Assessing prolonged grief symptoms using experience sampling methodology: The development of the prolonged grief symptoms - short ecological assessment (PGS-SEA) scale

Early grief reactions have been hypothesized to fluctuate within persons and to be one of the strongest predictors of Prolonged Grief Disorder (PGD). Experience Sampling Methodology (ESM) offers an opportunity to examine (early) PGD dynamics in daily contexts. For this, however, a brief and valid ES...

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Main Authors: Turan Deniz Ergun, Peter M. ten Klooster, Ernst T. Bohlmeijer, Gerben J. Westerhof, Minita Franzen, Lonneke I.M. Lenferink
Format: Article
Language:English
Published: Elsevier 2025-07-01
Series:Comprehensive Psychiatry
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Online Access:http://www.sciencedirect.com/science/article/pii/S0010440X25000240
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author Turan Deniz Ergun
Peter M. ten Klooster
Ernst T. Bohlmeijer
Gerben J. Westerhof
Minita Franzen
Lonneke I.M. Lenferink
author_facet Turan Deniz Ergun
Peter M. ten Klooster
Ernst T. Bohlmeijer
Gerben J. Westerhof
Minita Franzen
Lonneke I.M. Lenferink
author_sort Turan Deniz Ergun
collection DOAJ
description Early grief reactions have been hypothesized to fluctuate within persons and to be one of the strongest predictors of Prolonged Grief Disorder (PGD). Experience Sampling Methodology (ESM) offers an opportunity to examine (early) PGD dynamics in daily contexts. For this, however, a brief and valid ESM scale is needed to accurately assess PGD symptoms in everyday life. We investigated the psychometric properties of ESM items developed to assess momentary prolonged grief symptoms in daily life (ESM-PGD). Additionally, we aimed to create a valid brief scale for future ESM studies. Bereaved adults (N = 169) whose loved ones died 3–6 months earlier completed 11 ESM-PGD items based on 10 PGD symptoms, as defined in DSM-5-TR, five times a day for 14 consecutive days at semi-random intervals. We performed multilevel confirmatory factor analysis (MCFA), calculated root-mean-square of successive differences (RMSSD) and intraclass correlations (ICC), and conducted correlational analyses of ESM-PGD items with related mental health symptoms (e.g., depression) to identify the best-performing items. MCFA confirmed that the hypothesized one-factor model fits the data well with good composite reliability at the between- and within-person levels. All ESM-PGD items were able to distinguish between people with and without early PGD. Examination of within-person level factor loadings, ICCs and RMSSDs revealed that not all ESM-PGD items were able to capture fluctuations of momentary PGD symptoms. The best-performing items were selected, resulting in a valid 2-item Prolonged Grief Symptoms – Short Ecological Assessment (PGS-SEA) scale for assessing PGD in daily life to facilitate ESM-research on PGD.
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spelling doaj-art-e3e159ce2cd643e5b859a7364c40beba2025-08-20T01:50:00ZengElsevierComprehensive Psychiatry0010-440X2025-07-0114015259710.1016/j.comppsych.2025.152597Assessing prolonged grief symptoms using experience sampling methodology: The development of the prolonged grief symptoms - short ecological assessment (PGS-SEA) scaleTuran Deniz Ergun0Peter M. ten Klooster1Ernst T. Bohlmeijer2Gerben J. Westerhof3Minita Franzen4Lonneke I.M. Lenferink5Department of Psychology, Health & Technology, Faculty of Behavioural Management and Social Sciences, University of Twente, P.O. Box 217, 7500 AE Enschede, the Netherlands; Corresponding author.Department of Psychology, Health & Technology, Faculty of Behavioural Management and Social Sciences, University of Twente, P.O. Box 217, 7500 AE Enschede, the NetherlandsDepartment of Psychology, Health & Technology, Faculty of Behavioural Management and Social Sciences, University of Twente, P.O. Box 217, 7500 AE Enschede, the NetherlandsDepartment of Psychology, Health & Technology, Faculty of Behavioural Management and Social Sciences, University of Twente, P.O. Box 217, 7500 AE Enschede, the NetherlandsDepartment of Psychology, Education & Child Studies, Erasmus