Treatment Development: Bereavement in Older Adults

治疗方法的发展：老年人的丧亲之痛

• 批准号: 6965286
• 负责人: Ronald E. Acierno
• 金额: $ 17.52万
• 依托单位: MEDICAL UNIVERSITY OF SOUTH CAROLINA
• 依托单位国家: 美国
• 财政年份: 2005
• 资助国家: 美国
• 起止时间: 2005-09-15 至 2007-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6965286
• 关键词: anxiety disorders; behavioral /social science research tag; bereavement; clinical research; clinical trials; disease /disorder prevention /control; gender difference; group therapy; handbook; health care cost /financing; health care policy; human middle age (35-64); human old age (65+); human subject; human therapy evaluation; interview; longitudinal human study; major depression; male; mood disorders; outcomes research; psychological stressor; psychological tests; psychotherapy; racial /ethnic difference; therapy design /development; videotape /videodisc

DESCRIPTION (provided by applicant): Fully one-third of the older adults who experience the death of a spouse suffer from "complicated bereavement," a syndrome that shares features with both depression and post-traumatic stress disorder (PTSD). Older adults suffering from complicated bereavement are more likely to experience health-related functional problems, psychological illness, and mortality for at least three years following the death of a spouse. Despite these outcomes of one of the most common stressful events, virtually no standardized, effective, easily administered, and cost-effective programs exist, either in hospitals or in communities to treat and / or prevent complicated bereavement and its associated medical and mental health sequelae. The present R-21 proposal will address this need by developing a novel intervention for older adults suffering from complicated bereavement. Guided by data from preliminary studies with older adults and trauma victims conducted at our center, and with the help of several notable consultants and leaders in the field, a treatment manual will be developed and refined. Moreover, we will subject this intervention to preliminary evaluation using a randomized controlled 2x4 factorial design (treatment by time). Specifically, a multidisciplinary behavioral treatment will be compared to typically offered treatment (bereavement groups) at pre-treatment, post-treatment and at 3 and 6 month follow-up assessments using standardized and validated dependent measures of mental health, health related functioning, and interpersonal impairment in areas associated with "complicated bereavement." The experimental treatment is based on exposure-based psychological treatment models for PTSD and behavioral activation treatment models for major depression. The proposed treatment will incorporate methodology and findings from our current treatment outcome studies with victims of violence, as well as with findings from existing empirical intervention projects of other researchers in this area.

描述（由申请人提供）： 经历配偶死亡的老年人中有三分之一患有“复杂的丧亲”，这是一种具有抑郁症和创伤后应激障碍（PTSD）特征的综合征。患有复杂丧亲的老年人更有可能在配偶去世后至少三年内与健康相关的功能问题，心理疾病和死亡率。尽管有这些最常见的压力事件之一的结果，但在医院或社区中都存在几乎没有标准化，有效，易于管理和具有成本效益的计划，可以治疗和 /或预防复杂的丧亲及其相关的医学和心理健康后遗症。 目前的R-21提案将通过为患有复杂丧亲的老年人开发新的干预措施来满足这一需求。在我们中心进行的老年人和创伤受害者的初步研究的数据的指导下，并在该领域的几位著名顾问和领导者的帮助下，将制定和完善治疗手册。此外，我们将使用随机控制的2x4阶乘设计（按时间处理）对这种干预进行初步评估。具体而言，将在治疗前，治疗后以及在3和6个月的随访评估中，使用标准化和经过验证的精神健康，与健康相关功能以及与“复杂丧亲”相关的领域的人际关系损害进行跨学科行为治疗（丧亲组）进行比较。实验治疗基于基于暴露的心理治疗模型，用于PTSD和针对严重抑郁症的行为激活治疗模型。拟议的治疗方法将与我们当前的治疗结果研究中的方法和发现与暴力受害者以及该领域其他研究人员现有的经验干预项目的发现结合起来。