Department of Clinical Psychology, Psychotherapy and Experimental Psychopathology, Johannes Gutenberg University Mainz, Mainz, Germany.
Department of Psychology, University of Zurich, Zurich, Switzerland.
Eur J Psychotraumatol. 2023;14(2):2254584. doi: 10.1080/20008066.2023.2254584. Epub 2023 Sep 28.
Grief is a multi-faceted experience including emotional, social, and physical reactions. Research in ICD-11 prolonged grief disorder (PGD) in different cultural contexts has revealed different or potentially missing grief symptoms that may be relevant. This study thus aimed to explore the prevalence of somatic symptom distress and its associations with grief and negative affect in a culturally diverse sample of bereaved individuals with symptoms of PGD. Based on cross-sectional survey data from the Measurement and Assessment of Grief (MAGIC) project, this study included 1337 participants (mean age 23.79 yrs, 76.1% female) from three regions (USA: 62.3%, Turkey/Iran: 24.2%, Cyprus/Greece: 13.5%), who experienced a loss of a significant other. Associations between somatic symptom distress (Somatic Symptom Scale, SSS-8), symptoms of PGD (International Prolonged Grief Disorder Scale, IPGDS-33), anxiety (Generalized Anxiety Disorder Questionnaire, GAD-7), depression (Patient Health Questionnaire, PHQ-9) as well as demographic and loss related characteristics were investigated. Three hundred and thirteen participants (23.4%) scored above the proposed cut-off for clinically severe PGD. 'High' or 'very high' levels of somatic symptom distress were more frequent in a possible PGD group (58.2%), than in a non-PGD group (22.4%), < .001, as divided per cut-off in the IPGDS. In a multiple regression analysis, PGD symptoms were significantly but weakly associated with somatic symptom distress (= 0.08, < .001) beyond demographics, loss-related variables, and negative affect. Negative affect (anxiety and depression) mediated the relationship of PGD symptoms with somatic symptom distress and the indirect effect explained 58% of the variance. High levels of somatic symptom distress can be observed in a substantial proportion of bereaved across cultures. Our findings suggest that PGD is related to somatic symptom distress partly and indirectly through facets of negative affect.
悲痛是一种多方面的体验，包括情绪、社交和身体反应。在不同文化背景下对 ICD-11 延长悲痛障碍（PGD）的研究揭示了不同的或可能缺失的悲痛症状，这些症状可能是相关的。因此，这项研究旨在探索躯体症状困扰在具有 PGD 症状的文化多样化样本中的患病率及其与悲痛和负性情绪的关系。本研究基于 MAGIC 项目的横断面调查数据，包括来自三个地区（美国：62.3%，土耳其/伊朗：24.2%，塞浦路斯/希腊：13.5%）的 1337 名有悲痛经历的个体（平均年龄 23.79 岁，76.1%为女性）。这些个体经历了失去重要他人。研究了躯体症状困扰（躯体症状量表，SSS-8）、PGD 症状（国际延长悲痛障碍量表，IPGDS-33）、焦虑（广泛性焦虑障碍问卷，GAD-7）、抑郁（患者健康问卷，PHQ-9）以及人口统计学和与损失相关的特征之间的关系。313 名参与者（23.4%）的得分高于 PGDD 提议的临床严重程度的截止值。在可能的 PGD 组（58.2%）中，躯体症状困扰的“高”或“非常高”水平比非 PGD 组（22.4%）更常见， < .001，根据 IPGDS 的截止值进行分组。在多元回归分析中，PGD 症状与躯体症状困扰显著但微弱相关（= 0.08， < .001），超出了人口统计学、与损失相关的变量和负性情绪。负性情绪（焦虑和抑郁）介导了 PGD 症状与躯体症状困扰的关系，间接效应解释了 58%的方差。在不同文化背景的悲痛人群中，可能会观察到高水平的躯体症状困扰。我们的发现表明，PGD 与躯体症状困扰部分相关，部分通过负性情绪的各个方面间接相关。
