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Although there is awareness of the impact of grief on survivors’ well-being, almost no research exists on the impact of death on sports team bereavement. The present study surveyed 40 members of athletic teams (coaches, staff, and athletes) from various levels to determine what happens in the aftermath of a team member’s death. Findings of the survey indicated that many of the respondents experienced acute grief responses affecting performance, which memorialization and community support was helpful whereas the news media was often not. In addition, a need for appropriate resources and a school bereavement policy specific to student athletes was seen. In line with the dual process model, the responses indicated use of both emotion focused and restoration focused coping. Implications of the findings suggested that addressing bereavement needs for athletes, and their coaches was tantamount to mitigating some of the complications associated with disenfranchised grief.

Urbanization influences food quality and availability for many avian species, with increased access to human refuse and food subsidies in built environments. In relation to such nutritional intakes and their presumed impact on microbes harbored in the intestinal tract and metabolic profiles of host physiological systems, our overall knowledge of the role of gut microbiome (GM) and metabolomic expression in the avian host lags far behind our understanding of mammals. Therefore, the objective of this investigation was to examine the potential differential effect of an urban modeled versus control (i.e., bird seed) diet on the GM, the metabolic profiles of plasma, liver, adipose, kidney, and muscle tissues, and circulating endotoxin and inflammatory factors in urban-caught mourning doves ( Zenaida macroura). We hypothesized that the urban diet would differently impact the profiles of the GM and tissue metabolomes and increase plasma lipopolysaccharide (LPS) and proinflammatory factors compared with animals fed a seed diet. After a 4-wk-diet period, contents of the large intestine were sequenced to profile the microbiome, metabolomic analyses were performed on plasma and tissue homogenates, and circulating LPS and inflammatory markers were assessed. The composition of the GM was significantly dissimilar between diets, with greater abundance of Erysipelatoclostridiaceae, Sanguibacteraceae, Oribacterium, and Sanguibacter and decreased circulating LPS in the urban-fed birds. These differences were largely not reflected in the surveyed metabolomes and plasma inflammatory markers. This research supports the notion that the microbial composition in urban doves is impacted by diet, though may only weakly associate with host physiology.

One of the most difficult experiences to adapt to in human life is death. During the COVID-19 pandemic and the complex period defined as the new normal, individuals lose their loved ones, and those left behind lose their unique ties with each death. Encountering significant difficulties in the treatment process, interruption of death rituals, inability to fully utilize social support resources and sudden/multiple deaths increase the risk of individuals who are left behind to encounter complex grief and related psychosocial problems. This review article consists of two main parts. In the first part, the COVID-19 pandemic is examined in the context of deaths and grief, and the risks posed by pandemic-specific conditions during the grieving process are examined. In the second part of the study, psychosocial interventions to be carried out in grief during the pandemic period are discussed in the light of the main components of the intervention and grief models. It is considered that this study will inspire good and evidence-based practices of all professionals working in the field of grief, especially social workers and psychologists., İnsan yaşamında uyum sağlanılması en zorlu deneyimlerden birisi ölümdür. COVID-19 pandemisi sürecinde ve yeni normal olarak tanımlanan karmaşık dönemde bireyler sevdiklerini kaybetmekte, geride kalanlar, her bir ölümle eşsiz bağlarını yitirmektedir. Tedavi sürecinde önemli güçlüklerle karşılaşması, ölüme ilişkin ritüellerin sekteye uğraması, sosyal destek kaynaklarından tam anlamıyla yararlanılamaması, ani ve çoklu ölümler, geride kalan bireylerin karmaşık yasla ve buna bağlı psikososyal sorunlarla karşılaşma riskini artırmaktadır. Derleme niteliğindeki bu çalışma iki temel bölümden oluşmaktadır. Birinci bölümde COVID-19 pandemisi, ölümler ve yas bağlamında incelenmekte, pandemiye özgü koşulların yas sürecinde oluşturduğu riskler irdelenmektedir. Çalışmanın ikinci bölümünde ise pandemi döneminde yas özelinde yürütülecek psikososyal müdahaleler, müdahalenin temel bileşenleri ve yas modelleri ışığında ele alınmaktadır. Bu çalışmanın, başta sosyal hizmet uzmanları ve psikologlar olmak üzere yas alanında çalışan tüm profesyonellerin iyi ve kanıta dayalı uygulamalarına esin kaynağı olacağı değerlendirilmektedir.

Bereaved family members are known to have a higher risk of suicide, although relevant research is lacking. We aimed to clarify the percentage of bereaved family members of patients with cancer who experience suicidal ideation and the associated factors.We conducted a secondary analysis of two cross-sectional nationwide bereavement surveys in Japan, analyzing data from a total of 17,237 bereaved family members of patients with cancer. The Patient Health Questionnaire 8 (PHQ-8) and Item 9 of the PHQ-9 were used to assess depression (PHQ-8 score ≥10) and suicidal ideation, respectively. We assessed items such as socio-demographic data, complicated grief (CG), preparedness for bereavement, and perceived social support. Logistic regression analysis was used to reveal factors related to suicidal ideation.Overall, 11 % of subjects reported some amount of suicidal ideation in the previous two weeks, with a suicidal ideation rate as high as 42 % among those with a higher risk of depression. Significant associations (all p 0.0001) were found between suicidal ideation and the family member's depressive state (OR: 10.01), poor physical health status during caregiving (OR: 1.24), poor psychological health status during caregiving (OR: 1.38) pre-existing mental illness (OR: 1.38), insufficient preparedness for bereavement (OR: 0.59), and poor perceived social support (OR: 1.42).The respondents were limited to family members of patients with cancer in Japan, and the study involved cross-sectional self-reported data.Clinicians should identify bereaved family members at a high risk of suicide by carefully assessing these risk factors identified in the present study.

