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

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

Investigating the Social Correlates Associated With Getting Help After a Suicide or Not: An Important Unexamined Bereavement Question.

Seeking to provide more systematic information on treatment-seeking and those not seeking help after a suicide, we investigated demographic, experiential and grief problems related correlates among recently suicide bereaved adults, conducting an on-line survey of a sample of U.S. 1,132 adults who lost a loved one to suicide during the last six years. Focusing upon first-degree relative loss survivors (n = 222) we hypothesized those not seeking help would be more likely to report conventional religiosity, greater social support and more use of alternative treatment modalities. Instead, we found those not seeking help were almost twice as likely to not attend religious services, compared to help seekers. Social support enhanced the bereaved individuals' pursuit of treatments and those who did not obtain help appeared reluctant to getting non-traditional treatment support. Help seekers were more likely to experience post-traumatic growth and less likely to see suicide loss survivorship as stigmatizing.

Examining the Associations Between Substance Misuse and Suicide Bereavement.

Focusing on the understudied question of substance misuse among suicide bereaved adults we investigated patterns of binge drinking and non-prescribed drug use among a recently bereaved sample (n = 1,132). Comparing our respondents to the non-bereaved, those in the 2022 National Survey of Drug Use and Health (n = 71,369), we did not find heightened problematical substance misuses among our respondents. With t-tests and multiple regression analyses we examined whether binge drinkers and non-prescribed drug users had heightened levels of grief difficulties, PTSD, self-blaming and depression compared to others not bingeing or using non-prescribed drugs. Results showed binge drinkers had more of all these grieving problems when important confounding variables were also considered. Analysis of the demographic correlates of bingeing showed them dimly aware of their own additional grieving and substance misusing problems. Since 75% indicated being under the care of counseling professionals, this represents an important opportunity for psycho-educational helping.

Examining grieving problem correlates of anticipation of the death vs. shock among overdose death and suicide bereaved adults.

We conducted an online survey with individuals bereaved by drug deaths (n = 115), suicide (n = 185) and sudden natural deaths (n = 103), including questions about anticipating the death vs. shock, other behaviors, established measures of mental health and grieving difficulties. Results showed more drug death bereaved anticipating their loved one's death while suicide bereaved were more shocked. Death shocked respondents showed greater PTSD, other mental health, and grieving problems; those anticipating the death had less PTSD, grieving problems, and engaged in more meaning-making. These contrasting patterns should call for diverging clinical strategies in offering aid to these traumatically bereaved mourners.

Personality and Grief-Related Panic Attacks: Analysis of Neuroticism, Worry, and Anxiety Sensitivity.

Grief-related panic attacks (GRPAs) are a relatively common yet debilitating psychological reaction to loss, the mechanisms of which remain poorly understood among scholars. The purpose of this study was to identify the personality traits that underlie GRPAs in a sample of 314 bereaved adults. The results indicate that GRPAs were relatively common (55.4%) and that anxiety sensitivity uniquely predicted both frequency and impairment associated with these kinds of attacks, while taking into account the effects of neuroticism, trait worry, grief, and gender. Findings suggest that anxiety sensitivity may be a risk factor for GRPAs and magnified grief for some mourners. Clinical implications and future directions are discussed.

Predictors of Stigma, Guilt, and Shame among Adults Bereaved by Fatal Overdose.

With the spectacular rise of US overdose deaths, bereavement for these affected families has become a matter of increasing concern. Qualitative research has highlighted the role of stigmatization as well as guilt and shame among this population. However, the magnitude and pre-death predictors of stigmatization, guilt, and shame have yet to be assessed quantitatively. In the current study, we assess the magnitude of stigmatization, guilt, and shame among 115 adults bereaved by overdose by drawing comparisons with 185 adults bereaved by suicide. Results revealed no significant differences regarding overall levels of stigmatization, guilt, and shame between the overdose and suicide bereaved. Among the overdose bereaved, regression models indicated a number of pre-death factors associated with stigmatization, guilt, and shame, such as the frequency of the decedent's drug use, family drug use severity, and interpersonal conflict between the bereaved and the decedent. Implications and future directions for research are discussed.

Grief memoirs: The familiarity of helping professionals with the genre and its potential incorporation into grief therapy.

The grief memoir is a fast-developing genre that in recent decades has become a popular form of public mourning and self-therapy in many Western cultures, especially in the United States and Great Britain. We surveyed 76 helping professionals to assess if the grief memoir is a genre with which they are familiar and whether they employ such narratives as an adjunct in their work with the bereaved. Most bibliotherapeutic studies focus either on self-help or affective literature. This study is unique in evaluating a life writing genre which promises to combine the therapeutic benefits of both.

