Department of Clinical Psychology, Faculty of Social Sciences, Utrecht University, Utrecht, The Netherlands.
ARQ Nationaal Psychotrauma Centre, Diemen, The Netherlands.
Clin Psychol Psychother. 2020 Nov;27(6):955-964. doi: 10.1002/cpp.2482. Epub 2020 Jun 14.
The death of a loved one may precipitate symptoms of prolonged grief disorder (PGD), post-traumatic stress disorder (PTSD) and depression. Brooding about the causes and consequences of one's negative affect (NA), also termed depressive rumination, has been linked to distress after loss. The role of dysregulation of positive affect (PA) has received less attention. We examined (1) the factor structure of depressive rumination and PA dysregulation and (2) to what extent these factors were related to PGD, PTSD and depression symptom levels. Self-report data were included from 235 Dutch bereaved people who completed measures tapping symptoms of PGD, PTSD and depression. Depressive rumination and PA regulation strategies were assessed with the Ruminative Response Scale (RRS) Brooding Scale and the Response to Positive Affect (RPA) Questionnaire (including three subscales: emotion-focused and self-focused rumination and dampening), respectively. Confirmatory factor analyses and structural equation modelling were used for data analyses. The four-factor model (i.e., depressive rumination and the three RPA subscales) showed the best fit. An increase in depressive rumination was related to higher distress levels (across all outcomes in univariate and multivariate analyses). An increase in emotion-focused rumination about PA was associated with less depression. More dampening of PA was related to higher PTSD levels. Findings suggest that, alongside the regulation of NA, the regulation of PA plays a role in how people respond to the death of a loved one. This points to the need for more research on NA and PA regulation in grief.
亲人的离世可能会引发长期悲伤障碍（PGD）、创伤后应激障碍（PTSD）和抑郁的症状。对自身负性情绪（NA）的原因和后果进行沉思，也称为抑郁反刍，与丧失后的痛苦有关。积极情绪（PA）失调的作用则受到较少关注。我们研究了（1）抑郁反刍和 PA 失调的因素结构，以及（2）这些因素与 PGD、PTSD 和抑郁症状水平的关系。自我报告数据来自 235 名荷兰丧亲者，他们完成了评估 PGD、PTSD 和抑郁症状的量表。抑郁反刍和 PA 调节策略分别使用反刍反应量表（RRS）沉思量表和积极情绪反应（RPA）问卷进行评估（包括三个子量表：情绪聚焦和自我聚焦的反刍和抑制）。采用验证性因子分析和结构方程模型进行数据分析。四项因素模型（即抑郁反刍和三个 RPA 子量表）显示出最佳拟合。抑郁反刍的增加与更高的痛苦水平相关（在单变量和多变量分析中的所有结果中均如此）。对 PA 的情绪聚焦反刍增加与抑郁程度降低相关。PA 的抑制程度增加与 PTSD 水平升高相关。研究结果表明，除了对 NA 的调节外，PA 的调节在人们对亲人离世的反应中也起着重要作用。这表明需要对悲伤中的 NA 和 PA 调节进行更多研究。
