Thank you Scott for the info which directly applies to the article Being a popular article I wasn't taking it too seriously :-)
--Mike On Wed, Aug 4, 2010 at 1:52 PM, Lilienfeld, Scott O <[email protected]> wrote: > Hi All - I've been following the discussion of pathological grief with some > interest, and TIPSTERS have raised some useful points. I am by no means an > apologist for DSM-IV or V (in fact, have criticized both) and don't have a > good enough handle on the recent research literature to evaluate many of the > claims re: the proposal for pathological grief disorder (PGS). Nevertheless, > when discussing these claims, it's crucial to understand that the draft > criteria are much more stringent (e.g., they don't imply that a diagnosis can > be made in 2 weeks) than implied in some recent TIPS messages. > > Below are the draft criteria for DSM-V (or now DSM-5, as it seems to be > abbreviated increasingly). Note in particular Criterion D (Timing) below. > Again, many interesting and troubling questions can be raised about these > draft criteria; but they certainly don't imply that anyone grieving over the > loss of a loved one (and yes, I've been there too), even for a couple of > months, will receive diagnoses of a mental disorder in DSM-5. Perhaps other > draft criteria for PGS are floating around too, but if so, I'm not aware of > them. > > > ..Scott > > ______________________________________________________________________ > Table 3. Criteria for PGD proposed for DSM-V and ICD-11. > > Category Definition > > A. Event: Bereavement (loss of a significant other) > B. Separation distress: The bereaved person experiences yearning (e.g., > craving, pining, or longing for the deceased; physical or emotional suffering > as > a result of the desired, but unfulfilled, reunion with the deceased) daily or > to a disabling degree. > C. Cognitive, emotional, and behavioral symptoms: The bereaved person must > have five (or more) of the following symptoms experienced daily or to > a disabling degree: > 1. Confusion about one's role in life or diminished sense of self (i.e., > feeling that a part of oneself has died) > 2. Difficulty accepting the loss > 3. Avoidance of reminders of the reality of the loss > 4. Inability to trust others since the loss > 5. Bitterness or anger related to the loss > 6. Difficulty moving on with life (e.g., making new friends, pursuing > interests) > 7. Numbness (absence of emotion) since the loss > 8. Feeling that life is unfulfilling, empty, or meaningless since the loss > 9. Feeling stunned, dazed or shocked by the loss > D. Timing: Diagnosis should not be made until at least six months have > elapsed since the death. > E. Impairment: The disturbance causes clinically significant impairment in > social, occupational, or other important areas of functioning (e.g., domestic > responsibilities). > F. Relation to other mental disorders: The disturbance is not better > accounted for by major depressive disorder, generalized anxiety disorder, or > posttraumatic stress disorder. > > -----Original Message----- > From: Michael Smith [mailto:[email protected]] > Sent: Wednesday, August 04, 2010 11:33 AM > To: Teaching in the Psychological Sciences (TIPS) > Subject: Re: [tips] DSM and grieving > > I think the main point of the article is that the bereavement > exclusion was dropped and an additional point is that this is the > result of one person's decision...gives one such faith in the > scientific process. > > To the effect that, if you grieve longer than 2 weeks, regardless of > the cause, then you should be treated as you now have a mental > illness. > > Most ordinary people will rightly consider this a ridiculous statement. > > --Mike > > > > On Tue, Aug 3, 2010 at 4:34 PM, Mike Palij <[email protected]> wrote: >> My reaction to the article is somewhat different from that of Nancy's. >> I can understand her reaction but as someone who's had his own >> share of bereavement, I would say that some people are able to >> get through the grieving process in a "reasonable" amount of time >> and others have great difficulty in doing so and may require assistance >> in getting through the process. The loss of a spouse, in contrast >> to the loss of a child, is a far more common event but it is recognized >> as a potentially risky situation for the surviving spouse because of >> the increased risk of that spouse's death, something referred to at >> the "widowhood effect". One review of the widowhood effect provides >> three general explanations for thie effect: (a) the death of a spouse >> directly causes the death of the surviving spouse through some >> process/mechanism, (b) "Homogamy", that is, husbands and wives >> are similar in many respects and one should expect a correlation >> between the time of death of one spouse and another, and (c) members >> of a couple are exposed to many of the same environmental variables >> which may cause the non-simulatneous death of both). More info >> can be obtained