TRAUMATIC GRIEF TREATMENT--A RANDOMIZED CONTROLLED STUDY

说明（改编自申请人的摘要）：本申请要求 资助一项为期5年的治疗"创伤性悲伤"的研究。"16岁以上 在美国每年有一百万人失去亲人。大幅度 少数人，悲伤是慢性的，使人衰弱的，并因精神病或 医疗问题。在这些情况下，干预是明确表示，但有 关于如何最好地治疗这些人的信息很少。该领域 一直缓慢发展异常悲伤反应的标准，缺乏这样的 标准阻碍了治疗方法的开发和测试。借助于一个 新的工具，复杂悲伤清单（ICG），我们现在可以可靠地 一种目前被称为"创伤性悲伤"的综合症"在20%的 对于失去亲人的人来说，创伤性悲伤与长期的 发病率创伤性悲伤的症状不同于 抑郁症，并且对抑郁症的标准治疗没有反应。 因此，我们着手开发一种有针对性的创伤性悲伤治疗方法， （TGT）。10例患者的初步数据显示了稳健的治疗效果， 比发表的悲伤咨询报告所达到的效果更好。我们现在提出一个 随机对照试验来测试TGT的功效。我们的主要目标是 比较创伤性悲伤治疗（TGT）与对照，人际关系， 心理治疗（IPT）对创伤性悲伤，抑郁，焦虑， 功能障碍、自尊和社会支持。我们计划进行 所有随机化受试者在第16周和第40周的评估。我们将 进行探索性分析和仪器开发，以测试和完善 与TGT的假定作用机制相关的假设。我们假设 TGT将导致显着更大的改善创伤性悲伤比 IPT，并且这些差异将在6个月随访时持续。几乎 十年来对丧亲之痛的描述和治疗的研究 我们的研究小组已经为治疗试验做好了准备， 求婚我们已经了解到，在那些与丧亲有关的人中， 精神病学是精神和身体疾病的最大风险 (i.e.,那些有创伤性悲伤的人），我们已经发展出了一种似乎是 对这一耐药人群进行有效干预。时间 这有利于对创伤性悲伤治疗的有效性进行对照研究。

DESCRIPTION (Adapted from the Applicant's Abstract): This application requests funding for a 5 year study of a treatment for "traumatic grief." Over 16 million people are bereaved each year in the United States. For a substantial minority, grief is chronic, debilitating, and complicated by psychiatric or medical problems. In these cases, intervention is clearly indicated, yet there is little information about how best to treat such individuals. The field has been slow to develop criteria for abnormal grief reactions, and lack of such criteria has impeded development and testing of treatments. With the aid of a new instrument, the Inventory of Complicated Grief (ICG), we can now reliably identify a syndrome currently designated "traumatic grief." Found in 20% of bereaved persons, traumatic grief is associated with significant long-term morbidity. Symptoms of traumatic grief are distinct from symptoms of depression, and do not respond to standard treatments for depression. Therefore, we undertook development of a targeted Traumatic Grief Treatment (TGT). Pilot data in 10 patients show a robust treatment effect, much larger than that achieved by published reports of grief counseling. We now propose a randomized controlled trial to test the efficacy of TGT. Our primary aim is to compare effects of traumatic grief treatment (TGT) to a control, interpersonal psychotherapy (IPT) on measures of traumatic grief, depression, anxiety, functional impairment, self esteem and social support. We plan to conduct assessments of all randomized subjects at 16 weeks and 40 weeks. We will conduct exploratory analyses and instrument development to test and refine hypotheses related to putative mechanisms of action of TGT. We hypothesize that TGT will result in significantly greater improvement in traumatic grief than IPT, and that these differences will be sustained at 6-month follow-up. Almost a decade of work on the description and treatment of bereavement-related distress has prepared our research group for the treatment trial we now propose. We have come to understand who among those with bereavement-related symptomatology is at greatest risk for psychiatric and physical morbidity (i.e., those with traumatic grief) and we have developed what appears to be an effective intervention for this treatment-resistant population. The time is propitious for a controlled study of the efficacy of Traumatic Grief Treatment.