Cognitive Behavioral Intervention for Persistent Complex Grief Symptomatology

Alexis Hernández Stevens; Bárbara de los Angeles Pérez Pedraza; Ana Luisa Facundo Castañeda; Karla Patricia Valdés García

doi:10.29057/jbapr.v7i14.15449

Authors

Alexis Hernández Stevens Universidad Autonoma de Coahuila https://orcid.org/0009-0008-0956-7392
Bárbara de los Angeles Pérez Pedraza Universidad Autonoma de Coahuila https://orcid.org/0000-0001-9685-3814
Ana Luisa Facundo Castañeda Universidad Autonoma de Coahuila https://orcid.org/0009-0001-6303-3956
Karla Patricia Valdés García Universidad Autonoma de Coahuila https://orcid.org/0000-0002-1681-1954

DOI:

https://doi.org/10.29057/jbapr.v7i14.15449

Keywords:

COVID-19, Persistent Complex Grief, Cognitive Distortions, Case Study, Cognitive Behavioral Therapy

Abstract

This study aimed to reduce symptoms associated with persistent complex grief in a female patient through a 13-session intervention based on the cognitive-behavioral model and acceptance and commitment. A clinical case study was conducted with a woman who lost her husband to COVID-19 without having funeral rituals. The participant was assessed using a grief, complex grief, and cognitive distortions questionnaire. The results indicated a significant but small decrease in general grief symptoms (PC=11.11), a decrease in complex grief (PC=42.11), and a small decrease in cognitive distortions. This suggests that the cognitive-behavioral intervention led to a reduction in grief symptoms and cognitive rumination, which in turn had an indirect impact on sleep quality, motivation, and socialization.

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References

[1] Aguinaga Arcos, S. N., & Pérez Mori, D. N. (2022). Duelo y el duelo complicado: Una revisión de la literatura científica en el tiempo. Journal of Neuroscience and Public Health, 2(1), 197–204. https://doi.org/10.46363/jnph.v2i1.4

[2] Duffy, M., & Wild, J. (2023). Living with loss: a cognitive approach to prolonged grief disorder – incorporating complicated, enduring and traumatic grief. Behavioural and Cognitive Psychotherapy, 1–14. https://doi.org/10.1017/s1352465822000674

[3] INEGI. (2022). Mortalidad. Demografía y sociedad. https://www.inegi.org.mx/temas/mortalidad/

[4] Carr, D., Boerner, K., & Moorman, S. (2020). Bereavement during the Coronavirus pandemic: Unprecedented challenges require novel interventions. Journal of Aging and Social Policy, 32(4–5), 425–431. https://doi.org/10.1080/08959420.2020.1771232

[5] Ceberio, M. R. (2021). COVID-19: La muerte en soledad. Aislamiento, miedo al contagio y duelo en pandemia. Ajayu, 19(2), 248–268. http://www.scielo.org.bo/scielo.php?script=sci_arttext&pid=S207721612021000200001

[6] Burrell, A., & Selman, L. E. (2020). How do funeral practices impact bereaved relatives’ mental health, grief, and bereavement? A mixed methods review with implications for COVID-19. OMEGA – Journal of Death and Dying, 81(3), 251–285. https://doi.org/10.1177/0030222820941296

[7] Mortazavi, S. S., Shahbazi, N., Taban, M., Alimohammadi, A., & Shati, M. (2023). Mourning during Corona: A phenomenological study of grief experience among close relatives during COVID-19 pandemics. OMEGA – Journal of Death and Dying, 87(4), 1088–1108. https://doi.org/10.1177/00302228211032736

[8] Samaan, M., Diefenbacher, A., Schade, C., Dambacher, C., Pontow, I. M., Pakenham, K., & Fydrich, T. (2021). A clinical effectiveness trial comparing ACT and CBT for inpatients with depressive and mixed mental disorders. Psychotherapy Research, 31(3), 355–368. https://doi.org/10.1080/10503307.2020.1802080

[9] Kürümlüoğlugil, R., & Tanrıverdi, D. (2022). The effects of psychoeducation on cognitive distortions, negative automatic thoughts, and dysfunctional attitudes of patients diagnosed with depression. Psychology, Health & Medicine, 27(10), 2085–2095. https://doi.org/10.1080/13548506.2021.1944654

[10] Linero, A. P. (2020). Efectividad de la intervención en el sentimiento de culpa desde el enfoque cognitivo conductual aplicado a una paciente de 20 años en proceso de duelo [Trabajo de grado no publicado, Universidad del Norte, División de Ciencias Sociales y Humanas].

