Abstract
Background: A distinct grief-specific disorder is included in the ICD-11. Lack of clarity remains regarding whether different proposed diagnostic criteria capture similar or different diagnostic entities. Our aim was to examine the specificity of four proposed diagnostic criteria-sets for pathological grief in a population-based sample.
Methods: Participants were 206 conjugally bereaved elderly Danes (59% female; mean age = 72.5 years, SD = 4.2; range 65–81) who completed self-report questionnaires six months post-loss. The main measure was the Danish version of Inventory of Complicated Grief-Revised.
Results: Results indicate substantial agreement between Prolonged Grief Disorder (PGD), Persistent Complex Bereavement Disorder (PCBD) and ICD-11-PGD (kappa's = 0.69–0.84), which found 6–9% of cases tested positive for pathological grief. Complicated Grief (CG) was partly in agreement with the three other symptom-diagnostic tests (kappa's = 0.13–0.20), and the prevalence-rate of pathological grief was 48%.
Limitations: The low response-rate of 39%. The selective inclusion of data ≥6 months post-loss prevents a comparison of acute and prolonged grief reactions. Using self-reported data, not diagnostic interviews, challenges the validity of our findings. Using a sample of elderly people may limit the generalizability of our results to other age groups.
Conclusion: We suggest that PGD, PCBD and ICD-11-PGD may be more discriminative in identifying a specific grief-related psychopathology, while CG may identify a broader set of grief reactions.
Original language | English |
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Pages (from-to) | 52-59 |
Number of pages | 8 |
Journal | Journal of Affective Disorders |
Volume | 251 |
DOIs | |
Publication status | Published - 15 May 2019 |
Funding
This research was funded by The Aarhus University Research Foundation (Grant No. 21700 ) with scientific help and resources by Unit for Psycho-oncology and Heath Psychology. Department of Psychology, Aarhus University, Denmark. The funding financed salary for the fourth author. We would like to acknowledge these two organizations for their support for this study. Maja O'Connor is an Associate Professor of Clinical Psychology at Unit for Bereavement Research, Department of Psychology, Aarhus University, Denmark and Senior Researcher at The Danish National Center for Grief. She had specialized in adult bereavement with specific interest in prolonged grief disorder and other type of complicated grief reactions. Mathias Lasgaard is a senior researcher at DEFACTUM Central Denmark Region, Aarhus, Denmark and an associate professor at the Department of Psychology, University of Southern Denmark. His research focuses on mental health with a particular interest in loneliness and applied research. Lene Larsen (PhD) is a clinical psychologist and consultant at the Danish Nation Center for Grief in Copenhagen, Denmark. Her clinical work and research activities focus on the treatment of complicated grief reactions in children, young adults, and adults. Maja Johannsen , Ph.D., MSc, is postdoctoral fellow at the Unit for Bereavement Research, Department of Psychology, Aarhus University. Her research focuses on translational research, with a specific interest in third wave cognitive therapies. Moreover, she has experience with various research methodologies, such as meta-analyses, health economic evaluation, surveys, and mediation. Clinically as well as in her research, she has gained experience with a diversity of populations, including cancer survivors, bereaved adults, and individuals with chronic disease, e.g. Chronic Obstructive Pulmonary Disease (COPD). Marie Lundorff , MSc, is a PhD student at Unit for Bereavement Research, Department of Psychology and Behavioural Sciences, Aarhus University, Denmark. Marie's work centres around variations in long-term adjustment following bereavement as well as the nosological, symptomatic, and diagnostic nature of prolonged grief disorder. Ingeborg Farver-Vestergaard is a post doctoral fellow at Unit for Bereavement Research, Department of Psychology and Behavioural Sciences, Aarhus University, Denmark. Her work centres around clinical aspects of individuals with chronic disease, specifically with Mindfulness Based Cognitive Therapy for patients with Chronic Obstructive Pulmonary Disease (COPD). Moreover, she has experience with various research methodologies, such as meta-analyses, surveys, and mediation. Paul A. Boelen is professor of clinical psychology at Utrecht Universitity and Arq Psychotrauma Expert Group. He has specialized in research on phenomenology, course, maintaining mechanisms, and treatment of disturbed grief in children and adults.
Keywords
- Complicated grief
- Diagnostic specificity
- DSM-5
- ICD-11-PGD
- Persistent complex bereavement disorder
- Prolonged grief disorder