Understanding the impact of complicated grief on combat related posttraumatic stress disorder, guilt, suicide, and functional impairment in a clinical trial of post‐9/11 service members and veterans

Simon, Naomi M.; Hoeppner, Susanne S.; Lubin, Rebecca E.; Robinaugh, Donald J.; Malgaroli, Matteo; Norman, Sonya B.; Acierno, Ron; Goetter, Elizabeth M.; Hellberg, Samantha N.; Charney, Meredith E.; Bui, Éric; Baker, Arthur M.; Smith, Erin R.; Kim, H. Myra; Rauch, Sheila A. M.

doi:10.1002/da.22911

Cited by 34 publications

(18 citation statements)

References 50 publications

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“…The combination of PTSD and probable PGD also appeared to have a clinical impact, as participants who met criteria for PTSD and probable PGD had higher PTSD symptom severity. This is consistent with previous findings among veterans with combat-related PTSD that those with PGD had greater severity of PTSD (46). SMI clients who have experienced grief and loss may experience particular challenges that may require additional support.…”

Section: Discussionsupporting

confidence: 92%

Trauma Exposure and Prolonged Grief Disorder Among Persons Receiving Community Mental Health Services: Rates and Correlates

Yanos

Waynor

et al. 2022

Front. Psychiatry

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BackgroundPersons with serious mental illnesses (SMIs) are at increased risk for exposure to trauma and posttraumatic stress disorder (PTSD). Prolonged Grief Disorder (PGD) may also impact this population but has been seldom studied.AimsThe present study investigated the rate of both PTSD and PGD among clients receiving community mental health services, and the clinical correlates of co-occurring PTSD/PGD.MethodsTrauma history, PTSD and PGD were assessed among 536 individuals receiving community mental health services (Study 1). A subsample of 127 individuals from Study 1 who met DSM-5 criteria for PTSD based on diagnostic interview completed measures of psychiatric symptoms (Study 2).ResultsIn Study 1, 92.4% of participants receiving community mental health services had experienced a traumatic event, 49.6% met criteria for probable and provisional PTSD, 14.7% scored positive for probable PGD, and 11.9% met criteria for probable and provisional PTSD as well as probable PGD. In Study 2, participants meeting diagnostic DSM-5 criteria for PTSD and probable PGD had more self-reported PTSD symptoms, but did not differ on other outcomes.ConclusionsFindings highlight the need for trauma informed services including grief counseling for persons with SMI.

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Section: Discussionsupporting

confidence: 92%

Trauma Exposure and Prolonged Grief Disorder Among Persons Receiving Community Mental Health Services: Rates and Correlates

Yanos

Waynor

et al. 2022

Front. Psychiatry

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“…Additional areas of weakness included dropout/withdrawal rates (e.g., less than 60% of participants completed the study, Simon et al, 2020;dropout/withdrawal not reported, Stayton et al, 2019) and study designs without comparison or control groups.…”

Section: Quality Assessment and Risk Of Biasmentioning

confidence: 99%

Addressing co‐occurring suicidal thoughts and behaviors and posttraumatic stress disorder in evidence‐based psychotherapies for adults: A systematic review

Rozek

Baker

Rugo

et al. 2021

Journal of Traumatic Stress

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Posttraumatic stress disorder (PTSD) is a well-established risk factor for suicidal thoughts and behaviors. Historically, guidelines for treating PTSD have recommended against the use of trauma-focused therapies with patients who are high-risk for suicide likely due to concerns about potential suicide-related iatrogenesis, specifically the "triggering" of suicidal behaviors. This systematic review examines evidence for the impact of treatments specifically designed to treat PTSD or suicide on both PTSD-and suicide-related outcomes. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed and a total of 33 articles met full inclusion criteria, of which 23 examined PTSD treatments, 4 examined suicidefocused treatments, and 6 examined combined treatments. PTSD and combined treatments reduced both PTSD-and suicide-related outcomes, with most studies examining Cognitive Processing Therapy or Prolonged Exposure. Suicide-focused treatments (e.g., cognitive therapies for suicide prevention) also reduced suicide-related outcomes, but findings were mixed for their impact on PTSD-related outcomes. Overall, PTSD treatments had the most support, primarily due to a larger number of studies examining their outcomes. This supports current clinical guidelines, which suggest utilizing PTSD treatments for individuals at risk for suicide and who have PTSD. Suicide-focused and combined treatments also appeared to be promising formats although additional research is needed. Future research should seek to compare the effectiveness

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“…Additional areas of weakness included dropout/withdrawal rates (e.g., less than 60% of participants completed the study, Simon et al, 2020; dropout/withdrawal not reported, Stayton et al, 2019) and study designs without comparison or control groups.…”

Section: Quality Assessment and Risk Of Biasmentioning

confidence: 99%

Addressing Co-occurring Suicidal Thoughts and Behaviors and Posttraumatic Stress Disorder in Evidence-Based Psychotherapies for Adults: A Systematic Review

Rozek¹,

Baker²,

Rugo³

et al. 2021

Preprint

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Posttraumatic stress disorder (PTSD) is a well-established risk factor for suicidal thoughts and behaviors. Historically, guidelines for treating PTSD have recommended against the use of trauma-focused therapies with patients who are high-risk for suicide likely due to concerns about potential suicide-related iatrogenesis, specifically the “triggering” of suicidal behaviors. This systematic review examines evidence for the impact of treatments specifically designed to treat PTSD or suicide on both PTSD- and suicide-related outcomes. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed and a total of 33 articles met full inclusion criteria, of which 23 examined PTSD treatments, 4 examined suicide-focused treatments, and 6 examined combined treatments. PTSD and combined treatments reduced both PTSD- and suicide-related outcomes, with most studies examining Cognitive Processing Therapy or Prolonged Exposure. Suicide-focused treatments (e.g., cognitive therapies for suicide prevention) also reduced suicide-related outcomes, but findings were mixed for their impact on PTSD-related outcomes. Overall, PTSD treatments had the most support, primarily due to a larger number of studies examining their outcomes. This supports current clinical guidelines, which suggest utilizing PTSD treatments for individuals at risk for suicide and who have PTSD. Suicide-focused and combined treatments also appeared to be promising formats although additional research is needed. Future research should seek to compare the effectiveness of the approaches to the treatment of PTSD and suicidal thoughts and behaviors concurrently, as well as to inform guidelines aimed at supporting decisions about the selection of an appropriate treatment approach.

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Understanding the impact of complicated grief on combat related posttraumatic stress disorder, guilt, suicide, and functional impairment in a clinical trial of post‐9/11 service members and veterans

Abstract: This is the author manuscript accepted for publication and undergone full peer review but has not been through the copyediting, typesetting, pagination and proofreading process, which may lead to differences between this version and the Version of Record. Please cite this article as

Cited by 34 publications

References 50 publications

Trauma Exposure and Prolonged Grief Disorder Among Persons Receiving Community Mental Health Services: Rates and Correlates

Trauma Exposure and Prolonged Grief Disorder Among Persons Receiving Community Mental Health Services: Rates and Correlates

Addressing co‐occurring suicidal thoughts and behaviors and posttraumatic stress disorder in evidence‐based psychotherapies for adults: A systematic review

Addressing Co-occurring Suicidal Thoughts and Behaviors and Posttraumatic Stress Disorder in Evidence-Based Psychotherapies for Adults: A Systematic Review

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