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Holly G Prigerson - One of the best experts on this subject based on the ideXlab platform.
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Consensus criteria for Traumatic Grief: A preliminary empirical test
British Journal of Psychiatry, 2018Co-Authors: Holly G Prigerson, Selby C. Jacobs, Paul K. Maciejewski, Camille B. Wortman, Paul A. Pilkonis, Robert A Rosenheck, M. Katherine Shear, Charles F Reynolds, Jonathan R. T. Davidson, Janet B W WilliamsAbstract:Background Studies suggest that symptoms of Traumatic Grief constitute a distinct syndrome worthy of diagnosis. Aims A consensus conference aimed to develop and test a criteria set for Traumatic Grief. Method The expert panel proposed consensus criteria for Traumatic Grief. Receiver operator characteristic (ROC) analyses tested the performance of the proposed criteria on 306 widowed respondents at seven months post loss. Results ROC analyses indicated that three of four separation distress symptoms (e.g. yearning, searching, loneliness) had to be endorsed as at least 'sometimes true' and four of the final eight Traumatic distress symptoms (e.g. numbness, disbelief, distrust, anger, sense of futility about the future) had to be endorsed as at least 'mostly true' to yield a sensitivity of 0.93 and a specificity of 0.93 for a diagnosis of Traumatic Grief. Conclusions Preliminary analyses suggest the consensus criteria for Traumatic Grief have satisfactory operating characteristics, and point to directions for further refinement of the criteria set.
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Traumatic Loss, Complicated Grief, and Terrorism
Journal of Aggression Maltreatment & Trauma, 2004Co-Authors: Ilona L. Pivar, Holly G PrigersonAbstract:The experience of losing loved ones is an inevitable outcome of acts of terror. In assessing mental health outcomes in survivors of such acts, researchers have frequently not measured the distress of bereavement even when losses occur. This article defines current concepts of complicated and Traumatic Grief and reviews the progress researchers have made in measuring the full extent of distress caused by violent and Traumatic events. The authors suggest that measurement of complicated and Traumatic Grief must be included in research and assessment protocols within cultural contexts in order to develop successful treatments for survivors of terrorist acts.
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psychotherapy of Traumatic Grief a review of evidence for psychotherapeutic treatments
Death Studies, 2000Co-Authors: Selby C. Jacobs, Holly G PrigersonAbstract:The authors present the concept of Traumatic Grief and then review controlled studies that pertain to its psychotherapeutic treatment. They conclude that it will most likely be a specific therapy for Traumatic Grief that will be proven most effective in systematic studies completed in the future.
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quality of life impairments associated with diagnostic criteria for Traumatic Grief
Psychological Medicine, 2000Co-Authors: Gabriel K Silverman, Selby C. Jacobs, Paul K. Maciejewski, M K Shear, Stanislav V Kasl, F S Noaghiul, Holly G PrigersonAbstract:Background. This study examined the association between a diagnosis of Traumatic Grief and quality of life outcomes. Method. Sixty-seven widowed persons were interviewed at a median of 4 months after their loss. The multiple regression procedure was used to estimate the effects of a Traumatic Grief diagnosis on eight quality of life domains, controlling for age, sex, time from loss and diagnoses of major depressive episode and post-Traumatic stress disorder. Results. A positive Traumatic Grief diagnosis was significantly associated with lower social functioning scores, worse mental health scores, and lower energy levels than a negative Traumatic Grief diagnosis. In each of these domains, Traumatic Grief was found to be a better predictor of lower scores than either major depressive episode or post-Traumatic stress disorder. Conclusions. The results suggest that a Traumatic Grief diagnosis is significantly associated with quality of life impairments. These findings provide evidence supporting the criterion validity of the proposed consensus criteria and the newly developed diagnostic interview for Traumatic Grief - the Traumatic Grief Evaluation of Response to Loss (TRGR2L).
