Complicated Grief: A Conceptual Analysis of the Field

Abstract

A great deal of research, notably by Prigerson and colleagues (e.g., Prigerson & Jacobs, 2001; see Prigerson & Maciejewski, this issue) and Horowitz and colleagues (e.g., Horowitz, this issue; Horowitz, Bonanno, & Holen, 1993), has recently been conducted with the purpose of establishing criteria for the designation of Complicated Grief (CG) as a mental disorder for inclusion in DSM-V. Some dissenting voices have been heard from teams of researchers adopting different approaches and/or using different criteria and diagnostic categorizations. We argue the need for a conceptual framework as a starting point for understanding the different positions on this CG—DSM controversy. This analysis is used as a tool to evaluate the questions posed by the Editor of this Special Issue, Colin Murray Parkes: (1) Should Complicated Grief be regarded as a psychiatric disorder? (2) Does the syndrome described by Prigerson and colleagues meet the required scientific criteria? Discrepancies emerge between scholars in the ways that they have conceptualized and assessed complicated grief and associated disorders: Examination of the positions of researchers within the framework reveals five systematically different approaches. We argue that potential criteria and diagnostic categorization systems emerging from the different perspectives need to be considered. General implications of DSM-V (non)inclusion are summarized.