Trajectories of depression following spousal and child bereavement: A comparison of the heterogeneity in outcomes
Trajectories of depression following spousal and child bereavement: A comparison of the heterogeneity in outcomes
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DOI：
10.1016/j.jpsychires.2015.07.017
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发表时间：
2015-10-01
影响因子：
4.8
通讯作者：
Bonanno, George A.
中科院分区：
文献类型：
--
作者：
Maccallum, Fiona;Galatzer-Levy, Isaac R.;Bonanno, George A.
我们对失去至爱亲人的个人反应的理解，很大程度上来自对丧偶的研究。目前尚不确定调查结果与其他丧亲事件有多大关联。目前研究的一个主要方法局限性是依赖于对功能的回顾报告，并使用自行选择参与悲伤研究的个人样本。为了解决这些局限性，在目前的研究中，我们应用了潜在生长混合模型(LGMM)在一个基于人群的前瞻性样本中，以确定配偶和孩子在晚年失去亲人后抑郁的轨迹。样本包括2512名失去亲人的成年人，他们在失去亲人之前和之后分别接受了一次和三次评估。确定了四个离散的轨迹：恢复力(很少或没有抑郁；68.2%)，慢性悲伤(失去后出现抑郁；13.2%)，抑郁-改善(失去前高度抑郁，失去后下降；11.2%)，以及先前存在的慢性抑郁(所有评估中的高度抑郁；7.4%)。这些轨迹在孩子和配偶的丧失中都存在。有一些证据表明，在晚年失去孩子与慢性悲痛轨迹的相关性更强，与弹性轨迹的相关性较小。然而，当模型中包括协变量时，这些差异就消失了。讨论了这些分析的局限性。这些发现增加了我们对丧亲后结果的多样性的理解，并强调了使用前瞻性设计来绘制反应结果的异质性的重要性。(C)2015爱思唯尔有限公司。保留所有权利。
Our understanding of how individuals react to the loss of a close loved one comes largely from studies of spousal bereavement. The extent to which findings are relevant to other bereavements is uncertain. A major methodological limitation of current studies has been a reliance on retrospective reporting of functioning and use of samples of individuals who have self-selected for participant in grief research. To address these limitations, in the current study we applied Latent Growth Mixture Modelling (LGMM) in a prospective population-based sample to identify trajectories of depression following spousal and child bereavement in later life. The sample consisted of 2512 individual bereaved adults who were assessed once before and three times after their loss. Four discrete trajectories were identified: Resilience (little or no depression; 68.2%), Chronic Grief (an onset of depression following loss; 13.2%), Depressed-Improved (high pre-loss depression that decreased following loss; 11.2%), and Pre-existing Chronic Depression (high depression at all assessments; 7.4%). These trajectories were present for both child and spousal loss. There was some evidence that child loss in later life was associated more strongly with the Chronic Grief trajectory and less strongly with the Resilience trajectory. However these differences disappeared when covariates were included in the model. Limitations of the analyses are discussed. These findings increase our understanding of the variety of outcomes following bereavement and underscore the importance of using prospective designs to map heterogeneity of response outcomes. (C) 2015 Elsevier Ltd. All rights reserved.