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Gepubliceerd in: Journal of Abnormal Child Psychology 7/2016

23-12-2015

Persistent Complex Bereavement Disorder Symptom Domains Relate Differentially to PTSD and Depression: A Study of War-Exposed Bosnian Adolescents

Auteurs: Meredith A. Claycomb, Ruby Charak, Julie Kaplow, Christopher M. Layne, Robert Pynoos, Jon D. Elhai

Gepubliceerd in: Research on Child and Adolescent Psychopathology | Uitgave 7/2016

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Abstract

Persistent Complex Bereavement Disorder (PCBD) is a newly proposed diagnosis placed in the Appendix of the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) as an invitation for further research. To date, no studies have examined the dimensionality of PCBD or explored whether different PCBD criteria domains relate in similar, versus differential, ways to other psychological conditions common to war-exposed bereaved youth, including symptoms of Posttraumatic Stress Disorder (PTSD) and depression. We evaluated the dimensionality of proposed PCBD B and C symptom domains, and their respective relations with measures of PTSD and depression, in 1142 bereaved Bosnian adolescents exposed to the 1992–1995 Bosnian civil war. Instruments included the UCLA PTSD Reaction Index, the Depression Self-Rating Scale, and the UCLA Grief Screening Scale (a prototype measure of PCBD symptoms). We investigated potential differences in grief, PTSD, and depression scores as a function of cause of death. We then examined hypothesized differential relations between PCBD B and C symptom domain subscales and selected external correlates, specifically measures of depression and the four-factor emotional numbing model of PTSD. Results of both analyses provide preliminary evidence of a multidimensional structure for PCBD in this population, in that the PCBD Criterion C subscale score covaried more strongly with each of the four PTSD factors and with depression than did PCBD Criterion B. We conclude by discussing theoretical, methodological, clinical, and policy-related implications linked to the ongoing study of essential features of PCBD.
Voetnoten
1
We assessed a 1-factor and 2-factor CFA model of PCBD Criterion B and Criterion C, but did not include the analyses here because the prototype nature of the GSS measure provides insufficient item coverage to be considered a content-valid representation of PCBD. Nonetheless, for the CFA of the 2-factor PCBD model, we obtained the following results: χ 2 (df = 19) = 136.34, Scaled χ 2  = 150.25, CFI/TLI = 0.96/0.94, RMSEA = 0.08, 90 % CI [0.065, 0.089], SRMR = 0.04, BIC = 23,801.96. All factor loadings were above 0.30, and the factor correlation was 0.99. The one-factor model of PCBD did not converge. Further results are available upon request from the corresponding author.
 
2
Due to the larger percentage of females in this study (70 %), we conducted analyses showing that the same joint model fit in females and males. The joint model for males, χ 2  = 257.41, Scaled χ 2  = 313.08, CFI/TLI = 0.94/0.93, RMSEA = 0.045, 90 % CI [0.035, 0.054], SRMR = 0.05, BIC = 21,861.57), and for females, χ 2  = 522.68, Scaled χ 2  = 597.37, CFI/TLI = 0.94/0.92, RMSEA = 0.055, 90 % CI [0.05, 0.06], SRMR = 0.04, BIC = 51,978.22) indicated adequate fit indices for the model. The factor loadings of the PTSD Emotional numbing model ranged from 0.28–0.74 among males, and 0.36–0.78 among females. The correlation between factors of PTSD and scores on criteria B and C of PCBD, and depression ranged from 0.33–0.87 in males and 0.40–0.92 in females. The adequate fit indices along with the range of correlations across males and females indicates that the relationship found between the variables is similar across males and females.
 
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Metagegevens
Titel
Persistent Complex Bereavement Disorder Symptom Domains Relate Differentially to PTSD and Depression: A Study of War-Exposed Bosnian Adolescents
Auteurs
Meredith A. Claycomb
Ruby Charak
Julie Kaplow
Christopher M. Layne
Robert Pynoos
Jon D. Elhai
Publicatiedatum
23-12-2015
Uitgeverij
Springer US
Gepubliceerd in
Research on Child and Adolescent Psychopathology / Uitgave 7/2016
Print ISSN: 2730-7166
Elektronisch ISSN: 2730-7174
DOI
https://doi.org/10.1007/s10802-015-0107-7

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