Paul A. Boelen

Prolonged Grief Disorder: Psychometric Validation of Criteria Proposed for DSM-V and ICD-11

Holly Prigerson and colleagues tested the psychometric validity of criteria for prolonged grief disorder (PGD) to enhance the detection and care of bereaved individuals at heightened risk of persistent distress and dysfunction.

Prospective linkages between peer victimization and externalizing problems in children: a meta-analysis

Previous meta-analytic research has shown both concurrent and prospective linkages between peer victimization and internalizing problems in youth. However, the linkages between peer victimization and externalizing problems over time have not been systematically examined, and it is therefore unknown if externalizing problems are antecedents of victimization, consequences of victimization, both, or neither. This study provides a meta-analysis of 14 longitudinal studies examining prospective linkages between peer victimization and externalizing problems (n = 7,821). Two prospective paths were examined: the extent to which peer victimization at baseline predicts future residualized changes in externalizing problems, as well as the extent to which externalizing problems at baseline predict future residualized changes in peer victimization. Results revealed significant associations between peer victimization and subsequent residualized changes in externalizing problems, as well as significant associations between externalizing problems and subsequent residualized changes in peer victimization. Hence, externalizing problems function as both antecedents and consequences of peer victimization.

Intolerance of uncertainty and social anxiety

Research has shown that intolerance of uncertainty (IU)--the tendency to react negatively to situations that are uncertain--is involved in generalized anxiety disorder (GAD). There is uncertainty about the specificity of IU. Some studies have shown that IU is specific for GAD. Other studies have shown that IU is also involved in obsessive compulsive disorder (OCD). No studies have yet examined IU in social anxiety, although it is possible that IU plays a role in anxiety responses that can be experienced in social-evaluative situations. This study examined the relationship between IU and social anxiety among 126 adults. Findings revealed that IU explained a significant amount of variance in social anxiety severity when controlling for established cognitive correlates of social anxiety (e.g., fear of negative evaluation) and for neuroticism. Furthermore, it was found that IU was related with symptom levels of GAD, OCD, and social anxiety, but not depression, when controlling the shared variance among these symptoms.

RELIABILITY AND VALIDITY OF THE DUTCH VERSION OF THE INVENTORY OF TRAUMATIC GRIEF (ITG)

The psychometric properties of the Dutch version of the Inventory of Traumatic Grief (ITG) were investigated in two studies with bereaved adults who had suffered the loss of a first-degree relative. In Study 1, exploratory factor analysis indicated that the items of the ITG clustered together into one underlying factor. In addition, the internal consistency of the ITG and its short-term temporal stability were found to be high. In Study 2 it was found that the ITG exhibited adequate discriminative, concurrent, and construct validity. Furthermore, an ITG cutoff score for a diagnosis of traumatic grief was determined, with a sensitivity of 86% and a specificity of 76%, providing evidence in favor of the predictive validity of the ITG.

The prevalence and characteristics of complicated grief in older adults

BACKGROUND Complicated grief is a prolongation of the normal grieving process with distinct characteristics. It impairs mental and physical health and can potentially greatly impact the quality of life of sufferers and their families. The prevalence and characteristics of complicated grief in the general population are currently unclear. The aims of the present study were therefore to evaluate the prevalence of complicated grief in a population-based cohort, examine the overlap between anxiety and depression and identify common bereavement-related and socio-demographic characteristics. METHODS Based within the Rotterdam Study, 5741 older adults were evaluated. Complicated grief was assessed with a 17-item Inventory of Complicated Grief. RESULTS Prevalence within the general population was 4.8%. Current grief was reported by 1089 participants, and of these 277 (25.4%) were diagnosed with complicated grief. Inflated anxiety and depression rates were documented in people with complicated grief, but the vast majority remained free from co-morbidity. Time since bereavement and relationship to deceased, particularly when the source was a spouse or child, were predictive of complicated grief. People with complicated grief were older, had a lower level of education, and more cognitive impairment. CONCLUSIONS The prevalence of complicated grief in older adults in the general population was noteworthy. Several factors were predictive of complicated grief and it was demonstrated as a separate condition to anxiety and depression. These findings highlight the need for prevention, diagnosis and treatment options for older adults with complicated grief and for recognition of complicated grief as a distinct diagnosis.

