Grief Scores Research Articles

Perinatal Grief Counseling and Its Effect on Grief Levels in Women Who Underwent Pregnancy Termination: A Comparative Experimental Study.

This study was designed as a two-group pre-test post-test comparative experimental study to examine the effects of grief counseling on perinatal grief levels in women who underwent pregnancy termination before discharge from the clinic. This study was conducted with 70 women who underwent medical termination of pregnancy. The intervention group (n = 35) received perinatal grief care, while the control group (n = 35) received only routine hospital care. In this study, the Introductory Information Form, Perinatal Grief Scale, and evaluation form of the care received were completed. While the perinatal grief level of the intervention group decreased after the application of grief care, a significant difference between the groups was detected only in women with a history of medical termination according to obstetric characteristics (p < .05). The findings obtained from this study showed that perinatal grief care support decreased grief scores on perinatal grief instruments and their sub-dimensions in the intervention group.

The Norwegian traumatic grief inventory-self report plus (TGI-SR+): a psychometric evaluation in traumatically bereaved people

ABSTRACT Background: Prolonged grief disorder (PGD) has been added to the ICD-11 and DSM-5-TR. The Traumatic Grief Inventory-Self Report Plus (TGI-SR+) assesses self-rated PGD intensity as defined in ICD-11 and DSM-5-TR. The TGI-SR + is available in multiple languages, but has not been validated yet in Norwegian. Objective: The aim of this study was to evaluate the psychometric properties of the Norwegian TGI-SR + . Method: Bereaved adults (N = 307) whose child or sibling died ≥6 months ago due to a sudden or violent loss completed the TGI-SR + and measures for posttraumatic stress, depression, and precursor PGD symptoms. We examined the factor structure and internal consistency of the ICD-11 and DSM-5-TR PGD items. Convergent validity and known-groups validity was evaluated. Probable PGD cases, pair-wise agreement between diagnostic scoring rules for both PGD criteria-sets, and cut-off scores were calculated. Results: The 1-factor model for ICD-11 and DSM-5-TR PGD showed the best fit and demonstrated good internal consistency. Convergent validity was supported by strong associations between summed ICD-11 and DSM-5-TR PGD scores and summed posttraumatic stress, depression, and precursor prolonged grief scores. Known-groups validity was supported by PGD intensity being related to educational level and time since loss. The perfect pair-wise agreement was reached using the ICD-11 and DSM-5-TR PGD diagnostic scoring rules. The optimal cut-off score for detecting probable PGD cases, when summing all TGI-SR + items, was ≥73. Conclusions: The Norwegian TGI-SR + seems a valid and reliable instrument to assess ICD-11 and DSM-5-TR PGD intensity after losing a child or sibling under traumatic circumstances.

The relationship between healthcare satisfaction after miscarriage and perinatal grief symptoms: A cross-sectional study on Portugal residents

Objective15–20% of identified pregnancies result in miscarriage, which may lead to persistent symptoms of psychological morbidities in some women. Healthcare satisfaction is among the factors believed to influence such negative psychological responses. Here, we present the results of a study conducted in Portugal that analyzes the relationship between healthcare satisfaction, information and support provision and perinatal grief symptoms. MethodsIn a cross-sectional study, symptoms of perinatal grief, degree of satisfaction with healthcare received, and information and support provision data were collected through an online survey aimed at women in Portugal who suffered a miscarriage. 873 were considered eligible. Correlations were performed between perinatal grief scores and healthcare satisfaction rates. Finally, the proportions of information and support received were compared after distributing the sample in groups according to their perinatal grief levels. ResultsHealthcare satisfaction correlated significantly with perinatal grief scores, the latter increasing as satisfaction levels decreased. 61.1% of our sample received information about the physical consequences of miscarriage and showed a significantly lower rate of above-threshold perinatal grief symptoms in this group. 18.2% received information about its mental health consequences, with no significant differences in above-threshold symptom rates. 11.7% were offered or recommended mental health support, but no significant differences in above-threshold symptom rates were found. ConclusionHealthcare satisfaction and information on after-miscarriage physical changes correlated significantly with reduced perinatal grief rates after miscarriage. However, any effects of mental health information and psychological support provision need further studies. Training for healthcare providers dealing with pregnancy loss, implementing national guidelines that include follow-up on the parents' physical and psychological health, and including a specialized area in medical structures are advised.

