Latent trajectories of DSM-5-TR-based Prolonged Grief Disorder: findings from a data pooling project MARBLES.

Background: With the release of the text revision of the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5-TR), criteria for Prolonged Grief Disorder (PGD) were included. This necessitates studying grief trajectories based on these criteria.Objective: This is the first study examining latent trajectories of DSM-5-TR-based PGD symptom levels and testing whether specific risk factors (e.g. cause of death) predicted PGD trajectories.Method: We evaluated latent DSM-5-TR PGD trajectories using pooled existing data collected at 6-12, 13-24, and 25-60 months post-loss in Danish and Dutch bereaved adults (N = 398). Latent Growth Mixture Modelling (LGMM) was employed to determine the trajectories. Multinomial logistic regression analyses were used to examine which risk factors predicted class membership.Results: The four-class LGMM solution with a quadratic term was best-fitting the data. This solution represented four trajectories: High stable PGD (6%), High PGD quick recovery (10%), High PGD slow recovery (35%), and Low PGD symptoms (49%). Participants with a higher educational level were more likely to be assigned to the Low PGD symptoms trajectory compared to High stable PGD and High PGD slow recovery trajectories. Unnatural causes of death increased the likelihood of being in the High stable PGD and High PGD slow recovery trajectories compared to the Low PGD symptoms trajectory.Conclusions: Consistent with prior research, the Low PGD symptoms trajectory was the most common. A significant minority experienced high and stable levels of PGD within five years after the loss. About one-third of participants experienced high acute grief levels that decreased slowly; how slow decreasing symptoms relate to an individual's functioning requires further attention. This study demonstrates that a significant minority of bereaved people develop acute PGD symptomatology that does not diminish within five years post-loss, emphasizing the need for early screening for PGD to prevent long-lasting complaints.

This is the first latent trajectory study based on DSM-5-TR Prolonged Grief Disorder (PGD) criteria. Data were analysed using latent growth mixture modelling.Stable high (6%), quick recovery (10%), slow recovery (35%), low symptoms (49%) PGD trajectories arose.Early screening and treatment of PGD seems warranted.

Characteristics of positive and negative autobiographical memories central to identity: emotionality, vividness, rehearsal, rumination, and reflection.

Introduction: Some events are remembered as more central to a person's identity than others. However, it is not entirely clear what characterizes these autobiographical memories central to one's identity. In this study, we examined the effects of various characteristics on centrality to identity of positive and negative memories. Characteristics such as emotionality, vividness, and how frequently a memory is retrieved and shared with others as well as ruminative and reflective self-foci were studied. Methods: The sample included 356 participants (18-92 years of age). First, participants responded to demographic questions and individual difference questionnaires. Next, they recalled memories in response to 12 emotional cue words. The cue words were balanced for emotional valence (i.e., six positive and six negative) and presented in a random order. After retrieving all memories, participants rated them regarding centrality, using the short seven-item Centrality of Event Scale and other memory characteristics, on a seven-point Likert scale. Multivariate multilevel regression was used for data analyzes, to consider multiple characteristics at the same time and account for data dependency within individual. Results: The results showed that emotionality, vividness, and frequency of memory retrieval contributed to higher centrality of memories, and employing a reflective self-focus resulted in rating memories as more central. In specific cases, these characteristics were associated differently with centrality of positive and negative memories. Discussion: Central memories can be perceived as markers in a person's life story. The findings of this study suggest that these marker events are also highly available in a person's memory system, by being actively emotional, visually rich, and frequently retrieved. Moreover, not only memory characteristics but also individual's features are important to fully understand the autobiographical memory centrality.

Psychological empowerment and quality of life in haematopoietic stem cell transplantation patients: A quantitative study.

