There is increasing support for the recognition of complicated grief (CG), or pathological reactions to grief, as its own mental health syndrome. Most individuals who experience grief struggle with similar emotions during the grieving process. However, some people exhibit more severe and persistent symptoms that result in impaired sleep, increased stress, and poor quality of life and often require psychological intervention. The proposed changes to the DSM include listing CG as a unique syndrome, but controversy exists over precisely which subgroup it should fall under. People who have major depressive disorder (MDD) or posttraumatic stress (PTSD) may show symptoms that are somewhat like those of complicated grief. But it is necessary to understand the cognitive processes that underlie CG in order to determine if CG is truly a form of MDD or not. To better identify the way in which the symptoms of CG are processed compared to the symptoms of MDD and PTSD, Ann-Marie J. Golden of the Emotion Research Group and Medical Research Council Cognition and Brain Sciences Unit in Cambridge, England, looked at the executive functioning, personal narratives, self-cognitions, and other symptoms in 272 grieving individuals.
Golden conducted three separate studies that examined individuals whose symptoms of grief ranged from normal to both moderate and severe CG. After analyzing all of the data, Golden found that the individuals who had CG did not exhibit negative attributions about themselves, whether related to the bereavement or otherwise. Golden believes that these findings indicate that cognitive processing in individuals with CG is unique and should not be classified in the same way as PTSD, MDD, or other mood disorders. Golden said, “The current data are consistent with the distinctiveness of CG as a discrete syndrome, in line with proposals for the inclusion of a bereavement-related adjustment disorder in the DSM–V; the data are also consistent with other evidence indicating that CG has distinct phenomenology, merits a different treatment approach, and has differential predictive validity.” She added that symptom similarity notwithstanding, people who are suffering with CG are better able to show their emotions than those with PTSD and MDD. These findings are beneficial to clinicians who treat individuals with CG and may help them realize the importance of fully exploring their clients’ attributions and appraisals. But clinicians are cautioned to proceed slowly so as not to exacerbate the extreme emotional state of their clients.
Golden, A.-M. J., Dalgleish, T. (2012, February 13). Facets of Pejorative Self-Processing in Complicated Grief. Journal of Consulting and Clinical Psychology. Advance online publication. doi: 10.1037/a0027338
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