IL LUTTO DOPO UNA PERDITA TRAUMATICA: ESPERIENZE, BISOGNI E APPLICAZIONI PRATICHE DEL SUPPORTO ONLINE.

The way of providing psychological support is changing, fast approaching the advantages provided by digitalization, particularly in light of the recent global upheavals. Also bereavement support is dealing with the implementation of different ways of reaching grieving people, and mental health professionals must investigate the possibilities offered by telematic tools, as well as the limits that online communication entails, especially for this specific population. The aim of the present study is to identify the practical implications, strengths, and limitations of the use of online bereavement support tools. In order to accomplish this aim, three studies were conducted and two specific bereavement experiences have been investigated: suicide losses and COVID-19 losses. Study 1 explored cross-sectionally the psychological state and perceived social support of Italian suicide survivors, and investigated differences in gender, kinship, help-seeking behavior, employing a rule-based system (RBS) analysis, an inference engine system able to identify implications among a set of variables. One-hundred and thirty-two (103 females and 29 males) suicide survivors answered an anonymous online survey. RBS analysis identified different help-seeking behaviors: survivors experiencing low level of social support may avoid going to a psychologist and resolve to GPs, look for advice in online forums and rely on people out of their narrower informal network such as coworkers. These unique study’s results offer insight to identify which specific areas would be fruitful to investigate while assessing social support in bereaved individuals. In Study 2, a thematic qualitative analysis was carried out on 30 live-chat transcripts of conversations between anonymous suicide survivors and a trained operator from a major Italian association providing online bereavement support. Five themes were identified to understand live-chat users’ experience with the service and their specific needs: meaning-making, reactions to the loss, resources, needs, and interactions with the operator. Suicide survivors showed to use the live-chat as a safe space in which to disclose nonsocially desirable details (included suicidal ideation) and to make sense of suicide through the reconstruction of events and the deceased's motivations. Study 3 explored qualitatively the bereavement experiences of twenty-five (23 females and 2 males) Italian family members who have lost a significant other to COVID-19 writing on a dedicated online support group. Thematic analysis of the posts showed five themes: group’s uses to respond to needs, shared crisis narrative, responses to grief, retelling narrative of death, and the context of the mourning process. Users were aware of the existence of the research and were also directly asked what they found particularly useful about the group. Participants used the group not only for memorialization purposes but also to share their loss experience and to find a community of other grievers equally shocked by the apparent unjustness of the death of their loved ones. The findings of this research might provide useful avenues for future research in order to fully capture the experience and consequences of Italian mourners’ uses of online tools.The way of providing psychological support is changing, fast approaching the advantages provided by digitalization, particularly in light of the recent global upheavals. Also bereavement support is dealing with the implementation of different ways of reaching grieving people, and mental health professionals must investigate the possibilities offered by telematic tools, as well as the limits that online communication entails, especially for this specific population. The aim of the present study is to identify the practical implications, strengths, and limitations of the use of online bereavement support tools. In order to accomplish this aim, three studies were conducted and two specific bereavement experiences have been investigated: suicide losses and COVID-19 losses. Study 1 explored cross-sectionally the psychological state and perceived social support of Italian suicide survivors, and investigated differences in gender, kinship, help-seeking behavior, employing a rule-based system (RBS) analysis, an inference engine system able to identify implications among a set of variables. One-hundred and thirty-two (103 females and 29 males) suicide survivors answered an anonymous online survey. RBS analysis identified different help-seeking behaviors: survivors experiencing low level of social support may avoid going to a psychologist and resolve to GPs, look for advice in online forums and rely on people out of their narrower informal network such as coworkers. These unique study’s results offer insight to identify which specific areas would be fruitful to investigate while assessing social support in bereaved individuals. In Study 2, a thematic qualitative analysis was carried out on 30 live-chat transcripts of conversations between anonymous suicide survivors and a trained operator from a major Italian association providing online bereavement support. Five themes were identified to understand live-chat users’ experience with the service and their specific needs: meaning-making, reactions to the loss, resources, needs, and interactions with the operator. Suicide survivors showed to use the live-chat as a safe space in which to disclose nonsocially desirable details (included suicidal ideation) and to make sense of suicide through the reconstruction of events and the deceased's motivations. Study 3 explored qualitatively the bereavement experiences of twenty-five (23 females and 2 males) Italian family members who have lost a significant other to COVID-19 writing on a dedicated online support group. Thematic analysis of the posts showed five themes: group’s uses to respond to needs, shared crisis narrative, responses to grief, retelling narrative of death, and the context of the mourning process. Users were aware of the existence of the research and were also directly asked what they found particularly useful about the group. Participants used the group not only for memorialization purposes but also to share their loss experience and to find a community of other grievers equally shocked by the apparent unjustness of the death of their loved ones. The findings of this research might provide useful avenues for future research in order to fully capture the experience and consequences of Italian mourners’ uses of online tools

