Measuring Maladaptive Cognitions in Complicated Grief: Introducing the Typical Beliefs Questionnaire.
OBJECTIVES
Maladaptive 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.


DESIGN
Study 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.


SETTING
Academic medical centers in Boston, New York, Pittsburgh, and San Diego from 2010-2014.


PARTICIPANTS
394 bereaved adults who met criteria for complicated grief.


MEASUREMENTS
The TBQ along with assessments of complicated grief symptoms and related avoidance, depression symptoms, functional impairment, and perceived social support.


RESULTS
The 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.


CONCLUSIONS
This 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.
['Skritskaya|Natalia A|NA|', 'Mauro|Christine|C|', 'Olonoff|Matthew|M|', 'Qiu|Xin|X|', 'Duncan|Sarah|S|', 'Wang|Yuanjia|Y|', 'Duan|Naihua|N|', 'Lebowitz|Barry|B|', 'Reynolds|Charles F|CF|', 'Simon|Naomi M|NM|', 'Zisook|Sidney|S|', 'Shear|M Katherine|MK|']
D060825:Cognitive Dysfunction D005260:Female D006117:Grief D006801:Humans D008297:Male D008875:Middle Aged D011594:Psychometrics D011795:Surveys and Questionnaires
Complicated grief treatment assessment measurement/psychometrics