Traumatic Bereavement Research Articles

Social support and complicated grief: A longitudinal study on bereaved parents after the Utøya terror attack in Norway

On the 22nd of July 2011, Norway experienced its most extreme act of terror in recent times. The terror attacks at the Government Quarters and Utoya, claiming the lives of 77 people, left a nation in shock and numerous people grieving. Such traumatic bereavement is associated with an increased risk of chronically elevated grief symptoms, and identifying protective factors is important. The purpose of this study was to investigate the effect of social support on complicated grief over time among bereaved parents after the terror attack on Utoya. Our sample consisted of 86 bereaved parents ( M age = 51.6 years, 52.3% women), who completed the Crisis Support Scale (CSS) and the Inventory of Complicated Grief (ICG) 18, 28, and 40 months after the loss of their child. The results showed a decrease in levels of complicated grief with time. Men had lower levels of complicated grief than women. Findings did not, however, show that parents with higher levels of social support had significantly lower levels of complicated grief compared to parents with less social support. Furthermore, our results did not suggest an accelerated recovery directly due to these factors of social support and gender. Implications and suggestions for further research are discussed. «/><meta name=

Meaning and Mourning: The Search for Significance in Tragic Loss

The death of a significant person, especially when it comes tragically or prematurely, can shake the foundations of our assumptive and relational world and lead to anguished attempts to find meaning in the loss and in our lives in its aftermath. In this chapter I summarize what is known about complicated grief following difficult losses, review one program of research focused on this attempt at meaning reconstruction, describe recently developed measures of meaning in mourning, and discuss several therapeutic techniques for helping clients make sense of the death and rework their attachment relationship to the deceased. I conclude by illustrating some of this work in my therapy with a couple who had lost not one but two children to tragic accidents, as they tried to adapt to a compound traumatic bereavement.

Traumatic bereavement: Basic research and clinical implications.

Traumatic bereavement: Basic research and clinical implications.

Support for Relatives Bereaved by Psychiatric Patient Suicide: National Confidential Inquiry Into Suicide and Homicide Findings.

International suicide prevention strategies recommend providing support to families bereaved by suicide. The study objectives were to measure the proportion of cases in which psychiatric professionals contact next of kin after a patient's suicide and to investigate whether specific, potentially stigmatizing patient characteristics influence whether the family is contacted. Annual survey data from England and Wales (2003-2012) were used to identify 11,572 suicide cases among psychiatric patients. Multivariate regression analysis was used to describe the association between specific covariates (chosen on the basis of clinical judgment and the published literature) and the probability that psychiatric staff would contact bereaved relatives of the deceased. Relatives were not contacted after the death in 33% of cases. Contrary to the hypothesis, a violent method of suicide was independently associated with greater likelihood of contact with relatives (adjusted odds ratio=1.67). Four patient factors (forensic history, unemployment, and primary diagnosis of alcohol or drug dependence or misuse) were independently associated with less likelihood of contact with relatives. Patients' race-ethnicity and recent alcohol or drug misuse were not associated with contact with relatives. Four stigmatizing patient-related factors reduced the likelihood of contacting next of kin after patient suicide, suggesting inequitable access to support after a potentially traumatic bereavement. Given the association of suicide bereavement with suicide attempt, and the possibility of relatives' shared risk factors for suicide, British psychiatric services should provide more support to relatives after patient suicide.

Bereavement and Traumatic Bereavement: Working with the Two-Track Model of Bereavement

Bereavement following loss through death is a universal human experience, but how it is experienced and understood is mediated by many variables. In this article, we stress the importance of a bifocal approach to understanding, assessing and intervening following the loss of significant persons using the framework of the Two-Track Model of Bereavement. This model examines both biopsychosocial functioning as well as the nature of the ongoing relationship with the deceased and the death story in working with the bereaved. It is particularly suited to identify adaptive and maladaptive responses to loss and to optimally focus interventions where needed. Two case vignettes are presented to orient the discussion. Traumatic bereavements, a term indicating the interface between trauma and loss, increase the likelihood of complications following loss and these are considered. Bereavements that occur under external traumatic circumstances increase the risk for dysfunction, symptomatic difficulties and complicated grief. In addition, there are forms of traumatic bereavement that arise due to subjective elements related to aspects of the psychological relationship to the deceased and the relational bond with him or her. Clinically, there is a need to identify and understand the various aspects of the traumas of bereavement and to intervene appropriately. Interventions based on the Two-Track Model of Bereavement will be described.

