BEREAVEMENTNUR AINA BINTI AB KADIR082012100061

CONTENTS

Definitions Normal reaction of bereavement Abnormal reaction of bereavement Differences between bereavement

& depression

DEFINITIONS Bereavement: the fact of loss through

death Bereavement reaction: any

psychological, physiological or behavioral response to bereavement

Bereavement process: un umbrella term that refers to the emergence of bereavement reactions over time

DEFINITIONS Grief: the feelings & associated

behaviors, eg crying, accompanying the awareness of irrevocable loss

Grieving process: the changing affective state over time

Mourning: the social expressions of grief, including funerals, visitations, and rituals. Bereaved Deceased

NORMAL BEREAVEMENT REACTIONS

Protest behaviour Despair and detachment Reorganize and recovery

accept reality, ways to keep memory

COMPLICATED BEREAVEMENT Risk factors Multiple, sudden, unexpected deaths,

suicide, murder,and stigmatized deaths Preexisting personality in the bereaved:

insecurity, low self esteem, dependence, difficulties coping with stress, relationship

Depression, prior substance abuse, multiple concurrent life stresses or other crises, perceived lack of support

COMPLICATED PROCESSES

CHRONIC GRIEF

HYPERTROPHIC GRIEF

DELAYED GRIEF

CHRONIC GRIEF Most common Unremitting grief, highlighted by

bitterness and idealization of the dead

Extremely close relationship between the bereaved and the deceased

Ambivalent, dependent, social supports are lacking

COMPLICATED BEREAVEMENT HYPERTROPHIC

GRIEF After sudden and

unexpected death Customary coping

strategies are ineffective in mitigating anxiety

Disruption of family stability

Long term course

DELAYED GRIEF Absent/inhibited

grief Prolonged denial Anger, guilt

OTHERS UNRESOLVED

GRIEF Arrests in the

normal process of grief

Common Depressive

symptoms and syndromes, chronic mourning

TRAUMATIC GRIEF Both grief & PTSD Grief more both

chronic & hypertrophic

Violence, victimization, volition

Fear, horror, vulnerability, disintegration of cognitive assumptions may ensue

BEREAVEMENT VS DEPRESSION

QUESTION. A 10 year-old girl is brought in for treatment by her father

following the unexpected death of her mother due to a heart attack 6 weeks previously. The father is worried because the child is not sleeping well, has lost 7lb because of a decreased appetite, seems to be tired much of the time, and is preoccupied with memories of her mother. He notes that she cannot concentrate on her usual favourite television shows and has lost interest in many of her previous social activities. The patient reports that she deeply misses her mother, and she smiles in recalling many pleasant memories of their life together. Which of the following is the most likely diagnosis?

A. Adjustment disorder with depressed mood B. Major depression C. Normal bereavement D. Dysthymic disorder E. Sleep disorder

REFERENCES

Kaplan & Saddock’s, Synopsis of Psychiatry, volume 2.

Case Files Psychiatry by Toy and Klamen,5th edition.