Examining bereavement-related needs and outcomes among survivors of sudden loss: A latent profile analysis.

OBJECTIVE: Recognizing important bereavement-related needs among sudden loss survivors (e.g., suicide, overdose)-a population that is burgeoning and at risk for deleterious outcomes-is a critical task as needs may reflect modifiable grief-related variables that can assist with post-loss adjustment. METHODS: Latent profile analysis was used among 347 sudden loss survivors to (a) identify distinct patterns of needs among survivors of sudden loss, (b) assess predictors of such profiles, and (c) investigate differences in profiles in terms of bereavement outcomes. RESULTS: Four classes of bereavement-related needs were identified: a low needs class, a moderate needs-spiritual class, a moderate needs-relational class, and a high needs (HN) class. Clear differences emerged between need classes with the HN class evidencing the greatest level of grief and mental health sequelae. CONCLUSION: Tending to bereavement-related needs is critical, as they indicate the degree of distress and reflect modifiable therapeutic variables.

Spirituality Influences Emotion Regulation During Grief Talk: The Moderating Role of Prolonged Grief Symptomatology.

A growing body of research demonstrates that religion greatly affects people's adjustment to loss. However, little is known about the influence of religiosity on emotion regulation during grief. The present study attempts to fill this void in the literature by examining the predictive relationship between variables assessing facets of religiosity and emotion regulation during an interview about loss in a sample of bereaved adults. The results demonstrated that religiousness, spirituality, and negative religious coping were correlated with emotion reactivity following an interview. Spirituality's influence was also found to be moderated by prolonged grief symptoms, as spirituality predicted more adaptive emotion regulation among those with low-to-mild levels of prolonged grief symptomatology, but not among participants with elevated prolonged grief disorder (PGD) symptoms. These findings support the beneficial effects of religion in bereavement adjustment as well as its limits.

Investigating risk for grief severity: Attachment to the deceased and relationship quality.

Previous research examining the interrelationship between attachment, relationship quality, and bereavement outcomes suffers from a lack of precision and sophistication in the measurement of the core constructs of interest. The present study adapted an existing measure of attachment and employed a novel instrument of relationship quality to examine specific attachment to and relationship quality with the deceased as contributors to grief symptom severity. A sample of 385 bereaved college students completed measures retrospectively assessing relationship quality, attachment to the deceased, and grief symptomatology. Findings indicate that specific attachment to the deceased differs significantly from global attachment style and that relationship quality and attachment anxiety and avoidance interact in significant ways to predict the risk of grief severity. Specifically, individuals with a Preoccupied attachment style (high anxiety, low avoidance) are most at risk for adverse grief reactions in the context of high relationship closeness and conflict. This study is limited by an over-representation of extended family loss, which may have unique implications for attachment and relationship quality. Grief therapists should consider the implications of attachment and relationship quality with the deceased in the selection of relationship-enhancing or relational problem-solving interventions.

Distinguishing the meaning making processes of survivors of suicide loss: An expansion of the meaning of loss codebook.

Suicide loss represents particularly a difficult form of bereavement due to the challenges that volitional death poses to survivors. Understanding these challenges requires recognition of the idiosyncratic processes of meaning reconstruction for this specific group of grievers. The current study investigates such processes in survivors of suicide loss (SOSL) by utilizing the Meaning of Loss Codebook (MLC) to analyze the narratives of eight SOSL. The findings contribute to a broader understanding of meaning making following suicide, strengthen the validity of the MLC by demonstrating its appropriateness for SOSL, and illuminate unique challenges faced by SOSL, resulting in the proposal of supplemental MLC codes. Research and clinical implications are discussed.

Closeness and Conflict With the Deceased: Exploring the Factor Structure of the Quality of Relationships Inventory in a Bereaved Student Sample.

With mounting empirical evidence that interpersonal closeness and conflict with the deceased prior to death are significant predictors of grief reactions following loss, accurate empirical examination of these two constructs is of high importance. Despite the utility of the Quality of Relationships Inventory (QRI) in numerous domains of research, the original instrument was not constructed with a predeath, mourner-decedent relationship in mind. Therefore, this study clarified the factor structure of a modified QRI focusing on major dimensions of the predeath relationship with the deceased-dynamics that could have strong implications for the survivor's bereavement trajectory. An exploratory factor analysis of 386 bereaved adults revealed two salient factors, deemed closeness and conflict. These results suggest that the modified bereavement version of the QRI, designated the Quality of Relationships Inventory-Bereavement version, is well positioned to advance research in thanatology, with possible limitations noted in the range of relationships to which it is applicable.

Domains of Social Support That Predict Bereavement Distress Following Homicide Loss.