The role of personality traits in trajectories of long-term posttraumatic stress and general distress six years after the tsunami in Southeast Asia

The aims were to examine whether trajectories of posttraumatic stress (PTS) and general distress are related to personality traits and to investigate personality's contributing factor to PTS and general distress. The sample was 2549 Swedish tourists who survived the 2004 Indian Ocean tsunami and responded to postal surveys at 1, 3 and 6years after the tsunami, including assessment of personality traits, PTS and general distress. The sample was categorized into a direct exposure group and an indirect exposure comparison group.For both PTS and general distress, individuals with a resilient trajectory were lower in the trait neuroticism than those in the symptomatic trajectories whereas there were no differences in personality traits between the resilient trajectory and the low exposure comparison group. Neuroticism was strongly related to trajectories of both PTS and general distress even when adjusting for important risk factors such as traumatic bereavement and exposure severity. Other personality traits demonstrated weak associations with the trajectories. The present findings correspond with the notion of neuroticism as a vulnerability factor for symptomatic long-term trajectories of posttraumatic and general distress whereas resiliency was not predicated by particularly low levels of neuroticism.

Violent Deaths and Traumatic Bereavement: The Importance of Appropriate Death Notification

The communication of a death due to unexpected and traumatic causes is considered a very sensitive issue that can deeply affect both operators responsible for reporting the incident and the mourning process of family members, relatives, and other survivors. By focusing particularly on cases of traumatic death, this article tries to explain how inadequate communication of death may adversely affect the course of mourning. The article also illustrates the basic principles of correct notification of death. In this way, we hope to contribute to the ongoing dialogue on this topic and the promotion of new studies aimed at setting best practices for those professionally involved in the challenging task of communicating that a life has ended. This would be important in order to safeguard the emotional integrity of notifiers whilst effectively helping the survivors to cope with the early stages of their difficult mourning process.

Trauma in the childhood stories of people who have injected drugs

Aim: To document childhood trauma in the life stories of people who have injected drugs. Method: Fifty-five participants (38 m, 17 f) recruited via Scottish recovery networks, who had injected drugs in the previous five years, were interviewed by peer researchers using the Life Story method. Results: Remembered childhood trauma included persistent violence, repeated sexual abuse, neglect and traumatic bereavements. Many traumas were related to adult alcohol use. Few participants told of no trauma, some of severe trauma contributing to subsequent drug problems, some recounted stories including traumatic events, but not linked to later drug problems. A few told of initial severe behavioural problems leading to trauma for the child and to drug problems. Drug problems followed trauma by various routes, without straightforward cause and effect: direct use of drugs as avoidant coping; juvenile heavy recreational use that escalated; forming relationships in mid to late teens with criminals. For men, this involved enmeshment in drug dealing, crime and prison. Some women formed relationships with men who injected drugs, who often introduced them to drugs, and some of whom were violently abusive. Heroin injecting was an effective means of blotting out distressing thoughts and feelings. Although, childhood stories also contained positive memories, factors that might have promoted resilience were rarely mentioned. Conclusions: Severe childhood trauma was common and gravitated people towards problem drug use via various pathways. Participants had often normalised the problems and did not remember adult help. Parental alcohol use contributed to trauma. Addiction services need to be more trauma minded.

Treating Traumatic Bereavement: A Practitioner’s Guide Pearlman Laurie Anne , Wortman Camille , Feuer Catherine et al Treating Traumatic Bereavement: A Practitioner’s Guide 358pp £24.45 Guilford Press 9781462513178 1462513174

TRAUMATIC BEREAVEMENT differs from other experience of grief and loss, and counsellors can find interactions with bereaved people highly challenging.

Traumatic Bereavement and Terror: The Psychosocial Impact on Parents and Siblings 1.5 Years After the July 2011 Terror Killings in Norway

On July 22, 2011, 69 people attending a political youth camp in Norway were killed in a terror attack. Findings concerning the psychosocial impact on bereaved parents (n = 67) and siblings (n = 36) showed a high prevalence of complicated grief (82% vs. 75%), posttraumatic stress reactions (63% vs. 72%), and general psychological distress (88% vs. 75%) 1.5 years after the killings. There were significant gender differences, and the loss had a substantial negative impact on parents’ and siblings’ work and school situations. Potential contributing factors are discussed in light of the magnitude of the event and the chronic stress following the terror attack.