클라이언트 사망을 경험한 사회복지사를 위한 집단인지행동치료 효과성 연구

The objective of this study was to develop and validate a group cognitive behavioral therapy based on William Worden's four-stage grief model for social workers who have experienced client death. For this study, both the experimental group and the comparison group completed pre-tests and post-tests to assess their levels of prolonged grief, PTSD, anxiety, and depression. In addition, the experimental group completed SUDs before and after each session. This group cognitive behavioral therapy was conducted online due to the COVID-19 pandemic. The study revealed that the experimental group had a significantly lower prolonged grief score. Furthermore, their post-traumatic stress symptoms, anxiety, and depression were found to be lower than their pre-score, although this difference was not statistically significant. The SUDs for the experimental group were measured before and after each session, and a reduction was observed. A plan to assist social workers in their recovery from the death of a client was proposed based on the findings of the study.

Knowledge and attitudes of medical students toward death: a cross-sectional comparative study between an Arab and a Western University

BackgroundCultural factors influence attitudes toward death, and gender disparities are evident. Prior studies show that medical students have limited knowledge about death and are uncomfortable with it. Moreover, there is limited research that has examined factors that influence medical students’ knowledge and attitudes toward death.ObjectivesThe objectives of the study were to compare cultural and gender differences in relation to knowledge and attitudes toward loss and grief and to screen for complicated grief among medical students at the Arabian Gulf University and the University of Toronto.MethodsA cross-sectional study was disseminated to medical students at both universities in 2022. The variables in the survey included four parts: demographic characteristics of the participants, religious observance, history of encountering loss of a loved one, grief following loss, attitude toward death, and learning about how to deal with grief and death during medical school. The brief grief questionnaire and the death attitude profile-revised scales were used.ResultsThe study sample consisted of 168 medical students, with 74.1% being female. Complicated grief scores were higher among Arabian Gulf University students (3.87 ± 2.39) than among University of Toronto students (2.00 ± 1.93) and were higher for participants with a higher degree of religious observance in both schools (p < 0.05). Death avoidance (p = 0.003), approach acceptance (p < 0.001), and escape acceptance (p = 0.038) domains were significantly higher among Arabian Gulf University students than among University of Toronto students. Almost three-quarters of University of Toronto students reported not being taught about grief, compared to 54% of Arabian Gulf University students.ConclusionsArabian Gulf University medical students scored higher on complicated grief, most likely due to cultural and religious factors. Females at both institutions as well as those who indicated a higher level of religious observance reported higher scores of complicated grief. The study highlights how cultural and religious beliefs influence medical students’ attitudes toward death and bereavement. It provides valuable insight into the knowledge and attitudes of medical students toward loss.

Grief in the practice of oncology: Prevalence and impact.

253 Background: Oncology providers regularly face death and serious illness while shepherding patients through the cancer journey. International research shows that oncologists frequently experience grief and that grief is linked to compassion fatigue. Providing care for patients with terminal cancer has been linked to burnout, but the relationship between grief and burnout has not been explored. We sought to describe the prevalence of grief in oncology providers in the US and its link to burnout. Methods: We surveyed 255 Duke oncology providers, including in the Duke Cancer Network. Our survey included demographics, two questions about burnout, and an adaptation of the Traumatic Grief Inventory. Results: We received 128 responses, with 50% response rate. Our sample included 26% attendings, 12% fellows, and 62% advanced practice providers, with 78% of providers from the academic setting and 22% from the community. Of 123 participants who completed the grief inventory, 92 (94%) endorsed feelings of grief in the past year. Approximately half of participants endorsed burnout, and they attributed an average of 30.6% of their burnout to grief. Oncologists with personal grief, in academic settings, and &lt;10 years in practice had higher grief scores trending toward statistical significance. Using logistic regression, we found that burden of grief predicted burnout in providers. For each increase in one point on the grief scale there was a 15% increase in odds of experiencing burnout (95% CI 7% - 22%). Conclusions: The prevalence of grief among US oncologists has not been studied. We found that the experience of professional grief is widespread among oncology providers, with 94% answering at least “sometimes” to any item on an adapted grief inventory. Moreover, we found grief to be an important predictor of burnout, suggesting a key opportunity for intervention in support of oncology providers. [Table: see text]

