Prolonged Grief Disorder Symptoms Research Articles

Prolonged grief disorder symptoms and posttraumatic growth among Chinese shidu parents: A latent transition analysis.

Chinese shidu parents (bereaved parents who have lost the only child) may experience prolonged grief disorder, as well as posttraumatic growth (PTG). This study aimed to examine their latent classes and transition patterns of prolonged grief disorder symptoms and PTG. Based on a longitudinal design, 265 shidu parents completed the Prolonged Grief Scale-Revised and Short Form of Posttraumatic Growth Inventory for Chinese Shidu Parents twice with an interval of about 5 months. Latent class analysis and latent transition analysis were performed to identify subgroups and their transition possibilities over time. Four latent classes that changed over time were identified: a "growth" class, a "combined grief and growth" class, a "low grief" class, and a "high grief" class. From Time 1 to Time 2, the proportion of the growth class and the low grief class increased. Shidu parents in the growth class or combined class had about a 36% probability of moving to low grief class. Compared with individuals in the high grief class (8.5%), members in the low grief class (20.4%) had a higher probability of moving to the growth class. Moreover, 29.0% of shidu parents suffered from persistent grief. Adjustment to child loss displayed substantial variations between individuals. PTG reported by shidu parents can be both stable and temporary. About 30% of shidu parents suffered from persistent and severe grief, and designing grief-focused treatment may be beneficial for them. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Sudden gains in the treatment of children and adolescents with prolonged grief.

Sudden gains describe large and stable reductions in symptoms between two consecutive treatment sessions and have not yet been investigated in prolonged grief disorder (PGD), a new disorder in the 11th edition of the International Classification of Diseases and text revision of the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders characterized by separation distress and accompanying symptoms beyond 6 months of bereavement. The study aimed to examine the occurrence of sudden gains and their relation to treatment outcome and content during cognitive behavioral therapy (CBT) and supportive counseling for children and adolescents with PGD symptoms. We used data from 118 patients (50% female; age: M = 12.93, SD = 2.81) who were randomized to receive either nine individual sessions of CBT or nondirective supportive counseling. Session-by-session PGD symptoms were assessed using the Grief Checklist. We identified sudden gains using the original criteria by Tang and DeRubeis (1999) and compared treatment outcomes between sudden gainers and nonsudden gainers using linear mixed models. Nine patients (7.63%) experienced a total of 10 sudden gains. Most sudden gains occurred during CBT. We found no differences between sudden gainers and nonsudden gainers regarding PGD symptoms, posttraumatic stress, and depressive symptoms, but problem behaviors declined toward the follow-up assessments in sudden gainers. Sudden gains seem to be a rare event with limited clinical relevance in the treatment of PGD symptoms in children and adolescents. Results imply future research into predictors of sudden gains and other forms of symptom change during PGD treatment. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Living with grief and thriving after loss: a qualitative study of Chinese parents whose only child has died

ABSTRACT Introduction: Chinese bereaved parents over the age of 49 who have lost their only child are known as shidu parents. This study aimed to explore their symptoms of prolonged grief disorder (PGD) and post-traumatic growth (PTG). Methods: Shidu parents who experienced the loss of their only child at least six months prior and had no biological or adopted children at the time of the study were recruited. Eleven shidu parents participated in individual interviews conducted in Mandarin via WeChat video or voice calls. The interview guide was developed by the first researcher and refined through discussions with doctoral students and a professor specializing in bereavement. Reflexive thematic analysis was used to analyse the data from the semi-structured interviews. Results: The interviewees (3 men and 8 women) were aged between 53 and 72 years, and the time since their child’s loss ranged from 2.25 to 24 years. Four themes of PGD symptoms were identified: Separation distress, Cognitive, emotional, and behavioural symptoms, Somatic responses and Changes in grief responses. Subtheme of ‘feelings of inferiority or shame’ and ‘somatic responses’ were prominent among this group, potentially representing culturally relevant grief reactions. They also experienced genuine PTG that helped them adapt to life without the child: changes in self-perception, changes in interpersonal relationships, and a changed philosophy of life. The subtheme of ‘living for self’ emerged as a potentially unique PTG among shidu parents. Conclusion: Shidu parents share some important similarities with bereaved individuals across cultures, but also exhibit some unique characteristics. Considering their persistent intense grief, regular screening for grief severity, physical issues, and suicidal ideation is essential. Culturally sensitive interventions that acknowledge and validate their sense of inferiority or shame may be beneficial. Additionally, fostering PTG may support shidu parents in coping with their loss and adapting to life.

