TRAUMATIC GRIEF TREATMENT--A RANDOMIZED CONTROLLED STUDY

创伤性悲伤治疗——一项随机对照研究

• 批准号: 6774689
• 负责人: M Katherine Shear
• 金额: $ 33.3万
• 依托单位: UNIVERSITY OF PITTSBURGH AT PITTSBURGH
• 依托单位国家: 美国
• 财政年份: 2000
• 资助国家: 美国
• 起止时间: 2000-08-15 至 2005-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6774689
• 关键词: anxiety; behavioral /social science research tag; clinical research; clinical trials; cognitive behavior therapy; depression; grief; human subject; human therapy evaluation; longitudinal human study; self concept; social support network

DESCRIPTION (Adapted from the Applicant's Abstract): This application requests funding for a 5 year study of a treatment for "traumatic grief." Over 16 million people are bereaved each year in the United States. For a substantial minority, grief is chronic, debilitating, and complicated by psychiatric or medical problems. In these cases, intervention is clearly indicated, yet there is little information about how best to treat such individuals. The field has been slow to develop criteria for abnormal grief reactions, and lack of such criteria has impeded development and testing of treatments. With the aid of a new instrument, the Inventory of Complicated Grief (ICG), we can now reliably identify a syndrome currently designated "traumatic grief." Found in 20% of bereaved persons, traumatic grief is associated with significant long-term morbidity. Symptoms of traumatic grief are distinct from symptoms of depression, and do not respond to standard treatments for depression. Therefore, we undertook development of a targeted Traumatic Grief Treatment (TGT). Pilot data in 10 patients show a robust treatment effect, much larger than that achieved by published reports of grief counseling. We now propose a randomized controlled trial to test the efficacy of TGT. Our primary aim is to compare effects of traumatic grief treatment (TGT) to a control, interpersonal psychotherapy (IPT) on measures of traumatic grief, depression, anxiety, functional impairment, self esteem and social support. We plan to conduct assessments of all randomized subjects at 16 weeks and 40 weeks. We will conduct exploratory analyses and instrument development to test and refine hypotheses related to putative mechanisms of action of TGT. We hypothesize that TGT will result in significantly greater improvement in traumatic grief than IPT, and that these differences will be sustained at 6-month follow-up. Almost a decade of work on the description and treatment of bereavement-related distress has prepared our research group for the treatment trial we now propose. We have come to understand who among those with bereavement-related symptomatology is at greatest risk for psychiatric and physical morbidity (i.e., those with traumatic grief) and we have developed what appears to be an effective intervention for this treatment-resistant population. The time is propitious for a controlled study of the efficacy of Traumatic Grief Treatment.

描述（改编自申请人的摘要）：本申请要求 资助一项为期 5 年的“创伤性悲伤”治疗研究。 16岁以上 美国每年有数百万人失去亲人。对于实质性的 在少数人中，悲伤是慢性的、使人衰弱的，并且因精神或其他原因而变得复杂。 医疗问题。在这些情况下，明确表明需要进行干预，但 关于如何最好地治疗这些人的信息很少。该领域有 制定异常悲伤反应的标准进展缓慢，而且缺乏这样的标准 标准阻碍了治疗方法的开发和测试。借助一个 新工具，复杂悲伤清单（ICG），我们现在可以可靠地 确定一种目前被称为“创伤性悲伤”的综合症。发现于 20% 对于失去亲人的人来说，创伤性悲伤与显着的长期影响有关。 发病率。创伤性悲伤的症状与创伤性悲伤的症状不同 抑郁症，并且对抑郁症的标准治疗没有反应。 因此，我们开发了一种有针对性的创伤性悲伤治疗方法 （TGT）。 10 名患者的试验数据显示出强大的治疗效果，而且效果更大 比已发表的悲伤咨询报告所取得的成果还要多。我们现在提出一个 随机对照试验测试 TGT 的功效。我们的首要目标是 比较创伤性悲伤治疗 (TGT) 与对照、人际关系治疗的效果 心理治疗（IPT）针对创伤性悲伤、抑郁、焦虑、 功能障碍、自尊和社会支持。我们计划进行 在 16 周和 40 周时对所有随机受试者进行评估。我们将 进行探索性分析和仪器开发以测试和完善 与 TGT 的假定作用机制相关的假设。我们假设 相比之下，TGT 对创伤性悲伤的改善效果显着更大 IPT，并且这些差异将在 6 个月的随访中持续存在。几乎 十年来致力于描述和治疗丧亲之痛 痛苦已经让我们的研究小组为我们现在的治疗试验做好了准备 提出。我们已经了解了那些与丧亲之痛有关的人 症状学是精神和身体发病的最大风险 （即那些患有创伤性悲伤的人），我们已经开发出一种似乎是 对这一耐药人群进行有效干预。时间是 有利于创伤性悲伤治疗功效的对照研究。