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Distinguishing a disorder of persistent and impairing grief from normative grief allows clinicians to identify this often undetected and disabling condition. As four diagnostic criteria sets for a grief disorder have been proposed, their similarities and differences need to be elucidated.
Participants were family members bereaved by US military service death (N = 1732). We conducted analyses to assess the accuracy of each criteria set in identifying threshold cases (participants who endorsed baseline Inventory of Complicated Grief ⩾30 and Work and Social Adjustment Scale ⩾20) and excluding those below this threshold. We also calculated agreement among criteria sets by varying numbers of required associated symptoms.
All four criteria sets accurately excluded participants below our identified clinical threshold (i.e. correctly excluding 86–96% of those subthreshold), but they varied in identification of threshold cases (i.e. correctly identifying 47–82%). When the number of associated symptoms was held constant, criteria sets performed similarly. Accurate case identification was optimized when one or two associated symptoms were required. When employing optimized symptom numbers, pairwise agreements among criteria became correspondingly ‘very good’ (κ = 0.86–0.96).
The four proposed criteria sets describe a similar condition of persistent and impairing grief, but differ primarily in criteria restrictiveness. Diagnostic guidance for prolonged grief disorder in International Classification of Diseases, 11th Edition (ICD-11) functions well, whereas the criteria put forth in Section III of Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) are unnecessarily restrictive.
This study investigated the characteristics of subjective memory complaints (SMCs) and their association with current and future cognitive functions.
A cohort of 209 community-dwelling individuals without dementia aged 47–90 years old was recruited for this 3-year study. Participants underwent neuropsychological and clinical assessments annually. Participants were divided into SMCs and non-memory complainers (NMCs) using a single question at baseline and a memory complaints questionnaire following baseline, to evaluate differential patterns of complaints. In addition, comprehensive assessment of memory complaints was undertaken to evaluate whether severity and consistency of complaints differentially predicted cognitive function.
SMC and NMC individuals were significantly different on various features of SMCs. Greater overall severity (but not consistency) of complaints was significantly associated with current and future cognitive functioning.
SMC individuals present distinctive features of memory complaints as compared to NMCs. Further, the severity of complaints was a significant predictor of future cognition. However, SMC did not significantly predict change over time in this sample. These findings warrant further research into the specific features of SMCs that may portend subsequent neuropathological and cognitive changes when screening individuals at increased future risk of dementia.
The World Health Organization (WHO) International Classification of Disease (ICD-11) is expected to include a new diagnosis for prolonged grief disorder (ICD-11PGD). This study examines the validity and clinical utility of the ICD-11PGD guideline by testing its performance in a well-characterized clinical sample and contrasting it with a very different criteria set with the same name (PGDPLOS).
We examined data from 261 treatment-seeking participants in the National Institute of Mental Health (NIMH)-sponsored multicenter clinical trial to determine the rates of diagnosis using the ICD-11PGD guideline and compared these with diagnosis using PGDPLOS criteria.
The ICD-11PGD guideline identified 95.8% [95% confidence interval (CI) 93.3–98.2%] of a treatment-responsive cohort of patients with distressing and impairing grief. PGDPLOS criteria identified only 59.0% (95% CI 53.0–65.0%) and were more likely to omit those who lost someone other than a spouse, were currently married, bereaved by violent means, or not diagnosed with co-occurring depression. Those not diagnosed by PGDPLOS criteria showed the same rate of treatment response as those who were diagnosed.
The ICD-11PGD diagnostic guideline showed good performance characteristics in this sample, while PGDPLOS criteria did not. Limitations of the research sample used to derive PGDPLOS criteria may partly explain their poor performance in a more diverse clinical sample. Clinicians and researchers need to be aware of the important difference between these two identically named diagnostic methods.
