The Experts below are selected from a list of 51519 Experts worldwide ranked by ideXlab platform
Katherine M Shear - One of the best experts on this subject based on the ideXlab platform.
-
acceptability feasibility and outcome of a screening programme for complicated Grief in integrated primary and behavioural health care clinics
Family Practice, 2019Co-Authors: Sapana R Patel, Natalia Skritskaya, Andrea Cole, Virna Little, Elizabeth Lever, Lisa B Dixon, Katherine M ShearAbstract:BACKGROUND Complicated Grief, a syndrome of persistent Grief diagnosed >6 months following the loss of someone close is expected to be included in the 11th revision of the International Classification of Diseases as a new diagnosis called prolonged Grief disorder. Complicated Grief is associated with impaired functioning and health comorbidity and does not respond to treatments for depression. Individuals may seek help in primary care where providers need to be familiar with the syndrome. OBJECTIVE This study examines the acceptability, feasibility and outcome of a screening programme for complicated Grief among diverse adults receiving behavioural health services in integrated primary care. METHODS Behavioural health providers (n = 14) administered the Brief Grief Questionnaire and the Inventory of Complicated Grief during routine assessment and completed an acceptability survey. Descriptive statistics described rates of complicated Grief symptoms and sample demographics, health and service use. RESULTS Most providers (71%) reported the Brief Grief Questionnaire to be a moderate to very useful assessment instrument and the Inventory of Complicated Grief moderate to very useful for developing a treatment plan (57%). Of the 2425 patients screened, 1015 reported a loss over 6 months ago. Of these 1015, 28% (n = 282) screened positive on the Brief Grief Questionnaire and 22% (n = 228) endorsed symptoms of complicated Grief (Inventory of Complicated Grief score ≥25), considered at high risk for needing clinical care. CONCLUSIONS A screening programme for identifying complicated Grief was acceptable to providers, feasible to implement and useful in identifying complicated Grief in integrated primary care clinics.
-
performance of dsm 5 persistent complex bereavement disorder criteria in a community sample of bereaved military family members
American Journal of Psychiatry, 2016Co-Authors: Stephen J Cozza, Melanie M Wall, Joscelyn E Fisher, Christine Mauro, Jing Zhou, Claudio D Ortiz, Natalia Skritskaya, Carol S Fullerton, Robert J Ursano, Katherine M ShearAbstract:Objective:The purpose of this article was to examine the accuracy of DSM-5 proposed criteria for persistent complex bereavement disorder in identifying putative cases of clinically impairing Grief and in excluding nonclinical cases. Performance of criteria sets for prolonged Grief disorder and complicated Grief were similarly assessed.Method:Participants were family members of U.S. military service members who died of any cause since September 11, 2001 (N=1,732). Putative clinical and nonclinical samples were derived from this community sample using cutoff scores from the Inventory of Complicated Grief and the Work and Social Adjustment Scale. Items from a self-report Grief measure (Complicated Grief Questionnaire) were matched to DSM-5 persistent complex bereavement disorder, prolonged Grief disorder, and complicated Grief criteria. Endorsed items were used to identify cases.Results:Criteria sets varied in their ability to identify clinical cases. DSM-5 persistent complex bereavement disorder criteria id...
-
bereavement and complicated Grief
Current Psychiatry Reports, 2013Co-Authors: Katherine M Shear, Angela Ghesquiere, Kim GlickmanAbstract:Bereavement is a common experience in adults aged 60 and older. Loss of a loved one usually leads to acute Grief characterized by yearning and longing, decreased interest in ongoing activities, and frequent thoughts of the deceased. For most, acute Grief naturally evolves into a state of integrated Grief, where the bereaved is able to reengage with everyday activities and find interest or pleasure. About 7 % of bereaved older adults, however, will develop the mental health condition of Complicated Grief (CG). In CG, the movement from acute to integrated Grief is derailed, and Grief symptoms remain severe and impairing. This article reviews recent publications on the diagnosis of CG, risk factors for the condition and evidenced-based treatments for CG. Greater attention to CG detection and treatment in older adults is needed.
-
Grief and mourning gone awry pathway and course of complicated Grief
Dialogues in clinical neuroscience, 2012Co-Authors: Katherine M ShearAbstract:Complicated Grief is a recently recognized condition that occurs in about 7% of bereaved people. People with this condition are caught up in rumination about the circumstances of the death, worry about its consequences, or excessive avoidance of reminders of the loss. Unable to comprehend the finality and consequences of the loss, they resort to excessive avoidance of reminders of the loss as they are tossed helplessly on waves of intense emotion. People with complicated Grief need help, and clinicians need to know how to recognize the symptoms and how to provide help. This paper provides a framework to help clinicans understand bereavement, Grief, and mourning. Evidence-based diagnostic criteria are provided to help clinicians recognize complicated Grief, and differentiate it from depression as well as anxiety disorder. We provide an overview of risk factors and basic assumptions and principles that can guide treatment.
-
brief measure for screening complicated Grief reliability and discriminant validity
PLOS ONE, 2012Co-Authors: Masaya Ito, Katherine M Shear, Satomi Nakajima, Daisuke Fujisawa, Mitsunori Miyashita, Yoshiharu Kim, Angela Ghesquiere, Melanie M WallAbstract:Background Complicated Grief, which is often under-recognized and under-treated, can lead to substantial impairment in functioning. The Brief Grief Questionnaire (BGQ) is a 5-item self-report or interview instrument for screening complicated Grief. Although investigations with help-seeking samples suggest that the BGQ is valid and reliable, it has not been validated in a broader population. Methodology/Principal Findings A questionnaire was mailed to a randomly selected sample (n = 5000) residing in one of 4 areas of Japan. The BCQ was examined for responders who were bereaved more than 6 months and less than 10 years (n = 915). Non-specific psychological distress was assessed with the K6 screening scale. Multiple group confirmatory factor analysis supported a uni-dimensional factor structure and the invariance of parameters across gender and age. Cronbach's alpha was sufficiently high (alpha = .75) to confirm internal consistency. Average Variance Extracted (0.39) was higher than the shared covariance (0.14) between BGQ and K6, suggesting discriminant validity. Conclusions The results of this study support the reliability and validity of the BGQ in the Japanese population. Future studies should examine predictive validity by using structured interviews or more detailed scales for complicated Grief.
Imogen Oneill - One of the best experts on this subject based on the ideXlab platform.
-
family focused Grief therapy a randomized controlled trial in palliative care and bereavement
American Journal of Psychiatry, 2006Co-Authors: David W Kissane, Maria Mckenzie, Dean Philip Mckenzie, Sidney Bloch, Chaya Moskowitz, Imogen OneillAbstract:Objective: The aim of family focused Grief therapy is to reduce the morbid effects of Grief among families at risk of poor psychosocial outcome. It commences during palliative care of terminally ill patients and continues into bereavement. The authors report a randomized, controlled trial. Method: Using the Family Relationships Index, the authors screened 257 families of patients dying from cancer: 183 (71%) were at risk, and 81 of those (44%) participated in the trial. They were randomly assigned (in a 2:1 ratio) to family focused Grief therapy (53 families, 233 individuals) or a control condition (28 families, 130 individuals). Assessments occurred at baseline and 6 and 13 months after the patient’s death. The primary outcome measures were the Brief Symptom Inventory, Beck Depression Inventory, and Social Adjustment Scale. The Family Assessment Device was a secondary outcome measure. Analyses allowed for correlated family data and employed generalized estimating equations based on intention to treat and...
