scholarly journals Peritraumatic distress predicts prolonged grief disorder symptom severity after the death of a parent in children and adolescents

2021 ◽  
Vol 12 (1) ◽  
pp. 1936916
Author(s):  
Alexis Revet ◽  
Agnès Suc ◽  
Françoise Auriol ◽  
A. A. A. Manik J. Djelantik ◽  
Jean-Philippe Raynaud ◽  
...  
Keyword(s):  
Children And Adolescents ◽  
Symptom Severity ◽  
Prolonged Grief Disorder ◽  
Prolonged Grief ◽  
Death Of A Parent ◽  
Disorder Symptom ◽  
Peritraumatic Distress

scholarly journals Predicting Suicidal Risk in a Cohort of Depressed Children and Adolescents

Crisis ◽  
2012 ◽  
Vol 33 (1) ◽  
pp. 13-20 ◽  
Author(s):  
Sarah E. Hetrick ◽  
Alexandra G. Parker ◽  
Jo Robinson ◽  
Nicole Hall ◽  
Alasdair Vance
Keyword(s):  
Depressive Disorder ◽  
Children And Adolescents ◽  
Symptom Severity ◽  
Cross Sectional Study ◽  
Family Dysfunction ◽  
Dysthymic Disorder ◽  
Sectional Study ◽  
Cross Sectional ◽  
Targeted Interventions ◽  
Disorder Symptom

Background: In children and adolescents with a depressive disorder, predicting who will also go on to exhibit suicide-related behaviors (SRBs), including suicide attempt or self-harm, is a key challenge facing clinicians. Aims: To investigate the relative contributions of depressive disorder severity, hopelessness, family dysfunction, and perceived social support to the risk of suicide-related behaviors. Methods: This was a cross-sectional study of a group of 10–16-year-olds with major depressive disorders and dysthymic disorder. Results: Child-rated depressive disorder symptom severity emerged as the greatest predictor of risk. Hopelessness and family dysfunction were also significant predictors of SRBs. In combination these variables were strong predictors, accounting for 66% of the variance. This is a cross-sectional study design, rather than longitudinal, therefore risk prediction over time was not possible. Conclusions: Understanding the child and adolescents depressive disorder symptom severity from their perspective, their level of hopelessness, as well as their family context is critical in understanding the risk of SRBs. These findings may help to provide direction for targeted interventions to address these clinical risk factors.

scholarly journals Naltrexone Treatment for Prolonged Grief Disorder: Study Protocol for a Randomized, Triple-Blinded, Placebo-Controlled Trial

2020 ◽  
Author(s):  
James Gang ◽  
James Kocsis ◽  
Jonathan Avery ◽  
Paul Maciejewski ◽  
Holly Prigerson
Keyword(s):  
Symptom Severity ◽  
Pharmacological Treatment ◽  
Controlled Trial ◽  
Prolonged Grief Disorder ◽  
Prolonged Grief ◽  
Increased Risk ◽  
Oral Naltrexone ◽  
Naltrexone Treatment ◽  
Reward Pathway

Abstract BACKGROUNDThere is a lack of effective pharmacotherapy for prolonged grief disorder (PGD). Evidence suggests that the neurobiology of PGD involves the same circuitry as the reward pathway. Based upon this evidence, we hypothesize that PGD can be conceptualized as a disorder of addiction, and therefore could benefit from being treated with medications that are currently used to treat such disorders. One such medication is naltrexone, which is currently used to treat alcohol and opioid dependence. Oral naltrexone was chosen for its mechanism of action, safety, and convenience. The primary aim of this study is to establish the efficacy of using oral naltrexone as a pharmacological treatment for PGD. Specifically, we hypothesize that participants receiving naltrexone will demonstrate reduced PGD symptoms when compared to placebo.METHODS/DESIGNThis is a randomized, placebo-controlled, triple-blinded (to healthcare professionals, participants, and data analysts) in which we propose to enroll 46 participants who meet criteria for Prolonged Grief Disorder (PGD). Participants will be randomly assigned to the naltrexone 50 mg oral arm or placebo arm; medications will be over-encapsulated to appear identical. Participants will take their assigned medication for 8 weeks, with monthly clinic visits to assess symptom severity, social closeness, and adverse reactions. Weekly surveys of Prolonged Grief-13-Revised (PG-13-R) will be used to relate naltrexone use to changes in PGD symptom severity. Follow-up 4 weeks after their last visit will assess the longevity of treatment, as well as any lingering adverse reactions.DISCUSSIONThis study is the first to investigate the use of oral naltrexone as pharmacological treatment for PGD. The acute and debilitating nature of the disorder, in addition to the evidence demonstrating the increased risk of comorbidities, highlights the need for pharmacological treatment like naltrexone that can act more rapidly, may help those for whom psychotherapy may not be effective, and/or may augment psychotherapy to promote PGD symptom grief resolution.TRIAL REGISTRATIONClinicalTrials.gov, NCT04547985. Registered on 8/31/2020, https://clinicaltrials.gov/ct2/show/NCT04547985.

