Bereaved Young Adults Study

NCT05352243 | Completed

• 1 other identifier: 21-001728
• Study Type: interventional
• Target: 178
• Locations: 1 country
• Sites: 1

Brief Summary

Bereaved adolescents and emerging adults are at risk for developing psychological disorders and complicated grief. Clinical grief interventions and conventional wisdom reflect an implicit assumption that sharing and expressing one's feelings surrounding a loss (i.e., emotional disclosure) facilitates psychological adjustment. However, studies of emotional disclosure have yielded null results in bereaved samples. Individuals who have encountered stressful life events, including interpersonal loss, often report a desire to "give back" to others in similar situations. Empirical evidence suggests that providing support to others can be equally, if not more, beneficial than receiving support. The opportunity to support others experiencing stressful circumstances may address common feelings of powerlessness and engender a sense of meaning, enhancing positive affect and reducing distress. Interventions that leverage prosocial behaviors are associated with positive effects, including increases in wellbeing in non-bereaved populations. To date, no research has examined the utility of prosocial interventions for bereaved individuals. The present study tests a novel expressive helping intervention that combines elements of expressive disclosure and prosocial writing. Expressive helping will be compared to traditional expressive disclosure and a neutral writing control condition in a sample of bereaved young adults. Participants (N=156) will be randomized to one of three conditions-expressive disclosure, expressive helping, or a neutral writing control-and complete three weekly 20-minute writing sessions. Measures of psychological distress, well-being, and hypothesized mediators will be administered before, immediately following (within 48 hours of the final writing session), one month, and two months after the writing sessions. It is hypothesized that the participants in the expressive helping condition will evidence greater increases in well-being and decreases in grief-related distress at the one and two-month follow-ups, as compared to the other two groups.

Conditions

Bereavement

Keywords

Expressive Disclosure; Prosocial; Expressive Writing; Peer Helping; Young Adults

Outcome Measures

Primary Outcomes (2)

• Change in Wellbeing

  Wellbeing within the past two weeks will be measured at baseline, post-intervention, and the 1-month follow-up via the 14-item Mental Health Continuum-Short Form (MHC-SF; Keyes, 2009). The MHC-SF is comprised of three empirically derived subscales: the 3-item Emotional Well-Being Subscale, the 6-item Psychological Well-Being Subscale, and the 5-item Social Well-Being Subscale. Higher scores on each subscale, and the total score overall (range: 0-56), indicate greater well-being.

  Baseline (≤2 weeks of starting the intervention), post-intervention survey (≤1 week after the final writing assignment), the 1-month follow-up, and 2-month follow up.

• Change in Grief Reactions

  Grief-related distress within the past two weeks will be measured using the 18-item Traumatic-Grief Inventory Self-Report version (TGI-SR; Boelen et al., 2019). The TGI-SR includes items that reflect the criteria for Prolonged Grief Disorder (PGD) and Persistent Complex Bereavement Disorder set forth by the Diagnostic and Statistical Manual of Mental Disorders and International Classification of Diseases, respectively. Higher scores (range: 18-90) indicate more severe potentially impairing grief reactions.

  Baseline (≤2 weeks of starting the intervention), post-intervention survey (≤1 week after the final writing assignment), the 1-month follow-up, and 2-month follow up.

Secondary Outcomes (3)

• Change in Physical Symptoms

  Baseline (≤2 weeks of starting the intervention), post-intervention survey (≤1 week after the final writing assignment), the 1-month follow-up, and 2-month follow up.

• Change in Anxiety

  Baseline (≤2 weeks of starting the intervention), post-intervention survey (≤1 week after the final writing assignment), the 1-month follow-up, and 2-month follow up.

• Change in Depressive Symptoms

  Baseline (≤2 weeks of starting the intervention), post-intervention survey (≤1 week after the final writing assignment), the 1-month follow-up, and 2-month follow up.

