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Objective: The Traumatic Grief Inventory‐Self Report Plus (TGI‐SR+) measures the most recent prolonged grief disorder (PGD) symptom sets defined in the 11th edition of the International Statistical of Diseases and Related Health Problems (ICD‐11) and the text revision of the fifth edition of the Diagnostical and Statistical Manual of Mental Disorders (DSM‐5‐TR). However, the TGI‐SR+ has not yet been translated and validated in Chinese. This study aims to evaluate the psychometric properties of the Chinese translation of the TGI‐SR+. Methods: We examined the Chinese TGI‐SR+'s factor structure, internal consistency, convergent validity, discriminant validity, known‐groups validity, and optimal clinical cut‐off scores in 443 Chinese bereaved adults. Results: Confirmatory factor analyses showed that the two‐factor models showed the best fit for the Chinese TGI‐SR+ items assessing ICD‐11 and DSM‐5‐TR prolonged grief symptoms. Items assessing ICD‐11 and DSM‐5‐TR prolonged grief symptoms demonstrated good internal consistency. Associations of TGI‐SR+ scores with symptom levels of prolonged grief (assessed by the International Prolonged Grief Disorder Scale), posttraumatic stress, anxiety, and depression supported convergent and discriminant validity. Associations with background/loss‐related variables provided evidence for known‐groups validity. Cut‐off points for probable ICD‐11 PGD (liberal scoring rule), probable ICD‐11 PGD (conservative scoring rule), and probable DSM‐5‐TR PGD were ≥67, ≥75, and ≥68, respectively. Discussion: The Chinese TGI‐SR+ appears to be a reliable and valid measure to assess prolonged grief symptoms per ICD‐11 and DSM‐5‐TR among Chinese bereaved adults. [ABSTRACT FROM AUTHOR]

Most studies examining prolonged grief disorder (PGD) in people bereaved during the COVID‐19 pandemic are focused on psychopathology. However, mental health encompasses both absence of psychopathology and presence of well‐being. This is the first study examining symptom profiles of early PGD and subjective mental well‐being in 266 Dutch adults recently bereaved during the pandemic. Early PGD and well‐being indicators were assessed with the Traumatic Grief Inventory–Self Report Plus and the World Health Organization–Five Well‐Being Index, respectively. Latent class analysis identified four classes: low PGD/high well‐being (32%), low PGD/moderate well‐being (24%), moderate PGD/high well‐being (23%) and high PGD/low well‐being class (21%). People in the poorer mental health classes were more likely to be female, lower educated, suffering from a mental disorder, have a poor health status, closer kinship to the deceased, and higher risk of severe COVID‐19. Classifying adults according to symptom profiles of negative and positive outcomes provides a more complete picture of mental health in bereaved people and offers potential intervention targets. [ABSTRACT FROM AUTHOR]

Road traffic accidents (RTAs) are among the most frequent negative life‐events. About one in five RTA survivors is susceptible to posttraumatic stress disorder (PTSD). Knowledge about needs for, and usage of, mental health services (MHSs) may improve options for care for RTA victims. The current study aimed to assess rates of victims using different MHSs, including psychotherapy, pharmacotherapy and support groups, and to explore correlates of needs for and use of these MHSs. Further, we aimed to estimate the treatment gap in post‐RTA care, defined as including people with probable PTSD who did not use MHSs and people wanting but not getting help from MHSs. Dutch victims of nonlethal RTAs (N = 259) completed self‐report measures on needs for and use of MHSs and PTSD. Results showed that 26% of participants had utilized care from psychotherapy, pharmacotherapy or support groups. Among people with probable PTSD, this was 56%. Increased posttraumatic stress was the strongest correlate of MHS use. Forty‐eight participants (17.8%) had an unmet care need and represented the treatment gap. Commonly reported reasons and barriers preventing MHS use were perceptions that problems were limited or would disappear without care and financial worries. Regarding possible future care, participants reported a preference for face‐to‐face (over online) help from a psychologist (over other professionals). The treatment gap for Dutch RTA victims may be limited. However, a significant number of RTA victims need care but do not obtain this care. Care options may be improved by reducing practical barriers to MHSs and increasing mental health literacy and acceptability of different forms of care (besides face‐to‐face care). [ABSTRACT FROM AUTHOR]

The International Classification of Diseases Eleventh Edition (ICD‐11), and the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM‐5‐TR), now include prolonged grief disorder (PGD). Since criteria for PGD in both classification systems differ from prior proposed grief disorders and each other, the validation of a single instrument to screen for prolonged grief (PG) symptoms of both new diagnoses is critical for bereavement research and care. Therefore, we evaluated the psychometric properties of the Swedish version of the Traumatic Grief Inventory Self‐Report Plus (TGI‐SR+). Two‐hundred and forty‐eight bereaved parents completed questions about sociodemographic and loss‐related variables, the TGI‐SR+, and symptom measures of post‐traumatic stress (PTS), depression and an older measure of PG symptoms, the Prolonged Grief Disorder‐13 (PG‐13). Confirmatory factor analyses showed that a one‐factor model best fit DSM‐5‐TR and ICD‐11 PG symptoms and the analyses of the internal consistency and inter‐item correlations showed that these symptoms could be reliably assessed. In support of convergent validity, DSM‐5‐TR and ICD‐11 PG symptoms correlated with symptoms of PTS, depression and PG assessed with the PG‐13. In support of known‐groups validity, DSM‐5‐TR and ICD‐11 PG symptoms were higher among lower educated (vs. higher educated) participants and related negatively to time since loss. ROC analyses showed optimal cut‐off score of ≥71 and ≥72 to determine probable caseness for DSM‐5‐TR and ICD‐11 PGD, respectively. Results support the reliability and validity of the Swedish TGI‐SR+ as a screening instrument for PG in research and bereavement care. [ABSTRACT FROM AUTHOR]