Latent classes of acute grief reactions in the shadow of collective trauma and its predictors in bereaved adults.

The current study explored grief reaction profiles after the October 7th, 2023, Israeli massacre regarding the loss of significant others. It investigated factors worsening pre-existing grief in 2,028 adult civilians, with 1,263 reporting pre- or post-massacre loss. Participants completed self-reports on prolonged grief disorder (PGD), post-traumatic stress disorder (PTSD), complex PTSD (CPTSD), cognitive emotional regulation (CER), and assumptive worldviews. Latent class analysis identified four classes of probable PGD among those with lifetime loss: "high PGD-both core and emotional pain" (35.9 %); "Medium PGD-emotional pain" (6.9 %); "medium to high PGD-high core, medium emotional pain" (23 %); and "low PGD-both core and emotional pain" (34.5 %). The subsample analysis of individuals experiencing lifetime loss with concurrent October 7th loss indicated three classes of probable PGD: "high PGD symptoms" (47.9 %), "high to medium PGD-high core with medium emotional pain symptoms" (15.9 %), and "low PGD symptoms" (36.2 %). The subsample analysis of those who experienced concurrent recent loss related to the October 7th attack showed two classes related to indicative of acute grief: "high PGD symptoms" (69 %), and "low PGD symptoms" (31 %). Negative CER coping strategies were associated significantly with the high PGD in all three groups, and with increased risk of PTSD and CPTSD symptoms compared to the "low PGD symptoms" group. Collective bereavement amid collective trauma can activate prior individual grief reactions, even without current losses from the traumatic event. Those experiencing loss tied to severe traumatic events may face higher susceptibility to developing pathological grief.

Bereaved Family Quality of Life Varies With Comorbid Psychological Distress and ICU-Care Quality.

Health-related quality of life (HRQOL) is highly endorsed, but HRQOL studies scarcely investigate the following: ICU family members; modifiable end-of-life (EOL) ICU-care factors; conjoint associations with prolonged grief disorder (PGD), post-traumatic stress disorder (PTSD), and depression; and long-term bereavement outcomes. Exploratorily investigate associations of PGD-PTSD-depressive-symptom states (resilient, subthreshold-depression dominant, PGD dominant, and PGD-PTSD-depression comorbid) and quality of EOL ICU care with families' HRQOL 6-24 months post loss. This cohort study examined symptoms of PGD (11 items of the PG-13), PTSD (Impact of Event Scale-Revised), and depression (Hospital Anxiety and Depression Scale), and HRQOL (Medical Outcomes Study 36-Item Short-Form Health Survey) among 303 ICU family members. Quality of EOL ICU care was measured by objective process-based care-quality indicators abstracted from medical records and classified by subjective family-assessed quality of patient dying and death (QODD). Associations were simultaneously examined by multivariate hierarchical linear modeling with resilient state and high QODD class as reference. Physical and mental HRQOL were worse in the 3 more distressed symptom states, especially mental HRQOL which showed an incremental dose-response effect: subthreshold depression-dominant (β [95% CI]=-2.419 [-3.374, -1.464]), PGD-dominant (-8.366 [-10.116, -6.616]), and PGD-PTSD-depression comorbid (-14.736 [-17.772, -11.700]) states. Mental HRQOL was significantly worse in the 3 poorer QODD classes: moderate (-1.085 [-2.138, -0.032]), poor to uncertain (-4.362 [-5.616, -3.108]), and worst (-3.239 [-4.433, -2.045]). HRQOL was not associated with objective care-quality indicators. Bereaved family members' HRQOL was significantly associated with PGD-PTSD-depressive-symptom states and QODD classes-both modifiable through high-quality EOL ICU care.

Exploring the Relationship Between Prolonged Grief and Borderline Personality Symptoms.

