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Abschied am Beginn des Lebens

Behandlung spezifischer Trauersymptome nach dem Verlust eines Kindes

Farewell at the beginning of life

Treatment of specific grief symptoms after the loss of a child

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Zusammenfassung

Hintergrund

Schwangerschaftsverluste betreffen bis zu 20 % aller diagnostizierten Schwangerschaften. Für viele Frauen ist der Verlust ihres Kindes mit intensiven Trauerreaktionen und einer posttraumatischen Stresssymptomatik verbunden.

Ziel der Arbeit

Ein internetbasiertes Behandlungsprogramm für Eltern, die ihr Kind in der Schwangerschaft verloren haben, wird vorgestellt sowie dessen kurz- und langfristige Wirksamkeit auf spezifische Trauersymptome untersucht.

Material und Methoden

Hierzu wurden 228 Personen zufällig der Interventionsgruppe (IG, n = 115) und der Wartekontrollgruppe (WKG; n = 113) zugeteilt. Das 5‑wöchige kognitiv-behaviorale Behandlungskonzept bestand aus den Elementen Selbstkonfrontation, kognitive Restrukturierung und Abschied. Das Ausmaß der Trauer wurde mithilfe der Münchener Trauerskala erfasst. Die Datenerhebung erfolgte vor, direkt nach sowie 3 und 12 Monate nach Ende des Behandlungsprogramms.

Ergebnisse

Die 2 ∙ 2-ANOVA („analysis of variance“, Varianzanalyse) mit Messwiederholung ergab für die Gesamtskala und die Subskalen einen signifikanten Interaktionseffekt Gruppe ∙ Zeit. Trauer insgesamt sowie Traurigkeit, Verlustangst und schuldhafte Verarbeitung nahmen in der IG signifikant stärker ab als in der WKG. Ärger nahm in der IG signifikant ab und die Sinnsuche zu, während in der WKG keine Veränderungen auftraten. Die Effekte waren in der IG mit Ausnahme der Skala Sinnsuche über die Zeit stabil.

Schlussfolgerung

Das vorgestellte internetbasierte Behandlungskonzept führt zu einer praktisch bedeutsamen Reduktion der Trauersymptomatik und kann daher eine niedrigschwellige Behandlungsalternative für Eltern, die ihr Kind in der Schwangerschaft verloren haben, darstellen.

Abstract

Background

Pregnancy loss occurs in 20% of all diagnosed pregnancies. For many women, the loss of a child is related to intense grief reactions and posttraumatic stress symptoms.

Objective

To introduce an Internet-based intervention program for parents who have lost their child during pregnancy and to investigate the short and long-term effects on specific grief symptoms.

Material and methods

The study cohort consisted of 228 individuals who were randomly allocated to the intervention group (IG, n = 115) or to the waiting list control group (WCG; n = 113). The cognitive behavioral treatment program consisted of elements of self-confrontation, cognitive restructuring and farewell and lasted for 5 weeks. The extent of grief was measured with the Munich grief scale. Data were collected before, immediately after as well as 3 and 12 months after the end of the treatment program.

Results

The 2×2 ANOVA (analysis of variance) with repeated measurements revealed a significant interaction effect of group time for the total scale and all five subscales. Total grief, sadness, loss anxiety and feelings of guilt showed a significantly stronger decrease in the IG compared to the WCG. Anger was significantly decreased and the search for meaning significantly increased in the IG only. With the exception of the scale search for meaning, the effects stayed stable over time in the IG.

Conclusion

The presented Internet-based treatment program led to a practical and relevant reduction of grief symptoms and can therefore pose a low-threshold treatment alternative for parents who have lost their child during pregnancy.

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Förderung

Das Projekt wurde durch das Bundesministerium für Familie, Senioren, Frauen und Jugend gefördert.

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Authors and Affiliations

  1. Klinik und Poliklinik für Psychosomatische Medizin und Psychotherapie, Universitätsmedizin Leipzig, Semmelweisstr. 10, 04103, Leipzig, Deutschland

    Anette Kersting, Ruth Dölemeyer & Katja Linde

  2. MSB Medical School Berlin, Berlin, Deutschland

    Birgit Wagner

Authors
  1. Anette Kersting
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  2. Ruth Dölemeyer
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  3. Birgit Wagner
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  4. Katja Linde
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Corresponding author

Correspondence to Anette Kersting.

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Interessenkonflikt

A. Kersting, R. Dölemeyer, B. Wagner und K. Linde geben an, dass kein Interessenkonflikt besteht.

Alle beschriebenen Untersuchungen am Menschen wurden mit Zustimmung der Ethikkommission des Universitätsklinikums Münster durchgeführt. Von allen beteiligten Patienten liegt eine Einverständniserklärung vor.

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Redaktion

M. Cierpka, Heidelberg

B. Strauß, Jena

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Kersting, A., Dölemeyer, R., Wagner, B. et al. Abschied am Beginn des Lebens. Psychotherapeut 62, 560–566 (2017). https://doi.org/10.1007/s00278-017-0221-9

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  • DOI: https://doi.org/10.1007/s00278-017-0221-9

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