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Copyright of European Journal of Psychotraumatology is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of European Journal of Psychotraumatology is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

It is crucial to optimize global mental health research to address the high burden of mental health challenges and mental illness for individuals and societies. Data sharing and reuse have demonstrated value for advancing science and accelerating knowledge development. The FAIR (Findable, Accessible, Interoperable, and Reusable) Guiding Principles for scientific data provide a framework to improve the transparency, efficiency, and impact of research. In this review, we describe ethical and equity considerations in data sharing and reuse, delineate the FAIR principles as they apply to mental health research, and consider the current state of FAIR data practices in global mental health research, identifying challenges and opportunities. We describe noteworthy examples of collaborative efforts, often across disciplinary and national boundaries, to improve Findability and Accessibility of global mental health data, as well as efforts to create integrated data resources and tools that improve Interoperability and Reusability. Based on this review, we suggest a vision for the future of FAIR global mental health research and suggest practical steps for researchers with regard to study planning, data preservation and indexing, machine-actionable metadata, data reuse to advance science and improve equity, metrics and recognition. [ABSTRACT FROM AUTHOR]

More recently, the prolonged grief disorder (PGD) has been recognized as a mental health disorder following bereavement, which is distinct from depression and PTSD. However, the number and proposed symptom items vary across the ICD‐11 and the DSM‐5‐TR criteria for PG. The Traumatic Grief Inventory‐Self Report Plus (TGI‐SR+), which is an updated version of the TGI‐SR, is currently the only robust instrument that assesses PG according to the ICD‐11 and DSM‐5‐TR criteria. For research and clinical use among French‐speaking countries, the forward‐backward procedure was applied to translate the TGI‐SR+ into French language. Exploratory factor analysis and parallel analysis converged towards a two‐dimensional structure for the TGI‐SR+, representing adaptation difficulties and traumatic separation distress. However, items mapping onto ICD‐11 and DSM‐5‐TR criteria for PG represented a one‐dimensional structure. Findings based on item response theory method provided strong evidence for discriminative characteristics of the items. The internal reliability was excellent for the TGI‐SR+ (McDonald's ω = 0.97) and ICD‐11 and DSM‐5‐TR criteria for PGD (McDonald's ω = 0.95). We also demonstrated a very high temporal stability for the TGI‐SR+ total score (ICC =.91, p < 0.0001) and ICD‐11 PGD and DSM‐5‐TR PGD (ICC = 0.90, and ICC = 0.88, ps < 0.0001, respectively). The concurrent validity of the instrument was also demonstrated, such that the TGI‐SR+ total score and all combinations were positively and significantly associated with the levels of depression, anxiety and post‐traumatic stress symptoms. However, the effect sizes were moderate. We conclude that for research and clinical use among French bereaved populations, the TGI‐SR+ is a sound tool with very good psychometric properties. [ABSTRACT FROM AUTHOR]

Non-fatal traffic accidents may give rise to mental health problems, including posttraumatic stress (PTS) and depression. Clinical evidence suggests that victims may also experience grief reactions associated with the sudden changes and losses caused by such accidents. The aim of this study was to examine whether there are unique patterns of symptoms of PTS, depression, and grief among victims of non-fatal traffic accidents. We also investigated associations of emerging symptom patterns with sociodemographic variables and characteristics of the accident, and with transdiagnostic variables, including self-efficacy, difficulties in emotion regulation, and trauma rumination. Participants (N = 328, Mage = 32.6, SDage = 17.5 years, 66% female) completed self-report measures tapping the study variables. Using latent class analysis (including symptoms of PTS, depression, and grief), three classes were identified: a no symptoms class (Class 1; 59.1%), a moderate PTS and grief class (Class 2; 23.1%), and a severe symptoms class (Class 3; 17.7%). Summed symptom scores and functional impairment were lowest in Class 1, higher in Class 2, and highest in Class 3. Psychological variables were similarly ordered with the healthiest scores in Class 1, poorer scores in Class 2, and the worst scores in Class 3. Different sociodemographic and accident related variables differentiated between classes, including age, education, and time since the accident. In a regression including all significant univariate predictors, trauma rumination differentiated Class 2 from Class 1, all three psychological variables differentiated Class 3 from Class 1, and difficulties with emotion regulation and trauma rumination differentiated Class 3 from Class 2. This study demonstrates that most people respond resiliently to non-fatal traffic accident. Yet, approximately one in three victims experiences moderate to severe mental health symptoms. Increasing PTS coincided with similarly increasing grief, indicating that grief may be considered in interventions for victims of traffic accidents. Trauma rumination strongly predicted class membership and appears a critical treatment target to alleviate distress. [ABSTRACT FROM AUTHOR]

Copyright of European Journal of Psychotraumatology is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Worldwide, health care professionals are facing unprecedented stress levels due to the continuing COVID-19 pandemic. A rapid systematic review of peer-reviewed studies examining psychological symptoms in HCW working during COVID-19 pandemic in early 2020. 13,999 participants were included. After 3,408 studies were screened for inclusion, 10 were included in the final analysis. About half of HCW presented with possible PTSD (i.e., scored above a clinical cutoff). An update of the search should be conducted. These initial studies suggest a high rate of possible PTSD diagnosis in frontline HCW. [ABSTRACT FROM AUTHOR]

