Abstract
The Depressive and Anxious Avoidance in Prolonged Grief Questionnaire (DAAPGQ) was developed to measure depressive and anxious avoidance behaviors, which, according to cognitive-behavioral models, are supposed to play an important role in the development and maintenance of prolonged grief. The present study aimed to develop a German version of the DAAPGQ and evaluate its psychometric properties and validity within a representative sample of the German general population (N = 2531). The German-language DAAPGQ was developed using a forward-backward translation procedure. Then, a subsample of individuals who reported having lost a significant other (N = 1371) of a representative sample was assessed with the German DAAPGQ, along with information on sociodemographic characteristics, prolonged grief symptom severity (PG-13), general anxiety (GAD-2) and depression (PHQ-2). The factor structure of the DAAPGQ was evaluated using confirmatory factor analyses, reliability by calculating internal consistency on subscale level and convergent validity by correlations between DAAPQG subscale sores with PG-13, GAD-2 and PHQ-2 sum scores. As expected, a two-factor model with correlated latent variables showed good fit to the data, replicating findings from the original version. Internal consistency was high for both subscales (Cronbach’s α .86 and .95, respectively). Convergent validity was established by theoretically expected and statistically significant positive correlations of DAAPGQ subscales with symptom severity of prolonged grief, depression, and anxiety and negative correlations with time since loss. Furthermore, the addition of depressive and anxious avoidance significantly improved the prediction of prolonged grief symptom severity over sociodemographic and loss-related information. In sum, our results suggest that the German-language DAAPGQ is a reliable and valid measure of depressive and anxious avoidance and a useful tool to improve our knowledge on the role of avoidance in prolonged grief. We also provide descriptive data to improve the applicability of the DAAPGQ for individual diagnostics.
Highlights
Grief is a natural response to the death of a loved one, and most bereaved are able to cope with the loss over time
As the criteria for Prolonged Grief Disorder (PGD) changed over time, we use the term PGD symptoms throughout the manuscript to refer to the various grief disorders proposed over the years such as pathological, complicated, traumatic or prolonged grief or persistent complex bereavement disorder [4,5,6,7,8]
This study aimed to provide a German version of the DAAPGQ and evaluate its psychometric properties and validity in a large sample of bereaved individuals drawn from a representative sample of the German general population
Summary
Grief is a natural response to the death of a loved one, and most bereaved are able to cope with the loss over time. For an estimated 10% of the bereaved, the grief reaction becomes abnormally persistent and causes significant impairment in functioning [1]. Considering only people bereaved by unnatural losses such as homicide, suicide or accidents, revealed an even substantially higher rate of 49% [2]. This condition, called Prolonged Grief Disorder (PGD), is part of the newest revision of the International Classification of Diseases (ICD-11) as a new diagnostic entity. As the criteria for PGD changed over time, we use the term PGD symptoms throughout the manuscript to refer to the various grief disorders proposed over the years such as pathological, complicated, traumatic or prolonged grief or persistent complex bereavement disorder [4,5,6,7,8]
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