Conflict of interest: EB has received honoraria from Laboratoires Servier. NMS has research grants from American Foundation for Suicide Prevention, Forest Laboratories, NIMH, DOD, Glaxo SmithKline, NARSAD Sepracor and also has received honoraria for speaking/CME from MGH Psychiatry Academy. MKS has research grant from American Foundation for Suicide Prevention and NIMH. All other authors declare that they have no conflicts of interest.
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Research Article
PERILOSS DISSOCIATION, SYMPTOM SEVERITY, AND TREATMENT RESPONSE IN COMPLICATED GRIEF
Article first published online: 4 DEC 2012
DOI: 10.1002/da.22029
© 2012 Wiley Periodicals, Inc.
Additional Information
How to Cite
Bui, E., Simon, N. M., Robinaugh, D. J., LeBlanc, N. J., Wang, Y., Skritskaya, N. A., Mauro, C. and Shear, M. K. (2013), PERILOSS DISSOCIATION, SYMPTOM SEVERITY, AND TREATMENT RESPONSE IN COMPLICATED GRIEF. Depress. Anxiety, 30: 123–128. doi: 10.1002/da.22029
Publication History
- Issue published online: 25 JAN 2013
- Article first published online: 4 DEC 2012
- Manuscript Accepted: 2 NOV 2012
- Manuscript Revised: 22 OCT 2012
- Manuscript Received: 11 MAY 2012
Funded by
- Centre Hospitalier Universitaire de Toulouse
- Abstract
- Article
- References
- Cited By
Keywords:
- peritraumatic dissociation;
- complicated grief;
- treatment response;
- drop out;
- prediction
Background
Complicated grief (CG) is a bereavement-specific syndrome characterized by traumatic and separation distress lasting over 6 months. Little is known about the role of dissociation experienced during or immediately after the loss of a loved one (i.e. periloss dissociation [PLD]) in CG. The present study aimed to examine the psychometric properties of the PLD-adapted Peritraumatic Dissociative Experiences Questionnaire and its association with symptom severity, treatment response, and drop-out rate.
Methods
PLD data collected as part of a randomized controlled trial of two loss-focused psychotherapy approaches for CG were examined. Treatment-seeking individuals with primary CG (n = 193) were assessed for PLD at the initial visit, 95 of whom were randomized and completed at least one treatment session.
Results
The PLD-adapted Peritraumatic Dissociative Experiences Questionnaire was found to be internally consistent (α = 0.91) with good convergent and divergent validity. After controlling for age, gender, time since loss, and current comorbid psychiatric diagnosis, self-reported PLD was associated with greater CG symptom severity (P < .01). However, contrary to our hypotheses, after controlling for age, baseline symptoms severity, psychiatric comorbidity, and treatment arm, PLD was predictive of better treatment response (P < .05) and lower study discontinuation (P < .01).
Conclusions
PLD may be useful in identifying individuals at risk for CG and those who might respond to psychotherapy. Additional research should investigate the relationship of PLD with treatment outcome for different treatment approaches, and whether PLD prospectively predicts the development of CG.