Development and validation of first clinical diagnostic interview for assessing Prolonged
Grief Disorder (PGD) with the ICD 11 and DSM 5 Tr criteria.
Background: With WHO's introduction of PGD in the ICD 11, which will be implemented in Health
Services worldwide from January 2022, there is a need to accurately diagnose people with
ICD-11PGD (PGD caseness) with a valid structured clinical interview.
With ICD-11 a slightly different set of symptoms for PGD is defined as the gold standard for
PGD. This standard will be used for diagnosing and understanding PGD in future research and
health service. ICD-11 aims to be descriptive, e.g. provides a support for the clinicians to
identify PGD by describing common reactions and symptoms of this disorder, but there is still
a need to evaluate the validity of these criteria. Strict diagnostic criteria with defined
numbers, combinations, and intensity of symptoms (e.g. for the use in research) are not yet
defined in ICD-11 and no structured clinical interview that measure ICD-11 or the upcoming
DSM 5 tr PGD has yet been developed and validated for this purpose. This means that the field
currently stand without reliable ways to classify accurately who has PGD diagnosis and who
has not. Without such constructs, PGD is not possible to identify, and ultimately to treat,
in a validated and reliable way.
There is therefore a need to develop accurate tests that measure ICD 11 PGD, both in a
structured clinical interview for use in direct meetings between patients and health service
professionals and in relation to a self-report scale. The investigators already developed the
Aarhus PGD scale but still need a structured clinical interview.
Aim: In this project we will
Develop and validate the first structured, clinical interview for ICD-11 PGD and DSM-5
Tr PGD
Identify a valid clinical cut-off for diagnostic PGD on The Aarhus PGD Scale.
Method:
Based on the ICD-11 and DSM 5 Tr PGD criteria and our work with the self-report scale above
the investigators will develop a structured, clinical interview, The Aarhus PGD Interview, in
line with the strategy used in SCID-I interviews [6]. This study will examine the content
validity, the concurrent validity, the test-retest reliability and the inter-rater
reliability of this interview.
After the Aarhus PGD Interview is validated, this study will compare the participant's scores
on the Aarhus PGD Scale for ICD 11 and DSM 5 Tr PGD with the clinical interview as the gold
standard. This will allow investigating the diagnostic test accuracy of the ICD-11 PGD scale,
and to identify a valid clinical cut-off on this scale.
Perspectives: The main aim of this study is to develop and validate the first structured,
clinical interview for ICD 11 and DSM 5 Tr PGD. It will provide reliable constructs to
separate PGD from other, trans-diagnostic forms of complicated grief reactions such as PTSD,
depression and anxiety following a loss. The ability to identify who actually has a diagnosis
of PGD and are in need of treatment is crucial to be able to allocate health benefits as
efficient and helpful as possible. It is also crucial in identifying the vast majority of
bereaved people with normal grief reactions, and to reduce the risk of pathologizing healthy
grief, which is a concern brought on by the introduction of PGD as a diagnostic entity