Social Interaction Within a Trauma-Exposed Population During the Early Phase of COVID-19
The novel coronavirus (COVID-19) has led to significant stressors and shifts in social life, yet social interactions experienced by people with trauma exposure during the COVID pandemic is largely unknown. This study assessed frequency of interactions, social support given and received, and prosocial behavior using online survey methods (=1049). We examined differences in experiences across three groups: no trauma exposure, trauma-exposed with low PTSD symptoms, and trauma-exposed with high PTSD symptoms. We also explored correlations between social interactions and PTSD symptom clusters. Results indicated significant differences across groups and the high PTSD group reported stronger associations between social interaction variables and symptom clusters, on average.
Effectiveness of a Cancer Bereavement Therapeutic Group
This study examined the effectiveness of a novel cancer bereavement group. Twenty-seven participants attended a sixsession cancer bereavement therapeutic group. Data were collected at baseline, intervention completion, and three-month follow-up. Grief intensity and symptoms of posttraumatic stress disorder (PTSD), depression, and anxiety were reduced postintervention, and self-compassion increased. At follow-up, improvement remained for grief, PTSD, and depression. A small quasi-experimental waiting-list comparison group showed no change on any measure between baseline and waiting-list end. This study provides preliminary evidence that a brief therapeutic group is an effective intervention for cancer bereavement.
Restorative Retelling for Violent Death: An Investigation of Treatment Effectiveness, Influencing Factors, and Durability
Many adults who have lost a loved one to violent death suffer from depression, posttraumatic stress disorder (PTSD), and complicated grief. Limited research has examined structured group interventions for violent death survivors or characteristics (e.g., types of loss, quality and type of relationship with the deceased) that may impact response to intervention. This records review of 91 survivors examined the effectiveness of Restorative Retelling (RR), a brief structured group intervention for violent loss survivors. Participants completed depression, PTSD, and complicated grief measures at pre- and post-treatment and at 1-year follow-up for a subset of participants. Findings revealed statistically significant changes in depression and PTSD symptoms (Cohen's d values ranged from .33-.46) at post-treatment, with significant changes observed across all domains at 1-year follow-up. Treatment response appeared to be influenced by high distress, gender, and relationship with the deceased. Results imply a large-scale randomized control trial to determine treatment efficacy.
Children's Coping in the Context of Disasters and Terrorism
Disasters and terrorism present significant and often overwhelming challenges for children and families worldwide. Individual, family, and social factors influence disaster reactions and the diverse ways in which children cope. This article links conceptualizations of stress and coping to empirical knowledge of children's disaster reactions, identifies limitations in our current understanding, and suggests areas for future study of disaster coping. Coping strategies, developmental trajectories influencing coping, and the interplay between parent and child coping represent critical areas for advancing the field and for informing programs and services that benefit children's preparedness and foster resilience in the face of mass trauma.
Coping Strategies Used by School Staff After a Crisis: A Research Note
There is much literature on crisis support in schools but little on how school staff are affected. This research had two aims: to begin to explore the coping strategies used by school staff after a crisis event, and to investigate measures that might prove valuable for future research. Seven cases are presented using three measures: the WHO (Five) Wellbeing Index, the Impact of Event Scale-Revised, and the Ways of Coping-Revised. Results from this initial study show great variation in the range of responses reported by teachers.
Disciplinary Wounds: Has Grief Become the Identified Patient for a Field Gone Awry?
In the last few decades, grief and loss research in the psychological domain has focused almost exclusively on its dysfunctional nature. I examine what is underneath these questions about pathology and suggest that our discipline is suffering from an attachment wound where we have dissociated from our historical roots when it comes to the study of grief and loss. I argue that we need to ask new questions about grief and loss and present two examples of my collaborative work to illustrate innovative ways of thinking about and researching grief.
Disambiguating Dependency and Attachment Among Conjugally Bereaved Adults
This study aims to investigate the effects of dependency and attachment in adjusting to the loss of a loved one by directly comparing the relative contribution of each to bereavement outcomes among midlife adults. Comparisons among attachment and dependency are made using models that control for attachment among three groups of bereaved adults (=102): prolonged grievers (=25), resolved grievers (=41), and a married comparison group (=36). Prolonged grievers displayed higher marginal means of dysfunctional detachment dependency and lower marginal means of healthy dependency compared to resolved grievers and married adults, even when controlling for attachment style. Findings suggest that attachment and dependency predict unique domains of grief outcome.
