Abstract
BackgroundExposure to trauma and bereavement is common in conflict-affected regions. Previous research suggests considerable heterogeneity in responses to trauma and loss with varying symptom representations. The purpose of the current study was to (1) identify classes of prolonged grief disorder (PGD) and posttraumatic stress disorder (PTSD) symptom profiles among individuals who were exposed to both trauma and loss due to the Colombian armed conflict and (2) to examine whether sociodemographic, loss and trauma-related characteristics could predict class membership.MethodsThree hundred eight victims of internal displacement who had experienced trauma and loss were assessed through measures of PGD (PG-13), PTSD (PCL-C), and social support (DUKE-UNC). Latent class analysis (LCA) was performed to analyze differential profiles by symptoms of PGD and PTSD and multinomial logistic regression was used to analyze predictors of class membership.ResultsLCA revealed a four-class solution: a resilient class (23.6%), a PTSD-class (23.3%), a predominately PGD class (25.3%) and a high distress-class with overall high values of PGD and PTSD (27.8%). Relative to the resilient class, membership to the PGD class was predicted by the loss of a close family member and the exposure to a higher number of assaultive traumatic events, whereas membership to the PTSD class was predicted by the perception of less social support. Compared to the resilient class, participants in the high distress-class were more likely to be female, to have lost a close relative, experienced more accidental and assaultive traumatic events, and perceived less social support.DiscussionSpecific symptom profiles emerged following exposure to trauma and loss within the context of the Colombian armed conflict. Profiles were associated with distinct types of traumatic experiences, the degree of closeness to the person lost, the amount of social support perceived, and gender. The results have implications for identifying distressed subgroups and informing interventions in accordance with the patient’s symptom profile.
Highlights
Exposure to trauma and bereavement is common in conflict-affected regions
While prolonged grief disorder (PGD) was rejected as a diagnosis in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5, [3]) and has only been introduced as a condition for further study (“persistent bereavement related disorder”), PGD is proposed for inclusion in the forthcoming edition of the International Classification of Diseases (ICD-11; [4])
Comparing membership to the PGD class with the posttraumatic stress disorder (PTSD) class, membership to the PGD class was predicted by the loss of a close family member and by less time that had elapsed since the loss
Summary
Exposure to trauma and bereavement is common in conflict-affected regions. Previous research suggests considerable heterogeneity in responses to trauma and loss with varying symptom representations. The purpose of the current study was to (1) identify classes of prolonged grief disorder (PGD) and posttraumatic stress disorder (PTSD) symptom profiles among individuals who were exposed to both trauma and loss due to the Colombian armed conflict and (2) to examine whether sociodemographic, loss and trauma-related characteristics could predict class membership. People are exposed to trauma and bereavement in the context of violent conflicts and systematic human rights violations. The high rates of posttraumatic stress disorder (PTSD) and depression as a consequence of traumatic experiences within these conflicts have been documented in several studies [1]. Traumatic experiences within violent conflicts often involve the loss of significant others and studies have addressed maladaptive grief in conflictaffected populations only recently. Evidence suggests that a significant number of individuals experience persistent distressing grief symptoms after the loss of a loved one. While PGD was rejected as a diagnosis in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5, [3]) and has only been introduced as a condition for further study (“persistent bereavement related disorder”), PGD is proposed for inclusion in the forthcoming edition of the International Classification of Diseases (ICD-11; [4])
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