Dual Process Intervention for Recently Bereaved Spouses

描述（由申请人提供）：对老年寡妇来说，长期的丧亲调整过程会影响她们生活的方方面面。本研究将基于双过程模型（Dual Process Model， DPM）来测试一种新的、有希望的干预方法，该方法包括传统的悲伤支持小组关注，但增加了多维调整过程中所需的教育、日常生活技能建设和能力要素。该模型强调了对两种类型的丧亲相关压力源的适应需求，每种压力源都有自己独特的过程：损失取向（loss orientation， LO），处理与丧亲相关的心理-情绪压力源；恢复（restoration， R），侧重于应对与新丧偶状态相关的次级压力源。这两个过程之间的波动是一个关键因素，因为有效的适应需要一个方面在不同的时间比另一个方面更重要、更相关或更紧迫。本研究的目的是：(1)比较DPM干预与传统支持团体在增强丧亲适应方面的有效性；(2)确定DPM干预在多大程度上促进了丧亲取向与恢复之间的振荡。样本包括330名50岁以上的寡妇，她们在基线时失去亲人2-4个月。将采用随机的实验前后设计，并进行随访（测试后3个月和9个月），其中参与者将被分配到DPM治疗组（每周14次，重点是损失取向、恢复和振荡）或LO对照组。LO结果包括抑郁、悲伤、应对自我效能和孤独，R结果由能力、精通和个人成长衡量。振荡将通过日常生活清单来评估。自我管理的问卷还包括健康状况、社会支持、自尊、社区资源的使用以及宗教/精神资源的测量。假设DPM干预条件下的受试者随着时间的推移在所有适应和振荡测量方面比LO对照组表现出更大的改善。分析策略包括重复测量方差分析（ANOVA），其中“时间”是主体内因素，“群体分配”是主体间的主要因素。本研究的发现可能会通过拓宽焦点，超越传统的心理-情感方法，刺激对成人丧亲干预的内容和传递模式转变的开始。

DESCRIPTION (provided by applicant): The long-term bereavement adjustment process for older widow(er)s can impact every aspect of their lives. This study will test a new, promising intervention approach based on the Dual Process Model (DPM) of coping with bereavement that includes the traditional grief support group focus but adds educational, daily life skill-building, and competency elements needed in the multidimensional adjustment process. This model emphasizes the need for adaptation to two types of bereavement-related stressors, each having its own unique process: loss orientation (LO), which addresses psycho-emotional stressors associated with the loss itself, and restoration (R), which focuses on coping with secondary stressors related to one's new widowhood status. Oscillation between the two processes is a key element because effective adaptation requires one aspect to emerge with greater importance, relevance, or urgency over the other at different times. The aims of this study are to (1) compare the effectiveness of the DPM intervention versus a traditional support group in enhancing bereavement adaptation, and (2) determine the extent to which oscillation between loss orientation and restoration can be facilitated by the DPM intervention. The sample includes 330 widow(er)s, aged 50+ who are bereaved 2-4 months at baseline. A randomized pre/post experimental design will be employed with follow-up (3 & 9 months after post-test) in which participants will be assigned to either the DPM treatment condition (14 weekly sessions focusing on loss orientation, restoration, and oscillation) or the LO comparison group. LO outcomes include depression, grief, coping self-efficacy, and loneliness with R outcomes measured by competencies, mastery, and personal growth. Oscillation will be assessed by an inventory of daily life. Self-administered questionnaires also include measures of health status, social support, self-esteem, use of community resources, and religious/spiritual resources. It is hypothesized that subjects in the DPM intervention condition will demonstrate greater improvements on all adaptation and oscillation measures over time than those in the LO comparison group. Analytical strategy consists of repeated measures analysis of variance (ANOVA) with "time" the within-subject factor and "group assignment" the primary between-subjects factor. Findings from this study may stimulate the beginning of a paradigm shift in the content and delivery of bereavement interventions for adults by broadening the focus beyond the traditional psycho-emotional approach.