Background: Research on bereavement after terrorism is limited and primarily aiming on short-term consequences.Objective: To better understand the long-term health consequences of terrorism, we studied bereaved parents and siblings eight years after the Utøya terrorist attack in Norway. We examined the participants\' symptom levels of prolonged grief (PG) and post-traumatic stress (PTS), as well as their psychosocial functioning and employment status.Method: Bereaved parents (n = 88) and siblings (n = 34) aged 19 and above (mean age  = 49.7 years, SD = 13.8 years, 59.8% female) completed the Inventory of Complicated Grief (ICG), the Impact of Event Scale-Revised (IES-R), and the Work and Social Adjustment Scale (WSAS) to assess PG, PTS, and functional impairment, respectively. In addition, information about employment status was obtained. The proportion of participants scoring above recommended thresholds on the ICG, IES-R, and WSAS was calculated. Differences between parents and siblings and gender differences on these measures were examined.Results: In total, 62.3% of the participants had scores on the ICG indicating a risk for prolonged grief, while 45.9% scored over cutoff on the IES. There was a high overlap between symptoms of PG and PTS. Females had significantly higher scores on both the ICG and the IES compared to males. There were no differences between parents and siblings regarding PG and PTS symptoms. One out of three showed severe functional impairment on the WSAS. Approximately 30% of all the bereaved were outside the labour force, and one third of the parents had become unable to work after the terrorist attack.Conclusion: Many bereaved parents and siblings, following the Utøya terror attack, report long-lasting health consequences with symptoms of PG and PTS and functional impairment. The results suggest a need for follow up of bereaved after a terror attack and identify family members in need of health services.
Eight years after the Utøya terrorist attack bereaved parents and siblings still report high levels of prolonged grief and post-traumatic stress symptoms.There were no differences between parents and siblings regarding prolonged grief and post-traumatic stress symptoms.Many bereaved are still suffering functional impairments. Post-traumatic stress symptoms are found to be an important predictor for functional impairments.

Background: Due to the job characteristics, firefighters are repeatedly exposed to trauma incidents. However, not all firefighters exhibit the same level of post-traumatic stress disorder (PTSD) or post-traumatic growth (PTG). Despite this, few studies have looked into firefighters\' PTSD and PTG.Objective: This study identified subgroups of firefighters based on their PTSD and PTG levels, and investigated the influence of demographic factors and PTSD/PTG-related factors on latent class classification.Method: Latent profile analysis was used to examine the patterns of PTSD and PTG among 483 firefighters in South Korea. Using a cross-sectional design, demographic factors and job factors were examined as group covariates through a three-step approach. PTSD-related factors such as depression and suicide ideation, as well as PTG-related factors such as emotion-based response were analysed as differentiating factors.Results: Four classes were identified and named \'Low PTSD-low PTG (65.2%),\' \'Mid PTSD-mid PTG (15.5%),\' \'Low PTSD-high PTG (15.3%),\' and \'High PTSD-mid PTG (3.9%).\' The likelihood of belonging to the group with high trauma-related risks increased with more rotating shift work and years of service. The differentiating factors revealed differences based on the levels of PTSD and PTG in each group.Conclusions: 34.8% of firefighters experienced changes due to traumatic events while on the job, and some required serious attention. Modifiable job characteristics, such as the shift pattern, indirectly affected PTSD and PTG levels. Individual and job factors should be considered together when developing trauma interventions for firefighters.
Firefighters were classified into four groups based on their levels of PTSD and PTG. 65.2% of the participants belonged to the ‘Low PTSD-low PTG’ group.The shift pattern and years of service predicted the likelihood of group classification.This implies that, despite being frequently exposed to threatening events, not all firefighters experience trauma, and that job characteristics influence trauma-related vulnerabilities.

Background: Parents are a key source of support for children exposed to single-incident/acute traumas and can thereby play a potentially significant role in children\'s post-trauma psychological adjustment. However, the evidence base examining parental responses to child trauma and child posttraumatic stress symptoms (PTSS) has yielded mixed findings.Objective: We conducted a systematic review examining domains of parental responding in relation to child PTSS outcomes.Method: Studies were included if they (1) assessed children (6-19 years) exposed to a potentially traumatic event, (2) assessed parental responses to a child\'s trauma, and (3) quantitatively assessed the relationship between parental responses and child PTSS outcomes. A systematic search of three databases (APAPsycNet, PTSDpubs, and Web of Science) yielded 27 manuscripts.Results: Parental overprotection, trauma communication, avoidance of trauma discussion and of trauma reminders, and distraction were consistently related to child PTSS. There was more limited evidence of a role for trauma-related appraisals, harsh parenting, and positive parenting in influencing child outcomes. Significant limitations to the evidence base were identified, including limited longitudinal evidence, single informant bias and small effect sizes.Conclusion: We conclude that key domains of parental responses could be potential intervention targets, but further research must validate the relationship between these parental responses and child PTSS outcomes.
