Original Articles

Patterns, Predictors, and Prognostic Validity of Persistent Complex Bereavement Disorder Symptoms in Recently Bereaved Adults

A Latent Class Analysis

Boelen, Paul A. PhD^∗,†,‡; Smid, Geert E. MD, PhD^†,‡,§; Mitima-Verloop, Huibertha B. MSc^∗,†; de Keijser, Jos PhD^∥; Lenferink, Lonneke I.M. PhD^∗,∥

Author Information

^∗Department of Clinical Psychology, Faculty of Social Sciences, Utrecht University, Utrecht

^†Arq Psychotrauma Expert Group

^‡Foundation Centrum '45, Diemen

^§University of Humanistic Studies, Utrecht

^∥Department of Clinical Psychology and Experimental Psychopathology, Faculty of Behavioural and Social Sciences, University of Groningen, Groningen, the Netherlands.

Send reprint requests to Paul A. Boelen, PhD, Department of Clinical Psychology, Faculty of Social Sciences, Utrecht University, PO Box 80140, 3508 TC Utrecht, the Netherlands. E-mail: [email protected].

P.A.B. and L.I.M.L. undertook the statistical analyses. P.A.B. and H.B.M.-V. collected most of the data. P.A.B. and L.I.M.L. wrote the completed draft of the manuscript. All authors contributed to and have approved the final manuscript.

The Journal of Nervous and Mental Disease 207(11):p 913-920, November 2019. | DOI: 10.1097/NMD.0000000000001053

Abstract

Persistent complex bereavement (PCBD) was entered to DSM-5. No studies have yet examined the nature, prevalence, prognostic validity, and underlying mechanisms of PCBD symptom patterns in recently bereaved people. Knowledge on these issues could improve the early identification and treatment of disturbed grief. Latent class analysis was used to identify subgroups characterized by different PCBD symptom patterns among recently (≤6 months) bereaved adults (n = 476). In a subgroup (n = 251), we assessed associations of class membership with PCBD severity and functional impairment assessed 3 years later. Associations between class membership and sociodemographic and cognitive-behavioral variables were also examined. We identified a resilient (50.0%), separation distress (36.1%), and high PCBD symptoms (13.9%) class. Class membership had prognostic value as evidenced by associations with PCBD severity and functional impairment assessed 3 years later. Deaths of partners/children, unexpectedness of the loss, and maladaptive cognitions and avoidance behaviors were also associated with membership of the pervasive symptom classes.