Prolonged grief and the disruption of meaning: Establishing a mediation model
Abstract
This study aimed to test the hypothesis that meaning making is a mediating process in the relationship between risk factors for prolonged grief disorder (PGD) and subsequent emergence of PGD symptomatology. A survey design was employed with prospective measurement of PGD. The following variables were assessed 2-12 months postloss among adults across North America and Europe (N = 357): (a) risk factors for PGD (insecure attachment, social support, neuroticism, violent loss, and spousal loss) and (b) meaning made. Meaning made was measured using the Grief and Meaning Reconstruction Inventory (GMRI) as well as using the Integration of Stressful Life Experiences-Short Form (ISLES-SF). At a 7-10-months follow-up (n = 171) symptoms of PGD were assessed. The mean age at the second assessment point was 44.3 years (SD = 16.1) and the majority of the sample identified as female (71.9%). Process analysis was employed to test a series of simple mediation models. When the GMRI was used as a measure of meaning, the indirect effect of each risk factor on PGD symptoms, as mediated by meaning made, was significant (95% CI). When the ISLES-SF was used to measure meaning, the indirect effect of each risk factor with the exception of violent loss was significant (95% CI). The study demonstrates that meaning making serves to mediate the adverse impact of multiple PGD risk factors on the development of PGD symptomatology. Specifically, the study suggests that PGD risk factors exacerbate symptoms of PGD by impeding the meaning-making process. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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The meaning reconstruction model focuses on the crucial role of meaning-making in recovery and posttraumatic growth after the death of a significant person.
“This model focuses on the crucial role of meaning-making in recovery and posttraumatic growth after the death of a significant person (69, 88–90).”
From Ayahuasca-assisted meaning reconstruction therapy for grief: a non-randomized clinical trial protocol (2025) · cites this paper as [88]
Meaning-making prospectively predicts positive adaptation to bereavement.
“added to a growing literature, indicate that meaning-making prospectively predicts positive adaptation to bereavement (88, 92–95).”
From Ayahuasca-assisted meaning reconstruction therapy for grief: a non-randomized clinical trial protocol (2025) · cites this paper as [88]
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Aktürk, B. E., Kaptanoglu, O., & Kaptanoglu, M. I. (2026) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2026.1983790
- Authors
- Milman, E., Neimeyer, R. A., Fitzpatrick, M., MacKinnon, C. J., Muis, K. R., & Cohen, S. R.
- Venue
- Journal of Counseling Psychology
- Published
- 2019-11
- Volume
- 66
- Issue
- 6
- Pages
- 714-725
- ISSN
- 0022-0167 (ISSN-L)
- 1939-2168
- OpenAlex
- W2981889148
- Cited by
- 67
- References
- 0
- Citations by year
- 2026: 4 · 2025: 12 · 2024: 10 · 2023: 5 · 2022: 13 · 2021: 9 · 2020: 12 · 2019: 1 · 2017: 1
- FWCI
- 10.21
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Counseling Psychology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Grief, Bereavement, and Mental Health
- Social Sciences › Anthropology › Death, Funerary Practices, and Mourning
- Social Sciences › Health › Religion, Spirituality, and Psychology
- Keywords
- prolonged grief disorder, meaning-making, mediation, risk factors, insecure attachment, social support, neuroticism, death of a spouse, bereavement, grief
- MeSH terms
- Adult, Female, Follow-Up Studies, Grief, Humans, Life Change Events, Male, Middle Aged, Prospective Studies, Surveys and Questionnaires, Time Factors, Negotiating
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