title: Performance of DSM-5 Persistent Complex Bereavement Disorder Criteria in a Community Sample of Bereaved Military Family Members.
abstract: OBJECTIVE
  The purpose of this article was to examine the accuracy of DSM-5 proposed criteria for persistent complex bereavement disorder in identifying putative cases of clinically impairing grief and in excluding nonclinical cases. Performance of criteria sets for prolonged grief disorder and complicated grief were similarly assessed.
  
  
  METHODS
  Participants were family members of U.S. military service members who died of any cause since September 11, 2001 (N=1,732). Putative clinical and nonclinical samples were derived from this community sample using cutoff scores from the Inventory of Complicated Grief and the Work and Social Adjustment Scale. Items from a self-report grief measure (Complicated Grief Questionnaire) were matched to DSM-5 persistent complex bereavement disorder, prolonged grief disorder, and complicated grief criteria. Endorsed items were used to identify cases.
  
  
  RESULTS
  Criteria sets varied in their ability to identify clinical cases. DSM-5 persistent complex bereavement disorder criteria identified 53%, prolonged grief disorder criteria identified 59%, and complicated grief criteria identified more than 90% of putative clinical cases. All criteria sets accurately excluded virtually all nonclinical grief cases and accurately excluded depression in the absence of clinical grief.
  
  
  CONCLUSIONS
  The DSM-5 persistent complex bereavement disorder criteria accurately exclude nonclinical, normative grief, but also exclude nearly half of clinical cases, whereas complicated grief criteria exclude nonclinical cases while identifying more than 90% of clinical cases. The authors conclude that significant modification is needed to improve case identification by DSM-5 persistent complex bereavement disorder diagnostic criteria. Complicated grief criteria are superior in accurately identifying clinically impairing grief.
authors.affiliation: From the Department of Psychiatry, Uniformed Services University of the Health Sciences, Bethesda, Md.; the School of Public Health and the School of Social Work, Columbia University, New York; and the University College of Physicians and Surgeons, Columbia University, New York.
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Cozza
authors.affiliation: From the Department of Psychiatry, Uniformed Services University of the Health Sciences, Bethesda, Md.; the School of Public Health and the School of Social Work, Columbia University, New York; and the University College of Physicians and Surgeons, Columbia University, New York.
authors.forename: Joscelyn E
authors.initials: JE
authors.lastname: Fisher
authors.affiliation: From the Department of Psychiatry, Uniformed Services University of the Health Sciences, Bethesda, Md.; the School of Public Health and the School of Social Work, Columbia University, New York; and the University College of Physicians and Surgeons, Columbia University, New York.
authors.forename: Christine
authors.initials: C
authors.lastname: Mauro
authors.affiliation: From the Department of Psychiatry, Uniformed Services University of the Health Sciences, Bethesda, Md.; the School of Public Health and the School of Social Work, Columbia University, New York; and the University College of Physicians and Surgeons, Columbia University, New York.
authors.forename: Jing
authors.initials: J
authors.lastname: Zhou
authors.affiliation: From the Department of Psychiatry, Uniformed Services University of the Health Sciences, Bethesda, Md.; the School of Public Health and the School of Social Work, Columbia University, New York; and the University College of Physicians and Surgeons, Columbia University, New York.
authors.forename: Claudio D
authors.initials: CD
authors.lastname: Ortiz
authors.affiliation: From the Department of Psychiatry, Uniformed Services University of the Health Sciences, Bethesda, Md.; the School of Public Health and the School of Social Work, Columbia University, New York; and the University College of Physicians and Surgeons, Columbia University, New York.
authors.forename: Natalia
authors.initials: N
authors.lastname: Skritskaya
authors.affiliation: From the Department of Psychiatry, Uniformed Services University of the Health Sciences, Bethesda, Md.; the School of Public Health and the School of Social Work, Columbia University, New York; and the University College of Physicians and Surgeons, Columbia University, New York.
authors.forename: Melanie M
authors.initials: MM
authors.lastname: Wall
authors.affiliation: From the Department of Psychiatry, Uniformed Services University of the Health Sciences, Bethesda, Md.; the School of Public Health and the School of Social Work, Columbia University, New York; and the University College of Physicians and Surgeons, Columbia University, New York.
authors.forename: Carol S
authors.initials: CS
authors.lastname: Fullerton
authors.affiliation: From the Department of Psychiatry, Uniformed Services University of the Health Sciences, Bethesda, Md.; the School of Public Health and the School of Social Work, Columbia University, New York; and the University College of Physicians and Surgeons, Columbia University, New York.
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Ursano
authors.affiliation: From the Department of Psychiatry, Uniformed Services University of the Health Sciences, Bethesda, Md.; the School of Public Health and the School of Social Work, Columbia University, New York; and the University College of Physicians and Surgeons, Columbia University, New York.
authors.forename: M Katherine
authors.initials: MK
authors.lastname: Shear
mesh_terms: D000275:Adjustment Disorders / Q000175:diagnosis* / Q000523:psychology*; D000328:Adult; D000368:Aged; D001601:Bereavement; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005190:Family / Q000523:psychology*; D005260:Female; D006117:Grief; D006801:Humans; D008297:Male; D008875:Middle Aged; D008889:Military Personnel / Q000523:psychology*; D011594:Psychometrics / Q000706:statistics & numerical data; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires