Prolonged grief disorder following the Coronavirus (COVID-19) pandemic

Eisma, Maarten C.; Boelen, Paul A.; Lenferink, Lonneke

doi:10.1016/j.psychres.2020.113031

Cited by 224 publications

(223 citation statements)

References 6 publications

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“…It is important to note that proposed changes for a revised DSM-5 currently under consideration include creating a formal diagnosis of PGD in the DSM section II (35). We agree with those advocating for the inclusion of PGD in a DSM-5 revision in the chapter on trauma and stressor-related disorders rather than in the chapter on depressive disorders (36). Irrespective of any decision on where to place the bereavement diagnosis, we believe it valuable for any modification of the DSM regarding disordered bereavement to retain the specification "with traumatic bereavement" as an important qualifier.…”

Section: Traumatic Bereavementssupporting

confidence: 62%

Traumatic Bereavements: Rebalancing the Relationship to the Deceased and the Death Story Using the Two-Track Model of Bereavement

2020

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Bereavements that occur under external traumatic circumstances increase the risk for dysfunction, trauma symptomatology, as well as disordered and prolonged grief. While the majority of individuals who have experienced traumatic bereavements do not meet formal criteria for posttraumatic stress disorder (PTSD), persistent complex bereavement disorder (PCBD), or prolonged grief disorder (PGD), the degree of distress and dysfunction for these bereaved can be quite significant. The assessment and intervention paradigms in use with traumatic bereavements often prioritize the trauma and bypass the centrality of the interpersonal loss. By using a bifocal approach in conceptualizing bereavement, the Two-Track Model of Bereavement (TTMB) rebalances the approach to the class of traumatic bereavements. Track I examines biopsychosocial functioning and symptoms of trauma, and track II focuses on the nature of the ongoing relationship with the deceased and the death story that may also have elements of traumatic response. The model and its application serve to identify both adaptive and maladaptive responses to loss along both axes to optimally focus interventions where needed. The story of the death, the psychological relationship with the deceased, and the presence of biopsychosocial difficulties each have a part to play in assessment and intervention. A case study of assessment and intervention following traumatic bereavement due to suicide illustrates how attention to each of these factors in the TTMB can facilitate change. Ultimately, the relational bond with the deceased is a major vector in grief and mourning. Assessment and intervention with traumatic bereavements require attention to dysfunction and symptoms of trauma as well as to the death story and the state of the relationship to the deceased.

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Section: Traumatic Bereavementssupporting

confidence: 62%

Traumatic Bereavements: Rebalancing the Relationship to the Deceased and the Death Story Using the Two-Track Model of Bereavement

2020

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“…33 Moreover, during times of a crisis, such as the COVID-19 pandemic, it seems more relevant than ever to further examine the effectiveness of online CBT for distressed bereaved people, as it will allow them to retain access to evidence-based care. 34 A potential downside to online CBT is the high dropout rate found in earlier studies. 33 35 It has been argued that a strong therapeutic alliance might support adherence to online treatment and mediates treatment effects.…”

Section: Cbt For Grief-related Distressmentioning

confidence: 99%

Online cognitive–behavioural therapy for traumatically bereaved people: study protocol for a randomised waitlist-controlled trial

et al. 2020

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IntroductionThe traumatic death of a loved one, such as death due to a traffic accident, can precipitate persistent complex bereavement disorder (PCBD) and comorbid post-traumatic stress disorder (PTSD) and depression. Waitlist-controlled trials have shown that grief-specific cognitive–behavioural therapy (CBT) is an effective treatment for such mental health problems. This is the first study that will examine the effectiveness of online CBT (vs waitlist controls) in a sample exclusively comprised of people bereaved by a traumatic death. Our primary hypothesis is that people allocated to the online CBT condition will show larger reductions in PCBD, PTSD and depression symptom levels at post-treatment than people allocated to a waitlist. We further expect that reductions in symptom levels during treatment are associated with reductions of negative cognitions and avoidance behaviours and the experience of fewer accident-related stressors. Moreover, the effect of the quality of the therapeutic alliance on treatment effects and drop-out rates will be explored.Methods and analysisA two-arm (online CBT vs waiting list) open-label parallel randomised controlled trial will be conducted. Participants will complete questionnaires at pretreatment and 12 and 20 weeks after study enrolment. Eligible for participation are Dutch adults who lost a loved one at least 1 year earlier due to a traffic accident and report clinically relevant levels of PCBD, PTSD and/or depression. Multilevel modelling will be used.Ethics and disseminationEthics approval has been received by the Medical Ethics Review Board of the University Medical Center Groningen (METc UMCG: M20.252121). This study will provide new insights in the effectiveness of online CBT for traumatically bereaved people. If the treatment is demonstrated to be effective, it will be made publicly accessible. Findings will be disseminated among lay people (eg, through newsletters and media performances), our collaborators (eg, through presentations at support organisations), and clinicians and researchers (eg, through conference presentations and scientific journal articles).Trial registration numberNL7497.

