Trajectories of avoidance and maladaptive cognitions in Complicated Grief Treatment: An investigation with older adults

• Applicant: Dr. Franziska Meichsner
• Subject Area: Personality Psychology, Clinical and Medical Psychology, Methodology
• Term: from 2018 to 2019
• Project identifier: Deutsche Forschungsgemeinschaft (DFG) - Project number 404681275

Complicated Grief is a prolonged and distressing form of grief and has an estimated prevalence of 9.8%. Due to bereavement being one of the most commonly experienced life events in older age, the prevalence is higher in older adults. Complicated Grief has been proposed as a new category for the forthcoming ICD-11 and is characterized by an intense longing for the deceased, difficulties accepting the reality of the death, avoiding reminders of the loss, and preoccupation with the circumstances of the death. Avoidance (e.g., avoiding to visit the grave or deal with the belongings of the deceased) and maladaptive grief-related cognitions (e.g., counterfactual thinking on the circumstances of the death or the own grief reaction) are core processes of Complicated Grief. They play key roles in the syndrome’s development and maintenance and are closely related to symptom severity.Treatments based on the principles of cognitive behavioral therapy are effective, but their working mechanisms are not completely understood yet. Initial evidence supports that avoidance and maladaptive grief-related cognitions warrant further attention as working mechanisms. Studies with older adults are of particular interest, but are still lacking to this date.It is therefore the aim of the project to investigate the two core processes avoidance and maladaptive grief-related cognitions as working mechanisms of treatment for Complicated Grief in older adults. The project will use data from a clinical trial that included 151 individuals aged 50 years and older. Participants received either 16 weeks of Complicated Grief Treatment or a control intervention and data were collected over 48 weeks. Complicated Grief Treatment integrates cognitive-behavioral strategies, such as those used in the treatment of posttraumatic stress disorder, with interpersonal therapy as well as motivational interviewing techniques. Strong empirical support is available.The project will address the following questions: 1) How does avoidance change during treatment and a follow-up period and how is the change related to Complicated Grief symptom severity? 2) How do maladaptive grief-related cognitions change and how is the change related to Complicated Grief symptom severity? 3) What is the association between avoidance and maladaptive grief-related cognitions during treatment and a follow-up period?The focus on the core processes avoidance and maladaptive grief-related cognitions will advance our knowledge on how an effective treatment for Complicated Grief works. The project will also make an important contribution to understanding mechanisms of action in psychotherapy with older adults.

• DFG Programme: Research Fellowships
• International Connection: USA
• Host: Professorin Katherine Shear, Ph.D.