Development of an inventory to assess grief reactions: the Comprehensive Inventory of Responses to Common Life Events (CIRCLE)
There is a need for more longitudinal empirical research on grief in order to illuminate fully the course of grief. One necessary tool for assessing grief responses over time is an assessment instrument that is designed to measure the multidimensional nature of grief and that takes into account other factors (e.g., concurrent life events) which might affect the grief process;On the basis of previous research, it is clear that a grief reaction probably includes four types of symptoms: affective, behavioral, cognitive, and physiological. Following a review of the literature, a description of characteristics assumed to be part of the grief process, and a summary of instruments that have been used to assess grief, a proposal was made for a new instrument to assess the grief process: the Comprehensive Inventory of Responses to Common Life Events (CIRCLE). The CIRCLE assesses reactions to life events a subject has experienced and measures present symptomatology along the four dimensions listed above;A total of 335 subjects participated in this research. Most were single, Anglo/White, traditionally-aged college students. Subjects rated their current reactions to 60 life events and responded to questions which measured present symptomatology in five areas (affect, behavior, interpersonal behavior, cognitions, and physical symptoms). A principal factors analysis with varimax rotation was performed for each symptom checklist individually using squared multiple correlations as the initial communality estimates;A total of nineteen scales resulted from the factor analyses. The Affect Checklist included five scales (Grief/Fear, Anger/Hurt, Anxiety/Depression, Happiness/Calmness, Alienation); the Behaviors Checklist included four scales (Directionlessness, Purposefulness, Spontaneity, Emotionality); the Interpersonal Behaviors Checklist included three scales (Relationship Facilitating, Relationship Distancing, Withdrawal); the Cognitions Checklist included two scales (Self-Confidence, Self-Disparagement); and the Physical Symptoms Checklist included five scales (Physiological Correlates of Depression, Physiological Correlates of Anxiety, Gastrointestinal Symptoms, Respiratory Symptoms, Miscellaneous Symptoms). A second-order factor analysis revealed the presence of two main factors: Negative Symptoms and Positive Symptoms;A majority of the symptom checklist scales were reasonably reliable, and over half the Negative Symptom scales appeared to be valid measures of grief. However, additional research is needed to clarify more precisely the relationship between the four types of symptoms measured by the CIRCLE (affect, behaviors, cognitions, physiological symptoms) and the construct of grief. In addition, further research is needed to understand the relationship between the personality variables used in the CIRCLE and the construct of grief. In conclusion, the results reported here are to be considered preliminary; a great deal of work remains to be completed before the CIRCLE is ready for research and clinical use.