Boelen Paul A, Olff Miranda, Smid Geert E
Department of Clinical Psychology, Faculty of Social Sciences, Utrecht University.
Arq Psychotrauma Expert Group, Diemen, The Netherlands.
Eur J Psychotraumatol. 2019 Apr 15;10(1):1591331. doi: 10.1080/20008198.2019.1591331.
Traumatic loss involves the loss of loved ones in the context of potentially traumatizing circumstances and is a commonly reported traumatic event. It may give rise to disturbed grief, called prolonged grief disorder (PGD) in ICD-11 and persistent complex bereavement disorder (PCBD) in DSM-5, combined with posttraumatic stress disorder (PTSD) and depression. The recent inclusion of grief disorders in both DSM-5 and ICD-11 have spurred research on grief-related psychopathology. This special issue on traumatic loss includes 10 articles and two letters. Topics addressed include diagnostic criteria for PGD, children's perspectives on life after parental intimate partner homicide, and the impact of visiting the site of deaths caused by terror. Early indicators of problematic grief trajectories are addressed, as well as moderators and mediators of disordered grief, including coping strategies, rumination, and meaning-making. Further, a meta-analysis synthesizing research findings on correlates of disturbed grief following traumatic loss is presented. Finally, specialized treatments as Eye Movement Desensitisation and Reprocessing (EMDR) and Cognitive Behavioural Therapy (CBT) for grief are addressed, and predictors of treatment response for CBT for PGD including levels of self-blame and avoidance are scrutinized. As such, the articles included in this special issue increase our understanding of the needs of people confronted with traumatic loss and bring promising findings with regard to diagnosis, prevention, and specialized treatment in children, young people and adults. This article also introduces a hypothetical staging, profiling, and stepped care model which may offer a template to integrate existing and emerging research findings on possible courses and correlates of grief, in order to inform treatment decisions.
创伤性丧失是指在可能造成创伤的情况下失去亲人，这是一种常见的创伤性事件。它可能引发紊乱的悲伤情绪，在《国际疾病分类第11版》（ICD - 11）中称为持续性复杂悲伤障碍（PGD），在《精神疾病诊断与统计手册第5版》（DSM - 5）中称为持续性复杂丧亲障碍（PCBD），并伴有创伤后应激障碍（PTSD）和抑郁症。最近，DSM - 5和ICD - 11都将悲伤障碍纳入其中，这推动了对悲伤相关精神病理学的研究。本期关于创伤性丧失的特刊包括10篇文章和2封信。涉及的主题包括PGD的诊断标准、儿童对父母亲密伴侣 homicide 后生活的看法，以及参观恐怖袭击死亡现场的影响。探讨了悲伤轨迹出现问题的早期指标，以及紊乱悲伤的调节因素和中介因素，包括应对策略、沉思和意义构建。此外，还呈现了一项荟萃分析，综合了创伤性丧失后紊乱悲伤相关因素的研究结果。最后，讨论了针对悲伤的特殊治疗方法，如眼动脱敏再处理疗法（EMDR）和认知行为疗法（CBT），并审视了PGD的CBT治疗反应的预测因素，包括自责和回避程度。因此，本期特刊中的文章增进了我们对遭受创伤性丧失者需求的理解，并在儿童、青少年和成年人的诊断、预防及特殊治疗方面带来了有前景的发现。本文还介绍了一种假设的阶段划分、特征描述和逐步护理模型，该模型可能为整合关于悲伤可能过程和相关因素的现有及新出现的研究结果提供一个模板，以便为治疗决策提供参考。
