Pérdida significativa como factor del alcoholismo / Perda significativa como fator de alcoolism / Significant loss as a factor in alcoholism

La relación de la pérdida significativa de un ser queridoy el alcoholismo ha minimizado las implicaciones sobremecanismos de afrontamientos para generar conductassaludables. Este artículo se basa en entrevistas semiestructuradasa profundidad en hombres de entre 30 y 70 años, conmás de 10 años en Alcohólicos Anónimos del Estado deTamaulipas, México. El objetivo fue reflexionar sobre lossignificados de la pérdida significativa de un ser querido yel alcoholismo. En la búsqueda del significado, se explicaque un factor que lleva al alcoholismo no es una sola pérdidasignificativa de personas queridas, sino un cúmulo tambiende pérdidas materiales y no materiales, se reflejaron recursoslimitados para afrontar las pérdidas, la relación entre lapérdida significativa con el alcoholismo fue mediado pordos principales aspectos, las creencias sobre los efectos queproduce el consumo de alcohol como formas de escapar de larealidad y las influencia de la familia al inicio del consumode alcohol. Por otra parte, la presencia de lo espiritual, laconciencia y las emociones que experimentan durante suproceso de duelo y alcoholismo, los llevó a identificar elproblema de la adicción, que permitió influir en el procesode rehabilitación.(AU)

A relação entre a perda significativa de um ente querido e oalcoolismo tem minimizado as implicações nos mecanismosde enfrentamento para gerar comportamentos saudáveis.Este artigo é baseado em entrevistas semiestruturadas emprofundidade com homens entre 30 e 70 anos, com mais de10 anos em Alcoólicos Anônimos no Estado de Tamaulipas,México. O objetivo foi refletir sobre os significados da perdasignificativa de um ente querido e do alcoolismo. Na buscade sentido, explica-se que um fator que leva ao alcoolismonão é uma única perda significativa de entes queridos, mastambém um acúmulo de perdas materiais e imateriais,recursos limitados foram refletidos para enfrentar as perdas,a relação entre a perda significativa com o alcoolismo foimediada por dois aspectos principais, as crenças sobre osefeitos que o consumo de álcool produz como formas defuga da realidade e a influência da família no início doconsumo de álcool. Por outro lado, a presença do espiritual,da consciência e das emoções que vivenciam durante oprocesso de luto e alcoolismo, levaram-nos a identificar oproblema da dependência, o que lhes permitiu influenciaro processo de reabilitação.(AU)

The relationship between the significant loss of a lovedone and alcoholism has minimized the implications oncoping mechanisms to generate healthy behaviors. Thisarticle is based on in-depth semi-structured interviews withmen between the ages of 30 and 70, with more than 10years in Alcoholics Anonymous in the State of Tamaulipas,Mexico. The objective was to reflect on the meanings of the significant loss of a loved one and alcoholism. In thesearch for meaning, it is explained that a factor that leadsto alcoholism is not a single significant loss of loved ones,but also an accumulation of material and non-materiallosses, limited resources were reflected to face the losses,the relationship between the loss significant with alcoholismwas mediated by two main aspects, beliefs about the effectsthat alcohol consumption produces as ways of escapingfrom reality and the influence of the family at the beginningof alcohol consumption. On the other hand, the presenceof the spiritual, the conscience and the emotions that theyexperience during their mourning process and alcoholism,led them to identify the problem of addiction, which allowedthem to influence the rehabilitation process.(AU)

Healing grief - an online self-help intervention programme for bereaved Chinese with prolonged grief: study protocol for a randomised controlled trial.

Background: In China, mental health services do not currently meet the needs of bereaved people with symptoms of prolonged grief disorder (PGD). Internet-based grief interventions may help fill this gap, but such programmes have not yet been developed or evaluated in China. The proposed study aims to investigate the effectiveness, acceptability, and feasibility of an online self-help intervention programme named Healing Grief for bereaved Chinese with prolonged grief, and to explore the psychological mechanisms of potential improvements.Methods: We designed a two-arm randomised controlled trial. At least 128 participants will be randomly assigned to either an Internet-based intervention group or a waitlist-control group. The Internet-based intervention will be developed based on the dual process model, integrating techniques of psychoeducation, behavioural activation, cognitive reappraisal, and meaning reconstruction, and will be delivered via expressive writing. The intervention comprises six modules, with two sessions in each module, and requires participants to complete two sessions per week and complete the intervention in 6 weeks. The primary outcomes include effectiveness, acceptability, and feasibility. The effectiveness will be assessed by measures of prolonged grief, posttraumatic stress, anxiety, and depressive symptoms. Acceptability and feasibility will be evaluated using survey and interview on user experience characteristics. Secondary outcomes include moderators and mediators, such as dual process coping, grief rumination, mindfulness, and continuing bond, to explore the psychological mechanisms of potential improvement. Assessments will take place at pre-intervention, post-intervention, and 3-month follow-up.Conclusion: The proposed study will determine the effectiveness, acceptability, and feasibility of the newly developed online self-help intervention for bereaved Chinese with prolonged grief and clarify how the intervention helps with symptom improvements. Such an intervention may play an important role in easing the imbalance between the delivery and receipt of bereavement psychological services in China.

