title: Initial Validation of a Comprehensive Assessment Instrument for Bereavement-Related Grief Symptoms and Risk of Complications: The Indicator of Bereavement Adaptation-Cruse Scotland (IBACS).
abstract: OBJECTIVE
  This study assessed the validity of the Indicator of Bereavement Adaptation Cruse Scotland (IBACS). Designed for use in clinical and non-clinical settings, the IBACS measures severity of grief symptoms and risk of developing complications.
  
  
  METHODS
  N = 196 (44 male, 152 female) help-seeking, bereaved Scottish adults participated at two timepoints: T1 (baseline) and T2 (after 18 months). Four validated assessment instruments were administered: CORE-R, ICG-R, IES-R, SCL-90-R. Discriminative ability was assessed using ROC curve analysis. Concurrent validity was tested through correlation analysis at T1. Predictive validity was assessed using correlation analyses and ROC curve analysis. Optimal IBACS cutoff values were obtained by calculating a maximal Youden index J in ROC curve analysis. Clinical implications were compared across instruments.
  
  
  RESULTS
  ROC curve analysis results (AUC = .84, p < .01, 95% CI between .77 and .90) indicated the IBACS is a good diagnostic instrument for assessing complicated grief. Positive correlations (p < .01, 2-tailed) with all four instruments at T1 demonstrated the IBACS' concurrent validity, strongest with complicated grief measures (r = .82). Predictive validity was shown to be fair in T2 ROC curve analysis results (n = 67, AUC = .78, 95% CI between .65 and .92; p < .01). Predictive validity was also supported by stable positive correlations between IBACS and other instruments at T2. Clinical indications were found not to differ across instruments.
  
  
  CONCLUSIONS
  The IBACS offers effective grief symptom and risk assessment for use by non-clinicians. Indications are sufficient to support intake assessment for a stepped model of bereavement intervention.
authors.affiliation: Department of Clinical Psychology, Utrecht University, Utrecht, The Netherlands.
authors.forename: Catherine
authors.identifier: http://orcid.org/0000-0002-7453-3817
authors.initials: C
authors.lastname: Newsom
authors.affiliation: Department of Clinical Psychology, Utrecht University, Utrecht, The Netherlands.
authors.forename: Henk
authors.initials: H
authors.lastname: Schut
authors.affiliation: Department of Clinical Psychology, Utrecht University, Utrecht, The Netherlands.|Department of Clinical Psychology and Experimental Psychopathology, University of Groningen, Groningen, The Netherlands.
authors.forename: Margaret S
authors.initials: MS
authors.lastname: Stroebe
authors.affiliation: Cruse Bereavement Care Scotland, Perth, Scotland.
authors.forename: Stewart
authors.initials: S
authors.lastname: Wilson
authors.affiliation: Cruse Bereavement Care Scotland, Perth, Scotland.
authors.forename: John
authors.initials: J
authors.lastname: Birrell
mesh_terms: D000328:Adult; D019540:Area Under Curve; D001601:Bereavement; D005260:Female; D006117:Grief; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D011594:Psychometrics / Q000379:methods*; D012372:ROC Curve; D012307:Risk Factors; D013313:Stress Disorders, Post-Traumatic / Q000473:pathology