-
psychosocial morbidity associated with patterns of family functioning in palliative care baseline data from the family focused Grief therapy controlled trial
Palliative Medicine, 2003Co-Authors: David W Kissane, Maria Mckenzie, Dean Philip Mckenzie, Andrew Forbes, Imogen Oneill, Sidney BlochAbstract:Family Focused Grief Therapy (FFGT) is a new model of brief intervention, which is commenced during palliative care for those families shown to be at high risk of poor adaptation, and continued preventively into bereavement with the aim of improving family functioning and reducing the morbid consequences of Grief. In this paper, baseline data on 81 families (363 individuals) selected by screening from a palliative care population are explored to confirm our previously reported observation that high levels of psychosocial morbidity are positively associated with worsening family dysfunction. The Family Relationships Index (FRI) was used for screening and the Family Assessment Device (FAD) as an independent family outcome measure. The Beck Depression Inventory (BDI), Brief Symptom Inventory (BSI) and Social Adjustment Scale (SAS) were the psychosocial measures. Families were classified according to their functioning based on the FRI. To allow for correlated family data, statistical analyses employed the generalized estimating equation (GEE) method, controlling for gender and depression (BDI). Screening of 257 families (701 individuals) revealed 74 (29%) well-functioning families and 183 (71%) at some risk of morbid outcome. Of the latter, 81 (44%) gave informed consent to enter a randomized controlled trial of FFGT. Patients had a mean age of 57 years, 51% were male and they suffered from cancer, with a median length of illness from diagnosis to death of 25 months. In accordance with the FFGT model, their family types were identified as Intermediate 51%, Sullen 26% and Hostile 23%. These were significantly associated with steadily increasing levels of distress (BSI) and poor social adjustment (SAS). The FAD confirmed the concurrent accuracy of the FRI. As significantly greater levels of psychosocial morbidity were present in families whose functioning as a group was poorer, support was generated for a clinical approach that screens for families rather than individuals at high risk. The predictive validity of the FRI as a screening measure was confirmed. Overall, these baseline data point to the importance of a family-centred model of care.
Robert J Ursano - One of the best experts on this subject based on the ideXlab platform.
-
examination of factor structure of the inventory of complicated Grief icg in a sample of bereaved military family members with persistent and elevated Grief
International Journal of Methods in Psychiatric Research, 2017Co-Authors: Joscelyn E Fisher, Melanie M Wall, Stephen J Cozza, Christine Mauro, Claudio D Ortiz, Carol S Fullerton, Naomi M Simon, Jill Harringtonlamorie, Yuanjia Wang, Robert J UrsanoAbstract:Knowledge about the effect of a US service member's death on surviving family members is limited. In order to identify their Grief-related health care needs, a first step is to identify the characteristics of persistent and elevated Grief in a military family sample. The present study identified military family members (n = 232) bereaved more than six months who endorsed an elevated level of Grief. A confirmatory factor analysis and test of measurement invariance of factor structure were used to compare the factor structure of their Inventory of Complicated Grief (ICG) responses to that of a bereaved non-military-related clinical research sample with similar Grief levels. Results confirmed an equivalent five-factor structure of the ICG in both the military family sample and the clinical research sample. The similarity in factor structure was present despite differences in demographic characteristics and bereavement experiences between samples. Thus, the ICG reliably measures persistent and elevated Grief in military family samples and provides Grief symptom profiles that facilitates better understanding of their Grief-related needs.
-
performance of dsm 5 persistent complex bereavement disorder criteria in a community sample of bereaved military family members
American Journal of Psychiatry, 2016Co-Authors: Stephen J Cozza, Melanie M Wall, Joscelyn E Fisher, Christine Mauro, Jing Zhou, Claudio D Ortiz, Natalia Skritskaya, Carol S Fullerton, Robert J Ursano, Katherine M ShearAbstract:Objective:The purpose of this article was to examine the accuracy of DSM-5 proposed criteria for persistent complex bereavement disorder in identifying putative cases of clinically impairing Grief and in excluding nonclinical cases. Performance of criteria sets for prolonged Grief disorder and complicated Grief were similarly assessed.Method:Participants were family members of U.S. military service members who died of any cause since September 11, 2001 (N=1,732). Putative clinical and nonclinical samples were derived from this community sample using cutoff scores from the Inventory of Complicated Grief and the Work and Social Adjustment Scale. Items from a self-report Grief measure (Complicated Grief Questionnaire) were matched to DSM-5 persistent complex bereavement disorder, prolonged Grief disorder, and complicated Grief criteria. Endorsed items were used to identify cases.Results:Criteria sets varied in their ability to identify clinical cases. DSM-5 persistent complex bereavement disorder criteria id...
