丧亲儿童和青少年哀伤研究现状

通过系统回顾国内外相关文献,对丧亲儿童和青少年哀伤研究现状进行综述。丧亲事件中,部分丧亲儿童会出现延长性哀伤障碍,从而导致睡眠困难、焦虑、抑郁甚至自杀念头等生理心理健康问题。但目前我国医务人员对丧亲儿童和青少年哀伤的关注较国外少,且存在无针对性的测量工具、干预措施单一、无量化的干预措施评价工具等问题,建议根据我国社会文化背景发展相关测量工具,丰富哀伤相关干预措施并进行大样本验证,帮助其尽快从哀伤中恢复,预防不良心理健康的发生。     

A Randomized Open Trial Assessing the Feasibility of Behavioral Activation for Pathological Grief Responding

This study investigated the feasibility of using behavioral activation to treat enduring postbereavement mental health difficulties using a two-arm, multiple baseline design comparing an immediate start group to a delayed start group at baseline, 12-, 24-, and 36-weeks postrandomization. Participants received 12–14 sessions of behavioral activation within a 12-week intervention period starting immediately after the first assessment or after 12 weeks for the delayed start group. Prolonged grief, posttraumatic stress, and depression symptoms were assessed as outcomes. Compared with no treatment, behavioral activation was associated with large reductions in prolonged, complicated, or traumatic grief; posttraumatic stress disorder; and depression symptoms in the intent-to-treat analyses. Seventy percent of the completer sample at posttreatment and 75 percent at follow-up responded to treatment with 45 percent at posttreatment and 40 percent at follow-up being classified as evidencing high-end state functioning at 12-week follow-up.     

The working life of a medium: a qualitative examination of mediumship as a support service for the bereaved

Despite widespread scepticism, it has been estimated that around 10% of the UK adult population regularly visit a medium and television programmes showing mediumship demonstrations draw in millions of viewers. While many assume mediumship to be purely for entertainment, an alternative discourse presents it as being a service offered to comfort and support the bereaved. In this qualitative study, data were collected through semi-structured interviews with nine working mediums and examined with an interpretative phenomenological analysis which aims to understand the lived experiences of participants. Three key superordinate themes emerged, Responsibility and Ethics, Passion to Help and Therapeutic Value. These themes are discussed in terms of mediums’ perception of their work as a helping profession and an ethical framework which illustrates awareness of the vulnerability of sitters. We also consider whether mediums may be equipped to deal with sitters experiencing complicated grief.     

Religious Doubt and Spiritual Growth Among Adults Bereaved of a Grandparent

Religious beliefs and bereavement provide contexts for personal growth (Benore & Park, 2004). The death of a grandparent may be especially well-suited to prompt such growth. Using data from 164 adults, ages 18 to 51 years, bereaved of a grandparent, the authors examined whether religious doubt relates to current grief via perceived spiritual growth. Mediation analyses showed that fewer religious doubts were associated with spiritual growth in bereavement, but spiritual growth was associated with higher levels of current grief. Results are discussed within a framework for including family processes in bereavement research that includes religious doubt and spiritual growth.     

Intolerance of uncertainty and emotional distress following the death of a loved one

Abstract

Research has shown that intolerance of uncertainty (IU) – the tendency to react negatively to situations that are uncertain – is involved in worry and generalized anxiety disorder, as well as in other anxiety symptoms and disorders. To our knowledge, no studies have yet examined the association between IU and emotional distress connected with the death of a loved one. Yet, it seems plausible that those who have more difficulties to tolerate the uncertainties that oftentimes occur following such a loss experience more intense distress. The current study examined this assumption, using self-reported data from 134 bereaved individuals. Findings showed that IU was positively and significantly correlated with symptom levels of complicated grief and posttraumatic stress disorder (PTSD), even when controlling for time since loss (the single demographic/loss-related variable associated with symptom levels), and for neuroticism and worry, which are both correlates of IU. Furthermore, IU was specifically related with worry and symptom levels of PTSD, but not complicated grief, when controlling the shared variance between worry, complicated grief severity, and PTSD-severity. The present findings complement prior research that has shown that IU is a cognitive vulnerability factor for worry, and indicate that it may also be involved in emotional distress following loss.     

