丧失（心理学）的概念定义、理论、测量

延长哀伤障碍是一种由亲近的人去世引发的病理性哀伤反应, 即死亡发生6个月后, 个体对死者的想念影响到了生活各方面, 且社会功能受损, 其最近20年才开始受到临床心理学研究者关注和探讨。本文首先回顾了概念提出及后续发展, 并讨论了其与持续性复杂哀伤相关障碍的区别与联系。随后, 本文综述了其独立的诊断标准、评估工具和流行病学调查、以及与正常哀伤、抑郁症和创伤后应激障碍的区别。接下来, 本文对其病理机制的理论思考和实证研究进行了讨论。最后, 本文指出未来可考察诊断标准的跨文化适用性、丰富病理机制的理论与研究。

失独者在哀伤阶段的不良情绪源于“个人主观经验”，表现出对丧亲事实的惯习解释、偏差解释或迷思解释，进而造成无心工作、自行封闭、脱离社会，出现严重的心理问题甚至自杀。社会工作者可以运用哀伤历程理论与任务中心模式，评估失独者对客观现实的解释能力与状况，改善其认知水平，提高其自我宣泄能力，调适与转化他们的个人主观经验。

创伤性事件的影响不会终止于亲身经历创伤性事件的当事人, 也会波及到当事人的后代。以往的研究从父母、孩子 and 环境等方面探讨了创伤代际传递的影响因素, 发现创伤的传递主要表现为症状、任务以及身份的传递, 并从心理动力学、社会文化、家庭系统、生理机制及存在意义理论方面解释了创伤代际传递的机制。未来研究应更重视创伤传递过程中不同代之间在表现形式、诊断和治疗上的差异, 关注代际创伤的积极意义, 并重视国内集体性创伤的代际传递。

以80名3-5～6-5岁儿童为被试,用个别访谈法和关键词编码法研究了他们对人、事、物三个维度(随时发生性、伤感性、难修复性)的丧失认知及其与亲密度的关系,结果发现:(1)他们对丧失认知是随着年龄发展而不断提高的,但在发展水平上存在差异;(2)对广义和狭义死亡的认知具有一致性;(3)丧失是一种破坏性情感,对儿童情感的伤害程度与其对所爱的人、事、物的亲密程度有关;(4)对丧失认知表现出自我中心性和情感色彩。

Five grief group counseling sessions were conducted for six college students from S University in Guangdong Province to evaluate the effectiveness, therapeutic factors, and intervention mechanism of the grief counseling group-based intervention for bereaved college students. Results showed that group-based grief counseling interventions can, to some extent, help members regulate their grief emotions, deepen their understanding of life, enhance their social support during grief, and assist them in reconstructing the meaning of life. The intervention mechanism includes the following four aspects: using arts to provide a non-verbal communication channel; promoting life awareness through group expression; facilitating social support for grief through interpersonal interaction; and encouraging the expression of the meaning of life through contemplation of bereavement. To assist bereaved students go through the grieving stage smoothly, colleges and universities need to pay more attention to bereaved students, carry out grief counseling groups reasonably, incorporate specialized life education courses into the compulsory curriculum, enhance students’ understanding of life and death, and promote awareness of end-of-life care and advance directives.

Complex Posttraumatic Stress Disorder (CPTSD)is expected to occur after exposing to prolonged and repeated interpersonal traumatic events. Besides the core symptoms of PTSD,its symptoms include affective dysregulation,negative self-concept, and disturbances in relationships. The prevalence and construct of CPTSD in various culture has been assessed in a range of studies. The research found that the formation of CPTSD is not only associated with psychological processes such as the destruction of autonomy and loss of trust,but also may relate to the damage of brain areas of emotional functions. Currently,the three-phase-based treatment of CPTSD is an advocated and effective intervention. Future researches should explore the relationship between the complex trauma and CPTSD,clarify the concept and the applicability of the diagnostic tools in diverse cultural context,thoroughly analyze the causes and specific treatments for CPTSD.

