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，旨在了解慢性悲伤反应，并着眼于为评估和临床干预提供新的方向。虽然大多数丧失亲人的人在一年内就能从损失中恢复过来，但很大一部分人（约10- 20%）患有慢性抑郁症和其他与悲伤有关的症状，身体疾病和健康问题增加，工作效率下降。传统的应对失去的模式对这些困难提供了很少的见解，现有的治疗慢性悲伤已经被证明是相对无效的。拟建项目的主要目标是对配偶死亡导致的慢性症状升高的个体的认知和情感机制有更精确的理解。该项目将通过一系列实验任务和访谈程序，将长期悲伤的个体（抑郁症加重、创伤后应激障碍和失去亲人后1.5至3年的分离痛苦）与恢复的丧亲个体和未丧亲个体进行比较。本研究的主要目的是评估慢性悲伤个体(1)依恋动态和(2)有效情绪调节能力的预测缺陷，以及(3)探索这两套机制之间的接口。具体而言，我们预测慢性悲伤个体将表现出以下特征：在不同情境下对已故配偶的表征的可及性提高，但在受到威胁后无法使用这种表征进行情绪修复：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；注意偏向于张着嘴的厌恶面孔，而远离闭着嘴的厌恶面孔（即，注意专注于社会道德拒绝）；当他们被已故配偶的形象刺激时，他们的情绪调节缺陷会加剧。

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.