DSM-V Diagnostic Criteria for Bereavement-Related Disorders in Children and Adolescents: Developmental Considerations

Abstract

Two bereavement-related disorders are proposed for the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-V): Adjustment Disorder Related to Bereavement, to be located in the main body of the text as an official diagnostic entity; and Bereavement-Related Disorder, including a Traumatic Death Specifier, to be located in the Appendix as an invitation for further research. These diagnoses currently do not include developmentally informed criteria, despite the importance of developmental processes in the ways children and adolescents grieve. In this article, we draw upon a selective review of the empirical literature and expert clinical knowledge to recommend developmentally informed modifications and specifiers of the proposed criteria for both bereavement disorders and strategies to improve future research. This article is derived from an invited report submitted to the DSM-V Posttraumatic Stress Disorder, Trauma, and Dissociative Disorders Sub-Work Group, and suggested modifications have received preliminary approval to be incorporated into the DSM-V at the time of this writing. Adoption of these proposals will have far-reaching consequences, given that DSM-V criteria will influence both critical treatment choices for bereaved youth and the next generation of research studies.

Psychosocial functioning after losing a close friend in an extreme terror incident

“…Normal and complicated grief are part of a continuum, rather than being categorically different (Holland, Neimeyer, Boelen, & Prigerson, 2008). Ongoing maturation and development may, in addition to shifts in symptomatology with increasing age, add to the complexity of understanding and studying normal and complicated reactions for adolescents and young adults (Kaplow, Layne, Pynoos, Cohen, & Lieberman, 2012).…”

Sudden Loss and Psychiatric Disorders Across the Life Course: Toward a Developmental Lifespan Theory of Bereavement-Related Risk and Resilience

“…The grief field is in need of research designs and conceptual frameworks that clarify potentially differential relations between specific characteristics of bereavement (e.g., circumstances of the death [13]), age-related reactions to the loss (e.g., coping [14], grief reactions [15]), and developmental trajectories across the lifespan (10,16,17), including risks for proximal and distal adverse outcomes (e.g., substance abuse, depression) (5). The Keyes et al study contributes to such theory-building work by using a large population-based sample and focusing on a range of psychiatric outcomes across the life course.…”

“…Multidimensional grief theory postulates that specific dimensions of maladaptive grief (including those described by Keyes et al, such as separation distress and disruptions in selfconcept [15]) may differentially confer risk for various psychiatric disorders (6,18). Future research that incorporates multidimensional measures of grief (23) and bereavement-related contextual factors (24) carries promise for explicating diverse ways in which bereavement, grief, and circumstances of the death may intersect and differentially contribute to psychiatric risk or resilience across the lifespan (8,10,17,18).…”

Internalizing and Externalizing Symptoms Moderate Treatment Response to School-Based Trauma and Grief Component Therapy for Adolescents

“…The generalizability of our study results is also limited by the nascent state of the grief field and a current lack of consensus regarding how to best define and assess MG reactions (Kaplow et al, 2012). Finally, although program implementation and fidelity was monitored via live supervision and weekly phone calls with the treatment developers, future studies should include additional methods for monitoring fidelity.…”