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Background: Prolonged Grief Disorder (PGD) is a new disorder included in ICD-11 (WHO, 2018). There is a growing body of literature surrounding the prevalence and correlates of ICD-11 PGD symptoms as assessed using various measures. This study was the first to assess levels of ICD-11 PGD symptoms as measured by the International Prolonged Grief Disorder Scale (IPGDS), a self-report scale directly aligned with the ICD-11 definition of PGD, among the United Kingdom adult general population, and identify correlates. Method: Participants included 2025 adults who participated in Wave 5 of the COVID-19 Psychological Research Consortium Study (C19PRC-UK). Prevalence rates of PGD were estimated based on two commonly used algorithms defined as 'strict' and 'moderate'. Sociodemographic, loss-related, and mental health correlates (i.e., anxiety, depression, mental health treatment seeking, loneliness) of strict and moderate PGD were then examined using multinomial logistic regressions. Results: It was found that 2.4% (n = 43) of participants met probable caseness for PGD using the strict criteria while 7.9% (n = 140) met probable caseness for PGD using the moderate criteria. Multinomial logistic regression analysis results showed, as predicted, that income, time since bereavement, death of a child, religiosity, and depression were associated with both moderate and strict PGD. Correlates of moderate PGD included country of residence, urbanicity, younger age of bereaved, and loneliness. Conclusions: This study highlights that some symptoms of PGD are commonly reported in the general population, although relatively few meet the criteria for clinical significance. The routine assessment for PGD following a bereavement is discussed and the development of appropriate interventions are recommended. [ABSTRACT FROM AUTHOR]

Purpose: Loneliness is a recognised public-health concern that is traditionally regarded as a unidimensional construct. Theories of loneliness predict the existence of subtypes of loneliness. In this study, latent class analysis (LCA) was used to test for the presence of loneliness subtypes and to examine their association with multiple mental health variables.Methods: A nationally representative sample of US adults (N = 1839) completed the De Jong Gierveld Loneliness Scale, along with self-report measures of childhood and adulthood trauma, psychological wellbeing, major depression, and generalized anxiety.Results: When treated as a unidimensional construct, 17.1% of US adults aged 18-70 were classified as lonely. However, the LCA results identified four loneliness classes which varied quantitatively and qualitatively: 'low' (52.8%), 'social' (8.2%), 'emotional' (26.6%), and 'social and emotional' (12.4%) loneliness. The 'social and emotional' class were characterised by the highest levels of psychological distress, followed by the 'emotional' class. The 'social' loneliness class had similar mental health scores as the 'low' loneliness class. Childhood and adulthood trauma were independently related to the most distressed loneliness classes.Conclusions: Current findings provide support for the presence of subtypes of loneliness and show that they have unique associations with mental health status. Recognition of these subtypes of loneliness revealed that the number of US adults aged 18-70 experiencing loneliness was twice as high as what was estimated when loneliness was conceptualized as a unidimensional construct. The perceived quality, not the quantity, of interpersonal connections was associated with poor mental health. [ABSTRACT FROM AUTHOR]

Background: Heterotypic psychopathological continuity (i.e. one disorder predicting another at a later time point) contradicts the conventional view that psychiatric disorders are discrete, static entities. Studying this phenomenon may help to tease out the complex mechanisms that underpin psychiatric comorbidity. To date, no studies have explicitly compared heterotypic effects within and across higher order dimensions of psychopathology.Methods: Patterns of homotypic and heterotypic psychopathological continuity were examined using cohort data from the Avon Longitudinal Study of Parents and Children (ALSPAC, N = 4815). Eight common psychiatric disorders were assessed at age 7.5 and again at age 14 years using the maternal report version of the Development and Well-Being Assessment (DAWBA). Cross-lagged models were used to compare patterns of homotypic and heterotypic continuity within and across three higher order dimensions of psychopathology; internalizing-fear, internalizing-distress, and externalizing.Results: Homotypic continuity was universal. Considerable heterotypic continuity was observed even after controlling for homotypic continuity and the presence of all disorders at baseline. Heterotypic continuity was more common within higher order dimensions, but a number of significant cross-dimension effects were observed, with ADHD acting as a strong predictor of subsequent internalizing disorders.Conclusions: Heterotypic continuity may reflect elements of shared aetiology, or local-level interactions between disorders. [ABSTRACT FROM AUTHOR]

