Morbid grief I: Are close relatives of the "redterror" victims of Addis Ababa still suffering from a morbid grief and other complications of bereavement?

Abstract: To assess whether close relatives of the "red-terror" victims of the Ethiopian revolution of late 1970's are still suffering from a morbid grief and other complications of bereavement, a study was carried out in Addis Ababa, Ethiopia, between February and May 1995. Ninety one close relatives (sample I ) have rated themselves with the Texas Inventory of Grief 18 years after bereavement and 89(97.8%) of them were found to have a profound grief reaction. Compared to 87 non-bereaving control group (sample II), they have scored significantly higher (P <0.001) on the General Health Questionnaire-30 items version (GHQ-30), Beck Depression Inventory (BDI) and State Anxiety Inventory (SAI). The correlation (r=+0.843, P<0.001) between the brief (BTIG) and the expanded (ETIG) forms of Texas Inventory of Grief has indicated that the two forms are equally reliable and useful in measuring grief reaction. All the rating scales are self-rating, Amharic translated with acceptable face validity, but they are not yet concurrently validated with their corresponding English versions. BTIG was recommended as a useful paper-and-pencil screening instrument with an arbitrary cut-off point of 16.24 (i.e. - 1.96 Z- score) for this particular group and it was suggested that respondents scoring 16.24 and above which amounts to 89(97.8%) be considered as probable cases of morbid grief and as candidates for bereavement counselling. [Ethiop. J. Health Dev. 1997;11(3):241-249

Morbid grief II: The phenomenology of pathologic grief process, depression and anxiety among close relatives of ‘red-terror’ victims

Abstract: To study the phenomenology of morbid grief and it's association to general distress, depression and anxiety, 91 randomly selected close relatives of the ‘red-terror’ victims completed four sets of questionnaires. All the questionnaires are self-rating, Amharic translated and with acceptable face validity, but not yet concurrently validated with their corresponding English versions. The percentage of positive endorsement and the mean score of each of the 34-items of ETIG (Expanded Texas Inventory of Grief) has ranged from 85.7% to 100% and from 1.71 to 4.81 respectively, indicating high degree of morbid grief. Items indicating ‘good outcome’ were found to show the opposite, i.e. ‘bad outcome’ even 18 years after the bereavement. The syndromes that belong to the complications of grief reaction are vivid and circumscribed. The magnitudes of endorsement and the mean scores of some of the items appear to be characteristic of the nature and circumstances of the loss and appropriate interpretation is necessary. The correlations between BTIG mean scores and the mean scores of GHQ-30 (General Health Questionnaire-30 item version), BDI (Beck Depression Inventory), and SAI (State Anxiety Inventory) were found to be weak, but significant. The GHQ-30, the BDI, and the SAI mean scores were found to have moderate to strong positive correlation coefficient to one another indicating common linkage they have to the pathologic grief reaction. [Ethiop. J. Health Dev. 1997;11(3):251-256

Morbid grief III: The influence of variables on the degree of grief reaction, depression and anxiety among close relatives of the "red-terror" victims

Abstract: To analyze some of the variables of the bereaved and of the victims that could significantly influence the degree of grief reaction, depression and anxiety, 91 randomly selected close relatives of victims of the ‘red-terror’ have completed the ETIG (Expanded Texas Inventory of Grief), BDI (Beck Depression Inventory), and SAI (State Anxiety Inventory) 18 years after the loss. All these questionnaires are self-rating, Amharic-translated and with acceptable face validity, but they are not yet concurrently validated with their corresponding English versions. The results have shown that the older age group (60-79 yrs) had a mean score of (131.63) on ETIG which is significantly higher (P<0.05) than that (118.56) of the youngest age group (20-39 yrs). The widows/ers had the highest mean score (139.95) on ETIG which is significantly higher (P<0.01 and P<0.001) than those of married (124.83) and singles (117.61), respectively. They were also found to have a mean score of 56.62 on SAI which is significantly higher (P<0.05) than that of singles (47.70) only. Parents who lost son(s) had a mean score of 132.26 on ETIG which is significantly higher (P<0.01) than those who lost brother(s) (118.93). Among the variables of the victims, where the dead body was given to relatives for funeral services, the mean score on the ETIG was 109.2 and this was found to be significantly lower (P<0.02 and P<0.001) than where the dead body was left on the street and not given to relatives (127.89) or where the dead body was neither left on the street nor given to relatives (129), respectively. It was recommended that the older age group, widows/ers, parents who lost son(s) and those who could not confirm the death of the victim by seeing the dead body, should get priority for counselling. [Ethiop. J. Health Dev. 1997;11(3):257-261