P.A. Boelen

Utrecht University | UU · Division of Clinical Psychology

Objective: Prolonged Grief Disorder (PGD) was newly included in ICD-11 and resembles Persistent Complex Bereavement Disorder (PCBD) newly included in DSM-5. In adults, PGD can be successfully treated using cognitive behavioral therapy (CBT). There is no evidence yet that CBT interventions can successfully alleviate PGD in children and adolescents....

Background: Research on the mental health of homicidally bereaved children and young people is scarce. Despite the importance of timely referral of those at risk of developing severe mental health problems, few convincing risk factors have been identified. The effectiveness of current treatment models is unclear. Objective: This study examined fact...

Background. Grief is a common experience in adolescence. Evidence-based therapies are not readily accessible for grieving young people. Internet-based cognitive behaviour therapy (CBT) for grief in adolescents has recently been investigated in a pilot randomised controlled trial. Research is required to determine acceptability as this unguided inte...

Background: The death of a child is one of the most devastating experiences a parent can go through. Bereaved parents show an increased risk for mental and physical health problems and have an increased risk of developing prolonged grief. Rationale: There are few studies evaluating the effects of psychosocial interventions for bereaved parents, an...

Objective The Traumatic Grief Inventory‐Self Report Plus (TGI‐SR+) measures the most recent prolonged grief disorder (PGD) symptom sets defined in the 11 th edition of the International Statistical of Diseases and Related Health Problems (ICD‐11) and the text revision of the fifth edition of the Diagnostical and Statistical Manual of Mental Disorde...

Objective: Valid and reliable instruments to assess the most recent prolonged grief disorder (PGD) criteria, as defined in the DSM-5-TR and ICD-11, are lacking. This study aimed to provide an initial validation of the Traumatic Grief Inventory - Kids - Clinician-Administered (TGI-K-CA) for assessing Prolonged Grief Disorder (PGD) symptoms in bereav...

Background: Perceiving that society disregards grief after pregnancy loss (disenfranchised grief) elevates bereaved parents’ psychological burden. Objective: In this research, we aimed to compare the disenfranchisement of pregnancy loss with four other loss types considering the bereaved’s gender. Method: We collected data from Turkish participan...

Most studies examining prolonged grief disorder (PGD) in people bereaved during the COVID-19 pandemic are focused on psychopathology. However, mental health encompasses both absence of psychopathology and presence of well-being. This is the first study examining symptom profiles of early PGD and subjective mental well-being in 266 Dutch adults rece...

This study explores the experiences of Iranian bereaved spouses who lost partners in Road Traffic Collisions (RTCs) one to three years earlier. Seventeen participants were interviewed using purposive sampling. Three central themes emerged: (1) "The unfillable void," revealing the profound emptiness experienced by the bereaved, the factors that main...

Grief is highly prevalent in adolescents, however, there have been no studies investigating internet delivered cognitive behaviour therapy for grief in adolescents (ICBT-G-A). In this paper, the co-design of an unguided ICBT-G-A intervention is described, and a protocol outlined for a pilot randomised controlled trial of the intervention. Participa...

The vital role social relationships play in mental health and well-being has been well-documented. Disruption of an intimate bond through bereavement can be enduringly stressful, with loneliness featuring prominently, possibly compromising mental and physical health. We systematically reviewed studies examining loneliness across marital status grou...

Background: Prolonged Grief Disorder (PGD) has recently been included in both the ICD-11 and DSM-5-TR diagnostic manuals. Studying its prevalence and correlates across cultures is vital for more effective identification, treatment, and prevention. Objective: This study aimed to examine prevalence rates of ICD-11-based PGD, in a representative Slova...

Background: The coronavirus disease 2019 (COVID-19) pandemic is associated with an increase in mortality rates globally. Given the high numbers of deaths and the potentially traumatic characteristics of COVID-19 deaths, it has been expected that grief-related distress is higher in COVID-19 bereaved (compared to non-COVID-19 bereaved) people. This s...

Objective: This controlled trial aimed to examine short- and long-term effects of a therapist-guided online grief-focused cognitive behavioral therapy (CBT) compared to self-guided online CBT, in reducing early prolonged grief disorder (PGD), posttraumatic stress disorder (PTSD), and depression symptoms in adults bereaved during the COVID-19 pandem...