As a universal human reaction to perceived and/or actual loss, grief is becoming increasingly pervasive at all levels of society. Among the broad spectrum of loss experiences, those associated with dementia are perhaps of the most complex. The shift toward considering loss and grief within the context of dementia caregiving is promising. However, pre-loss grief is understudied, and interventions are lacking. Only few studies have evaluated the effectiveness of pre-loss psychosocial grief interventions for dementia caregivers. Preliminary findings from an ongoing clinical trial testing the effects of an 8-week, group-based online video intervention with dementia caregivers indicate that compared to precoronavirus disease 2019 pandemic, the experience of loss and separation was exacerbated by loss of control and severe physical contact restrictions in long-term care facilities. Finding effective grief interventions that can be translated into clinical and community-based environments is necessary to alleviate dementia caregivers' emotional distress and improve their quality of life. [ Journal of Psychosocial Nursing and Mental Health Services, 60 (10), 7–10.]

Clinical theories of adaptation in bereavement highlight a need for flexible shifting between mental states. However, the prolonged motivational salience of the deceased partner may be a complicating factor, particularly when coupled with perseverative thinking about the loss. We investigated how prolonged grief might relate to resting state functional brain network connectivity in a sample of older adults (n = 38) who experienced the death of a partner 6-36 months prior, and whether intranasal oxytocin (as a neuropeptide involved in pair-bonding) had differential effects in participants with more prolonged grief symptoms. Higher scores on the Inventory of Complicated Grief (ICG) were associated with lower anticorrelation (i.e., higher functional connectivity) between the default-retrosplenial – cingulo-opercular-dACC network pair. Intranasal oxytocin increased coactivation the same default-retrosplenial – cingulo-opercular-dACC circuit but ICG scores did not moderate effects of oxytocin, contrary to our prediction. Higher ICG scores were associated with longer dwell time in a state characterized by in a dynamic functional connectivity state featuring positive correlations among default, frontoparietal, and cingulo-opercular networks across both placebo and oxytocin sessions. Dwell time was not significantly affected by oxytocin, and higher prolonged grief symptoms were not associated with more variability in dynamic functional connectivity states over the scan. Results offer preliminary evidence that prolonged grief symptoms in older adults are associated with patterns of static and time-varying functional connectivity, and may specifically involve a default network-salience-related circuit that is sensitive to oxytocin.

To better understand suicide loss survivors’ experiences and barriers to accessing support and mental health care, 28 (21 women and 7 men) suicide loss survivors were interviewed. Using qualitative analysis of 28 in-depth, semi-structured phone interviews data, three categories emerged: Life before Suicide, Life after Suicide, and Meaning of Life. This deeper understanding of suicide loss survivors along with inclusion of experiences of male and rural participants’ suicide loss, fill previously identified research gaps. Our findings suggest importance in providing emotional support and mental health resources to those with suicide intent or experiences with suicide loss. Most importantly, the recognition of suicide loss survivors extends beyond the immediate family and includes cousins, friends, and work associates. Recognition of extended suicide loss survivors’ bereavement will provide additional opportunities for healthcare providers to effectively intervene with this vulnerable population.

WHAT IS KNOWN ON THE SUBJECT?: Losing a family member due to suicide has been described as a traumatic experience, as suicide-bereaved relatives grapple to accept the particular character of death and the core elements of guilt, self-criticism and stigma it inflicts. There are long-term consequences for those who bereave due to the suicide of their beloved on, a high risk for mental and physical health problems included. Feelings of guilt and self-stigma influence help-seeking behaviour among suicide-bereaved individuals. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: Coping mechanisms adopted by suicide-bereaved individuals mediate the impact of suicide on their family, and especially on the quality of relationships among them. Supporting others in need can help alleviate guilt and self-blame for the suicide while it enables the bereaved to fulfil their need to keep a non-traumatizing, or even positive bond with the deceased. WHAT THE IMPLICATIONS FOR PRACTICE ARE?: Nursing interventions to facilitate suicide-bereaved family members' participation in self-help support groups and promote their engagement in supporting others in need are important. Mental health nurses need to facilitate the replacement of dysfunctional coping strategies, such as substance use or self-blame with more adaptive ones focused on the personal needs of the bereaved, in order to help them embrace a non-traumatizing memory of the deceased while being in peace with the social environment. Screening for mental health problems and management of shame, self-stigma and guilt during the grieving period needs to be a priority in nursing interventions.INTRODUCTION: Losing a family member to suicide is a traumatic experience which includes guilt and self-stigma. Yet, there is lack of data synthesis on the survivors' experience.A meta-synthesis of qualitative data on the interpretation of loss in suicide-bereaved family members, their coping strategies and the effects on family.A meta-ethnographic synthesis following a systematic literature search and evaluation of the methodological quality of the selected studies was applied.The narratives of 326 individuals (parents/siblings/children/spouses) reported in sixteen studies were analysed. Trying to achieve a balance between keeping alive a non-traumatizing memory of the deceased, destigmatizing and liberating themselves from self-blame, self-criticism and guilt while being able to transform this experience into support towards others in need, was identified as the essence of the experience of the bereaved.Although suicide within a family is a traumatic experience, spiritual and existential implications among the bereaved have been reported; their coping mechanisms mediate the impact of suicide on family sustainability.Nursing interventions to facilitate adoption of coping strategies centred on keeping a non-traumatizing memory of the deceased among the bereaved and promote their participation in self-help groups and activities to support others in need are important.

The death of a loved one in the intensive care unit (ICU) may have a psychological impact on relatives of deceased ICU patients. The first aim of this review is to give an overview of different bereavement support strategies and possible different effects on anxiety, depression, Post-traumatic Stress Disorder (PTSD), and complicated grief. Secondly to assess if there is a difference in organization among bereavement support strategies mentioned in literature.A multi-database search (Pubmed, Web of Science, PsychInfo, Medline, and Embase) was conducted until February 6, 2021. Articles were screened and selected by two independent researchers. Methodological quality of the included articles was assessed using the Delphi List for Quality Assessment of Randomized Clinical Trials and the Newcastle-Ottawa scale (NOS) for nonrandomized trials.The primary literature search revealed 1668 articles, including 769 duplicates. Seven articles were included in this review, of which six were randomized controlled trials and one was a prospective cross-sectional study. We found that a bereavement strategy consisting of a communication strategy and a brochure lowered the appearance of symptoms of PTSD, anxiety, and depression. A brochure, condolence card, and phone call as bereavement support can lower the risk of prolonged grief. Receiving information about CPR and getting the choice to attend CPR led to fewer frequencies of PTSD, depression, and traumatic/complicated grief.A bereavement strategy consisting of multiple parts, including family participation and a brochure may reduce the levels of anxiety, depression, PTSD, and/or complicated bereavement in family members of deceased ICU patients.