In China, mental health services are not widely available for bereaved people.The proposed study will be the first one to develop and evaluate an Internet-based self-help grief intervention for bereaved Chinese with prolonged grief.The proposed study will determine whether and how the intervention helps to improve the mental health of bereaved Chinese with prolonged grief.

Considerazioni etico-giuridiche sui criteri di priorità di cura per i pazienti in terapia intensiva durante la pandemia di COVID-19 / Consideracions ètic-jurídiques sobre els criteris de prioritat de cura pels pacients en teràpia intensiva durant la pandèmia de la COVID-19 / Consideraciones ético-jurídicas sobre los criterios de prioridad de atención para los pacientes en terapia intensiva durante la pandemia de COVID-19 / Ethical-legal considerations on priority care criteria for patients in intensive therapy during the COVID-19 pandemic

Ci si è chiesti se la pandemia abbia modificato il modo in cui la morte e il morire vengano pensati. L’incontrollata diffusione del contagio e la mancanza di un’adeguata risposta organizzativa in termini di sanità pubblica ha determinato ben presto nelle TI una sproporzione tra domanda di assistenza (insufficienza respiratoria acuta) e risorse disponibili (personale formato, posti-letto, ventilatori meccanici). I clinici si sono così trovati nella condizione di dover decidere quali pazienti ammettere in TI e quali escludere. Sia in Italia che in Spagna si è fatto ricorso al triage: sono state elaborate alcune raccomandazioni che hanno destato perplessità e critiche nell’ambito medico ed etico-giuridico.(AU)

En aquest article es reflexiona sobre la forma en què la pandèmia derivada de la COVID-19 ha alterat determinats processos assistencials davant de la mort. La ràpida propagació incontrolada de la malaltia i la manca de resposta organitzativa en termes de salut pública aviat van conduir a una desproporció entre la demanda assistencial en cures intensives i els recursos humans imaterials per satisfer-la. En ocasions, els metges s'han vist en el dilema de decidir quins pacients tractar i quins excloure a les unitats de cures intensives. Tant a Espanya com a Itàlia s'ha fet servir el triatge i s'han publicat algunes recomanacions que han suscitat algunes crítiques en l'àmbit mèdic, ètic i legal. Es planteja el dubte de si aquestes mesures excepcionals es poden aplicar quan es recupera la normalitat sociosanitària.(AU)

En este artículo se reflexiona sobre la forma en que la pandemia derivada del COVID-19 ha alterado determinados procesos asistenciales frente a la muerte. La rápida propagación incontrolada de la enfermedad y la faltade respuesta organizativa en términos de salud pública pronto condujeron a una desproporción entre la demanda asistencial en cuidados intensivos y los recursos humanos y materiales para satisfacerla. En ocasiones, los médicos se han visto en el dilema de decidir qué pacientes tratar y cuales excluir en las unidades de cuidados intensivos. Tanto en España como en Italia se ha usado el triaje y se han publicado algunas recomendaciones que han suscitado ciertas críticas en el ámbito médico, ético y legal. Se plantea el interrogante de que estas medidas excepcionales se puedan aplicar cuando se recupera la normalidad socio sanitaria.(AU)

This paper reflects on the way in which the pandemic derived from COVID-19 has altered certain care processes in the face of death. The rapid uncontrolled spread of the disease, and the lack of organizational response in terms of public health soon led to a disproportion between the demand for intensive care and the human and material resources to meet it. At times, doctors have been faced with the dilemma of deciding which patients to treat and which to exclude in intensive care units. Both in Spain and Italy triage has been used and some recommendations have been published that have provoked some criticism in the medical, ethical and legal field. The question arises whether these exceptional measures can be applied when socio-sanitary normality is restored.(AU)

[Association between therapeutic adherence and phases of grief in patients with type 2 diabetes mellitus]. / Asociación entre la adherencia terapéutica y las fases de duelo en pacientes con diabetes mellitus tipo 2.

