Natalia A Skritskaya1, Christine Mauro2, Matthew Olonoff3, Xin Qiu2, Sarah Duncan2, Yuanjia Wang2, Naihua Duan4, Barry Lebowitz5, Charles F Reynolds6, Naomi M Simon7, Sidney Zisook5, M Katherine Shear8. 1. Columbia University School of Social Work, Columbia University, New York, NY. Electronic address: ns2712@columbia.edu. 2. Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, NY. 3. New York State Psychiatric Institute, New York, NY. 4. Division of Biostatistics, Department of Psychiatry, Columbia University, New York, NY. 5. Department of Psychiatry, University of California, San Diego, La Jolla, CA. 6. Department of Psychiatry, University of Pittsburgh School of Medicine and Department of Community and Behavioral Health Science, University of Pittsburgh Graduate School of Public Health, Western Psychiatry Institute and Clinic, Pittsburgh, PA. 7. Center for Anxiety and Traumatic Stress Disorders, Massachusetts General Hospital, Boston, MA; Harvard Medical School, Boston, MA. 8. Columbia University School of Social Work, Columbia University, New York, NY; Department of Psychiatry, Columbia University College of Physicians and Surgeons, New York, NY.
Abstract
OBJECTIVES: Maladaptive cognitions related to loss are thought to contribute to development of complicated grief and are crucial to address in treatment, but tools available to assess them are limited. This paper introduces the Typical Beliefs Questionnaire (TBQ), a 25-item self-report instrument to assess cognitions that interfere with adaptation to loss. DESIGN: Study participants completed an assessment battery during their initial evaluation and again after completing treatment at 20 weeks. Test-retest reliability was assessed on a subsample of the participants who did not show change in complicated grief severity after the first 4 weeks of treatment. To examine latent structure of the TBQ, an exploratory factor analysis (EFA) was performed. SETTING: Academic medical centers in Boston, New York, Pittsburgh, and San Diego from 2010-2014. PARTICIPANTS: 394 bereaved adults who met criteria for complicated grief. MEASUREMENTS: The TBQ along with assessments of complicated grief symptoms and related avoidance, depression symptoms, functional impairment, and perceived social support. RESULTS: The TBQ exhibited good internal consistency (α = 0.82) and test-retest reliability (N = 105; intraclass correlation coefficient = 0.74). EFA indicated a five-factor structure: "Protesting the Death," "Negative Thoughts About the World," "Needing the Person," "Less Grief is Wrong" and "Grieving Too Much." The total score and all factors showed sensitivity to change with treatment. CONCLUSIONS: This new tool allows a clinician to quickly and reliably ascertain presence of specific maladaptive cognitions related to complicated grief, and subsequently, to use the information to aid a diagnostic assessment, to structure the treatment, and to measure treatment outcomes.
OBJECTIVES: Maladaptive cognitions related to loss are thought to contribute to development of complicated grief and are crucial to address in treatment, but tools available to assess them are limited. This paper introduces the Typical Beliefs Questionnaire (TBQ), a 25-item self-report instrument to assess cognitions that interfere with adaptation to loss. DESIGN: Study participants completed an assessment battery during their initial evaluation and again after completing treatment at 20 weeks. Test-retest reliability was assessed on a subsample of the participants who did not show change in complicated grief severity after the first 4 weeks of treatment. To examine latent structure of the TBQ, an exploratory factor analysis (EFA) was performed. SETTING: Academic medical centers in Boston, New York, Pittsburgh, and San Diego from 2010-2014. PARTICIPANTS: 394 bereaved adults who met criteria for complicated grief. MEASUREMENTS: The TBQ along with assessments of complicated grief symptoms and related avoidance, depression symptoms, functional impairment, and perceived social support. RESULTS: The TBQ exhibited good internal consistency (α = 0.82) and test-retest reliability (N = 105; intraclass correlation coefficient = 0.74). EFA indicated a five-factor structure: "Protesting the Death," "Negative Thoughts About the World," "Needing the Person," "Less Grief is Wrong" and "Grieving Too Much." The total score and all factors showed sensitivity to change with treatment. CONCLUSIONS: This new tool allows a clinician to quickly and reliably ascertain presence of specific maladaptive cognitions related to complicated grief, and subsequently, to use the information to aid a diagnostic assessment, to structure the treatment, and to measure treatment outcomes.
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Authors: Naomi M Simon; M Katherine Shear; Charles F Reynolds; Stephen J Cozza; Christine Mauro; Sidney Zisook; Natalia Skritskaya; Donald J Robinaugh; Matteo Malgaroli; Julia Spandorfer; Barry Lebowitz Journal: Depress Anxiety Date: 2020-01 Impact factor: 6.505
Authors: Natalia A Skritskaya; Christine Mauro; Angel Garcia de la Garza; Franziska Meichsner; Barry Lebowitz; Charles F Reynolds; Naomi M Simon; Sidney Zisook; M Katherine Shear Journal: Depress Anxiety Date: 2019-12-05 Impact factor: 6.505
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