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Cited by 103Grief, Bereavement, and Mental HealthDeath, Funerary Practices, and MourningPosttraumatic Stress Disorder Research

Are there gender differences in prolonged grief trajectories? A registry-sampled cohort study

Lundorff, Marie, Bonanno, George A., Johannsen, Maja, O'Connor, Maja·2020·Journal of Psychiatric Research
DOI 10.1016/j.jpsychires.2020.06.030
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Abstract

Research suggests variation in how grief develops across time, and gender may account for some of this variation. However, gender differences in growth patterns of the newly codified ICD-11 prolonged grief disorder (PGD) are unknown. This study examined gender-specific variances in grief trajectories in a registry-sampled cohort of 857 spousal bereaved individuals (69.8% female). Participants completed self-report questionnaires of PGD symptoms at 2, 6, and 11 months post-loss. Using Growth Mixture Modeling, four PGD trajectories emerged: resilient characterized by low symptoms (64.4%), moderate-stable characterized by moderate symptoms (20.4%), recovery characterized by elevated symptoms showing a decrease over time (8.4%), and prolonged grief characterized by continuous elevated symptoms (6.8%). Similar proportions of men and women comprised the four trajectories. Gender influenced the parameter estimates of the prolonged grief trajectory as men evidenced more baseline symptoms (higher intercept) than women did and a decreasing symptom-level (negative slope), while women showed symptom-increase over time (positive slope). The prolonged grief trajectory captured the largest proportion of probable PGD cases in both genders. Low optimism and low mental health predicted membership in this class. Altogether, the absolute majority of both men and women followed a low-symptom resilient trajectory. While a comparable minority followed a high-symptom prolonged grief trajectory, men and women within this trajectory expressed varying symptom development. Men expressed prolonged grief as an acute, decreasing reaction, whereas women showed an adjourned, mounting grief reaction. This study suggests that gender may influence symptom development in highly distressed individuals across early bereavement.

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  • Further studies with larger sample sizes or longer-term time frames have observed distinct trajectories: most people are resilient, a smaller but significant proportion have grief symptoms improving over time, others have moderate and persistent symptoms, and a smaller group exhibits high levels of grief symptoms that do not improve over time.

    “Further studies, particularly those with larger sample sizes or longer-term time frames, have observed distinct trajectories in which most people are resilient to the effects of bereavement, a smaller but significant proportion have grief symptoms improving over time, others have moderate and persistent symptoms, and a smaller group exhibits high levels of grief symptoms that do not improve over”

    From Emerging experience with selected new categories in the <scp>ICD</scp>‐11: complex <scp>PTSD</scp>, prolonged grief disorder, gaming disorder, and compulsive sexual behaviour disorder (2022) · cites this paper as [91]

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Authors
Lundorff, M., Bonanno, G. A., Johannsen, M., & O'Connor, M.
Affiliations
  • Aarhus University (DK)
  • Columbia University (US)
Corresponding author
Lundorff, Marie
ORCID
Venue
Journal of Psychiatric Research
Publisher
Elsevier BV
Published
2020-10
Volume
129
Pages
168-175
ISSN
0022-3956 (ISSN-L)
DOI
10.1016/j.jpsychires.2020.06.030
OpenAlex
W3045152731
Cited by
103
References
45
Citations by year
2026: 21 · 2025: 24 · 2024: 16 · 2023: 27 · 2022: 10 · 2021: 4 · 2020: 1
FWCI
4.20
Type
journal article
Language
en
Open access
closed
Licence
Locations
  • Journal of Psychiatric Research (publishedVersion)
  • PubMed (publishedVersion)
Funders
Aarhus Universitets Forskningsfond (AUFF - E\u22122015-FLS-8-63, 2015-FLS-8-63)
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, gender differences, grief trajectories, death of a spouse, bereavement, ICD-11, growth mixture modeling, optimism, mental health, symptom development
MeSH terms
Bereavement, Female, Grief, Humans, Male, Registries, Sex Characteristics, Cohort Studies

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