Department of Pediatrics, Baylor College of Medicine/Texas Children's Hospital, Houston, Texas, USA.
UCLA/Duke University National Center for Child Traumatic Stress; & Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles.
J Trauma Stress. 2018 Apr;31(2):244-254. doi: 10.1002/jts.22277.
The inclusion of Persistent Complex Bereavement Disorder (PCBD) in the DSM-5 appendix signifies a call for research regarding the distinguishing features and clinical utility of proposed PCBD criteria. Rigorously constructed tools for assessing PCBD are lacking, especially for youth. This study evaluated the validity and clinical utility of the PCBD Checklist, a 39-item measure designed to assess PCBD criteria in youth aged 8 to18 years. Test construction procedures involved: (a) reviewing the literature regarding developmental manifestations of proposed criteria, (b) creating a developmentally informed item pool, (c) surveying an expert panel to evaluate the clarity and developmental appropriateness of candidate items, (d) conducting focus groups to evaluate the comprehensibility and acceptability of items, and (e) evaluating psychometric properties in 367 bereaved youth (M = 13.49, 55.0% female). The panel, clinicians, and youth provided favorable content validity and comprehensibility ratings for candidate items. As hypothesized, youth who met full PCBD criteria, Criterion B (e.g., preoccupation with the deceased and/or circumstances of the death), or Criterion C (e.g., reactive distress and/or social/identity disruption) reported higher posttraumatic stress and depressive symptoms than youth who did not meet these criteria, η = .07-.16. Youth who met Criterion C reported greater functional impairment than youth who did not, η = .08-.12. Youth who qualified for the "traumatic bereavement specifier" reported more frequent posttraumatic stress symptoms than youth who did not, η = .04. Findings support the convergent, discriminant, and discriminant-groups validity, developmental appropriateness, and clinical utility of the PCBD Checklist.
将持续性复杂丧亲障碍(PCBD)纳入 DSM-5 附录表明,需要研究拟议的 PCBD 标准的区别特征和临床实用性。缺乏用于评估 PCBD 的严格构建工具,特别是针对年轻人的工具。本研究评估了 PCBD 清单的有效性和临床实用性,该清单是一种 39 项的测量工具,旨在评估 8 至 18 岁年轻人的 PCBD 标准。测试构建程序包括:(a)审查关于拟议标准的发展表现的文献,(b)创建一个发展性的项目库,(c)调查一个专家小组,以评估候选项目的清晰度和发展适宜性,(d)进行焦点小组讨论,以评估项目的理解性和可接受性,以及(e)在 367 名丧亲的年轻人中评估心理测量特性(M = 13.49,55.0%为女性)。小组、临床医生和年轻人对候选项目提供了有利的内容有效性和可理解性评分。正如假设的那样,符合完全 PCBD 标准、标准 B(例如,对死者和/或死亡情况的关注)或标准 C(例如,反应性痛苦和/或社会/身份中断)的年轻人比不符合这些标准的年轻人报告了更高的创伤后应激和抑郁症状,η =.07-.16。符合标准 C 的年轻人比不符合标准 C 的年轻人报告了更大的功能障碍,η =.08-.12。符合“创伤性丧亲指定”标准的年轻人比不符合该标准的年轻人报告了更频繁的创伤后应激症状,η =.04。研究结果支持 PCBD 清单的收敛性、区分性和区分性群体有效性、发展适宜性和临床实用性。