Psychometric evaluation of the Swedish Traumatic Grief Inventory Self‐Report Plus (TGI‐SR+) in bereaved parents

Abstract

The International Classification of Diseases Eleventh Edition (ICD‐11), and the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM‐5‐TR), now include prolonged grief disorder (PGD). Since criteria for PGD in both classification systems differ from prior proposed grief disorders and each other, the validation of a single instrument to screen for prolonged grief (PG) symptoms of both new diagnoses is critical for bereavement research and care. Therefore, we evaluated the psychometric properties of the Swedish version of the Traumatic Grief Inventory Self‐Report Plus (TGI‐SR+). Two‐hundred and forty‐eight bereaved parents completed questions about sociodemographic and loss‐related variables, the TGI‐SR+, and symptom measures of post‐traumatic stress (PTS), depression and an older measure of PG symptoms, the Prolonged Grief Disorder‐13 (PG‐13). Confirmatory factor analyses showed that a one‐factor model best fit DSM‐5‐TR and ICD‐11 PG symptoms and the analyses of the internal consistency and inter‐item correlations showed that these symptoms could be reliably assessed. In support of convergent validity, DSM‐5‐TR and ICD‐11 PG symptoms correlated with symptoms of PTS, depression and PG assessed with the PG‐13. In support of known‐groups validity, DSM‐5‐TR and ICD‐11 PG symptoms were higher among lower educated (vs. higher educated) participants and related negatively to time since loss. ROC analyses showed optimal cut‐off score of ≥71 and ≥72 to determine probable caseness for DSM‐5‐TR and ICD‐11 PGD, respectively. Results support the reliability and validity of the Swedish TGI‐SR+ as a screening instrument for PG in research and bereavement care.

Prevalence and correlates of ICD-11-based Prolonged Grief Disorder in a Representative Slovakian Sample of Recently Bereaved Adults

“…Our second main finding was that, in the whole sample as well as the recently (<6 months) and more remotely bereaved (≥6 months) subsamples considered separately, PGD symptoms formed a unitary factor. This is consistent with prior research showing that PGD symptoms as defined in ICD-11 are best described as forming one dimension (Ashouri & Yousefi, 2023;Boelen & Lenferink, 2020;Kokou-Kpolou et al, 2022;Lenferink et al, 2022Lenferink et al, , 2024. Notably, some other studies have found these symptoms to represent two distinguishable dimensions of separation distress and accompanying symptoms (e.g., Hyland et al, 2024;O'Conner et al, 2023); however, in most of the studies examining the dimensionality, both the one-and two-dimensional models evidenced acceptable fit.…”

“…We found no evidence that PGD severity and caseness differed as a function of gender, age, and education. Some other recent studies similarly found no association with gender (e.g., Hyland et al, 2024;Lenferink et al, 2024). Regarding age, Hyland et al (2024) observed that increased age was associated with a lower chance of meeting criteria for PGD in their UK (but not their Irish) sample.…”

“…The internal consistency of these items was ωtotal = .96. In keeping with prior research (e.g., Ashouri & Yousefi, 2023;Kokou-Kpolou et al, 2022;Lenferink et al, 2024), the cultural deviation item was not included.…”

“…The second aim was to examine the factor structure of PGD symptoms. Consistent with prior research (e.g., Lenferink et al, 2022Lenferink et al, , 2024, we evaluated the fit of a unitary model (with all symptoms loading on one dimension) and a two-factor model (representing two separation distress symptoms, and all "accompanying" symptoms as distinct factors). The third aim was to examine the endorsement rates all PGD symptoms, in order to enhance our understanding of the performance of each symptom as indicator of PGD (cf.…”

Latent trajectories of DSM-5-TR-based Prolonged Grief Disorder: findings from a data pooling project MARBLES

“…However, there are indications that different measures assessing grief intensity correlate very strongly (i.e. correlations ≥ .80) (Lenferink, van Dijk et al, 2023 ). This suggests that different grief measures have more communalities than differences, however caution is warranted when comparing the results across studies using different grief measures and different criteria-sets for prolonged grief (see for discussion: Boelen & Lenferink, 2020 ; Eisma, 2023 ; Lenferink et al, 2021 ).…”