OBJECTIVE: To evaluate the association between therapeutic adherence and the phases of grief in patients with type 2 diabetes mellitus. DESIGN: Cross-sectional observational study. SITE: Family Medicine Unit No. 53 of the Mexican Institute of Social Security in the State of Guanajuato. PARTICIPANTS: A total of 354 patients with type 2 diabetes mellitus were recruited, of whom 236 corresponded to the group without therapeutic adherence and 118 to the group with therapeutic adherence. INTERVENTIONS: Two structured surveys were administered to both groups. MAIN MEASUREMENTS: The Morisky 8 scale was used to measure therapeutic adherence and the phases of grief scale (EFD-66) to measure grief due to loss of health. RESULTS: The median denial phase and depression phase scores were higher in the nonadherence group than in the adherence group (p=.000). The median negotiation phase and acceptance phase score was higher in the adherence group than in the nonadherence group (p=.000). Multivariate analysis identifies that denial is the main factor associated with non-adherence (OR=1.25; 95% CI: 1.14-1.37); while negotiation (OR=0.88; 95% CI: 0.82-0.94) and acceptance are associated with adherence (OR=0.79; 95% CI: 0.75-0.83). CONCLUSIONS: There is an association between therapeutic adherence and phases of 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.

To lose a friend: the relationship between professional help and grief among close bereaved friends after the terror attack, 22 July 2011.

Background: Close friends are often an overlooked group of bereaved people. This study is based on a sub-project on young adults who experienced the loss of a close friend in the terrorist attack on Utøya, Norway, on 22 July 2011.Objective: The aim of this longitudinal study was to explore the relationship between complicated grief reactions, the need for help, and help received after losing a close friend to a traumatic death.Method: In total, data from 89 people (with a mean age of 21 years, 76.4% female) were collected at one or more of the four time-points: 18, 28, 40, and 102 months after the incident. Latent growth modelling was used to analyse levels of grief reactions and change over time, experienced need for help, and help received.Results: According to the results, the bereaved friends in our study were profoundly impacted by the loss and experienced level of reactions indicating complicated grief (mean scores on the Inventory of Complicated Grief varied from 36.2 to 23.7). A need for help was related to a decrease in grief symptoms, whereas a prolonged need for help was related to no reduction or an increase in grief. Received help was not related to decrease in grief symptoms.Conclusions: These findings underscore the need for continuous professional help, and demonstrate that the present help measures used after traumatic events may not adequately meet the needs of close bereaved friends. This emphasizes the importance of acknowledging friends as bereaved and that follow-up measures should also include this group. Finally, the study highlights the need to learn more about how professional can help bereaved friends.

Young adults who experience the traumatic loss of a close friend may experience levels of grief reactions indicating complicated grief.The need for help reported after experiencing the loss of a close friend is high; this is also the case when some time has passed since the loss.Bereaved friends need more acknowledgement, and help measures after traumatic events often do not meet their need for help and follow-up after the loss.

On the path to recovery: traumatic stress research during the COVID-19 pandemic 2021-2023.

This Special Issue of the European Journal of Psychotraumatology (EJPT) presents 51 articles published between 2021 and 2023 and follows the Special Issue on pandemic-related traumatic stress research published in 2021 (O'Donnell, M. L., & Greene, T. [2021]. Understanding the mental health impacts of COVID-19 through a trauma lens. European Journal of Psychotraumatology, 12(1), 1982502). Research on traumatic stress during the pandemic has cast the spotlight on vulnerable populations and groups, notably front-line healthcare workers; people faced with major losses including the deaths of loved ones; those who personally survived debilitating and often life-threatening viral infection; and students who were isolated and experienced profound delays in their education, relationships, and emerging independence. The papers in this collection underscore the associations between COVID-19 related stressors and a plethora of adverse mental health sequelae, including posttraumatic stress reactions, and draw attention to the ubiquity of grief and moral injury and their wide-ranging and detrimental impact. Currently, there is a paucity of evidence on interventions to enhance resources, self-efficacy, and hope for affected groups and individuals through societal, organisational, and healthcare systems; however early research on the prevention of COVID-related traumatic stress disorders provides a basis for both hope and preparedness for the future.

