title: Identifying vulnerability in grief: psychometric properties of the Adult Attitude to Grief Scale.
abstract: OBJECTIVE
  Grief is a reaction to a significant loss that can profoundly affect all aspects of life and capacity to function well. The consequences can vary from severe psychological distress through to physical disturbances and significant social problems. This study sought to identify a measure of vulnerability in grief, by examining the psychometric properties of the Adult Attitude to Grief (AAG) scale in a sample of 168 people seeking help in their bereavement.
  
  
  METHODS
  The factor structure of the scale, its internal consistency, its construct validity and optimum classification cutoffs were tested.
  
  
  RESULTS
  Confirmatory factor analysis broadly supported the factor structure of the AAG, but identified one item that could profitably be reworded. Internal consistency of the three subscales was acceptable. Construct validity and discriminative validity were supported by correlations with allied constructs (depression and anxiety) and a significant difference between scores for clients with Prolonged Grief Disorder and those without. A correlation with counsellors' own clinical ratings of vulnerability demonstrated criterion-related validity of the AAG. Using receiver operating characteristic methods, optimum cutoff scores on the scale were identified for the classification of different levels of vulnerability.
  
  
  CONCLUSIONS
  The AAG was found to be a psychometrically promising tool for identifying vulnerability in grief.
authors.affiliation: Research Institute for Social Sciences, Keele University, Staffordshire, ST5 5BG, UK, j.sim@keele.ac.uk.
authors.forename: Julius
authors.initials: J
authors.lastname: Sim
authors.forename: Linda
authors.initials: L
authors.lastname: Machin
authors.forename: Bernadette
authors.initials: B
authors.lastname: Bartlam
mesh_terms: D000328:Adult; D001007:Anxiety / Q000523:psychology; D003863:Depression / Q000523:psychology; D005163:Factor Analysis, Statistical; D005260:Female; D006117:Grief; D006801:Humans; D008297:Male; D008875:Middle Aged; D010555:Personality Inventory / Q000706:statistics & numerical data*; D011594:Psychometrics / Q000295:instrumentation*; D011788:Quality of Life; D012372:ROC Curve; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires; D035862:Vulnerable Populations / Q000523:psychology*; D055815:Young Adult