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Biomedical subjects

E K Rynearson

Publications and source records attributed to E K Rynearson.

13 recordsLinked to original sources
PubMed1995

Bereavement after homicide. A comparison of treatment seekers and refusers.

BACKGROUND: This brief report presents initial findings from a prospective descriptive study of adults after the homicide of a family member. Within the first year of bereavement, the responses and risk factors associated with unrecovered grief and post-traumatic stress disorder in subjects who requested or refused supportive psychotherapy were compared. METHOD: Fifty-two adult members of 237 families contacted within three months of a homicide attended a specialised out-patient clinic (32 requested, and 20 refused, supportive therapy) after a structured interview and completion of measures of grief (TRIG), trauma (RIES and DES), and death imagery. RESULTS: Only two risk factors (childhood history of sexual abuse and lack of religious faith) were associated with treatment seeking. Treatment-seeking subjects also scored significantly higher (P < 0.001) on all measures of grief, trauma, and intrusive re-enactment imagery of the dying. CONCLUSION: Adults who seek therapy after the homicide of a family member are highly reactive to all measures of trauma, grief, and death imagery.

Adolescent↗
PubMed1993

Bereavement after homicide: a synergism of trauma and loss.

OBJECTIVE: The purpose of this study was to examine the intensity and relationship of trauma and responses to bereavement in family members after homicide. METHOD: The authors established an outpatient clinic that offered evaluation and supportive psychotherapy after the homicide of a family member. A standardized evaluation protocol was followed with 18 adults in order to detail variables of previous trauma, bereavement, and psychiatric disorder. Standardized measures of bereavement (Texas Revised Inventory of Grief) and trauma (Impact of Event Scale and Dissociative Experiences Scale) were also administered. RESULTS: As a group, the 18 adults were characterized by a high frequency of antecedent psychiatric disorder (N = 12), the homicide of a child (N = 12), and an intensely idealized attachment to the decreased, whose image of violent dying recurred as a disorganizing flashback and dream. The measures of bereavement and trauma showed generally higher levels of intensity in the 18 subjects in the present study than in normal subjects and other cohorts of bereaved subjects. CONCLUSIONS: For those who have lost a family member through homicide, recognition of a relatively specific pattern of dysfunctional responses of grief and trauma would promote early identification and psychiatric referral.

Adult↗
PubMed1987

Psychotherapy of pathologic grief. Revisions and limitations.

A significant minority (14 per cent) of a nonpatient bereaved population may be presumed to develop intense and enduring pathologic grief responses. The promise of recovery with short-term, focused intervention appears to be misleading, as a sizable proportion of patients with pathologic grief will be unresponsive to treatment. Prospective studies have demonstrated a positive correlation of dependent attachment, conflicted attachment, and unexpected loss with specific pathologic grief syndromes; preliminary reports suggest that these specific grief syndromes require specific interventions. The presentation of a nonresponsive case illustrates the clinical application and limitation of a revised strategy of treatment. The development and maintenance of formative imagery and symbols is of crucial support to the patient and therapist.

Conflict, Psychological↗
PubMed1984

Short-term group psychotherapy. A successful approach to functional complaints.

The term "functional illness" describes a large group of patients who have psychologically determined physical symptoms for which they repeatedly seek medical treatment to little or no avail. At the Mason Clinic, Seattle, we in the section of behavioral medicine have devised a psychotherapeutic format for treating these chronically disabled patients. With short-term intensive group psychotherapy, patients with functional complaints are removed from the discouraging isolation of their home environment for three or four weeks, yet are spared the expense and stigma of psychiatric hospitalization. Group support is coupled with intensive self-inquiry in daily psychodynamic treatment. This immersion in a variety of therapeutic modalities helps foster new adaptations to past and present psychological conflicts. In addition to symptomatic relief, some degree of constructive and enduring personality change takes place.

Adult↗
PubMed1984

Bereavement after homicide: a descriptive study.

The act of homicide specifically influences the clinical presentation of subsequent bereavement. Retrospective reports of 15 individuals who lost a relative through homicide revealed cognitive, behavioral, and affective reactions associated with the homicide. Several of these reactions match those described in the DSM-III diagnosis of posttraumatic stress disorder, chronic or delayed type. The identification of bereaved individuals with the homicide and the therapeutic implications of bereavement after homicide are discussed.

Adult↗
PubMed1982

Unresolved bereavement: medical reenactment of a loved one's terminal illness.

In our psychiatric practice in Seattle, we have found several cases of complicated bereavement in which the patient has been unable to accept the death of her mother for an unusually long time and, consequently, continues to complain of physical symptoms similar to those of her mother. These patients initially sought medical care from primary care physicians, who tried to treat the symptoms without considering the cause. In some instances, needless medical and even surgical procedures were pursued to no avail. We believe that such patients usually require only referral for psychiatric care, which unfortunately often is palliative but not curative.

Adult↗
PubMed1981

Suicide internalized: an existential sequestrum.

Suicidal bereavement involves more than the personalized reaction to the death of another. The bereaved is also left with the cognitive and emotional dilemma of death as a chosen option for existence. This existential contradiction creates enduring changes in cognitive and emotional perspective. The author reviews these changes and their therapeutic implications.

Adaptation, Psychological↗
PubMed1978

Humans and pets and attachment.

The bond between human and pet depends on their commonality as animals and their mutual need for attachment. Under abnormal circumstances of developmental frustration a human may displace an overdetermined need for attachment to the pet. The attachment relationship is pathological because of its defensive purpose, and its interruption can create enduring psychiatric reactions. The paper details the developmental determinants for this interaction.

Adult↗