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.
PERILOSS DISSOCIATION, SYMPTOM SEVERITY, AND TREATMENT RESPONSE IN COMPLICATED GRIEF
Article first published online: 4 DEC 2012
© 2012 Wiley Periodicals, Inc.
Depression and Anxiety
Volume 30, Issue 2, pages 123–128, February 2013
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
- 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
- Centre Hospitalier Universitaire de Toulouse
- peritraumatic dissociation;
- complicated grief;
- treatment response;
- drop out;
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.
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.
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).
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.