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.

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.

scholarly journals Optimizing the clinical utility of four proposed criteria for a persistent and impairing grief disorder by emphasizing core, rather than associated symptoms

2019 ◽  
Vol 50 (3) ◽  
pp. 438-445 ◽  
Author(s):  
Stephen J. Cozza ◽  
M. Katherine Shear ◽  
Charles F. Reynolds ◽  
Joscelyn E. Fisher ◽  
Jing Zhou ◽  
...  
Keyword(s):  
Social Adjustment ◽  
Military Service ◽  
International Classification Of Diseases ◽  
Prolonged Grief ◽  
Case Identification ◽  
Diagnostic And Statistical Manual ◽  
Us Military ◽  
Associated Symptoms ◽  
Classification Of Diseases

AbstractBackgroundDistinguishing a disorder of persistent and impairing grief from normative grief allows clinicians to identify this often undetected and disabling condition. As four diagnostic criteria sets for a grief disorder have been proposed, their similarities and differences need to be elucidated.MethodsParticipants were family members bereaved by US military service death (N= 1732). We conducted analyses to assess the accuracy of each criteria set in identifying threshold cases (participants who endorsed baseline Inventory of Complicated Grief ⩾30 and Work and Social Adjustment Scale ⩾20) and excluding those below this threshold. We also calculated agreement among criteria sets by varying numbers of required associated symptoms.ResultsAll four criteria sets accurately excluded participants below our identified clinical threshold (i.e. correctly excluding 86–96% of those subthreshold), but they varied in identification of threshold cases (i.e. correctly identifying 47–82%). When the number of associated symptoms was held constant, criteria sets performed similarly. Accurate case identification was optimized when one or two associated symptoms were required. When employing optimized symptom numbers, pairwise agreements among criteria became correspondingly ‘very good’ (κ= 0.86–0.96).ConclusionsThe four proposed criteria sets describe a similar condition of persistent and impairing grief, but differ primarily in criteria restrictiveness. Diagnostic guidance for prolonged grief disorder in International Classification of Diseases, 11th Edition (ICD-11) functions well, whereas the criteria put forth in Section III of Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) are unnecessarily restrictive.

A case series: Efficacy of short term EMDR on patients with persistent complex bereavement disorder (PCBD)

2017 ◽  
Vol 41 (S1) ◽  
pp. S360-S361
Author(s):  
F.D. Usta ◽  
A.B. Yasar ◽  
A.E. Abamor ◽  
M. Caliskan
Keyword(s):  
Sleep Disturbances ◽  
Case Series ◽  
Traumatic Loss ◽  
Degree Relative ◽  
Current Case ◽  
Prolonged Grief ◽  
Persistent Complex Bereavement ◽  
Competing Interest ◽  
Persistent Complex Bereavement Disorder ◽  
Emdr Therapy

Grief is a normal response to loss of someone to whom a bond was formed; however, prolonged grief is considered pathological. Persistent complex bereavement disorder (PCBD) is defined as a persistent longing for the deceased over 12 months. Several treatment ways have been used for traumatic loss including eye movement desensitization and reprocessing (EMDR). In the current case series, effectiveness of EMDR on three PCBD patients will be indicated. Three patients applied to the clinic with similar complaints based on different traumatic backgrounds; commonly, all experienced death of a first-degree relative. Complaints of the patients were over-thinking about the deceased, sleep disturbances, self-blaming, social isolation, avoiding talks about lost relative, and loss of interest in activities. After pre-interviews, they were advised EMDR therapy. One session of EMDR was applied to two of the patients, and two EMDR sessions were conducted on one of them. After the sessions, the patients reported not feeling guilty about the loss anymore, returning their normal routines, feeling better, and showing decreased avoidance. Additionally, the scores of scales (CAPS, BAI, BDI, and IES-R) significantly declined. EMDR therapy can show successful results in a shorter time than other treatment ways used for PCBD treatment [1].Disclosure of interestThe authors have not supplied their declaration of competing interest.

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.

Bipolar and related disorders in DSM-5 and ICD-10

CNS Spectrums ◽  
2016 ◽  
Vol 21 (4) ◽  
pp. 318-323 ◽  
Author(s):  
Alexander Kaltenboeck ◽  
Dietmar Winkler ◽  
Siegfried Kasper
Keyword(s):  
Negative Impact ◽  
Bipolar Disorders ◽  
Diagnostic Categories ◽  
Diagnostic And Statistical Manual ◽  
Dsm 5 ◽  
Previous Edition ◽  
Classification Of Diseases ◽  
Icd 10 ◽  
International Statistical Classification

Bipolar disorders are a group of psychiatric disorders with profound negative impact on affected patients. Even if their symptomatology has long been recognized, diagnostic criteria have changed over time and diagnosis often remains difficult. The Fifth Edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), issued in May 2013, comprises several changes regarding the diagnosis of bipolar disorders compared to the previous edition. Diagnostic categories and criteria for bipolar disorders show some concordance with the internationally also widely used Tenth Edition of the International Statistical Classification of Diseases and Related Health Problems (ICD-10). However, there are also major differences that are worth highlighting. The aim of the following text is to depict and discuss those.

