The dimensionality and somatisation correlates of ICD-11 prolonged grief disorder

Background: Somatisation is common among individuals experiencing prolonged grief, yet the specificity of associations between International Classification of Diseases (ICD-11) Prolonged Grief Disorder (PGD) symptom dimensions and somatic distress remains unclear. Accumulating evidence indicates that PGD is best conceptualised as a multidimensional construct comprising Loss, Emotional Reactivity, and Emotional Numbing. Whether these symptom dimensions exhibit differential associations with somatic burden remains underexamined. Objective: This study tested whether ICD-11 PGD symptoms are best represented by a multidimensional structure and whether specific symptom dimensions uniquely predict somatic distress. Method: Data were drawn from a United States subgroup ( n  = 395) of the Measurement and Assessment of Grief in an International Cross-Cultural Sample (MAGIC) study. PGD symptoms were assessed using the International Prolonged Grief Disorder Scale (IPGDS), and somatic distress using the Somatic Symptom Scale-8 (SSS-8). Competing structural models were estimated using exploratory structural equation modelling. Associations between latent PGD dimensions and somatic distress were examined using a structural model adjusting for demographic and loss-related covariates. Results: A three-factor solution comprising Loss, Emotional Reactivity, and Emotional Numbing provided superior fit relative to one- and two-factor models. All three dimensions were positively associated with somatic distress, although after covariate adjustment, Emotional Numbing emerged as the only PGD dimension uniquely associated with somatic distress ( β  = .29, p  < .01). Conclusions: ICD-11 PGD is characterised by a multidimensional symptom structure, with Emotional Numbing showing the strongest unique association with somatic symptoms. These findings suggest that emotional disengagement may capture the PGD component most closely linked to somatic burden. Future research should examine whether this pattern generalises across samples, measurement instruments, and diagnostic thresholds.