Adaption to the loss of a loved one due to suicide can be complicated by feelings of guilt, shame, responsibility, rejection, and stigmatization. Therefore people bereaved by suicide have an ...increased risk for developing complicated grief which is related to negative physical and mental disorders and an increased risk for suicidal behavior. Grief interventions are needed for this vulnerable population. The aim of this systematic review was to provide an overview of the current state of evidence concerning the effectiveness of interventions that focus on grief for people bereaved by suicide.
We conducted a systematic literature search using PubMed, Web of Science, and PsycINFO for articles published up until November 2016. Relevant papers were identified and methodological quality was assessed by independent raters. A narrative synthesis was conducted.
Seven intervention studies met the inclusion criteria. Two interventions were based on cognitive-behavioral approaches, four consisted of bereavement groups, and one utilized writing therapy. As five of the seven interventions were effective in reducing grief intensity on at least one outcome measure, there is some evidence that they are beneficial. Bereavement groups tend to be effective in lowering the intensity of uncomplicated grief, as are writing interventions in lowering suicide-specific aspects of grief. Cognitive-behavioral programs were helpful for a subpopulation of people who had high levels of suicidal ideation.
On average, methodological quality was low so the evidence for benefits is not robust. The stability of treatment effects could not be determined as follow-up assessments are rare. Generalizability is limited due to homogeneous enrollments of mainly female, white, middle-aged individuals.
People bereaved by suicide are especially vulnerable to developing complicated grief. Therefore, grief therapies should be adapted to and evaluated in this population. Prevention of complicated grief may be successful in populations of high risk individuals.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Prolonged grief disorder (PGD) was recently included as a disorder in the ICD-11 and DSM-5-TR. Although both classification systems use the same name, the criteria content, and diagnostic approach ...vary. This study aimed to estimate the respective prevalence of PGD
and PGD
and examine the diagnostic agreement while varying the diagnostic algorithm of PGD
(bereavement vs. symptom period; varying number of accessory symptoms).
A representative sample of the German general population (N = 2,509) was investigated, of which n=1,071 reported the loss of a close person. PGD symptoms were assessed with the Traumatic Grief Inventory - Self Report Plus (TGI-SR+).
The point prevalence of PGD among the bereaved varied between 4.7%-6.8%, depending on the criteria and diagnostic algorithm. The prevalence of PGD
was significantly lower than the prevalence of PGD
. The diagnostic agreement between both criteria sets was substantial and increased after the number of accessory symptoms for PGD
was increased from one to three. The most common symptoms were intrusive thoughts/images related to the deceased person, longing for the deceased person, and difficulty accepting the loss.
The results demonstrate that the prevalence of PGD significantly varies depending on the application of the diagnostic algorithm and criteria. PGD affects a substantial proportion of the general population and should be addressed by healthcare providers. However, applying the minimum ICD-11 criteria could lead overestimating the prevalence. Therefore, further harmonizing the ICD-11 and DSM-5-TR criteria and diagnostic algorithm for PGD seems appropriate.
Abstract
Background
During pregnancy, women`s bodies undergo rapid changes in body weight and body size within a relatively short period of time. Pregnancy may therefore be associated with an ...increased vulnerability for the development of body image dissatisfaction that has been linked to adverse health outcomes for mother and child. The present study aims to examine changes in body image during pregnancy as well as predictors of body image dissatisfaction. This is the first study using a tailored, multidimensional measure of body image especially developed for the pregnant population.
Methods
A prospective longitudinal design with a quantitative approach was applied. Healthy pregnant women (
N
= 222) were assessed using standardized instruments at two time points (T1: 18th-22th week of gestation, T2: 33th-37th week of gestation). The impact of demographic, weight- and health-related, behavioral, and psychological factors assessed at T1 on body image dissatisfaction at T1 and T2 was examined using stepwise linear regression analyses.