Child post-traumatic stress symptoms following acute trauma are consistently related to post-trauma parental overprotection, avoidance of trauma discussion and of trauma reminders, and promotion of distraction from trauma-related thoughts and stimuli.The findings from this review provide a potential rationale for targeting these parental domains in clinical interventions addressing children’s post-traumatic stress symptoms.Future research is needed to validate the longitudinal relationship between parental response domains following children’s traumatic exposure and child post-traumatic stress symptoms.

Background: How do we remember what happened shortly before a traumatic experience? There has been little focus on the temporal context of trauma memories, but a few studies suggest that aspects of what happened in the moments prior to a traumatic experience may be selectively enhanced and prioritized in memory.Objective: The main aim of this study was to investigate the occurrence, nature, and content of voluntary memories about what happened shortly before a disaster. The participants were individuals who had survived a fire on the passenger ferry Scandinavian Star 26 years earlier.Methods: Data collection took the form of face-to-face interviews. The analysis was carried out in two steps. First, all the narratives from participants who were aged 7 years or older at the time of the fire (N = 86) were coded in terms of the presence of detailed descriptions of what happened before the fire. Next, the narratives that included detailed descriptions of the moments before (N = 28) were included in a thematic analysis, focusing on coding the mode and the content.Results: More than one-third of the participants reported detailed accounts of what happened in the hours, minutes, or seconds before the fire. These memories included detailed descriptions of sensory impressions, dialogues, actions, and thoughts. Two themes stood out in the thematic analysis: (1) unusual observations and danger cues; and (2) counterfactual thoughts.Conclusion: The finding that specific details from the moments before a traumatic event may be vividly recalled indicates that peripheral details of traumatic events can be prioritized in memory. Such details may be interpreted as warning signals. Future research should examine whether such memories might stimulate long-standing thoughts of the world as being dangerous, and hence carry the threat forward in time.
A qualitative study exploring the occurrence, nature, and content of memories about what happened shortly before a disaster.For some trauma survivors, experiences or observations shortly before a traumatic event can be vividly recalled in detail, after more than two decades.Such detailed memories of what happened before a traumatic experience may be interpreted as warning signals; furthermore, they may stimulate long-standing thoughts of the world as dangerous, thus carrying the threat forward in time.

The Skills for Life Adjustment and Resilience (SOLAR) programme is a brief, scalable, psychosocial skill-building programme designed to reduce distress and adjustment difficulties following disaster.
We tested the feasibility, acceptability, efficacy and safety of a culturally adapted version of SOLAR in two remote, cyclone-affected communities in the Pacific Island nation of Tuvalu.
This pilot adopted a quasi-experimental, control design involving 99 participants. SOLAR was administered to the treatment group (n = 49) by local, non-specialist facilitators (i.e. \'Coaches\') in a massed, group format across 5 consecutive days. The control group (n = 50) had access to Usual Care (UC). We compared group differences (post-intervention vs. post-control) with psychological distress being the primary outcome. We also examined whether changes were maintained at 6-month follow-up.
Large, statistically significant group differences in psychological distress were observed after controlling for baseline scores in favour of the SOLAR group. Mean group outcomes were consistently lower at 6-month follow-up than at baseline. SOLAR was found to be acceptable and safe, and programme feedback from participants and Coaches was overwhelmingly positive.
Findings contribute to emerging evidence that SOLAR is a flexible, culturally adaptable and scalable intervention that can support individual recovery and adjustment in the aftermath of disaster. RCTs to strengthen evidence of SOLAR\'s efficacy are warranted.