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Diagnostic criteria for Traumatic Grief.
Death Studies, 2000Co-Authors: Selby C. Jacobs, Carolyn M. Mazure, Holly G PrigersonAbstract:This article reviews the rationale for the development of diagnostic criteria for Traumatic Grief. Traumatic Grief is a new nosologic entity that a panel of experts recently proposed. It is a direct descendent of the concept of pathologic Grief, and it has roots in attachment behavior, separation distress, and Traumatic distress. We present consensus, diagnostic criteria for Traumatic Grief and discuss them in relation to another recently proposed set of criteria. In conclusion, we recommend the development of empirically tested, consensus, diagnostic criteria for Traumatic Grief. Diagnostic criteria would facilitate early detection and intervention for those bereaved persons afflicted by this disorder and lead to additional studies of the prevalence, the nature, and the treatment of the disorder.
Katherine M Shear - One of the best experts on this subject based on the ideXlab platform.
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Traumatic Grief among adolescents exposed to a peer s suicide
American Journal of Psychiatry, 2004Co-Authors: Nadine M Melhem, Charles F Reynolds, Katherine M Shear, Nancy L Day, Richard O Day, David A BrentAbstract:OBJECTIVE: The phenomenology of Grief among children and adolescents is not well studied. A syndrome of Traumatic Grief, distinct from depression and anxiety, has been described among bereaved adults. The purpose of this study was to describe the symptoms and course of Traumatic Grief among adolescents exposed to a peer’s suicide and to examine the relationship between Traumatic Grief and depression and postTraumatic stress disorder (PTSD) in this population. METHOD: A total of 146 friends and acquaintances of 26 suicide victims were included in this study. Subjects were interviewed at 6, 12–18, and 36 months after the peer’s suicide. A subgroup was also interviewed 6 years afterward. The Texas Revised Inventory of Grief was administered at 6, 12–18, and 36 months; the Inventory of Complicated Grief was administered at the 6-year assessment. RESULTS: Principal component analysis of the Texas Revised Inventory of Grief resulted in two factors: one assessing a Traumatic Grief reaction and another assessing ...
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Traumatic Grief treatment case histories of 4 patients
The Journal of Clinical Psychiatry, 2002Co-Authors: Kate L Harkness, Katherine M Shear, Ellen Frank, Rebecca SilbermanAbstract:Background: Traumatic Grief treatment is a newly developed intervention for a debilitating bereavement-related condition. Traumatic Grief treatment uses imaginal and in vivo exposure techniques to target emotional distress and behavioral avoidance hypothesized to be core features of the syndrome, along with interpersonal psychotherapy techniques to engage patients and maintain rapport. The present report describes 4 case histories of patients treated in this way. Method: Each patient met our criterion for Traumatic Grief, defined as a score of at least 25 on the Inventory of Complicated Grief. Additionally, all 4 patients met DSM-IV criteria for a current episode of major depression and I patient for bipolar II disorder. The treatment course followed a direct replication design and ranged from 14 to 18 weekly 60- to 90-minute sessions. Results: These 4 cases illustrate reduction in distress during exposure to painful emotional memories and avoided situations that was associated with decreased scores on measures of Traumatic Grief, depression, and anxiety and increased participation in and enjoyment of daily-life activities. Conclusion: Case histories of Traumatic Grief treatment suggest it is a promising treatment for individuals suffering from Traumatic Grief. It appears that imaginal reliving and in vivo exposure are effective in reducing Grief intensity and lead to reduction in symptoms.