Introduction The decision to terminate a pregnancy due to fetal anomalies can have a significant emotional impact, especially in second‐trimester terminations. Previous studies on the psychological consequences of pregnancy termination have had limitations, and little is known about the outcomes for partners and the impact of fetal donation. Theref...

Due to the presumed high risk for prolonged grief disorder (PGD) in people bereaved during the COVID-19 pandemic, it is crucial to examine how grief develops over time in this population. This is the first study examining longitudinal symptom-profiles of PGD severity in people bereaved during the pandemic. We aimed to identify latent trajectories o...

Background: Police officers encounter various potentially traumatic events (PTEs) and may be compelled to engage in actions that contradict their moral codes. Consequently, they are at risk to develop symptoms of Posttraumatic Stress Disorder (PTSD), but also moral stress or moral injury (MI). To date, MI in police officers has received limited att...

Objective: A better understanding of the development of prolonged grief disorder can help professionals identify bereaved in need of intervention efforts and improve the efficiency of services. We aimed to examine the prevalence of and risk factors for prolonged grief disorder in a sample of young, bereaved terrorist attack survivors almost a decad...

Decades after World War II, major commemorations are still organised to collectively remember this war. Aiming for inclusive societies, the perspectives of immigrants with different war experiences are important to be heard in relation to these commemorations. Research reveals that commemorations can kindle difficult emotions such as sadness and br...

Posterpresentation - EAOHP 5 June 2024- Pre-job loss grief reactions in sick-listed employees: The down side of work attachment

Most children confronted with the death of a loved one do not experience persisting psychological problems. However, for some, acute grief reactions develop into prolonged grief disorder (PGD) and other mental health problems. Research findings suggest that bereavement outcomes in children are associated with negative cognitions and avoidant coping...

Road traffic accidents (RTAs) are among the most frequent negative life‐events. About one in five RTA survivors is susceptible to posttraumatic stress disorder (PTSD). Knowledge about needs for, and usage of, mental health services (MHSs) may improve options for care for RTA victims. The current study aimed to assess rates of victims using differen...

Background: Studies suggest that cognitive behavioral therapies (CBTs) may be efficacious in reducing symptoms of prolonged grief disorder (PGD), but no comprehensive overview and pooled estimate of CBTs' effect on PGD in adulthood exist. We conducted a systematic review and meta-analysis of randomized controlled trials. Method: Studies were sel...

Background: The traumatic loss of a child in a road traffic accident (RTA) can lead to mental health issues in parents, such as symptoms of prolonged grief (PG) and posttraumatic stress (PTS). Latent class analysis (LCA) provides insights into different responses to such losses. Methods: Using LCA, 148 parents that were bereaved at least twelve mon...

Abstract Background: With this study, we aimed to explore the emotional experiences of sick-listed employees facing imminent job loss, as this emotional distress may hinder successful job search outcomes. The study had two objectives: (1) to develop and validate the Imminent Job Loss Scale (IJLS) for assessing pre-job loss grief reactions and (2) t...

Background: Refugees often suffer from trauma-related psychopathology, specifically posttraumatic stress disorder (PTSD). Negative world assumptions are strongly correlated with the development, course, and severity of PTSD. Objective: This study aimed to investigate whether there are distinct profiles of PTSD and negative world assumptions (NWA) a...

Mobile health (mHealth) apps have been shown to be useful to monitor and reduce mental health problems across a variety of stress-related and affective disorders, yet research on the value of apps for prolonged grief is scarce. Therefore, the main aim of this study was to elucidate bereaved parents' experiences of using the self-help app My Grief w...

Insecure attachment is proposed to be a risk factor in the development and persistence of severe grief. Although prior research demonstrates positive cross-sectional and longitudinal correlations between attachment styles and prolonged grief symptoms, controlled longitudinal analyses yield fewer convincing results. Therefore, we sought to further c...

Background. Prolonged Grief Disorder (PGD) has recently been included in both the ICD-11 and DSM-5-TR diagnostic manuals. Studying its prevalence and correlates across cultures is vital for more effective identification, treatment, and prevention. Objective. This study aimed to examine prevalence rates of ICD-11-based PGD, in a representative Slova...