Five diagnostic criteria sets for pathological grief are currently used in research. Studies evaluating their performance indicate that it is not justified to generalise findings regarding prevalence rates and predictive validity across studies using different diagnostic criteria of pathological grief. We provide recommendations to move the bereavement field forward. [ABSTRACT FROM AUTHOR]

People bereaved through road traffic accidents (RTAs) are at risk for severe and disabling grief (i.e., pathological grief). Knowledge about needs and use of bereavement care, including psychotherapy, pharmacotherapy, and support groups, is limited. This study charted (correlates of) the needs and use of bereavement care in RTA bereaved people. Furthermore, although online grief treatment seems effective, it is unknown whether it is perceived as acceptable. Accordingly, we examined the acceptability of online treatment. Dutch RTA bereaved adults (N = 273) completed self‐report measures about needs and use of bereavement care, acceptability of online grief treatment, and pathological grief. Regression analyses were used to identify correlates of care needs and use and acceptability of online treatment. The majority (63%) had received help from psychotherapy, pharmacotherapy, and/or support groups. One in five participants had not used bereavement care services, despite reporting elevated pathological grief levels and/or expressing a need for care, pointing to a treatment gap. Use of psychological support before the loss was the strongest predictor of bereavement care needs and use following the loss. A minority (35%) reported being inclined to use online grief treatment if in need of support. More openness towards online services was related to greater acceptability of online treatment. In conclusion, 20% of RTA bereaved people with pathological grief or care needs had not received care. This treatment gap may be reduced by improving accessibility of online treatments. However, as only 35% was open to using online treatments, increasing the acceptability of (online) treatments appears important. [ABSTRACT FROM AUTHOR]

Cognitive behavior therapy (CBT) interventions are effective in alleviating disturbed grief. CBT is typically delivered face-to-face. Government policy during the coronavirus (COVID-19) pandemic (quarantine and social distancing) may impede access to face-to-face therapy. Psychotherapy is now widely delivered remotely. In this article, various points of attention related to the application of CBT for disturbed grief using telephone or videoconferencing (or video calling) services are discussed. Additionally, we explore possible ways in which individual risk factors and stressors connected with COVID-19 can be addressed in treatment. Remote treatment brings challenges but also opportunities to help people in shifting from unhealthy to healthy grieving. [ABSTRACT FROM AUTHOR]

Objective(s): Yearning, a hallmark of grief disorders, relates to rumination and potentially to cognitive avoidance. We developed an 8‐item short form of the only existing validated yearning measure, the Yearning in Situations of Loss Scale (YSL), to improve its validity and administration ease. Method: Cross‐sectional surveys were conducted among bereaved Dutch (N = 313) and German (N = 235) community samples and an American treatment‐seeking sample (N = 95). All samples completed the YSL, and community samples additionally measures of rumination, loss‐related avoidance, complicated grief (CG), and depression. Results: A one‐factor model provided a good fit to the YSL Short Form (YSL‐SF) in the community samples. A two‐factor structure (cognitive and emotional yearning)best fitted the YSL‐SF in the treatment‐seeking sample. YSL‐SF scores correlated positively with rumination, loss‐related avoidance, and with CG symptoms whilst controlling for rumination and loss‐related avoidance. Conclusion: The YSL‐SF appears an easy‐to‐administer and valid measure of yearning after bereavement. [ABSTRACT FROM AUTHOR]

Background: Previous latent trajectory studies in adult bereaved people have identified individual differences in reactions postloss. However, prior findings may not reflect the complete picture of distress postloss, because they were focused on depression symptoms following nonviolent death. We examined trajectories of symptom-levels of persistent complex bereavement disorder (PCBD), depression, and posttraumatic stress disorder (PTSD) in a disaster-bereaved sample. We also investigated associations among these trajectories and background and loss-related factors, psychological support, and previous mental health complaints.Methods: Latent class growth modeling was used to identify distinct trajectories of PCBD, depression, and PTSD symptoms in people who lost loved ones in a plane disaster in 2014. Participants (N = 172) completed questionnaires for PCBD, depression, and PTSD at 11, 22, 31, and 42 months postdisaster. Associations among class membership and background and loss-related variables, psychological support, and previous mental health complaints were examined using logistic regression analyses.Results: Two PCBD classes emerged: mild (81.8%) and chronic (18.2%) PCBD. For both depression and PTSD, three classes emerged: mild (85.6% and 85.2%), recovered (8.2% and 4.4%), and chronic trajectory (6.2% and 10.3%). People assigned to the chronic PCBD, depression, or PTSD class were less highly educated than people assigned to the mild/recovered classes.Conclusions: This is the first latent trajectory study that offers insights in individual differences in longitudinal symptom profiles of PCBD, depression, and PTSD in bereaved people. We found support for differential trajectories and predictors across the outcomes. [ABSTRACT FROM AUTHOR]

Background: After a potentially traumatic event (PTE), children often show symptoms of acute stress disorder (ASD), which may evolve into posttraumatic stress (PTS) disorder. A growing body of literature has employed latent class analysis (LCA) to disentangle the complex structure underlying PTS symptomatology, distinguishing between homogeneous subgroups based on PTS presentations. So far, little is known about subgroups or classes of ASD reactions in trauma-exposed children. Objective: Our study aimed to identify latent classes of ASD symptoms in children exposed to a single-incident PTE and to identify predictors of class membership (gender, age, cultural background, parental education, trauma type, and trauma history). Method: A sample of 2287 children and adolescents (5–18 years) was derived from the Prospective studies of Acute Child Trauma and Recovery (PACT/R) Data Archive, an international archive including studies from the USA, UK, Australia, and Switzerland. LCA was used to determine distinct subgroups based on ASD symptoms. Predictors of class membership were examined using a three-step approach. Results: Our LCA yielded a three-class solution: low (42%), intermediate (43%) and high (15%) ASD symptom severity that differed in terms of impairment and number of endorsed ASD symptoms. Compared to the low symptoms class, children in the intermediate or high severity class were more likely to be of female gender, be younger of age, have parents who had not completed secondary education, and be exposed to a road traffic accident or interpersonal violence (vs. an unintentional injury). Conclusions: These findings provide new information on children at risk for ASD after single-incident trauma, based on a unique set of international data. Classifying children based on latent symptom profiles helps to identify target groups for prevention and intervention after exposure to a PTE. [ABSTRACT FROM AUTHOR]