Stressors and traumatic events occurring due to the COVID-19 pandemic are associated with a wide range of mental health problems, including posttraumatic stress reactions, especially among vulnerable groups (e.g., front-line healthcare workers, individuals who faced major losses such as the deaths of loved ones, those who survived debilitating and often life-threatening infection).Loss and moral injury are common and potentially debilitating features of the pandemic.Societal, organisational, and healthcare system interventions to enhance resources, efficacy, and hope for affected groups and individuals are still in the early stages, although preliminary research on the prevention of COVID-related traumatic stress disorders is promising.

O luto materno em situação de violência policial: contribuições psicanalíticas / Maternal grief in situations of police violence: psychoanalytic contributions / Duelo materno en situaciones de violencia policial: aportes psicoanalíticos

A polícia brasileira já foi considerada a mais letal e frequentemente alveja jovens negros marginalizados (Araújo, 2015). As mães desses indivíduos perdem seus filhos precocemente de maneira abrupta e violenta. Para muitas mães a perda de um filho constitui a maior do mundo, o que torna relevante questionar: como a perda de um filho pela violência policial repercute no enlutamento materno? Foram encontrados poucos estudos sobre o tema, apesar de sua prevalência e dos impactos negativos permanentes na vida dessas mães (Gomes, 2019). Por meio de uma revisão bibliográfica não sistemática sobre o tema do luto e das perdas violentas, e com base em depoimentos publicizados de mães que perderam seus filhos pela violência policial, focalizamos como a psicanálise tem um importante papel na escuta dessas mulheres, que podem traçar diferentes caminhos de trabalho psíquico. Como resultado, vimos que a perda de um filho possui caráter traumático e nela se destaca a natureza narcísica da relação mãe-filho, rompida abruptamente pela morte. Este estudo oferece algumas contribuições para o entendimento desse sofrimento e para a escuta dessas mulheres, que, como muitas se autodenominam, são "mães sem nome". (AU)

Brazilian police were once considered the most lethal and often target marginalized young black men (Araújo, 2015). The mothers of these individuals lose their children early in an abrupt and violent manner. To many mothers, the loss of a child is the biggest one in the world, which makes it relevant to ask: How does the loss of a child to police violence affect maternal mourning? Few studies have been found on the topic, despite its prevalence and the permanent negative impacts on the lives of these mothers (Gomes, 2019). Through a non-systematic literature review on the theme of grief and violent loss, and based on publicized testimonials of mothers who have lost their children to police violence, we focused on how psychoanalysis has an important role in listening to these women, who can trace different paths of psychic work. As a result, we concluded that the loss of a child has a traumatic issue, and the narcissistic nature of the mother-child relationship, abruptly broken by death, stands out. This study offers some contributions to the understanding of this suffering and to the listening of these women, who, as many call themselves, "mothers without a name". (AU)

La policía brasileña fue considerada la más letal y frecuentemente ataca a los jóvenes negros marginados (Araújo, 2015). Las madres de estas personas pierden a sus hijos tempranamente de forma abrupta y violenta. Para muchas madres, la pérdida de un hijo es la mayor del mundo, lo que hace pertinente preguntarse: ¿cómo la pérdida de un hijo por la violencia policial afecta al duelo materno? Se encontraron pocos estudios sobre este tema, a pesar de su prevalencia y de los impactos negativos permanentes en la vida de estas madres (Gomes, 2019). Mediante una revisión bibliográfica no sistemática sobre el tema del duelo y de las pérdidas violentas, y a partir de testimonios difundidos de madres que perdieron a sus hijos por la violencia policial, nos centramos en cómo el psicoanálisis tiene un papel importante en la escucha de estas mujeres, que pueden trazar diferentes caminos de trabajo psíquico. Como resultado, vimos que la pérdida de un hijo tiene carácter traumático y destaca la naturaleza narcisista de la relación madre-hijo, rota abruptamente por la muerte. Este estudio ofrece algunas contribuciones a la comprensión de este sufrimiento y a la escucha de estas mujeres que, como muchas se autode-nominan, son "madres sin nombre". (AU)

Latent trajectories of DSM-5-TR-based Prolonged Grief Disorder: findings from a data pooling project MARBLES.

