No full-text available
To read the full-text of this research,
you can request a copy directly from the author.
Diagnostic criteria for complications of bereavement in the DSM-5
Abstract
the Diagnostic Statistical Manual of Mental Disorders Volume 5 (DSM-5) is the most recent update (2013) in a series published by the American Psychiatric Association which aims to provide authoritative guidance to psychiatrists on the diagnosis of mental disorders. This article outlines the main changes in the DSM-5 regarding issues relating to bereavement, including discussion of diagnostic categories of Major Depressive Episodes, Adjustment Disorder, Persistent Complex Bereavement Disorder (PCBD) and Separation Anxiety Disorder.
... Although it is expected that prevalence rates will vary depending on the sample and the postloss duration, the numbers seem to be on an upward trend. In a practitioner-targeted article introducing changes to the DSM-5, renowned British grief scholar C. M. Parkes (2014) reported an estimated prevalence of PCBD among bereaved adults to be between 2.4% and 4.8%. These numbers are likely drawn from studies by Fujisawa et al. (2010) and Newson et al. (2011), respectively. ...
... the DSM-5, renowned British grief scholar C. M.Parkes (2014) reported an estimated prevalence of PCBD among bereaved adults to be between 2.4% and 4.8%. These numbers are likely drawn from studies byFujisawa et al. (2010) andNewson et al. (2011), respectively. ...
This preprint is an uncorrected manuscript accepted for publication in The Palgrave Encyclopedia of Critical Perspectives on Mental Health.
See the published version via:
https://www.researchgate.net/publication/359051298_Medicalization_of_Grief_Its_Developments_and_Paradoxes_In_Lester_JN_O'Reilly_M_eds_The_Palgrave_Encyclopedia_of_Critical_Perspectives_on_Mental_Health_Palgrave_Macmilla
... There is an estimated prevalence of the condition of 2.4-4.8%, and greater in females than males (Parkes, 2014), but if one looks only at bereaved individuals, one finds studies that indicate that as much as 20-33% of all such persons meet the criteria for [PCBD, as it was conceived in section III of DSM-V] (Piper and Ogrodniczuk, 2013). This means that a very high number of bereaved people will potentially qualify for this psychiatric diagnosis. ...
Major Depressive Disorder (MDD) is a serious condition with a large disease burden. It is often claimed that MDD is a “brain disease.” What would it mean for MDD to be a brain disease? I argue that the best interpretation of this claim is as offering a substantive empirical hypothesis about the causes of the syndrome of depression. This syndrome-causal conception of disease, combined with the idea that MDD is a disease of the brain, commits the brain disease conception of MDD to the claim that brain dysfunction causes the symptoms of MDD. I argue that this consequence of the brain disease conception of MDD is false. It incorrectly rules out genuine instances of content-sensitive causation between adverse conditions in the world and the characteristic symptoms of MDD. Empirical evidence shows that the major causes of depression are genuinely psychological causes of the symptoms of MDD. This rules out, in many cases, the “brute” causation required by the brain disease conception. The existence of cases of MDD with non-brute causes supports the reinstatement of the old nosological distinction between endogenous and exogenous depression.
... Central to both the theoretical and practical perspectives which shape care for bereaved people is the search for clarity about the nature of normal grief and the characteristics of complex grief. The attempt to reconcile tensions between these is often problematic, as seen in the discussion about the way in which grief and its complex variations have been defined in the DSM-5 (Parkes 2014). Alongside the 'theories debate' has been the growth in counselling as an increasingly established form of nonmedical intervention, which has impinged significantly on less formal forms of bereavement care and the services which provide it. ...
A key challenge for service providers and practitioners in the field of bereavement is to match clients’ varied needs with equally diverse approaches to care. In order to provide these appropriate and effective interventions, it is crucial to have a reliable means of assessing levels of vulnerability in bereaved clients. The Range of Response to Loss model (RRL) and Adult Attitude to Grief scale (AAG) have evolved as practice tools able to profile the variable nature of client grief by identifying the initially instinctive reactions to loss alongside more aware coping responses. This paper describes the theoretical concepts which underpin the AAG, and recent research which confirms the factor structure of the scale and its capacity to identify varied levels of vulnerability. The application of the AAG to practice as an assessment/ outcome tool and guide to intervention are set out and future developments such as potential inclusion in the CORE IMS discussed.
In the sociology of the emotions, it has been common to approach emotions as socially constructed. Researchers have rightly asked how society and social processes shape emotional life, and this approach has generated many valuable insights. In this article, I argue that we should also approach the relation between emotions and society from a complementary perspective and ask how society itself is constituted through specific emotional processes. Social researchers of existential leanings have argued along these lines, pointing out how the human fear of death is crucial for the constitution of society. I argue that an equally fundamental emotion for the constitution of society is grief. I take up Tony Walter’s claim that grief underlies the very constitution of society and seek to develop it into a broader understanding of how human social life presuppose practices of grief and mourning, which enable collectives to move into the future on the basis of their past. I end with a brief discussion of how the current pathologization of grief may impact societal processes and our views of human beings.