scholarly journals Różne sposoby definiowania autyzmu. Przegląd stanowisk

2021 ◽  
pp. 49-62
Author(s):  
Maja Drzazga-Lech ◽  
Monika Kłeczek ◽  
Marta Ir
Keyword(s):  
Autism Spectrum Disorder ◽  
Autism Spectrum ◽  
Autism Spectrum Condition ◽  
Statistical Classification ◽  
Statistical Manual ◽  
Diagnostic And Statistical Manual ◽  
Classification Of Diseases ◽  
International Statistical Classification ◽  
Spectrum Condition

Autyzm jest pojęciem wieloznacznym, nieostrym. W nomenklaturze medycznej kilkakrotnie już zmieniał się jego zakres semantyczny. W artykule przedstawiono sposoby występowania tego pojęcia w klasyfikacjach międzynarodowych DSM (Diagnostic and Statistical Manual of Mental Disorders) i ICD (International Statistical Classification of Diseases and Related Health Problems). Cechą wspólną tych definicji jest redukcjonistyczne podejście do pacjenta (jednostki zredukowanej do objawów chorobowych) i myślenie w kategoriach choroby bądź zaburzenia (ASD – Autism Spectrum Disorder). Obecnie istnieją również inne ujęcia autyzmu, o uznanie prawomocności których zabiegają aktorzy społeczni/grupy interesu spoza establishmentu medycznego. W opinii publicznej silnie zakorzenione jest skojarzenie autyzmu z puzzlem bądź kolorem niebieskim spopularyzowane przez fundację Autism Speaks. Ponadto w wydarzeniach medialnych, publikacjach o charakterze popularno-naukowym, naukowym, w tym w literaturze terapeutycznej, coraz częściej występuje określenie „stany ze spektrum autyzmu” (Autism Spectrum Condition). Ukazanie sporu o definicję autyzmu jest istotne, gdyż z argumentacji każdej ze stron wynikają implikacje w stosunku do zdrowia.

scholarly journals Surviving violent, traumatic loss after severe political persecution: lessons from the evaluation of a Venezuelan asylum seeker

2021 ◽  
Vol 14 (3) ◽  
pp. e239025
Author(s):  
Jennifer H McQuaid ◽  
Michelle Alejandra Silva ◽  
Katherine C McKenzie
Keyword(s):  
Traumatic Loss ◽  
Statistical Manual ◽  
Cultural Rights ◽  
Diagnostic And Statistical Manual ◽  
High Commissioner ◽  
Persistent Complex Bereavement ◽  
Mental Health Effects ◽  
Political Persecution ◽  
Persistent Complex Bereavement Disorder

In July 2019, the United Nations High Commissioner for Refugees (UNHCR) released a report urging the Venezuelan government to take immediate action to address the ‘grave violations of economic, social, civil, political and cultural rights’ occurring in the country. This case study highlights the human rights violations occurring in Venezuela through the case of a Venezuelan woman who experienced political persecution and traumatic loss resulting from her opposition to the ruling socialist party. As the clinical team of evaluators explored the mental health effects of surviving threats on her own life and the politically motivated assassination of her husband, it was agreed that the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition did not fully capture the extent of her suffering. Case discussion broadens the lens beyond the client’s experiences of posttraumatic stress disorder (PTSD) and depression to include persistent complex bereavement disorder, and emphasises the importance of addressing the sequelae of traumatic loss in a multifaceted way that broadens understanding of emotional functioning postmigration.

scholarly journals Complex PTSD: Psychotherapy of Prolonged Traumatization

2021 ◽  
Vol 29 (3) ◽  
pp. 69-87
Author(s):  
M.A. Padun
Keyword(s):  
Traumatic Stress ◽  
Complex Trauma ◽  
Diagnostic Category ◽  
International Classification Of Diseases ◽  
Emotional Dysregulation ◽  
Post Traumatic Stress ◽  
Classification Of Diseases ◽  
Post Traumatic ◽  
The Impact

The article considers a new diagnostic category — complex post-traumatic stress disorder (CPTSD), introduced into the International Classification of Diseases (ICD-11). Differences in the mechanism of influence of situational and prolonged trauma are analyzed. CPTSD diagnostic criteria are compared to PTSD and BPD (borderline personality disorder) symptoms. The term “disturbances in self-organi¬zation” is analyzed, which explains the main mechanism of the impact of complex trauma and includes emotional dysregulation, disturbances in self-perception and relationships. Psychotherapeutic approaches developed for PTSD were shown to be insufficient for the treatment of CPTSD. The article reviews an approach to CPSTD therapy based on the consensus of experts in the field of post-traumatic stress and its possible limitations are discussed. “Component based psychotherapy” — another approach to CPTSD therapy — is described. Specific features of psychotherapy for complex trauma are discussed.

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