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June 27, 2007

The Stage Theory of Grief

Author Affiliations

Letters Section Editor: Robert M. Golub, MD, Senior Editor.

JAMA. 2007;297(24):2692-2694. doi:10.1001/jama.297.24.2692-b

To the Editor: Dr Maciejewski and colleagues1 present the first empirical investigation of the stage model of grief. While the study adds important information, I disagree that their data represent “normal patterns of grief processing over time.”

First, the authors excluded participants who met criteria for complicated grief, but they did not account for other neuropsychiatric entities such as major depression, dementia, or personality disorders. Each of these could affect normal bereavement. In this case, “average” is a better descriptor than “normal.”

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