What is “machine longing”?
Intense longing exhibited by cartoon robots?
Or a clever pun describing a network analysis of long-term grief symptoms? (Malgaroli et al., 2022).
My late wife was a writer who was very fond of robots and Futurama. This post is an opportunity to incorporate all of them into a brief narrative of the computational psychiatry of protracted grief disorder.
Concertgoers booed the avant-garde tuba-playing robot, but it wasn’t programmed to feel sad or stop. #Citybots #Warsaw #TwitterFiction
— S. Kay (@blueberrio) March 16, 2014
Prolonged grief disorder (PGD) is an ICD-11 diagnosis that overlaps with other formulations of “pathological grief”, including “persistent complex grief disorder” (PCBD) and “complicated grief”. The ICD-11 definition and symptoms can be found here.
“Prolonged grief disorder is a disorder in which, following the death of a partner, parent, child or other person close to the bereaved, there is a persistent and pervasive grief reaction characterized by longing for the deceased or persistent preoccupation with the deceased accompanied by intense emotional pain (e.g. sadness, denial, guilt, having lost a dead, difficult, by oneself, inability to experience positive mood, emotional numbness, difficulty engage in social or other activities).
The symptoms must persist for at least six months, taking into account different cultural norms for death. The overlap between PGD and PCBD appear in purple in the figure below.
– click on the image for a larger view –
Infographics. Disordered grief: prolonged grief disorder and persistent complex grief disorder (BMJ).
Painful and prolonged longing for the lost loved one is an obvious core symptom.
Looking for her partner and cheese enchiladas in mole sauce at the festive restaurant, she celebrates life and Cinco de Mayo. @blueberry
— Seven By Twenty (archive only) (@7×20) May 5, 2011
(NOTE: A celebration of life is seen as a more adaptive response.)
But there is so much more… An aptly titled article by Lenferink and Eisma (2018) indicated that there are 37,650 ways to have “persistent complex grief disorder” but only 48 ways to have “prolonged grief disorder”. 1 For a PCBD diagnosis (a DSM-5 construct), a person must have at least one of four Cluster I symptoms and at least six out of twelve Cluster II symptoms. For a PGD diagnosis, a person must have at least one of two Cluster I symptoms and at least three out of five Cluster II symptoms. This is a rather astonishing degree of symptom heterogeneity, and much more complicated than Infographics suggests. It may even limit the utility of these diagnostic categories, as may be the case for psychiatric diagnoses in general (see RDoC).
This is where computational methods can help in understanding symptom profiles and grief trajectories (Malgaroli et al., 2022). Data-driven analyzes using unsupervised machine learning methods can identify patterns within the heterogeneity. Network analyzes have identified the centrality of loneliness (Fried et al., 2015) and a social/identity symptom cluster that includes role confusion and meaninglessness (Malgaroli et al., 2018). In the review article, the authors believed that this was new and stated that “A more surprising and salient result showed that meaninglessness and role confusion were strongly central elements.”
But I’m not surprised at all.
my wife (@blueberry) wrote microfiction – standalone miniature stories as well as longer collections. Her book Dependent was a complete apocalypse in tweets. After the nuclear crisis occurs in Part 2, the protagonist channels the pain of loss in a heartbreaking (and prophetic) way.
Left behind
The bright, hollow sky absorbs my grief as I mourn our lost love. I cry and clutch my knees and want to die. You can’t calm me down, gone.
I don’t feel that often anymore. Which is good, because it’s unbearable. But I still feel anxious, confused, disoriented, sad and lonely.
Footnote
1 This article is the younger sibling of 636,120 ways to have PTSD.
References
Lenferink LI, Eisma MC. (2018). 37,650 ways to have “persistent complex grief disorder” but only 48 ways to have “prolonged grief disorder”. Psychiatry research 261:88-9. (PDF)
Malgaroli M, Maccallum F, Bonanno GA. (2018). Symptoms of persistent complex grief disorder, depression, and PTSD in a conjugally bereaved sample: a network analysis. Psychological Medicine 48(14):2439-48.
Malgaroli M, Maccallum F, Bonanno GA. (2022). Machine Longing: How Advances in Computational Methods Lead to New Insights into Reactions to Loss. Current opinion in psychology 43:13-7. (PDF)
