IntroductionLoss-adaptation has been described as being characterized by ‘waves of grief’, whichmay result in a Prolonged Grief Disorder (PGD). Although this assumption about thefluctuating nature of grief is supported by theoretical work, it is not (yet) supported byempirical work. We are the first to explore to what extent PGD reactions fluctuate ineveryday life and whether fluctuations in PGD reactions are related to overall PGDlevels using experience sampling methodology (ESM).MethodsData from 38 bereaved individuals (74% women, on average 6 years post-loss, 47%lost a parent) were analyzed. For two weeks, five times per day, participants reportedon the severity of 11 PGD reactions in the past three hours (ESM-PGD). At baseline,overall PGD severity (B-PGD) in the past two weeks was assessed with telephone interviews using the Traumatic Grief Inventory–Clinician Administered. Root MeanSquare of Successive Differences (RMSSD) were calculated to reflect fluctuations inESM-PGD. Spearman correlations between RMSSD values of the 11 ESM-PGDreactions and B-PGD scores were computed.ResultsMean B-PGD scores were below the clinical cut-off. Some fluctuations in ESM-PGDreactions were found, as indicated by varying RMSSD values, but also floor effectswere detected. B-PGD levels were related to RMSSD values for ESM-PGD (ρ between.37 and .68, all p < .05; and between .36 and .63 after removal of floor effects).DiscussionWe found that (some) ESM-PGD reactions fluctuated in everyday life. This may offernew theoretical insights into loss-adaptation, which may result in optimizing PGDtreatment