The loss of a child in a family is a painful experience. Despite this, most studies focus on the grieving experience of parents. Our understanding of sibling bereavement therefore remains underexplored. This study aims to address this gap by exploring the bereavement experience of younger bereaved siblings from the perspective of the bereaved child and the parents.This study is a qualitative study conducted in Hong Kong. We recruited eleven bereaved families from 2019 to 2020. Semi-structured interviews were conducted separately with bereaved children and parents. Thematic analyses were performed.Eleven bereaved siblings, aged 5 to 11, and their parents were interviewed. Four themes were generated: Parents' unawareness of bereaved siblings' grief, protecting parents from grief, comparison with the deceased siblings, and learning how to grieve.Our findings suggest that the family dynamics and interactions in the grieving experience are complex. The impact of grief on the bereaved child could emanate from the loss of the sibling or from the grief of the parents or from family interactions.This study highlights the importance of viewing the sibling bereavement experience in a family context and of enhancing sibling bereavement services. Helping professionals should not only provide more bereavement support to the bereaved siblings individually, but they should also enhance parents' capacity to support their bereaved children.

Sibling bereavement is one of the most distressing adverse life events during childhood but has received less attention in research than other forms of childhood bereavement. This integrative review identifies potential risk and protective factors for maladaptive coping following sibling bereavement and the influence of these factors on adjustment to loss.Articles were limited to peer-reviewed studies, published in English in 2000 and beyond. Target population was bereaved siblings 0-18 years, and outcomes examined grief experiences by child self-report or parent-proxy report.The Whittemore and Knafl integrative framework was applied. Multidimensional Grief Theory guided the review with twenty-five studies synthesized across its domains: Separation Distress, Existential/Identity Crisis, and Circumstance-Related Distress.Adjustment following sibling death is a complex process associated with a host of risk and protective factors that contribute to the bereavement process for this population. Age, sex, circumstance-related factors, continuing bonds, parental distress, and limited social support were critical influencing factors.Definitive predictor variables were not identified but a combination of variables that influence the adjustment of bereaved siblings are discussed.Future research is needed to explore the risk and protective factors of maladaptive coping to inform intervention development to promote individual and family adjustment following sibling death.

Background An activity to provide a tangible keepsake following the death of a loved one is termed ‘memory making’. However, limited evidence is available related to professionals' education and support to provide memory making opportunities in the adult intensive care unit (ICU). Having a greater understanding of healthcare professionals’ experiences can inform future patient/family care and support for professionals in end-of-life care. Objective The objective of this study was to describe what participants perceive memory making to be, if they have facilitated memory making activities as part of their practice, if they perceive it as part of their role, and if they have the necessary skills to do so. Methods Seventy-five registered nurses (75% response rate), 19 medical doctors (76% response rate), and two social workers (66.7% response rate) completed a survey at a single tertiary referral centre in an adult ICU. Results Participants reported memory making to include the creation of tangible keepsakes as well as nontangible activities. Overall, participants reported high agreement scores that the responsibility for initiating memory making predominately belonged to the nurse. Participants reported skills most needed involved the ability to interact with the family, being open to the concept, and integrating memory making into their standard of care. Having developed a rapport with families was considered an enabler, whereas lack of knowledge and clinical workload were reported as inhibitors to offering memory making. Conclusions Overall, participants in this study reported positive experiences with offering memory making to families during end-of-life care in the adult ICU. Nurses are more likely to perceive professional responsibility for offering memory making, likely due to their increased time at the bedside and higher prominence and leadership in other end-of-life practices. To support professionals, education should include conceptual knowledge, procedural knowledge of keepsake creations, communication techniques using reflective practices, and organisational support to facilitate time requirements.

Black communities have been affected disproportionately by the negative conditions associated with COVID-19, such as higher levels of morbidity and mortality, unemployment, underemployment, food insecurity, homelessness, grief and loss, and the pandemics of intersectionality. This adversity is often associated with greater vulnerabilities in the areas of psychological functioning and wellness. Black communities have historically had negative experiences with the medical establishment. Despite recent increases, Black Americans still tend to underutilize mental health services due to many barriers, such as stigma, attitudes of mistrust, geographical inaccessibility, lack of affordable options, the availability of culturally humble mental health providers, myths of Black invincibility, and challenges navigating complex systems of care. Due to the physical and psychological impacts of the polypandemic, Black populations are in even greater need of mental health care. Additionally, there is increased risk to the mental health of Black children in relation to trauma and the suicide crisis. This article will focus on our responsibility as a clinical community to reduce and eliminate the obstacles to service utilization among Black populations using the following strategies: understanding historic cultural mistrust;enhancing the pipeline of Black psychologists;integrating cultural adaptations into therapy;acknowledgment of the suicidal crisis and impact of adverse childhood experiences among Black children and youth;affirming the importance of religious/spiritual worldview and practices;and prioritizing self-care for psychologists. (PsycInfo Database Record (c) 2021 APA, all rights reserved) Impact Statement The present study identifies multiple strategies psychologists can employ to increase mental health utilization among Black populations, particularly during COVID-19, including understanding historical cultural mistrust, enhancing the pipeline of Black clinicians, and integrating cultural adaptations into therapy. The importance of prioritizing self-care is demonstrated through findings in the literature as well as data from a predominantly Black independent practice in order to maximize client engagement. (PsycInfo Database Record (c) 2021 APA, all rights reserved)

