ashley

    2012-01-01

    The effectiveness of grief counseling may be enhanced through the utilization of equine-assisted psychotherapy (EAP). An experiential, solution-focused, and natural approach, EAP provides clients with the opportunity to discover solutions to challenges that exist within themselves. Counselors and equine specialists team with horses to provide a…

  2. Grief Experiences and Expectance of Suicide

    ERIC Educational Resources Information Center

    Wojtkowiak, Joanna; Wild, Verena; Egger, Jos

    2012-01-01

    Suicide is generally viewed as an unexpected cause of death. However, some suicides might be expected to a certain extent, which needs to be further studied. The relationships between expecting suicide, feeling understanding for the suicide, and later grief experiences were explored. In total, 142 bereaved participants completed the Grief…

  3. Association between anticipatory grief and problem solving among family caregivers of persons with cognitive impairment.

    PubMed

    Fowler, Nicole R; Hansen, Alexandra S; Barnato, Amber E; Garand, Linda

    2013-04-01

    Measure perceived involvement in medical decision making and determine if anticipatory grief is associated with problem solving among family caregivers of older adults with cognitive impairment. Retrospective analysis of baseline data from a caregiver intervention (n = 73). Multivariable regression models testing the association between caregivers' anticipatory grief, measured by the Anticipatory Grief Scale (AGS), with problem-solving abilities, measured by the social problem solving inventory-revised: short form (SPSI-R: S). 47/73 (64%) of caregivers reported involvement in medical decision making. Mean AGS was 70.1 (± 14.8) and mean SPSI-R: S was 107.2 (± 11.6). Higher AGS scores were associated with lower positive problem orientation (p = .041) and higher negative problem orientation scores (p = .001) but not other components of problem solving-rational problem solving, avoidance style, and impulsivity/carelessness style. Higher anticipatory grief among family caregivers impaired problem solving, which could have negative consequences for their medical decision making responsibilities.

  4. Psychometric Properties of the Grief Cognitions Questionnaire for Children (GCQ-C).

    PubMed

    Spuij, Mariken; Prinzie, Peter; Boelen, Paul A

    2017-01-01

    Negative thinking is seen as an important mediating factor in the development of prolonged grief disorder (PGD), a syndrome encompassing debilitating symptoms of grief. No measure of specific grief related cognitions is available yet. Based on an adult measure of negative thinking in adults we developed a questionnaire for children, the Grief Cognitions Questionnaire for Children (GCQ-C). This study investigated several psychometric properties of the GCQ-C. Both reliability and validity were investigated in this study, in which hundred fifty-one children and adolescents (aged 8-18 years) participated. Findings showed that items of the GCQ-C represented one underlying dimension. Furthermore, the internal consistency and temporal stability were found to be adequate. Third, the findings supported the concurrent validity (e.g., significant positive correlations with self-report indices of PGD, depression and posttraumatic stress disorder), convergent and divergent validity of the GCQ-C. This study provides further evidence for the importance of negative thinking in PGD in children and adolescents.

  5. Physiological and psychological symptoms of grief in widows.

    PubMed

    Kowalski, Susan D; Bondmass, Mary D

    2008-02-01

    In this cross-sectional descriptive survey of 173 widows, we describe their grief symptoms using an open-ended questionnaire and the Revised Grief Experience Inventory. Self-reported physical symptoms included pain, gastro-intestinal problems, medical/surgical conditions, sleep disturbances, and neurological/circulatory issues. Psychological symptoms were reported as depression, anxiety, and loneliness. The mean total grief score was 71.4 +/- 30.2 (possible range 22-132). Physical symptoms were significantly correlated with the total mean grief score, and subscales of physical distress, depression, existential tension, and guilt. When the subjects were grouped by years since loss, (range 1-5 years), there was no significant decrease found in overall grief scores, suggesting symptoms of grief experienced by widows may continue up to at least 5 years. (c) 2007 Wiley Periodicals, Inc.

  6. "It may not be pretty, but it's honest": examining parental grief on the Callapitter blog.

    PubMed

    DeGroot, Jocelyn M; Carmack, Heather J

    2013-01-01

    Following the death of a child, parents are turning to alternative means of communication to express their grief In this instrumental case study, the authors explore how 1 woman, Amy Ambrusko, communicates her grief experience on her blog, emotionally negotiating loss and parental grief. Guided by M. S. Miles's (1984) parental grief model, the authors argue that the Callapitter blog serves as a case study illustration of online parental grief. Specifically, Ambrusko displays parental grief in three ways: (re)questioning reality, experiencing discursive and corporeal guilt, and rationalizing a "new normal." This analysis highlights the changing nature of communicating about grief and underscores how grief blogs challenge contemporary social death rules.

  7. Longitudinal changes and predictors of prolonged grief for bereaved family caregivers over the first 2 years after the terminally ill cancer patient's death.

    PubMed

    Tsai, Wei-I; Prigerson, Holly G; Li, Chung-Yi; Chou, Wen-Chi; Kuo, Su-Ching; Tang, Siew Tzuh

    2016-05-01

    A significant minority of bereaved caregivers experience prolonged grief. However, few longitudinal studies have examined prolonged grief, especially in an Asian context. We explored longitudinal changes and factors predicting prolonged grief in bereaved caregivers of terminally ill Taiwanese cancer patients. Observational, prospective, and longitudinal. Prolonged grief symptoms were measured with the PG-13 at 6, 13, 18, and 24 months postloss. A convenience sample of 493 caregivers (83.3% participation rate) of terminally ill cancer patients was recruited from a medical center in Taiwan. The prevalence of prolonged grief decreased significantly over time from the patient's death (7.73%, 1.80%, 2.49%, and 1.85% at 6, 13, 18, and 24 months postloss, respectively, p < 0.05 at all times in reference to 6 months postloss). Caregivers' likelihood of prolonged grief was significantly higher if they had severe preloss depressive symptoms, negatively perceived their relative's dying situation, and were poorly prepared for the patient's death. However, the likelihood of prolonged grief decreased significantly with greater perceived concurrent social support and subjective caregiving burden right before the patient's death. Prolonged grief in bereavement diminished over time and was predicted by modifiable factors before, during, and after bereavement. To facilitate bereavement adjustment and avoid prolonged grief, healthcare professionals should develop and provide at-risk caregivers with effective interventions starting when patients are still alive to improve their dying experience, to facilitate preparedness for the patient's forthcoming death, to alleviate caregivers' preloss depressive symptoms, and to enhance their perceived postloss social support. © The Author(s) 2015.

  8. Birth mother grief and the challenge of adoption reunion contact.

    PubMed

    March, Karen

    2014-07-01

    A large body of work exists on the grief expressed by birth mothers over the loss of their children to adoption. Less is known about the grief emotions that surface when these women are contacted by adopted adults who seek contact relationships. The themes of mourning, grief, and bereavement that emerged in the qualitative interview data of 33 reunited birth mothers indicate more attention be given to these social psychological processes. Suggestions for future research possibilities and implications for clinical practice are explored.

  9. Factorial Validity of the Texas Revised Inventory of Grief-Present Scale among Bereaved Older Adults

    PubMed Central

    Futterman, Andrew; Holland, Jason M.; Brown, Patrick J.; Thompson, Larry W.; Gallagher-Thompson, Dolores

    2010-01-01

    The Texas Revised Inventory of Grief – Present Scale (TRIG-Present) is one of the most widely used grief measures; however, few studies have empirically examined the validity and underlying factor structure of TRIG Present Scale scores. Hence, the present investigation sought to examine the factorial validity of the TRIG-Present Scale (those scores which index current grief) among two samples of bereaved older adults—a community-dwelling sample, made-up of 162 individuals who experienced a diverse set of losses in terms of relationship to the deceased and time since loss, as well as a recently-widowed sample, made-up of 212 individuals who were assessed at 2 and 12-months postloss. Across both samples, we found support for a 3-factor model, composed of clusters of items representing Emotional Response, Thoughts, and Non-Acceptance regarding a loss. Additionally, this 3-factor model exhibited significant invariance from 2 to 12-months postloss in the recently-widowed sample. Analyses examining the convergent validity of these three factors also suggest that this conceptualization of the TRIG-Present Scale could have practical advantages and potentially influence the way in which clinicians/researchers assess grief and evaluate bereavement interventions. PMID:20822280

  10. Evaluation of the perinatal grief intensity scale in the subsequent pregnancy after perinatal loss.

    PubMed

    Hutti, Marianne H; Armstrong, Deborah S; Myers, John

    2013-01-01

    To evaluate the reliability and validity of the Perinatal Grief Intensity Scale (PGIS) for identifying a woman's grief intensity in the immediate subsequent pregnancy after a miscarriage, stillbirth, or neonatal death. A web-based approach was used to collect data from 227 pregnant women after each woman had experienced a perinatal loss in her previous pregnancy. Participants completed a demographic information form and the 14-item PGIS. Cronbach's alphas for the PGIS total scale and subscales were high: 0.75 (PGIS total), 0.80 (Reality), 0.82 (Confront Others), and 0.80 (Congruence), which indicated good internal consistency reliability. Validity was supported by factor analysis of the PGIS, which accounted for 66.94% of the total variance. Mothers in the neonatal death group experienced more intense grief, as measured by the PGIS, when compared with mothers in the miscarriage or stillbirth groups. Data from this study provided initial support for the reliability and validity of the PGIS in women in their immediate subsequent pregnancies after perinatal loss as well as the concepts of the grief intensity theoretical framework. © 2013 AWHONN, the Association of Women's Health, Obstetric and Neonatal Nurses.

  11. Non-invasive measurement of skin autofluorescence to evaluate diabetic complications

    PubMed Central

    Yamanaka, Mikihiro; Matsumura, Takeshi; Ohno, Rei-ichi; Fujiwara, Yukio; Shinagawa, Masatoshi; Sugawa, Hikari; Hatano, Kota; Shirakawa, Jun-ichi; Kinoshita, Hiroyuki; Ito, Kenji; Sakata, Noriyuki; Araki, Eiichi; Nagai, Ryoji

    2016-01-01

    Although the accumulation of advanced glycation end-products (AGEs) of the Maillard reaction in our body is reported to increase with aging and is enhanced by the pathogenesis of lifestyle-related diseases such as diabetes, routine measurement of AGEs is not applied to regular clinical diagnoses due to the lack of conventional and reliable techniques for AGEs analyses. In the present study, a non-invasive AGEs measuring device was developed and the association between skin AGEs and diabetic complications was evaluated. To clarify the association between the duration of hyperglycemia and accumulation of skin fluorophores, diabetes was induced in mice by streptozotocin. As a result, the fluorophore in the auricle of live mice was increased by the induction of diabetes. Subsequent studies revealed that the fingertip of the middle finger in the non-dominant hand is suitable for the measurement of the fluorescence intensity by the standard deviation value. Furthermore, the fluorescence intensity was increased by the presence of diabetic microvascular complications. This study provides the first evidence that the accumulation of fluorophore in the fingertip increases with an increasing number of microvascular complications, demonstrating that the presence of diabetic microvascular complications may be predicted by measuring the fluorophore concentration in the fingertip. PMID:27013780

  12. Factors associated with the grief after stillbirth: a comparative study between Brazilian and Canadian women.

    PubMed

    Paris, Gisele Ferreira; Montigny, Francine de; Pelloso, Sandra Marisa

    2016-01-01

    To verify the association between complicated grief and sociodemographic, reproductive, mental, marital satisfaction, and professional support characteristics in women after stillbirth. Cross-sectional study with 26 women who had stillbirth in 2013, living in the city of Maringá, Brazil, and eight women who attended the Centre d'Études et de Rechercheen Intervention Familiale at the University of Quebec en Outaouais, in Canada. The instrument was administered as an interview to a small number of mothers of infants up to three months (n=50), who did not participate in the validation study. By applying the short version of the Perinatal Grief Scale, the prevalence of complicated grief in Brazilian women was found to be higher (35%) in relation to Canadian women (12%).Characteristics of the Brazilian women associated with the grief period included the presence of previous pregnancy with live birth, absence of previous perinatal loss, postpartum depression, and lack of marital satisfaction. For the Canadians it was observed that 80% of the women presenting no grief made use of the professional support group. In both populations the occurrence of complicated grief presented a higher prevalence in women with duration of pregnancy higher than 28 weeks. The women that must be further investigated during the grief period are those living in Brazil, making no use of a professional support group, presenting little to no marital satisfaction, having no religion, and of a low educational level. Verificar aassociação entre o luto complicado e as características sociodemográficas, reprodutivas, mentais, de satisfação conjugal e apoio profissional em mulheres após óbito fetal. Estudo transversal com 26 mulheres que tiveram óbito fetal no ano de 2013 residentes no município de Maringá, Brasil, e 18 mulheres participantes do Centre d'Études et de Rechercheen Intervention Familiale, na Universidade do Quebec em Outaouais, no Canadá. Por meio da aplicação da vers

  13. The grief process: a preparation for death.

    PubMed

    Curry, L C; Stone, J G

    1991-01-01

    Despite the multitude of losses we experience in our lifetime, death is likely to be the most paramount. Acceptance of losses and death takes time and energy as an individual passes through various phases of a process known as the grief process. Elisabeth Kübler-Ross (1969) has defined five stages in the grief process that individuals pass through in moving toward acceptance of losses. A case study has been presented to share one family's journey through these five stages. If a strict disease-oriented viewpoint is adopted, then the case was a failure: the patient died. From an emotional and spiritual viewpoint, however, this individual and his family achieved success, as they had time to complete their journey to acceptance.

  14. Parents' experiences of pediatric palliative care and the impact on long-term parental grief.

    PubMed

    van der Geest, Ivana M M; Darlington, Anne-Sophie E; Streng, Isabelle C; Michiels, Erna M C; Pieters, Rob; van den Heuvel-Eibrink, Marry M

    2014-06-01

    Approximately 25% of children diagnosed with cancer eventually die. Losing a child puts parents at increased risk for developing psychological problems. To explore parents' perceptions of the interaction with health care professionals (communication, continuity of care, and parental involvement) and symptom management during the pediatric palliative phase, and to investigate the influence on long-term grief in parents who lost a child to cancer. A total of 89 parents of 57 children who died of cancer between 2000 and 2004 participated in this retrospective cross-sectional study by completing a set of questionnaires measuring grief (Inventory of Traumatic Grief), parents' perceptions of the interaction with health care professionals (communication, continuity of care, and parental involvement), and symptom management during the palliative phase. Care was assessed on a five point Likert scale (1=disagree and 5=agree). Parents highly rated communication (4.6±0.6), continuity of care (4.3±0.6), and parental involvement (4.6±0.7) during the palliative phase. Parents' most often reported physical and psychological symptoms of their child during the palliative phase were fatigue (75%), pain (74%), anxiety to be alone (52%), and anger (48%). Higher ratings of parents on communication (β=-9.08, P=0.03) and continuity of care (β=-11.74, P=0.01) were associated with lower levels of long-term parental grief. The severity of the child's dyspnea (β=2.96, P=0.05), anxiety to be alone (β=4.52, P<0.01), anxiety about the future (β=5.02, P<0.01), anger (β=4.90, P<0.01), and uncontrolled pain (β=6.60, P<0.01) were associated with higher levels of long-term parental grief. Multivariate models combining the interaction with health care professionals and symptom management showed a significant influence of both aspects on long-term parental grief. Both interaction with health care professionals, especially communication and continuity of care, and symptom management in

  15. Design of a scale for measuring post-surgical complications in third molar surgery.

    PubMed

    Aravena, P C; Astudillo, P; Manterola, C

    2014-08-01

    The aim of this study was to design a scale for measuring the extent and severity of post-surgical complications in third molar surgery. A multi-stage study using a quantitative methodology and qualitative interview strategy was employed. The degree of importance of signs and symptoms in the evaluation of post-surgical complications was initially observed using a self-report questionnaire administered to maxillofacial surgeons and surgical residents at the International Conference of Oral and Maxillofacial Surgeons in 2011. Then, using exploratory factor analysis, the items and components of the scale were established, with internal consistency determined using Cronbach's alpha. Finally, a group of experts performed a face validity analysis and provided conceptual definitions for the items and components. Thirty-six signs and symptoms were evaluated by 100 respondents, with the most relevant being 'suppuration' and 'abscess'. Factor analysis of the results identified three factors, defined as 'secondary complication', 'soft tissue infection', and 'osseous involvement' (Cronbach's alpha>0.7). Finally, a preliminary scale was designed comprised of these three components and 10 items. In this way, a preliminary scale for measuring post-surgical complications was designed to standardize the semiological concepts of post-surgical assessment. This scale will be assessed in a future investigation. Copyright © 2014 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  16. Distinctiveness of prolonged grief disorder symptoms among survivors of the Great East Japan Earthquake and Tsunami.

