Supportive and non-supportive social experiences following suicide loss: a qualitative study.

BACKGROUND: Suicide bereavement entails profound social stressors, including stigma and communication barriers, which can impair social support for suicide loss survivors (SLS). Despite recognized benefits of empathetic interactions, social support, and self-disclosure in mitigating adverse mental health outcomes after suicide loss, we lack a comprehensive understanding of the factors influencing perceived social support among SLS within their broader social environments. To address this gap, our study explores the diverse social experiences of SLS beyond their immediate circles. Specifically, we identify characteristics that define both supportive and non-supportive social experiences of SLS, as well as the facilitators and barriers to social support in the context of suicide bereavement. METHODS: In 2022, we conducted structured online individual interviews with a diverse sample of 18 SLS in Germany. We analyzed these interviews using qualitative content analysis. RESULTS: We examined the social experiences of SLS across three phases and social contexts: (1) the immediate aftermath of the loss; (2) during bereavement practices; and (3) over time. Our findings show that proactive responses and personalized mourning rituals significantly enhance SLS' sense of community support, while encounters characterized by avoidance or intrusive curiosity lead to feelings of isolation. Over time, supportive interactions often emerge from peers with similar experiences, promoting openness and shared vulnerability. Conversely, superficial engagement, along with experiences of others depersonalizing and avoiding conversations about the loss, contribute to a sense of marginalization. CONCLUSIONS: Our findings highlight the importance of proactive engagement and open dialogue, calling for societal and communicative shifts toward inclusive and compassionate approaches in addressing suicide loss. This study underscores the need for comprehensive strategies that enhance both suicide and grief literacy and address the taboo and stigma surrounding suicide, ultimately fostering supportive social environments for SLS.

Moving Forward: A Close Look at Healing Process After Traumatic Parental Death.

Recovery from traumatic grief after parental loss is a challenging and gradual process. The current study aimed to capture the rich and nuanced experiences of adolescents' healing process after traumatically losing their parent(s). A phenomenological approach was utilized for data collection and analysis. To reach the research aim, interviews with 15 Iranian adolescents who had lost their parent(s) at least three-year ago were conducted. Two main themes from Colaizzi's analysis including Grief work and Rebuilding new life were extracted from data. Findings highlight an understanding of how adolescents with an experience of traumatic parental death would heal and could provide valuable insights into creating successful interventions and support systems tailored to help them cope with the devastating effects of traumatic loss and grief.

Somatic symptoms and insomnia among bereaved parents and siblings eight years after the Utøya terror attack.

Background: Levels of prolonged grief symptoms (PGS) and post-traumatic stress symptoms (PTSS) can be high, many years following bereavement after terror, but knowledge concerning somatic health is scarce. Terrorism is a serious public health challenge, and increased knowledge about long-term somatic symptoms and insomnia is essential for establishing follow-up interventions after terrorism bereavement.Objective: To study the prevalence of somatic symptoms and insomnia and their association with PGS, PTSS, and functional impairment among terrorism-bereaved parents and siblings.Methods: A cross-sectional quantitative study included 122 bereaved individuals from the Utøya terror attack in Norway in 2011. The sample comprised 88 parents and 34 siblings aged 19 years and above (Mage = 49.7 years, SDage = 13.8 years, 59.8% females). The participants completed questionnaires 8 years after the attack assessing somatic symptoms (Children's Somatic Symptoms Inventory) and insomnia (Bergen Insomnia Scale) along with measures of PGS (Inventory of Complicated Grief), PTSS (Impact of Event Scale-Revised), and functional impairment (Work and Social Adjustment Scale).Results: Fatigue was the most frequently reported somatic symptom (88% of females and 65% of males). Females reported statistically significantly more somatic symptoms than males. In total, 68% of the bereaved individuals scored above the cut-off for insomnia. There were no statistically significant gender differences for insomnia. Female gender, intrusion, and arousal were associated with somatic symptoms. Intrusion and somatic symptoms were associated with insomnia. Somatic symptoms, avoidance, and hyperarousal were associated with functional impairment.Conclusion: Many bereaved parents and siblings report somatic symptoms and insomnia eight years after the terror attack. Somatic symptoms are associated with functional impairment. Long-term follow-up and support after traumatic bereavement should focus on somatic symptoms and insomnia.

Many bereaved individuals, especially females, reported insomnia and somatic symptoms, including fatigue, pain, and other related symptoms.Somatic symptoms, avoidance, and hyperarousal were identified as being associated with functional impairment among the bereaved.Post-traumatic stress symptoms played a more significant role than prolonged grief symptoms in explaining the reduced physical health experienced by the bereaved.