BACKGROUND: Legacy interventions are standard in most children’s hospitals, but little is known about how bereaved parents understand and describe the concept of legacy that these interventions are designed to Address. The aim of this qualitative study was to understand the legacy experiences and perceptions of parents who have experienced perinatal or early infant (less than three months of age) loss. METHODS: Grounded in constructionist epistemology and phenomenological qualitative traditions, ten bereaved parents completed an in-depth phenomenological interview regarding their perceptions of and experiences with the legacy of their deceased child. Interviews were transcribed verbatim and analyzed using an open, inductive coding process to illuminate the essence of participants’ experiences. RESULTS: Three themes were identified: 1) legacies are composed of memories and experiences that have a lasting effect on others; 2) healthcare experiences both generate and participate in infants’ legacies; and 3) parents’ legacy perceptions are shaped by cultural conceptions, spiritual beliefs, and grief experiences. Parents described experiences and interactions with community members and healthcare providers that honored or challenged their perceptions of their child’s unique legacy. CONCLUSIONS: In the context of perinatal or early infant loss, bereaved parents describe legacy as enduring, unique to each child and family, and heavily influenced by healthcare experiences and staff relationships. Parent-led, legacy-oriented interventions are needed in maternal/fetal, labor/delivery, and neonatal intensive care settings to support parent coping with loss.

Perinatal loss may remain unexplained, despite current technology, modern preventive care measures, and advanced diagnostic procedures. Culturally sensitive and competent discussions should be prioritized in medicine, but religious and spiritual feelings are often marginalized. Here we highlight our reflections on the importance of the spiritual and theological responses to parents grieving stillbirth. Chaplains are critical for the wellbeing of both families and physicians.

In healthcare institutions across the country, the role of poetry continues to emerge within the liminal spaces between the medical humanities and clinical care. While the field of narrative medicine is well-developed generally, formal review of the state of poetry as a healing modality is limited. Poetry in the medical humanities literature has often been described by its indefinability as much as by its impact on healing. The power of poetry in healthcare is thought to be multi-faceted and deserves to be explored further. Poetry can be medicine for both patient and clinician. "Poetic Medicine" is a modality that has been utilized for the healing of grief, loss, wounds of the psyche and spirit, and as a process for expanding resiliency in healthcare-applications that are particularly relevant to the practice of hospice and palliative medicine-for patient and clinician alike. While numerous approaches share common themes, current programs bringing poetry into healthcare have been operating largely in isolation from each other-with a lack of national consensus on definitions or structures of interventions. Such isolation is a major restriction to the study and growth of Poetic Medicine. While it is not known with certitude, the number of Poetic Medicine programs in healthcare in the United States appears to be growing. In this paper, we propose an initial framework to define the role and impact of poetry in healthcare and then describe two different, well-established Poetic Medicine programs in the United States.

Objective The efficacy of behavioral activation (BA) for depression has been firmly established, and training therapists in BA may be less time-intensive than for standard interventions. Because BA addresses problematic avoidance behaviors, BA holds promise as a treatment for posttraumatic stress disorder (PTSD). We conducted a meta-analysis of both randomized controlled trials and uncontrolled studies involving the use of BA for the treatment of PTSD. Outcomes of interest were PTSD symptoms, anxiety, depression, and grief. Method Meta-analyses included published studies in which BA served as the primary form of treatment for PTSD symptoms, whether PTSD was a primary or secondary outcome. Analyses were performed using Comprehensive Meta Analysis software with a random-effects model. Results Eight studies (3 controlled, 5 uncontrolled) with a total sample size of 564 participants met final inclusion criteria. The primary analysis for controlled studies indicated a significant improvement in PTSD symptoms for BA compared with the case for wait-list control (Hedges's g = 1.484) and for uncontrolled (Hedges's g = 0.717) studies. Secondary analyses indicated improvement in anxiety, grief, and depression (Hedges's g ranging from 0.28 to 2.29). No significant difference in effectiveness was observed for BA versus 2 active treatment comparison conditions (cognitive processing therapy and Internet-guided exposure). Effect sizes were not moderated by treatment modality (in-person vs. remote delivery) or by use of completer versus intention-to-treat data. Conclusions BA appears to be effective for PTSD symptoms, but additional randomized controlled trials are needed to increase confidence in these findings. (PsycINFO Database Record (c) 2020 APA, all rights reserved).

The death of a spouse is associated with maladaptive immune alterations; grief severity may exacerbate this link. We investigated whether high grief symptoms were associated with an amplified inflammatory response to subsequent stress among 111 recently bereaved older adults. Participants completed a standardized psychological stressor and underwent a blood draw before, 45 min after, and 2 hr after the stressor. Those experiencing high grief symptoms (i.e., scoring > 25 on the Inventory of Complicated Grief) experienced a 45% increase in interleukin-6 (IL-6; a proinflammatory cytokine) per hour, whereas those experiencing low grief symptoms demonstrated a 26% increase. In other words, high grief was related to a 19% increase in IL-6 per hour relative to low grief. The grief levels of recently bereaved people were associated with the rate of change in IL-6 following a subsequent stressor, above and beyond depressive symptoms. This is the first study to demonstrate that high grief symptoms promote inflammation following acute stress.

El cine constituye una poderosa herramienta cultural que opera de múltiples maneras en el rescate de memorias, así como en la reparación colectiva y conceptualización interdisciplinaria de experiencias traumáticas en comunidades devastadas por sistemáticas violaciones a sus derechos fundamentales. Hace perceptibles las prolongaciones de silenciadas o legitimadas violencias políticas tanto en el individuo como en el tejido social trastornado por perturbadoras marcas que desbaratan la existencia y la convivencia. Las expresiones cinematográficas no hacen referencia al ayer únicamente, sino que, sobre todo, cuestionan las pautas convencionales empleadas para articular pasado, presente y futuro a fin de explorar horizontes posibles. Como detonadoras de memoria y generadoras de conciencia, robustecen diferentes modi memorandi que tratan el pasado violento demasiado activo aún.

