Prolonged grief and depression after unnatural loss: latent class analyses and cognitive correlates
Open accessAbstract
This study sought to identify (a) subgroups among people confronted with unnatural/violent loss characterized by different symptoms profiles of prolonged grief disorder (PGD) and depression, and (b) socio-demographic, loss-related, and cognitive variables associated with subgroup membership. We used data from 245 individuals confronted with the death of a loved one due to an accident (47.3%), suicide (49%) or homicide (3.7%). Latent class analysis revealed three classes of participants: a resilient-class (25.3%), a predominantly PGD-class (39.2%), and a combined PGD/Depression-class (35.5%). Membership in the resilient-class was predicted by longer time since loss and lower age; membership in the combined class was predicted by lower education. Endorsement of negative cognitions about the self, life, the future, and one's own grief-reactions was lowest in the Resilient-class, intermediate in the PGD-class, and highest in the combined PGD/Depression-class. When all socio-demographic, loss-related, and cognitive variables were included in multinomial regression analyses predicting class-membership, it was found that negative cognitions about one's grief was the only variable predicting membership of the PGD-class. Negative cognitions about the self, life, and grief predicted membership of the combined PGD/Depression-class. These findings provide valuable information for the development of interventions for different subgroups of bereaved individuals confronted with unnatural/violent loss.
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Unnatural losses may cause more mental health difficulties because of the disruption of positive and self-evident assumptions about the world and due to more intrusive and negative memories.
“Theoretically, unnatural losses may cause more mental health difficulties because of the disruption of positive and self-evident assumptions about the world (i.e., 'the world is a safe place') and due to more intrusive and negative memories.”
From The prevalence of prolonged grief disorder in bereaved individuals following unnatural losses: Systematic review and meta regression analysis (2020) · cites this paper as Boelen et al., 2016
The Introduction (page unavailable) says unnatural or violent losses carry elevated risks of disturbed grief, PTSD, and depression, and discusses maladaptive cognitions and negative beliefs about the world and safety as possible contributors. It does not say that more intrusive and negative memories explain the greater difficulties; the paper’s reported findings concern negative cognitions, not memories. (LLM, conf=0.85)
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Cites
Diagnostic and Statistical Manual of Mental Disorders
Williams, J. B. W., & First, M. B. (2013) · Oxford University Press eBooks · doi:10.1093/acrefore/9780199975839.013.104 · Cited by 109,841 · see citing works
Diagnostic and Statistical Manual of Mental Disorders
(2012) · Springer eBooks · doi:10.1007/springerreference_121117 · Cited by 20,769 · see citing works
Collins, L. M., & Lanza, S. T. (2009) · Cited by 2,536 · 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
Self-citationMultiple recurrences of major depressive disorder
Solomon, D. A., Keller, M. B., Leon, A. C., Mueller, T. I., Lavori, P. W., Shea, M. T., Coryell, W., Warshaw, M., Turvey, C., Maser, J. D., et al. (2000) · American Journal of Psychiatry · doi:10.1176/appi.ajp.157.2.229 · Cited by 835 · see citing works
Latent Class and Latent Transition Analysis
Lanza, S. T., Flaherty, B. P., & Collins, L. M. (2003) · Handbook of Psychology · doi:10.1002/0471264385.wei0226 · Cited by 767 · see citing works
Diagnosis and classification of disorders specifically associated with stress: proposals for ICD-11
Maercker, A., Brewin, C. R., Bryant, R. A., Cloitre, M., van Ommeren, M., Jones, L. M., Humayan, A., Kagee, A., Llosa, A. E., Rousseau, C., et al. (2013) · World Psychiatry · doi:10.1002/wps.20057 · Cited by 762 · see citing works
SCL-90. Handleiding bij een multidimensionele psychopathologie-indicator
Arrindell, W. A., & Ettema, J. H. M. (2003) · Research portal (Tilburg University) · Cited by 629 · see citing works
Predictors of complicated grief: a systematic review of empirical studies
Lobb, E. A., Kristjanson, L. J., Aoun, S. M., Monterosso, L., Halkett, G. K. B., & Davies, A. (2010) · Death Studies · doi:10.1080/07481187.2010.496686 · Cited by 611 · cited 2× · see citing works
“There is growing evidence that persistent negative thinking about global belief themes including the self, life, the world, the future, and safety, as well as catastrophi-cally interpreting one's responses to the loss is associated with psychopathology following loss (Lobb et al., 2010).”
