Couple’s Relationship After the Death of a Child: a Systematic Review

When a child dies, the parents must address the changes in their relationship as well as the way that these changes affect their individual adjustment. These two perspectives are addressed in this systematic review. Five databases were systematically searched for papers published in English between January 2000 and February 2014. Of the 646 publications, 24 papers met the inclusion criteria. The results suggest that a child’s death can cause cohesive as well as detrimental effects on a couple’s relationship. Variables that may produce differential outcomes for the marital relationship include situational factors, such as the cause and type of death and the child’s age at the time of death; dyad-level factors, such as surviving children, the pre-death characteristics of the relationship, communication and incongruent grieving; and individuallevel factors, such as the family of origin’s processing of trauma, social support, religious affiliation and finding meaning. Aspects such as marital quality and the couple’s interdependence were found to influence each parent’s individual adjustment. Larger, prospective, ethically conducted studies should be implemented to consolidate these findings. Mental health professionals may benefit from a deeper understanding of the risk and protective factors regarding marital adjustment after a child’s death

Rates and risks for prolonged grief disorder in a sample of orphaned and widowed genocide survivors

<p>Abstract</p> <p>Background</p> <p>The concept of Prolonged Grief Disorder (PGD) has been defined in recent years by Prigerson and co-workers, who have developed and empirically tested consensus and diagnostic criteria for PGD. Using these most recent criteria defining PGD, the aim of this study was to determine rates of and risks for PGD in survivors of the 1994 Rwandan genocide who had lost a parent and/or the husband before, during or after the 1994 events.</p> <p>Methods</p> <p>The PG-13 was administered to 206 orphans or half orphans and to 194 widows. A regression analysis was carried out to examine risk factors of PGD.</p> <p>Results</p> <p>8.0% (<it>n </it>= 32) of the sample met criteria for PGD with an average of 12 years post-loss. All but one person had faced multiple losses and the majority indicated that their grief-related loss was due to violent death (70%). Grief was predicted mainly by time since the loss, by the violent nature of the loss, the severity of symptoms of posttraumatic stress disorder (PTSD) and the importance given to religious/spiritual beliefs. By contrast, gender, age at the time of bereavement, bereavement status (widow versus orphan), the number of different types of losses reported and participation in the funeral ceremony did not impact the severity of prolonged grief reactions.</p> <p>Conclusions</p> <p>A significant portion of the interviewed sample continues to experience grief over interpersonal losses and unresolved grief may endure over time if not addressed by clinical intervention. Severity of grief reactions may be associated with a set of distinct risk factors. Subjects who lose someone through violent death seem to be at special risk as they have to deal with the loss experience as such and the traumatic aspects of the loss. Symptoms of PTSD may hinder the completion of the mourning process. Religious beliefs may facilitate the mourning process and help to find meaning in the loss. These aspects need to be considered in the treatment of PGD.</p

Work focused treatment of common mental disorders and return to work: A comparative outcome study

The aim of this study was to compare the effectiveness of two individual-level psychotherapy interventions: (a) treatment as usual consisting of cognitive-behavioral therapy (CBT) and (b) work-focused CBT (W-CBT) that integrated work aspects early into the treatment. Both interventions were carried out by psychotherapists with employees on sick leave because of common mental disorders (depression, anxiety, or adjustment disorder). In a quasi-experimental design, 12-month follow-up data of 168 employees were collected. The CBT group consisted of 79 clients, the W-CBT group of 89. Outcome measures were duration until return to work (RTW), mental health problems, and costs to the employer. We found significant effects on duration until RTW in favor of the W-CBT group: full RTW occurred 65 days earlier. Partial RTW occurred 12 days earlier. A significant decrease in mental health problems was equally present in both conditions. The average financial advantage for the employer of an employee in the W-CBT group was estimated at $5,275 U.S. dollars compared with the CBT group. These results show that through focusing more and earlier on work-related aspects and RTW, functional recovery in work can be substantially speeded up within a regular psychotherapeutic setting. This result was achieved without negative side effects on psychological complaints over the course of 1 year. Integrating work-related aspects into CBT is, therefore, a fruitful approach with benefits for employees and employers alike.status: publishe

Do they match? Prospective students’ experiences with choosing university programmes

When transitioning from high school to university, young people must choose a programme that fits them. We argue that prospective students who can test this fit before starting the programme, will make a better choice. We propose an integrated framework where testing person-environment fit on ability beliefs, interests and sense of belonging possibly contributes to making the right choice. Dutch matching procedures are supposed to serve as a fit-test for prospective students choosing a university programme. 61 prospective students at four Dutch universities were interviewed on the role of matching in their programme choice. Different elements of matching appear to allow for testing fit but vary in which aspects of fit can be tested and the impact they have. It can be cautiously stated that the more aspects of fit that can be tested, the more a matching procedure impacts prospective students’ final programme choice

Do they match? Prospective students’ experiences with choosing university programmes

When transitioning from high school to university, young people must choose a programme that fits them. We argue that prospective students who can test this fit before starting the programme, will make a better choice. We propose an integrated framework where testing person-environment fit on ability beliefs, interests and sense of belonging possibly contributes to making the right choice. Dutch matching procedures are supposed to serve as a fit-test for prospective students choosing a university programme. 61 prospective students at four Dutch universities were interviewed on the role of matching in their programme choice. Different elements of matching appear to allow for testing fit but vary in which aspects of fit can be tested and the impact they have. It can be cautiously stated that the more aspects of fit that can be tested, the more a matching procedure impacts prospective students’ final programme choice

The role of companions in aiding older cancer patients to recall medical information

Objectives: This study investigates information recall in unaccompanied and accompanied older cancer patients and their companions. Methods: One hundred cancer patients (aged X65 years) and 71 companions completed a recall questionnaire after a nursing consultation preceding chemotherapy treatment. Recall was checked against the actual communication in video-recordings of the consultations. Patients also completed measures of anxiety and memory-related beliefs. Results: Findings revealed that recall in patient and companion couples together was higher than their separate recall scores (both proportional and absolute), indicating that they supplement each other. Proportionally, unaccompanied patients recalled almost as much as couples, whereas their absolute recall scores were lower. Younger age and higher education were associated with higher recall in both patients and companions. Patients’ memory-related beliefs predicted the recall scores of their companions rather than their own recall score. When patients reported memory complaints, recall was lower in their companion. In contrast, when patients indicated that they did not understand all information, their companion recalled more. Conclusions: These findings indicate that, although an interrelationship exists between recall in patients and their companions, accompanied patients are likely to benefit from the extra information that their companions remember