Results
T-tests for paired samples revealed that dissatisfaction with strength-related aspects of body image, dissatisfaction with body parts, and concerns about sexual attractiveness increased significantly from the middle to the end of pregnancy. In contrast, preoccupation with appearance, dissatisfaction with complexion, and prioritization of appearance over function were significantly reduced over time. Stepwise linear regression analyses revealed that factors influencing body image depend on the component of body image investigated. Overall, a low level of self-esteem and a high level of pregnancy-specific worries were risk factors for several components of body image dissatisfaction. Besides these, poor sleep quality, low levels of physical activity, disturbed eating behavior, and higher levels of BMI and weight gain were significant predictors.
Conclusions
The results highlight the multidimensional nature of body image and show positive as well as negative changes during pregnancy. Overall, modifiable psychological, behavioral, and weight-related factors appear relevant to the extent of body image dissatisfaction.
This study aimed to provide a German translation of the Body Image in Pregnancy Scale (BIPS) - a measure tailored to pregnancy-specific aspects of body image while being consistent to the ...multifaceted theoretical framework of body image - and to test its psychometric properties and validity.
The English-language original version of the BIPS was translated into German language using a forward-backward translation rationale. Face validity of the items was tested in cognitive interviews (n = 5). An online survey was conducted among 291 pregnant women. After conducting standard item analyses, factorial validity was tested using principal-axis factor analysis (PAF). Convergent and incremental validity with measures of body dissatisfaction (FFB), depression (EPDS), anxiety (GAD-7), self-esteem (RSE), and eating disorder psychopathology (EDE-Q) was tested by bivariate correlations and multiple linear hierarchical regression analyses.
The PFA revealed a 32 item and 6-factor solution resembling the dimensions preoccupation with appearance, dissatisfaction with strength-related aspects, dissatisfaction with body parts, dissatisfaction with complexion, prioritization of appearance over function, and concerns about sexual attractiveness. Internal consistency on a subscale level was good to excellent (.79 ≤ Cronbach's α ≤ .91). Consistent with theoretical assumptions, we found significant positive correlations of BIPS-G subscales with depression, anxiety and eating disorder psychopathology and negative correlations of BIPS-G subscales with self-esteem. BIPS-G subscales substantially improved the prediction of depression, anxiety, self-esteem and eating disorder psychopathology over demographic factors and body dissatisfaction (.03 ≤ ΔR
≤ .15, all p-values < 0.05).
The German version of the BIPS appeared to be a reliable and valid measure which has the capacity to enhance future research on body image during pregnancy in German-speaking populations.
Background: The loss of a loved one due to suicide can be a traumatic event associated with prolonged grief and psychological distress.
Objective: This study examined the efficacy of an ...Internet-based cognitive-behavioural grief therapy (ICBGT) specifically for people bereaved by suicide.
Methods: In a randomized controlled trial, 58 participants with prolonged grief disorder (PGD) symptoms who had lost a close person to suicide were randomly allocated either to the intervention group (IG) or waitlist-control group (WCG). The 5-week intervention comprised ten writing assignments in three phases: self-confrontation, cognitive restructuring, and social sharing. Symptoms of PGD, common grief reactions after suicide, depression, and general psychopathology were assessed at pre-, post-test and follow-up.
Results: Between-group effect sizes were large for the improvement of PGD symptoms in treatment completers (d
ppc2
= 1.03) and the intent-to-treat analysis (d
ppc2
= 0.97). Common grief reactions after suicide and depressive symptoms also decreased in the IG compared to the WCG (moderate to large effects). The results are stable over time. Only for general psychopathology, there was no significant time by group interaction effect found.
Conclusions: The ICBGT represents an effective treatment approach for people suffering from PGD symptoms after bereavement by suicide. Considering the effect sizes, the small treatment dose, duration, and the stability of the results, the ICBGT constitutes an appropriate alternative to face-to-face grief interventions.
Internet-based cognitive-behavioural grief therapy specifically for people bereaved by suicide with Prolonged Grief Disorder (PGD) effectively reduces symptoms of PGD, common grief reactions after suicide and depressive symptoms.
Between-group effect sizes were large for the improvement of PGD symptoms (ITT d
ppc2
=0.97).
