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1.
J Psychiatr Pract ; 28(3): 234-239, 2022 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-35511100

RESUMO

Reports of destructive behavior by military personnel after demobilization have become more frequent; however, the pathways that might lead these individuals to commit such acts are not clear enough. This column presents the case of a retired soldier who reported the onset of pyromania after military service, and the relationship between dissociation and reenactment of the trauma is discussed. The main conclusions are that psychotherapy of traumatized patients should focus on helping them create a verbal representation of the trauma and that integrating ceremonies and rituals into treatment is a possible and significant option.


Assuntos
Luto , Piromania/psicologia , Militares , Piromania/diagnóstico , Pesar , Humanos , Psicoterapia
2.
J Gerontol Nurs ; 48(5): 19-26, 2022 May.
Artigo em Inglês | MEDLINE | ID: mdl-35511060

RESUMO

The current mixed methods study investigated what changes in quality of life (QOL) mean to older adults with complicated grief treated with Accelerated Resolution Therapy (ART) post-hospice services. An informational matrix, which included select patient characteristics (e.g., number of comorbidities, single versus multiple deaths, relationship role), four identified qualitative themes, end of study QOL scores measured by the Centers for Disease Control and Prevention Health-Related QOL Healthy Days Module, and changes in scores from baseline to end of study, was created to analyze the data. Results showed that although a history of multiple deaths may contribute to greater improvements in QOL with therapy, having at least one comorbidity resulted in a richer description and endorsement of QOL in response to treatment. This is the first longitudinal, randomized controlled trial using a mixed methods approach to examine QOL of hospice family caregivers with complicated grief who are receiving ART. This study identifies potential links of QOL and caregiver characteristics, providing nurses with foundational knowledge for assessment, care, and further research on the experiences of complicated grief. [Journal of Gerontological Nursing, 48(5), 19-26.].


Assuntos
Cuidados Paliativos na Terminalidade da Vida , Qualidade de Vida , Idoso , Cuidadores , Comorbidade , Pesar , Humanos
3.
Soins Psychiatr ; 43(338): 25-28, 2022.
Artigo em Francês | MEDLINE | ID: mdl-35598911

RESUMO

After a presentation of the clinical speci-ficities of complex traumas in exiled patients, the psychotherapeutic issues and processes at work in the treatment of traumatic mourning are detailed through a clinical case. Emphasis is placed on the articulation and interface between the private and collective dimensions of grief.


Assuntos
Pesar , Psicoterapia , Humanos , Psicoterapia/métodos
4.
5.
Math Biosci Eng ; 19(6): 5380-5392, 2022 Mar 25.
Artigo em Inglês | MEDLINE | ID: mdl-35603360

RESUMO

Bereavement exclusion (BE) is a criterion for excluding the diagnosis of major depressive disorder (MDD). Simplistically, this criterion states that an individual who reports MDD symptoms should not be diagnosed as suffering from this mental illness, if such an individual is grieving a sorrowful loss. BE was introduced in 1980 to avoid confusing MDD with normal grief, because several cognitive and physical symptoms of grief and depression can look similar. However, in 2013, BE was removed from the MDD diagnosis guidelines. Here, this controversial topic is computationally investigated. A virtual population is generated according to the Brazilian data of death rate and MDD prevalence and its five kinds of individuals are clustered by using a Kohonen's self-organizing map (SOM). In addition, by examining the current guidelines for diagnosing MDD from an analytical perspective, a slight modification is proposed. With this modification, an adequate clustering is achieved by the SOM neural network. Therefore, for mathematical consistency, unbalanced scores should be assigned to the items composing the MDD diagnostic criteria. With the proposed criteria, the co-occurrence of normal grief and MDD can also be satisfactorily clustered.


