The Mediating Role of Integration of Loss in the Relationship Between Dissociation and Prolonged Grief Disorder

Hasson‐Ohayon, Ilanit; Peri, Tuvia; Rotschild, Itai; Tuval‐Mashiach, Rivka

doi:10.1002/jclp.22479

Cited by 8 publications

(5 citation statements)

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“…'This event is incomprehensible to me'; 'Since this event happened, I don't know where to go next in my life') to which the respondent indicates agreement or disagreement on a 5-point scale. We implemented the validated Hebrew version (Hasson-Ohayon, Peri, Rotschild, & Tuval-Mashiach, 2017). The scale's internal reliability was high in the current study (Cronbach's α = .91)…”

Section: The Integration Of Stressful Life Experiences Scale (Isles; mentioning

confidence: 93%

Narrative reconstruction therapy for prolonged grief disorder – a pilot study

Elinger

Hasson‐Ohayon

Bar‐Kalifa

et al. 2021

European Journal of Psychotraumatology

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Background: Prolonged grief disorder (PGD) is a chronic and disabling condition that affects approximately 10% of non-traumatically bereaved people. Narrative reconstruction (NR), originally designed for the treatment of posttraumatic stress disorder (PTSD), is a timelimited integrative therapy consisting of exposure to the loss memory, detailed written reconstruction of the loss memory narrative, and an elaboration of the personal significance of that memory for the bereaved. Objective: This pilot study examined the efficacy of NR therapy in reducing symptoms in bereaved people diagnosed with PGD. Method: Ten PGD patients participated in the study and were treated with 16 weekly sessions of NR. PGD, PTSD, and depression symptoms, as well as levels of loss integration, were assessed at pre-treatment, post-treatment, and at a 3-month follow-up. Results: Following NR, participants showed significant reductions in PGD, depression, and PTSD symptoms, and elevated levels of trauma integration. Symptoms showed further improvement at the three-month follow-up. Conclusions: These findings provide preliminary evidence for the feasibility and efficacy of NR in treating PGD. Narrative reconstruction therapy requires further evaluation in randomized controlled trials. Terapia de reconstrucción narrativa para trastorno de duelo prolongado -un estudio pilotoAntecedentes: El trastorno de duelo prolongado (PGD en su sigla en inglés) es una condición crónica y discapacitante que afecta aproximadamente al 10% de las personas que experimentan un duelo no traumático. La reconstrucción narrativa (NR en su sigla en inglés) fue diseñada originalmente para el tratamiento del trastorno de estrés postraumático (TEPT), es una terapia integrativa de tiempo limitado que consiste en la exposición a la memoria de la pérdida, la reconstrucción escrita detallada de la memoria narrativa de la pérdida, y una elaboración del significado personal de esa memoria para la persona experimentando el duelo. Objetivo: Este estudio piloto examina la eficacia de la terapia NR en reducir los síntomas en las personas experimentando duelo que han sido diagnosticadas con el PGD. Método: Diez pacientes con PGD participaron en el estudio y fueron tratados con 16 sesiones semanales de NR. Los síntomas de PGD, TEPT, y depresión, como también los niveles de integración de la pérdida, fueron evaluados previo al tratamiento, luego del tratamiento, y a los 3 meses de seguimiento. Resultados: Siguiendo NR, los participantes mostraron reducciones significativas en los síntomas de PGD, depresión, y TEPT, y niveles elevados de integración del trauma. Los síntomas mostraron mayores mejoras a los tres meses de seguimiento. Conclusión: Estos hallazgos proveen evidencia preliminar para la factibilidad y eficacia del NR en tratar el PGD. La terapia de reconstrucción narrativa requiere mayor evaluación en ensayos controlados aleatorizados.

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Section: The Integration Of Stressful Life Experiences Scale (Isles; mentioning

confidence: 93%

Narrative reconstruction therapy for prolonged grief disorder – a pilot study

Elinger

Hasson‐Ohayon

Bar‐Kalifa

et al. 2021

European Journal of Psychotraumatology

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“…Milman and colleagues (2019) found a mediating role of meaning made for predicting protracted grief by a series of risk factors, which in turn was moderated by ruminative tendencies; thus, the stronger the ruminative tendency, the weaker the prediction of protracted grief by meaning made. Finally, Hasson‐Ohayon, Peri, Rotschild, and Tuval‐Mashiach (2017) found that self‐reported integration of the event into self‐narrative (a proxy to meaning made) mediated the relation between dissociative tendencies and protracted grief.…”

Section: Meaning Making‐attempts Meaning Made and Adjustmentmentioning

confidence: 99%

Only some attempts at meaning making are successful: The role of change‐relatedness and positive implications for the self

Huang

Schmiedek

Habermas

2020

Journal of Personality

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Objective Although meaning making and specifically autobiographical reasoning are expected to relate to well‐being, findings tend to be mixed. Attempts at meaning making do not always lead to meaning made. We aimed to disentangle these complex relationships and also explore the role of level of education. Method Ninety participants (mean age 36.73 years, SD = 7.27; 74.4% women, 25.6% men) who had experienced the loss of a parent through death, going missing, or Alzheimer's disease narrated this loss, a sad, a turning point, and a self‐defining memory, and completed questionnaires assessing depression, trauma symptoms, and protracted grief. Three aspects of autobiographical reasoning (quantity, valence, and change‐relatedness of self‐event connections) were related to meaning made (sophistication of meaning making) and symptom level. Results Years of education correlated both with positive implications of autobiographical reasoning and with meaning made. The quantity, positivity, and change‐relatedness of attempts at meaning making (self‐event connections) predicted accomplished meaning made, and positivity alone predicted less prolonged grief. Conclusions Adapting the life story after a loss such that change of the self is acknowledged and positive change can be constructed helps finding meaning and lowering protracted grief. These changes in narrative identity are supported by more years of education.

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“…It includes 16 items (e.g., “This event is incomprehensible to me”; “Since this event happened, I don't know where to go next in my life”) to which the respondent indicates agreement or disagreement on a 5‐point scale. We implemented the validated Hebrew version (Hasson‐Ohayon et al, 2017). The scale's Cronbach's α was .87 at baseline and .91 in the post‐treatment and follow‐up assessments.…”

Section: Methodsmentioning

confidence: 99%

A quasi‐experimental trial of narrative reconstruction for prolonged grief disorder: Symptomatic improvement and enhanced memory integration

Elinger,

Hasson‐Ohayon,

Bar‐Shachar

et al. 2023

J Clin Psychol

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BackgroundProlonged grief disorder (PGD) was recently approved as a formal diagnosis in the DSM‐5‐TR. The implementation of bereavement interventions is frequently requested, but their effectiveness has been controversial. Narrative reconstruction (NR) is a time‐limited integrative therapy, originally developed for the treatment of post‐traumatic stress disorder (PTSD) and adapted for the treatment of PGD. NR consists of exposure to the loss memory, a detailed written reconstruction of the loss memory narrative, and an elaboration of the personal significance of that memory for the bereaved.ObjectivesIn this study we evaluated the efficacy of NR for PGD.MethodIn this study, 33 participants with PGD were quasi‐randomized—that is, assigned to an immediate (n = 20) or delayed (n = 13) 16‐session NR intervention. PGD, intrusion, avoidance and depression symptoms, as well as levels of the loss memory integration, were assessed at pretreatment, post‐treatment, and at a 3‐month follow‐up.ResultsMixed linear models showed significant intervention effects for PGD and intrusive symptomatology. Results also showed an increase in integration of the loss memory, and improvements remained stable for all outcomes at follow‐up.ConclusionIn this study we established NR as an effective intervention for PGD and call for further validation in future studies. Integrating this intervention into the routine care of people with PGD seems important and beneficial.

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The Mediating Role of Integration of Loss in the Relationship Between Dissociation and Prolonged Grief Disorder

Abstract: The effect of people's dissociative tendencies on their PGD symptoms seems to occur via the impairment of their ability to integrate the memory of their loss into their general autobiographical memory. Empirical and clinical implications are discussed.

Cited by 8 publications

References 62 publications

Narrative reconstruction therapy for prolonged grief disorder – a pilot study

Narrative reconstruction therapy for prolonged grief disorder – a pilot study

Only some attempts at meaning making are successful: The role of change‐relatedness and positive implications for the self

A quasi‐experimental trial of narrative reconstruction for prolonged grief disorder: Symptomatic improvement and enhanced memory integration

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