Rynearson E K
Section of Psychiatry, Virginia Mason Clinic.
Psychiatr Clin North Am. 1987 Sep;10(3):487-99.
A significant minority (14 per cent) of a nonpatient bereaved population may be presumed to develop intense and enduring pathologic grief responses. The promise of recovery with short-term, focused intervention appears to be misleading, as a sizable proportion of patients with pathologic grief will be unresponsive to treatment. Prospective studies have demonstrated a positive correlation of dependent attachment, conflicted attachment, and unexpected loss with specific pathologic grief syndromes; preliminary reports suggest that these specific grief syndromes require specific interventions. The presentation of a nonresponsive case illustrates the clinical application and limitation of a revised strategy of treatment. The development and maintenance of formative imagery and symbols is of crucial support to the patient and therapist.
在非患者丧亲人群中，相当一部分少数群体（14%）可能会出现强烈且持久的病理性悲伤反应。短期、针对性干预能康复的前景似乎具有误导性，因为相当一部分病理性悲伤患者对治疗无反应。前瞻性研究表明，依赖型依恋、矛盾型依恋和意外丧失与特定的病理性悲伤综合征呈正相关；初步报告表明，这些特定的悲伤综合征需要特定的干预措施。一个无反应病例的呈现说明了一种修订治疗策略的临床应用及局限性。形成性意象和象征的发展与维持对患者和治疗师至关重要。