Although the heterogeneity of posttraumatic stress (PTS) symptoms has been well-documented in various traumatized samples, no study has investigated the heterogeneity of Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, PTS symptomatology in samples exclusively composed of bereaved people. We examined what classes could be distinguished based on the endorsement of self-rated Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, PTS symptoms in a sample of 509 bereaved people confronted with losses due to a variety of causes and a sample of 331 homicidally bereaved people. Associations between class membership and sociodemographic and loss-related variables were also examined. On the basis of latent class analyses, conducted in both samples separately, we identified three PTS classes: a No disturbance, Intermediate disturbance, and Pervasive disturbance class, characterized by low, moderate, and high probability of endorsement of PTS symptoms, respectively. In both samples, the largest class was characterized by participants who endorsed intermediate PTS symptom levels. As expected, being a woman, more closely related to the deceased person, more recently bereaved, and (in the sample of 509 bereaved people) confronted with unexpected loss were related to classes with more PTS disturbances. There is evidence that intermediate PTS levels are associated with negative outcomes. Because this seems to be a relative large group in the current study, it is useful to further our knowledge about variables underlying and maintaining subclinical PTS levels. [ABSTRACT FROM AUTHOR]

The Traumatic Grief Inventory Self-Report version (TGI-SR) is an 18-item self-report measure. It was designed to assess symptoms of Persistent Complex Bereavement Disorder (PCBD) included in Diagnostic and Statistical Manual of Mental Disorders (DSM)-5 and Prolonged Grief Disorder (PGD) proposed by an international group of experts in grief. The research in this article used data from a bereaved patient sample and people who lost loved ones in the Ukrainian airplane crash in July 2014. Findings indicated that the TGI-SR is a reliable and valid tool to assess disturbed grief in research and to identify people needing a more comprehensive assessment of their grief in clinical settings. [ABSTRACT FROM AUTHOR]

Background and Objectives: Major negative life-events including bereavement can precipitate perceived positive life-changes, termed posttraumatic growth (PTG). While traditionally considered an adaptive phenomenon, it has been suggested that PTG represents a maladaptive coping response similar to cognitive avoidance. To clarify the function of PTG, it is crucial to establish concurrent and longitudinal associations of PTG with post-event mental health problems. Yet, longitudinal studies on this topic are scarce. The present study fills this gap in knowledge.Design: A two-wave longitudinal survey was conducted.Methods: Four-hundred and twelve bereaved adults (87.6% women) filled out scales assessing PTG and symptoms of depression, anxiety, prolonged grief, and posttraumatic stress at baseline and 6 months later.Results: The baseline concurrent relationships between all symptom levels and PTG were curvilinear (inverted U-shape). Cross-lagged analyses demonstrated that symptom levels did not predict levels of PTG 6 months later, or vice versa.Conclusions: Findings suggest PTG after loss has no substantive negative or positive effects on mental health. Development of specific treatments to increase PTG after bereavement therefore appears premature. [ABSTRACT FROM AUTHOR]

Background: Studies on mental health following disasters have primarily focused on post-traumatic stress disorder (PTSD), yet severe, enduring, and disabling grief [i.e. complicated grief (CG)] also appears relevant. Objective: The present study examines symptom profiles of PTSD and CG among bereaved Sichuan earthquake survivors 1 year after the disaster. Method: Self-report measures of demographic, disaster, and loss-related characteristics and symptoms of PTSD and CG were administered among 803 survivors (63% women; mean age = 46.7 years). Latent class analysis (LCA) was performed to identify subgroups of people with different PTSD and CG symptom profiles. Results: The LCA demonstrated that a five-class solution yielded the best fit, consisting of a CG class with low PTSD and high CG (N = 208), a combined class with high PTSD and high CG (N = 205), a class with low PTSD and partial CG (N = 145), a class with partial PTSD and CG (N = 136), and a resilient class with low PTSD and CG (N = 108). Being a woman (vs man), losing a child or spouse (vs other), being injured (vs non-injured), and/or having a missing family member (vs non-missing) predicted membership of the CG class compared to other classes. Conclusions: CG appears to be a unique consequence of disasters involving many casualties. Disaster survivors should be screened for CG and provided with appropriate psychological treatment. [ABSTRACT FROM AUTHOR]

Twenty-three nonclinical relatives of long-term missing persons were interviewed. Patterns of functioning over time were studied retrospectively by instructing participants to draw a graph that best described their pattern. Patterns most frequently drawn were a recovery and resilient/stable pattern. Participants were also asked to select 5 out of 15 cards referring to coping strategies, which they considered most helpful in dealing with the disappearance. Acceptance, emotional social support, mental disengagement, and venting emotions were most frequently chosen. This study provided some indication of coping strategies that could be strengthened in treatment for those in need of support. [ABSTRACT FROM AUTHOR]

