title: 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.
authors.affiliation: Department of Clinical Psychology, Utrecht University, Utrecht, The Netherlands; Arq Psychotrauma Expert Group, Diemen, The Netherlands. Electronic address: P.A.Boelen@uu.nl.
authors.forename: Paul A
authors.initials: PA
authors.lastname: Boelen
authors.affiliation: Department of Child and Adolescent Studies, Utrecht University, Utrecht, The Netherlands.
authors.forename: Albert
authors.initials: A
authors.lastname: Reijntjes
authors.affiliation: Department of Clinical Psychology, Utrecht University, Utrecht, The Netherlands; Arq Psychotrauma Expert Group, Diemen, The Netherlands.
authors.forename: A A A Manik
authors.initials: AAAM
authors.lastname: J Djelantik
authors.affiliation: Arq Psychotrauma Expert Group, Diemen, The Netherlands; Foundation Centrum '45, Diemen, The Netherlands.
authors.forename: Geert E
authors.initials: GE
authors.lastname: Smid
mesh_terms: D000328:Adult; D001601:Bereavement; D003643:Death; D003863:Depression / Q000523:psychology*; D005260:Female; D006117:Grief; D006708:Homicide / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D055500:Resilience, Psychological; D013313:Stress Disorders, Post-Traumatic / Q000523:psychology; D013405:Suicide / Q000523:psychology*
keywords: Depression; Prolonged-grief; Unnatural-loss; Violent-loss