Purpose: A number of social, familial, and psychological factors have been identified to explain the onset of mood and anxiety disorders among adolescent and young adult populations. The purpose of this study is to identify the shared and unique predictors of anxiety and mood disorders by simultaneously testing a range of established psychosocial risk factors.Method: A national birth cohort of the Danish population born in 1984 and tracked over the course of the first 21 years of their life was used in the current study (n = 54,458). Psychosocial risk factors including paternal and maternal history of any anxiety and mood disorder, parental history of self-harming behaviour, advanced paternal age, gender, urban dwelling, economic deprivation, family dissolution, and childhood adversity were used to predict diagnosis of both anxiety and mood disorders from ages 10 to 21 years.Results: Binary logistic regression analysis showed that being female and a parental history of a mood or anxiety disorder are the strongest predictors of both disorders. Economic deprivation, and family dissolution also increase likelihood of both disorders. Urban dwelling and childhood adversity are predictors of anxiety disorders but not mood disorders.Conclusion: Between the ages of 10 and 21 years, anxiety and mood disorders share many common risk factors. However, urban dwelling and childhood adversity appear to be unique predictors of anxiety disorders. Results suggest there is no dominant factor in the prediction of either disorder, rather the accumulation of different risk factors is most deleterious. [ABSTRACT FROM AUTHOR]

Childhood abuse (CA) has been found to be related to the development of a variety of psychiatric disorders in adulthood. Although CA is also associated with adult loneliness, few studies have investigated the role of loneliness as a mediator in the relationship between CA and adult psychopathology. Using data from a large, general population sample a mediation model was proposed and tested. Controlling for a range of background variables, the results from a series of regression analyses found that loneliness mediated the association between CA and six adult psychiatric disorders. The findings of this study highlight the importance of loneliness to the development of psychopathology. Theoretical and practical implications are discussed. [ABSTRACT FROM AUTHOR]

Purpose: Recurrent research evidence indicates that childhood sexual abuse (CSA) is associated with psychosis and psychosis-like experiences (PLEs). Many individuals however who have experienced psychosis have never been sexually abused in childhood and many individuals who have experienced CSA have never experienced psychosis. Method: The current study sought to model the co-occurrence of CSA and PLEs using data from the Adult Psychiatric Morbidity Survey. Latent class analysis was employed to identify distinct classes of individuals in the general population who were characterised by the presence, co-occurrence or absence of PLEs and/or CSA. Multinomial logistic regression analysis was utilised to validate membership of classes characterised by both CSA and PLEs using a series of variables that have been proposed to delineate the co-occurrence of these phenomena. Results: Four hypothesised classes were identified, (1) a CSA-PLE co-occurrence class, (2) a PLE-only class, (3) a CSA-only class and (4) a CSA and PLE free baseline class. CSA-PLE co-occurrence was characterised by neurotic disorder, social isolation, adult sexual molestation and a history of post-traumatic stress disorder (PTSD). PLE occurrence in the absence of CSA was characterised by neurotic disorder, social isolation, a history of PTSD, childhood physical abuse, and uniquely by discrimination and non-sexual trauma post-16 years. Conclusions: The findings indicated that a distinct group of individuals in the population was characterised by the co-occurrence of CSA and PLEs. In the absence of CSA, individuals who experienced PLEs were likely to endure a wide range of other, non-sexual, traumatic and adverse experiences. The CSA-PLE co-occurrence class and its associated psychosocial risk profile was discussed in relation to established trauma-based perspectives of psychosis and PLEs. [ABSTRACT FROM AUTHOR]

Purpose: Research has shown that sexual trauma represents a specific threat for psychosis, particularly among females. Sexual trauma among females, however, has also been shown to enhance the risk for further revictimisation. Females are likely to exhibit distinct lifetime trauma profiles, i.e. female sexual trauma victims are often more likely to experience particular forms of re-victimisation, such as intimate partner and domestic violence. Methods: This study used data from the Adult Psychiatric Morbidity Survey (2007) to profile lifetime histories of sexual trauma and domestic violence among female participants ( N = 4,111). Results: The latent class analysis revealed four lifetime victimisation classes: (i) a multiple victimisation class; (ii) an intimate partner victimisation class; (iii) a sexual victimisation class; and (iv) a victimisation-free class. Multivariate logistic regression revealed that there was a strong association between class membership and a diagnosis of psychosis and that the victimisation classes were significantly associated with all psychotic-like experiences. Compared to the victimisation-free class, the multiple victimisation class displayed an increased likelihood of experiencing all psychotic experiences except mania. The intimate partner victimisation class was also associated with an increased likelihood of experiencing all psychotic experiences; however, the odds ratios for this class were lower than those recorded for the multiple victimisation class. Conclusions: These findings reflect female-specific variation in both victimisation history and psychosis-related vulnerability. Acknowledging such sex-specific variation may advance our understanding of the complex associations that continue to emerge between trauma and psychosis for both males and females. [ABSTRACT FROM AUTHOR]

