11-20-2024

Silver lining: New approaches in treating prolonged grief disorder

It is an invisible suffering that many people endure in silence and that has a massive impact on their lives: In the case of prolonged grief disorder, those affected cannot get over the loss of a loved one. A study led by KU psychologist Prof. Dr. Rita Rosner has now further developed two therapy methods and applied them to more than 200 patients. The results are a silver lining that those affected can find help.

It is normal for people to grieve after the death of a family member or close friend. However, while the pain of loss usually slowly diminishes within months or a year and the relatives feel much better afterwards and hardly experience any restrictions in their daily lives, severe longing, helplessness, fear or anger occur far beyond that in the case of prolonged grief. "It's a pain that doesn't go away. The feelings overwhelm the affected person and can permeate every aspect of life", explains Rita Rosner, Chair of Biological and Clinical Psychology at the KU. She has long been working on the phenomenon of prolonged grief disorder (PGD), which has now been included as a disorder in the ICD-11, the international classification system for medical diagnoses.

Based on various studies, experts assume that around five percent of mourners develop such a disorder. If the loss was very unexpected or the circumstances of the death were particularly traumatic, this increases the likelihood of PGD, as does the likelihood of PGD in people who are already suffering from a mental illness for other reasons. "For many patients, the death of a loved one already occurred many years ago", explains Rosner. But they were still suffering from the loss. Those affected are sometimes unable to pursue their profession or take care of their family. The unbroken feelings of missing the dead can also manifest themselves in the fact that the deceased child's room remains untouched or the deceased husband's jacket is still hanging in the wardrobe. Medication is not effective for prolonged grief disorder – but psychotherapy can help in many cases.

In a study funded by the German Research Foundation (DFG) with two million euros, a total of 212 patients have been treated over the past three years. This makes it one of the largest studies on prolonged grief disorder to date; other studies had much smaller sample groups. The PROGRID ("Prolonged Grief Disorder") project involved the Psychotherapeutic University Outpatient Clinic of the KU in Ingolstadt, which was in charge of the project, as well as the universities in Frankfurt, Marburg and Leipzig. In the past, those affected by PGD were treated like patients with depression or post-traumatic stress disorder, says Rosner. "But the interventions did not really fit." The study therefore sought new ways of helping PGD patients.

Together with colleagues, Rosner developed Prolonged Grief-specific Cognitive Behavioral Therapy (PG-CBT). Present-Centered Therapy (PCT) offers a different approach to the patient's problems. While the latter focuses on the patient's current problems and works on overcoming them, cognitive behavioral therapy focuses on the moment that triggered the disorder: the painful moment of loss, the circumstances of the death, the personal relationship that the grieving person had with the deceased. Both treatments aim at helping the patient to adapt to the new reality of life, i.e. a world without the deceased, to suffer less and be less restricted in daily life, explains Rita Rosner.

In the study, the patients (the majority of whom were female) were divided into two equal groups upon diagnosis and assigned to one of the two treatment methods. The researchers speak of a randomized and blinded clinical trial. In a next step, treatment started with 20 to 24 sessions. After six months, the success of the therapy was evaluated, and a follow-up examination was carried out after a further six months. "Both methods have proven to be effective", concludes Rita Rosner. Cognitive behavioral therapy showed an even better effect than present-centered therapy – although the differences in the long-term effect were less pronounced. However, both forms of therapy would help to alleviate general psychological stress and symptoms of depression.

According to Rita Rosner, the PROGRID study underlines the importance of having different treatment approaches available to meet the different needs and preferences of grieving people. "Psychotherapy research in this area is still in its early days", says Rosner. However, the results of the study have shown that many of those affected could find effective help. The next step is now to build and expand on the knowledge gained and further refine treatment methods.

Back to overview

Silver lining: New approaches in treating prolonged grief disorder

This website uses cookies