Other Outcomes (4)

• Change in Universality

  Baseline (≤2 weeks of starting the intervention), directly after each writing session, post-intervention survey (≤1 week after the final writing assignment), the 1-month follow-up, and 2-month follow up.

• Change in Psychological Distance

  Baseline (≤2 weeks of starting the intervention), directly after each writing session, post-intervention survey (≤1 week after the final writing assignment), the 1-month follow-up, and 2-month follow up.

• Change in Generativity

  Baseline (≤2 weeks of starting the intervention), directly after each writing session, post-intervention survey (≤1 week after the final writing assignment), the 1-month follow-up, and 2-month follow up.

Study Arms (3)

Expressive Disclosure

ACTIVE COMPARATOR

Participants will be instructed to write about their deepest thoughts and feelings surrounding their bereavement experience.

Behavioral: Expressive Disclosure

Expressive Helping

EXPERIMENTAL

Participants will be instructed to write about their deepest thoughts and feeling surrounding their bereavement experience in their first two essays and to provide advice and support for someone who recently experienced a loss in their final essay.

Behavioral: Expressive Helping

Fact-Writing

SHAM COMPARATOR

Participants will be instructed to write objectively about different time frames (e.g., routine for getting up in the morning, routine for going to sleep at night).

Behavioral: Fact-Writing

Interventions

Expressive Disclosure BEHAVIORAL

Prior to each writing session, participants will receive general instructions for completing the writing (e.g., write continuously for 20 minutes, do not worry about grammar, sentence structure, repetition), and be reminded that their writing will remain confidential. Three writing sessions will be spaced 1-2 weeks apart. A weekly writing prompt will instruct participants to write about their deepest thoughts and feelings surrounding their bereavement experience.

Expressive Disclosure

Expressive Helping BEHAVIORAL

Prior to each writing session, participants will receive general instructions for completing the writing (e.g., write continuously for 20 minutes, do not worry about grammar, sentence structure, repetition), and be reminded that their first two writing will remain confidential, and their final essay will be de-identified before being provided to newly bereaved young adults. Three writing sessions will be spaced 1-2 weeks apart. In the first two writing sessions, participants will receive a writing prompt that will instruct them to write about their deepest thoughts and feelings surrounding their bereavement experience. For the final writing session, participants will receive a writing prompt instructing them to provide advice and support for a newly bereaved young adult.

Expressive Helping

Fact-Writing BEHAVIORAL

Prior to each writing session, participants will receive general instructions for completing the writing (e.g., write continuously for 20 minutes, do not worry about grammar, sentence structure, repetition), and be reminded that their writing will remain confidential. Three writing sessions will be spaced 1-2 weeks apart. A weekly writing prompt will instruct participants to write objectively about different time frames (e.g., routine for getting up in the morning, routine for going to sleep at night).

Fact-Writing

Eligibility Criteria

• Age: 18 Years - 26 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64)

You may qualify if:

• Experienced the death of a loved one within the last 5 years, but more than 6 months ago.
• Endorse having close relationship with loved one at time of their death (i.e., 5 or above on 1-10 likert scale with 1 being not at all close, and 10 being extremely close).
• Endorse moderate to severe distress about the loss (i.e., 5 or above on 1-10 likert scale with 1 being not at all distressed, and 10 being extremely distressed).
• Feel comfortable writing in English (due to the linguistic nature of the writing sessions).
• Have access to the Internet and a computer to complete the assessments and writing sessions.

You may not qualify if:

• \. Express active psychosis or suicidal ideation, or any other circumstances that, in the opinion of the investigators, compromise participant safety.

Sponsors & Collaborators

• University of California, Los Angeles: lead

Study Sites (1)

University of California, Los Angeles

Los Angeles, California, 90095, United States

Location

Related Publications (14)

• Ayduk O, Kross E. From a distance: implications of spontaneous self-distancing for adaptive self-reflection. J Pers Soc Psychol. 2010 May;98(5):809-29. doi: 10.1037/a0019205.