from a review by Elwert & Cristakis in their 2008 >> review article in the journal Demography which is available here: >> http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2789302/ >> >> I admit to being surprised at people who are able to "snap back" after >> the death of a spouse and re-marry within a year a two -- I simply >> do not understand it. Similarly, the loss of a child, the loss of a parent, >> the loss of a close friend, the loss of a loved one, the loss of someone >> who had substantial meaning to one, all of these will be handled differently >> by different people. Some will get over the loss though it may take years, >> while some may never be able to get over the loss though, perhaps, the pain >> of the loss might be mitigated with passage of time. For this latter group, >> I think some form of psychotherapy may be appropriate in helping to >> process the loss, appreciate the significance of the loss, and to develop >> the rationale why one needs to move on. >> >> Just a couple of points more: >> >> (1) The widowhood effect varies by race. I'll leave it up to the reader to >> speculate what is the form of this interaction. Then go and read this: >> http://asr.sagepub.com/content/71/1/16.abstract >> >> (2) Severe bereavement effects have been seen with animals. The >> example that stands out in my memory is from the National Geographic's >> PBS special on Jane Goodall in which the male Flint, who had problems >> been weaned from his mother Flo, died shortly after her death, apparently >> from depression and grief; see: >> http://en.wikipedia.org/wiki/Kasakela_chimpanzee_community#Flint >> I recommend watching the original documentary "Among the Wild >> Chimpanzees" to fully appreciate what happened. >> >> My own opinion is that pharamacotherapy is probably not very useful >> in this situation though for some it may provide some temporary relief. >> Losing a loved one under traumatic situations (e.g., watching them die >> in front of you) can also lead to PTSD which would have be dealt with >> seperate from the effects of grieving. >> >> -Mike Palij >> New York University >> [email protected] >> >> >> >> >> >> On Tue, 03 Aug 2010 12:14:09 -0700, Dr. Nancy Melucci wrote: >>>I just read the story. It is even more outrageous when they suggest >>>that the grieving for the loss of a child - the worst possible lost, made >>>even harder in modern times when so few of us experience it (so >>>more isolating than ever in an already death denying culture) - is >>>more like a treatable illness than a normal reaction. >>> >>>Two modern cultural themes emerge of course - fear of being sued >>>("I'd rather call it depression...") and of course the gigantic gold mine >>>that labeling more and more of the colorful, unsettling and some times >>>deeply painful emotional states that comprise a full life has become to >>>psychiatry and the pharmaceutical industry. >>> >>>I have become more and more comfortable in my lectures criticizing >>>the unscientific and shoddy construction of the DSM. And teaching >>>the views of Szasz as serious insights and not the rantings of a fringe >>>dweller. >>> >>>When we are happy all the time, no one will be happy anymore. >>> >>>Nancy Melucci >>>Long Beach City Colleg >>>Long Beach CA >> >> -----Original Message----- >> From: Dennis Goff <[email protected]> >> To: Teaching in the Psychological Sciences (TIPS) >> <[email protected]> >> Sent: Tue, Aug 3, 2010 6:52 am >> Subject: [tips] DSM and grieving >> >> I heard this story on NPR yesterday morning and thought that it could be used >> as a nice introduction to some of the controversies surrounding the new >> edition >> of the DSM or even a class discussion about the definition of a psychological >> disorders. The story discusses diagnosing "grief reactions" as a depression. >> >> "The DSM committee removed the bereavement exclusion - a small, almost >> footnote >> at the bottom of the section that describes the symptoms of major depression >> - >> from the manual." >> >> The title of the piece - "Is Emotional Pain Necessary?" >> >> http://www.npr.org/templates/story/story.php?storyId=128874986&ps=cprs >> tiny http://tinyurl.com/2g7yc22 >> >> --- >> You are currently subscribed to tips as: [email protected]. >> To unsubscribe click here: >> http://fsulist.frostburg.edu/u?id=13541.42a7e8017ab9578358f118300f4720fb&n=T&l=tips&o=3964 >> or send a blank email to >> leave-3964-13541.42a7e8017ab9578358f118300f472...@fsulist.frostburg.edu >> > > --- > You are currently subscribed to tips as: [email protected]. > To unsubscribe click here: > http://fsulist.frostburg.edu/u?id=13509.d0999cebc8f4ed4eb54d5317367e9b2f&n=T&l=tips&o=3983 > or send a blank email to > leave-3983-13509.d0999cebc8f4ed4eb54d5317367e9...@fsulist.frostburg.edu > > This e-mail message (including any attachments) is for the sole use of > the intended recipient(s) and may contain confidential and privileged > information. 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