    PubMed

    Tsutsui, Takumi; Hasegawa, Yukako; Hiraga, Masashi; Ishiki, Mikihito; Asukai, Nozomu

    2014-06-30

    Prolonged Grief Disorder (PGD) has been proposed for diagnostic classification as an independent psychiatric disorder. Previous research has investigated it in relation to other axis I disorders in order to determine whether it could be considered an independent nosological entity. The distinctiveness of this condition was apparent in cases of ordinary bereavement and in those following human-made disasters. However, this disorder may be expanded to include bereavement resulting from natural disasters. The present study aims to explore the differences between this disorder and posttraumatic stress disorder or major depressive disorder as experienced after the Great East Japan Earthquake and Tsunami. The subjects were 82 hospital workers. Each type of disorder was assessed by means of the Inventory of Complicated Grief, the Impact of Event Scale-Revised, and the Center for Epidemiological Studies Depression Scale. Exploratory factor analysis showed 3 dimensions, with PGD items independently clustering in the same dimension. Our findings support the uniqueness of PGD even in a post-natural disaster situation in a non-Western culture and warrant grief intervention for high-risk bereaved survivors.

  17. Live Discharge from Hospice and the Grief Experience of Dementia Caregivers.

    PubMed

    Wladkowski, Stephanie P

    2016-01-01

    When an individual has dementia, family members are involved in many care transitions in their roles as caregivers. One such transition is the 'live' discharge from hospice services. This occurs when an individual no longer meets eligibility criteria. This can be difficult for caregivers who have been anticipating an end to understand in the context of their grief process. This qualitative study (N = 24) explored the experience of caregivers of adults with dementia, including Alzheimer's disease, who experienced a 'live' discharge from hospice. Specifically, the experience of grief is examined. Results from this study highlight the complexity of caring for someone with a terminal disease and the grief experience in end-of-life care as caregivers struggle to understand the individual's terminal prognosis as temporary. This is further complicated for caregivers who must resume caregiving responsibilities or assume a new caregiving role after experiencing a loss of hospice services. Finally, hospice social workers are well positioned to offer emotional and other concrete support to caregivers who experience a 'live' discharge.

  18. John Bowlby's Model of Grief and the Problem of Identification.

    ERIC Educational Resources Information Center

    Klass, Dennis

    1988-01-01

    Asserts that John Bowlby's model of grief is inadequate to account for phenomena associated with most grief. Also examines work of Freud and the Freudians, and works of Parkes, Raphael, and Worden. Suggests possible modifications in the Bowlby model by reviewing the work of Attig, Lopata, and Marris. (Author/NB)

  19. Grief and Loss: Towards an Existential Phenomenology of Child Spirituality

    ERIC Educational Resources Information Center

    Walters, David A.

    2008-01-01

    Western cultures have taken on a death-denying and grief-avoiding dimension, suggesting that children in particular are to be protected from the harshness of loss and death. As a result, many children grow up without having consciously experienced the pain of major loss and grief. It is argued that having been spared from suffering, from the pain…

  20. Coping with Grief: Guidelines and Resources for Assisting Children

    ERIC Educational Resources Information Center

    Heath, Melissa Allen; Leavy, Deon; Hansen, Kristina; Ryan, Katherine; Lawrence, Lacey; Sonntag, Amy Gerritsen

    2008-01-01

    This article provides basic information for school-based mental health professionals, teachers, staff, and administrators to support students coping with grief, and more specifically, grief related to death. The information is consolidated into guidelines and key points in providing support; suggested children's books and activities; Web sites…

  1. The Role of Hardiness in the Resolution of Grief.

    ERIC Educational Resources Information Center

    Campbell, Jane; And Others

    1991-01-01

    Investigated relation of personality factor of hardiness to resolution of grief. In anonymous sample of 70 widows, hardiness was significant predictor of grief resolution in addition to general mental health, time since death, and widow's age. Whether death was expected did not relate to course of resolution. (Author/NB)

  2. Attachment, Loss of Spouse, and Grief in Elderly Adults.

    ERIC Educational Resources Information Center

    Sable, Pat

    1991-01-01

    Administered Texas Inventory of Grief to and conducted interviews with 81 widows between the ages of 26 and 82. Compared to younger women, older women showed more intense grief at time of interview and reported more feelings of anxiety and depression. Findings showed that older women did not tolerate or adapt to bereavement more successfully than…

  3. The Grief Grapevine: Facebook Memorial Pages and Adolescent Bereavement

    ERIC Educational Resources Information Center

    Frost, Mardi

    2014-01-01

    How adolescents use the social networking site Facebook to express grief is a growing area of research. In reviewing current literature, it is evident that many questions still remain unanswered. Additionally, this ever-evolving platform for grief, mourning and bereavement may hold many implications for educators, policy developers and school…

  4. Rhetorical Dimensions of the Post-September Eleventh Grief Process

    ERIC Educational Resources Information Center

    Schwartzman, Roy; Tibbles, David

    2005-01-01

    This essay examines Presidential rhetoric and popular culture practices in light of the stages of grief enumerated by Elisabeth Kubler-Ross. The authors find a consistent retrenchment of grief into the anger phase, where the pain of losing national invulnerability is transferred to externalized aggression. Reconciliation is suggested by means of…

  5. Families and the Grief Process. ARCH Factsheet Number 21.

    ERIC Educational Resources Information Center

    Braza, Kathleen

    This fact sheet points out that knowledge of the process of grief (defined as one's own personal experience of loss) and ways of helping individuals and families cope with their loss experiences can be an invaluable asset to crisis nurseries and respite care programs and their service providers. The fact sheet lists the emotions of grief, and…

  6. Grief and Loss: Towards an Existential Phenomenology of Child Spirituality

    ERIC Educational Resources Information Center

    Walters, David A.

    2008-01-01

    Western cultures have taken on a death-denying and grief-avoiding dimension, suggesting that children in particular are to be protected from the harshness of loss and death. As a result, many children grow up without having consciously experienced the pain of major loss and grief. It is argued that having been spared from suffering, from the pain…

  7. John Bowlby's Model of Grief and the Problem of Identification.

    ERIC Educational Resources Information Center

    Klass, Dennis

    1988-01-01

    Asserts that John Bowlby's model of grief is inadequate to account for phenomena associated with most grief. Also examines work of Freud and the Freudians, and works of Parkes, Raphael, and Worden. Suggests possible modifications in the Bowlby model by reviewing the work of Attig, Lopata, and Marris. (Author/NB)

  8. Grief and Loss Education: Recommendations for Curricular Inclusion

    ERIC Educational Resources Information Center

    Doughty Horn, Elizabeth A.; Crews, Judith A.; Harrawood, Laura K.

    2013-01-01

    Currently, the Council for Accreditation of Counseling and Related Educational Programs (2009) does not require course work on grief and loss, and it is possible for counselors to practice without any formal training in the area. The purpose of this article is to highlight the need for additional grief and loss education in the curriculum, provide…

  9. Supporting Students with Autism Spectrum Disorder through Grief and Loss

    ERIC Educational Resources Information Center

    Hume, Kara; Regan, Tara; Megronigle, Laura; Rhinehalt, Charlene

    2016-01-01

    All student populations require support from school staff during times of grief and loss. The grief process is highly personalized and depends on multiple factors, including the type of bond and relationship with the person, the student's prior experience of loss, and the age and developmental stage of the student (Quinn-Lee, 2014). Grief…

  10. Alexithymia and Grief Reactions in Bereaved Japanese Women

    ERIC Educational Resources Information Center

    Nakao, Mutsuhiro; Kashiwagi, Masayo; Yano, Eiji

    2005-01-01

    To examine the relationship between grief reactions and alexithymia, 54 Japanese women (33 outpatients attending a psychosomatic clinic and 21 normal healthy participants) completed the Texas Inventory of Grief (TIG), the 20-item Toronto Alexithymia Scale (TAS-20), and the Profile of Mood States (POMS). Each woman had experienced the death of a…

  11. Grief Counseling Groups in a Medium-Security Prison

    ERIC Educational Resources Information Center

    Olson, Margaret J.; McEwen, Margaret A.

    2004-01-01

    The authors discuss their facilitation of four grief counseling groups with male inmates in a state prison over a two-year period. Worden's Tasks of Mourning were used as a guide for the group process. Disenfranchised grief and gender and cultural issues in grieving are explored. Catalytic exercises are described, and written feedback from inmates…

  12. Strengthening Grief Support for Children with Developmental Disabilities

    ERIC Educational Resources Information Center

    Sormanti, Mary; Ballan, Michelle S.

    2011-01-01

    Although a sizable literature investigates and describes children's grief, the majority of information focuses on typically developing children. Far less has been published about the loss and grief of children with developmental disabilities (DD), even though this population experiences significant and multiple losses, increasing their…

  13. Personal Fear of Death and Grief in Bereaved Mothers

    ERIC Educational Resources Information Center

    Barr, Peter; Cacciatore, Joanne

    2008-01-01

    The study explored the relation of fear of death (Multidimensional Fear of Death Scale) to maternal grief (Perinatal Grief Scale-33) following miscarriage, stillbirth, neonatal death, or infant/child death. The 400 women participants were recruited from the website, e-mail lists, and parent groups of an organization that supports bereaved parents.…

  14. The Grief Grapevine: Facebook Memorial Pages and Adolescent Bereavement

    ERIC Educational Resources Information Center

    Frost, Mardi

    2014-01-01

    How adolescents use the social networking site Facebook to express grief is a growing area of research. In reviewing current literature, it is evident that many questions still remain unanswered. Additionally, this ever-evolving platform for grief, mourning and bereavement may hold many implications for educators, policy developers and school…

  15. Continuing Relationships with the Deceased: Disentangling Bonds and Grief

    ERIC Educational Resources Information Center

    Schut, Henk A. W.; Stroebe, Margaret S.; Boelen, Paul A.; Zijerveld, Annemieke M.

    2006-01-01

    Some studies of the relationship between continuing bonds and grief intensity have claimed that continuing bonds lead to poor adaptation to bereavement. However, operationalizations of continuing bonds and grief intensity appear to overlap conceptually. Thus, it is still unclear what character the connection between continuing bonds and grief…

  16. Grief and Loss Education: Recommendations for Curricular Inclusion

    ERIC Educational Resources Information Center

    Doughty Horn, Elizabeth A.; Crews, Judith A.; Harrawood, Laura K.

    2013-01-01

    Currently, the Council for Accreditation of Counseling and Related Educational Programs (2009) does not require course work on grief and loss, and it is possible for counselors to practice without any formal training in the area. The purpose of this article is to highlight the need for additional grief and loss education in the curriculum, provide…

  17. Supporting Students with Autism Spectrum Disorder through Grief and Loss

    ERIC Educational Resources Information Center

    Hume, Kara; Regan, Tara; Megronigle, Laura; Rhinehalt, Charlene

    2016-01-01

    All student populations require support from school staff during times of grief and loss. The grief process is highly personalized and depends on multiple factors, including the type of bond and relationship with the person, the student's prior experience of loss, and the age and developmental stage of the student (Quinn-Lee, 2014). Grief…

  18. Coping with Grief: Guidelines and Resources for Assisting Children

    ERIC Educational Resources Information Center

    Heath, Melissa Allen; Leavy, Deon; Hansen, Kristina; Ryan, Katherine; Lawrence, Lacey; Sonntag, Amy Gerritsen

    2008-01-01

    This article provides basic information for school-based mental health professionals, teachers, staff, and administrators to support students coping with grief, and more specifically, grief related to death. The information is consolidated into guidelines and key points in providing support; suggested children's books and activities; Web sites…

  19. Resolving Child and Adolescent Traumatic Grief: Creative Techniques and Interventions

    ERIC Educational Resources Information Center

    Edgar-Bailey, Meredith; Kress, Victoria E.

    2010-01-01

    This article presents a review of creative interventions that can be helpful in facilitating the resolution of traumatic grief in children and adolescents. Traumatic grief is conceptualized as a condition in which a person loses a close loved one (e.g., a parent or a sibling) in a traumatic manner, and ensuing trauma-related symptoms disrupt the…

  20. Radical Acceptance: A Nondual Psychology Approach to Grief and Loss

    ERIC Educational Resources Information Center

    Theriault, Brian

    2012-01-01

    This article explores the application of nondual psychology in transforming grief and loss into the experience of nondual consciousness. Nondual consciousness is the collapse of the dualistic notions of self and other through the direct realization of the stateless state of no-self. The experience of grief and loss serves as a catalyst to this…

  1. Personal Fear of Death and Grief in Bereaved Mothers

    ERIC Educational Resources Information Center

    Barr, Peter; Cacciatore, Joanne

    2008-01-01

    The study explored the relation of fear of death (Multidimensional Fear of Death Scale) to maternal grief (Perinatal Grief Scale-33) following miscarriage, stillbirth, neonatal death, or infant/child death. The 400 women participants were recruited from the website, e-mail lists, and parent groups of an organization that supports bereaved parents.…

  2. Radical Acceptance: A Nondual Psychology Approach to Grief and Loss

    ERIC Educational Resources Information Center

    Theriault, Brian

    2012-01-01

    This article explores the application of nondual psychology in transforming grief and loss into the experience of nondual consciousness. Nondual consciousness is the collapse of the dualistic notions of self and other through the direct realization of the stateless state of no-self. The experience of grief and loss serves as a catalyst to this…

  3. "It May Not Be Pretty, but It's Honest": Examining Parental Grief on the Callapitter Blog

    ERIC Educational Resources Information Center

    DeGroot, Jocelyn M.; Carmack, Heather J.

    2013-01-01

    Following the death of a child, parents are turning to alternative means of communication to express their grief. In this instrumental case study, the authors explore how 1 woman, Amy Ambrusko, communicates her grief experience on her blog, emotionally negotiating loss and parental grief. Guided by M. S. Miles's (1984) parental grief model, the…

  4. "It May Not Be Pretty, but It's Honest": Examining Parental Grief on the Callapitter Blog

    ERIC Educational Resources Information Center

    DeGroot, Jocelyn M.; Carmack, Heather J.

