Abstract
Background: Violently bereaved individuals are at increased risk of developing severe and comorbid disorders. Comorbidity may increase psychiatric symptom severity and suicide risk and decrease psychosocial functioning compared with having one disorder. We aimed to identify subgroups of individuals with similar symptom patterns, describe prevalence rates and overall levels of prolonged grief disorder (PGD), posttraumatic stress disorder (PTSD), major depressive disorder (MDD), and generalized anxiety disorder (GAD) per class, and explore associations between class membership and personal and homicide related variables.
Methods: We investigated the comorbidity of symptoms of PGD, PTSD, MDD, and GAD in a sample of 923 treatment-seeking homicidally bereaved individuals by deploying latent class analysis.
Results: Three subgroups were identified: (i) a moderate distress, low depression class (12.4%), (ii) a high distress, moderate depression class (42.7%), and (iii) a high distress and high depression class (45.0%). Prevalence rates and total scores of the questionnaires followed the pattern of iii ≥ ii ≥ i (ps ≤ .001). Being female and having experienced prior life stress distinguished between all classes (ps ≤ .05).
Limitations: The data-driven analytic approach and reliance on self-reported routine outcome monitoring data limit the generalizability and validity of the study. Strengths include the large sample size and the inclusion of four measures in a treatment-seeking, violently bereaved sample.
Conclusions: Classes were most clearly distinguishable based on symptom severity, indicating high comorbidity following bereavement by homicide. This argues for an integrated treatment that targets different complaints simultaneously rather than successively.
| Original language | English |
|---|---|
| Pages (from-to) | 234-241 |
| Journal | Journal of Affective Disorders |
| Volume | 292 |
| DOIs | |
| Publication status | Published - 1 Sept 2021 |
Bibliographical note
Funding Information:BG and RW collected, entered, and managed the data. LL, MD and SS designed the study, analyzed the data, and together with PB and GS did the writing. All authors contributed to the article and approved the submitted version. This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. The funding sources of this study had no involvement in the conduct of this research and/or preparation of the article. The authors would kindly like to thank to the staff of ASSIST Trauma Care for the data collection, data-entering and valuable suggestions, and dr. Niels van der Aa for his assistance with preparing the dataset for the statistical analyses.
Publisher Copyright:
© 2021
Funding
BG and RW collected, entered, and managed the data. LL, MD and SS designed the study, analyzed the data, and together with PB and GS did the writing. All authors contributed to the article and approved the submitted version. This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. The funding sources of this study had no involvement in the conduct of this research and/or preparation of the article. The authors would kindly like to thank to the staff of ASSIST Trauma Care for the data collection, data-entering and valuable suggestions, and dr. Niels van der Aa for his assistance with preparing the dataset for the statistical analyses.
Keywords
- Anxiety
- Bereavement
- Depression
- Grief
- Homicide
- PTSD
