Alterações da memória autobiográfica como marcadores clínicos no transtorno de luto prolongado : uma revisão integrativa

Abstract

Prolonged Grief Disorder (PGD), recently included in Section II of the DSM-5-TR (2023), is characterized by persistent and clinically significant distress following the death of a loved one. The international literature has indicated that alterations in the functioning of Autobiographical Memory (AM) – the system responsible for retrieving personal memories situated in time and space – constitute core cognitive markers of this disorder. This study aimed to analyze, through an integrative literature review, how alterations in AM functioning manifest in individuals with PGD, identifying their potential patterns as differential clinical markers and the methodological limitations of current models. The search was conducted in the PubMed/MEDLINE, PsycINFO, and CAPES Portal databases, using the descriptors "Grief", "Bereavement", and "Autobiographical Memory", with a time frame from 2010 to 2025. The selection followed the PRISMA flowchart, and methodological quality was assessed using the Joanna Briggs Institute (JBI) tool. Of the 86 articles initially identified, 9 were included in the qualitative synthesis. Most studies (77.7%) were classified as having moderate risk of bias, mainly due to non-compliance with the minimum temporal criterion of 12 months post-loss required by the DSM-5-TR. The findings indicate that individuals with PGD exhibit selective overgeneralization of AM, with difficulty retrieving specific memories of everyday life without the deceased, while loss-related memories maintain high specificity. The "sense of unreality" emerged as an exclusive marker of PGD, distinguishing it from Major Depressive Disorder and Post-Traumatic Stress Disorder (PTSD). It is concluded that AM alterations constitute core mechanisms in the maintenance of PGD, acting as differential clinical markers. However, the identified methodological limitations – especially the inadequacy of the temporal criterion and the reliance on a single assessment instrument – recommend caution in interpreting the consolidated models and point to the need for further research with greater methodological rigor in the national context.