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叙事重构治疗延长哀伤障碍的准实验研究:症状改善和增强记忆整合。

A quasi-experimental trial of narrative reconstruction for prolonged grief disorder: Symptomatic improvement and enhanced memory integration.

机构信息

Department of Psychology, Bar-Ilan University, Ramat Gan, Israel.

Department of Psychology, Ben-Gurion University, Beer Sheva, Israel.

出版信息

J Clin Psychol. 2023 Dec;79(12):2849-2868. doi: 10.1002/jclp.23583. Epub 2023 Aug 17.

DOI:10.1002/jclp.23583
PMID:37590286
Abstract

BACKGROUND

Prolonged grief disorder (PGD) was recently approved as a formal diagnosis in the DSM-5-TR. The implementation of bereavement interventions is frequently requested, but their effectiveness has been controversial. Narrative reconstruction (NR) is a time-limited integrative therapy, originally developed for the treatment of post-traumatic stress disorder (PTSD) and adapted for the treatment of PGD. NR consists of exposure to the loss memory, a detailed written reconstruction of the loss memory narrative, and an elaboration of the personal significance of that memory for the bereaved.

OBJECTIVES

In this study we evaluated the efficacy of NR for PGD.

METHOD

In this study, 33 participants with PGD were quasi-randomized-that is, assigned to an immediate (n = 20) or delayed (n = 13) 16-session NR intervention. PGD, intrusion, avoidance and depression symptoms, as well as levels of the loss memory integration, were assessed at pretreatment, post-treatment, and at a 3-month follow-up.

RESULTS

Mixed linear models showed significant intervention effects for PGD and intrusive symptomatology. Results also showed an increase in integration of the loss memory, and improvements remained stable for all outcomes at follow-up.

CONCLUSION

In this study we established NR as an effective intervention for PGD and call for further validation in future studies. Integrating this intervention into the routine care of people with PGD seems important and beneficial.

摘要

背景

延长哀伤障碍(PGD)最近在 DSM-5-TR 中被批准为正式诊断。经常要求实施丧亲干预措施,但它们的有效性一直存在争议。叙事重构(NR)是一种限时的综合疗法,最初是为创伤后应激障碍(PTSD)的治疗而开发的,并被改编用于治疗 PGD。NR 包括对失去记忆的暴露、对失去记忆叙事的详细书面重构,以及对失去亲人的个人意义的阐述。

目的

本研究评估了 NR 对 PGD 的疗效。

方法

在这项研究中,33 名患有 PGD 的参与者被准随机分配 - 即立即(n=20)或延迟(n=13)接受 16 节 NR 干预。在治疗前、治疗后和 3 个月随访时评估 PGD、侵入性症状、回避和抑郁症状,以及失去记忆整合的水平。

结果

混合线性模型显示 PGD 和侵入性症状的干预效果显著。结果还显示,失去记忆的整合度增加,所有结果在随访时仍保持稳定。

结论

在这项研究中,我们确立了 NR 是治疗 PGD 的有效干预措施,并呼吁在未来的研究中进一步验证。将这种干预措施纳入有 PGD 的人的常规护理中似乎很重要且有益。

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