Symptoms of persistent complex bereavement disorder, depression, and PTSD in a conjugally bereaved sample: a network analysis

2018 ◽  
Vol 48 (14) ◽  
pp. 2439-2448 ◽  
Author(s):  
Matteo Malgaroli ◽  
Fiona Maccallum ◽  
George A. Bonanno
Keyword(s):  
Network Analysis ◽  
Graphical Models ◽  
Community Sample ◽  
Self Report ◽  
Post Traumatic Stress ◽  
Dsm 5 ◽  
Persistent Complex Bereavement ◽  
Core Symptoms ◽  
Persistent Complex Bereavement Disorder ◽  
Conjugally Bereaved

AbstractBackgroundComplicated and persistent grief reactions afflict approximately 10% of bereaved individuals and are associated with severe disruptions of functioning. These maladaptive patterns were defined in Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) as persistent complex bereavement disorder (PCBD), but its criteria remain debated. The condition has been studied using network analysis, showing potential for an improved understanding of PCBD. However, previous studies were limited to self-report and primarily originated from a single archival dataset. To overcome these limitations, we collected structured clinical interview data from a community sample of newly conjugally bereaved individuals (N= 305).MethodsGaussian graphical models (GGM) were estimated from PCBD symptoms diagnosed at 3, 14, and 25 months after the loss. A directed acyclic graph (DAG) was generated from initial PCBD symptoms, and comorbidity networks with DSM-5 symptoms of major depressive disorder (MDD) and post-traumatic stress disorder (PTSD) were analyzed 1 year post-loss.ResultsIn the GGM, symptoms from the social/identity PCBD symptoms cluster (i.e. role confusion, meaninglessness, and loneliness) tended to be central in the network at all assessments. In the DAG, yearning activated a cascade of PCBD symptoms, suggesting how symptoms lead into psychopathological configurations. In the comorbidity networks, PCBD and depressive symptoms formed separate communities, while PTSD symptoms divided in heterogeneous clusters.ConclusionsThe network approach offered insights regarding the core symptoms of PCBD and the role of persistent yearnings. Findings are discussed regarding both clinical and theoretical implications that will serve as a step toward a more integrated understanding of PCBD.

scholarly journals Network analysis of persistent complex bereavement disorder in conjugally bereaved adults.

2014 ◽  
Vol 123 (3) ◽  
pp. 510-522 ◽  
Author(s):  
Donald J. Robinaugh ◽  
Nicole J. LeBlanc ◽  
Heidi A. Vuletich ◽  
Richard J. McNally
Keyword(s):  
Network Analysis ◽  
Persistent Complex Bereavement ◽  
Persistent Complex Bereavement Disorder ◽  
Conjugally Bereaved

scholarly journals Performance of DSM-5 Persistent Complex Bereavement Disorder Criteria in a Community Sample of Bereaved Military Family Members

2016 ◽  
Vol 173 (9) ◽  
pp. 919-929 ◽  
Author(s):  
Stephen J. Cozza ◽  
Joscelyn E. Fisher ◽  
Christine Mauro ◽  
Jing Zhou ◽  
Claudio D. Ortiz ◽  
...  
Keyword(s):  
Community Sample ◽  
Family Members ◽  
Military Family ◽  
Dsm 5 ◽  
Persistent Complex Bereavement ◽  
Persistent Complex Bereavement Disorder

Behavioral Activation and Therapeutic Exposure vs. Cognitive Therapy for Grief Among Combat Veterans: A Randomized Clinical Trial of Bereavement Interventions

2021 ◽  
pp. 104990912198902
Author(s):  
Ron Acierno ◽  
Brooke Kauffman ◽  
Wendy Muzzy ◽  
Melba Hernandez Tejada ◽  
Carl Lejuez
Keyword(s):  
Cognitive Therapy ◽  
Behavioral Activation ◽  
Controlled Trial ◽  
Patient Characteristics ◽  
Department Of Veterans Affairs ◽  
Post Traumatic Stress ◽  
Significant Treatment ◽  
Persistent Complex Bereavement ◽  
Treatment Gains ◽  
Persistent Complex Bereavement Disorder

Approximately two-thirds of Operations Enduring Freedom, Iraqi Freedom, and New Veterans reported knowing someone who was killed or seriously injured, lost someone in their immediate unit, or personally saw dead or seriously injured Americans (Hoge et al., 2004; Thomas et al., 2010; Toblin et al., 2012). Thus, it is not surprising that prevalence of Persistent Complex Bereavement Disorder (PCBD) is high in these groups. Importantly, PCBD impact appears to be independent of both Post-Traumatic Stress Disorder (PTSD) and Major Depressive Disorder (Bonnano, 2007), 2 disorders that are also highly prevalent in these groups, thus tailored treatments for grief are indicated. The Department of Veterans Affairs suggests Cognitive Therapy for Grief as a first line psychotherapy, however treatments relatively more focused on behavior change and exposure to grief cues also may be useful for this population. To address this question, the present study used a randomized controlled trial to compare a 7-session program of Behavioral Activation and Therapeutic Exposure for Grief vs. Cognitive Therapy for Grief among 155 OIF/OEF/OND veterans. Both treatments produced significant treatment gains over baseline, and these improvements were maintained over 6-month followup; however no differences were observed between groups. Given equal efficacy, implications for matching treatment to patient characteristics are discussed.

