[Grief and grief work].
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Adaptation, Psychological↗
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Grief and grief reactions.
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Adaptation, Psychological↗
Grief: how long does grief go on?
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Adaptation, Psychological↗
The management of pathological grief.
Earlier descriptions of pathological grief are reviewed. From the study of recently bereaved widows major forms of pathological grief are outlined. These are suppressed or inhibited grief and distorted grief, including forms with extreme anger or extreme guilt. Other grief variants are noted. The management of pathological grief is outlined; specifically the encouragement of the expression of suppressed affects especially sadness, anger and guilt; as well as the going over of memories and feelings to do with the lost relationship. Consideration is given to: the establishment of the therapeutic contract; the specific exploration of the response to the death and the pre-existing relationship; resistances; interpretation of defences; assessment of progress of mourning; social network factors; termination; and transference and counter-transference.
Affective Symptoms↗
Grief response of parents to neonatal death and parent participation in deciding care.
We determined the grief response to neonatal death of 50 mother-father pairs by administering a questionnaire and conducting a semistructured interview during the infant postmortem review. As measured by a parent grief score, maternal grief significantly exceeded paternal grief (t = 5.89, P less than .0001). Parent grief was not significantly related to birth weight, duration of life, extent of parent-infant contact, previous perinatal loss, parent age, or distance from the hospital of birth to the regional center (Pearson product-moment correlation coefficients). However, the attitudes and behavior of family, friends, and health care personnel in the hospital of birth often adversely influenced parent grieving. Of 39 mother-father pairs whose infants required respirator support, 18 participated in a group decision with their physician to withdraw respirator support when the prospects of infant survival seemed hopeless (limited respirator care group). No significant differences in parent grief scores were found (t tests) when the limited respirator care group was compared to those parents of infants who died despite uninterrupted respirator care. Our data suggest that informed parents can participate as partners with their physician in difficult infant care decision, even when death results, and adjust to their loss with healthy grieving.
Attitude to Death↗
Grief-related facsimile illness.
One aspect of the grief process which is frequently mentioned in the literature on mourning but has not yet received adequate clinical attention is the tendency for the bereaved to assume symptoms and behavior of the deceased. This paper presents evidence that pathologic identificantion 1) is an important clinical syndrome that is frequently misdiagnosed and mistreated, 2) defines a population at high medical and surgical risk, 3) can be diagnosed by history alone, and 4) carries a good prognosis when identified and properly managed. Four of a series of ten clinical cases are presented and discussed. Analysis of the cases reveals a number of common features, including 1) an arrest of the normal grief process; 2) a presentation of symptoms identical or nearly identical to those experienced by the deceased; 3) previous ineffective and inappropriate treatment endeavors; 4) referral for reasons other than a recognition of an abnormal grief state; and 5) improvement or recovery during treatment aimed at facilitating the grief response. Based on a survey of the literature and the clinical material analyzed, the authors conclude that patients who present with psychologic identification with the deceased have a distinct clinical syndrome (grief-related facsimile illness) for which recognition is important to institute proper management. Contrary to the reports in the literature, it frequently presents as other than hypochondriasis. When identified, this syndrome carries a good prognosis.
Adult↗
The management of ordinary grief.
Considerable experience with the problem of ordinary grief has led to the development of some basic management principles which are presented in this paper. The discussion is centered around a case history which originated in a family practice setting. A transcribed interview with the patient emphasizes technique. The working through of grief requires an early and open expression of the pain associated with loss of a loved one. After a discussion of the dynamics of anxiety, grief, and hostility that underlie a grief reaction, specific suggestions for means of helping the bereaved express their feelings and work out their grief are offered.
Aged↗
[Stages of grief in coping with diabetes?].
Forms of coping with diabetes were determined on the basis of self-ratings of emotions (depressive, sad, angry, anxious) and responses on a 30-item "stages of grief" questionnaire by 52 inpatients aged between 25 and 50 (diabetes duration 1 to 35 years) at the beginning of a 12 day diabetes education program. Psychometric qualities of the instruments were evaluated. To test empirically the notion of grief stages in coping with diabetes, the frequency of emphasis on one or more emotional areas or stages of grief was determined and tested to ascertain whether various conditions occurred more frequently than was expected by chance. Results indicated that shortly after diabetes manifestation scores on protest and depression with respect to diabetes were elevated. The majority of cases could not be assigned to a single emotion or stage of grief but displayed negative emotional reactions in different content areas simultaneously. Consequently the concept of grief stages for coping with diabetes as well as recommendations based on this concept are questioned.
Adaptation, Psychological↗
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↗
Psychiatry: unresolved grief. Clinical considerations.
Unresolved grief refers either to the absence or to the prolongation of normal grief. It is identified by (1) painful response to recall of the deceased, (2) realization of not having accepted the loss or of not being able to grieve, and (3) unaccountable depression, emergence of medical symptoms on the anniversary of the loss, or both. Three clinical syndromes can be defined in relation to the stage at which the grief process has been arrested. Treatment involves encouraging patients to talk about the deceased and guiding them through a normal grief reaction. Psychiatric evaluation should be considered when suicidal ideation is present.
