Pathological grief: Persistent Complex Bereavement Disorder (PCBD) Flashcards
What disorder is complicated/prolonged grief classed as, and what classification system is used?
Persistent Complex Bereavement Disorder (PCBD) or Prolonged Grief Disorder (PGD)
DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition)
What is the difference between normal and complicated grief, in terms of their timeframes?
Normal grief lasts 6 months-1 year
Complicated grief lasts many months-years
Give examples of physical responses to complicated grief?
Fatigue, digestive problems, depressions
Give examples of emotional responses to complicated grief?
Intense sadness and distress, anger, loneliness
Give examples of behavioural responses to complicated grief?
Social withdrawal, not functioning, avoid reminders of loss, can’t work
Give examples of cognitive responses to complicated grief?
Emptiness, suicidal ideation, self-blame, desire to be with the deceased, hallucinations of the deceased, constantly thinking/talking about death
How does PCBD initially affect the time frame of normal bereavement?
Grief is unshakable and doesn’t improve over time
How does PCBD initially affect major functioning of an individual?
Causes unusual, severe symptoms that impair major functioning
How does PCBD initially affect moods and emotions?
Causes intense emotions/moods
Give examples of other health conditions that PCBD is associated with causing?
Suicidal ideation and attempts, cancer, hypertension, cardiovascular events, immune dysfunction, poor health behaviours
How does PCBD affect the rates of service use and sick leave?
Makes rates higher
What are the 5 types of complicated grief?
Chronic grief: Lasts for prolonged/extended time period
Delayed grief: Postponed so that it occurs after person dies
Disenfranchised grief: Unacknowledged/unvalidated by social norms
Compounded grief: Occurs after multiple losses
Anticipatory grief: Occurs prior to a known future loss eg. knows that person is going to die soon
In the diagnostic criteria for PCBD, what disorder does the person need to currently have and for how long after bereavement?
Current diagnosis of grief disorder due to prolonged symptoms causing significant, functional impairment
for at least 1 month after 6 months of bereavement
In diagnostic criteria of PCBD, which one of 4 symptoms needs to be persistent, along with a current grief disorder and 2 other symptoms for at least 1 month?
One of the following persistent symptoms:
Intense yearning for the deceased
Preoccupations with the deceased
Recurrent thoughts that life is meaningless without deceased
Urge to join deceased in death
In the diagnostic criteria of PCBD, which 2 of the following symptoms need to present for at least 1 month, along with current grief disorder and another persistent symptom?
Shocked, stunned, numb since death
disbelief/inability to accept loss
Rumination about circumstances/consequences of death
Experiencing pain that deceased suffered from, or hearing/seeing deceased
Anger/bitterness about death
Hard to trust/care for others
Intense reactions to reminders/memory of deceased
Avoidance of reminders of the deceased, or the opposite: seeking out reminders to feel close to the deceased
How can PCBD be differentiated from normal grief?
PCBD symptoms usually last longer and cause functional impairment for much longer time after death
How can PCBD be differentiated from depressive disorder?
PCBD sadness focused on loss of deceased
How can PCBD be differentiated from PTSD?
PTSD causes intrusive thoughts about traumatic event but PCBD causes thoughts about deceased/circumstances of death
How can PCBD be differentiated from Separation Anxiety Disorder?
SAD is from separation from living individual but PCBD is from separation from deceased
In which kinds of deaths are risk factors most often linked to development of PCBD?
untimely, unexpected or violent death
Give examples of risk factors that indicate pre-loss PCBD?
pre-existing mental health conditions or inadequate coping mechanisms, lack of knowledge about death, has previous experience, conflict/difficult relationship with deceased
Which 4 populations have higher risk of pre-loss PCBD?
children, adolescents, young spouses, elderly in long-term relationships
Give examples of risk factors that indicate during-loss PCBD?
Loss caused by violence, trauma, accident eg. suicide, others can’t offer support and comfort, loss caused by inheritable disease or long-term illness, death associated with stigma/shame eg. AIDS
Give examples of risk factors that indicate post-loss PCBD?
inadequate family or community support, traumatic reminders eg. anniversaries, birthdays, future losses and bereavement
