Am J Psychiatry 1993; 150:258-261
Copyright © 1993 by American Psychiatric Association
Bereavement after homicide: a synergism of trauma and loss
EK Rynearson and JM McCreery
Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle.
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.