The Impact of Patient Suicide on Clinicians.

The experience of patient suicide on clinicians is associated with complex affective states that include grief, guilt, shame, and fear and distressing subjective experiences of incompetence and helplessness. The authors review the literature of the subject and highlight the work of Rajagopalan and colleagues in Singapore, who implemented a one-time reflective group session to help clinicians process the experience of patient suicide to reduce psychological distress and prevent burnout and moral injury.

Interpersonal psychotherapy for traumatic grief following a loss due to COVID-19: a case report.

Interpersonal psychotherapy (IPT) is a highly regarded evidence-based psychotherapy that aims to alleviate the suffering of clients and improve their interpersonal functioning. Research has demonstrated the effectiveness of IPT in depressive, bipolar and eating disorders. IPT also focuses on grief and loss as a problem area to help clients address and process their grief symptoms, leading them to reach a phase of finding meaning. However, traumatic grief which is characterized by someone who has both symptoms of trauma and grief can further complicate treatment. As for Posttraumatic Stress Disorder (PTSD), IPT can be a choice of treatment by addressing perceived isolation and emotional dysregulation through mobilizing adequate social support. This case study highlights the efficacy of IPT in treating complicated grief with traumatic experiences caused by the loss of a loved one during the COVID-19 pandemic, without undergoing exposure-based therapy. The treatment course consisted of 12 sessions scheduled twice weekly, and the client received antidepressant medication augmented with antipsychotic medication. After undergoing IPT, the client experienced an improvement in symptoms, gradual recovery of functional disability, and more meaningful interpersonal relationships. The case study presented provides evidence to suggest that IPT is a promising treatment approach for individuals struggling with trauma related to grief.

¿Existe el duelo complicado traumático? Diferencias sintomatológicas entre el duelo complicado tras una muerte traumática y una no traumática / Is there a traumatic complicated grief? Symptomatological differences between complicated grief after a traumatic and a non-traumatic death

Objetivo: Examinar la existencia del duelo complicado traumático como un constructo diferente al de duelo complicado analizando si la sintomatología de duelo complicado y de estrés postraumático es diferente en las personas que sufren duelo complicado tras una muerte traumática y no traumática. Método: Un grupo de 89 dolientes con duelo complicado tras una muerte por atentado terrorista y un grupo de 54 dolientes con duelo complicado tras una muerte por edad o enfermedad completaron el Inventario de Duelo Complicado (IDC) y versiones de la Escala de Verificación del Trastorno de Estrés Postraumático (PCL-S o PCL-5). Resultados: ANCOVA realizados sobre las puntuaciones en los ítems del IDC y en los 16 ítems comunes a las dos versiones de la PCL revelaron que los dos grupos de dolientes no diferían en ninguno de los síntomas de duelo complicado ni de estrés postraumático, salvo en dos síntomas de duelo complicado en los cuales las diferencias iban en direcciones opuestas. Conclusiones: Aunque una muerte traumática como, por ejemplo, por atentado terrorista, incrementa la gravedad de las reacciones de duelo y la probabilidad de sufrir duelo complicado, este duelo complicado es similar al que pueden sufrir las personas tras una muerte no traumática, al menos respecto a sus síntomas y a los síntomas simultáneos de estrés postraumático. Por tanto, no se puede hablar de un duelo complicado traumático como diferente al duelo complicado (AU)

Objective: To examine the existence of complicated traumatic grief as a different construct from complicated grief, analyzing whether the symptoms of complicated grief and post-traumatic stress are different in people who suffer complicated grief after a traumatic and non-traumatic death. Method: A group of 89 mourners with complicated grief after a death from a terrorist attack and a group of 54 mourners with complicated grief after a death due to age or illness completed the Inventory of Complicated Grief (ICG) and versions of the PTSD Checklist Scale (PCL-S or PCL-5). Results: ANCOVA performed on the scores on the IDC items and on the 16 items common to the two versions of the PCL revealed that the two groups of mourners did not differ in any of the symptoms of complicated grief or post-traumatic stress, except in two complicated grief symptoms in which the differences went in opposite directions. Conclusions: Although a traumatic death, such as a terrorist attack, increases the severity of grief reactions and the probability of suffering complicated grief, this complicated grief is similar to what people can suffer after a non-traumatic death, at least concerning its symptoms and the simultaneous symptoms of post-traumatic stress. Therefore, one cannot speak of complicated traumatic grief as different from complicated grief (AU)

Rates of Prolonged Grief Disorder: Considering relationship to the person who died and cause of death.

