Cross-Lagged Analyses of Prolonged Grief and Depression Symptoms With Insomnia Symptoms
Behavior Therapy(2023)
摘要
Prolonged grief disorder, characterized by severe, persistent and disabling grief, has recently been added to the DSM-5-TR and ICD-11. Treatment for prolonged grief symptoms shows limited effectiveness. It has been suggested that pro-longed grief symptoms exacerbate insomnia symptoms, whereas insomnia symptoms, in turn, may fuel prolonged grief symptoms. To help clarify if treating sleep distur-bances may be a viable treatment option for prolonged grief disorder, we examined the proposed reciprocal rela-tionship between symptoms of prolonged grief and insom-nia. On three time points across 6-month intervals, 343 bereaved adults (88% female) completed questionnaires to assess prolonged grief, depression, and insomnia symp-toms. We applied random intercept cross-lagged panel models (RICLPMs) to assess reciprocal within-person effects between prolonged grief and insomnia symptoms and, as a secondary aim, between depression and insomnia symptoms. Changes in insomnia symptoms predicted changes in prolonged grief symptoms but not vice versa. Additionally, changes in depression and insomnia symp-toms showed a reciprocal relationship. Our results suggest that targeting insomnia symptoms after bereavement is a viable option for improving current treatments for pro-longed grief disorder.
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关键词
prolonged grief disorder,complicated grief,depres-sion,insomnia,random intercept cross-lagged panel model
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