This application is the second revision of an application that responds to PA-03-014 inviting grant applications for older adults. The application is modified to address reviewers concerns and to add additional pilot data. Seniors are the demographic group most likely to be bereaved. According to the National Council on Aging (www.aoa.gov/prof/ Statistics/ profile/2Q03/2003profile.pdf), in 2002, more than 10 million older Americans were widowed. These people are at risk for a debilitating reaction called Traumatic or Complicated Grief (CG: the term now used for this condition). Studies confirm that Complicated Grief can be reliably identified and occurs in about 10-20% of bereaved individuals. CG appears to carry much of the risk for negative outcomes of bereavement. CG can affect health status and influence decisions about personal health care. The risk of hypertension is 10 times greater among widowed subjects who meet consensus criteria for CG compared to those who do not, while subjects with CG are 17 times less likely to have visited a physician in the months since the death. Despite its high prevalence and significant morbidity, there are no proven efficacious treatments. The PI of this application developed a novel psychotherapy called Complicated Grief Treatment (CGT), and has now completed a study (MH60783) comprised of adults over age 18, that confirmed efficacy of this approach. However, most participants were less than 60 years old. Participants >age 60 (n=29) were less likely to be employed and more likely to live alone. CGT and IPT produced similar results in older and younger adults, with better response to CGT in both groups. However, confirmation of efficacy among seniors is important, since older people have different vulnerabilities and different problems in adjusting to grief than younger adults. We thus assembled a group of highly experienced geriatric researchers skilled in assessment and management of problems in older people, e.g. physical infirmity, cognitive dysfunction, social isolation, disruption of daily routine. We propose to conduct a randomized controlled study of CGT v IPT in individuals >65 years of age.
Our specific aims are: 1) To compare results of 16 sessions of either CGT or standard IPT. We hypothesize that CGT will produce a higher response rate and shorter time to response than IPT, and that responders will show significantly greater

Agency
National Institute of Health (NIH)
Institute
National Institute of Mental Health (NIMH)
Type
Research Project (R01)
Project #
5R01MH070741-04
Application #
7817096
Study Section
Special Emphasis Panel (ZMH1-ERB-H (06))
Program Officer
Niederehe, George T
Project Start
2007-09-21
Project End
2012-04-30
Budget Start
2010-05-01
Budget End
2011-04-30
Support Year
4
Fiscal Year
2010
Total Cost
$542,597
Indirect Cost
Name
Columbia University (N.Y.)
Department
Other Health Professions
Type
Schools of Social Work
DUNS #
049179401
City
New York
State
NY
Country
United States
Zip Code
10027
Fisher, Joscelyn E; Mauro, Christine; Cozza, Stephen J et al. (2017) Examination of factor structure of the inventory of complicated grief (ICG) in a sample of bereaved military family members with persistent and elevated grief. Int J Methods Psychiatr Res 26:
Glickman, Kim; Shear, M Katherine; Wall, Melanie M (2017) Mediators of Outcome in Complicated Grief Treatment. J Clin Psychol 73:817-828
Glickman, Kim; Shear, M Katherine; Wall, Melanie (2016) Exploring Outcomes Related to Anxiety and Depression in Completers of a Randomized Controlled Trial of Complicated Grief Treatment. Clin Psychol Psychother 23:118-24
Keyes, Katherine M; Pratt, Charissa; Galea, Sandro et al. (2014) The burden of loss: unexpected death of a loved one and psychiatric disorders across the life course in a national study. Am J Psychiatry 171:864-71
Mash, Holly B Herberman; Fullerton, Carol S; Shear, M Katherine et al. (2014) Complicated grief and depression in young adults: personality and relationship quality. J Nerv Ment Dis 202:539-43
Shear, M Katherine; Wang, Yuanjia; Skritskaya, Natalia et al. (2014) Treatment of complicated grief in elderly persons: a randomized clinical trial. JAMA Psychiatry 71:1287-95
Wang, Yuanjia; Chen, Huaihou; Zeng, Donglin et al. (2013) Auxiliary marker-assisted classification in the absence of class identifiers. J Am Stat Assoc 108:553-565
Ghesquiere, Angela; Shear, M Katherine; Duan, Naihua (2013) Outcomes of bereavement care among widowed older adults with complicated grief and depression. J Prim Care Community Health 4:256-64
Shear, M Katherine; Ghesquiere, Angela; Glickman, Kim (2013) Bereavement and complicated grief. Curr Psychiatry Rep 15:406
Shear, M Katherine; Skritskaya, Natalia A (2012) Bereavement and anxiety. Curr Psychiatry Rep 14:169-75

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