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一项针对丧亲兄弟姐妹的治疗师支持的基于互联网的干预措施:一项随机对照试验。

A therapist-supported internet-based intervention for bereaved siblings: A randomized controlled trial.

作者信息

Wagner Birgit, Hofmann Laura, Maaß Ulrike

机构信息

Department of Clinical Psychology and Psychotherapy, Medical School Berlin, Berlin, Germany.

Department of Clinical Psychology and Psychotherapy, Institute for Psychology, Potsdam University, Potsdam, Germany.

出版信息

Palliat Med. 2022 Dec;36(10):1532-1543. doi: 10.1177/02692163221122344. Epub 2022 Oct 20.

Abstract

BACKGROUND

The loss of a sibling can have a long-term impact on the mental and physical health of the surviving sibling throughout adolescence and later adulthood. Even though bereaved siblings can be identified as a high-risk group, evidence-based interventions for this bereavement group are still missing.

AIM

To evaluate the treatment effects of an internet-based writing intervention for bereaved siblings aged 16-65 years.

DESIGN

A two-armed randomized controlled trial (DRKS00011514) compared the intervention to a waiting list control group. The 6-week intervention consisted of six structured writing assignments that were based on cognitive behavioral therapy, focusing on the specific situation of bereaved siblings.

SETTING/PARTICIPANTS: Eighty-six bereaved siblings (loss >1 month ago, no severe psychiatric symptoms) were randomly allocated to the intervention group ( = 47) or the waiting list control group ( = 39). Primary outcomes were symptoms of prolonged grief disorder and depression; secondary outcomes were posttraumatic stress symptoms and survivor guilt.

RESULTS

Symptoms of depression and prolonged grief disorder improved significantly in the intention-to-treat analyses from pre-to post-measurement compared with the control group ( = -0.62,  = 0.33). In the intervention group, all primary and secondary outcomes decreased significantly from baseline to 12-month follow-up (s = -0.38 to -1.04). A significant clinical change could be found for depression (34%) compared to the waitlist control group (10%).

CONCLUSIONS

Bereaved siblings profited from this brief internet-based writing intervention in the short- and long-term. However, future research, such as dismantling studies, may help to further optimize the benefits of an intervention aimed at bereaved siblings.

摘要

背景

兄弟姐妹的离世可能会对幸存的兄弟姐妹在整个青春期及成年后的身心健康产生长期影响。尽管丧亲的兄弟姐妹可被视为高危群体,但针对这一丧亲群体的循证干预措施仍然缺失。

目的

评估针对16 - 65岁丧亲兄弟姐妹的基于互联网的写作干预的治疗效果。

设计

一项双臂随机对照试验(DRKS00011514)将干预组与等待列表对照组进行比较。为期6周的干预包括六项基于认知行为疗法的结构化写作任务,重点关注丧亲兄弟姐妹的具体情况。

设置/参与者:八十六名丧亲兄弟姐妹(丧亲时间>1个月前,无严重精神症状)被随机分配到干预组(n = 47)或等待列表对照组(n = 39)。主要结局为持续性悲伤障碍和抑郁症状;次要结局为创伤后应激症状和幸存者内疚感。

结果

与对照组相比,意向性分析中从测量前到测量后,抑郁和持续性悲伤障碍症状有显著改善(β = -0.62,p = 0.33)。在干预组中,从基线到随访12个月,所有主要和次要结局均显著下降(βs = -0.38至-1.04)。与等待列表对照组(10%)相比,抑郁出现了显著的临床变化(34%)。

结论

丧亲的兄弟姐妹在短期和长期内都从这种简短的基于互联网的写作干预中获益。然而,未来的研究,如拆解研究,可能有助于进一步优化针对丧亲兄弟姐妹的干预措施的益处。

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