Homicidally bereaved individuals may experience symptoms of Complicated Grief (CG) and Posttraumatic Stress Disorder (PTSD). This Randomized Controlled Trial examined the effectiveness of an 8-session treatment encompassing Cognitive Behavioural Therapy (CBT) and Eye Movement Desensitization and Reprocessing (EMDR) to reduce self-rated CG and PTSD symptoms in 85 Dutch adult homicidally bereaved men and women. We compared changes in symptoms of CG (assessed using the Inventory of Complicated Grief) and PTSD (assessed using the Impact of Event Scale) between an intervention group and a waitlist control group. The treatment was effective in reducing CG and PTSD symptoms, from pretreatment to posttreatment. It can be concluded that EMDR and CBT seem promising treatments for homicidally bereaved individuals for both men and women, and regardless of the time since the loss. Further research is needed to examine whether a combined treatment of EMDR and CBT together is of added value in situations where grief and trauma are intertwined over offering only one of the two treatment modalities.
In the literature on bereavement, claims are made that homicidal loss is associated with posttraumatic stress reactions, depression, and other severe mental health problems. It is surprising that only a few studies have investigated the nature and prevalence of emotional symptoms following homicidal bereavement and a reference to systematic, empirical research is seldom provided. This article reviews the available literature to investigate whether these claims have empirical evidence. Three databases were searched to identify relevant studies. This approach was supplemented with a bibliography search. Eligible studies included English-language peer-reviewed articles that assessed psychopathology in the homicidally bereaved, as defined in the Diagnostic and Statistical Manual of Mental Disorders. Of the 360 potentially relevant articles, 8 studies (13 references) met predefined inclusion criteria. Homicide-related psychopathology among the bereaved assessed in these studies includes posttraumatic stress disorder (PTSD), depression, complicated grief, and substance abuse. Prevalence of lifetime homicide-related PTSD varied from 19.1% to 71% across studies. Current PTSD varied between 5.2% and 6%. The reviewed literature was inconclusive regarding the course of symptoms over time and the severity of psychopathology among the homicidally bereaved, compared to individuals bereaved by other causes of death. A comparison of the nature and prevalence of psychopathology between studies was complicated by unequal sample sizes and type, recruitment strategy, study design, and time since loss. Limitations of the included studies are discussed, as well as implications for clinical practice, policy, and future research.
People confronted with homicidal loss have to cope with separation distress, related to their loss, and traumatic distress, associated with the circumstances surrounding the death. These reactions are related to complicated grief (CG) and posttraumatic stress disorder (PTSD). The psychological effects for people who have lost someone through homicide, in terms of PTSD and CG, are largely unclear. This cross-sectional study (a) examined the prevalence of self-rated PTSD and self-rated CG in a community-based sample of 312 spouses, family members, and friends of homicide victims and (b) aimed to identify socio-demographic, loss-related, and perpetrator-related correlates of PTSD and CG. Participants were recruited via support organizations for homicidally bereaved individuals in the Netherlands (i.e., support group), and by casemanagers of a governmental organization, which offers practical, non-psychological, support to bereaved families (i.e., casemanager group). Prevalence of self-rated PTSD was 30.9% (support group) and 37.5% (casemanager group), prevalence of CG was 82.7% (support group) and 80.6% (casemanager group). PTSD and CG severity scores varied as a function of the relationship with the victim; parents were at greater risk to develop emotional problems, compared with other relatives of the victim. Time since loss was negatively associated with PTSD and CG scores.
This study examined associations of symptoms of Prolonged Grief Disorder (PGD), Posttraumatic Stress Disorder (PTSD), anger, and revenge thoughts and feelings with different categories of negative cognitions and indices of anxious and depressive avoidance behaviors, among 331 homicidally bereaved individuals. Outcomes showed that symptom levels of PGD and PTSD were higher among individuals who had more negative cognitions about the self, were more inclined to catastrophically misinterpret their grief reactions, and tended to engage in depressive avoidance. Anger was strongly associated with negative cognitions about the self. Revenge thoughts and feelings were associated with pessimistic cognitions and anxious avoidance of loss-related stimuli.
Feelings of revenge are a common human response to being hurt by others. Among crime victims of severe sexual or physical violence, significant correlations have been reported between revenge and Posttraumatic Stress Disorder (PTSD). Homicide is one of the most severe forms of interpersonal violence. It is therefore likely that individuals bereaved by homicide experience high levels of revenge, which may hamper efforts to cope with traumatic loss. The relationship between revenge and psychological adjustment following homicidal loss has not yet been empirically examined. In the current cross-sectional study, we used self-report data from 331 spouses, family members and friends of homicide victims to examine the relationships between dispositional revenge and situational revenge on the one hand and symptom-levels of PTSD and complicated grief, as well as indices of positive functioning, on the other hand. Furthermore, the association between revenge and socio-demographic and offense-related factors was examined. Participants were recruited from a governmental support organization, a website with information for homicidally bereaved individuals, and members of support groups. Levels of both dispositional and situational revenge were positively associated with symptoms of PTSD and complicated grief, and negatively with positive functioning. Participants reported significantly less situational revenge in cases where the perpetrator was a direct family member than cases where the perpetrator was an indirect family member, friend, or someone unknown. Homicidally bereaved individuals reported more situational revenge, but not more dispositional revenge than a sample of students who had experienced relatively mild interpersonal transgressions.
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