Influencia de la psicopatología emocional y el tipo de pérdida en la intensidad de los síntomas de duelo

  1. Manuel Fernández-Alcántara 1
  2. M. Nieves Pérez-Marfil 1
  3. Andrés Catena-Martínez 1
  4. Miguel Pérez-García 1
  5. Francisco Cruz-Quintana 1
  1. 1 Centro de Investigación Mente, Cerebro y Comportamiento (CIMCYC). Universidad de Granada, España
Revista:
Revista iberoamericana de psicología y salud

ISSN: 2171-2069

Año de publicación: 2016

Volumen: 7

Número: 1

Páginas: 15-24

Tipo: Artículo

DOI: 10.1016/J.RIPS.2015.10.002 DIALNET GOOGLE SCHOLAR lock_openAcceso abierto editor

Otras publicaciones en: Revista iberoamericana de psicología y salud

Resumen

The loss of a loved one may provoke complicated grief, which is characterized by intense symptoms of yearning, sadness, or loss of life meaning. Identifying those at risk of developing complicated grief is crucial to provide adequate treatment. However, little is known about the symptom profile or the influence that the type of loss may have on grief intensity. A descriptive design was carried out. A total of 68 participants that have lost a loved one due to death, at least six months ago, took part on the research. They completed a range of emotional self-report measures. All psychopathological variables showed high and significant relations with the intensity of grief. The centrality perceived and feelings of hostility predicted the score of complicated grief. Finally, the loss of a son was associated with complicated grief and with higher scores on the experiences of loss and emotional psychopathology. Symptom profile of those with complicated grief is associated with a large number of psychopathological variables, including depression, anxiety and post-traumatic stress disorder. The loss of a son seems to be an important risk factor for developing complicated grief.

