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Objective: To evaluate the feasibility, acceptability, and effects of family-centered advance care planning (ACP) in patients with breast cancer. Methods: In this randomized controlled trial, 80 breast cancer patients were assigned to either a family-centered ACP group or a standard care group. Outcomes were measured at baseline and one month after the intervention using the Advance Care Planning Acceptance Questionnaire (ACPQ), Templer Death Anxiety Scale (T-DAS), Functional Assessment of Cancer Therapy - Breast (FACT-B), and a self-designed questionnaire. Results: Compared to controls, the intervention group showed higher ACP acceptance and improved quality of life (excluding physical well-being and additional concerns), along with lower death anxiety and reduced preference for life-sustaining treatments and aggressive end-of-life care. Conclusion: Family-centered ACP is feasible and acceptable for breast cancer patients. It enhances ACP engagement, improves quality of life, and reduces death anxiety. This study was prospectively registered in a publicly accessible clinical trial registry.

Although death is a universal and inevitable aspect of life, it remains largely avoided in early childhood education settings. This mixed-method study explores early childhood educators' comfort levels, beliefs, and preparedness regarding discussions about death with young children and their death-related metaphors. Data were collected by convenience sampling from 166 early childhood educators across various regions of Türkiye through an online form. Quantitative findings revealed that educators feel unprepared and uncomfortable addressing death, highlighting significant gaps in both pre-service and in-service training. Qualitative analysis showed that educators' metaphors most frequently emphasized inevitability and noncorporeal continuation sub-components. These findings emphasize the urgent need to strengthen teacher education curricula and provide targeted professional development to better support early childhood educators in addressing death sensitively and effectively.

Induced After-Death Communication (IADC) therapy, which uses bilateral stimulation derived from EMDR, is an emerging approach to reducing grief symptoms in bereaved individuals. The present study evaluated the IADC protocol, consisting of two 90-min sessions, in 43 bereaved adults with assessments at four time points including a one-month waitlist period to provide control data. Large reductions in grief symptoms were observed from baseline to follow-up (global grief severity d = 1.56; average daily sadness d = 1.33). Two-thirds of participants who exceeded the clinical cutoff score for prolonged grief at baseline scored below this threshold at follow-up. Treatment effects were comparable across delivery methods (in-person vs. online) and were not moderated by time since loss or baseline symptom severity. After-death communications occurred in 79% of participants during therapy and predicted stronger continuing bonds with the deceased. These findings support IADC as an efficient treatment option for bereaved individuals.

This study examined the impact of meaning-making of loss on the duration of grief and the moderating role of cause of death. This cross-sectional study recruited 320 participants who experienced loss from suicide or other causes. Participants completed an online questionnaire assessing meaning-making using the Integration of Stressful Life Experiences Scale and complicated grief using the Inventory of Complicated Grief. General linear models were applied to examine the hypotheses. We observed that cause of death (suicide vs other causes) moderated the associations between meaning-making and the duration of grief. The results were further validated using the bootstrap resampling. The effects between meaning-making and the duration of grief were significant among suicide loss survivors, whereas this effect was not observed among participants who experienced loss from other causes. This study highlights the critical role of meaning-making of loss in affecting the duration of grief among suicide loss survivors.

Objective: This study investigates the effectiveness of imagery rescripting interventions for adults experiencing parental loss, a profoundly traumatic event. Method: Thirty-five participants were randomly assigned to either an imagery rescripting (IR) group, a reading and writing intervention group, or a control group. The IR intervention, applied once a week for three weeks, incorporated components. Results: Results demonstrated that the IR group showed significant reductions in grief-related emotions and improvements in cognitive appraisals compared to the other groups. These positive changes persisted for at least one week post-treatment. While both intervention groups experienced emotional shifts, the IR group exhibited greater changes in cognitive appraisals. Conclusions: This study highlights the potential of imagery rescripting in addressing complex grief and suggests further exploration of imagery-based therapies for emotional distress related to parental loss.

