Prolonged Grief

Where to After Diagnostic and Statistical Manual of Mental Disorders, 5th Edition?

Richard A. Bryant

Disclosures

Curr Opin Psychiatry. 2014;27(1):21-26. 

In This Article

What Is Complicated/Prolonged Grief?

The proposed disorder was intended to describe severe and disabling grief reactions that do not abate in the 12 months after the death of a close other. The core of the diagnosis was a persistent yearning or missing the deceased, or preoccupation with the circumstance of the death. In addition to this central element, there were additional symptoms that could be present: difficulty accepting the death, feelings of loss of a part of oneself, anger about the loss, guilt or blame regarding the death, or difficulty in engaging with new social or other activities due to the loss.[1] Importantly, these persistent reactions need to be outside one's cultural norm – recognizing the variability in societal frameworks of mourning and grief. The terms given to the condition has altered over the years, including traumatic grief, complicated grief, and prolonged grief. The most common terms are currently complicated grief or prolonged grief – reflecting two emphases in thinking about the condition. Whereas complicated grief suggests that these reactions are qualitatively distinct from the reactions seen in the acute phase of grief, the term prolonged grief suggests that the acute reactions simply persist, and the bereaved person is 'stuck' in their grief response. We will use the term 'prolonged grief' because at this stage there is no evidence that the symptoms of persistent grief are different from those observed in the normative reactions to bereavement in the acute phase.

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