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comorbidity of axis i disorders in patients with Traumatic Grief
The Journal of Clinical Psychiatry, 2001Co-Authors: Nadine M Melhem, Charles F Reynolds, Ellen Frank, Carlos Rosales, Jason Karageorge, Katherine M ShearAbstract:Background: Traumatic Grief has been found to be a distinct disorder from both depression and anxiety; however, there is no information in the literature regarding comorbidity of Traumatic Grief with other psychiatric disorders. Method: Twenty-three bereaved subjects who presented for treatment of Traumatic Grief symptomatology were included in this study. The Inventory of Complicated Grief (ICG) was used to confirm the presence of Traumatic Grief and assess its severity. In addition, the Structured Clinical Interview for DSM-IV was performed. Results: Most subjects met criteria for a current or lifetime Axis I diagnosis. Fifty-two percent (N = 12) met criteria for current major depressive disorder, and 30% (N = 7), for current postTraumatic stress disorder (PTSD). ICG scores and functional impairment were higher among patients with more than one concurrent Axis I diagnosis. Conclusion: Comorbid major depressive disorder and PTSD may be prevalent in patients presenting for treatment of Traumatic Grief.
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Traumatic Grief treatment a pilot study
American Journal of Psychiatry, 2001Co-Authors: Katherine M Shear, Charles F Reynolds, Ellen Frank, Edna B Foa, Christine R Cherry, Joni Vander Bilt, Sophia MastersAbstract:OBJECTIVE: The effects of a treatment program targeting debilitating Grief symptoms were tested in a pilot study. METHOD: Twenty-one individuals experiencing Traumatic Grief were recruited for participation, and 13 completed the full 4-month protocol. The treatment protocol used imaginal re-living of the death, in vivo exposure to avoided activities and situations, and interpersonal therapy. RESULTS: Significant improvement in Grief symptoms and associated anxiety and depression was observed for both completer and intent-to-treat groups. CONCLUSIONS: The Traumatic Grief treatment protocol appears to be a promising intervention for debilitating Grief.
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a post hoc comparison of paroxetine and nortriptyline for symptoms of Traumatic Grief
The Journal of Clinical Psychiatry, 1998Co-Authors: Marianne Zygmont, Holly G Prigerson, Mark D. Miller, Patricia R. Houck, Katherine M Shear, Charles F ReynoldsAbstract:BACKGROUND This report presents the results of an open-trial pilot study of paroxetine for symptoms of Traumatic Grief, compared with the effects of nortriptyline in an archival contrast group. METHOD Data are presented on 15 subjects (4 men, 11 women), ranging in age from 40 to 79 years (mean age = 57 years), who experienced the loss of a spouse (N = 8), child (N =5), grandchild (N = 1), or parent (N = 1). Subjects were required to have a baseline score on the Inventory of Complicated Grief (ICG) of > or = 20. Treatment with paroxetine began at a median of 17 months (range, 6-139 months) after the loss. Paroxetine-treated subjects received a psychotherapy tailored for Traumatic Grief. Depressive symptoms were assessed by using the Hamilton Rating Scale for Depression (HAM-D). The ICG and the HAM-D were administered weekly over 4 months of paroxetine treatment (median dose = 30 mg/day). The group receiving paroxetine were then compared with a group (N = 22) participating in a separate trial of nortriptyline (median dose = 77.5 mg/day) for treatment of bereavement-related major depressive episodes. RESULTS Level of Traumatic Grief symptoms (ICG) decreased by 53%, and depression ratings (HAM-D) decreased by 54% in paroxetine-treated subjects. Nortriptyline showed clinical effects comparable to those of paroxetine. CONCLUSION Paroxetine may be an effective agent in the treatment of Traumatic Grief symptoms. A comparison of the paroxetine-treated group with a nortriptyline-treated group suggests that both agents have comparably beneficial effects on the symptoms of Traumatic Grief (as well as those of depression). However, the higher rate of diagnostic comorbidity in the paroxetine-treated group, together with the greater chronicity of their symptoms and the greater safety of paroxetine in overdose, leads us to favor paroxetine over nortriptyline for Traumatic Grief symptoms in general psychiatric practice. Further controlled evaluation of paroxetine for Traumatic Grief is necessary.
Paul A. Boelen - One of the best experts on this subject based on the ideXlab platform.