Objective: Numerous studies of both clinical and large-scale population based samples have demonstrated that adverse childhood events are risk factors for subsequent psychosis. This study assessed the relationships between adverse childhood events and auditory and visual hallucinatory experiences. Method: The study analysed data from the National Comorbidity Survey Replication conducted in the US that assessed (all before age 16) rape, sexual assault and physical assault. Psychosis symptomatology was represented by lifetime experience of auditory and visual hallucinations. Control variables included gender, age, urbanity, ethnicity, marital status, education, employment status, alcohol dependence and drug dependence. Results: All three adverse events were significantly related to both types of hallucinations. Those who had been raped as children were 3.3 times more likely to have experienced visual hallucinations and 3.5 times more likely to have experienced auditory hallucinations compared to those who had not been raped in childhood. Both rape and physical assault significantly predicted visual and auditory hallucinations. A significant dose-response relationship was also found. Conclusions: Previous findings indicating that adverse events in childhood may be causally related to subsequent psychosis are supported. The psychological and biological mechanisms underlying the relationship are already the subject of investigation. Repeated recommendations concerning routine enquiry about adverse experiences in childhood in order to facilitate comprehensive formulations and appropriate treatment, also receive support from these findings. [ABSTRACT FROM AUTHOR]

Purpose: This study assessed the distribution of posttraumatic stress disorder (PTSD) symptoms and psychosis indicators among a large sample of individuals with a lifetime diagnosis of PTSD. The identification of a psychotic PTSD subtype was also predicted. Method: Using data from the National Comorbidity Survey a latent class analysis was conducted on the PTSD symptoms of intrusion, avoidance, and hyperarousal and the psychosis hallucination and delusion indicators. Results: Results indicated four latent classes, two of which had relatively high probabilities of endorsing the hallucination and delusion indicators. These classes were associated with a broad range of traumatic experiences. One particular class had high probabilities of endorsing both the psychosis indicators and the PTSD symptoms and was associated with a broad range of comorbid psychiatric disorders. Conclusion: There was a candidate class that met the characteristics expected to be evident in a psychotic PTSD subtype. [ABSTRACT FROM AUTHOR]

Background: Exposure to traumatic events has been implicated in the onset and development of a range of psychiatric disorders. People can be exposed to multiple traumatic events and previous research suggests that traumatic experiences may cluster at the individual level. Methods: This study aimed to examine the distribution of traumatic experiences in a large nationally representative sample using latent class analysis, and estimate the relationship between these classes and a number of demographic and clinical variables. Data from the National Comorbidity Survey was used. Results: Four latent classes, each representative of a range of traumatic experiences were identified. The classes were labelled 'high risk' (class 1), 'exposure to non-sexual adult interpersonal/non-interpersonal trauma' (class 2), 'intermediate risk/sexual abuse' (class 3), and 'low risk' (class 4). Each of the latent classes was predicted by several of the demographic variables. In addition, membership of classes 1, 2, and 3 increased the risk of each of the clinical variables. Conclusions: The findings have clinical implications for the assessment of trauma histories across a range of psychiatric diagnoses. [ABSTRACT FROM AUTHOR]

Objective: Previous research has suggested that psychosis is better described as a continuum rather than a dichotomous entity. This study aimed to describe the distribution of positive psychosis-like symptoms in two large community samples using an item response mixture model.Method: An item response mixture model was used to explain the pattern of psychosis-like symptom endorsement. This model incorporated two elements. First, a continuous non-normal latent variable to explain the observed pattern of data. Second, a categorical latent variable to explain the variation in the continuous non-normal latent variable.Results: For both samples, representing broadly and narrowly defined psychosis, the best fitting model was a four-class solution. In both cases, the classes differed quantitatively rather than qualitatively.Conclusions: The analysis showed that psychosis-like symptoms at the population level could be best explained by four classes that appeared to represent an underlying continuum. [ABSTRACT FROM AUTHOR]

