Quality of Life Research

, Volume 23, Issue 4, pp 1211–1220 | Cite as

Identifying vulnerability in grief: psychometric properties of the Adult Attitude to Grief Scale

  • Julius SimEmail author
  • Linda Machin
  • Bernadette Bartlam


Purpose Grief is a reaction to a significant loss that can profoundly affect all aspects of life and capacity to function well. The consequences can vary from severe psychological distress through to physical disturbances and significant social problems. This study sought to identify a measure of vulnerability in grief, by examining the psychometric properties of the Adult Attitude to Grief (AAG) scale in a sample of 168 people seeking help in their bereavement.

Methods The factor structure of the scale, its internal consistency, its construct validity and optimum classification cutoffs were tested.

Results Confirmatory factor analysis broadly supported the factor structure of the AAG, but identified one item that could profitably be reworded. Internal consistency of the three subscales was acceptable. Construct validity and discriminative validity were supported by correlations with allied constructs (depression and anxiety) and a significant difference between scores for clients with Prolonged Grief Disorder and those without. A correlation with counsellors’ own clinical ratings of vulnerability demonstrated criterion-related validity of the AAG. Using receiver operating characteristic methods, optimum cutoff scores on the scale were identified for the classification of different levels of vulnerability.

Conclusion The AAG was found to be a psychometrically promising tool for identifying vulnerability in grief.


Adult Attitude to Grief scale Vulnerability Psychometrics Validity Reliability Factor analysis 

List of symbols


Adult Attitude to Grief scale


Comparative fit index


Generalized Anxiety Disorder Assessment 7


Prolonged Grief Disorder Scale


Prolonged grief disorder


Patient Health Questionnaire 9


Root means square error of approximation


Receiver operating characteristic


Tucker–Lewis Index


Weighed least squares mean and variance adjusted



This study was funded by the North Staffordshire Medical Institute. The authors wish to thank the Dove Service (North Staffordshire, UK), St Giles Hospice (Lichfield, UK) and the Marie Curie Hospices (Belfast and Hampstead, UK) for their help with data collection, Aisling Bartlam for help with data entry, and Kelvin Jordan for advice on the manuscript.


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Copyright information

© Springer Science+Business Media Dordrecht 2013

Authors and Affiliations

  1. 1.Research Institute for Social SciencesKeele UniversityStaffordshireUK

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