Adult↗
[Grief, depression and anxiety after spontaneous abortion--a study of systematic evaluation and factors of influence].
Recent studies demonstrate profound and long-lasting adverse psychological and family sequelae of a spontaneous abortion. However, decisive issues of quality, course and determinants cannot be answered sufficiently due to shortcomings of research (e.g. lack of representative samples and adequate measures, reliance on cross-sectional study designs). Grief reactions and their determinants are differentiated in relation to depressiveness and anxiety in 86 patients from a longitudinal study, employing the Perinatal Grief Scale (Thoedter et al. 1988) and standardized symptom checklists. For the majority of the women, around the 10th week of gestation, the embryo is psychologically represented in fantasies, dreams and concrete arrangements in reality. Immediately after the abortion, these women react with painful feelings of "active grief" and "despair". Additional stresses in the pregnancy and lack of social support predict "self-reproachful coping". Women with recurrent abortions who have no children show depressive reactions. Retrospectively, these also present more anxiety and depressive moods during pregnancy. Results support reliability and validity of the grief scale. Implications for counselling and psychotherapy of women after a spontaneous abortion are discussed with respect to these risk constellations.
Abortion, Spontaneous↗
The grief response to mid-trimester fetal loss.
This descriptive study examines the grief response of mothers who experienced a fetal loss in the middle trimester of pregnancy. Twenty mothers who lost a baby through spontaneous abortion or perinatal death within 1 year participated in this study. Data were collected by mailed questionnaires. All characteristics typical of the grief response were identified, including despair, anger or hostility, guilt, loss of control, rumination, depersonalization, somatization, and death anxiety. Comparison of the study population to a group of parents who suffered the loss of a child and to a group of women who had suffered the death of a close relative demonstrated that the study group presented a grief response similar in nature and intensity to the two normative groups. This study supports previous studies that indicated the existence of grief after mid-trimester fetal loss. Replication of this study with a larger sample is recommended to further support these findings.
Abortion, Spontaneous↗
Management of grief in the hypochondriac.
This paper illustrates the presentation and management of a grief reaction in a chronic hypochondriacal patient seen in a family medicine office. The manifestations of grief in the hypochondriacal patient are influenced by the unique characteristics of the chronic, somatic complainer in whom the grief reaction appeared as an intensification of the chronic complaints. The treatment of the grief reaction in these patients should take into account the techniques for managing the hypochondriacal patient.
Chronic Disease↗
Grief and rage: collective emotions in the politics of peace and the politics of gender in Israel.
Collective emotions of rage and grief dominate Israeli political discourses regarding the Middle East conflict. The weekly peace vigils of the Women in Black who protest the state's occupation of the West Bank and Gaza and the opposition which the vigils encounter, publicly display politicized collective emotions. In these weekly confrontations, grief and rage articulate intense contestations regarding the politics of peace as well as the politics of gender in Israel. Rage and grief unravel two drastically different visions of transcending national vulnerabilities and two disparate constructions of gender identity.
Emotions↗
Grief response of parents after referral of the critically ill newborn to a regional center.
Attitudes, feelings, and behavior were studied in 101 mother-father pairs whose critically ill newborn infants survived after referral from the hospital of birth to a regional neonatal intensive-care unit for special care. As measured by an anticipatory-grief score, most parents experienced grief reactions similar to those whose infants do not survive the newborn period. The level of anticipatory grief did not appear to be associated with severity of infant illness as determined by the need for respirator therapy or major surgical procedures. The fathers reported drastic alteration in daily activity while wife and infant were hospitalized in separate facilities, and they assumed a central role in maintaining family stability during the crisis. These data suggest that an organized family-support program could play a prominent part in maintaining family stability during the delivery of newborn intensive care.
Adult↗
[Psychotherapy of depressed elderly patients with pathologic grief reaction].
Loss events not sufficiently worked through frequently are the core syndrome of depressive illness in the elderly. The frequency and symptom pattern of pathological grief reactions as well as influencing factors in 155 patients 60 year old or older treated for endogenous, neurotic and reactive depression, are described. Special issues of the psychodynamics of pathological grief reactions in the elderly are discussed; problems of counter-transference are pointed out. The developmental potential in the elderly often is underestimated. Psychotherapy of pathological grief reactions in the elderly offers important and rarely used possibilities.
Adjustment Disorders↗
[Abnormal grief reaction].
Pathological grief reactions following the death of a child are reported on the basis of five case studies. In contrast to acute grief reactions these pathological syndromes are of long standing. One parent had not truly accepted the death of the child. The denial of reality is sometimes a defence against aggression towards the deceased, because of his having left one behind. The mourning process comes to no end but remains in its initial phase. At the same time the life of the mourner stands still, as in the house and the family everything is left unchanged. Family interactions alter, particularly between the parents. For the genesis of these grief syndromes the following is of relevance: The death occurs at a time, when another child cannot replace the one who died. Mature independence had not been reached by either parent or child. Death destroyed expectations that this child would succeed in that which the parent had been unable to achieve. The parent had not seen the child after death--a gap in the continuity of experiencing which made acceptance of the irreversibility of the loss even more difficult.
Adaptation, Psychological↗