Intolerance of Uncertainty (IU) is a transdiagnostic vulnerability factor involved in depression and anxiety symptoms and disorders. IU encompasses Prospective IU (“Unforeseen events upset me greatly”) and Inhibitory IU (“The smallest doubt can stop me from acting”). Research has yet to explore whether subgroups or classes of people exist characterized by different profiles of IU. This study used latent class analysis to identify such subgroups and examined if different classes of IU were distinct in terms of several cognitive vulnerabilities and psychological symptoms. Data were obtained from 519 students completing a 12‐item measure of IU. Four subgroups were identified, characterized by low IU, predominantly Prospective IU, predominantly Inhibitory IU, and high IU, respectively. People in the high IU class reported cognitive vulnerabilities and depression and anxiety more than people in the low IU class. Inhibitory IU was more strongly associated with poor outcomes than was Prospective IU. [ABSTRACT FROM AUTHOR]

Research has shown that the amount of media exposure is associated with post‐event mental health problems. Whether bereaved individuals have negative experiences with media reports and whether they are associated with post‐event mental health is unclear. This study evaluated these experiences and associations following the MH17‐disaster. How media reports were experienced (nine topics, modified MAS), depression symptoms (QIDS‐SR), functional problems (WSAS) and event‐related coping‐self‐efficacy (CSE) were assessed about one year post‐disaster (May‐August 2015) among Dutch bereaved (N = 152). A substantial minority reported negative experiences such as reports made me angry (30%) and made me sad (48%). Latent profile analysis with symptoms, problems and coping self‐efficacy as indicators, identified four classes of post‐disaster mental health: a Well‐functioning(class 1), 35.1%; a Mild‐problems(class 2), 30.4%; a Sub‐clinical(class 3), 27.0%; and a Clinical(class 4), 7.4%. Differences in symptoms, problems and coping self‐efficacy levels between classes were large according to Cohen's ds. Multivariate logistic regression (MLR) showed that the Clinical(class 4) compared to the Well‐functioning(class 1), more often that felt that reports strongly “embarrassed me,” “made me feel sad,” “filled me with fear” and “served as a magnifying glass.” Future research should assess opportunities and effects of limiting media consumption. [ABSTRACT FROM AUTHOR]

Adaptive regulation of positive and negative affect after the loss of a loved one may foster recovery. In two studies, using similar methods but different samples, we explored the association between positive (i.e., dampening and enhancing) and negative (i.e., rumination) affect regulation strategies and symptoms levels of postloss psychopathology. Study 1 used data from 187 people confronted with the death of a loved one. In study 2, the sample consisted of 134 relatives of long-term missing persons. Participants completed self-reports tapping prolonged grief, depression, posttraumatic stress symptoms, and affect regulation strategies. Hierarchical regression analyses showed that both negative and positive affect regulation strategies explained significant amounts of variance symptom levels in both samples. In line with previous work, our results suggest that negative and positive affect regulation strategies relate to postloss psychopathology. Future research should explore how both affect regulation strategies may adequately be addressed in treatment. [ABSTRACT FROM AUTHOR]

Background: Health-related quality of life (HRQoL) is widely used as an outcome measure in the evaluation of treatment interventions in patients with chronic obstructive pulmonary disease (COPD). In order to address challenges associated with existing fixed-length measures (e.g., too long to be used routinely, too short to ensure both content validity and reliability), a COPD-specific item bank (COPD-SIB) was developed.Methods: Items were selected based on literature review and interviews with Dutch COPD patients, with a strong focus on both content validity and item comprehension. The psychometric quality of the item bank was evaluated using Mokken Scale Analysis and parametric Item Response Theory, using data of 666 COPD patients.Results: The final item bank contains 46 items that form a strong scale, tapping into eight important themes that were identified based on literature review and patient interviews: Coping with disease/symptoms, adaptability; Autonomy; Anxiety about the course/end-state of the disease, hopelessness; Positive psychological functioning; Situations triggering or enhancing breathing problems; Symptoms; Activity; Impact.Conclusions: The 46-item COPD-SIB has good psychometric properties and content validity. Items are available in Dutch and English. The COPD-SIB can be used as a stand-alone instrument, or to inform computerised adaptive testing. [ABSTRACT FROM AUTHOR]

Background Numerous instruments are available to measure HRQoL in patients with COPD, covering a wide array of domains ranging from symptoms such as dyspnea, cough and wheezing, to social and emotional functioning. Currently no information or guide is available yet to aid the selection of domains for a particular study or disease population. The aim of this paper is to identify which domains of health-related quality of life (HRQoL) are most important with respect to Chronic Obstructive Pulmonary Disease (COPD), from the patient perspective. Methods Twenty-one Dutch patients with Chronic Obstructive Pulmonary Disease (COPD) were asked to describe important domains impacted by COPD freely; second, they were presented with cues (domains from the Patient-Reported Outcomes Measurement Information System (PROMIS) framework) and were asked to select the domains that were most relevant to them. During the interview, the patients were asked to indicate in which way the selected domains impact their lives. Both the answers to the open question, and the patient statements motivating nomination of PROMIS domains were coded into themes. Results The most relevant (sub)domains of HRQoL for patients with COPD were: physical health (fatigue, physical functioning), social health (instrumental support, ability to participate in social roles and activities, companionship, and emotional support), and coping with COPD. Conclusion We identified which domains of HRQoL are most important to patients with COPD. One of these (coping with COPD) is not explicitly covered by PROMIS, or by traditional questionnaires that are used to measure HRQoL in COPD. [ABSTRACT FROM AUTHOR]

