ship with the deceased, including positive asp ects of the relationship and distress over the
separation. In individuals with the traumatic be reavement specifier of persistent complex be-
reavement disorder, the distressin g thoughts or feelings may be more overtly related to the
manner of death, with distressing fantasies of  what happened. Both persistent complex be-
reavement disorder and PTSD can involve avoi dance of reminders of distressing events.
Whereas avoidance in PTSD is characterized by  consistent avoidance of  internal and external
reminders of the traumatic experience, in persistent complex bereavement disorder, there is
also a preoccupation with the loss and yearning  for the deceased, which is absent in PTSD. 
Separation anxiety disorder. Separation anxiety disorder is characterized by anxiety
about separation from current attachment figures, whereas persistent complex bereavement
disorder involves distress about separation from a deceased individual. 
Comorbidity  
The most common comorbid disorders with pe rsistent complex bere avement disorder are
major depressive disorder, PT SD, and substance use disorders. PTSD is more frequently
comorbid with persistent complex bereavement disorder when the deat h occurred in trau-
matic or violent circumstances.
Caffeine Use Disorder
Proposed Criteria 
A problematic pattern of caffeine use leading to clinically significant impairment or distress, as
manifested by at least the first three of the following criteria occurring within a 12-month period: 
1. A persistent desire or unsuccessful efforts to cut down or control caffeine use.
2. Continued caffeine use despite knowledge of having a persistent or recurrent physical
or psychological problem that is likely to have been caused or exacerbated by caffeine.