ABSTRACT

Prolonged grief disorder, a condition characterized by severe, persistent, and disabling grief, is newly included in ICD-11 and DSM-5-TR. Prolonged grief symptoms can be effectively treated with face-to-face or internet-delivered cognitive behavioral therapy. Traumatic losses may elicit higher prevalence of severe grief reactions. While face-to-face cognitive behavioral therapy appears efficacious in treating prolonged grief symptoms in traumatically bereaved individuals, it is not yet clear if internet-based cognitive behavioral therapy is efficacious for this population. Therefore, we investigated the efficacy of a 12-week internet-delivered cognitive behavioral therapy for people bereaved through traffic accidents in a randomized waitlist-controlled trial (registration number: NL7497, Dutch Trial Register). Forty adults bereaved though a traffic accident were randomized to internet-based cognitive behavioral therapy (n = 19) or a waitlist control condition (n = 21). Prolonged grief, post-traumatic stress, and depression symptoms were assessed at baseline, post-treatment, and 8-week follow-up. Dropout in the treatment condition was relatively high (42%) compared to the control condition (19%). Nevertheless, multilevel analyses showed that internet-based cognitive behavioral therapy strongly reduced prolonged grief, post-traumatic stress, and depression symptoms relative to the control condition at post-treatment and follow-up. We conclude that internet-based cognitive behavioral therapy appears a promising treatment for traumatically bereaved adults.

摘要

长期悲伤障碍是一种以严重、持续和致残悲伤为特征的疾病，新纳入 ICD-11 和 DSM-5-TR。长期悲伤症状可以通过面对面或互联网提供的认知行为疗法得到有效治疗。创伤性损失可能会引起严重悲伤反应的发生率更高。虽然面对面的认知行为疗法似乎可以有效治疗遭受创伤的丧亲者的长期悲伤症状，但目前尚不清楚基于互联网的认知行为疗法是否对这一人群有效。因此，我们在一项随机候补对照试验（注册号：NL7497，荷兰试验登记册）中研究了为期 12 周的互联网认知行为疗法对交通事故死者家属的疗效。n  = 19) 或候补名单控制条件 ( n  = 21)。在基线、治疗后和 8 周随访时评估长期悲伤、创伤后应激和抑郁症状。与对照条件（19%）相比，治疗条件下的脱落率相对较高（42%）。然而，多层次分析表明，与治疗后和随访时的控制条件相比，基于互联网的认知行为疗法极大地减少了长期悲伤、创伤后应激和抑郁症状。我们的结论是，基于互联网的认知行为疗法对于遭受创伤的成年人来说似乎是一种有前景的治疗方法。