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, UILJ, UKNU, UL, UM, UPUK
Bereavement due to cancer increases the risk of prolonged grief disorder. However, specialized treatment options for prolonged grief after a loss due to illness are still scarce.
The aim of this ...study is to extend previous findings by evaluating a web-based cognitive behavioral intervention with asynchronous therapist support, consisting of structured writing tasks adapted specifically for prolonged grief after cancer bereavement.
The intervention was evaluated in a purely web-based randomized waitlist-controlled trial. Open-access recruitment of participants was conducted on the web. Prolonged grief (Inventory of Complicated Grief), depression, anxiety, posttraumatic stress, posttraumatic growth, somatization, sleep quality, and mental and physical health were assessed on the web via validated self-report measures.
A total of 87 participants were randomized into the intervention group (IG; 44/87, 51%) or the waitlist control group (43/87, 49%). Of the participants, 7% (6/87) dropped out of the study (5/44, 11%, in the IG). Of the 39 completers in the IG, 37 (95%) completed all intervention tasks. The intervention reduced symptoms of prolonged grief (intention-to-treat: P<.001; η
=0.34; Cohen d=0.80) to a clinically significant extent. It had favorable effects on depression, anxiety, posttraumatic stress, posttraumatic growth, and overall mental health but not on somatization, sleep quality, or physical health.
The web-based intervention for prolonged grief after cancer bereavement is effective in reducing symptoms of prolonged grief disorder and accompanying syndromes in a timely, easily realizable manner and addresses specific challenges of bereavement to illness. Considering web-based approaches in future mental health care policy and practice can reduce health care gaps for those who are bereaved to cancer.
German Clinical Trial Register U1111-1186-6255; https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00011001.
Physical and cognitive activity seems to be an effective strategy by which to promote age-sensitive fluid cognitive abilities in older adults.
In this randomized controlled trial, 70 healthy senior ...citizens (age 60-75) were allocated to a physical, cognitive, combined physical plus cognitive, and waiting control group. The trial assessed information processing speed, short-term memory, spatial relations, concentration, reasoning, and cognitive speed.
In contrast to the control group, the physical, cognitive, and combined training groups enhanced their concentration immediately after intervention. Only the physical training group showed improved concentration 3 months later. The combined training group displayed improved cognitive speed both immediately and three months after intervention. The cognitive training group displayed improved cognitive speed 3 months after intervention.
Physical, cognitive, and combined physical plus cognitive activity can be seen as cognition-enrichment behaviors in healthy older adults that show different rather than equal intervention effects.
•Only few studies investigated the association between breastfeeding and attachment.•There is some evidence that breastfeeding contributed to infant attachment security.•Maternal attachment style was ...related to breastfeeding behaviour.•More adequately powered prospective studies are needed to draw a solid conclusion.
In the popular and scientific literature an association between breastfeeding and attachment is often supposed although this has not been systematically investigated. This is the first review that provides a systematic overview of the current state of research on the association between breastfeeding and attachment. The objective is to determine whether breastfeeding is associated with child attachment as well as if maternal attachment is associated with breastfeeding behaviour.
A systematic electronic literature search for English language articles published from 1963 to 2019 using the databases Web of Science, PubMed, PsycInfo, and PsycArticles was conducted. Studies were included if (1) the association between breastfeeding and attachment of the child or maternal attachment style and breastfeeding was investigated, (2) participants were mothers or mother-child dyads, and (3) quantitative measures of breastfeeding and attachment were used. Study quality was rated using the NIH Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies.
Studies examining mothers or mother-child dyads were reviewed. Sample sizes varied between N = 60 and N = 8900 participants. On average, mothers were between 27.56 and 32.50 years old.
Eleven studies were eligible for inclusion. Of seven studies examining breastfeeding and child attachment, four found that a longer duration of breastfeeding was significantly associated with higher levels of attachment security after controlling for various covariates. No significant differences in attachment security between breastfeeding and bottle-feeding were reported, but one study found higher levels of attachment disorganization for bottle-feeding, although mean levels were below a clinically relevant level. The initiation of breastfeeding directly after childbirth was not related to child attachment. Of four studies examining maternal attachment and breastfeeding, three found a significant association between secure attachment of the mother and breastfeeding behaviour. Secure attached mothers initiated breastfeeding more often and preferred breast- over bottle-feeding than insecure attached mothers. Mixed results were found for breastfeeding duration. Most studies had limitations regarding adequate sample size, and valid and reliable measurement of breastfeeding.
