ABSTRACT
A minority of bereaved individuals develops persistent, disabling, and distressing symptoms of grief. As yet, there is no category for a bereavement related disorder in the most frequently used classification system, the Diagnostic and Statistical Manual for Mental Disorders (DSM). Since the mid-1990s, researchers and clinicians have increasingly pled for the inclusion of a syndrome of grief – by turns referred to as pathological, complicated, and, more recently, prolonged grief disorder – in the DSM system. Horowitz and colleagues proposed criteria for “pathological grief” in 1993 (Horowitz, Bonanno, & Holen, 1993) and refined criteria for “complicated grief disorder” in 1997 (Horowitz et al., 1997). Comparable to posttraumatic stress disorder (PTSD), this condition was conceptualized as consisting of intrusive symptoms and signs of avoidance and failure to adapt. In that same period, two influential studies were published by Prigerson and colleagues. In one of these studies, Prigerson, Frank et al. (1995) differentiated symptoms of complicated grief from bereavement-related depression and found complicated grief to be associated with health impairments over and above depression. In the other study, the Inventory of Complicated Grief (ICG) was introduced as a 19-item measure of complicated grief, together with data supporting the scale’s psychometric properties (Prigerson, Maciejewski, et al., 1995).
