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回顾与展望:应对灵活性的不同维度可预测长期丧亲结局。

Looking back and moving forward: dimensions of coping flexibility divergently predict long-term bereavement outcomes.

机构信息

Columbia University, New York, United States.

Center for Behavioral Cardiovascular Health, Columbia University Irving Medical Center, New York, United States.

出版信息

Anxiety Stress Coping. 2023 May;36(3):275-290. doi: 10.1080/10615806.2022.2099545. Epub 2022 Jul 19.

Abstract

BACKGROUND AND OBJECTIVES

Bereavement is a serious public health concern. Some people suffer prolonged and debilitating functional impairment after the death of a loved one. Evidence suggests that flexibility in coping approaches predicts resilience after stressful life events, but its long-term effects after the unique experience of bereavement are unknown. Which strategies of coping flexibility predict better-or worse-adjustment over time for bereaved people and at what times?

DESIGN AND METHODS

The present study used path analyses to investigate longitudinal effects of forward-focus and loss-focus coping strategies on symptoms of persistent complex bereavement disorder (PCBD), depression, and posttraumatic stress disorder in a spousally bereaved adult sample ( = 248) at three time-points after the loss (∼3 months, ∼14 months, and ∼25 months).

RESULTS

Forward-focus coping demonstrated adaptive utility overall, with sooner effects on PCBD than on depression. By contrast, loss-focus coping demonstrated a delayed-onset, maladaptive pattern.

CONCLUSIONS

The findings contribute to the coping flexibility literature by suggesting that the adaptiveness or maladaptiveness of different coping strategies may depend on the context that requires coping. In particular, forward-focus coping may be substantially more advantageous than loss-focus coping in the context of bereavement. Implications, limitations, and future research directions are discussed.

摘要

背景和目的

丧亲是一个严重的公共卫生问题。有些人在失去亲人后会经历长时间的、衰弱的功能障碍。有证据表明,应对方式的灵活性可以预测人们在经历压力性生活事件后的适应能力,但在经历丧亲这一独特经历后的长期影响尚不清楚。哪些应对灵活性策略可以预测丧亲者随着时间的推移更好或更差的调整,以及在什么时候?

设计和方法

本研究使用路径分析来调查在配偶丧亲的成年样本(n=248)中,前瞻性和损失聚焦应对策略对持续性复杂丧亲障碍(PCBD)、抑郁和创伤后应激障碍症状的纵向影响,在丧失后三个时间点(约 3 个月、约 14 个月和约 25 个月)进行测量。

结果

前瞻性应对总体上表现出适应性效用,对 PCBD 的影响比抑郁更早。相比之下,损失聚焦应对表现出延迟出现的适应不良模式。

结论

这些发现通过表明不同应对策略的适应性或不适应性可能取决于需要应对的情境,为应对灵活性文献做出了贡献。特别是,在丧亲的情境中,前瞻性应对可能比损失聚焦应对具有明显更大的优势。讨论了这些发现的意义、局限性和未来的研究方向。

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Trajectories of prolonged grief one to six years after a natural disaster.自然灾害后 1 至 6 年持续性悲伤的轨迹。
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