Complicated Grief Treatment in Elderly Adults

老年人复杂的悲伤治疗

• 批准号: 7048173
• 负责人: M Katherine Shear
• 金额: $ 48.26万
• 依托单位: COLUMBIA UNIV NEW YORK MORNINGSIDE
• 依托单位国家: 美国
• 财政年份: 2007
• 资助国家: 美国
• 起止时间: 2007-09-21 至 2012-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7048173
• 关键词: Address; Adult; Affect; African American; Age; Age-Years; Aging; American; Anxiety; Applications Grants; Area; Bereavement; Caucasians; Caucasoid Race; Cessation of life; Child; Chronic; Clinical; Condition; Consensus; Daily; Data; Disruption; Elderly; Eligibility Determination; Equipment and supply inventories; Face; Feeling; Feeling suicidal; Friends; Grief reaction; Guilt; Health; Health Status; Healthcare; High Prevalence; Hypertension; Image; Impaired cognition; Impairment; Individual; Intervention Studies; Life; Loneliness; Love; Major Depressive Disorder; Measures; Mediator of activation protein; Memory; Mental Depression; Mood Disorders; Morbidity - disease rate; Outcome; Parents; Participant; Persons; Pharmaceutical Preparations; Physicians; Prevalence; Psychotherapy; Quality of life; Randomized Controlled Trials; Range; Rate; Reaction; Relapse; Relative (related person); Reporting; Research; Research Personnel; Risk; Risk Factors; Siblings; Sleep; Sleep disturbances; Social isolation; Social support; Standards of Weights and Measures; Subgroup; Substance abuse problem; Suicide; Symptoms; Techniques; Testing; Thinking; Time; United States; Visit; Widowhood; Woman; aging population; cognitive function; daily functioning; depressive symptoms; experience; follow-up; handicapping condition; improved; men; middle age; mild neurocognitive impairment; novel; older patient; programs; response; social; statistics; yearning; young adult

DESCRIPTION (provided by applicant): This application is the second revision of an application that responds to PA-03-014 inviting grant applications for older adults. The application is modified to address reviewers concerns and to add additional pilot data. Seniors are the demographic group most likely to be bereaved. According to the National Council on Aging (http://www.aoa.gov/prof/ Statistics/ profile/2Q03/2003profile.pdf), in 2002, more than 10 million older Americans were widowed. These people are at risk for a debilitating reaction called Traumatic or Complicated Grief (CG: the term now used for this condition). Studies confirm that Complicated Grief can be reliably identified and occurs in about 10-20% of bereaved individuals. CG appears to carry much of the risk for negative outcomes of bereavement. CG can affect health status and influence decisions about personal health care. The risk of hypertension is 10 times greater among widowed subjects who meet consensus criteria for CG compared to those who do not, while subjects with CG are 17 times less likely to have visited a physician in the months since the death. Despite its high prevalence and significant morbidity, there are no proven efficacious treatments. The PI of this application developed a novel psychotherapy called Complicated Grief Treatment (CGT), and has now completed a study (MH60783) comprised of adults over age 18, that confirmed efficacy of this approach. However, most participants were less than 60 years old. Participants > age 60 (n=29) were less likely to be employed and more likely to live alone. CGT and IPT produced similar results in older and younger adults, with better response to CGT in both groups. However, confirmation of efficacy among seniors is important, since older people have different vulnerabilities and different problems in adjusting to grief than younger adults. We thus assembled a group of highly experienced geriatric researchers skilled in assessment and management of problems in older people, e.g. physical infirmity, cognitive dysfunction, social isolation, disruption of daily routine. We propose to conduct a randomized controlled study of CGT v IPT in individuals > 65 years of age. Our specific aims are: 1) To compare results of 16 sessions of either CGT or standard IPT. We hypothesize that CGT will produce a higher response rate and shorter time to response than IPT, and that responders will show significantly greater

描述(由申请人提供)：本申请是对PA-03-014邀请老年人拨款申请的第二次修订。对应用程序进行了修改，以解决审查者的关切并添加额外的试点数据。老年人是最有可能失去亲人的人口群体。根据国家老龄委员会(http://www.aoa.gov/prof/统计/Profile/2Q03/2003profile.pdf)的数据，2002年，美国有1000多万老年人丧偶。这些人面临着一种叫做创伤性或复杂性悲痛的衰弱反应的风险(CG：现在用来描述这种情况的术语)。研究证实，复杂的悲痛可以可靠地识别出来，并发生在大约10%-20%的丧失亲人的人中。丧失亲人的负面后果，CG似乎承担了很大的风险。CG可以影响健康状况并影响有关个人保健的决策。在符合CG普遍标准的寡居受试者中，患高血压的风险是那些不符合标准的人的10倍，而在死亡后的几个月里，患有CG的受试者去看医生的可能性要低17倍。尽管它的发病率很高，发病率也很高，但目前还没有被证明有效的治疗方法。该应用程序的PI开发了一种名为复杂悲伤治疗(CGT)的新型心理疗法，现在已经完成了一项由18岁以上成年人组成的研究(MH60783)，证实了这种方法的有效性。然而，大多数参与者的年龄都不到60岁。60岁的参与者(n=29)不太可能有工作，更有可能独自生活。CGT和IPT在老年人和年轻人中产生了类似的结果，两组对CGT的反应都更好。然而，在老年人中确认有效性是重要的，因为老年人在适应悲伤方面与年轻人有不同的脆弱性和不同的问题。因此，我们召集了一批经验丰富的老年研究人员，他们擅长评估和管理老年人的问题，例如身体虚弱、认知障碍、社交孤立、日常生活中断。我们建议在65岁的人群中进行CGT和IPT的随机对照研究。我们的具体目标是：1)比较CGT和标准IPT的16次会议的结果。我们假设CGT将产生比IPT更高的应答率和更短的反应时间，并且应答者将表现出更大的