Dual Process Intervention for Recently Bereaved Spouses

描述(申请人提供)：对于年长的寡妇(呃)S来说，长期的丧亲调整过程会影响到他们生活的方方面面。这项研究将测试一种新的、有前景的干预方法，该方法基于应对丧亲之痛的双过程模型(DPM)，包括传统的悲伤支持小组重点，但增加了多维适应过程中所需的教育、日常生活技能建设和能力要素。该模型强调需要适应两种与丧亲有关的压力源，每种压力源都有自己独特的过程：损失定向(LO)，解决与丧失本身相关的心理-情感压力源；恢复(R)，重点应对与新的丧偶身份有关的次要压力源。这两个过程之间的振荡是一个关键因素，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干预和传统支持组在增强丧亲适应方面的有效性，以及(2)确定DPM干预可以在多大程度上促进丢失定向和恢复之间的振荡。研究对象为丧亲2~4个月的S寡妇(女)，年龄50岁。将采用随机化的前后实验设计，并进行随访(后测试后3个月至9个月)，参与者将被分配到DPM治疗条件(每周14次，重点关注丢失方向、修复和振荡)或LO对照组。LO结果包括抑郁、悲伤、应对自我效能感和孤独，R结果通过能力、掌握和个人成长来衡量。振动性将通过日常生活的清单进行评估。自我管理的问卷还包括健康状况、社会支持、自尊、社区资源使用和宗教/精神资源的衡量标准。假设在DPM干预条件下，随着时间的推移，在所有适应和振荡测量方面，受试者将比LO对照组的受试者有更大的进步。分析策略包括重复测量方差分析(ANOVA)，“时间”是受试者内的因素，“小组分配”是主要的受试者之间的因素。这项研究的发现可能会通过拓宽关注焦点，超越传统的心理-情感方法，刺激成人丧亲干预内容和交付的范式转变的开始。

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.