Assuntos
Luto , Transtorno Depressivo Maior , Depressão/diagnóstico , Depressão/epidemiologia , Transtorno Depressivo Maior/diagnóstico , Transtorno Depressivo Maior/epidemiologia , Transtorno Depressivo Maior/psicologia , Pesar , Humanos , Prevalência
6.
Cien Saude Colet ; 27(4): 1595-1604, 2022 Apr.
Artigo em Português, Inglês | MEDLINE | ID: mdl-35475838

RESUMO

This paper results from research that analyzed the narratives of mothers of autistic children about their experiences with their children, produced and shared by them through videos on YouTube. We used a qualitative methodology to debate the logic and meanings attributed to illness, health, motherhood, and childcare, towards a narrative reconstruction produced by us researchers. We observed that these women spoke primarily about their experiences as mothers of autistic children and directly addressed the emotional difficulties of having a child with autism, such as mourning the ideal child promoted by the diagnosis and the construction of care for an autistic child. Through the videos, the mothers form an identification group based on the premise that they lived everyday experiences, generating significant value and becoming an existential capital. Talking about such experiences in public and far-reaching spaces like YouTube produces, among other things, collective memories that develop a caring community. We understand that the individual story reported and produced in the videos can emotionally and pragmatically help others with a similar experience, re-inhabiting daily life.


Este artigo é resultado de uma pesquisa que analisou narrativas de mães de autistas sobre suas experiências com seus filhos, que foram produzidas e compartilhadas por elas por meio de vídeos no YouTube. Utilizamos a metodologia qualitativa, que nos permitiu debater a lógica e os significados atribuídos à doença, à saúde, à maternidade e ao cuidado dos filhos, em direção a uma reconstrução narrativa produzida por nós, pesquisadoras. Observamos que essas mulheres falavam prioritariamente sobre suas experiências como mães de autistas e abordavam diretamente os percalços emocionais de ter um filho com autismo, tais como o luto do filho ideal promovido pelo diagnóstico e a construção do cuidado de uma criança autista. Por meio dos vídeos, as mães formam um grupo de identificação, baseado na premissa de que viveram experiências comuns, as quais geram um grande valor e se transformam em um capital existencial. Falar sobre tais experiências em um espaço público e de grande alcance como o YouTube produz, entre outras coisas, memórias coletivas que possibilitam o desenvolvimento de uma comunidade afetiva. Compreendemos que a história individual relatada e produzida nos vídeos pode ajudar emocionalmente e pragmaticamente outros que possuem uma vivência parecida, permitindo que o cotidiano seja reabitado.


Assuntos
Transtorno Autístico , Mídias Sociais , Criança , Feminino , Pesar , Humanos , Mães/psicologia , Narração
7.
J Perinat Neonatal Nurs ; 36(2): 115-117, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35476764
8.
Ugeskr Laeger ; 184(17)2022 Apr 25.
Artigo em Dinamarquês | MEDLINE | ID: mdl-35485793

RESUMO

Ectopic pregnancy results in an urgent, sometimes lifethreatening condition and always leads to pregnancy loss. We conducted a literature search on mental health after ectopic pregnancy. The level of anxiety, depression, posttraumatic stress and grief was high, comparable to the level after miscarriage. Several interventions such as good communication, information or follow-up counselling sessions improved mental health. We recommend that clinicians focus on these aspects during admission and follow-up at the general practitioners.


Assuntos
Aborto Espontâneo , Gravidez Ectópica , Aborto Espontâneo/etiologia , Aborto Espontâneo/psicologia , Ansiedade/etiologia , Feminino , Pesar , Humanos , Saúde Mental , Gravidez , Gravidez Ectópica/etiologia
9.
BMC Geriatr ; 22(1): 301, 2022 Apr 08.
Artigo em Inglês | MEDLINE | ID: mdl-35395751