Psychological adaptation following homicide loss can prove more challenging for grievers than other types of losses. Although social support can be beneficial in bereavement, research is mixed in terms of identifying whether it serves as a buffer to distress following traumatic loss. In particular, studies have not parsed out specific domains of social support that best predict positive bereavement outcomes. Recruiting a sample of 47 African Americans bereaved by homicide, we examined six types of social support along with the griever's perceived need for or satisfaction with each and analyzed them in relation to depression, anxiety, complicated grief, and posttraumatic stress disorder outcomes. Results of multivariate analyses revealed that the griever's level of satisfaction with physical assistance at the initial assessment best predicted lower levels of depression, anxiety, and posttraumatic stress disorder levels 6 months later, while less need for physical assistance predicted lower complicated grief at follow-up. Clinical implications and suggestions for future research are discussed.

Revealing carrier-envelope phase through frequency mixing and interference in frequency resolved optical gating.

We demonstrate that full temporal characterisation of few-cycle electromagnetic pulses, including retrieval of the carrier envelope phase (CEP), can be directly obtained from Frequency Resolved Optical Gating (FROG) techniques in which the interference between non-linear frequency mixing processes is resolved. We derive a framework for this scheme, defined Real Domain FROG (ReD-FROG), for the cases of interference between sum and difference frequency components and between fundamental and sum / difference frequency components. A successful numerical demonstration of ReD-FROG as applied to the case of a self-referenced measurement is provided. A proof-of-principle experiment is performed in which the CEP of a single-cycle THz pulse is accurately obtained and demonstrates the possibility for THz detection beyond optical probe duration limitations inherent to electro-optic sampling.

Role of misalignment-induced angular chirp in the electro-optic detection of THz waves.

A general description of electro-optic detection including non-collinear phase matching and finite transverse beam profiles is presented. It is shown theoretically and experimentally that non-collinear phase matching in ZnTe (and similar materials) produces an angular chirp in the χ(2)-generated optical signal. Due to this, in non-collinear THz and probe arrangements such as single-shot THz measurements or through accidental misalignment, measurement of an undistorted THz signal is critically dependent on having sufficient angular acceptance in the optical probe path. The associated spatial walk-off can also preclude the phase retardation approximation used in THz-TDS. The rate of misalignment-induced chirping in commonly used ZnTe and GaP schemes is tabulated, allowing ready analysis of a detection system.

Prevalence and Co-Occurrence of Psychiatric Conditions Among Bereaved Adults.

Importance: Rates of grief-related psychiatric conditions, such as prolonged grief disorder (PGD), posttraumatic stress disorder (PTSD), and major depressive disorder (MDD), among bereaved adults in the US are largely unknown due to limited studies that leverage national samples. Objective: To assess risk factors for and prevalence rates and co-occurrence of PGD, PTSD, and MDD among bereaved adults in the US. Design, Setting, and Participants: Data for this survey study were collected from a large US panel sample between October 10 and 28, 2022, using a web-based survey. Participants were aged 18 years or older and were proficient in English. Data analysis was conducted between March and June 2023. Main Outcomes and Measures: Probable psychiatric conditions were assessed with validated measures that used conservative cutoff scores, duration, and impairment criteria. These measures included the revised Prolonged Grief Disorder scale for PGD, the PTSD Checklist for DSM-5 for PTSD, and the Patient Health Questionnaire-9 for MDD. Data were analyzed using basic descriptives and logistic regression. Results: A total of 2034 adults (n = 1529 and 505 in the bereaved and comparison groups, respectively) completed the study. Respondents had a mean (SD) age of 40.7 (15.9) years; the majority were women (1314 [64.6%]) and had at least some college experience (1394 [68.5%]). With regard to race and ethnicity, 392 respondents (19.3%) were Black, 138 (6.8%) were Hispanic, and 1357 (66.7%) were White. Among bereaved adults, 312 (20.4%), 518 (33.9%), and 461 (30.2%) met criteria for a presumptive diagnosis of PGD, PTSD, and MDD, respectively. Comorbidities were common, with 441 participants (28.8%) meeting criteria for at least 2 co-occurring disorders. Comorbid PGD, PTSD, and MDD were more common than any 2 co-occurring or isolated disorders; the presence of co-occurring conditions was more likely among respondents who reported a traumatic loss. Age and educational attainment were associated with the risk of psychiatric conditions; less time since the index death, loss of a psychologically close other, and a traumatic loss experience were associated with increased risk of PGD, PTSD, and MDD or their co-occurrence. Conclusions and Relevance: In this study, the majority of bereaved adults did not meet presumptive criteria for PGD, PTSD, or MDD. Nevertheless, PGD, PTSD, and MDD were highly prevalent and comorbid, particularly among those who experienced traumatic loss. These findings underscore the need for integrated psychological care that leverages transdiagnostic mechanisms of evidence-based practice.

