Prolonged Grief, Depressive, and Posttraumatic Stress Symptoms: Random-Intercept Cross-Lagged Panel Analyses

Abstract

Prolonged grief symptoms often co-occur with depressive and posttraumatic stress (PTS) symptoms, but the temporal relationships between prolonged grief symptoms and other postloss psychopathology symptoms are not well understood. Insights into the temporal relationships can inform treatment decisions for bereaved adults. Therefore, we aimed to clarify these temporal relationships. Three-hundred seven bereaved adults within their first bereavement year (78% female) completed questionnaires to assess prolonged grief, depressive, and PTS symptoms at five time points at 1.5-month intervals. Random-intercept cross-lagged panel modeling was utilized to inspect reciprocal relationships between these symptoms. Higher prolonged grief symptoms than usual predicted other psychopathology symptoms and vice versa across at least one interval in all bivariate models. In a model including prolonged grief, depressive, and PTS symptoms, within-person fluctuations in acute grief (i.e., grief occurring between 0 and 6 months after loss) levels predicted other postloss symptoms but not vice versa. Most variance could be attributed to stable differences between individuals. Future research should examine the clinical utility of targeting acute grief reactions to prevent the emergence of other postloss psychopathology.