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Death of a loved one: Prevalence, risk, and protective factors for prolonged grief disorder

Award Number: R01MH137201
ORGANIZATION: NATIONAL INSTITUTE OF MENTAL HEALTH
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)
PERIOD OF PERFORMANCE START DATE: 07/12/2024
PERIOD OF PERFORMANCE END DATE: 02/28/2029

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Death of a loved one: Prevalence, risk, and protective factors for prolonged grief disorder - Bereavement is highly prevalent among older adults, a rapidly growing demographic of the US population that is projected to double by 2050. Estimates suggest that 3%- 10% of bereaved adults experience clinically significant levels of prolonged grief disorder (PGD), with older adults at higher risk. Recognition, prevention, and effective treatment of PGD is critical to reduce excess mortality among older adults, yet the capacity to identify and refer cases has lagged because PGD has not historically been included in the major psychiatric diagnostic manuals until the most recent editions of the Diagnostic and Statistical Manual of Mental Disorders 5th Edition Text Revision (DSM-5-TR) and International Classification of Diseases 11th Revision (ICD-11). As a result, it is only now possible to fill the historical knowledge gap around the prevalence and risk/protective factors for this highly impairing condition. The long-term goal of our work is to ascertain and validate PGD case status among older adults enrolled in an ongoing longitudinal study and identify modifiable factors that improve health outcomes for at-risk people. The central aim of this proposal is to use the unparalleled epidemiological resources of three >30-year longitudinal studies to characterize prevalent PGD consistent with newly introduced criteria in the DSM-5-TR for the first time in an ongoing cohort with exceptionally high response rates. First, we will ascertain probable PGD case status among 91,630 older adults with >30 years of prospective longitudinal data in the Nurses’ Health Study (NHS), NHS II, and Health Professionals Follow-Up Study (HPFS) and validate PGD case status among a randomly sampled bereaved subcohort of 27,115 adults. We will test apriori hypotheses regarding prevalence: a) PGD increases with age; b) After adjusting for sex differences in survival via inverse probability of censoring weighting, the prevalence of PGD does not meaningfully differ by sex; and c) Inclusion of sex and age in models will improve accuracy, as quantified using the mean absolute difference metric of model adequacy. Second, we will harness a novel data science approach to identify risk factors associated with PGD based on more than 30 years of prospective longitudinal data spanning biomarkers, genetics, psychosocial variables, and prior psychiatric history. Third, using a similar analytic approach, we will identify protective factors guided by the NIH Common Fund-supported Science of Behavior Change framework associated with reduced risk for PGD. Impact: The recent inclusion of PGD as a diagnostic category in the DSM-5-TR and ICD-11 affords healthcare professionals an infrastructure to identify and mobilize targeted bereavement-related services. The proposed project will address a gap in our understanding of PGD among older adults, thus advancing NIMH Strategic Goal 2: Charting mental illness trajectories to determine when, where, and how to intervene. Results will deliver insights into risk and protective factors that can inform targeted primary prevention efforts for the millions of older adults currently at risk of PGD.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2026 ( Subtotal = $814,052 )
2026	2026	PRESIDENT AND FELLOWS OF HARVARD COLLEGE	1033 MASSACHUSETTS AVE STE 3	CAMBRIDGE	MA	02138	MIDDLESEX	USA	Mental Health Research Grants	000	3	4/17/2026	NON-COMPETING CONTINUATION	$814,052
														Subtotal = $814,052

Issue Date FY: 2025 ( Subtotal = $703,594 )
2025	2025	HARVARD COLLEGE PRESIDENT & FELLOWS OF	677 HUNTINGTON AVE	BOSTON	MA	02115	SUFFOLK	USA	Mental Health Research Grants	001	2	3/14/2025	NON-COMPETING CONTINUATION	$703,594
2025	2024	HARVARD COLLEGE PRESIDENT & FELLOWS OF	677 HUNTINGTON AVE	BOSTON	MA	02115	SUFFOLK	USA	Mental Health Research Grants	000	1	12/3/2024	NEW	$0
														Subtotal = $703,594

Issue Date FY: 2024 ( Subtotal = $843,442 )
2024	2024	HARVARD COLLEGE PRESIDENT & FELLOWS OF	677 HUNTINGTON AVE	BOSTON	MA	02115	SUFFOLK	USA	Mental Health Research Grants	000	1	7/12/2024	NEW	$843,442
														Subtotal = $843,442

Grand Total All Awards = $2,361,088

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Death of a loved one: Prevalence, risk, and protective factors for prolonged grief disorder

Award Number: R01MH137201

ORGANIZATION: NATIONAL INSTITUTE OF MENTAL HEALTH

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

PERIOD OF PERFORMANCE START DATE: 07/12/2024

PERIOD OF PERFORMANCE END DATE: 02/28/2029

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