RESUMO

BACKGROUND: The process of aging renders older people susceptible for adverse outcomes upon stress. Various indicators derived from complex systems theory have been proposed for quantifying resilience in living organisms, including humans. We investigated the ability of system-based indicators in capturing the dynamics of resilience in humans who suffer the adversity of spousal bereavement and tested their predictive power in mortality as a finite health transition. METHODS: Using longitudinal register data on weekly healthcare consumption of all Danish citizens over the age of 65 from January 1st, 2011, throughout December 31st, 2016, we performed statistical comparisons of the indicators 'average', 'slope', 'mean squared error', and 'lag-1 autocorrelation' one year before and after spousal bereavement, stratified for age and sex. The relation between levels of these indicators before bereavement and mortality hazards thereafter was determined by time to event analysis. We assessed the added value for mortality prediction via the time dependent area (AUC) under the receiver operating characteristic curve. RESULTS: The study included 934,003 citizens of whom 51,890 experienced spousal bereavement and 2862 died in the first year thereafter. Healthcare consumption is increased, more volatile and accelerating with aging and in men compared to women (all p-values < 0.001). All dynamic indicators before bereavement were positively related with mortality hazards thereafter (all p-values < 0.001). The average discriminative performance for the 1-year mortality risk of the model with only age as a predictor (AUC: 68.9% and 70.2%) was significantly increased with the addition of dynamical indicators (78.5% and 82.4%) for males and females, respectively. CONCLUSIONS: Dynamic indicators in time series of health care expenditures are strong predictors of mortality risk and could be part of predictive models for prognosis after life stressors, such as bereavement.


Assuntos
Luto , Gastos em Saúde , Idoso , Envelhecimento , Feminino , Pesar , Humanos , Masculino , Fatores de Tempo
10.
Elife ; 112022 Apr 13.
Artigo em Inglês | MEDLINE | ID: mdl-35416149

RESUMO

As she closes the door on her time in academia, a neuroscientist faces unexpected grief.


Assuntos
Pesar , Cabeça , Feminino , Humanos
11.
Tijdschr Psychiatr ; 64(3): 160-165, 2022.
Artigo em Holandês | MEDLINE | ID: mdl-35420145

RESUMO

BACKGROUND: The care for people with trauma- and stressor-related disorders is multidisciplinary. The place of chaplaincy care in multidisciplinary trauma care has received limited attention. AIM: Exploration of the place of chaplaincy care in relation to psychotrauma, moral injury, grief and palliative care and in time in relation to exposure to psychotrauma as a basis for a model of multidisciplinary collaboration. METHOD: Inventory and discussion of the position of chaplaincy care in the literature and guidelines for trauma- and stressor-related disorders. RESULTS: Chaplaincy care may support finding meaning and reconnection in people at risk of trauma and PTSD, moral injury, and traumatic grief. Chaplaincy care is increasingly available for palliative and multicultural care recipients. Most guidelines for trauma care recommend the availability of chaplaincy care or research into the effectiveness of complementary existential, spiritual or meaning-making interventions. CONCLUSION: Traumatic stressors represent limit experiences, whereby the quest for meaning, existential and moral orientation are pre-eminently at stake. The use of chaplaincy care supports finding meaning and reconnection and may thereby potentially contribute to the prevention of traumatic exposure to stressors, persistent symptoms after exposure, and worsening of chronic trauma- and stressor related symptoms.


Assuntos
Transtornos de Estresse Pós-Traumáticos , Pesar , Humanos , Princípios Morais , Transtornos de Estresse Pós-Traumáticos/terapia
12.
PLoS One ; 17(4): e0265284, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35390013

RESUMO

As a global threat, the COVID-19 pandemic has been an important factor in increasing death rate worldwide. As the virus spreads across international borders, it causes severe illness, death, and disruptions in our daily lives. Death and dying rituals and customs aid bereaved people in overcoming their grief. In this sense, the purpose of this study was to access thoughts and feelings of Portuguese adults and the impact of the loss in daily life during COVID-19. A structured online questionnaire was applied (snowball sampling) and qualitative data on death and mourning namely the impact of the loss in daily life, was collected. One hundred and sixty-six individuals have lost someone since the beginning of the pandemic and were included. Analysis was inspired by Braun and Clark's content analysis. Most participants were female (66.9%), the median age was of 37.3 years, and 70.5% had a high education degree. Moreover, 30.7% of the participants present anxiety symptoms and 10.2% depression symptoms. The answers of studied participants gave insights on the extent of the loss in day-to-day life and four thematic themes were found: (1) The perceived inadequacy of the funeral rituality, (2) Sadness, fear and loneliness, (3) Changes in sleeping and concentration and increased levels of anxiety and (4) Concerns regarding the pandemic situation. We found a high prevalence of anxiety and depression symptoms in the study sample. Also, the changes in post mortem procedures, have shown to be of great importance in the mourning procedure of the participants.