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Traumatic Grief following Traumatic loss: Nature, correlates, and treatment
Grief Matters: The Australian Journal of Grief and Bereavement, 2020Co-Authors: Paul A. BoelenAbstract:Traumatic Grief refers to the sudden, unexpected death of a loved one under circumstances that are unnatural and traumatising. Examples are losses due to traffic accidents, terrorist attacks, suicide and homicide. Traumatic losses can lead to Traumatic Grief, which refers to a combination of separation distress and Traumatic distress and, more formally, to a combination of symptoms of persistent complex bereavement disorder, postTraumatic stress disorder, and often also depression. This article addresses prevalence rates of, and risk factors for, Traumatic Grief. In addition, cognitive behavioral mechanisms and interventions for Traumatic Grief are described.
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post migration stressors and their association with symptom reduction and non completion during treatment for Traumatic Grief in refugees
Frontiers in Psychiatry, 2020Co-Authors: A Manik A A J Djelantik, Paul A. Boelen, Rolf J. Kleber, Annemiek De Heus, Diede Kuiper, Geert E. SmidAbstract:Background: Resettled refugees exposed to trauma and loss are at risk to develop mental disorders such as postTraumatic stress disorder (PTSD) and persistent complex bereavement disorder (PCBD). Post-migration stressors have been linked to poor mental health in mental health and treatment effects. Aim: Our aim was to evaluate reductions in PTSD and PCBD symptoms and to explore the presence of post-migration stressors and their associations with symptom change and non-completion in a Traumatic Grief focused treatment in a cohort of refugees. Methods: Paired sample t-tests were used to test the significance of the symptom reductions in PTSD and PCBD symptoms during treatment. The presence of post-migration stressors was derived from a qualitative analysis of the patient files. Associations between post-migration stressors and symptom reductions as well as non-completion were calculated. Results: In this uncontrolled study, 81 files of consecutive patients were included. Significant reductions in both PCBD and PTSD symptomatology with medium effect sizes were found. Patients experienced a mean of three different post-migration stressors during the treatment. Undocumented asylum seekers were more likely to be non-completers. Ongoing conflict in the country of origin was associated with smaller PTSD symptom reductions and the total number of post-migration stressors was associated with smaller PCBD symptom reductions. Conclusions: Treatment for resettled refugees for Traumatic Grief coincides with alleviations in both PCBD and PTSD symptomatology. Specific post-migration stressors were associated with reduced treatment effects and increased non-completion. This is a first step towards well-informed improvements of mental health interventions for resettled refugees.
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further validation of the Traumatic Grief inventory self report tgi sr a measure of persistent complex bereavement disorder and prolonged Grief disorder
Death Studies, 2019Co-Authors: Paul A. Boelen, Jos De Keijser, A Manik A A J Djelantik, Lonneke I M Lenferink, Geert E. SmidAbstract:The Traumatic Grief Inventory Self-Report version (TGI-SR) is an 18-item self-report measure. It was designed to assess symptoms of Persistent Complex Bereavement Disorder (PCBD) included in Diagnostic and Statistical Manual of Mental Disorders (DSM)-5 and Prolonged Grief Disorder (PGD) proposed by an international group of experts in Grief. The research in this article used data from a bereaved patient sample and people who lost loved ones in the Ukrainian airplane crash in July 2014. Findings indicated that the TGI-SR is a reliable and valid tool to assess disturbed Grief in research and to identify people needing a more comprehensive assessment of their Grief in clinical settings.