Background The COVID-19 pandemic and accompanying societal measures have impacted children and their families all over the world. Little is known about the factors associated with mental health outcomes in young children (i.e., 1 to 6 years old) during the pandemic. The current study aimed to examine associations with potential risk and protective...

Background: With the release of the text revision of the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5-TR), criteria for Prolonged Grief Disorder (PGD) were included. This necessitates studying grief trajectories based on these criteria. Objective: This is the first study examining latent trajectories of DSM-5-TR-based...

Background: Most studies examining prolonged grief disorder (PGD) symptoms in people bereaved during the COVID-19 pandemic are focused on the presence or absence of psychopathology. However, mental health does not only represent absence of psychopathology, but also presence of well-being. This is the first study examining symptom-profiles of acute...

The International Classification of Diseases Eleventh Edition (ICD-11), and the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR), now include prolonged grief disorder (PGD). Since criteria for PGD in both classification systems differ from prior proposed grief disorders and each other, the validation of...

Background: Most studies examining prolonged grief disorder (PGD) symptoms in people bereaved during the COVID-19 pandemic are focused on either the presence or absence of psychopathology. However, good mental health does not only represent absence of psychopathology, but also presence of well-being (WB). This is the first study examining symptom-p...

Background Adolescence is a period marked by important physical and social changes, which often leads to an increase of body dissatisfaction. Recent studies have shown an association between interoception and body dissatisfaction in female adolescents. One variable that may contribute to the association between interoceptive awareness and body diss...

Aim: To evaluate the effect of access to the My Grief app, based on cognitive-behavioural principles, on psychopathology symptoms and evaluate the helpfulness and user experience of the app, in bereaved parents. Method: Parents who had lost a child 1-10 years ago were randomised to access My Grief (n = 126) or a waitlist (n = 122). Participants rep...

Mobile health (mHealth) apps have been shown to be useful to monitor and reduce mental health problems across a variety of stress-related and affective disorders, yet research on the value of apps for prolonged grief is scarce. Therefore, the main aim of this study was to elucidate bereaved parents' experiences of using the self-help app My Grief w...

The International Classification of Diseases eleventh edition (ICD-11) and the Diagnostic and Statistical Manual of Mental Disorders fifth edition, text revision (DSM-5-TR) now include prolonged grief disorder (PGD). Since criteria for PGD in both classification systems differ from prior proposed grief disorders and each other, the validation of a...

Purpose: With this study, we aimed to explore the emotional experiences of sick-listed employees facing imminent job loss, as this emotional distress may hinder successful job search outcomes. The study had two objectives: (1) to develop and validate the Imminent Job Loss Scale (IJLS) for assessing pre-job loss grief reactions and (2) to examine it...

Background: With this study, we aimed to explore the emotional experiences of sick-listed employees facing imminent job loss, as this emotional distress may hinder successful job search outcomes. The study had two objectives: (1) to develop and validate the Imminent Job Loss Scale (IJLS) for assessing pre-job loss grief reactions and (2) to examine...

The aim of this study is to translate, adapt, and validate the Traumatic Grief Inventory Self-Report version (TGI-SR) to its Brazilian version. The study was conducted following the steps of translation: content validation, cognitive interviews, final test in target population, back-translation, and authors’ evaluation. The sample comprised 304 ber...

Background and objectives: Savoring beliefs refer to people's beliefs about their ability to generate, increase, and prolong enjoyment from positive experiences. The role of these beliefs in affecting responses to negative events is largely unexplored. This study aimed to increase knowledge about the role of savoring beliefs in symptoms of posttra...

Prolonged grief disorder, a condition characterized by severe, persistent, and disabling grief, is newly included in ICD-11 and DSM-5-TR. Prolonged grief symptoms can be effectively treated with face-to-face or internet-delivered cognitive behavioral therapy. Traumatic losses may elicit higher prevalence of severe grief reactions. While face-to-fac...

Introduction Unaccompanied refugee minors (URMs) are at increased risk of developing mental health problems, such as symptoms of posttraumatic stress disorder (PTSD) and depression. In addition, URMs face several barriers to mental health care. Few studies have evaluated trauma-focused interventions for URMs that target these issues. The current st...

This study provided a detailed description of the experiences of 60 treatment-seeking children and young people following parental intimate partner homicide (PIPH) in the United Kingdom, and evaluated the potential effectiveness of the traumatic grief focused cognitive behavioral therapy they received. A paired samples t-test showed that mean pre-a...