Prolonged grief disorder (PGD) is a new diagnosis that is often mistaken for other psychopathologies. We report a case of PGD in a patient who screened positive for personality disorder. Both PGD and personality disorder symptoms were much improved after a course of prolonged grief disorder therapy. A bereaved woman in her mid-20s sought treatment for depression 9 months after the death of her father. Her depressive symptoms responded well to antidepressant medication and a brief course of interpersonal psychotherapy. However, prolonged grief symptoms persisted at a clinically significant level. Elements of her history, as well as her score of 9 out of 10 on the McLean Screening Instrument for Borderline Personality Disorder, indicated a possible diagnosis of borderline personality disorder. Yet, after completing a course of prolonged grief disorder therapy, both her grief and borderline symptoms were much reduced. This case raises the possibility of an association between prolonged grief and borderline symptoms. Disruption of attachment relationships provides a possible way of understanding this association. The case we present raises the possibility that prolonged grief disorder may better explain symptoms in some patients presenting with borderline personality disorder symptoms.

“I Changed After the Death”: Symptoms of Psychopathology Predict Lower Agency and Communion Themes in Loss Narratives Over 16 Months

Abstract Purpose Some individuals struggle to adjust after the death of a close other. Constructing an adaptive narrative about the loss is important to adjustment but symptoms of psychopathology may interfere with this process. We examined whether psychopathology symptoms measured 2 months after the loss of a spouse or parent predicted loss narratives with lower agency and communion themes as well as more negative emotional tone and self-event connections. Method Participants included 507 adults from the Aarhus Bereavement Study who completed psychopathology symptom measures at 2, 6, 11, and 18 months after the death of their spouse or parent. Symptom measures included prolonged grief disorder (PGD), PTSD, depression, and anxiety. Eighteen months after the death, participants wrote a narrative about the loss and answered questions about its emotional qualities (i.e., tone, self-event connections). The narratives were content coded for agency and communion themes. Results Multiple regressions showed that higher PGD symptoms at 2 months predicted less adaptive loss narratives at 18 months, even after controlling for neuroticism and age. Conclusion Individuals who experience high symptom levels are struggling to construct adaptive loss narratives. This may hinder identity changes needed to accommodate their altered life circumstances.

Toward Centrality Evaluation of Yearning Symptoms for Prolonged Grief Disorder: A Cross-Cultural Approach

Background: The new ICD-11 diagnosis of prolonged grief disorder (PGD) is characterized by the prominent role of yearning as hallmark symptom. A secondary analysis of eight international datasets on PGD was conducted to evaluate this assumption. Additionally, cross-cultural comparison explored whether the centrality of yearning differs across world regions. Methods: Primary studies originated from German-speaking countries (n = 4 samples), other European countries and Israel (n = 3 samples), as well as China (n = 1 samples). Different PGD measures were used, including yearning and longing as symptoms. For the centrality assessment of yearning, PGD symptoms were ranked by their factor loadings from confirmatory factor analyses, followed by statistical testing to determine significant differences between yearning and other symptoms of PGD in their factor loading estimates. Subsequently, ranking positions of yearning in three world regions (German-speaking, other Europe-Israel, and China) were compared. Finally, proxy thresholds for individuals at high-risk states for PGD were defined for the different datasets, and sensitivity-specificity analyses of yearning were performed. Results: Yearning was ranked high in five out of 12 models tested. In the German-speaking region, it was predominantly ranked among the most central symptoms; in the other Europe-Israel region as well as China, it tended to fall into the middle or lower rankings of symptom centrality. Sensitivity values were consistently high, while specificity values indicated moderate levels. Discussion: In line with previous research on the general outcomes of grief, the present study showed that yearning may be subject to a culture-specific distribution. Other central symptoms such as feeling as if a part of oneself died have also been shown to potentially play a central role in PGD across world regions. On the other hand, the sensitivity-specificity analyses revealed that yearning can be considered a significant (diagnostically highly sensitive) symptom for individuals in high-risk states for PGD, although it has only moderate specificity (i.e., its absence does not necessarily indicate individuals experiencing normative grief). Nonetheless, a culture-sensitive approach to psychopathology should consider the cultural differences in the centrality of this symptom group. More research is needed to better understand the role of yearning and its determinants across world regions.

Development and validation of the caregiver-report version of the international grief questionnaire (IGQ-CG): Results from a Ukrainian sample of parents.