Paul A. Boelen - One of the best experts on this subject based on the ideXlab platform.
-
the longitudinal and cross sectional associations of Grief and complicated Grief with sleep quality in older adults
Behavioral Sleep Medicine, 2019Co-Authors: Jelena Milic, Paul A. Boelen, Heidi Saavedra C Perez, Lisette A Zuurbier, Judith A C Rietjens, Albert Hofman, Henning TiemeierAbstract:Objective/Background: About 15% of grievers experience complicated Grief. We determined cross-sectional and longitudinal relations of Grief and complicated Grief with sleep duration and quality in the general population of elderly adults. Participants: We included 5,421 men and women from the prospective population-based Rotterdam Study. Methods: The Inventory of Complicated Grief was used to define Grief and complicated Grief. We assessed sleep with the Pittsburgh Sleep Quality Index. Results: After 6 years, 3,511 (80% of survivors) underwent the follow-up interview. Complicated Grief was cross-sectionally associated with shorter sleep duration and lower sleep quality. These associations were explained by the presence of depressive symptoms. The prospective analyses showed that sleep duration and sleep quality did not decline further during follow-up of persons who experienced Grief or complicated Grief. Conclusion: In community-dwelling, middle-aged and older adults, persons with normal and complicated ...
-
Day patient treatment for traumatic Grief: preliminary evaluation of a one-year treatment programme for patients with multiple and traumatic losses
European journal of psychotraumatology, 2017Co-Authors: Annemiek De Heus, Paul A. Boelen, Simone M. De La Rie, Sophie M. C. Hengst, A. A. A. Manik J. Djelantik, Geert E. SmidAbstract:Background: Bereaved individuals who have lost a loved one under traumatic circumstances can develop symptoms of Persistent Complex Bereavement Disorder (PCBD) and/or Posttraumatic Stress Disorder (PTSD). This is particularly common in refugees, as they frequently have been confronted with multiple traumatic losses. For patients with severe PTSD and traumatic Grief a treatment programme was developed, embedding individual traumatic Grief focused therapy in a group-based multidisciplinary day patient treatment programme. The day patient treatment comprised a weekly five-hour programme consisting of three phases with a duration of four months each. Objective: To evaluate the feasibility and potential effectiveness of the treatment programme. Method: Data were analyzed from 16 participants treated between October 2013 and March 2014. PTSD severity and PTSD/PCBD diagnoses were measured during the initial and final phases of treatment using the Clinician-Administered PTSD Scale for DSM-IV (CAPS) and the Traumatic Grief Inventory Self Report (TGI-SR). One clinical case is presented in more detail. Treatment attendance was also registered and therapist satisfaction was evaluated in a focus group. Results: Thirteen patients (81%) completed the treatment. Each day of the treatment programme was attended by a mean of 76% of the participants. In the focus group, therapists noted symptom reduction in their patients and they therefore regarded Brief Eclectic Psychotherapy for Traumatic Grief (BEP-TG) as an effective therapy for their patients. During treatment, significant decreases in PTSD severity as well as diagnosable PTSD and PCBD were observed. Conclusions: Results support the feasibility and potential effectiveness of the day patient treatment programme for traumatic Grief. The programme appears to be particularly suitable for refugees with severe PTSD and PCBD psychopathology, who may not benefit enough from usual care.
