Biomedical subjects

Paul A Boelen

Publications and source records attributed to Paul A Boelen.

10 recordsLinked to original sources

PubMed2026

Effectiveness of grief interventions in underrepresented regions: a systematic review and exploratory meta-analysis.

Background: Most evidence on grief and bereavement interventions originates from Western, Educated, Industrialized, Rich, and Democratic (WEIRD) populations, raising concerns about the generalizability and cultural relevance of existing findings in diverse global contexts. Individuals confronted with the death of a close person, particularly in cases of sudden or potentially traumatic loss, may be at increased risk of adverse psychological and physical health outcomes, highlighting the importance of effective interventions. This study aimed to synthesize evidence on the effectiveness of grief interventions in underrepresented regions.Method: A systematic search of Web of Science, APA PsycInfo, and Scopus, supplemented by manual reference checks, identified randomized controlled trials (RCTs) targeting bereaved individuals in underrepresented regions. Meta-analyses were conducted to estimate overall and subgroup effects based on control type, loss type, and intervention characteristics.Results: Fourteen RCTs comprising 1122 participants were included. Grief interventions demonstrated a significant moderate-to-large effect compared to control conditions (SMD = -0.74, 95% CI [-1.01, -0.47]). Substantial heterogeneity was observed (I² = 77%). No significant subgroup differences were identified.Conclusion: Grief interventions show promising effectiveness across diverse cultural and geographical contexts. However, the limited and heterogeneous evidence base highlights the need for more high-quality RCTs and for the development of culturally sensitive and contextually grounded approaches to mental health care in underrepresented regions.

Humans↗

PubMed2006

Negative cognitions and avoidance in emotional problems after bereavement: a prospective study.

Cognitive behavioural conceptualisations of grief propose that negative cognitions and avoidance strategies play a key role in emotional problems after bereavement. In the current study, this assumption was examined. Ninety-seven individuals who had lost a relative less than 5 months ago completed questionnaires tapping background and loss-related variables, negative cognitions (about the self, life, the future, and one's own grief reactions), avoidance, and symptoms of complicated grief (CG) and depression. Of these mourners, 70 people (72%) completed symptom measures again 6 months later at T2 (7-10 months after the loss), and 60 (62%) completed symptoms measures still 9 months later at T3 (16-19 months after the loss). Among other things, results showed that all four cognitive variables and the avoidance variable were strongly associated with concurrent and prospective symptom levels, even when the influence of relevant background/loss-related variables was controlled. In addition, independent of initial symptom levels, most of the cognitive variables predicted later CG and depression. The avoidance variable only predicted additional variance in depression at T3 beyond T1 symptom levels. Findings indicate that negative cognitions are important in emotional problems after bereavement and that the role of avoidance in the development of these problems needs further scrutiny.

Adult↗

PubMed2006

Continuing relationships with the deceased: disentangling bonds and grief.

Some studies of the relationship between continuing bonds and grief intensity have claimed that continuing bonds lead to poor adaptation to bereavement. However, operationalizations of continuing bonds and grief intensity appear to overlap conceptually. Thus, it is still unclear what character the connection between continuing bonds and grief bears and how strong the relationship is. Three studies are reported, 2 of which examine the perception of conceptual overlap between continuing bonds and grief intensity, and 1 that examines whether reducing this perceived conceptual overlap affects the association between continuing bonds and grief intensity. In the first 2 studies, extent of perception of conceptual overlap was established, and subscales for the bonds and grief measures were derived that could be considered less overlapping. In the third study, relationships between bonds, grief, and well-being were calculated for the original scales and those reduced on the basis of deleted perceived overlap. When conceptual overlap was reduced, the relationship between grief and continuing bonds was slightly lower but not significantly so, as happened to the relationship between bonds and well-being. By contrast, the link between grief intensity and well-being did not diminish after deleting the overlapping items. These patterns suggest that future research should continue to explore whether the association between continuing bonds and grief intensity is due to conceptual overlap.

Adaptation, Psychological↗

PubMed2006

Continuing bonds and grief: a prospective analysis.

Using data of 56 bereaved individuals, this study examined associations of various manifestations of continuing bonds, assessed at 7-12 months post-loss, with concurrent and prospective (9 months later) symptoms of grief and depression. Among other things it was found that, independent of initial symptom levels, manifestations of continuing bonds differed in their associations with subsequent grief and depression. That is, continuing bonds through recovering memories was a strong predictor of grief but not depression, whereas continuing bonds through the use of the deceased's possessions was a weak predictor of both grief and depression. In part, these findings contradict earlier prospective findings.

Adaptation, Psychological↗

PubMed2005

Complicated grief, depression, and anxiety as distinct postloss syndromes: a confirmatory factor analysis study.

