Abstract
Background
The death of a child causes severe, disruptive grief. Prolonged grief disorder (PGD) was formally adopted as a diagnosis in DSM-5-TR in 2022. The Parent Bereavement Questionnaire (PBQ), a bereavement measure developed specifically for parents, was validated prior to these criteria, and its performance under current diagnostic standards is unknown.Methods
We conducted a secondary analysis of 244 mothers (>12 months post-loss) whose infants died suddenly and unexpectedly from SIDS or unascertained causes, recruited through a large-scale, multi-center prospective cohort study that investigated risks for sudden infant death syndrome and international parent-support organizations. Ten PBQ items were mapped onto DSM-5-TR PGD criteria and evaluated for internal consistency, factor structure, and criterion validity; nine additional items assessing parent-salient grief domains were analyzed separately.Results
The 10-item PBQ core demonstrated strong internal consistency (α = 0.88), a unidimensional factor structure. PBQ scores showed strong concordance with the algorithmic classification of probable PGD (AUC = 0.93); 23% of mothers met this probable-PGD threshold. Supplemental items reflecting social disconnection, self-blame, and difficulty trusting others formed distinct but related domains and were independently associated with mental health treatment history.Conclusions
We provide psychometric support for the PBQ core as a brief, DSM-5-TR-aligned tool for screening PGD-associated symptoms in bereaved mothers, a population often disconnected from healthcare. Pediatricians and community providers may use it to identify at-risk parents and guide individualized, trauma-informed support. Supplemental domains such as social disconnection, self-blame, and difficulty trusting others may serve as correlates of PGD risk and as targets for tailored intervention.