Purpose: The World Health Organization's 11th revision to the International Classification of Diseases manual (ICD-11) will differentiate between two stress-related disorders: PTSD and Complex PTSD (CPTSD). ICD-11 proposals suggest that trauma exposure which is prolonged and/or repeated, or consists of multiple forms, that also occurs under circumstances where escape from the trauma is difficult or impossible (e.g., childhood abuse) will confer greater risk for CPTSD as compared to PTSD. The primary objective of the current study was to provide an empirical assessment of this proposal.Methods: A stratified, random probability sample of a Danish birth cohort (aged 24) was interviewed by the Danish National Centre for Social Research (N = 2980) in 2008-2009. Data from this interview were used to generate an ICD-11 symptom-based classification of PTSD and CPTSD.Results: The majority of the sample (87.1%) experienced at least one of eight traumatic events spanning childhood and early adulthood. There was some indication that being female increased the risk for both PTSD and CPTSD classification. Multinomial logistic regression results found that childhood sexual abuse (OR = 4.98) and unemployment status (OR = 4.20) significantly increased risk of CPTSD classification as compared to PTSD. A dose-response relationship was observed between exposure to multiple forms of childhood interpersonal trauma and risk of CPTSD classification, as compared to PTSD.Conclusions: Results provide empirical support for the ICD-11 proposals that childhood interpersonal traumatic exposure increases risk of CPTSD symptom development. [ABSTRACT FROM AUTHOR]

Background: Loneliness is a prevalent and urgent public health issue. Optimal planning of community approaches to loneliness requires a differentiated understanding of loneliness across the life span. We identified groups at high risk of loneliness by exploring the relationship between loneliness and socio-demographic and health-related factors across multiple age groups.Methods: This was a combined population-based questionnaire survey and register data study based on a representative sample, including 33,285 Danish individuals aged 16-102 years. Loneliness was measured using the Three-Item Loneliness Scale.Results: The relation between loneliness and age took a shallow U-shaped distribution. Ethnic minority status, receiving disability pensions or being unemployed, living alone, prolonged mental disorder, and psychiatric treatment were strongly associated with severe loneliness. Socio-demographic and health-related factors were associated with an increased risk of severe loneliness in specific age groups. Being female, having a low educational level and living in a deprived area were only associated with loneliness in adolescence/emerging adulthood. Receiving disability pensions and living alone (i.e., divorced), on the other hand, were strongly associated with loneliness in early and middle adulthood and young-old age.Conclusion: Ethnic minority status, living alone, and prolonged mental disorder may well be key factors in determining the generic level of loneliness in a given population. Other conditions are associated with an increased risk of severe loneliness in specific age groups and may moderate the age-loneliness relation. These findings may help to identify populations within communities at risk of loneliness and thereby support the implementation of policies and public health interventions across the life span. [ABSTRACT FROM AUTHOR]

Purpose: Traumatic events in adolescence rarely occur in isolation. Multiple traumatic experiences are prevalent, diverse and a well-established risk factor for mental health disorders. The aim of this study was to explore and explain the heterogeneity in trauma profiles in a nationally representative sample of US adolescents. Method: Using latent class analysis, data on 10,123 adolescents aged between 13 and 18 from the National Comorbidity Survey Adolescent Supplement were examined. In addition, the relationships between the emergent classes and demographic and clinical variables were explored. Results: A four-class solution was the best fit of adolescent trauma patterns, with classes labelled as low risk, sexual assault risk, non-sexual risk and high risk. When compared to the low risk class, those in the other classes were significantly more likely not to live with either biological parent, display symptoms indicative of mood and anxiety disorders, and to have higher rates of disorder comorbidity. Conclusions: This provides evidence of four distinct groups of adolescents who have experienced a variety of traumas. Evidence demonstrates the increased risk of adolescents with a history of trauma meeting the diagnostic criteria for not only individual disorders but also comorbidity across disorder categories. [ABSTRACT FROM AUTHOR]

Purpose: The COVID-19 pandemic has affected the way many individuals go about their daily lives. This study attempted to model the complexity of change in lifestyle quality as a result of the COVID-19 pandemic and its context within the UK adult population. Methods: Data from the COVID-19 Psychological Research Consortium Study (Wave 3, July 2020; N = 1166) were utilised. A measure of COVID-19-related lifestyle change captured how individuals' lifestyle quality had been altered as a consequence of the pandemic. Exploratory factor analysis and latent profile analysis were used to identify distinct lifestyle quality change subgroups, while multinomial logistic regression analysis was employed to describe class membership. Results: Five lifestyle dimensions, reflecting partner relationships, health, family and friend relations, personal and social activities, and work life, were identified by the EFA, and seven classes characterised by distinct patterns of change across these dimensions emerged from the LPA: (1) better overall (3.3%), (2) worse except partner relations (6.0%), (3) worse overall (2.5%), (4) better relationships (9.5%), (5) better except partner relations (4.3%), (6) no different (67.9%), and (7) worse partner relations only (6.5%). Predictor variables differentiated membership of classes. Notably, classes 3 and 7 were associated with poorer mental health (COVID-19 related PTSD and suicidal ideation). Conclusions: Four months into the pandemic, most individuals' lifestyle quality remained largely unaffected by the crisis. Concerningly however, a substantial minority (15%) experienced worsened lifestyles compared to before the pandemic. In particular, a pronounced deterioration in partner relations seemed to constitute the more severe pandemic-related lifestyle change. [ABSTRACT FROM AUTHOR]