scholarly journals Naltrexone treatment for prolonged grief disorder: study protocol for a randomized, triple-blinded, placebo-controlled trial

Trials ◽  
2021 ◽  
Vol 22 (1) ◽  
Author(s):  
James Gang ◽  
James Kocsis ◽  
Jonathan Avery ◽  
Paul K. Maciejewski ◽  
Holly G. Prigerson
Keyword(s):  
Symptom Severity ◽  
Pharmacological Treatment ◽  
Adverse Reactions ◽  
Controlled Trial ◽  
Prolonged Grief Disorder ◽  
Prolonged Grief ◽  
Link Type ◽  
Increased Risk ◽  
Oral Naltrexone ◽  
Grief Resolution

Abstract Background There is a lack of effective pharmacotherapy for prolonged grief disorder (PGD). Evidence suggests that the neurobiology of PGD involves the same circuitry as the reward pathway. Based upon this evidence, we hypothesize that PGD can be conceptualized as a disorder of addiction and therefore could benefit from being treated with medications that are currently used to treat such disorders. One such medication is naltrexone, which is currently used to treat alcohol and opioid dependence. Oral naltrexone was chosen for its mechanism of action, safety, and convenience. The primary aim of this study is to establish the efficacy of using oral naltrexone as a pharmacological treatment for PGD. Specifically, we hypothesize that participants receiving naltrexone will demonstrate reduced PGD symptoms when compared to placebo. Methods/design This is a randomized, placebo-controlled, triple-blinded (to healthcare professionals/study staff, participants, and data analysts) study in which we propose to enroll 48 participants who meet criteria for Prolonged Grief Disorder (PGD). Participants will be randomly assigned to the naltrexone 50 mg oral arm or placebo arm; medications will be over-encapsulated to appear identical. Participants will take their assigned medication for 8 weeks, with clinic visits every 4 weeks to assess symptom severity, social closeness, and adverse reactions. Weekly surveys of Prolonged Grief-13-Revised (PG-13-R) will be used to relate naltrexone use to changes in PGD symptom severity. Follow-up 4 weeks after their last visit will assess the longevity of treatment, as well as any lingering adverse reactions. Discussion This study is the first to investigate the use of oral naltrexone as pharmacological treatment for PGD. The acute and debilitating nature of the disorder, in addition to the increased risk of comorbidities, highlights the need for pharmacological treatment like naltrexone that can act more rapidly, may help those for whom psychotherapy may not be effective, and/or may augment psychotherapy to promote PGD symptom grief resolution. Trial registration ClinicalTrials.govNCT04547985. Registered on 8/31/2020.

Prolonged Grief Disorder

2014 ◽  
Author(s):  
A.H. Jordan ◽  
B.T. Litz
Keyword(s):  
Prolonged Grief Disorder ◽  
Prolonged Grief

Risk Factors of Prolonged Grief Disorder: A Conceptual Framework

2011 ◽  
Author(s):  
Evgenia Milman ◽  
Christopher J. Mackinnon ◽  
Martin Drapeau
Keyword(s):  
Risk Factors ◽  
Conceptual Framework ◽  
Prolonged Grief Disorder ◽  
Prolonged Grief

scholarly journals Development and preliminary evaluation of EMPOWER for surrogate decision-makers of critically ill patients

2021 ◽  
pp. 1-11
Author(s):  
Wendy G. Lichtenthal ◽  
Martin Viola ◽  
Madeline Rogers ◽  
Kailey E. Roberts ◽  
Lindsay Lief ◽  
...  
Keyword(s):  
Critically Ill ◽  
Critically Ill Patients ◽  
Experiential Avoidance ◽  
Decision Makers ◽  
Post Intervention ◽  
Prolonged Grief ◽  
Surrogate Decision Makers ◽  
Surrogate Decision ◽  
Peritraumatic Distress

