Testing the latent structure of ICD-11 prolonged grief disorder symptoms in the UK adult population: An exploratory structural equation modeling approach

The latent structure of ICD-11 prolonged grief disorder (PGD), as measured using the International Prolonged GriefDisorder Scale (IPGDS), was assessed in a large general population sample of bereaved adults from the United Kingdom. Data were derived from Wave 5 of the COVID-19 Psychological Research Consortium Study (C19PRC-UK). Exploratory structural equation modeling (ESEM) was used to assess the latent structure of the IPGDS. Identified factors were explored in relation to known correlates (i.e., gender, age of the bereaved, income, bereavement timeframe, age of the deceased) and functional impairment. Three factors-Loss, Emotional Numbing, and Emotional Reactivity-emerged in the best-fitting ESEM model,.2(92, N = 1,763) = 273.70, p <.001, CFI =.97, TLI =.96, RMSEA =.048, SRMR =.020. All factors were significantly associated with bereavement timeframe, beta s = -.15--.20, and age of the deceased, beta s = -.22-.31. Lower income predicted both Loss and Emotional Numbing; younger age of the bereaved predicted both Loss and Emotional Reactivity; and female gender was a unique predictor of Loss. Functional impairment was associated only with Emotional Numbing, beta=.89. The findings highlight the multidimensional structure of PGD. However, the patterns of factor/cross-factor loadings observed in the present study indicate that a "simple" structure was not attainable. Associations between factors and covariates attest to the discriminant validity of the factors, and the association between Emotional Numbing and functional impairment may afford clinicians an opportunity to better understand and target the most disruptive features of grief.