Prolonged grief and depression after unnatural loss: Latent class analyses and cognitive correlates

Abstract

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.

Keywords: Depression; Prolonged-grief; Unnatural-loss; Violent-loss.