Consensus criteria for traumatic grief

BACKGROUND Studies suggest that symptoms of traumatic grief constitute a distinct syndrome worthy of diagnosis. AIMS A consensus conference aimed to develop and test a criteria set for traumatic grief. METHOD The expert panel proposed consensus criteria for traumatic grief. Receiver operator characteristic (ROC) analyses tested the performance of the proposed criteria on 306 widowed respondents at seven months post loss. RESULTS ROC analyses indicated that three of four separation distress symptoms (e.g. yearning, searching, loneliness) had to be endorsed as at least 'sometimes true' and four of the final eight traumatic distress symptoms (e.g. numbness, disbelief, distrust, anger, sense of futility about the future) had to be endorsed as at least 'mostly true' to yield a sensitivity of 0.93 and a specificity of 0.93 for a diagnosis of traumatic grief. CONCLUSIONS Preliminary analyses suggest the consensus criteria for traumatic grief have satisfactory operating characteristics, and point to directions for further refinement of the criteria set.

[1]  B. Raphael,et al.  The Bereavement Response: A Cluster Analysis , 1996, British Journal of Psychiatry.

[2]  C. Reynolds,et al.  Traumatic Grief: A Case of Loss-Induced Trauma , 1997 .

[3]  Helena Chmura Kraemer,et al.  Evaluating Medical Tests: Objective and Quantitative Guidelines , 1992 .

[4]  M. Eisenbruch.  The cultural bereavement interview: a new clinical research approach for refugees. , 1990, The Psychiatric clinics of North America.

[5]  C. Reynolds,et al.  Traumatic Grief, Depression and Caregiving in Elderly Spouses of the Terminally Ill , 1997 .

[6]  C. Reynolds,et al.  Inventory of complicated grief: A scale to measure maladaptive symptoms of loss , 1995, Psychiatry Research.

[7]  Daniel J Buysse,et al.  Acute open-trial nortriptyline therapy of bereavement-related depression in late life. , 1991, The Journal of clinical psychiatry.

[8]  C. Reynolds,et al.  Gender Differences in Complicated Grief among the Elderly , 1996 .

[9]  D. Kupfer,et al.  Anxiety among widowed elders: is it distinct from depression and grief? , 1996, Anxiety.

[10]  Daniel J Buysse,et al.  Sleep in the wake of complicated grief symptoms: An exploratory study , 1997, Biological Psychiatry.

[11]  D. Kupfer,et al.  Complicated grief and bereavement-related depression as distinct disorders: preliminary empirical validation in elderly bereaved spouses. , 1995, The American journal of psychiatry.

[12]  M K Shear,et al.  Traumatic grief as a risk factor for mental and physical morbidity. , 1997, The American journal of psychiatry.

[13]  Sigmund Freud,et al.  Mourning and Melancholia , 1922 .

[14]  S. Zisook,et al.  Depression through the first year after the death of a spouse. , 1991, The American journal of psychiatry.

[15]  C. M. Parkes.  Bereavement; studies of grief in adult life , 1972 .