    2013-01-01

    Following the death of a child, parents are turning to alternative means of communication to express their grief. In this instrumental case study, the authors explore how 1 woman, Amy Ambrusko, communicates her grief experience on her blog, emotionally negotiating loss and parental grief. Guided by M. S. Miles's (1984) parental grief model, the…

  5. Hierarchies of loss: a critique of disenfranchised grief.

    PubMed

    Robson, Patricia; Walter, Tony

    Two aspects of the concept of disenfranchised grief are examined: its binary assumption that grief is either enfranchised or disenfranchised; and its emancipatory agenda that grief should not be socially regulated. Focusing on the mourner's relationship to the deceased, we argue that social norms about the legitimacy of bereavement are not binary (yes-no), but are scalar or hierarchical, or even more complex still. We report on a tool for identifying hierarchies of loss, and describe the hierarchy identified by this tool in one British study. If norms about loss are not binary but hierarchical, how has disenfranchised grief--which claims to be a theory of norms--become an uncontested concept within bereavement research and clinical practice? We point to its rhetorical value in the postmodern politics of grief and its seductive emancipatory symbolism within the clinic; its value both for clinical practice and for empirical research into bereavement norms, however, may be limited.

  6. Grief functions as an honest indicator of commitment.

    PubMed

    Winegard, Bo M; Reynolds, Tania; Baumeister, Roy F; Winegard, Benjamin; Maner, Jon K

    2014-05-01

    Grief is a puzzling phenomenon. It is often costly and prolonged, potentially increasing mortality rates, drug abuse, withdrawal from social life, and susceptibility to illness. These costs cannot be repaid by the deceased and therefore might appear wasted. In the following article, we propose a possible solution. Using the principles of social selection theory, we argue that an important selective pressure behind the human grief response was the social decisions of other humans. We combine this with insights from signaling theory, noting that grief shares many properties with other hard-to-fake social signals. We therefore contend that grief was shaped by selective forces to function as a hard-to-fake signal of (a) a person's propensity to form strong, non-utilitarian bonds and (b) a person's current level of commitment to a group or cause. This theory explains many of the costly symptoms of grief and provides a progressive framework for future research.

  7. Dementia Caregiver Grief and Bereavement: An Integrative Review.

    PubMed

    Arruda, Elizabeth H; Paun, Olimpia

    2017-06-01

    Alzheimer's disease and related dementias make up the fifth leading cause of death for individuals of 65 years of age and older in the United States. Seventy percent of these individuals will die in long-term care settings. The aim of this integrative review was to examine and synthesize the evidence on grief and bereavement in Alzheimer's disease and related dementias caregivers. This review identified five critical gaps in the existing evidence: (a) a lack of ethnic and gender diversity among caregivers studied, (b) limited use of valid instruments to study dementia caregiver grief and bereavement, (c) no substantive research examining dementia caregiver grief and bereavement for caregivers whose family members die in long-term care, (d) a lack of evidence examining the effect of hospice services on dementia caregiver grief and bereavement, and (e) a lack of grief and bereavement interventions for dementia caregivers whose family members die in long-term care.

  8. Helping Children in Times of Need: Grief, Loss, Separation & Divorce. A Handbook for Parents Assisting Children through Grief and Loss.

    ERIC Educational Resources Information Center

    Parker, Judith A.

    Although a world of uncertainty and continual change is difficult to explain to children, by exploring and discussing the process of grief, parents can begin to understand the significance and necessity of the grief process and help their children to cope with difficult events. This booklet offers parents advice on how to talk with children about…

  9. Helping Children in Times of Need: Grief, Loss, Separation & Divorce. A Handbook for Parents Assisting Children through Grief and Loss.

    ERIC Educational Resources Information Center

    Parker, Judith A.

    Although a world of uncertainty and continual change is difficult to explain to children, by exploring and discussing the process of grief, parents can begin to understand the significance and necessity of the grief process and help their children to cope with difficult events. This booklet offers parents advice on how to talk with children about…

  10. Three-dimensional measurement of small mechanical parts under a complicated background based on stereo vision

    SciTech Connect

    Ren Zhiguo; Liao Jiarui; Cai Lilong

    2010-04-01

    We present an effective method for the accurate three-dimensional (3D) measurement of small industrial parts under a complicated noisy background, based on stereo vision. To effectively extract the nonlinear features of desired curves of the measured parts in the images, a strategy from coarse to fine extraction is employed, based on a virtual motion control system. By using the multiscale decomposition of gray images and virtual beam chains, the nonlinear features can be accurately extracted. By analyzing the generation of geometric errors, the refined feature points of the desired curves are extracted. Then the 3D structure of the measured parts can be accurately reconstructed and measured with least squares errors. Experimental results show that the presented method can accurately measure industrial parts that are represented by various line segments and curves.

  11. Vascular ultrasound measures before pregnancy and pregnancy complications: A prospective cohort study.

    PubMed

    Harville, Emily W; Juonala, Markus; Viikari, Jorma S A; Kähönen, Mika; Raitakari, Olli T

    2017-02-01

    To examine the relationship between pre-pregnancy indicators of cardiovascular risk and pregnancy complications and outcomes. Data from 359 female participants in the Cardiovascular Risk in Young Finns Study were linked with the national birth registry. Flow-mediated dilatation (FMD; maximum change in the left brachial artery diameter after rest and hyperemia); carotid intima-media thickness (IMT); Young's elastic modulus (YEM); and carotid artery distensibility (Cdist) at the visit prior to the pregnancy were examined as predictors of hypertensive disorders, birthweight, and gestational age using multivariable linear regression with adjustment for confounders (age, BMI, smoking, and socioeconomic status). No relations were seen between FMD, IMT, or the stiffness indices, and hypertensive disorders. Higher pre-pregnancy FMD was associated with lower gestational age, while increased Cdist was associated with reduced birthweight-for-gestational-age. Some cardiovascular ultrasound measures of pre-pregnancy may predict pregnancy complications, but the association is likely to be small.

  12. [A nurse's experience applying grief counseling to a bereaved family].

    PubMed

    Hsiao, Wen-Ling

    2010-04-01

    This case report describes a nurse's experience applying William Worden's Grief Counseling on a young woman whose mother had passed away after a brief period in a coma. The report describes how the nurse facilitated this case and assisted the woman though the grief process, during which the woman completed the four tasks of mourning. Seven behavioral process records were analyzed base on Worden's grief responses. Emotional reactions included shock, denial, guilt and fear. Insomnia was the sole physical reaction indicated. Cognitive reactions included disbelief with regard to the death and preoccupation with her mother. Social withdrawal, avoidance of mentioning her mother, calling out, sighing and crying comprised the main behavioral reactions. The author applied the concepts and principles of grief counseling by accompanying and supporting this case though the grief process, and helping the patient complete the four tasks of mourning, which are: (1) to experience the pain of grief, (2) to accept the reality of the death, (3) to adjust to life after the death, and (4) to move on with life. It is hoped that this case report will help nursing staffs be more sensitive and receptive to family grieving and be better equipped to provide proper grief care.

  13. Grief Experiences Among Female American and Arab Undergraduate College Students.

    PubMed

    Varga, Mary Alice; McClam, Tricia M; Hassane, Sofoh

    2015-01-01

    The purpose of this study was to compare the incidence of grief among American and Arab female undergraduate students, the effects of their grief, and risk of prolonged grief disorder. A total of 471 female undergraduate students, 308 (65.4%) from the United Arab Emirates and 163 (34.6%) from the United States, completed a survey about their grief experiences. Students experiencing a significant loss also completed the Prolonged Grief Disorder Questionnaire. Findings revealed that overall approximately 38.4% (n = 181) of all 471 students experienced the loss of a significant person in their lives within the past 24 months; a similar percentage was found in each sub group. Students reported various grief effects with American students experiencing more effects related to sleep, relationships, academics, physical well-being, religion/spirituality, and outlook on life than Arab students. Only a small number (10, 5.52%) of students met the criteria for prolonged grief disorder; however, most students were female Arab students. Limitations of the study and recommendations for future research are provided.

  14. Grief and Women: Stillbirth in the Social Context of India

    PubMed Central

    Roberts, Lisa R.; Anderson, Barbara A.; Lee, Jerry W.; Montgomery, Susanne B.

    2015-01-01

    INTRODUCTION Few in Western society would argue the potentially devastating impact of stillbirth related grief; but in many developing countries where stillbirth remains the highest in the world, perinatal grief is barely recognized as an issue. The purpose of this study was to explore how poor, rural central Indian women perceive and cope with stillbirths. METHODS Seventeen key informant interviews and two focus groups (N = 33) with local health care providers, family members, and women who experienced stillbirth were conducted over a 1-month period in 2011 and then systematically coded for emerging themes using grounded theory methods to explore how women experienced stillbirth. RESULTS Although usually never talked about and not recognized as an issue, perinatal grief emerged as a significant shared experience by all. The perceptions of stillbirth-related grief emerged in three major themes and bear evidence of gender and power issues and indicate that local social norms negatively factor heavily into their perinatal grief experiences. DISCUSSION The findings in this richly textured study add to the limited literature regarding rural, central Indian women's experiences with stillbirth and factors influencing their resulting perinatal grief. In light of the void of recognition of this phenomenon in Indian society, a better understanding of the context in which poor Indian women experience perinatal grief will be a first step toward developing much needed culturally rooted interventions to positively impact the women's abilities to better cope with stillbirth in the context of their realities. PMID:26594592

  15. Long-Term Effects of the Family Bereavement Program on Multiple Indicators of Grief in Parentally Bereaved Children and Adolescents

    ERIC Educational Resources Information Center

    Sandler, Irwin N.; Ma, Yue; Tein, Jenn-Yun; Ayers, Tim S.; Wolchik, Sharlene; Kennedy, Cara; Millsap, Roger

    2010-01-01

    Objectives: This article reports on results from a randomized experimental trial of the effects of the Family Bereavement Program (FBP) on multiple measures of grief experienced by parentally bereaved children and adolescents over a 6-year period. Method: Participants were 244 youths (ages 8-16, mean age = 11.4 years) from 156 families that had…

  16. Family Anticipatory Grief: An Integrative Literature Review.

    PubMed

    Coelho, Alexandra; Barbosa, António

    2017-09-01

    Despite all the investment in research, uncertainty persists in anticipatory grief (AG) literature, concerning its nuclear characteristics and definition. This review aimed to synthesize recent research in order to develop further knowledge about the family experience of AG during a patient's end of life. An integrative review was performed using standard methods of analysis and synthesis. The electronic databases Medline, Web of Knowledge, and EBSCO and relevant journals were systematically searched since 1990 to October 2015. Twenty-nine articles were selected, the majority with samples composed of caregivers of terminally ill patients with cancer. From systematic comparison of data referring to family end-of-life experience emerged 10 themes, which correspond to AG nuclear characteristics: anticipation of death, emotional distress, intrapsychic and interpersonal protection, exclusive focus on the patient care, hope, ambivalence, personal losses, relational losses, end-of-life relational tasks, and transition. For the majority of family caregivers in occidental society, AG is a highly stressful and ambivalent experience due to anticipation of death and relational losses, while the patient is physically present and needed of care, so family must be functional and inhibit grief expressions. The present study contributes to a deeper conceptualization of this term and to a more sensitive clinical practice.

  17. The grief process for patient, family, and physician.

    PubMed

    Bruce, Christine A

    2002-09-01

    In the grieving process, patient, family, and health professionals have the same needs-rest, relaxation, nourishment, a sense of security, trust, hope in the future, and humor among them. Grief, defined as a shared, universal, and natural neuropsychobiologic expression in response to loss, is distinct from mourning, a practice that varies in expression across diverse cultures. To aid in an understanding of grief and its effects, the author looks at the models for grief proposed by Kubler-Ross, Bowlby, Parkes, Worden, and Wolfelt. Addressing patients' concerns requires physicians be empathic, attentive, and respective and have willingness to take time, be present, and listen.

  18. Seasonal affective disorder, grief reaction, and adjustment disorder.

    PubMed

    Osborn, Justin; Raetz, Jacqueline; Kost, Amanda

    2014-09-01

    Seasonal affective disorder is a subtype of other affective disorders. The most studied treatment is light therapy, although second-generation antidepressants are also an option. Grief reactions are normal for patients experiencing loss, and primary care providers (PCPs) should be aware of both the expected course of grief and the more severe symptoms that indicate complex grief. Adjustment disorder is a time-limited abnormal response to a stressor. PCPs can manage patients with adjustment disorder by arranging counseling, screening for suicidality, assessing for substance abuse, and ruling out other psychiatric diagnoses. At present there are no reliable data to suggest medication management. Copyright © 2014 Elsevier Inc. All rights reserved.

  19. Planting hope in loss and grief: self-care applications of horticultural therapy for grief caregivers in Taiwan.

    PubMed

    Lin, Yeh-Jen; Lin, Chi Yun; Li, Yu-Chan

    2014-01-01

    In 2008, the Taiwan Association for Care and Counseling for Loss organized a workshop about Horticultural Therapy, conducted as a participatory action research (PAR). Nineteen grief caregivers participated. Specific goals were designed according to a survey of participant expectations and focus-group discussions. The workshop content included lectures and interactive activities. Results demonstrated that most participants displayed an increased awareness of personal loss and meaning in grief, indicating that horticulture and nature appreciation might relieve individual grief and stress. The report introduces the rationale, evolution, execution, and results of the program development.

  20. Predictors of grief in bereaved family caregivers of person's with Alzheimer's disease: a prospective study.

    PubMed

    Romero, Melissa M; Ott, Carol H; Kelber, Sheryl T

    2014-01-01

    The purpose of this prospective study was to identify factors in 66 spouses and adult child caregivers of person's with Alzheimer's disease prior to the death that predicted higher levels of grief in bereavement. A hierarchical regression model was tested. Predeath grief, dysfunctional coping, depression, social support, and decreased positive states of mind explained 54.7% of the variance in postdeath grief. Factors that contributed significantly to postdeath grief included predeath grief and depression. Results from this study indicate that risk factors for postdeath grief can be predicted prior to the death.

  1. Efficacy of metacognitive therapy for prolonged grief disorder: protocol for a randomised controlled trial

    PubMed Central

    Wenn, Jenine; O'Connor, Moira; Breen, Lauren J; Kane, Robert T; Rees, Clare S

    2015-01-01

    Introduction Studies of effective psychotherapy for individuals suffering from the effects of prolonged grief disorder (PGD) are scarce. This paper describes the protocol for an evaluation of a metacognitive therapy programme designed specifically for PGD, to reduce the psychological distress and loss of functioning resulting from bereavement. Methods and analysis The proposed trial comprises three phases. Phase 1 consists of a review of the literature and semistructured interviews with key members of the target population to inform the development of a metacognitive therapy programme for Prolonged Grief. Phase 2 involves a randomised controlled trial to implement and evaluate the programme. Male and female adults (N=34) will be randomly assigned to either a wait list or an intervention group. Measures of PGD, anxiety, depression, rumination, metacognitions and quality of life will be taken pretreatment and posttreatment and at the 3-month and 6-month follow-up. The generalised linear mixed model will be used to assess treatment efficacy. Phase 3 will test the social validity of the programme. Discussion This study is the first empirical investigation of the efficacy of a targeted metacognitive treatment programme for PGD. A focus on identifying and changing the metacognitive mechanisms underpinning the development and maintenance of prolonged grief is likely to be beneficial to theory and practice. Ethics Ethics approval was obtained from Curtin University Human Research Ethics Committee (Approval number HR 41/2013.) Trial registration number ACTRN12613001270707. PMID:26646828

  2. Towards a cognitive-behavioural intervention for adult grief reactions.

    PubMed

    Kavanagh, D J

    1990-09-01

    Published accounts of behavioural interventions for grief have relied on exposure and habituation to grief cues as the primary strategy. Such an approach is excessively narrow, since it does not adequately confront the challenges that are posed by a bereavement. Many people cope with a bereavement by themselves, and for those, intervention may well be counterproductive. A cognitive-behavioural intervention, following models for depression/anxiety, can assist vulnerable individuals obtain a more rapid or complete adjustment.

