Bereaved Survivors Research Articles

Early predictors of prolonged grief among bereaved trauma survivors 8.5 years after a terrorist attack.

A better understanding of the development of prolonged grief disorder can help professionals identify bereaved in need of intervention efforts and improve the efficiency of services. We aimed to examine the prevalence of and risk factors for prolonged grief disorder in a sample of young, bereaved terrorist attack survivors almost a decade postloss. In total, 165 bereaved survivors (Mage = 27.75, SD = 4.27; 45.5% females) of the 2011 terror attack on Utøya island, Norway, participated in face-to-face, semistructured interviews. At 4-5 months after the attack, early posttraumatic reactions were measured using the Brief Grief Questionnaire, University of California at Los Angeles PTSD Reaction Index, the Hopkins Symptom Checklist-8, and the eight-item Children's Somatic Symptoms Inventory. At 8.5 years postloss, the Traumatic Grief Inventory-Self Report Plus was used to assess prolonged grief disorder. To explore the association between participants' sociodemographic characteristics, early postloss clinical characteristics, and later prolonged grief reactions, we used multiple linear regression analyses. We found that 4.8% of the participants fulfilled the Diagnostic and Statistical Manual of Mental Disorders, fifth edition, text revision diagnostic criteria for prolonged grief disorder 8.5 years after their traumatic loss. Lower age and high levels of early somatic complaints predicted higher prolonged grief reactions almost a decade postloss. Young, bereaved survivors may be at particularly high risk of experiencing persistent grief reactions following the traumatic loss of a peer. Pending replication of our findings, professionals should focus on identifying bereaved who experience intense somatic symptoms early after a traumatic loss. Targeting these symptoms may alleviate the exacerbation of persistent grief reactions several years after a traumatic loss. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Sobreviventes enlutados por suicídio e as possibilidades para posvenção no contexto da saúde pública brasileira

Abstract Death by suicide leaves many people negatively affected in its wake. Many so-called bereaved survivors will at some point need care and support, known as suicide postvention. This theoretical essay, based on the corresponding literature, institutional documents, and legal frameworks, seeks to discuss possibilities for suicide postvention within Brazilian public health. Suicide postvention is better structured internationally than in Brazil, which currently focuses on support groups for bereaved survivors centered in non-governmental organizations. We must look to territorial and community-based health services, like the Psychosocial Care Centers, and envisage affordable and resolute postvention actions, such as free prevention lines, early home visits, therapeutic listening and grief counseling.

Prolonged grief disorder among bereaved survivors after the 2011 Van Earthquake in Turkey

The aim of the current study was to investigate the ratio and predictors of probable Prolonged Grief Disorder (PGD) among bereaved survivors eight years after the 2011 Van earthquake. Among a sample of 495 survivors who experienced loss as a result of this earthquake, 8.9% met the criteria of probable PGD. In the binary logistic regression analysis, being woman, being aged 40 or over, personal injury, property damage, losing family members, and the psychological impact of the earthquake predicted probable PGD. The current study highlights the importance of considering PGD among bereaved survivors after earthquakes.

Association Between Prolonged Grief and Attitudes Toward Reconciliation in Bereaved Survivors of the Khmer Rouge Regime in Cambodia.

BackgroundDuring the Khmer Rouge regime in Cambodia, about a quarter of the population died, resulting in many individuals losing close relatives. Still today, many individuals are suffering from the psychological consequences of these losses, which might also affect the process of reconciliation within the Cambodian society. The aim of this paper is therefore to investigate the association between symptoms of prolonged grief and attitudes toward reconciliation.MethodsA sample of 775 survivors of the Khmer Rouge regime who lost relatives during the conflict were interviewed about their losses and traumatic events, prolonged grief (PG; Complicated Grief Assessment Self-Report, CGA-SR), posttraumatic stress disorder (PTSD Checklist - Civilian Version) and attitudes toward reconciliation (Readiness to Reconcile Inventory, RRI).ResultsA higher symptom severity of PG was significantly associated with readiness to reconcile even when controlling for other relevant variables (β = −0.22; p <.001). Persons who met caseness criteria for PG were significantly less ready to reconcile, t(773) = 5.47, p <.001, than persons who did not meet caseness for PG.ConclusionPG seems to be a relevant mental health correlate of attitudes toward reconciliation. The results of the current study underline the importance of also considering PG with regard to the reconciliation process in Cambodia and possibly also in other post-conflict regions.