Conceptualizing an HIV Diagnosis Through a Model of Grief and Bereavement

For people living with HIV/AIDS, grief and bereavement typically refer to the loss of life felt in the HIV community. However, changes in HIV treatments allow care providers to view HIV grief in a way that considers physical, social, and emotional loss, as well as a loss of the life they had previously pictured for themselves. Kübler‐Ross's ( 1969 ) model of bereavement is presented as a way to conceptualize clients living with HIV who are dealing with grief and bereavement. In addition, popular bereavement counseling approaches relevant to clients with HIV are discussed, and a case illustration is provided.     

Cross-Lagged Analyses of Prolonged Grief and Depression Symptoms With Insomnia Symptoms

Prolonged grief disorder, characterized by severe, persistent and disabling grief, has recently been added to the DSM-5-TR and ICD-11. Treatment for prolonged grief symptoms shows limited effectiveness. It has been suggested that prolonged grief symptoms exacerbate insomnia symptoms, whereas insomnia symptoms, in turn, may fuel prolonged grief symptoms. To help clarify if treating sleep disturbances may be a viable treatment option for prolonged grief disorder, we examined the proposed reciprocal relationship between symptoms of prolonged grief and insomnia. On three time points across 6-month intervals, 343 bereaved adults (88% female) completed questionnaires to assess prolonged grief, depression, and insomnia symptoms. We applied random intercept cross-lagged panel models (RICLPMs) to assess reciprocal within-person effects between prolonged grief and insomnia symptoms and, as a secondary aim, between depression and insomnia symptoms. Changes in insomnia symptoms predicted changes in prolonged grief symptoms but not vice versa. Additionally, changes in depression and insomnia symptoms showed a reciprocal relationship. Our results suggest that targeting insomnia symptoms after bereavement is a viable option for improving current treatments for prolonged grief disorder.     

The Feeling-Tone Questionnaire: Reliability and Validity of a Direct Patient Assessment Screening Instrument for the Detection of Depressive Symptoms in Cases of Dementia

The purpose of this study was to develop a reliable and valid measure of affective disorder in elderly demented patients. The field lacks instruments which are sensitive to detecting depressive signs in severely as well as mildly and moderately demented subjects. Two samples of subjects were chosen for study. The first sample consisted of subjects from six institutions, which were chosen for study from a probability sample of 25 long-term care institutions in New York City. This sample was part of the Cross-National Institutional Study conducted in New York and London (Gurland et al., 1979; Mann et al., 1984). Thirty patients were selected at random within each institution. The second sample consisted of 52 inpatients at Willard Psychiatric Center, a traditional state psychiatric hospital in upstate New York. All subjects had a chart diagnosis of dementia and were 60 years old or older. The mean age of the sample was 82 years and 56% of the subjects were female. The Feeling-Tone Questionnaire, which was developed for these analyses, consists of 16 dichotomous items and 16 5-point Likert ratings of affect. The reliability of this scale using Cronbach's alpha is .91 for the long-term care institutional sample and .90 for the psychiatric hospital sample. Interrater reliability for two raters on ten cases is .99. Test–retest reliability on ten cases with a 1-day to 2-day interval between trials is .81. A short mood scale was developed from the observational data as a validity measure for the Feeling-Tone Questionnaire. Evidence for the validity of the Feeling-Tone Questionnaire is provided.     

Mapping grief: A study in practice using a quantitative and qualitative approach to exploring and addressing the range of responses to loss

The Adult Attitude to Grief (AAG) scale was devised for an earlier study (Machin, 2001) to test the validity of a concept of loss, which proposed that grief reactions fall broadly into three categories — ‘overwhelmed’, ‘balanced’ and ‘controlled’. There was statistical support for the proposed differences but the AAG scale, more importantly, provided insight into the diverse reactions taking place in individual bereaved respondents. This paper describes a second study undertaken to examine the clinical usefulness of the AAG scale with clients receiving help within the Psychological Services Operating Unit of the North Staffordshire Combined Healthcare (NHS) Trust. The scale has been used both in its original form with bereaved clients and in a modified form with clients having distress symptoms associated with other losses, such as relationship breakdown or the onset of chronic illness. The use of the AAG scale in this clinical setting suggests that, both as an assessment tool and as a cue for therapeutic dialogue, it provides a promising way of mapping the general and particular characteristics of response to loss in individual clients. Consideration is also given to varying therapeutic approaches needed to help clients regain the equilibrium disturbed by their grief.     