… For nearly a century, bereavement theorists have … the bereavement field without a guiding theoretical base. In this article, the authors consider alternative perspectives on bereavement …

… This chapter seeks to determine the nature of adaptive coping with bereavement and … impact and significance of different ways of coping with bereavement. At the start of the twenty4irst*…

… bereavement and physical and mental health. Although grief is not a disease and most people adjust without professional psychological intervention, bereavement … grief or bereavement-…

Several interventions have been implemented to address the adverse psychological and physical consequences associated with bereavement. In this review, we summarize four major theories of bereavement, present a qualitative review of bereavement intervention studies, and assess the overall effectiveness of bereavement intervention studies in a quantitative meta-analysis. Summaries of the theories are drawn from published theoretical works. The qualitative and quantitative reviews were based on searches of Medline, PsychINFO, and Dissertation Abstracts International databases using the keywords "bereaved" and "bereavement." Overall, the interventions were largely methodologically flawed, rarely specified what theory of bereavement they were testing, and slowed surprisingly weak effect sizes. Possible interpretations for the small effect sizes are discussed, and future directions are outlined.

… Not surprisingly, given this taboo, the social implications of bereavement … bereavement. In bringing together some of the most prominent scholars in the field (from psychiatry, psychology…

… DEPATHOLOGIZING BEREAVEMENT Formost of the past century, the scholarly literature on bereavement has been dominated by the fields of clinical psychology, social work, and …

… This evolution is reflected in the growth of new areas of study, such as behavioral immunology and health psychology. Thus, it seems likely that the study of bereavement will be …

… Spousal bereavement can cause a rise in depressive … explanation, in which bereavement directly affects particular … The network model indicated that bereavement mainly affected …

Understanding of the bereavement experience has broadened and … of bereavement to which people must adapt, affecting how they grieve personally and mourn publicly. Bereavement …

… of bereavement on psychological health and well–being. We focus on marital bereavement … against the deleterious effects of bereavement. We then review previous research and fi…

… and bereavement. We hypothesized that such a measure would have the ability to detect cases in which bereavement … to clinical psychology in establishing the first clinical psychology …

In this review article, the authors integrate the theoretical, empirical, and clinical literature relevant to the phenomenon of college student bereavement. They synthesize information on …

… ” looks like in a healthy person other than Freud’s conjecture that the prime aspect of melancholia is ambivalence toward the lost object, whereas in “real mourning,” it is grieving over …

… writers attempt to trace the theoretical literature on grief and mourning. His work is … mourning and in differentiating mourning from depression. Freud took up the discussion of mourning …

The primary purpose of the present article is to provide an overview of three theories of mourning—The Dual Process Model of Coping with Bereavement, Meaning Reconstruction and Loss, and Attachment Theory and Loss: Revisited. These are linked both by their emphasis on the phenomenological and by ideas such as balance and flexibility. Connections are drawn between the mourning theories and counseling theories that are commonly employed by mental health counselors.

… Most historical accounts of theoretical ideas about grief begin with Freud's (1917/1957) Mourning and Melancholia, according to which grief has a specific function: to detach thoughts …

… grief was resolved when decathexis from the lost loved one was complete and the grieving … Freud termed these mourning activities "grief work." Freud's theory of grief remained in …

… Although anticipatory grief is a much-debated and critiqued bereavement concept… theory. Focusing on end-of-life intensive care practices, this paper integrates work on anticipatory grief …

… In this paper, I put forward the hypothesis that grief and mourning are important promoters of healing in psychotherapy in general. All patients have suffered losses of one kind or another…

… Since Freud, psychoanalytic object relational theory has elaborated and amended the Freudian critique with studies demonstrating the validity of the parental projection theory. However…

… measures of grief and discusses the differentiation of normal grief reaction from pathological grief and … Finally, we propose future directions for research on the development of new grief …

BACKGROUND In 2022, the International Classification of Diseases (ICD-11) and an update of the Diagnostic Statistical Manual of Mental Disorders (DSM 5 TR) were released for implementation worldwide and now include the new Prolonged Grief Disorder (PGD). The newest definition of PGD is based on robust clinical research from the Global North yet until now has not been tested for global applicability. METHODS The current study assesses the new PGD ICD-11 criteria in a large international sample of 1393 bereaved adults. The majority of the sample was included in the USΑ. Additionally, we conduct a sub-sample analysis to evaluate the psychometric properties, probable caseness of PGD, and differences in network structure across three regions of residency (USA, Greece-Cyprus, Turkey-Iran). RESULTS The psychometric validity and reliability of the 33-item International Prolonged Grief Disorder Scale (IPGDS) were confirmed across the whole sample and for each regional group. Using the strict diagnostic algorithm, the probable caseness for PGD for the whole sample was 3.6 %. Probable caseness was highest for the Greece-Cyprus group (6.9 %) followed by Turkey-Iran (3.2 %) and the USA (2.8 %). Finally, the network structure of the IPGDS standard items and cultural supplement items (total of 33 items) confirmed the strong connection between central items of PGD, and revealed unique network connections within the regional groups. LIMITATIONS Future research is encouraged to include larger sample sizes and a more systematic assessment of culture. CONCLUSION Overall, our findings confirm the global applicability of the new ICD-11 PGD disorder definition as evaluated through the newly developed IPGDS. This scale includes culturally sensitive grief symptoms that may improve clinical precision and decision-making.

