Inventory of Complicated Grief

The Inventory of Complicated Grief (ICG) is a highly validated clinical measure designed to assess the severity of maladaptive grief reactions following the…

Questions: 19
Duration: 10 min
Original title: ICG — Inventory of Complicated Grief
Adaptation: Inventory of Complicated Grief
Authors: Prigerson, H.G., Maciejewski, P.K., Reynolds, C.F. 3rd, Bierhals, A.J., Newsom, J.T., Fasiczka, A., Frank, E., Doman, J., & Miller, M.
Created: 1995

The Inventory of Complicated Grief (ICG) is a highly validated clinical measure designed to assess the severity of maladaptive grief reactions following the loss of a loved one. While acute mourning is a natural process, a subset of individuals experiences a prolonged, intense clinical picture that disrupts daily functioning. This instrument reliably identifies these persistent symptoms, such as profound yearning, deep-seated disbelief, and the kind of avoidance behavior that keeps individuals disconnected from their current life.

By administering the ICG, clinicians obtain a standardized baseline that distinguishes pathological bereavement from normative sorrow or signs of a patient experiencing depression. The scale serves as a reliable anchor to track clinical change over time, ensuring therapeutic interventions remain closely targeted to the patient's actual emotional landscape and alerting the provider to signs that often map onto the clinical criteria for prolonged grief disorder.

Example result

Fictitious result, computed from a sample set of answers.

Overall score

36/ 76

A 19-item self-report questionnaire developed by Prigerson and colleagues (1995) to assess symptoms of complicated grief / prolonged grief in bereaved adults: separation distress (yearning, searching, loneliness), shock and disbelief, difficulty accepting the loss, anger and bitterness, avoidance, and identity and interpersonal impairments. The instrument measures a single dimension of maladaptive grief, clinically distinct from bereavement-related depression and anxiety, and predictive of long-term functional impairment.

0–25

Below clinical threshold

26–29

Probable complicated grief

30–76

Severe complicated grief

Score ≥ 30: inclusion threshold used by Shear et al. (2005) for complicated grief warranting targeted treatment.

cliniquemixed · condition: Prolonged grief · military bereaved, ICG ≥ 30 · United States · n = 232 · 2017 · Fisher et al. (2017)

076

M = 42.13 ± 9.65

Scoring

Sum, total score from 0 to 76, each item is scored on a 5-point scale (from 0 to 4).

Have your patient take this test

Assign it in one click: your patient answers on their phone, you receive the score and its interpretation.

Assign this test to a patient

What the test measures

The ICG maps the specific cognitive, emotional, and behavioral indicators of complicated grief, focusing on symptoms that persist intensely beyond the normative mourning period.

Preoccupation: intrusive thoughts and an intense longing for the deceased that dominate daily life.
Experiential avoidance: deliberate efforts to dodge reminders of the loss and the reality of the absence.
Emotional dysregulation: persistent bitterness, anger, and feeling stunned or overwhelmed by the death.
Social disconnection: an inability to trust others, withdrawing from relationships, and profound loneliness.
Somatic and perceptual symptoms: adopting the deceased's physical symptoms or encountering everyday 'unusual' experiences such as transient visual and auditory perceptions of them.

This measure is intended for adults who have lost a close loved one and are struggling with significant emotional impairment.

When and why to use it

Clinicians use the ICG to formalize symptom tracking and clarify the formulation approach when a patient's grieving process appears stalled or excessively debilitating.

Baseline evaluation: mapping the initial severity of maladaptive grief symptoms during intake to inform treatment planning.
Differential support: distinguishing prolonged grief reactions from standard depressive episodes or trauma-related distress.
Screening for clinical risk: identifying individuals whose scores cross the established clinical threshold, signaling a need for targeted intervention.
Monitoring therapeutic progress: tracking subtle shifts in rumination and separation distress across the course of therapy.

Using a validated cutoff provides a clear objective anchor, helping clinicians map the maintaining processes that separate clinically significant complicated grief from the normal, albeit painful, trajectory of bereavement.