Background: With the release of the text revision of the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5-TR), criteria for Prolonged Grief Disorder (PGD) were included. This necessitates studying grief trajectories based on these criteria.Objective: This is the first study examining latent trajectories of DSM-5-TR-based PGD symptom levels and testing whether specific risk factors (e.g. cause of death) predicted PGD trajectories.Method: We evaluated latent DSM-5-TR PGD trajectories using pooled existing data collected at 6-12, 13-24, and 25-60 months post-loss in Danish and Dutch bereaved adults (N = 398). Latent Growth Mixture Modelling (LGMM) was employed to determine the trajectories. Multinomial logistic regression analyses were used to examine which risk factors predicted class membership.Results: The four-class LGMM solution with a quadratic term was best-fitting the data. This solution represented four trajectories: High stable PGD (6%), High PGD quick recovery (10%), High PGD slow recovery (35%), and Low PGD symptoms (49%). Participants with a higher educational level were more likely to be assigned to the Low PGD symptoms trajectory compared to High stable PGD and High PGD slow recovery trajectories. Unnatural causes of death increased the likelihood of being in the High stable PGD and High PGD slow recovery trajectories compared to the Low PGD symptoms trajectory.Conclusions: Consistent with prior research, the Low PGD symptoms trajectory was the most common. A significant minority experienced high and stable levels of PGD within five years after the loss. About one-third of participants experienced high acute grief levels that decreased slowly; how slow decreasing symptoms relate to an individual's functioning requires further attention. This study demonstrates that a significant minority of bereaved people develop acute PGD symptomatology that does not diminish within five years post-loss, emphasizing the need for early screening for PGD to prevent long-lasting complaints.

This is the first latent trajectory study based on DSM-5-TR Prolonged Grief Disorder (PGD) criteria. Data were analysed using latent growth mixture modelling.Stable high (6%), quick recovery (10%), slow recovery (35%), low symptoms (49%) PGD trajectories arose.Early screening and treatment of PGD seems warranted.

Experiences of grief and moral sentiments in survivors of the armed conflict in Medellín, Colombia.

The objective of the study is to understand the experience of grief and moral sentiments in survivors of the armed conflict in the city of Medellín, Colombia, through qualitative research. In total, 32 people affected by different victimising acts in the context of the armed conflict participated. There is a direct relationship between moral sentiments and the processes of handling and processing loss. Moral sentiments frame the experience of emotions in the victim, after the events have occurred, which influence the way in which the pain experienced is processed. These sentiments permeate the processes of dealing with the incident in survivors, the ways in which they perceive themselves and the perpetrators, and the social stances they adopt to face life. We conclude that moral factors play a role in the emotional recovery of victims and are indicative the possibility or difficulty of processing the events that occurred.

The semiology of migration.

INTRODUCTION: The phenomenon of migration generates a series of experiences in the human being that are translated into emotions, feelings, adaptation processes, grief and psychopathological processes, and even pathological expressions, represented by clinical pictures of different kinds. OBJECTIVE: The purpose of this article is to carry out a conceptual and clinical reflection on the semiology around the concept and experience of migration, in order to illustrate the complexity that it entails as a human phenomenon. METHODS: A reduced narrative review, circumscribed and restricted to the semiological, psychopathological and clinical aspects of migration. DISCUSSION: The separation, ruptures and losses that derive from migration do not go unnoticed by the individual. They are inscribed in his/her corporality as physiological injuries that affect his/her life and as symbolic injuries that affect his/her existence. CONCLUSIONS: Migration supposes a rupture of the totality of being. The context, the perception of others and relationships are cut off from the total unity that is the individual, as if he/she lost half of him/herself.

¿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)

Cuidados enfermeros en el duelo perinatal. Una revisión sistemática y crítica de las actitudes y los conocimientos en la práctica clínica / Nursing care in perinatal grief. A systematic and critical review of attitudes and knowledge in clinical practice