DIGITAL MONITORING OF SLEEP, MEALS, AND EXERCISE AS A PREVENTIVE INTERVENTION FOR DEPRESSION IN BEREAVED SPOUSES

The death of a spouse brings profound change to bereaved survivors’ lifestyle and daily routine. These changes disrupt circadian rhythms which, in turn, places individuals at high risk for depression. The purpose of this study is to examine the feasibility and acceptability of a 12-week behavioral intervention that targets the timing and regularity of sleep, meals, and physical activity via digital monitoring and motivational health coaching. Participants were 60+ years of age and assessed on intervention acceptability and adherence, depression symptoms (Hamilton Rating Scale for Depression) and the rest-activity rhythm, (a downstream indicator of the body’s circadian rhythm (via actigraphic technology). The intervention was rated highly by participants (n=55); 88% were compliant in digital monitoring and 95% were retained. Depression symptoms declined from pre-to post-intervention; and the regularity of circadian rhythms increased. An intervention that targets the regularity of day- and nighttime activities may reduce depression in older spousally-bereaved adults.

Association between earthquake experience and depression 37 years after the Tangshan earthquake: a cross-sectional study

ObjectiveTo investigate the association between the Tangshan earthquake and depression after 37 years.Design and settingA cross-sectional study conducted in Tangshan from 2013 to 2014.ParticipantsThe sample included 5024 participants born before...

Trajectories of prolonged grief one to six years after a natural disaster

BackgroundThe long-term trajectories of prolonged grief are poorly understood. The aims were to examine the course of grief among bereaved disaster survivors up to six years post loss and factors predicting worse bereavement outcome. A third aim was to explore differences in grief indicators between trajectories.MethodsBereaved Swedish tourists who survived the 2004 Indian Ocean tsunamis responded to surveys including the Inventory of Complicated Grief 1 to 6 years after the disaster. Latent growth mixture modeling was used to identify longitudinal trajectories of grief. Multinomial logistic regression analysis was used to examine predictors of class membership.ResultsThree trajectories were identified: resilient (41% of the sample), recovering (48%), and chronic (11%). The strongest predictor of chronic grief was the loss of one’s child. When examining grief indicators, the chronic trajectory was characterized by not accepting the loss, while yearning was common in all trajectories.ConclusionsThis study highlights the importance of considering how traumatically bereaved individuals can be affected by loss for several years after a disaster, especially after losing one’s child. An inability to accept the loss, more so than yearning, appears to characterize bereaved survivors at risk of a chronic trajectory of grief.

Prevalence and risk factors of prolonged grief disorder among bereaved survivors seven years after the Wenchuan earthquake in China: A cross-sectional study

BackgroundThis study aimed to determine the prevalence and predictive factors of prolonged grief disorder (PGD) among those bereaved by the Wenchuan earthquake in Southwestern China seven years after the event. MethodsA cross-sectional survey based on census tracts was conducted on the bereaved earthquake survivors. Responses to the questionnaire regarding PGD and its potential associated factors were obtained either through face-to-face or telephone interview. PGD was screened by a validated Chinese version of the PGD questionnaire-13 (PG-13). Bivariate and multivariate regression analyses were used to determine the prevalence and associated risk factors of PGD. ResultsA total of 1464 bereaved earthquake survivors, with a response rate of 97.6%, were included in the study. Of the 1464 respondents studied, 124 (8.47%) were diagnosed with PGD. Multivariate regression analysis demonstrated that PGD in the bereaved earthquake individuals was significantly associated with several factors, including age, economic burden, close kinship with the deceased, and living with the deceased before the loss. Wenchuan earthquake bereaved aged 41–60 years were more likely to develop PGD compared to those aged younger than 40 or older than 60 (OR = 2.075, 95%CI = 1.297–3.319). Those who had a close kinship with the deceased had a higher tendency to develop PGD (OR = 5.144, 95%CI = 2.716–9.740). The odds of PGD among the earthquake bereaved with economic burdens were higher relative to those who did not experience an economic burden (OR = 8.123, 95%CI = 2.657–24.831). Those who living with the deceased before loss also had a higher tendency to develop PGD (OR = 0.179, 95%CI = 0.053–0.602). ConclusionsThis study revealed that a significantly high proportion (8.47%) of the Wenchuan earthquake-bereaved remain grieving seven years after the event. Those diagnosed with PGD should receive appropriate interventions from clinical psychologists. The risk factors identified in this study are crucial for the early screening and prevention of PGD in future nursing and psycho-clinical practices.

