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In this revised esition, Thomas Attig tells tales of survival to illustrate the poignant suffering that the loss of a loved one entails. Dr. Attig shows how through grieving we meet daunting challenges, make choices, and reshape our lives forever. In so doing, he redefines grief as an active, coping process rather than a stage to be endured, or a problem to be overcome. The book's many valuable lessons inform and instruct a wide audience of clinicians, caregivers, friends and family members of bereaved persons, and those who seek a general, non-clinical perspective on their own experience of grief.This version includes updated references and a new introduction.

The author's memoir recounting his wife Liz's death shortly after the birth of their daughter Madeline and how he and his daughter Maddy have built a life for themselves--grounded in large part in the life and marriage he shared with Liz.

The aim of the study was to investigate the perception of the family functioning in parents of children with autism spectrum disorders (ASD) with normal-range intelligence and the relationships between family functioning, parenting stress and quality of life. Dyads of parents of children with ASD without intellectual disability and parents of typically developing children (controls) completed a set of self-report questionnaires. Parents of children with ASD reported lower functioning of the family as a whole and their own functioning as family members; they exhibited higher levels of parenting stress and lower quality of life. Mothers of children with ASD experienced more stress in personal domain than fathers. Relationships between family functioning, parenting stress and quality of life have been established. There were also moderate to strong correlations in mother-father dyads between their assessments of family functioning, parenting stress and QoL in social relationships and environmental domains.

To assess whether the psychological variables perceived stress, neuroticism and coping strategies, are associated with Premenstrual Syndrome (PMS) and Premenstrual Dysphoric Syndrome (PMDD). Case-control study with incident cases using the Spanish public healthcare system. 3 major public hospitals and one family counseling and planning center. Women consulting for troubles related to menstruation and for other motives such as screening for uterine cancer, contraception counselling or desire for pregnancy. Logistic regression. Odds of PMS and PMDD. 285 PMS and 285 age-matched controls, as well as 88 PMDD cases and 176 controls participated in the study. Medium and high levels of perceived stress were associated with an increase in the odds of PMS (Odds Ratio (OR) = 2.49; 95%CI: 1.41-4.39 and OR = 4.90; 95%CI: 2.70-8.89, respectively). For PMDD the results were: OR = 2.61; 95%CI: 1.35-5.05 and OR = 5.79; 95%CI: 2.63-12.76, respectively. Subjects with medium and high levels of neuroticism were also at higher odds of suffering from PMS (OR = 2.53; 95%CI: 1.06-6.06 and OR = 8.05; 95%CI: 3.07-2.12, respectively). For PMDD, the results were OR = 3.70; 95%CI: 1.27-10.77 and 5.73: 95%CI: 1.96-16.77, respectively. High levels in the large majority of coping strategies were also associated with increased odds of PMS and PMDD. Psychological factors including perceived stress, neuroticism and coping strategies are strongly related to PMS/PMDD. This association is unlikely to be due to confounding or misclassification bias. A reverse causation process cannot be ruled out although its likelihood is remote.

Background Childhood obesity is a rising worldwide health issue with significant physical, psychological, and social implications. Beyond physical health, obesity has profound psychological effects, particularly on body image perception and self-esteem, which can be exacerbated by bullying and social stigmatization. Aim To assess body image perception among bullied obese children in Egypt and to examine the relationship between obesity, bullying experiences, and body image dissatisfaction. Methods This case-control study was conducted on 86 Egyptian children aged 5 to 10 years who attended the outpatient nutrition and immunity clinic at the Medical Research Centre of Excellence (MRCE). A comprehensive, structured questionnaire and clinical examination were used and analyzed to assess participants. Results The study included 86 children; 40 males and 46 females. Out of 86 children, 44 children were obese with mean of age (8.16 ± 1.78 y) and 42 were healthy children as controls with mean of age (7.69 ± 1.8. 55 y). A total of 27 children (34.6%) in the study population displayed acanthosis nigricans. Students in the obesity group reported higher rates of school bullying (36.4%) as compared to controls (11.9%). The family bullying was significantly higher in the obesity group at 40.9% compared to the control group at 7.1% ( p  = 0.001). A significant difference ( p  = 0.000) in sadness feeling was reported in obese children (56.8%) as compared with controls (11.9%). Children with family refusal showed statistically significant higher occurrences of expressing low self-esteem by refusing to be photographed (50%) and showing sadness (75%), especially in females. Conclusion This study highlights the obesity and its association with obesity-related health risks and emotional distress. School refusal was strongly linked to bullying and academic pressure. Negative school interactions affected family relationships, while family denial increased bullying and emotional distress. Females showed greater vulnerability to sadness than males.

