Premium
Changes in typical beliefs in response to complicated grief treatment
Author(s) -
Skritskaya Natalia A.,
Mauro Christine,
Garcia de la Garza Angel,
Meichsner Franziska,
Lebowitz Barry,
Reynolds Charles F.,
Simon Naomi M.,
Zisook Sidney,
Shear M. Katherine
Publication year - 2020
Publication title -
depression and anxiety
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.634
H-Index - 129
eISSN - 1520-6394
pISSN - 1091-4269
DOI - 10.1002/da.22981
Subject(s) - citalopram , psychology , clinical psychology , grief , placebo , distress , psychiatry , depression (economics) , medicine , anxiety , antidepressant , alternative medicine , macroeconomics , pathology , economics
Background Prolonged grief disorder (PGD) is a new diagnosis in the 11th edition of the International Classification of Diseases, estimated to affect 1 in 10 bereaved people and causing significant distress and impairment. Maladaptive thoughts play an important role in PGD. We have previously validated the typical beliefs questionnaire (TBQ), which contains five kinds of thinking commonly seen in PGD: protesting the death, negative thoughts about the world, needing the person, less grief is wrong, and grieving too much. The current paper examines the role of maladaptive cognition as measured by the TBQ in PGD and its change with treatment. Methods Among participants in a multisite clinical trial including 394 adults, we examined (a) the relationship between maladaptive thoughts at baseline and treatment outcomes, (b) the relationship between maladaptive thoughts and suicidality at baseline and posttreatment, and (c) the effect of treatment with and without complicated grief therapy (CGT) on maladaptive thinking. Results TBQ scores were associated with treatment outcomes and were strongly related to suicidal thinking before and after treatment. TBQ scores showed significantly greater reduction in participants who received CGT with citalopram versus citalopram alone (adjusted mean standard error [ SE ] difference, −2.45 [0.85]; p = .004) and those who received CGT with placebo versus placebo alone (adjusted mean [ SE ] difference, −3.44 [0.90]; p < .001). Conclusions Maladaptive thoughts, as measured by the TBQ, have clinical and research significance for PGD and its treatment.