BACKGROUND Grief reactions that become abnormally persistent and cause significant impairment in functioning have been introduced as new diagnostic entities within the classification systems DSM-5 and ICD-11 termed persistent complex bereavement disorder (PCBDDSM-5) and prolonged grief disorder (PGDICD-11), respectively. In order to assess these conditions, reliable and valid assessment instruments are indispensable. This systematic review examines available assessment tools for disordered grief, reviews their psychometric properties and assesses the extent to which they reflect the diagnostic entities. METHODS A systematic search of PubMed, PsycINFO and Web of Science databases was conducted. English language articles describing either the development of a measure for assessing PGD in adults or the validation of such a measure were included. RESULTS Overall 2215 publications were screened, 29 of which met the eligibility criteria. Three of the eleven described assessment tools are structured clinical interviews, one tool is a carer-based assessment and the remaining tools are self-report questionnaires. Most instruments demonstrate excellent or good reliability and validity. No tool assesses the current diagnostic criteria for PGDICD-11 fully. While three tools cover all diagnostic criteria for PCBDDSM-5, only one (TGI-SR) provides an adequate, empirically tested diagnostic algorithm. LIMITATIONS The inclusion of only English-language publications may have led to omission of relevant measurement tools and/or validation studies in different languages. CONCLUSIONS The newly released ICD-11 criteria for PGD could serve as a gold standard for diagnosis and build a foundation for the development of more precise assessment tools. Recommendations for clinical practice and future research are provided.

Following traumatic loss, defined as the death of a loved one due to unexpected or violent circumstances, adults may experience a myriad of grief-related problems. Given the addition of Prolonged Grief Disorders into the Diagnostic and Statistical Manual for Mental Disorders Fifth Edition, Text-Revision and influx of unexpected deaths due to the global Coronavirus pandemic, there is heightened interest in the measurement of grief-related processes. We conducted a systematic review according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines to identify measures of grief used in studies of adults who experienced traumatic loss. Searches yielded 164 studies that used 31 unique measures of grief-related constructs. The most commonly used instrument was the Inventory of Complicated Grief-Revised. Half of the measures assessed constructs beyond diagnosable pathological grief responses. Given the wide variation and adaptations of measures reviewed, we recommend greater testing and uniformity of measurement across the field. Future research is needed to adapt and/or design measures to evaluate new criteria for Prolonged Grief Disorder.

… The purpose of this paper is to describe a short version of a grief scale developed for research on pregnancy loss (spontaneous abortion, ectopic pregnancy, fetal death, and neonatal …

Abstract Millions of people are grieving the loss of someone who died of COVID-19. However, there have been no screening tools developed to identify individuals who may be suffering from dysfunctional grief during the pandemic. Therefore, the objective of this study was to develop and evaluate the properties of the Pandemic Grief Scale (PGS), which is a brief mental health screener to identify probable cases of dysfunctional grief associated with a COVID-19 death. This 5-item scale, which was based on 831 adults who lost someone to COVID-19, demonstrated solid reliability (αs = 0.86), factorial validity (PCA and CFA support), and construct validity with strong correlations with suicidal ideation and substance use coping. The PGS measures COVID-19 grief equivalently across demographic groups, and discriminates well between persons with and without dysfunctional grief using an optimized cut score of ≥ 7 (87% sensitivity and 71% specificity). An alarming 66% of the sample scored in the clinical range. The PGS also demonstrates incremental validity by explaining 18% additional variance in functional impairment due to a COVID-19 loss beyond measures of depression and generalized anxiety. These results support the PGS as an efficient and valid screening tool for clinical research and practice during a pandemic.