Complicated grief: Is there a place in psychiatry?

2017 ◽  
Vol 41 (S1) ◽  
pp. S458-S458
Author(s):  
S.L. Azevedo Pinto ◽  
J. Soares ◽  
A. Silva ◽  
R. Curral
Keyword(s):  
Depressive Disorders ◽  
Complicated Grief ◽  
Adjustment Disorder ◽  
Classification Systems ◽  
Post Traumatic Stress ◽  
Adequate Treatment ◽  
Psychiatric Syndrome ◽  
Persistent Complex Bereavement ◽  
Competing Interest ◽  
Persistent Complex Bereavement Disorder

IntroductionGrief is as normal reactive to a significant personal loss. It is characterized by affective, cognitive, behavioural and physiological symptoms. The grieving process is usually divided in five different stages, but in most cases presents a benign course, with decreased suffering and better adaptation to the new context. However, when high levels of emotional suffering or disability persist over a long time period, it becomes a case of complicated grief (CG), which should be adequately addressed.ObjectivesTo review the characteristics of CG, the evidence that supports it as an individual pathological entity, and its place in current classification systems.MethodsWe performed a bibliographic search in Pubmed and PsychInfo, of articles written in English, Portuguese and Spanish, containing the key words: grief, bereavement, psychiatry, classification.ResultsThe main issue regarding grief is the degree to which it is reasonable to interfere with a usually benign process. Since DSM-III bereavement has been referred to as an adaptive reaction to an important loss, which should not be diagnosed as major depressive disorder or adjustment disorder. However, DSM-5 has stated persistent complex bereavement disorder as an independent entity. In fact, CG fulfils the general criteria of every psychiatric syndrome, namely regarding specific diagnosis criteria, differential diagnosis from depressive disorders and post-traumatic stress disorder, and improvement with adequate treatment.ConclusionIt is important to correctly approach CG, since it presents with characteristic diagnosis features and much improvement may be achieved once adequate treatment is provided.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Discrepancies in Self- and Informant-Reports of Personality Pathology: Examining the DSM-5 Section III Trait Model

2019 ◽  
Author(s):  
Michael Carnovale ◽  
Erika Carlson ◽  
Lena C. Quilty ◽  
Michael Bagby
Keyword(s):  
Factor Model ◽  
Five Factor Model ◽  
Community Sample ◽  
Elevated Risk ◽  
Self Report ◽  
Personality Pathology ◽  
Future Directions ◽  
Potential Approach ◽  
Dsm 5 ◽  
Severity Scores

A proposed feature of personality pathology involves disturbances in identity, of which a lack of insight is one such manifestation. From recommendations in the literature, one potential approach to assess and quantify such impairment and link it to personality pathology, would be to obtain self- and informant reports and subsequently index the degree personality pathology severity exacerbates self-other discrepancies. The current study examines the degree to which self- and informant-reports of DSM-5 Section III trait scores are discrepant (i.e., mean-level discrepancies and correlational accuracy), as well as whether general personality pathology severity moderates these characteristics. Target participants (N = 208) in an elevated-risk community sample completed the Personality Inventory for DSM-5 (PID-5), and knowledgeable informants rated targets using the informant version of the PID-5. General personality pathology severity was assessed via an aggregate of Five Factor Model PD prototype scores derived from self-report, informant-report, and interview ratings. Mean-level discrepancies and correlational accuracy (and their moderation by general personality pathology) for PID-5 domains, facets, and PD scores were subsequently examined. Results suggested that targets tended to mostly rate themselves only slightly lower than informants across all PID-5 scores (median dz = .21), and correlational accuracy across all PID-5 scores was moderate (median r = .33). Importantly, however, mean-level discrepancies increased as general personality pathology severity scores increased. Implications and future directions for the multi-method assessment of dimensional personality pathology are discussed.

scholarly journals A cognitive approach to persistent complex bereavement disorder (PCBD)

2017 ◽  
Vol 10 ◽  
Author(s):  
Michael Duffy ◽  
Jennifer Wild
Keyword(s):  
Cognitive Model ◽  
Diagnostic Category ◽  
Post Traumatic Stress ◽  
Cognitive Approach ◽  
Prolonged Grief ◽  
Diagnostic And Statistical Manual ◽  
Classification Of Diseases ◽  
International Statistical Classification ◽  
Persistent Complex Bereavement ◽  
Persistent Complex Bereavement Disorder

AbstractPersistent complex bereavement disorder (PCBD) has been included in the appendix of the fifth edition of the Diagnostic and Statistical Manual for Mental Disorders as a condition for further study, and a new diagnostic category of prolonged grief disorder (PGD) is likely to be added to the International Statistical Classification of Diseases and Related Health Problems (ICD-11) (Maercker et al., 2013). Whilst there is increasing evidence that prolonged grief has distinct characteristics (Bryant, 2012), there are clinical features that overlap with post-traumatic stress disorder (PTSD), such as intrusive memories, emotional numbing, and avoidance of trauma or loss reminders. Here we describe how the cognitive model for persistent PTSD (Ehlers and Clark, 2000) and trauma-focused cognitive therapy for PTSD (Ehlers et al., 2005) have been helpful in treating persistent complex grief.