Antecedentes: El programa de Destrezas para la Adaptación a la Vida y Resiliencia (SOLAR en sus siglas en inglés) es un programa breve, escalable y de desarrollo de destrezas psicosociales diseñado para reducir el malestar y las dificultades de adaptación después de un desastre.Objetivos: Probamos la viabilidad, aceptabilidad, eficacia y seguridad de una versión de SOLAR culturalmente adaptada en dos comunidades remotas afectadas por ciclones en la nación Insular de Tuvalu en el Pacífico.Método: Este piloto adoptó un diseño de control cuasiexperimental, involucrando n = 99 participantes. Se administró SOLAR al grupo de tratamiento (n = 49) por facilitadores locales no especialistas (es decir ‘Entrenadores’) en un formato de grupo masivo durante cinco días consecutivos. El grupo control (n = 50) tuvo acceso a la Atención Habitual (AH). Comparamos las diferencias entre los grupos (post-intervención versus post-control) siendo el resultado primario el malestar psicológico. Examinamos también si los cambios se mantuvieron a los 6 meses de seguimiento.Resultados: Se observaron diferencias grandes estadísticamente significativas entre los grupos en el malestar psicológico después de controlar los puntajes basales a favor del grupo SOLAR. Los resultados promedio del grupo fueron consistentemente más bajos a los 6 meses de seguimiento que al inicio. Se encontró que SOLAR era aceptable y seguro, y la retroalimentación del programa por los participantes y entrenadores fue extremadamente positiva.Conclusiones: Los hallazgos contribuyen a la evidencia emergente que SOLAR es una intervención flexible, culturalmente adaptable y escalable que puede apoyar la recuperación individual y la adaptación después de un desastre. Se justifica la realización de ECAs para fortalecer la evidencia de la eficacia de SOLAR.
背景:生活调整和心理韧性技能 (SOLAR) 计划是一个简短的, 可扩展的社会心理技能培养计划, 旨在减少灾难后的痛苦和适应困难。目的: 我们在太平洋岛国图瓦卢的两个受飓风影响的偏远社区考查了文化适应版 SOLAR 的可行性, 可接受性, 有效性和安全性。方法: 该试行采用了包含 99 名参与者的准实验控制设计。 SOLAR 由当地的非专业辅导员 (即‘教练’) 以集体, 小组形式连续五天提供给治疗组 (n= 49) 。对照组 (n= 50) 可以使用常规护理 (UC) 。我们比较了以心理困扰为主要结果的组间差异 (干预后与控制后) 。我们还考查了变化是否在 6 个月的随访中得以保持。结果: 在控制有利于 SOLAR 组的基线分数后, 观察到心理困扰的大且统计学显著的组间差异。在 6 个月的随访中, 平均组的结果始终低于基线。 SOLAR 被认为是可以接受和安全的, 参与者和教练的计划反馈非常积极。结论: 研究结果有助于为SOLAR 是一种灵活, 文化适应性强且可扩展的干预措施, 可以支持灾后个人恢复和调整提供证据。有必要进行 RCT 以加强 SOLAR 有效性的证据。.

BACKGROUND: COVID-19 deaths elevate the prevalence of prolonged grief and post-traumatic stress symptoms among the bereaved, yet few studies have examined potential positive outcomes. Moreover, how COVID-19 bereavement affects individual-level mental health outcomes is under-researched.
OBJECTIVE: This is the first study to use latent profile analysis (LPA) to identify heterogeneous profiles of prolonged grief, post-traumatic stress and post-traumatic growth among people bereaved due to COVID-19 and to identify predictors of latent class membership.
METHODS: Four hundred and twenty-two Chinese participants who were bereaved due to COVID-19 completed an online survey between September and October 2020. The survey included the International (ICD-11) Prolonged Grief Disorder Scale (IPGDS), the Post-traumatic Stress Disorder Checklist for DSM-5 (PCL-5) and the Post-traumatic Growth Inventory (PTGI). LPA was run in Mplus, and the 3-step auxiliary approach was used to test the predicting effects of potential predictors of latent class membership identified with chi-square tests and ANOVAs.
RESULTS: Four latent profiles were identified: resilience (10.7%), growth (20.1%), moderate-combined (42.2%) and high-combined (27.0%). The bereaved who shared a close relationship with the deceased and identified COVID-19 as the fundamental cause of death were more likely to be in the high-combined group. A conflictful bereaved-deceased relationship reduces the chance of being in the growth group. Moreover, the death of a younger person and loss of a partner attributed to maladaptive outcomes.