Referencias bibliográficas

  • Arizmendi, B. J. y O’Connor, M. -F. (2015). What is ‘‘normal’’ in grief? Australian Critical Care, 1-5 http://dx.doi.org/10.1016/j.aucc.2015.01.005
  • Berntsen, D. y Rubin, D. C. (2006). The centrality of event scale: A measure of integrating a trauma into one’s identity and its relation to post-traumatic stress disorder symptoms. Behaviour Research and Therapy, 44, 219-231. http://dx.doi.org/10.1016/j.brat.2005.01.009
  • Boelen, P. A. (2012). Variables mediating the linkage between loss centrality and postloss psychopathology. The Journal of Nervous and Mental Disease, 200, 801-806. http://dx.doi.org/10.1097/NMD.0b013e318266ba02
  • Boelen, P. A. y Prigerson, H. G. (2012). Commentary on the Inclusion of Persistent Complex Bereavement-Related Disorder in DSM-5. Death Studies, 36, 771-794. http://dx.doi.org/10.1080/07481187.2012.706982
  • Boelen, P. A., Van Den Bout, J., De Keijser, J. y Hoijtink, H. (2003). Reliability and validity of the Dutch version of the inventory of traumatic grief (ITG). Death Studies, 27, 227-247. http://dx.doi.org/10.1080/07481180302889
  • Bonanno, G. A. y Burton, C. L. (2013). Regulatory Flexibility: An Individual Differences Perspective on Coping and Emotion Regulation. Perspectives on Psychological Science, 8, 591-612. http://dx.doi.org/10.1177/1745691613504116
  • Bonanno, G. A. y Diminich, E. D. (2013). Positive adjustment to adversity-trajectories of minimal-impact resilience and emergent resilience. Journal of Child Psychology and Psychiatry, and Allied Disciplines, 54, 378-401. http://dx.doi.org/10.1111/jcpp.12021
  • Bonanno, G. A., Papa, A., Lalande, K., Westphal, M. y Coif-man, K. (2004). The importance of being flexible: the ability to both enhance and suppress emotional expression predicts long-term adjustment. Psychological Science, 15, 482-487. http://dx.doi.org/10.1111/j.0956-7976.2004.00705.x
  • Bonanno, G. A., Westphal, M. y Mancini, A. D. (2011). Resilience to loss and potential trauma. Annual Review of Clinical Psychology, 7, 511-535. http://dx.doi.org/10.1146/annurev-clinpsy-032210-104526
  • Bosquet-del Moral, L., Campos-Calderón, C. P., Hueso-Montoro, C., Pérez-Marfil, N., Hernández-Molinero, Á., Arcos-Ocón, L. y Cruz-Quintana, F. (2012). Vivencias y experiencias de duelo en madres tras un proceso de enfermedad oncológica de sus hijos. Medicina Paliativa, 19, 64-72. http://dx.doi.org/10.1016/j.medipa.2010.11.003
  • Bryant, R. A., Kenny, L., Joscelyne, A., Rawson, N., Maccallum, F., Cahill, C. y Nickerson, A. (2014). Treating Prolonged Grief Disorder. JAMA Psychiatry, 71, 1332. http://dx.doi.org/10.1001/jamapsychiatry.2014.1600
  • Crespo, M. y Gómez, M. (2012). La evaluación del estrés postraumático: Presentación de la escala de Evaluación Global de Estrés Postraumático (EGEP). Clínica Y Salud, 23, 25-41.
  • Derogatis, L. R. (2002). SCL-90-R: Cuestionario de 90 síntomas [adaptación Española de J. L. González de Rivera]. Madrid: TEA Ediciones.
  • Esmaeilpour, K. y Bakhshalizadeh Moradi, S. (2015). The severity of grief reactions following death of first-grade relatives. Iranian Journal of Psychiatry and Clinical Psychology, 20, 363-371.
  • Fasse, L. y Zech, E. (2015). The Dual Process Model of Coping with Bereavement in the test of the subjective experiences of bereaved spouses. An interpretative phenomenological analysis. OMEGA-Journal of Death and Dying., http://dx.doi.org/10.1177/0030222815598668
  • Fernández-Alcántara, M., De los Santos-Roig, M., Pérez-Marfil, M. N., Catena-Martínez, A., Pérez-García, M., Martí-García, C. y Cruz-Quintana, F. (2015). Adaptación al castellano de la Centrality of Event Scale (CES). Universitas Psychologica, 14 http://dx.doi.org/10.11144/Javeriana.upsy14-2.acce
  • Fernández-Alcántara, M., García-Caro, M. P., Pérez-Marfil, M. N. y Cruz-Quintana, F. (2013). Experiencias y obstáculos de los psicólogos en el acompañamiento de los procesos de fin de vida. Anales de Psicologia, 29, 1-8. http://dx.doi.org/10.6018/analesps.29.1.139121
  • García, J. A. y Landa, V. (2015). Family Physicians and Primary Bereavement Care. International Journal of Emergency Mental Health and Human Resilience, 17, 548-551.
