CT Complicated Grief & Trauma 3 — Questions and Answers
Question 1: Which neurobiological finding has been associated with Prolonged Grief Disorder compared to normal grief?
- Reduced activity in the nucleus accumbens when viewing the deceased's image
- Elevated nucleus accumbens activation in response to reminders of the deceased (Correct answer)
- Decreased cortisol response to loss-related stimuli
- Hyperactivation of the prefrontal cortex during grief processing
Correct answer: Elevated nucleus accumbens activation in response to reminders of the deceased
Neuroimaging studies have found elevated nucleus accumbens (reward circuitry) activation in PGD, suggesting grief may involve reward-seeking for the deceased that perpetuates longing.
Question 2: In Shear's Complicated Grief Treatment model, 'aspirational goals' serve what function?
- Identifying cognitive distortions that maintain grief
- Reconnecting the bereaved to future-oriented life engagement (Correct answer)
- Facilitating imaginal conversations with the deceased
- Measuring symptom severity at treatment midpoint
Correct answer: Reconnecting the bereaved to future-oriented life engagement
Aspirational goals in CGT help clients envision and work toward a meaningful future life, counteracting the stagnation characteristic of complicated grief.
Question 3: A bereaved parent avoids all rooms where their child slept and refuses to speak the child's name, stating 'it's too painful.' From a complicated grief perspective, this behavior is BEST described as:
- Healthy boundary-setting during acute grief
- Maladaptive avoidance maintaining grief complications (Correct answer)
- A culturally appropriate grief ritual
- Resilient coping through emotional regulation
Correct answer: Maladaptive avoidance maintaining grief complications
Prolonged avoidance of reminders prevents the emotional processing needed for adaptation and is a key maintenance factor in complicated grief.
Question 4: Which of the following BEST describes the concept of 'shattered assumptions' as it relates to traumatic loss?
- The physical shock experienced when news of a death is delivered
- The collapse of beliefs about the world as benevolent, meaningful, and self-worthy (Correct answer)
- The inability to recall pre-loss autobiographical memories
- Disruption of social networks following bereavement
Correct answer: The collapse of beliefs about the world as benevolent, meaningful, and self-worthy
Janoff-Bulman's Shattered Assumptions Theory holds that traumatic loss destroys core beliefs about the world's benevolence, meaningfulness, and one's own self-worth.
Question 5: A clinician notes that a grief client repeatedly reconstructs a positive narrative about the deceased while denying any ambivalence. According to complicated grief theory, this may indicate:
- Successful integration of the loss
- Idealization that inhibits authentic grieving (Correct answer)
- Healthy use of the continuing bonds
- Resilience through meaning-making
Correct answer: Idealization that inhibits authentic grieving
Extreme idealization of the deceased can prevent the bereaved from processing ambivalent feelings, which may complicate grief and delay adaptation.
Question 6: The DSM-5-TR specifies that Prolonged Grief Disorder symptoms must persist for at least how long after bereavement for adults?
- 3 months
- 6 months
- 12 months (Correct answer)
- 18 months
Correct answer: 12 months
DSM-5-TR requires that PGD symptoms be present for at least 12 months following the death for adults (6 months for children).
Question 7: Secondary losses following traumatic bereavement MOST commonly complicate grief by:
- Providing distraction from the primary loss
- Adding cumulative stressors that deplete coping resources (Correct answer)
- Accelerating the grieving timeline
- Reducing the perceived importance of the original loss
Correct answer: Adding cumulative stressors that deplete coping resources
Secondary losses (financial, social, role-based) pile additional stressors onto the bereaved, depleting adaptive coping capacity and intensifying grief complications.
CT Complicated Grief & Trauma 3
Which neurobiological finding has been associated with Prolonged Grief Disorder compared to normal grief?