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）：本申请是对 PA-03-014 邀请老年人拨款申请的回应的申请的第二次修订。该应用程序经过修改，以解决审阅者的担忧并添加额外的试点数据。老年人是最有可能失去亲人的人群。根据国家老龄化委员会 (http://www.aoa.gov/prof/Statistics/profile/2Q03/2003profile.pdf) 的统计，2002 年，超过 1000 万美国老年人丧偶。这些人面临着一种使人衰弱的反应，称为创伤性或复杂性悲伤（CG：现在用于描述这种情况的术语）。研究证实，复杂的悲伤可以被可靠地识别，并且大约 10-20% 的丧亲者会出现这种悲伤。 CG 似乎承担着丧亲之痛带来负面后果的大部分风险。 CG 可以影响健康状况并影响个人医疗保健决策。与不符合 CG 共识标准的丧偶受试者相比，丧偶受试者患高血压的风险高出 10 倍，而患有 CG 的受试者在死亡后几个月内去看医生的可能性要低 17 倍。尽管其患病率很高且发病率很高，但尚无经过证实的有效治疗方法。该应用程序的 PI 开发了一种名为复杂悲伤治疗 (CGT) 的新型心理疗法，现已完成一项由 18 岁以上成年人组成的研究 (MH60783)，证实了这种方法的功效。然而，大多数参与者的年龄都在 60 岁以下。年龄 > 60 岁的参与者 (n=29) 就业的可能性较小，独居的可能性较大。 CGT 和 IPT 在老年人和年轻人中产生相似的结果，两组对 CGT 的反应都更好。然而，在老年人中确认疗效很重要，因为老年人在适应悲伤方面比年轻人有不同的脆弱性和不同的问题。因此，我们聚集了一批经验丰富的老年研究人员，擅长评估和管理老年人的问题，例如：身体虚弱、认知功能障碍、社会孤立、日常生活中断。我们建议对 65 岁以上的个体进行 CGT 与 IPT 的随机对照研究。我们的具体目标是： 1) 比较 16 次 CGT 或标准 IPT 的结果。我们假设 CGT 会比 IPT 产生更高的响应率和更短的响应时间，并且响应者将表现出明显更高的响应率。