Department of Clinical Psychology and Experimental Psychopathology, University of Groningen, Groningen, The Netherlands.
Clin Psychol Psychother. 2022 Jan;29(1):299-312. doi: 10.1002/cpp.2635. Epub 2021 Jul 20.
After bereavement, a significant minority experiences severe, persistent, and disabling grief, termed prolonged grief or complicated grief. Prolonged grief treatments may be enhanced by improving understanding of malleable risk factors in post-loss psychological adaptation. Repetitive negative thought (e.g., rumination, worry) constitutes such a risk factor. Rumination and worry are both theorized to be maladaptive through interrelations with affect, yet this assumption has not been systematically investigated in the bereaved. We aimed to fill this gap in knowledge with a baseline survey and 10-day daily diary investigation among a bereaved sample. Survey between-subject analyses (N = 113) demonstrated that trait rumination and worry, trait negative affect and prolonged grief symptoms are positively related to each other and negatively related with trait positive affect. Within-subject multilevel analyses of diaries (N = 62) demonstrated that trait rumination and trait worry relate positively to daily negative affect and negatively to daily positive affect. Daily rumination and worry showed similar relationships with daily negative and positive affect. A stronger relationship emerged between daily rumination and daily negative affect in people with higher prolonged grief symptom levels. Findings consistently support interrelations between repetitive negative thought, affect, and prolonged grief symptoms. Rumination appears particularly detrimental in people with severe grief reactions. Results align with research demonstrating the effectiveness of targeting repetitive negative thought in prolonged grief treatments. Additionally, our study demonstrates the potential feasibility and usefulness of using daily diaries to study behaviours of relevance to post-loss adaptation in everyday life.
在丧亲之后,一小部分人会经历严重、持续和致残的悲伤,称为延长悲伤或复杂悲伤。通过提高对丧亲后心理适应中可改变风险因素的理解,延长悲伤的治疗可能会得到改善。重复的消极思维(例如,沉思、担忧)就是这样的一个风险因素。理论上,沉思和担忧都通过与情绪的相互作用而变得适应不良,但这一假设在丧亲人群中尚未得到系统研究。我们旨在通过对丧亲样本进行基线调查和为期 10 天的日常日记调查来填补这一知识空白。调查中的被试间分析(N=113)表明,特质性沉思和担忧、特质性消极情绪和延长悲伤症状彼此之间呈正相关,与特质性积极情绪呈负相关。日记中的被试内多层分析(N=62)表明,特质性沉思和特质性担忧与每日消极情绪呈正相关,与每日积极情绪呈负相关。每日沉思和担忧与每日消极和积极情绪也存在类似的关系。在悲伤症状水平较高的人群中,每日沉思与每日消极情绪之间的关系更为密切。研究结果一致支持重复消极思维、情绪和延长悲伤症状之间的相互关系。沉思在悲伤反应严重的人群中显得尤为不利。研究结果与证明针对延长悲伤治疗中重复消极思维的有效性的研究一致。此外,我们的研究还表明,使用日常日记来研究日常生活中与丧亲后适应相关的行为具有潜在的可行性和实用性。