School of Health Sciences, Massey University, Wellington, New Zealand.
Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Epidemiology and Biostatistics, Amsterdam Public Health, Amsterdam, The Netherlands.
J Gerontol B Psychol Sci Soc Sci. 2020 Sep 14;75(8):1668-1678. doi: 10.1093/geronb/gbz039.
This study examined trajectories of emotional functioning in three domains (depressive symptoms, emotional, and social loneliness) for individuals who experienced spousal bereavement and investigated cross-domain adaptation. We hypothesized that emotional difficulties after bereavement would be more detectable in emotional loneliness than depressive symptoms or social loneliness.
Using latent class growth analysis, we modeled changes in depressive symptoms, emotional loneliness, and social loneliness from 12 years pre- to 12 years post-bereavement on data from 686 older adults to identify trajectories indicating adaptive and maladaptive functioning in each domain.
Most participants reported depressive symptoms below the clinically relevant threshold by showing a resilient (15.5%) or a slightly elevated (53.5%) trajectory post-bereavement. One third (31%) reported clinically relevant depressive symptoms. More than half of the sample reported emotional loneliness post-bereavement, varying form prolonged (17%), increasing and prolonged (28.3%), and chronically high (8.9%) levels. Remaining participants displayed resilience (13.5%) or recovery (32.3%). Social loneliness showed four trajectories: very low and resilient (43.3%), low and resilient (27.5%), increasing (20.2%), and chronically high (9%) levels. One third of participants maintained adaptive, whereas 12% displayed maladaptive, functioning across all domains post-bereavement.
An increase in emotional loneliness was the most commonly observed change after spousal bereavement. This highlights the central role of emotional loneliness in depression after bereavement.
本研究考察了经历配偶丧亡的个体在三个领域（抑郁症状、情感和社交孤独）的情绪功能轨迹，并探讨了跨领域适应。我们假设，丧亲后的情绪困难在情感孤独中比抑郁症状或社交孤独更易察觉。
使用潜在类别增长分析，我们对 686 名老年人的数据进行建模，以识别表明每个领域适应性和适应不良功能的轨迹，这些数据涵盖了从丧亲前 12 年到丧亲后 12 年的抑郁症状、情感孤独和社交孤独的变化。
大多数参与者的抑郁症状低于临床相关阈值，表现出有弹性（15.5%）或丧亲后轻微升高（53.5%）的轨迹。三分之一（31%）的人报告有临床相关的抑郁症状。超过一半的样本在丧亲后报告有情感孤独，从持续（17%）、增加和持续（28.3%）到慢性高（8.9%）不等。其余参与者表现出有弹性（13.5%）或恢复（32.3%）。社交孤独有四个轨迹：非常低和有弹性（43.3%）、低和有弹性（27.5%）、增加（20.2%）和慢性高（9%）。三分之一的参与者在丧亲后保持了适应性功能，而 12%的参与者在所有领域都表现出了适应性不良的功能。
情感孤独的增加是配偶丧亡后最常见的变化。这突出了情感孤独在丧亲后抑郁中的核心作用。
