Inventory of Complicated Grief
Also known as: ICG, Prigerson ICG
The Inventory of Complicated Grief (ICG) is a 19-item self-report measure developed by Prigerson and colleagues in 1995 to assess complicated grief—a persistent, impairing form of grief that goes beyond typical bereavement. Designed to distinguish complicated grief from bereavement-related depression, the ICG has become the gold-standard screening and diagnostic instrument in bereavement research and clinical practice.
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When to use it
The ICG is indicated in bereaved individuals 6+ months post-loss who present with persistent, impairing grief symptoms. Primary settings include: grief counselling and psychotherapy services; psychiatric and primary care clinics screening for complicated grief in bereaved patients; bereavement research studies; follow-up assessment after major loss (death of spouse, child, parent); and early identification of high-risk individuals who may benefit from targeted interventions. Particularly valuable in populations at risk for prolonged or complicated grief (e.g., loss of a child, sudden/violent death, concurrent stressors).
Strengths & limitations
- Well-validated in multiple populations (bereaved spouses, parents, adolescents) with strong psychometric properties (Cronbach's α typically >0.80, test-retest reliability r>0.80).
- Clear cutoff score (≥25) with high sensitivity and specificity for identifying complicated grief; aligns with DSM-5-TR Prolonged Grief Disorder criteria.
- Brief (19 items, <10 minutes) and simple to administer in clinical and research settings; requires no special training.
- Extensively used in outcome research, allowing comparison across studies and populations; demonstrates responsiveness to grief therapy interventions.
- Captures both cognitive (yearning, intrusive thoughts) and functional (avoidance, role impairment) dimensions of complicated grief.
- Does not assess protective factors (meaning-making, post-loss growth) that characterize resilience in bereavement; focuses exclusively on pathology.
- Cutoff score of 25 may not be universally optimal; some studies suggest context- or population-specific thresholds (e.g., higher cutoff in early grief, lower in protracted grief).
- Limited cultural validation; primarily normed in Western, predominantly white populations; may require adaptation for diverse cultural grief expressions.
- Cannot diagnose complicated grief independently; requires clinical judgment regarding symptom onset, duration, and functional impairment to meet DSM-5-TR criteria.
- Time window (past 2 weeks) is short; may not capture fluctuations in grief intensity over longer periods or distinguish acute exacerbations from baseline complicated grief.
Frequently asked
What is the difference between complicated grief (ICG ≥25) and normal grief?
Normal grief involves sadness, yearning, and temporary functional impairment that gradually improves over months to years. Complicated grief is characterized by prolonged, intense yearning, intrusive preoccupation with the deceased, avoidance, emotional numbness, and persistent impairment in work, social, or daily functioning—lasting 6+ months and causing significant distress. ICG scores <25 typically reflect normal bereavement; scores ≥25 suggest complicated grief requiring specialized intervention.
Can the ICG be used to assess grief shortly after loss (within the first 3 months)?
The ICG can be administered at any time post-loss to document symptom severity, but diagnostic interpretation differs. In the acute phase (0–3 months), elevated scores reflect normal acute grief. The diagnostic threshold (ICG ≥25 indicating complicated grief) applies when assessed 6+ months post-loss. Early administration (3–6 months) can be useful for risk stratification to identify individuals at risk for chronic complicated grief.
Is the ICG copyrighted or free to use?
The ICG is in the public domain and free to use for research and clinical purposes. No permission or licensing fee is required. The scale has been widely disseminated in academic literature and can be obtained from published sources or by contacting the authors. Some institutions may request institutional review board (IRB) approval before administering the scale in clinical or research settings.
Has the ICG been translated into other languages?
Yes, the ICG has been translated and validated in Dutch, German, Spanish, Japanese, Portuguese, Italian, and other languages. Cross-cultural studies show generally consistent factor structure and similar cutoff scores across populations, though cultural norms around grief expression may influence item endorsement. Clinicians using translated versions should consult validation studies specific to the target population.
Can the ICG be used to predict who will develop complicated grief in the future?
When administered early in bereavement (3–6 months post-loss), the ICG can help identify individuals at elevated risk for persistent complicated grief. High early scores predict slower grief resolution and higher risk for complications. However, the ICG is best used as a clinical screening tool in conjunction with contextual assessment (e.g., manner of death, presence of concurrent stressors, prior trauma history) rather than as a standalone predictive algorithm.
Sources
- Prigerson, H. G., Frank, E., Kasl, S. V., et al. (1995). Complicated grief and bereavement-related depression as distinct disorders: Preliminary empirical validation in elderly bereaved spouses. American Journal of Psychiatry, 152(1), 22–30. DOI: 10.1176/ajp.152.1.22 ↗
How to cite this page
ScholarGate. (2026, June 3). Inventory of Complicated Grief. ScholarGate. https://scholargate.app/en/bereavement-psychology/inventory-complicated-grief
Which method?
Set this method beside its closest kin and read them side by side — the library lays the books on the table; the choice is yours.
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