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非自然丧失后持续的悲伤和抑郁:潜在类别分析和认知相关性。

Prolonged grief and depression after unnatural loss: Latent class analyses and cognitive correlates.

机构信息

Department of Clinical Psychology, Utrecht University, Utrecht, The Netherlands; Arq Psychotrauma Expert Group, Diemen, The Netherlands.

Department of Child and Adolescent Studies, Utrecht University, Utrecht, The Netherlands.

出版信息

Psychiatry Res. 2016 Jun 30;240:358-363. doi: 10.1016/j.psychres.2016.04.012. Epub 2016 Apr 8.

Abstract

This study sought to identify (a) subgroups among people confronted with unnatural/violent loss characterized by different symptoms profiles of prolonged grief disorder (PGD) and depression, and (b) socio-demographic, loss-related, and cognitive variables associated with subgroup membership. We used data from 245 individuals confronted with the death of a loved one due to an accident (47.3%), suicide (49%) or homicide (3.7%). Latent class analysis revealed three classes of participants: a resilient-class (25.3%), a predominantly PGD-class (39.2%), and a combined PGD/Depression-class (35.5%). Membership in the resilient-class was predicted by longer time since loss and lower age; membership in the combined class was predicted by lower education. Endorsement of negative cognitions about the self, life, the future, and one's own grief-reactions was lowest in the Resilient-class, intermediate in the PGD-class, and highest in the combined PGD/Depression-class. When all socio-demographic, loss-related, and cognitive variables were included in multinomial regression analyses predicting class-membership, it was found that negative cognitions about one's grief was the only variable predicting membership of the PGD-class. Negative cognitions about the self, life, and grief predicted membership of the combined PGD/Depression-class. These findings provide valuable information for the development of interventions for different subgroups of bereaved individuals confronted with unnatural/violent loss.

摘要

本研究旨在

(a) 在经历异常/暴力丧失的人群中识别出具有不同持续性创伤后应激障碍(PGD)和抑郁症状谱的亚组;(b) 确定与亚组归属相关的社会人口学、丧失相关和认知变量。我们使用了 245 名因意外(47.3%)、自杀(49%)或他杀(3.7%)而失去亲人的个体的数据。潜在类别分析揭示了三组参与者:坚韧组(25.3%)、主要为 PGD 组(39.2%)和 PGD/抑郁混合组(35.5%)。坚韧组的成员特征为丧失后时间较长和年龄较小;混合组的成员特征为受教育程度较低。在自我、生活、未来和自身悲伤反应方面持消极认知的程度在坚韧组中最低,在 PGD 组中中等,在 PGD/抑郁混合组中最高。当将所有社会人口学、丧失相关和认知变量纳入预测类别归属的多项二项式回归分析中时,发现对自身悲伤的消极认知是预测 PGD 组归属的唯一变量。对自我、生活和悲伤的消极认知预测了 PGD/抑郁混合组的归属。这些发现为针对经历异常/暴力丧失的不同丧亲亚组开发干预措施提供了有价值的信息。

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