Prolonged Grief Disorder: Psychometric Validation of Criteria Proposed for DSM-V and ICD-11

被引:1274
作者
Prigerson, Holly G. [1 ,2 ,3 ]
Horowitz, Mardi J. [4 ]
Jacobs, Selby C. [5 ]
Parkes, Colin M. [6 ,7 ]
Aslan, Mihaela [8 ]
Goodkin, Karl [9 ,10 ]
Raphael, Beverley [11 ]
Marwit, Samuel J. [12 ]
Wortman, Camille [13 ]
Neimeyer, Robert A. [14 ]
Bonanno, George A. [15 ]
Block, Susan D. [1 ,2 ,3 ]
Kissane, David [16 ]
Boelen, Paul [17 ]
Maercker, Andreas [18 ]
Litz, Brett T. [19 ,20 ,21 ]
Johnson, Jeffrey G. [22 ]
First, Michael B. [22 ]
Maciejewski, Paul K. [1 ,2 ]
机构
[1] Brigham & Womens Hosp, Dept Psychiat, Boston, MA 02115 USA
[2] Dana Farber Canc Inst, Ctr Psychooncol & Palliat Care Res, Boston, MA 02115 USA
[3] Harvard Univ, Sch Med, Ctr Palliat Care, Boston, MA USA
[4] Univ Calif San Francisco, Sch Med, Dept Psychiat, San Francisco, CA 94143 USA
[5] Yale Univ, Sch Med, Dept Psychiat, New Haven, CT USA
[6] St Christophers Hosp, Sydenham, England
[7] St Josephs Hosp, Hackney, England
[8] Yale Univ, Sch Med, Dept Internal Med, New Haven, CT 06510 USA
[9] Cedars Sinai Med Ctr, Dept Psychiat & Behav Neurosci, Los Angeles, CA 90048 USA
[10] Univ Calif Los Angeles, David Geffen Sch Med, Dept Psychiat & Behav Sci, Los Angeles, CA 90095 USA
[11] Univ Western Sydney, Sch Med, Dept Populat Mental Hlth & Disasters, Penrith, NSW 1797, Australia
[12] Univ Missouri, Dept Psychol, St Louis, MO 63121 USA
[13] SUNY Stony Brook, Dept Psychol, Stony Brook, NY 11794 USA
[14] Univ Memphis, Dept Psychol, Memphis, TN 38152 USA
[15] Columbia Univ, Teachers Coll, Dept Counseling & Clin Psychol, New York, NY 10027 USA
[16] Mem Sloan Kettering Canc Ctr, Dept Psychiat & Behav Sci, New York, NY 10021 USA
[17] Univ Utrecht, Dept Clin & Hlth Psychol, Utrecht, Netherlands
[18] Univ Zurich, Dept Clin Psychol, Zurich, Switzerland
[19] Vet Affairs Boston Healthcare Syst, Boston, MA USA
[20] Natl Ctr PTSD, Boston, MA USA
[21] Boston Univ, Sch Med, Boston, MA 02118 USA
[22] Columbia Univ, Dept Psychiat, New York, NY USA
关键词
BEREAVEMENT-RELATED DEPRESSION; COMPLICATED GRIEF; TRAUMATIC GRIEF; DIAGNOSTIC-CRITERIA; PHYSICAL HEALTH; MENTAL-HEALTH; DISTINCT; ANXIETY; MORTALITY; SYMPTOMS;
D O I
10.1371/journal.pmed.1000121
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background: Bereavement is a universal experience, and its association with excess morbidity and mortality is well established. Nevertheless, grief becomes a serious health concern for a relative few. For such individuals, intense grief persists, is distressing and disabling, and may meet criteria as a distinct mental disorder. At present, grief is not recognized as a mental disorder in the DSM-IV or ICD-10. The goal of this study was to determine the psychometric validity of criteria for prolonged grief disorder (PGD) to enhance the detection and potential treatment of bereaved individuals at heightened risk of persistent distress and dysfunction. Methods and Findings: A total of 291 bereaved respondents were interviewed three times, grouped as 0-6, 6-12, and 12-24 mo post-loss. Item response theory (IRT) analyses derived the most informative, unbiased PGD symptoms. Combinatoric analyses identified the most sensitive and specific PGD algorithm that was then tested to evaluate its psychometric validity. Criteria require reactions to a significant loss that involve the experience of yearning (e. g., physical or emotional suffering as a result of the desired, but unfulfilled, reunion with the deceased) and at least five of the following nine symptoms experienced at least daily or to a disabling degree: feeling emotionally numb, stunned, or that life is meaningless; experiencing mistrust; bitterness over the loss; difficulty accepting the loss; identity confusion; avoidance of the reality of the loss; or difficulty moving on with life. Symptoms must be present at sufficiently high levels at least six mo from the death and be associated with functional impairment. Conclusions: The criteria set for PGD appear able to identify bereaved persons at heightened risk for enduring distress and dysfunction. The results support the psychometric validity of the criteria for PGD that we propose for inclusion in DSM-V and ICD-11.
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页数:12
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