Peer Support Services for Bereaved Survivors: A Systematic Review.

This systematic literature review assesses the evidence regarding benefits of peer support services for bereaved survivors of sudden or unexpected death. Reports were included that addressed peer support services for adults who experienced death of a family member, close friend, or coworker. Of the 32 studies meeting all inclusion criteria, most showed evidence that peer support was helpful to bereaved survivors, reducing grief symptoms and increasing well-being and personal growth. Studies also showed benefits to providers of peer support, including increased personal growth and positive meaning in life. Several studies addressed the growing trend of Internet-based peer support programs, finding that these are beneficial in part due to their easy accessibility. Peer support appears to be especially valuable for survivors of suicide loss, a result that may be related to stigma and lack of support from family and friends experienced by many suicide survivors. The reviewed studies provide consistent evidence that peer support is beneficial to bereaved survivors.

Prevalence and risk factors of complicated grief among Sichuan earthquake survivors

BackgroundDisasters usually involves massive casualties, yet few post-disaster studies explore the prevalence of complicated grief (CG) among survivors. Complicated grief is a distinct psychological disorder, and is associated with impaired physical and psychological functions. Given such gap in the literature and the significance of this topic, this study is hoped to offer more information of complicated grief among survivors who lost their loved ones in disaster. Adopting a large scale survey, the prevalence and risk factors of CG among bereaved survivors one year after the Sichuan earthquake in China were explored. MethodsIn total 803 bereaved survivors participated the study by filling a questionnaire on measuring CG symptoms, posttraumatic stress disorder (PTSD) symptoms, intrapersonal factors, earthquake related factors, bereavement related factors, and an interpersonal factor. ResultsThere were 71.1% of the participants scored higher than the cutoff point of CG symptoms. Close relationship with the deceased, PTSD symptoms, losing means of livelihood, physical injury, and terrifying experience in the earthquake, were identified to be risk factors for CG. LimitationsThe study was cross-sectional and the data was collected through a self-reported questionnaire. The sample was recruited from one of the most severely affected counties, thus the generalizability of the results should be interpreted with caution. ConclusionsA large portion of bereaved earthquake survivors suffered from CG symptoms one year after the disaster. Risk factors found in this study can be used to identify high risk groups, who need special care, support, and bereavement interventions.

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

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.

Symptoms of posttraumatic stress disorder and depression among bereaved and non-bereaved survivors following the 2008 Sichuan earthquake

Many studies have suggested that unexpected death of a loved one is an important risk factor of posttraumatic stress disorder (PTSD) and depression among disaster survivors, but few have examined the magnitude of psychiatric morbidities among bereaved survivors. This study examined the prevalence rates of clinically significant PTSD and depressive symptoms and their associated risk factors among Chinese adult survivors following the 2008 Sichuan earthquake. Two hundred and fifty-one bereaved adults were compared with 1474 non-bereaved adult survivors. The estimated rates of PTSD and depressive symptoms were 65.6% and 64.8% for those who lost first-degree family members, 34.1% and 45.5% for those who lost second-degree relatives, and 27.1% and 37.5% for non-bereaved survivors respectively. Loss of a child was a significant predictor of psychopathological symptoms. The results suggested that effective and sustainable mental health services were required, especially for bereaved single-child parents.

