Interventions for adult survivors of intrafamilial homicide: A review of the literature.

Individuals bereaved by intrafamilial homicide, in which the perpetrator and decedent were both members of the same family, experience an elevated risk for risk for mental health complications. Given the contextual complexity of intrafamilial homicide (IFH) and the negative sequalae this form of loss can engender, psychological interventions may assist survivors with adjustment on a number of fronts. This scoping review therefore addresses an important knowledge gap by summarizing the limited information on interventions specific to intrafamilial homicide survivors. Results failed to identify interventions specific to IFH bereavement, though interventions that may be deemed appropriate are highlighted and described. As such, this scoping review provides a practical synthesis of evidence-based and evidence-informed psychological interventions for traumatic loss that are applicable to and may hold promise for this vulnerable population. Recommendations for future research and best practices with intrafamilial homicide survivors are also discussed.

Development and psychometric validation of the Dying Imagery Scale-Revised.

Survivors of sudden death losses frequently experience vivid imagery associated with the events surrounding their loved one's death. This paper describes the development and psychometric validation of the Dying Imagery Scale-Revised (DIS-R), a 15-item measure assessing three forms of death imagery, including Reenactment, Remorse, and Revenge imagery. The first study details the development of the DIS-R in a sample of suddenly bereaved college students. The second study examines the validity and reliability of the DIS-R among suddenly bereaved adults. Results suggest that the measure is psychometrically sound and may provide clinically useful information for bereavement counselors.

Interventions for child and adolescent survivors of intrafamilial homicide: A review of the literature.

The nature of intrafamilial homicide is complex and traumatic. Child survivors are at significant risk for maladjustment, including negative psychological sequela, grief complications, and contextual challenges associated with the homicide. Thus, children may benefit from services addressing specific psychosocial challenges following intrafamilial homicide. In this paper, we review the literature to identify trauma- and grief-informed interventions implemented for youth following violent bereavement. Given limited research on this vulnerable population, we discuss interventions that show promise for child survivors, exploring specific needs, challenges, and potential implications of these interventions for treating children and families experiencing intrafamilial homicide bereavement.

Social isolation and the mitigation of coronavirus anxiety: The mediating role of meaning.

This study examined core belief violation and meaning making as mechanisms mediating the relationship between adherence to social isolation policies for mitigating coronavirus transmission and reduced coronavirus anxiety (CA). Adherence to social isolation policies (social distancing, sheltering in place, and cessation of long-distance travel), use of nonsocial precautionary measures (handwashing, wearing a mask), core belief violation, meaning made of the COVID pandemic, and CA were assessed in a sample of 408 North Americans. Process analysis revealed that adhering to social isolation policies predicted lower levels of CA and that this effect was largely mediated by conservation of core beliefs (e.g., in predictability, control, and self-agency) and ability to make meaning of the pandemic. In contrast, exclusive reliance on nonsocial protections such as handwashing and mask wearing was associated with high levels of CA. These results suggest that social isolation policies support the integrity of adherents' meaning systems, thereby mitigating distress, which carries useful implications for both policy and psychological intervention.

Modeling pandemic depression and anxiety: The mediational role of core beliefs and meaning making.

Background: The aim of this research was to examine core belief violation and disrupted meaning making as primary cognitive processes regulating mental health during the pandemic. The study tested the hypothesis that both these cognitive processes function as mediating mechanisms, accounting for the adverse mental health effects of multiple pandemic stressors. Methods: A survey design (N = 2380) assessed demographic variables associated with poor pandemic mental health (gender, age, ethnicity, education), direct COVID stressors (diagnosis, death), indirect COVID stressors (unemployment, increased living costs, childcare loss), core belief violation, meaning made of the pandemic, coronavirus anxiety (CA), depression, and general anxiety. RESULTS: Core belief violation and disrupted meaning making explained the severity of depression, general anxiety, and CA to a significantly greater degree than did demographics, direct COVID stressors, and indirect COVID stressors combined. In addition, core belief violation and disrupted meaning making significantly mediated the impact of direct and indirect COVID stressors on all mental health outcomes. Specifically, each stressor was associated with increased core belief violation and decreased meaning making of the pandemic, in turn, those whose core beliefs were violated and those who made less meaning of the pandemic experienced greater depression, general anxiety, and CA. Limitations: The use of a cross-sectional design prohibited assessment of alternative causal orders. Conclusions: This study describes the first unifying model of pandemic mental health, establishing violation of core beliefs and the inability to make meaning of the pandemic as targets for clinical intervention in the context diverse pandemic stressors.

Prolonged grief and the disruption of meaning: Establishing a mediation model.

