Complicated grief: A case study of pathological bereavement

The current edition of the Diagnostic and Statistical Manual lacks a diagnostic category that would directly target the symptoms of complicated grief syndrome. Without such a category, clinicians treating the pathologically bereaved client must assign a diagnosis with similar symptomology, the treatment for which may not be efficacious for bereavement. This single-case study was designed to identify the symptoms of complicated grief as it differs from both a normal grieving process and other forms of pathology often diagnosed in the bereaved. In addition, this study included an illustration of how clinicians treating a bereaved individual could see the symptoms of complicated grief but fail to address the symptoms in the treatment process. This study included a description of a traumatically bereaved individual with a clinical history of multiple diagnoses and treatments that failed to address her grief. As the treatment progressed, the client's pathology worsened. Data from the clinical record were analyzed to determine whether treating clinicians recognized symptoms of a pathological grief reaction in the bereaved client. Diagnostic and treatment approaches for complicated grief were reviewed. Information acquired from the case study demonstrated the importance of accurately identifying bereavement- related pathology and the need for tailoring treatment plans to the specific needs of a severely bereaved individual. Results of the study provide evidence in support of the inclusion of a diagnostic category of Complicated Grief in a future edition of the Diagnostic and Statistical Manual. Conclusions of the study and recommendations for future research are presented.