Patterns, Predictors, and Prognostic Validity of Persistent Complex Bereavement Disorder Symptoms in Recently Bereaved Adults

Boelen, Paul A.; Smid, Geert E.; Verloop, Bertine; Keijser, Jos de; Lenferink, Lonneke

doi:10.1097/nmd.0000000000001053

Cited by 26 publications

(30 citation statements)

References 27 publications

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“…A total of 316 participants completed this questionnaire (response rate of 68.5%). (For another study based on this research project, see Boelen, Smid, Mitima-Verloop, De Keijser, & Lenferink, 2019).…”

Section: Methodsmentioning

confidence: 99%

Facilitating grief: An exploration of the function of funerals and rituals in relation to grief reactions

2019

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The loss of a loved one through death is usually followed by a funeral and engagement in various grief rituals. We examined the association between the evaluation of the funeral, the use of grief rituals and grief reactions. Bereaved individuals from the Netherlands completed questionnaires, six months and three years post-loss (n ¼ 552/289). Although the funeral and rituals were considered helpful, no significant association between evaluation of the funeral and usage of grief rituals and grief reactions was found. More insight in the engagement in rituals will ultimately serve bereaved individuals to cope with loss.

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Section: Methodsmentioning

confidence: 99%

Facilitating grief: An exploration of the function of funerals and rituals in relation to grief reactions

2019

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“…One issue that has particular theoretical and clinical relevance concerns the nature and correlates of responses to loss in the first months of bereavement. This is important because these initial responses have proven to be important predictors of later responses [6,8].…”

Section: Introductionmentioning

confidence: 99%

“…In one recent study [8], we used latent class analysis (LCA) to examine if subgroups could be identified and characterized by similar symptom patterns of PCBD, among 476 people bereaved within the previous half year. LCA is a person-centred method that identifies classes of persons based on overlapping responses to a set of indicators (e.g.…”

Section: Introductionmentioning

confidence: 99%

“…The current study further examined patterns and correlates of early responses to loss. We expanded our prior study [8] by focusing on symptoms of PGD (as put forth by Prigerson et al [3]) rather than PCBD, by examining classes based not only on symptoms of grief but also symptoms of PTSD and depression, and by evaluating the prognostic value of classes in predicting functioning 6 months rather than 3 years later. Criteria for PCBD as per DSM-5 and PGD as per Prigerson et al [3] have attracted increasing attention from researchers; although these conditions are largely similar in terms of core symptoms, prevalence rates, and prognostic validity [11,12], little, if anything, is, to the best of our knowledge, known about patterns and correlates of symptoms of PCBD and PGD among the very recently bereaved.…”

Section: Introductionmentioning

confidence: 99%

“…unrealness, four domains of negative cognitions, and depressive and anxious avoidance). Based on prior research [8,22] we predicted that, if LCA would reveal classes characterized by different levels of distress, people in the more disturbed classes would more strongly endorse these cognitive behavioural variables. Enhancing knowledge about the associations between different symptom patterns and these modifiable cognitive behavioural variables was considered to have clinical relevance, e.g.…”

Section: Introductionmentioning

confidence: 99%

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Symptoms of prolonged grief, posttraumatic stress, and depression in recently bereaved people: symptom profiles, predictive value, and cognitive behavioural correlates

Boelen

Lenferink

2019

Soc Psychiatry Psychiatr Epidemiol

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Purpose Prior latent class analyses (LCA) have focused on people who were bereaved more than 6 months earlier. Research has yet to examine patterns and correlates of emotional responses in the first few months of bereavement. We examined whether subgroups could be identified among very recently (≤ 6 months) bereaved adults, based on their endorsement of symptoms of prolonged grief disorder (PGD), posttraumatic stress disorder (PTSD), and depression. Associations of class membership with overall disturbed grief, PTSD, and depression-assessed concurrently and at 6 months follow-up-were examined. Furthermore, we examined differences between classes regarding socio-demographics, loss-related, and cognitive behavioural variables. Methods PGD, PTSD, and depression self-report data from 322 Dutch individuals bereaved ≤ 6 months earlier were subjected to LCA; N = 159 completed the follow-up assessment. Correlates of class membership were examined. Results Three classes were identified: a low symptom class (N = 114; 35.4%), a predominantly PGD class (N = 96; 29.8%), and a high symptom class (N = 112; 34.8%). PGD, PTSD, and depression scores (assessed concurrently and at 6 months follow-up) differed significantly between classes, such that low symptom class < predominantly PGD class < high symptom class. Being a woman, younger, more recently bereaved, experiencing deaths of a partner/child and unnatural losses, plus maladaptive cognitions and avoidance behaviours were associated with membership of the pervasive symptom classes. Conclusion In the first 6 months of bereavement, meaningful subgroups of bereaved people can be distinguished, which highlights the relevance of early detection of people with elevated bereavement-related distress and offering them preventive interventions that foster adaptation to loss.

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Associations of depressive rumination and positive affect regulation with emotional distress after the death of a loved one

Boelen

Lenferink

2020

Clin Psychology and Psychoth

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The death of a loved one may precipitate symptoms of prolonged grief disorder (PGD), post-traumatic stress disorder (PTSD) and depression. Brooding about the causes and consequences of one's negative affect (NA), also termed depressive rumination, has been linked to distress after loss. The role of dysregulation of positive affect (PA) has received less attention. We examined (1) the factor structure of depressive rumination and PA dysregulation and (2) to what extent these factors were related to PGD, PTSD and depression symptom levels. Self-report data were included from 235 Dutch bereaved people who completed measures tapping symptoms of PGD, PTSD and depression. Depressive rumination and PA regulation strategies were assessed with the Ruminative Response Scale (RRS) Brooding Scale and the Response to Positive Affect (RPA) Questionnaire (including three subscales: emotion-focused and self-focused rumination and dampening), respectively. Confirmatory factor analyses and structural equation modelling were used for data analyses. The four-factor model (i.e., depressive rumination and the three RPA subscales) showed the best fit. An increase in depressive rumination was related to higher distress levels (across all outcomes in univariate and multivariate analyses). An increase in emotion-focused rumination about PA was associated with less depression. More dampening of PA was related to higher PTSD levels. Findings suggest that, alongside the regulation of NA, the regulation of PA plays a role in how people respond to the death of a loved one. This points to the need for more research on NA and PA regulation in grief.

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Patterns, Predictors, and Prognostic Validity of Persistent Complex Bereavement Disorder Symptoms in Recently Bereaved Adults

Cited by 26 publications

References 27 publications

Facilitating grief: An exploration of the function of funerals and rituals in relation to grief reactions

Facilitating grief: An exploration of the function of funerals and rituals in relation to grief reactions

Symptoms of prolonged grief, posttraumatic stress, and depression in recently bereaved people: symptom profiles, predictive value, and cognitive behavioural correlates

Associations of depressive rumination and positive affect regulation with emotional distress after the death of a loved one

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