Assuntos
Luto , COVID-19 , Adulto , COVID-19/epidemiologia , Feminino , Pesar , Humanos , Pandemias , Portugal/epidemiologia
13.
Sci Rep ; 12(1): 5746, 2022 Apr 06.
Artigo em Inglês | MEDLINE | ID: mdl-35388038

RESUMO

Diagnosis of chronic disease in a child can result in unresolved grief (UG) in parents. This study aimed to evaluate the efficacy of psychological insight-oriented therapy (IOT) as a treatment for UG compared to disease related education in parents of children with cystic fibrosis (CF). Sequence of delivery, first IOT then disease related education (or vice versa) was also examined, to let all participants experience both interventions. Parents were screened for UG. Parents with UG were randomised to either five 1-h sessions of IOT or five 1-h sessions of education. Measures were assessed pre-intervention, after the first intervention period (primary efficacy assessment), and after the second intervention period (swapping intervention). Forty-seven parents were screened of which 46.8% (22/47) had UG. Median duration of UG was 5 years (range: 6 months-14 years). Anxiety (50% vs. 20%, p = 0.03) and stress (59% vs. 28%, p = 0.03) were significantly more prevalent in parents with UG. There was no difference between arms in the odds of UG resolving either following the first intervention period (OR 0.88; 95% CI 0.5, 1.5) or the second intervention period (OR 0.91; 95% CI 0.5, 1.6). While not statistically significant, adjusted mean values for seven of the eight mental health measures were lower in the IOT (first) arm compared to the ED (first) arm, following the first intervention period. UG is a significant burden for families affected by CF. Provision of disease related education and psychological support, regardless of sequence, can result in resolution of grief.Trial registration number: ACTRN12621000796886, date of registration 24/06/2021, retrospectively registered.


Assuntos
Fibrose Cística , Criança , Fibrose Cística/terapia , Pesar , Humanos , Saúde Mental , Pais/psicologia , Projetos Piloto
14.
Crit Care ; 26(1): 102, 2022 04 11.
Artigo em Inglês | MEDLINE | ID: mdl-35410374

RESUMO

BACKGROUND/OBJECTIVE: Bereaved ICU family surrogates' psychological distress, e.g., anxiety, depression, and post-traumatic stress disorder (PTSD), is usually examined independently, despite the well-recognized comorbidity of these symptoms. Furthermore, the few studies exploring impact of psychological distress on development of prolonged grief disorder (PGD) did not consider the dynamic impact of symptom evolution. We identified surrogates' distinct patterns/states of comorbid psychological distress and their evolution over the first 3 months of bereavement and evaluated their associations with PGD at 6-month postloss. METHODS: A longitudinal observational study was conducted on 319 bereaved surrogates. Symptoms of anxiety, depression, PTSD, and PGD were measured by the anxiety and depression subscales of the Hospital Anxiety and Depression Scale, Impact of Event Scale-Revised scale, and the PGD-13, respectively. Distinct psychological-distress states and their evolution were examined by latent transition analysis. Association between psychological-distress states and PGD symptoms was examined by logistic regression. RESULTS: Three distinct comorbid psychological-distress states (prevalence) were initially identified: no distress (56.3%), severe-depressive/borderline-anxiety distress (30.5%), and severe-anxiety/depressive/PTSD distress (13.3%). Except for those in the stable no-distress state, surrogates tended to regress to states of less psychological distress at the subsequent assessment. The proportion of participants in each psychological-distress state changed to no distress (76.8%), severe-depressive/borderline-anxiety distress (18.6%), and severe-anxiety/depressive/PTSD distress (4.6%) at 3-month postloss. Surrogates in the severe-depressive/borderline-anxiety distress and severe-anxiety/depressive/PTSD-distress state at 3-month postloss were more likely to develop PGD at 6-month postloss (OR [95%] = 14.58 [1.48, 143.54] and 104.50 [10.45, 1044.66], respectively). CONCLUSIONS: A minority of family surrogates of ICU decedents suffered comorbid severe-depressive/borderline-anxiety distress and severe-anxiety/depressive/PTSD symptoms during early bereavement, but they were more likely to progress into PGD at 6-month postloss.


