Trajectories of grief-related psychopathology: A decade after the MH17 plane disaster

Abstract

Violent losses increase the risk for prolonged grief disorder (PGD), posttraumatic stress disorder (PTSD), and major depressive disorder (MDD). Little is known about the course of grief-related psychopathology in the long term. Hence, we examined their latent trajectories, overlap, and predictors to enhance our understanding of differential long-term responses to violent loss. MH17-bereaved people (N = 299) completed annual self-report measures from one to nine years post-loss. Prolonged grief (PG), posttraumatic stress (PTS), and major depression (MD) symptom trajectories were identified using latent class growth modeling. Overlap in trajectory membership was examined using frequencies. Predictors of trajectory membership were examined using multinomial regression analyses. Four PG symptom trajectories emerged: low (41.0 %), moderate decreasing (34.2 %), high (13.5 %), and recovered (11.3 %). Four PTS symptom trajectories emerged: low (56.2 %), recovered (19.6 %), moderate increasing (17.6 %), and high (6.6 %). Four MD symptom trajectories emerged: low (55.7 %), moderate (19.6 %), moderate decreasing (15.1 %), and high (9.5 %). The findings indicate that if people report psychopathology, this often entails PGD by itself, and sometimes in combination with PTSD and MDD, yet rarely PTSD or MDD by itself. Around one in 20 people was assigned to all three high symptom trajectories. Different predictors were found across disorders. To conclude, most MH17-bereaved people reported low grief-related psychopathology, yet one in six reported high grief-related psychopathology levels (i.e., at least probable PGD, PTSD, or MDD) nearly a decade later. There is no indication of a delayed onset of grief-related psychopathology.