This collection of essays examines how I house the grief for the losses of my religion and my grandfather. My first essay, “Body of Feathers,” looks at my body as a house of shame and how I transformed my body into something that could be mine instead. It explores a series of moments from my life where I felt disconnected from my body, usually because of rules or expectations set by someone other than me. In the essay, I move from feeling like I had no control of my body, to taking back control and experiencing my body as mine for the first time. The second essay, “Obituary,” houses the grandfather I knew and loved but shares space with the grandfather I didn’t know, and who didn’t know me. I center most of my essay in the final few moments with my grandfather before he died and weave memories of him and drafts of the obituary I didn’t write for him at the time. I complicate truths that I chose to ignore and write about the truths I only learned after he was gone. It is ultimately a eulogy for his life and a eulogy for the things I never got to say to my grandfather.

Among the many people experiencing grief in response to opioid overdose deaths, individuals with opioid use disorder (OUD) bear one of the largest emotional burdens. Grief and loss of social support networks have the potential to destabilize OUD and result in overdose, suicide, and other harmful consequences. However, few clinicians discuss how overdose losses impact their patients with OUD, let alone consider the role of grief in treatment outcomes. Lessons from the acquired immunodeficiency syndrome (AIDS) epidemic and crack cocaine crisis can inform our understanding of grief in the context of stigma and societal injustices. In this commentary, we describe how these historical lessons can be adapted to the opioid overdose crisis to improve the care of people with OUD.

A brief screener assessing experience of exposure to suicide for use in therapeutic settings is warranted. To examine the concurrent validity of such a screening tool, labeled as the Suicide Exposure Experience Screener (SEES), the associations of the two SEES items: (i) reported closeness with the person who died by suicide and (ii) perceived impact of suicide death with psychological distress are presented.Five separate datasets comprising surveys from Australia, Canada, and the United States (NOverall, closeness and impact were significantly correlated with measures of global distress across five different datasets, showing small to medium effect sizes. Closeness and impact were also intercorrelated demonstrating a large effect size across all surveys. This report used cross-sectional data and comprised varied sample sizes across different datasets that influenced statistical significance of obtained effects and did not tease apart the roles of cumulative exposure of suicide and prolonged bereavement in experiencing global distress.The SEES has clinical utility in determining psychological distress in bereaved individuals and is recommended for use in therapeutic settings.

Although death is inevitable as a human being, talking about or planning for it may be an uncomfortable topic. Recently, due to the COVID-19 pandemic, we are witnessing an increase in deaths around us as well as globally, and health and social services professionals are more engaged in the death, dying, and bereavement services than ever. Dr. Eyetsemitan's book

Background: Few studies of health impacts of parental death focus on the developmental stage of adolescence and young adulthood and in particular, expected parental death from terminal illness. Aim: To systematically review the health impact of expected parental death on adolescent and young adult children aged 15–25 years and provide a basis for further research and clinical practice. Design: Systematic review registered on PROSPERO (CRD42017080282). Data sources: Pubmed, PsycINFO, CINAHL, MEDLINE and Cochrane databases were searched with no restrictions on publication date with the last search in March 2021. Eligible articles included studies of adolescent and young adult children (defined by age range of 15–25 years) exposed to parental death due to terminal illness, and with reported health outcomes (physical, psychological or social). Articles were reviewed using the QualSyst tool. Results: Ten articles met the inclusion criteria. Adolescent and young adult children reported poor family cohesion and communication with associated negative psychological outcomes. They reported distrust in the health care provided to their terminally ill parent, increased psychological distress and risk of unresolved grief, anxiety and self-harm. Some experience was positive with posttraumatic growth identified. Conclusions: This review specifically analysed the health impact of expected parental death on adolescent and young adult children. It highlights their need for age-appropriate psychosocial support and clear information during parental illness, death and bereavement.

Internet-based cognitive-behavioural grief therapy (ICBGT) has proven to be effective for people bereaved by suicide, however the extent to which patients can benefit from therapy seems to differ. This study investigates predictors of initial grief as well as change in grief severity following treatment in an ICBGT for people bereaved by suicide. Data was gathered from a randomized control trial including 57 people participating in a 5-week intervention. Change in grief symptoms was calculated using absolute change scores of grief. In order to examine best overall combination of independent variables, best subset regressions were conducted. Higher levels of pre-test grief were associated with worse sleep quality (β = 0.32, p = .002), lower self-esteem (β = -0.37, p = .002), lower support seeking (β = -0.38, p = .006), and a higher need for social support (β = 0.28, p = .028). A greater reduction in grief severity was associated with higher self-efficacy (β = -0.49, p = .001), higher attachment anxiety (β = -0.31, p = .017) and higher pre-test grief symptoms (β = -0.39, p = .006). Attention should be paid to the intensity of grief, the attachment style and a positive self-image, as these variables seem to influence the extent, to which patients' symptoms of PGD subside following ICBGT. To specifically target factors of patients that require improvement, further studies are needed.

Objective Research has shown that complicated grief has the potential to adversely affect bereaved individuals, and in this context, understanding how mental health professionals engage with it in practice is of relevance. Gaining an understanding of professionals’ knowledge, attitudes, skills and training in relation to complicated grief could provide insights that will inform their training and professional development. The aim of this study was to consider professionals’ engagement with complicated grief, as represented by self-reported knowledge, attitudes, skills and training. Methods The study used a three-phase mixed methods design (systematic review, qualitative interviews, and a quantitative survey) with empirical data being collected from psychologists, psychiatrists and counselor/psychotherapists. Results Analysis yielded 15 integrated findings across the three phases, which were grouped into two clusters: the first highlighted tension between professionals’ reported confidence and competence and the second explored the parameters and contribution of research and training in this area. Conclusion Professionals’ perception of their competence to work with complicated grief seems overstated and research and professional practice are not aligned. Practice implications These findings are positioned to inform empirically supported training that addresses identified deficits in professionals’ knowledge, attitudes and skills. It is important therefore that training is reflective of the needs of different professional groups.

