Evidence map›Paper›PMID 41355741›Full record

Observational studyDialogues in clinical neuroscience2026

Autonomic evidence that avoidance matters in the mourning process: A prospective observational study in Japan.

Takuya Yoshiike, Tomoki Yajima, Tomohiro Utsumi, Srishti Tripathi, Aoi Kawamura, Kentaro Nagao, Kentaro Matsui, Yoko Matsuda, Mitsunari Abe, Masaya Ito and 2 more

Abstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Dialogues in clinical neuroscience, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Takuya YoshiikeDepartment of Sleep-Wake Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan.ORCID 0000-0002-6071-8167
Tomoki YajimaDepartment of Sleep-Wake Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan.ORCID 0009-0006-6768-8761
Tomohiro UtsumiDepartment of Sleep-Wake Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan.ORCID 0000-0002-4673-7230
Srishti TripathiDepartment of Sleep-Wake Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan.ORCID 0009-0008-9680-6442
Aoi KawamuraDepartment of Sleep-Wake Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan.ORCID 0000-0002-7320-2848
Kentaro NagaoDepartment of Sleep-Wake Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan.ORCID 0000-0001-6497-2835
Kentaro MatsuiDepartment of Sleep-Wake Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan.ORCID 0000-0003-4538-5381
Yoko MatsudaCognitive Behavioral Therapy and Research Institute, Musashino University, Tokyo, Japan.
Mitsunari AbeDepartment of Advanced Neuroimaging, Integrative Brain Imaging Center, National Center of Neurology and Psychiatry, Tokyo, Japan.ORCID 0000-0002-3913-2292
Masaya ItoDepartment of Research and Development, National Center for Cognitive Behavior Therapy and Research, National Center of Neurology and Psychiatry, Tokyo, Japan.ORCID 0000-0003-2295-9733
Satomi NakajimaCognitive Behavioral Therapy and Research Institute, Musashino University, Tokyo, Japan.ORCID 0000-0003-3481-2421
Kenichi KuriyamaDepartment of Sleep-Wake Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan.ORCID 0000-0002-0254-4357

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionEvidence provides support for the therapeutic benefits of targeting avoidance in prolonged grief. However, it is not clear whether avoidance interferes with mourning through altered resilience to stress, as measured by heart rate variability (HRV).

methodsThirty-five adults (30 female; mean age: 39.2 years), who had been bereaved for more than one year, participated in this prospective, observational study. At each of the initial assessments and up to six-month follow-ups, grief symptoms were assessed using the Complicated Grief Questionnaire, and a resting electrocardiogram was recorded to extract the high-frequency component of HRV (HF-HRV). To differentiate avoidance from grief itself, principal component analysis was used.

resultsA nonlinear cross-sectional relationship was observed between avoidance and HF-HRV (coefficient = 0.29,

conclusionDespite its palliative gain, avoidance relates to the maintenance of grief longitudinally through attenuated autonomic resilience to stress.

Indexed as

Autonomic Nervous SystemAvoidance LearningGriefHeart RateAdultCross-Sectional StudiesElectrocardiographyFemaleHumansJapanMaleMiddle AgedProspective Studiesautonomic nervous systemAvoidancebereavementheart rate variabilityprolonged grief

Identifiers

PMID41355741
PMCPMC12687905

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.