Brickell Claire, Munir Kerim
Francis Weld Peabody Academic Society, Harvard Medical School, USA.
Harv Rev Psychiatry. 2008;16(1):1-12. doi: 10.1080/10673220801929786.
Bereavement and loss have significant impact on the lives of individuals with intellectual disability (ID). Although there is a growing impetus to define the symptoms of grief that predict long-term functional impairment, little is known about maladaptive grieving among individuals with ID. We examine the literature concerning the phenomenology of traumatic grief (TG) in the general population, along with what is known about the manifestations of grief in individuals with ID. We then apply modern theories of grief and grief resolution to individuals with ID in order to highlight potential areas of vulnerability in this population and to lay the groundwork for interventions that will facilitate their adaptation to loss. We provide a theoretical framework for the proposition that individuals (including children and adults) with ID are more susceptible to TG, based on an increased risk of secondary loss, barriers to communicating about the loss, and difficulty finding meaning in the loss. We conclude that individuals with ID should be considered as potential candidates for targeted bereavement interventions. Further research is required, however, in order to develop population-appropriate measurement scales for testing these hypotheses.
丧亲和丧失对智力残疾(ID)个体的生活有着重大影响。尽管越来越有动力去界定那些预示长期功能损害的悲伤症状,但对于智力残疾个体中的适应不良性悲伤却知之甚少。我们研究了普通人群中创伤性悲伤(TG)现象学的相关文献,以及智力残疾个体中悲伤表现的已知情况。然后,我们将现代悲伤理论和悲伤解决理论应用于智力残疾个体,以突出该人群潜在的脆弱领域,并为促进他们适应丧失的干预措施奠定基础。基于继发性丧失风险增加、关于丧失的沟通障碍以及在丧失中难以找到意义,我们为智力残疾个体(包括儿童和成人)更容易患创伤性悲伤这一观点提供了一个理论框架。我们得出结论,智力残疾个体应被视为针对性丧亲干预的潜在对象。然而,为了开发适用于该人群的测量量表来检验这些假设,还需要进一步的研究。