Department of Clinical and Health Psychology, Utrecht University, PO Box 80140, 3508 TC Utrecht, The Netherlands.
J Affect Disord. 2010 Sep;125(1-3):374-8. doi: 10.1016/j.jad.2010.01.076. Epub 2010 Mar 2.
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.
Self-reported data were available from two samples; 572 mourners recruited via the internet and 408 mourners recruited via healthcare workers.
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.
This study relied on self-reported data. Not all PGD-criteria and depression-criteria were assessed.
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.
本研究考察了延长哀伤障碍（PGD）、抑郁和创伤后应激障碍（PTSD）症状的独特性。我们比较了单因素模型和四个层次模型的拟合度，其中症状形成了三个不同的相关高阶维度，而 PTSD 症状以不同的方式建模。
两个样本都提供了自我报告的数据；572 名通过互联网招募的哀悼者和 408 名通过医护人员招募的哀悼者。
在样本 1 中，单一模型不适合数据。四个层次模型都拟合得更好。在 PTSD 症状构成再体验、回避、抑郁和高度警觉四个较低阶因素的模型中，数据拟合得最好。当删除一个较弱的 PGD 症状和一个较弱的 PTSD 症状，并允许相似项目的误差项相关时，拟合度进一步提高。样本 1 的结果在样本 2 中得到了复制。
本研究依赖于自我报告的数据。并非所有的 PGD 标准和抑郁标准都进行了评估。
这是第一个确认性因素分析研究，表明 PGD、抑郁和 PTSD 的症状代表了可区分的综合征。PGD 症状应在寻求治疗的丧亲者的评估和治疗中得到解决。
