https://aub.ie/MilitaryREACH-Cozza16TRIP

Cozza, S. J., Fisher, J. E., Mauro, C., Zhou, J. Ortiz, C. D., Skritskaya, N.… Shear, M. K. (2016). Performance of DSM-5 persistent complex bereavement disorder criteria in a community sample of bereaved military family members. American Journal of Psychiatry, 173(9), 919-929. https://doi.org/10.1176/appi.ajp.2016.15111442

https://doi.org/10.1176/appi.ajp.2016.15111442

Other

Air Force
Army
Coast Guard
Marine Corps
Multiple branches
Navy

Active Duty

Child of a service member or veteran
Military families
Parent of a service member or veteran
Spouse of service member or veteran

Adulthood (18 yrs & older)
Aged (65 yrs & older)
Middle age (40 - 64 yrs)
Thirties (30 - 39 yrs)
Young adulthood (18 - 29 yrs)

Cross-Sectional Study
Quantitative Study
Secondary Analysis

Cozza, Stephen J., Fisher, Joscelyn E., Mauro, Christine, Zhou, Jing, Ortiz, Claudio D., Skritskaya, Natalia, Wall, Melanie M., Fullerton, Carol S., Ursano, Robert J., Shear, M. Katherine

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 identified 53%, prolonged grief disorder criteria identified 59%, and complicated grief criteria identified more than 90% of putative clinical cases. All criteria sets accurately excluded virtually all nonclinical grief cases and accurately excluded depression in the absence of clinical grief. Conclusions: The DSM-5 persistent complex bereavement disorder criteria accurately exclude nonclinical, normative grief, but also exclude nearly half of clinical cases, whereas complicated grief criteria exclude nonclinical cases while identifying more than 90% of clinical cases. The authors conclude that significant modification is needed to improve case identification by DSM-5 persistent complex bereavement disorder diagnostic criteria. Complicated grief criteria are superior in accurately identifying clinically impairing grief.

American Psychiatric Association

Article
REACH Publication

Department of Psychiatry, Uniformed Services University of the Health Sciences, SJC
Department of Psychiatry, Uniformed Services University of the Health Sciences, JEF
Department of Psychiatry, Uniformed Services University of the Health Sciences, CM
Department of Psychiatry, Uniformed Services University of the Health Sciences, JZ
Department of Psychiatry, Uniformed Services University of the Health Sciences, CDO
Department of Psychiatry, Uniformed Services University of the Health Sciences, NS
Department of Psychiatry, Uniformed Services University of the Health Sciences, MMW
Department of Psychiatry, Uniformed Services University of the Health Sciences, CSF
Department of Psychiatry, Uniformed Services University of the Health Sciences, RJU
Department of Psychiatry, Uniformed Services University of the Health Sciences, MKS