PTSD among bereaved parents following the violent deaths of their 12- to 28-year-old children: a longitudinal prospective analysis.

This study examined the prevalence of posttraumatic stress disorder (PTSD) among parents bereaved by the violent deaths of their 12- to 28-year-old children. A community-based sample of 171 bereaved mothers and 90 fathers was recruited by a review of Medical Examiner records and followed for 2 years. Four important findings emerged: Both parents' gender and children's causes of death significantly affected the prevalence of PTSD symptoms. Twice as many mothers and fathers whose children were murdered met PTSD caseness (full diagnostic) criteria compared with accident and suicide bereavement. Symptoms in the reexperiencing domain were the most commonly reported. PTSD symptoms persisted over time, with 21% of the mothers and 14% of the fathers who provided longitudinal data still meeting caseness criteria 2 years after the deaths. Parents who met caseness criteria for PTSD, compared with those who did not, were significantly different on multiple study variables. Both theoretical and clinical implications for the findings are discussed.

Parents' evaluation of a preventive intervention following the sudden, violent deaths of their children.

A preventive intervention for 156 bereaved parents whose 12- to 28-year-old children died by accident, homicide, or suicide was tested using a multisite longitudinal cohort pretest/posttest experimental design. Reported here are bereaved parents' evaluations of the two-dimensional support program. Problem-focused support was rated by parents' perceptions of readiness, relevance, timing, and understanding of the information and skills presented. Emotion-focused support was rated by the identification of I. Yalom's (1985) therapeutic group factors and group leader/clinician support. Over 70% of all the person/session responses showed that both support dimensions were rated at 6 or 7 on a 7-point scale (e.g., 0 = not at all relevant, 7 = very relevant.) Additional exploratory analyses examined the extent to which 5 participant and treatment characteristics influenced parents' evaluations. Clinical implications and future research directions are suggested.

Should psychiatrists administer anesthesia for ECT?

Whether psychiatrists are qualified to give anesthesia for ECT is controversial. At the authors' hospital, over a 9-year period ECT resulted in no mortality and minimal morbidity; in 98.8% of the treatments, anesthesia was given by psychiatrists. The average nursing time required for cases in which anesthesiologists administered anesthetic was longer than that for psychiatrists' cases. This difference may be related to succinylcholine dose and efficacy of ECT. The authors' surveys indicated that psychiatrists and anesthesiologists have differing opinions on whether psychiatrists should administer anesthesia for ECT and that few psychiatry residency programs which teach ECT provide training in anesthesia.