Boelen, P. A., Schoot, R. van de, Hout, M. van den, Keijser, J. de, & Bout, J. van den (2010). Prolonged grief disorder, depression, and posttraumatic stress-disorder are distinguishable syndromes. Journal of Affective Disorders, 125, 374-378.
Background: This study examined the distinctiveness of symptoms of Prolonged Grief Disorder (PGD), depression, and posttraumatic stress disorder (PTSD). We compared the fit of a onefactor model with the fit of four hierarchical models in which symptoms formed three distinct correlated higher-order dimensions, and PTSD-items were modeled in different ways. Methods: Self-reported data were available from two samples; 572 mourners recruited via the internet and 408 mourners recruited via healthcare workers. Results: In Sample 1, the unitary model did not fit the data. The four hierarchical models all fit better. The model in which PTSD-items constituted four lower-order factors of reexperiencing, avoidance, dysphoria, and hyperarousal fit the data best. The fit was further improved, when one weak PGD-item and one weak PTSD-item were removed, and error-terms of similar items were allowed to correlate. Findings from Sample 1 were replicated in Sample 2. Limitations: This study relied on self-reported data. Not all PGD-criteria and depression-criteria were assessed. Conclusions: This is the first confirmatory factor analysis study showing that symptoms of PGD, depression, and PTSD represent distinguishable syndromes. PGD-symptoms should be addressed in the assessment and treatment of bereaved people seeking treatment.