Posttraumatic Stress Disorder, Depression, and Prolonged Grief Disorder in Families Bereaved by a Traumatic Workplace Death: The Need for Satisfactory Information and Support

Remembering the Dead: What Community Newspaper Memorials Reveal

People will understandably continue to remember significant persons long after their deaths. One possible remembrance practice is the placement of a memorial about the deceased person in a community newspaper. It is not clear what these memorials are intended to do, how they are constructed, who places them in a public sphere for open viewing, and what purpose or purposes they serve. As these memorials could be important for grief management and other personal, family, or social purposes, an examination of memorials to the dead appearing over one year in the Edmonton Journal, the primary newspaper for a Canadian city of one million inhabitants, was conducted. This research project found memorials were uncommon (N = 567) compared to obituaries (N = 4,865), and very uncommon in relation to the number of decedents who could have been memorialized. Memorial authors were most often parents or children, with memorials usually appearing on a second year or later death anniversary. Two content themes were identified: (a) enduring love for the deceased, and (b) a continuing if not permanent remembrance of them. The findings raise many questions, but primarily how people can openly and constructively grieve long after the death of a loved one.

Traumatic loss: a systematic review of potential risk factors differentiating between posttraumatic stress disorder and prolonged grief disorder

Background: When traumatic events and losses intersect in the form of traumatic loss, these events can trigger both posttraumatic stress disorder and pathological grief.Objective: This systematic review investigates which characteristics differentiate between the development of the respective disorders or are associated with comorbidity.Method: A systematic literature search using Medline, PubMed, APA PsycInfo and Web of Science yielded 46 studies which met the inclusion criteria. In these studies, PTSD was assessed using 17 and pathological grief using 16 different validated instruments. In the quality assessment, 12 studies were classified as average, 30 as above average, and 4 as excellent. The investigated risk factors were categorized into 19 superordinate clusters and processed using narrative synthesis.Results: The relationship to the deceased, mental health issues, and religious beliefs seem to be associated specifically with pathological grief symptoms compared to PTSD symptoms. Social support and social emotions emerged as significant correlates and potential risk factors for both PTSD and pathological grief. Included studies had mainly cross-sectional designs.Conclusions: Differentiating factors between pathological grief and PTSD appear to exist. The results should be considered within the limitations of the heterogeneity of the included studies and the research field. There is a lack of studies (1) using a longitudinal study design, (2) starting data collection early following the traumatic loss, (3) using standardized, up-to-date measurement instruments and (4) including comorbidity in their analyses. Further research is urgently needed for more accurate (acute) screenings, prognoses, and interventions following traumatic loss.

Living with mesothelioma: a systematic review of mental health and well-being impacts and interventions for patients and their informal carers

OBJECTIVES

Mesothelioma is an aggressive cancer predominantly affecting the lung and abdominal linings. It can have a unique impact on mental health and well-being (MHWB) due to its incurability, poor prognosis and asbestos-exposure causation. This review's aims were to identify/synthesise international evidence on mesothelioma's MHWB impacts; explore MHWB interventions used by patients and carers; and identify evidence of their effectiveness.

DESIGN

Systematic review.

DATA SOURCES

Databases, searched March 2022 and March 2024, were MEDLINE; CINAHL; PsycINFO; Cochrane Library; ASSIA.

ELIGIBILITY CRITERIA

We included study designs focusing on psychological impacts of living with mesothelioma and MHWB interventions used by patients and informal carers, published in English since January 2002.

DATA EXTRACTION AND SYNTHESIS

A team of reviewers screened included studies using standardised methods. Quality was assessed using validated tools: Mixed-Methods Appraisal tool for primary research and Joanna Briggs Institute Critical Appraisal Checklist for Systematic Reviews.

RESULTS

Forty-eight studies met the inclusion criteria: 20 qualitative, 16 quantitative, nine reviews, two mixed-methods, one combined systematic review/qualitative study. UK studies predominated. Many MHWB impacts were reported, including traumatic stress, depression, anxiety and guilt. These were influenced by mesothelioma's causation, communication issues and carer-patient relational interactions. Participants used wide-ranging MHWB interventions, including religious/spiritual practice; talking to mental-health professionals; meaning-making. Some strategies were presented as unhelpful, for example, denial. Participants reported lack of access to support.

CONCLUSIONS

Most qualitative studies were rated high quality. The quality of the quantitative studies and reviews varied. The sparse literature regarding MHWB in mesothelioma means more research is needed into impacts on patients and carers, including trauma. To enable access to evidence-based support, research is recommended concerning MHWB interventions' effectiveness in mesothelioma.

PROSPERO REGISTRATION NUMBER

CRD42022302187.

