Loss, Bereavement, and Prolonged Grief Disorder
The primary focus of our research has been to advance understanding of the interpersonal and intrapersonal factors that influence the quality of life of individuals confronting life-threatening illness and death. Our work has concentrated on an examination of psychosocial determinants of terminally ill patient's understanding of illness, their surviving family member's reactions to their death, and the way interpersonal dynamics influence medical decision-making, care and related end-of-life (EOL) outcomes. Determinants examined include: Physician-patient communication, ethnic and spiritual influences on care, and how care, preparation for, and the quality of a patient's death affect surviving family members' bereavement adjustment. We lead the research effort justifying the inclusion of Prolonged Grief Disorder (PGD) as a new diagnostic entity for included in the DSM-V and ICD-11. In a series of studies stemming from an NIMH R01 field trial of consensus criteria for this disorder, we have conducted the foundational psychiatric epidemiologic investigations to define Prolonged Grief Disorder. Our scales to assess pathological grief (termed "complicated" and "traumatic" before we settled on "prolonged") have been described as the standard grief measures advocated for the field. Our grief scales have been translated into over 15 foreign languages, used for a wide variety of traumatic (e.g., 9/11, London bombings, Hurricane Katrina; Chinese earthquake 2008) and non-traumatic (terminally ill patients, caregiving parents, spouses, offspring) losses, and have been cited over 180 times in the literature. Dr. Prigerson directs the Department of Psychosocial Oncology and Palliative Care Research seminar series and teaches seminars to the Brigham and Women's Hospital psychiatry residents on psychiatric epidemiology, psycho-oncology and grief, specifically. She also hosts many visiting and local scholars in research collaborations. Her goals are to continue to foster the development of promising junior investigators and to advance the evidence base pointing the way toward best practices in the care provided to advanced cancer patients and their family members who survive them.