Are there gender differences in prolonged grief trajectories? A registry-sampled cohort study
Are there gender differences in prolonged grief trajectories? A registry-sampled cohort study
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DOI：
10.1016/j.jpsychires.2020.06.030
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发表时间：
2020-10-01
影响因子：
4.8
通讯作者：
O'Connor, Maja
中科院分区：
文献类型：
--
作者：
Lundorff, Marie;Bonanno, George A.;O'Connor, Maja
研究表明，随着时间的推移，悲伤的发展方式会有所不同，性别可能会解释其中的一些差异。然而，新编纂的ICD-11延长性悲伤障碍（PGD）的生长模式的性别差异尚不清楚。本研究探讨了性别差异的悲伤轨迹在登记处抽样队列的857配偶丧失个人（69.8%女性）。参与者在丢失后2个月、6个月和11个月完成了PGD症状的自我报告问卷。使用生长混合模型，出现了四种PGD轨迹：以轻度症状为特征的弹性（64.4%），以中度症状为特征的中度稳定（20.4%），以症状升高为特征的恢复（8.4%），以及以持续升高的症状为特征的长期悲伤（6.8%）。男性和女性的比例相似，构成了这四种轨迹。性别影响了长期悲伤轨迹的参数估计，因为男性比女性表现出更多的基线症状（更高的截距），并且随着时间的推移，抑郁水平下降（负斜率），而女性则表现出抑郁水平增加（正斜率）。在两种性别的可能的PGD病例中，延长的悲伤轨迹占最大比例。低乐观和低心理健康预测在这个类的成员。总的来说，绝大多数男性和女性都遵循低症状弹性轨迹。虽然一个类似的少数遵循高症状的长期悲伤轨迹，男性和女性在这个轨迹表示不同的症状发展。男性表示长期的悲伤作为一个急性，减少反应，而女性表现出一个延期，安装悲伤的反应。这项研究表明，性别可能会影响早期丧亲高度痛苦的个人症状的发展。
Research suggests variation in how grief develops across time, and gender may account for some of this variation. However, gender differences in growth patterns of the newly codified ICD-11 prolonged grief disorder (PGD) are unknown. This study examined gender-specific variances in grief trajectories in a registry-sampled cohort of 857 spousal bereaved individuals (69.8% female). Participants completed self-report questionnaires of PGD symptoms at 2, 6, and 11 months post-loss. Using Growth Mixture Modeling, four PGD trajectories emerged: resilient characterized by low symptoms (64.4%), moderate-stable characterized by moderate symptoms (20.4%), recovery characterized by elevated symptoms showing a decrease over time (8.4%), and prolonged grief characterized by continuous elevated symptoms (6.8%). Similar proportions of men and women comprised the four trajectories. Gender influenced the parameter estimates of the prolonged grief trajectory as men evidenced more baseline symptoms (higher intercept) than women did and a decreasing symptom-level (negative slope), while women showed symptom-increase over time (positive slope). The prolonged grief trajectory captured the largest proportion of probable PGD cases in both genders. Low optimism and low mental health predicted membership in this class. Altogether, the absolute majority of both men and women followed a low-symptom resilient trajectory. While a comparable minority followed a high-symptom prolonged grief trajectory, men and women within this trajectory expressed varying symptom development. Men expressed prolonged grief as an acute, decreasing reaction, whereas women showed an adjourned, mounting grief reaction. This study suggests that gender may influence symptom development in highly distressed individuals across early bereavement.