More than one-third of people who are grieving meet the DSM-5 criteria for prolonged grief disorder, a study in the Journal of Affective Disorders has found. Yet the results suggest that most people who are bereaved feel that their grief is a normal response to loss regardless of how long they’ve been grieving.
“Although respondents’ views of the normalcy of their grief may be subject to bias, as in any other area of self-evaluation, it is useful to know how bereaved individuals themselves view their grief experiences,” wrote Kara Thieleman, Ph.D., of Arizona State University and colleagues.
The researchers surveyed 1,137 bereaved adults using the Prolonged Grief-13-Revised scale (PG-13-R), which is used to identify patients who meet the DSM-5 criteria for prolonged grief disorder. The PG-13-R asks whether an individual has experienced bereavement, how many months it has been since the loss, and whether symptoms of grief have caused impairment in the individual’s functioning. For example, it asks “Do you feel yourself longing or yearning for the person who died?” Respondents were also asked to rate how normal of a response they believed each PG-13-R item to be. For example, they were asked “Do you feel it is normal for you to yearn for this person?” The average time since the loss was 10.6 years.
Overall, 34.3% of respondents met the criteria for a diagnosis of prolonged grief disorder, and 37.6% reported their grief impaired their functioning. When the researchers analyzed rates of prolonged grief disorder according to respondents’ relationship to the people who died, they found that bereaved parents had the highest rate of prolonged grief disorder at 41.6%, followed by bereaved spouses/partners at 33.7% and siblings at 29.4%. According to cause of death, those bereaved by overdose had the highest rate at 59.1%, followed by homicide/suicide at 46% and accidental causes at 36%.
Nearly all respondents—98.1%—agreed that their overall emotional responses to their loss were normal and understandable, and fewer than 12% reported that a diagnosis of prolonged grief disorder would be helpful to them. Furthermore, 59.9% of those who lost a child, 63.6% of those who lost a spouse or partner, 42.5% of those who lost a parent, 33.3% of those who lost a sibling, 58.5% of those who lost a friend, and 51.9% of those who lost someone in another category reported that a diagnosis of prolonged grief disorder would be “very unhelpful.”
“In sum, differences in norms regarding the intensity, duration, and trajectory of grief among bereaved subgroups complicate the question of how to identify when grief may constitute a disorder,” Thieleman and colleagues wrote. “While more research is needed … it may be worthwhile to consider the context in which loss occurs when determining whether symptoms constitute normal grieving or potential disorder.”
For related information, see the Psychiatric News article “Assembly Approves New Diagnosis of Prolonged Grief Disorder for DSM-5-TR.”
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