  3. Grief elaboration in families with handicapped member.

    PubMed

    Calandra, C; Finocchiaro, G; Raciti, L; Alberti, A

    1992-01-01

    Families with handicapped member seem to follow the same five stages (rejection and isolation, anger, dealing with the problem, depression, acceptance) of Kubler-Ross grief elaboration theory while dealing with the narcissistic wound of a handicapped child. Some of these families show a block in one of the stages. The effort of psychotherapy is to remove the block and let them reach the last stage. In this paper families under systemic psychotherapeutic treatment are analyzed, who had in common the birth of a child with low or modest invalidating signs and psychotic or autistic features. The families structure did not show the characteristics of a psychotic family. Nevertheless either one or both parents ignored the evidence of their child disease and they built a "disease-incongrous" wait around the child, trying to push away the painful reality. The authors explain the importance of this approach for the improvement of the autistic traits.

  4. Brief Internet-based intervention reduces posttraumatic stress and prolonged grief in parents after the loss of a child during pregnancy: a randomized controlled trial.

    PubMed

    Kersting, Anette; Dölemeyer, Ruth; Steinig, Jana; Walter, Franziska; Kroker, Kristin; Baust, Katja; Wagner, Birgit

    2013-01-01

    The loss of a child during pregnancy causes significant psychological distress for many women and their partners, and may lead to long-lasting psychiatric disorders. Internet-based interventions using exposure techniques and cognitive restructuring have proved effective for posttraumatic stress disorder (PTSD) and prolonged grief. This study compared the effects of an Internet-based intervention for parents after prenatal loss with a waiting list condition (WLC). The Impact of Event Scale - Revised assessed symptoms of PTSD; the Inventory of Complicated Grief and the Brief Symptom Inventory assessed depression, anxiety, and general mental health. The 228 participants (92% female) were randomly allocated to a treatment group (TG; n = 115) or a WLC group (n = 113). The TG received a 5-week cognitive behavioral intervention including (1) self-confrontation, (2) cognitive restructuring, and (3) social sharing. The TG showed significantly reduced symptoms of posttraumatic stress, prolonged grief, depression, and anxiety relative to the WLC control group. Intention-to-treat analysis revealed treatment effects of between d = 0.84 and d = 1.02 for posttraumatic stress and prolonged grief from pre- to posttreatment time points. Further significant improvement in all symptoms of PTSD and prolonged grief was found from the posttreatment evaluation to the 12-month follow-up. The attrition rate of 14% was relatively low. The Internet-based intervention proved to be a feasible and cost-effective treatment, reducing symptoms of posttraumatic stress, grief, depression, anxiety, and general mental health after pregnancy loss. Low-threshold e-health interventions should be further evaluated and implemented routinely to improve psychological support after pregnancy loss. Copyright © 2013 S. Karger AG, Basel.

  5. The Nature of Attachment Relationships and Grief Responses in Older Adults: An Attachment Path Model of Grief.

    PubMed

    Kho, Yan; Kane, Robert T; Priddis, Lynn; Hudson, Josephine

    2015-01-01

    Various researchers have theorized that bereaved adults who report non-secure attachment are at higher risk of pathological grief. Yet past findings on avoidant attachment representations and grief have yielded limited and contradictory outcomes. Little research has been conducted with older adults to identify the psychological processes that mediate between self-reported attachment representations and the patterns of grief. To examine the impacts of avoidant attachment and anxious attachment dimensions on emotion and non-acceptance, in response to the loss of a conjugal partner, and the mediating effect of yearning thoughts. Men (N = 21) and women (N = 68) aged 60 years and above who had lost a partner within the last 12 to 72 months were invited to participate. Participants rated their levels of yearning thoughts about the deceased, emotions and non-acceptance on the Texas Revised Inventory of Grief (TRIG-Present), and their type and level of general romantic attachment on the Experiences In Close Relationship questionnaire (ECR). Structural equation modelling (SEM) indicated that individuals who reported higher levels of avoidant attachment reported less emotional responses and less non-acceptance. SEM also showed that individuals who reported higher levels of anxious attachment reported greater emotional responses and greater non-acceptance. SEM further indicated that these relationships were mediated by yearning thoughts. People adopt different grief coping patterns according to their self-reported attachment representations, with the nature of their yearning thoughts influencing the process. Grief therapy may be organized according to individual differences in attachment representations.

  6. Can Grief be a Mental Disorder?: An Exploration of Public Opinion.

    PubMed

    Breen, Lauren J; Penman, Emma L; Prigerson, Holly G; Hewitt, Lauren Y

    2015-08-01

    Despite growing empirical evidence, the distinction between normal and pathological grief remains controversial. Few studies have investigated public attitudes towards distinguishing normal from pathological grief. An international sample of 348 participants from a wide range of cultures was asked if certain expressions of grief could be considered a mental disorder and to explain their answer. Analysis revealed that the majority (74.7%) agreed that grief could be considered a mental disorder. The presence of pervasive distress, of harm to self and/or others, functional impairment, and persistent grief were described as the circumstances under which grief can be a mental disorder. Reasons grief is not a mental disorder were that it is normal, temporary, in response to an event, and that efforts to include it in diagnostic manuals will lead to medicalization and stigma. The investigation of public norms informs the inclusion of pathological grief in diagnostic nosology.

  7. Continuing Bonds and Reconstructing Meaning: Mitigating Complications in Bereavement

    ERIC Educational Resources Information Center

    Neimeyer, Robert A.; Baldwin, Scott A.; Gillies, James

    2006-01-01

    Drawing on attachment theory and constructivist conceptualizations of bereavement, the authors assessed the relation between continuing bonds coping and meaning reconstruction following the death of a loved one and complicated grief symptomatology. Five hundred six young adults in the first two years of bereavement from a variety of losses…

  8. Descriptions of Social Support in Treatment Narratives of Complicated Grievers

    ERIC Educational Resources Information Center

    Wilsey, Stephanie A.; Shear, M. Katherine

    2007-01-01

    The authors performed a qualitative analysis of revisiting exercise narratives provided by 22 bereaved individuals undergoing complicated grief (CG) treatment. Revisiting entails telling the story of the death. Most participants described social interactions in the narratives, viewing others as helpful (n = 7), unhelpful (n = 7), or both (n = 6).…

  9. Descriptions of Social Support in Treatment Narratives of Complicated Grievers

    ERIC Educational Resources Information Center

    Wilsey, Stephanie A.; Shear, M. Katherine

    2007-01-01

    The authors performed a qualitative analysis of revisiting exercise narratives provided by 22 bereaved individuals undergoing complicated grief (CG) treatment. Revisiting entails telling the story of the death. Most participants described social interactions in the narratives, viewing others as helpful (n = 7), unhelpful (n = 7), or both (n = 6).…

  10. Clinical features distinguishing grief from depressive episodes: A qualitative analysis.

    PubMed

    Parker, Gordon; McCraw, Stacey; Paterson, Amelia

    2015-05-01

    The independence or interdependence of grief and major depression has been keenly argued in relation to recent DSM definitions and encouraged the current study. We report a phenomenological study seeking to identify the experiential and phenomenological differences between depression and grief as judged qualitatively by those who had experienced clinical (n=125) or non-clinical depressive states (n=28). Analyses involving the whole sample indicated that, in contrast to grief, depression involved feelings of hopelessness and helplessness, being endless and was associated with a lack of control, having an internal self-focus impacting on self-esteem, being more severe and stressful, being marked by physical symptoms and often lacking a justifiable cause. Grief was distinguished from depression by the individual viewing their experience as natural and to be expected, a consequence of a loss, and with an external focus (i.e. the loss of the other). Some identified differences may have reflected the impact of depressive "type" (e.g. melancholia) rather than depression per se, and argue for a two-tiered model differentiating normative depressive and grief states at their base level and then "clinical" depressive and 'pathological' grief states by their associated clinical features. Comparative analyses between the clinical and non-clinical groups were limited by the latter sub-set being few in number. The provision of definitions may have shaped subjects׳ nominated differentiating features. The study identified a distinct number of phenomenological and clinical differences between grief and depression and few shared features, but more importantly, argued for the development of a two-tiered model defining both base states and clinical expressions. Copyright © 2015 Elsevier B.V. All rights reserved.

  11. When hope and grief intersect: rates and risks of prolonged grief disorder among bereaved individuals and relatives of disappeared persons in Colombia.

    PubMed

    Heeke, Carina; Stammel, Nadine; Knaevelsrud, Christine

    2015-03-01

    Forced disappearance is a frequent phenomenon in violent conflicts and regimes, yet little is known about unresolved grief processes as a possible outcome of the disappearance of a loved one. This study investigates prolonged grief disorder (PGD) and its risk factors in a sample of persons who lost a significant other to disappearance as compared with a sample of bereaved individuals, both groups having experienced displacement due to the armed conflict in Colombia. In a cross-sectional study conducted in four Colombian provinces, 73 persons who lost a significant other to disappearance and 222 bereaved individuals completed measures of PGD (PG-13), depression (HSCL-25), and PTSD (PCL-C) via face-to-face interviews. Trauma- and loss-related variables, including the extent to which significant others of disappeared persons hoped that their loved one was still alive, were assessed. Results indicated that 23% of participants who lost a significant other to disappearance met criteria for PGD as compared to 31.5% in bereaved participants. No differences were found between the two groups in terms of symptom severity of PGD, depression, posttraumatic stress disorder, or traumatic exposure. Regression analysis indicated that, among relatives and friends of disappeared persons, the extent of hope predicted PGD above and beyond depression severity whereas among bereaved persons, PGD was predicted by time since the loss, the number of traumatic events and symptom severity of PTSD and depression. The instruments were not validated for use in Colombia; generalizability of findings is limited. Forced disappearance is related to prolonged grief reactions, particularly when those left behind maintain hope that the disappeared person is still alive. Copyright © 2014 Elsevier B.V. All rights reserved.

  12. [A Clinical Case of Grief Hallucination through the Mourning Work Normal Grief and Spiritual Care].

    PubMed

    Kurotori, Isaku; Kato, Satoshi

    2015-01-01

    Auditory or visual hallucinations of a deceased person are well known in the normal course of the bereavement process. According to DSM-5, this symptom is included in the associated features supporting diagnosis of persistent complex bereavement disorder. In Japan, however, little is known about these hallucinatory experiences during grieving, and few reports on their prevalence are available. Here, we have reported a clinical case of such experiences following the loss of a spouse. A 66-year-old patient presented to the outpatient department with insomnia after her husband's death. She was preoccupied with a sense of loss and absolute loneliness. One day, she confessed to regularly encountering her husband's ghost at night; the ghost was distinguishable from a dream and provided the bereaved wife with some degree of comfort. The appearances lasted for 15 months and occurred several times a week without disturbing her social functioning. She gradually became aware that her husband was returning from the spirit world to give her solace. Her treatment was focused on resolving her conflicting feelings concerning her grief at his death and her relief at his no longer suffering from disease. While accepting her experiences, she started to review the days they spent together and appreciated his attachment. Therefore she completed the work of mourning and the ghost no longer appeared. One year after the departure of the ghost, she still attends the hospital regularly and there has been no recurrence. A reconstruction of her internal world leads us to conclude that the support of normal grief with such hallucinations prevents the intense experience of loss from generating pathological grief. Furthermore, we suggest reconsidering the importance of the mourning work and the inclusion of both the bereaved and deceased person in the medical context.

  13. Non-invasive lower limb small arterial measures co-segregate strongly with foot complications in people with diabetes.

    PubMed

    Lanting, Sean Michael; Twigg, Stephen M; Johnson, Nathan Anthony; Baker, Michael Kevin; Caterson, Ian Douglas; Chuter, Vivienne Helaine

    2017-03-01

    It is unclear how well non-invasive lower-limb vascular assessments can identify those at risk of foot complications in people with diabetes. We aimed to investigate the relationship between a history of foot complication (ulceration or amputation) and non-invasive vascular assessments in people with diabetes. Bilateral ankle-brachial index (ABI), toe brachial index (TBI) and continuous wave Doppler (CWD) were performed in 127 adults with diabetes (97% type 2; age 66.08±11.4years; 55% men; diabetes duration 8.8±7.6years; 28% on insulin therapy; 31% with foot complication history. Correlations were performed between known risk factors for, and documented history of, foot complication. Regression analysis was used to determine the effect of TBI on the likelihood of a prior foot complication. By logistic regression, the likelihood of foot complication history was highest in those with TBI <0.6 (OR=7.74, p=0.001); then longer diabetes duration (OR=1.06, p=0.05). HbA1c did not independently predict history of foot complications (OR=1.10, p=0.356). Likelihood of previous foot complication in this population was ~8 times higher when TBI was <0.6. Such clinical risk profiling was not shown by other non-invasive measures. Prioritizing TBI as a measure of lower-limb vascular disease may be useful to prospectively identify those at risk of diabetic foot complications. Copyright © 2016 Elsevier Inc. All rights reserved.

  14. Consulting with Teachers in Two Areas: Grief and Mourning: Relaxation Techniques.

    ERIC Educational Resources Information Center

    McBeath, Marcia

    1980-01-01

    Consultation with teachers remains untried by many counselors. Possible consultation areas are grief management and relaxation training. Grief is the normal reaction to loss. Being aware of the various stages is the first step in helping someone through the grief process. Relaxation techniques can be learned with proper guidance. (Author/BEF)

  15. Do Grief Self-Help Books Convey Contemporary Perspectives on Grieving?

    ERIC Educational Resources Information Center

    Dennis, Michael Robert

    2012-01-01

    Grief therapy and psychology literatures of the modern Western world conceptualized bereavement and grief as processes to be "worked through" so that other relationships could be pursued. In the last decade or so, however, grief theorists have endorsed the value of attaining new meaning(s) and continuing bonds with our lost loved ones instead of…

  16. The effects of gestational age and gender on grief after pregnancy loss.

    PubMed

    Goldbach, K R; Dunn, D S; Toedter, L J; Lasker, J N

    1991-07-01

    The roles of gestational age and gender in grief reactions following loss of pregnancy were explored. Parents with losses later in pregnancy reported more intense grief than did those whose losses were earlier. Women expressed higher levels of grief than did men six to eight weeks after the loss; however, this difference had decreased by one and two years after the loss.

  17. Sudden Death and Bereavement Outcomes: The Impact of Resources on Grief Symptomatology and Detachment.

    ERIC Educational Resources Information Center

    Reed, M. D.

    1993-01-01

    Examined grief, family detachment, and impact of resources following sudden bereavement among family members of victims of suicide and accidental deaths. Most grief-stricken survivors were more detached from family. Self-esteem emerged as strongest predictor of grief and played role in mediating influences of religious participation and exercise…

  18. The Experience of Grief after Bereavement: A Phenomenological Study with Implications for Mental Health Counseling.

    ERIC Educational Resources Information Center

    Muller, Elizabeth D.; Thompson, Charles L.