In the Shadow of Tragic Loss: The Psychology of Traumatic Bereavement

In the Shadow of Tragic Loss: The Psychology of Traumatic Bereavement

Traumatic Bereavement and Mindfulness: A Preliminary Study of Mental Health Outcomes Using the ATTEND Model

This article presents a quasi-experimental study of a mindfulness-based intervention for traumatically bereaved individuals using a single group with pre-test and post-test design. The intervention consists of the ATTEND model, which is comprised of the following elements practiced by the clinician: attunement, trust, therapeutic touch, egalitarianism, nuance, and death education. The study is based on the charts of 42 clients seeking grief counseling at a mental health agency viewed retrospectively. Participants’ intake scores on the Impact of Event Scale-Revised (IES-R), which measures trauma symptoms, and 25-item Hopkins Symptom Checklist (HSCL-25), which measures depressive and anxious symptoms, were compared to their scores after an average of 14.64 hours of counseling. Paired samples t tests showed a statistically significant decline in trauma symptoms on the IES-R, and in anxious and depressive symptoms on the HSCL-25. These results provide preliminary support for the use of this mindfulness-based approach for difficulties associated with traumatic bereavement, though more extensive research is needed to determine the effectiveness of this approach.

Psychopathologies des demandeurs d’asile en Europe, traumatisme et fonctionnement défensif

Refugees seeking asylum are a particularly vulnerable population. It has been observed that among the most commonly-occurring disorders exhibited in this population, there is a high incidence of post-traumatic stress disorder, generalized anxiety disorder, and depression. These disorders may be linked to the difficult paths that refugees are forced to undertake, as well as to different traumatic events which are particularly destructive psychologically (deliberate physical, sexual and/or psychological violence, traumatic bereavements in the context of war, or social and political instability, socio-economic, familial or administrative difficulties), which compromise their view of their short-term futures. In the face of the weight of these life events, the question of the psychological resources of the individual is at the forefront of our understanding of mental health and the capacity to adjust to trauma. Our study aims to apprehend in a dynamic way, the different strategies used by asylum seekers in our western countries to adjust psychologically to traumatic and stressful events. The aim of this research is to study the links between mental health and anxious and depressive psychopathologies as well as the defensive modalities of these subjects. One hundred and twenty adult asylum seekers, living in refugee centres in Slovakia, France and Norway have agreed to participate in this study. We tried to assess the psychopathological disorders manifesting in these populations, notably PTSD, major depression and generalized anxiety disorder. Using the DSQ-60 we also tried to establish the links between the psychopathologies observed in this population and the defence mechanisms employed. Our results reveal that 60% of subjects do indeed suffer from psychopathological disorders with an important comorbidity of PTSB and depression (64.2%). Furthermore, the seriousness of the symptoms is correlated with less adaptive defence mechanisms (a higher incidence of defence mechanisms such as acting-out and distorted self-image). The recourse to mechanisms such as affiliation, repression and idealization is found to be used less by the study's target group. Rather, they tend to resort to defence mechanisms such as projection, low self-esteem, withdrawal, acting-out and hypochondria. Our results highlight the importance of the affiliation mechanism, which holds the potential to facilitate adaptation and resilience in these vulnerable subjects. It could also be offered as part of a therapeutic care proposal.

Witness to Suffering: Mindfulness and Compassion Fatigue among Traumatic Bereavement Volunteers and Professionals

This study used a survey to investigate the relationship between mindfulness and compassion fatigue and compassion satisfaction among 41 volunteers and professionals at an agency serving the traumatically bereaved. Compassion fatigue comprises two aspects: secondary traumatic stress and burnout. Because prior research suggests that compassion satisfaction may protect against compassion fatigue, the authors hypothesized that (a) mindfulness would be positively correlated with compassion satisfaction, (b) mindfulness would be inversely correlated with compassion fatigue, and (c) there would be differences between respondents with a personal history of traumatic bereavement and those with no such history. Correlation analyses supported the first two hypotheses; an independent means t test did not provide evidence for the latter hypothesis, although the number ofnontraumatically bereaved respondents was small. Overall, this sample showed surprisingly high levels of compassion satisfaction and low levels of compassion fatigue, even among respondents thought to be at higher risk of problems due to personal trauma. Implications of these findings are particularly relevant for social workers and other professionals employed in positions in which they encounter trauma and high emotional stress.

