Spuij Mariken, Prinzie Peter, Dekovic Maja, van den Bout Jan, Boelen Paul A
Department of Child and Adolescent Studies, Utrecht University, PO Box 80140, Utrecht, TC 3508, The Netherlands.
Trials. 2013 Nov 20;14:395. doi: 10.1186/1745-6215-14-395.
There is growing recognition of a syndrome of disturbed grief referred to as prolonged grief disorder (PGD). PGD is mostly studied in adults, but clinically significant PGD symptoms have also been observed in children and adolescents. Yet, to date no effective treatment for childhood PGD exists. The aims of this study are: (1) to investigate the effectiveness of Grief-Help, a nine-session cognitive-behavioural treatment for childhood PGD, combined with five sessions of parental counselling, immediately after the treatment and at three, six and twelve months follow-up; (2) to examine tentative mediators of the effects of Grief-Help, (i.e., maladaptive cognitions and behaviours and positive parenting), and (3) to determine whether demographic variables, child personality, as well as symptoms of PGD, anxiety, and depression in parents moderate the treatment effectiveness.
METHODS/DESIGN: We will conduct a Randomised Controlled Trial (RCT) in which 160 children and adolescents aged 8-18 years are randomly allocated to cognitive behavioural Grief-Help or to a supportive counselling intervention; both treatments are combined with five sessions of parental counselling. We will recruit participants from clinics for mental health in the Netherlands. The primary outcome measure will be the severity of Prolonged Grief Disorder symptoms according to the Inventory of Prolonged Grief for Children (IPG-C). Secondary outcomes will include PTSD, depression and parent-rated internalizing and externalizing problems. Mediators like positive parenting and maladaptive cognitions and behaviours will be identified. We will also examine possible moderators including demographic variables (e.g. time since loss, cause of death), psychopathology symptoms in parents (PGD, anxiety and depression) and child personality. Assessments will take place in both groups at baseline, after the treatment-phase and three, six and twelve months after the post-treatment assessment.
We aim to contribute to the improvement of mental health care for children and adolescents suffering from loss. By comparing Grief-Help with supportive counselling, and by investigating mediators and moderators of its effectiveness we hope to provide new insights in the effects of interventions for bereaved children, and their mechanisms of change.
Netherlands Trial Register NTR3854.
一种被称为持续性悲伤障碍（PGD）的悲伤紊乱综合征正日益受到关注。PGD大多在成年人中进行研究，但在儿童和青少年中也观察到了具有临床意义的PGD症状。然而，迄今为止，尚无针对儿童PGD的有效治疗方法。本研究的目的是：（1）调查“悲伤帮助”疗法的有效性，这是一种针对儿童PGD的为期九节的认知行为疗法，并结合五节家长咨询课程，在治疗结束后以及治疗后三个月、六个月和十二个月进行随访；（2）检验“悲伤帮助”疗法效果的潜在中介因素（即适应不良的认知和行为以及积极的养育方式）；（3）确定人口统计学变量、儿童个性以及父母的PGD、焦虑和抑郁症状是否会调节治疗效果。
方法/设计：我们将进行一项随机对照试验（RCT），将160名8至18岁的儿童和青少年随机分配到认知行为“悲伤帮助”疗法组或支持性咨询干预组；两种治疗方法均结合五节家长咨询课程。我们将从荷兰的心理健康诊所招募参与者。主要结局指标将是根据儿童持续性悲伤量表（IPG-C）评估的持续性悲伤障碍症状的严重程度。次要结局指标将包括创伤后应激障碍、抑郁以及家长评定的内化和外化问题。将确定诸如积极养育方式以及适应不良的认知和行为等中介因素。我们还将研究可能的调节因素，包括人口统计学变量（如丧亲后的时间、死亡原因）、父母的精神病理学症状（PGD、焦虑和抑郁）以及儿童个性。两组将在基线、治疗阶段结束后以及治疗后评估的三个月、六个月和十二个月进行评估。
我们旨在为改善遭受丧亲之痛的儿童和青少年的心理健康护理做出贡献。通过将“悲伤帮助”疗法与支持性咨询进行比较，并通过研究其效果的中介因素和调节因素，我们希望为丧亲儿童干预措施的效果及其变化机制提供新的见解。
荷兰试验注册编号NTR3854。
