tent distressing preoccupations regarding the traumatic nature of the death (often in re-
sponse to loss reminders), including the deceased’s last moments, degree of suffering
and mutilating injury, or the malicious or intentional nature of the death.
Diagnostic Features 
Persistent complex bereavement disorder is diagnosed only if at least 12 months (6 months
in children) have elapsed since the death of someone with whom the bereaved had a close
relationship (Criterion A). This time fram e discriminates normal grief from persistent
grief. The condition typically involves a pe rsistent yearning/longing for the deceased
(Criterion B1), which may be associated with  intense sorrow and frequent crying (Crite-
rion B2) or preoccupation with  the deceased (Criterion B3).  The individual may also be
preoccupied with the manner in which the person died (Criterion B4). 
Six additional symptoms are required, includ ing marked difficulty accepting that the in-
dividual has died (Criterion C1) (e.g. preparing meals for them), disbelief that the individual is
dead (Criterion C2), distressing memories of the deceased (Criterion C3), anger over the loss
(Criterion C4), maladaptive appraisals about oneself in relation to the deceased or the death
(Criterion C5), and excessive avoidance of reminders of the loss  (Criterion C6). Individuals
may also report a desire to die because they wish to be with the deceased (Criterion C7); be dis-
trustful of others (Criterion C8);  feel isolated (Criterion C9); believe that life has no meaning or
purpose without the deceased (C riterion C10); experience a di minished sense of identity in
which they feel a part of themselves has died or been lost (Criterion C11); or have difficulty en-