Bayesian evaluation of informative hypotheses

An introduction to bayesian evaluation of informative hypotheses. - Bayesian evaluation of inforative hypotheses. - A further study of prior distributions and the Bayes factor. - Beyond analysis of variance. - Evaluations.

Ruminative coping as avoidance: a reinterpretation of its function in adjustment to bereavement

The paper argues for a reconceptualization of ruminative coping with the death of a loved one as an avoidant rather than a confrontational strategy. Ruminative coping has been characterized within the bereavement field as persistent, repetitive and passive focus on negative emotions and symptoms. It has been theoretically described and empirically shown to be a maladaptive process, being conceptually related to complicated/chronic/prolonged grief. Furthermore, it has been contrasted with denial and suppression processes—which, too, have been understood to be maladaptive and associated with major complications following bereavement. Here evidence is reviewed and the case made that rumination is not an opposite form of coping from suppression or denial, but that it is a similar phenomenon to these, and different from the types of confrontation that take place in so-called “grief work”. Implications with respect to intervention for complicated grief are discussed.

Complicated grief and uncomplicated grief are distinguishable constructs.

With data from 242 mourners who received help post-loss and were at least 6 months removed from their loss, it was found that symptoms proposed as denoting complicated grief (CG) are distinguishable from reactions representing uncomplicated grief (UG). With data from a subgroup of 130 mourners, CG but not UG was found to relate to concurrent distress and disability.

Prolonged Grief Disorder, depression, and posttraumatic stress disorder are distinguishable syndromes.

BACKGROUND This study examined the distinctiveness of symptoms of Prolonged Grief Disorder (PGD), depression, and posttraumatic stress disorder (PTSD). We compared the fit of a one-factor model with the fit of four hierarchical models in which symptoms formed three distinct correlated higher-order dimensions, and PTSD-items were modeled in different ways. METHODS Self-reported data were available from two samples; 572 mourners recruited via the internet and 408 mourners recruited via healthcare workers. RESULTS In Sample 1, the unitary model did not fit the data. The four hierarchical models all fit better. The model in which PTSD-items constituted four lower-order factors of reexperiencing, avoidance, dysphoria, and hyperarousal fit the data best. The fit was further improved, when one weak PGD-item and one weak PTSD-item were removed, and error-terms of similar items were allowed to correlate. Findings from Sample 1 were replicated in Sample 2. LIMITATIONS This study relied on self-reported data. Not all PGD-criteria and depression-criteria were assessed. CONCLUSIONS This is the first confirmatory factor analysis study showing that symptoms of PGD, depression, and PTSD represent distinguishable syndromes. PGD-symptoms should be addressed in the assessment and treatment of bereaved people seeking treatment.

The role of cognitive variables in psychological functioning after the death of a first degree relative.

The present study sought to explore the relationship between negative cognitions and emotional problems after bereavement, with a group of 329 adults who had suffered the loss of a first degree relative. The following cognitions were assessed: global negative beliefs, cognitions about self-blame, negative cognitions about other peoples responses after the loss, and negative cognitions about ones own grief reactions. Results showed that each of these cognitive variables was significantly related to the severity of symptoms of traumatic grief, depression and anxiety, even when background and loss-related variables that were initially found to influence symptom severity, were statistically controlled. When the shared variance between the cognitive variables was controlled, it was found that global negative beliefs about life, the world, and the future, and threatening interpretations of grief reactions each explained a unique proportion of variance in traumatic grief symptom severity. Global negative beliefs about life, the self and the future, and threatening interpretations of grief explained most variance in depression, while negative beliefs about the self and threatening interpretations of grief explained most variance in anxiety. Overall, the findings are in support of cognitive theories of grief, and suggest that effective treatment of problematic grief will need to address negative cognitions.