Table of Contents
Aarhus Prolonged Grief Disorder Scale (A-PGDs)
Description
The Aarhus Prolonged Grief Disorder Scale (A-PGDs; O’Connor et al., 2023) is a self-report instrument designed to operationalize Prolonged Grief Disorder (PGD) as defined by both the ICD-11 and DSM-5-TR. The initial development of items for the A-PGDs was based on the symptomatic descriptions of PGD in the ICD-11 and DSM-5-TR, a review of existing PGD scales (Ito et al., 2012; Prigerson et al., 2009), and collaborative discussions between the first and last authors of the scale. The items were subsequently translated into Danish. Feedback from open discussions within a focus group led to slight adjustments in the wording of the A-PGDs items. Data for the scale’s validation were collected from a sample of bereaved adults. Exploratory structural equation modeling was employed to assess the scale’s validity and factor structure, which revealed a 20-item measure comprising two factors. The reliability and validity of the A-PGDs have been reported.
Purpose
The A-PGDs is a scale developed for the operationalization of ICD-11 and DSM-5-TR Prolonged Grief Disorder (PGD).
Validity
Construct Validity: The results derived from the factor analysis provided support for the structural validity of the A-PGDs.
Content/Concurrent Validity: Baseline PGD symptoms were found to predict core symptoms. Depression, conversely, was observed to predict only associated symptoms. Among the identified factors, associated symptoms was the sole predictor of functional impairment.
Reliability
Internal Consistency: The Cronbach’s alpha coefficient for PGDICD11 was 0.88, indicating strong internal consistency. Similarly, the Cronbach’s alpha for DSM-5-TR PGD was 0.90, also demonstrating high internal consistency.
Test-Retest Reliability: A subsample of participants completed the A-PGDs during a re-test phase. Evidence for test-retest reliability was generally strong (p < .001), with large correlations observed between items across the initial test and retest (r ≥ 0.59). There was a tendency for test-retest stability to be higher for items that loaded onto the core-symptom cluster of ICD-11 PDG (excluding self-blame) and DSM-5 PGD (r ≥ 0.72) when compared to the associated symptom clusters (r ≥ 0.59).
Factor Analysis
Confirmatory Factor Analysis/Exploratory Structural Equation Modeling:
PGD ICD11: Models 2 to 4 all exhibited acceptable levels of error, with SRMR and RMSEA values less than 0.08. Only Model 4 demonstrated an acceptable fit according to both the Comparative Fit Index (CFI) and Tucker-Lewis Index (TLI). However, the Bayesian Information Criterion (BIC) indicated that the increased precision gained in Model 4 did not sufficiently outweigh the disadvantages associated with its increased complexity (Δ14.2).
PGD DSM5TR: Overall, incremental and absolute fit statistics indicated a continuous improvement in model fit as the number of latent dimensions increased. Similar to the ICD-11 models, Models 2 to 4 all displayed acceptable levels of error, with SRMR and RMSEA values less than 0.08. Only Models 3 and 4 showed acceptable fit according to both the CFI and TLI. The BIC suggested that the increased precision achieved in Model 4 was nearly sufficient to outweigh the disadvantages of its increased complexity (ΔBIC 10.9). Furthermore, a ΔRMSEA of 0.019 indicated a significant improvement in the four-factor model, supported by all other fit statistics.
Instrument
Test Type: Original
Format: Items are rated using Likert-scale and yes/no response options.
Language Available: English and Danish.
Population Group: Human (Male and Female).
Age Group: Adulthood (18 years and older).
Population Details: The study participants were bereaved adults located in Denmark.
Test Methodology: The methodology included Test Validity, Concurrent Validity, Construct Validity, Content Validity, Test Reliability, Internal Consistency, Test-Retest Reliability, Factor Analysis, Confirmatory Factor Analysis, and Structural Equation Modeling.
Keywords
Antagonistic Feelings, Diagnostic and Statistical Manual, DSM-5-TR, Emotional Distress, ICD-11, International Classification of Diseases, Prolonged Grief, Separation Distress.
Authors
O’Connor, Maja
Affiliation: Aarhus University Department of Psychology, Unit for Bereavement Research
Correspondence Address: Aarhus University, Department of Psychology, Unit for Bereavement Research, Aarhus, Denmark.
Email: [email protected]
Vang, Maria Louison
Author ORCID Identifier: 0000-0001-7031-4070
Affiliation: University of Southern Denmark National Center for Psychotraumatology
Shevlin, Mark
Affiliation: Ulster University School of Psychology
Elklit, Ask
Affiliation: University of Southern Denmark National Center for Psychotraumatology
Komischke-Konnerup, Katrine B.
Affiliation: Aarhus University Department of Psychology, Unit for Bereavement Research
Lundorff, Marie
Author ORCID Identifier: 0000-0003-0162-5750
Affiliation: Aarhus University Department of Psychology, Unit for Bereavement Research
Bryant, Richard
Affiliation: University of New South Wales School of Psychology
Permissions & Fee and Test Year
Permissions: May be used for Research/Teaching.
Fee: No fee.
Test Year: 2023.
Website: creativecommons.org/licenses/by/4.0/deed.en
Files
No file is available.
