Department of Psychiatry, UCLA School of Medicine, Neuropsychiatric Institute and Hospital, Center for the Health Sciences, University of California-Los Angeles, 760 Westwood Plaza, Los Angeles, CA 90024-1759, USA.
Palliat Support Care. 2010 Mar;8(1):7-15. doi: 10.1017/S1478951509990654. Epub 2010 Feb 18.
Exploration of complicated grief focusing on the relationship of post-traumatic stress disorder (PTSD) and complicated grief in a population of women at high risk for developing breast cancer. Special reference is made to women who have experienced a material death.
We reflected on the clinical attributes of the Revlon UCLA High Risk Clinic population in terms of their own perceived risk of developing breast cancer. For part of our population, their perceived risk was coupled with their reactions to the loss of their mothers to breast cancer. We compared and contrasted this pattern of reactions to those described by Licihtenthal et al. (2004) in their developmental review of complicated grief as a distinct disorder.
We concluded that our population of women differed from Lichtenthal et al.'s (2004) model for complicated grief. Lichtenthal's group postulated that the key element of complicated grief involves the protracted nature of separation anxiety and distress and excludes PTSD. In our populations, the daughter with complicated grief experiences a combination of separation anxiety and a type of PTSD involving anxiety over the perceived certainty of her own future diagnosis of breast cancer. It was noteworthy that Lichtenthal's model population was composed of individuals caring for terminally ill spouses. Significantly, the spousal caretakers did not have an ongoing genetic link to their partners whereas our population is genetically linked. We postulate that this accounts for the unique presentation of complicated grief and ptsd in our population.
We submit that this combination of complicated grief and PTSD requires a cognitive reframing of their perceived inevitability of developing breast cancer and desensitization techniques to help high risk women pursue preventative health care rather than avoiding it.
探讨创伤后应激障碍（PTSD）与高危乳腺癌女性人群中复杂悲伤之间的关系，重点关注复杂悲伤。特别提到了经历过亲人离世的女性。
我们从自身对罹患乳腺癌风险的感知角度出发，对 Revlon UCLA 高危诊所人群的临床特征进行了反思。对于我们人群中的一部分人来说，他们的感知风险与他们对母亲因乳腺癌而离世的反应有关。我们将这种反应模式与 Lichtenthal 等人（2004 年）在其对复杂悲伤作为一种独特障碍的发展性综述中描述的模式进行了比较和对比。
我们得出结论，我们的女性人群与 Lichtenthal 等人（2004 年）的复杂悲伤模型不同。Lichtenthal 小组假设，复杂悲伤的关键要素涉及分离焦虑和痛苦的持续性质，并排除了 PTSD。在我们的人群中，患有复杂悲伤的女儿会经历分离焦虑和一种涉及对自身未来乳腺癌诊断的确定性的焦虑的 PTSD。值得注意的是，Lichtenthal 模型人群由照顾绝症配偶的个体组成。重要的是，配偶照顾者与他们的伴侣没有遗传联系，而我们的人群则有遗传联系。我们假设这解释了我们人群中复杂悲伤和 PTSD 的独特表现。
我们认为，这种复杂悲伤和 PTSD 的组合需要对她们发展乳腺癌的必然性进行认知重构，并采用脱敏技术，帮助高危女性接受预防性保健，而不是回避。
