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Cognitive predictors of grief trajectories in the first months of loss: A latent growth mixture model.

ABSTRACT: OBJECTIVE:The identification of modifiable cognitive antecedents of trajectories of grief is of clinical and theoretical interest. METHOD:The study gathered 3-wave data on 275 bereaved adults in the first 12-18 months postloss (T1 = 0-6 months, T2 = 6-12 months, T3 = 12-18 months). Participants completed measures of grief severity, cognitive factors (loss-related memory characteristics, negative appraisals, unhelpful coping strategies, and grief resilience), as well as measures of interpersonal individual differences (attachment and dependency). Latent growth mixture modeling was used to identify classes of grief trajectories. Predictors of class membership were identified using multinomial logistic regression and multigroup structural equation modeling. RESULTS:Four latent classes were identified: 3 high grief classes (Stable, Low Adaptation, and High Adaptation) and a low grief class (Low Grief). When considered separately, variance in all four cognitive factors predicted membership of the high grief classes. When considered together, membership of the high grief classes was predicted by higher mean scores on memory characteristics. More negative appraisals predicted low or no adaptation from high grief severity. Losing a child also predicted membership to the stable class. Fast adaptation of high grief was predicted by a pattern of high memory characteristics but low engagement with unhelpful coping strategies. CONCLUSIONS:The findings have implications for clinical practice and point to early cognitive predictors of adaptation patterns in grief. Findings are consistent with cognitive models highlighting the importance of characteristics of memory, negative appraisals, and unhelpful coping strategies in the adaptation to highly negative life events. (PsycINFO Database Record (c) 2020 APA, all rights reserved).

SUBMITTER: Smith KV

PROVIDER: S-EPMC6939605 | biostudies-literature | 2020 Feb

REPOSITORIES: biostudies-literature

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Cognitive predictors of grief trajectories in the first months of loss: A latent growth mixture model.

Smith Kirsten V KV Ehlers Anke A

Journal of consulting and clinical psychology 20190926 2

<h4>Objective</h4>The identification of modifiable cognitive antecedents of trajectories of grief is of clinical and theoretical interest.<h4>Method</h4>The study gathered 3-wave data on 275 bereaved adults in the first 12-18 months postloss (T1 = 0-6 months, T2 = 6-12 months, T3 = 12-18 months). Participants completed measures of grief severity, cognitive factors (loss-related memory characteristics, negative appraisals, unhelpful coping strategies, and grief resilience), as well as measures of ...[more]

PMID: 31556649

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Project description:The very early postnatal period witnesses extraordinary rates of growth, but structural brain development in this period has largely not been explored longitudinally. Such assessment may be key in detecting and treating the earliest signs of neurodevelopmental disorders.To assess structural growth trajectories and rates of change in the whole brain and regions of interest in infants during the first 3 months after birth.Serial structural T1-weighted and/or T2-weighted magnetic resonance images were obtained for 211 time points from 87 healthy term-born or term-equivalent preterm-born infants, aged 2 to 90 days, between October 5, 2007, and June 12, 2013.We segmented whole-brain and multiple subcortical regions of interest using a novel application of Bayesian-based methods. We modeled growth and rate of growth trajectories nonparametrically and assessed left-right asymmetries and sexual dimorphisms.Whole-brain volume at birth was approximately one-third of healthy elderly brain volume, and did not differ significantly between male and female infants (347?388 mm3 and 335?509 mm3, respectively, P?=?.12). The growth rate was approximately 1%/d, slowing to 0.4%/d by the end of the first 3 months, when the brain reached just more than half of elderly adult brain volume. Overall growth in the first 90 days was 64%. There was a significant age-by-sex effect leading to widening separation in brain sizes with age between male and female infants (with male infants growing faster than females by 200.4 mm3/d, SE?=?67.2, P?=?.003). Longer gestation was associated with larger brain size (2215 mm3/d, SE?=?284, P?=?4×10-13). The expected brain size of an infant born one week earlier than average was 5% smaller than average; at 90 days it will not have caught up, being 2% smaller than average. The cerebellum grew at the highest rate, more than doubling in 90 days, and the hippocampus grew at the slowest rate, increasing by 47% in 90 days. There was left-right asymmetry in multiple regions of interest, particularly the lateral ventricles where the left was larger than the right by 462 mm3 on average (approximately?5% of lateral ventricular volume at 2 months). We calculated volume-by-age percentile plots for assessing individual development.Normative trajectories for early postnatal brain structural development can be determined from magnetic resonance imaging and could be used to improve the detection of deviant maturational patterns indicative of neurodevelopmental disorders.

Dataset Information

Cognitive predictors of grief trajectories in the first months of loss: A latent growth mixture model.

Publications

Cognitive predictors of grief trajectories in the first months of loss: A latent growth mixture model.

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