Prolonged Grief Disorder
Conditions
Brief summary
The investigators aim to compare the efficacy of an IBI targeting complicated grief symptoms (LIVIA 2.0) compared to an already investigated IBI (LIVIA 1) using a guidance on demand design in a randomised controlled trial (RCT). More specifically, the investigators will test the following primary hypotheses: * Both interventions will significantly increase participants' well-being and decrease their distress, and those changes will be stable until follow-up. * LIVIA 2.0 will be more efficient than LIVIA 1 on all measure outcomes. * LIVIA 2.0 will have less dropouts than LIVIA 1.
Detailed description
Secondary objectives are the following: * Participants of LIVIA 2.0 will require less guidance (number of people requesting support and number of e-mails exchanged) than participants in LIVIA 1. The investigators will also explore which session triggers more requests of guidance. * Using a monitoring of participants' state throughout the completion of the programme in LIVIA 2.0, the investigators will explore the short-term efficacy of each module on participants' weekly mood, solitude feelings and grief symptoms. * The investigators will compare participants' satisfaction in both versions of LIVIA. * The investigators will also explore the role of attachment style, type of loss, relationship quality with the partner, the interpersonal closeness with the lost person, symptom severity and level of solitude at onset as moderators of the efficacy of the programmes. * The investigators will explore the semantic content of the exercises included in the programme to see if this is related with the improvement over the assessment period.
Interventions
DEVICELIVIA
The study aim to compare the efficacy of an IBI targeting complicated grief symptoms (LIVIA 2.0) compared to an already investigated IBI (LIVIA 1) using a guidance on demand design in a randomised controlled trial. Both programs are composed of 10 weekly sessions proposing educational material, questionnaires and exercises. They are based on current scientific theories of grief but present their content differently. Compared to LIVIA 1, LIVIA 2.0 is less based on academic readings and participants can choose more freely which topics and exercises they want to do. LIVIA 2.0 also offers a system of reminder messages to maximize adherence as well as more elaborate automated guidance.
Sponsors
Debrot Anik
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
SINGLE (Subject)
Intervention model description
The study aim to compare the efficacy of an IBI targeting complicated grief symptoms (LIVIA 2.0) compared to an already investigated IBI (LIVIA 1) using a guidance on demand design in a randomised controlled trial. Both programs are composed of 10 weekly sessions proposing educational material, questionnaires and exercises. They are based on current scientific theories of grief but present their content differently. Compared to LIVIA 1, LIVIA 2.0 is less based on academic readings and participants can choose more freely which topics and exercises they want to do. LIVIA 2.0 also offers a system of reminder messages to maximize adherence as well as more elaborate automated guidance.
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
* Bereavement or separation/divorce * Either of these events should have happened more than 6 months before participating in the study * Feeling the need for support to cope with the loss (a diagnosis of complicated grief is not necessary) * Age: 18 years or older * Regular Internet access * Mastery of the French language - Approved ICF
Exclusion criteria
* Moderate to acute current suicidality (SIDAS \> 19) * Severe psychological or somatic disorders which need immediate treatment. * Concomitant psychotherapy * Prescription or change in dosage of psychoactive drugs in the month prior or during the self-help intervention. * Inability to follow the procedures of the study, e.g. due to comprehension problems * Enrolment of the investigator, his/her family members, employees, and other dependent persons.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in complicated grief symptoms | Pretest; 12-week post-test; 3-month Follow-up | assessed with a French version (Cherblanc & Zech, 2021) of The Traumatic Grief Inventory (Boelen et al., 2019), on a scale ranging from 1 = never to 5 = always. The mean score is used as a final score. Higher score represent a higher symptom load. |
| Change in depression symptoms | Pretest; 12-week post-test; 3-month Follow-up | assessed with the Patient Health Questionnaire-9 (Kroenke & Spitzer, 2002; Kroenke, Spitzer & Williams, 2001), on a scale ranging from 0 = never to 4 = practically every day. The sum of the scores is used as a final score. Higher score represent a higher symptom load. |
| Change in well-being | Pretest; 12-week post-test; 3-month Follow-up | measured with the French version (Villieux et al., 2016) of the Flourishing Scale (Diener et al., 2010), on a scale ranging from 1 = I completely disagree, to 7 = I completely agree. The mean score is used as a final score. Higher score represent a better psychological well-being. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Satisfaction with the program (utility, clarity, impact, etc.) assessed by an adapted version of the CSQ-I | 12-week post-test | The investigators will measure the satisfaction with the program, by using a translated and adapted version of the Client Satisfaction Questionnaire (CSQ-I; Boß et al., 2016) assessing different quantitative and qualitative questions. These questions will be evaluated separately. |
| Change in the monitoring of the mood, solitude feelings and grief symptoms | Days 1, 8, 15, 22, 29, 36, 43, 50, 57, 64, 71, 78, 85 | The investigators will weekly monitor the mood of the participants of LIVIA 2 using a single item (How would you describe your current mood on a scale ranging from 0 (very bad) to 6 (very good). Moreover, the investigators will weekly monitor the grief and solitude symptoms on a scale ranging from 1 (strongly disagree) to 5 (strongly agree) with the following items: During the past 24 hours: (1) I have felt negative emotions ; (2) I have had negative images or thoughts ; (3) I felt blocked in my behaviour (what I do, my activities) ; (4) I felt lonely ; (5) I felt like I had a clear sense of who I am and what I want in life. |
| Change in anxiety symptoms | Pretest; 12-week post-test; 3-month Follow-up | assessed with the Generalized Anxiety Scale (Micoulaud-Franchi et al., 2016; Spitzer et al., 2006), on a scale ranging from 0 = never to 4 = practically every day. The sum of the scores is used as a final score. Higher score represent a higher symptom load. |
| Degree of required guidance in each group | 12-week Post-test | number of participants requiring guidance and number of e-mails exchanged |
| Indicators of verbal immediacy (use of first-person pronouns and present tense words) and so-called we-talk (first-person plural pronouns) | 12-week Post-test | The investigators will analyse the linguistic behaviours and the semantic content in the exercises where the participants are required to describe a situation related to the loss. The objective is to test if some semantic categories (e.g. we-talk, Bourassa et al., 2018) are associated with the efficacy of the programme. |
| Change in grief coping strategies | Pretest; 12-week post-test; 3-month Follow-up | measured with the Coping with Bereavement Questionnaire (Ryckebosch-Dayez et al., 2016), on a scale ranging from 1 = almost never to 5 = always. Higher scores represent a higher use of the coping strategy. |
| Change in aspects related to identity | Pretest; 12-week post-test; 3-month Follow-up | Measured with three scales: 1. The Self-Concept Clarity (Brunot et al., 2015; Campbell et al., 1996) has a scale ranging from 1 = I completely disagree to 5 = I completely agree. The mean score is used as a final score. Higher score represent a lesser clarity of the self-concept. 2. The Centrality of Event Scale (Berntsen & Rubin, 2006; Ceschi et al., 2009) has a scale ranging from 1 = I completely disagree to 5 = I completely agree. The mean score is used as a final score. Higher score represent a higher centrality of the event of loss. 3. Questions about self-continuity (Lampraki et al., 2019), on a scale ranging from 1 = does not suit me to 5 = suits me perfectly. The mean score is used as a final score. Higher score represent a higher self-continuity. |
Countries
Switzerland
Outcome results
None listed