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

Live-chat support for people bereaved by suicide: a content analysis.

Background: People bereaved by suicide, or \u201csurvivors\u201d, are subject to increased risk of complicated grief and suicide, and struggle to obtain proper support. The aim of this study was to explore experiences and needs of survivors who find help on live-chats. No such analysis has been conducted so far. Methods: Qualitative content analysis was carried out on 30 live-chat conversations occurred between 2014 and 2019 through the software ATLAS.ti8 and by means of a Grounded Theory approach. Transcripts were retrieved from one of the major associations in Italy providing free of charge online support. Information about the sample was retrieved from the transcripts: users had different age (from 18 to 60 years), degrees of kinship with the deceased, and time distance from the loss (between 10 days and 36 months). Findings: Five macro-categories were identified: Reactions, Needs, Resources, Intervention of the operator and Sense-making of the loss. The latter included attempts at finding explanations for the suicide. A strong sense of responsibility towards those remaining emerged as the main reason for seeking help. However, several users reported lack of family support and, sometimes, dissatisfaction with formal support. Conclusions: Live-chat services represent a safe space where survivors can obtain useful information and start their process of meaning making of the loss. Because of its anonymity and availability, live-chats may represent a valid first line of support and a tool for prevention of suicidal ideation. Insights obtained from this study would help in the implementation of better services for survivors

Cultural scripts of gender and suicide: an analysis on Italian newspapers_2021 International Society of Critical Health Psychology (ISCHP) Conference

Suicide beliefs and attitudes vary by culture and, often, also by the gender of the suicidal person, as related to dominant femininity/masculinity ideologies. Suicide attitudes, as components of the suicide script, describe and prescribe the conditions when suicide is potentially permissible, for whom, and via what method. Studies (mostly from Anglophone countries) show that suicide scripts act as models and impact suicide prevalence. This study explored cultural scripts of gender and suicide in a new setting, Italy, through an analysis of newspapers suicide stories. Suicide stories in 2009-2019 newspapers were identified. Analyses focused on the who (e.g., the sex of the suicide decedent), how (i.e., the method), and why (e.g., the presumed suicide-cause). A total of 748 male and 175 female suicide stories were identified. Men’s suicide stories focused on work or community roles. When men’s suicide was associated with physical illness, it was narrated as a dignified decision. Relationship motives typically involved jealousy or a break-up. Suicide-emulation concerns appeared only in men’s stories. Women’s suicide stories focused on their presumed psychological fragility and inadequacy. When relationship motives were mentioned, they typically involved lovesickness. This study documented differences in how men’s and women’s suicide are narrated in Italian newspapers. The more-positive (e.g., suicide as an agentic, powerful, and dignified response to external adversities) connotation of male suicide stories, relative to female suicide stories (e.g., suicide as a symptom of psychological weakness and inadequacy) may offer a key for understanding men’s higher suicide mortality

Live-Chat Support for People Bereaved Due to Suicide: A Thematic Analysis

Background: People bereaved by suicide often face isolation, complicated grief and increased suicide risk. Aims T o explore how live chat can support survivors in the ir bere a vement process . Method A t hematic analysis wa s carried out on 30 live chat conversations through the software ATLAS.ti8. Transcripts were retrieved from a major Italian association providing online support. The u sers had different age s (18 to 60 years), degrees of kinship with the deceased blood rel at ed and not )), and time distance from the loss (between 48 hr and 10 years Results Five themes were identified: m eaning making, r eactions to the loss, r esources, n eeds and i nteractions with the operator Survivors used the live chat as a safe space in wh ich to disc lose nonsocially desirable details and to make sense of suicide through the reconstruction of events and the deceased\u2019s motivations . G i ven the li mited social resources and the dissatisfaction with the available formal support , users resort ed to justificati on , rationalization or faith and found support and reassurance in the live chats Limitations: S ome conversations were fragmented and lacked detailed information on the users . Conclusion Because of their anonymity and accessibility , live chats represent a valid first line fo rm of s upport from which survivors may obtain useful information and start a meaning making process