With the release of the text revision of the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5-TR), criteria for Prolonged Grief Disorder (PGD) were included. This necessitates studying grief trajectories based on these criteria. Accordingly, this is the first study examining latent trajectories of DSM-5-TR based PGD symptom...

Commemorative events, organized in the aftermath of war or large-scale violence, can have an emotional impact on those who are attending. We examined several characteristics that might influence this impact. In a quasi-experimental pretest-posttest study, participants (n = 307) watched footage of the broadcast of the Dutch National Commemoration, i...

Background: Around 10% of bereaved youths experience symptoms of prolonged grief disorder (PGD). Recently, PGD was included in the two main classification systems for mental disorders: the ICD-11 and DSM-5-TR. Assessing PGD symptoms in youth is currently hindered by the lack of instruments for ICD-11 and DSM-5-TR criteria. To fill this gap, we deve...

Background: Around 10% of bereaved youths experience symptoms of prolonged grief disorder (PGD). Recently, PGD was included in the two main classification systems for mental disorders: the ICD-11 and DSM-5-TR. Assessing PGD symptoms in youth is currently hindered by the lack of instruments for ICD-11 and DSM-5-TR criteria. To fill this gap, we dev...

The aim of this systematic review and meta-analysis was to provide an overview of existing controlled trials focusing on the impact of multiple family therapy (MFT) on mental health problems and family functioning, and to examine the efficacy of MFT. Relevant studies were selected following a screening of 3376 studies identified by a systematic sea...

Background: The disappearance of a significant person is an ambiguous loss due to the persistent uncertainty about the whereabouts of the person. Measures specifically capturing the psychological consequences of ambiguous loss are lacking. Therefore, this study aimed to develop the Ambiguous Loss Inventory Plus (ALI+) and evaluated its suitability...

Background: The coronavirus disease 2019 (COVID-19) pandemic is associated with an increase in mortality rates globally. Given the high numbers of deaths and the potentially traumatic characteristics of COVID-19 deaths, it is expected that grief-related distress levels are higher in COVID-19 bereaved (compared to non-COVID-19 bereaved) people. This...

Objective: This randomized-waitlist controlled trial is the first study examining short-term effects of a self-guided online grief-specific cognitive behavioral therapy (CBT) in reducing early persistent complex bereavement disorder (PCBD), posttraumatic stress disorder (PTSD), and depression symptoms in adults bereaved during the COVID-19 pandemi...

Background: There is a need for an interview-based measure to assess Prolonged Grief Disorder (PGD) included in the text revision of the fifth Diagnostic and Statistical Manual for Mental Disorder (DSM-5-TR) and 11th edition of the International Classification of Disease (ICD-11). We evaluated the psychometric properties of the Traumatic Grief Inv...

Background and Objectives A rise in prolonged grief disorder (PGD) levels was expected due to COVID-19 deaths. We tested this assumption, by comparing PGD-severity among people who experienced a death of a loved one during the pandemic caused by a natural (e.g., illness), COVID-19, or unnatural (e.g., accidents, suicides, homicides) loss on average...

Prolonged grief disorder, a condition characterized by severe, persistent and disabling grief, is newly included in ICD-11 and DSM-5-TR. Prolonged grief symptoms can be effectively treated with face-to-face or internet-delivered cognitive behavioral therapy. Traumatic losses may elicit higher prevalence of severe grief reactions. While face-to-face...

The field of traumatic stress is often referred to as being in a state of controversy and lack of continuity. Throughout history, disputes repeatedly centered on defining the psychological consequences of severe adverse events and on their causes. Even to this day this is current. To understand these controversies, an extensive historical literatur...

Aim: Parents are increasingly confronted with loss during their child's end of life. Healthcare professionals struggle with parental responses to loss. This study aimed to understand parental coping with grief during their child's end of life. Methods: A grounded theory study was performed, using semi-structured interviews with parents during th...

Objectives: In the present study, we examined relations between premigration, perimigration, and postmigration risk factors (i.e., potentially traumatic events [PTEs], postmigration living problems [PMLPs], stressful life events) and psychological symptoms (i.e., anxiety/depression, posttraumatic stress) in Syrian emerging adults with refugee back...