In the fifth edition of the diagnostic manual of the American Psychiatric Association (the DSM), published in 2013, a new diagnosis for complicated grief was included named “Persistent complex bereavement disorder”. When the World Health Organization will publish its next edition of its system, the ICD, in 2018, it is expected that a new diagnosis called “Prolonged grief disorder” will also be included in this manual. In this article, I first briefly present the emerging diagnostic criteria for grief and situate the rise of the psychiatric grief diagnoses in the context of what has been called the “diagnostic culture” of contemporary society. I then raise the question about the legitimacy of diagnoses for complicated grief. I discuss the diagnoses in light of four general theories of mental disorders: The naturalist theory of Boorse, the harmful dysfunction theory of Wakefield, the phenomenological theory in the tradition of Jaspers and the nominalist theory of Bolton. I end with a general discussion of thinking of grief as a mental disorder and recommend a cautious approach, according to which grief should primarily be thought of as an existential condition that may lead to mental disorders, but which is not a mental disorder in itself.
While complicated grief has been addressed in part through some recommendations for modifications in the upcoming fifth version of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), there remain reasons for substantial concern about its scope therein and within clinical practice. The authors issue a call to the field, reiterating that complicated grief is complicated and cannot be confined to just one syndrome or disorder. Continued research is urged, and specific caveats are identified for exploring the complex dimensions of loss and grief. The authors advocate for ongoing dialogue about and investigation of various potential forms of complicated grief.
Recent studies have suggested that the vulnerability to complicated grief (CG) may be rooted in insecure attachment styles developed in childhood. The aim of this study was to examine the etiologic relevance of childhood separation anxiety (CSA) to the onset of CG relative to major depressive disorder, posttraumatic stress disorder, and generalized anxiety disorder in bereaved individuals. The Structured Clinical Interview for the DSM-IV, Inventory of Complicated Grief-Revised, and CSA items from the Panic Agoraphobic Spectrum Questionnaire were administered to 283 recently bereaved community-dwelling residents at an average of 10.6 months postloss. CSA was significantly associated with CG (OR = 3.2; 95% CI, 1.2-8.9), adjusting for sex, level of education, kinship relationship to the deceased, prior history of psychiatric disorder, and history of childhood abuse. CSA was not significantly associated with major depressive disorder, posttraumatic stress disorder, or generalized anxiety disorder.
Loving and grieving are two sides of the same coin: we cannot have one without risking the other. Only by understanding the nature and pattern of loving can we begin to understand the problems of grieving. Conversely, the loss of a loved person can teach us much about the nature of love.
The DSM-5 Anxiety, Obsessive-Compulsive Spectrum, Posttraumatic, and Dissociative Disorders Work Group has proposed criteria for Persistent Complex Bereavement-Related Disorder (PCBRD) for inclusion in the appendix of DSM-5. The authors feel that it is important that dysfunctional grief will become a formal condition in DSM-5 because that would facilitate research and would imply recognition of the suffering of a significant minority of bereaved individuals who experience difficulties in their process of recovery from loss. However, as detailed in this commentary, we oppose the inclusion of the proposed criteria set for PCBRD for several reasons, including the fact that these criteria lack empirical evidence. In our view, it is better to include empirically validated criteria for prolonged grief disorder in DSM-5, possibly expanded with a few symptom criteria that are tapped by the Inventory of Complicated Grief the most widely used instrument to measure dysfunctional grief.
Grief and the DSM-5. Psychology Today Available at http://www.psychologytoday.com/blog/your-personal- renaissance/201305/grief-and-the-dsm-5
- D Dreher
Dreher D (2013). Grief and the DSM-5. Psychology Today.
Available at http://www.psychologytoday.com/blog/your-personal-
renaissance/201305/grief-and-the-dsm-5 [Accessed 10 October
2014].
Is mourning madness? The wrongheaded movement to classify grief as a mental disorder
- L Granek
Granek, L (2012). Is mourning madness? The wrongheaded
movement to classify grief as a mental disorder. Slate. March 12.
Available at: http://www.slate.com/articles/life/grieving/2012/03/
complicated_grief_and_the_dsm_the_wrongheaded_movement_to_
list_mourning_as_a_mental_disorder_.html [Accessed 10 October
2014].
Symposium on complicated grief. Introduction and conclusions
Parkes CM (Guest Editor) (2006a). Symposium on complicated grief.
Introduction and conclusions. Omega 52(1) 1-112.
International classification of disease volume II (ICD-11) Beta version online
World Health Organisation (2014). International classification of
disease volume II (ICD-11) Beta version online: http://apps.who.int/
classifications/icd11/browse/l-m/en (Accessed 14th May 2014).