Prolonged grief, depression, and posttraumatic stress in disaster-bereaved individuals: latent class analysis

Background: Along with the implementation of the one-child policy in China, a special group of bereaved parents called ‘shiduer’ (失独者), meaning parents bereaved by the loss of their only child, emerged. Although previous research has examined the physical and psychological health of this population, individual differences in physical and psychological outcomes are still not well understood.Objective: This study aimed to identify heterogenous subgroups of Chinese bereaved parents who lost their only child based on the physical and psychological health of this population as well as the predictive factors of each subgroup.Method: Latent profile analysis was used to explore underlying patterns of physical and psychological indicators including subjective physical health, negative psychological outcomes (i.e. depression, post-traumatic stress disorder and prolonged grief disorder) and positive psychological outcomes (i.e. post-traumatic growth) among a sample of Chinese bereaved parents who lost their only child (N = 536). A three-step approach was used to examine the effects of covariates including quality of spousal relationship and recruitment channels on psychological and physical outcomes.Results: A three-profile model identified severity-based groupings of a ‘resilient’ subgroup (n = 153), a ‘coping’ subgroup (n = 338) and a ‘dysfunctional’ subgroup (n = 45). Less satisfaction with spousal relationship and recruitment from institutions in the community and online self-help groups (vs. offline support groups) are associated with the membership of the ‘coping’ or ‘dysfunctional’ subgroup compared to the ‘resilient’ subgroup.Conclusions: There is heterogeneity regarding the physical and psychological health of Chinese parents after losing their only child. The predictive effects of the quality of spousal relationship and the recruitment channels could provide directions for professional intervention.

Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Latent profiles of physical and psychological outcomes of bereaved parents in China who lost their only child

Zhou

Huang

et al. 2018

“…In particular, strong grief reactions, post-traumatic stress disorder (PTSD), and developmental difficulties have been observed (Eth & Pynoos, 1994; Hardesty, Campbell, McFarlane, & Lewandowski, 2008; Harris-Hendriks, Black, & Kaplan, 2000), in line with reactions to other major traumatic loss reported in the broader literature (e.g. Boelen & Smid, 2017; Christ, Siegel, & Christ, 2002; Lenferink, de Keijser, Smid, Djelantik, & Boelen, 2017; Miller, 2009). While clinical experience suggests that a substantial number of children require long-term mental health and social services, little empirical evidence is available regarding the circumstances and outcomes of children bereaved by parental intimate partner homicide.…”

Section: Introductionmentioning

confidence: 73%

Children’s perspectives on life and well-being after parental intimate partner homicide

Alisic

Groot

Snetselaar

et al. 2017

Background: While there is no doubt that parental intimate partner homicide is associated with strong grief and post-traumatic stress reactions among the children who have been bereaved, there is little in-depth insight into how children and young people see and describe their circumstances and needs. Objective: Our aim was to shed light on children’s and young people’s perspectives on their life after parental intimate partner homicide. In particular, we were interested in how they experienced their living arrangements, social environment, and general well-being. Method: We conducted semi-structured interviews with 23 children and young people (8–24 years old; 15 females and eight males) who had been younger than 18 years when one of their parents killed the other (21 children lost their mother, two children lost their father). We used thematic analysis to synthesize the findings. Results: While most participants were fairly content with themselves and their living arrangements, they also expressed substantial and persistent difficulties, including distress, conflicts between family members, and feelings of unsafety. Most importantly, children’s self-image, their perspectives on their biological parents, and their views on their broader (family) environment varied considerably from participant to participant, and also between siblings. Conclusions: It is unlikely that straightforward guidelines can be given with regard to where the children should live after parental homicide, or whether they should be in contact with the perpetrating parent. Rather, this study’s findings underline the need to explore children’s individual viewpoints carefully during decision-making processes.

“…Most participants will be recruited during an on-going longitudinal survey study that started in May 2015 (Lenferink, de Keijser, Smid, Djelantik, & Boelen, 2017). In the first measurement occasion of this survey study, about one-year post-disaster, participants are asked whether they are interested in receiving information about a treatment study.…”

Section: Methodsmentioning

confidence: 99%

Cognitive therapy and eye movement desensitization and reprocessing for reducing psychopathology among disaster-bereaved individuals: study protocol for a randomized controlled trial

Lenferink

Piersma

Keijser

et al. 2017

Self Cite

Background: Confrontation with a traumatic (e.g. disaster-related) loss is a risk factor for the development of psychopathology, including symptoms of prolonged grief (PG), posttraumatic stress (PTS), and depression. Although interventions have been developed for reducing post-loss psychopathology, more research into the effectiveness of treatment is needed to improve care for bereaved persons. Cognitive therapy (CT) and eye movement desensitization and reprocessing (EMDR) have been shown to be effective in trauma-exposed populations. We hypothesize that CT and EMDR are also effective in reducing symptoms among people exposed to traumatic loss. Objective: In this article we describe the rationale of a randomized controlled trial (RCT) to examine (1) treatment effects of CT and EMDR for reducing PG, PTS, and depression among traumatically bereaved people, and (2) the associations between improvements in PG, PTS, and depression symptoms on the one hand and tentative mechanisms of change, including a sense of unrealness, negative cognitions, avoidance behaviour, and intrusive memories, on the other hand. Method: A two-armed (intervention versus waiting list controls) RCT will be conducted. Participants will be asked to fill in questionnaires prior to treatment, during treatment, and one, 12, and 24 weeks post-treatment. Potential participants are people who have lost one or multiple significant other(s) in the Ukrainian plane disaster in 2014 with clinically significant levels of self-rated PG, PTS, and/or depression. Multiple regression, including analysis of covariance, and multilevel regression analyses will be used. Discussion: There is a need for treatment for psychopathology following traumatic loss. Strengths of this study are the development of a treatment that targets grief and trauma-related complaints and the examination of potential mechanisms of change in CT and EMDR. Bereaved people, clinicians, and researchers could benefit from the results of this study.