Using Irish strandings data collected between 2002 and 2014, seasonal and annual trends in the number of strandings for all strandings identified to species level (N = 1480), and for the five most frequently reported species: common dolphin (25.7% of records), harbour porpoise (22.2%), long-finned pilot whale (8.8%), striped dolphin (6.9%) and bottlenose dolphin (6.9%) were investigated. With the exception of bottlenose dolphins, there was a significant linear increase in the number of strandings across years for all species and for all strandings collectively, that were identified to species-level. Only common dolphins demonstrated a significant increase in the proportion of records relative to all other strandings, which may be indicative of a real rise in the number of strandings of this species. Common dolphins and harbour porpoises showed a similar significant difference in monthly strandings, with more strandings occurring during the earlier months of the year. Significant differences in the gender of stranded animals were found in common, striped, bottlenose and Atlantic white-sided dolphins and sperm and pygmy sperm whales. Live and mass stranding events were primarily comprised of pelagic species. Most strandings occurred on the south and west coasts, with two hotspots for live and mass strandings identified. The patterns and trends identified are discussed in relation to the caveats in interpreting strandings data. Specifically to Ireland, the findings highlight the urgent need to build on the current volunteer reporting network and augment this comprehensive dataset with post-mortem examinations to better understand the cause of the trends identified. The importance of strandings data in informing conservation and management guidelines of these species’ is discussed.
To evaluate patterns of water consumption from plain water, beverages and foods among Mexican children and adolescents and to compare actual patterns of total daily water intake with the Dietary Reference Intakes (DRI).
We analysed one 24 h dietary recall from Mexican children and adolescents. We calculated intakes of total daily water and water from foods and from beverages. Actual total water intake per capita was subtracted from the DRI for water to calculate the shortfall.
Mexican National Health and Nutrition Survey in 2012.
Mexican children and adolescents (n 6867) aged 1–18 years.
Approximately 73 % of children and adolescents aged 1–18 years reported drinking plain water. Beverages and plain water represented 65·5 % and 26·5 % of total daily water intake, respectively. Among 1–3-year-olds, the top three main sources of water were from foods, plain water and water from plain milk. Among 4–8- and 9–13-year-olds, the main sources were from foods, plain water and agua fresca (fruit water). Among 14–18-year-olds, the main sources of water were plain water, water from foods and soda. A higher proportion of 1–3-year-olds and 4–8-year-olds met the DRI for water (38 % and 29 %, respectively). Among 9–13-year-olds and 14–18-year-olds, 13–19 % of children met the DRI for water.
Total daily water intakes remain below DRI levels in all age groups. Although plain water still contributes the greatest proportion to daily water intake among fluids, caloric beverages are currently major sources of water especially among older children and adolescents.
While the etiology of gender roles across the lifespan remains a matter for debate, conformity to masculine norms has been associated with poorer physical and mental health outcomes amongst men. This study reports data from two online samples of Australian men (Ns = 343, 525), focusing on age group differences for masculinity and depression. Consistent with prediction, cross-sectional data reported that conformity to masculine norms attenuated throughout the lifespan. Further, both samples indicated that the relationship between masculinity and depression increased with age. Findings are interpreted within the context of men resolving gender role–related conflicts across the lifespan.
Difficulties in intimate partner relationships are known to have detrimental effects on mental health. The association between relationship difficulties and depression is particularly strong for individuals with a tendency for rumination. While the link between rumination and depression has long been established, the indirect effects of shame and emotion regulation on this relationship remain less clear. The present study reports on longitudinal data of 65 participants (36 males) who had experienced recent relationship difficulties with their partner. Respondents provided Time 1 data for rumination (brooding and reflection), shame (personal feelings of shame) and relationship difficulties. Approximately 15 weeks later, Time 2 data was collected for emotion regulation (cognitive reappraisal, expressive suppression), relationship difficulties and depression. Mediation analyses with bias-corrected bootstrapping indicated that shame fully mediated the relationship between brooding and depression, and partially mediated the relationship between reflection and depression. The indirect effects remained significant with covariates (relationship difficulties at Time 1, and cognitive reappraisal and expressive suppression at Time 2). Results suggest that self-evaluations related to shame contribute to the relationship between rumination and depression, independent of affect regulation. Implications for the role of shame in relationship difficulties are discussed.