Background: The disappearance of a loved one is a unique type of loss, also termed 'ambiguous loss', which may heighten the risk for developing prolonged grief (PG), depression, and posttraumatic stress (PTS) symptoms. Little is known about protective and risk factors for psychopathology among relatives of missing persons. A potential protective factor is self-compassion, referring to openness toward and acceptance of one's own pain, failures, and inadequacies. One could reason that self-compassion is associated with lower levels of emotional distress following ambiguous loss, because it might serve as a buffer for getting entangled in ruminative thinking about the causes and consequences of the disappearance ('grief rumination'). Objective: In a sample of relatives of missing persons we aimed to examine (1) the prediction that greater self-compassion is related to lower symptom-levels of PG, depression, and PTS and (2) to what extent these associations are mediated by grief rumination. Method: Dutch and Belgian relatives of long-term missing persons (N = 137) completed self-report measures tapping self-compassion, grief rumination, PG, depression, and PTS. Mediation analyses were conducted. Results: Self-compassion was significantly, negatively, and moderately associated with PG, depression, and PTS levels. Grief rumination significantly mediated the associations of higher levels of self-compassion with lower levels of PG (a*b = −0.11), depression (a*b = −0.07), and PTS (a*b = −0.11). Specifically, 50%, 32%, and 32% of the effect of self-compassion on PG, depression, and PTS levels, respectively, was accounted for by grief rumination. Conclusions: Findings suggest that people with more self-compassion experience less severe psychopathology, in part because these people are less strongly inclined to engage in ruminative thinking related to the disappearance. Strengthening a self-compassionate attitude using, for instance, mindfulness-based interventions may therefore be a useful intervention to reduce emotional distress associated with the disappearance of a loved one. [ABSTRACT FROM AUTHOR]

Background: Confrontation with a traumatic (e.g. disaster-related) loss is a risk factor for the development of psychopathology, including symptoms of prolonged grief (PG), posttraumatic stress (PTS), and depression. Although interventions have been developed for reducing post-loss psychopathology, more research into the effectiveness of treatment is needed to improve care for bereaved persons. Cognitive therapy (CT) and eye movement desensitization and reprocessing (EMDR) have been shown to be effective in trauma-exposed populations. We hypothesize that CT and EMDR are also effective in reducing symptoms among people exposed to traumatic loss. Objective: In this article we describe the rationale of a randomized controlled trial (RCT) to examine (1) treatment effects of CT and EMDR for reducing PG, PTS, and depression among traumatically bereaved people, and (2) the associations between improvements in PG, PTS, and depression symptoms on the one hand and tentative mechanisms of change, including a sense of unrealness, negative cognitions, avoidance behaviour, and intrusive memories, on the other hand. Method: A two-armed (intervention versus waiting list controls) RCT will be conducted. Participants will be asked to fill in questionnaires prior to treatment, during treatment, and one, 12, and 24 weeks post-treatment. Potential participants are people who have lost one or multiple significant other(s) in the Ukrainian plane disaster in 2014 with clinically significant levels of self-rated PG, PTS, and/or depression. Multiple regression, including analysis of covariance, and multilevel regression analyses will be used. Discussion: There is a need for treatment for psychopathology following traumatic loss. Strengths of this study are the development of a treatment that targets grief and trauma-related complaints and the examination of potential mechanisms of change in CT and EMDR. Bereaved people, clinicians, and researchers could benefit from the results of this study. Planteamiento: Confrontar una pérdida traumática (p.ej., una pérdida relacionada con un desastre) es un factor de riesgo para el desarrollo de una psicopatología, tal como síntomas de duelo prolongado (DP), estrés postraumático (EPT) y depresión. Aunque se han desarrollado intervenciones para reducir la psicopatología post-pérdida, se necesita más investigación sobre la eficacia del tratamiento para mejorar la atención a las personas en duelo. Se ha demostrado que la terapia cognitiva (TC) y la desensibilización y reprocesamiento por movimientos oculares (EMDR) son efectivas en poblaciones expuestas a trauma. La hipótesis plantea que la TC y EMDR también son eficaces en la reducción de síntomas en personas expuestas a una pérdida traumática. Objetivo: En este artículo se describe la justificación de usar de un ensayo controlado aleatorio (ECA) para examinar: a) los efectos del tratamiento de la TC y EMDR para reducir el DP, el EPT y la depresión en personas con un duelo traumático y b) las asociaciones entre las mejorías del DP y los síntomas de depresión, por un lado, y los mecanismos tentativos de cambio, que incluyen una sensación de irrealidad, cogniciones negativas, comportamiento de evitación y recuerdos intrusivos, por otro lado. Método: Se llevará a cabo un ECA de dos brazos (intervención frente a lista de espera). Se les pedirá a los participantes que rellenen cuestionarios antes del tratamiento, durante el tratamiento, y una, 12 y 24 semanas después del tratamiento. Los participantes potenciales son personas que han perdido uno o varios seres queridos en el desastre aéreo ucraniano en 2014 con niveles clínicamente significativos de auto-puntuaciones de DP, EPT y/o depresión. Se usará una regresión múltiple, que incluye un análisis de covarianza, y un análisis de regresión multinivel. Discusión: Existe necesidad de tratamiento para la psicopatología después de una pérdida traumática. Los puntos fuertes de este estudio son el desarrollo de un tratamiento que se centra en el duelo y las quejas relacionadas con el trauma, y el examen de los posibles mecanismos de cambio en TC y EMDR. Las personas en duelo, los clínicos y los investigadores podrían beneficiarse de los resultados de este estudio. 背景：遭遇创伤性丧失（如灾难相关的丧失）是精神病理发展的风险因素，包括延长哀伤（PG）症状、创伤后应激（PTS）和抑郁。尽管已经有减少丧失后精神病理的干预方法，还需要更多关于治疗效果的研究来改善对丧亲者的关怀。已经发现认知疗法（CT）和眼动脱敏与再加工（EMDR）对创伤暴露人群的效果。我们假设CT和EMDR在减少暴露于创伤性丧失者症状上也同样有效。 目标：在本文中我们描述了一个随机对照试验（RCT）的原理用来探究：a）CT和EMDR在创伤性丧亲群体中减轻PG、PTS和抑郁的治疗效果；b）PG、PTS和抑郁症状改进和潜在改变机制（包括非真实感、负性认知、回避行为和闯入记忆）的关联。 方法：进行一个双组设计（干预vs等待控制组）RCT。被试会被要求在治疗前、治疗中、治疗后的1、12、24周填写问卷。潜在被试在2014年乌克兰空难中失去1个或者多个重要他人，并在自评PG、PTS和/或抑郁上达到临床显著水平。使用多重回归包括协方差分析，和多水平回归分析进行统计。 讨论：在创伤丧失后需要进行心理病理治疗。本研究的优势在于发展一种针对哀痛和创伤相关的主诉的治疗方法，并探究CT和EMDR变化的潜在机制。丧亲者、临床工作者和研究人员都可以从本研究结果中获益。 [ABSTRACT FROM AUTHOR]

