title: Complicated grief associated with hurricane Katrina.
abstract: BACKGROUND
  Although losses are important consequences of disasters, few epidemiological studies of disasters have assessed complicated grief (CG) and none assessed CG associated with losses other than death of loved one.
  
  
  METHODS
  Data come from the baseline survey of the Hurricane Katrina Community Advisory Group, a representative sample of 3,088 residents of the areas directly affected by Hurricane Katrina. A brief screen for CG was included containing four items consistent with the proposed DSM-V criteria for a diagnosis of bereavement-related adjustment disorder.
  
  
  RESULTS
  Fifty-eight and half percent of respondents reported a significant hurricane-related loss: Most-severe losses were 29.0% tangible, 9.5% interpersonal, 8.1% intangible, 4.2% work/financial, and 3.7% death of loved one. Twenty-six point one percent respondents with significant loss had possible CG and 7.0% moderate-to-severe CG. Death of loved one was associated with the highest conditional probability of moderate-to-severe CG (18.5%, compared to 1.1-10.5% conditional probabilities for other losses), but accounted for only 16.5% of moderate-to-severe CG due to its comparatively low prevalence. Most moderate-to-severe CG was due to tangible (52.9%) or interpersonal (24.0%) losses. Significant predictors of CG were mostly unique to either bereavement (racial-ethnic minority status, social support) or other losses (prehurricane history of psychopathology, social competence.).
  
  
  CONCLUSIONS
  Nonbereavement losses accounted for the vast majority of hurricane-related possible CG despite risk of CG being much higher in response to bereavement than to other losses. This result argues for expansion of research on CG beyond bereavement and alerts clinicians to the need to address postdisaster grief associated with a wide range of losses.
authors.affiliation: Columbia University School of Social Work and Columbia University College of Physicians and Surgeons, New York, New York, USA. ks2394@columbia.edu
authors.forename: M Katherine
authors.initials: MK
authors.lastname: Shear
authors.forename: Katie A
authors.initials: KA
authors.lastname: McLaughlin
authors.forename: Angela
authors.initials: A
authors.lastname: Ghesquiere
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Gruber
authors.forename: Nancy A
authors.initials: NA
authors.lastname: Sampson
authors.forename: Ronald C
authors.initials: RC
authors.lastname: Kessler
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D055867:Cyclonic Storms / Q000191:economics / Q000401:mortality; D004190:Disasters; D005260:Female; D006117:Grief; D006801:Humans; D008016:Life Change Events; D008297:Male; D001523:Mental Disorders / Q000191:economics / Q000453:epidemiology / Q000401:mortality; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors; D013405:Suicide / Q000523:psychology; D055815:Young Adult