Long-Term Outcomes of War-Related Death of Family Members in Kosovar Civilian War Survivors

Exposure to war-related experiences can comprise a broad variety of experiences and the very nature of certain war-related events has generally been neglected. To examine the long-term outcomes of war-related death of family members, the authors investigated the prevalence rates of major depressive episode (MDE), anxiety disorders, and quality of life among civilian war survivors with or without war-related death of first-degree family members 9 years after the war in Kosovo. Compared to participants without war-related death of family members, those who had experienced such loss had significantly higher prevalence rates of MDE, posttraumatic stress disorder, and generalized anxiety disorder, and reported a lower quality of life 9 years after the war. These results indicate that bereaved civilian survivors of war experience significant mental health problems many years after the war.

Comparison of the PTSD symptoms, depression and anxiety between bereaved and non-bereaved survivors after Wenchuan earthquake

Objective To compare the differences of PTSD symptoms, depression and anxiety between bereaved and non-bereaved survivors, and to explore the risk factors of PTSD among victims of the Sichuan earthquake 2008. Methods To investigate the mental health status among 560 survivors of disaster six-month after the earthquake using post-traumatic stress disorder Checklist, Beck Depression Inventory (BDI), and Hamilton Anxiety Scale (HAMA). Results There were 10.9% of victims who lost their relatives in the earthquake. The rates of PTSD symptoms among bereaved survivors (44.4% ) were significantly higher than non-bereaved group (15.1% ) (P<0.05). The rates of depression, anxiety, and suicidal ideation among bereaved survivors (55.5% , 44.4%, and 44.5% ) were significantly higher than that of the non-bereaved group respectively ( 17.4%, 16.7%, and 14.2% ) (P<0.001). Bereaved survivors with PTSD symptoms reported comorbidity of medium to severe depression (79.2%) and anxiety symptoms (75%). Bereaved survivors with medium to severe depression reported comorbidity of anxiety symptoms (83.4%) . Total score of depression and anxiety, previous anxiety, nightmare, and feeling of being lonely could predict the level of PTSD symptoms. Conclusion The rates of depression, anxiety, suicidal ideation, and PTSD symptoms of bereaved survivors were significantly higher than non-bereaved group. There were multi-factors which could predict PTSD in bereaved survivors. Bereaved survivors were high risk victims of PTSD, depression, and anxiety. Key words: Post-traumatic stress disorder; Anxiety; Depression; Bereavers

Key Factors Affecting Dying Children and Their Families

The death of a child alters the life and health of others immediately and for the rest of their lives. How a child dies influences parents' abilities to continue their role functions as well as siblings' abilities to make and maintain friendships, and may be the basis for health care providers' decisions to exit direct care roles. Thus, facilitating a "good death"-an obvious care priority for all involved with the dying child-ought also to be a priority for the health of bereaved families and affected health care providers. Making this a care priority is complicated by a serious lack of data, as details of the last hours or weeks of a dying child or adolescent's life are largely unknown. The purpose of this paper is to identify key factors that affect the course of dying children and adolescents and that of their bereaved survivors, and to link those key factors to needed research that could produce clinically relevant findings to improve the care of these patients. Key factors described here include suffering (physical, psychological, and spiritual), communication, decision making, prognostic ambiguities, ability of the seriously ill child to give assent to research participation, and educational preparation of health care providers to give competent end-of-life care.

Prevalence of psychiatric disorders among bereaved survivors of a disastrous earthquake in taiwan.

This study investigated the prevalence of psychiatric disorders and risk factors for posttraumatic stress disorder (PTSD) and major depressive disorder among bereaved survivors of a severe earthquake in Taiwan. A total of 120 survivors received a psychiatric interview conducted by board-certified psychiatrists. The two most prevalent disorders were PTSD (37 percent) and major depressive disorder (16 percent). The risk factors for PTSD were psychosocial stressors and initial feelings of guilt. The risk factor for major depressive disorder was female gender. Only 25 percent of the survivors with PTSD and 26 percent of those with major depressive disorder sought help at primary care clinics. These results indicate a need to develop an effective outreach strategy for dealing with psychiatric disorders among disaster victims.

A theory of healing in the aftermath of youth suicide. Implications for holistic nursing practice.