BACKGROUND: Prolonged Grief Disorder (PGD) was recently included in DSM-5-TR. The rate of PGD is known to vary according to a number of factors and little is known about how bereaved individuals view the diagnosis. METHODS: This cross-sectional study assessed PGD rates using the Prolonged Grief-13-Revised (PG-13-R) among a large sample (n = 1137) of bereaved individuals, considering the relationship to the deceased and cause of death. It also investigated bereaved individuals' attitudes toward the diagnosis. RESULTS: Overall, 34.3 % of the sample met PGD criteria. Bereaved parents had the highest rate (41.6 %), followed by bereaved spouses/partners (33.7 %) and siblings (29.4 %). According to cause of death, those bereaved by substance overdose had the highest rate (59.1 %), followed by homicide/suicide (46 %) and accidental (36 %). The majority of respondents (65-95.6 %) viewed their responses, as measured by the PG-13-R items, as normal, and 98.1 % agreed that their responses in general were normal. Fewer than 12 % reported that a PGD diagnosis would be helpful to them. LIMITATIONS: This study used a self-selecting, non-representative sample that was predominantly female and white. Findings may or may not apply to more diverse groups and cannot be generalized. This study also used a self-report measure rather than a clinical interview. CONCLUSIONS: In line with prior research, this study found higher rates of PGD in specific subgroups, including bereaved parents, spouses, and those who lost loved ones to substance overdose, homicide/suicide, or accidents. Bereaved individuals in this sample generally did not view receiving a diagnosis of PGD as helpful.

Bereavement Needs Assessment in Nurses: Elaboration and Content Validation of a Professional Traumatic Grief Scale.

The COVID-19 pandemic has caused a series of biopsychosocial repercussions among nursing professionals. The impossibility of anticipating the events, the numerous deaths, the excessive workload, the lack of personal health and the necessary means of protection made it difficult to regulate the impact and the elaboration of grief to the point of becoming, on many occasions, a traumatic grief whose physical and psychological manifestations are becoming more and more evident. The main objective of this research was to develop a scale for a group of symptoms based on professional traumatic grief. The development consisted of two phases: (I) instrument design through a literature review and focus groups of bereavement experts and healthcare professionals who experience the grief process in their work; and (II) validation of the content of the instrument. A total of 25 final items were established as suitable for inclusion in the instrument. It is expected that the experiences and results obtained through the development and validation of a scale of specific symptomatology of professional traumatic grief in health professionals will allow the assessment and detection of symptomatology in order to develop programs and strategies for early intervention and prevention.

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.

Prolonged grief, post-traumatic stress, and functional impairment in parents and siblings 8 years after the 2011 Utøya terror attack.

Background: Research on bereavement after terrorism is limited and primarily aiming on short-term consequences.Objective: To better understand the long-term health consequences of terrorism, we studied bereaved parents and siblings eight years after the Utøya terrorist attack in Norway. We examined the participants' symptom levels of prolonged grief (PG) and post-traumatic stress (PTS), as well as their psychosocial functioning and employment status.Method: Bereaved parents (n = 88) and siblings (n = 34) aged 19 and above (mean age = 49.7 years, SD = 13.8 years, 59.8% female) completed the Inventory of Complicated Grief (ICG), the Impact of Event Scale-Revised (IES-R), and the Work and Social Adjustment Scale (WSAS) to assess PG, PTS, and functional impairment, respectively. In addition, information about employment status was obtained. The proportion of participants scoring above recommended thresholds on the ICG, IES-R, and WSAS was calculated. Differences between parents and siblings and gender differences on these measures were examined.Results: In total, 62.3% of the participants had scores on the ICG indicating a risk for prolonged grief, while 45.9% scored over cutoff on the IES. There was a high overlap between symptoms of PG and PTS. Females had significantly higher scores on both the ICG and the IES compared to males. There were no differences between parents and siblings regarding PG and PTS symptoms. One out of three showed severe functional impairment on the WSAS. Approximately 30% of all the bereaved were outside the labour force, and one third of the parents had become unable to work after the terrorist attack.Conclusion: Many bereaved parents and siblings, following the Utøya terror attack, report long-lasting health consequences with symptoms of PG and PTS and functional impairment. The results suggest a need for follow up of bereaved after a terror attack and identify family members in need of health services.