AIM: This study aimed to evaluate the relationship between psychological empowerment, depression, anxiety, and quality of life in people with haematopoietic stem cell transplantation (HSCT). DESIGN: A longitudinal prospective study. METHODS: A sample of 150 people with haematological was recruited at Santaros Clinics in Lithuania between September 2020 and April 2022. Demographic characteristics, cancer-related characteristics, depression, anxiety, psychological empowerment and quality of life (QoL) were assessed using self-report questionnaires before and 10-12 weeks after HSCT. Descriptive statistics, correlation and moderation analyses were performed. RESULTS: The results showed that psychological empowerment had a significant correlation with patients' depression, anxiety and QoL. Patients who were more empowered before HSCT had a subjectively better QoL before and after HSCT and were less depressed after transplantation. The results showed that empowerment was a moderator between depression and QoL after transplantation, but it had a significant effect on the QoL only among patients who are less depressed. PATIENT OR PUBLIC CONTRIBUTION: With this study, we aim to contribute to a better understanding of the psychological experiences of people with HSCT. Particularly, psychological empowerment is an important factor in preparing for this treatment. Medical professionals like nurses can be crucial contributors to implementing and strengthening psychological empowerment.

Personal reminiscence styles and adaptation to bereavement: how meaning mediates their relationship.

OBJECTIVES: Personal reminiscence styles are known to influence a person's well-being, but research regarding their impact on bereavement outcomes is limited. Based on previous findings, we assumed ruminative and reflective reminiscence styles to be associated with feelings of grief and personal growth, and that meaning-making efforts and the degree of having meaning-made of losing a loved one potentially mediate these relationships. METHODS: The final study sample consisted of 198 participants aged between18 and 75 years (Mage = 40.58, SD = 39.0), 83.3% were female. In a first step, we ran separate mediation models to examine the associations between reminiscence styles, processes of making meaning of the loss and bereavement. Based on these results, we build a parsimonious, inclusive pathway model. RESULTS: Our findings indicate that a ruminative reminiscence style is related to feelings of grief and personal growth through its associations with meaning-made. A reflective reminiscence style, in contrast, is associated with feelings of grief through its relation to meaning-making efforts. Moreover, a reflective reminiscence style is directly related to personal growth. CONCLUSION: Findings are discussed regarding their implications for both areas of research - autobiographical remembering and adaptation to bereavement, as well as their applicability in clinical settings.

A multilevel factor analysis of the short form of the Centrality of Event Scale.

Introduction: The Centrality of Event Scale (CES) has frequently been used to measure the degree to which positive and negative life events are perceived central to a person's identity and life story; and previous research suggests that individuals rate their most positive memory as more central compared to their most negative one. When comparing the centrality of two (or more) memories within individuals, one needs to ensure that the CES (or its short form) is equally valid for different types of events (i.e., positive and negative) as well as on different levels of analyses (i.e., on the between-person and the within-person level), pointing to the issue of measurement invariance. Methods: Three-hundred sixty-five adults (18-89 years of age) reported up to ten positive and up to ten negative autobiographical memories. For each memory reported, participants completed the seven-item short form of the CES, which measures three different components of centrality: Events can form a central component of identity (two items), a turning point in the life story (three items), and a reference point for everyday inferences (two items). Results: Based on exploratory and confirmatory factor analyses, we found a two-factor structure (Self-Perception and Life-Course) to fit the data best at both levels of analyses and for both positive and negative events. Strict measurement invariance could be applied for positive and negative events at between-person level and at within-person level. The two factors, which measure the impact of an event on either a person's self-perception or their (future) life course, were rated higher for positive compared to negative memories. This difference, however, was stronger for the self-perception factor. Discussion: The present study provides a first examination of the factorial structure of the CES short form on two levels (within and between persons) as well as for two types of life events (positive and negative). Whereas, a unidimensional scale might be sufficient to measure the centrality of stressful or traumatic life events, a more fine-graded measure seems better suited to understand the different roles of positive and negative life events for a person's identity and life story.

The valence and the functions of autobiographical memories: Does intensity matter?

Autobiographical memories serve psychosocial functions in daily life and the use of memories is related to their valence. In the present study, we examined whether functions are also related to the intensity of positive and negative memories. Our sample included 110 participants (57-89 years of age). Memories were prompted with 30 emotionally neutral cue words. Participants rated the emotional quality of each memory and indicated how frequently they had recalled it for self-continuity, directing behavior, social-bonding, and mood-enhancement. We used multilevel modeling to test whether individual differences in the use of memories can explain why individuals recall different numbers of positive and negative memories as well as memories high or low in intensity. Each function revealed its specific pattern regarding valence and intensity but also regarding within-person and between-person effects. Mood-enhancement showed the strongest relations, which points to the importance of considering emotion regulation as a function of autobiographical memory.