Traumatic loss: a systematic review of potential risk factors differentiating between posttraumatic stress disorder and prolonged grief disorder

被引:2
作者
Jann, Philipp [1 ,2 ]
Netzer, Jessica [1 ]
Hecker, Tobias [1 ,3 ]
机构
[1] Bielefeld Univ, Dept Clin Psychol & Violence Res, Postbox 100131,Univ str 25, D-33501 Bielefeld, Germany
[2] Inst Emergency Psychol, Univ str 25, D-33615 Bielefeld, Germany
[3] Bielefeld Univ, Inst Interdisciplinary Res Conflict & Violence, Bielefeld, Germany
关键词
Traumatic loss; posttraumatic stress disorder; PTSD; grief; PGD; PCBD; risk factors; systematic review; P & eacute; rdida traum & aacute; tica; TEPT; trastorno de estr & eacute; s postraum & aacute; tico; trastorno de duelo prolongado; tico complejo; duelo; factores de riesgo; revisi & oacute; n sistem & aacute; COMPLICATED GRIEF; SOCIAL SUPPORT; MENTAL-HEALTH; PSYCHIATRIC-DISORDERS; BEREAVED INDIVIDUALS; PROTECTIVE FACTORS; FAMILY-MEMBERS; VIOLENT DEATH; SYMPTOMS; DEPRESSION;
D O I
10.1080/20008066.2024.2371762
中图分类号
B849 [应用心理学];
学科分类号
040203 ;
摘要
Background: When traumatic events and losses intersect in the form of traumatic loss, these events can trigger both posttraumatic stress disorder and pathological grief.Objective: This systematic review investigates which characteristics differentiate between the development of the respective disorders or are associated with comorbidity.Method: A systematic literature search using Medline, PubMed, APA PsycInfo and Web of Science yielded 46 studies which met the inclusion criteria. In these studies, PTSD was assessed using 17 and pathological grief using 16 different validated instruments. In the quality assessment, 12 studies were classified as average, 30 as above average, and 4 as excellent. The investigated risk factors were categorized into 19 superordinate clusters and processed using narrative synthesis.Results: The relationship to the deceased, mental health issues, and religious beliefs seem to be associated specifically with pathological grief symptoms compared to PTSD symptoms. Social support and social emotions emerged as significant correlates and potential risk factors for both PTSD and pathological grief. Included studies had mainly cross-sectional designs.Conclusions: Differentiating factors between pathological grief and PTSD appear to exist. The results should be considered within the limitations of the heterogeneity of the included studies and the research field. There is a lack of studies (1) using a longitudinal study design, (2) starting data collection early following the traumatic loss, (3) using standardized, up-to-date measurement instruments and (4) including comorbidity in their analyses. Further research is urgently needed for more accurate (acute) screenings, prognoses, and interventions following traumatic loss. When traumatic events and losses intersect in the form of traumatic loss, these events can trigger both posttraumatic stress disorder and pathological grief. This systematic review investigates which characteristics can differentiate between the development of the respective disorders or are associated with comorbidity.The relationship to the deceased, mental health issues, and religious beliefs seem to be specific characteristics for predicting pathological grief. Social support and social emotions were frequently reported as significant correlates of both PTSD and pathological grief.The studies to date have been very heterogeneous and mainly cross-sectional. Further research considering both disorders after traumatic loss in longitudinal study designs is urgently indicated for better (acute) screenings, prognoses, and interventions. Antecedentes: Cuando los eventos traum & aacute;ticos y las p & eacute;rdidas se cruzan en forma de p & eacute;rdida traum & aacute;tica, estos eventos pueden desencadenar tanto un trastorno de estr & eacute;s postraum & aacute;tico (TEPT) como duelo patol & oacute;gico.Objetivo: Esta revisi & oacute;n sistem & aacute;tica investiga qu & eacute; caracter & iacute;sticas diferencian entre el desarrollo de los respectivos trastornos o est & aacute;n asociadas con la comorbilidad.M & eacute;todo: Una b & uacute;squeda sistem & aacute;tica de literatura utilizando Medline, PubMed, APA PsycInfo y Web of Science arroj & oacute; 46 estudios que cumpl & iacute;an con los criterios de inclusi & oacute;n. En estos estudios, el TEPT se evalu & oacute; utilizando 17 instrumentos validados y el duelo patol & oacute;gico utilizando 16 instrumentos diferentes validados. En la evaluaci & oacute;n de calidad, 12 estudios fueron clasificados como promedio, 30 como superiores al promedio y 4 como excelentes. Los factores de riesgo investigados fueron categorizados en 19 grupos superordinados y se procesaron mediante s & iacute;ntesis narrativa.Resultados: La relaci & oacute;n con el fallecido, los problemas de salud mental y las creencias religiosas parecen estar espec & iacute;ficamente asociados con s & iacute;ntomas de duelo patol & oacute;gico en comparaci & oacute;n con los s & iacute;ntomas de TEPT. El apoyo social y las emociones sociales surgieron como correlatos significativos y posibles factores de riesgo tanto para el TEPT como para el duelo patol & oacute;gico. Los estudios incluidos ten & iacute;an principalmente dise & ntilde;os transversales.Conclusiones: Parecen existir factores diferenciadores entre el duelo patol & oacute;gico y el TEPT. Los resultados deben considerarse dentro de las limitaciones de la heterogeneidad de los estudios incluidos y del campo de investigaci & oacute;n. Hay una falta de estudios que (1) utilicen un dise & ntilde;o de estudio longitudinal, (2) comiencen la recopilaci & oacute;n de datos temprano despu & eacute;s de la p & eacute;rdida traum & aacute;tica, (3) usen instrumentos de medici & oacute;n estandarizados y actualizados y (4) que incluyan la comorbilidad en sus an & aacute;lisis. Se necesita urgentemente m & aacute;s investigaci & oacute;n para evaluaciones (agudas) m & aacute;s precisas, pron & oacute;sticos e intervenciones despu & eacute;s de una p & eacute;rdida traum & aacute;tica.
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