Predictors and Diagnostic Markers of Prolonged Grief

长期悲伤的预测因素和诊断标志

• 批准号: 8664926
• 负责人: GEORGE A BONANNO
• 金额: $ 54.55万
• 依托单位: COLUMBIA UNIVERSITY TEACHERS COLLEGE
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-07-15 至 2016-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8664926
• 关键词: Acute; Adult; Affect; Affective; Age; Attention; Bereavement; Biological Markers; Brain; Cessation of life; Clinical; Clinical assessments; Computer software; Cross-Cultural Comparison; Depressed mood; Development; Diagnosis; Diagnostic; Duchenne muscular dystrophy; Early Intervention; Emotional; Emotions; Exhibits; Eye; Face; Grief reaction; Growth; Individual; Individual Differences; Intervention; Interview; Knowledge; Life; Maps; Measures; Mental Depression; Methods; Modeling; North America; Oral cavity; Outcome; Pathology; Patient Self-Report; Pattern; Phase; Physiological; Procedures; Process; Questionnaires; Recovery; Recovery of Function; Recruitment Activity; Research; Sampling; Scientific Advances and Accomplishments; Series; Shapes; Smiling; Spouses; Stimulus; Structure; Symptoms; aged; base; design; effective intervention; emotion regulation; experience; flexibility; follow-up; intimate behavior; longitudinal design; neuropsychological; positive emotional state; prevent; response; showing emotion; sound

DESCRIPTION (provided by applicant): This project represents the second phase of a larger research agenda to investigate the development of Prolonged Grief (PG) pathology with an eye toward informing new directions in assessment and clinical intervention. Typically close to 50% of bereaved individuals experience acute grief symptoms in the early months after a loss. Many eventually recover, but a significant subset (10%-15% of all bereaved individuals) continued to suffer from PG reactions that compromise their ability to function for several years and often longer. Extending the previous phase of the research, which was limited to a cross-sectional design, the primary objective of the current project includes a longitudinal design, multiple methods for identifying PG (diagnoses, latent growth mixture modeling), measures of early predictors of the development of PG pathology, and biomarkers (EMG, ERP) of PG-related deficits. The project will assess conjugally bereaved individuals at 4, 14, and 25 months post-loss using structured clinical interviews and a set of experimental and interview tasks. The primary aims are (1) to map diagnoses and longitudinal patterns of PG versus recovery, (2) to assess early deficits in emotion and emotion-related brain activity as predictors of the development of later PG, and (3) to assess emotion regulation and emotion-related brain activity later in bereavement as markers of PG-related deficits. One set of hypotheses predicts that bereaved people with acute grief at 4 months will develop PG at later assessments if they (a) fail to evidence context sensitive emotional responding (e.g., negative emotion in negative topics); (b) generate overall less positive emotion; and (c) exhibit reduced flexibility in modulating both affective experience and emotional expression. A second set of hypotheses predicts that bereaved individuals with PG at 18 months will (a) experience less comfort from representation of the deceased (measured by self-report and facial EMG) and (b) show greater attention toward open-mouth sad faces when primed with spouse-associate words; and (c) express greater nonverbal sadness and less nonverbal positive emotion when describing intimacy with the deceased.

描述（由申请人提供）：该项目代表了更大的研究议程的第二阶段，以调查长期悲伤（PG）病理的发展，以期为评估和临床干预方面的新方向提供信息。通常，在损失后的早期几个月中，接近50％的丧亲个体经历了急性悲伤症状。许多人最终恢复了，但是有一个显着的子集（占所有丧亲者的10％-15％）继续遭受PG反应，损害了其运作能力几年，而且通常更长。扩展了研究的上一个阶段，该研究仅限于横截面设计，当前项目的主要目标包括纵向设计，识别PG的多种方法（诊断，潜在生长混合物建模），PG病理学发展的早期预测指标，以及PG降低deficits的生物标志物（EMG，ERP）的早期预测指标。该项目将使用结构化的临床访谈以及一组实验和访谈任务来评估损失后4、14和25个月的共偶治亲人的个体。主要目的是（1）绘制PG与恢复的纵向模式，（2）评估情绪和情绪相关的大脑活动的早期缺陷，作为后期PG发展的预测因素，（3）评估情绪调节和情绪相关的大脑活动，后来在丧亲中作为PG与PG相关的缺乏症的标志物。一组假设预测，如果他们（a）无法证明情境敏感的情绪响应（例如，负面话题中的负面情绪），则在4个月时急性悲伤的丧亲者将在以后的评估中发展PG； （b）产生总体积极情绪； （c）在调节情感体验和情绪表达时表现出降低的灵活性。第二组假设预测，在18个月时患有PG的丧亲者将（a）通过代表死者（通过自我报告和面部EMG来衡量）的舒适感较少，并且（b）在用配偶合作的词语启动时，对露天性悲伤的表情更加关注； （c）在描述与死者的亲密关系时，表达更大的非语言悲伤和较少的非语言积极情绪。