Consciousness, and the weaponization of lies

In the current resurgence of studies investigating anomalous information reception (AIR) in mediumship, it has become a major challenge to balance ecological validity and rigorous control.To describe the method and present preliminary findings of a new controlled semi-naturalistic protocol combining ecological validity and control to investigate AIR in psychography (automatic writing), a form of mediumship that does not allow for instantaneous feedback.Experienced Brazilian psychography mediums and bereaved sitters were selected and blinded to each other until the automatic writing experimental sessions began. Mediums were continually monitored and filmed during all the procedures. Sitters filled in questionnaires on grief, spirituality, and paranormal beliefs. Investigators controlled all information received by the mediums: names of the sitter and deceased, age and cause of death and short interviews (usually ≤ 1 min). The experimental automatic writing sessions took place under the view of sitters and researchers. Immediately after the sessions, and then a few months later, sitters rated how likely the letter is to have come from their deceased loved ones.A total of 142 sitters and three mediums participated, producing 26 automatically written letters to 21 sitters. Mediums felt comfortable with the protocol. Most sitters were women (82.4%) and had completed higher education (57.8%). Sitters who received letters had higher grief scores. At the time, 96.2% of letters were considered definitely or probably from the deceased relative, with a small but significant decline (92.3%) a few months later.The new controlled semi-naturalistic method was well accepted and seems to be promising as a complementary method for investigating AIR in mediumship. Information obtained by mediums during sitters` brief interviews is a limitation, but they were registered by video recording and will be taken in consideration in the future analysis that will explore further the accuracy and probability of leakage of verifiable items of information in the letters.

Psychosocial Intervention on the Dual-Process Model for a Group of COVID-19 Bereaved Individuals in Wuhan: A Pilot Study.

Wuhan was the first large city where the initial breakout of COVID-19 took numerous lives. A group of social workers and mental health specialists coordinated the “Be Together Program” (BTP), a psychosocial grief intervention program to help a group of Wuhan COVID-19 bereaved people. Under the Dual-process model framework, BTP used the internet and social media as the main tools, combined with group and individual intervention. Additionally, it employed a “Supermarket Mode” with abundant intervention themes and approaches for BTP participants to choose according to their special needs. Additionally, Chinese cultural elements are integrated into the program. At the end of the program, the grief scores of participants in the qualified sample reduced significantly, and the prevalence of the potential Prolonged Grief Disorder diagnosis reduced from 75% to 12%. The study also found that the BTP was especially effective for those who had high levels of grief reaction.

The Relationship Between Family Caregivers’ Anticipatory Grief and Severity of Dementia

Grandparents are increasingly providing extensive and custodial care for their grandchildren. Many factors have contributed to a societal rise in caregiving among grandparents, including addiction, incarceration, dual-income families, and the cost of childcare. Past work has highlighted positive effects of grandparenting (e.g. reduced dementia risk); however, research is limited that examines the day to day challenges grandparent caregivers experience. The goal of this research was to examine daily experiences of stressors, positive events, physical symptoms, and daily mood of grandparent caregivers. Participants (n=18 grandparent caregivers) filled out a diary survey for five consecutive days that measured daily stressors and positive events. A total of 90 diaries were completed. Stressors were reported on 97.6% of days. Multilevel analysis examining emotional and physical reactivity to daily events showed that, controlling for age and gender, on days when participants reported more stressors than average, they reported higher negative affect (p=.019), lower positive affect (p=.003) and more physical symptoms (p=.002). Positive events were not significantly associated with daily mood or daily physical symptoms. Overall, the findings supported the hypothesis that grandparent caregivers experience emotional and physical reactivity to the daily challenges they experience. Future research should examine resources and supports to reduce the impact of daily stressors, as well as the particular challenges among underrepresented groups, particularly Black and Latino grandparents, who provide disproportionate levels of care for their grandchildren. The current study highlights the potential vulnerability and daily needs for support among grandparents who provide regular and custodial care for their grandchildren.

The Relationship Between Family Caregivers’ Anticipatory Grief and Severity of Dementia.

