Prolonged grief reaction

Question 1

What is grief?

Answer 1

natural response to bereavement, and includes thoughts, feelings, behaviors, and physiologic reactions.

Question 2

What is prolonged grief disorder?

Answer 2

Unusually protracted, intense, + disabling grief
Characterised by maladaptive thoughts, dysfunctional behaviors, dysregulated emotions, +/or serious psychosocial problems impeding adaptation to the loss.

Question 3

Give 3 broad signs of prolonged grief disorder

Answer 3

Intense + persistent grief, for at least 6-12 months after the loss

Persistence of early grief defensive processes

Impaired functioning: concentration, performing ADLs, or difficulty trusting/ caring for others

Question 4

Give 4 examples of symptoms in prolonged grief disorder

Answer 4

YEARNING + preoccupation with deceased

Rumination + SELF-BLAME

LOSS of INTEREST in ongoing LIFE + suicidality

DISBELIEF + difficulty accepting death

Question 5

What are the 5 stages of grief?

Answer 5

Denial: numbness + pseudo-hallucinations of deceased, both auditory + visual. May even prepare meals for deceased.

Anger: commonly directed against other family + HCPs

Bargaining

Depression

Acceptance

Question 6

Give 2 types of atypical grief reaction

Answer 6

DELAYED grief: when >2w passes before grieving begins

PROLONGED grief: often 2-4y (can be from 6m)

Question 7

Give 4 risk factors for prolonged grief reaction

Answer 7

Bereaved of child or spouse
Death of a young person
Violent death (eg, accident, homicide, natural disaster, or suicide)
Bereaved multiple times

Question 8

What screening tool can be used for prolonged grief reaction?

Answer 8

**Brief Grief Questionnaire: **

• Difficulty accepting the death
• Impaired functioning secondary to grief
• Disturbing images or thoughts of the death
• Avoiding things related to the deceased
• Feeling cut off or distant from people

Question 9

What is the management for a prolonged grief reaction?

Answer 9

Prolonged grief disorder therapy or CBT
Psychoeducation