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Review
. 2012 Jun;14(2):210-4.
doi: 10.31887/DCNS.2012.14.2/snakajima.

Complicated grief in those bereaved by violent death: the effects of post-traumatic stress disorder on complicated grief

Satomi Nakajima  1 , Masaya Ito, Akemi Shirai, Takako Konishi
Affiliations
Review

Complicated grief in those bereaved by violent death: the effects of post-traumatic stress disorder on complicated grief

Satomi Nakajima et al. Dialogues Clin Neurosci. 2012 Jun.

Abstract
in English, Spanish, French

Violent death, such as homicide, accident, and suicide, is sudden, unexpected, and caused by intentional power, The prevalence of complicated grief among those bereaved by violent death is 12.5% to 78.0%. The factors affecting this prevalence rate are considered to be comorbid mental disorders, lack of readiness for the death, difficulty in making sense of the death, high level of negative appraisal about the self and others, and various social stressors. Post-traumatic stress disorder is, in particular, considered to contribute to the development of complicated grief by suppressing function of the medial prefrontal cortex and the anterior cingulate cortex, which works at facilitating the normal mourning process. An understanding of the mechanism and biological basis of complicated grief by violent death will be helpful in developing effective preventive intervention and treatment.

La muerte violenta como el homicidio, un accidente o el suicidio es repentina e inesperada y causada por una energía intencional. La prevalencia de duelo complicado entre los deudos de quienes han fallecido por una muerte violenta es entre 12,5% y 78,0%. Se considera que los factores que afectan esta prevalencia son trastornos mentales comórbidos, falta de preparación para la muerte, dificultad para encontrarle sentido a la muerte, una importante evaluación negativa de sí mismo y de los otros y varios estresores sociales. Se considera que el trastorno por estrés postraumático contribuye en forma especial al desarrollo del duelo complicado al suprimir la función de la corteza prefrontal medial y de la corteza angulada anterior, las cuales actúan facilitando el proceso de duelo normal. Una comprensión del mecanismo y de las bases biológicas del duelo complicado a raíz de una muerte violenta será útil para el desarrollo de intervenciones preventivas y tratamientos efectivos.

La mort violente, à la suite d'un homicide, d'un accident ou d'un suicide, est brutale, inattendue et provoquée de façon volontaire. La prévalence des deuils compliqués chez ceux subissant une perte par mort violente est de 12,5 à 78 %. Les facteurs exerçant une influence sur cette prévalence sont les troubles mentaux associés, l'absence de préparation à la mort, la difficulté à donner un sens à la mort, un degré élevé d'évaluation négative de soi et des autres et différents facteurs sociaux de stress. L'état de stress post-traumatique participe en particulier au développement de la douleur morale compliquée en supprimant la fonction des cortex médian préfrontal et angulaire antérieur qui contribue à faciliter le processus normal de deuil. La compréhension des mécanismes et des fondements biologiques du deuil compliqué à la suite d'une mort violente aidera à développer des actions et des traitements préventifs efficaces.

Keywords: brain function; complicated grief; post-traumatic stress disorder; traumatic loss; violent death.

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