Anticipatory grief is the process of experiencing normal bereavement before the physical death of a significant person. To date, anticipatory grief has been related to higher levels of caregiver depression, anxiety, subjective burden, and poorer problem solving. Additionally, higher levels anticipatory grief are observed in caregivers of those with Alzheimer’s Disease and Related Dementias (ADRD) compared to caregivers of those with mild cognitive impairment, implying a relationship between disease severity and caregiver anticipatory grief. Analyses were performed on data for ADRD caregivers (n=56) enrolled in the IU Telephone Acceptance and Commitment Therapy for Caregiver (TACTICs) trial; an RCT evaluating an ACT intervention for ADRD caregivers with anxiety. Inclusion criteria included identifying as the primary caregiver of an ADRD patient, and clinically significant anxiety (GAD7 score >10). The average age of caregivers was 61.9 years, 41.1% were spouses, 83.9% were white and 14.3% were black. Mean anticipatory grief scores were notably higher (84.6) compared to the previously reported means across the literature (74.9). Using multiple regression models, we determined a caregivers’ anticipatory grief, as measured by the anticipatory grief scale, is not significantly associated with the patients’ dementia severity, as measured by the Dementia Severity Rating Scale (DSRS) (p=0.66), Results revealed that higher levels of caregiver burden, as measured by the Zarit Burden Index, are significantly associated with more anticipatory grief (p< 0.01). Understanding these relationships contributes to a better understanding of ADRD caregivers, identifying “high-risk” caregivers, and informing future interventions and care.

The Relationship Between Family Caregivers’ Anticipatory Grief and Severity of Dementia

Background/Objective: Anticipatory grief is the process of experiencing normal bereavement before the physical death of a significant person. To date, anticipatory grief has been related to higher levels of caregiver depression, anxiety, subjective burden, and poorer problem solving. Additionally, higher levels anticipatory grief are observed in caregivers of those with Alzheimer’s Disease and Related Dementias (ADRD) compared to caregivers of other conditions. The primary objective of this analysis is to determine the relationship between caregiver anticipatory grief and dementia severity, as measured by the Anticipatory Grief Scale (AGS) and Dementia Severity Rating Scale (DSRS), respectively.&#x0D; Methods: Multiple regression analyses were performed on data for ADRD caregivers (n=56) enrolled in the IU Telephone Acceptance and Commitment Therapy for Caregivers (TACTICs) trial; an RCT testing an ACT intervention for ADRD caregiver anxiety. Inclusion criteria included identifying as the primary caregiver of an ADRD patient and clinically significant anxiety (GAD7 score &gt;10).&#x0D; Results: The average age of caregivers was 61.9 years, 41.1% were spouses, 83.9% were white and 14.3% were black. Mean anticipatory grief scores were notably higher (84.6) compared to the previously reported means across the literature. Multiple regression models showed a caregivers’ anticipatory grief is not significantly associated with the patients’ dementia severity as measured by the Dementia Severity Rating Scale (t=0.87). Results also revealed that higher levels of caregiver burden, as measured by the Zarit Burden Index, are significantly associated with more anticipatory grief (t=&lt; 0.1).&#x0D; Conclusion and Potential Impact: Understanding these relationships contributes to better understanding ADRD caregivers, identifying “high-risk” caregivers, and informing future interventions and care.

The Loss of a Service Dog Through Death or Retirement: Experiences and Impact on Partners

This study was designed to better understand how service dog partners experience the loss of their service dog. An anonymous survey was distributed to service dog partners who had lost a dog within the last five years. One-way ANOVAs were used to assess loss differences (retirement vs. death) on scores for Centrality of Events Scale, Warwick-Edinburgh Mental Well-Being Scale, Social Constraints Measure, and Self-Compassion Scale. Linear regression was conducted on the total bereavement score to determine the impact of the above assessment measures. We found higher grief scores for those whose service dog died compared to those whose dog retired. Perceptions of social constraints and feelings related to the centrality of the event were predictors of overall grief for those who lost a dog due to retirement; centrality of event feelings predicted grief level for those experiencing a death. Findings suggest a need for grief support for service dog partners.

Investigating the severity of the grief experience among people whose family members died of COVID-19