Objetivo: Revisar y sintetizar la evidencia disponible sobre las actitudes y conocimientos de las enfermeras ante el duelo perinatal de los progenitores. Método: Se realizó una revisión sistemática de artículos originales publicados desde enero del 2016 hasta febrero del 2023, sin límite de idioma, en las bases de datos Scopus, PubMed, Cinahl, PsycINFO, ScienceDirect y Web Of Science. Se utilizó el marco metodológico de la Declaración Preferred Reporting Items for Systematic reviews and Meta-Analyse (PRISMA) para revisiones sistemáticas y metaanálisis. Todo el proceso se efectuó por pares, siendo solventadas las discrepancias por un tercer revisor. Se evaluó la calidad de los artículos siguiendo los criterios Critical Appraisal Skills Programme Español (CASPe). Resultados: Se obtuvieron 12 artículos en esta revisión tras aplicar los criterios de inclusión, de los cuales, salvo un estudio cuantitativo transversal (8,33%), los demás eran análisis cualitativos realizados mediante entrevistas (75%) o grupos de discusión (16,66%). Se destaca que existen diferentes problemas biopsicosociales relacionados con las necesidades de cuidado que demanda la familia y que, por escasa formación o cultura del profesional sanitario, no se abordan de una manera adecuada. Los estudios encontrados muestran diversos recursos para atender adecuadamente el duelo perinatal, existiendo discrepancias en relación con permitir o no que se muestre y/o coja el cuerpo del bebé fallecido; existen también desacuerdos respecto a si el equipo asistencial debe fundamentar su práctica en protocolos o teorías como la del duelo de Kübler-Ross. La mayoría de los estudios (75%) consideran necesarias más formación y sensibilización contemplando la naturaleza biopsicosocial del usuario.(AU)

Aim: To review and synthesize the available evidence on the attitudes and knowledge of nurses regarding the perinatal grief of the parents. Methods: A systematic review of original articles published from January 2016 to February 2023 without language limit in the Scopus, PubMed, Cinahl, PsycINFO, ScienceDirect and Web Of Science databases was carried out. The PRISMA Statement methodological framework was used for systematic reviews and meta-analyses. The entire process was carried out in pairs, with discrepancies being resolved by a third reviewer. The quality of the articles was evaluated following the Critical Appraisal Skills Program Spanish (CASPe criteria). Results: Twelve articles were obtained in this review after applying the inclusion criteria, of which. Except for one cross-sectional quantitative study (8.33%), the rest were qualitative studies carried out through interviews (75%) or discussion groups (16.66%). It is highlighted that there are different biopsychosocial problems related to the care needs demanded by the family and that, due to poor training or culture of the health professional, are not adequately addressed. The studies found show various resources to adequately attend to perinatal grief, there being discrepancies in relation to allowing or not allowing the body of the deceased baby to be shown and/or taken; There are also disagreements regarding whether the healthcare team should base its practice on protocols or theories such as the Kübler-Ross theory of grief. Most of the studies (75%) consider that more training and awareness is necessary, contemplating the biopsychosocial nature of the user.(AU)

Somatic symptom distress and ICD-11 prolonged grief in a large intercultural sample.

Background: Grief is a multi-faceted experience including emotional, social, and physical reactions. Research in ICD-11 prolonged grief disorder (PGD) in different cultural contexts has revealed different or potentially missing grief symptoms that may be relevant.Objective: This study thus aimed to explore the prevalence of somatic symptom distress and its associations with grief and negative affect in a culturally diverse sample of bereaved individuals with symptoms of PGD.Methods: Based on cross-sectional survey data from the Measurement and Assessment of Grief (MAGIC) project, this study included 1337 participants (mean age 23.79 yrs, 76.1% female) from three regions (USA: 62.3%, Turkey/Iran: 24.2%, Cyprus/Greece: 13.5%), who experienced a loss of a significant other. Associations between somatic symptom distress (Somatic Symptom Scale, SSS-8), symptoms of PGD (International Prolonged Grief Disorder Scale, IPGDS-33), anxiety (Generalized Anxiety Disorder Questionnaire, GAD-7), depression (Patient Health Questionnaire, PHQ-9) as well as demographic and loss related characteristics were investigated. Three hundred and thirteen participants (23.4%) scored above the proposed cut-off for clinically severe PGD.Results: 'High' or 'very high' levels of somatic symptom distress were more frequent in a possible PGD group (58.2%), than in a non-PGD group (22.4%), p < .001, as divided per cut-off in the IPGDS. In a multiple regression analysis, PGD symptoms were significantly but weakly associated with somatic symptom distress (ß = 0.08, p < .001) beyond demographics, loss-related variables, and negative affect. Negative affect (anxiety and depression) mediated the relationship of PGD symptoms with somatic symptom distress and the indirect effect explained 58% of the variance.Conclusions: High levels of somatic symptom distress can be observed in a substantial proportion of bereaved across cultures. Our findings suggest that PGD is related to somatic symptom distress partly and indirectly through facets of negative affect.

30.8% of bereaved adults showed 'high' or 'very high' levels of somatic symptom distress.Anxiety and depression partially mediate relationship of PGD symptoms with somatic symptom distress.Findings encourage practitioners to consider somatic symptom distress in psychotherapeutic treatment of PGD.

