It's not who you lose, it's who you are: Identity and symptom trajectory in prolonged grief

Effectiveness and Acceptability of Interventions Offered for Those Bereaved by Parental Loss to Suicide in Childhood: A Mixed Methods Systematic Review

OBJECTIVES

Identify interventions offered for children bereaved by parental suicide, investigate reported effectiveness and explore the acceptability of identified interventions.

METHOD

Six electronic databases were systematically searched for primary studies investigating intervention effectiveness and acceptability, (August 2011 to June 2023). Eligibility required inclusion of participants bereaved by parental suicide during childhood among sample populations. Methodological quality was evaluated applying JBI critical appraisal tools. Narrative synthesis was conducted using parallel-results convergent design.

RESULTS

Of the 22 eligible reports, 19 articles reported on 12 manual-based supports provided during childhood; three papers described users' experiences of various specified intervention types offered following childhood loss. Twenty-one studies reported on interventions offered for heterogeneous participant groups that included children bereaved by parental suicide. Time from loss to intervention generally included both recent (1 < 30mths) and more distant loss, with just one intervention described as solely for recently bereaved children. Eight interventions (n = 12 studies) demonstrated significant positive effects (p < 0.05), for maladaptive grief, mental health, quality of life. Only one study investigated suicide-related outcomes. Qualitative findings (n = 8 studies) facilitated development of four acceptability themes: Perceived utility, Relationships, Components and Delivery.

CONCLUSIONS

Heterogeneity in causes of loss/trauma and relationships with the deceased limit specific conclusions regarding effectiveness/acceptability of reviewed interventions for children bereaved by parental suicide. Few sub-group analyses of effects were reported, and qualitative evidence specifically from children bereaved by parental suicide was limited. Further research is recommended regarding mixed-user interventions, specifically for children bereaved by parental suicide.

How reminiscing about deceased close others together with continuing bonds relates to grief severity and personal growth: a cross-sectional study with bereaved adults

OBJECTIVES

One of the reasons why people engage in reminiscences about their past is to maintain intimacy with deceased close others. Although previous research alerts to the negative effects of reminiscence for intimacy maintenance on mental health, little is known about its relation to individuals' reactions to loss (i.e. grief severity and personal growth). In two samples, we focus on time since loss and continuing bonds, to elucidate the role of reminiscence for intimacy maintenance in grief.

METHOD

The samples comprised 111 and 198 bereaved adults. All participants rated the frequency of reminiscence for intimacy maintenance and loss-related variables, such as time since loss, continuing bonds, and grief severity. Sample 2 additionally completed measures of personal growth, loss-centrality, and their interconnectedness with the deceased.

RESULTS

Reminiscence on intimacy maintenance was positively related to grief severity. This relation was independent of time since loss and partly driven by externalized bonds. Internalized bonds mediated the relation between reminiscence for intimacy maintenance and grief severity (in sample 1) and personal growth (in sample 2).

CONCLUSION

Continuing bonds help explain why reminiscing for intimacy maintenance can be harmful in terms of grief severity but also fosters personal growth after the loss.

Operationalization, implications and correlates of the cultural deviance criterion for ICD-11 and DSM-5 prolonged grief disorder

Prolonged Grief Disorder (PGD) is included in ICD-11 and DSM-5-TR and includes a requirement of cultural deviance. This study examined endorsement rates and factors associated with endorsement of this criterion among Danish bereaved spouses (n = 425) and their adult children (n = 159) four years post-loss. In total, 7.5% (n = 44) participants endorsed this criterion. Both including and excluding the criterion, the prevalence rates for probable DSM-5-TR PGD were 1.4% (n = 8) and 1.7% (n = 10), respectively and for probable ICD-11 PGD were 1.4% (n = 8) and 2.2% (n = 13), respectively. Age and gender of the deceased, age of the bereaved, greater grief severity, and comorbid psychopathology were positively associated with endorsement of the criterion. Findings demonstrate low endorsement of the cultural deviation criterion, that its inclusion excludes several potential PGD cases, and unanticipated associations with several factors raise questions about the criterion's validity.