Complicated Grief Treatment in Elderly Adults

老年人复杂的悲伤治疗

• 批准号: 7817096
• 负责人: M Katherine Shear
• 金额: $ 54.26万
• 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/7817096
• 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; Consensus; Data; 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; 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; Reaction; Relapse; Relative (related person); Reporting; Research; Research Personnel; Risk; Risk Factors; Siblings; Sleep; Sleep disturbances; Social isolation; Social support; Subgroup; Substance abuse problem; Suicide; Symptoms; Techniques; Testing; Thinking; Time; United States; Visit; Widowhood; Woman; aging population; cognitive function; daily functioning; depressive symptoms; effective therapy; experience; follow-up; handicapping condition; improved; loved ones; meetings; men; middle age; mild neurocognitive impairment; novel; older patient; programs; response; social; standard care; statistics; treatment response; 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）：此申请是对PA-03-014响应老年人邀请赠款申请的申请的第二次修订。修改了该应用程序以解决审核者的疑虑并添加其他试点数据。老年人是最有可能死去的人口组。根据全国老龄化理事会（http://www.aoa.gov/prof/ statistics/profile/2q03/2003/2003profile.pdf），2002年，超过1000万的美国人丧偶。这些人有一种使人衰弱的反应的风险，称为创伤或复杂的悲伤（CG：现在用于这种情况的术语）。研究证实，可以可靠地发现复杂的悲伤，并发生在约10-20％的丧亲个体中。 CG似乎承担了丧亲负面结果的许多风险。 CG会影响健康状况并影响有关个人卫生保健的决策。与没有CG共识标准的寡妇相比，与没有CG共识标准的寡妇相比，高血压的风险高10倍，而CG的受试者在死亡以来几个月中拜访医师的可能性少17倍。尽管其流行率很高，而且发病率很高，但仍未得到证实的有效治疗方法。该应用程序的PI开发了一种新型的心理治疗，称为复杂的悲伤治疗（CGT），现在已经完成了一项由18岁以上成年人组成的研究（MH60783），证实了这种方法的功效。但是，大多数参与者的年龄不到60岁。参与者> 60岁（n = 29岁）的使用者较小，并且更有可能独自生活。 CGT和IPT在老年人和年轻人中产生了类似的结果，两组对CGT的反应更好。但是，确认老年人的功效很重要，因为老年人在适应悲伤方面的脆弱性和不同的问题与年轻人相比。因此，我们组建了一群经验丰富的老年医学研究人员，熟练于评估和管理老年人的问题，例如身体虚弱，认知功能障碍，社会隔离，日常工作的破坏。我们建议对65岁的个体进行CGT V IPT的随机对照研究。我们的具体目的是：1）比较16个CGT或标准IPT的结果的结果。我们假设CGT将产生比IPT更高的响应率和更短的响应时间，并且响应者将显示出明显更大的响应率