The diagnosis of autism spectrum disorder (ASD) in a child affects family processes, increases parenting stress and marital conflicts, and may lead to parental psychopathology. It may also affect the prognosis for their children. The aim of this study is to determine depression and burnout levels as well as their predictors among parents of children with ASD compared with those of healthy children. We also sought to evaluate rate of complementary and alternative medicine (CAM) interventions among parents and explore the associations of this phenomenon in an exploratory fashion. 145 children with ASD and 127 control children were enrolled along with their mothers and fathers. Beck Depression Inventory and Maslach Burnout Inventory were used to evaluate parents’ depression symptoms and burnout levels. Symptoms of children with ASDs were evaluated according to the Childhood Autism Rating Scale by the clinicians. Family, child and CAM variables were screened by means of a sociodemographic data form. Descriptive, bivariate and correlation analyses were used in statistical evaluations. Predictors of burnout were evaluated with multiple regression analysis. Burnout and depression levels among parents of children with ASD were significantly elevated compared to controls. Burnout levels of mothers were significantly elevated compared to fathers while depression scores of fathers were significantly elevated compared to mothers. Maternal burnout was significantly predicted by presence of functional speech in child while paternal burnout was significantly predicted by paternal vocation. Maternal depression was associated with paternal depression, lack of speech in child and attendance of child to special education services. Paternal depression was associated with autistic symptom severity and maternal depression. More than half the parents sought CAM interventions. Education level did not affect search for CAM interventions while both maternal and paternal psychopathology and presence of epilepsy among children increased use of CAM methods. Psychological support should be provided to both mothers and fathers of a child receiving a diagnosis of ASD. Addressing parents’ burnout and stress levels and facilitating their negotiation of knowledge on etiology and treatments for ASD may be beneficial for the family unit as a whole.

Autism-Assistance Dogs (AADs) are highly-skilled service animals trained primarily to ensure the safety of an autistic child by preventing elopement and mitigating ‘meltdowns’. Although anecdotal accounts and case-studies have indicated that AADs confer benefits above and beyond safety, empirical support anchored in validated clinical, behavioral, and physiological measures is lacking. To address this gap, we studied children and their families before and after receiving a well-trained AAD using a within-subject, repeated-measures design. Notably, this study is the first to assess change in a biomarker for chronic stress in both autistic children and their parents. Final analyses included pre-/post-AAD data from 11 triads (parent/handler-dog-child) demonstrating significantly positive psychosocial and biobehavioral effects of AADs.

Although there is increasing research interest in the parenting of children with ASD, at present, little is known about everyday strategies used to manage problem behaviour. We conducted a meta-synthesis to explore what strategies parents use to manage irritability, non-compliance, challenging behaviour and anxiety in their children with ASD. Approaches included: (1) accommodating the child; (2) modifying the environment; (3) providing structure, routine and occupation; (4) supervision and monitoring; (5) managing non-compliance with everyday tasks; (6) responding to problem behaviour; (7) managing distress; (8) maintaining safety and (9) analysing and planning. Results suggest complex parenting demands in children with ASD and problem behaviour. Findings will inform the development of a new measure to quantify parenting strategies relevant to ASD.

Pregnant women and new mothers seeking asylum are subject to major challenges that may affect their health and increase their vulnerability. The study aim was to investigate asylum seeking women's experiences and perceived needs during pregnancy and early motherhood whilst living in state-provided accommodation in one federal state in Southern Germany, with a particular focus on psychosocial factors. In this exploratory case study, individual semi-structured interviews were conducted with participants in pregnancy and up to the six-week postnatal assessment. Two female interviewers performed interviews assisted by female professional interpreters. Interviews were recorded digitally and transcribed verbatim. An inductive approach was taken to content analysis of interview material. 21 interviews were performed with nine women seeking asylum in pregnancy and early motherhood. Women shared experiences and perceived consequences on their psychosocial health. The following five key themes were identified during content analysis: a) psychosocial stressors, b) stressful living circumstances, c) stressful relationships, d) social support and e) coping styles. Psychosocial factors were a significant source of mental stress for participants, especially due to future uncertainties linked with the asylum seeking process. Living circumstances were also marked by stressors including a lack of privacy, verbal and physical threats and experiences of powerlessness. Further strain and emotional pressure were caused by stressful relationships with the unborn child's father. Social support and personal coping styles provided relief for some participants. This study provides in-depth insights into the experiences and perceived needs of pregnant asylum seekers and new mothers living in state-provided accommodation. Key results identified psychosocial factors such as future uncertainties, stressful living circumstances and stressful relationships, as social determinants of health that were perceived to adversely affect women's health. Adequate social support and individual coping styles increased resilience and counterbalanced psychosocial stressors during the asylum seeking process.