Background &amp; Objectives: COVID-19 has made the grief process more complicated and brought about loads of unexpressed grief. This study aimed at determining the severity of grief reactions due to the death of a first-degree relative (FDR) affected by COVID-19. Methods: This analytic cross-sectional study was conducted to determine the grief score of people over 18 years old with the experience of losing one of their FDRs (i.e. father, mother, and siblings) because of COVID-19. Convenience sampling was employed to gather the data. The instrument used in this study was the Grief Experience Questionnaire (GEQ-34) that was filled in through phone calls. The inclusion criteria included the tendency to participate in the study, age of over 18, and the experience of FDR’s death. On the other hand, the exclusion criteria were severe discomfort and restlessness while talking on the phone. To analyze the data, descriptive statistics and multiple linear regression were employed to diagnose the factors affecting grief, using SPSS version 22 with a significance level of 0.05. Results: The findings indicated that the mean score of GEQ was 67.22±19.24, ranging from 34 to 126. In this study, 54.5% of the bereaved had an experience of low-level grief, 40.2% moderately experienced the grief, and 5.3% were highly affected. There was a positive relationship between the gender of the mourners, widows, or widowers with the grief score, while a negative relationship was observed between being an employed mourner as well as the age of the dead person with the grief score. Conclusion: COVID-19 pandemic has brought about quite a lot of changes in the social and economic situation; mourning condition has become a complicated challenge. To facilitate the grief process and prevent psychological problems, it is recommended that some changes take place in this process. For example, online memorials, and online meetings of mourning can replace the traditional ones. Television, mass media, and clergymen can play a great role in making these changes in funeral rituals.

Controlled semi-naturalistic protocol to investigate anomalous information reception in mediumship: Description and preliminary findings

IntroductionIn the current resurgence of studies investigating anomalous information reception (AIR) in mediumship, it has become a major challenge to balance ecological validity and rigorous control. ObjectiveTo describe the method and present preliminary findings of a new controlled semi-naturalistic protocol combining ecological validity and control to investigate AIR in psychography (automatic writing), a form of mediumship that does not allow for instantaneous feedback. MethodExperienced Brazilian psychography mediums and bereaved sitters were selected and blinded to each other until the automatic writing experimental sessions began. Mediums were continually monitored and filmed during all the procedures. Sitters filled in questionnaires on grief, spirituality, and paranormal beliefs. Investigators controlled all information received by the mediums: names of the sitter and deceased, age and cause of death and short interviews (usually ≤ 1 min). The experimental automatic writing sessions took place under the view of sitters and researchers. Immediately after the sessions, and then a few months later, sitters rated how likely the letter is to have come from their deceased loved ones. ResultsA total of 142 sitters and three mediums participated, producing 26 automatically written letters to 21 sitters. Mediums felt comfortable with the protocol. Most sitters were women (82.4%) and had completed higher education (57.8%). Sitters who received letters had higher grief scores. At the time, 96.2% of letters were considered definitely or probably from the deceased relative, with a small but significant decline (92.3%) a few months later. ConclusionThe new controlled semi-naturalistic method was well accepted and seems to be promising as a complementary method for investigating AIR in mediumship. Information obtained by mediums during sitters` brief interviews is a limitation, but they were registered by video recording and will be taken in consideration in the future analysis that will explore further the accuracy and probability of leakage of verifiable items of information in the letters.

Parenting through grief: A cross-sectional study of recently bereaved adults with minor children

Background: Grieving adults raising parentally-bereaved minor children experience persistently elevated symptoms of depression and grief. However, the factors associated with their mental health outcomes are not well understood. Aim: To investigate the psychosocial and demographic characteristics associated with grief distress and depressive symptom severity in bereaved adults with minor children. Design: Cross-sectional, web-based survey. Setting/participants: Eight hundred forty-five bereaved adults raising minor (age <18 years) children who had experienced the death of a co-parent. Primary outcomes were grief distress (Prolonged Grief Disorder-13), depressive symptoms (Patient-Reported Outcomes Measurement Information System-Depression), and widowed parenting self-efficacy (WPSES). Results: Mean grief scores were 33.5; mean depression scores were 58.3. Among the 690 individuals more than 6 months bereaved, 132 (19.3%) met criteria for prolonged grief disorder. In adjusted models, participants reporting higher grief scores were more recently bereaved, identified as mothers, non-Caucasian, had lower education and income, and had not anticipated their co-parent’s death. The statistical modeling results for depression scores were similar to grief scores except that depression was not associated with anticipation of co-parent death. Parents reporting lower WPSES scores had higher grief and depression scores. Retrospective assessments of more intense parenting worries at the time of co-parent death were also associated with higher grief and depression scores. Conclusions: For bereaved adults with minor children, unanticipated co-parent death was linked with higher grief distress but not symptoms of depression. Addressing parenting concerns may represent a common pathway for improving the mental health of parentally-bereaved families.

