Department of Psychology, 1555University of Bath, United Kingdom.
Department of Psychology, 3647University of Groningen, the Netherlands.
Trauma Violence Abuse. 2021 Oct;22(4):793-803. doi: 10.1177/1524838019881716. Epub 2019 Oct 22.
Research has demonstrated that approximately 45-50% of individuals show healthy levels of psychological and physical functioning in the first 12 months post-loss. Homicidal bereavement (loss due to murder or manslaughter) does not appear to follow this pattern. Homicide-related mental health difficulties are a serious problem worldwide, displaying high rates of lifetime incidence, high chronicity, and role impairment. Individuals are at increased risk to develop symptoms of post-traumatic stress disorder (PTSD), complicated grief (CG), and depression. Nevertheless, a systematic review specifically on the efficacy of psychological interventions following homicidal loss has not yet been conducted. The current systematic review (registered via PROSPERO) aimed to review the psychological interventions available and report their effectiveness. Of 77 records, 7 met predefined inclusion criteria. Studies presented different methodologies, tested different clinical models, and treatment conditions. Thus, a narrative systematic review was conducted. Studies included manualized interventions to deliver 1:1 and group sessions. Cognitive behavioral therapy, restorative retelling, and eye movement desensitization and reprocessing were the main models used together with psychoeducational elements about trauma and grief responses. Overall, symptoms of PTSD, CG, and depression decreased significantly postintervention. Sustained improvements were reported for PTSD and depressive symptoms at the follow-up measurements. Mixed results were found regarding how individual (age, gender) and external factors (time since loss, relationship with the deceased) impact on symptom progression. As a result of differences in methodologies, categorization of therapies, methodological differences, and small sample sizes, important questions remain unanswered. Further randomized controlled trials and could be considered.
研究表明，大约有 45-50%的人在丧亲后的头 12 个月内表现出健康的心理和生理功能。杀人丧亲（因谋杀或过失杀人而失去亲人）似乎不符合这种模式。与杀人有关的心理健康问题是一个全球性的严重问题，其终身发病率、慢性率和角色障碍率都很高。个体患创伤后应激障碍（PTSD）、复杂性悲伤（CG）和抑郁症的风险增加。然而，目前尚未对杀人丧亲后的心理干预效果进行系统评价。本系统评价（通过 PROSPERO 注册）旨在回顾现有的心理干预措施，并报告其效果。在 77 条记录中，有 7 条符合预先设定的纳入标准。这些研究采用了不同的方法，测试了不同的临床模型和治疗条件。因此，进行了叙述性系统评价。研究包括针对 1:1 和小组会议的手册化干预。认知行为疗法、恢复性重述、眼动脱敏与再加工是主要使用的模式，同时还有关于创伤和悲伤反应的心理教育内容。总体而言，干预后 PTSD、CG 和抑郁症状显著减轻。在随访测量时，PTSD 和抑郁症状的持续改善得到了报告。关于个体（年龄、性别）和外部因素（丧亲时间、与死者的关系）如何影响症状进展，得出了混合的结果。由于方法学、治疗分类、方法学差异和样本量小的差异，重要问题仍未得到解答。可以考虑进一步进行随机对照试验和荟萃分析。