InfluentialBereavement and Mental Health after Sudden and Violent Losses: A Review
Kristensen, P., Weisæth, L., & Heir, T. (2012) · Psychiatry · doi:10.1521/psyc.2012.75.1.76 · Cited by 497 · see citing works
Grief and bereavement: what psychiatrists need to know
ZISOOK, S., & SHEAR, K. (2009) · World Psychiatry · doi:10.1002/j.2051-5545.2009.tb00217.x · Cited by 451 · see citing works
Kaltman, S. I., & Bonanno, G. A. (2003) · Journal of Anxiety Disorders · doi:10.1016/s0887-6185(02)00184-6 · Cited by 319 · 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
Self-citationPosttraumatic stress disorder and prolonged grief in refugees exposed to trauma and loss
Nickerson, A., Liddell, B. J., Maccallum, F., Steel, Z., Silove, D. M., & Bryant, R. A. (2014) · BMC Psychiatry · doi:10.1186/1471-244x-14-106 · Cited by 196 · see citing works
Litz, B. T., Schorr, Y., Delaney, E., Au, T., Papa, A., Fox, A. B., Morris, S., Nickerson, A., Block, S., & Prigerson, H. G. (2014) · Behaviour Research and Therapy · doi:10.1016/j.brat.2014.07.005 · Cited by 139 · see citing works
Psychometric Properties of the Grief Cognitions Questionnaire (GCQ)
Boelen, P. A., & Lensvelt‐Mulders, G. (2005) · Journal of Psychopathology and Behavioral Assessment · doi:10.1007/s10862-005-2409-5 · Cited by 124 · see citing works
Self-citationCognitive–behavioral variables mediate the impact of violent loss on post-loss psychopathology.
Boelen, P. A., de Keijser, J., & Smid, G. E. (2014) · Psychological Trauma Theory Research Practice and Policy · doi:10.1037/tra0000018 · Cited by 101 · see citing works
Self-citationvan der Houwen, K., Stroebe, M., Schut, H. A. W., Stroebe, W., & van den Bout, J. (2010) · Social Science & Medicine · doi:10.1016/j.socscimed.2010.06.047 · Cited by 75 · see citing works
Prolonged grief disorder three decades post loss in survivors of the Khmer rouge regime in Cambodia
Stammel, N., Heeke, C., Bockers, E., Chhim, S., Taing, S., Wagner, B., & Knaevelsrud, C. (2013) · Journal of Affective Disorders · doi:10.1016/j.jad.2012.05.063 · Cited by 73 · see citing works
Hruska, B. J., Irish, L. A., Pacella‐LaBarbara, M. L., Sledjeski, E. M., & Delahanty, D. L. (2014) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2014.06.009 · Cited by 49 · see citing works
An Item Response Theory Analysis of a Measure of Complicated Grief
Boelen, P. A., & Hoijtink, H. J. A. (2009) · Death Studies · doi:10.1080/07481180802602758 · Cited by 41 · see citing works
Self-citationBoelen, P. A. (2015) · Journal of Trauma & Dissociation · doi:10.1080/15299732.2015.1027841 · Cited by 36 · see citing works
Self-citationProlonged grief disorder: cognitive–behavioral theory and therapy
Stroebe, M., Schut, H. A. W., & van den Bout, J. (2013) · Routledge eBooks · doi:10.4324/9780203105115-27 · Cited by 12 · see citing works
Flagged first, then by citations
Research works printed but not linked: 1
- Muthén, L.K., Muthén, B.O., 2011. Mplus User's Guide. Muthén & Muthén, Los An- geles, CA (Sixth edition).