Background: Hundreds of individuals lost one or more significant others in the MH17 plane crash in 2014 in Ukraine. The current study is the first to explore subgroups of disaster-bereaved individuals based on presence of psychopathology clusters. This may inform the development of diagnostic instruments and tailored interventions. Objective: Aims of the current study were to examine (1) subgroups based on presence of prolonged grief disorder (PGD), major depressive disorder (MDD), and posttraumatic stress disorder (PTSD) symptom clusters and (2) associations between class membership, disaster-related variables (i.e. experiencing multiple losses, conducting multiple burials for the same deceased, and time to confirmation of death), and a sense of unrealness. Method: Self-rated PGD (10 items of the Traumatic Grief Inventory represented in two symptom clusters), MDD (16-item Quick Inventory Of Depressive Symptomatology represented in one symptom cluster), and PTSD (20-item PTSD Checklist for DSM-5 represented in four symptom clusters) from 167 participants were subjected to latent class analysis to identify subgroups (i.e. classes). Correlates of class membership were assessed using the three-step approach. Results: A three-class solution yielded the best model fit. Class 1 (Resilient class; 20.0%) was predominantly characterized by low probability of PGD, MDD, and PTSD symptom clusters, class 2 (PGD class; 41.8%) by moderate to high probability of presence of PGD, and class 3 (Combined class; 38.2%) by moderate to high probability of presence of PGD, MDD, and PTSD symptom clusters. Compared with the Resilient class, a sense of unrealness was more likely to be experienced by individuals in the PGD class and the Combined class. Conclusions: Our results indicate that subgroups of disaster-bereaved individuals can be distinguished based on the presence of PGD, MDD, and PTSD symptom clusters. A sense of unrealness was the strongest distinguishing feature of the subgroups. [ABSTRACT FROM AUTHOR]

Objective: A prior study with people exposed to a traumatic event indicated that posttraumatic anger is a multidimensional construct that consists of five factors comprising anger at (a) the criminal justice system, (b) other people, (c) the self, and (d) a perpetrator and (e) a desire for revenge. Preliminary evidence shows that anger at the self and perpetrators is related to posttraumatic stress disorder (PTSD) symptoms. Expanding the focus from trauma victims to people exposed to a traumatic loss of a significant other, for example, due to road traffic accidents, may enhance our knowledge on factors that are amenable to change in the treatment of prolonged grief disorder (PGD) and PTSD., Method: We examined the (a) factor structure of the 20-item Posttraumatic Anger Questionnaire in 209 Dutch people bereaved by road traffic accidents using confirmatory factor analysis and (b) associations between the posttraumatic anger factors and PGD and PTSD using structural equation models., Results: The expected five-factor structure of the Posttraumatic Anger Questionnaire was supported. Anger at the self was related to greater PGD (β = .35) and PTSD (β = .50) symptoms over and above known risk factors of distress. A desire for revenge (β = .20) was uniquely and positively associated with PTSD symptoms., Conclusion: Pending replication of our findings in longitudinal studies, we conclude that anger subtypes relate differently to distress after traumatic loss. Anger toward the self seems the most detrimental type of anger and may therefore be an important target in treatment. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Background: Firefighters face regular exposure to potentially traumatic events, which is associated with the development of post-traumatic stress disorder (PTSD) and depression. Despite the high comorbidity, there remains limited understanding of the co-occurrence of PTSD and depression in terms of symptom patterns. Due to the unique stressors added by the COVID-19 pandemic, it is relevant to also understand this comorbidity in light of the impact of the COVID-19 pandemic. Objective: This study aimed to identify PTSD and depression symptom profiles in firefighters, and correlates thereof, using latent profile analysis (LPA). Method: 139 Dutch Firefighters (93% male) completed self-report surveys prior to the COVID-19 pandemic (T1) and after the outbreak COVID-19 pandemic (T2) on PTSD, depression, COVID-19 related stressors and other relevant correlates. Results: LPA demonstrated the best fit for a three-profile solution for PTSD and depression at T2 encompassing a low symptom profile (35%), a moderate symptom profile (46%), and an elevated symptom profile (19%). Profiles displayed mostly below clinical range scores for both PTSD and depression at T2. PTSD severity at T1, depression severity at T1, loneliness at T2, COVID-19-related stressors at T2 were significantly and positively related to PTSD and depression symptom profiles at T2. Conclusion: Our results shed light on the resilience of firefighters. Even in light of COVID-19 pandemic, firefighters seemed to maintain generally low levels of psychopathology. Despite firefighters' overall resilience, our findings highlight loneliness and the negative impact of the COVID-19 pandemic as potential risk factors for increased severity of PTSD and depression symptoms.

