Cognitive and Emotional Mechanisms in Chronic Grief

描述(由申请者提供)：这个项目代表了一个更大的研究议程的第一阶段，目的是了解慢性悲痛反应，并着眼于为评估和临床干预提供新的方向。虽然大多数失去亲人的人在一年内就能从损失中恢复过来，但相当一部分人(约10%-20%)患有慢性抑郁症和其他与悲伤相关的症状，以及更多的身体疾病和健康问题，以及工作效率下降。传统的应对失去的模式几乎没有提供对这些困难的洞察，现有的治疗慢性悲痛的方法被证明相对无效。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的慢性症状上升的认知和情感机制。该项目将使用一套实验任务和访谈程序，将长期悲痛的个人(抑郁加剧、创伤后应激障碍和失去亲人后1.5到3年的分离痛苦)与恢复的丧失亲人和未失去亲人的个人进行比较。主要目的是评估长期悲伤个体的预期缺陷(1)依恋动态和(2)有效情绪调节的能力，以及(3)探索这两套机制之间的接口。具体地说，我们预测，长期悲痛的人将证明以下几点：在不同背景下，更容易获得已故配偶的表征，但也无法在受到威胁后使用该表征修复情绪：使用积极情绪调节负面情绪的能力降低，灵活调节情绪表达的能力降低；注意力偏向于张嘴厌恶的面孔，而不是闭着嘴的厌恶面孔(即，注意力专注于社会道德拒绝)；当他们被已故配偶的表征预先准备好时，他们在情绪调节方面的缺陷加剧。

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.