The American Psychiatric Association (APA) proposes to include a new grief disorder—Prolonged Grief Disorder—in its forthcoming Diagnostic and Statistical Manual-5-Text Revised (DSM-5-TR), which is scheduled for release in 2021. Members of the National Child Traumatic Stress Network have developed recommendations to make these diagnostic criteria more developmentally informed and helpful for providers who serve bereaved children and adolescents.

The NCTSN encourages providers and members of the public to educate themselves about the newly-proposed grief disorder and to participate as informed consumers during a public comment period, which is scheduled for early April to mid-May 2020. This public comment period presents a critical opportunity to advocate for developmentally-informed diagnostic criteria.

The resources below are intended to help readers become informed about this process and prepare themselves to participate in the APA’s upcoming public discussion:

• Webinar Presentation: Developmental Recommendations and Implications for a Prolonged Grief Disorder in DSM-5-TR: Become an Informed Consumer and Advocate. Reviews the draft diagnostic criteria and proposed developmental modifications. He will also discuss some of the implications, risks, and opportunities that a new grief disorder can bring to the field of child and adolescent bereavement.
   
• Proposed APA Draft Criteria for Prolonged Grief Disorder. Are the original, unmodified criteria that the APA is submitting for public comment.
   
• Brief Summary of Developmental Recommendations. Lists our team’s developmental recommendations for modifying proposed Prolonged Grief Disorder criteria, including a brief commentary accompanying each recommended change. Begins with a quick summary of our recommendations that you can copy, paste, and modify in the APA Public Commentary Window to personalize your message.
   
• Invited Presentation to the APA Expert Panel. Summarizes the evidence to date regarding Persistent Complex Bereavement Disorder, a provisional disorder listed in the appendix of DSM-5 and provides an overview of multidimensional grief theory and how it can be used to guide modularized, assessment-driven treatment of bereaved youth. An abbreviated version of this presentation was delivered by Dr. Christopher Layne at the Workshop on Developing Criteria for a Disorder of Pathological Grieving for DSM-5-TR, hosted by the American Psychiatric Association (Layne, Kaplow, Oosterhoff, & Hill, 3 June 2019). 
   
• Final Developmental Recommendations Report. Contains recommendations for developmental modifications to DSM-5-TR Prolonged Grief Disorder criteria. This report also includes responses to questions posed by the American Psychiatric Association expert panel, which draw upon multiple sources of evidence, including published studies and unpublished analyses of practice-research network data and clinic data (Layne, Oosterhoff, Pynoos, & Kaplow, 2020).

How can I participate in this process as an informed consumer?

As outlined in the Final Report, the APA draft criteria do not include the proposed developmental recommendations. These recommendations, if they are to be adopted, will be incorporated following the public discussion. Thus, we encourage providers who serve bereaved children and adolescents, as well as interested members of the public, to inform themselves by reviewing the proposed criteria, invited presentation, and final recommendations report, and then participating in the APA’s public discussion once it opens. When participating in the discussion, visitors are free to endorse some or all of the developmental recommendations, disagree and offer their own recommendations, or make general comments. 

To receive updates related to the development of DSM-5-TR Prolonged Grief Disorder click here.

What is the timeline for public comment on these diagnostic criteria?

Once the public comment period opens, information about how to participate will be posted here. After the public comment period closes (scheduled for mid-May 2020), the APA Assembly will meet in November 2020 and have the opportunity to review and approve the diagnostic criteria. If approved by the Assembly, Prolonged Grief Disorder criteria will go to the APA Board, which will consider them in either December 2020 or March 2021. If approved by the APA Board, Prolonged Grief Disorder criteria will become final and will be incorporated into the online version of the DSM, which is the official version at any given time.