Development and Validation of the Holistic Grief Effects Instrument for Bereaved College Students Mary Alice Varga (bio) and David E. Balk (bio) As the rate of individuals enrolling in higher education institutions increases, the incidence of grief experiences increases, as well. Thus, the need to understand grief among college student populations is imperative. College students are also at a critical point in their lifespan development, forming their identities as emerging adults (Erikson, 1968). Loss experience can result in grief reactions displaying in different ways, and grief effects can have a significant impact on a college student’s collegiate career and holistic development. On a given campus, approximately 30% of college students can be classified as bereaved and experiencing grief effects (Varga & Varga, 2019). The Holistic Impact of Bereavement framework (Balk, 2011) illustrates the specific grief effects college students may experience, including those related to the physical, cognitive, behavioral, interpersonal, emotional, and spiritual aspects of life. Emotional reactions include sadness or depression, anger, shock, disbelief, fear, and denial, while physical grief effects include crying, headaches, weight loss, loss of energy, and insomnia (Balk, 2011). Cognitive effects include difficulty concentrating and lower grade point averages (Servaty-Seib & Hamilton, 2006). Behavioral grief effects, such as problematic alcohol consumption, tobacco use, drug use, sexual promiscuity, or disordered eating, can occur, while interpersonal grief effects often include isolation, loneliness, and changes in relationships. Finally, students who experience effects related to their spirituality may have an altered sense of the world (Balk, 2011). While several studies have outlined varied college student grief reactions, there has not been a comprehensive instrument developed to identify students’ holistic grief effects. The Holistic Grief Effects Instrument was developed to help identify the varying individualized effects grief can have on a student. Correctly identifying these effects will allow educators and campus personnel to tailor grief support appropriately. METHOD Participants A total of 889 students participated in data collection at a mid-sized state university in the southeastern United States. The institutional review board, the vice president for student affairs, and the dean of students approved the study with the director of the University Counseling Center’s support. The Office of Information Technology provided a random sample of [End Page 607] 5,000 student email addresses. An email sent to the students contained an invitation to participate in the study and an incentive of being entered into a drawing to win one of two $25 Amazon Gift Cards. A total of 527 students experienced a loss and completed the entire survey. Participants identified as female (n = 406, 77%), male (n = 95, 18%), or other (n = 26, 5%), White/Caucasian (n = 290, 55%), Black/African American (n = 179, 34%), Hispanic (n = 25, 5%), Other (n = 16, 3%), Asian (n = 10, 2%), and Asian American (n = 7, 1%). Almost half of the students (n = 238, 45%) reported the loss of a grandparent, followed by parents (n = 75, 14%) and friends (n = 70, 13%). The main causes of death were illness (n = 334; 63%) and accidents (n = 62, 12%). Instrument Development Items for the Holistic Grief Effects Instrument were empirically generated based on the Holistic Impact of Bereavement framework and dimension descriptions (Balk, 2011). Previous literature outlining grief reactions, three surveys administered over five years, and 45 qualitative interviews with bereaved individuals (Varga, 2019) also provided the research needed to identify each concept (Carpenter, 2018) for content validity. For additional expert validity, three researchers reviewed the final 51 items: (a) an expert in thanatology, (b) an educational researcher, and (c) a psychometrics expert. The reviewers made no additional recommendations. Students answered answer each survey item about the loss they considered to be the most difficult to experience. Items began with the stem, “As a result of my grief . . .” Students responded to each item on a five-point Likert, with responses ranging from 1 (strongly disagree) to 5 (strongly agree). RESULTS An exploratory factor analysis (EFA) was conducted in SPSS 25 using a principal axis factor with a varimax rotation containing six forced factors (Tabachnick & Fidell, 2013) chosen to theoretically parallel (Carpenter, 2018) the six dimensions outlined in the Holistic Impact of Bereavement (Balk, 2011). The EFA revealed six significant factors accounting for 58.28% of...