Reports of destructive behavior by military personnel after demobilization have become more frequent; however, the pathways that might lead these individuals to commit such acts are not clear enough. This column presents the case of a retired soldier who reported the onset of pyromania after military service, and the relationship between dissociation and reenactment of the trauma is discussed. The main conclusions are that psychotherapy of traumatized patients should focus on helping them create a verbal representation of the trauma and that integrating ceremonies and rituals into treatment is a possible and significant option.

In this article, Anita Rau Badami's second novel, The Hero's Walk (2000), is analysed through the perspective of the field of affects. This analysis examines how the author, through the imagery of water, presents the non-physical reality of feelings and emotions. Water is the most receptive of the elements, a source of continuous, intimate and transitory metamorphoses. In the form of storms, floods, and other types of natural phenomena related to this element, it is possible to observe how Badami makes use of a metaphorical conceptualisation of intense emotional states related to the psychological trauma that arises from the loss of a loved one. For the purpose of analysis, several important sources in the field of affect theory and water symbolism will be considered. Special emphasis will also be placed on the body (and the house as an integral extension of it) as a receptacle for contained emotions in the processing of pain. El presente artículo tiene como objetivo analizar la segunda novela de Anita Rau Badami, The Hero's Walk (2000) desde el ámbito de los afectos, estudiando cómo la autora, a través de la imaginería del agua, presenta la realidad no física de los sentimientos y las emociones. El agua es el más receptivo de los elementos, fuente de continuas metamorfosis íntimas y transitorias. En forma de tormentas, inundaciones y otros tipos de fenómenos naturales relacionados con este elemento, observamos cómo Badami hace uso de una conceptualización metafórica de intensos estados emocionales relacionados con el trauma psicológico derivado de la pérdida de un ser querido. Para el análisis se tendrán en cuenta diversas fuentes de gran relevancia en el campo de la teoría de los afectos y el simbolismo del agua como forma de expresar las emociones. Asimismo, se hará también especial hincapié en el cuerpo (y la casa como extensión del mismo) como receptáculo de emociones contenidas en el encausamiento del dolor.

Background The decisional burden on caregivers in the end-of-life (EOL) care for patients with cardiovascular diseases (CVD) is unknown. We aimed to evaluate the frequency and circumstances of caregiver difficulties in decision-making during EOL care for CVD patients, its determinants, and associations with psychological distress in the bereaved caregivers. Methods We conducted a cross-sectional survey using a questionnaire for bereaved caregivers of CVD patients who had died in 10 tertiary care centers. We assessed their overall and situation-specific decision-making difficulties during EOL care. The questionnaire also covered the attitudes of patients, caregivers, and attending physicians during EOL care and the respondents’ depression (Patient Health Questionnaire-9) and grief status (Brief Grief Questionnaire). Results We enrolled 266 bereaved caregivers [median age, 65 (57-72) years; 38.4% male] of CVD patients. Overall, 28.9% of them experienced difficulties in decision-making. The most difficult decision-making situations involved informing the patient of the prognosis (18.2%), life-prolonging treatment (17.9%), and discontinuation of hydration and artificial nutrition (15.6%). Difficulties were associated with patient and/or caregiver factors (poor understanding of disease status and the patient's wishes, caregiver's emotional inability), physician factors (poor understanding of the patient's and/or caregiver's values, inadequate support for decision-making), and both (insufficient communication, conflict of opinions and wishes). Decision-making difficulties were associated with subsequent depression (20.5% vs. 10.3%, p=0.029) and complicated grief (27.0% vs. 9.0%, p Conclusions Approximately 30% of bereaved caregivers experienced decisional burdens during EOL care of CVD patients. The caregiver's decisional burdens were associated with subsequent psychological distress.

The authors in this article will present storytelling through the lens of the humanbecoming family model. From this perspective, storytelling can be viewed as the following: (a) family storytelling as a mode of fostering personal and family becoming, (b) family storytelling as a confirming of family beliefs and values, and (c) family storytelling as a way of addressing issues of grief and loss. Selected literature is presented to highlight the essences, paradoxes, and processes of the humanbecoming family model.

Investigating the concordance of prolonged grief disorder (PGD) criteria that have been recently introduced to the 5th text revision of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR) and the International Classification of Diseases 11th Revision (ICD-11).N = 193 treatment-seeking bereaved adults were assessed with the prolonged grief disorder 13 + 9 interview. Data were examined in terms of (a) diagnostic rates for PGDDSM-5-TR and PGDICD-11, including increases of the PGDICD-11 accessory symptom threshold (PGDICD-11-X+) and time criterion (PGDICD-11-12 months), (b) dimensionality, (c) the frequency with which single PGD symptoms occur, and (d) concurrent validity in terms of psychological symptoms and loss-related characteristics.The diagnostic rate of PGDDSM-5-TR (52%) was significantly lower than that of PGDICD-11 (76%) and agreement between the two criteria sets was moderate, κ = 0.51, 95% CI [0.47-0.55]. Increasing the PGDICD-11 accessory symptom threshold did not improve the diagnostic agreement. In contrast, increasing the ICD-11 time criterion led to almost perfect agreement between PGDICD-11-12 months and PGDDSM-5-TR, κ = 0.91, 95% CI [0.89-0.93]. Confirmatory factor analysis results indicated a one-factor model fit best for both PGDDSM-5-TR and PGDICD-11. Emotional pain symptoms (e.g., guilt) were predominantly reported by patients with a PGDICD-11 diagnosis, while attachment disturbance symptoms (e.g., identity disruption) were reported more often by patients with a PGDDSM-5-TR diagnosis.Despite methodological limitations of this study, results indicate discordance in PGDDSM-5-TR and PGDICD-11 regarding diagnostic rates and single symptom occurrence, while the factor structure is similar. Changes in the ICD-11 time criterion could reduce these differences. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Thousands of people have died of COVID-19 in El Salvador. However, little is known about the mental health of those who are mourning the loss of a loved one to COVID-19. Therefore, the objective of this study was to examine the dysfunctional grief associated with COVID-19 death among Salvadoran adults. A sample of 435 Salvadorans (M = 29 years; SD = 8.75) who lost a family member or loved one to COVID-19 completed a digital survey using the Google Forms platform, during April 2 and 28, 2022. The results revealed that 35.1% reported clinically elevated symptoms of dysfunctional grief and among those mourners, and 25.1% also exhibited clinical levels of coronavirus anxiety. A binary logistic regression revealed that predictor variables such as COVID-19 anxiety (p = .003), depression (p = .021), and COVID-19 obsession (p = .032) were significant (χ2 = 84.31; Nagelkerke R2 = .242) and predict a 24.2% chance of dysfunctional bereavement.

