Cozza Stephen J, Fisher Joscelyn E, Hefner Kathryn R, Fetchet Mary A, Chen Shenglin, Zuleta Rafael F, Fullerton Carol S, Ursano Robert J
Center for the Study of Traumatic Stress, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA.
Voices of September 11th, New Canaan, Connecticut, USA.
J Trauma Stress. 2020 Dec;33(6):1137-1143. doi: 10.1002/jts.22548. Epub 2020 Aug 17.
Returning human remains to family members after a loved one's death is thought to support grief adaptation. However, no known research has examined the effects that notifications of fragmented remains have on bereaved family members. We examined the number of notifications received, continuing questions about the death, grief severity, and posttraumatic stress (PTS) in family members bereaved by the September 11, 2001 attacks (N = 454). One notification was associated with fewer continuing questions compared to zero notifications, p = .037, or two or more notifications, p = .009. A model using notifications and continuing questions to predict grief severity showed there was no difference between receiving one and zero notifications, p = .244; however, receipt of two or more notifications was associated with higher grief severity compared to zero notifications, p = .032. A similar model demonstrated that receipt of any notifications was associated with PTS, ɳ = .026, p = .006. Having continuing questions was associated with grief severity, ɳ = .170, p < .001; and PTS, ɳ = .086, p < .001. Additionally, participants who received one notification and chose not to receive more had fewer continuing questions compared to all other participants, and participants who received two or more notifications and chose no future notifications had higher PTS levels compared to all other participants. The results indicate that human remains notification is not associated with reduced grief severity but is associated with PTS. These findings should inform notification policy and guide families' notification choice after traumatic deaths.
在亲人去世后将遗体归还家属被认为有助于哀伤调适。然而，尚无已知研究考察过零碎遗体通知对丧亲家属的影响。我们调查了2001年9月11日袭击事件中丧亲家属（N = 454）收到的通知数量、关于死亡的持续疑问、哀伤严重程度和创伤后应激（PTS）情况。与未收到通知（p = 0.037）或收到两份及以上通知（p = 0.009）相比，收到一份通知与较少的持续疑问相关。一个使用通知和持续疑问来预测哀伤严重程度的模型显示，收到一份通知和未收到通知之间没有差异（p = 0.244）；然而，与未收到通知相比，收到两份及以上通知与更高的哀伤严重程度相关（p = 0.032）。一个类似的模型表明，收到任何通知都与创伤后应激相关（ɳ = 0.026，p = 0.006）。存在持续疑问与哀伤严重程度相关（ɳ = 0.170，p < 0.001）；也与创伤后应激相关（ɳ = 0.086，p < 0.001）。此外，收到一份通知且选择不再接收更多通知的参与者比所有其他参与者有更少的持续疑问，而收到两份及以上通知且选择不再接收未来通知的参与者比所有其他参与者有更高的创伤后应激水平。结果表明，遗体通知与降低哀伤严重程度无关，但与创伤后应激相关。这些发现应为通知政策提供参考，并指导家庭在创伤性死亡后的通知选择。
