Commentary on the Inclusion of Persistent Complex Bereavement-Related Disorder in DSM-5

Death Studies ◽  
2012 ◽  
Vol 36 (9) ◽  
pp. 771-794 ◽  
Author(s):  
Paul A. Boelen ◽  
Holly G. Prigerson
Keyword(s):  
Related Disorder ◽  
Dsm 5 ◽  
Persistent Complex Bereavement

Prospective evaluation of the DSM-5 persistent complex bereavement disorder criteria in adults: dimensional and diagnostic approaches

2020 ◽  
pp. 1-10 ◽  
Author(s):  
Elie G. Aoun ◽  
Giovanna Porta ◽  
Nadine M. Melhem ◽  
David A. Brent
Keyword(s):  
Functional Impairment ◽  
High Sensitivity ◽  
Close Relative ◽  
Related Disorder ◽  
Prolonged Grief ◽  
Dsm 5 ◽  
Persistent Complex Bereavement ◽  
Persistent Complex Bereavement Disorder ◽  
Grief Reactions ◽  
Over Time

Abstract Background We examine the performance of the Diagnostic and Statistical Manual of Mental Disorders-fifth edition (DSM-5) persistent complex bereavement-related disorder (PCBD) criteria in bereaved adults to identify prolonged grief cases determined prospectively. Methods Bereaved adults (n = 138) were assessed at 8, 21, 32, 67, and 90 months after the sudden death of a spouse or close relative. We used latent class growth analysis to identify the longitudinal trajectories of grief assessed using the Inventory for Complicated Grief. To validate the trajectory that corresponded to prolonged grief, we examined the baseline predictors of these trajectories and their relationship with functional impairment. Results We found three distinct trajectories of grief reactions. One of these trajectories (13.8%) showed high and sustained grief reactions that persisted for almost 7.5 years after the death. Participants with prolonged grief showed greater functional impairment [relative risk ratio (RRR) = 0.82, 95% confidence interval (CI): 0.70 to −0.97; p = 0.02] and higher self-reported depression (RRR = 1.21, 95% CI 1.09 to 1.96; p = 0.001) than participants whose grief reactions subsided over time. The original PCBD (requiring 6 criterion C symptoms) criteria correctly identified cases (57.9–94.7%) with perfect specificity (100%) but low to high sensitivity (5.6–81.3%); however, its sensitivity increased when revising criterion C to require ⩾3 (45.5–94.1%). The dimensional approach showed high sensitivity (0.50–1) and specificity (0.787–0.97). Conclusions We recommend revisions to the PCBD criteria, which are overly restrictive and may exclude cases with clinically significant grief-related distress and impairment. In the meantime, clinicians need to monitor grief symptoms over time using available dimensional approaches to reduce the burden of grief.

scholarly journals Diagnosing Posttraumatic Stress Disorder in Refugees

2020 ◽  
Author(s):  
Shafaz Veettil ◽  
Anastasiya Vinokurtseva
Keyword(s):  
Posttraumatic Stress Disorder ◽  
Posttraumatic Stress ◽  
Predictive Power ◽  
Stress Disorder ◽  
High Sensitivity ◽  
Symptom Cluster ◽  
Related Disorder ◽  
Dsm 5 ◽  
Health Distress ◽  
Sensitivity Specificity

Global crises has amounted to the forced international displacement of 25.4 million refugees. Refugees from conflict-affected areas are especially vulnerable to posttraumatic stress disorder (PTSD) compared to the general population due to their past and present hardships and history of trauma. PTSD is characterized by a constellation of symptoms identified by the Diagnostic and Statistical Manual of Mental Disorders (DSM). DSM-5 departed from DSM-IV by reclassifying PTSD as a trauma- and stressor-related disorder and introducing a fourth symptom cluster—negative alterations in mood/cognition—to the previous three-symptom cluster model. In severely traumatized refugees, this new cluster exhibited relatively high sensitivity, specificity, positive predictive power, and negative predictive power—in concordance with the range of symptoms exhibited by this population—and allowed for the applicability of the DSM-5 criteria. However, the Western sample basis of the DSM-5 might make it inferior to alternative models as a diagnostic tool for PTSD in refugees and as a springboard for treatment. In addition (and possibly due) to PTSD, refugees are at high risk for mental health distress and suffer from poor health outcomes. Optimizing diagnostic criteria and overcoming barriers to diagnosis and access to care would benefit patients and facilitate treatment.

Adjustment Disorders in Cancer

2021 ◽  
pp. 313-319
Author(s):  
Froukje de Vries ◽  
Sarah Hales ◽  
Gary Rodin ◽  
Madeline Li
Keyword(s):  
Psychiatric Disorder ◽  
Cancer Patients ◽  
Diagnostic Criteria ◽  
Adjustment Disorder ◽  
Evidence Base ◽  
Adjustment Disorders ◽  
Related Disorder ◽  
Dsm 5 ◽  
And Behaviors

Adjustment disorder (AD) refers to a condition in which an individual reacts to an identifiable stressor with disproportionate symptoms and behaviors. It is now considered as a stress-related disorder in both the DSM-5 and ICD-11 and is the most commonly diagnosed psychiatric disorder in cancer patients. Nevertheless, this diagnosis remains problematic in terms of its conceptualization and evidence base. The specificity of the diagnostic criteria has been questioned and concern has been expressed that it medicalizes distress and increases the likelihood of unnecessary psychopharmacological interventions. However, evidence suggests that categorizing distress as AD may actually lead to appropriate interventions aimed at prevention or treatment. This chapter focuses on the validity and utility of the concept of and diagnostic criteria for AD and reviews the available evidence base regarding treatment of this disorder in cancer patients.