The International Grief Questionnaire (IGQ) is a self-report measure of ICD-11 Prolonged Grief Disorder (PGD) in adults. This study sought to develop and validate a caregiver-report version of the IGQ for children and adolescents aged 7-17 years; the IGQ-Caregiver Version (IGQ-CG). 639 parents living in Ukraine provided data on themselves and one child in their household as part of the "The Mental Health of Parents and Children in Ukraine Study: 2023 Follow-up" study. The latent structure of the scale was tested using confirmatory factor analysis (CFA), while convergent validity was assessed through associations with other mental health correlates. Prevalence rates of probable ICD-11 PGD were estimated. CFA results supported a correlated two-factor model ('core' and 'associated' symptoms) and the internal reliability of the scale scores were acceptable. Convergent validity was supported through significant correlations with internalizing symptoms, while contact with the deceased, time since bereavement, and parental PGD were associated with higher scores on the IGQ-CG latent variables. The prevalence of probable ICD-11 PGD was 1.4%, and amongst those with a lifetime bereavement, the conditional rate was 3.2%. The IGQ-CG produces reliable and valid scores for ICD-11 PGD symptoms in children and adolescents as reported by their caregivers.

A role for event centrality in prolonged grief disorder.

Having a traumatic or negative event at the centre of one's identity is associated with adverse psychological outcomes including post-traumatic stress, depression, and prolonged grief disorder (PGD). However, direct investigation of the role of centrality of a bereavement-event in the maintenance of PGD symptoms is scarce and has not compared immediate and long-term changes in event centrality nor examined the nature of the loss. Data from bereaved partners and adult children in The Aarhus Bereavement Study at four time points over 26months post-loss were included in this study. Participants completed a PGD symptom measure and the Centrality of Events Scale (CES) on each occasion. Results suggest that bereaved partners had higher PGD and CES scores than bereaved adult children at all four post-bereavement time points. Regardless of relationship type, maintaining higher CES scores over time predicted PGD symptoms, over and above initial symptoms. Our findings suggest a risk factor for maintaining PGD symptoms is the continued centrality of the bereavement to ones' life story and autobiographical memory. This finding links the mechanisms for maintaining PGD symptoms to those involved in other disorders such as post-traumatic stress, with implications for theoretical models of prolonged grief as well as treatment.

Correlates of public stigma towards prolonged grief disorder

BackgroundPublic stigma for grief may reduce the social support provided to bereaved persons and increase bereavement-related distress. The general public reports more stigmatizing responses towards bereaved persons with prolonged grief disorder (PGD) than towards persons experiencing non-clinical grief. No studies to date have investigated whether personal characteristics of the general public relate to public stigma towards PGD. The present study examined whether participants’ socio-demographic characteristics and personal bereavement experiences are associated with stigmatizing responses towards PGD. MethodWe combined data of three previously published vignette experiments to conduct a secondary analysis. All studies presented members of the general public (N = 452) with a description of a male bereaved person with PGD symptoms and a PGD diagnosis. Participants rated three indicators of public stigma - negative attributes (competence, warmth), emotional reactions (fear, anger), and preferred social distance. First, we examined whether gender, age, and educational level related to public stigma towards PGD. Second, we examined the association of participants’ personal bereavement experiences with public stigma. ResultsRegression analyses demonstrated that participants’ socio-demographic characteristics explained a significant amount of variance for warmth (ΔR² = .03; p < .05) and anger (ΔR² = .05; p < .01): Male participants rated the person in the vignette as less warm (β = -.13, p < .05). Being older related to lower ratings of warmth (β = -.12, p < .05) and higher ratings of anger (β = .18, p < .01). Participants’ educational level was not associated with stigma. Participants’ bereavement experiences explained a significant amount of variance for preferred social distance (ΔR² = .11; p <. 05): Participants reporting higher personal grief severity preferred less social distance from a person with PGD (β = -.29, p < .05). A higher number of experienced losses, the recency of the bereavement, and the cause of death (natural vs. unnatural) did not relate to public stigma. ConclusionsMale and older persons are more likely to demonstrate public stigma towards PGD. Experiencing severe grief oneself is associated with less preferred social distance from a person with PGD. Anti-stigma interventions may advance the public's knowledge about grief and PGD and address specific target groups (men and older persons).

