***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
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    Input: This prospect i ve study investigated the impact of group composition on the outcome of 2 forms of time-limited , short-term group therapy ( interpretive , supportive ) with 110 out patients from 18 therapy groups , who presented with complicated grief . The composition variable was based on the patient 's level of quality of object relations . The higher the percentage of patients in a therapy group who had a history of relatively mature relationships , the better the outcome for all patients in the group , regardless of the form of therapy or the individual patient 's quality of object relations score . The findings have direct clinical implication s for composing short-term therapy groups for out patients with complicated grief and possibly for other types of group therapies and patient problems Background : AIDS-related bereavement is a severe life stressor that may be particularly distressing to persons themselves infected with HIV . Increasing evidence suggests that psychological health is associated with disease progression , HIV-related symptoms , and mortality . Purpose : This study assessed change in health-related quality of life among HIV+ persons following a group intervention for coping with AIDS-related loss . Methods : The sample included 235 HIV+ men and women of diverse ethnicities and sexual orientations who had experienced an AIDS-related loss within the previous 2 years . Participants were r and omly assigned to a 12-week cognitive-behavioral bereavement coping group intervention or offered individual psychotherapy upon request .  Quality of life was assessed at baseline and 2 weeks after the intervention . Results : Participants in the group intervention demonstrated improvements in general health-related and HIV-specific quality of life , while those in the comparison remained the same or deteriorated . Effect sizes indicated that the majority of change occurred in women . Conclusion : This bereavement group aim ed at improving coping with grief also had a positive impact on health-related quality of life among HIV+ men and women , and suggests that cognitive-behavioral interventions may have a broad impact on both emotional and physical health BACKGROUND Complicated grief ( CG ) is a bereavement-specific syndrome characterized by traumatic and separation distress lasting over 6 months . Little is known about the role of dissociation experienced during or immediately after the loss of a loved one ( i.e. , periloss dissociation [ PLD ] ) in CG . The present study aim ed to examine the psychometric properties of the PLD-adapted Peritraumatic Dissociative Experiences Question naire and its association with symptom severity , treatment response , and drop-out rate . METHODS PLD data collected as part of a r and omized controlled trial of two loss-focused psychotherapy approaches for CG were examined . Treatment-seeking individuals with primary CG ( n = 193 ) were assessed for PLD at the initial visit , 95 of whom were r and omized and completed at least one treatment session . RESULTS The PLD-adapted Peritraumatic Dissociative Experiences Question naire was found to be internally consistent ( α = 0.91 ) with good convergent and divergent validity . After controlling for age , gender , time since loss , and current comorbid psychiatric diagnosis , self-reported PLD was associated with greater CG symptom severity ( P < .01 ) . However , contrary to our hypotheses , after controlling for age , baseline symptoms severity , psychiatric comorbidity , and treatment arm , PLD was predictive of better treatment response ( P < .05 ) and lower study discontinuation ( P < .01 ) . CONCLUSIONS PLD may be useful in identifying individuals at risk for CG and those who might respond to psychotherapy . Additional research should investigate the relationship of PLD with treatment outcome for different treatment approaches , and whether PLD prospect ively predicts the development of CG CONTEXT Complicated grief is a debilitating disorder associated with important negative health consequences , but the results of existing treatments for it have been disappointing . OBJECTIVE To compare the efficacy of a novel approach , complicated grief treatment , with a st and ard psychotherapy ( interpersonal psychotherapy ) . DESIGN Two-cell , prospect i ve , r and omized controlled clinical trial , stratified by manner of death of loved one and treatment site . SETTING A university-based psychiatric research clinic as well as a satellite clinic in a low-income African American community between April 2001 and April 2004 . PARTICIPANTS A total of 83 women and 12 men aged 18 to 85 years recruited through professional referral , self-referral , and media announcements who met criteria for complicated grief . INTERVENTIONS