Assuntos
Angústia Psicológica , Transtornos de Estresse Pós-Traumáticos , Comorbidade , Depressão/psicologia , Pesar , Humanos , Unidades de Terapia Intensiva , Transtornos de Estresse Pós-Traumáticos/complicações , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Transtornos de Estresse Pós-Traumáticos/psicologia
15.
JAMA ; 327(13): 1233, 2022 04 05.
Artigo em Inglês | MEDLINE | ID: mdl-35380581
16.
J Consult Clin Psychol ; 90(4): 303-313, 2022 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-35446077

RESUMO

OBJECTIVE: Investigating the concordance of prolonged grief disorder (PGD) criteria that have been recently introduced to the 5th text revision of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR) and the International Classification of Diseases 11th Revision (ICD-11). METHOD: N = 193 treatment-seeking bereaved adults were assessed with the prolonged grief disorder 13 + 9 interview. Data were examined in terms of (a) diagnostic rates for PGDDSM-5-TR and PGDICD-11, including increases of the PGDICD-11 accessory symptom threshold (PGDICD-11-X+) and time criterion (PGDICD-11-12 months), (b) dimensionality, (c) the frequency with which single PGD symptoms occur, and (d) concurrent validity in terms of psychological symptoms and loss-related characteristics. RESULTS: The diagnostic rate of PGDDSM-5-TR (52%) was significantly lower than that of PGDICD-11 (76%) and agreement between the two criteria sets was moderate, κ = 0.51, 95% CI [0.47-0.55]. Increasing the PGDICD-11 accessory symptom threshold did not improve the diagnostic agreement. In contrast, increasing the ICD-11 time criterion led to almost perfect agreement between PGDICD-11-12 months and PGDDSM-5-TR, κ = 0.91, 95% CI [0.89-0.93]. Confirmatory factor analysis results indicated a one-factor model fit best for both PGDDSM-5-TR and PGDICD-11. Emotional pain symptoms (e.g., guilt) were predominantly reported by patients with a PGDICD-11 diagnosis, while attachment disturbance symptoms (e.g., identity disruption) were reported more often by patients with a PGDDSM-5-TR diagnosis. CONCLUSIONS: Despite methodological limitations of this study, results indicate discordance in PGDDSM-5-TR and PGDICD-11 regarding diagnostic rates and single symptom occurrence, while the factor structure is similar. Changes in the ICD-11 time criterion could reduce these differences. (PsycInfo Database Record (c) 2022 APA, all rights reserved).


Assuntos
Luto , Classificação Internacional de Doenças , Adulto , Manual Diagnóstico e Estatístico de Transtornos Mentais , Pesar , Humanos
17.
Artigo em Inglês | MEDLINE | ID: mdl-35409760

RESUMO

Individuals bereaved by suicide represent an important group in terms of postvention. While peer support groups are often accessed by those bereaved, few studies have examined their impact in terms of physical and mental health wellbeing. The aim of this study was to examine psychosocial outcomes of individuals attending suicide bereavement peer support groups in Ireland. Between August 2020 and June 2021, all members were invited to complete a survey, with new members also surveyed at three- and six-month follow-up, to examine changes in wellbeing, depressive symptoms and grief reactions. Results were analyzed using descriptive statistics and mixed linear regression models. The 75 participants were mostly female, with lower levels of overall wellbeing and a higher prevalence of depressive symptoms and suicidal ideation than the general population. Participants also reported high levels of social adjustment difficulties and grief reactions, which were more pronounced for those more recently bereaved. At follow-up (n = 28), a significant improvement in wellbeing and a reduction in grief reactions were found, adjusting for time since bereavement. Participants identified the groups as creating a safe space and providing a sense of belonging and hope. Notwithstanding the small number of participants at follow-up, these findings underline the enduring mental health challenges for those bereaved by suicide and provide further evidence for the role of peer support in postvention.


