Research Article: Rumination in bereaved parents: Psychometric evaluation of the Swedish version of the Utrecht Grief Rumination Scale (UGRS)

Date Published: March 19, 2019

Publisher: Public Library of Science

Author(s): Josefin Sveen, Lilian Pohlkamp, Ulrika Kreicbergs, Maarten C. Eisma, Manuel Fernández-Alcántara.


Bereaved parents may be at higher risk to develop persistent, severe and disabling grief, termed prolonged grief. Grief rumination, repetitive thinking about the causes and consequences of the loss, is a malleable cognitive process that maintains prolonged grief. Grief rumination can be measured with the Utrecht Grief Rumination Scale (UGRS). The present study aimed to examine the psychometric properties of the new Swedish version of the UGRS in a sample of bereaved parents.

A Swedish nationwide postal survey including measures of demographic and loss-related variables, grief rumination (UGRS), and symptoms of prolonged grief, posttraumatic stress, anxiety, depression, and insomnia, was completed by 226 parents (133 mothers and 93 fathers) who lost a child to cancer in the past five years. Psychometric properties of the UGRS were examined through confirmatory factor analyses (CFA), reliability analyses, and assessment of UGRS score associations with symptoms of prolonged grief, posttraumatic stress, depression, anxiety, and insomnia.

The internal consistency of the Swedish UGRS was good. The CFA yielded an acceptable fit for a two-factor hierarchical model with five sub-factors. Grief rumination was positively associated with all psychopathology symptom measures. Higher scores on UGRS were found in parents with possible prolonged grief disorder compared to those without (d = 1.47). Moreover, the Swedish UGRS was associated with prolonged grief symptoms over and above loss-related and demographic variables and other psychopathology symptoms.

The Swedish UGRS demonstrated good psychometric properties, which supports its use as a measure to assess grief rumination in Swedish bereaved parents in research and practice.

Partial Text

Despite the fact that most people adjust to bereavement without professional intervention, this life-event is associated with an increased risk of developing a wide range of physical and mental health problems [1, 2] and increased mortality [3]. Some subgroups of bereaved people may be at a heightened risk to develop mental health problems, including people who experience violent loss or the loss of a partner or child [4, 5].

This is the first study to validate a Swedish version of the Utrecht Grief Rumination Scale (UGRS). The analyses of reliability and validity indicates that the Swedish UGRS has satisfactory psychometric properties in parents who have lost a child to cancer.

In summary, this study supports the use of the Swedish UGRS to measure grief rumination in bereaved parents. The Swedish UGRS was shown to have good reliability. The findings support the UGRS construct validity, discriminant validity, and concurrent validity. As such, UGRS appears a useful scale in research to increase the understanding of the role that grief rumination plays in mental health problems in bereaved parents in Sweden. Should future research on other samples of bereaved persons and clinical samples confirm the evidence for the validity of the Swedish UGRS, it may prove to be a useful instrument to study rumination in Swedish bereaved people in general.