University Rotterdam, 3062 PA Rotterdam, the NetherlandsDepartment of Psychology, Health & Technology, Faculty of Behavioural Management and Social Sciences, University of Twente, P.O. Box 217, 7500 AE Enschede, the Netherlands; Department of Clinical Psychology, Faculty of Social and Behavioural Sciences, Utrecht University, P.O. Box 80140, 3508 TC Utrecht, the Netherlands; Department of Clinical Psychology and Experimental Psychopathology, Faculty of Behavioral and Social Sciences, University of Groningen, Grote Kruisstraat 2/1, 9712 TS Groningen, the NetherlandsEarly grief reactions have been hypothesized to fluctuate within persons and to be one of the strongest predictors of Prolonged Grief Disorder (PGD). Experience Sampling Methodology (ESM) offers an opportunity to examine (early) PGD dynamics in daily contexts. For this, however, a brief and valid ESM scale is needed to accurately assess PGD symptoms in everyday life. We investigated the psychometric properties of ESM items developed to assess momentary prolonged grief symptoms in daily life (ESM-PGD). Additionally, we aimed to create a valid brief scale for future ESM studies. Bereaved adults (N = 169) whose loved ones died 3–6 months earlier completed 11 ESM-PGD items based on 10 PGD symptoms, as defined in DSM-5-TR, five times a day for 14 consecutive days at semi-random intervals. We performed multilevel confirmatory factor analysis (MCFA), calculated root-mean-square of successive differences (RMSSD) and intraclass correlations (ICC), and conducted correlational analyses of ESM-PGD items with related mental health symptoms (e.g., depression) to identify the best-performing items. MCFA confirmed that the hypothesized one-factor model fits the data well with good composite reliability at the between- and within-person levels. All ESM-PGD items were able to distinguish between people with and without early PGD. Examination of within-person level factor loadings, ICCs and RMSSDs revealed that not all ESM-PGD items were able to capture fluctuations of momentary PGD symptoms. The best-performing items were selected, resulting in a valid 2-item Prolonged Grief Symptoms – Short Ecological Assessment (PGS-SEA) scale for assessing PGD in daily life to facilitate ESM-research on PGD.http://www.sciencedirect.com/science/article/pii/S0010440X25000240Prolonged griefExperience sampling methodologyEcological momentary assessmentMultilevel factor analysisBereavement
spellingShingle Turan Deniz Ergun
Peter M. ten Klooster
Ernst T. Bohlmeijer
Gerben J. Westerhof
Minita Franzen
Lonneke I.M. Lenferink
Assessing prolonged grief symptoms using experience sampling methodology: The development of the prolonged grief symptoms - short ecological assessment (PGS-SEA) scale
Comprehensive Psychiatry
Prolonged grief
Experience sampling methodology
Ecological momentary assessment
Multilevel factor analysis
Bereavement
title Assessing prolonged grief symptoms using experience sampling methodology: The development of the prolonged grief symptoms - short ecological assessment (PGS-SEA) scale
title_full Assessing prolonged grief symptoms using experience sampling methodology: The development of the prolonged grief symptoms - short ecological assessment (PGS-SEA) scale
title_fullStr Assessing prolonged grief symptoms using experience sampling methodology: The development of the prolonged grief symptoms - short ecological assessment (PGS-SEA) scale
title_full_unstemmed Assessing prolonged grief symptoms using experience sampling methodology: The development of the prolonged grief symptoms - short ecological assessment (PGS-SEA) scale
title_short Assessing prolonged grief symptoms using experience sampling methodology: The development of the prolonged grief symptoms - short ecological assessment (PGS-SEA) scale
title_sort assessing prolonged grief symptoms using experience sampling methodology the development of the prolonged grief symptoms short ecological assessment pgs sea scale
topic Prolonged grief
Experience sampling methodology
Ecological momentary assessment
Multilevel factor analysis
Bereavement
url http://www.sciencedirect.com/science/article/pii/S0010440X25000240
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