Distinctiveness of prolonged‐grief‐disorder‐ and depressive‐symptom trajectories in the first 2 years of bereavement for family caregivers of terminally ill cancer patients
Abstract
Objective: Grief reactions in bereaved caregivers of cancer patients have been identified individually as distinct prolonged grief disorder (PGD)—and major depressive disorder (MDD)—symptom trajectories, but no research has examined whether the patterns of change (trajectories) for PGD and MDD symptoms synchronize during bereavement. We conducted a secondary analysis study to investigate the construct distinctiveness of PGD and MDD by simultaneously identifying and examining similarities and differences between bereaved caregivers' PGD‐ and depressive‐symptom trajectories from immediately post‐loss through 2 years later. Methods: PGD and depressive symptoms were measured for 849 cancer patients' caregivers over their first 2 years of bereavement using 11 grief‐symptom items of the prolonged grief‐13 scale (PG‐11) and the center for epidemiologic studies‐depression (CES‐D) scale, respectively. PGD‐ and depressive‐symptom trajectories were identified using latent class growth analysis with continuous latent‐class indicators (total PG‐11 and CES‐D scores). Concordance of caregiver participants' membership in PGD‐ and depressive‐symptom trajectories was examined by a percentage and a kappa value. Results: Five distinct symptom trajectories were identified for both PGD and MDD, with four shared trajectories (endurance, transient‐reaction, resilience, and prolonged‐symptomatic) having different prevalence rankings. Nonetheless, unique trajectories were identified for PGD (potential recurrence) and depressive symptoms (chronically distressed), respectively. Concordance between membership in PGD‐ and depressive‐symptom trajectories was moderate (61.3%, kappa [95% CI]: 0.49 [0.44, 0.53]). Conclusion: PGD and MDD are related but distinct constructs indicated by the unique trajectories identified for each, different prevalence rankings for PGD‐ and depressive‐symptom trajectories, and moderate concordance between membership in PGD‐ and depressive‐symptom trajectories, respectively.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Prolonged grief disorder and depression follow some of the same trajectories after bereavement, but there are also trajectories unique to each.
“It appears that, whereas prolonged grief disorder and depression follow some of the same trajectories after bereavement, there are also trajectories unique to each 93 .”
Cites
The Measurement of Observer Agreement for Categorical Data
Landis, J. R., & Koch, G. G. (1977) · Biometrics · doi:10.2307/2529310 · Cited by 81,148 · see citing works
The CES-D Scale: A Self-Report Depression Scale for Research in the General Population
Radloff, L. S. (1977) · Applied Psychological Measurement · doi:10.1177/014662167700100306 · Cited by 53,267 · see citing works
Prolonged grief disorder: psychometric validation of criteria proposed for DSM-V and ICD-11
Prigerson, H. G., Horowitz, M. J., Jacobs, S. C., Parkes, C. M., Aslan, M., Goodkin, K., Raphael, B., Marwit, S. J., Wortman, C., Neimeyer, R. A., et al. (2009) · PLoS Medicine · doi:10.1371/journal.pmed.1000121 · Cited by 1,863 · see citing works
Health outcomes of bereavement.
Stroebe, M., Schut, H., & Stroebe, W. (2007) · The Lancet · doi:10.1016/s0140-6736(07)61816-9 · Cited by 1,746 · see citing works
Latent Variable Analysis: Growth Mixture Modeling and Related Techniques for Longitudinal Data
Muthén, B. (2004) · Sage eBooks · doi:10.4135/9781412986311.n19 · Cited by 1,541 · see citing works
Prevalence of prolonged grief disorder in adult bereavement: A systematic review and meta-analysis
Lundorff, M., Holmgren, H., Zachariae, R., Farver-Vestergaard, I., & O’Connor, M. (2017) · Journal of Affective Disorders · doi:10.1016/j.jad.2017.01.030 · Cited by 876 · see citing works
Kessler, R. C. (2012) · Psychiatric Clinics of North America · doi:10.1016/j.psc.2011.11.005 · Cited by 871 · see citing works
Resilience to loss and chronic grief: A prospective study from preloss to 18-months postloss
Bonanno, G. A., Wortman, C. B., Lehman, D. R., Tweed, R. G., Haring, M., Sonnega, J., Carr, D., & Nesse, R. M. (2002) · Journal of Personality and Social Psychology · doi:10.1037/0022-3514.83.5.1150 · Cited by 836 · see citing works
Resilience to loss and chronic grief: a prospective study from preloss to 18-months postloss.
