Prolonged Grief Disorder: Implications for Rituals and Medical Practice
Brandon Joa, Villanova University

Taking an integrative approach toward developmental psychology and neurophysiology, we select findings from the psychological and medical literature on guilt and bereavement that are relevant to considering how guilt contributes to the development of prolonged grief disorder (PGD) in bereaved persons. Mention of guilt is ubiquitous in literature on general grief and PGD, including 54 articles related to the neuropsychological development and manifestations of guilt and grief, as well as their neuroimaging correlates, that met review criteria. However, mechanisms connecting guilt to development of PGD are scarce. Aspects of guilt, including developmental and prosocial aspects, are conceptually connected to many PGD criteria, opening avenues to explore treatment of PGD by targeting guilt. This review is particularly timely as medical practitioners and ministers will need to address an anticipated increased incidence of PGD during and after the COVID-19 pandemic. We discuss established treatments for PGD and emphasize the role of ritual, including religious liturgies, in preventing and resolving PGD.