Assuntos
Luto , Suicídio , Feminino , Seguimentos , Pesar , Humanos , Masculino , Grupos de Autoajuda , Suicídio/psicologia
18.
Nurs Sci Q ; 35(2): 184-190, 2022 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-35392724

RESUMO

The authors in this article will present storytelling through the lens of the humanbecoming family model. From this perspective, storytelling can be viewed as the following: (a) family storytelling as a mode of fostering personal and family becoming, (b) family storytelling as a confirming of family beliefs and values, and (c) family storytelling as a way of addressing issues of grief and loss. Selected literature is presented to highlight the essences, paradoxes, and processes of the humanbecoming family model.


Assuntos
Comunicação , Pesar , Humanos
19.
Psychiatr Danub ; 34(1): 3-10, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35467604

RESUMO

Love is a delicate experience that delves into the foundations of the psyche, and many sources of the emotional experience of love remain unconscious. The nature of love is twofold and contradictory, regressive and progressive, constructive and destructive, connecting and separating, directed toward the object and the self. The ability to idealize is a precondition for "falling in love". Abrupt disappointments can be traumatizing, but gradual ones include the work of mourning and may lead to a more authentic relationship that is less obscured by narcissistic needs. Some aspects of projective identification, which can be a defense, a primitive form of object relation, and a path for psychological change, may be present in all forms of love. These are the close interaction of self and object, blurred boundaries between them, the need that the other person feels what one feels, and a strong desire to continue the relationship. A therapeutic setting can enable the long-term transformation of love in transference and more mature expressions of love in life. The maturation of narcissism is the hallmark of mature love. One of the prerequisites for mature love is a mature superego, which does not require suffering as a prerequisite for satisfying one's needs. Clear differentiation of the boundaries of the self enables safe (temporary) blurring or disappearing of its boundaries and satisfaction of needs for repetition of lost fusion with the primary object of love. Mature love also means the capacity for tolerating ambivalence, i.e., the capacity to integrate both love and hatred experiences of the same person. One can see love as a "glue" that helps integrate different aspects of the psyche into a harmonious whole.


Assuntos
Amor , Apego ao Objeto , Pesar , Humanos , Narcisismo
20.
J Gynecol Obstet Hum Reprod ; 51(4): 102353, 2022 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-35247609

RESUMO

PURPOSE: To evaluate emotional distress and prenatal attachment throughout a subsequent pregnancy after Termination of Pregnancy (TOP) for fetal abnormality. METHODS: Observational study, in a French Tertiary Maternity. POPULATION: 25 women in a subsequent pregnancy after a medical termination of pregnancy for foetal abnormality, 18-year-old and older. Prenatal Interviews at 20 Gestationnal weeks (GW), 27 GW and 35 GW and Postnatal at 3 months and at each time self-administered questionnaires of anxiety, post-traumatic stress syndrome (PCLS) depressive symptoms (EPDS), prenatal attachment (PAI) and Perinatal Grief Scale (PGS). RESULTS: Pregnancy onset, i.e. before 20 GW, showed increased prevalence of anxiety (16/23, 66.7%), depression (7/23, 30.4%) and post-traumatic stress symptoms (4/16, 25%). Total score on PGS is higher in onset of pregnancy than in the third trimester (p = 0.005). Prenatal attachment was lower during early pregnancy (p = 0.003) and correlated inversely with grief intensity (p = 0.022). During late pregnancy, emotional symptoms decrease, and prenatal attachment stopped increase positively, specifically among women whose foetal abnormality in previous pregnancies were diagnosed late, at an average of 25 GW. CONCLUSION: This research shows the specific dynamics of pregnancies following TOP and highlights the necessity for early prenatal psychological support. One should also pay special attention to prenatal attachment during late pregnancy even after knowing that the fetus is healthy.


Assuntos
Ansiedade , Pesar , Aborto Eugênico/psicologia , Adolescente , Adulto , Ansiedade/epidemiologia , Ansiedade/psicologia , Família , Feminino , Feto/anormalidades , Humanos , Gravidez/psicologia , Terceiro Trimestre da Gravidez , Inquéritos e Questionários
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