Background: The coronavirus disease 2019 (COVID-19) pandemic is associated with an increase in mortality rates globally. Given the high numbers of deaths and the potentially traumatic characteristics of COVID-19 deaths, it is expected that grief-related distress levels are higher in COVID-19 bereaved (compared to non-COVID-19 bereaved) people. This...

To date, there have been no cohort studies of sexual harassment incidence and its relation to mental health within humanitarian field-workers. Research among numerous occupations suggests an association between workplace sexual harassment and several health complaints. This study examined the incidence and severity of sexual harassment and its asso...

Loneliness can be prominent in bereavement, possibly leading to compromised mental and physical health. We systematically reviewed the extent of loneliness across marital status groups, examining the prevalence, intensity, risk factors, and correlates of loneliness in widowhood, compared to other marital statuses. Studies that met predefined criter...

The present study aimed to examine whether day‐level engagement in non‐work activities can mitigate the adverse outcomes of job loss. Based on Jahoda’s latent deprivation model, we hypothesised that engaging in such activities (e.g., meeting others) can fulfil five basic needs (e.g., need for time structure) and that fulfilment of these needs mitig...

Deaths of relatives and peers in potentially traumatizing circumstances may lead to symptoms of prolonged grief (PG,e.g.,yearning, preoccupation) and posttraumatic stress (PTS, e.g., re-experiencing, hypervigilance). There is limited knowledge about how symptoms of PG and PTS co-occur following such events. The current study aimed to identify patte...

Victims of crimes have been granted increasing procedural rights to participate in the juridical process since the mid 1990s. However, knowledge about the (anti)-therapeutic effect of participation is limited. We examined the associations between symptom levels of persistent complex bereavement disorder (PCBD), posttraumatic stress disorder (PTSD),...

Background: The death of a child is a devastating experience for most parents. Consequently, bereaved parents are at risk to develop physical and mental health problems, including prolonged grief disorder. Rationale: There is a lack of evaluated psychosocial interventions for bereaved parents. The aim of this study was to examine the feasibility of...

Objective: This randomized-waitlist controlled trial is the first study examining short-term effects of a self-guided online grief-specific cognitive behavioral therapy (CBT) in reducing early persistent complex bereavement disorder (PCBD), posttraumatic stress disorder (PTSD), and depression symptoms in adults bereaved during the COVID-19 pandemic...

Background Posttraumatic Stress Disorder (PTSD) is often reported by refugees that faced violence and persecution. Some stressful events may also entail moral conflicts or dilemmas, described as “potentially morally injurious events” (PMIE). Very few studies have yet investigated the nature of these PMIEs in traumatized refugees, using both quantit...

How traumatic events (TEs) should be defined, and how specific TEs are for Post-traumatic Stress Disorder (PTSD) were examined in a general mental health care population. Three definitions of TEs were defined, according to the PTSD criteria of DSM-IV. Half of the sample reported any TE, with a high prevalence of TEs among non-PTSD disorders. Previo...

Background A key feature of anorexia nervosa is body image disturbances and is often expressed by dysfunctional body-related behaviours such as body checking and body avoiding. These behaviours are thought to contribute to both the maintenance and relapse of AN, yet empirical evidence is scarce. One variable that may contribute to the need for enga...

There is growing interest in psychological factors maintaining healthy functioning following adverse events. One such variable is a sense of coherence (SOC), an orientation to life, comprising manageability, comprehensibility, and meaningfulness. Little research has examined the role of SOC in adjustment to bereavement. The present longitudinal stu...

In a significant minority of people, involuntarily job loss can result in symptoms of job loss-related complicated grief (JLCG). The present cognitive-behavioral framework is introduced to explain the underlying processes that may lead to the development and maintenance of JLCG symptoms. Three core processes play a central role, namely (1) negative...

Background Previous research has provided insight into the grief of suicide survivors, but little is known about grief following physician-assisted dying (PAD), and no prior study specifically focused on grief following PAD due to a mental disorder. The current study aims to increase insight into experiences preceding PAD or suicide of a loved one...

Background There is a lack of existing research on grief following the intentional death of people suffering from a mental disorder. Our study aims to provide insight into grief experiences and social reactions of bereaved persons who lost their life partners, who were suffering from a mental disorder, to physician-assisted dying (PAD) or suicide....