Improving the understanding and treatment of complex grief: an important issue for psychotraumatology

Abstract

In the Netherlands, every year 500,000 people are confronted with the death of a close relative. Many of these people experience little emotional distress. In some, bereavement precipitates severe grief, distress, and dysphoria. A small yet significant minority of bereaved individuals develops persistent and debilitating symptoms of persistent complex bereavement disorder (PCBD) (also termed prolonged grief disorder), posttraumatic stress disorder, and depression. Knowledge about early identification of, and preventive care for complex grief has increased. Moreover, in recent years there has been an increase in treatment options for people for whom loss leads to persistent psychological problems. That said, preventive and curative treatments are effective for some, but not all bereaved individuals experiencing distress and dysfunction following loss. This necessitates further research on the development, course, and treatment of various stages of complex grief, including PCBD.Highlights of the article“Complex grief” is an informal term referring to debilitating, non-normative grief.It will likely be named Prolonged Grief Disorder in the forthcoming ICD-11.It is named Persistent Complex Bereavement Disorder in DSM-5.Research on the development, course, and treatment of complex grief is needed.This research should address different stages and manifestations of complex grief.

Attachment styles, grief responses, and the moderating role of coping strategies in parents bereaved by the Sewol ferry accident

“…Furthermore, the sudden loss of a child in an accident is often extremely difficult because children are often closely related to a parent’s sense of self and identity, including how they views themselves in the past, present, and future (Boelen, 2016). In this context, self-conscious emotions , feelings defined in a self-evaluative process in relation to societal standards for behaviour, might be important in the grieving process of bereaved parents.…”

Participant experiences of Eye Movement Desensitisation and Reprocessing vs. Cognitive Behavioural Therapy for grief: similarities and differences

“…Issues surrounding the controversy over a proposed diagnostic criteria for grief (either PGD or PCBD) are the potential for pathologizing what may be considered normal reactions to loss. Another issue is that a focus on a diagnosis such as PCBD may not capture all the psychological morbidity following the death of a loved one (Boelen, 2016). …”

Understanding mothers’ experiences of positive changes after neonatal death

“…It adds a unique contribution to an important and understudied area by generating an understanding of some of the potential facilitators and barriers of positive growth. It introduces another potential dimension for how traumatic loss of a neonatal baby may be experienced, instead of focusing on complex grief (Boelen, 2016). This study introduces the possibility that some mothers consciously make choices in relation to how they cope with their experience.…”

“…When a baby dies, bereaved mothers almost always experience grief (Buchi et al, 2007). However, mothers may also experience long-term symptoms of post-traumatic stress disorder (Jind, 2003), complex grief (Boelen, 2016), anxiety and depression (Vance et al, 1995), and marital problems (Baddenhorst & Hughes, 2007). The death of a baby has wide-reaching effects, including influencing parenting of subsequent children (Warland, O’Leary, McCutcheon, & Williamson, 2011) and poorer parental health outcomes (Li, Hansen, Mortensen, & Olsen, 2002).…”