Skritskaya Natalia A, Mauro Christine, Olonoff Matthew, Qiu Xin, Duncan Sarah, Wang Yuanjia, Duan Naihua, Lebowitz Barry, Reynolds Charles F, Simon Naomi M, Zisook Sidney, Shear M Katherine
Columbia University School of Social Work, Columbia University, New York, NY.
Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, NY.
Am J Geriatr Psychiatry. 2017 May;25(5):541-550. doi: 10.1016/j.jagp.2016.09.003. Epub 2016 Sep 19.
Maladaptive cognitions related to loss are thought to contribute to development of complicated grief and are crucial to address in treatment, but tools available to assess them are limited. This paper introduces the Typical Beliefs Questionnaire (TBQ), a 25-item self-report instrument to assess cognitions that interfere with adaptation to loss.
Study participants completed an assessment battery during their initial evaluation and again after completing treatment at 20 weeks. Test-retest reliability was assessed on a subsample of the participants who did not show change in complicated grief severity after the first 4 weeks of treatment. To examine latent structure of the TBQ, an exploratory factor analysis (EFA) was performed.
Academic medical centers in Boston, New York, Pittsburgh, and San Diego from 2010-2014.
394 bereaved adults who met criteria for complicated grief.
The TBQ along with assessments of complicated grief symptoms and related avoidance, depression symptoms, functional impairment, and perceived social support.
The TBQ exhibited good internal consistency (α = 0.82) and test-retest reliability (N = 105; intraclass correlation coefficient = 0.74). EFA indicated a five-factor structure: "Protesting the Death," "Negative Thoughts About the World," "Needing the Person," "Less Grief is Wrong" and "Grieving Too Much." The total score and all factors showed sensitivity to change with treatment.
This new tool allows a clinician to quickly and reliably ascertain presence of specific maladaptive cognitions related to complicated grief, and subsequently, to use the information to aid a diagnostic assessment, to structure the treatment, and to measure treatment outcomes.
与丧失相关的适应不良认知被认为会导致复杂性哀伤的发展，并且在治疗中加以解决至关重要，但用于评估这些认知的工具有限。本文介绍了典型信念问卷（TBQ），这是一种包含25个条目的自评工具，用于评估妨碍适应丧失的认知。
研究参与者在初始评估时完成一套测评，在20周完成治疗后再次进行测评。对治疗前4周后复杂性哀伤严重程度未发生变化的参与者子样本评估重测信度。为检验TBQ的潜在结构，进行了探索性因素分析（EFA）。
2010 - 2014年位于波士顿、纽约、匹兹堡和圣地亚哥的学术医疗中心。
394名符合复杂性哀伤标准的丧亲成年人。
TBQ以及对复杂性哀伤症状及相关回避、抑郁症状、功能损害和感知社会支持的评估。
TBQ表现出良好的内部一致性（α = 0.82）和重测信度（N = 105；组内相关系数 = 0.74）。EFA表明存在五因素结构：“抗议死亡”、“对世界的消极想法”、“需要那个人”、“哀伤较少是错误的”以及“哀伤过度”。总分及所有因素均显示出对治疗变化的敏感性。
这种新工具使临床医生能够快速且可靠地确定与复杂性哀伤相关的特定适应不良认知的存在，并随后利用这些信息辅助诊断评估、构建治疗方案以及测量治疗结果。