Cited by
Sorted by citations
Prigerson, H. G., Boelen, P. A., Xu, J., Smith, K. V., & Maciejewski, P. K. (2021) · World Psychiatry · doi:10.1002/wps.20823 · Cited by 476 · see citing works
Self-citationDjelantik, A. A. A. M. J., Smid, G. E., Mroz, A., Kleber, R. J., & Boelen, P. A. (2020) · Journal of Affective Disorders · doi:10.1016/j.jad.2020.01.034 · Cited by 395 · see citing works
Self-citationProlonged grief disorder for ICD-11: the primacy of clinical utility and international applicability
Killikelly, C., & Maercker, A. (2017) · European Journal of Psychotraumatology · doi:10.1080/20008198.2018.1476441 · Cited by 187 · see citing works
Trajectories of grief, depression, and posttraumatic stress in disaster‐bereaved people
Lenferink, L. I. M., Nickerson, A., Keijser, J., Smid, G. E., & Boelen, P. A. (2020) · Depression and Anxiety · doi:10.1002/da.22850 · Cited by 140 · see citing works
Self-citationDjelantik, A. A. A. M. J., Robinaugh, D. J., Kleber, R. J., Smid, G. E., & Boelen, P. A. (2020) · Depression and Anxiety · doi:10.1002/da.22880 · Cited by 110 · see citing works
Self-citationChanges in typical beliefs in response to complicated grief treatment
Skritskaya, N. A., Mauro, C., Garcia de la Garza, A., Meichsner, F., Lebowitz, B., Reynolds, C. F., Simon, N. M., Zisook, S., & Shear, M. K. (2020) · Depression and Anxiety · doi:10.1002/da.22981 · Cited by 24 · see citing works
An investigation of approach behaviour in Prolonged Grief
Maccallum, F., & Bryant, R. A. (2019) · Behaviour Research and Therapy · doi:10.1016/j.brat.2019.05.002 · Cited by 16 · see citing works
Normal complications and abnormal assumptions after perinatal death
Cacciatore, J., & Thieleman, K. (2019) · MCN The American Journal of Maternal/Child Nursing · doi:10.1097/nmc.0000000000000486 · Cited by 15 · see citing works
- Authors
- Boelen, P. A., Reijntjes, A., J. Djelantik, A. A. A. M., & Smid, G. E.
- Affiliations
- Utrecht University (NL)
- Arq Psychotrauma Expert Group (NL)
- Corresponding author
- Boelen, Paul A.
- Venue
- Psychiatry Research
- Publisher
- Elsevier BV
- Published
- 2016-06
- Volume
- 240
- Pages
- 358-363
- ISSN
- 0165-1781 (ISSN-L)
- OpenAlex
- W2321264351
- Cited by
- 125
- References
- 23
- Citations by year
- 2026: 6 · 2025: 13 · 2024: 13 · 2023: 27 · 2022: 11 · 2021: 15 · 2020: 6 · 2019: 15 · 2018: 10 · 2017: 7 · 2016: 2
- FWCI
- 15.20
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Psychiatry Research (publishedVersion)
- PubMed (publishedVersion)
- Utrecht University Repository (Utrecht University) (submittedVersion, other-oa)
- Utrecht University Repository (Utrecht University) (submittedVersion)
- Data Archiving and Networked Services (DANS) (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, depression, bereavement, suicide bereavement, homicide, accident deaths, negative thinking, grief, resilience, symptom subtypes, bereavement interventions
- MeSH terms
- Adult, Bereavement, Death, Depression, Female, Grief, Homicide, Humans, Male, Middle Aged, Stress Disorders, Post-Traumatic, Suicide, Resilience, Psychological
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