The Norwegian traumatic grief inventory-self report plus (TGI-SR+): a psychometric evaluation in traumatically bereaved people

ABSTRACT Background: Prolonged grief disorder (PGD) has been added to the ICD-11 and DSM-5-TR. The Traumatic Grief Inventory-Self Report Plus (TGI-SR+) assesses self-rated PGD intensity as defined in ICD-11 and DSM-5-TR. The TGI-SR + is available in multiple languages, but has not been validated yet in Norwegian. Objective: The aim of this study was to evaluate the psychometric properties of the Norwegian TGI-SR + . Method: Bereaved adults (N = 307) whose child or sibling died ≥6 months ago due to a sudden or violent loss completed the TGI-SR + and measures for posttraumatic stress, depression, and precursor PGD symptoms. We examined the factor structure and internal consistency of the ICD-11 and DSM-5-TR PGD items. Convergent validity and known-groups validity was evaluated. Probable PGD cases, pair-wise agreement between diagnostic scoring rules for both PGD criteria-sets, and cut-off scores were calculated. Results: The 1-factor model for ICD-11 and DSM-5-TR PGD showed the best fit and demonstrated good internal consistency. Convergent validity was supported by strong associations between summed ICD-11 and DSM-5-TR PGD scores and summed posttraumatic stress, depression, and precursor prolonged grief scores. Known-groups validity was supported by PGD intensity being related to educational level and time since loss. The perfect pair-wise agreement was reached using the ICD-11 and DSM-5-TR PGD diagnostic scoring rules. The optimal cut-off score for detecting probable PGD cases, when summing all TGI-SR + items, was ≥73. Conclusions: The Norwegian TGI-SR + seems a valid and reliable instrument to assess ICD-11 and DSM-5-TR PGD intensity after losing a child or sibling under traumatic circumstances.

Prevalence and correlates of ICD-11-based prolonged grief disorder in a representative Slovakian sample of recently bereaved adults

ABSTRACT Background: Prolonged Grief Disorder (PGD) has recently been included in both the ICD-11 and DSM-5-TR diagnostic manuals. Studying its prevalence and correlates across cultures is vital for more effective identification, treatment, and prevention. Objective: This study aimed to examine prevalence rates of ICD-11-based PGD, in a representative Slovakian sample in response to deaths of loved ones occurring during the previous year. Further aims were to examine the factor structure of PGD symptoms and correlates of summed PGD item scores and PGD ‘caseness’. Method: Self-reported data on PGD, depression, anxiety, alcohol use, and descriptive characteristics were gathered from a representative sample of the Slovak population (N = 319). Results: Data were gathered from N = 1853 people; 319 participants (17.2%) reported a loss in the past year. The prevalence of probable PGD among these bereaved participants was 1.99% for recent losses (<6 months, n = 151) and 7.75% for more distant losses (6–12 months, n = 130). The most frequently endorsed symptoms included longing/yearning for the deceased, sadness, denial/unrealness, and difficulty accepting the death. PGD symptoms had a unitary factor structure which was consistent for subsamples bereaved 1–5 and 6–12 months. The severity of PGD varied with kinship. Depression and anxiety, but not alcohol misuse, were associated with PGD severity and PGD caseness. Conclusions: These findings underscore that a significant group of people develop PGD between 6–12 months following a loss. This emphasises the need for targeted psychological interventions.

Cluster analysis of prolonged grief, posttraumatic stress, and depression symptoms in bereaved asylum seekers and refugees