    2003-01-01

    Phenomenological methods were used to explore the experience of grief after bereavement. Nine bereaved adults volunteered to participate in interviews in which they discussed their experience of grief after the death of a loved one. An analysis of the interviews revealed the following themes in the experience of grief after bereavement: Coping,…

  19. Do Grief Self-Help Books Convey Contemporary Perspectives on Grieving?

    ERIC Educational Resources Information Center

    Dennis, Michael Robert

    2012-01-01

    Grief therapy and psychology literatures of the modern Western world conceptualized bereavement and grief as processes to be "worked through" so that other relationships could be pursued. In the last decade or so, however, grief theorists have endorsed the value of attaining new meaning(s) and continuing bonds with our lost loved ones instead of…

  20. Grief and Loss in Schools: A Perspective for School Social Workers

    ERIC Educational Resources Information Center

    Massat, Carol Rippey; Moses, Helene; Ornstein, Eric

    2008-01-01

    Students and other members of a school community frequently experience grief and loss. This article uses a dual process model to describe students' grief and loss. It also describes the manifestations of grief at different stages of children's development, as well as interventions at different levels of the school environment. The ability to help…

  1. Grief Counseling Groups for Adolescents Based on Re-Membering Practices

    ERIC Educational Resources Information Center

    Granados, Stephanie; Winslade, John; De Witt, Megan; Hedtke, Lorraine

    2009-01-01

    Focusing on "re-membering" practices is new to grief counseling. Traditional approaches to grief counseling are guided by the concepts of stages or tasks, usually to move the person toward accepting the reality of loss and to "say goodbye" to their deceased loved one. This alternative approach to grief counseling, driven by…

  2. Acts of Resistance: Breaking the Silence of Grief Following Traffic Crash Fatalities

    ERIC Educational Resources Information Center

    Breen, Lauren J.; O'Connor, Moira

    2010-01-01

    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…

  3. Concept clarification of grief in mothers of children with an addiction.

    PubMed

    Zucker, Donna M; Dion, Kimberly; McKeever, Roxanna P

    2015-04-01

    To report an analysis of the concept of grief in mothers of children with an addiction. The concept of grief in this context is poorly understood and often synonymously used with concepts depression, loss and chronic sorrow. In the US, the core concept grief has been recently revised by both NANDA and the DSM-V in efforts to better understand and characterize the concept. The plethora of literature on grief worldwide often characterizes grief as a response to a death. Concept analysis. Search terms 'parental grief' and 'substance abuse' yielded 30 articles. A second review using terms 'grief' and 'substance abuse' yielded 323 articles, in PsychInfo, CINAHL, PubMed databases from 1980-2013. Limits for articles in English and for the terms 'death' and 'child' yielded 13 usable articles. The hybrid model of concept analysis, using a theoretical phase, an empirical phase and a final phase when a clarified definition of grief emerged. Definitions in the literature and defining characteristics of grief outline bio-psycho-social aspects of the concept. For one mother grief was accompanied by recurring feelings of sadness across time, while for the other mother grief was seen as coping, after having passed through a variety of stages of grief. For both, grief was seen to fall on a continuum. Grief is a universal concept and has a trajectory. Case study data have been essential in clarifying understandings of grief as experienced by mothers of addicted children and will provide direction for meaningful and tailored interventions. © 2014 John Wiley & Sons Ltd.

  4. Exploring Oncology Nurses’ Grief: A Self-study

    PubMed Central

    Barbour, Lisa C.

    2016-01-01

    Oncology nursing, like many other nursing fields, often provides nurses with the opportunity to get to know their patients and their families well. This familiarity allows oncology nurses to show a level of compassion and empathy that is often helpful to the patient and their family during their struggle with cancer. However, this familiarity can also lead to a profound sense of grief if the patient loses that struggle. This self-study provided me the opportunity to systematically explore my own experience with grief as an oncology nurse, helping me to identify specific stressors and also sources of stress release. PMID:27981166

  5. Chronic Grief Management for Dementia Caregivers in Transition: Intervention Development and Implementation

    PubMed Central

    Paun, Olimpia; Farran, Carol J.

    2013-01-01

    Research reveals that Alzheimer’s disease (AD) caregivers (CGs) do not relinquish their role after placing a family member in long-term care. Caregivers report increased emotional upset around the time of placement, with sustained losses over time leading to chronic grief. Chronic grief increases caregivers’ risk for depression and suicide. There are no documented interventions designed to decrease CGs chronic grief post placement. The Chronic Grief Management Intervention (CGMI) builds on existing evidence to target caregiver chronic grief in the transition of a family member into long-term care. The intervention is structured into three major components: 1) knowledge, 2) skill in communication and conflict resolution, and 3) chronic grief mangement skill. The 12-week intervention was pilot tested with thirty four caregivers for feasibility and preliminary effects on caregiver skill, knowledge, chronic grief, and depression. This article presents a general study description while focusing on the development and implementation of the CGMI. PMID:22084962

  6. Mindfulness-based Intervention for Perinatal Grief Education and Reduction among Poor Women in Chhattisgarh, India: a Pilot Study

    PubMed Central

    Roberts, Lisa; Montgomery, Susanne

    2017-01-01

    Introduction Stillbirth is a significant public health problem in low-to-middle-income countries and results in perinatal grief, often with negative psychosocial impact. In low-resource settings, such as Chhattisgarh, India, where needs are high, it is imperative to utilize low-cost, effective interventions. Mindfulness-based stress reduction (MBSR) is an empirically sound intervention that has been utilized for a broad range of physical and mental health problems, and is adaptable to specific populations. The main objective of this pilot study was to explore the feasibility and effectiveness of a shortened, culturally adapted mindfulness-based intervention to address complex grief after stillbirth. Methods We used an observational, pre-post-6-week post study design. The study instrument was made up of descriptive demographic questions and validated scales and was administered as a structured interview due to low literacy rates. We used a community participatory approach to culturally adapt the five-week mindfulness-based intervention and delivered it through two trained local nurses. Quantitative and qualitative data analyses explored study outcomes as well as acceptability and feasibility of the intervention. Results 29 women with a history of stillbirth enrolled, completed the pretest and began the intervention; 26 completed the five-week intervention and post-test (89.7%), and 23 completed the six-week follow-up assessment (88.5%). Pretest results included elevated psychological symptoms and high levels of perinatal grief, including the active grief, difficulty coping, and despair subscales. General linear modeling repeated measures was used to explore posttest and six-week follow up changes from baseline, controlling for significantly correlated demographic variables. These longitudinal results included significant reduction in psychological symptoms; four of the five facets of mindfulness changed in the desired direction, two significantly; as well as

  7. Efficacy of metacognitive therapy for prolonged grief disorder: protocol for a randomised controlled trial.

    PubMed

    Wenn, Jenine; O'Connor, Moira; Breen, Lauren J; Kane, Robert T; Rees, Clare S

    2015-12-08

    Studies of effective psychotherapy for individuals suffering from the effects of prolonged grief disorder (PGD) are scarce. This paper describes the protocol for an evaluation of a metacognitive therapy programme designed specifically for PGD, to reduce the psychological distress and loss of functioning resulting from bereavement. The proposed trial comprises three phases. Phase 1 consists of a review of the literature and semistructured interviews with key members of the target population to inform the development of a metacognitive therapy programme for Prolonged Grief. Phase 2 involves a randomised controlled trial to implement and evaluate the programme. Male and female adults (N=34) will be randomly assigned to either a wait list or an intervention group. Measures of PGD, anxiety, depression, rumination, metacognitions and quality of life will be taken pretreatment and posttreatment and at the 3-month and 6-month follow-up. The generalised linear mixed model will be used to assess treatment efficacy. Phase 3 will test the social validity of the programme. This study is the first empirical investigation of the efficacy of a targeted metacognitive treatment programme for PGD. A focus on identifying and changing the metacognitive mechanisms underpinning the development and maintenance of prolonged grief is likely to be beneficial to theory and practice. Ethics approval was obtained from Curtin University Human Research Ethics Committee (Approval number HR 41/2013.) ACTRN12613001270707. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  8. Rumination and avoidance as predictors of prolonged grief, depression, and posttraumatic stress in female widowed survivors of war.

    PubMed

    Morina, Nexhmedin

    2011-12-01

    This study examined independent contributions of rumination and experiential avoidance in predicting symptoms of psychological distress among female widowed survivors of war. A decade after the war in Kosovo, 100 widowed survivors of war completed measures of rumination, experiential avoidance, depression, posttraumatic stress, and prolonged grief. Results showed that both rumination and experiential avoidance significantly predicted the symptom severity of prolonged grief, depression, and posttraumatic stress. Furthermore, rumination accounted for additional variance above and beyond experiential avoidance and vice versa. Finally, the interaction of rumination and experiential avoidance did not provide significant explanatory power over and above the individual main effects. These findings suggest that rumination and experiential avoidance may be significant factors in understanding and treating psychological distress following exposure to potentially traumatic events and loss due to violence.

  9. Innovative Moments in Grief Therapy: Reconstructing Meaning Following Perinatal Death

    ERIC Educational Resources Information Center

    Alves, Daniela; Mendes, Ines; Goncalves, Miguel M.; Neimeyer, Robert A.

    2012-01-01

    This article presents an intensive analysis of a good outcome case of constructivist grief therapy with a bereaved mother, using the Innovative Moments Coding System (IMCS). Inspired by M. White and D. Epston's narrative therapy, the IMCS conceptualizes therapeutic change as resulting from the elaboration and expansion of unique outcomes (or as we…

  10. Grief in Two Guises: "Mourning and Melancholia" Revisited

    ERIC Educational Resources Information Center

    Green, Viviane

    2013-01-01

    This paper is a re-reading of Freud's classic paper. The themes of mourning and melancholia are viewed in relation to children and adolescents with illustrations from case histories. Mourning is interpreted in a broader sense: not only as grief (both expectable and traumatic) but as a response to the developmental process itself as phases of…

  11. Helping People Cope with Tragedy and Grief: Information, Resources & Linkages.

    ERIC Educational Resources Information Center

    Walz, Garry R., Ed.; Kirkman, Chris J.

    Following the horrific experiences of September 11th, 2001, efforts were undertaken to gather information to provide counselors with the help they need for counseling those in the face of tragedy. With this publication, information about trauma and grief counseling becomes readily available. Guides for responding to tragedies are included from…

  12. Race as a Factor in Teachers' Responses to Children's Grief.

    ERIC Educational Resources Information Center

    Atkinson, Trudie L.

    1982-01-01

    Investigated how teachers respond to children in death-related situations. When Black and non-Black teachers were compared, no differences were evident in attitudes toward death or belief in an afterlife. However, significant differences appeared in the responses they chose to children's grief. (Author)

  13. Play and Healing: Therapeutic Recreation's Role in Coping with Grief.

    ERIC Educational Resources Information Center

    Sorensen, Beth; King, Kathryn

    1999-01-01

    Camp Releaf, a weekend camp in North Carolina, uses therapeutic recreation to help children in grades K-8 develop positive coping skills for dealing with the recent death of a family member. The camp's therapeutic activities are described. Sidebars outline the nature of grief in different age groups and suggestions for working with grieving…

  14. Strengthening Grief Support for Adolescents Coping with a Peer's Death

    ERIC Educational Resources Information Center

    Balk, David E.; Zaengle, Donna; Corr, Charles A.

    2011-01-01

    This article offers suggestions for strengthening school-based grief support following an adolescent's death. Such interventions must be considered within the context of: (a) development during adolescence; (b) the role of peers in adolescent development; and (c) the fact that an adolescent peer's death is a non-normative life crisis in developed…

  15. Religiosity Related to Grief Levels of Bereaved Mothers and Fathers.

    ERIC Educational Resources Information Center

    Bohannon, Judy Rollins

    1991-01-01

    Examined religiosity and bereaved mothers' (n=143) and fathers' (n=129) scores on Grief Experience Inventory. High church attendance had significant inverse relationship with death anxiety. Mothers who attended church more frequently reported significantly less loss of control, rumination, depersonalization, and optimism/despair. Church attendance…

  16. Grief in Two Guises: "Mourning and Melancholia" Revisited

    ERIC Educational Resources Information Center

    Green, Viviane

    2013-01-01

    This paper is a re-reading of Freud's classic paper. The themes of mourning and melancholia are viewed in relation to children and adolescents with illustrations from case histories. Mourning is interpreted in a broader sense: not only as grief (both expectable and traumatic) but as a response to the developmental process itself as phases of…

  17. The Grief Group: A University and Hospice Collaboration

    ERIC Educational Resources Information Center

    O'Neill, Daniel; Fry, Michele

    2013-01-01

    This report describes a joint effort of a community hospice and a university counseling center to provide a campus grief group for university students led by a hospice counselor and a counseling center clinical psychologist. Hospice provided a curriculum outlining topics and activities for each of the group's six meetings. Notices announcing…

  18. Grief and social support after the death of a spouse.

    PubMed

    Kaunonen, M; Tarkka, M T; Paunonen, M; Laippala, P

    1999-12-01

    The death of a spouse is one of the most stressful events in a person's life. Social support has been shown to be widely beneficial in moderating the effects of both chronic and acute stress. The answers of Finnish widows and widowers (n=318) were analysed in order to investigate the sources of social support, what is the nature of support received, and whether social support is connected with coping with grief. The Hogan Grief Reactions Checklist was used to describe the grief as well as answers to open-ended questions about what helped the widowed persons cope with their grief. Kahn's theory of social support was used as a framework in the content analysis of the open-ended answers. The results showed that Finnish widows and widowers receive social support most often from their own family and friends. They perceived the received support most helpful, but also the support that the grieving person can give to other family members is seen as important. Results suggest that those who had had social support were able to grieve by allowing themselves to disorganize and experience panic behaviour.

  19. Scrapbooking as an Intervention for Grief Recovery with Children

    ERIC Educational Resources Information Center

    Williams, Kristie; Lent, Jonathan

    2008-01-01

    This article describes scrapbooking in the context of bereavement counseling. For the purposes of this article, scrapbooking combines many different types of art-related therapy interventions into one concrete format to utilize in counseling with children who are working to overcome grief or trauma related to the loss of a parent. A case…

  20. Effectiveness of Grief Therapy: A Meta-Analysis.

    ERIC Educational Resources Information Center

    Allumbaugh, Denise Litterer; Hoyt, William T.

    1999-01-01

    Describes analyses based on 35 studies on effectiveness of Grief Therapy. Clients with no-treatment control groups showed little improvement, possibly because of the relatively long delay between loss and treatment. Client selection procedures appear to contribute strongly to variability in effect size (ESs). The majority of studies involving…

  1. Enhancement of Death Acceptance by a Grief Counseling Course.

    ERIC Educational Resources Information Center

    Irwin, Harvey J.; Melbin-Helberg, Elizabeth B.

    1992-01-01

    Investigated impact of grief counseling course in terms of two-component formulation of death acceptance. Compared to controls, participants showed significant and sustained increase in cognitive confrontation of death and in assimilation of attitudes at emotional level. Identified predictors of extent of effect included individual's initial death…

  2. The Stigmatized Deaths in Jonestown: Finding a Locus for Grief

    ERIC Educational Resources Information Center

    Moore, Rebecca

    2011-01-01

    This article considers the stigmatized deaths in Jonestown, Guyana, in 1978, in which more than 900 Americans died of mass murder and suicide, and how this led to the disenfranchisement of grief. It examines the rituals of exclusion by which bodies were handled and describes the experiences of Jonestown survivors. It then looks at the ways in…

  3. Grief and Needs of Adults with Acquired Visual Impairments

    ERIC Educational Resources Information Center

    Murray, Shirley A.; McKay, Robert C.; Nieuwoudt, Johan M.

    2010-01-01

    This report aims to illuminate the complex phenomenon of grief and the needs experienced throughout the time course of their impairments by adults with acquired visual impairments. The study applied a phenomenological research strategy using 10 case studies of South African adults, visually impaired within and beyond six years. Qualitative…

  4. Grief in Separated, Divorced, and Widowed Women: Similarities and Differences.

    ERIC Educational Resources Information Center

    Petiet, Carole Anne

    To systematically test previous assumptions about grief in widows and divorcing women, 410 separated, divorced, or widowed women, between the ages of 23 and 76, with at least one child, completed the Multiple Affect Adjective Checklist, the Revised UCLA Loneliness Scale, the Coopersmith Self-Esteem Inventory--Form C, the Attachment Index, and the…

  5. Designing and Conducting Grief Workshops for College Students

    ERIC Educational Resources Information Center

    Vickio, Craig J.