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Day patient treatment for Traumatic Grief: preliminary evaluation of a one-year treatment programme for patients with multiple and Traumatic losses
European journal of psychotraumatology, 2017Co-Authors: Annemiek De Heus, Paul A. Boelen, Simone M. De La Rie, Sophie M. C. Hengst, A. A. A. Manik J. Djelantik, Geert E. SmidAbstract:Background: Bereaved individuals who have lost a loved one under Traumatic circumstances can develop symptoms of Persistent Complex Bereavement Disorder (PCBD) and/or PostTraumatic Stress Disorder (PTSD). This is particularly common in refugees, as they frequently have been confronted with multiple Traumatic losses. For patients with severe PTSD and Traumatic Grief a treatment programme was developed, embedding individual Traumatic Grief focused therapy in a group-based multidisciplinary day patient treatment programme. The day patient treatment comprised a weekly five-hour programme consisting of three phases with a duration of four months each. Objective: To evaluate the feasibility and potential effectiveness of the treatment programme. Method: Data were analyzed from 16 participants treated between October 2013 and March 2014. PTSD severity and PTSD/PCBD diagnoses were measured during the initial and final phases of treatment using the Clinician-Administered PTSD Scale for DSM-IV (CAPS) and the Traumatic Grief Inventory Self Report (TGI-SR). One clinical case is presented in more detail. Treatment attendance was also registered and therapist satisfaction was evaluated in a focus group. Results: Thirteen patients (81%) completed the treatment. Each day of the treatment programme was attended by a mean of 76% of the participants. In the focus group, therapists noted symptom reduction in their patients and they therefore regarded Brief Eclectic Psychotherapy for Traumatic Grief (BEP-TG) as an effective therapy for their patients. During treatment, significant decreases in PTSD severity as well as diagnosable PTSD and PCBD were observed. Conclusions: Results support the feasibility and potential effectiveness of the day patient treatment programme for Traumatic Grief. The programme appears to be particularly suitable for refugees with severe PTSD and PCBD psychopathology, who may not benefit enough from usual care.
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the Traumatic Grief inventory self report version tgi sr introduction and preliminary psychometric evaluation
Journal of Loss & Trauma, 2017Co-Authors: Paul A. Boelen, Geert E. SmidAbstract:ABSTRACTPersistent Complex Bereavement Disorder (PCBD) is a disorder of Grief newly included in the “Emerging Measures and Models” section of the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5; American Psychiatric Association, 2013). Prolonged Grief Disorder (PGD) is a disorder with similar symptoms, likely to be included in the forthcoming 11th edition of the International Classification of Diseases (ICD-11; World Health Organization, 1992). We developed the Traumatic Grief Inventory Self-Report version (TGI-SR), an 18-item measure, for the assessment of symptoms of PCBD and PGD in clinical and research settings. This study was an initial attempt to evaluate psychometric properties of the TGI-SR. To this end, the measure was administered to 327 patients of a mental health institute specialized in the treatment of psychopathology associated with loss and trauma. We found evidence that items of the TGI-SR (all 18 items, as well as the selection of 17 items representing PCB...
Charles F Reynolds - One of the best experts on this subject based on the ideXlab platform.
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Consensus criteria for Traumatic Grief: A preliminary empirical test
British Journal of Psychiatry, 2018Co-Authors: Holly G Prigerson, Selby C. Jacobs, Paul K. Maciejewski, Camille B. Wortman, Paul A. Pilkonis, Robert A Rosenheck, M. Katherine Shear, Charles F Reynolds, Jonathan R. T. Davidson, Janet B W WilliamsAbstract:Background Studies suggest that symptoms of Traumatic Grief constitute a distinct syndrome worthy of diagnosis. Aims A consensus conference aimed to develop and test a criteria set for Traumatic Grief. Method The expert panel proposed consensus criteria for Traumatic Grief. Receiver operator characteristic (ROC) analyses tested the performance of the proposed criteria on 306 widowed respondents at seven months post loss. Results ROC analyses indicated that three of four separation distress symptoms (e.g. yearning, searching, loneliness) had to be endorsed as at least 'sometimes true' and four of the final eight Traumatic distress symptoms (e.g. numbness, disbelief, distrust, anger, sense of futility about the future) had to be endorsed as at least 'mostly true' to yield a sensitivity of 0.93 and a specificity of 0.93 for a diagnosis of Traumatic Grief. Conclusions Preliminary analyses suggest the consensus criteria for Traumatic Grief have satisfactory operating characteristics, and point to directions for further refinement of the criteria set.