ABSTRACT Background: Refugees and asylum seekers (ASRs) are frequently exposed to loss in addition to a variety of other stressors and often display high levels of various psychological symptoms. Objective: The study aimed to primarily determine clusters of prolonged grief disorder (PGD), posttraumatic stress disorder (PTSD), and depression symptoms in bereaved ASRs and secondly identify predictors of cluster membership. Sociodemographic – and flight-related variables were investigated in exploratory analyses. Method: ASRs in Germany (N = 92) with interpersonal loss exposure, i.e. at least one missing or deceased relative or friend, were assessed with interview-based questionnaires for PGD, PTSD, and depressive symptoms. We used k-means cluster analysis to distinguish symptom profiles and logistic regression analyses to identify predictors of cluster membership. Results: We found a three-cluster-solution. The PGD-cluster (30%) was characterised predominantly by PGD symptoms, while the PGD/PTSD-cluster (32%) had high PGD and PTSD and moderate depressive symptoms. The resilient cluster (38%) showed low symptoms overall. insecure residence status predicted membership in the PGD and PGD/PTSD clusters relative to the resilient cluster, whilst higher attachment anxiety predicted membership in the PGD/PTSD cluster relative to the other clusters. Explorative analysis revealed duration of stay as a significant predictor. Conclusion: Findings can extend the current knowledge about different symptom profiles among bereaved ASRs in Europe. Insights to attachment – and migration-related variables distinguishing between these profiles offer starting points for interventions.

Testing the distinctiveness of prolonged grief disorder from posttraumatic stress disorder and depression in large bereaved community samples

BackgroundThis study sought to test the distinctiveness of symptoms of prolonged grief disorder (PGD) from posttraumatic stress disorder (PTSD) and depression. MethodsConfirmatory factor analysis (CFA) and target exploratory factor analysis (EFA), were used to test the distinctiveness of PGD from PTSD and depression symptoms in a large sample of adults bereaved for at least six months (N = 1917). Identified factors were explored in relation to demographic (i.e., age, gender) and loss-related (i.e., time since bereavement, nature of death, relationship to deceased, age of deceased, and frequency of contact with deceased) correlates. ResultsThe CFA model provided a good fit to the data, while the target EFA provided a slightly improved fit. All items loading strongly and significantly onto their respectively factors, and the IGQ items had few significant cross-factor loadings. All demographic and loss-related variables (except for death of a sibling and death from other causes) were associated with each of the factors, however, these associations were strongest for the PGD factor. LimitationsParticipants were recruited using a non-probability sampling method and were from a relatively affluent Western nation. ConclusionFindings from the current study demonstrate that PGD reflects an empirically distinguishable albeit related disorder to PTSD and depression in a sample of bereaved adults. The identification of correlates common to PGD, PTSD, and depression, as well as those unique to PGD, affords a comprehensive understanding of the risk factors associated with bereavement-related psychopathology.

A comprehensive investigation of comorbidities of prolonged grief disorder in a bereaved inpatient psychiatric sample

Prolonged Grief Disorder (PGD) was recently added to ICD-11 and DSM-5-TR. Depression and Posttraumatic Stress Disorder (PTSD) are frequent comorbidities, but findings regarding comorbid somatoform disorder and personality disorders remain mixed and studies with severely impaired patients are scarce. It was therefore the objective of the present study to examine comorbidities of PGD in a bereaved inpatient psychiatric sample. We assessed N = 101 bereaved inpatients in a psychiatric hospital with clinical interviews and self-report questionnaires. We calculated differences between patients with and without a PGD-diagnosis in number and type of comorbid disorders as well as associations between the severity of PGD and comorbid disorders. On average, patients had 2.53 comorbid psychiatric diagnoses. Patients with and without a PGD-diagnosis did not differ in their number of comorbid diagnoses, and there was no association between number of comorbid diagnoses and PGD-severity. However, patients with PGD, had significantly more comorbid diagnoses belonging to neurotic-, stress-related and somatoform disorders of the ICD-10. Patients with PGDICD-11 also had significantly higher scores in self-reported depressive, PTSD-, and somatoform symptoms, as well as the negative affectivity personality domain than those without a PGD diagnosis. To the best of our knowledge, this is the first study to provide insights into comorbidities of PGD in a bereaved inpatient psychiatric sample. It highlights the importance of considering PGD symptoms as part of the complaints of bereaved patients to achieve a tailored treatment approach. Future longitudinal studies are needed to unveil relationships between pre-existing mental disorders and PGD.

End-of-life care and grief: study conducted with family members of COVID-19 victims.