Eight years after the Utøya terrorist attack bereaved parents and siblings still report high levels of prolonged grief and post-traumatic stress symptoms.There were no differences between parents and siblings regarding prolonged grief and post-traumatic stress symptoms.Many bereaved are still suffering functional impairments. Post-traumatic stress symptoms are found to be an important predictor for functional impairments.

Dealing with bereaved children: a case study.

INTRODUCTION: A personal reflection on managing bereaved children (BC) following unexpected death of a parent. QUESTIONS: What evidence is available to assist ambulance clinicians when supporting BC? METHODS: A literature search on BC in pre-hospital environments was undertaken. RESULTS: Paucity of literature necessitated search expansion beyond pre-hospital/ambulance focus, and use of supplementary sources of credible information from registered bereavement charities and help groups. CONCLUSION: More research is needed to better support this vulnerable, unique demographic. It is hoped that this article will encourage further discussion and research into this topic.

When Nurses Become Patients. Validation of the Content of the Diagnostic Label Professional Traumatic Grief.

(1) Background: The Covid-19 pandemic has put our healthcare systems to the test, exposing their vulnerability and demanding a high degree of commitment and dedication from healthcare teams to confront and contain the disease. In this sense, nursing professionals have played a prominent role in the treatment of complex cases that have required hospitalisation and have manifested pre-existing health complications or mortality. This unprecedented situation made it difficult to regulate the emotional impact and manage grief, often turning it into a traumatic grief whose psychological and emotional manifestations are increasingly evident but very little researched in the current context. (2) Purpose: Validation of the definition, defining characteristics and related factors for the proposal of the nursing diagnosis of professional traumatic grief. (3) Method: Based on Fehring's content validation model, the label name, defining characteristics and other related factors were agreed upon by Spanish experts. (4) Results: The content validity index was 0.9068. A total of 21 defining characteristics were validated by the experts, as all of them scored above 0.6. With respect to the related factors of the proposed 10, all were validated. (5) Conclusion: The present study supports the proposal to develop a nursing diagnosis for professional traumatic grief. The use of standardised language is only the first step in establishing professional traumatic grief as a diagnostic category.

What bereaved parents want health care providers to know when their babies are stillborn: a community-based participatory study.

BACKGROUND: Bereaved parents experience higher rates of depressive and post-traumatic stress symptoms after the stillbirth of a baby than after live-birth. Yet, these effects remain underreported in the literature and, consequently, insufficiently addressed in health provider education and practice. We conducted a participatory based study to explore the experiences of grieving parents during their interaction with health care providers during and after the stillbirth of a baby. METHODS: This community-based participatory study utilized four focus groups comprised of twenty-seven bereaved parents (44% fathers). Bereaved parents conceptualized the study, participating at all stages of research, analyses, and drafting. Data were reduced into a main theme and subthemes, then broad-based member checked to ensure fidelity and nuances within themes. RESULTS: The major theme that emerged centered on provider acknowledgement of the baby as an irreplaceable individual. Subthemes reflected 1) acknowledgement of parenthood and grief, 2) recognition of the traumatic nature of stillbirth, and 3) acknowledgement of enduring grief coupled with access to support. It was important that providers realized how grief was experienced within health care and social support systems, concretized by their desire for long-term, specialized support. CONCLUSIONS: Both mothers and fathers feel that acknowledgement of their baby as an individual, their parenthood, and their enduring traumatic grief by healthcare providers are key elements required in the process of initiating immediate and ongoing care after the stillbirth of a baby.

Ritual in Therapy for Prolonged Grief: A Scoping Review of Ritual Elements in Evidence-Informed Grief Interventions.

The aim of this article of to analyze ritual in evidence-informed treatments for prolonged and traumatic grief. A scoping review is conducted in order to give an overview of existing literature on ritual and symbolic interventions in grief therapies for prolonged grief and the type of evidence supporting these interventions. The 22 studies reported in this review reveal a variety of ritual elements ranging from symbolic expression and interaction, writing assignments, dialogue with the deceased or an imaginary person, to farewell ceremonies at the end of the treatment. The interventions are studied within different populations (e.g., bereaved spouses, perinatal loss, grief after violent death, and genocide). Almost all studies show significant effects of the grief treatment, trauma and related symptoms. However, the effects are mostly measured for the entire treatment and not separately for the ritual intervention. In the discussion we focus on the role of ritual and culture in prolonged grief treatment.

Learnings from supporting traumatic grief in the aftermath of sudden epilepsy deaths.