Coping with recent COVID-19 deaths: A Qualitative Study with Grieving Family Members in Italy

Background: Loss maladjustment, often associated with increased psychological and physical\ua0health issues, could represent a risk in COVID-19 mourners due to the unexpected and violent conditions characterizing COVID-19 deaths. This is the first study to explore and differentiate among bereavement experiences of family members who have lost a significant other to COVID-19. Methods: Twenty individuals bereaved by COVID-19\u2019s first wave in Lombardy region, one of the earliest and most serious clusters worldwide, were interviewed between 1 and 3 months after their loss. Thematic analysis was carried out through the software ATLAS.ti8. Participants (15 F, 5 M) were mourning a parent (16), a spouse (1) or a grandparent (3). Findings: Five themes were identified: illness trajectories of COVID-19 patients; coping with the loss; resources; COVID-19 impact on mourners\u2019 lives; and looking forward. Mourners considering their loved one\u2019s departure as premature and unjust experienced a totaling anger: instead of undergoing a sense-making process, they focused all their attention on denouncing institutions and looking for culprits. Administration\u2019s mismanagement determined a widespread lack of trust in health professionals, also affecting mourners\u2019 search for psychological help. Participants relied mainly on virtual informal support, but the limitations of telematic-only support in the long-term emerged. Acceptance occurred particularly in those able to find alternative ways to share their grief and use it as a turning point. Discussion: The peculiar characteristics of COVID-19 deaths can amplify individual differences in the start of a meaning-making process. Results propose new insights for COVID-19 grief support within the meaning-making model

Uncertainty, shock and anger: Recent loss experiences of first-wave COVID-19 pandemic in Italy

The aim of this study is to explore qualitatively bereavement experiences of family members who have lost a significant other to coronavirus disease 2019 (COVID-19) in relation to mourners' needs and resources. Twenty individuals bereaved by the first wave of COVID-19 from the most heavily impacted Italian region were interviewed via video call between 1 and 3 months after their loss. Through a thematic analysis, four main themes were identified: reconstructions of the loss experience, responses to grief, resources and looking forward. The suddenness of the death and lack of farewell by means of a funeral prevented participants from realizing the loss and undertaking a meaning-making process. When anger was the main reaction to the loss, mourners focussed all their attention on denouncing medical and government institutions. Acceptance occurred particularly in those who found a way to share their grief and use it as a turning point. Participants relied mainly on informal support offered virtually, but mourners may have sought out in-person comfort in the long term. The results of this study propose new insights for COVID-19 bereavement support and trace the path for health promotion within a community shook by a communal grief experience. Please refer to the Supplementary Material section to find this article's Community and Social Impact Statement

Suicide Scripts in Italian Newspapers: Women's Suicide as a Symptom of Personal Problems and Men's Suicide as a Symptom of Social Problems

Background: There is substantial variability, by culture, in suicide rates, and also in suicide beliefs and attitudes. Suicide beliefs and attitudes predict actual suicidality. They also are elements of cultural scripts of suicide. Most suicide-scripts research has been conducted in Anglophone countries. Aims: This study investigates women's and men's suicide scripts in Italy. Methods: Italy's suicide scripts, including beliefs about what causes suicide, were explored via analyses of newspaper stories (N = 923) of women's and men's suicides. Results: Italian newspapers mostly featured men's suicide stories, consistent with Italian men's higher suicide mortality. Women's suicide was narrated as an unexpected act signaling personal (e.g., emotional and private-relationship) problems. By contrast, men's suicide was framed as relatively understandable response to serious public-life/social adversities (e.g., an economic downturn), and as a death of legitimate despair. Limitations: Social media suicide stories were not included in this study. Conclusion: In Italy, as in several countries with higher male suicide mortality, female suicide is psychologized and considered irrational while male suicide is viewed as a symptom of serious public-life/social problems, and therefore as deserving respect and empathy. The preference for social explanations of male suicide, together with the empathic attitudes, may contribute to male suicide being relatively more permissible and less stigmatized, and therefore also to men's higher suicide mortality