Background: Prolonged grief disorder (PGD) has been added to the ICD-11 and DSM-5-TR. The Traumatic Grief Inventory-Self Report Plus (TGI-SR+) assesses self-rated PGD intensity as defined in ICD-11 and DSM-5-TR. The TGI-SR + is available in multiple languages, but has not been validated yet in Norwegian. Objective: The aim of this study was to evaluate the psychometric properties of the Norwegian TGI-SR + . Method: Bereaved adults ( N  = 307) whose child or sibling died ≥6 months ago due to a sudden or violent loss completed the TGI-SR + and measures for posttraumatic stress, depression, and precursor PGD symptoms. We examined the factor structure and internal consistency of the ICD-11 and DSM-5-TR PGD items. Convergent validity and known-groups validity was evaluated. Probable PGD cases, pair-wise agreement between diagnostic scoring rules for both PGD criteria-sets, and cut-off scores were calculated. Results: The 1-factor model for ICD-11 and DSM-5-TR PGD showed the best fit and demonstrated good internal consistency. Convergent validity was supported by strong associations between summed ICD-11 and DSM-5-TR PGD scores and summed posttraumatic stress, depression, and precursor prolonged grief scores. Known-groups validity was supported by PGD intensity being related to educational level and time since loss. The perfect pair-wise agreement was reached using the ICD-11 and DSM-5-TR PGD diagnostic scoring rules. The optimal cut-off score for detecting probable PGD cases, when summing all TGI-SR + items, was ≥73. Conclusions: The Norwegian TGI-SR + seems a valid and reliable instrument to assess ICD-11 and DSM-5-TR PGD intensity after losing a child or sibling under traumatic circumstances.

The International Classification of Diseases Eleventh Edition (ICD-11), and the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR), now include prolonged grief disorder (PGD). Since criteria for PGD in both classification systems differ from prior proposed grief disorders and each other, the validation of a single instrument to screen for prolonged grief (PG) symptoms of both new diagnoses is critical for bereavement research and care. Therefore, we evaluated the psychometric properties of the Swedish version of the Traumatic Grief Inventory Self-Report Plus (TGI-SR+). Two-hundred and forty-eight bereaved parents completed questions about sociodemographic and loss-related variables, the TGI-SR+, and symptom measures of post-traumatic stress (PTS), depression and an older measure of PG symptoms, the Prolonged Grief Disorder-13 (PG-13). Confirmatory factor analyses showed that a one-factor model best fit DSM-5-TR and ICD-11 PG symptoms and the analyses of the internal consistency and inter-item correlations showed that these symptoms could be reliably assessed. In support of convergent validity, DSM-5-TR and ICD-11 PG symptoms correlated with symptoms of PTS, depression and PG assessed with the PG-13. In support of known-groups validity, DSM-5-TR and ICD-11 PG symptoms were higher among lower educated (vs. higher educated) participants and related negatively to time since loss. ROC analyses showed optimal cut-off score of ≥71 and ≥72 to determine probable caseness for DSM-5-TR and ICD-11 PGD, respectively. Results support the reliability and validity of the Swedish TGI-SR+ as a screening instrument for PG in research and bereavement care., (© 2023 The Authors. Clinical Psychology & Psychotherapy published by John Wiley & Sons Ltd.)

Background: There is a need for an interview-based measure to assess Prolonged Grief Disorder (PGD) included in the text revision of the fifth Diagnostic and Statistical Manual for Mental Disorder (DSM-5-TR) and 11th edition of the International Classification of Disease (ICD-11). We evaluated the psychometric properties of the Traumatic Grief Inventory-Clinician Administered (TGI-CA); a new interview measuring DSM-5-TR and ICD-11 PGD severity and probable caseness., Methods: In 211 Dutch and 222 German bereaved adults, the: (i) factor structure, (ii) internal consistency, (iii) test-retest reliability, (iv) measurement invariance across subgroups (e.g., differing in language), (v) prevalence of probable caseness, (vi) convergent validity, and (vii) known-groups validity were examined., Results: Confirmatory factor analyses (CFAs) showed acceptable fit for the unidimensional model for DSM-5-TR and ICD-11 PGD. Omega values indicated good internal consistency. Test-retest reliability was high. Multi-group CFAs demonstrated configural and metric invariance for DSM-5-TR and ICD-11 PGD criteria for all group-comparisons; for some we found support for scalar invariance. Rates of probable caseness for DSM-5-TR PGD were lower than ICD-11 PGD. Optimal agreement in probable caseness was reached when increasing the number of accessory symptoms for ICD-11 PGD from 1+ to 3+. Convergent and known-groups validity was demonstrated for both criteria-sets., Limitations: The TGI-CA was developed to assess PGD severity and probable caseness. Clinical diagnostic interviews for PGD are needed., Conclusions: The TGI-CA seems a reliable and valid interview for DSM-5-TR and ICD-11 PGD symptomatology. More research in larger and more diverse samples is needed to further test its psychometric properties., Competing Interests: Conflict of interest None., (Copyright © 2023 The Author(s). Published by Elsevier B.V. All rights reserved.)