Complicated grief

About: Complicated grief is a research topic. Over the lifetime, 1301 publications have been published within this topic receiving 50281 citations.

The dual process model of coping with bereavement: rationale and description

Abstract: There are shortcomings in traditional theorizing about effective ways of coping with bereavement, most notably , with respect to the so - called "grief work hypothesis . " Criticisms include imprecise definition , failure to represent dynamic processing that is characteristic of grieving , lack of empirical evidence and validation across cultures and historical periods , and a limited focus on intrapersonal processes and on health outcomes . Therefore , a revised model of coping with bereavement , the dual process model , is proposed . This model identifies two types of stressors , loss - and restoration - oriented , and a dynamic , regulatory coping process of oscillation , whereby the grieving individual at times confronts , at other times avoids , the different tasks of grieving . This model proposes that adaptive coping is composed of confrontation avoidance of loss and restoration stressors . It also argues the need for dosage of grieving , that is , the need to take respite from dealing with either ...

Prolonged Grief Disorder: Psychometric Validation of Criteria Proposed for DSM-V and ICD-11

Abstract: Background: 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. Methods and Findings: 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. Conclusions: 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 the Editors’ Summary.

Inventory of Complicated Grief: A scale to measure maladaptive symptoms of loss

Abstract: Certain symptoms of grief have been shown (a) to be distinct from bereavement-related depression and anxiety, and (b) to predict long-term functional impairments. We termed these symptoms of "complicated grief" and developed the Inventory of Complicated Grief (ICG) to assess them. Data were derived from 97 conjugally bereaved elders who completed the ICG, along with other self-report scales measuring grief, depression, and background characteristics. Exploratory factor analyses indicated that the ICG measured a single underlying construct of complicated grief. High internal consistency and test-retest reliabilities were evidence of the ICG's reliability. The ICG total score's association with severity of depressive symptoms and a general measure of grief suggested a valid, yet distinct, assessment of emotional distress. Respondents with ICG scores > 25 were significantly more impaired in social, general, mental, and physical health functioning and in bodily pain than those with ICG scores < or = 25. Thus, the ICG, a scale with demonstrated internal consistency, and convergent and criterion validity, provides an easily administered assessment for symptoms of complicated grief.

Treatment of complicated grief: a randomized controlled trial

Abstract: ContextComplicated grief is a debilitating disorder associated with important negative health consequences, but the results of existing treatments for it have been disappointing.ObjectiveTo compare the efficacy of a novel approach, complicated grief treatment, with a standard psychotherapy (interpersonal psychotherapy).DesignTwo-cell, prospective, randomized controlled clinical trial, stratified by manner of death of loved one and treatment site.SettingA university-based psychiatric research clinic as well as a satellite clinic in a low-income African American community between April 2001 and April 2004.ParticipantsA total of 83 women and 12 men aged 18 to 85 years recruited through professional referral, self-referral, and media announcements who met criteria for complicated grief.InterventionsParticipants were randomly assigned to receive interpersonal psychotherapy (n = 46) or complicated grief treatment (n = 49); both were administered in 16 sessions during an average interval of 19 weeks per participant.Main Outcome MeasureTreatment response, defined either as independent evaluator-rated Clinical Global Improvement score of 1 or 2 or as time to a 20-point or better improvement in the self-reported Inventory of Complicated Grief.ResultsBoth treatments produced improvement in complicated grief symptoms. The response rate was greater for complicated grief treatment (51%) than for interpersonal psychotherapy (28%; P = .02) and time to response was faster for complicated grief treatment (P = .02). The number needed to treat was 4.3.ConclusionComplicated grief treatment is an improved treatment over interpersonal psychotherapy, showing higher response rates and faster time to response.