[11] Martínez-Medina, C. B., & Rodríguez-Orozco, A. R. (2023). Prolonged grief disorder treatment: An approach to COVID-19 grief. Salud Mental, 46(3), 165–175. https://doi.org/10.17711/SM.0185-3325.2023.021

[12] American Psychiatric Association. (2014). Manual diagnóstico y estadístico de los trastornos mentales (5ª ed.). Editorial Médica Panamericana.

[13] Boelen, P. A., de Keijser, J., van den Hout, M. A., & van den Bout, J. (2007). Treatment of complicated grief: A comparison between cognitive‐behavioral therapy and supportive counseling. Journal of Consulting and Clinical Psychology, 75(2), 277–284. https://doi.org/10.1037/0022-006X.75.2.277

[14] Shear, M. K., Wang, Y., Skritskaya, N., Duan, N., Mauro, C., & Ghesquiere, A. (2016). Treatment of complicated grief in elderly persons: A randomized clinical trial. JAMA Psychiatry, 71(11), 1287–1295. https://doi.org/10.1001/jamapsychiatry.2014.1600

[15] Ato, M., López-García, J. J., & Benavente, A. (2013). Un sistema de clasificación de los diseños de investigación en psicología. Anales de Psicología / Annals of Psychology, 29(3), 1038–1059. https://doi.org/10.6018/analesps.29.3.178511

[16] Muñoz, M., Ausín, B., & Panadero, S. (2001). Manual práctico de evaluación psicológica clínica (2ª ed.). Editorial Pirámide.

[17] Prigerson, H. G., Maciejewski, P. K., Reynolds, C. F., Bierhals, A. J., Newsom, J. T., Fasiczka, A., Frank, E., Doman, J., & Miller, M. (1995). Inventory of Complicated Grief [Instrument manual]. Harvard Medical School, Center for Psychosocial Epidemiology and Outcomes Research.

[18] Limonero, J. T., & Maté Méndez, J. (2009). Adaptación al castellano del Inventario de Duelo Complicado [Manuscrito no publicado]. https://www.researchgate.net/publication/234101905

[19] Faschingbauer, T. R. (1981). Texas Revised Inventory of Grief (TRIG) [Manual]. Psychologists Press.

[20] García, J. A., Landa, V., Trigueros, M. C., & Gaminde, I. (2005). Inventario Texas Revisado de Duelo (ITRD): Adaptación al castellano, fiabilidad y validez. Atención Primaria, 35(7), 353–358. https://doi.org/10.1157/13074293

[21] Ruiz, J. M., & Luján, J. (1991). Inventario de pensamientos automáticos (IPA) [Instrumento de evaluación psicológica no publicado].

[22] Naranjo, K. X. (2020). Cualidades esenciales de análisis psicométrico del Inventario de Pensamientos Automáticos-Distorsiones Cognitivas de Ruiz y Luján en estudiantes de bachillerato de la Unidad Educativa Paul Dirac de Quito, 2019–2020 [Tesis inédita de licenciatura, Universidad correspondiente].

[23] American Psychological Association. (2017). Ethical principles of psychologists and code of conduct. https://www.apa.org/ethics/code

[24] World Medical Association. (2013). World Medical Association Declaration of Helsinki: Ethical principles for medical research involving human subjects. JAMA, 310(20), 2191–2194. https://doi.org/10.1001/jama.2013.281053

[25] Boelen, P. A., Lenferink, L. I. M., & Spuij, M. (2021). CBT for prolonged grief in children and adolescents: A randomized clinical trial. American Journal of Psychiatry, 178(7), 615–623. https://doi.org/10.1176/appi.ajp.2020.20050548

[26] Julian, L., & Hernández, A. (2022). Intervención cognitivo-conductual en el duelo complicado: Un estudio de caso. Clínica Contemporánea, 13(2), e8. https://doi.org/10.5093/cc2022a8

[27] Komischke-Konnerup, K. B., O’Connor, M., Hoijtink, H., & Boelen, P. A. (2023). Cognitive-behavioral therapy for complicated grief reactions: Treatment protocol and preliminary findings from a naturalistic setting. Cognitive and Behavioral Practice, 30(2), 344–357. https://doi.org/10.1016/j.cbpra.2023.01.007

[28] Levy Yeyati, E. (2022). Trastorno por duelo prolongado: Un nuevo diagnóstico en el DSM-5-TR. Vertex Revista Argentina de Psiquiatría, 33(156), 51–55. https://doi.org/10.53680/vertex.v33i156.179

[29] Levy Yeyati, E. (2018). Emociones y soluciones: Terapia de activación emocional (EAT). Editorial Akadia.