Table 1.1 Adult Tasks of Mourning Compared to Children’s Figure 1.1 A Cognitive Behavioural Conceptualisation of Complicated Grief (Boelen, Van den Hout, & Var den Bout, 2006). The cognitive behavioural model of Prolonged Grief (see Figure 1.1) is inspired by Beck's general cognitive behavioural model of psychopathology (Beck, 1976) and, more specifically, Ehlers and Clark's (2000) cognitive model of PTSD. The cognitive behavioural model of PGD proposes that three interrelated processes account for the fact that some people suffer from bereavement to a degree that it can be described as PGD (Prigerson et al., 2009): (1) insufficient elaboration and integration of the loss within autobiographical memory; (2) persistent negative thinking; and (3) anxious and depressive avoidance behaviours. Next, these three processes will be described in more detail. Table 2.1 Demographic Characteristics, Loss Related Characteristics, and Scores on Prolonged Grief and Depression Measures Across Samples Note. CDI = Children’s Depression Inventory. IPG-C = Inventory of Prolonged Grief for Children. IPG-A = Inventory of Prolonged Grief for Adolescents. Note. IPG-C = Inventory of Prolonged Grief for Children. IPG-A = Inventory of Prolonged Grief for Adolescents. Table 2.2 Abbreviated Items of the Dutch IPG-C and IPG-A and Factor-Loadings in the One- Factor Solutions Note. Samples sizes differ due to occasional missing values. CDI = Children’s Depression Inventory. CBCL = Child Behaviour Checklist. CPSS = Child Posttraumatic Stress Disorder Symptom Scale. EGI = Extended Grief Inventory. IPG-C = Inventory of Prolonged Grief for Children. YSR = Youth Self Report. *p<0.01.** p< 0.001. Table 2.3 Correlations Between Study Measures among Children and Adolescents from Samples 2 and 3 Note. Samples sizes differ due to occasional missing values. CDI = Children’s Depression Inventory. CPSS : Child Posttraumatic Stress-Disorder Symptom Scale. IPG = Inventory of Prolonged Grief. * p< 0.05. ** p < 0.01. *** p < 0.001. Note. CFI = comparative fit index; RMSEA = root mean square error of approximation; TLI = Tucker-Lewis index. Table 3.2 Fit Statistics for Competing Models of the Factor Structure of Prolonged Grief, Depression, and Posttraumatic Stress Symptoms Table 3.3 Factor-Loadings for Symptoms of Prolonged Grief, Depression, and Post-Traumatic Stress in Children and Adolescent Samples Note. PG = Prolonged Grief. PTS = Posttraumatic Stress. * p< 0.05. ** p < 0.01. *** p < 0.001. Table 4.1 Abbreviated Item Content, Item Mapping for Tested Models, and Item Descriptives (N = 332) Note. DY = Dysphoria. EN = Emotional Numbing. HY = Hyperarousal. P = Posttraumatic Stress. RE = Reexperiencing. AV = Avoidance. * p<0.001. fable 4.2. Demographic Variables, Loss Related Characteristics, and Symptom-Scores in Total Sample and Subsamples Distinguished by PTSD Status Note. Samples sizes differ due to occasional missing values. CDI = Children’s Depression Inventory. CBCL = Child Behaviour Checklist. CPSS = Child Posttraum Disorder Symptom Scale. IPG = Inventory of Prolonged Grief. * p< 0.05. ** p < 0.01. *** p < 0.001. Note. AIC = Akaike information criterion; CFl = comparative fit index; RMSEA = root mean square error o approximation; SRMR = standardised root mean square residual. TLI = Tucker-Lewis index. Table 4.3 Fit Statistics for Six Competing Models of the Factor Structure of Posttraumatic Stress Table 4.4 Correlations of PTSD Total Score and PTSD Factor Scores with Concomitant Clinical Symptoms and Functional Impairment Note. CDI = Children’s Depression Inventory. CBCL = Child Behaviour Checklist. CPSS = Child Posttraumatic Stress Disorder Symptom Scale. IPG = Inventory of Prolonged Grief. * p< 0.05. * p < 0.01. *** p < 0.001. Note. CDI = Children’s Depression Inventory. IPG-C = Inventory of Prolonged Grief for Children. fisit was planned. In total, 121 families were approached and parents and children of 8 68.6%) agreed to participate. Home visits were conducted by trained graduate student: uring the visits, aims of the study were explained and questionnaires were administerec 3efore completion of the questionnaires, assent was obtained from children (aged 8 to 1. /ears), whereas informed consent from parents and adolescents (aged 13 to 18 years). | 1eeded, the students could help with completion of the questionnaires (e.g., read question or dyslectic youth). Sample 1 included 83 children. Thirty children and adolescents were o1 1 waiting list for a support group. They filled in the GCQ-C a second time, approximately si veeks later (M = 5.67, SD = 1.67 weeks, range 3 to 9 weeks) and