  • García, J. A., Landa, V., Grandes, G., Pombo, H. y Mauriz, A. (2013). Effectiveness of ‘‘primary bereavement care’’ for widows: a cluster randomized controlled trial involving family physicians. Death Studies, 37, 287-310. http://dx.doi.org/10.1080/07481187.2012.722041
  • García-Caro, M. P., Cruz-Quintana, F., Schmidt Río-Valle, J., Muñoz-Vinuesa, A., Montoya-Juárez, R., Prados-Peña, D. y Botella-López, M. C. (2010). Influencia de las emociones en el juicio clínico de los profesionales de la salud a propósito del diagnóstico de enfermedad terminal. International Journal of Clinical and Health Psychology, 10, 57-73.
  • García-García, J., Landa, V., Trigueros-Manzano, M. y Gaminde-Inda, I. (2001). Inventario de experiencias en duelo (IED): adaptación al castellano, fiabilidad y validez. Atención Primaria, 27, 86-93.
  • García-García, J., Landa-Petralanda, V., Trigueros-Manzano, M. y Gaminde-Inda, I. (2005). Inventario Texas Revisado de Duelo (ITRD): adaptación al castellano, fiabilidad y validez. Atención Primaria, 35, 353-358.
  • Gillies, J. y Neimeyer, R. A. (2006). Loss, Grief, and the Search for Significance: Toward a Model of Meaning Reconstruction in Bereavement. Journal of Constructivist Psychology, 19(1), 31-65. http://dx.doi.org/10.1080/10720530500311182
  • Golden, A. -M., Dalgleish, T. y Mackintosh, B. (2007). Levels of specificity of autobiographical memories and of biographical memories of the deceased in bereaved individuals with and without complicated grief. Journal of Abnormal Psychology, 116, 786-795. http://dx.doi.org/10.1037/0021-843X.116.4.786
  • Gupta, S. y Bonanno, G. A. (2011). Complicated grief and deficits in emotional expressive flexibility. Journal of Abnormal Psychology, 120, 635-643. http://dx.doi.org/10.1037/a0023541
  • Herberman Mash, H. B., Fullerton, C. S. y Ursano, R. J. (2013). Complicated grief and bereavement in young adults following close friend and sibling loss. Depression and Anxiety, 30, 1202-1210. http://dx.doi.org/10.1002/da.22068
  • Jordan, A. H. y Litz, B. T. (2014). Prolonged Grief Disorder: Diagnostic, Assessment, and Treatment Considerations. Pro-fessional Psychology: Research and Practice, 45, 180-187. http://dx.doi.org/10.1037/a0036836
  • Kersting, A., Brähler, E., Glaesmer, H. y Wagner, B. (2011). Prevalence of complicated grief in a representative population-based sample. Journal of Affective Disorders, 131, 339-343. http://dx.doi.org/10.1016/j.jad.2010.11.032
  • Lannen, P. K., Wolfe, J., Prigerson, H. G., Onelov, E. y Kreic-bergs, U. C. (2008). Unresolved grief in a national sample of bereaved parents: Impaired mental and physical health 4 to 9 years later. Journal of Clinical Oncology, 26, 5870-5876. http://dx.doi.org/10.1200/JCO.2007.14.6738
  • Limonero-García, J., Lacasta-Reverte, M., García, J., Maté-Méndez, J. y Prigerson, H. G. (2009). Adaptación al castellano del inventario de duelo complicado. Medicina Paliativa, 16, 291-297.
  • Lotterman, J. H., Bonanno, G. A. y Galatzer-Levy, I.(2014). The heterogeneity of long-term grief reactions. Journal of Affective Disorders, 167, 12-19. http://dx.doi.org/10.1016/j.jad.2014.05.048
  • Maccallum, F. y Bryant, R. A. (2013). A Cognitive Attachment Model of prolonged grief: integrating attachments, memory, and identity. Clinical Psychology Review, 33, 713-727. http://dx.doi.org/10.1016/j.cpr.2013.05.001
  • Maccallum, F., Galatzer-Levy, I. R. y Bonanno, G. A. (2015). Trajectories of depression following spousal and child bereavement: A comparison of the heterogeneity in outcomes. Journal of Psychiatric Research, 69, 72-79. http://dx.doi.org/10.1016/j.jpsychires.2015.07.017
  • Mancini, A. D., Griffin, P. y Bonanno, G. A. (2012). Recent trends in the treatment of prolonged grief. Current Opinion in Psychiatry, 25, 46-51. http://dx.doi.org/10.1097/YCO.0b013e32834de48a
  • Middleton, W., Raphael, B., Burnett, P. y Martinek, N. (1998). A longitudinal study comparing bereavement phenomena in recently bereaved spouses, adult children and parents. The Australian and New Zealand Journal of Psychiatry, 32, 235-241. http://dx.doi.org/10.3109/00048679809062734
