Bereavement

2021 ◽  
pp. 773-784
Author(s):  
David W. Kissane
Keyword(s):  
Palliative Care ◽  
Complicated Grief ◽  
Anticipatory Grief ◽  
Desirable Outcome ◽  
Bereaved Children ◽  
Cognitive Behavioural ◽  
Pathological Grief ◽  
Post Traumatic ◽  
Traumatic Distress ◽  
Special Circumstances

The phenomena and trajectory of mourning as a normal adaptive process are differentiated from clinical depression, avoidant and complicated grief, post-traumatic distress disorder, and other forms of pathological grief. Anticipatory grief can be a particular challenge during palliative care. The family is recognized as the major source of social support and the environment in which grief is shared with others. Key risk factors for pathological bereavement outcomes can be identified on admission to palliative care, permitting preventive models of psychological care to be used through palliative care into bereavement. Models of therapy include supportive-expressive, interpersonal, cognitive behavioural, family focused, and specific therapy for complicated grief. Pharmacotherapy can judiciously accompany psychotherapy. Life-cycle issues include bereaved children, siblings, parents, and grief for the very elderly. Grief can be stigmatized and ambiguous in special circumstances, yet positive growth is a desirable outcome from any loss.

Bereavement

2015 ◽  
Author(s):  
David W. Kissane ◽  
Talia I. Zaider
Keyword(s):  
Palliative Care ◽  
Complicated Grief ◽  
Anticipatory Grief ◽  
Desirable Outcome ◽  
Bereaved Children ◽  
Cognitive Behavioural ◽  
Pathological Grief ◽  
Post Traumatic ◽  
Traumatic Distress ◽  
Special Circumstances

The phenomena and trajectory of mourning as a normal adaptive process are differentiated from clinical depression, avoidant and complicated grief, post-traumatic distress disorder, and other forms of pathological grief. Anticipatory grief can be a particular challenge during palliative care. The family is recognized as the major source of social support and the environment in which grief is shared with others. Key risk factors for pathological bereavement outcomes can be identified on admission to palliative care, permitting preventive models of psychological care to be used through palliative care into bereavement. Models of therapy include supportive-expressive, interpersonal, cognitive behavioural, family focused, and specific therapy for complicated grief. Pharmacotherapy can judiciously accompany psychotherapy. Life-cycle issues include bereaved children, siblings, parents, and grief for the very elderly. Grief can be stigmatized and ambiguous in special circumstances, yet positive growth is a desirable outcome from any loss.

Grief and Bereavement

2014 ◽  
pp. 149-160
Author(s):  
William S. Breitbart
Keyword(s):  
Risk Factors ◽  
Palliative Care ◽  
Complicated Grief ◽  
Anticipatory Grief ◽  
Comprehensive Overview ◽  
Traumatic Grief ◽  
Grief And Bereavement ◽  
Bereavement Care ◽  
Routine Assessment

Bereavement care is an integral dimension of palliative care. Identifying risk factors for complicated grief and routine assessment of the bereaved allow the psycho-oncologist to proactively intervene and reduce unnecessary morbidity. This chapter provides a comprehensive overview of definitions regarding grief and bereavement, the features of normal grief, anticipatory grief, inhibited or delayed grief, chronic grief, traumatic grief, and complicated grief, as well as a review of interventions used to support the bereaved.

The Role of Stress Sensitization in Progression of Post-Traumatic Distress Following Deployment

2012 ◽  
Author(s):  
Geert Smid ◽  
Rolf Kleber ◽  
Arthur Rademaker ◽  
Mirjam van Zuiden ◽  
Eric Vermetten
Keyword(s):  
Stress Sensitization ◽  
Post Traumatic ◽  
Traumatic Distress

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.

Adult separation anxiety in patients with complicated grief: relationship with post traumatic stress versus mood spectrum symptomatology

2011 ◽  
Vol 26 (S2) ◽  
pp. 142-142
Author(s):  
C. Carmassi ◽  
C. Socci ◽  
M. Corsi ◽  
I. Pergentini ◽  
E. Massimetti ◽  
...  
Keyword(s):  
Social Adjustment ◽  
Traumatic Stress ◽  
Separation Anxiety ◽  
Complicated Grief ◽  
Self Report ◽  
Post Traumatic Stress ◽  
Event Scale ◽  
Control Subjects ◽  
Post Traumatic ◽  
The Impact

IntroductionAround 9–20% of bereaved individuals experience symptoms of complicated grief (CG) associated with significant distress and impairment. Increasing research has been focused on identifying the distinctive set of psychiatric symptoms that characterize this condition with respect to major depression, corroborating the need to include this syndrome in the forthcoming DSM-V as a distinctive diagnosis. Vulnerability to CG has been rooted in attachment disturbances and authors reported that symptoms of separation anxiety in childhood should be considered as predictors of CG onset in adulthood.ObjectivesTo date no study explored symptoms of adult separation anxiety among patients with CG with respect to healthy control subjects (HC).AimsTo explore adult separation anxiety and mood spectrum symptoms in patients with CG with respect to HC.Methods53 patients with CG and 50 control subjects were recruited, Department of Psychiatry, University of Pisa. Assessments: SCID-I/P, the Inventory of Complicated Grief (ICG), the Adult Separation Anxiety Questionnaire (ASA-27), the Work and Social Adjustment Scale (WSAS), the Impact of Event Scale (IES) and the Mood Spectrum-Self Report (MOODS-SR) lifetime version.ResultsPatients with CG reported significantly higher scores on the MOODS-SR, ASA_27, IES and WSAS with respect to controls. The scores on the ASA_27 were more strongly associated with IES scores with respect to other scales.ConclusionsOur results suggest a correlation between adult separation anxiety and CG onset after the loss of a loved one in adulthood, with a possible correlation to a post-traumatic stress symptomatology. Further studies are needed.

