COMPLICATED GRIEF RISK QUESTIONNAIRE

Colin M. Parkes and Robert S. Weiss

(Authors of the original English version, 1983)
Jesus A García-García, Victor Landa, Gonzalo Grandes, Amaia Mauriz, Izaskun Andollo
(Authors of the version adapted to Spanish, 2001)

Instructions : Circle only one answer per question. Leave it blank if you don't know
what to answer.

1. Do you have children under 14 years old in your home?

0. None.
1. One.
2. Two.
3. Three.
4. Four.
5. Five or more.

- 2. What was/is the social class/occupation of the person who contributed/contributes

the most income to the family?

1. Liberal professional or executive (higher careers).

2. Semi-liberal professional (middle careers).
3. Office worker or administrative staff (general office work).
4. Qualified worker (“having a trade”, industrial officer or master,...).
5. Semi-skilled worker (specialist laborer).
6. Unskilled worker (laborer).

* If you have any questions, choose the answer that you think is most accurate.

- 3. Planned employment outside the home?

0. Full time.
1. Part time.
3. Retired.
4. Only work at home.
5. Stopped.

- 4. Do you cling to the deceased and/or become consumed with thoughts of him/her
returning?

1. Never.
2. Rarely.
3. Moderately.
4. Frequently.
5. Constantly.
6. Constantly and intensely.
 5. Anger?

1. No (or normal).
2. Mild irritability.
3. Moderate irritability: occasional outbursts.
4. Severa: he has missed his relationships.
5. Extreme: always bitter.

- 6. Guilt/Self-reproach?

1. No.
2. Mild: vague and general.
3. Moderates: some clear self-reproach.
4. Severe: obsessed with her guilt.
5. Extremes: it is a fundamental problem.

- 7. Current relationships?

1. You have a very close relationship with another person.

2. He has the affection of his family that supports him and allows him to
express his
feelings.
3. He has a family that supports him but lives at a distance.
4. Doubtful.
5. None of the above.

- 8. How do you think he will manage?

1. Good: normal grief and recovery without special help.

2. Fair: but probably manages without special help.
3. I have my doubts: I may need special help.
4. Badly: requires special help.
5. Very bad: requires urgent help.

NB:

Score: -between 0 and 14 I low risk.

-15osuperior I high risk.