NEW YORK (Reuters) -- It's normal to feel sadness and grief with the passing of a loved one, but an intense and persistent yearning for the person who died, difficulties "moving on" with life after a period of time, and a sense that life and the future are meaningless and purposelessness, are signs of "complicated grief," warns a group of Dutch doctors.
"Although some of these symptoms also occur in people with normal (as opposed to complicated) grief, in people with complicated grief these symptoms are very intense and persist for at least 6 months to the point of functional impairment," Dr. Paul A. Boelen, a psychologist and psychotherapist from Utrecht University in The Netherlands told Reuters.
In other words, he said, "people with complicated grief are basically stuck in a state of chronic grieving."
Complicated grief is a fairly new concept, Boelen said. It is not currently included in the Diagnostic and Statistical Manual of Mental Disorders, the official diagnostic system from the American Psychiatric Association. However, Boelen predicted it would be in included in the next edition of the DSM.
"That is because, among other things, there is now very much evidence that complicated grief is a very debilitating mental health condition, that is distinct from more familiar depressive and anxious symptoms and syndromes, and that poses people at risk for considerable and persistent health impairments," Boelen said.
He and his colleagues present a model of complicated grief in the current issue of Clinical Psychology: Science and Practice. They hope their conceptualization of the condition will help facilitate research on this new concept.
Who is most at risk for complicated grief? General bereavement research has indicated that people confronted with deaths that are violent (resulting from suicide, homicide, accidents) and that are untimely (loss of child) have greater risks of getting stuck in the process of mourning than people confronted with other losses, according to Boelen.
"Moreover, personality styles such as insecure attachment and high neuroticism have been found to be risk factors," he said. Negative thinking and particular types of avoidance behaviors (i.e., suppressing thoughts and emotions about the loss, and failing to adapt ones everyday life) also put people at risk for CG.
Boelen and colleagues have developed a cognitive-behavioral treatment approach, which aims to get the individual to process the loss, identify and change problematic beliefs and interpretations about the loss. This strategy has proven to be "very successful," Boelen said.