Prolonged Grief in Refugees Seeking Treatment for PTSD: Comorbidity with Post-Traumatic Stress Symptoms and Network Structure

IF 3.2 3区 心理学 Q1 PSYCHOLOGY, CLINICAL
Franziska Lechner-Meichsner, Mirjam Sophie Rueger, Kai Jannik Nehler, Thomas Ehring, Hannah Preiss, nee Schumm, Nexhmedin Morina, Dana Churbaji, Ricarda Mewes, Julia Giesebrecht, Cornelia Weise, Regina Steil
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引用次数: 0

Abstract

Refugees often experience traumatic events and the loss of loved ones, leading to post-traumatic stress disorder (PTSD), complex PTSD (cPTSD) and prolonged grief disorder (PGD). It has been repeatedly shown that comorbidity between PGD and PTSD is frequent especially after violent losses, but only few studies have investigated the relationship between PGD and cPTSD. The network approach to psychopathology is well suited to investigate associations between different symptoms. We therefore combined a traditional investigation of the probable prevalence of PGD and its comorbidity with PTSD and cPTSD in refugees and used network analysis to identify central symptoms and bridge symptoms. A total N of 92 treatment-seeking refugees who had experienced both loss and traumatic events completed a self-report measure of PGD and clinical interviews for PTSD and cPTSD. We determined the probable prevalence of PGDICD-11 and rates of comorbidity. Network centrality and associations between symptoms of PGD and cPTSD were examined using network analysis. The probable prevalence of PGDICD-11 was 28.04%. Of those with probable PGDICD-11, 65.38% also met criteria for comorbid PTSDICD-11 and 19.23% for comorbid cPTSD. The most central PGD symptom in the network was difficulties engaging in social or other activities, and the most central cPTSD symptom was negative self-concept. The most important PGD bridge symptom was emotional numbness. Results underscore the importance of screening for PGD in treatment-seeking traumatized refugees in order to consider it in treatment planning. The relatively small sample size and the stability indices call for cautious interpretation of the results.

Trial Registration

DRKS-ID: DRKS00019876.

Summary

  • This is the first prolonged grief and post-traumatic stress symptom network analysis in refugees.
  • Prolonged grief disorder is an important mental health problem in refugees.
  • Emotional numbness and avoidance were the most important bridge symptoms.
  • Screening for PGD is important in traumatized treatment-seeking refugees.
  • Culturally sensitive grief-focused interventions should be offered to refugees.

Abstract Image

寻求创伤后应激障碍治疗的难民的长期悲伤:与创伤后应激症状和网络结构的共病
难民经常经历创伤性事件和失去亲人,导致创伤后应激障碍(PTSD)、复杂PTSD (cPTSD)和长期悲伤障碍(PGD)。多次研究表明,PGD和PTSD的共病发生率很高,特别是在暴力损失后,但很少有研究调查PGD和cPTSD之间的关系。精神病理学的网络方法非常适合于调查不同症状之间的联系。因此,我们结合了对难民中PGD的可能患病率及其与PTSD和cPTSD的合并症的传统调查,并使用网络分析来确定中心症状和桥梁症状。共有92名寻求治疗的难民,他们经历过失去和创伤事件,完成了PGD的自我报告测量和PTSD和cPTSD的临床访谈。我们确定了PGDICD-11的可能患病率和合并症的发生率。网络中心性和PGD和cPTSD症状之间的关联使用网络分析进行检验。PGDICD-11的可能患病率为28.04%。在可能患有PGDICD-11的患者中,65.38%符合合并ptsd的标准,19.23%符合合并cPTSD的标准。网络中最核心的cpgd症状是参与社交或其他活动的困难,最核心的cPTSD症状是消极的自我概念。最重要的PGD过桥症状是情绪麻木。结果强调了在寻求治疗的创伤难民中筛查PGD的重要性,以便在治疗计划中考虑它。相对较小的样本量和稳定性指标要求对结果进行谨慎的解释。试验注册DRKS-ID: DRKS00019876。这是第一个难民长期悲伤和创伤后应激症状网络分析。长期悲伤障碍是难民中一种重要的心理健康问题。情绪麻木和回避是最重要的桥状症状。对寻求创伤治疗的难民进行PGD筛查很重要。应向难民提供具有文化敏感性的以悲伤为重点的干预措施。
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来源期刊
Clinical psychology & psychotherapy
Clinical psychology & psychotherapy PSYCHOLOGY, CLINICAL-
CiteScore
6.30
自引率
5.60%
发文量
106
期刊介绍: Clinical Psychology & Psychotherapy aims to keep clinical psychologists and psychotherapists up to date with new developments in their fields. The Journal will provide an integrative impetus both between theory and practice and between different orientations within clinical psychology and psychotherapy. Clinical Psychology & Psychotherapy will be a forum in which practitioners can present their wealth of expertise and innovations in order to make these available to a wider audience. Equally, the Journal will contain reports from researchers who want to address a larger clinical audience with clinically relevant issues and clinically valid research.
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