Abstract Though most mourners are resilient, a minority of the bereaved experience disabling grief accompanied by clinically significant impairment in important areas of functioning. Although impairment measures exist, they have notable limitations in the context of bereavement. Therefore, the objective of this study was to develop and evaluate the Grief Impairment Scale (GIS), which was designed to identify the impact of grief on biopsychosocial functioning. The resulting 5-item scale, which was based on 363 adults who are struggling with grief, demonstrated solid reliability, factorial validity, and convergent and divergent validity with correlations with measures of impairment, prolonged grief, and psychological distress. The GIS also measures grief-related functioning equivalently across demographic groups and satisfactorily discriminates between persons with and without impairment using an optimized cut score of ≥ 9 (79% sensitivity and 74% specificity). These results provide preliminary support for the GIS as a flexible tool for clinical research and practice.

… Purpose Grief is a reaction to a significant loss that can profoundly affect all aspects of life … in grief, by examining the psychometric properties of the Adult Attitude to Grief (AAG) scale in a …

Many children and adolescents experience the death of a close person, such as a family member or a friend. However, there is a scarcity of literature on the assessment of grief in bereaved youth. The use of validated instruments is essential to advance our knowledge of grief in children and adolescents. We conducted a systematic review, adhering to PRISMA guidelines, to identify instruments that measure grief in this population and explore their characteristics. Searches in six databases (Medline, PsycINFO, Embase, Emcare, Scopus, and Web of Science) identified 24 instruments, encompassing three categories: general-purpose grief scales, maladaptive grief scales, and specialized grief scales. We extracted data using a predetermined list of descriptive and psychometric properties. Findings indicate a need to direct research towards more stringent validation of existing instruments and the design of new instruments in line with developments in the understanding of grief in this population.

… scale is designed to assess grief processes as a result of both death and non-death losses. The process of grieving … Focusing a measure of grief on a specific group, in this case college …

… The purpose of the present study was to develop a brief scale for the measurement of caregiver grief, to examine and confirm its factor structure, and to determine construct validity. To …

… to determine whether additional assessment or support is … grief in the initial assessments, a third assessment should be … grief, whereby bereavement distress triggers an intense grief …

Background Anticipatory grief (AG) refers to the experience of grief symptoms by patients or their caregivers in response to life-threatening illnesses, even before an actual loss has occurred. The selection of valid and reliable patient-reported outcome measures (PROMs) to assess AG is essential for early identification, effective intervention, and the reduction of prolonged grief disorder. This study summarizes psychometric properties of AG PROMs and recommends the most effective PROMs. Methods Nine databases (PubMed, EMBASE, Web of Science, CINAHL, Cochrane Library, PsycINFO, CNKI, Wanfang, China Biology Medicine Database) were searched from inception to December 2024. Search terms include “preparatory” or “preparedness” or “pre-loss” or “pre-death” or “anticipatory,” “grief” or “mourn” or “bereave,” “surveys and questionnaires” or “assess” or “instrument” or “measure” or “inventory” or “scale” or “interview.” Eligible studies included those reporting the development or validation of any AG assessment for patients with chronic illnesses and their informal caregivers. Extracted psychometric properties encompassed content validity, structural validity, internal consistency, cross-cultural validity, reliability, measurement error, criterion validity, hypothesis testing, and responsiveness. We conducted a reliability generalization meta-analysis of internal consistency (Cronbach’s alpha) for identical AG PROMs across different studies. Quality assessment, measurement property ratings, synthesis, and modified grading of evidence were conducted following the COSMIN methodology for systematic reviews. Results A total of 20 studies comprising of 13 AG PROMs were included. 2 PROMs were designed for patient assessment, and 11 targeted informal caregivers. PG-12 demonstrated high-quality evidence in assessing informal caregiver AG, with satisfactory content validity and internal consistency, supporting grade A. MM-CGI-CCPS showed insufficient evidence for structural validity and internal consistency, warranting grade C; the remaining tools are suggested as grade B due to limited evidentiary support. Conclusion This review confirms PG-12 as a grade A PROM for measuring AG in informal caregivers. However, no grade A PROMs were identified for assessing AG in patients. Future studies are needed to further validate the methodological quality and measurement properties of PROMs used in patient populations. Significant concerns remain regarding other existing PROMs, particularly in content validity, structural validity, cross-cultural adaptation, measurement error, and reliability, which increase uncertainty in available evidence. Systematic review registration https://www.crd.york.ac.uk/PROSPERO/view/CRD42024624205, identifier (CRD42024624205).