Development and Validation of an Instrument for Measuring Individual Motives for Playing Digital Games

Individual motives for playing digital games have been studied from a variety of theoretical perspectives using different measurement instruments. However, an instrument that roots the social, rule-based narrative essence of digital games in a theory on human behavior acknowledging that not all behavior is consciously motivated has hitherto been lacking. A framework based on social cognitive theory that integrates these dimensions is proposed. After comparing the advantages of this framework to existing approaches, the development of a measurement instrument is discussed. This development concerns the generation and evaluation of an item pool and also testing the instrument for reliability and validity on different samples and different populations. Results suggest psychometric as well as theoretical soundness of the instrument.     

No pain,no gain: cross-lagged analyses of posttraumatic growth and anxiety,depression, posttraumatic stress and prolonged grief symptoms after loss

Background and objectives: Major negative life-events including bereavement can precipitate perceived positive life-changes, termed posttraumatic growth (PTG). While traditionally considered an adaptive phenomenon, it has been suggested that PTG represents a maladaptive coping response similar to cognitive avoidance. To clarify the function of PTG, it is crucial to establish concurrent and longitudinal associations of PTG with post-event mental health problems. Yet, longitudinal studies on this topic are scarce. The present study fills this gap in knowledge.

Design: A two-wave longitudinal survey was conducted.

Methods: Four-hundred and twelve bereaved adults (87.6% women) filled out scales assessing PTG and symptoms of depression, anxiety, prolonged grief, and posttraumatic stress at baseline and 6 months later.

Results: The baseline concurrent relationships between all symptom levels and PTG were curvilinear (inverted U-shape). Cross-lagged analyses demonstrated that symptom levels did not predict levels of PTG 6 months later, or vice versa.

Conclusions: Findings suggest PTG after loss has no substantive negative or positive effects on mental health. Development of specific treatments to increase PTG after bereavement therefore appears premature.     

Development and Validation of the Homophobia Scale

This study describes the development and validation of the Homophobia Scale. The scale was developed to assess the cognitive, affective, and behavioral components of homophobia. The participants (n=321 for the field trials and n=122 for test–retest reliability) were college students from a large Midwestern university. Results yielded a 25-item questionnaire consisting of three factors: a factor that assesses mainly negative cognitions regarding homosexuality, a factor that assess primarily negative affect and avoidance of homosexual individuals, and a factor that assesses negative affect and aggression toward homosexual individuals. Concurrent validity was established using The Index of Homophobia (Hudson & Ricketts, 1980). The phases of scale development and implications of the results are discussed.     

Development and Validation of an Instrument to Measure Attitudes Toward Sexist/Nonsexist Language

Despite documented, negative effects of sexist language, some people still strongly oppose inclusive language. Their attitudes need study, but existing measures of attitude lack comprehensiveness or validity. This paper reports construction and validation of the 42-item Inventory of Attitudes Toward Sexist/Nonsexist Language (IASNL), which is based on a conceptual framework related to beliefs about language, recognition of sexist language, and willingness to use inclusive language. Four studies tested the IASNL's content validity (9 content experts, 329 other participants), construct validity, and reliability (31 advocates of inclusive language, 298 additional respondents). Cronbach alphas were high and validity measures were strong. Two short forms of the IASNL were also created—the IASNL-General and the IASNL-Sport. The IASNL-General is in the Appendix.     

Divergent and Convergent Validation of the Complicated Grief Prototype Narrative

Although there is a prototype narrative for complicated grief (CG), there are neither divergent nor convergent validity studies of its clinical value. We evaluated the CG prototype narrative using a sociodemographic questionnaire and the Clinical Interview for Complicated Grief Diagnosis. We first conducted a convergent validation analysis followed by a divergent validation analysis. Results showed that participants with CG identified significantly more with the complicated grief prototype narrative than participants without CG.     

