Distinguishing grief from depression during acute recovery from spinal cord injury

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Study investigated whether grief is a psychometrically sound construct that is distinct from depression in individuals who recently sustained a spinal cord injury (SCI). A total of 206 patients with SCI were recruited from inpatient rehabilitation units at 3 SCI Model System sites. Most patients were non-Hispanic whites (85 percent) and most patients had sustained a cervical SCI (64.4 percent). Various injury etiologies were represented, with the majority being accounted for by falls (31.5 percent) and vehicle-related accidents (33.5 percent). An adapted version of the 12-item structured clinical interview for Prolonged Grief Disorder was used to assess symptoms of grief, and the Patient Health Questionnaire-9 was used to measure depression. Demographic and injury-related data were also collected. A principal component analysis of the grief measure suggested a 2-component solution. The content of items loading on the separate components suggested 2 subscales: loss (6 items; Cronbach alpha = .810) and trauma (6 items; Cronbach alpha = .823). Follow-up principal component analyses including both grief and depression measures suggested clear differentiation of grief-related loss from depression. The prevalence of clinically significant levels of grief was low (6 percent), and levels of depression were consistent with previous findings related to inpatient rehabilitation (23.5 percent). The items used to assess grief symptoms in this study appear to capture a psychometrically reliable construct that is distinct from that of depression.

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