Department of Developmental Psychology, Ulm University, Ulm, Germany.
Department of Clinical Psychology, Faculty of Social Sciences, Utrecht University, Utrecht, the Netherlands.
Eur J Psychotraumatol. 2023;14(2):2281183. doi: 10.1080/20008066.2023.2281183. Epub 2023 Nov 27.
With the release of the text revision of the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5-TR), criteria for Prolonged Grief Disorder (PGD) were included. This necessitates studying grief trajectories based on these criteria. This is the first study examining latent trajectories of DSM-5-TR-based PGD symptom levels and testing whether specific risk factors (e.g. cause of death) predicted PGD trajectories. We evaluated latent DSM-5-TR PGD trajectories using pooled existing data collected at 6-12, 13-24, and 25-60 months post-loss in Danish and Dutch bereaved adults ( = 398). Latent Growth Mixture Modelling (LGMM) was employed to determine the trajectories. Multinomial logistic regression analyses were used to examine which risk factors predicted class membership. The four-class LGMM solution with a quadratic term was best-fitting the data. This solution represented four trajectories: High stable PGD (6%), High PGD quick recovery (10%), High PGD slow recovery (35%), and Low PGD symptoms (49%). Participants with a higher educational level were more likely to be assigned to the Low PGD symptoms trajectory compared to High stable PGD and High PGD slow recovery trajectories. Unnatural causes of death increased the likelihood of being in the High stable PGD and High PGD slow recovery trajectories compared to the Low PGD symptoms trajectory. Consistent with prior research, the Low PGD symptoms trajectory was the most common. A significant minority experienced high and stable levels of PGD within five years after the loss. About one-third of participants experienced high acute grief levels that decreased slowly; how slow decreasing symptoms relate to an individual's functioning requires further attention. This study demonstrates that a significant minority of bereaved people develop acute PGD symptomatology that does not diminish within five years post-loss, emphasizing the need for early screening for PGD to prevent long-lasting complaints.
随着《精神障碍诊断与统计手册》第五版修订本（DSM-5-TR）的发布，延长哀伤障碍（PGD）的标准被纳入其中。这就需要根据这些标准研究哀伤轨迹。这是第一项研究，旨在检查基于 DSM-5-TR 的 PGD 症状水平的潜在轨迹，并测试特定的风险因素（例如死因）是否可以预测 PGD 轨迹。我们使用丹麦和荷兰丧亲成年人在丧失后 6-12、13-24 和 25-60 个月期间收集的现有数据评估了基于 DSM-5-TR 的潜在 PGD 轨迹（ = 398）。使用潜在增长混合模型（LGMM）来确定轨迹。使用多项逻辑回归分析来检查哪些风险因素预测了类别归属。具有二次项的四类 LGMM 解决方案最适合数据。该解决方案代表了四种轨迹：高稳定 PGD（6%）、高 PGD 快速恢复（10%）、高 PGD 缓慢恢复（35%）和低 PGD 症状（49%）。与高稳定 PGD 和高 PGD 缓慢恢复轨迹相比，具有较高教育水平的参与者更有可能被分配到低 PGD 症状轨迹。与低 PGD 症状轨迹相比，非自然原因的死亡增加了处于高稳定 PGD 和高 PGD 缓慢恢复轨迹的可能性。与先前的研究一致，低 PGD 症状轨迹是最常见的。少数人在丧失后五年内经历了高而稳定的 PGD 水平。大约三分之一的参与者经历了高急性悲伤水平，这些水平下降缓慢；症状下降的速度如何与个体的功能有关，需要进一步关注。这项研究表明，少数丧亲者会出现急性 PGD 症状，这些症状在丧失后五年内不会减轻，这强调了早期筛查 PGD 的必要性，以预防长期的投诉。