Participants were r and omly assigned to receive interpersonal psychotherapy ( n = 46 ) or complicated grief treatment ( n = 49 ) ; both were administered in 16 sessions during an average interval of 19 weeks per participant . MAIN OUTCOME MEASURE Treatment response , defined either as independent evaluator-rated Clinical Global Improvement score of 1 or 2 or as time to a 20-point or better improvement in the self-reported Inventory of Complicated Grief . RESULTS Both treatments produced improvement in complicated grief symptoms . The response rate was greater for complicated grief treatment ( 51 % ) than for interpersonal psychotherapy ( 28 % ; P = .02 ) and time to response was faster for complicated grief treatment ( P = .02 ) . The number needed to treat was 4.3 . CONCLUSION Complicated grief treatment is an improved treatment over interpersonal psychotherapy , showing higher response rates and faster time to response Abstract The relationships between patient personality variables and outcome for 107 psychiatric out patients with complicated grief who completed either interpretive or supportive short-term group therapy  were investigated . The personality variables were assessed prior to treatment with the  NEO-Five Factor Inventory ( NEO-FFI ) . For patients in both forms of therapy , extraversion , conscientiousness , and openness were directly associated with favorable treatment outcome . In contrast , neuroticism was inversely related to favorable outcome for patients in both forms of therapy . Agreeableness was directly related to favorable improvement in grief symptomatology for patients in interpretive therapy , but not for those in supportive therapy . The results highlight the importance of assessing patient personality in order to predict response to short-term group therapy . Possible explanations and clinical implication s of these findings are discussed Background This study examines the prevalence and nature of bereavement help-seeking among the population who experienced an " expected " death in the five years before their survey response . Such whole population data are not limited by identification through previous access to specific services nor practitioners . Methods In a r and omised , cross-sectional , state-wide population -based survey , 6034 people over two years completed face-to-face interviews in South Australia by trained interviewers  using piloted questions ( 74.2 % participation rate ) . Respondent demographics , type of grief help sought , and circumstantial characteristics were collected . Uni- and multi-variate logistic regression models were created . Results One in three people ( 1965/6034 ) had experienced an ' expected ' death of someone close to them in the last five years . Thirteen per cent sought help for their grief from one or more : friend/family members ( 10.7 % ) ; grief counselors ( 2.2 % ) ; spiritual advisers ( 1.9 % ) ; nurses/doctors ( 1.5 % ) . Twenty five respondents ( 1.3 % ) had not sought , but would have valued help with their grief . In multi-variate regression modeling , those who sought professional help ( 3.4 % of the bereaved ) had provided more intense care ( OR 5.39 ; CI 1.94 to14.98 ; p < 0.001 ) , identified that they were less able to ' move on ' with their lives ( OR 7.08 ; CI 2.49 to 20.13 ; p = 0.001 ) and were more likely not to be in full- or part-time work ( OR 3.75 ; CI 2.31 – 11.82 ; p = 0.024 ; Nagelkerke 's R2 = 0.33 ) . Conclusion These data provide a whole-of- population baseline of bereavement help-seeking . The uniquely identified group who wished they had sought help is one where potentially significant health gains could be made as we seek to underst and better any improved health outcomes as a result of involving bereavement services Complicated grief ( CG ) is a debilitating syndrome that can be reliably identified , but there is a paucity of research examining treatment of CG . A targeted psychotherapy for complicated grief ( CGT ) was recently shown to be efficacious [ Shear , K. , Frank , E. , Houck , P.R. , Reynolds , C.F. , 3rd , 2005 . Treatment of complicated grief : a r and omized controlled trial . Journal of the American Medical Association 293 , 2601 - 2608 ] . We provide a detailed examination of the association of naturalistic pharmacotherapy use with treatment response and study completion in the psychotherapy study . Patients on an antidepressant medication were more likely to complete a full course of CGT  ( 91 % vs. 58 % completed ) , while antidepressant use had no effect on completion rates for the comparator , interpersonal psychotherapy ( 70 % vs. 77 % ) . Our naturalistic data underscore the need for prospect i ve , r and omized controlled studies of CG pharmacotherapy and psychotherapy alone and in combination OBJECTIVE Most family caregivers adapt well to the death of their care recipient relative ; however , a sizable minority continues to experience postdeath psychiatric morbidity . The purpose of this study was to better underst and why some caregivers manifest clinical levels of complicated grief postdeath . This is the first study to prospect ively assess predictors of complicated grief among family caregivers of patients with dementia who experience the death of their care recipient . METHOD The sample of bereaved caregivers is drawn from a larger study of 1,222 family caregivers providing in-home care to their relative with dementia . In-home assessment s of caregivers and patients were carried out at baseline and six-month intervals for a total of 18 months . This article is based on the 217 caregivers who experienced the death of their care recipient in the course of the study . Three logistic regression models are tested to identify pre- and postbereavement predictors of complicated grief , including sociodemographic factors , characteristics of the caregiving experience , including participation in a caregiver intervention , other psychiatric morbidities , and medication use . RESULTS Twenty percent of dementia caregivers evidence d complicated grief along with high levels of depressive symptomatology postdeath . Controlling for sociodemographic factors , caregivers who had high levels of preloss depressive symptoms and burden , reported positive features of the caregiving experience , and were caring for a more cognitively impaired patient were more likely to report clinical levels of complicated grief postloss . In addition , caregivers who were enrolled in a psychosocial caregiver intervention design ed to reduce depression and burden reported lower levels of complicated grief . CONCLUSION This study identifies predictors of complicated grief for which interventions could be developed to not only ease caregiver distress , but also serve as preventive interventions for bereavement . Reducing the burden of active caregiving , treating depression before the death of the loved one and providing supportive psychosocial and skills training caregiver interventions can prevent the emergence of postdeath psychiatric morbidity This study examined the longitudinal effects of coping on outcome one year following completion of a r and omized , controlled trial of a group coping intervention for AIDS-related bereavement . Bereaved HIV-positive participants ( N = 267 ) were administered measures of grief , psychiatric distress , quality of life , and coping at baseline , post-intervention , and at 4- , 8- , and 12-month follow-ups . Coping strategies directly impacted all outcome variables for both study conditions . Additionally , the coping intervention moderated the relationship between avoidant coping and the longitudinal course of grief and psychiatric distress , result ing in greater reductions in grief and distress for intervention participants after accounting for avoidant coping strategies Objective To examine the effectiveness of a family based grief counselling programme to prevent complicated grief among first degree relatives and spouses of someone who had committed suicide . Design Cluster r and omised controlled trial with follow-up at 13 months after the suicide . Setting General practice s in the Netherl and s. Participants 122 first degree relatives and spouses of 70 people who committed suicide ; 39 families ( 68 participants ) were allocated to intervention , 31 families ( 54 participants ) to control . Intervention A family based , cognitive behaviour counselling programme of four sessions with a trained psychiatric nurse counsellor between three to six months after the suicide . Control participants received usual care . Main outcome measures Self report complicated grief . Secondary outcomes were the presence of maladaptive grief reactions , depression , suicidal ideation , and perceptions of being to blame for the suicide . Results The intervention was not associated with a reduction in complicated grief ( mean difference −0.61 , 95 % confidence interval −6.05 to 4.83 ; P=0.82 ) . Secondary outcomes were not affected either . When adjusted for baseline inequalities , the intervention reduced the risk of perceptions of being to blame ( odds ratio 0.18 , 0.05 to 0.67 ; P=0.01 ) and maladaptive grief reactions ( 0.39 , 0.15 to 1.01 ; P=0.06 ) . Conclusions A cognitive behaviour grief counselling programme for families bereaved by suicide did not reduce the risk of complicated grief or suicidal ideation or the level of depression . The programme may help to prevent maladaptive grief reactions and perceptions of blame among first degree relatives and spouses . Trial registration Current Controlled Trials IS RCT N66473618 This study investigated the feasibility of using behavior 
    Output:
    
Overall , study quality was poor , with the majority of interventions showing a risk of bias in several key areas .