a third time after 30 week M = 28.97, SD= 2.12 weeks, range 25 to 34 weeks). These children and adolescents did no eceive psychotherapy or other professional aid during this time interval. Table 5.2 Abbreviated Items of the GCQ-C and Factor-Loadings in the One-Factor Solutions interpreted in a meaningful way. Overall, the findings suggested that, within the present Note. Samples sizes differ due to occasional missing values; IPG-C, CDI, CPSS and CATS were filled in by N = 151, CBCL by 144 parents and YSR by 92 adolescents. CDI = Children’s Depression Inventory. CBCL = Child Behaviour Checklist. CPSS = Child Posttraumatic Stres: Disorder Symptom Scale. IPG-C = Inventory of Prolonged Grief for Children. YSR = Youth Self Report. *p <0.01.** p< 0,001. Table 5.3 Correlations between Study Measures in Children Table 6.1 Interventions for Bereaved Children and Adolescents Table 6.1 Continued Table 6.1 Continued Table 6.1 Continued Table 6.2 Summary of FBP Curriculum (2003): Sessions and Topics for Both Children and Parents Table 7.1 Summarised Content of Sessions Note. CBCL scores are raw scores. CDI = Children’s Depression Inventory. CBCL Child Behaviour Checklist. CPSS = Child Posttraumatic Stress-Disorder Symptom Sca IPG-C = Inventory of Prolonged Grief for Children. RCI = Reliable Change Index. Table 7.2 Scores on Symptom Measures at Pre-treatment and Post-treatment Per Child Note. CDI = Children’s Depression Inventory. CBCL = Child Behaviour Checklist. CPSS = Child Posttraumatic Stress Disorder Symptom Scale. IPG-C = Inventory of Prolonged Grief for Children. * p< 0.05. ** p <0.01.*** p < 0.001. Table 7.3 Scores on Symptom Measures at Pre-treatment and Post-treatment for All Si Participants Note. Scores on items 1 through 4 range from 1 (totally disagree) to 5 (totally agree); scores on item 5 range from 0 (lowest) to 10 (highest). Table 7.4 Summary of Feasibility Data her father’s death. Exploring the immediate effects of these cognitions helped Debby to see that ruminating about other’s being to blame did not relieve her pain. The fear that mother would die too was targeted by calculating the chance that this would happen. Discussing that Debby could live with her favorite aunt if this disaster would in fact happen brought further relief to this fear. Problem solving skills were taught to help Debby provide support to her mother in other ways than constantly staying close to her (e.g., by phoning mother instead or staying physically close and by encouraging mother to make use of support that was offered by friends). According to RClIs (Table 7.2), Debby improved significantly (i.e. RCls > 1.96; Jacobson & Truax, 1991) on the IPG and CBCL. (0 her mother in other ways than constantly staying close to her (e.g., by phoning mother Note. CBCL scores are raw scores. CDI = Children’s Depression Inventory. CBCL = Child Behaviour Checklist. CPSS = Child Posttraumatic Stress-Disorder Symptom Scale. IPG-C = Inventory of Prolonged Grief for Children. Table 8.1 Means, Standard Deviations and Z Statistics (Wilcoxon Signed-Rank Tests) for Outcome Measures at Pre-Treatment and Post-Treatment seeking help following bereavement reported by Spuij, Prinzie et al. (2012). On the CDI six participants scored above the > 13 cut-off indicative of clinical depression (Kovacs, 1992). Compared with a Dutch reference group (Verhulst et al., 1996), scores on the CBCL Internalizing scale of six participants fell within the subclinical or clinical range; scores on the CBCL Externalising scale of four participants fell within the subclinical or clinical range; and scores on the CBCL total scale of four participants fell within the clinical range. Thus although distress levels varied, participants all experienced moderate to severe levels of distress at pre-treatment. Note. CDI = Children’s Depression Inventory. CBCL = Child Behaviour Checklist. CPSS = Child Posttraumatic Stress-Disorder Symptom Scale. IPG-C = Inventory of Prolonged Grief for Children. * p < 0.05. Table 8.2 Reliable Change Indices for Changes in Symptoms from Pre-Treatment to Post- Treatment for all 10 Patients CBCL = Child Behaviour Checklist. CDI = Children’s Depression Inventory. CPSS = Child Posttraumatic Stress-Disorder Symptom Scale. GBQ-C = Grief | Questionnaire for Children. GCQ-C = Grief Cognition Questionnaire for Children. HADS = Hospital Anxiety and Depression Scale. HiPIC = Hierarchical P. Inventory for Children. |CG-r = Inventory of Prolonged Grief-revised. IPG-C = Inventory of Prolonged Grief for Children. MFP = Mother-Father-Peer Scale. PPQ = Practices Questionnaire. Table 9.1 Assessment Schedule
