Doering Bettina K, Barke Antonia, Vogel Anna, Comtesse Hannah, Rosner Rita
Clinical and Biological Psychology, Catholic University Eichstaett-Ingolstadt, Eichstaett, Germany.
Clinical Psychology and Psychotherapy, Brandenburg Medical School Theodor Fontane, Neuruppin, Germany.
Front Psychiatry. 2022 Apr 26;13:853698. doi: 10.3389/fpsyt.2022.853698. eCollection 2022.
Most people adapt to bereavement over time. For a minority, the grief persists and may lead to a prolonged grief disorder (PGD). Identifying grievers at risk of PGD may enable specific prevention measures. The present study examined the extent to which the subjective unexpectedness of the death predicted grief outcomes above and beyond known sociodemographic and objective loss-related variables in a sample drawn from a population-representative investigation. In our sample ( = 2,531), 811 participants (M 55.1 ± 17.8 years, 59.2% women) had experienced the loss of a significant person six or more months ago. Participants provided demographic and loss-related information, perceptions of the unexpectedness of the death and completed the Prolonged Grief Disorder-13 + 9 (PG-13 + 9). The PG-13 + 9 was used to determine PGD caseness. A binary logistic regression investigated predictors of PGD caseness, and a linear regression predictors of grief severity. ANCOVAs compared PGD symptoms between the groups who had experienced an "expected" vs. "unexpected" loss, while controlling for the relationship to the deceased and time since loss. The loss of a child (OR = 23.66; 95%CI, 6.03-68.28), or a partner (OR = 5.32; 95%CI, 1.79-15.83), the time since loss (OR = 0.99; 95%CI, 0.99-1.00) and the unexpectedness of the death (OR = 3.58; 95%CI, 1.70-7.69) were significant predictors of PGD caseness (Nagelkerke's R = 0.25) and grief severity. Participants who had experienced the loss as unexpected (vs. expected) reported higher scores on all PGD symptoms. Unexpectedness of the death emerged as significant risk factor for PGD, even after controlling for demographic and other loss-related variables. While our findings replicate previous research on the importance of the relationship to the deceased as a risk factor for PGD, they also highlight the importance of assessing the subjective unexpectedness of a death and may help to identify risk groups who can profit from preventive interventions.
大多数人会随着时间的推移适应丧亲之痛。对于少数人来说,悲痛会持续存在,并可能导致持续性悲伤障碍(PGD)。识别有患PGD风险的悲伤者可能有助于采取特定的预防措施。本研究考察了在一项具有人口代表性的调查样本中,死亡的主观意外性在已知的社会人口统计学和与客观损失相关的变量之外,对悲伤结果的预测程度。在我们的样本(n = 2531)中,811名参与者(平均年龄55.1±17.8岁,59.2%为女性)在六个月或更久之前经历了重要人物的离世。参与者提供了人口统计学和与损失相关的信息、对死亡意外性的认知,并完成了持续性悲伤障碍-13 + 9(PG-13 + 9)量表。PG-13 + 9量表用于确定PGD病例情况。二元逻辑回归分析调查了PGD病例情况的预测因素,线性回归分析了悲伤严重程度的预测因素。协方差分析比较了经历“意外”与“预期”损失的两组之间的PGD症状,同时控制与逝者的关系以及自损失发生后的时间。孩子的离世(比值比[OR] = 23.66;95%置信区间[CI],6.03 - 68.28)、伴侣的离世(OR = 5.32;95%CI,1.79 - 15.83)、自损失发生后的时间(OR = 0.99;95%CI,0.99 - 1.00)以及死亡的意外性(OR = 3.58;95%CI,1.70 - 7.6)是PGD病例情况(Nagelkerke's R = 0.25)和悲伤严重程度的显著预测因素。经历意外(而非预期)损失的参与者在所有PGD症状上的得分更高。即使在控制了人口统计学和其他与损失相关的变量之后,死亡的意外性仍是PGD的显著风险因素。虽然我们的研究结果重复了先前关于与逝者关系作为PGD风险因素重要性的研究,但它们也凸显了评估死亡主观意外性的重要性,并可能有助于识别能够从预防性干预中获益的风险群体。