Bonanno, G. A., Wortman, C. B., Lehman, D. R., Tweed, R. G., Haring, M., Sonnega, J., Carr, D., & Nesse, R. M. (2002) · Journal of Personality and Social Psychology · doi:10.1037//0022-3514.83.5.1150 · Cited by 773 · see citing works
Looking for resilience: Understanding the longitudinal trajectories of responses to stress
Norris, F. H., Tracy, M., & Galea, S. (2009) · Social Science & Medicine · doi:10.1016/j.socscimed.2009.03.043 · Cited by 625 · see citing works
Geiser, C. (2012) · Cited by 564 · see citing works
Latham, A. E., & Prigerson, H. G. (2004) · Suicide and Life-Threatening Behavior · doi:10.1521/suli.34.4.350.53737 · Cited by 448 · see citing works
Birnbaum, H. G., Kessler, R. C., Kelley, D., Ben-Hamadi, R., Joish, V. N., & Greenberg, P. E. (2010) · Depression and Anxiety · doi:10.1002/da.20580 · Cited by 380 · see citing works
Zhang, B., El-Jawahri, A. R., & Prigerson, H. G. (2006) · Journal of Palliative Medicine · doi:10.1089/jpm.2006.9.1188 · Cited by 307 · see citing works
Bonanno, G. A., Neria, Y., Mancini, A., Coifman, K. G., Litz, B., & Insel, B. (2007) · Journal of Abnormal Psychology · doi:10.1037/0021-843x.116.2.342 · Cited by 288 · see citing works
Boelen, P. A., & van den Bout, J. (2005) · American Journal of Psychiatry · doi:10.1176/appi.ajp.162.11.2175 · Cited by 256 · see citing works
Galatzer‐Levy, I. R., & Bonanno, G. A. (2012) · Social Science & Medicine · doi:10.1016/j.socscimed.2012.02.022 · Cited by 216 · see citing works
When Caregiving Ends: The Course of Depressive Symptoms After Bereavement
Aneshensel, C. S., Botticello, A., & Yamamoto‐Mitani, N. (2004) · Journal of Health and Social Behavior · doi:10.1177/002214650404500405 · Cited by 215 · see citing works
Widowhood and Mortality: A Meta-Analysis
Moon, J. R., Kondo, N., Glymour, M. M., & Subramanian, S. V. (2011) · PLoS ONE · doi:10.1371/journal.pone.0023465 · Cited by 199 · see citing works
Looking beyond the mean in grief trajectories: A prospective, population-based cohort study
Nielsen, M. K., Carlsen, A. H., Neergaard, M. A., Bidstrup, P. E., & Guldin, M.-B. (2019) · Social Science & Medicine · doi:10.1016/j.socscimed.2018.10.007 · Cited by 138 · cited 2× · see citing works
“PGD symptoms in that study were measured only 6 months and 3 years post-loss.(19) Therefore, it is difficult to know whether high PGD symptoms started before 6 months post-loss for the late-grief trajectory and when high PGD symptoms were resolved post-loss to judge whether bereaved individuals in those groups are com…”
BackgroundO’Connor, M., Lasgaard, M., Shevlin, M. E., & Guldin, M. (2010) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2010.04.009 · Cited by 135 · see citing works
Spousal Bereavement in Older Adults
Ott, C. H., Lueger, R. J., Kelber, S. T., & Prigerson, H. G. (2007) · The Journal of Nervous and Mental Disease · doi:10.1097/01.nmd.0000243890.93992.1e · Cited by 128 · see citing works
Trajectories of grief: Comparing symptoms from the <i>DSM‐5</i> and ICD‐11 diagnoses
Bonanno, G. A., & Malgaroli, M. (2020) · Depression and Anxiety · doi:10.1002/da.22902 · Cited by 112 · see citing works
Guldin, M., Kjaersgaard, M. I. S., Fenger‐Grøn, M., Parner, E. T., Li, J., Prior, A., & Vestergaard, M. (2017) · World Psychiatry · doi:10.1002/wps.20422 · Cited by 89 · see citing works
Boerner, K., Wortman, C. B., & Bonanno, G. A. (2005) · The Journals of Gerontology Series B: Psychological Sciences and Social Sciences · doi:10.1093/geronb/60.2.p67 · Cited by 78 · see citing works
Depressive Symptom Trajectories and Associated Risks Among Bereaved Alzheimer Disease Caregivers
Zhang, B., Mitchell, S. L., Zivin, K., Jones, R. N., & Prigerson, H. G. (2008) · American Journal of Geriatric Psychiatry · doi:10.1097/jgp.0b013e318157caec · Cited by 68 · see citing works
Tang, S. T., Chen, J.-S., Wen, F.-H., Chou, W.-C., Chang, J. W.-C., Hsieh, C.-H., & Chen, C. H. (2019) · Journal of the National Comprehensive Cancer Network · doi:10.6004/jnccn.2018.7106 · Cited by 58 · see citing works
Self-citationO’Connor, M., Nickerson, A., Aderka, I. M., & Bryant, R. A. (2015) · Depression and Anxiety · doi:10.1002/da.22349 · Cited by 51 · see citing works
