Doering Bettina K, Boelen Paul A, Eisma Maarten C, Barke Antonia
Clinical and Biological Psychology, Catholic University Eichstaett-Ingolstadt, Eichstaett, Germany.
Clinical Psychology, Utrecht University, Utrecht, Netherlands.
Front Psychol. 2021 Jan 18;11:620987. doi: 10.3389/fpsyg.2020.620987. eCollection 2020.
Whereas the majority of bereaved persons recover from their grief without professional assistance, a minority develops pathological grief reactions. Etiological models postulate that dysfunctional cognitions may perpetuate such reactions. The Grief Cognitions Questionnaire (GCQ) assesses thoughts after bereavement in nine interrelated domains. A short form (GCQ-SF) with four domains is often used. However, an evaluation of the psychometric properties of the GCQ-SF and its utility compared to the GCQ is lacking and these instruments have not been validated in German.
German bereaved persons (time since loss 35.3 ± 34.6 months) responded to an online survey containing the GCQ, measures of grief severity, grief rumination, symptoms of depression and anxiety, and optimism and pessimism. 585 participants (18-78 years, 88% women) were included. Item analyses and confirmatory factor analyses were conducted. Correlations between the GCQ and GCQ-SF and grief rumination, optimism and pessimism assessed construct validity. Criterion-related validity was assessed by comparing whether the correlation of the GCQ (and the GCQ-SF) with grief severity was higher than with anxious and depressive symptoms. Logistic regression and receiver-operator characteristics (ROC) compared the questionnaires on their ability to predict probable prolonged grief 'caseness' (ICG ≥ 25, time since loss ≥6 months).
Internal consistencies for both questionnaires were identical and excellent (α = 0.96). Confirmatory factor analyses obtained a satisfactory fit for models with nine and four correlated subscales and respective higher-order factor models. The GCQ and the GCQ-SF correlated higher with grief severity than with other measures of psychopathology. The logistic regression showed a significant association between the GCQ-SF and prolonged grief 'caseness'. Of the remaining subscales of the GCQ, only one subscale ('Others') contributed to the prediction. The ROC analyses showed nearly identical areas under the curve.
The translated GCQ and GCQ-SF demonstrated very good psychometric properties. The correlations with grief severity highlight the questionnaires' clinical relevance. The questionnaires possessed identical diagnostic specificity and sensitivity. Whenever a timesaving assessment of the most typical grief-specific cognitions is important, the GCQ-SF represents an alternative to the GCQ. The original GCQ may still be superior when a more detailed description of a bereaved person's cognitions is desirable.
尽管大多数丧亲者在没有专业帮助的情况下从悲痛中恢复过来，但少数人会出现病理性悲痛反应。病因模型假定功能失调的认知可能使此类反应持续存在。悲痛认知问卷（GCQ）在九个相互关联的领域评估丧亲后的想法。通常使用包含四个领域的简版（GCQ-SF）。然而，缺乏对GCQ-SF心理测量特性及其与GCQ相比效用的评估，并且这些工具尚未在德语中得到验证。
德国丧亲者（丧亲后时间为35.3±34.6个月）对一项在线调查做出回应，该调查包含GCQ、悲痛严重程度测量、悲痛沉思、抑郁和焦虑症状以及乐观和悲观情绪。纳入了585名参与者（18 - 78岁，88%为女性）。进行了项目分析和验证性因素分析。GCQ与GCQ-SF以及悲痛沉思、乐观和悲观之间的相关性评估了结构效度。通过比较GCQ（和GCQ-SF）与悲痛严重程度的相关性是否高于与焦虑和抑郁症状的相关性来评估效标关联效度。逻辑回归和受试者操作特征（ROC）比较了问卷预测可能的延长悲痛“病例”（ICG≥25，丧亲后时间≥6个月）的能力。
两份问卷的内部一致性相同且极佳（α = 0.96）。验证性因素分析对具有九个和四个相关子量表以及各自高阶因素模型的模型获得了令人满意的拟合。GCQ和GCQ-SF与悲痛严重程度的相关性高于与其他精神病理学测量的相关性。逻辑回归显示GCQ-SF与延长悲痛“病例”之间存在显著关联。在GCQ的其余子量表中，只有一个子量表（“其他”）对预测有贡献。ROC分析显示曲线下面积几乎相同。
翻译后的GCQ和GCQ-SF表现出非常好的心理测量特性。与悲痛严重程度的相关性突出了问卷的临床相关性。问卷具有相同的诊断特异性和敏感性。每当对最典型的悲痛特异性认知进行省时评估很重要时，GCQ-SF是GCQ的一种替代选择。当需要对丧亲者的认知进行更详细描述时，原始的GCQ可能仍然更优。
