Abstract
Bereavement is a universal experience, and its association with excess morbidity and mortality is well established. Nevertheless, grief becomes a serious health concern for a relative few. For such individuals, intense grief persists, is distressing and disabling, and may meet criteria as a distinct mental disorder. At present, grief is not recognized as a mental disorder in the DSM-IV or ICD-10. The goal of this study was to determine the psychometric validity of criteria for prolonged grief disorder (PGD) to enhance the detection and potential treatment of bereaved individuals at heightened risk of persistent distress and dysfunction. A total of 291 bereaved respondents were interviewed three times, grouped as 0-6, 6-12, and 12-24 mo post-loss. Item response theory (IRT) analyses derived the most informative, unbiased PGD symptoms. Combinatoric analyses identified the most sensitive and specific PGD algorithm that was then tested to evaluate its psychometric validity. Criteria require reactions to a significant loss that involve the experience of yearning (e.g., physical or emotional suffering as a result of the desired, but unfulfilled, reunion with the deceased) and at least five of the following nine symptoms experienced at least daily or to a disabling degree: feeling emotionally numb, stunned, or that life is meaningless; experiencing mistrust; bitterness over the loss; difficulty accepting the loss; identity confusion; avoidance of the reality of the loss; or difficulty moving on with life. Symptoms must be present at sufficiently high levels at least six mo from the death and be associated with functional impairment. The criteria set for PGD appear able to identify bereaved persons at heightened risk for enduring distress and dysfunction. The results support the psychometric validity of the criteria for PGD that we propose for inclusion in DSM-V and ICD-11. Please see later in the article for Editors' Summary.
Highlights
Bereavement is a universal experience to which most individuals adequately adjust
The criteria set for prolonged grief disorder (PGD) appear able to identify bereaved persons at heightened risk for enduring distress and dysfunction
The results support the psychometric validity of the criteria for PGD that we propose for inclusion in DSM-V and ICD-11
Summary
Bereavement is a universal experience to which most individuals adequately adjust. numerous studies have shown that bereaved individuals have higher rates of disability and medication use than their nonbereaved counterparts [1,2,3,4,5,6,7], and are themselves at heightened risk of death [8,9,10,11]. Following a major loss, such as the death of a spouse, a noteworthy minority of bereaved individuals experiences ‘‘a clinically significant behavioral or psychological syndrome or pattern that occurs in an individual and that is associated with present distress or disability’’ [12]. These are the requirements for meeting the definition of a mental disorder in the Diagnostic Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) [12]. They may deny their loss, feel desperately lonely and adrift, and want to die themselves
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