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Traumatic Grief among adolescents exposed to a peer s suicide
American Journal of Psychiatry, 2004Co-Authors: Nadine M Melhem, Charles F Reynolds, Katherine M Shear, Nancy L Day, Richard O Day, David A BrentAbstract:OBJECTIVE: The phenomenology of Grief among children and adolescents is not well studied. A syndrome of Traumatic Grief, distinct from depression and anxiety, has been described among bereaved adults. The purpose of this study was to describe the symptoms and course of Traumatic Grief among adolescents exposed to a peer’s suicide and to examine the relationship between Traumatic Grief and depression and postTraumatic stress disorder (PTSD) in this population. METHOD: A total of 146 friends and acquaintances of 26 suicide victims were included in this study. Subjects were interviewed at 6, 12–18, and 36 months after the peer’s suicide. A subgroup was also interviewed 6 years afterward. The Texas Revised Inventory of Grief was administered at 6, 12–18, and 36 months; the Inventory of Complicated Grief was administered at the 6-year assessment. RESULTS: Principal component analysis of the Texas Revised Inventory of Grief resulted in two factors: one assessing a Traumatic Grief reaction and another assessing ...
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comorbidity of axis i disorders in patients with Traumatic Grief
The Journal of Clinical Psychiatry, 2001Co-Authors: Nadine M Melhem, Charles F Reynolds, Ellen Frank, Carlos Rosales, Jason Karageorge, Katherine M ShearAbstract:Background: Traumatic Grief has been found to be a distinct disorder from both depression and anxiety; however, there is no information in the literature regarding comorbidity of Traumatic Grief with other psychiatric disorders. Method: Twenty-three bereaved subjects who presented for treatment of Traumatic Grief symptomatology were included in this study. The Inventory of Complicated Grief (ICG) was used to confirm the presence of Traumatic Grief and assess its severity. In addition, the Structured Clinical Interview for DSM-IV was performed. Results: Most subjects met criteria for a current or lifetime Axis I diagnosis. Fifty-two percent (N = 12) met criteria for current major depressive disorder, and 30% (N = 7), for current postTraumatic stress disorder (PTSD). ICG scores and functional impairment were higher among patients with more than one concurrent Axis I diagnosis. Conclusion: Comorbid major depressive disorder and PTSD may be prevalent in patients presenting for treatment of Traumatic Grief.
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Traumatic Grief treatment a pilot study
American Journal of Psychiatry, 2001Co-Authors: Katherine M Shear, Charles F Reynolds, Ellen Frank, Edna B Foa, Christine R Cherry, Joni Vander Bilt, Sophia MastersAbstract:OBJECTIVE: The effects of a treatment program targeting debilitating Grief symptoms were tested in a pilot study. METHOD: Twenty-one individuals experiencing Traumatic Grief were recruited for participation, and 13 completed the full 4-month protocol. The treatment protocol used imaginal re-living of the death, in vivo exposure to avoided activities and situations, and interpersonal therapy. RESULTS: Significant improvement in Grief symptoms and associated anxiety and depression was observed for both completer and intent-to-treat groups. CONCLUSIONS: The Traumatic Grief treatment protocol appears to be a promising intervention for debilitating Grief.
