The traumatization of grief? A conceptual framework for understanding the trauma-bereavement interface

Scientific opinion differs on whether pathological (or complicated, traumat ic) grief is an entity distinct from post-traumatic stress disorder. Some a rgue that it is different, and for the creation of a new category of pathol ogical grief for the DSM system, while others consider bereavement and asso ciated grief reactions to fall within the category of traumatic life events , for which the existing system would offer adequate classification. Althou gh investigators have begun to explore similarities and differences in the trauma and bereavement domains, there is still confusion and lack of consen sus about definitions and basic concepts. A conceptual framework, suggested here, may help bring clarity to the area. Our analysis shows that the lack of consensus about the nature of reactions and disorders of bereavement is due to concentration on different parts of the framework. Furthermore, the lack of differentiation between traumatic and non-traumatic bereavement ha s caused neglect of the unique features of nontraumatic grief reactions. Th ese components need further exploration, especially since extension of DSM classification is currently under consideration.