DSM-5 PTSD and Post-Traumatic Stress Disorder Spectrum in Patients with Fibromyalgia: Possible Correlations with Subthreshold Autism Spectrum?

2017 ◽  
Vol 41 (S1) ◽  
pp. S722-S722
Author(s):  
C. Carmassi ◽  
C. Manni ◽  
G. Cipollone ◽  
C. Tagliarini ◽  
M.T. Avella ◽  
...  
Keyword(s):  
Traumatic Stress ◽  
Autism Spectrum ◽  
Self Report ◽  
Post Traumatic Stress ◽  
Potentially Traumatic Events ◽  
Dsm 5 ◽  
American College Of Rheumatology ◽  
Stress Spectrum ◽  
Post Traumatic ◽  
Competing Interest

IntroductionPTSD is extremely common in patients with fibromyalgia (FM) with rates up to 57%, and it often correlates with increased severity of the disease.ObjectivesThe aim of this study was to investigate the presence of PTSD, diagnosed according to DSM-5 criteria, and of Post-Traumatic Stress Spectrum symptoms in a sample of patients with FM.MethodsSixty-one patients, 7 males and 54 females, with FM, diagnosed according to American College of Rheumatology (ACR) at the Unit of Rheumatology of A.O.U.P clinics, were assessed by: SCID-5; Trauma and Loss Spectrum Self-Report (TALS-SR); Adult Autism Subthreshold Spectrum (AdAS Spectrum).ResultsPatients with FM with full and partial PTSD reported a significantly higher number of losses and potentially traumatic events in the TALS-SR than patients without PTSD. Significantly, higher AdAS Spectrum scores in almost all domains were reported in patients with PTSD with respect to those with partial or without PTSD. Moderate to good correlations were highlighted amongst most of the TALS-SR and ADAS-Spectrum domains.ConclusionsSignificant DSM-5 PTSD rates emerged in our sample of patients with FM. Significant correlations were found between Adult Subthreshold Autism Spectrum and Post-Traumatic Stress Spectrum, corroborating recent hypotheses that indicate autism spectrum symptoms as vulnerability factors for PTSD.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Network Analyses of the Symptoms in the Coronavirus Anxiety Scale (CAS) and its Associations with Depression, Anxiety, Stress and Alcohol Use

2021 ◽  
Author(s):  
Rapson Gomez ◽  
Deon Tullett-Prado ◽  
Shaun Watson ◽  
Vasileios Stavropoulos
Keyword(s):  
Network Analysis ◽  
Alcohol Use ◽  
Sleep Disturbances ◽  
Tonic Immobility ◽  
Community Sample ◽  
Anxiety Symptoms ◽  
Anxiety Scale ◽  
Self Report ◽  
Network Analyses ◽  
Abdominal Distress

Abstract Background The Covid-19 Pandemic and subsequent actions taken by national/international organizations has generated a large amount of anxiety which may roam into the realm of pathology – COVID Anxiety. In order to measure this phenomenon, measures such as the CAS have been developed. The CAS being a self-report measure of anxiety-related physiologically symptoms that are aroused by information and thoughts related to COVID-19. However, as the CAS is fairly new tit requires validation and examination. This study fulfils this need through the use of Network Analysis. Methods The study used regularized partial correlation network analysis (EBICglasso) to examine the network structure of ratings of COVID anxiety symptoms as presented in the Coronavirus Anxiety Scale (CAS) and how these symptoms are related to distress (combination of depression, anxiety, stress) and alcohol use. A total of 968 adults from an Australian community sample completed the CAS, and measures of depression, anxiety, stress and alcohol use. Results The findings showed that the most central CAS symptom was abdominal distress, followed by tonic immobility. The symptom with the lowest strength centrality value was dizziness. Also, the network revealed at least moderate effect size connections for tonic immobility with dizziness, sleep disturbances abdominal distress, and for abdominal distress with appetite loss. Additionally, distress was associated positively with dizziness, tonic immobility and appetitive loss. Alcohol use was associated positively with dizziness and abdominal distress, and negatively with tonic immobility and appetitive loss. Conclusions Overall, the findings showed a novel understanding of the structure of the COVID anxiety symptoms in the CAS, and how these symptoms are associated with distress and alcohol use. The clinical implications of the findings for assessment and treatment of COVID anxiety and its comorbidity with distress and alcohol use are discussed.

Sign in / Sign up

Export Citation Format

Share Document