Evidence on the Conceptual Distinctness of Normal Grief From Depression

Abstract. Background: The distinctness of grief from depression has been the subject of a long scholarly debate, even influencing definitions of diagnostic criteria. Aims: This study aims at clarifying the issue by a multifaceted analysis of data from a large German sample. Method: A community sample of 406 bereaved persons answered the Wuerzburg Grief Inventory (WGI), a multidimensional grief questionnaire designed to measure normal grief in the German language, and the General Depression Scale – Short Version (GDS-S), a self-report depression scale. Data were analyzed by factor analysis to identify structural (dis-)similarities of the constructs, and analysis of variance (ANOVA) to identify the influence of the factors relationship to the deceased, type of death, and time since loss on grief measures and depression scores. Results: Factor analysis clustered items referring to grief-related impairments and depression into one factor, items referring to other dimensions of grief on separate factors, however. Relationship to the deceased influenced the grief measures impairments and nearness to the deceased, but not depression scores if controlled for impairments. Type of death showed specific effects on grief scores, but not on depression scores. Time since loss influenced grief scores, but not depression scores. Limitations: The analysis is based on a self-selected community sample of grieving persons, self-report measures, and in part, on cross-sectional data. Conclusion: Factor analysis and objective data show a clear distinction of dimensions of grief and depression. The human experience of grief contains a sense of nearness to the lost person, feelings of guilt, and positive aspects of the loss experience in addition to components resembling depression.

Posttraumatic Distress Symptoms and Their Response to Treatment in Adults With Prolonged Grief Disorder.

Posttraumatic stress disorder and prolonged grief disorder (PGD) arise following major life stressors and may share some overlapping symptomatology. This study aimed to examine the presence and response to treatment of posttraumatic stress symptoms (PTSS) in bereaved adults with a primary diagnosis of PGD. A randomized controlled trial of 395 adults with PGD (defined as an Inventory of Complicated Grief score ≥ 30 plus confirmation on structured clinical interview) randomly assigned participants to either complicated grief treatment (CGT) with citalopram, CGT plus placebo, citalopram, or placebo between March 2010 and September 2014. This secondary analysis examined the presence of PTSS (per the Davidson Trauma Scale) at baseline and change in PTSS with treatment using longitudinal mixed-effects regression and examined the role of violent compared to nonviolent deaths (loss type). High levels of PTSS were present at baseline, regardless of loss type, and were associated with increased functional impairment (P < .001). CGT with placebo demonstrated efficacy for PTSS compared to placebo in both threshold (OR = 2.71; 95% CI, 1.13-6.52; P = .026) and continuous (P < .001; effect size d = 0.47) analyses, and analyses were suggestive of a greater effect for CGT plus citalopram compared to citalopram alone (threshold analysis: OR = 2.84; 95% CI, 1.20-6.70; P = .017; continuous analysis: P = .053; d = 0.25). In contrast, citalopram did not differ from placebo, and CGT plus citalopram did not differ from CGT plus placebo. Bereavement-related PTSS are common in bereaved adults with PGD in the context of both violent and nonviolent death and are associated with poorer functioning. CGT shows efficacy for PTSS, while the antidepressant citalopram does not. : ClinicalTrials.gov identifier: NCT01179568.

Psychological Reactions in Women with Pregnancy Termination Due to Fetal Anomaly

OBJECTIVE: We aimed to determine and compare grief, depression, and post-traumatic stress scores in women who underwent termination of pregnancy due to fetal anomaly in the first vs. second-trimester of pregnancy. STUDY DESIGN: Forty-three women who underwent termination of pregnancy for fetal anomaly were subdivided into two categories in this prospective-cohort study: First-trimester group, which was defined as termination of pregnancy performed &lt;14 weeks of gestation, and Second-trimester termination of pregnancy who underwent termination of pregnancy between 20 and 28 weeks of pregnancy. Eight weeks after the termination of pregnancy, the Beck Depression Inventory, Perinatal Grief Scale-short version, and Impact of Event Scale-Revised were performed with face-to-face interviews. RESULTS: Twenty-four women in the first-trimester group and 19 women in the second-trimester group were enrolled. The mean Beck Depression Inventory score was 7.3±4.2 in the first-trimester group and 11.1±4.6 in the second-trimester group (p=0.033). The mean Perinatal Grief Scale-short scores were 86.3±17.2 and 101.4±29.2 in the first and second-trimester groups, respectively (p=0.014). Impact of Event Scale-Revised scores of the first trimester and second-trimester groups were 22.5±8.6 and 35.3±17.1, respectively (p=0.022). Depression was detected in 29.1% of women in the first-trimester group and 57.8% in the second-trimester group (p=0.023). Perinatal grief was significantly higher in the second-trimester group (45.8% vs. 84.2% p&lt;0.01). Post-traumatic stress was significantly higher in the second-trimester group (41.6% vs. 73.6%, p=0.031). CONCLUSION: Our study indicates that termination of pregnancy for fetal anomaly causes severe psychiatric problems in most women. Depression, grief, and post-traumatic stress are more prominent in women who underwent termination of pregnancy in the second trimester of pregnancy than in the first trimester.