Objective This study assessed the validity of the Indicator of Bereavement Adaptation Cruse Scotland (IBACS). Designed for use in clinical and non-clinical settings, the IBACS measures severity of grief symptoms and risk of developing complications. Method N = 196 (44 male, 152 female) help-seeking, bereaved Scottish adults participated at two timepoints: T1 (baseline) and T2 (after 18 months). Four validated assessment instruments were administered: CORE-R, ICG-R, IES-R, SCL-90-R. Discriminative ability was assessed using ROC curve analysis. Concurrent validity was tested through correlation analysis at T1. Predictive validity was assessed using correlation analyses and ROC curve analysis. Optimal IBACS cutoff values were obtained by calculating a maximal Youden index J in ROC curve analysis. Clinical implications were compared across instruments. Results ROC curve analysis results (AUC = .84, p < .01, 95% CI between .77 and .90) indicated the IBACS is a good diagnostic instrument for assessing complicated grief. Positive correlations (p < .01, 2-tailed) with all four instruments at T1 demonstrated the IBACS' concurrent validity, strongest with complicated grief measures (r = .82). Predictive validity was shown to be fair in T2 ROC curve analysis results (n = 67, AUC = .78, 95% CI between .65 and .92; p < .01). Predictive validity was also supported by stable positive correlations between IBACS and other instruments at T2. Clinical indications were found not to differ across instruments. Conclusions The IBACS offers effective grief symptom and risk assessment for use by non-clinicians. Indications are sufficient to support intake assessment for a stepped model of bereavement intervention.

The study evaluated the Perinatal Bereavement Grief Scale (PBGS), the first scale designed to measure grief following reproductive loss in terms of yearning for the lost pregnancy and …

Abstract Objective Expectant parents who live through perinatal loss experience intense grief, which is not always acknowledged or accepted. A screening tool to detect bereaved parents’ grief reactions can guide professionals, including perinatal palliative care teams, to provide follow-up for those in need. This review's goal is to identify and synthesize the international published literature on existent instruments specifically measuring the grieving process after any perinatal loss and to identify factors that could moderate grief reactions. Method Systematic review (PROSPERO # CRD42018092555) with critical synthesis. PUBMED, Cochrane, and PsycINFO databases were searched in English language articles using the keywords “perinatal” AND (“grief” OR “bereavement” OR mourning) AND (“scale” OR “questionnaire” OR “measure” OR “assessment”) up to May 2018. Eligibility criteria included every study using a measure to assess perinatal grief after all kinds of perinatal losses, including validations and translations to other languages and interventions designed to alleviate grief symptoms. Results A total of 67 papers met inclusion criteria. Seven instruments measuring perinatal grief published between 1984 and 2002 are described. The Perinatal Grief Scale (PGS) was used in 53 of the selected studies. Of those, 39 analyzed factors associated with grief reactions. Six articles used PGS scores to evaluate pre- and post-bereavement interventions. Studies in English language only might have limited the number of articles. Significance of results The PGS is the most used standardized measures to assess grief after perinatal loss. All parents living through any kind of perinatal loss should be screened.

… This assessment is important because evidence suggests that … The aim of this article is to investigate grief assessment, with a … on the content of such an assessment. This includes both …

… validated scale to measure grief rumination exists. Therefore, the current contribution aims to validate the Utrecht Grief Rumination Scale (UGRS), a scale developed to measure grief-…

To date, several theoretical models have been proposed to explain how the expected and natural grief processes turns into psychiatric disorders. Nevertheless, there is a paucity of empirical research examining the basic assumption of psychoanalytic theory regarding pre-death conflict and bereavement related guilt. Accordingly, the current study aimed to investigate the mediator role of bereavement related guilt in the relationship between the pre-death conflict and maladaptive grief process. The sample consisted of 447 bereaved adults who lost a loved one due to death in the last 5 years. The Unfinished Business in Bereavement (UBBS), Bereavement Guilt Scale (BGS), Beck Depression Inventory (BDI), and Prolonged Grief Disorder Scale (PG-13) scales were administered. The results indicated that the UBBS scores were positively correlated with both BDI and PG-13 scores, and BGS scores mediated these relationships. Obtained findings were discussed in relation to psychoanalytic theory and existing studies in the grief literature.