Clinical library

750+ clinical tools

A library built with and for clinicians, ready to use in session and extend between appointments.

Access all the tools

Several resource types

Psychoeducation handouts

Understand at a glance

Interactive exercises

To do and fill in

Interactive programs

A structured path

Audios

Meditation and relaxation

Psychometric tests

Automatic scoring

The questions

The following questions ask about how you are currently experiencing the death of your loved one. For each statement, please indicate how often you have experienced this feeling or situation over the past month.
1. I think about this person so much that it's hard for me to do the things I normally do.
This item probes the extent to which preoccupation with the deceased impairs daily functioning.
- Never
- Rarely
- Sometimes
- Often
- Always
2. Memories of the person who died upset me.
This item assesses the emotional distress triggered by memories of the deceased.
- Never
- Rarely
- Sometimes
- Often
- Always
3. I can't accept the death of the person who died.
This item measures the cognitive struggle to acknowledge the reality of the loss.
- Never
- Rarely
- Sometimes
- Often
- Always
4. I feel drawn to and long for the person who died.
This item captures the intensity of separation distress and yearning for the lost loved one.
- Never
- Rarely
- Sometimes
- Often
- Always
5. I feel drawn to places and things associated with the person who died.
This item evaluates the behavioral pull toward physical reminders of the deceased.
- Never
- Rarely
- Sometimes
- Often
- Always
6. I can't help feeling angry about their death.
This item gauges the presence of anger directed at the fact of the death.
- Never
- Rarely
- Sometimes
- Often
- Always
7. I can't believe what happened.
This item assesses ongoing feelings of shock or an inability to comprehend the loss.
- Never
- Rarely
- Sometimes
- Often
- Always
8. I feel stunned or dazed by what happened.
This item captures the dissociative or numbing emotional response to the bereavement.
- Never
- Rarely
- Sometimes
- Often
- Always
9. Since they died, it's hard for me to trust people.
This item measures the impact of the loss on the individual's ability to rely on others.
- Never
- Rarely
- Sometimes
- Often
- Always
10. Since they died, I feel like I've lost the ability to care about others, or I feel distant from the people I care about.
This item probes emotional blunting and interpersonal withdrawal following the death.
- Never
- Rarely
- Sometimes
- Often
- Always
11. I have pain in the same areas of my body or I have some of the same symptoms that the person who died had.
This item assesses somatic identification, where the bereaved mimics the physical pain or symptoms of the deceased.
- Never
- Rarely
- Sometimes
- Often
- Always
12. I go out of my way to avoid things that remind me of the person who died.
This item evaluates active behavioral efforts to escape triggers associated with the loss.
- Never
- Rarely
- Sometimes
- Often
- Always
13. I feel that life is empty without the person who died.
This item captures the subjective sense of meaninglessness and void in life without the deceased.
- Never
- Rarely
- Sometimes
- Often
- Always
14. I hear the voice of the person who died speaking to me.
This item gauges auditory hallucinatory experiences related to the deceased.
- Never
- Rarely
- Sometimes
- Often
- Always
15. I see the person who died standing before me.
This item assesses visual hallucinatory experiences or transient illusions of the deceased.
- Never
- Rarely
- Sometimes
- Often
- Always
16. I feel it's unfair to go on living when this person died.
This item probes survivor guilt and the sense of injustice surrounding continuing to live.
- Never
- Rarely
- Sometimes
- Often
- Always
17. I feel bitter about this person's death.
This item measures enduring feelings of bitterness and resentment regarding the death.
- Never
- Rarely
- Sometimes
- Often
- Always
18. I envy people who haven't lost someone close to them.
This item captures feelings of alienation and jealousy toward those who have not experienced a similar loss.
- Never
- Rarely
- Sometimes
- Often
- Always
19. I feel very lonely since they died.
This item assesses the pervasive sense of isolation that persists after the bereavement.
- Never
- Rarely
- Sometimes
- Often
- Always