Sudden gains in the treatment of children and adolescents with prolonged grief.

IF 4.5 1区心理学 Q1 PSYCHOLOGY, CLINICAL

Journal of consulting and clinical psychology Pub Date : 2025-01-01 DOI:10.1037/ccp0000932

Franziska Lechner-Meichsner, Mariken Spuij, Paul A Boelen

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引用次数: 0

Abstract

Objective: Sudden gains describe large and stable reductions in symptoms between two consecutive treatment sessions and have not yet been investigated in prolonged grief disorder (PGD), a new disorder in the 11th edition of the International Classification of Diseases and text revision of the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders characterized by separation distress and accompanying symptoms beyond 6 months of bereavement. The study aimed to examine the occurrence of sudden gains and their relation to treatment outcome and content during cognitive behavioral therapy (CBT) and supportive counseling for children and adolescents with PGD symptoms.

Method: We used data from 118 patients (50% female; age: M = 12.93, SD = 2.81) who were randomized to receive either nine individual sessions of CBT or nondirective supportive counseling. Session-by-session PGD symptoms were assessed using the Grief Checklist. We identified sudden gains using the original criteria by Tang and DeRubeis (1999) and compared treatment outcomes between sudden gainers and nonsudden gainers using linear mixed models.

Results: Nine patients (7.63%) experienced a total of 10 sudden gains. Most sudden gains occurred during CBT. We found no differences between sudden gainers and nonsudden gainers regarding PGD symptoms, posttraumatic stress, and depressive symptoms, but problem behaviors declined toward the follow-up assessments in sudden gainers.

Conclusions: Sudden gains seem to be a rare event with limited clinical relevance in the treatment of PGD symptoms in children and adolescents. Results imply future research into predictors of sudden gains and other forms of symptom change during PGD treatment. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

查看原文本刊更多论文

在治疗长期悲伤的儿童和青少年方面取得了突然的进展。

目的：突然获益描述了在两次连续治疗期间症状的大幅度和稳定的减少，并且尚未在延长悲伤障碍（PGD）中进行调查，PGD是第11版国际疾病分类和第五版精神障碍诊断和统计手册的文本修订中的一种新疾病，其特征是分离痛苦和丧亲6个月以上的伴随症状。本研究旨在探讨在认知行为治疗（CBT）和对PGD症状的儿童和青少年进行支持性咨询时，突然获益的发生及其与治疗结果和内容的关系。方法：118例患者的资料(女性占50%；年龄：M = 12.93, SD = 2.81)，随机接受9次单独的CBT治疗或非指导性支持性咨询。每个会话的PGD症状都使用悲伤检查表进行评估。我们使用Tang和DeRubeis（1999）的原始标准确定了突然增益，并使用线性混合模型比较了突然增益者和非突然增益者的治疗结果。结果：9例（7.63%）患者共10次突然获益。大多数突然增加发生在CBT期间。我们发现突然获得者和非突然获得者在PGD症状、创伤后应激和抑郁症状方面没有差异，但问题行为在突然获得者的随访评估中有所下降。结论：在儿童和青少年PGD症状的治疗中，突然获益似乎是一种罕见的事件，临床相关性有限。这一结果暗示了未来对PGD治疗期间突然获益和其他形式症状改变的预测因素的研究。（PsycInfo Database Record (c) 2025 APA，版权所有）。

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来源期刊

Journal of consulting and clinical psychology PSYCHOLOGY, CLINICAL-

CiteScore

9.00

自引率

3.40%

发文量

期刊介绍： The Journal of Consulting and Clinical Psychology® (JCCP) publishes original contributions on the following topics: the development, validity, and use of techniques of diagnosis and treatment of disordered behaviorstudies of a variety of populations that have clinical interest, including but not limited to medical patients, ethnic minorities, persons with serious mental illness, and community samplesstudies that have a cross-cultural or demographic focus and are of interest for treating behavior disordersstudies of personality and of its assessment and development where these have a clear bearing on problems of clinical dysfunction and treatmentstudies of gender, ethnicity, or sexual orientation that have a clear bearing on diagnosis, assessment, and treatmentstudies of psychosocial aspects of health behaviors. Studies that focus on populations that fall anywhere within the lifespan are considered. JCCP welcomes submissions on treatment and prevention in all areas of clinical and clinical–health psychology and especially on topics that appeal to a broad clinical–scientist and practitioner audience. JCCP encourages the submission of theory–based interventions, studies that investigate mechanisms of change, and studies of the effectiveness of treatments in real-world settings. JCCP recommends that authors of clinical trials pre-register their studies with an appropriate clinical trial registry (e.g., ClinicalTrials.gov, ClinicalTrialsRegister.eu) though both registered and unregistered trials will continue to be considered at this time.