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a post hoc comparison of paroxetine and nortriptyline for symptoms of Traumatic Grief
The Journal of Clinical Psychiatry, 1998Co-Authors: Marianne Zygmont, Holly G Prigerson, Mark D. Miller, Patricia R. Houck, Katherine M Shear, Charles F ReynoldsAbstract:BACKGROUND This report presents the results of an open-trial pilot study of paroxetine for symptoms of Traumatic Grief, compared with the effects of nortriptyline in an archival contrast group. METHOD Data are presented on 15 subjects (4 men, 11 women), ranging in age from 40 to 79 years (mean age = 57 years), who experienced the loss of a spouse (N = 8), child (N =5), grandchild (N = 1), or parent (N = 1). Subjects were required to have a baseline score on the Inventory of Complicated Grief (ICG) of > or = 20. Treatment with paroxetine began at a median of 17 months (range, 6-139 months) after the loss. Paroxetine-treated subjects received a psychotherapy tailored for Traumatic Grief. Depressive symptoms were assessed by using the Hamilton Rating Scale for Depression (HAM-D). The ICG and the HAM-D were administered weekly over 4 months of paroxetine treatment (median dose = 30 mg/day). The group receiving paroxetine were then compared with a group (N = 22) participating in a separate trial of nortriptyline (median dose = 77.5 mg/day) for treatment of bereavement-related major depressive episodes. RESULTS Level of Traumatic Grief symptoms (ICG) decreased by 53%, and depression ratings (HAM-D) decreased by 54% in paroxetine-treated subjects. Nortriptyline showed clinical effects comparable to those of paroxetine. CONCLUSION Paroxetine may be an effective agent in the treatment of Traumatic Grief symptoms. A comparison of the paroxetine-treated group with a nortriptyline-treated group suggests that both agents have comparably beneficial effects on the symptoms of Traumatic Grief (as well as those of depression). However, the higher rate of diagnostic comorbidity in the paroxetine-treated group, together with the greater chronicity of their symptoms and the greater safety of paroxetine in overdose, leads us to favor paroxetine over nortriptyline for Traumatic Grief symptoms in general psychiatric practice. Further controlled evaluation of paroxetine for Traumatic Grief is necessary.
Anthony P. Mannarino - One of the best experts on this subject based on the ideXlab platform.
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Trauma-Focused CBT for Traumatic Grief in Military Children
Journal of Contemporary Psychotherapy, 2011Co-Authors: Judith A. Cohen, Anthony P. MannarinoAbstract:Although military children are typically as resilient as the general child population, the ongoing conflict has exposed military children to unusual stressors such as repeated deployment, severe injury, or the death of a parent or sibling. U.S. forces have experienced more than 5,600 casualties during Operation Iraqi Freedom and Operation Enduring Freedom, with growing numbers of suicides among Service members. These deaths have affected thousands of military children. Most bereaved military children experience adaptive Grief characterized by deep sadness, longing for the deceased person, and being comforted by positive memories of the deceased. A smaller number of military children develop childhood Traumatic Grief, characterized by trauma symptoms that interfere with adaptive grieving. Children with Traumatic Grief get “stuck” on the Traumatic aspects of the death such as picturing the imagined or real details of the death; imagining the pain their loved one experienced in the moments before dying; wishing for revenge; and becoming angry at those who do not understand or share the child’s thoughts and feelings about the death. These children avoid reminders of the deceased person. Trauma-focused cognitive behavioral therapy (TF-CBT) is an evidence-based treatment for children with trauma symptoms including those with Traumatic Grief. TF-CBT may be particularly suitable for military families. This article describes the clinical application of TF-CBT for Traumatic Grief in military children.
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supporting children with Traumatic Grief what educators need to know
School Psychology International, 2011Co-Authors: Judith A. Cohen, Anthony P. MannarinoAbstract:Following Traumatic deaths children may develop Childhood Traumatic Grief (CTG), a condition in which trauma symptoms interfere with adaptive child grieving. Educators have an important role in supporting children who have CTG. Key contributions that educators can make are to (a) recognize CTG symptoms in school settings; (b) refer children for mental health evaluations when appropriate; (c) recognize reminders that trigger trauma symptoms and identify ways to manage these triggers and responses in school settings; (d) support CTG treatments in school by reinforcing children’s use of stress-management strategies; (e) respect confidentiality; (f) recognize the importance of cultural issues in CTG; and (g) maintain good communication with parents and other helping professionals.
