학술논문

Measuring Maladaptive Cognitions in Complicated Grief: Introducing the Typical Beliefs Questionnaire
Document Type
article
Source
American Journal of Geriatric Psychiatry. 25(5)
Subject
Clinical and Health Psychology
Psychology
Mental Health
Clinical Research
Depression
Behavioral and Social Science
Cognitive Dysfunction
Female
Grief
Humans
Male
Middle Aged
Psychometrics
Surveys and Questionnaires
Complicated grief
assessment
measurement/psychometrics
treatment
Clinical Sciences
Public Health and Health Services
Cognitive Sciences
Geriatrics
Clinical sciences
Health services and systems
Clinical and health psychology
Language
Abstract
ObjectivesMaladaptive cognitions related to loss are thought to contribute to development of complicated grief and are crucial to address in treatment, but tools available to assess them are limited. This paper introduces the Typical Beliefs Questionnaire (TBQ), a 25-item self-report instrument to assess cognitions that interfere with adaptation to loss.DesignStudy participants completed an assessment battery during their initial evaluation and again after completing treatment at 20 weeks. Test-retest reliability was assessed on a subsample of the participants who did not show change in complicated grief severity after the first 4 weeks of treatment. To examine latent structure of the TBQ, an exploratory factor analysis (EFA) was performed.SettingAcademic medical centers in Boston, New York, Pittsburgh, and San Diego from 2010-2014.Participants394 bereaved adults who met criteria for complicated grief.MeasurementsThe TBQ along with assessments of complicated grief symptoms and related avoidance, depression symptoms, functional impairment, and perceived social support.ResultsThe TBQ exhibited good internal consistency (α = 0.82) and test-retest reliability (N = 105; intraclass correlation coefficient = 0.74). EFA indicated a five-factor structure: "Protesting the Death," "Negative Thoughts About the World," "Needing the Person," "Less Grief is Wrong" and "Grieving Too Much." The total score and all factors showed sensitivity to change with treatment.ConclusionsThis new tool allows a clinician to quickly and reliably ascertain presence of specific maladaptive cognitions related to complicated grief, and subsequently, to use the information to aid a diagnostic assessment, to structure the treatment, and to measure treatment outcomes.