Abstract Objective The objectives of this study were to develop and refine EMPOWER (Enhancing and Mobilizing the POtential for Wellness and Resilience), a brief manualized cognitive-behavioral, acceptance-based intervention for surrogate decision-makers of critically ill patients and to evaluate its preliminary feasibility, acceptability, and promise in improving surrogates’ mental health and patient outcomes. Method Part 1 involved obtaining qualitative stakeholder feedback from 5 bereaved surrogates and 10 critical care and mental health clinicians. Stakeholders were provided with the manual and prompted for feedback on its content, format, and language. Feedback was organized and incorporated into the manual, which was then re-circulated until consensus. In Part 2, surrogates of critically ill patients admitted to an intensive care unit (ICU) reporting moderate anxiety or close attachment were enrolled in an open trial of EMPOWER. Surrogates completed six, 15–20 min modules, totaling 1.5–2 h. Surrogates were administered measures of peritraumatic distress, experiential avoidance, prolonged grief, distress tolerance, anxiety, and depression at pre-intervention, post-intervention, and at 1-month and 3-month follow-up assessments. Results Part 1 resulted in changes to the EMPOWER manual, including reducing jargon, improving navigability, making EMPOWER applicable for a range of illness scenarios, rearranging the modules, and adding further instructions and psychoeducation. Part 2 findings suggested that EMPOWER is feasible, with 100% of participants completing all modules. The acceptability of EMPOWER appeared strong, with high ratings of effectiveness and helpfulness (M = 8/10). Results showed immediate post-intervention improvements in anxiety (d = −0.41), peritraumatic distress (d = −0.24), and experiential avoidance (d = −0.23). At the 3-month follow-up assessments, surrogates exhibited improvements in prolonged grief symptoms (d = −0.94), depression (d = −0.23), anxiety (d = −0.29), and experiential avoidance (d = −0.30). Significance of results Preliminary data suggest that EMPOWER is feasible, acceptable, and associated with notable improvements in psychological symptoms among surrogates. Future research should examine EMPOWER with a larger sample in a randomized controlled trial.

scholarly journals Long-term prevalence and predictors of prolonged grief disorder amongst bereaved cancer caregivers: A cohort study

2019 ◽  
Vol 17 (5) ◽  
pp. 507-514 ◽  
Author(s):  
Rachel D. Zordan ◽  
Melanie L. Bell ◽  
Melanie Price ◽  
Cheryl Remedios ◽  
Elizabeth Lobb ◽  
...  
Keyword(s):  
Mental Health ◽  
Palliative Care ◽  
Psychological Health ◽  
Linear Regression Analysis ◽  
Population Based ◽  
Anticipatory Grief ◽  
Prolonged Grief Disorder ◽  
Prolonged Grief ◽  
Cancer Caregivers

AbstractContextThe short-term impact of prolonged grief disorder (PGD) following bereavement is well documented. The longer term sequelae of PGD however are poorly understood, possibly unrecognized, and may be incorrectly attributed to other mental health disorders and hence undertreated.ObjectivesThe aims of this study were to prospectively evaluate the prevalence of PGD three years post bereavement and to examine the predictors of long-term PGD in a population-based cohort of bereaved cancer caregivers.MethodsA cohort of primary family caregivers of patients admitted to one of three palliative care services in Melbourne, Australia, participated in the study (n= 301). Sociodemographic, mental health, and bereavement-related data were collected from the caregiver upon the patient's admission to palliative care (T1). Further data addressing circumstances around the death and psychological health were collected at six (T2,n= 167), 13 (T3,n= 143), and 37 months (T4,n= 85) after bereavement.ResultsAt T4, 5% and 14% of bereaved caregivers met criteria for PGD and subthreshold PGD, respectively. Applying the total PGD score at T4, linear regression analysis found preloss anticipatory grief measured at T1 and self-reported coping measured at T2 were highly statistically significant predictors (bothp< 0.0001) of PGD in the longer term.ConclusionFor almost 20% of caregivers, the symptoms of PGD appear to persist at least three years post bereavement. These findings support the importance of screening caregivers upon the patient's admission to palliative care and at six months after bereavement to ascertain their current mental health. Ideally, caregivers at risk of developing PGD can be identified and treated before PGD becomes entrenched.

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