Ott Carol H, Lueger Robert J, Kelber Sheryl T, Prigerson Holly G
College of Nursing, University of Wisconsin-Milwaukee, 53201-0413, USA.
J Nerv Ment Dis. 2007 Apr;195(4):332-41. doi: 10.1097/01.nmd.0000243890.93992.1e.
The purpose of this study was to identify empirically patterns of grief among 141 older bereaved spouses. A longitudinal hierarchical cluster procedure with the Ward agglomeration method was used to identify distinct clusters based on grief scores. Three clusters were identified: common (49%), resilient (34%), and chronic (17%) grief. Members of the common grief cluster experienced elevated levels of grief and depressive symptoms that decreased over time. Members of the resilient cluster experienced the lowest levels of grief and depression and the highest quality of life. The chronic grief cluster experienced the highest levels of grief and depression, more sudden deaths, the lowest self-esteem, and the highest marital dependency. The majority in this chronic cluster also met proposed criteria for a diagnosis of complicated grief. Five out of every six bereaved spouses adjusted well over time, and about a third of these showed considerable resilience without negative consequences. One out of six experienced a chronic grief syndrome. Early identification of this syndrome can lead to referral to newly emergent treatments specific for grief.
本研究的目的是通过实证确定141位丧偶老年配偶的悲伤模式。采用具有沃德凝聚法的纵向分层聚类程序,根据悲伤得分确定不同的聚类。识别出了三个聚类:常见悲伤型(49%)、坚韧型(34%)和慢性悲伤型(17%)。常见悲伤型聚类的成员经历了较高水平的悲伤和抑郁症状,且这些症状随时间推移而减轻。坚韧型聚类的成员经历的悲伤和抑郁水平最低,生活质量最高。慢性悲伤型聚类的成员经历的悲伤和抑郁水平最高,突发死亡情况更多,自尊水平最低,婚姻依赖程度最高。这个慢性悲伤型聚类中的大多数人也符合复杂悲伤诊断的提议标准。每六位丧偶配偶中有五位随着时间推移调整得很好,其中约三分之一表现出相当的恢复力且没有负面后果。六分之一的人经历了慢性悲伤综合征。对这种综合征的早期识别可以促使转介到专门针对悲伤的新出现的治疗方法。