Department of Clinical Psychology, Faculty of Social Sciences, Utrecht University, PO Box 80140, 3508 TC Utrecht, the Netherlands; ARQ National Psychotrauma Centre, Nienoord 5, NL-1112 XE Diemen, the Netherlands.
Psychiatry Res. 2021 Aug;302:114033. doi: 10.1016/j.psychres.2021.114033. Epub 2021 May 27.
Bereavement may precipitate significant mental health problems. Prolonged grief disorder (PGD) is included in section 2 of the forthcoming DSM-5 text-revision (DSM-5-TR). Research using earlier criteria of disordered grief showed that bereaved people may have distinct symptom patterns-including high, low, and comorbid symptomatology. Building on that work, we used latent class analysis to identity subgroups of bereaved individuals based on their endorsement of symptoms of PGD (per DSM-5-TR), posttraumatic stress, and depression. We also examined if class-membership was associated with socio-demographic and loss-related variables and anxious and depressive avoidance behaviors. Self-reported data were available from 436 people, mostly women, mostly bereaved by the death of their partner or child. Three subgroups were identified, evidencing low symptom levels (34.2%), predominantly PGD symptoms (38.7%), and high symptom levels (27%), respectively. Shorter time since loss, lower education, loss of a partner, and unnatural/violent deaths increased chances of inclusion in the high symptoms class. Anxious and depressive avoidance were lowest in the low symptoms class, higher in the PGD class, and strongest in the high symptoms class. Findings show that PGD per DSM-5-TR is a distinct condition and underscore that reducing avoidance behaviors is important in the treatment of post-loss psychopathology.
丧亲可能会引发严重的心理健康问题。延长哀伤障碍(PGD)被列入即将发布的 DSM-5 文本修订版(DSM-5-TR)的第 2 节。使用早期障碍性悲伤标准进行的研究表明,丧亲者可能具有明显的症状模式,包括高、低和共病症状。在此基础上,我们使用潜在类别分析,根据丧亲者对 PGD(根据 DSM-5-TR)、创伤后应激和抑郁症状的认可程度,确定丧亲个体的亚组。我们还研究了类别的成员资格是否与社会人口和与损失相关的变量以及焦虑和抑郁回避行为相关。自我报告的数据来自 436 人,大多数是女性,主要是伴侣或孩子去世的丧亲者。确定了三个亚组,分别是低症状水平(34.2%)、主要是 PGD 症状(38.7%)和高症状水平(27%)。损失后时间较短、教育程度较低、失去伴侣和非自然/暴力死亡会增加被归入高症状类别的几率。在低症状组中,焦虑和抑郁回避行为最低,在 PGD 组中较高,在高症状组中最强。研究结果表明,DSM-5-TR 中的 PGD 是一种独特的疾病,并强调在治疗失去亲人后的精神病理学时,减少回避行为很重要。