Journal of Abnormal Child Psychology

, Volume 44, Issue 7, pp 1361–1373 | Cite as

Persistent Complex Bereavement Disorder Symptom Domains Relate Differentially to PTSD and Depression: A Study of War-Exposed Bosnian Adolescents

  • Meredith A. Claycomb
  • Ruby Charak
  • Julie Kaplow
  • Christopher M. Layne
  • Robert Pynoos
  • Jon D. Elhai


Persistent Complex Bereavement Disorder (PCBD) is a newly proposed diagnosis placed in the Appendix of the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) as an invitation for further research. To date, no studies have examined the dimensionality of PCBD or explored whether different PCBD criteria domains relate in similar, versus differential, ways to other psychological conditions common to war-exposed bereaved youth, including symptoms of Posttraumatic Stress Disorder (PTSD) and depression. We evaluated the dimensionality of proposed PCBD B and C symptom domains, and their respective relations with measures of PTSD and depression, in 1142 bereaved Bosnian adolescents exposed to the 1992–1995 Bosnian civil war. Instruments included the UCLA PTSD Reaction Index, the Depression Self-Rating Scale, and the UCLA Grief Screening Scale (a prototype measure of PCBD symptoms). We investigated potential differences in grief, PTSD, and depression scores as a function of cause of death. We then examined hypothesized differential relations between PCBD B and C symptom domain subscales and selected external correlates, specifically measures of depression and the four-factor emotional numbing model of PTSD. Results of both analyses provide preliminary evidence of a multidimensional structure for PCBD in this population, in that the PCBD Criterion C subscale score covaried more strongly with each of the four PTSD factors and with depression than did PCBD Criterion B. We conclude by discussing theoretical, methodological, clinical, and policy-related implications linked to the ongoing study of essential features of PCBD.


Persistent complex bereavement disorder Grief Bereavement Posttraumatic stress disorder Depression Adolescent War trauma 


Compliance with Ethical Standards


The funding organization was UNICEF Bosnia & Herzegovina.


Drs. Layne, Kaplow, and Pynoos are the authors of the Persistent Complex Bereavement Disorder (PCBD) Checklist, a measure of child and adolescent grief reactions, as well as co-authors of Trauma and Grief Component Therapy for Adolescents (in press, Cambridge University Press).

Conflict of Interest

The authors declare that they have no conflict of interest.


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Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  • Meredith A. Claycomb
    • 1
  • Ruby Charak
    • 2
  • Julie Kaplow
    • 3
  • Christopher M. Layne
    • 4
  • Robert Pynoos
    • 4
  • Jon D. Elhai
    • 5
  1. 1.Department of PsychologyUniversity of ToledoToledoUSA
  2. 2.Department of PsychologyUniversity of Nebraska-LincolnLincolnUSA
  3. 3.Department of Psychiatry and Behavioral SciencesUniversity of Texas Health Science Center at HoustonHoustonUSA
  4. 4.UCLA/Duke University National Center for Child Traumatic Stress, and Department of Psychiatry and Biobehavioral SciencesUniversity of CaliforniaLos AngelesUSA
  5. 5.Department of Psychology and Department of PsychiatryUniversity of ToledoToledoUSA

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