BACKGROUND Studies suggest that cognitive behavioral therapies (CBTs) may be efficacious in reducing symptoms of prolonged grief disorder (PGD), but no comprehensive overview and pooled estimate of CBTs' effect on PGD in adulthood exist. We conducted a systematic review and meta-analysis of randomized controlled trials. METHOD Studies were selected independently by two researchers based on a systematic literature search in Pubmed, APA PsycInfo, Web of Science, and Embase. Meta-analyses provided pooled effect sizes for the effects of CBTs on PGD symptoms and secondary outcomes. We explored potential moderators of effect, risk of bias of included studies, and evaluated the quality of the meta-analytical evidence through the Grading of Recommendations, Assessment, Development, and Evaluation system. RESULTS The meta-analysis included 22 studies of 2,602 bereaved adults (averaged study Mage = 49 years). CBTs had a statistically significant medium effect on PGD symptoms at postintervention (K = 22, g = 0.65, 95% CI [0.49, 0.81]), and a large effect at follow-up (K = 7, g = 0.90, 95% CI [0.37, 1.43]). Statistically significant small-to-medium effects were found at postintervention on posttraumatic stress symptoms (K = 10, g = 0.74, 95% CI [0.49, 0.98]), depression (K = 19, g = 0.53, 95% CI [0.36, 0.71]), and anxiety (K = 9, g = 0.35, 95% CI [0.22, 0.49]). The effects on PGD remained unchanged when adjusted for possible outliers. None of the moderator analyses reached statistical significance. CONCLUSION This review suggests that CBTs are efficacious in reducing PGD symptoms in adulthood. Generalization of findings should be done with caution due to considerable inconsistency and indirectness of meta-analytic evidence. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

中文翻译：

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针对长期悲伤症状的以悲伤为中心的认知行为疗法：系统评价和荟萃分析。


背景 研究表明，认知行为疗法 (CBT) 可能有效减轻长期悲伤障碍 (PGD) 的症状，但目前尚无 CBT 对成年后 PGD 影响的全面概述和汇总估计。我们对随机对照试验进行了系统回顾和荟萃分析。方法 研究由两名研究人员根据 Pubmed、APA PsycInfo、Web of Science 和 Embase 的系统文献检索独立选择。荟萃分析提供了 CBT 对 PGD 症状和次要结果影响的汇总效应大小。我们探索了潜在的效应调节因素、纳入研究的偏倚风险，并通过建议分级、评估、开发和评估系统评估了荟萃分析证据的质量。结果 荟萃分析包括 22 项研究，涉及 2,602 名失去亲人的成年人（平均研究年龄 = 49 岁）。 CBT 对干预后的 PGD 症状具有统计显着的中等影响（K = 22，g = 0.65，95% CI [0.49，0.81]），并且在随访中具有很大的影响（K = 7，g = 0.90，95%） CI [0.37，1.43]）。干预后发现对创伤后应激症状（K = 10，g = 0.74，95% CI [0.49，0.98]）、抑郁症（K = 19，g = 0.53，95% CI [0.36] 具有统计学显着性的中小效果，0.71]）和焦虑（K = 9，g = 0.35，95% CI [0.22，0.49]）。根据可能的异常值进行调整后，对 PGD 的影响保持不变。调节分析均未达到统计显着性。结论 本综述表明 CBT 可有效减少成年期的 PGD 症状。由于荟萃分析证据存在相当大的不一致和间接性，因此应谨慎推广研究结果。 （PsycInfo 数据库记录 (c) 2024 APA，保留所有权利）。