TRAUMATIC GRIEF TREATMENT--A RANDOMIZED CONTROLLED STUDY

描述(改编自申请人摘要)：本申请请求 资助一项为期5年的“创伤性悲痛”治疗研究。超过16岁 在美国，每年有数百万人失去亲人。对于一个实质性的 少数族裔，悲伤是慢性的，使人虚弱，并伴有精神疾病或 医疗问题。在这些情况下，干预是明确的，但仍存在 关于如何最好地治疗这些人的信息很少。这一领域有 在制定异常悲痛反应的标准方面进展缓慢，而且缺乏这样的标准 标准阻碍了治疗方法的开发和测试。借助于一个 新的仪器，复杂悲伤清单(ICG)，我们现在可以可靠地 找出一种目前被称为“创伤性悲痛”的综合症。在20%的 失去亲人的人，创伤性悲痛与重要的长期 发病率。创伤性悲痛的症状与 抑郁症，并且对抑郁症的标准治疗没有反应。 因此，我们开展了有针对性的创伤性悲痛治疗 (TGT)。在10名患者中的试点数据显示了强大的治疗效果，远大于 比发表的悲痛咨询报告所达到的效果更好。我们现在提出一项 TGT疗效的随机对照试验。我们的主要目标是 创伤性悲伤治疗(TGT)与对照、人际关系的效果比较 心理治疗(IPT)，测量创伤性悲伤、抑郁、焦虑、 功能障碍、自尊和社会支持。我们计划进行 在16周和40周对所有随机受试者进行评估。我们会 进行探索性分析和仪器开发以测试和改进 与TGT可能作用机制相关的假说。我们假设 TGT对创伤性悲痛的改善作用明显大于 这些差异将在6个月的随访期内保持。差不多了 十年来对丧亲相关疾病的描述和治疗 危难已经使我们的研究小组为我们现在的治疗试验做好了准备 求婚。我们逐渐明白，在那些与丧亲有关的人中， 症状学是精神和身体疾病的最大风险。 (即，那些有创伤性悲痛的人)，我们已经发展出一种似乎是 对这一耐药人群进行有效干预。时间是 有利于创伤性悲痛治疗效果的对照研究。

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.