The purpose of this family-focused, grounded-theory study was to develop a substantive theory that explains how individual family members heal in the aftermath of youth suicide. Individual healing following youth suicide is conceptualized as a process of "journeying toward wholeness." In response to youth suicide, survivors characteristically tap into their innate strengths and coping capabilities. Eventually, most survivors move toward healing. Precipitated by youth suicide, individual healing was found to be a contextually mediated, ongoing, dynamic, and recursive process. Most often initiated by a family survivor who was emotionally and spiritually close to the youth prior to suicide, healing emanated from the survivor's consciousness as an act of volition. This study brings to light the idea that bereaved family survivors of youth suicide have the potential to heal in response to the decisions they make and the healthy bonds they create and maintain between themselves and the deceased youth.

Cultural Variation in Lesbian Bereavement Experiences in Ohio

When a lesbian woman dies, her survivors may not be recognized by health care providers who have limited knowledge of lesbian culture. The objective of this research was to learn about the experiences of lesbian survivors in the context of lesbian culture in Ohio. The three research questions were as follows: (1) Who are the bereaved lesbian survivors when a lesbian woman dies? (2) What are the experiences of these survivors? and (3) What aspects of lesbian culture are evident in the bereavement experiences of these survivors? An emergent ethnographic design was used to learn more about the cultural experiences of bereaved lesbian survivors in the state of Ohio. The design included participant observation, field notes, key informants, artifacts, audiotaped in-person and telephone interviews, demographic data, and kinship network diagrams. Seventeen self-identified survivors were located by networking and advertising in Ohio, and interviewed first in person and then for follow-up by telephone. Cultural data were analyzed using field note coding and data summary charts for themes which emerged from the literature and the experiences of survivors. This article discusses cultural variations on lesbian bereavement experiences in Ohio, using the imagery of four villages: The Big Village, the Womyn's Land, the Rainbow Village, and the Carnival Village.

Between Death and Judgment: Conflicting Images of the Afterlife in Late Seventeenth-Century English Eulogies

One of the more troublesome issues facing Protestant reformers after the abolition of the Roman Catholic purgatory in the early sixteenth century was the need to explain the status of body and soul in the interim between death and resurrection. Eager to identify the precise destination of the whole person after bodily expiration but before the general judgment, preachers sought to bring comfort to bereaved survivors of the recently departed by formulating an acceptable counterpoise to the centuries-old Roman Catholic geography of the other world. Unlike the authors of learned theological treatises on the nature of the soul and body, eulogists faced the unenviable task of interpreting the experience of death and its sequel to an audience that often lacked the sophistication required for the rigors of sustained exegesis. The task of the eulogist was to attempt to make plain the contours of postmortem existence in a manner designed both to warn and to reassure. In their efforts to define an emotionally satisfying alternative to the Roman Catholic story, however, English Protestants formulated an increasingly wide variety of disparate—and sometimes contradictory—accounts of life after death, each of which was normatively based upon a personal understanding of scripture. By the late seventeenth century, even as English funeral sermons that treated the afterlife began to reflect a broad consensus regarding the separate destinations of body and soul, there remained much confusion over the precise condition of those eternal partners before Christ's promised return. The failure to resolve this dilemma in a satisfactory manner and the inability to arrive at an acceptable consensus on a matter of central concern to believing Christians contributed to the growth of mortalist and annihilationist theories by the close of the century. Conceptual disarray within the orthodox camp, then, provided an opportunity for more innovative thinkers to step forward, persons whose understanding of eschatological time, anchored in their own unique interpretation of the Christian scriptures, negated any need for continued debate about a putative “middle place”.

Trauma and suicide in our schools

Abstract Trauma occurs in our schools; suicide is one such event. Postvention deals with the traumatic aftereffects in survivors. It involves offering mental health services to the bereaved survivors. School systems are an especially critical force in these endeavors. Strategies include consultation, crisis intervention, community linkage, assessment and counselling, education, liaison with the media, and follow-up. An outline of this type of prevention (within a framework of prevention/intervention/postvention) is provided with illustration of three cases: a suicide, a school bus accident, and a crossing-guard incident.