Psychometric Properties of the Spanish Version of the Traumatic Grief Inventory Self Report Plus (TGI-SR+)

BACKGROUND

The grieving process caused by the loss of a loved one triggers a range of responses. While most people experience adaptive grief, some may experience intense distress and persistent symptoms. Prolonged Grief Disorder is commonly diagnosed using the ICD-11 and the DSM-5-TR. Few instruments assess criteria from both simultaneously, underscoring the importance of the Traumatic Grief Inventory Self-Report Plus (TGI-SR+). This study aimed to analyse the psychometric properties of the scores from the Spanish version of the TGI-SR+.

METHOD

Data were analysed from 229 participants who were bereaved between March 2020 and March 2022. The Spanish TGI-SR+ was used alongside measures of psychopathology and prolonged grief. We performed confirmatory factor analysis, reliability tests, bivariate correlations and group comparisons.

RESULTS

Confirmatory factor analysis of the TGI-SR+ demonstrated a one-factor structure with high reliability ( ϖ = .99). Convergent validity was shown by correlations with anxiety, depression, post-traumatic stress and prolonged grief (p < .001). Differences by sex and educational level were observed. Optimal screening cut-off points were identified for the total sample and for those meeting the criteria for prolonged grief.

CONCLUSIONS

The Spanish version of the TGI-SR+ is a valuable instrument for assessing prolonged grief in Spanish-speaking populations.

Prevalence and Correlates of Complicated Grief in Military Primary Care: Implications for Healthcare Providers

Grief is a universal experience, but for approximately 1 in 10 individuals, grief can become impairing. Despite servicemembers' frequent exposure to death, research on grief in the military remains limited. The purpose of the study was to explore the prevalence and correlates of complicated grief (CG) in military primary care. A quantitative survey was conducted with 161 non-treatment-seeking service members, veterans, and their dependents, of whom 138 reported a significant loss. Results revealed that 35% of the respondents who were bereaved met the cut-off score of 25 on the Inventory of Complicated Grief (ICG). Furthermore, 10% met the cut-off score of 30 on the Prolonged Grief Disorder-13-Revised Scale (PG-13-R). Importantly, death by suicide and pre-existing mental health conditions were associated with greater symptom severity. These findings have important implications for primary care providers and other clinicians working with military populations.

Measuring Grief in the Context of Traumatic Loss: A Systematic Review of Assessment Instruments

Following traumatic loss, defined as the death of a loved one due to unexpected or violent circumstances, adults may experience a myriad of grief-related problems. Given the addition of Prolonged Grief Disorders into the Diagnostic and Statistical Manual for Mental Disorders Fifth Edition, Text-Revision and influx of unexpected deaths due to the global Coronavirus pandemic, there is heightened interest in the measurement of grief-related processes. We conducted a systematic review according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines to identify measures of grief used in studies of adults who experienced traumatic loss. Searches yielded 164 studies that used 31 unique measures of grief-related constructs. The most commonly used instrument was the Inventory of Complicated Grief-Revised. Half of the measures assessed constructs beyond diagnosable pathological grief responses. Given the wide variation and adaptations of measures reviewed, we recommend greater testing and uniformity of measurement across the field. Future research is needed to adapt and/or design measures to evaluate new criteria for Prolonged Grief Disorder.

What Exactly Is "Complicated" Grief? A Scoping Research Literature Review to Understand Its Risk Factors and Prevalence

Most people will experience bereavement grief, but some suffer from persistent or prolonged (PoP) grief, grief that used to be identified as "complicated" before recent DSM-5 and ICD-11 definitional developments. In 2020, a scoping literature review was undertaken to identify and consolidate contemporary evidence from research articles published in 2018 or 2019 in paper-based and open access peer-review journals on: (a) the incidence or prevalence of PoP grief, and (b) who develops it or is diagnosed as suffering from it, and correspondingly what causative factors or predictors are associated with PoP grief. All of the 11 identified research articles reported an incidence or prevalence rate, with these varying greatly, but with a much higher rate now that a 6-month post-death measurement timeframe is used. The predictors or factors among people who were identified as having PoP grief also varied considerably, although sudden and unexpected deaths were often implicated.

Bereaved UK military families: A mixed methods study on the provision of practical and emotional support

Traumatic deaths of military personnel can have tragic consequences for the lives and health of bereaved significant others. To mitigate the effects, the UK Armed Forces enhanced the support for bereaved military families. However, little is known about whether the support has been satisfactory. The present research applied mixed methods to explore the experiences of bereaved UK military families (N = 264) with different types of support and how it historically changed over time. The findings suggest that although support has improved, further improvements are required in the provision of financial information, administrative support, and access to psychological support for all bereaved family members.

Prevalence and risk factors of posttraumatic stress disorder among Chinese shidu parents: A systemic review and meta-analysis

BACKGROUND

Losing the only child is an extremely distressful life event for parents. Previous studies indicated that shidu parents were more vulnerable to develop posttraumatic stress disorder (PTSD). This study aims to calculate the pooled prevalence of PTSD and identify its risk factors.

