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Cited by 120Grief, Bereavement, and Mental HealthDeath, Funerary Practices, and MourningPosttraumatic Stress Disorder Research

Symptoms of prolonged grief, posttraumatic stress, and depression in recently bereaved people: symptom profiles, predictive value, and cognitive behavioural correlates

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Boelen, Paul A., Lenferink, Lonneke I.M.·2020·Social Psychiatry and Psychiatric Epidemiology
DOI 10.1007/s00127-019-01776-wPMC PMC7275015
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Abstract

Purpose: Prior latent class analyses (LCA) have focused on people who were bereaved more than 6 months earlier. Research has yet to examine patterns and correlates of emotional responses in the first few months of bereavement. We examined whether subgroups could be identified among very recently (≤ 6 months) bereaved adults, based on their endorsement of symptoms of prolonged grief disorder (PGD), posttraumatic stress disorder (PTSD), and depression. Associations of class membership with overall disturbed grief, PTSD, and depression—assessed concurrently and at 6 months follow-up—were examined. Furthermore, we examined differences between classes regarding socio-demographics, loss-related, and cognitive behavioural variables. Methods: PGD, PTSD, and depression self-report data from 322 Dutch individuals bereaved ≤ 6 months earlier were subjected to LCA; N = 159 completed the follow-up assessment. Correlates of class membership were examined. Results: Three classes were identified: a low symptom class ( N = 114; 35.4%), a predominantly PGD class ( N = 96; 29.8%), and a high symptom class ( N = 112; 34.8%). PGD, PTSD, and depression scores (assessed concurrently and at 6 months follow-up) differed significantly between classes, such that low symptom class < predominantly PGD class < high symptom class. Being a woman, younger, more recently bereaved, experiencing deaths of a partner/child and unnatural losses, plus maladaptive cognitions and avoidance behaviours were associated with membership of the pervasive symptom classes. Conclusion: In the first 6 months of bereavement, meaningful subgroups of bereaved people can be distinguished, which highlights the relevance of early detection of people with elevated bereavement-related distress and offering them preventive interventions that foster adaptation to loss.

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  • Proposed core maintaining mechanisms in prolonged grief disorder are inability to integrate the reality of the loss, avoidance behavior, and negative loss-related cognitions.

    “Proposed core maintaining mechanisms in prolonged grief disorder are i) the inability to integrate the reality of the loss in autobiographical memory (i.e., lack of acceptance of the loss), ii) avoidance behavior (e.g., social with drawal, avoidance of situations that trigger feelings about the loss), and iii) negative loss-related cognitions (e.g., catastrophic mis interpretations) (e.g”

    From Group-based compassion-focused therapy for prolonged grief symptoms in adults – Results from a randomized controlled trial (2022) · cites this paper as Boelen and Lenferink, 2020

    The Introduction identifies a sense of unrealness about the loss, negative cognitions, and avoidance as cognitive-behavioural variables drawn from conceptualizations of disturbed grief. The Discussion reports that these variables were more strongly endorsed in higher-symptom groups. The paper does not establish them as core maintaining mechanisms or specify a failure to integrate the loss into autobiographical memory; its findings concern associations in recently bereaved people. (LLM, conf=0.82)

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  • Negative loss-related cognitions and avoidance behaviors are related to complicated grief reactions, including PGS.

    “Studies have shown that negative loss-related cognitions and avoidance behaviors are related to complicated grief reactions, including PGS (e.g., Boelen et al., 2003a, 2003b; Boelen and Lenferink, 2020; Boelen and Van Den Hout, 2008).”

    From Group-based compassion-focused therapy for prolonged grief symptoms in adults – Results from a randomized controlled trial (2022) · cites this paper as Boelen and Lenferink, 2020

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Cited by

Sorted by citations

Authors
Boelen, P. A., & Lenferink, L. I. M.
Affiliations
  • Utrecht University (NL)
  • University of Groningen (NL)
Corresponding author
Boelen, Paul A.
ORCID
Venue
Social Psychiatry and Psychiatric Epidemiology
Publisher
Springer Science and Business Media LLC
Published
2019-09-18
Volume
55
Issue
6
Pages
765-777
ISSN
  • 0933-7954 (ISSN-L)
  • 1433-9285
DOI
10.1007/s00127-019-01776-w
PMC
PMC7275015
OpenAlex
W2973711652
Cited by
120
References
11
Citations by year
2026: 14 · 2025: 18 · 2024: 12 · 2023: 28 · 2022: 22 · 2021: 17 · 2020: 7 · 2019: 1
FWCI
13.72
Type
journal article
Language
en
Open access
Licence
Locations
  • Social Psychiatry and Psychiatric Epidemiology (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • University of Groningen research database (University of Groningen / Centre for Information Technology) (publishedVersion, cc-by)
  • Utrecht University Repository (Utrecht University) (submittedVersion, other-oa)
  • University of Groningen research database (University of Groningen / Centre for Information Technology) (submittedVersion, cc-by)
  • Utrecht University Repository (Utrecht University) (submittedVersion)
Topics
  • Social Sciences › Psychology › Clinical Psychology › Grief, Bereavement, and Mental Health
  • Social Sciences › Anthropology › Death, Funerary Practices, and Mourning
  • Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
Keywords
prolonged grief disorder, post-traumatic stress disorder, depression, bereavement, symptom profiles, latent class analysis, maladaptive cognitions, avoidance behavior, unnatural death, adaptation to loss
MeSH terms
Latent Class Analysis, Adult, Avoidance Learning, Bereavement, Cognition, Demography, Depression, Female, Humans, Male, Middle Aged, Netherlands, Predictive Value of Tests, Stress Disorders, Post-Traumatic, Time Factors, Widowhood, Self Report, Symptom Assessment

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