Bereavement in the Aftermath of Suicide, Overdose, and Sudden-Natural Death: Evaluating a New Measure of Needs.

Bereavement has been associated with a number of adverse outcomes, including mortality, particularly among those who experience the sudden loss of a close other. With rising rates of sudden death in the United States, fueled by an alarming increase in fatal overdose deaths, identifying bereavement-related needs among the sudden-death bereaved is essential. The present study investigated the factor structure, internal reliability, and validity of the Sudden Bereavement Needs Inventory (SBNI) in a sample of sudden loss survivors (i.e., fatal overdose, suicide, and sudden-natural loss; N = 403). Confirmatory factor analysis supported a six-factor structure, with items reflecting pragmatic, informational, spiritual, relational, meaning, and emotional needs. SBNI factors showed adequate internal consistency, with significant associations between SBNI scores, loss characteristics, and mental health outcomes (e.g., prolonged grief symptoms, meaning-making, posttraumatic stress disorder [PTSD] symptoms, and anxiety), supporting the scale's validity and highlighting the potential applicability of the instrument in both research and clinical contexts. Future research should examine test-retest reliability of the SBNI, particularly through the lens of understanding whether and how bereavement needs change over time.

Exploring the mental health correlates of overdose loss.

Despite the exorbitant rise in overdose-related deaths, little is known about the mental health burden associated with this form of loss. Using validated self-report instruments, the present study investigated the prevalence of pathological symptoms of prolonged grief disorder (PGD), posttraumatic stress disorder (PTSD), major depressive disorder (MDD) and generalized anxiety disorder (GAD), and suicide risk among a sample of overdose loss survivors (n = 115). Comparison groups consisting of other sudden loss survivors (suicide and sudden-natural loss) were employed to illuminate any shared or unique mental health challenges. Consistent with this study's primary hypothesis, results indicated that the overall mental health burden of overdose loss is substantial. Specifically, after controlling for a number of covariates, overdose loss survivors were approximately three times more likely to meet the symptom severity threshold for PGD, PTSD, and MDD compared to sudden-natural loss survivors. Overdose loss survivors also appeared to be at risk for GAD symptoms and suicide, but differences were non-significant after accounting for a number of covariates. Overall, this study is the first to examine this particular constellation of mental health outcomes associated with overdose bereavement, underscoring the need for additional empirical and clinical attention placed on this burgeoning population.

Electron bunch length measurements from laser-accelerated electrons using single-shot THz time-domain interferometry.

Laser-plasma wakefield-based electron accelerators are expected to deliver ultrashort electron bunches with unprecedented peak currents. However, their actual pulse duration has never been directly measured in a single-shot experiment. We present measurements of the ultrashort duration of such electron bunches by means of THz time-domain interferometry. With data obtained using a 0.5 J, 45 fs, 800 nm laser and a ZnTe-based electro-optical setup, we demonstrate the duration of laser-accelerated, quasimonoenergetic electron bunches [best fit of 32 fs (FWHM) with a 90% upper confidence level of 38 fs] to be shorter than the drive laser pulse, but similar to the plasma period.

Concomitant rib fractures and minor liver or spleen injuries in blunt trauma: what is the potential for missed diaphragmatic injuries?

Nonoperative management (NOM) of blunt liver or spleen injuries (LSI) is widely accepted, but diaphragmatic injuries (DI) can be elusive. We hypothesize that rib fractures and minor LSI (RF+ minor LSI) are associated with DI. Patients with blunt injury undergoing exploratory laparotomy between January 1, 2000, and December 31, 2007, were identified from our registry. The association between injury variables and DI was examined with logistic regression. Organ Injury Scores of the liver and spleen of Grade I/II were defined as "minor." A potentially nonoperative (PNO) patient had a rib fracture and minor LSI but no bowel injury or hypotension (systolic blood pressure less than 90 mmHg). The incidence of DI was 7.5 per cent (53 of 705) overall but 20 per cent (seven of 35) in patients with RF + minor LSI. Nineteen PNO patients had four (21.1%) DIs. RF + LSI (3.26 [1.74-6.12], P < 0.001) and motor vehicle collisions (4.93 [2.36-10.32], P < 0.001) were independently associated with DI. The incidence of laparotomy in all critically ill blunt injury patients (n = 2177) decreased significantly (P = 0.003). RF + minor LSI are associated with DI even when there are no other operative injuries. Because NOM is increasingly accepted, the potential for missed DI exists. When high-quality imaging is not available or is equivocal, further studies should be considered.