METHOD

We conducted a systematic literature search in PubMed, Web of Science, Embase, China National Knowledge Infrastructure (CNKI), Wanfang databases, Vip databases. We performed a meta-analysis using random effects models to calculate the pooled PTSD in shidu parents. Associated factors for PTSD was evaluated by determining standardized mean difference (SMD) with 95% CIs. All analyses were performed using the Stata 16.0.

RESULTS

Eight articles (covering 2,722 shidu parents) were included in this study. The pooled prevalence of PTSD was 46.8% (95%CI: 33.2%-60.3%) among Chinese shidu parents. Female (SMD[95%CI]: 0.41[0.20, 0.62]), higher education level (SMD[95%CI]: 0.15[0.03, 0.28]), lower income (SMD[95%CI]: 0.33[0.13, 0.53]), losing a daughter (SMD[95%CI]: 0.16[0.03, 0.28]) and shorter time since loss (SMD[95%CI]: 0.24[0.07, 0.40]) were significantly associated with a higher PTSD prevalence. Registered residence, cause of death, age of the child, and having a grandchild were not associated with PTSD.

LIMITATIONS

Some variables included in this meta-analysis were only measured twice, which limited the conclusions to some extent.

CONCLUSION

This meta-analysis indicated that nearly half of shidu parents experienced PTSD and provided evidence of risk factors for PTSD in shidu parents. Further research is suggested to determine how these factors interact. Effective interventions should be conducted to shidu parents with PTSD.

Association between psychological morbidities and information provision, reliability, and satisfaction among disaster victims: A cross-sectional study

Providing information about disaster relief services and recovery processes reduces the damage from disasters and enables disaster victims to respond to disasters effectively. The present study aimed to clarify the associations between provision, reliability, satisfaction of information and satisfaction with media coverage and the risk of psychological morbidities (post-traumatic stress disorder [PTSD], depression, and anxiety). This was a cross-sectional survey - 1337 disaster victims who had experience of disasters within 2 years, such as earthquakes were enrolled in the 3rd Disaster Victims Panel Survey, 2018. Logistic regression analysis was used to investigate the associations between psychological morbidities and provision, reliability, and satisfaction of information. Reliability of information was assessed with a dichotomized variable and satisfaction with information or media was assessed 4 levels with 'neutral' by a single retrospective self-report item. The risks of depression (odds ratio [95% CI] = 1.478 [1.078-2.028]; p = 0.015) and anxiety (1.879 [1.262-2.798]; p = 0.002) were significantly higher in uninformed victims. Those who received reliable information were less likely to report depression (0.538 [0.381-0.758]; p < 0.001) and anxiety (0.362 [0.229-0.573]; p < 0.001), and those who received unreliable information were more likely to report PTSD (1.714 [1.045-2.810]; p = 0.033) and depression (1.742 [1.029-2.950]; p = 0.039). Satisfactory information was related to lower risks of depression (0.543 [0.380-0.778]; p = 0.001) and anxiety (0.352 [0.215-0.575]; p < 0.001). Disaster victims who were unsatisfied with media coverage had higher risks of PTSD (5.363 [3.672-7.833]; p < 0.001), depression (5.911 [3.377-10.347]; p < 0.001) and anxiety (5.840 [2.837-12.022]; p < 0.001). Providing information and providing reliable and satisfactory information might reduce the risk of psychological morbidities. Our results suggest that providing reliable and satisfactory information during disasters could reduce the psychiatric burden of disasters.

Grief Reactions of Potential Organ Donors' Bereaved Relatives: An Observational Study

BACKGROUND

Most family members of potential organ donors experience the death of their relative in an intensive care unit. While under an emotional burden, bereaved relatives must make a decision that will affect the life of other patients. A better understanding of grief within the context of organ donation will help intensive care unit staff better support families during this process.

OBJECTIVES

To empirically describe the emotional reactions of potential organ donors' family members facing a loved one's death and analyze the relationship of these reactions to factors that occur in the process of illness and death.

METHODS

A prospective observational study was conducted in 16 Spanish hospitals for 36 months. Data of 421 relatives of potential organ donors, collected through a previously validated instrument, included relatives' emotional responses, deceased's and relatives' characteristics, circumstances of death, and behavior of health care staff.

RESULTS

Unexpected deaths were linked to more intense emotional reactions and less acceptance of death than were anticipated deaths. Additional stressors, such as perception of poor treatment by hospital staff, perception of deficient medical care, and poor relationships among family members, were associated with stronger reactions.

CONCLUSIONS

Observation and analysis of the factors studied may help hospital staff members anticipate bereaved relatives' emotional reactions and provide better support during the grieving process, increasing family members' well-being and facilitating a better-informed organ donation decision.