    2008-01-01

    If colleges and universities are truly committed to promoting the well-being of their students and fostering their academic success, they must attend to the needs of grieving students. One way to do this is to invite students to use the university's counseling services following the death of a loved one. However, although grief counseling can be…

  6. The Stigmatized Deaths in Jonestown: Finding a Locus for Grief

    ERIC Educational Resources Information Center

    Moore, Rebecca

    2011-01-01

    This article considers the stigmatized deaths in Jonestown, Guyana, in 1978, in which more than 900 Americans died of mass murder and suicide, and how this led to the disenfranchisement of grief. It examines the rituals of exclusion by which bodies were handled and describes the experiences of Jonestown survivors. It then looks at the ways in…

  7. Grief and Needs of Adults with Acquired Visual Impairments

    ERIC Educational Resources Information Center

    Murray, Shirley A.; McKay, Robert C.; Nieuwoudt, Johan M.

    2010-01-01

    This report aims to illuminate the complex phenomenon of grief and the needs experienced throughout the time course of their impairments by adults with acquired visual impairments. The study applied a phenomenological research strategy using 10 case studies of South African adults, visually impaired within and beyond six years. Qualitative…

  8. Strengthening Grief Support for Adolescents Coping with a Peer's Death

    ERIC Educational Resources Information Center

    Balk, David E.; Zaengle, Donna; Corr, Charles A.

    2011-01-01

    This article offers suggestions for strengthening school-based grief support following an adolescent's death. Such interventions must be considered within the context of: (a) development during adolescence; (b) the role of peers in adolescent development; and (c) the fact that an adolescent peer's death is a non-normative life crisis in developed…

  9. Music Therapy with Bereaved Youth: Expressing Grief and Feeling Better

    ERIC Educational Resources Information Center

    McFerran, Katrina

    2011-01-01

    Music therapy is a promising intervention with bereaved youth. In comparison to other programs, it appears particularly effective for promoting the resolution of grief-related feelings; providing opportunities to express and release feelings through musical participation. Descriptions from music therapy participants are supported by research…

  10. Teachers' Perceptions of Their Role Facing Children in Grief

    ERIC Educational Resources Information Center

    Dyregrov, Atle; Dyregrov, Kari; Idsoe, Thormod

    2013-01-01

    A questionnaire was sent to teachers in the western part of Norway to survey the attitudes and thoughts teachers have about grief in young people and how they look upon their supportive role. A total of 138 school personnel answered the questionnaire, a 44.5% response rate. In addition six focus group interviews were conducted to get in-depth…

  11. Innovative Moments in Grief Therapy: Reconstructing Meaning Following Perinatal Death

    ERIC Educational Resources Information Center

    Alves, Daniela; Mendes, Ines; Goncalves, Miguel M.; Neimeyer, Robert A.

    2012-01-01

    This article presents an intensive analysis of a good outcome case of constructivist grief therapy with a bereaved mother, using the Innovative Moments Coding System (IMCS). Inspired by M. White and D. Epston's narrative therapy, the IMCS conceptualizes therapeutic change as resulting from the elaboration and expansion of unique outcomes (or as we…

  12. Music Therapy with Bereaved Youth: Expressing Grief and Feeling Better

    ERIC Educational Resources Information Center

    McFerran, Katrina

    2011-01-01

    Music therapy is a promising intervention with bereaved youth. In comparison to other programs, it appears particularly effective for promoting the resolution of grief-related feelings; providing opportunities to express and release feelings through musical participation. Descriptions from music therapy participants are supported by research…

  13. Supporting Children with Traumatic Grief: What Educators Need to Know

    ERIC Educational Resources Information Center

    Cohen, Judith A.; Mannarino, Anthony P.

    2011-01-01

    Following traumatic deaths children may develop Childhood Traumatic Grief (CTG), a condition in which trauma symptoms interfere with adaptive child grieving. Educators have an important role in supporting children who have CTG. Key contributions that educators can make are to (a) recognize CTG symptoms in school settings; (b) refer children for…

  14. Scrapbooking as an Intervention for Grief Recovery with Children

    ERIC Educational Resources Information Center

    Williams, Kristie; Lent, Jonathan

    2008-01-01

    This article describes scrapbooking in the context of bereavement counseling. For the purposes of this article, scrapbooking combines many different types of art-related therapy interventions into one concrete format to utilize in counseling with children who are working to overcome grief or trauma related to the loss of a parent. A case…

  15. Religiosity Related to Grief Levels of Bereaved Mothers and Fathers.

    ERIC Educational Resources Information Center

    Bohannon, Judy Rollins

    1991-01-01

    Examined religiosity and bereaved mothers' (n=143) and fathers' (n=129) scores on Grief Experience Inventory. High church attendance had significant inverse relationship with death anxiety. Mothers who attended church more frequently reported significantly less loss of control, rumination, depersonalization, and optimism/despair. Church attendance…

  16. Parental Grief Following the Death of a Child from Cancer: The Ongoing Odyssey.

    PubMed

    Snaman, Jennifer M; Kaye, Erica C; Torres, Carlos; Gibson, Deborah; Baker, Justin N

    2016-09-01

    The death of a child is a devastating event that results in profound grief and significant psychosocial and physical morbidities in parents. The parental grief journey is a complex phenomenon necessitating the utilization of newer models of bereavement with a focus on relationships and exploration of parents' perceived meanings of the experience. To further characterize the grief journey of parents whose child died from cancer in order to better identify parents who can benefit from additional bereavement support and design strategies to improve bereavement services for these parents. We conducted focus group sessions with 11 bereaved parents. The parents were given two prompts to describe their grief journey before and after their child's death, and their responses in a narrative form were audio-recorded. The responses were coded and studied independently by semantic content analysis. Collation and analysis of the coded responses to both prompts results in the emergence of four concepts from the parental narratives: (1) description of the grief trajectory and evolution of grief over time, (2) mechanisms of parental coping throughout the grief journey, (3) factors that exacerbate parental grief, and (4) sources of parental support throughout the grief journey. The narratives highlighted that parents whose child died of cancer experience a unique and evolving form of grief and they wish to continue their bond with the deceased child. We recommend that healthcare providers and institutions incorporate support systems into a comprehensive bereavement program for families of children who die from cancer. © 2016 Wiley Periodicals, Inc.

  17. Grief related to the experience of being the sibling of a child with cancer.

    PubMed

    Jenholt Nolbris, Margaretha; Enskär, Karin; Hellström, Anna-Lena

    2014-01-01

    Few studies have described the well siblings' experience of grief when a brother or sister is treated for cancer. Knowing how sibling grief is expressed will guide clinician and family efforts to provide appropriate support. The aim of this study was to describe siblings' reports of grief related to the experience of having a brother or sister with cancer. A qualitative descriptive method was chosen based on open-ended interviews with 29 siblings aged 8 to 24 years. Qualitative content analysis was applied to the interview data. Four categories of grief were identified: anticipatory grief after receiving information about the cancer diagnosis, grief and concern about the ill sibling's loss of a normal life, grief about being unimportant and forgotten in the family, and grief that continues after the sibling's death as a kind of bond. Despite variations in age and gender among participating siblings, their thoughts were similar. Grief was experienced differently from the time of the diagnosis onward, in the form of concerns related to the illness and situation of the ill sibling. Grief related to sibling bonds remained after death. This study recommends offering siblings realistic information about their ill sibling and support for them in their situation from diagnosis and continuously thereafter. To meet the needs of well siblings, it is necessary to ask the siblings about their thoughts and discuss with them their emotions and worries.

  18. Parental Grief Following the Brain Death of a Child: Does Consent or Refusal to Organ Donation Affect Their Grief?

    ERIC Educational Resources Information Center

    Bellali, Thalia; Papadatou, Danai

    2006-01-01

    The purpose of this study was to investigate the grieving process of parents who were faced with the dilemma of donating organs and tissues of their underage brain dead child, and to explore the impact of their decision on their grief process. A grounded theory methodology was adopted and a semi-structured interview was conducted with 11 bereaved…

  19. Parental Grief Following the Brain Death of a Child: Does Consent or Refusal to Organ Donation Affect Their Grief?

    ERIC Educational Resources Information Center

    Bellali, Thalia; Papadatou, Danai

    2006-01-01

    The purpose of this study was to investigate the grieving process of parents who were faced with the dilemma of donating organs and tissues of their underage brain dead child, and to explore the impact of their decision on their grief process. A grounded theory methodology was adopted and a semi-structured interview was conducted with 11 bereaved…

  20. MR Imaging Measurements of Altered Placental Oxygenation in Pregnancies Complicated by Fetal Growth Restriction.

    PubMed

    Ingram, Emma; Morris, David; Naish, Josephine; Myers, Jenny; Johnstone, Edward

    2017-07-14

    Purpose To evaluate oxygen-enhanced and blood oxygen level-dependent (BOLD) magnetic resonance (MR) imaging parameters in normal pregnancies and those complicated by fetal growth restriction (FGR). Materials and Methods This case-control study was approved by the local research ethics committee. Informed consent was obtained from all subjects. From October 2010 to October 2015, 28 women with uncomplicated pregnancies (individualized birthweight ratio [IBR] >20th percentile and delivery >37 weeks) and 23 with pregnancies complicated by FGR (IBR <5th percentile and abnormal Doppler ultrasonography [US] studies) underwent MR imaging. Differences in placental longitudinal R1 (1/T1) and transverse R2* (1/T2*) were quantified, with subjects breathing either air or oxygen. The difference in R1 (ΔR1) after hyperoxia was converted to change in partial pressure of oxygen (ΔPo2). Data were acquired prospectively, with retrospective interpretation of group differences (unpaired t tests). Diagnostic models were developed by using logistic regression analysis with gestational age as a covariate. Results The mean baseline R1 and R2* for normal pregnancies (R1: 0.59 sec(-1), 95% confidence interval [CI]: 0.58 sec(-1), 0.60 sec(-1); R2*: 17 sec(-1), 95% CI: 14 sec(-1), 20 sec(-1)) were significantly different from those of pregnancies complicated by FGR (R1: 0.63 sec(-1), 95% CI: 0.62 sec(-1), 0.65 sec(-1); R2*: 26 sec(-1), 95% CI: 22 sec(-1), 32 sec(-1)) (P < .0001). The ΔR1 showed a significant negative association with gestational age (P < .0001) in the combined cohort, with the FGR group having a ΔR1 that was generally 61.5% lower than that in the normal pregnancy group (P = .003). The area under the receiver operating characteristic curve for the differentiation between pregnancy complicated by FGR and normal pregnancy by using ΔPo2, baseline R1, and baseline R2* was 0.91 (95% CI: 0.82, 0.99). Conclusion R1, R2*, and ΔPo2 were significantly different between normal

  1. Parentally Bereaved Children's Grief: Self-System Beliefs as Mediators of the Relations between Grief and Stressors and Caregiver-Child Relationship Quality

    ERIC Educational Resources Information Center

    Wolchik, Sharlene A.; Ma, Yue; Tein, Jenn-Yun; Sandler, Irwin N.; Ayers, Tim S.

    2008-01-01

    We investigated whether 3 self-system beliefs--fear of abandonment, coping efficacy, and self-esteem--mediated the relations between stressors and caregiver-child relationship quality and parentally bereaved youths' general grief and intrusive grief thoughts. Cross-sectional (n = 340 youth) and longitudinal (n = 100 youth) models were tested. In…

  2. High-sensitive cardiac troponin T measurements in prediction of non-cardiac complications after major abdominal surgery.

    PubMed

    Noordzij, P G; van Geffen, O; Dijkstra, I M; Boerma, D; Meinders, A J; Rettig, T C D; Eefting, F D; van Loon, D; van de Garde, E M W; van Dongen, E P A

    2015-06-01

    Postoperative non-cardiac complication rates are as high as 11-28% after high-risk abdominal procedures. Emerging evidence indicates that postoperative cardiac troponin T elevations are associated with adverse outcome in non-cardiac surgery. The aim of this study was to determine the relationship between postoperative high-sensitive cardiac troponin T elevations and non-cardiac complications in patients after major abdominal surgery. This prospective observational single-centre cohort study included patients at risk for coronary artery disease undergoing elective major abdominal surgery. Cardiac troponin was measured before surgery and at day 1, 3, and 7. Multivariable logistic regression analysis was performed to examine the adjusted association for different cut-off concentrations of postoperative myocardial injury and non-cardiac outcome. In 203 patients, 690 high-sensitive cardiac troponin T measurements were performed. Fifty-three patients (26%) had a non-cardiac complication within 30 days after surgery. Hospital mortality was 4% (8/203). An increase in cardiac troponin T concentration ≥100% compared with baseline was a superior independent predictor of non-cardiac postoperative clinical complications (adjusted odds ratio 4.3, 95% confidence interval 1.8-10.1, P<0.001) and was associated with increased length of stay (9 days, 95% confidence interval 7-11 vs 7 days, 95% confidence interval 6-8, P=0.004) and increased hospital mortality (12 vs 2%, P=0.028). A postoperative high-sensitive cardiac troponin T increase ≥100% is a strong predictor of non-cardiac 30 day complications, increased hospital stay and hospital mortality in patients undergoing major abdominal surgery. NCT02150486. © The Author 2015. Published by Oxford University Press on behalf of the British Journal of Anaesthesia. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  3. Posttraumatic growth following pregnancy termination for fetal abnormality: the predictive role of coping strategies and perinatal grief.

    PubMed

    Lafarge, Caroline; Mitchell, Kathryn; Fox, Pauline

    2017-09-01

    Research about termination for fetal abnormality (TFA) suggests that it is a traumatic event with potential negative psychological consequences. However, evidence also indicates that following traumatic events individuals may experience growth. Although TFA's negative psychological outcomes are well documented, little is known of the potential for growth following this event. Therefore, the study's objectives were to measure posttraumatic growth (PTG) post-TFA, examine the relationship between PTG, perinatal grief and coping, and determine the predictors of PTG. An online, retrospective survey was conducted with 161 women. Eligible participants were women over 18 who had undergone TFA. Participants were recruited from a support organisation. They completed the Brief COPE, Short Perinatal Grief Scale and Posttraumatic Growth Inventory. Data were analysed using regression analyses. Moderate levels of PTG were observed for "relating to others," "personal strengths" and "appreciation of life." "Positive reframing" was a significant predictor of PTG. Despite using mainly "adaptive" coping strategies, women's grief levels were high. "Adaptive" coping strategies such as, "positive reframing" are relevant to TFA. They may act as protective factors against distress and as foundations for growth, implicating that interventions such as Cognitive Behavioural Therapy, which aim to reframe women's experience, may be beneficial.

  4. The relative importance of avoidance and restoration-oriented stressors for grief and depression in bereaved parents.

    PubMed

    Harper, Mairi; O'Connor, Rory C; O'Carroll, Ronan E

    2015-01-01

    Previous research has identified a number of individual risk factors for parental bereavement including the sex of the parent, the sex of the child, avoidance-focussed coping style and time since death. These factors emerged from research where variables were tested univariately and their relative importance is currently unknown. The current research, therefore, aims to investigate which risk factors are important, multivariately, for the outcomes of grief and depression in parents following the death of their child. Psychosocial measures were completed by 106 bereaved parents four years post-loss, recruited from death records in Scotland. The cause of the child's death included long-term illness and stillbirths as well as sudden and violent deaths. In multivariate regression analyses, depression was predicted by higher avoidance-focussed coping and higher number of restoration-oriented stressors such as relationship difficulties, problems at work and financial issues. Grief was predicted by higher avoidance, restoration stressors and level of continuing bonds. The present study adds to the knowledge about the phenomenon of parental bereavement with participants recruited directly from death records rather than through support, clinical or obituary sources. Factors previously found to be associated with outcomes when tested univariately such as sudden, violent death or sex of the parent were not significant when tested multivariately. This study highlights that different vulnerability factors exist for grief and depression in bereaved parents.