This study aimed to test the hypothesis that meaning making is a mediating process in the relationship between risk factors for prolonged grief disorder (PGD) and subsequent emergence of PGD symptomatology. A survey design was employed with prospective measurement of PGD. The following variables were assessed 2-12 months postloss among adults across North America and Europe (N = 357): (a) risk factors for PGD (insecure attachment, social support, neuroticism, violent loss, and spousal loss) and (b) meaning made. Meaning made was measured using the Grief and Meaning Reconstruction Inventory (GMRI) as well as using the Integration of Stressful Life Experiences-Short Form (ISLES-SF). At a 7-10-months follow-up (n = 171) symptoms of PGD were assessed. The mean age at the second assessment point was 44.3 years (SD = 16.1) and the majority of the sample identified as female (71.9%). Process analysis was employed to test a series of simple mediation models. When the GMRI was used as a measure of meaning, the indirect effect of each risk factor on PGD symptoms, as mediated by meaning made, was significant (95% CI). When the ISLES-SF was used to measure meaning, the indirect effect of each risk factor with the exception of violent loss was significant (95% CI). The study demonstrates that meaning making serves to mediate the adverse impact of multiple PGD risk factors on the development of PGD symptomatology. Specifically, the study suggests that PGD risk factors exacerbate symptoms of PGD by impeding the meaning-making process. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Rumination moderates the role of meaning in the development of prolonged grief symptomatology.

OBJECTIVE: To address the etiology of prolonged grief disorder (PGD) by examining whether rumination moderates the role of meaning-making in mediating the impact of PGD risk factors. METHOD: A survey assessing PGD risk factors (low social support, insecure attachment, violent loss, neuroticism, and loss of a spouse), meaning, and rumination was administered 2-12 months postloss among adults across North America and Europe (mean age = 44.3, 71.9% female). At a 7-10 months follow-up, symptoms of PGD were assessed (n = 171). RESULTS: When measuring meaning with the Grief and Meaning Reconstruction Inventory, the moderated mediation pathway was significant for each PGD-risk factor. However, when measuring meaning with the Integration of Stressful Life Experiences-Short Form, the pathway was significant for every risk factors except violent loss. CONCLUSIONS: Rumination appears to moderate meaning-making in the development of PGD symptomatology. These findings highlight rumination as a target for intervention with at-risk grievers.

The Relationship Between Experiences With the Criminal Justice System and Mental Health Outcomes Among Survivors of Homicide.

Homicide survivors are at increased risk for mental health disorders, including depression, posttraumatic stress disorder (PTSD), and complicated grief (CG). Accordingly, this survey study examined how satisfaction with the criminal justice system (CJS) was associated with depression, PTSD, and CG among 47 homicide survivors. It also examined how satisfaction with specific aspects of the CJS related to satisfaction with the overall CJS. Satisfaction with the overall CJS was uniquely associated with depression (odds ratio [OR] = 2.32; 95% confidence interval [CI] [1.16, 4.66]) while satisfaction with the police department was uniquely associated with CG (OR = 2.14; 95% CI [1.02, 4.47]). Satisfaction with having input into the CJS process and satisfaction with efforts devoted by the CJS to apprehend the perpetrator were uniquely related to satisfaction with the overall CJS (ß = .49, p = .003 and ß = .40, p = .007, respectively).

Prolonged grief symptomatology following violent loss: the mediating role of meaning.

Background: Prolonged Grief Disorder (PGD) is over-represented among those who have lost loved ones to violent causes. To tailor PGD interventions for this vulnerable population it is critical to examine the aetiology of PGD specifically in the context of violent death bereavement. Previous studies have suggested that violent loss increases symptoms of PGD by hindering the mourner's ability to make meaning of the death or its aftermath. However, these studies have relied on cross sectional data that preclude genuine prediction and have not differentiated among specific themes of meaning. Objective: This study aimed to identify specific themes of meaning that mediate the detrimental impact of violent loss on subsequent emergence of PGD symptomatology among the violently bereft. Method: A longitudinal, prospective design (N = 171) was used to assess violent loss and themes of meaning an average of six months post-loss allowing for prediction of PGD symptoms an average of eight months later. Results: Violent loss had a significant indirect effect on PGD symptomatology when meaning themes focusing on sense of peace and continuing bonds served as mediators. Conclusions: This study demonstrates the mediating role that specific meaning themes play in the development of PGD symptomatology following violent loss. These findings highlight the potential benefits of applying a meaning-based intervention approach with the violently bereft.

