Trauma,Grief and Depression in Nairobi Children After the 1998 Bombing of the American Embassy

Despite the increasingly dangerous world where trauma and loss are common, relatively few studies have explored traumatic grief in children. The 1998 American Embassy bombing in Nairobi, Kenya, provided an unfortunate opportunity to examine this topic. This report describes findings in 156 children who knew someone killed in the incident, assessed 8 to 14 months after the explosion. Bomb-related posttraumatic stress was associated with physical exposure, acute response, posttraumatic stress related to other negative life events, type of bomb-related loss, and subsequent loss. Grief was associated with bomb-related posttraumatic stress, posttraumatic stress related to other negative life events, and type of bomb-related loss. The study supports the developing literature on traumatic grief and the need for studies exploring the potentially unique aspects of this construct.     

Parental depression, family functioning, and obesity among African American children

Obesity has reached an epidemic level in America (National Center for Health Statistics [NCHS] 1999), and this epidemic is more acute for African Americans than for other groups ofAmericans. In this study, 44 parent-child dyads completed measurements of height, weight, depression, and body fat composition. In addition, parents completed a demographic questionnaire, and instruments, which measured family functioning, parental psychopathology, child behavior, and cardiovascular risks. Several models emerged for predicting childhood and parental body mass index, parental depression, and child behavioral problems. Findings indicated a role for parental depression in childhood obesity. These findings are discussed in light of Bandura 's Social Cognitive Theory, and the family's role in childhood obesity.     

Parental depression, family functioning and obesity among African American children

Obesity has reached an epidemic level in America (National Center for Health Statistics [NCHS] 1999), and this epidemic is more acute for African Americans than for other groups of Americans. In this study, 44 parent-child dyads completed measurements of height, depression, and body fat composition. In addition, parents completed a demographic questionnaire, and instruments, which measured family functioning, parental psychopathology, child behavior, and cardiovascular risks. Several models emerged for predicting childhood and parental body mass index, parental depression, and child behavioral problems. Findings indicated a role for parental depression in childhood obesity. These findings are discussed in light of Bandura's Social Cognitive Theory, and the family's role in childhood obesity.     

Managing grief and depression at the end of life

Psychological distress is common in terminally ill persons and can be a source of great suffering. Grief is an adaptive, universal, and highly personalized response to the multiple losses that occur at the end of life. This response may be intense early on after a loss manifesting itself physically, emotionally, cognitively, behaviorally, and spiritually; however, the impact of grief on daily life generally decreases with time. Although pharmacologic interventions are not warranted for uncomplicated grief, physicians are encouraged to support patients by acknowledging their grief and encouraging the open expression of emotions. It is important for the physician to distinguish uncomplicated grief reactions from more disabling psychiatric disorders such as major depression. The symptoms of grief may overlap with those of major depression or a terminal illness or its treatment; however, grief is a distinct entity. Feelings of pervasive hopelessness, helplessness, worthlessness, guilt, lack of pleasure, and suicidal ideation are present in patients with depression, but not in those experiencing grief. Psychotherapy and antidepressant medications reduce symptoms of distress and improve quality of life for patients with depression. Physicians may consider psychostimulants, such as methylphenidate, for patients who have depression with a life expectancy of only days to weeks.     

Clinical Review: Communication and logistics in the response to the 1998 terrorist bombing in Omagh, Northern Ireland

The Omagh bombing in August 1998 produced many of the problems documented in other major incidents. An initial imbalance between the demand and supply of clinical resources at the local hospital, poor information due to telecommunication problems, the need to triage victims and the need to transport the most severely injured significant distances were the most serious issues. The Royal Group Hospitals Trust (RGHT) received 30 severely injured secondary transfers over a 5-hour period, which stressed the hospital's systems even with the presence of extra staff that arrived voluntarily before the hospital's major incident plan was activated. Many patients were transferred to the RGHT by helicopter, but much of the time the gained advantage was lost due to lack of a helipad within the RGHT site. Identifying patients and tracking them through the hospital system was problematic. While the major incident plan ensured that communication with the relatives and the media was effective and timely, communication between the key clinical and managerial staff was hampered by the need to be mobile and by the limitations of the internal telephone system. The use of mobile anaesthetic teams helped maintain the flow of patients between the Emergency Department and radiology, operating theatres or the intensive care unit (ICU). The mobile anaesthetic teams were also responsible for efficient and timely resupply of the Emergency Department, which worked well. In the days that followed many victims required further surgical procedures. Coordination of the multidisciplinary teams required for many of these procedures was difficult. Although only seven patients required admission to adult general intensive care, no ICU beds were available for other admissions over the following 5 days. A total of 165 days of adult ICU treatment were required for the victims of the bombing.     