-
disturbed Grief prolonged Grief disorder and persistent complex bereavement disorder
BMJ, 2017Co-Authors: Paul A. Boelen, Geert E. SmidAbstract:PRIYA SUNDRAM #### What you need to know Each individual’s Grief process is unique. The concept of stages of Grief occurring in a specific order is a popular, yet inadequate representation of what grieving people go through.1 Traditional models developed to understand Grief therefore often unhelpfully suggest that all bereaved individual do, and even should, follow the same process towards recovery from loss. The newer Grief task model2 offers a more neutral framework to describe normal and disturbed Grief. The model proposes that normal Grief is the successful achievement of certain “Grief tasks,” whereas complications in managing these tasks might indicate disturbed Grief. There is no recommended or specific order in which to achieve these tasks. Grief tasks include: to accept the reality of the loss; to process the associated pain; to adjust to a world without the deceased; and to find an enduring connection with the deceased in the midst of embarking on a new life. The model also describes challenges faced following losses other than bereavement (Box ‘Grief following events other than bereavement’). Doctors from any specialty can identify …
-
prolonged Grief disorder and persistent complex bereavement disorder but not complicated Grief are one and the same diagnostic entity an analysis of data from the yale bereavement study
Worlds Poultry Science Journal, 2016Co-Authors: Paul K. Maciejewski, Paul A. Boelen, Andreas Maercker, Holly G PrigersonAbstract:There exists a general consensus that prolonged Grief disorder (PGD), or some variant of PGD, represents a distinct mental disorder worthy of diagnosis and treatment. Nevertheless, confusion remains over whether different names and proposed symptom criteria for this disorder identify the same or different diagnostic entities. This study aimed to determine whether PGD, complicated Grief (CG), and persistent complex bereavement disorder (PCBD) as described by the DSM-5 are substantively or merely semantically different diagnostic entities. Data were derived from the Yale Bereavement Study, a longitudinal community-based study of bereaved individuals funded by the US National Institute of Mental Health, designed explicitly to evaluate diagnostic criteria for disordered Grief. The results suggested that the difference between PGD and PCBD is only semantic. The level of agreement between the original PGD test, a new version of the PGD test proposed for ICD-11 and the PCBD test was high (pairwise kappa coefficients = 0.80-0.84). Their estimates of rate of disorder in this community sample were similarly low (∼10%). Their levels of diagnostic specificity were comparably high (95.0-98.3%). Their predictive validity was comparable. In contrast, the test for CG had only moderate agreement with those for PGD and PCBD; its estimate of rate of disorder was three-fold higher (∼30%); its diagnostic specificity was poorer, and it had no predictive validity. We conclude that PGD, PCBD and proposed ICD-11, but not CG, symptom-diagnostic tests identify a single diagnostic entity. Ultimately, brief symptom-diagnostic tests, such as the one proposed here for ICD-11, may have the greatest clinical utility.
-
internet based exposure and behavioral activation for complicated Grief and rumination a randomized controlled trial
Behavior Therapy, 2015Co-Authors: Maarten C Eisma, Paul A. Boelen, Henk Schut, Margaret Stroebe, Wolfgang Stroebe, Jan Van Den Bout, Jaap LanceeAbstract:This study examined the effectiveness and feasibility of therapist-guided Internet-delivered exposure (EX) and behavioral activation (BA) for complicated Grief and rumination. Forty-seven bereaved individuals with elevated levels of complicated Grief and Grief rumination were randomly assigned to three conditions: EX (N=18), BA (N=17), or a waiting-list (N=12). Treatment groups received 6 homework assignments over 6 to 8weeks. Intention-to-treat analyses showed that EX reduced complicated Grief, posttraumatic stress, depression, Grief rumination, and brooding levels relative to the control group at posttreatment (d=0.7-1.2). BA lowered complicated Grief, posttraumatic stress, and Grief rumination levels at posttreatment (d=0.8-0.9). At 3-month follow-up, effects of EX were maintained on complicated Grief and Grief rumination (d=0.6-1.2), and for BA on complicated Grief, posttraumatic stress, and Grief rumination (d=0.8-0.9). EX reduced depression more strongly than BA (d=0.6). Completers analyses corroborated results for EX, and partially those for BA, but no group differences were detected. BA suffered from high dropout (59%), relative to EX (33%) and the waiting-list (17%). Feasibility appeared higher for EX than BA. Results supported potential applicability of online exposure but not behavioral activation to decrease complicated Grief and rumination.
