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BackgroundComplicated grief (CG) is a bereavement-specific syndrome distinct from but commonly comorbid with posttraumatic stress disorder (PTSD). While bereavement is common among military personnel (Simon et al., 2018), there is little research on the impact of CG comorbidity on PTSD treatment outcomes.MethodsTo evaluate the impact of comorbid CG on PTSD treatment outcomes we analyzed data from a randomized trial comparing prolonged exposure, sertraline, and their combination in veterans with a primary diagnosis of combat-related PTSD (n = 194). Assessment of PTSD, trauma-related guilt, functional impairment, and suicidal ideation and behavior occurred at baseline and weeks 6, 12, and 24 during the 24-week trial.ResultsCG was associated with lower PTSD treatment response (odds ratio (OR) = 0.29, 95% confidence interval (CI) [0.12, 0.69], p = 0.005) and remission (OR = 0.28, 95% CI [0.11, 0.71], p = 0.007). Those with CG had greater severity of PTSD (p = 0.005) and trauma-related guilt (

The death of a loved one is one of life's greatest stressors. Most bereaved individuals experience a period of acute grief that diminishes in intensity as they adapt to the changes brought about by their loss. Over the past four decades, a growing body of research has focused on a form of prolonged grief that is painful and impairing. There is a substantial and growing evidence base that supports the validity and significance of a grief-related disorder, including the clinical value of being able to diagnose it and provide effective targeted treatment. ICD-11 will include a new diagnosis of prolonged grief disorder (PGD). DSM-5 called this condition persistent complex bereavement disorder (PCBD) and included it in Section III, signaling agreement that a diagnosis is warranted while further research is needed to determine the optimal criteria. Given the remaining uncertainties, reading this literature can be confusing. There is inconsistency in naming the condition (including complicated grief as well as PGD and PCBD) and lack of uniformity in identifying it, with respect to the optimal threshold and timeframe for distinguishing it from normal grief. As an introductory commentary for this Depression and Anxiety special edition on this form of grief, the authors discuss the history, commonalities, and key areas of variability in identifying this condition. We review the state of diagnostic criteria for DSM-5 and the current ICD-11 diagnostic guideline, highlighting the clinical relevance of making this diagnosis.

Background: Despite increased attention on treatment and prevention for suicidal adolescents, we know little about potential intervention targets. Episodic future thinking—the ability to imagine detailed, personal, and future‐oriented events—is a modifiable cognitive process that has been linked with suicidal ideation (SI) in adolescents. However, until now its modifiability has only been tested in adults. Method: Adolescents (N = 176, ages 15–19; 71% SI) completed performance‐based measures of episodic future thinking (i.e., Experimental Recombination Paradigm) and memory immediately before and after an Episodic Specificity Induction (ESI). Results: Adolescents produced a greater number of future episodic details after (vs. before) the ESI but showed no change in non‐episodic details (e.g., semantic information). Patterns of change in episodic future thinking were not moderated by SI history. Adolescents overall did not demonstrate change in past episodic detail counts after the ESI. However, there were select moderating effects of SI history on this effect. Conclusion: Results show that episodic future thinking can change immediately following an episodic specificity induction among adolescents, regardless of whether they have previously experienced SI. This demonstration of within‐person change constitutes a foundational first step in examining malleability of episodic future thinking in adolescents and offers preliminary evidence of a cognitive mechanism that may be leveraged in service of reducing adolescents' SI. [ABSTRACT FROM AUTHOR]

BackgroundComplicated grief (CG) has been recently included in the DSM-5, under the term "persistent complex bereavement disorder," as a condition requiring further study. To our knowledge, no psychometric data on any structured clinical interview for CG (SCI-CG) is available to date. In this manuscript, we introduce the SCI-CG, a 31-item "SCID-like" clinician-administered instrument to assess the presence of CG symptoms.MethodsParticipants were 281 treatment-seeking adults with CG (77.9% [n = 219] women, mean age = 52.4, standard deviation [SD] = 17.8) who were assessed with the SCI-CG and measures of depression, posttraumatic stress, anxiety, functional impairment.ResultsThe SCI-CG exhibited satisfactory internal consistency (α = .78), good test-retest reliability (interclass correlation [ICC] 0.68, 95% CI [0.60-0.75]), and excellent interrater reliability (ICC = 0.95, 95% CI [0.89-0.98]). Exploratory factor analyses revealed that a five-factor structure, explaining 50.3% of the total variance, was the best fit for the data.ConclusionsThe clinician-rated SCI-CG demonstrates good internal consistency, reliability, and convergent validity in treatment-seeking individuals with CG and therefore can be a useful tool to assess CG. Although diagnostic criteria for CG have yet to be adequately validated, the SCI-CG may facilitate this process. The SCI-CG can now be used as a validated instrument in research and clinical practice.

The current paper presents an integrated formal model of typical and atypical development based on the mechanisms of mutualism and resource competition. The mutualistic network model is extended with the dynamics of competition for limited resources, such as time and environmental factors. The proposed model generates patterns that resemble established phenomena in cognitive development: the positive manifold, developmental phases, developmental delays and lack of early indicators in atypical development, developmental regression, and "quasi‐autism" caused by extreme environmental deprivation. The presented modeling framework fits a general movement towards formal theory construction in psychology. The model is easy to replicate and develop further, and we offer several avenues for future work. [ABSTRACT FROM AUTHOR]