TY - JOUR
T1 - Co-occurrence of approach and avoidance in prolonged grief
T2 - a latent class analysis
AU - Eisma, Maarten C.
AU - Lenferink, Lonneke
N1 - Funding Information:
Maarten C. Eisma was supported by a Dutch Research Council (Nederlandse Organisatie voor Wetenschappelijk Onderzoek, NWO) Veni grant [Grant ID: 016.veni195.113].
Publisher Copyright:
© 2023 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.
PY - 2023/4
Y1 - 2023/4
N2 - Background: Prolonged grief disorder (PGD) has been included in the International Classification of Diseases (ICD-11) and the Diagnostic and Statistical Manual of Mental Disorders 5 Text Revision (DSM-5-TR). Loss-related avoidance behavior perpetuates grief and effective interventions for prolonged grief symptoms target such avoidance behavior. Yet, behaviors characterized by approach of loss-related cues (i.e. rumination, yearning, proximity seeking) are also implicated in prolonged grief reactions. Objective: To solve this paradox, we will test the Approach Avoidance Processing Hypothesis, which holds that loss-related approach and avoidance behaviors co-occur in PGD, using latent class analyses (LCA).Methods: Two-hundred eighty-eight bereaved adults (92% female) completed questionnaires assessing loss-related approach behaviors (rumination, yearning, proximity seeking), loss-related avoidance behaviors (anxious avoidance, experiential avoidance) and ICD-11 andDSM-5-TR prolonged grief symptoms. Results: LCA demonstrated the best fit for a three-class solution comprising a low approach/low avoidance class (n= 98, 34%), a high approach/low avoidance class (n= 79, 27%), and a high approach/high avoidance class (n= 111, 39%). The latter class showed significantly higher prolonged grief symptom levels and higher odds of probable PGD compared to the other classes. Conclusions: Co-occurrence of loss-related approach and avoidance appears characteristic to prolonged grief reactions. Distinguishing bereaved people with these behavioral patterns from those solely experiencing loss-related approach behaviors may improve the efficacy of PGD therapies.
AB - Background: Prolonged grief disorder (PGD) has been included in the International Classification of Diseases (ICD-11) and the Diagnostic and Statistical Manual of Mental Disorders 5 Text Revision (DSM-5-TR). Loss-related avoidance behavior perpetuates grief and effective interventions for prolonged grief symptoms target such avoidance behavior. Yet, behaviors characterized by approach of loss-related cues (i.e. rumination, yearning, proximity seeking) are also implicated in prolonged grief reactions. Objective: To solve this paradox, we will test the Approach Avoidance Processing Hypothesis, which holds that loss-related approach and avoidance behaviors co-occur in PGD, using latent class analyses (LCA).Methods: Two-hundred eighty-eight bereaved adults (92% female) completed questionnaires assessing loss-related approach behaviors (rumination, yearning, proximity seeking), loss-related avoidance behaviors (anxious avoidance, experiential avoidance) and ICD-11 andDSM-5-TR prolonged grief symptoms. Results: LCA demonstrated the best fit for a three-class solution comprising a low approach/low avoidance class (n= 98, 34%), a high approach/low avoidance class (n= 79, 27%), and a high approach/high avoidance class (n= 111, 39%). The latter class showed significantly higher prolonged grief symptom levels and higher odds of probable PGD compared to the other classes. Conclusions: Co-occurrence of loss-related approach and avoidance appears characteristic to prolonged grief reactions. Distinguishing bereaved people with these behavioral patterns from those solely experiencing loss-related approach behaviors may improve the efficacy of PGD therapies.
KW - prolonged grief
KW - complicated grief
KW - avoidance
KW - rumination
KW - yearning
KW - continuing bonds
U2 - 10.1080/20008066.2023.2190544
DO - 10.1080/20008066.2023.2190544
M3 - Article
SN - 2000-8066
VL - 14
JO - European Journal of psychotraumatology
JF - European Journal of psychotraumatology
IS - 2
M1 - 2190544
ER -