Boelen Paul A, Smid Geert E, Mitima-Verloop Huibertha B, de Keijser Jos, Lenferink Lonneke I M
Department of Clinical Psychology, Faculty of Social Sciences, Utrecht University, Utrecht.
Arq Psychotrauma Expert Group.
J Nerv Ment Dis. 2019 Nov;207(11):913-920. doi: 10.1097/NMD.0000000000001053.
Persistent complex bereavement (PCBD) was entered to DSM-5. No studies have yet examined the nature, prevalence, prognostic validity, and underlying mechanisms of PCBD symptom patterns in recently bereaved people. Knowledge on these issues could improve the early identification and treatment of disturbed grief. Latent class analysis was used to identify subgroups characterized by different PCBD symptom patterns among recently (≤6 months) bereaved adults (n = 476). In a subgroup (n = 251), we assessed associations of class membership with PCBD severity and functional impairment assessed 3 years later. Associations between class membership and sociodemographic and cognitive-behavioral variables were also examined. We identified a resilient (50.0%), separation distress (36.1%), and high PCBD symptoms (13.9%) class. Class membership had prognostic value as evidenced by associations with PCBD severity and functional impairment assessed 3 years later. Deaths of partners/children, unexpectedness of the loss, and maladaptive cognitions and avoidance behaviors were also associated with membership of the pervasive symptom classes.
持续性复杂丧亲之痛（PCBD）已被纳入《精神疾病诊断与统计手册》第五版（DSM - 5）。尚无研究探讨近期丧亲者中PCBD症状模式的本质、患病率、预后效度及潜在机制。了解这些问题有助于改善对复杂悲痛的早期识别与治疗。采用潜在类别分析在近期（≤6个月）丧亲的成年人（n = 476）中识别以不同PCBD症状模式为特征的亚组。在一个亚组（n = 251）中，我们评估了类别归属与3年后评估的PCBD严重程度及功能损害之间的关联。还考察了类别归属与社会人口学及认知行为变量之间的关联。我们识别出一个适应良好组（50.0%）、分离痛苦组（36.1%）和高PCBD症状组（13.9%）。类别归属具有预后价值，这在与3年后评估的PCBD严重程度及功能损害的关联中得到证实。伴侣/子女死亡、丧失的意外性以及适应不良认知和回避行为也与普遍症状类别的归属相关。
