ICG: Inventory of Complicated Grief

What this assessment is

The Inventory of Complicated Grief, or ICG, is a 19-item self-report measure of grief-related symptoms.

It produces one total from 0 to 76. Higher scores indicate more frequent or intense grief-related problems.

The ICG was published in 1995. Its name reflects the term used at that time. Current clinical systems use prolonged grief disorder, which has defined timing, symptom, and impairment requirements.

An ICG score is not a diagnosis.

Keep that boundary clear.

Who it was designed for

The original development study02757-2>) involved 97 older adults who had lost a spouse.

Researchers have since used the ICG with other bereaved adult groups. Those uses do not make one threshold valid across every type of loss, age group, culture, or language.

This page covers the original 19-item ICG. Revised, shortened, and diagnosis-specific grief measures have different content and scoring rules.

Use evidence from a population and version that fit the purpose of the assessment.

Context comes first.

How it is administered

The person rates each grief-related experience on a five-level scale scored from 0 to 4.

The original ICG does not set one fixed recent recall period. It asks about the person's experience after the death.

Completion commonly takes about five to seven minutes.

All 19 responses are needed for the standard total. The original publication does not provide a general method for prorating an incomplete form.

Use complete data.

What it measures

The ICG covers experiences such as yearning, preoccupation with the person who died, disbelief, anger, emotional numbness, loneliness, and disruption to identity or daily life.

The responses are combined into one symptom total. The standard ICG does not report separate diagnostic subscales.

The BGQ is a five-item grief screen. The ICG asks about a wider range of symptoms, but neither measure can replace a clinical assessment.

Grief intensity must be considered with time since the death, cultural expectations, functioning, and the circumstances of the loss.

How scoring works

Score each response from 0 to 4 and add all 19 values.

The total ranges from 0 to 76. Higher totals indicate greater grief-symptom burden.

There are no standard reverse-scored questions and no standard overall percentage score.

Do not transfer scoring rules from another grief measure. Do not calculate a standard ICG total when responses are missing unless the selected protocol validates a method.

How to interpret an ICG score

The original study found that scores above 25 were associated with greater impairment in its sample of conjugally bereaved older adults.

Later research has often used 30 or more as an eligibility or probable-case boundary. A clinical review of prolonged grief assessment reports both 25 and 30 in the literature.

These values serve different research and screening purposes. They are not universal severity bands.

Name the rule.

State whether a protocol uses greater than 25, 30 or more, or another rule. Also state the population and purpose from which the rule came.

For repeated assessment, the direction and size of change may be more useful than assigning a label at one boundary.

What the score cannot tell you

The ICG cannot confirm prolonged grief disorder. It predates the current diagnosis and does not, by itself, establish every required symptom, duration, exclusion, and impairment condition.

The distinction is important.

The total cannot separate grief from depression, posttraumatic stress, or another condition when symptoms overlap.

It does not explain the meaning of the relationship, the circumstances of the death, or the support available to the person.

A low total does not invalidate distress. A high total does not identify one correct treatment.

Evidence and limitations

The original study found strong internal consistency and linked higher ICG scores with functional impairment in its sample.

The measure became widely used in grief research, which allows comparison across many studies. That history also creates a problem: studies have used different thresholds and sometimes treated an older symptom measure as if it directly represented a newer diagnosis.

The ICG is more detailed than a very brief screen, but it still reduces a complex bereavement experience to one total.

Detail still gets lost.

Record the exact form, language, time since the death, missing-response handling, and any threshold used.