Victims and survivors
John C. Gunn, Pamela J. Taylor in Forensic Psychiatry, 2014
It is not only the person who dies who is the victim of a homicide. The act also creates secondary victims in the family and friends of that person, and perhaps the wider community too. Homicide differs from other crimes because of its irreversibility, and because of the stigma and social taboo surrounding it, which affect all those who were close to the primary victim (Raphael, 1997). These differences result in qualitatively and quantitatively different responses from those to other crime victims and from normal bereavement responses (Mezey et al., 2002). A diagnosis of ‘traumatic grief’ has been proposed to incorporate the two core components of trauma and loss (Horowitz, 1997; Prigerson et al., 1997, 1999). Other effects may be physical ill-health, cognitive impairments, psychological disorders, including PTSD, depression, phobic avoidance, and impaired work and social function (Rynearson, 1984; Murray-Parkes, 1993; Mezey et al., 2002). Being a woman and/or a parent increases the risk of such disorder (Murphy et al., 1999).
Psychiatric Emergencies in Grief
R. Thara, Lakshmi Vijayakumar in Emergencies in Psychiatry in Low- and Middle-Income Countries, 2017
Researchers have suggested that the word bereavement be used to refer to the fact of the loss; the word grief should then be used to describe the emotional, cognitive, functional, and behavioral responses to the death. Also, grief is often used more broadly to refer to the response to other kinds of loss. For example, people grieve the loss of their youth, of opportunities, and of functional abilities. The word mourning is sometimes used interchangeably with bereavement and grief, usually referring more specifically to the behavioral manifestations of grief, which are influenced by social and cultural rituals, such as funerals, visitations, or other customs. Complicated grief, sometimes referred to as unresolved or traumatic grief, is the current designation for a syndrome of prolonged and intense grief that is associated with substantial impairment in work, health, and social functioning.
Can Good Come from Bad?
John R. Cutcliffe, José Carlos Santos, Paul S. Links, Juveria Zaheer, Henry G. Harder, Frank Campbell, Rod McCormick, Kari Harder, Yvonne Bergmans, Rahel Eynan in Routledge International Handbook of Clinical Suicide Research, 2013
Bereavement from suicide has been associated with psychiatric disorders such as Posttraumatic Stress Disorder (PTSD) and Prolonged Grief Disorder (PG) (Latham & Prigerson, 2004; Mitchell et al., 2004). Investigations of emotional memory for trauma reconceptualize the sequelae of traumatic events, like suicide bereavement, as memory for an event that becomes central to the bereaved's identity and personal narrative (Berntsen & Rubin, 2006). It is the appraisal of the memory that causes pathological symptom profiles, such as PTSD (Berntsen & Rubin, 2006), and grief reactions associated with continued preoccupation with the decedent (Safer, Bonanno, & Field, 2001). Newer investigations of “cognitive scarring” that may be associated with identity-level “trait hopelessness” in suicide survivors are also possible outcomes of suicide bereavement (Rudd et al., 2009), but have yet to be investigated.
Subjective Experience of Art Therapists in the Treatment of Bereaved Clients
Published in Art Therapy, 2019
Bereavement researchers stress that grief is a normal reaction to the death of a loved one. Most people, in time, come to terms with their loss. However, if the grief process is hindered and the bereaved person suffers psychological distress or impaired functioning, psychotherapeutic intervention might be of help (Rubin et al., 2012). Complicated grief was first delineated through the psychoanalytic lens (e.g., Deutch, 1937) and continues to concern clinicians and researchers today (Stroebe et al., 2008). A central concept refers to pathological mourning, which describes persistent feelings of helplessness and hopelessness (Bibring, 1953) around achieving the desired return of the deceased (Bleichmar, 2010). The psychic suffering in pathological mourning could trigger defensive processes that are an attempt to avoid pain (e.g., Brenner, 1982; Pollock, 1989). Traumatic grief is a loss following trauma (Rynearson, 2001). In such cases, therapeutic interventions should address the double focus of loss and trauma in an integrated and interrelated manner (Rubin et al., 2012). Grief therapy emphasizes the therapist’s need to address the complexities of the client’s mourning process. In the two-track model (Rubin 1981, 1999), therapeutic interventions should relate to both tracks, with attention to the dynamics of each and their interactions. According to the DPM, therapy will encourage either loss-oriented or restoration-oriented coping strategies, contributing to the ability to oscillate between them (Stroebe, Schut, & Stroebe, 2005).
Exhibition and Film About Miscarriage, Infertility, and Stillbirth: Art Therapy Implications
Published in Art Therapy, 2020
Traumatic experiences can be categorized into different levels of intensity. Simple trauma stems from a single incident whereas developmental trauma originates during early childhood which impairs typical healthy development (Perry, 2009; van der Kolk, 2014). Complex trauma is multilayered and relates to multiple traumatic events that impair functioning (van der Kolk, Hart & Burbridge, 2002). Traumatic grief results from the death of a significant other followed by yearning, searching, or longing, and later by persistent depressive symptoms that cause significant impairment (Jacobs, Mazure, & Prigerson, 2000). The psychological and psychosocial impact of people who have experienced miscarriage conforms to this definition of traumatic grief (DeFrain, Millspaugh, & Xiaolin, 1996).
Prolonged Grief Disorder: Identification and Management
Published in Issues in Mental Health Nursing, 2023
Complicated or prolonged grief as a mental health problem is long-established in the literature without historical recognition as a Diagnostic and Statistical Manual of Mental Disorders (DSM) diagnosis (Shear, 2015; Shear & Shair, 2005). It was nearly twenty years ago when experts began to advocate for inclusion of a complicated grief diagnosis in the DSM (Horowitz et al., 2003; Shear et al., 2011), yet such a diagnosis and associated criteria were not included in the DSM-5 (American Psychiatric Association [APA], 2013) despite inclusion as an International Classification of Diseases 11th Revision (ICD-11) diagnosis. In March 2022, updated DSM-5 text revisions were released (DSM-5-TR), which included prolonged grief disorder, a significant change from past editions (APA, 2022) and one that will improve diagnostic clarity for individuals experiencing post-grief mental health symptoms moving forward. Psychiatric nurses must familiarize themselves with prolonged grief disorder diagnostic criteria, in addition to what is known about epidemiology and treatment modalities, to provide high-quality mental health care across populations. This article provides a brief overview of prolonged grief disorder and emerging information related to epidemiology, diagnosis, and treatment.
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