Efectos de la educación emocional en el duelo por la pérdida de un ser querido en la infancia y la adolescencia: una revisión sistemática guiada por las directrices PRISMA / Effects of grief education programs in children and adolescents facing the loss of a loved one: a prisma-driven systematic review

Introducción: Diferentes estudios surgidos desde el año 2020 indican que 5,2 millones de niños y niñas han perdido al menos un progenitor o cuidador como consecuencia de la pandemia de COVID-19. Estos datos ponen de manifiesto la importancia de educar en el duelo a los niños y adolescentes y protegerlos de posibles complicaciones en la elaboración del duelo.Objetivo: Analizar si hasta el momento se han realizado investigaciones que avalúen los efectos de los programas de educación emocional en la elaboración del duelo por la pérdida de un ser querido.Método: Se ha realizado una revisión sistemática siguiendo las directrices PRISMA que ha permitido identificar 8 estudios localizados en las bases de datos PsycInfo, Pubmed, ERIC y Dialnet que cumplían con los criterios de inclusión. Resultados y conclusiones: Los resultados indican que la educación emocional sí influye en la relación que los niños y adolescentes establecen con el duelo, la pérdida y la muerte. Asimismo, la falta de claridad en algunos resultados y el uso de instrumentos no específicos para avaluar el duelo, hace que estos deban ser valorados con precaución y hace aconsejable más investigación que supere las limitaciones de la actual.(AU)

Introduction: Several studies published since 2020 claim that about 5.2 million children have lost at least one parent or parental figure to COVID-19. These data support the importance of grief psychoeducation with children and adolescents as this may be an effective intervention to protect them from eventual complications, such as prolonged grief disorder, posttraumatic stress disorder, or others. Aim: To analyse whether research has been conducted up to date on the effects of grief psychoeducation or emotional education programs on grief processes following the death of a parent or another loved one in children and adolescents. Materials and Methods: A PRISMA-driven systematic review has been carried out using databases PsycInfo, Pubmed, ERIC and Dialnet. 8 studies meeting all inclusion criteria have been identified and analysed.Results and conclusions: Results suggest that emotional education significantly impacts grieving processes in children and adolescents, besides shaping their relationships with bereavement, loss and death. Nonetheless, some of the located study results lack clarity and many studies did not use specific instruments to evaluate grief. This calls for prudence when interpreting positive results and encourages future research that hopefully overcomes limitations identified in previous studies.(AU)

Semiología de la Migración

Introducción: El fenómeno de la migración genera una serie de experiencias en el ser humano que se traducen en emociones, sentimientos, procesos de adaptación, duelos y procesos psicopatológicos, hasta expresiones patológicas representadas por cuadros clínicos de diferente índole. Objetivo: La intención de este artículo es realizar una reflexión conceptual y clínica de la semiología en torno al concepto y la experiencia de la migración, para con ello ilustrar la complejidad que entraría como fenómeno humano. Método: Revisión narrativa reducida, circunscrita y restringida a los aspectos semiológicos, psicopatológicos y clínicos de la migración. Discusión: La separación, las rupturas y las pérdidas que se derivan de la migración no pasan inadvertidas al individuo, se inscriben en su corporalidad como lesiones fisiológicas que afectan a su vida y como lesiones simbólicas que afectan a su existencia. Conclusiones: La migración supone una ruptura de la totalidad del ser. El contexto, el otro y las relaciones quedan cercenados de la unidad total que es el individuo, como si perdiera la mitad de sí mismo.

Introduction: The phenomenon of migration generates a series of experiences in the human being that are translated into emotions, feelings, adaptation processes, grief and psycho-pathological processes, and even pathological expressions, represented by clinical pictures of different kinds. Objective: The purpose of this article is to carry out a conceptual and clinical reflection on the semiology around the concept and experience of migration, in order to illustrate the complexity that it entails as a human phenomenon. Methods: A reduced narrative review, circumscribed and restricted to the semiological, psychopathological and clinical aspects of migration. Discussion: The separation, ruptures and losses that derive from migration do not go unnoticed by the individual. They are inscribed in his/her corporality as physiological injuries that affect his/her life and as symbolic injuries that affect his/her existence. Conclusions: Migration supposes a rupture of the totality of being. The context, the perception of others and relationships are cut off from the total unity that is the individual, as if he/she lost half of him/herself.