Development and Validation of the Clutter Image Rating

Few instruments are available to assess compulsive hoarding and severity of clutter. Accuracy of assessment is important to understanding the clinical significance of the problem. To overcome problems associated with over- and under-reporting of hoarding symptoms, the clutter image rating (CIR) was developed. This pictorial scale contains nine equidistant photographs of severity of clutter representing each of three main rooms of most people’s homes: living room, kitchen, and bedroom. The psychometric properties of this measure were examined in two studies. Internal consistency, test–retest, and interobserver reliabilities were good and convergent validity with other questionnaire and interview measures was also good. The CIR correlated more strongly with measures of clutter than with other hoarding and psychopathology scales. The CIR’s very brief pictorial assessment method makes it useful in clinical and treatment contexts for measuring the clutter dimension of compulsive hoarding. The Clutter Image Rating (CIR) is available in conjunction with the following publication: Steketee, G., & Frost, R.O. (2007). Treatment of compulsive hoarding. New York: Oxford University Press at .     

Development and Validation of the Shy Bladder Scale

Paruresis, characterized by the difficulty or inability to urinate in a variety of social contexts, is a scientifically under-studied phenomenon. One reason for this state of affairs is the paucity of reliable and valid measures for assessing this problem. The present article attempted to address this limitation by investigating the psychometric properties and validity of a new measure of paruresis: the Shy Bladder Scale (SBS). In two undergraduate samples, the SBS demonstrated excellent internal consistency and a stable factor structure assessing difficulty urinating in public, impairment and distress, and paruresis-related fear of negative evaluation. Undergraduate students evidenced very low levels of paruresis-related concerns. In contrast, SBS scores were markedly elevated among individuals recruited from an online support network who appeared to meet diagnostic criteria for paruresis-specific social phobia. Our findings highlight the SBS's potential utility as a measure of paruresis in clinical and research contexts.     

Diagnosis and Assessment of Depression and Suicidality Using the NIMH Diagnostic Interview Schedule for Children (DISC-2.3)

The Diagnostic Interview Schedule for Children (DISC-2.3) was studied in a sample of 265 adolescent inpatients to determine type and concurrent validity of depressive symptoms and depressive disorder diagnoses for different DISC-2.3 informants (parent, adolescent, both). The Children's Depression Rating Scale — Revised, Reynolds Adolescent Depression Scale (RADS), Suicide Ideation Questionnaire — Junior, Spectrum of Suicide Behavior Scale, and clinical consensus diagnoses were used to assess concurrent validity. Results indicated that (1) parents, compared to adolescents, reported a higher prevalence of all depressive symptoms with the exception of weight change; (2) DISC-2.3 depressive and suicidality symptoms were related positively to independent validating criteria for all informant conditions, suggesting good concurrent validity; (3) the DISC-2.3 both informant condition correctly identified the most depressive disorders; and (4) the parent, but not the adolescent, DISC-2.3 Informant condition contributed to the prediction of clinical consensus diagnoses of depression after taking into account RADS scores.     

Development and Initial Validation of the Child Routines Inventory

The importance of establishing predictable routines during childhood consistently has been emphasized in the popular parenting literature, despite a paucity of empirical evidence. The lack of research may be partially due to a lack of suitable instruments designed to measure children's routines. This study describes development and preliminary psychometric data in support of the Child Routines Inventory (CRI), an empirically derived, content-valid, parent-report measure of commonly occurring routines in school-aged children. Principal components analysis yielded a four-factor structure (composed of 36 items), accounting for 44.2% of the total variance. The CRI was found to have excellent internal consistency ( = .90), good test-retest reliability (r = .86), and preliminary evidence of construct validity, demonstrating a moderate relationship with measures of child behavior problems and family routines. These results suggest the CRI to be a promising new measure of child routines that would benefit from further validation studies.     

Assessment of Tripartite Factors of Emotion in Children and Adolescents I: Structural Validity and Normative Data of an Affect and Arousal Scale

The authors developed and evaluated a self-report measure for children designed to assess factors of the tripartite model of emotion (Clark & Watson, 1991). Factor analytic results from a large, multi-ethnic sample (n = 1,289) supported the structural validity of the scale, with the additional suggestion that negative affect appeared to contain two lower order dimensions in the item pool. Confirmatory factor analysis in an independent sample of 300 children and adolescents suggested favorable structure. Consistent with prediction, positive and negative affect emerged as relatively orthogonal dimensions. Physiological hyperarousal was found to be positively correlated with negative affect. Normative data are presented, and tests for differences by sex, grade level, and ethnicity demonstrated nonsignificant or minimal differences between groups. The implications for the assessment of tripartite factors and their relation to psychopathology in youth are discussed.