Melanie M Wall - One of the best experts on this subject based on the ideXlab platform.
-
examination of factor structure of the inventory of complicated Grief icg in a sample of bereaved military family members with persistent and elevated Grief
International Journal of Methods in Psychiatric Research, 2017Co-Authors: Joscelyn E Fisher, Melanie M Wall, Stephen J Cozza, Christine Mauro, Claudio D Ortiz, Carol S Fullerton, Naomi M Simon, Jill Harringtonlamorie, Yuanjia Wang, Robert J UrsanoAbstract:Knowledge about the effect of a US service member's death on surviving family members is limited. In order to identify their Grief-related health care needs, a first step is to identify the characteristics of persistent and elevated Grief in a military family sample. The present study identified military family members (n = 232) bereaved more than six months who endorsed an elevated level of Grief. A confirmatory factor analysis and test of measurement invariance of factor structure were used to compare the factor structure of their Inventory of Complicated Grief (ICG) responses to that of a bereaved non-military-related clinical research sample with similar Grief levels. Results confirmed an equivalent five-factor structure of the ICG in both the military family sample and the clinical research sample. The similarity in factor structure was present despite differences in demographic characteristics and bereavement experiences between samples. Thus, the ICG reliably measures persistent and elevated Grief in military family samples and provides Grief symptom profiles that facilitates better understanding of their Grief-related needs.
-
performance of dsm 5 persistent complex bereavement disorder criteria in a community sample of bereaved military family members
American Journal of Psychiatry, 2016Co-Authors: Stephen J Cozza, Melanie M Wall, Joscelyn E Fisher, Christine Mauro, Jing Zhou, Claudio D Ortiz, Natalia Skritskaya, Carol S Fullerton, Robert J Ursano, Katherine M ShearAbstract:Objective:The purpose of this article was to examine the accuracy of DSM-5 proposed criteria for persistent complex bereavement disorder in identifying putative cases of clinically impairing Grief and in excluding nonclinical cases. Performance of criteria sets for prolonged Grief disorder and complicated Grief were similarly assessed.Method:Participants were family members of U.S. military service members who died of any cause since September 11, 2001 (N=1,732). Putative clinical and nonclinical samples were derived from this community sample using cutoff scores from the Inventory of Complicated Grief and the Work and Social Adjustment Scale. Items from a self-report Grief measure (Complicated Grief Questionnaire) were matched to DSM-5 persistent complex bereavement disorder, prolonged Grief disorder, and complicated Grief criteria. Endorsed items were used to identify cases.Results:Criteria sets varied in their ability to identify clinical cases. DSM-5 persistent complex bereavement disorder criteria id...
-
brief measure for screening complicated Grief reliability and discriminant validity
PLOS ONE, 2012Co-Authors: Masaya Ito, Katherine M Shear, Satomi Nakajima, Daisuke Fujisawa, Mitsunori Miyashita, Yoshiharu Kim, Angela Ghesquiere, Melanie M WallAbstract:Background Complicated Grief, which is often under-recognized and under-treated, can lead to substantial impairment in functioning. The Brief Grief Questionnaire (BGQ) is a 5-item self-report or interview instrument for screening complicated Grief. Although investigations with help-seeking samples suggest that the BGQ is valid and reliable, it has not been validated in a broader population. Methodology/Principal Findings A questionnaire was mailed to a randomly selected sample (n = 5000) residing in one of 4 areas of Japan. The BCQ was examined for responders who were bereaved more than 6 months and less than 10 years (n = 915). Non-specific psychological distress was assessed with the K6 screening scale. Multiple group confirmatory factor analysis supported a uni-dimensional factor structure and the invariance of parameters across gender and age. Cronbach's alpha was sufficiently high (alpha = .75) to confirm internal consistency. Average Variance Extracted (0.39) was higher than the shared covariance (0.14) between BGQ and K6, suggesting discriminant validity. Conclusions The results of this study support the reliability and validity of the BGQ in the Japanese population. Future studies should examine predictive validity by using structured interviews or more detailed scales for complicated Grief.
