The couple met at a dance class and were immediately drawn to each other. Both were serious-minded but fun-loving people with many ideas for their shared future, They had a strong group of friends and socialized often. They were together for 9 years before George became ill, which was

5 years before he died. Christy was an exuberant, warm, loving person. Throughout her life, she had weathered her share of disappointment as well or better than most, but George’s death and the circumstances under which it occurred had her stymied. Diagnosis of complicated grief CG is not in DSM-IV, so there are no standard, Inhibitors,research,lifescience,medical official criteria. However there is considerable evidence that CG is a specific syndrome, different Inhibitors,research,lifescience,medical from normal grief and from other mood and anxiety disorders. The clinical picture can be understood as comprised of prolonged and intense acute grief symptoms

accompanied by an array of complicating thoughts, feelings, and behaviors. Symptoms of acute grief include intense yearning or longing for the person who died, intrusive or preoccupying thoughts or images of the deceased person, a sense of loss of meaning or purpose in a life without the deceased, and a cluster of other symptoms that interfere with activities or relationships with significant others. Complicating thoughts include incessant questioning, worrying, or ruminating over Inhibitors,research,lifescience,medical some aspect of the circumstances or consequences of the loss. Rather than reflecting

upon the reality and implications of the death, a person with CG may be caught up in counterfactual thinking, reviewing and perseverating on the “if Inhibitors,research,lifescience,medical only”s. A person with CG may be catastrophizing about the future or worrying incessantly about a range of bad things that may happen because his or her loved one is gone. Complicating emotional processes are negative valence emotions such as guilt, envy, bitterness, or anger, that Inhibitors,research,lifescience,medical are relentlessly activated and excessively painful, without periods of respite from positive emotions. Positive emotions, when they occur, are tinged with guilt. Overly negative emotions can focus the bereaved person’s mind on the painful events surrounding the death and increase the Selleck Docetaxel likelihood of thinking about negative consequences of the loss. It is difficult also to reflect and reappraise when negative emotions are very activated. Complicating behaviors include excessive avoidance of reminders of the loss, compulsive proximity seeking, or both. For example, people with CG may dramatically restrict their lives to try to avoid places they went with the deceased or situations the deceased would enjoy. They may avoid being with family or friends because of feeling envious, embarrassed, or anxious because of the death. At the same time, a person with CG may spend long periods of time trying to feel closer to the deceased person through pictures, keepsakes, clothing, or other items associated with the loved one.