This paper explores 18 infertile Canadian intended mothers' experiences using donor eggs to conceive. Their narratives reflect a persistent normative ideology of reproduction and motherhood in Canada, where reproduction is natural, and expected, mother and child are genetically related, and two (genetic) parent families are what is normal. These ideologies permeate intended mothers' experiences of infertility, and their relationship with their egg donor. Much of the intended mothers' grief over their infertility was attributable to the gap between their experience and their perceived sense of normality. While intended mothers' relationships with their egg donor varied across a 'relational spectrum', their desire to minimize the gap between their experience and normative motherhood resulted in many intended mothers choosing less inclusive relationships, to the left of the spectrum, so as to mentally distance themselves from their use of donor eggs. Ultimately, however, in choosing to pursue egg donation, and in normalizing a different understanding of motherhood for themselves, these intended mothers are influencing cultural practices in Canada. In the long run, they, and others like them, are likely to alter cultural attitudes and conceptions of 'normality' when it comes to reproduction and motherhood.

Background Physical activity benefits physical and mental health. However, limited research investigates if physical activity can improve outcomes from the grieving process following the death of a parent. Methods Semi-structured interviews were conducted with 14 individuals (n = 8 female; age M = 31.2 years), who had experienced the death of a parent when they were aged between 10 and 24 years old, using retrospective recall. Data were analysed inductively using thematic analysis. Results Six themes were identified. Physical activity was seen as; 1) ‘Therapeutic’; providing an 2) ‘Emotional Outlet’ and created a strong sense of 3) ‘Social Support’. Alongside it 4) ‘Builds Confidence’, and led to 5) ‘Finding Yourself’ and 6) ‘Improved Health and wellbeing’ (physical and psychological). Conclusion Physical activity has the potential to provide positive experiences following a parental bereavement. It can provide a sense of freedom and was seen to alleviate grief outcomes, build resilience, enable social support and create a stronger sense of self. Bereavement support services for young people who have experienced death of a parent should consider physical activity as a viable intervention to support the grieving process.

It was the purpose of this research to compare inhibitory control, which is a sub-factor of executive function, between grieving for a beloved person and grieving for a companion animal, taking into account whether the participants were suffering from prolonged grief at the time of grieving.

The NORHELP-study (Norwegiean Bereavement help study) is a mixed-method study exploring bereaved parents' and adult sibilings' needs for bereavement related help and support after child loss / loss of a sibling on a primary care level, and their experience with the received support. It furthermore explores the care-giver side, in investigating health professionals experiences with providing crisis support and long-term follow up for bereaved after sudden child loss. Thereby, the study seeks to explore to what extend the bereaveds' need for care is consistent with the care they actually received. Ultimately, the study seeks to nvestigate whether there is a connenction between the support received and long-term grief reactions such as complicated grief.

Relational savoring is the idea that savoring can be achieved through focusing on a critical relationship with another person and then extracting the positivity from that relationship (Borelli, et al., 2020). Relational savoring differs from regular savoring because in the former, it is the savoring of memories within a relationship that has attachment, and where the memories themselves have attachment-based content (i.e., protection, support, love) (Borelli, et al., 2020). This proposed study would seek to answer the question of whether relational savoring can act as a protective barrier against psychological distresses a bereaved person may experience by priming and enhancing positive emotions of attachment security to the lost loved one.

Background: Bereavement can be considered a potentially traumatic experience, and concerns have been raised about conducting grief research responsibly online. Objective: Given that online research introduces new methodological opportunities and challenges, we aimed to develop a greater understanding of how bereaved individuals experience participation in online research. Method: One day after participation in an online grief study, 876 participants, bereaved on average for 40 months, received a ‘check-in’ email to support well-being and offer further contact if needed. Although not explicitly asked to respond if no help was needed, 300 participants sent email replies, with only six requesting support. These responses were analysed qualitatively using content analysis. Results: Results suggested that participants found it acceptable to be asked about their grief and while difficult emotions were frequently described in response to the questionnaires, these reactions were temporary. A range of positive reactions was also reported, including new realizations arising from completing the research and changes in thinking related to grief. Participants also wrote about their appreciation for the study and how it was carried out, as well as a desire to contribute more to the study and to help others in a similar position. Conclusions: We suggest that the use of the check-in email to support well-being following study completion, along with advice on preparing to take part, contributed to positive experiences of participation and we recommend these strategies for future studies. These findings could allay clinical concerns about conducting online research with vulnerable populations, as well as raising questions about the possible therapeutic impact of measurement.

ZusammenfassungDas Weinen als fundamentaler menschlicher Emotionsausdruck wirft innerhalb verschiedener Fachdisziplinen seit jeher Fragen auf. In den letzten Jahren lässt sich auch innerhalb der klinischen Forschung eine zunehmende Beschäftigung mit diesem Thema beobachten. U. a. konnte im Rahmen einer Untersuchung an der Universität Kassel eine Systematisierung über verschiedene Formen des Weinens in der Psychotherapie und unterschiedliche therapeutische Verhaltensweisen im Umgang damit entwickelt werden. Im vorliegenden Artikel werden die Erkenntnisse dieser Untersuchung auf den Bereich des berufsbezogenen Coachings übertragen und nutzbar gemacht. Die Bedeutung des Weinens für das Coaching wird im Allgemeinen sowie im Zusammenhang mit Trauerprozessen und krisenhaften Entwicklungen diskutiert. Es werden verschiedene Implikationen für die beraterische Praxis abgeleitet.