  5. In memoriam: the disenfranchised grief of chaplains and the recovery of memory.

    PubMed

    Helsel, Philip Browning

    2008-01-01

    The article explores the disenfranchised grief of the chaplain from the perspective of the author's own experience in hospice chaplaincy. Borrowing from the works of Kenneth J. Doka on disenfranchised grief, Robert C. Dykstra on crisis ministry, and James Dittes on grief work in ministry, this article focuses on the grief work of chaplains. In doing so, it analyzes the theological perspective of remembrance, explaining how personal remembrances connect the chaplain with his or her own repressed grief in a way that communal events can not accomplish because of the chaplain's responsibility for the grief of the community in these settings. From the perspective of the Christian faith in its sacramental connections with the Lord's Supper, the spiritual practice of honoring the deceased and praying for their guidance is posed as a possible model of healing remembrance.

  6. Managing Loss and Change: Grief Interventions for Dementia Caregivers in a CBT-Based Trial.

    PubMed

    Meichsner, Franziska; Schinköthe, Denise; Wilz, Gabriele

    2016-05-01

    Dementia caregivers often experience loss and grief related to general caregiver burden, physical, and mental health problems. Through qualitative content analysis, this study analyzed intervention strategies applied by therapists in a randomized-controlled trial in Germany to assist caregivers in managing losses and associated emotions. Sequences from 61 therapy sessions that included interventions targeting grief, loss, and change were transcribed and analyzed. A category system was developed deductively, and the intercoder reliability was satisfactory. The identified grief intervention strategies were recognition and acceptance of loss and change,addressing future losses,normalization of grief, and redefinition of the relationship Therapists focused on identifying experienced losses, managing associated feelings, and fostering acceptance of these losses. A variety of cognitive-behavioral therapy-based techniques was applied with each strategy. The findings contribute to understanding how dementia caregivers can be supported in their experience of grief and facilitate the development of a manualized grief intervention. © The Author(s) 2015.

  7. Prolonged Grief in Palliative Family Caregivers: A Pilot Study in a Portuguese Sample.

    PubMed

    Coelho, Alexandra; Delalibera, Mayra; Barbosa, António; Lawlor, Peter

    2015-01-01

    Caregivers are particularly vulnerable to experience intense levels of distress following the loss. The aim of this prospective pilot study is to determine the incidence of prolonged grief disorder symptoms among caregivers. A total of 73 bereaved families responded to the Prolonged Grief Disorder Evaluation Instrument (PG-13) at 6 and 12 months following their loss. The incidence of prolonged grief disorder at the first assessment was 28.8%, and it decreased to 15.1% at the second assessment. The prevalence of prolonged grief disorder declined significantly over time (p = .041). In the second evaluation, six bereaved individuals continued to meet criteria for a diagnosis of prolonged grief disorder, 15 remitted, and 4 new (incident) cases emerged. The important differences in values that occur after 12 months suggest time is important in distinguishing between those at risk for persistent distress and those whose grief symptomatology will decrease with time.

  8. Disoriented grief: a lens through which to view the experience of Katrina evacuees.

    PubMed

    Malone, Pamela A; Pomeroy, Elizabeth C; Jones, Barbara L

    2011-01-01

    Many studies on the impact of natural disasters have focused primarily on immediate stress reactions and posttraumatic stress disorder (PTSD) symptoms rather than on evacuees' stories of grief and loss. Known categories of grief and loss do not fully capture the experiences of disaster survivors as evidenced by interviews of Hurricane Katrina evacuees in Austin, Texas. This article will describe their experiences through a resultant framework of Disoriented Grief.

  9. Grief and trauma intervention for children after disaster: exploring coping skills versus trauma narration.

    PubMed

    Salloum, Alison; Overstreet, Stacy

    2012-03-01

    This study evaluated the differential effects of the Grief and Trauma Intervention (GTI) with coping skills and trauma narrative processing (CN) and coping skills only (C). Seventy African American children (6-12 years old) were randomly assigned to GTI-CN or GTI-C. Both treatments consisted of a manualized 11-session intervention and a parent meeting. Measures of trauma exposure, posttraumatic stress symptoms, depression, traumatic grief, global distress, social support, and parent reported behavioral problems were administered at pre, post, 3 and 12 months post intervention. In general, children in both treatment groups demonstrated significant improvements in distress related symptoms and social support, which, with the exception of externalizing symptoms for GTI-C, were maintained up to 12 months post intervention. Results suggest that building coping skills without the structured trauma narrative may be a viable intervention to achieve symptom relief in children experiencing trauma-related distress. However, it may be that highly distressed children experience more symptom relief with coping skills plus narrative processing than with coping skills alone. More research on the differential effects of coping skills and trauma narration on child distress and adaptive functioning outcomes is needed.

  10. Health-Related Quality of Life in Bereaved HIV-Positive Adults: Relationships between HIV Symptoms, Grief, Social Support, and Axis II Indication

    PubMed Central

    Hansen, Nathan B.; Vaughan, Ellen L.; Cavanaugh, Courtenay E.; Connell, Christian M.; Sikkema, Kathleen J.

    2008-01-01

    Objective This study evaluated a model of the impact of borderline and antisocial personality disorder indications on HIV symptoms and health-related quality of life (HRQoL) in AIDS-bereaved adults, accounting for grief severity, social support and years since HIV diagnosis. Design Structural Equation modeling was used to test the proposed model in a sample of 268 HIV-seropositive adults enrolled in an intervention for coping with AIDS-related bereavement. Main Outcome Measures Functional Assessment of HIV Infection, HIV symptoms. Results The proposed model demonstrated excellent fit with study data and all hypothesized paths were supported. Personality disorder indication was directly related to HIV symptoms and HRQoL, and indirectly related through both social support and grief severity. Social support was negatively related to HIV symptoms and positively related to HRQoL, while grief severity was positively related to HIV symptoms and negatively related to HRQoL. Finally, HIV symptoms had a direct negative relationship with HRQoL. Conclusion Personality disorders have a direct negative effect on HIV symptoms and HRQoL, and indirect effects through grief severity and social support. PMID:19290717

  11. Grief and growth of bereaved siblings as related to attachment style and flexibility.

    PubMed

    Cohen, Orit; Katz, Michael

    2015-01-01

    This study examined the relationship between attachment style, coping flexibility, military/non-military cause of death, levels of grief reactions and posttraumatic growth (PTG), in 150 bereaved adult siblings in Israel. Insecurely attached participants, 72% of the sample, reported more grief and less PTG than did securely attached ones. Highly avoidant individuals exhibited the least amount of PTG. Securely attached siblings were more flexible and flexibly coping participants reported less grief and higher PTG. Cause of death was not related to grief and PTG. Discussion of these findings yields conditions enabling PTG after a sibling loss.

  12. Do grief self-help books convey contemporary perspectives on grieving?

    PubMed

    Dennis, Michael Robert

    2012-01-01

    Grief therapy and psychology literatures of the modern Western world conceptualized bereavement and grief as processes to be "worked through" so that other relationships could be pursued. In the last decade or so, however, grief theorists have endorsed the value of attaining new meaning(s) and continuing bonds with our lost loved ones instead of "moving on from," "letting go of" or "achieving closure from" them. This article tracks the evolution of thought pertaining to this shift and examines its relevance to grief self-help books that may offer Americans guidance in the ways of grieving.

  13. Politics, religions, and grief: the cases of American spiritualism and the Deuteronomic reform in Israel.

    PubMed

    Klass, Dennis; Goss, Robert

    2002-11-01

    The article is a contribution to the task of developing a cross-cultural model of grief. It shows that grief narratives can be complexly interwoven with the religious and political narratives of the culture. Two political reforms in which religious narratives figured prominently are given as case examples: 19th-century Spiritualism in North America and the Deuteronomic reform in 7th-century BCE Israel. Similarities and differences between the two are discussed. The article concludes that an adequate cross-cultural model of grief must be capable of explaining how a particular grief narrative relates to the politics and religious narratives in which it is set.

  14. Disciplinary Wounds: Has Grief Become the Identified Patient for a Field Gone Awry?

    PubMed Central

    GRANEK, LEEAT

    2014-01-01

    In the last few decades, grief and loss research in the psychological domain has focused almost exclusively on its dysfunctional nature. I examine what is underneath these questions about pathology and suggest that our discipline is suffering from an attachment wound where we have dissociated from our historical roots when it comes to the study of grief and loss. I argue that we need to ask new questions about grief and loss and present two examples of my collaborative work to illustrate innovative ways of thinking about and researching grief. PMID:24976797

  15. Anticipatory Grief in New Family Caregivers of Persons with Mild Cognitive Impairment and Dementia

    PubMed Central

    Garand, Linda; Lingler, Jennifer H.; Deardorf, Kaitlyn E.; DeKosky, Steven T.; Schulz, Richard; Reynolds, Charles F.; Dew, Mary Amanda

    2011-01-01

    Anticipatory grief is the process of experiencing normal phases of bereavement in advance of the loss of a significant person. To date, anticipatory grief has been examined in family caregivers to individuals who have had Alzheimer’s Disease (AD) an average of 3 to 6 years. Whether such grief is manifested early in the disease trajectory (at diagnosis) is unknown. Using a cross-sectional design, we examined differences in the nature and extent of anticipatory grief between family caregivers of persons with a new diagnosis of mild cognitive impairment (MCI, n=43) or AD (n=30). We also determined whether anticipatory grief levels were associated with caregiver demographics, caregiving burden, depressive symptoms and marital quality. Mean anticipatory grief levels were high in the total sample, with AD caregivers endorsing significantly more anticipatory grief than MCI caregivers. In general, AD caregivers endorsed difficulty functioning whereas MCI caregivers focused on themes of “missing the person” they once knew. Being a female caregiver, reporting higher levels of objective caregiving burden and higher depression levels each bore independent, statistically significant relationships with anticipatory grief. Given these findings, family caregivers of individuals with mild cognitive deficits or a new AD diagnosis may benefit from interventions specifically addressing anticipatory grief. PMID:21946013

  16. Prolonged grief symptoms related to loss of physical functioning: examining unique associations with medical service utilization.

    PubMed

    Holland, Jason M; Graves, Stacy; Klingspon, Kara L; Rozalski, Vincent

    2016-01-01

    Prolonged grief, a severe and chronic form of grieving most commonly studied in the context of bereavement, may have relevance to losses associated with chronic illness (e.g. grief related to loss of functioning or loss of a planned future). The purpose of the present study is to examine the unique associations between prolonged grief symptoms and service utilization patterns. An online self-report assessment battery was administered among a sample of 275 older adults with at least one chronic illness that caused significant physical impairment. Even after statistically controlling for relevant physical health (e.g. severity of physical limitations, somatic symptoms, number of chronic illnesses) and psychosocial variables (e.g. social support, depression/anxiety), more severe prolonged grief symptoms were associated with a greater number of emergency room visits, overnight stays in the hospital and total nights in the hospital. These findings highlight the importance of screening for prolonged grief symptomatology with older individuals with a debilitating chronic illness. Recent evidence suggests that prolonged grief may have relevance for losses associated with physical illness. The present study shows that prolonged grief reactions related to physical illness (e.g. grieving the loss of functioning) are uniquely associated with increased hospital-based service utilization. Given the relevance of prolonged grief reactions in this population, practitioners may wish to assess for these symptoms. Future clinical research should focus on developing interventions to target prolonged grief symptoms associated with these losses.

  17. Grieving online: newcomers' constructions of grief in an online support group.

    PubMed

    Varga, Mary Alice; Paulus, Trena M

    2014-01-01

    Research into peer conversations in online grief support groups remains scarce. The authors used discourse analysis to examine 107 initial posts to one such group to examine how newcomers constructed their initial posts to display their eligibility for membership. The authors identified three discursive features: formulating unusual stories of loss, describing uncontrollable emotional and physical states, and engaging in "troubles telling." These discursive patterns illustrate how grief is constructed in ways that may simultaneously conform to and resist norms around grief that exist offline. Implications for practitioners include the need to support individuals through validation of their "nonnormal" grief.

  18. Grief Interrupted: The Experience of Loss Among Incarcerated Women

    PubMed Central

    Harner, Holly M.; Hentz, Patricia M.; Evangelista, Maria Carmela

    2011-01-01

    Incarcerated women face a number of stressors apart from the actual incarceration. Nearly half of all women in prison experience the death of a loved one during their incarceration. Our purpose for this study was to explore the experience of grief and loss among incarcerated women using a phenomenological method. Our study approach followed van Manen's method of phenomenology and Munhall's description of existential lifeworlds. Our analysis revealed four existential lifeworlds: temporality: frozen in time; spatiality: no place, no space to grieve; corporeality: buried emotions; and relationality: never alone, yet feeling so lonely. The findings generated from this study can help mental health providers as well as correctional professionals develop policies and programs that facilitate the grief process of incarcerated women within the confines of imprisonment. PMID:20581074

  19. Loss and grief in the workplace: the challenge of leadership.

    PubMed

    Tehan, Mary; Thompson, Neil

    There is no part of human existence that loss and grief do not reach, and the workplace is no exception to this. This article is therefore concerned with some of the implications of loss and grief in work settings in general and for workplace leaders in particular. By way of example, it explores in particular the needs of bereaved caregivers returning to work and the potential for stigma to emerge in relation to employment and bereavement. Central to the article is an argument in favor of the need for change within the workplace, specifically within the structures and systems that support bereaved caregivers returning to work. This article critically reflects on the leadership management challenge of supporting bereaved caregivers returning to, or seeking, work and addressing the problem of stigma in relation to employment and bereavement. Some structural and policy changes are highlighted to assist employers and bereaved caregivers faced with this situation.