scholarly journals The effect of flexible cognitive–behavioural therapy and medical treatment, including antidepressants on post-traumatic stress disorder and depression in traumatised refugees: pragmatic randomised controlled clinical trial

2016 ◽  
Vol 208 (3) ◽  
pp. 252-259 ◽  
Author(s):  
Caecilie Böck Buhmann ◽  
Merete Nordentoft ◽  
Morten Ekstroem ◽  
Jessica Carlsson ◽  
Erik Lykke Mortensen
Keyword(s):  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Stress Disorder ◽  
Behavioural Therapy ◽  
Controlled Clinical Trial ◽  
Post Traumatic Stress ◽  
Cognitive Behavioural ◽  
Randomised Controlled Clinical Trial ◽  
Post Traumatic ◽  
Randomised Controlled

BackgroundLittle evidence exists on the treatment of traumatised refugees.AimsTo estimate treatment effects of flexible cognitive–behavioural therapy (CBT) and antidepressants (sertraline and mianserin) in traumatised refugees.MethodRandomised controlled clinical trial with 2×2 factorial design (registered with Clinicaltrials.gov, NCT00917397, EUDRACT no. 2008-006714-15). Participants were refugees with war-related traumatic experiences, post-traumatic stress disorder (PTSD) and without psychotic disorder. Treatment was weekly sessions with a physician and/or psychologist over 6 months.ResultsA total of 217 of 280 patients completed treatment (78%). There was no effect on PTSD symptoms, no effect of psychotherapy and no interaction between psychotherapy and medicine. A small but significant effect of treatment with antidepressants was found on depression.ConclusionsIn a pragmatic clinical setting, there was no effect of flexible CBT and antidepressants on PTSD, and there was a small-to-moderate effect of antidepressants and psychoeducation on depression in traumatised refugees.

Prisoner’s insomnia prevalence, insomnia associated factors and interventions with sleep as an outcome: a review and narrative analysis

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Chris Griffiths ◽  
Farah Hina
Keyword(s):  
Narrative Analysis ◽  
Associated Factors ◽  
Behavioural Therapy ◽  
Post Traumatic Stress ◽  
Content Type ◽  
Cognitive Behavioural ◽  
High Prevalence ◽  
Randomised Control Trials ◽  
Post Traumatic ◽  
Anxiety Depression

Purpose Insomnia is highly prevalent in prisoners. The purpose of this paper is a review of research evidence on interventions with sleep as an outcome (2000 to 2020) and rates of insomnia prevalence and associated factors in prisons (2015 to 2020). Design/methodology/approach An internet-based search used Medline, PubMed, PsycINFO (EBSCOhost), Embase, Web of Science and Scopus. Seven interventions and eight sleep prevalence or sleep-associated factor papers were identified. Findings Intervention research was very limited and the quality of the research design was generally poor. Interventions such as cognitive behavioural therapy for insomnia (CBT-I), yoga and mindfulness can be beneficial in a prison setting. This review identified a high prevalence of insomnia in prisons across the world, which was supported by recent evidence. Factors associated with insomnia include anxiety, depression, post-traumatic stress disorder, personality disorder and pain. Research limitations/implications There is a need for appropriately powered randomised control trials of CBT-I in prisons and a need to use objective measures of sleep quality. Originality/value Due to a lack of an up-to-date review, this paper fulfils the need for a review of the evidence on interventions in prison settings with sleep as an outcome, rates of insomnia prevalence and associated factors in prisons.

scholarly journals Evaluation of a Trauma-Focused CBT Training Programme for IAPT services

2017 ◽  
Vol 45 (5) ◽  
pp. 467-482 ◽  
Author(s):  
Hannah Murray
Keyword(s):  
Training Programme ◽  
Behavioural Therapy ◽  
Routine Practice ◽  
Post Traumatic Stress ◽  
Training Interventions ◽  
Psychological Therapies ◽  
Cognitive Behavioural ◽  
Co Morbidity ◽  
Early Life Trauma ◽  
Post Traumatic

Background: Therapists in Improving Access to Psychological Therapies (IAPT) services are often expected to treat complex presentations of post-traumatic stress disorder (PTSD), such as individuals with multiple, prolonged or early life trauma histories and significant co-morbidity, for which they have received minimal training. Although high recovery rates for PTSD have been demonstrated in randomized controlled trials, these are not always replicated in routine practice, suggesting that training interventions are required to fill the research–practice gap. Aims: This study investigated the outcomes of a therapist training programme on treating PTSD with trauma-focused cognitive behavioural therapy (TF-CBT). Method: Twenty therapists from ten IAPT services participated in the training, which consisted of workshops, webinars and consultation sessions over a 6-month period. Results: Feedback indicated that participants found the training highly acceptable. PTSD knowledge and self- and supervisor-rated competence on TF-CBT measures improved following the training and improvements were maintained a year later. Client outcomes on a PTSD measure improved following the training. Participants reported attempts to disseminate learning from the course back to their teams. Conclusions: The findings indicate that the training programme was successful in improving TF-CBT knowledge, skills and outcomes for IAPT therapists. Tentative support for training ‘trauma experts’ within IAPT services was found, although institutional constraints and staff turnover may limit the sustainability of the model.

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