ICD-11 and DSM-5-TR prolonged grief symptoms and quality of life: A criterion validity test

Objective: Two similar but distinct versions of prolonged grief disorder (PGD) have recently been included in the International Classification of Diseases eleventh edition (ICD-11) and the Diagnostic and Statistical Manual of Mental Disorders – fifth edition, Text-Revision (DSM-5-TR). This study provides a criterion validity test of both new criteria sets of PGD, by examining concurrent and longitudinal associations of ICD-11 and DSM-5-TR prolonged grief symptoms with quality of life (QOL). Methods: Bereaved adults completed a survey assessing ICD-11 and DSM-5-TR prolonged grief symptoms, depressive symptoms, insomnia symptoms and QOL at baseline and 6-month follow-up. Results: Both ICD-11 and DSM-5-TR prolonged grief symptoms related negatively to QOL concurrently, while controlling for insomnia and depressive symptoms. ICD-11 prolonged grief symptoms, but not DSM-5-TR prolonged grief symptoms, predicted QOL at 6-month follow-up, while controlling for baseline QOL and insomnia and depression symptoms. Conclusions: Results provide consistent evidence for the criterion validity of ICD-11 PGD, but mixed evidence for the criterion validity of DSM-5-TR PGD. Study results can help guide attempts to optimize and harmonize future PGD criteria.