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“…Researchers have voiced concerns that COVID-19 loss characteristics (e.g., experiencing sudden death, after intensive care admission) and circumstances (e.g., limited opportunities to shape death rituals, difficulties receiving social support, co-occurrence of secondary stressors, e.g., social isolation, infection, job loss) will hamper the grief process (e.g., Refs. 2,3 ). In addition, researchers have argued that aforementioned circumstances of loss may also disturb the grief process for those experiencing losses unrelated to COVID-19 during the pandemic, potentially leading to more severe grief reactions in the larger population of bereaved persons (e.g., Ref.…”

Section: Introductionmentioning

confidence: 99%

“…In addition, researchers have argued that aforementioned circumstances of loss may also disturb the grief process for those experiencing losses unrelated to COVID-19 during the pandemic, potentially leading to more severe grief reactions in the larger population of bereaved persons (e.g., Ref. 2 ). Accordingly, researchers have predicted long-term increases in prevalence of severe, persistent, and disabling grief, also termed prolonged grief disorder (PGD: International Classification of Diseases, Eleventh Revision) or persistent complex bereavement disorder (PCBD: Diagnostic and Statistical Manual of Mental Disorders [Fifth Edition]) in both populations.…”

Section: Introductionmentioning

confidence: 99%

Grief Before and During the COVID-19 Pandemic: Multiple Group Comparisons

Eisma¹,

Tamminga²

2020

Journal of Pain and Symptom Management

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133

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Context. Grief researchers are concerned that the coronavirus disease 2019 (COVID-19) pandemic will precipitate increases in severe, persistent, and disabling grief, termed prolonged grief disorder or persistent complex bereavement disorder. We recently demonstrated that higher grief levels are experienced after COVID-19-related bereavement than natural bereavement. Death circumstances during the pandemic (e.g., reduced social support, limited opportunities for death rituals) may also hamper the grief process for non-COVID-19-related bereavement, yet no quantitative research has specifically addressed this issue. Objectives. To test if grief severity is higher during than before the lockdown after non-COVID-19-related bereavement. Methods. A cross-sectional survey including questions on sociodemographic and loss-related variables and a grief measure was conducted among a sample of 1600 bereaved adults (78% females), participating before (n ¼ 731) or during (n ¼ 869) the pandemic, including people who had experienced a loss before the pandemic (n ¼ 456) or during the pandemic (n ¼ 200) recently (five months ago or less). Results. No significant differences emerged between grief levels in people participating before or during the pandemic. However, being recently bereaved during the pandemic elicited more severe grief than before it (d ¼ 0.17; d ¼ 0.18). Effects remained significant after controlling analyses for relevant loss-related variables. Conclusion. Among all bereaved persons, grief severity was no different during the pandemic compared with before the pandemic. However, experiencing a recent loss during the pandemic elicited more severe acute grief reactions than before the pandemic, suggesting that dealing with loss may be more difficult during this ongoing health crisis. J Pain Symptom Manage 2020;-:-e- .

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Prolonged grief disorder following the Coronavirus (COVID-19) pandemic

Cited by 224 publications

References 6 publications

Traumatic Bereavements: Rebalancing the Relationship to the Deceased and the Death Story Using the Two-Track Model of Bereavement

Traumatic Bereavements: Rebalancing the Relationship to the Deceased and the Death Story Using the Two-Track Model of Bereavement

Online cognitive–behavioural therapy for traumatically bereaved people: study protocol for a randomised waitlist-controlled trial

Grief Before and During the COVID-19 Pandemic: Multiple Group Comparisons

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