Mindful nonreactivity moderates the relationship between posttraumatic stress disorder and depression
PTSD and depression represent major individual and societal burdens. Depression is commonly comorbid with PTSD among veterans, although buffers of this relationship are unclear. We evaluated whether facets of mindfulness moderated the relationship between PTSD and depression in veterans with PTSD ( = 70). Three facets - nonjudging, acting with awareness, and nonreactivity - were assessed as moderators. Results indicated nonreactivity significantly attenuated the relationship between PTSD and depression (=.013), such that veterans with high nonreactivity (+1 SD) showed a nonsignificant relationship between PTSD and depression, whereas veterans with average (Mean; <.001) and low (-1 SD; <.001) nonreactivity exhibited a significant relationship.
The role of avoidance in complicated grief: A detailed examination of the Grief-Related Avoidance Questionnaire (GRAQ) in a large sample of individuals with complicated grief
Trauma-Informed Medical Care: Patient Response to a Primary Care Provider Communication Training
Trauma exposure predicts mental disorders and health outcomes; yet there is little training of primary care providers about trauma's effects, and how to better interact with trauma survivors. This study adapted a theory-based approach to working with trauma survivors, Risking Connection, into a 6-hour CME course, Trauma-Informed Medical Care (TI-Med), to evaluate its feasibility and preliminary efficacy. We randomized four primary care sites to training or wait-list conditions; PCPs at wait-list sites were trained after reassessment. Primary care providers (PCPs) were Family Medicine residents ( = 17; 2 sites) or community physicians ( = 13; 2 sites). Outcomes reported here comprised a survey of 400 actual patients seen by the PCPs in the study. Patients, mostly minority, completed surveys before or after their provider received training. Patients rated PCPs significantly higher after training on a scale encompassing partnership issues. Breakdowns showed lower partnership scores for those with trauma or posttraumatic stress symptoms. Future studies will need to include more specific trauma-related outcomes. Nevertheless, this training is a promising initial approach to teaching trauma-informed communication skills to PCPs.
Parent Grief 1-13 Months After Death in Neonatal and Pediatric Intensive Care Units
Describe changes in mothers' and fathers' grief from 1 to 13 months after infant/child neonatal/pediatric intensive care unit death and identify factors related to their grief.
Loss as Experienced by Ugandan Grandparent-Caregivers of Children Affected by HIV/AIDS
Despite increasing numbers of studies investigating grandparent-caregivers of children orphaned by HIV/AIDS in sub-Saharan Africa, research on their mental and physical health remains inadequate. We provide a qualitative account of the nature, extent, and relationships among multiple variations of loss emerging from 32 interviews with Ugandan grandparent-caregivers of grandchildren affected by HIV/AIDS. Regardless the type or nature of the loss, participants expressed physical, emotional, and financial distress as a result. This cumulative loss and subsequent grief could potentially be associated with mental and physical health problems. Research to further explore the concept of loss among this vulnerable population is recommended.
Associations between gender, torture, and health: A 5-year retrospective cohort analysis
Our purpose was to identify longitudinal associations between torture exposure, physical and mental health outcomes, and gender in a cohort of 143 war-affected Karen adults five years post resettlement. Results showed that participants who self-reported primary torture experiences had higher rates of certain mental and physical health diagnoses. We observed gender differences in health over time in the cohort. Findings have implications for how primary care and public health providers implement war trauma screening tools and timelines, targeted healthcare services, and community resources to promote health and prevent disease in populations that have trauma from torture or war.
Prevalence of parental bereavement among female sex workers (FSW) in Kibra, Kenya
Female sex workers (FSW) residing in Kibra, Kenya experience elevated exposure to adverse events, yet the prevalence of parental bereavement is not well characterized. This cross-sectional pilot study on 301 FSWs residing in Kibra, Kenya found that 67.7% of these women were parentally bereaved. Significantly fewer parentally bereaved women reported historical use of condoms and emergency contraception compared to non-bereaved women, and older age of paternal bereavement was significantly associated with current contraceptive use. Prevalence rates of bereavement among this cohort are well over the national Kenyan average, and further research on the specific impact of bereavement is warranted.
Coping with a loved one's substance use disorder or gambling disorder: what strategies really help?
