Persistent Complex Bereavement Disorder Symptom Domains Relate Differentially to PTSD and Depression: A Study of War-Exposed Bosnian Adolescents

Authors

Meredith A Claycomb, Department of Psychology University of Toledo
Ruby Charak, Department of Psychology University of Nebraska-Lincoln
Julie Kaplow, Department of Psychiatry and Behavioral Sciences University of Texas Health Science Center at Houston
Christopher M Layne, UCLA/Duke University National Center for Child Traumatic Stress, and Department of Psychiatry and Biobehavioral Sciences University of CaliforniaLos Angeles
Robert Pynoos, UCLA/Duke University National Center for Child Traumatic Stress, and Department of Psychiatry and Biobehavioral Sciences University of California Los Angeles
Jon D Elhai, Department of Psychology and Department of Psychiatry University of Toledo

Publication Date

10-1-2016

Journal

Journal of Abnormal Child Psychology

DOI

10.1007/s10802-015-0107-7

PMID

26695010

Published Open-Access

no

Keywords

adolescent, bereavement, Bosnia and Herzegovina, depression, DSM5, female, human, male, psychiatric status rating scales, stress disorders, post-traumatic, warfare, young adult

Abstract

Persistent Complex Bereavement Disorder (PCBD) is a newly proposed diagnosis placed in the Appendix of the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) as an invitation for further research. To date, no studies have examined the dimensionality of PCBD or explored whether different PCBD criteria domains relate in similar, versus differential, ways to other psychological conditions common to war-exposed bereaved youth, including symptoms of Posttraumatic Stress Disorder (PTSD) and depression. We evaluated the dimensionality of proposed PCBD B and C symptom domains, and their respective relations with measures of PTSD and depression, in 1142 bereaved Bosnian adolescents exposed to the 1992-1995 Bosnian civil war. Instruments included the UCLA PTSD Reaction Index, the Depression Self-Rating Scale, and the UCLA Grief Screening Scale (a prototype measure of PCBD symptoms). We investigated potential differences in grief, PTSD, and depression scores as a function of cause of death. We then examined hypothesized differential relations between PCBD B and C symptom domain subscales and selected external correlates, specifically measures of depression and the four-factor emotional numbing model of PTSD. Results of both analyses provide preliminary evidence of a multidimensional structure for PCBD in this population, in that the PCBD Criterion C subscale score covaried more strongly with each of the four PTSD factors and with depression than did PCBD Criterion B. We conclude by discussing theoretical, methodological, clinical, and policy-related implications linked to the ongoing study of essential features of PCBD.