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.     

Perception of autonomic reactions and actual heart rate in phobic patients

The relationship between perceived physiological arousal and actual heart-rate reactions was studied in two behavioral test situations. The subjects were 70 phobic patients (34 social phobics and 36 claustrophobics) who were given the general form of the Autonomic Perception Questionnaire about 1 month before the respective behavioral test and the specific form immediately after the test. The results showed significant correlations between APQ and actual heart rate for the social phobics, while the picture was more complicated for the claustrophobics. The implications of these results are discussed.This research was supported by Grant 05452 from the Swedish Medical Research Council.     

COVID-19, precarity and loneliness

In this paper I discuss Jungian psychological work of the trauma and loss experienced in reaction to COVID-19 with a man who represents a clinical composite. The issues of precarity, a concept used by the philosopher Judith Butler, are combined with the notions of lack and absence of French psychoanalyst André Green. The psychological and societal situation of precarity aroused the man’s childhood issues that were long repressed. The loneliness, isolation and death from COVID-19 mirrored his personal and the collective responses to the disaster from this global pandemic. He felt on the edge of collapse as what he knew of his world crashed and he found himself unable to cope. The subsequent Jungian work taking place through the virtual computer screen was taxing and restorative simultaneously for both analyst and analysand.     

Evidence for a motor mechanism of pain-induced aggression instigation in humans

The automatic skeletal motor responses of 20 male and 20 female student subjects (aged 20–36) receiving a painful stimulation (electric shock) were studied by examining voluntary concomitant extensions and flexions of the arm. These movements were either of long duration, allowing for an on-line control of their execution or, of short duration, requiring extensive pre-programming. Subjects were instructed either to push or to pull a lever upon receipt of an acoustic signal, which was paired or unpaired with an electric shock. Latencies for long duration movements (regardless of direction) were reduced by reception of painful stimulation. Latencies of short duration extensions and flexions were respectively reduced and increased by painful stimulation. Latencies of short duration movements were larger for females than males, regardless of movement direction. These data suggest that painful stimulation elicits automatic movements which affect programming of the termination of simultaneous voluntary movements. Implications of these findings for the study of aggressive behavior are discussed. © 1994 Wiley-Liss, Inc.     

Parents’ Experiences of Their Child’s Disclosure of Child Sexual Abuse

A child’s disclosure of sexual victimization is a difficult experience for parents and has been associated with traumatization, disbelief, denial, self-blame, and clinical difficulties. To date, most studies on parents’ responses have been quantitative assessments of the psychological impact of disclosure on parents. A paucity of research has qualitatively explored mothers’ experiences of their child’s disclosure of child sexual abuse (CSA) and fathers’ experiences have been even further neglected. The current study seeks to characterize parents’ experiences of their child’s disclosure of CSA and to uncover the process-oriented nature of parental responses. This qualitative study, using a grounded theory approach to analysis, involved interviews with 10 mothers and four fathers whose children (3–18 years) had experienced sexual abuse. Three themes emerged from the analysis. The first theme—making sense of the abuse in retrospect—captured the process through which parents sought to make sense of their child’s disclosure, focusing on why their child had not disclosed the abuse to them earlier, and how they had noticed something was wrong but misattributed their child’s behavior to other factors. The second theme—negotiating parental identity as protector—reflected how parents’ identity as a protector was challenged, their perception of their world had been forever altered, and they now experienced themselves as hypervigilant and overprotective. The final theme—navigating the services—pertained to parents’ struggle in navigating child protection and police services, and feelings of being isolated and alone. These findings highlight the need for empathy and parental support following child disclosure of sexual victimization.     

Touching Mortality, Touching Strength: Clinical Work with Dying Patients

This paper outlines some of the special stresses that must be shouldered by clinicians—physicians, nurses, chaplains, social workers, pastoral staff, and others—whose work focuses on dying and extremely vulnerable patients. The utility of a theory of generative death anxiety as a framework for interpreting the nature of these special stresses is suggested. Three common burnout reactions are examined. The paper concludes that positive acceptance of personal mortality may help clinicians avoid burnout and lead to better therapeutic practice. This framework for interpreting therapeutic practice demonstrates the integral role spirituality plays in work with this particular patient group.     

Psychometric Properties of the Grief Cognitions Questionnaire (GCQ)

Cognitive behavioral conceptualizations of complicated grief propose that negative cognitions play a core role in the development and persistence of emotional problems after bereavement, because they generate negative emotions and cause mourners to engage in counterproductive attempts to avoid the implications and the pain of the loss. To facilitate the assessment of potentially problematic cognitions after bereavement, the Grief Cognitions Questionnaire (GCQ) has been developed—a 38-item questionnaire representing 9 categories of cognitions. Building on a previous study that supported the reliability and validity of the GCQ, the current study further examined its psychometric properties, with data of 531 bereaved individuals who completed research questionnaires online through the Internet. Confirmatory factor analyses supported the nine-factor structure with 9 interrelated factors. The reliability and convergent and discriminative validity were found to be adequate. Altogether the GCQ seems to be a useful tool for the assessment of negative thinking after bereavement in research and clinical practice.     

Conceptualizing and Measuring Historical Trauma Among American Indian People

This article reports on the development of two measures relating to historical trauma among American Indian people: The Historical Loss Scale and The Historical Loss Associated Symptoms Scale. Measurement characteristics including frequencies, internal reliability, and confirmatory factor analyses were calculated based on 143 American Indian adult parents of children aged 10 through 12 years who are part of an ongoing longitudinal study of American Indian families in the upper Midwest. Results indicate both scales have high internal reliability. Frequencies indicate that the current generation of American Indian adults have frequent thoughts pertaining to historical losses and that they associate these losses with negative feelings. Two factors of the Historical Loss Associated Symptoms Scale indicate one anxiety/depression component and one anger/avoidance component. The results are discussed in terms of future research and theory pertaining to historical trauma among American Indian people.     

Maturing into Boyhood: James E. Dittes on Men and Meaning

In this essay, I review the progression of James E. Dittes' books on men and men's issues, including The Male Predicament, When Work Goes Sour, Men at Work, and Driven By Hope. Dittes moves from a palpable ambivalence toward men and their attendant griefs in earlier books to an increasingly unconditional affirmation of men in more recent ones. His own professional pilgrimage models his desire that men might mature into boyhood by coming to savor their inherent sense of expectancy as sons.     

Effects of decision-making on reactions to an evaluational stressor

The present study tested the hypothesis that an opportunity to make decisions enhances perceived control. This hypothesis predicts that decision-making will reduce the adverse effects of stress. Subjects worked on an intellectual task and their stress reactions were assessed using subjective and behavioral measures. Decision-making improved the highly anxious subjects' persistence with the task. This finding supports the hypothesis. However, less anxious subjects persisted less after being allowed to make decisions. Several explanations positing possible cognitive and motivational processes of the less anxious subjects are offered.