Cognitive and Emotional Mechanisms in Chronic Grief

描述（由申请人提供）：该项目代表了一个更大的研究议程的第一阶段，以了解慢性悲伤反应，着眼于为评估和临床干预提供新的方向。虽然大多数失去亲人的人在一年内从损失中恢复过来，但相当一部分人（约10- 20%）患有慢性抑郁症和其他与悲伤有关的症状，以及身体疾病和健康问题增加，工作效率降低。传统的应对损失的模式对这些困难几乎没有提供任何见解，而现有的慢性悲伤治疗方法已被证明相对无效。拟议项目的主要目标是更准确地了解因配偶死亡而丧失亲人的个人中慢性症状加剧的认知和情感机制。该项目将使用一组实验任务和访谈程序，将长期悲伤的个体（从1.5到3年的损失后抑郁症，创伤后应激障碍和分离困扰）与恢复的丧亲者和非丧亲者进行比较。主要目的是评估慢性悲伤个体的（1）依恋动力学和（2）有效情绪调节能力的预测缺陷，以及（3）探索这两组机制之间的界面。具体来说，我们预测，长期悲伤的人将证明以下几点：在不同的背景下，对已故配偶的表征的可访问性提高，但也无法使用这种表征来修复威胁后的情绪：使用积极情绪调节消极情绪的能力降低，灵活调节情绪表达的能力降低;注意力偏向于张开嘴的厌恶脸而远离闭着嘴的厌恶脸（即，注意力被社会道德排斥所占据）;以及当他们被已故配偶的代表所启动时，他们的情绪调节缺陷加剧。

DESCRIPTION (provided by applicant): This project represents the first stage in a larger research agenda to understand chronic grief reactions with an eye toward informing new directions in assessment and clinical intervention. Although most bereaved individuals recover from loss with one year, a substantial proportion (approximately 10-20 percent) suffer from chronic depression and other grief-related symptoms, as well as increased physical illness and health problems and reduced productivity at work. Traditional models of coping with loss have provided little insight into the these difficulties and existing treatments for chronic grief have proved relatively inefficacious. The primary objective of the proposed project is to develop a more precise understanding of the cognitive and emotional mechanisms that characterize chronic symptom elevations among individuals bereaved from the death of a spouse. The project will compare chronically grieved individuals (elevated depression, PTSD, and separation distress from 1.5 to 3 years post-loss) with recovered bereaved individuals and nonbereaved individuals using a set of experimental tasks and interview procedures. The primary aims are to assess predicted deficits in chronically grieved individuals' (1) attachment dynamics and (2) capacity for effective emotion regulation, and (3) to explore the interface between these two sets of mechanisms. Specifically, we predict that chronically grieved individuals will evidence the following: heightened accessibility for the representation of the deceased spouse across contexts, but also an inability to use that representation for mood repair following threat: reduced ability to use positive emotion to modulate negative emotion and reduced ability to flexibly regulation emotional expression; an attentional bias toward open-mouth disgust faces and away from closed-mouth disgust faces (i.e., attentional preoccupation with social-moral rejection); and an exacerbation of their deficits in emotion regulation when they are primed with the representation of the deceased spouse.