CONCLUSIONS: Serious attention needs to be paid to the mental health issues of people bereaved due to COVID-19 because nearly 70% of this group would have a moderate-combined or high-combined symptom profile. Special care should be given to those who lost someone younger, lost a partner or shared a close relationship with the deceased. Grief therapies that work on the conflicts between the deceased and the bereaved and unfinished business can be applied to facilitate growth.
Antecedentes: Las muertes por COVID-19 elevan la prevalencia de síntomas de duelo prolongado y estrés postraumático entre las personas en duelo, sin embargo, pocos estudios han examinado los posibles resultados positivos. Además, la forma en que el duelo por COVID-19 afecta los resultados de salud mental a nivel individual está poco investigada.Objetivo: Este es el primer estudio que utiliza el análisis de perfil latente (LPA) para identificar perfiles heterogéneos de duelo prolongado, estrés postraumático y crecimiento postraumático entre personas en duelo debido al COVID-19 y para identificar predictores de pertenencia a una clase latente.Métodos: Cuatrocientos veintidós participantes chinos que estaban en duelo debido a COVID-19 completaron una encuesta en línea entre septiembre y octubre de 2020. La encuesta incluyó la Escala Internacional de Trastorno por Duelo Prolongado (ICD-11) (IPGDS), la Lista de verificación de trastornos por estrés para el DSM-5 (PCL-5) y el Inventario de crecimiento postraumático (PTGI). Se ejecutó LPA en Mplus y se usó el enfoque auxiliar de 3 pasos para probar los efectos de concordancia de posibles predictores de pertenencia a una clase latente identificados con pruebas de chi-cuadrado y ANOVA.Resultados: Se identificaron cuatro perfiles latentes: resiliencia (10,7%), crecimiento (20,1%), combinado moderado (42,2%) y combinado alto (27,0%). Los deudos que compartían una relación cercana con el fallecido e identificaron al COVID-19 como la causa fundamental de muerte tenían más probabilidades de estar en el grupo de alta combinación. Una relación conflictiva con el fallecido reduce la posibilidad de estar en el grupo de crecimiento. Además, la muerte de una persona más joven y la pérdida de una pareja se asocian a resultados desadaptativos.Conclusiones: Se debe prestar mucha atención a los problemas de salud mental de las personas en duelo debido a COVID-19 porque casi el 70% de este grupo tendría un perfil de síntomas combinados moderados o combinados altos. Se debe prestar especial atención a quienes perdieron a alguien más joven, perdieron a una pareja o tuvieron una relación cercana con el fallecido. Las terapias de duelo que trabajan en los conflictos entre el fallecido y los deudos y en temáticas no resueltas, se pueden aplicar para facilitar el crecimiento.
背景: COVID-19 死亡增加了丧亲者的延长哀伤和创伤后应激症状的流行率, 但很少有研究考查潜在的积极结果。此外, 对 COVID-19 丧亲如何影响个体层面心理健康结果的研究不足。目的: 这是第一项使用潜在剖面分析 (LPA) 来确定因 COVID-19 丧亲者的延长哀伤, 创伤后应激和创伤后成长的异质剖面并确定潜在类别成员的预测因素的研究。方法: 422 名因 COVID-19 丧亲的中国参与者在 2020 年 9 月至 10 月期间完成了一项在线调查。该调查包括国际 (ICD-11) 延长哀伤障碍量表 (IPGDS), DSM-5创伤后应激障碍检查表 (PCL-5) 和创伤后成长量表 (PTGI) 。在 Mplus 中运行LPA, 并使用 3 步辅助方法来检验通过卡方检验和方差分析确定的潜在类别成员的潜在预测因子的预测效果。结果: 确定了四种潜在剖面:复原力(10.7%), 成长 (20.1%), 混合中等症状 (42.2%) 和混合高症状 (27.0%)。与死者关系亲密并确定 COVID-19 为根本死因的丧亲者更有可能属于混合高症状组。与死者有冲突会降低成为成长群体的几率。此外, 年轻人的死亡和丧失伴侣会增加适应不良的结果。结论: 需要认真关注因 COVID-19 丧亲者的心理健康问题, 因为该群体中有近 70% 的人具有混合中等或混合高症状剖面。应该给那些丧失更年轻人, 伴侣或与死者关系亲密的人提供特别护理。处理死者与丧亲者之间的冲突和未完成事件的哀伤疗法可用于促进成长。.