Purpose: Recurring evidence seems to suggest that sexual trauma in childhood may moderate associations between cannabis consumption and psychosis. It has also been suggested, however, that poor childhood mental health may explain linkages between these phenomena. Methods: The current study, using data from the National Comorbidity Survey-Replication ( N = 2,355), sought to revaluate the stability of the childhood trauma-cannabis interaction while statistically controlling for pre-trauma psychotic experiences and psychopathology in childhood. Results: Psychotic experiences that occurred before childhood sexual trauma significantly influenced adult psychosis symptomatology (psychosis pre-rape B = 0.10; psychosis pre-sexual assault B = 0.23). Social phobia ( B = 0.07) also conferred risk for adult psychosis. Pre-trauma childhood psychopathology, however, did not account for the interaction between childhood sexual trauma and cannabis consumption in a multivariate model. Childhood experiences of rape ( B = 0.15) and an interaction between cannabis use and childhood sexual assault ( B = 0.05) independently contributed to adult psychosis. Cannabis use conferred no independent risk. Conclusions: With specific regard to research methodology, the current findings offer further justification for the inclusion of childhood sexual trauma in analyses investigating associations between cannabis use and psychosis. [ABSTRACT FROM AUTHOR]

Purpose: Emerging evidence suggests that ICD-11 CPTSD is a more common condition than PTSD in treatment seeking samples although no study has explored risk factors and comorbidities of PTSD and CPTSD in veteran populations. In this study, risk factors and comorbidity between veterans meeting criteria for PTSD or CPTSD using the ICD-11 International Trauma Questionnaire (ITQ) were explored.Methods: A sample of help-seeking veterans who had been diagnosed with a mental health difficulty (n = 177) was recruited. Participants completed a range of mental health and functioning measures. Multinomial logistic regression analysis was conducted to explore differences in the above factors between participants meeting case criteria for PTSD, CPTSD or another mental health disorder.Results: Those with CPTSD appeared to have taken longer to seek help, reported higher rates of childhood adversity and more experiences of emotional or physical bullying during their military careers. Further, participants with CPTSD reported a greater burden of comorbid mental health difficulties including high levels of dissociation, anger, difficulties related to moral injury and common mental health difficulties and greater degree of impairment including social isolation, sleep difficulties and impaired functioning.Conclusions: Considering that CPTSD is a more debilitating condition than PTSD, there is now an urgent need to test the effectiveness of new and existing interventions in veterans with CPTSD. [ABSTRACT FROM AUTHOR]

Purpose: This study represents the first assessment of the prevalence of trauma exposure, and Posttraumatic Stress Disorder (PTSD) and Complex PTSD (CPTSD), ever conducted in the general population of the Republic of Ireland. Additionally, prevalence of past-year mental health service use, comorbidity with major depression and generalized anxiety, and risk factors associated with PTSD and CPTSD were assessed. Methods: A nationally representative sample of non-institutionalized Irish adults (N = 1020) completed self-report measures of trauma history, trauma-related psychopathology, mental health service use, and concurrent mental health problems. Results: Lifetime exposure to one or more traumatic events was 82.3%, and 67.8% reported experiencing two or more traumatic events. Males and females significantly differed in their frequency of exposure to eight of 16 traumatic events. The past-month prevalence for PTSD was 5.0% (95% CI 3.7%, 6.3%) and 7.7% (95% CI 6.1%, 9.4%) for CPTSD. Of those who screened positive for PTSD or CPTSD, 48.6% accessed mental health care in the past year. Comorbidity with major depression and generalized anxiety was high, especially among those with CPTSD. Several unique and shared risk factors for PTSD and CPTSD were identified. Conclusion: Approximately one-in-eight Irish adults met diagnostic requirements for PTSD or CPTSD, and comorbidity with other disorders was high. History of interpersonal trauma and exposure to multiple types of trauma in different developmental periods were associated with CPTSD. Many individuals did not access mental health care revealing a substantial mental health treatment gap. [ABSTRACT FROM AUTHOR]