Distinctiveness of prolonged grief disorder symptoms among survivors of the Great East Japan Earthquake and Tsunami

Abstract

Prolonged Grief Disorder (PGD) has been proposed for diagnostic classification as an independent psychiatric disorder. Previous research has investigated it in relation to other axis I disorders in order to determine whether it could be considered an independent nosological entity. The distinctiveness of this condition was apparent in cases of ordinary bereavement and in those following human-made disasters. However, this disorder may be expanded to include bereavement resulting from natural disasters. The present study aims to explore the differences between this disorder and posttraumatic stress disorder or major depressive disorder as experienced after the Great East Japan Earthquake and Tsunami. The subjects were 82 hospital workers. Each type of disorder was assessed by means of the Inventory of Complicated Grief, the Impact of Event Scale-Revised, and the Center for Epidemiological Studies Depression Scale. Exploratory factor analysis showed 3 dimensions, with PGD items independently clustering in the same dimension. Our findings support the uniqueness of PGD even in a post-natural disaster situation in a non-Western culture and warrant grief intervention for high-risk bereaved survivors.

Prolonged grief disorder and depression are distinct for caregivers across their first bereavement year

“…Furthermore, we found that the PG‐13 and CES‐D had invariant structures between 6 and 13 months postloss; namely, both tools shared and had distinct characteristics over time. Our longitudinal results extend previous cross‐sectional findings to demonstrate that although both PGD and depression are persistent emotional‐distress disorders for bereaved family caregivers of terminally ill cancer patients, these disorders possess specific and distinct characteristics. Therefore, health care professionals must recognize the distinction between symptoms of PGD and depression early in bereavement (as early as 6 months postloss, as suggested) to avoid missing bereaved caregivers with PGD by focusing only on depression and provide precise interventions tailored to the needs of bereaved caregivers with these different disorders.…”

“…The differences between symptoms of PGD and depression have initially and mostly been examined by exploratory factor analysis, which is inappropriate for examining the distinction between well‐developed instruments such as those for PGD and depression. Another approach more commonly used to distinguish symptoms of PGD and depression is confirmatory factor analysis (CFA), which tests whether an instrument's outcomes match its hypothesized factor structure (number of factors/dimensions) .…”

“…However, these dynamic characteristics have been neglected by mostly cross‐sectional studies validating their distinctiveness during bereavement, except for 2 studies . Furthermore, most of these studies were conducted in Western countries, with only 2 from Asia . The experience of PGD or depression during bereavement may differ in Asian and Western cultures due to different caregiving approaches and perceptions of caregiving burden .…”

“…14 PGD was also included as a new mental disorder distinct from depression in The International Classification of Diseases, 11th revision (ICD-11). 15 Indeed, symptoms of PGD and depression have been evaluated broadly and identified as distinct, 4,8,[16][17][18][19][20][21][22][23][24] but with some insufficiencies.…”

Prevalence and risk factors of complicated grief among Sichuan earthquake survivors

“…economic loss, physical injury) and traumatic experiences puts people at higher risk of CG than normal bereavement (Hargrave et al, 2012;Kristensen et al, 2012;Wijngaards-de Meij et al, 2005). Thirdly, as CG is distinct from other mental disorders (Bonanno et al, 2007;O'Connor et al, 2010;Tsutsui et al, 2014), it is associated with different types of symptoms and adaptation difficulties, and most importantly, it needs unique and specific types of support or intervention (Shear et al, 2005). Without an examination of or understanding regarding survivors' grief conditions, a complete picture of their mental health will not be available.…”