BACKGROUND: Complicated and persistent grief reactions afflict approximately 10% of bereaved individuals and are associated with severe disruptions of functioning. These maladaptive patterns were defined in Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) as persistent complex bereavement disorder (PCBD), but its criteria remain debated. The condition has been studied using network analysis, showing potential for an improved understanding of PCBD. However, previous studies were limited to self-report and primarily originated from a single archival dataset. To overcome these limitations, we collected structured clinical interview data from a community sample of newly conjugally bereaved individuals (N = 305). METHODS: Gaussian graphical models (GGM) were estimated from PCBD symptoms diagnosed at 3, 14, and 25 months after the loss. A directed acyclic graph (DAG) was generated from initial PCBD symptoms, and comorbidity networks with DSM-5 symptoms of major depressive disorder (MDD) and post-traumatic stress disorder (PTSD) were analyzed 1 year post-loss. RESULTS: In the GGM, symptoms from the social/identity PCBD symptoms cluster (i.e. role confusion, meaninglessness, and loneliness) tended to be central in the network at all assessments. In the DAG, yearning activated a cascade of PCBD symptoms, suggesting how symptoms lead into psychopathological configurations. In the comorbidity networks, PCBD and depressive symptoms formed separate communities, while PTSD symptoms divided in heterogeneous clusters. CONCLUSIONS: The network approach offered insights regarding the core symptoms of PCBD and the role of persistent yearnings. Findings are discussed regarding both clinical and theoretical implications that will serve as a step toward a more integrated understanding of PCBD.
BACKGROUND: Complicated and persistent grief reactions afflict approximately 10% of bereaved individuals and are associated with severe disruptions of functioning. These maladaptive patterns were defined in Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) as persistent complex bereavement disorder (PCBD), but its criteria remain debated. The condition has been studied using network analysis, showing potential for an improved understanding of PCBD. However, previous studies were limited to self-report and primarily originated from a single archival dataset. To overcome these limitations, we collected structured clinical interview data from a community sample of newly conjugally bereaved individuals (N = 305). METHODS: Gaussian graphical models (GGM) were estimated from PCBD symptoms diagnosed at 3, 14, and 25 months after the loss. A directed acyclic graph (DAG) was generated from initial PCBD symptoms, and comorbidity networks with DSM-5 symptoms of major depressive disorder (MDD) and post-traumatic stress disorder (PTSD) were analyzed 1 year post-loss. RESULTS: In the GGM, symptoms from the social/identity PCBD symptoms cluster (i.e. role confusion, meaninglessness, and loneliness) tended to be central in the network at all assessments. In the DAG, yearning activated a cascade of PCBD symptoms, suggesting how symptoms lead into psychopathological configurations. In the comorbidity networks, PCBD and depressive symptoms formed separate communities, while PTSD symptoms divided in heterogeneous clusters. CONCLUSIONS: The network approach offered insights regarding the core symptoms of PCBD and the role of persistent yearnings. Findings are discussed regarding both clinical and theoretical implications that will serve as a step toward a more integrated understanding of PCBD.
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: Geoffrey M Reed; Michael B First; Joël Billieux; Marylene Cloitre; Peer Briken; Sophia Achab; Chris R Brewin; Daniel L King; Shane W Kraus; Richard A Bryant Journal: World Psychiatry Date: 2022-06 Impact factor: 79.683
Authors: Ruth H Asch; Irina Esterlis; Frank R Wendt; Lorig Kachadourian; Steven M Southwick; Joel Gelernter; Renato Polimanti; Robert H Pietrzak Journal: World J Biol Psychiatry Date: 2021-05-20 Impact factor: 4.132
Authors: Karl Andriessen; Karolina Krysinska; Nicole T M Hill; Lennart Reifels; Jo Robinson; Nicola Reavley; Jane Pirkis Journal: BMC Psychiatry Date: 2019-01-30 Impact factor: 3.630