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

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.

Cultural Context in DSM Diagnosis: An American Indian Case Illustration of Contradictory Trends

2019 ◽  
Vol 57 (4) ◽  
pp. 567-580 ◽  
Author(s):  
Melanie E. Langa ◽  
Joseph P. Gone
Keyword(s):  
American Indian ◽  
Cultural Context ◽  
Illness Experience ◽  
Statistical Manual ◽  
Diagnostic And Statistical Manual ◽  
Dsm 5 ◽  
History Of ◽  
Culturally Diverse Populations ◽  
Persistent Complex Bereavement ◽  
Persistent Complex Bereavement Disorder

Recent revisions of the Diagnostic and Statistical Manual of Mental Disorders ( DSM) increasingly acknowledge the importance of cultural context for the diagnosis of mental illness. However, these same revisions include evolving diagnostic criteria that simultaneously decontextualize particular disorders such as Major Depressive Disorder (MDD) and Posttraumatic Stress Disorder (PTSD). As a result, the DSM reflects a contradictory role for context in psychiatric diagnosis. The case analysis presented here frames the consequences of this contradictory trend for an American Indian woman with a history of DSM-IV MDD and PTSD, whose diagnostic portrait is substantively altered in light of more recent DSM-5 criteria. Specifically, consideration of this respondent’s bereavement-related illness experience suggests that a sociocentric cultural frame of reference, which places high value on interdependent personal relationships, is not well-captured by DSM-5’s revised MDD or PTSD criteria, or the newly proposed categories of traumatic bereavement or Persistent Complex Bereavement Disorder. The respondent’s illness experience argues for greater recognition of this contradictory diagnostic trend, suggesting a need for future resolution of this tension toward more valid diagnosis for culturally diverse populations.

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 Two Cases of Persistent Complex Bereavement Disorder Diagnosed in the Acute Inpatient Unit

2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Olalekan Olaolu ◽  
Terrence Tumenta ◽  
Samuel Adeyemo ◽  
Olusegun Popoola ◽  
Oluwatoyin Oladeji ◽  
...  
Keyword(s):  
Adverse Effects ◽  
Psychiatric Disorders ◽  
Patient Outcomes ◽  
Inpatient Unit ◽  
Dsm 5 ◽  
Separation Distress ◽  
Pathological Grief ◽  
Persistent Complex Bereavement ◽  
Identity Disruption ◽  
Persistent Complex Bereavement Disorder

Pathological grief has been noted to have considerable adverse effects on affected individuals. In the DSM-5, the diagnosis of complicated grief is included under conditions for further study as Persistent Complex Bereavement Disorder (PCBD). PCBD can be easily missed because it is a relatively new and developing diagnosis. It can also be overlooked when it is comorbid with more common psychiatric disorders. We present 2 patients with PCBD diagnosed in the inpatient unit, while the patients were admitted for comorbid disorders. PCBD contributed immensely to both patients’ suffering and decline in functioning. This report highlights the presentation, diagnoses, and management of these patients. We theorize that paying attention to separation distress, reactive distress to loss, and identity disruption in individuals who have been bereaved for over 12 months will enhance treatment specificity and lead to better patient outcomes.

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.

Psychometric Properties of the Personality Inventory for DSM-5 in a Romanian Community Sample

2021 ◽  
Vol 21 (1) ◽  
pp. 3-20
Author(s):  
Ticu CONSTANTIN ◽  
Elena G. NICUȚĂ ◽  
Diana GRĂDINARU
Keyword(s):  
Personality Traits ◽  
Psychometric Properties ◽  
Community Sample ◽  
Personality Inventory ◽  
Scoring Methods ◽  
Good Reliability ◽  
Confirmatory Factor Analyses ◽  
Dsm 5 ◽  
The Hierarchical Structure ◽  
Mean Differences

The Personality Inventory for DSM-5 (PID-5) evaluates 25 maladaptive personality traits proposed in the Alternative Model of Personality Disorders. The questionnaire has been extensively investigated and validated in several languages. The current research sought to examine the psychometric properties of the instrument in a sample of nonclinical Romanian participants (N = 1276). Results indicated excellent internal consistency for the domain level, and very good reliability for the facet level. The assumption of unidimensionality was supported at both the domain and facet levels, apart from Risk Taking. Two domain scoring methods were also compared. One of them takes into consideration all the 25 lower order facets, whereas the other uses only 15 facets. Results show that mean differences across the two scoring methods were small, except for Disinhibition. Moreover, confirmatory factor analyses revealed slightly better fit indices for the model which uses 15 facets only. Lastly, the hierarchical structure of maladaptive personality traits was explored. Results are discussed in the light of previous literature.

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