title: Measuring Maladaptive Cognitions in Complicated Grief: Introducing the Typical Beliefs Questionnaire.
abstract: OBJECTIVE
  Maladaptive cognitions related to loss are thought to contribute to development of complicated grief and are crucial to address in treatment, but tools available to assess them are limited. This paper introduces the Typical Beliefs Questionnaire (TBQ), a 25-item self-report instrument to assess cognitions that interfere with adaptation to loss.
  
  
  METHODS
  Study participants completed an assessment battery during their initial evaluation and again after completing treatment at 20 weeks. Test-retest reliability was assessed on a subsample of the participants who did not show change in complicated grief severity after the first 4 weeks of treatment. To examine latent structure of the TBQ, an exploratory factor analysis (EFA) was performed.
  
  
  METHODS
  Academic medical centers in Boston, New York, Pittsburgh, and San Diego from 2010-2014.
  
  
  METHODS
  394 bereaved adults who met criteria for complicated grief.
  
  
  METHODS
  The TBQ along with assessments of complicated grief symptoms and related avoidance, depression symptoms, functional impairment, and perceived social support.
  
  
  RESULTS
  The TBQ exhibited good internal consistency (α = 0.82) and test-retest reliability (N = 105; intraclass correlation coefficient = 0.74). EFA indicated a five-factor structure: "Protesting the Death," "Negative Thoughts About the World," "Needing the Person," "Less Grief is Wrong" and "Grieving Too Much." The total score and all factors showed sensitivity to change with treatment.
  
  
  CONCLUSIONS
  This new tool allows a clinician to quickly and reliably ascertain presence of specific maladaptive cognitions related to complicated grief, and subsequently, to use the information to aid a diagnostic assessment, to structure the treatment, and to measure treatment outcomes.
authors: Columbia University School of Social Work, Columbia University, New York, NY. Electronic address: ns2712@columbia.edu.
authors: Natalia A
authors: NA
authors: Skritskaya
authors: Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, NY.
authors: Christine
authors: C
authors: Mauro
authors: New York State Psychiatric Institute, New York, NY.
authors: Matthew
authors: M
authors: Olonoff
authors: Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, NY.
authors: Xin
authors: X
authors: Qiu
authors: Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, NY.
authors: Sarah
authors: S
authors: Duncan
authors: Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, NY.
authors: Yuanjia
authors: Y
authors: Wang
authors: Division of Biostatistics, Department of Psychiatry, Columbia University, New York, NY.
authors: Naihua
authors: N
authors: Duan
authors: Department of Psychiatry, University of California, San Diego, La Jolla, CA.
authors: Barry
authors: B
authors: Lebowitz
authors: Department of Psychiatry, University of Pittsburgh School of Medicine and Department of Community and Behavioral Health Science, University of Pittsburgh Graduate School of Public Health, Western Psychiatry Institute and Clinic, Pittsburgh, PA.
authors: Charles F
authors: CF
authors: Reynolds
authors: Center for Anxiety and Traumatic Stress Disorders, Massachusetts General Hospital, Boston, MA; Harvard Medical School, Boston, MA.
authors: Naomi M
authors: NM
authors: Simon
authors: Department of Psychiatry, University of California, San Diego, La Jolla, CA.
authors: Sidney
authors: S
authors: Zisook
authors: Columbia University School of Social Work, Columbia University, New York, NY; Department of Psychiatry, Columbia University College of Physicians and Surgeons, New York, NY.
authors: M Katherine
authors: MK
authors: Shear
mesh_terms: D060825:Cognitive Dysfunction / Q000175:diagnosis* / Q000523:psychology*; D005260:Female; D006117:Grief; D006801:Humans; D008297:Male; D008875:Middle Aged; D011594:Psychometrics; D011795:Surveys and Questionnaires
keywords: Complicated grief; assessment; measurement/psychometrics; treatment