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Open accessJournal ArticleDOI: 10.1016/J.JPAINSYMMAN.2021.02.016

Correlates of Mental Health After COVID-19 Bereavement in Mainland China.

02 Mar 2021-Journal of Pain and Symptom Management (Elsevier)-Vol. 61, Iss: 6
Abstract: CONTEXT: Pioneering empirical studies show that people bereaved due to COVID-19 experience elevated acute grief, posttraumatic stress, anxiety, and depressive symptom levels, which relate to functional impairment. However, studies focused on Western samples and multivariate analyses of relations between potential risk factors and mental health in this population are lacking. OBJECTIVES: To assess the mental health of Chinese adults bereaved due to COVID-19. To elucidate the associations of demographic and loss-related characteristics with mental health after COVID-19 bereavement. METHODS: Four hundred twenty-two Chinese adults (56% male; Mean age: 32.73 years) recently bereaved due to COVID-19 completed an online survey. Demographic and loss-related characteristics and prolonged grief, posttraumatic stress, anxiety, and depressive symptoms were assessed. RESULTS: Clinically relevant prolonged grief (49%, n = 207), posttraumatic stress (22%, n = 92), depressive (70%; n = 294), and anxiety symptoms (65%; n = 272) were reported by a substantial group of participants. In four multiple regressions predicting each mental health indicator, Fs(15,406) = 5.08-7.74, Ps < 0.001, loss-characteristics (i.e., a shorter time since loss, ss =  -.12-.11, loss of a first-degree relative, ss =  .18-.37) and subjective loss experiences (i.e., feeling traumatized by the loss, ss =  .13-.18, or a close and/or conflictual relation with the deceased, ss =  .12-.23) related most consistently to mental health problems. CONCLUSION: Many Chinese adults bereaved due to COVID-19 experience severe mental health problems. The recent loss of first-degree relatives, feeling traumatized by the loss, and having a close and/or conflictual relationship with the deceased may elevate risk for these mental health problems, which could require indicated psychological treatment.

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Topics: Mental health (60%), Prolonged grief disorder (58%), Grief (57%) ... show more
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Open accessJournal ArticleDOI: 10.1177/02692163211019885
Abstract: Background:COVID-19 public health restrictions have affected end-of-life care experiences for dying patients and their families.Aim:To explore bereaved relatives’ experiences of quality of care and...

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Topics: Palliative care (62%), Public health (56%), Pandemic (51%)

10 Citations


Open accessJournal ArticleDOI: 10.1080/20008198.2021.1947563
Chuqian Chen1, Suqin Tang2Institutions (2)
Abstract: Background COVID-19 deaths elevate the prevalence of prolonged grief and post-traumatic stress symptoms among the bereaved, yet few studies have examined potential positive outcomes. Moreover, how COVID-19 bereavement affects individual-level mental health outcomes is under-researched. Objective This is the first study to use latent profile analysis (LPA) to identify heterogeneous profiles of prolonged grief, post-traumatic stress and post-traumatic growth among people bereaved due to COVID-19 and to identify predictors of latent class membership. Methods Four hundred and twenty-two Chinese participants who were bereaved due to COVID-19 completed an online survey between September and October 2020. The survey included the International (ICD-11) Prolonged Grief Disorder Scale (IPGDS), the Post-traumatic Stress Disorder Checklist for DSM-5 (PCL-5) and the Post-traumatic Growth Inventory (PTGI). LPA was run in Mplus, and the 3-step auxiliary approach was used to test the predicting effects of potential predictors of latent class membership identified with chi-square tests and ANOVAs. Results Four latent profiles were identified: resilience (10.7%), growth (20.1%), moderate-combined (42.2%) and high-combined (27.0%). The bereaved who shared a close relationship with the deceased and identified COVID-19 as the fundamental cause of death were more likely to be in the high-combined group. A conflictful bereaved-deceased relationship reduces the chance of being in the growth group. Moreover, the death of a younger person and loss of a partner attributed to maladaptive outcomes. Conclusions Serious attention needs to be paid to the mental health issues of people bereaved due to COVID-19 because nearly 70% of this group would have a moderate-combined or high-combined symptom profile. Special care should be given to those who lost someone younger, lost a partner or shared a close relationship with the deceased. Grief therapies that work on the conflicts between the deceased and the bereaved and unfinished business can be applied to facilitate growth.

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Topics: Prolonged grief disorder (64%), Grief (59%), Traumatic stress (54%) ... show more

1 Citations


Journal ArticleDOI: 10.1002/HPM.3330
Yiwei Liu1, Deshui Zhou2, Ximei Geng1Institutions (2)
Abstract: Since the outbreak of the novel coronavirus (COVID-19) pandemic, the number of individuals infected with the COVID-19 has been increasing worldwide, posed a substantial threat to mental health. Therefore, discovering the means for blocking the transmission path of COVID-19 and improving mental health is of great significance. Based on a survey on the life of urban and rural residents in China (in 2020), the study applied the least squares method to analyse the effect of closed-off management on the psychological anxiety and psychological stress caused by the COVID-19 pandemic. Furthermore, the bootstrap decomposition method was used to test for the mediating effects of satisfaction with and confidence in pandemic prevention. The study found that closed-off management in communities exerted a negative effect on psychological anxiety and stress caused by the COVID-19 pandemic. Additionally, satisfaction with and confidence in pandemic prevention played a mediating role on the psychological anxiety and stress caused by the COVID-19 pandemic. Therefore, closed-off management in communities will not only prevent the spread of the COVID-19, but also improve satisfaction with and confidence in pandemic prevention and control. Furthermore, it will alleviate the psychological anxiety and stress caused by the COVID-19 pandemic.

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Topics: Anxiety (53%), Mental health (52%), Pandemic (51%)

Journal ArticleDOI: 10.1080/07481187.2021.1974666
11 Sep 2021-Death Studies
Abstract: The COVID-19 pandemic, coupled with significant social changes due to legislative and public health requirements, has changed the way in which people experience grief. We examined whether dysfunctional grief symptoms, disrupted meaning, risk factors, and functional impairment differed between people bereaved from COVID-19 and from other natural or violent causes in this same period. A sample of 409 participants (67.73% male; M = 37.54 years) completed an online survey in June 2021. There were no statistically significant differences between the three groups on any of the outcome variables; all three groups manifested clinical levels of functional impairment equal to or greater than bereaved groups diagnosed with complicated or prolonged grief disorder prior to the pandemic. Disrupted meaning partially mediated the relationship between risk factors on the one hand and functional impairment and dysfunctional grief symptoms on the other. Findings indicate that deaths during COVID-19, rather than deaths from COVID-19, may precipitate symptoms of significant clinical concern.

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Topics: Prolonged grief disorder (66%), Grief (62%), Dysfunctional family (55%)

Open accessJournal ArticleDOI: 10.1111/BJC.12344
Marcin Sekowski, Holly G. Prigerson1Institutions (1)
Abstract: OBJECTIVES Prior studies have shown that pre-loss closeness and conflict with a deceased person are associated with the severity of symptoms of prolonged grief and/or depression. Nevertheless, mechanisms underlying these relationships are not well understood. We propose a theoretical model in which past closeness and conflict are related to prolonged grief and depression via concrete and symbolic continuing bonds (CB). The aim of our study was to test this model in a sample of bereaved family members. METHODS Individuals (N = 244) who had lost a family member from 0.5 to 8.0 years before the survey completed the Quality of Relationships Inventory-Bereavement Version, the Continuing Bonds Scale, the Prolonged Grief Disorder-13 scale, and the Patient Health Questionnaire-9. RESULTS The findings partially confirmed our model. Closeness was positively and moderately associated with symptoms of prolonged grief but not with symptoms of depression. Conflict was positively and weakly associated with symptoms of depression and prolonged grief. All of these relationships were only partially mediated by concrete/maladaptive and symbolic/adaptive CB. CONCLUSIONS The differences in the relationship of past closeness and conflict to prolonged grief and depression symptoms suggest that inter- and intrapersonal mechanisms of prolonged grief and depressive symptoms may be distinct. If future, especially longitudinal studies, confirm our model, CB would be a possible target for interventions for bereaved persons who had a close and/or conflicted relationship with a deceased family member and experience loss-related psychopathology. PRACTITIONER POINTS Continuing bonds (CB) are a potential target of interventions for bereaved persons who had a close and/or conflicted relationship with a deceased family member and experience symptoms of prolonged grief and/or depression. Internalization of the capacity to care for yourself and feel autonomous in a safe and stable therapeutic relationship may lead to increased self-confidence, promote working through past experiences in the relationship with the deceased, and gradual reduction of concrete forms of CB. Increasing awareness and acceptance of emotional experiences may contribute to the appreciation of past relationship with a deceased person and the growth of symbolic forms of CB. Future research should focus on verifying the effectiveness of the attachment-informed therapeutic approach to working with CB.