scholarly journals Measuring Internet Gaming Disorder and Gaming Disorder: Qualitative Content Validity Analysis of Validated Scales

2021 ◽  
Author(s):  
Veli-Matti Karhulahti ◽  
Marcel Martončik ◽  
Matus Adamkovic
Keyword(s):  
Content Validity ◽  
Internet Gaming Disorder ◽  
Semantic Content ◽  
Self Report ◽  
Gaming Disorder ◽  
Related Disorder ◽  
Dsm 5 ◽  
Internet Gaming ◽  
Survey Instruments ◽  
Practical Recommendations

Since 2013 when the DSM-5 manual was published, numerous scholars around the world have developed new self-report instruments for measuring internet gaming disorder or later a gaming disorder. However, each of these instruments utilizes different operationalizations of its criteria, making the pursue for a unified gaming-related disorder measure difficult to achieve. The main aim of the study was to assess how well do the items of the currently applied screening instruments operationalize the criteria as proposed in the diagnostic manuals. The article presents a semantic content validity review of the English items employed by 17 instruments that claim to measure either internet gaming disorder (DSM-5) or gaming disorder (ICD-11) by their official criteria. In all but one instrument the operationalizations of items did not fully adhere to the criteria as stated in the manuals. Besides providing examples and explanations of (non)adherence of items to the diagnostic manuals, the article presents new practical recommendations that researchers studying (internet) gaming disorder could take into account in order to improve the content validity of their survey instruments. The field of gaming disorder could greatly benefit from a more unified approach to measurement.

scholarly journals Cautioning Health-Care Professionals

2017 ◽  
Vol 74 (4) ◽  
pp. 455-473 ◽  
Author(s):  
Margaret Stroebe ◽  
Henk Schut ◽  
Kathrin Boerner
Keyword(s):  
Health Care ◽  
Health Care Professionals ◽  
Theory And Practice ◽  
Current Status ◽  
Stage Theory ◽  
Related Disorder ◽  
Loved One ◽  
Conceptual Clarity ◽  
Persistent Complex Bereavement ◽  
Specific Reactions

Science and practice seem deeply stuck in the so-called stage theory of grief. Health-care professionals continue to “prescribe” stages. Basically, this perspective endorses the idea that bereaved people go through a set pattern of specific reactions over time following the death of a loved one. It has frequently been interpreted prescriptively, as a progression that bereaved persons must follow in order to adapt to loss. It is of paramount importance to assess stage theory, not least in view of the current status of the maladaptive “persistent complex bereavement-related disorder” as a category for further research in DSM-5. We therefore review the status and value of this approach. It has remained hugely influential among researchers as well as practitioners across recent decades, but there has also been forceful opposition. Major concerns include the absence of sound empirical evidence, conceptual clarity, or explanatory potential. It lacks practical utility for the design or allocation of treatment services, and it does not help identification of those at risk or with complications in the grieving process. Most disturbingly, the expectation that bereaved persons will, even should, go through stages of grieving can be harmful to those who do not. Following such lines of reasoning, we argue that stage theory should be discarded by all concerned (including bereaved persons themselves); at best, it should be relegated to the realms of history. There are alternative models that better represent grieving processes. We develop guidelines to enhance such a move beyond the stage approach in both theory and practice.

scholarly journals Complicated grief: recent developments in diagnostic criteria and treatment

2018 ◽  
Vol 373 (1754) ◽  
pp. 20170273 ◽  
Author(s):  
Satomi Nakajima
Keyword(s):  
Diagnostic Criteria ◽  
Complicated Grief ◽  
Behavioural Therapy ◽  
Pathological State ◽  
Human Beings ◽  
Duration Of Symptoms ◽  
Related Disorder ◽  
Biological Studies ◽  
Persistent Complex Bereavement ◽  
Persistent Complex Bereavement Disorder

Although grief is a natural response to loss among human beings, some people have a severe and prolonged course of grief. In the 1990s, unusual grief persisting with a high level of acute symptoms became known as ‘complicated grief (CG)’. Many studies have shown that people who suffer from CG are at risk of long-term mental and physical health impairments and suicidal behaviours; it is considered a pathological state, which requires clinical intervention and treatment. DSM-5 (2013 Diagnostic and statistical manual of mental disorders , 5th edn) proposed ‘persistent complex bereavement disorder’ as a psychiatric disorder; it is similar to CG in that it is a trauma- and stress-related disorder. In recent years, there has been considerable research on the treatment of CG. Randomized controlled trials have suggested the efficacy of cognitive behavioural therapy including an exposure component that is targeted for CG. However, experts disagree about the terminology and diagnostic criteria for CG. The ICD-11 ( International classification of diseases , 11th revision) beta draft proposed prolonged grief disorder as a condition that differs from persistent complex bereavement disorder with respect to terminology and the duration of symptoms. This divergence has arisen from insufficient evidence for a set of core symptoms and the biological basis of CG. Future studies including biological studies are needed to reach consensus about the diagnostic criteria for CG. This article is part of the theme issue ‘Evolutionary thanatology: impacts of the dead on the living in humans and other animals’.

Adaptation and validation of the dimensional DSM-5 obsessive-compulsive related disorder scales in adolescents: Preliminary data

2018 ◽  
Vol 19 ◽  
pp. 99-104 ◽  
Author(s):  
B. Moreno-Amador ◽  
J.A. Piqueras ◽  
T. Rodriguez-Jimenez ◽  
J.C. Marzo ◽  
D. Mataix-Cols
Keyword(s):  
Preliminary Data ◽  
Obsessive Compulsive ◽  
Related Disorder ◽  
Dsm 5

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.

Sign in / Sign up

Export Citation Format

Share Document