Early indicators of problematic grief trajectories following bereavement
Djelantik, A. A. A. M. J., Smid, G. E., Kleber, R. J., & Boelen, P. A. (2017) · European Journal of Psychotraumatology · doi:10.1080/20008198.2018.1423825 · Cited by 49 · see citing works
Levy, L. H., Martinkowski, K. S., & Derby, J. F. (1994) · OMEGA - Journal of Death and Dying · doi:10.2190/5y05-tphn-ketw-hlhp · Cited by 46 · see citing works
Guldin, M., Jensen, A. B., Zachariae, R. H., & Vedsted, P. (2012) · Psycho-Oncology · doi:10.1002/pon.3120 · Cited by 40 · see citing works
Ling, S.-F., Chen, M.-L., Li, C., Chang, W.-C., Shen, W. C., & Tang, S. T. (2012) · Oncology nursing forum · doi:10.1188/13.onf.e32-e40 · Cited by 37 · see citing works
Self-citationTsai, W., Kuo, S., Wen, F., Prigerson, H. G., & Tang, S. T. (2018) · Psycho-Oncology · doi:10.1002/pon.4629 · Cited by 32 · see citing works
Self-citationMedical comorbidity in complicated grief: Results from the HEAL collaborative trial
Robbins-Welty, G. A., Stahl, S. T., Zhang, J., Anderson, S., Schenker, Y., Shear, M. K., Simon, N. M., Zisook, S., Skritskaya, N. A., Mauro, C., et al. (2017) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2017.09.017 · Cited by 31 · see citing works
Kuo, S., Chou, W., Chen, J., Chang, W., Chiang, M.-C., Hou, M., & Tang, S. T. (2016) · Journal of Palliative Medicine · doi:10.1089/jpm.2016.0116 · Cited by 30 · see citing works
Self-citationFood colourings, preservatives, and hyperactivity
Eigenmann, P., & Haenggeli, C. A. (2007) · The Lancet · doi:10.1016/s0140-6736(07)61643-2 · Cited by 29 · see citing works
Sun, Y., Möller, J., Lundin, A., Wong, S. Y. S., Yip, B. H. K., & Forsell, Y. (2018) · Social Psychiatry and Psychiatric Epidemiology · doi:10.1007/s00127-018-1515-0 · Cited by 23 · see citing works
Kuo, S., Sun, J., & Tang, S. T. (2017) · Journal of Clinical Nursing · doi:10.1111/jocn.13720 · Cited by 17 · see citing works
Self-citationTrajectories of complicated grief
Nam, I. (2015) · The European Journal of Psychiatry · doi:10.4321/s0213-61632015000300002 · Cited by 16 · see citing works
LeBlanc, N. J., Simon, N. M., Reynolds, C. F., Shear, M. K., Skritskaya, N. A., & Zisook, S. (2019) · Elsevier eBooks · doi:10.1016/b978-0-12-813333-0.00020-2 · Cited by 10 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Reed, G. M., First, M. B., Billieux, J., Cloitre, M., Briken, P., Achab, S., Brewin, C. R., King, D. L., Kraus, S. W., & Bryant, R. A. (2022) · World Psychiatry · doi:10.1002/wps.20960 · Cited by 182 · see citing works
- Authors
- Wen, F., Chou, W., Shen, W., & Tang, S. T.
- Affiliations
- Soochow University (TW)
- Chang Gung University (TW)
- Corresponding author
- Tang, Siew Tzuh
- Venue
- Psycho-Oncology
- Publisher
- Wiley
- Published
- 2020-07-22
- Volume
- 29
- Issue
- 10
- Pages
- 1524-1532
- ISSN
- 1057-9249 (ISSN-L)
- 1099-1611
- OpenAlex
- W3035183948
- Cited by
- 13
- References
- 40
- Citations by year
- 2026: 2 · 2025: 1 · 2024: 2 · 2023: 2 · 2022: 3 · 2021: 3
- FWCI
- 0.80
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Psycho-Oncology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Chang Gung Memorial Hospital, Linkou (BMRP888)
- Ministry of Science and Technology, Taiwan (MOST 107‐2314‐B‐182‐064‐MY3)
- National Health Research Institutes (NHRI‐EX109‐10704PI)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Grief, Bereavement, and Mental Health
- Social Sciences › Anthropology › Death, Funerary Practices, and Mourning
- Health Sciences › Medicine › Oncology › Cancer survivorship and care
- Keywords
- prolonged grief disorder, major depressive disorder, bereavement, family caregivers, cancer patients, symptom trajectories, depressive symptoms, construct distinctiveness, terminal illness, caregiver mental health
- MeSH terms
- Latent Class Analysis, Psychological Distress, Adult, Aged, Bereavement, Major Depressive Disorder, Female, Grief, Humans, Longitudinal Studies, Male, Middle Aged, Stress Disorders, Post-Traumatic, Terminal Care, Prevalence, Caregivers, Terminally Ill
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