The findings provide some evidence that breastfeeding might contribute to child attachment security. Furthermore, maternal attachment style might play a role in breastfeeding behaviour. However, more prospective studies are needed to draw a solid conclusion.
With regard to breastfeeding recommendations, health professionals should be aware of and communicate towards clients that the effect of breastfeeding on child attachment might be rather small. Screening of maternal attachment style as a part of maternity practice could be useful to support insecure attached mothers experiencing breastfeeding difficulties.
Abortion Stigma: A Systematic Review Hanschmidt, Franz; Linde, Katja; Hilbert, Anja ...
Perspectives on sexual and reproductive health,
12/2016, Letnik:
48, Številka:
4
Journal Article
Recenzirano
Odprti dostop
Context
Although stigma has been identified as a potential risk factor for the well‐being of women who have had abortions, little attention has been paid to the study of abortion‐related stigma.
...Methods
A systematic search of the databases Medline, PsycArticles, PsycInfo, PubMed and Web of Science was conducted; the search terms were “(abortion OR pregnancy termination) AND stigma*.” Articles were eligible for inclusion if the main research question addressed experiences of individuals subjected to abortion stigma, public attitudes that stigmatize women who have had abortions or interventions aimed at managing abortion stigma. To provide a comprehensive overview of this issue, any study published by February 2015 was considered. The search was restricted to English‐ and German‐language studies.
Results
Seven quantitative and seven qualitative studies were eligible for inclusion. All but two dated from 2009 or later; the earliest was from 1984. Studies were based mainly on U.S. samples; some included participants from Ghana, Great Britain, Mexico, Nigeria, Pakistan, Peru and Zambia. The majority of studies showed that women who have had abortions experience fear of social judgment, self‐judgment and a need for secrecy. Secrecy was associated with increased psychological distress and social isolation. Some studies found stigmatizing attitudes in the public. Stigma appeared to be salient in abortion providers’ lives. Evidence of interventions to reduce abortion stigma was scarce. Most studies had limitations regarding generalizability and validity.
Conclusion
More research, using validated measures, is needed to enhance understanding of abortion stigma and thereby reduce its impact on affected individuals.
Obesity and depression are prevalent complications during pregnancy and associated with severe health risks for the mother and the child. The co-occurrence of both conditions may lead to a particular ...high-risk group. This review provides a systematic overview of the association between pre-pregnancy obesity and antenatal or postnatal depression. We conducted a systematic electronic literature search for English language articles published between January 1990 and March 2017. Inclusion criteria were (a) adult pregnant women, (b) women with pre-pregnancy obesity and normal weight controls, (c) definition of obesity according to the IOM 1990/2009 criteria, (d) established depression measure, and (e) report on the association between pre-pregnancy obesity and antenatal or postnatal depression. Fourteen (eight prospective (PS), six cross-sectional (CS)) studies were included. One study reported data from a large community-based sample, and one reported cross-national data. Of 13 studies examining pre-pregnancy obesity and antenatal depression, 9 found a higher risk or higher levels of antenatal depression among women with obesity relative to normal weight (6 PS, 3 CS), while 4 studies found no association (2 PS, 2 CS). Of four studies examining pre-pregnancy obesity and postnatal depression, two studies found a positive association (two PS), one study (CS) reported different findings for different obesity classes, and one study found none (PS). The findings suggest that women with obesity are especially vulnerable to antenatal depression. There is a need to develop appropriate screening routines and targeted interventions to mitigate negative health consequences for the mother and the child. Research addressing the association between obesity and postnatal depression is too limited to draw solid conclusions. Results are mainly based on selective samples, and there is a need for further high-quality prospective studies examining the association between pre-pregnancy obesity and antenatal and postnatal depression.
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