This article aims to investigate the implications of grief among family members of COVID-19 victims; verify the prevalence of prolonged grief symptoms; and identify family members' expectations regarding end-of-life care for their loved ones affected by COVID-19. Descriptive, cross-sectional research, with a quantitative-qualitative approach. Data collection was performed using an online questionnaire, guided by the PG-13 instrument. Descriptive and inferential statistics were applied. The results were presented descriptively and with the aid of tables. The study sample included 142 family members, mostly female, who presented emotional, physical, social, and financial implications as a result of grief. A prevalence of prolonged grief symptoms was observed in 11.4% of the mourners with more than six months and 29.6% of those with less than six months. Three thematic categories were identified: transparency in communicating the health situation, access to moments of farewell, and promotion of comfort in care actions. The symptoms of Prolonged Grief Disorder have a significant association with the degree of kinship. In final care, family members' expectations were classified as: permission for a dignified farewell, effective communication, and promotion of comfort and care.

From loss to disorder: The influence of maladaptive coping on prolonged grief

Research indicates that post-bereavement coping strategies can be adaptive or maladaptive. Understanding which strategies lead to poorer outcomes is an important clinical and theoretical question with the potential to guide intervention.The Oxford Grief – Coping Strategies scale was developed from interviews with bereaved people with and without prolonged grief disorder (PGD) to assess the frequency of maladaptive cognitive and behavioural strategies after bereavement. Factorial and psychometric validity were assessed using exploratory and confirmatory factor analysis (N = 676). A three-wave cross-lagged panel model (N = 275) was used to assess the predictive validity of the tool in explaining symptoms of PGD.Results supported a four-factor solution (Avoidance, Proximity Seeking, Loss Rumination, Injustice Rumination) with good psychometric properties. The OG-CS predicted prospective symptoms of PGD in the short-term (6–12 months) and long term (12–18 months), controlling for baseline symptoms and autocorrelations. Subscale analyses demonstrated that the use of coping strategies predicted ICD-11 PGD in both the short-term and the long-term. However, avoidance was not predictive of outcomes early in the grieving process. At 6–12 months, avoidance predicted PGD at 12–18 months.

Prolonged Grief Disorder in ICD-11 and DSM-5-TR: Factor structure, and psychosocial and loss-related correlates in a sample of widowed persons.

This study sought to determine whether the symptoms of prolonged grief disorder (PGD) according to ICD-11 and DSM-5-TR have a unifactorial structure. Second, we sought to determine the sociodemographic and loss-related correlates of PGD symptom severity according to ICD-11 and DSM-5-TR. People who had lost a spouse (N = 144) in the past six months were examined using the Polish versions of the Prolonged Grief Disorder-13 scale (PG-13) and Inventory of Complicated Grief (ICG). Selected PG-13 and ICG items were included in the analyses to cover the PGD criteria according to ICD-11 and DSM-5-TR. Confirmatory factor analyses supported the one-dimensional structure of both sets of symptoms of the disorder. Briefer time since loss and loss due to an accident were associated with PGD symptom severity according to both ICD-11 and DSM-5-TR. PGD is a one-dimensional and internally consistent psychopathological syndrome. Widows and widowers who have recently lost their spouse due to an accident may be at especially heightened risk of developing severe levels of PGD symptoms.

Internet-based grief therapy program for bereaved individuals at risk: A case series study

Interest in internet-based interventions has increased considerably. The effectiveness of these applications continues to be investigated for the treatment of Prolonged Grief Disorder. This study includes preliminary findings of the internet-based and therapist-supported prolonged grief intervention program developed in Turkish. The internet-based program consists of 10 written sessions, and after each session the participants receive written feedback from the therapist. The program takes approximately 6-8 weeks. The preliminary findings of the program were handled in a proof-of-concept study style based on a case series design. Self-report measures were taken from the first eight participants who completed the program at four different times (pre-test, post-test, 1st and 3rd month follow-ups). In addition, the written contents of the first and last sessions were analyzed by content analysis. As a result of the descriptive findings, remarkable decreases were observed in traumatic grief, global meaning violation, depressive symptoms, and stress levels in a significant part of the participants between pre-post and follow-up measurements. Also, five of the participants had considerable increases in meaning reconstruction scores. In addition, the results of the content analysis indicated that following the intervention, the bereaved individuals expressed less negative and more positive content, as expected. These two data show that the intervention program is promising in reducing the symptoms of Prolonged Grief Disorder in bereaved individuals and may yield good results with controlled designs for a broader range of participants.