Antecedentes: El Trastorno de Duelo Prolongado (PGD en su sigla en inglés) está sobrerrepresentado entre aquellos que han perdido a sus seres queridos por causas violentas. Para adaptar las intervenciones de PGD para esta población vulnerable, es fundamental examinar la etiología del PGD, específicamente en el contexto de la experiencia de pérdida (bereavement) violenta. Estudios previos han sugerido que la pérdida violenta aumenta los síntomas del PGD al obstaculizar la capacidad del doliente (mourner) de dar sentido a la muerte o sus consecuencias. Sin embargo, estos estudios se han basado en datos transversales que impiden una predicción genuina y no han diferenciado entre temas específicos de significado. Objetivo: Este estudio tuvo como objetivo identificar los temas específicos de significado que median el impacto perjudicial de la pérdida violenta en la aparición posterior de la sintomatología PGD entre los dolientes. Método: Se utilizó un diseño prospectivo longitudinal (N = 171) para evaluar la pérdida violenta y los temas de significado, aproximadamente 6 meses después de la pérdida, lo que permitió la predicción de los síntomas de PGD en un promedio de 8 meses después. Resultados: La pérdida violenta tuvo un efecto indirecto significativo en la sintomatología del PGD cuando los temas de significado que se centran en la sensación de paz y continuidad de los vínculos/lazos sirvieron como mediadores. Conclusiones: El estudio demuestra el rol mediador que desempeñan los temas de específicos de significado en el desarrollo de la sintomatología del PGD después de la pérdida violenta. Estos hallazgos resaltan los beneficios potenciales de aplicar un enfoque de intervención basado en el significado con los dolientes.

Reconstructing Meaning with Others in Loss: A Feasibility Pilot Randomized Controlled Trial of a Bereavement Group.

More effective psychosocial interventions that target uncomplicated bereavement are needed for those actively seeking support. The objective of this study was to assess the feasibility of evaluating a unique meaning-based group counseling (MBGC) intervention with a randomized controlled trial (RCT) design. Twenty-six bereft individuals were randomly assigned to either MBGC or a control bereavement support group. Twenty participants (11 experimental, nine control) completed all aspects of the study including self-report measures at baseline, postintervention, and 3-month follow-up of meaning in life, anxiety, depression, and grief. Results support the feasibility of an RCT with MBGC.

The Grief and Meaning Reconstruction Inventory (GMRI): Initial Validation of a New Measure.

Although increasing numbers of grief theorists, researchers, and therapists have begun to focus on the quest for meaning in lives disrupted by loss, no convenient and psychometrically validated measure of meanings made specifically in bereavement has been available to guide their efforts. To construct such a measure, the authors began with a systematic content analysis of sense-making, benefit finding, and identity reconstruction themes gleaned from the narrative responses of a sample of 162 adults who were diverse in their age, ethnicity, relationship to the decedent, cause of death, and severity of their grief response. These were then formulated into a set of 65 candidate items in a Likert scale format representing the level of the respondent's endorsement of the item in the past week. Subsequent administration to a second sample of 300 bereaved respondents permitted factor analysis of this pilot version of the Grief and Meaning Reconstruction Inventory (GMRI), and reduced the items to 29, which loaded on 5 distinct factors, labeled Continuing Bonds, Personal Growth, Sense of Peace, Emptiness and Meaninglessness, and Valuing Life. Both the overall GMRI and its constituent factors showed good internal consistency and strong convergent validity in the form of negative correlations with established measures of bereavement-related negative emotions, symptoms of complicated grief, and more general psychological distress and mental health symptomatology, and positive correlations with grief related personal growth. The authors close by noting several specific research and clinical applications of the measure, which could play a useful role in testing and refining contemporary models of meaning made in the wake of loss.

Meaning-based group counseling for bereavement: bridging theory with emerging trends in intervention research.

A growing body of scholarship has evaluated the usefulness of meaning-based theories in the context of bereavement counseling. Although scholars have discussed the application of meaning-based theories for individual practice, there is a lack of inquiry regarding its implications when conducting bereavement support groups. The objective of this article is to bridge meaning-based theories with bereavement group practice, leading to a novel intervention and laying the foundation for future efficacy studies. Building on recommendations specified in the literature, this article outlines the theoretical paradigms and structure of a short-term meaning-based group counseling intervention for uncomplicated bereavement.

The meaning of loss codebook: construction of a system for analyzing meanings made in bereavement.

Recent research on grieving populations has emphasized the role of meaning making in adaptation to bereavement, typically relying on simple self-reports of the extent to which respondents have been able to find sense or benefit in their loss. The present article reports the development of a reliable and comprehensive coding system for analyzing meanings made in the wake of the death of a loved one, yielding a 30-category codebook demonstrating excellent reliability, and comprising both negative and positive themes that arise as grievers attempt to make sense of loss. Based on an intensive qualitative analysis of a diverse sample of 162 adults mourning the natural or violent death of a variety of loved ones, the Meaning of Loss Codebook could prove useful in process-outcome studies of grief therapy, analysis of naturalistic first-person writing about bereavement experiences in grief diaries and blogs, and clinical assessment of meanings made in the course of bereavement support or professional intervention.