Politics,religions, and grief: the cases of American spiritualism and the Deuteronomic reform in Israel

The article is a contribution to the task of developing a cross-cultural model of grief. It shows that grief narratives can be complexly interwoven with the religious and political narratives of the culture. Two political reforms in which religious narratives figured prominently are given as case examples: 19th-century Spiritualism in North America and the Deuteronomic reform in 7th-century BCE Israel. Similarities and differences between the two are discussed. The article concludes that an adequate cross-cultural model of grief must be capable of explaining how a particular grief narrative relates to the politics and religious narratives in which it is set.     

Ethnicity and the grief response: Mexican American versus Anglo American college students

Responses of 39 Mexican American college students were compared with those of 61 Anglo students via the Grief Experience Inventory. All participants had experienced, within the prior 2 years, the death of an individual they regarded as "close."In comparisons of ethnic groups, significant differences were found on two scales: Loss of Control and Somatization. The Mexican American sample had higher scores on both scales. While significant gender-related differences were found on three scales, no interactions between ethnicity and gender were found.     

Variations in grief,anxiety, depression,and health among family caregivers before and after the death of a close person in the context of palliative home care

Abstract

This article investigates longitudinal variations in grief, self-rated health, and symptoms of anxiety and depression among family caregivers in palliative care. Data were taken from a randomized psycho-educational intervention trial and were collected at four time-points; at baseline, upon completion, 2 months later, and 6 months after the patient’s death. In total, 117 family caregivers completed all questionnaires. The participants’ grief was stable across the measurements, while anxiety, depression, and health varied significantly (p?<?0.05). No significant differences were found between the intervention or control group. In conclusion, grief emerged as a constant phenomenon, distinct from symptoms of anxiety and depression.     

Identifying and managing preparatory grief and depression at the end of life

Grief and depression present similarly in patients who are dying. Conventional symptoms (e.g., frequent crying, weight loss, thoughts of death) used to assess for depression in these patients may be imprecise because these symptoms are also present in preparatory grief and as a part of the normal dying process. Preparatory grief is experienced by virtually all patients who are dying and can be facilitated with psychosocial support and counseling. Ongoing pharmacotherapy is generally not beneficial and may even be harmful to patients who are grieving. Evidence of disturbed self-esteem, hopelessness, an active desire to die and ruminative thoughts about death and suicide are indicative of depression in patients who are dying. Physicians should have a low threshold for treating depression in patients nearing the end of life because depression is associated with tremendous suffering and poor quality of life.     

Special issues in the grief of parents of murdered children

This paper is a report of one year's participant observation in a heal chapter of Parents of Murdered Children, a self-help group. The already difficult grief after the death of a child is complicated after murder by four special issues, (a.) Anger is focused on the person who willfully caused the death and there is a drive for revenge. (b) The grief cannot be resolved until the legal processes have been completed and within the court system the parent are caught up in a procedural labyrinth in which they have no legal standing, (c) Parents are fearful about the safety of themselves and other members of their family, (d) Parent of a murdered child is a taboo social role. The self-help process of Parents of Murdered Children as it differs from other self-help for for bereaved parents is discussed.     

Special issues in the grief of parents of murdered children

Abstract

This paper is a report of one year's participant observation in a heal chapter of Parents of Murdered Children, a self-help group. The already difficult grief after the death of a child is complicated after murder by four special issues, (a.) Anger is focused on the person who willfully caused the death and there is a drive for revenge. (b) The grief cannot be resolved until the legal processes have been completed and within the court system the parent are caught up in a procedural labyrinth in which they have no legal standing, (c) Parents are fearful about the safety of themselves and other members of their family, (d) Parent of a murdered child is a taboo social role. The self-help process of Parents of Murdered Children as it differs from other self-help for for bereaved parents is discussed.     

Effect of time since loss on grief,resilience, and depression among bereaved emerging adults

Grief research has typically centered on one time point, without considering the impact of multiple losses over time. In this study, 546 bereaved emerging adults were divided into three groups: those who experienced a recent loss (0–2 years ago), a past loss (>2 years ago), or a combination of both recent and past losses. Differences between the groups on resilience, depression, and grief symptomatology were examined. Those who had experienced both losses (recent and past) and recent losses endorsed significantly more grief symptoms than those in the past loss group. Findings highlight how multiple losses impact grief.