OBJECTIVE: The authors used confirmatory factor analysis to replicate earlier findings that complicated grief, depression, and anxiety are distinct syndromes. METHOD: Data were derived from 1,321 bereaved individuals. Complicated grief was measured with the Inventory of Traumatic Grief. Depression and anxiety were measured with the SCL-90. RESULTS: A model in which symptoms of complicated grief, depression, and anxiety loaded on separate factors was superior to a one-factor model, revealed good model fit, and was invariant across subgroups. CONCLUSIONS: Previous findings of a distinction among complicated grief, depression, and anxiety were confirmed.

Adult↗

PubMed2003

The role of cognitive variables in psychological functioning after the death of a first degree relative.

The present study sought to explore the relationship between negative cognitions and emotional problems after bereavement, with a group of 329 adults who had suffered the loss of a first degree relative. The following cognitions were assessed: global negative beliefs, cognitions about self-blame, negative cognitions about other people's responses after the loss, and negative cognitions about one's own grief reactions. Results showed that each of these cognitive variables was significantly related to the severity of symptoms of traumatic grief, depression and anxiety, even when background and loss-related variables that were initially found to influence symptom severity, were statistically controlled. When the shared variance between the cognitive variables was controlled, it was found that global negative beliefs about life, the world, and the future, and threatening interpretations of grief reactions each explained a unique proportion of variance in traumatic grief symptom severity. Global negative beliefs about life, the self and the future, and threatening interpretations of grief explained most variance in depression, while negative beliefs about the self and threatening interpretations of grief explained most variance in anxiety. Overall, the findings are in support of cognitive theories of grief, and suggest that effective treatment of problematic grief will need to address negative cognitions.

Anxiety Disorders↗

PubMed2003

Reliability and validity of the Dutch version of the inventory of traumatic grief (ITG).

The psychometric properties of the Dutch version of the Inventory of Traumatic Grief (ITG) were investigated in two studies with bereaved adults who had suffered the loss of a first-degree relative. In Study 1, exploratory factor analysis indicated that the items of the ITG clustered together into one underlying factor. In addition, the internal consistency of the ITG and its short-term temporal stability were found to be high. In Study 2 it was found that the ITG exhibited adequate discriminative, concurrent, and construct validity. Furthermore, an ITG cutoff score for a diagnosis of traumatic grief was determined, with a sensitivity of 86% and a specificity of 76%, providing evidence in favor of the predictive validity of the ITG.

Adult↗

PubMed2003

Traumatic grief as a disorder distinct from bereavement-related depression and anxiety: a replication study with bereaved mental health care patients.

OBJECTIVE: Earlier studies have shown that symptoms of traumatic grief are distinct from those of bereavement-related depression and anxiety. This study was an attempt to replicate that finding. METHOD: Data were derived from 103 patients. Traumatic grief was measured with the Inventory of Traumatic Grief. Depression and anxiety were measured with the Symptom Checklist. The distinctiveness of the three symptom clusters was determined with principal axis factoring. RESULTS: Symptoms of traumatic grief, depression, and anxiety clustered together in three distinct factors. CONCLUSIONS: These results confirm the previous finding of a distinction between symptoms of traumatic grief and symptoms of bereavement-related depression and anxiety.

Adult↗

PubMed2002

Positive thinking in bereavement: is it related to depression, anxiety, or grief symptomatology?

The present study sought to explore the relationship between positive thinking--operationalized as the frequency of positive automatic thoughts and dispositional optimism--and depression, anxiety, and traumatic grief symptomatology. Data were derived from 326 bereaved adults who had 3 yr. earlier experienced the loss of a first degree loved one. Analysis showed that positive thinking was inversely related to measures of depression, anxiety, and traumatic grief symptomatology. However, positive thinking did not covary with anxiety and traumatic grief when shared variance was controlled. Conversely, positive thinking remained inversely related to depression, even when anxiety and traumatic grief were controlled. The findings indicate that, among bereaved individuals, low positive thinking is a cognitive feature of depression that is relatively independent of anxiety and traumatic grief symptomatology.

Adaptation, Psychological↗

PubMedDate not supplied

The role of negative interpretations of grief reactions in emotional problems after bereavement.

This study explored the role of negative interpretations of grief reactions in emotional problems after bereavement, with 234 individuals who had been confronted with the death of a close relative. It was found that negative interpretations of grief reactions were highly associated with the degree to which these reactions were experienced as distressing, the degree to which mourners engaged in avoidance behaviours and the severity of symptoms of traumatic grief and depression, even when controlling for the frequency of grief reactions and the influence of relevant background variables. Furthermore, behavioural and cognitive avoidance strategies were significantly related to the severity of traumatic grief and depression. Negative interpretations of grief reactions and rumination explained most variance in symptom severity, when controlling for the shared variance between the predictor variables. The results have implications for the treatment of emotional problems after bereavement.

Adaptation, Psychological↗