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childhood Traumatic Grief a multi site empirical examination of the construct and its correlates
Death Studies, 2008Co-Authors: Elissa J. Brown, Robin F. Goodman, Judith A. Cohen, Lisa Amayajackson, Stephanie Handel, Heike Thiel De Bocanegra, Eileen Zatta, Anthony P. MannarinoAbstract:This study evaluated the construct of childhood Traumatic Grief (CTG) and its correlates through a multi-site assessment of 132 bereaved children and adolescents. Youth completed a new measure of the characteristics, attributions, and reactions to exposure to death (CARED), as well as measures of CTG, postTraumatic stress disorder (PTSD), depression, and anger. CTG was distinct from but highly correlated with PTSD, depression, and, to a lesser degree, anger. In contrast to a recent study of complicated Grief, CTG severity was significantly associated with the degree to which the death was viewed as Traumatic. CTG was also associated with caregivers' emotional reaction at the time of the death and caregivers' current sadness. Clinical implications and recommendations for future research are discussed.
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cognitive behavioral therapy for symptoms of trauma and Traumatic Grief in refugee youth
Child and Adolescent Psychiatric Clinics of North America, 2008Co-Authors: Laura K Murray, Judith A. Cohen, Heidi B Ellis, Anthony P. MannarinoAbstract:The diverse clinical presentation of refugee children and adolescents after their Traumatic experiences requires a treatment model that can mitigate a number of internalizing and externalizing symptoms. Refugee populations also require interventions that can adjust to the wide-ranging experiences likely encountered during preflight, flight, and resettlement. There is some evidence that immigration stressors or social stressors, such as discrimination, are associated with symptoms of postTraumatic stress disorder in refugee youth. Therefore refugee youth may benefit from multiple levels of services, ideally integrated. This article focuses on the mental and behavioral health component of services for refugee youth.
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a pilot study of modified cognitive behavioral therapy for childhood Traumatic Grief cbt ctg
Journal of the American Academy of Child and Adolescent Psychiatry, 2006Co-Authors: Judith A. Cohen, Anthony P. Mannarino, Virginia StaronAbstract:ABSTRACT Objective This pilot study evaluated outcomes for a modified 12-session protocol of cognitive-behavioral therapy for childhood Traumatic Grief (CBT-CTG) conducted between March 2004 and October 2005. CTG is an emerging condition characterized by a combination of postTraumatic stress and unresolved Grief symptoms. This two-module treatment model consisting of sequential trauma- and Grief-focused components was shortened from a previously presented 16-session protocol. Method Thirty-nine children ages 6 to 17 years old with CTG and their parents received the modified 12-session protocol of CBT-CTG. CTG and postTraumatic stress disorder (PTSD) symptoms were assessed at pretreatment, after the trauma-focused module, and after the Grief-focused module (at posttreatment). Child depression, anxiety, and behavioral symptoms, as well as parental depression and PTSD symptoms, were assessed at pre- and posttreatment. Results Children reported significant improvement in CTG, PTSD, depression, and anxiety, and parents reported significant improvement in children's PTSD, internalizing and total behavior problems, and their personal PTSD symptoms. Although PTSD significantly improved only during the trauma-focused module of treatment, CTG improved significantly during both trauma- and Grief-focused modules of treatment. Child satisfaction and parent satisfaction for this treatment protocol were also high. Conclusions These findings suggest that the shortened CBT-CTG protocol, which is similar in the number of sessions to what many community child bereavement programs offer, may be acceptable and efficacious for this population. The CBT-CTG model requires further evaluation in randomized, controlled treatment trials. J. Am. Acad. Child Adolesc. Psychiatry , 2006;45(12):1465-1473.