References
Ito, M., Nakajima, S., Fujisawa, D., Miyashita, Y., Konishi, S., Akechi, T., & Holland, J. C. (2012). The Inventory of Complicated Grief-Japanese Version: reliability and validity study. Psychiatry and Clinical Neurosciences, 66(2), 159-166.
O’Connor, M., Vang, M. L., Shevlin, M., Elklit, A., Komischke-Konnerup, K. B., Lundorff, M., & Bryant, R. A. (2023). Development and validation of the Aarhus Prolonged Grief Disorder Scale (A-PGDs). Journal of Affective Disorders, 342, 199-205.
Prigerson, H. G., Maciejewski, P. K., & Maercker, A. (2009). Prolonged grief disorder: Psychometric properties of an interview-based measure. Journal of Affective Disorders, 115(1-2), 183-188.
Items of the Aarhus Prolonged Grief Disorder Scale
Aarhus Prolonged Grief Disorder Scale (A-PGDs)
The following items are part of the Aarhus Prolonged Grief Disorder Self-Report Scale, designed for use with ICD-11 and DSM-5 Tr PGD (The Aarhus PGD-scale).
Please consider the name of the person you lost and respond to the questions in relation to your loss.
Each item is scored on the following 5-point scale:
Not at all
A little
To some extent
Very much
Overwhelmingly
| Item no. | Item formulation |
| 1. | Have you longed for [deceased’s name] during the past month? |
| 2. | Have you during the past month found yourself preoccupied with thoughts of [deceased’s name] even when you did not want to be thinking about them? |
| 3. | Have you had feelings of sadness or sorrow during the past month? |
| 4. | Have you felt guilty during the past month? |
| 5. | Have you felt angry during the past month? |
| 6. | During the past month, has it been hard for you to believe that [deceased’s name] is dead? |
| 7. | Have you blamed yourself for your loss during the past month? |
| 8. | During the past month, have you had trouble accepting that [deceased’s name] is dead? |
| 9. | During the past month, have you felt that you have lost a part of yourself? (e.g., feeling as though a part of you has died) |
| 10. | During the past month, have you been unable to experience positive emotions? |
| 11. | During the past month, have you felt emotionally numb? (e.g., having difficulties with feeling emotions as you used to do, being emotionally stunned) |
| 12. | Have you had difficulty engaging in social or other activities during the past month? |
| 13. | Have you felt loneliness during the past month? |
| 14. | During the past month, have you tried to avoid reminders that [deceased’s name] is dead? (e.g., avoiding certain thoughts, feelings, places, music, conversation topics, etc. or keeping yourself constantly going) |
| 15. | During the past month, have you felt that life is meaningless since [deceased’s name] has died? |
| 16. | Have you felt bitterness during the past month? |
| 17. | Overall, have these difficulties led to a decline in your level of functioning? (i.e., your ability to function in everyday life) |
If you answered “A little” (2) or higher to question 17, have you then experienced this every day or almost every day? Yes/No
| Item no. | Item formulation | Response |
| 17a. | Does this apply in relation to your work/study/daily tasks? | Yes/No |
| 17b. | Does this apply to your social life? | Yes/No |
| 17c. | Does this apply to your family life/domestic obligations? | Yes/No |
| 17d. | Does this apply to other areas than those mentioned? | Yes/No |
| 18) | Have any of your acquaintances expressed concern about your grief reaction? (e.g., that they feel that it exceeds what they consider normal in relation to your social, cultural or religious norms). | Yes/No |
| 19) | Are you worried about your own grief reaction, including that it is more severe or intense than you expected? (e.g., compared to the people you surround yourself with or what you think is normal). | Yes/No |
| 20) | Would you say that you felt this way during the last 6 months? (Please answer this question in relation to your total response to the questions above). | Yes/No |
Note on Marking:
Grey: only ICD-11.
Bold: only DSM-5-TR.
No marking: symptoms included in both ICD-11 and DSM-5-TR.
Cite this article
Mohammed looti (2026). Aarhus Prolonged Grief Disorder Scale (A-PGDs). PSYCHOLOGICAL SCALES. Retrieved from https://scales.arabpsychology.com/s/aarhus-prolonged-grief-disorder-scale-a-pgds/
Mohammed looti. "Aarhus Prolonged Grief Disorder Scale (A-PGDs)." PSYCHOLOGICAL SCALES, 5 Apr. 2026, https://scales.arabpsychology.com/s/aarhus-prolonged-grief-disorder-scale-a-pgds/.
Mohammed looti. "Aarhus Prolonged Grief Disorder Scale (A-PGDs)." PSYCHOLOGICAL SCALES, 2026. https://scales.arabpsychology.com/s/aarhus-prolonged-grief-disorder-scale-a-pgds/.
Mohammed looti (2026) 'Aarhus Prolonged Grief Disorder Scale (A-PGDs)', PSYCHOLOGICAL SCALES. Available at: https://scales.arabpsychology.com/s/aarhus-prolonged-grief-disorder-scale-a-pgds/.
[1] Mohammed looti, "Aarhus Prolonged Grief Disorder Scale (A-PGDs)," PSYCHOLOGICAL SCALES, vol. X, no. Y, ص Z-Z, April, 2026.
Mohammed looti. Aarhus Prolonged Grief Disorder Scale (A-PGDs). PSYCHOLOGICAL SCALES. 2026;vol(issue):pages.