最近的研究表明,体验复杂悲伤的成年人也很可能分离焦虑抑郁症状更差,以及其他心理健康挑战。

在2016年的研究学习中,卡米拉戈西和同事博士检查了复杂悲伤(CG)和分离焦虑症(Sepad)之间的关系。该研究涉及成人样本寻求CG的帮助1。研究人员想了解常见的Sepad是如何经历CG的人们,如果CG和Sepad的人更有可能遭受其他心理健康问题。

什么是复杂的悲伤?

Complicated grief, also known as traumatic grief or prolonged grief disorder, can occur after the death of a very close loved one. Research suggests that it affects between 10 to 20 percent of bereaved people2,它与对身心健康的负面影响有关3.

While everyone endures grief and emotional pain after the passing of a loved one, adults may be diagnosed with complicatedgrief if they also report persistent yearning, longing, and sorrow for at least 12 months (or six months for children). They must also report at least six of the following:

    • 接受死亡的重要困难
    • disbelief over the loss
    • difficulty with positive reminiscing about the deceased
    • anger
    • self-blame
    • 避免损失的提醒
    • 社会/身份中断

What Is Separation Anxiety Disorder?

分离焦虑症通常被认为只在儿童中看到的东西。但研究表明,人们可以在寿命中体验Sepad,甚至可以在某些情况下在成年期间开始4.。People who have SEPAD report intense and impairing anxiety about actual or imagined separations with their lovedor home environment, leading to a need to maintain physical proximity. SEPAD is thought to occur in about 23 to 40 percent of people with mental health problems5.

High Rates of Co-Occurrence

样本中151名成年人寻求治疗or CG, researchers found that nearly 70 percent also had SEPAD, which is a significantly higher rate than in previous studies. The individuals experiencing comorbid (simultaneous) CG and SEPAD were also more likely to report CG symptoms from the loss of a loved one other than a parent, spouse, or child. Interestingly, there were no differences in how the deaths occurred (either violently or nonviolently) between individuals with comorbid SEPAD and CG when compared to those with CG alone.

Further, individuals who had comorbid SEPAD and CG were more likely to report symptoms consistent with近期应激障碍(PTSD) and金宝博188滚球推荐over the course of their lifetimes. And those who reported having both CG and SEPAD also reported having more severe CG, as well as greater difficulties in their work, school, leisure, and family relationships.

具有Comorbid CG和Sepad的群体还报告了更多的贫困分离症状,包括增加的混乱,改变时间感知,不良感觉,感觉好像在醒来时梦想。而该群体报告了更多的抑郁症状。本研究的结果表明,经历CG和Sepad的个人患有很多痛苦 - 显着多于单独患有CG的人。

理论可以解释这种关系

该研究的研究人员表明,CG和Sepad症状之间的高相关可以通过附着理论解释。它的中央假设就是作为人类,我们有一个天生的动机,可以形成和保持密切的情绪债券,以满足我们的情感和工具需求。这种寻求和形成附件的过程在我们的神经生物学系统中硬连线6.

英国心理学家John Bowlby,一个附着理论中的核心人物,创造了“内部工作模型”一词,这是与他们历史源于我们历史的重要其他人的心理表达。这种内部工作模式有助于我们对看护人和家庭的期望产生期望,并有助于我们预测我们如何被他人对待。

当人们面临着一个被爱的人丧失时,急性悲伤(而不是复杂的悲伤)可能会破坏附件系统。急性悲伤的时期使我们能够将所爱的人的死亡纳入我们死者的内部工作模型,并处理损失的意义。但是,当我们没有完全处理或接受亲人的死亡时,复杂的悲伤就会出现7.

失去爱人的人也可以引发分离焦虑的发作。因此,CG和Sepad之间的高相关研究表明,两者的共同特征是分离困扰。重要的是要注意,CG和Sepad仍然被认为是明显的疾病,但这项研究可能表明这两个疾病的生活经历可能是相似的,核心情绪是与亲人分离的恐惧和痛苦。

Some Limitations

这项研究仅从一点介绍,因此我们不能得出结论,CG导致Sepad或Sepad导致CG。此外,我们无法确定人们是否有作为儿童的人可能更容易在成年期间在成年人中开发CG时,这面临着非常亲密的人的丧失。

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来源

1。Gesi, C., Carmassi, C., Shear, K., Shwartz, T., Ghesquiere, A., Khaler, J., Dell' Osso, L. (2016). Adult separation anxiety disorder in complicated grief: an exploratory study on frequency and correlates.综合精神病学(72), 6-12.

2。Shear, M.K. (2015). Clinical practice. Complicated grief.New England Journal of Med冰丝(372),153-160。

3.。Prigerson, H.G., Bierhals, A.J., Kasl, S.V., Reynolds, C.F. III, Shear, M.K., Day, N., et al. (1997). Traumatic grief as a risk factor for mental and physical morbidity.American Journal of Psychiatry(154),616-623。

4.。Pini, S, Abelli, M., Shear, K.M., Cardini, A., Lari, L., Gesi, C., et al. (2010). Frequency and clinical correlates of adult separation anxiety in a sample of 508 outpatients with mood and anxiety disorders.Acta Psychiacriaca Scandanavia.。2010年(122),40-46。

5. Silove,D.M.,Marnane,C.L.,Wagner,R,Manicavasagar,V.L.,&Rees,S。(2010)。焦虑诊所成人分离焦虑症的患病率和相关性。BMC Psychiatry (10),10-21。

6.。Bowlby, J.Attachment and Loss, Volume III:损失,悲伤和抑郁症。(1980).纽约:基本书。

7.剪切,K.,Monk,T.,Houck,P.,Melhem,N.,Frank,E.,Reynolds,C.等。(2007)。基于附着的复杂悲伤模型,包括避免的作用。European Archives of Psychiatry Clinical Neuroscience(257), 453–461.

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