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• Boelen PA, Djelantik AAAMJ, de Keijser J, Lenferink LIM, Smid GE. Further validation of the Traumatic Grief Inventory-Self Report (TGI-SR): A measure of persistent complex bereavement disorder and prolonged grief disorder. Death Stud. 2019;43(6):351-364. doi: 10.1080/07481187.2018.1480546. Epub 2018 Jul 17.

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• Eisenberg SA, Shen BJ, Schwarz ER, Mallon S. Avoidant coping moderates the association between anxiety and patient-rated physical functioning in heart failure patients. J Behav Med. 2012 Jun;35(3):253-61. doi: 10.1007/s10865-011-9358-0. Epub 2011 Jun 10.

  PMID: 21660588 BACKGROUND

• Gruenewald TL, Tanner EK, Fried LP, Carlson MC, Xue QL, Parisi JM, Rebok GW, Yarnell LM, Seeman TE. The Baltimore Experience Corps Trial: Enhancing Generativity via Intergenerational Activity Engagement in Later Life. J Gerontol B Psychol Sci Soc Sci. 2016 Jul;71(4):661-70. doi: 10.1093/geronb/gbv005. Epub 2015 Feb 25.

  PMID: 25721053 BACKGROUND

• Keyes, C. L. M. (2009). Atlanta: Brief description of the mental health continuum short form (MHC-SF).

  BACKGROUND

• Libby LK, Eibach RP. Looking back in time: self-concept change affects visual perspective in autobiographical memory. J Pers Soc Psychol. 2002 Feb;82(2):167-79.

  PMID: 11831407 BACKGROUND

• Pennebaker JW, Gonder-Frederick L, Stewart H, Elfman L, Skelton JA. Physical symptoms associated with blood pressure. Psychophysiology. 1982 Mar;19(2):201-10. doi: 10.1111/j.1469-8986.1982.tb02547.x. No abstract available.

  PMID: 7071299 BACKGROUND

• Pilkonis PA, Choi SW, Reise SP, Stover AM, Riley WT, Cella D; PROMIS Cooperative Group. Item banks for measuring emotional distress from the Patient-Reported Outcomes Measurement Information System (PROMIS(R)): depression, anxiety, and anger. Assessment. 2011 Sep;18(3):263-83. doi: 10.1177/1073191111411667. Epub 2011 Jun 21.

  PMID: 21697139 BACKGROUND

• Radloff, L. S. (1977). The CES-D scale: A self-report depression scale for research in the general population. Applied psychological measurement, 1(3), 385-401.

  BACKGROUND

• Ross M, Wilson AE. It feels like yesterday: self-esteem, valence of personal past experiences, and judgments of subjective distance. J Pers Soc Psychol. 2002 May;82(5):792-803.

  PMID: 12003478 BACKGROUND

• Stanton AL, Kirk SB, Cameron CL, Danoff-Burg S. Coping through emotional approach: scale construction and validation. J Pers Soc Psychol. 2000 Jun;78(6):1150-69. doi: 10.1037//0022-3514.78.6.1150.

  PMID: 10870915 BACKGROUND

• Weinberg, N., Uken, J. S., Schmale, J., & Adamek, M. (1995). Therapeutic factors: Their presence in a computer-mediated support group. Social Work with Groups, 18, 57-69.

  BACKGROUND

• Yalom, I. D. (1995). The theory and practice of group psychotherapy. Basic Books.

  BACKGROUND

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: PARTICIPANT
• Purpose: SUPPORTIVE CARE
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Principal Investigator

Study Record Dates

• First Submitted: April 22, 2022
• First Posted: April 28, 2022
• Study Start: January 24, 2022
• Primary Completion: September 1, 2022
• Study Completion: September 1, 2022
• Last Updated: May 16, 2023

Record last verified: 2023-05

Data Sharing

• IPD Sharing: Will not share

Locations

US (1)