This study presents the first comprehensive bibliometric analysis of suicidology research in Southeast Asia, examining 255 documents retrieved from the Scopus database spanning 1954 to 2025. The analysis explores publication trends, key authors, institutions, countries, journals, keyword patterns, and citation metrics. Findings indicate a notable surge in suicidology research between 2022 and 2024, likely driven by the mental health aftermath of the COVID-19 pandemic. Malaysia emerged as the most productive country, followed by Singapore and Thailand. Keyword analysis revealed "suicide", "adult", "adolescent", "suicidal ideation", and "suicide attempt" as dominant terms, reflecting both epidemiological priorities and ethical feasibility in research. Further, regional advancements such as the decriminalisation of attempted suicide in Singapore and Malaysia contributed to a more supportive research environment. This analysis provides valuable insights into the regional research landscape and offers strategic guidance for future studies, collaborations, and policy development tailored to Southeast Asia's unique socio-cultural and mental health contexts.

Communication about the end-of-life (EOL) is often avoided, despite its association with positive outcomes for those affected and their caregivers. Negative expectations seem to be a mechanism through which avoidance is maintained. This study examined existing expectations in talking about death to a significant other and validated a caregiver's version of the End-of-Life Conversation - Expectation Scale (EOLC-E-c) with a German community sample of N = 250. Participants most frequently expected EOL conversations to cause sadness in themselves and the other person. Confirmatory factor analysis supported the original three-factor structure: Expected own emotional burden (α = .92), expected emotional burden of the other person (α = .94), and communication self-efficacy (=.90). Internal consistency of the scale was excellent, and its validity was supported. Using the scale could be valuable for clinicians and researchers in understanding individuals' expectations concerning EOL conversations and in developing targeted interventions focusing on expectation violation.

Suicide risk is highly prevalent among substance users, a population vulnerable to complications in bereavement. This study used network analysis to examine relationships between Prolonged Grief Disorder (PGD) symptoms and suicide risk among bereaved individuals in addiction treatment. Participants were 196 bereaved substance users. The Risk of Suicide Scale and the Spanish version of the Inventory of Complicated Grief were applied. Gaussian Graphical Models with LASSO regularization explored associations between symptoms, assessing centrality, expected influence, and bridge centrality. Network robustness was tested via bootstrapping using R and SPSS. In that sense, the network of PGD symptoms and suicide risk showed good stability. "Disbelief over what happened," "feeling life is empty without the deceased," "bitterness over the death," and "thoughts of suicide" had the highest strength indicators. In conclusion, PGD symptoms play a crucial role in suicide risk among substance users, underscoring the need for targeted, personalized interventions.

This study conceptually contributes to the literature by exploring how post-traumatic growth (PTG) may function as a protective psychological mechanism that mitigates caregiving burden in home-based palliative care contexts. This descriptive study included 175 home healthcare patients and their caregivers. Data were collected using the Sociodemographic Data Form, the Zarit Caregiver Burden Scale, and the Post-Traumatic Growth Inventory. A significant negative correlation was found between PTG and caregiver burden (r = -0.342, p = .01). Beyond the statistical association, these findings suggest that caregivers who interpret their caregiving experience through a lens of personal development, meaning-making, or strengthened relational perspectives may perceive caregiving demands as more manageable. Thus, PTG appears to operate as a resilience-enhancing process that reduces the subjective strain of caregiving. Strengthening psychosocial support particularly for women caregivers may therefore foster PTG and ultimately lessen caregiver burden while improving the overall quality of home-based palliative care.

Background: Perinatal loss is a painful and often invisible experience that deeply challenges mental and emotional health, with lasting impact on those who endure it. Method: This study assessed guilt, depressive symptoms, and self-compassion in portuguese women after perinatal loss, considering timing of the loss. The mediating effect of self-compassion on guilt and depressive symptoms was also examined, as well as the relationships between variables. Of the 545 women who answered the online questionnaire, 501 were eligible. Results: Participants reported high depressive symptoms, and moderate guilt and self-compassion. Self-compassion correlated negatively with guilt and depressive symptoms, which were positively correlated. Mediation analysis using PROCESS (Hayes, 2013) showed that self-compassion significantly mediated the link between guilt and depressive symptoms (ß = .05; 95% CI [.03, .08]). Findings indicate self-compassion plays a protective role, mitigating effects of guilt and depression, and emphasize its clinical relevance as a therapeutic resource in perinatal grief.