Cognitive Behavior Couple Therapy-REBT Model for Traumatic Bereavement

Following the loss of a child, couple counseling focuses on their grief process as well as the impact of the loss on the marital relationship. Individual differences in reacting to and coping with the loss, different patterns of grieving, and differences in attitudes about relationship issues may cause further distress and increase marital conflicts and adaptation to the loss. When bereavement occurs under traumatic circumstances, the conflicts may be further complicated and involve problems in daily functioning related to distorted cognitions and attributions connected with traumatic bereavement. In this paper, cognitive grief therapy using the ABC model of REBT with a couple who lost a child under traumatic circumstances will be described.

Mental Health Risks in the Local Workforce Engaged in Disaster Relief and Reconstruction

To build a sustainable workforce for long-term disaster relief and reconstruction, more effort must be made to promote local relief workers' mental health. We conducted 25 semistructured interviews with local relief officials 10 months after the 2008 earthquake in China to investigate the stress and coping experiences in their personal lives as survivors. We conducted thematic analysis of interview transcripts. Traumatic bereavement and grief, housing and financial difficulties, and work-family conflict were the three main sources of stress in the respondents' personal lives. The coping themes were finding meaning and purpose in life through relief work, colleagues' support and understanding, suppression or avoidance of grief, appreciation for life, hardiness, optimism, letting nature take its course, and making up for loss. We suggest that relief work has a double-edged-sword effect on workers' coping abilities. We discuss the implications of this effect for work-life balance measures and trauma and grief counseling services.

Pharmacological Treatment Following Traumatic Bereavement: A Case Series

There is little evidence to guide the use of psychotropic medications immediately following bereavement. This article presents a review of the relevant literature, followed by a case series on the use of psychotropic medication in traumatically bereaved individuals. Of 20 active subjects, nine had been prescribed psychotropic medication in the days and weeks following a traumatic loss. The amount, type, and timing of medication in this sample is explored and compared to the extant literature. Results suggest that clinical practice may not be guided by empirical research in this area.

Efficacy of Writing for Recovery on Traumatic Grief Symptoms of Afghani Refugee Bereaved Adolescents: A Randomized Control Trial

Effective evidence-based intervention for traumatic bereavement is one of the current major research issues in the field of Post Traumatic Stress Disorder (PTSD) in children and adolescents. The "Writing for Recovery" group intervention is a new treatment approach developed by the Children and War Foundation for traumatized and bereaved children and adolescents after disasters. The purpose of this project was an empirical examination of this intervention with 12- to 18-year-old war bereaved Afghani refugees. Eighty-eight war bereaved Afghani refugees were screened using the Traumatic Grief Inventory for Children (TGIC). From those with the highest total score, 61 were randomly assigned to either an experimental (n = 29) or control group (n = 32). The experimental group received six sessions of group training on 3 consecutive days in their school. The difference of TGIC scores between the experimental group in pretest and posttest was significant (p = 0.001). Results of analysis of covariance also showed a significant effect of Writing for Recovery on the experimental group (p < 0.001). It is concluded that "Writing for Recovery" is an effective group intervention for bereaved children and adolescents after disasters.

Intrusive memories of trauma in PTSD and addiction

Aims and methodTo study intrusive phenomena relating to traumatic experiences in a community sample seeking treatment for substance use disorder and an in-patient sample from an addiction in-patient detoxification service in London. Perceived effect of drugs and drug use on traumatic intrusion and memory experiences was also analysed. The study was conducted using a semi-structured patient interview comprising a series of questionnaires.ResultsThe most frequently identified traumatic memories were those of traumatic bereavements. Substance use appears to have had the effect of dampening the memories for those with post-traumatic stress disorder (PTSD), and significantly more individuals reported that their memories were less vivid and less distressing before they ceased substance use.Clinical implicationsThe findings suggest that continued substance use could in part be motivated by its capacity to dampen distressing memories within the PTSD group. This should be addressed within a treatment plan of comorbid PTSD.

ATTEND: Toward a Mindfulness-Based Bereavement Care Model

Few, if any, mindfulness-based bereavement care models exist. The ATTEND (attunement, trust, touch, egalitarianism, nuance, and death education) model is an interdisciplinary paradigm for providers, including physicians, social workers, therapists, nursing staff, and others. Using a case example to enhance the breadth and depth of understanding, this article focuses on attunement as a means to moderate the negative effects of traumatic bereavement, support the framework for posttraumatic growth in the bereaved, improve psychological outcomes for providers, and set the stage for the other aspects of the ATTEND model.