Grief-related panic symptoms in Complicated Grief

Abstract

Background Although Complicated Grief (CG) has been associated with comorbid Panic Disorder (PD), little is known about panic attacks in CG, and whether panic symptoms may be grief-related. The present study examines the presence and impact of grief-related panic symptoms in CG. Methods Individuals with CG (n=146, 78% women, mean (SD) age =52.4(15.0)) were assessed for CG, DSM-IV diagnoses, work and social impairment, and with the Panic Disorder Severity Scale modified to assess symptoms “related to or triggered by reminders of your loss” and anticipatory worry. Results Overall, 39.7% reported at least one full or limited-symptom grief-related panic attack over the past week, and 32.2% reported some level of anticipatory worry about grief-related panic. Of interest, 17% met DSM criteria for PD. Among those without PD, 34.7% reported at least one full or limited-symptom grief-related panic attack over the past week, and this was associated with higher CG symptom severity (t=−2.23, p<0.05), and functional impairment (t=−3.31, p<0.01). Among the full sample, controlling for CG symptom severity and current PD, the presence of at least one full or limited-symptom grief-related panic attack was independently associated with increased functional impairment (B(SE)=4.86(1.7), p<0.01). Limitations Limitations include a lack of assessment of non grief-related panic symptoms and examination of a sample of individuals seeking treatment for CG. Conclusions Grief-related panic symptoms may be prevalent among individuals with CG and independently contribute to distress and functional impairment.

Personality and Grief-Related Panic Attacks: Analysis of Neuroticism, Worry, and Anxiety Sensitivity

“…For example, a recent study (Lee et al, 2020) found that perceptions of physiological reactions corresponding to a "wave" of grief-related emotions as threatening was directly linked to grief-related dysfunction. Also in accord with previous research was the finding that the participants high in grief also tended to experience more GRPAs and GRPA impairments than their less grieving counterparts (Bui et al, 2015;Robinaugh et al, 2014). Taken together, these findings extend the literature by suggesting that anxiety sensitivity is not only a risk factor for spontaneous panic attacks (Schmidt et al, 1997), but also for GRPAs and severe grief in the wake of a loss.…”

Risk factors for dysfunctional grief and functional impairment for all causes of death during the COVID-19 pandemic: The mediating role of meaning

“…showed that most participants scored in the clinical ranges for generalized anxiety (70%), depression (74%), dysfunctional grief (66%), and functional impairment (63%) due to this loss . Reinforcing these concerns, mean scores for functional impairment in both studies substantially exceeded scores on the same instrument for family members bereaved by US military service death (Cozza et al, 2020) and those who had lost loved ones in a major airline disaster (Lenferink, de Keijser, Smid, Djelantik, & Boelen, 2017) in the pre-pandemic era, and were equivalent to carefully diagnosed treatment seeking adults with complicated, prolonged grief disorder (Bui et al, 2015;Shear, Wang, Skritskaya, Duan, Mauro, & Ghesquiere, 2014). A study of 422 adults in mainland China (Tang & Xiang, 2021) bereaved from COVID-19 found that 38% met ICD-11 criteria for PGD, an incidence rate 3 to 4 times higher than pre-pandemic population estimates.…”

Emerging experience with selected new categories in the ICD‐11: complex PTSD, prolonged grief disorder, gaming disorder, and compulsive sexual behaviour disorder

“…Persistent grief reactions have been associated with marked occupational and social impairment 56 , impaired sleep 57 , increased rates of cancer and cardiovascular problems 58 and other medical conditions 59 , and poor health behaviours, such as increased alcohol and tobacco use 60,61 . There is also overwhelming evidence that persistent grief reactions are associated with elevated rates of other mental disorders and symptoms, including depression 62,63 , PTSD 52 , suicidality 64,65 , and panic 66 . Importantly, it has been shown that the symptoms of prolonged grief disorder contribute to impaired functioning beyond the effects of co-occurring depression and PTSD 67 .…”