Prolonged Grief Disorder: A New Diagnosis

Grief is a very personal and difficult journey for those who have lost a loved one.  Sometimes relief and the return to “new” normal functioning is slow to happen.  A new disorder addressing this issue, “prolonged grief disorder,” will be included in the forthcoming Diagnostic and Statistical Manual of Mental Disorders-5-TR, the psychological standard for making clinically accepted diagnoses. 

From the standpoint of a grief and loss therapist, this appears to be a timely adjustment to the understanding of the nature of grief.  After a non-violent loss, approximately one in every ten adults suffers over a prolonged period of time from significant grief. Significant grief may include a pervasive inability to move past the loss of a loved one.  Symptoms are significant enough to affect day-to-day functioning.

Diagnostic Criteria for Prolonged Grief Disorder (F43.8)

The newly described disorder is characterized by the following group of symptoms:

1. The death, at least 12 months ago, of a person who was close to the bereaved individual (for children and adolescents, at least six months ago).
2. Since the death, the development of a persistent grief response characterized by one or both of the following symptoms, which have been present most days to a clinically significant degree. In addition, the symptom(s) has occurred nearly every day for at least the last month:
   1. Intense yearning/longing for the deceased person.
   2. Preoccupation with thoughts or memories of the deceased person (in children and adolescents, preoccupation may focus on the circumstances of the death).
3. Since the death, at least three of the following symptoms have been present most days to a clinically significant degree. In addition, the symptoms have occurred nearly every day for at least the last month:
   1. Identity disruption (e.g., feeling as though part of oneself has died) since the death.
   2. Marked sense of disbelief about the death.
   3. Avoidance of reminders that the person is dead (in children and adolescents, may be characterized by efforts to avoid reminders).
   4. Intense emotional pain (e.g., anger, bitterness, sorrow) related to the death.
   5. Difficulty reintegrating into one’s relationships and activities after the death (e.g., problems engaging with friends, pursuing interests, or planning for the future).
   6. Emotional numbness (absence or marked reduction of emotional experience) as a result of the death.
   7. Feeling that life is meaningless as a result of the death.
   8. Intense loneliness as a result of the death.
4. The disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.
5. The duration and severity of the bereavement reaction clearly exceeds expected social, cultural, or religious norms for the individual’s culture and context.
6. The symptoms are not better explained by another mental disorder, such as major depressive disorder or post-traumatic stress disorder, and are not attributable to the physiological effects of a substance (e.g., medication, alcohol) or another medical condition.

Are You Struggling with Prolonged Grief?

Gratefully, years of research and clinical experience have resulted in a definitive categorization of this extended grief malady.  If you are struggling with grief and loss symptoms and wish to have the support of a grief and loss counselor, call for an appointment with our Compassionate Bereavement Care Certified Provider, Marie Ricks at (480) 668-8301 ext. 1016.