The majority of epilepsy deaths are sudden, unexpected, and most prevalent among young adults. The number of people affected by a death can be high, as extended family and social networks survive. Those bereaved are at risk of developing traumatic and complex grief reactions and need access to specialist bereavement support as soon as possible after a death. It helps bereaved families to know how the death happened. They want lessons to be learnt and deaths to be prevented in future. The process of investigation into the death - which can contribute to these aims - may alienate families if not handled well and cause further trauma. Loss of participation by those bereaved can lead to suboptimal investigation and missed opportunities for learning and prevention. With integrated specialist emotional and practical support, tailored to the individual, families can be empowered to participate as they choose, with those working to understand and prevent epilepsy deaths. SUDEP Action (formerly Epilepsy Bereaved) is a charity which provides specialist services for people bereaved by epilepsy. It is the only organization which delivers these services globally. It was set up by the bereaved for the bereaved and has developed its model through more than twenty years' experience of supporting bereaved people. If the bereaved are signposted to specialist support of the sort SUDEP Action provides as soon as possible after a death, that early intervention can help to alleviate the effects of traumatic bereavement and restore an element of control and choice as they navigate what is to come. Early intervention by signposting to skilled experienced epilepsy death-related bereavement services could be vital.

Does prolonged grief or suicide bereavement cause public stigma? A vignette-based experiment.

Prolonged grief disorder (PGD), characterized by severe, persistent and disabling grief, is newly included in the International Classification of Diseases 11 (ICD-11). Receiving a PGD diagnosis could lead to stigmatizing public reactions (i.e. public stigma), yet research on this topic is limited. Additionally, while there is evidence that experiencing suicide bereavement causes public stigma, no studies to date have investigated the interaction between PGD and cause of death on public stigma. To fill these knowledge gaps, this experimental study tested if a PGD diagnosis (vs. no diagnosis) and experiencing suicide bereavement (vs. homicide and natural loss) cause public stigma. Three hundred and seventeen adults from the general population were randomly assigned to read one of 6 different vignettes of a person with and without PGD who had lost a spouse through a suicide, homicide or a stroke. After reading a vignette, negative attributions, emotional reactions, and desire for social distance were assessed. Notably, only persons with PGD were attributed relatively more negative characteristics, and elicited more anger, anxiety and pro-social emotions, and a larger preferred social distance in participants. This study supports the claim that PGD causes public stigma, but nuances claims that suicide bereavement induces public stigma.

Traumatic loss: Mental health consequences and implications for treatment and prevention.

Traumatic loss involves the loss of loved ones in the context of potentially traumatizing circumstances and is a commonly reported traumatic event. It may give rise to disturbed grief, called prolonged grief disorder (PGD) in ICD-11 and persistent complex bereavement disorder (PCBD) in DSM-5, combined with posttraumatic stress disorder (PTSD) and depression. The recent inclusion of grief disorders in both DSM-5 and ICD-11 have spurred research on grief-related psychopathology. This special issue on traumatic loss includes 10 articles and two letters. Topics addressed include diagnostic criteria for PGD, children's perspectives on life after parental intimate partner homicide, and the impact of visiting the site of deaths caused by terror. Early indicators of problematic grief trajectories are addressed, as well as moderators and mediators of disordered grief, including coping strategies, rumination, and meaning-making. Further, a meta-analysis synthesizing research findings on correlates of disturbed grief following traumatic loss is presented. Finally, specialized treatments as Eye Movement Desensitisation and Reprocessing (EMDR) and Cognitive Behavioural Therapy (CBT) for grief are addressed, and predictors of treatment response for CBT for PGD including levels of self-blame and avoidance are scrutinized. As such, the articles included in this special issue increase our understanding of the needs of people confronted with traumatic loss and bring promising findings with regard to diagnosis, prevention, and specialized treatment in children, young people and adults. This article also introduces a hypothetical staging, profiling, and stepped care model which may offer a template to integrate existing and emerging research findings on possible courses and correlates of grief, in order to inform treatment decisions.

