Assessing prolonged grief disorder: A systematic review of assessment instruments

Grief reactions that become abnormally persistent and cause significant impairment in functioning have been introduced as new diagnostic entities within the classification systems DSM-5 and ICD-11 termed persistent complex bereavement disorder (PCBD_DSM-5) and prolonged grief disorder (PGD_ICD-11), respectively. In order to assess these conditions, reliable and valid assessment instruments are indispensable. This systematic review examines available assessment tools for disordered grief, reviews their psychometric properties and assesses the extent to which they reflect the diagnostic entities.

A systematic search of PubMed, PsycINFO and Web of Science databases was conducted. English language articles describing either the development of a measure for assessing PGD in adults or the validation of such a measure were included.

Overall 2215 publications were screened, 29 of which met the eligibility criteria. Three of the eleven described assessment tools are structured clinical interviews, one tool is a carer-based assessment and the remaining tools are self-report questionnaires. Most instruments demonstrate excellent or good reliability and validity. No tool assesses the current diagnostic criteria for PGD_ICD-11 fully. While three tools cover all diagnostic criteria for PCBD_DSM-5, only one (TGI-SR) provides an adequate, empirically tested diagnostic algorithm.

The inclusion of only English-language publications may have led to omission of relevant measurement tools and/or validation studies in different languages.

The newly released ICD-11 criteria for PGD could serve as a gold standard for diagnosis and build a foundation for the development of more precise assessment tools. Recommendations for clinical practice and future research are provided.