A quasi-experimental trial of narrative reconstruction for prolonged grief disorder: Symptomatic improvement and enhanced memory integration.

BACKGROUND: Prolonged grief disorder (PGD) was recently approved as a formal diagnosis in the DSM-5-TR. The implementation of bereavement interventions is frequently requested, but their effectiveness has been controversial. Narrative reconstruction (NR) is a time-limited integrative therapy, originally developed for the treatment of post-traumatic stress disorder (PTSD) and adapted for the treatment of PGD. NR consists of exposure to the loss memory, a detailed written reconstruction of the loss memory narrative, and an elaboration of the personal significance of that memory for the bereaved. OBJECTIVES: In this study we evaluated the efficacy of NR for PGD. METHOD: In this study, 33 participants with PGD were quasi-randomized-that is, assigned to an immediate (n = 20) or delayed (n = 13) 16-session NR intervention. PGD, intrusion, avoidance and depression symptoms, as well as levels of the loss memory integration, were assessed at pretreatment, post-treatment, and at a 3-month follow-up. RESULTS: Mixed linear models showed significant intervention effects for PGD and intrusive symptomatology. Results also showed an increase in integration of the loss memory, and improvements remained stable for all outcomes at follow-up. CONCLUSION: In this study we established NR as an effective intervention for PGD and call for further validation in future studies. Integrating this intervention into the routine care of people with PGD seems important and beneficial.

Narrative reconstruction therapy for prolonged grief disorder: Basic interventions and mechanisms of change.

Narrative reconstruction is a time-limited integrative therapy, originally developed in the context of post-traumatic stress disorder and adjusted for the treatment of prolonged grief disorder (PGD). It consists of exposure to the loss memory and narrating a detailed written reconstruction of it. In this paper, we describe narrative reconstruction interventions and modifications for the treatment of PGD as well as the underlying mechanisms of change including integration of the loss episode into the life narrative. A case demonstration of narrative reconstruction with a patient with PGD presented for illustration and the integrative nature of narrative reconstruction for PGD is discussed.

Narrative reconstruction therapy for prolonged grief disorder - a pilot study.

Background: Prolonged grief disorder (PGD) is a chronic and disabling condition that affects approximately 10% of non-traumatically bereaved people. Narrative reconstruction (NR), originally designed for the treatment of posttraumatic stress disorder (PTSD), is a time-limited integrative therapy consisting of exposure to the loss memory, detailed written reconstruction of the loss memory narrative, and an elaboration of the personal significance of that memory for the bereaved. Objective: This pilot study examined the efficacy of NR therapy in reducing symptoms in bereaved people diagnosed with PGD. Method: Ten PGD patients participated in the study and were treated with 16 weekly sessions of NR. PGD, PTSD, and depression symptoms, as well as levels of loss integration, were assessed at pre-treatment, post-treatment, and at a 3-month follow-up. Results: Following NR, participants showed significant reductions in PGD, depression, and PTSD symptoms, and elevated levels of trauma integration. Symptoms showed further improvement at the three-month follow-up. Conclusions: These findings provide preliminary evidence for the feasibility and efficacy of NR in treating PGD. Narrative reconstruction therapy requires further evaluation in randomized controlled trials.

Antecedentes: El trastorno de duelo prolongado (PGD en su sigla en inglés) es una condición crónica y discapacitante que afecta aproximadamente al 10% de las personas que experimentan un duelo no traumático. La reconstrucción narrativa (NR en su sigla en inglés) fue diseñada originalmente para el tratamiento del trastorno de estrés postraumático (TEPT), es una terapia integrativa de tiempo limitado que consiste en la exposición a la memoria de la pérdida, la reconstrucción escrita detallada de la memoria narrativa de la pérdida, y una elaboración del significado personal de esa memoria para la persona experimentando el duelo.Objetivo: Este estudio piloto examina la eficacia de la terapia NR en reducir los síntomas en las personas experimentando duelo que han sido diagnosticadas con el PGD.Método: Diez pacientes con PGD participaron en el estudio y fueron tratados con 16 sesiones semanales de NR. Los síntomas de PGD, TEPT, y depresión, como también los niveles de integración de la pérdida, fueron evaluados previo al tratamiento, luego del tratamiento, y a los 3 meses de seguimiento.Resultados: Siguiendo NR, los participantes mostraron reducciones significativas en los síntomas de PGD, depresión, y TEPT, y niveles elevados de integración del trauma. Los síntomas mostraron mayores mejoras a los tres meses de seguimiento.Conclusión: Estos hallazgos proveen evidencia preliminar para la factibilidad y eficacia del NR en tratar el PGD. La terapia de reconstrucción narrativa requiere mayor evaluación en ensayos controlados aleatorizados.

When blue is larger than red: colors influence numerical cognition in synesthesia.

In synesthesia, certain stimuli ("inducers") may give rise to perceptual experience in additional modalities not normally associated with them ("concurrent"). For example, color-grapheme synesthetes automatically perceive achromatic numbers as colored (e.g., 7 is turquoise). Although synesthetes know when a given color matches the one evoked by a certain number, colors do not automatically give rise to any sort of number experience. The behavioral consequences of synesthesia have been documented using Stroop-like paradigms, usually using color judgments. Owing to the unidirectional nature of the synesthetic experience, little has been done to obtain performance measures that could indicate whether bidirectional cross-activation occurs in synesthesia. Here it is shown that colors do implicitly evoke numerical magnitudes in color-grapheme synesthetes, but not in nonsynesthetic participants. It is proposed that bidirectional coactivation of brain areas is responsible for the links between color and magnitude processing in color-grapheme synesthesia and that unidirectional models of synesthesia might have to be revised.