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Topics: Prolonged grief disorder (66%), Complicated grief (66%), Grief (61%) ... show more

References
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11 results found


Journal ArticleDOI: 10.1111/J.1600-0447.1983.TB09716.X
Abstract: A self-assessment scale has been developed and found to be a reliable instrument for detecting states of depression and anxiety in the setting of an hospital medical outpatient clinic. The anxiety and depressive subscales are also valid measures of severity of the emotional disorder. It is suggested that the introduction of the scales into general hospital practice would facilitate the large task of detection and management of emotional disorder in patients under investigation and treatment in medical and surgical departments.

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31,600 Citations


Open access
01 Jan 2020-
Abstract: Globally, as of 10:47am CEST, 28 May 2020, there have been 5,556,679 confirmed cases of COVID-19, including 351,866 deaths, reported to WHO

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Topics: Coronavirus (58%)

1,791 Citations


Journal ArticleDOI: 10.1002/JTS.22059
Abstract: The Posttraumatic Stress Disorder Checklist (PCL) is a widely used DSM-correspondent self-report measure of PTSD symptoms. The PCL was recently revised to reflect DSM-5 changes to the PTSD criteria. In this article, the authors describe the development and initial psychometric evaluation of the PCL for DSM-5 (PCL-5). Psychometric properties of the PCL-5 were examined in 2 studies involving trauma-exposed college students. In Study 1 (N = 278), PCL-5 scores exhibited strong internal consistency (α = .94), test-retest reliability (r = .82), and convergent (rs = .74 to .85) and discriminant (rs = .31 to .60) validity. In addition, confirmatory factor analyses indicated adequate fit with the DSM-5 4-factor model, χ2 (164) = 455.83, p < .001, standardized root mean square residual (SRMR) = .07, root mean squared error of approximation (RMSEA) = .08, comparative fit index (CFI) = .86, and Tucker-Lewis index (TLI) = .84, and superior fit with recently proposed 6-factor, χ2 (164) = 318.37, p < .001, SRMR = .05, RMSEA = .06, CFI = .92, and TLI = .90, and 7-factor, χ2 (164) = 291.32, p < .001, SRMR = .05, RMSEA = .06, CFI = .93, and TLI = .91, models. In Study 2 (N = 558), PCL-5 scores demonstrated similarly strong reliability and validity. Overall, results indicate that the PCL-5 is a psychometrically sound measure of PTSD symptoms. Implications for use of the PCL-5 in a variety of assessment contexts are discussed.

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1,725 Citations


Open accessJournal ArticleDOI: 10.1073/PNAS.2007476117
Abstract: The coronavirus disease 2019 (COVID-19) pandemic has led to a large increase in mortality in the United States and around the world, leaving many grieving the sudden loss of family members. We created an indicator-the COVID-19 bereavement multiplier-that estimates the average number of individuals who will experience the death of a close relative (defined as a grandparent, parent, sibling, spouse, or child) for each COVID-19 death. Using demographic microsimulation-based estimates of kinship networks in the United States, the clear age gradient in COVID-19 mortality seen across contexts, and several hypothetical infection prevalence scenarios, we estimate COVID-19 bereavement multipliers for White and Black individuals in the United States. Our analysis shows that for every COVID-19 death, approximately nine surviving Americans will lose a grandparent, parent, sibling, spouse, or child. These estimates imply, for example, that if 190,000 Americans die from COVID-19, as some models project, then ∼1.7 million will experience the death of a close relative. We demonstrate that our estimates of the bereavement multiplier are stable across epidemiological realities, including infection scenarios, total number of deaths, and the distribution of deaths, which means researchers can estimate the bereavement burden over the course of the epidemic in lockstep with rising death tolls. In addition, we provide estimates of bereavement multipliers by age group, types of kin loss, and race to illuminate prospective disparities. The bereavement multiplier is a useful indicator for tracking COVID-19's multiplicative impact as it reverberates across American families and can be tailored to other causes of death.

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Topics: Grandparent (50%)

78 Citations


Open access
Laurie A. Burke1, Robert A. Neimeyer1Institutions (1)
01 Jan 2013-
Topics: Complicated grief (77%), Grief (66%)

52 Citations