Family members of people with substance use or gambling disorders (SUD/GD) struggle to cope with ongoing impacts to family life. Effective coping is critical but it is unclear which strategies are helpful for family members, as research is lacking. Female spouses/partners of people with SUD/GD (=211) reported helpfulness and use of engaged, tolerant, and withdrawal coping strategies. Withdrawal coping was most helpful, and commonly used. Some engaged coping strategies were unhelpful but frequently used. Coping is complex; research is needed into effective coping for differing goals and contexts Professionals should empower family members to use strategies helpful to their well-being.
Preliminary Results of Caregiver Speaks: A Storytelling Intervention for Bereaved Family Caregivers
When bereaved cancer caregivers have the opportunity to tell stories about their caregiving and bereavement journey, they are better able to make meaning of these experiences. Creating a space where they can share stories with other bereaved caregivers increases social validation, facilitates the meaning-making process, and reduces distress and risk for complicated grief. This study explored the feasibility and acceptability of an innovative storytelling intervention for bereaved family caregivers of cancer patients. Twenty-one participants engaged in the intervention, and eleven were interviewed about their experience. Results indicated study feasibility and intervention acceptability. Suggestions for future intervention were also provided.
Coping in the Time of COVID-19: Buffering Stressors With Coping Strategies
Policies to reduce the spread of COVID-19 are negatively impacting the psychological well-being of the general population. This cross-sectional study explores the associations of coping strategies with symptoms of depression and anxiety among adults residing in the United States. Our results showed that participants who turned to religion were less depressed or anxious. Those engaging in substance use, behavioral disengagement, and seeking social support for emotional reasons had increased odds of feelings of depression and anxiety about the future. These findings can be used to tailor intervention and policy-making efforts to reduce the mental health toll in the general population.
Parent-reported behavioral and emotional responses of children to disaster and parental psychopathology
Child disaster mental health research has been largely limited by investigation of one disaster at a time and inconsistent methods across different studies. This study assessed 160 survivors of 3 disasters with structured diagnostic interviews, asking about the behavioral and emotional disaster reactions their 266 children of ages 3-17. Most children had ≥1 postdisaster behavior change or disaster-related posttraumatic stress symptom. The children's postdisaster behavioral and emotional problems were associated with parental postdisaster psychopathology. The results underscore the importance of asking disaster survivors about their children's disaster reactions and considering parental disaster experiences and reactions in addressing their children's reactions.
Experiences of Fetal or Infant Loss among Tanzanian Women in HIV Care
This study examined the impact of fetal or infant loss on HIV care engagement. We conducted semi-structured interviews with 15 HIV-infected women who experienced fetal or infant loss while enrolled in prevention of mother-to-child transmission (PMTCT) services in Tanzania. Women attributed the loss to delays in receiving healthcare. Provider communication about the cause of the loss was poor, and women reported substantial distress related to the loss. One-fifth reported gaps in HIV care or disengagement from care following their loss. Loss of a fetus or infant is not uncommon in HIV endemic settings, and should be integrated into PMTCT guidelines.
From Shattered Assumptions to Weakened Worldviews: Trauma Symptoms Signal Anxiety Buffer Disruption
The fundamental assertion of worldview-based models of posttraumatic stress disorder is that trauma symptoms result when traumatic experiences cannot be readily assimilated into previously held worldviews. In two studies, we test the anxiety buffer disruption hypothesis, which states that trauma symptoms result from the disruption of normal death anxiety-buffering functions of worldview. In Study 1, participants with trauma symptoms greater than the cutoff for PTSD evinced greater death-thought accessibility than those with sub-clinical or negligible symptoms after a reminder of death. In Study 2, participants with clinically significant trauma symptoms showed no evidence of worldview defense though death-thoughts were accessible. These results support the anxiety buffer disruption hypothesis, and suggest an entirely new approach to experimental PTSD research.
Accommodating Bereaved Parents in the Workplace: A Scoping Review
Helpful workplace support strategies and accommodations (WSSA) for bereaved parents returning to work was assessed via comprehensive search of databases from 1990-1/21/22. 11 of 45 qualitative articles met inclusion. Bereaved parents often felt returning to work provided a coping strategy for and/or distraction from grief; however, some received insensitive comments by employer/coworkers. Helpful WSSA included flexibility on date to return to work and schedule. In conclusion, due to the intensity of their grief, bereaved parents benefit from a workplace offering individualized time off for bereavement & workplace accommodations to address potential difficulty meeting prior productivity demands.