Validation of the Persistent Complex Bereavement Disorder (PCBD) Checklist: A Developmentally Informed Assessment Tool for Bereaved Youth

Abstract

The inclusion of Persistent Complex Bereavement Disorder (PCBD) in the DSM-5 appendix signifies a call for research regarding the distinguishing features and clinical utility of proposed PCBD criteria. Rigorously constructed tools for assessing PCBD are lacking, especially for youth. This study evaluated the validity and clinical utility of the PCBD Checklist, a 39-item measure designed to assess PCBD criteria in youth aged 8 to18 years. Test construction procedures involved: (a) reviewing the literature regarding developmental manifestations of proposed criteria, (b) creating a developmentally informed item pool, (c) surveying an expert panel to evaluate the clarity and developmental appropriateness of candidate items, (d) conducting focus groups to evaluate the comprehensibility and acceptability of items, and (e) evaluating psychometric properties in 367 bereaved youth (M = 13.49, 55.0% female). The panel, clinicians, and youth provided favorable content validity and comprehensibility ratings for candidate items. As hypothesized, youth who met full PCBD criteria, Criterion B (e.g., preoccupation with the deceased and/or circumstances of the death), or Criterion C (e.g., reactive distress and/or social/identity disruption) reported higher posttraumatic stress and depressive symptoms than youth who did not meet these criteria, η = .07-.16. Youth who met Criterion C reported greater functional impairment than youth who did not, η = .08-.12. Youth who qualified for the "traumatic bereavement specifier" reported more frequent posttraumatic stress symptoms than youth who did not, η = .04. Findings support the convergent, discriminant, and discriminant-groups validity, developmental appropriateness, and clinical utility of the PCBD Checklist.

Comparison of DSM-5 criteria for persistent complex bereavement disorder and ICD-11 criteria for prolonged grief disorder in help-seeking bereaved children

“…Consequently, conclusions should stay tentative pending replication with measures specifically designed to assess the whole range of PCBD and PGD symptoms. Notably, such measures have been developed very recently (Andriessen, Hadzi-Pavlovic, Draper, Dudley, & Mitchell, 2018;Kaplow et al, 2018). Secondly, the prevalence rates of PCBD and PGD likely do not generalized to the general population of bereaved children.…”

“…Although our key interest was to evaluate the DSM-5 and ICD-11 criteria as currently defined, more research is urgently needed to examine whether these criteria are sufficiently developmentally sensitive to capture essential features of disturbed grief in childhood (cf. Kaplow et al, 2018).…”

Understanding grief reactions, thwarted belongingness, and suicide ideation in bereaved adolescents: Toward a unifying theory

“…Items are rated on a 5‐point Likert type scale ranging from 0 (not at all) to 4 (all the time). In prior research, the PCBD Checklist demonstrated strong internal consistency, clinical utility, and content, convergent, and discriminant validity (Kaplow, Layne, Oosterhoff, & Pynoos, ). Separate continuous sum scores for Criteria B and C were calculated, with higher values representing greater maladaptive grief reactions.…”

Measurement Invariance of the Persistent Complex Bereavement Disorder Checklist With Respect to Youth Gender, Race, Ethnicity, and Age

“…The construction and validation of developmentally sensitive assessment tools is an essential early step in ensuring that proposed diagnostic symptoms both accurately reflect the phenomenological experiences of bereaved youth and facilitate the rigorous empirical evaluation of PCBD as a diagnostic entity (Kaplow et al, 2012;Nader & Layne, 2009). The PCBD Checklist (Kaplow et al 2018;Layne et al, 2014), which assesses PCBD symptoms among youth ages 8-18 years, was designed to address this need. An initial psychometric evaluation of the PCBD Checklist in a sample of bereaved youth supported its reliability, validity, and two-factor structure (Kaplow et al, 2018).…”

“…The PCBD Checklist (Kaplow et al 2018;Layne et al, 2014), which assesses PCBD symptoms among youth ages 8-18 years, was designed to address this need. An initial psychometric evaluation of the PCBD Checklist in a sample of bereaved youth supported its reliability, validity, and two-factor structure (Kaplow et al, 2018). However, further examination of the measure's psychometric properties is needed to evaluate the generalizability of the measure across different populations and settings.…”