Background: Informal support of a bereaved parent is common after the loss of a child (stillborn, young or adult child); however, it is not clear which aspects of informal support were perceived to be helpful by the bereaved parent. The aim of this scoping review is to clarify from the standpoint of bereaved parents what are considered helpful and unhelpful characteristics of informal support given by the support network of bereaved parents. Methods: A comprehensive search of databases from 2000 to April 20, 2020 was conducted for clinical studies published in English on informal bereavement support of adult bereaved parents of stillborn to adult children; 52 articles met criteria for the scoping review. The databases included Ovid MEDLINE(R) and Epub Ahead of Print, In-Process & Other Non-Indexed Citations, and Daily, Ovid EMBASE, Ovid Cochrane Central Register of Controlled Trials, Ovid Cochrane Database of Systematic Reviews, Ovid PsycINFO, and Scopus. Results: Specific supportive strategies reported by parents as helpful more frequently included talking with other supportive persons felt to be supportive, meeting another person with a similar type of loss, and a loss-specific peer support group. Other support included peer support groups in general, tangible aid, talking with the spouse about the child who died and/or accepting each other's different grieving styles, and remembrance gestures. Specific supportive strategies reported by parents as unhelpful more frequently included feeling of stigma or blame due to type of death or feeling that the type of death was not considered equal to other deaths and platitudes & insensitive comments. Other unhelpful support included talking with others felt to be unsupportive about discussing the loss, others stating a time limit to grief, others actively avoiding or stopping all communication with the bereaved parent, and one spouse not accepting the grieving style of the other or the spouse not willing to discuss the loss. Conclusion: Support focused on supportive verbal and nonverbal communication towards the bereaved parent and tangible aid were noted to be helpful informal support. Feeling stigma for or judged by others due to the type of death or the death not being considered equal (such as in deaths due to suicide and stillborn deaths) to other types of deaths as well as informational support (utilization of clichés/platitudes, advice giving, statements about the process and end point of grieving) were noted to be unhelpful informal support.

There is limited research into bereavement and suicide bereavement as an antecedent of suicide in young people.We extracted information on the antecedents of suicide from official reports, primarily coroner inquests, on a 3-year national consecutive case series of all UK deaths by suicide in people aged 10-19.Between 2014 and 2016, there were 595 suicides by young people. 134 (25%) had been previously or recently bereaved; 51 (9%) by suicide, mainly of a friend or acquaintance. This is equivalent to 1 in 4 and 1 in 11, respectively, of all young people who die by suicide. Bereavement added to existing adversities - many antecedents of suicide were more likely in young people who were bereaved compared to those who were not, but there were few differences in the experiences of young people bereaved by suicide compared to other causes.This was an observational, not a risk factor study, and we did not use a control group. It is difficult to obtain data on non-suicide controls due to the ethical implications in contacting families, and the fact of suicide itself, its impact on disclosure and the reluctance of potential controls distorting any comparisons.Lasting bereavement support needs to be routinely and immediately available for young people, including those who have experienced the death of a friend or acquaintance. Vigilance of agencies for bereaved young people is required, especially if there is evidence of other adversities.

The Army New Parent Support Program (Army NPSP) provides home visitation services that promote positive parenting strategies and aims to prevent family violence for expectant military parents and military families with children from birth to age 3. Since the onset of the novel coronavirus (COVID-19), Army NPSP services have rapidly adapted to a telehealth model to fit with the suggested practices of physical distancing. Employing a grounded theory approach, nine virtual focus groups with 30 Army NPSP home visitors across eight installations were conducted to examine how this rapid shift has impacted their services, practice, and professional role. The present study identified two overarching themes: (1) working with families (e.g., continued engagement with families, increased communication, shifting family needs) and (2) adjusting to telework (e.g., technology, professional collaboration and communication, professional growth). Findings from these focus groups indicated that home visitors were actively engaged with their clients and experienced both challenges and benefits of telehealth. While the rapid transition was a big change, and home visitors missed the face-to-face interactions, they expressed that they were adapting and improving their virtual service delivery with time. Increased concerns regarding families' well-being due to social and physical isolation, increased symptoms of anxiety and depression, and grief for losses due to COVID-19, along with the ability to continue connections with these highly mobile families, points to the importance of telehealth as a means to implement parenting programs vital to military family well-being. (PsycInfo Database Record (c) 2021 APA, all rights reserved)

Context Globally, people most often die within hospitals. As such, healthcare providers in hospitals are frequently confronted with dying persons and their bereaved relatives. Objectives To provide an overview of the current role hospitals take in providing bereavement care. Furthermore, we want to present an operational definition of bereavement care, the way it is currently implemented, relatives’ satisfaction of receiving these services, and finally barriers and facilitators regarding the provision of bereavement care. Methods An integrative review was conducted by searching four electronic databases, from January 2011 to December 2020, resulting in 47 studies. Different study designs were included and results were reported in accordance with the theoretical framework of Whittemore and Knafl (2005). Results Only four articles defined bereavement care: two as services offered solely post loss and the other two as services offered pre and post loss. Although different bereavement services were delivered the time surrounding the death, the follow-up of bereaved relatives was less routinely offered. Relatives appreciated all bereavement services, which were rather informally and ad-hoc provided to them. Healthcare providers perceived bereavement care as important, but the provision was challenged by numerous factors (such as insufficient education and time). Conclusion Current in-hospital bereavement care can be seen as an act of care that is provided ad-hoc, resulting from the good-will of individual staff members. A tiered or stepped approach based on needs is preferred, as it allocates funds towards individuals-at-risk. Effective partnerships between hospitals and the community can be a useful, sustainable and cost-effective strategy.