  • Montoya-Juárez, R., García-Caro, M. P., Campos-Calderón, C., Schmidt-Rio-Valle, J., Sorroche-Navarro, C. y Cruz-Quintana, F. (2012). Suffering in children experiencing a terminal disease: The perspective of parents and professionals. Revista Da Escola de Enfermagem, 46, 1300-1305. http://dx.doi.org/10.1590/S0080-62342012000600003
  • Montoya-Juárez, R., García-Caro, M. P., Schmidt-Rio-Valle, J., Campos-Calderón, C., Sorroche-Navarro, C., Sánchez-García, R. y Cruz-Quintana, F. (2013). Suffering indicators in terminally ill children from the parental perspective. European Journal of Oncology Nursing, 17, 720-725. http://dx.doi.org/10.1016/j.ejon.2013.04.004
  • Pini, S., Gesi, C., Abelli, M., Muti, M., Lari, L., Cardini, A. y Shear, K. M. (2012). The relationship between adult separation anxiety disorder and complicated grief in a cohort of 454 outpatients with mood and anxiety disorders. Journal of Affective Disorders, 143, 64-68. http://dx.doi.org/10.1016/j.jad.2012.05.026
  • Prigerson, H. G., Horowitz, M. J., Jacobs, S. C., Parkes, C. M., Aslan, M., Goodkin, K. y Maciejewski, P. K. (2009). Prolonged grief disorder: Psychometric validation of criteria proposed for DSM-V and ICD-11. PLoS Medicine, 6 http://dx.doi.org/10.1371/journal.pmed.1000121
  • Prigerson, H. G., Maciejewski, P. K., Reynolds, C. F., Bierhals, A. J., Newsom, J. T., Fasiczka, A. y Miller, M. (1995). Inventory of Complicated Grief: a scale to measure maladaptive symptoms of loss. Psychiatry Research, 59, 65-79. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/8771222
  • Prigerson, H. G., Vanderwerker, L. C. y Maciejewski, P. K. (2008). Prolonged grief disorder: A case for Inclusion in DSM-V. En M. S. Stroebe, R. O. Hansson, H. Schut, y W. Stroebe (Eds.), Handbook of bereavement research and practice: Advances in theory and intervention (pp.165-186). Washington, DC: American Psychological Association.
  • Robinaugh, D. J. y McNally, R. J. (2013). Remembering the Past and Envisioning the Future in Bereaved Adults With and Without Complicated Grief. Clinical Psychological Science, 1, 290-300. http://dx.doi.org/10.1177/2167702613476027
  • Romero, V. (2013). Tratamiento del duelo: exploración y perspectivas. Psicooncología, 10, 377-392. http://dx.doi.org/10.5209/revPSIC.2013.v10.n2-3.43456
  • Shear, M. K., Simon, N., Wall, M., Zisook, S., Neimeyer, R., Duan, N. y Keshaviah, A. (2011). Complicated grief and related bereavement issues for DSM-5. Depression and Anxiety, 28, 103-117. http://dx.doi.org/10.1002/da.20780
  • Shear, M. K., Wang, Y., Skritskaya, N., Duan, N., Mauro, C. y Ghesquiere, A.(2014). Treatment of Complicated Grief in Elderly Persons. JAMA Psychiatry, 71, 1287. http://dx.doi.org/10.1001/jamapsychiatry.2014.1242
  • Simon, N. M., Shear, K. M., Thompson, E. H., Zalta, A. K., Perlman, C., Reynolds ,C. F. y Silowash, R.(2007). The prevalence and correlates of psychiatric comorbidity inindividuals with complicated grief. Comprehensive Psychiatry, 48, 395-399. http://dx.doi.org/10.1016/j.comppsych.2007.05.002
  • Simon, N. M., Wall, M. M., Keshaviah, A., Dryman, M. T., Leblanc, N. J. y Shear, M. K.(2011). Informing the symptom profile of complicated grief. Depression and Anxiety, 28, 118-126. http://dx.doi.org/10.1002/da.20775
  • Stroebe, M. y Schut, H. (2010). The dual process model of coping with bereavement: Rationale and description. Death Studies, 23, 197-224. http://dx.doi.org/10.1080/074811899201046
  • Wakefield, J. C. (2013a). DSM-5 grief scorecard: Assessment and outcomes of proposals to pathologize grief. World Psychiatry, 12, 171-173. http://dx.doi.org/10.1002/wps.20053
  • Wakefield, J. C. (2013b). The DSM-5 debate over the bereavement exclusion: Psychiatric diagnosis and the future of empirically supported treatment. Clinical Psychology Review, 33, 825-845. http://dx.doi.org/10.1016/j.cpr.2013.03.007
  • Zech, E.(2006). Psychologie du deuil: Impact et processus d’adaptation au décès d’un proche. Bruxelles: Editions Mardaga.
  • Zetumer, S., Young, I., Shear, M. K., Skritskaya, N., Lebowitz, B., Simon, N. y Zisook, S.(2015). The impact of losing a child on the clinical presentation of complicated grief. Journal of Affective Disorders, 170, 15-21. http://dx.doi.org/10.1016/j.jad.2014.08.021