Almor: her de Spike Jonze (2013) / Almor Her by Spike Jonze (2013)

Her habla de una sociedad en la que las palabras de amor y pasión pretenden ser los sentimientos mismos, pero sin embargo pueden ser dichas o escritas por encargo, como simple tarea laboral. O por un programa computacional contratado a tales fines. Una lectura posible del film es que, en el proceso de interacción con usuarios, el Sistema Operativo se humaniza y, conforme desarrolla una toma de conciencia de sí, se aleja del vínculo con los humanos que lo han creado

Her speaks of a society in which the words of love and passion pretend to be the feelings themselves, but can nevertheless be said or written on request, as a simple work task. Or by a computer program hired for such purposes. A possible reading of the film is that, in the process of interaction with users, the Operating System becomes humanized and, as it develops an awareness of itself, it moves away from the link with the humans who created it

Lineamientos técnicos para la atención psicosocial por duelo perinatal y primera infancia / Technical guidelines for psychosocial care for perinatal bereavement and early childhood

Los presentes lineamientos técnicos, constituyen una herramienta que permitirá al personal del Sistema Nacional Integrado de Salud, estandarizar conceptos y procedimientos para la atención psicosocial en duelo perinatal y primera infancia

The present technical guidelines are a tool that will enable the staff of the National Integrated Health System to standardize concepts and procedures for psychosocial care in perinatal and early childhood bereavement

Duelo anticipado en familiares de personas con demencia. Variables psicosociales asociadas y su impacto sobre la salud del cuidador. Una revisión de literatura / Anticipatory grief in family caregivers of persons with dementia. Psychosocial correlates and impact on caregiver's health: A literature review

Introducción Cuidar de un familiar con demencia puede suponer consecuencias negativas en el bienestar del cuidador. Uno de los procesos que se pueden vivenciar es el duelo anticipado, que se define como los sentimientos de dolor y pérdida que aparecen en el cuidador previamente al fallecimiento de la persona cuidada. Objetivos La revisión tuvo como objetivos conceptualizar el duelo anticipado en esta población, estudiar las variables psicosociales relacionadas, y conocer las repercusiones para la salud del cuidador. Método Se realizó una búsqueda sistemática siguiendo las directrices PRISMA en las bases de datos ProQuest, PubMed, Web of Science (WOS) y Scopus, incluyendo los estudios publicados en los últimos 10 años (2013-2023). Resultados Se obtuvo un total de 160 artículos, seleccionándose 15 finalmente. Se observa que el duelo anticipado se define como un proceso ambiguo al aparecer antes de la muerte del familiar enfermo. Ser cuidadora mujer, cónyuge del familiar con demencia, tener una relación más cercana con él y/o tener una importante responsabilidad en el cuidado se asocian a una mayor probabilidad de experimentar duelo anticipado. Respecto a la persona cuidada, si esta se encuentra en una fase severa de la enfermedad, es más joven y/o presenta comportamientos problemáticos, también se observa un mayor duelo anticipado en el cuidador. El duelo anticipado tiene un impacto significativo en la salud física, psicológica y social de los cuidadores, asociándose con una mayor sobrecarga, sintomatología depresiva y aislamiento social. Conclusiones El duelo anticipado resulta un concepto relevante en el contexto de las demencias, siendo necesario incluirlo en programas de intervención para esta población (AU)

Introduction Taking care of a relative with dementia may be linked to negative consequences for the caregiver. One of the processes that can be experienced is anticipatory grief, that is defined as the feelings of pain and loss that appear in the caregiver before the death of the person cared for. Objectives The review aimed to conceptualize anticipatory grief in this population, to study the related psychosocial variables, and to know the repercussions for the health of the caregiver. Method A systematic search was made under the directives of PRISMA statement in the ProQuest, PubMed, Web of Science (WOS), and Scopus databases, including studies published in the last 10 years (2013–2023). Results A total of 160 articles were obtained, 15 being finally selected. It is observed that anticipatory grief is defined as an ambiguous process since it appeared before the death of the sick family member. Being a female caregiver, spouse of a family member with dementia, having a closer relationship with him and/or having an important responsibility in care, are associated with a greater chance of experiencing anticipatory grief. In relation to the person cared for, if he or she is in a severe phase of the disease, is younger, and/or presents problematic behaviours, there is also greater anticipatory grief in the family caregiver. Anticipatory grief has a significant impact on caregivers’ physical, psychological, and social health, being associated with greater burden, depressive symptomatology, and social isolation. Conclusions Anticipatory grief turns out to be a relevant concept in the context of dementia, being necessary to include it in intervention programs for this population (AU)