  20. Which frailty measure is a good predictor of early post-operative complications in elderly hip fracture patients?

    PubMed

    Kua, Joanne; Ramason, Rani; Rajamoney, Ganesan; Chong, Mei Sian

    2016-05-01

    Current pre-operative assessment using, e.g., American Society of Anaesthesiologists score does not accurately predict post-operative outcomes following hip fracture. The multidimensional aspect of frailty syndrome makes it a better predictor of post-operative outcomes in hip fracture patients. We aim to discover which frailty measure is more suitable for prediction of early post-operative outcomes in hip fracture patients. Hundred consecutive hip fracture patients seen by the orthogeriatric service were included. We collected baseline demographic, functional and comorbidity data. In addition to ASA, a single blinded rater measured frailty using two scales (i) modified fried criteria (MFC) and (ii) reported edmonton frail scale (REFS). The MFC adopted a surrogate gait speed measure with two questions: (i) Climbing one flight of stairs and (ii) Ability to walk 1 km in the last 2 weeks. Immediate post-operative complications during the inpatient stay were taken as the primary outcome measure. Subjects had mean age of 79.1 ± 9.6 years. Sixty six percent were female and 87 % of Chinese ethnicity. Eighty two percent had surgery, of which 37.8 % (n = 31) had post-operative complications. Frailty, measured by MFC (OR 4.46, p = 0.04) and REFS (OR 6.76, p = 0.01) were the only significant predictors of post-operative complications on univariate analyses. In the hierarchical logistic regression model, only REFS (OR 3.42, p = 0.04) predicted early post-operative complications. At 6 months follow-up, REFS significantly predicted [basic activities of daily living (BADL)] function on the multivariable logistic regression models. (BADL, OR 6.19, p = 0.01). Frailty, measured by the REFS is a good predictor of early post-operative outcomes in our pilot study of older adults undergoing hip surgery. It is also able to predict 6 months BADL function. We intend to review its role in longer-term post-operative outcomes and validate its potential role in pre

  1. Measures of blood loss and red cell transfusion targets for caesarean delivery complicated by placenta praevia.

    PubMed

    Boyle, Rhonda K; Waters, Barbara A; O'Rourke, Peter K

    2010-06-01

    The objective of this study was to assess the association between transfusion, per cent drop in haemoglobin (Hb), and estimated blood loss during the delivery and the first postoperative week following caesarean delivery for placenta praevia. Clinical data predictive of an objective laboratory test for risk of haemorrhage and the need for transfusion were investigated. Transfusions outside national Guidelines were noted. Retrospective observational study of patients with placenta praevia, who were delivered consecutively by caesarean section at Royal Brisbane and Women's Hospital from 1999 to 2005. University-affiliated tertiary hospital. All caesareans were performed by one or more consultant obstetricians, gynaecology oncology surgeons and registrar assistants. Seventy-one (28.9%) of 246 patients with placenta praevia were transfused, with 45 of these receiving three or more red cell units. The antenatal Hb fell by a mean of 20.2% (SD 13.5). The average operative haemorrhage was estimated as 1225 mL (SD 996). No patient or surgical factors were significantly associated with changes in Hb. There was a significant association between per cent fall in antenatal Hb and both transfusion P < 0.001 and estimated loss P = 0.002. After transfusion, the Hb of 19 patients was higher than that recommended by Guidelines. Whether transfusion is necessary, but not the number of red cell units, can be planned by the effect of haemorrhage on antenatal Hb during delivery by caesarean section complicated by placenta praevia.

  2. Resident work hours: the five stages of grief.

    PubMed

    Barone, James E; Ivy, Michael E

    2004-05-01

    The authors describe their reactions, as surgical educators, to the mandate of the Accreditation Council for Graduate Medical Education to reduce resident work hours. They explain these reactions in terms of Dr. Elizabeth Kübler-Ross's five stages of grief: denial, anger, bargaining, depression, and finally acceptance ("which should not be mistaken for a happy stage"). The authors describe each stage of grief and use it to make specific comments on the difficulties that the mandate imposes. They then reveal that their views about the work-hours regulations differ: Dr. Ivy now sees them as an opportunity to grow and improve, and likens the resistance to the new restrictions to that of Europeans to the printing press. But Dr. Barone ("the older of the coauthors and a known curmudgeon") is not so sure, and shares many of the concerns described earlier in the five stages of grief, even though he has outwardly accepted the work-hours rules and insists on full compliance by his residents and faculty. In particular, he is saddened that some residents feel they have the absolute right to go home regardless of the situation on the surgery service, and this feeling is validated by the work-hours rules.

  3. Mindfulness-Based Intervention for Perinatal Grief in Rural India: Improved Mental Health at 12 Months Follow-Up.

    PubMed

    Roberts, Lisa R; Montgomery, Susanne B

    2016-12-01

    Stillbirth is a significant global health problem that frequently results in perinatal grief with compound negative psychosocial impact. In low-resource settings with exceedingly high stillbirth rates, such as rural Chhattisgarh, India, it is vital to utilize low-cost, effective interventions. Mindfulness-based stress reduction is an evidence-based intervention utilized for a broad range of physical and mental health problems, and is adaptable to specific populations. The objective of this study was to explore the sustained effectiveness of a shortened, culturally adapted mindfulness-based intervention (MBI) designed to address complex grief after stillbirth. We used an observational, mixed-methods pre-post study design with 6-week and 12-month follow-up assessments among women with a history of stillbirth (N = 22). Analyses explored study outcomes and continued use of mindfulness skills. Pretest results showed elevated psychological symptoms and high levels of perinatal grief. General linear modeling repeated measures was used to explore 6-week and 12-month follow-up changes from baseline, controlling for significantly correlated demographic variables. Longitudinal results indicated significant reductions in perinatal grief and psychological symptoms; four of the five facets of mindfulness changed in the desired direction; and resilience scores indicated thriving. The shortened, culturally adapted, MBI pilot brought about sustained, significant reductions of perinatal grief and mental health symptoms, and participants reported use of mindfulness skills in day-to-day life. This study shows that the significant mental health needs among rural women of various castes and ethnicities in Chhattisgarh following stillbirth were successfully addressed by a promising MBI with potential scalability and sustainability.

  4. Challenges in measuring complications and death due to invasive Salmonella infections.

    PubMed

    Qamar, Farah Naz; Azmatullah, Asma; Bhutta, Zulfiqar A

    2015-06-19

    Despite the highest burden of Typhoid fever in children globally, exact estimates of morbidity and mortality are lacking due to scarcity of published data. Despite a high prevalence and a socioeconomic burden in developing countries, published data with morbidity and mortality figures are limited especially Africa and South American regions. Data from the community is insufficient and most case fatality estimates are extrapolations from hospital based studies that do not cover all geographical regions, and include cases which may or not be culture confirmed, MDR resistant or sensitive cases, or from mixed populations of age (adults and children). Complications of typhoid such as intestinal perforation, bone marrow suppression, and encephalopathy are dependent on MDR/Fluoroquinolone resistant Salmonella infection, comorbidities such as malnutrition, and health-care access. Data is again insufficient to estimate the true burden of Typhoid Fever in different regions and groups of populations. Although there has been a rapid decline in cases in developed countries with the advent of improved sanitization, timely and easy access to health care and laboratories, this is still not the case in the developing countries where Typhoid deaths are still occurring. The way forward is to develop rapid and cost effective point of care diagnostic tests, put in place validated clinical algorithms for suspected clinical cases, and design prospective, and community based studies in different groups, implement maintenance of electronic health records in large public sector hospitals and regions to identify populations that will benefit most from the implementation of vaccine. Policies on public health education and typhoid vaccine may help to reduce morbidity and mortality due to the disease. Copyright © 2015. Published by Elsevier Ltd.

  5. Spleen Behind the Heart Complicates Lung-to-Head Ratio Measurement in Left-Sided Congenital Diaphragmatic Hernia.

    PubMed

    Basta, Amaya M; Lusk, Leslie A; Keller, Roberta L; Filly, Roy A

    2016-12-01

    In fetuses with left-sided congenital diaphragmatic hernia, intrathoracic herniation of the spleen is a common occurrence. The herniated spleen can reside posterior to the left atrium of the heart in the right hemithorax and is increasingly differentiated from the lung with the use of newer sonographic equipment. Estimation of the neonatal prognosis relies on accurate measurement of fetal lung size, particularly with commonly used measurements such as the lung-to-head ratio. Here we describe how herniation of the spleen behind the heart can complicate measurement of the lung-to-head ratio on sonography and lead to overestimation, with implications for perinatal prognostication and management. © 2016 by the American Institute of Ultrasound in Medicine.

  6. Social Practices of Encountering Death: A Discussion of Spiritual Health in Grief and the Significance of Worldview

    ERIC Educational Resources Information Center

    Sagberg, Sturla; Roen, Ingebrigt

    2011-01-01

    This article presents cases from informal situations of grief and a project called "I and death". These cases suggest that different worldviews affect the process of grief, and that children often do not get the support they need in terms of spiritual care. This affects attitudes towards grief in adulthood. Social practices of encountering death…

  7. Death and Grief: A Plan for Principals to Deal with Tragedy Affecting the School Community.

    ERIC Educational Resources Information Center

    Powers, Harry L.

    1987-01-01

    Spurred by the "Challenger" space shuttle tragedy, this article provides principals with guidelines for informing individual students about family deaths and dealing with grief affecting the entire school community. Thorough preparation can reduce intensity and misconceived actions associated with grief and demonstrate administrative leadership.…

  8. Caregiver Grief in Terminal Illness and Bereavement: A Mixed-Methods Study

    ERIC Educational Resources Information Center

    Waldrop, Deborah P.

    2007-01-01

    Caregivers experience multiple losses during the downhill trajectory of a loved one's terminal illness. Using mixed methods, this two-stage study explored caregiver grief during a terminal illness and after the care recipient's death. Caregiver grief was a state of heightened responsiveness during end-stage care: anxiety, hostility, depression,…

  9. Observing a Client's Grieving Process: Bringing Logical Positivism into Qualitative Grief Counselling Research

    ERIC Educational Resources Information Center

    Wilson, John; Gabriel, Lynne; James, Hazel

    2014-01-01

    This positional paper originates from our need as researcher/practitioners to establish a meaningful epistemological framework for research into bereaved people's journey through loss and grief over time. We describe how the field of grief research has a long and established biological basis, in keeping with a positivist epistemology.…

  10. Distinguishing Symptoms of Grief and Depression in a Cohort of Advanced Cancer Patients

    ERIC Educational Resources Information Center

    Jacobsen, Juliet C.; Zhang, Baohui; Block, Susan D.; Maciejewski, Paul K.; Prigerson, Holly G.

    2010-01-01

    Several studies have shown that the symptoms of grief are different from symptoms of depression among bereaved family members. This study is an attempt to replicate this finding among advanced cancer patients and examine clinical correlates of patient grief and depression. Analyses were conducted on data from interviews with 123 advanced cancer…

  11. Parental Reactions to the Special Education Individual Education Program Process: Looking through the Lens of Grief

    ERIC Educational Resources Information Center

    Haley, Melinda; Hammond, Helen; Ingalls, Lawrence; Marín, Merranda Romaro

    2013-01-01

    Parental grief reactions have typically been examined in situations where parents have a child diagnosed with a major medical or mental health condition. This study used the grief and loss model as conceptualized by Kubler-Ross (1969), Lamb (1988), and Kubler-Ross and Kessler (2005) as a foundation in examining parental reactions when a child has…

  12. The Relationship of Resilience with Attitude toward Grief in University Students

    ERIC Educational Resources Information Center

    Celik, Seher Balci

    2013-01-01

    The purpose of this study is to reveal whether university students' level of resilience differ by gender and attitude toward grief, and to identify to what extent resilience predicts attitude toward grief. 259 students studying at Ondokuz Mayis University participated in the study. The average age of the participants was 20.27 plus or minus 1.19.…

  13. A Pilot Study of Modified Cognitive-Behavioral Therapy for Childhood Traumatic Grief (CBT-CTG)

    ERIC Educational Resources Information Center

    Cohen, Judith A.; Mannarino, Anthony P.; Staron, Virginia R.

    2006-01-01

    Objective: This pilot study evaluated outcomes for a modified 12-session protocol of cognitive-behavioral therapy for childhood traumatic grief (CBT-CTG) conducted between March 2004 and October 2005. CTG is an emerging condition characterized by a combination of posttraumatic stress and unresolved grief symptoms. This two-module treatment model…

  14. Evaluation of Individual and Group Grief and Trauma Interventions for Children Post Disaster

    ERIC Educational Resources Information Center

    Salloum, Alison; Overstreet, Stacy

    2008-01-01

    This study evaluated a community-based grief and trauma intervention for children conducted postdisaster. Fifty six children (7 to 12 years old) who reported moderate to severe levels of symptoms of posttraumatic stress were randomly assigned to group or individual treatment. Treatment consisted of a manualized 10-session grief- and trauma-focused…

  15. Quality of life impairments associated with diagnostic criteria for traumatic grief.

    PubMed

    Silverman, G K; Jacobs, S C; Kasl, S V; Shear, M K; Maciejewski, P K; Noaghiul, F S; Prigerson, H G

    2000-07-01

    This study examined the association between a diagnosis of traumatic grief and quality of life outcomes. METHOD. Sixty-seven widowed persons were interviewed at a median of 4 months after their loss. The multiple regression procedure was used to estimate the effects of a traumatic grief diagnosis on eight quality of life domains, controlling for age, sex, time from loss and diagnoses of major depressive episode and post-traumatic stress disorder. A positive traumatic grief diagnosis was significantly associated with lower social functioning scores, worse mental health scores, and lower energy levels than a negative traumatic grief diagnosis. In each of these domains, traumatic grief was found to be a better predictor of lower scores than either major depressive episode or post-traumatic stress disorder. The results suggest that a traumatic grief diagnosis is significantly associated with quality of life impairments. These findings provide evidence supporting the criterion validity of the proposed consensus criteria and the newly developed diagnostic interview for traumatic grief the Traumatic Grief Evaluation of Response to Loss (TRGR2L).

  16. Grief: The Unrecognized Parental Response to Mental Illness in a Child.

    ERIC Educational Resources Information Center

    MacGregor, Peggy

    1994-01-01

    Notes that parents whose son or daughter develops serious mental illness experience grief that is often neither recognized by society nor addressed by mental health professionals. Describes some common elements of parental bereavement, losses experienced with mental illness, consequences of ignoring grief, and appropriate interventions for mental…

  17. Improving the understanding and treatment of complex grief: an important issue for psychotraumatology

    PubMed Central

    Boelen, Paul A.

    2016-01-01

    In the Netherlands, every year 500,000 people are confronted with the death of a close relative. Many of these people experience little emotional distress. In some, bereavement precipitates severe grief, distress, and dysphoria. A small yet significant minority of bereaved individuals develops persistent and debilitating symptoms of persistent complex bereavement disorder (PCBD) (also termed prolonged grief disorder), posttraumatic stress disorder, and depression. Knowledge about early identification of, and preventive care for complex grief has increased. Moreover, in recent years there has been an increase in treatment options for people for whom loss leads to persistent psychological problems. That said, preventive and curative treatments are effective for some, but not all bereaved individuals experiencing distress and dysfunction following loss. This necessitates further research on the development, course, and treatment of various stages of complex grief, including PCBD. Highlights of the article “Complex grief” is an informal term referring to debilitating, non-normative grief. It will likely be named Prolonged Grief Disorder in the forthcoming ICD-11. It is named Persistent Complex Bereavement Disorder in DSM-5. Research on the development, course, and treatment of complex grief is needed. This research should address different stages and manifestations of complex grief. PMID:27667723

  18. Parents' Grief Following Pregnancy Loss: A Comparison of Mothers and Fathers.

    ERIC Educational Resources Information Center

    Stinson, Kandi M.; And Others

    1992-01-01

    Examined gender differences in bereavement following miscarriage, ectopic pregnancy, stillbirth, and neonatal death. Interviewed 56 couples using Perinatal Grief Scale. Women scored significantly higher than men on most dimensions of grief at two months, one year, and two years postloss, except on dimension indicating most serious consequences of…

  19. Engaging Parents of Students with Disabilities: Moving beyond the Grief Model

    ERIC Educational Resources Information Center

    Allred, Keith W.

    2015-01-01

    Educators in many Western nations have used the Kübler-Ross stage model of grief for five decades as a lens to explain parental response to disability. A recent article in "Improving Schools," representing this deficit model, asserted that the grief lens is useful in understanding parent's response to learning that their child qualified…

  20. Are the Developmental Needs of Children in America Adequately Addressed during the Grief Process?

    ERIC Educational Resources Information Center

    Schoen, Alexis Ann; Burgoyne, Megan; Schoen, Sharon Faith

    2004-01-01

    There is no debate about the natural, normal, unique, and lifelong process of the grief of the death of a loved one. The loss is an intensely individualized experience. Yet, given an understanding of human growth and development, some general predictions about the concept of death and the grief reaction can be made based upon common patterns of…