La pérdida traumática implica la pérdida de seres queridos en el contexto de circunstancias potencialmente traumáticas y es un evento traumático comúnmente reportado. Puede dar lugar a un duelo perturbado, denominado trastorno de duelo prolongado (PGD) en el CIE-11 y trastorno de duelo complejo persistente (PCBD) en el DSM-5, combinado con trastorno de estrés postraumático (TEPT) y depresión. La reciente inclusión de trastornos de duelo tanto en el DSM-5 como en la CIE-11 ha estimulado la investigación en psicopatología relacionada con el duelo. Este número especial sobre la pérdida traumática de la European Journal of Psychotraumatology incluye diez artículos y dos cartas. Los temas abordados incluyen los criterios de diagnóstico de PGD, las perspectivas de los niños sobre la vida después del homicidio de la pareja íntima de los padres y el impacto de visitar el sitio de causas de muertes por terror. Se abordan indicadores tempranos de las trayectorias de duelo problemático, así como los moderadores y mediadores del trastorno de duelo, incluidas las estrategias de afrontamiento, la rumiación y la generación de significados. Además, se presenta un metanálisis que sintetiza los resultados de investigaciones sobre los correlatos del trastorno de duelo después de una pérdida traumática. Finalmente, se abordan tratamientos especializados como Desensibilización y Reprocesamiento por Movimiento Oculares (EMDR) y la Terapia Cognitiva Conductual (TCC) para situaciones de duelo, y se analizan los factores predictivos de la respuesta a tratamiento para la TCC para PGD, incluidos los niveles de auto-culpa y evitación. Así, los artículos incluidos en este número especial aumentan nuestra comprensión de las necesidades de las personas que enfrentan una pérdida traumática y aportan resultados prometedores con respecto al diagnóstico, prevención y tratamiento especializado tanto en niños como en jóvenes, así como en adultos. Este artículo también presenta un modelo hipotético de estadios, perfiles y atención escalonada que puede ofrecer una pauta para integrar los hallazgos de investigación existentes y emergentes sobre posibles cursos y correlatos de duelo, con el fin de guiar las decisiones de tratamiento.

Behind the lines: Toward an aesthetic framework for psychoanalytic psychotherapy.

This article describes the author's development of an aesthetic approach to psychoanalytic psychotherapy of patients suffering from traumatic levels of grief by describing her experiences as a patient, a therapist, and a consultant to the design firm that partnered with the National September 11 Memorial and Museum. Using Aristotle's On Poetics as an inspiration, this article explores the ways dialogical storytelling creates a therapeutic "action-plot" that transforms reversals of fortune. Attending to patients' first-person phenomenological experience (without attributing cause), therapists help them transform their losses by listening to their stories. Therapists dwell with them in uncertainties while marking time in regularly scheduled meetings; they accompany their patients on a journey while also orienting to their modes of travel. They simultaneously co-construct tales of the journey, attentive to the poetic dimensions of sight, sound, and space that they encounter. In so doing, therapists serve not just guides and judges, but artists, bringing meanings to the trail.

Public stigma of prolonged grief disorder: An experimental study.

Prolonged grief disorder (PGD), characterized by severe, persistent and disabling grief, is being considered for inclusion in the International Classification of Diseases' 11 (ICD-11) and a related disorder, Persistent Complex Bereavement Disorder (PCBD), is included for further investigation in the Diagnostic and Statistical Manual of Mental Disorders 5 (DSM-5). Establishing diagnoses for pathological grief may lead to stigmatization. Additionally, it has been argued that people experiencing severe grief responses after loss of non-family members (i.e., disenfranchised grief) may experience more stigmatizing reactions. Yet, no research to date has investigated this. To fill this gap in knowledge, 379 adults from the general population were randomly allocated to read one of 4 different vignettes of a person with and without a grief disorder diagnosis who had lost a friend or a spouse. After reading the vignettes, we assessed: 1) characteristics ascribed to the person, 2) emotional reactions to the person, and 3) desire for social distance. Notably, people with a diagnosis were attributed relatively more negative characteristics, and elicited more anger, anxiety and pro-social emotions and a stronger desire for social distance. Stigmatization and its negative consequences appear a valid concern to the establishment of pathological grief disorders in diagnostic manuals.

FEASIBILITY AND EFFECTIVENESS OF DYADIC PROLONGED EXPOSURE INTERVENTION FOR PREVENTING POSTTRAUMATIC GRIEF IN YOUNG CHILDREN: A CASE REPORT OF TWO SIBLINGS.

This article highlights the feasibility of a dyadic prolonged exposure (DPE) intervention (L. Rachamim, I. Mirochnik, L. Helpman, N. Nacasch, & E. Yadin, ) in a 3-year-old preschooler and in a 6-year-old kindergartener immediately following the traumatic death of their younger sibling. It presents a detailed case description of the DPE treatment addressing traumatic grief and includes transcribed treatment dialogue. At the time of treatment termination, both children and caregivers resumed normal functioning. The results suggest that DPE intervention may ameliorate posttraumatic grief symptoms in young children. Controlled studies of preventive interventions for this population are clearly warranted.