The longitudinal association of actigraphy-estimated sleep with grief in middle-aged and elderly persons

Most people experience grief after a loss, about 10% develop complicated grief, often accompanied by sleep complaints. Yet, the role of objectively estimated poor sleep remains unclear. Therefore, we assessed the cross-sectional and longitudinal association of actigraphy-estimated sleep with grief. We included 1,776 participants (mean age: 61.8 ± 8.9 years, 55% women) of a prospective population-based cohort. Of 1,471 participants (83%) repeated measures of grief were available (median follow-up 6 years, inter quartile range 5.6–6.3). At baseline, sleep was objectively estimated using actigraphy (mean duration 6.0 ± 0.8days). At baseline and follow-up, participants were asked about significant losses and completed the Dutch Inventory of Complicated Grief (17 items, cut-off ≥22). At baseline 1,521 (86%) participants experienced no grief, 44 (2%) acute grief (<6 months, any grief score), 158 (9%) non-complicated grief (≥6 months, grief score<22), and 53 (3%) complicated grief (≥6 months, grief score≥22). In those indicating any grief (n = 255), low sleep efficiency (B = −0.16, 95%CI = −0.30;-0.02), long sleep onset latency (B = 0.07, 95%CI = 0.01; 0.14), and long wake after sleep onset (B = 0.06, 95%CI = 0.01; 0.10) were cross-sectionally associated with more grief symptoms. Over time, those with a short total sleep time (OR = 0.59, 95%CI = 0.39; 0.91), low sleep efficiency (OR = 0.95, 95%CI = 0.91; 0.99), long sleep onset latency (OR = 1.02, 95%CI = 1.00; 1.04), and long wake after sleep onset (OR = 1.02, 95%CI = 1.00; 1.03) at baseline more often experienced complicated grief than non-complicated grief at follow-up. This study suggests that objectively estimated poor sleep is associated with grief over time. Poor sleep might not only accompany grief, but also be a risk factor for developing complicated grief after a loss.

Factors contributing to men\u2019s grief following pregnancy loss and neonatal death: further development of an emerging model in an Australian sample

BackgroundHistorically, men’s experiences of grief following pregnancy loss and neonatal death have been under-explored in comparison to women. However, investigating men’s perspectives is important, given potential gendered differences concerning grief styles, help-seeking and service access. Few studies have comprehensively examined the various individual, interpersonal, community and system/policy-level factors which may contribute to the intensity of grief in bereaved parents, particularly for men.MethodsMen (N = 228) aged at least 18 years whose partner had experienced an ectopic pregnancy, miscarriage, stillbirth, termination of pregnancy for foetal anomaly, or neonatal death within the last 20 years responded to an online survey exploring their experiences of grief. Multiple linear regression analyses were used to examine the factors associated with men’s grief intensity and style.ResultsMen experienced significant grief across all loss types, with the average score sitting above the minimum cut-off considered to be a high degree of grief. Men’s total grief scores were associated with loss history, marital satisfaction, availability of social support, acknowledgement of their grief from family/friends, time spent bonding with the baby during pregnancy, and feeling as though their role of ‘supporter’ conflicted with their ability to process grief. Factors contributing to grief also differed depending on grief style. Intuitive (emotion-focused) grief was associated with support received from healthcare professionals. Instrumental (activity-focused) grief was associated with time and quality of attachment to the baby during pregnancy, availability of social support, acknowledgement of men’s grief from their female partner, supporter role interfering with their grief, and tendencies toward self-reliance.ConclusionsFollowing pregnancy loss and neonatal death, men can experience high levels of grief, requiring acknowledgement and validation from all healthcare professionals, family/friends, community networks and workplaces. Addressing male-specific needs, such as balancing a desire to both support and be supported, requires tailored information and support. Strategies to support men should consider grief styles and draw upon father-inclusive practice recommendations. Further research is required to explore the underlying causal mechanisms of associations found.