Experiences of Parental Suicide-Bereavement: A Longitudinal Qualitative Analysis over Two Years

Limited research exists on the experiences of parents bereaved by suicide. Our earlier qualitative analysis examined the experiences of parents\u2019 suicide bereavement at 6 and 12 months after their loss. The current study aimed to extend the analysis over 24 months, outlining the key themes of parents\u2019 suicide bereavement experience. In the frames of a longitudinal study of suicide bereavement in Queensland, Australia, parents were interviewed at 6, 12, and 24 months after their loss. Thematic analysis was used to further explore new themes and three key themes identified in earlier analyses: searching for answers and sense-making, coping strategies and support, and finding meaning and purpose. Results at 24 months revealed a clearer differentiation between strategies adopted by mothers and fathers. Anger and blame had changed towards feelings of depression. A polarization was observed between parents still oscillating in brooding rumination and those who have shifted towards sense-making. The former more frequently reported depression symptoms, and the latter reported a more positive attitude towards life and acceptance of their loss. Consistent with the dual-process model, parents managed to reach acceptance after oscillating between sense-making and meaning making. Findings provide insights how suicide loss affects parents, with implications for postvention

Social Support and Help-Seeking Among Suicide Bereaved: A Study With Italian Survivors

Background: Research over how suicide survivors approach services is limited. Aims: This cross-sectional study explores the psychological state and perceived social support of Italian survivors, including those who have not sought for help, and investigates differences for gender or kinship with the departed. Methods: Rule-based system (RBS) analyses identified relationships between social support and reported formal/informal help-seeking behavior. One-hundred thirty-two (103F; 27M) suicide survivors (53 having never sought for support) answered an anonymous online survey. Life satisfaction, wellbeing, perceived social support, suicidal ideation and formal/informal help-seeking were investigated. Results: RBS analysis identified different help-seeking behaviors: survivors lacking social support may avoid reaching a psychologist and prefer GPs, look for advice in online forums and rely on people out of their narrower network such as co-workers. Conclusion: These unique study\u2019s results offer insight to identify which specific areas would be fruitful to investigate while assessing social support in bereaved individuals

Psychosocial support in liver transplantation. A dyadic study with patients and their family caregivers

Background: Our objectives were to investigate how perceived social support and tendency of either self-reliance or reliance on others correlated with emotional and physical overload, anxiety, depression and psychoticism in patients waiting for transplantation and their caregivers. Methods: 93 participants were recruited at Liver Transplantation Center of Padua Hospital: 51 patients waiting to be included in liver transplantation list (19 with alcohol-related illness) and 42 family caregivers. Both patients and caregivers filled in Kelly's Dependency Grids and Symptom Checklist (SCL-90). Patients also compiled the Medical Outcomes Study Social-Support Survey (MOS-SSS) and caregivers the Family Strain Questionnaire Short-Form (FSQ-SF). Findings: Patients' and caregivers' symptomatology positively correlated (\u3c1=.32, p<.05). When patients perceived more social support, their symptomatology decreased (\u3c1=-.31, p<.05). Family strain was higher than the mean level. The breadth of patients\u2019 and caregivers\u2019 networks correlated with a decrease in caregivers\u2019 symptomatology only. In alcohol-related pathologies the caregiver's strain positively correlated with several subscales of the patients\u2019 SCL-90 and negatively with their network extension. The dependency on one's own self correlated negatively with the symptoms of patients without alcohol problems. When caregivers depended on other people, Anxiety (\u3c1=. 37, p<.05) and Hostility increased (\u3c1=.39, p<.05). Discussion: Waiting for transplantation affects both the patient and the caregiver as a dyad. Social support and the breadth of available resources are important variables in patients\u2019 and caregivers\u2019 wellbeing. These results suggest the usefulness of a dyadic approach in research, prevention and care