Validation of a Brief Measure for Complicated Grief Specific to Reproductive Loss

Area of Science:

• Reproductive Health
• Psychology
• Grief Research

Background:

• Complicated grief reactions are common after reproductive loss (miscarriage, stillbirth, termination).
• Existing screening tools like the Edinburgh Postnatal Depression Scale are inadequate for detecting complicated grief in this population.
• Stigma surrounding reproductive loss can impede timely treatment and worsen patient outcomes.

Purpose of the Study:

• To design and preliminarily validate a novel five-item questionnaire for detecting complicated grief after any type of reproductive loss.
• To address the need for a specific, non-traumatic, and user-friendly screening tool for prolonged or complicated grief.

Main Methods:

• A five-item questionnaire was developed, modeled after the Brief Grief Questionnaire (BGQ), using sensitive language for reproductive loss.
• 140 women experiencing reproductive loss were recruited and validated the new tool against established measures for anxiety (PDSS), trauma (IES), and reproductive grief/depression (PGS).
• Statistical analyses included Cronbach's alpha, goodness of fit indices (RMSEA, CFI, SRMR), Average Variance Extracted (AVE), and Composite Reliability (CR).

Main Results:

• The questionnaire demonstrated good internal consistency (Cronbach's alpha = 0.77) and met preliminary criteria for discriminant validity.
• 51% of respondents screened positive for complicated grief using a score > 4 on the BGQ.
• The tool's model fit indices (CFI=0.89, SRMR=0.06) and validity metrics (AVE=0.42, CR=0.78) support its preliminary validation.

Conclusions:

• The newly developed five-item screening tool is internally consistent and shows preliminary validity for detecting complicated grief after reproductive loss.
• This investigator-created tool offers a promising, concise option for screening complicated grief in women experiencing reproductive loss.
• Further refinement and testing for sensitivity and specificity are recommended before widespread clinical application.