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：
长期的悲伤障碍，一种以严重为特征的疾病，持久性,和致残的悲伤，新包含在ICD-11和DSM-5-TR中。长时间的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在治疗创伤丧亲者的长期悲伤症状方面似乎有效，目前尚不清楚基于互联网的认知行为疗法是否对该人群有效.因此,我们在一项随机候补名单对照试验(登记号:NL7497,荷兰试验注册)中调查了一项为期12周的互联网认知行为疗法对因交通事故而失去亲人的人的疗效.40名因交通事故而丧亲的成年人被随机分配到基于互联网的认知行为疗法（n=19）或候补控制条件（n=21）。旷日持久的悲伤，创伤后应激,在基线时评估抑郁症状，治疗后,8周随访。与对照条件（19％）相比，治疗条件下的退出率相对较高（42％）。然而，多层次分析表明，基于互联网的认知行为疗法大大减少了长时间的悲伤，创伤后应激,治疗后和随访时相对于对照状况的抑郁症状。我们得出的结论是，基于互联网的认知行为疗法对于遭受创伤的丧亲者来说似乎是一种有希望的治疗方法。
