Cluster randomized controlled trial reveals significant reduction in posttraumatic stress symptoms among bereaved survivors, suggesting benefits of cultural adaptation.
Following the Jishishan earthquake in China, the demand for bereavement support for affected individuals has increased. This study aimed to test the efficacy of a Confucian-adapted, dual process model (DPM)-based group intervention. A cluster randomized controlled trial was conducted. Six sites were randomized to either the experimental group (Confucian-based dual-process bereavement group intervention, C-DPBGI, n = 30) or the control group (Confucian-based loss-oriented bereavement group intervention, C-LOBGI, n = 30). Participants received 12 sessions over 6 weeks. Assessments of posttraumatic stress symptoms (PTSS, measured by Impact of Event Scale-Revised) and general mental health (GHQ-12) were conducted at baseline, postintervention, and 8-week follow-up. Linear mixed models (LMM) were used for intention-to-treat analysis (N = 60). LMM analyses revealed significant reductions over time in both PTSS and general mental health distress for both groups (p < .001). A significant Time × Group interaction was found for PTSS, F(2, 116) = 5.71, p = .004, indicating a greater reduction in PTSS in the C-DPBGI group compared to the C-LOBGI group, particularly from baseline to postintervention (between-group Cohen's d = 0.64) and baseline to follow-up (between-group Cohen's d = 0.79). No significant Time × Group interaction was found for general mental health, F(2, 116) = 0.31, p = .733, suggesting similar improvement trajectories for both groups on this outcome. Both Confucian-adapted interventions showed efficacy in improving mental health among earthquake-bereaved individuals. The DPM-based C-DPBGI, incorporating both loss- and restoration-oriented components, demonstrated a significant advantage over the loss-oriented C-LOBGI in reducing PTSS, supporting the utility of the full DPM framework and cultural adaptation in this context. (PsycInfo Database Record (c) 2025 APA, all rights reserved).
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