Pociūnaitė-Ott, Justina

Due to the presumed high risk for prolonged grief disorder (PGD) in people bereaved during the COVID-19 pandemic, it is crucial to examine how grief develops over time in this population. This is the first study examining longitudinal symptom-profiles of PGD severity in people bereaved during the pandemic. We aimed to identify latent trajectories of DSM-5-TR PGD severity and predictors thereof in Dutch adults bereaved during the pandemic. Latent class growth modeling was employed to identify differential trajectories of PGD severity in 266 people bereaved on average 115 days prior when entering the study. Participants completed a PGD measure online (using the Traumatic Grief Inventory-Self Report-Plus) at three time-intervals six months apart. Associations between class-membership and socio-demographic, loss-related, health-related, and trauma-related characteristics were examined using multinomial logistic regression. Three trajectories were identified: Low/decreasing PGD symptoms (74%), Mild/stable PGD symptoms (18%), and High/decreasing PGD trajectory (8%). Closer kinship to the deceased, poorer self-rated health status, and having a mental disorder increased the likelihood of belonging to the Mild/stable PGD symptoms and High/decreasing PGD trajectories. This study provides insights in longitudinal PGD symptom-profiles in people bereaved during the pandemic. We found that PGD severity either remained low/mild or eventually decreased over time.

Background The death of a significant other can lead to prolonged grief disorder (PGD), characterized by intense grief reactions interfering with daily life. This study aims to identify latent profiles, and predictors thereof, of severity and fluctuation indices in PGD using experience sampling methodology (ESM) data from a novel Findable, Accessible, Interoperable, and Reusable (FAIR) data-archive. Methods Bereaved adults (N = 228) completed PGD items five times per day for two weeks using ESM. Latent profile analyses were run to identify profiles of fluctuating PGD reactions using four person-specific indicators derived from ESM-PGD items: mean, standard deviation, autocorrelation indicating inertia, and the root mean square of successive differences indicating instability. Background, loss-related characteristics, and psychopathology levels assessed before the ESM period were explored as potential predictors of profile membership. Results Five distinct profiles were identified: moderate PGD/low inertia/moderate fluctuation (46 %), moderate PGD/low inertia/high fluctuation (20 %), low PGD/low inertia/low fluctuation (19 %), high PGD/low inertia/low fluctuation (8 %), and low PGD/high inertia/low fluctuation (7 %). The most consistent differentiating predictors of profiles were gender, time since loss, and baseline psychopathology levels. Conclusions We found that at comparable levels of PGD severity, different fluctuation profiles exist in daily life of bereaved people suggesting that ESM may be an important tool for understanding the dynamic nature of PGD. Identifying these profiles enhances our understanding of individual differences in response to loss and could help to personalize bereavement care.

Background According to network theories, mental disorders, including prolonged grief disorder (PGD), comprise networks of dynamically connected symptoms. Examining how prolonged grief symptoms are connected over time could reveal the patterns driving their persistence. This study provides the first empirical investigation of prolonged grief symptom networks using self-reported data on prolonged grief assessed multiple times daily. Methods Adults whose partner, family member, or friend died on average 30 months ago (N = 229, 80 % women, M age  = 51) rated prolonged grief symptom intensity using 11 items (e.g., “In the past three hours, I found myself yearning for him/her”) five times per day for two weeks. We used a two-step multilevel vector autoregressive model to produce between-person, contemporaneous, and temporal networks. Results In the between-person network, yearning and sadness were the most strongly and positively connected symptoms. In the contemporaneous network, yearning, preoccupation, and sadness formed a cluster of positively connected symptoms. Simultaneously, difficulty reintegrating after the loss, emotional numbness, meaninglessness, and loneliness due to the loss formed another positively connected symptom cluster. In the temporal network, emotional numbness had the greatest positive influence on other prolonged grief symptoms at the subsequent timepoint. Conclusion We propose that targeting emotional suppression, promoting flexible emotion regulation, and supporting integrated continuing bonds (approach-behaviors) and targeting avoidance of the reality of the loss (avoidance-behaviors) may help people to adapt to loss.

Introduction: The majority of grief research has assessed Prolonged Grief (PG) symptoms using cross-sectional surveys, which are limited in capturing within-person changes in daily grief reactions. These dynamic PG reactions can be more effectively assessed using Experience Sampling Methodology (ESM). Accordingly, this data note presents a Findable, Accessible, Interoperable, and Reusable (FAIR) archive comprising three existing ESM projects investigating PG reactions in daily life. Methods: Participants in this archive completed three data collection phases: baseline measures (including sociodemographic and loss characteristics, and psychopathology measures), a 14-day ESM phase (rating PG reactions and contextual factors up to five times daily), and follow-up psychopathology assessments. The participants provided explicit digital consent for the use and reuse of their data in scientific research. Results: In total, 315 people are included in this archive, with a total of 22,050 ESM-measurement points. The majority of the participants were middle-aged, identified as women, and had completed higher education. Almost half of the sample (48.73%) experienced the loss of a partner or child, the majority of these losses were due to natural causes (70.06%), and happened less than a year ago (59.24%). The data are stored in a trusted repository. Discussion: This archive demonstrates that it is feasible to develop a FAIR archive including existing data on PG reactions in daily life. Given the resource-intensive nature and richness of these data, we encourage researchers to reuse and/or share ESM-data through this archive, helping to deepen our understanding of grief in natural settings.

Most bereavement research is focused on psychopathology, overlooking that mental health also includes well-being. This study is the first to examine mental health profiles based on ICD-11 Prolonged Grief (PG) symptoms, posttraumatic stress (PTS) symptoms, and well-being in a sample of Ukrainians bereaved during the full-scale Russian invasion. Participants were 290 adults (M age = 34.28, SD = 9.1 years), who had lost a loved one on average 5.3 months earlier. Over a third (35%) had lost a partner or child, due to illness (43%) or war (40%). The majority of participants (55%) scored above the threshold of clinically relevant PG symptoms. Latent profile analyses identified three distinct mental health profiles: (1) low PG symptoms/low PTS symptoms/high well-being (13%), (2) moderate PG symptoms/low PTS symptoms/moderate well-being (57%), (3) high PG symptoms/low PTS symptoms/low well-being (30%). People evidencing the third profile were more likely to have experienced the loss of a close person (partner or child) and to have been forcibly displaced compared to people in other profiles. Notably, the distribution of these profiles differs from previous studies, where profiles marked by low symptoms and high well-being were typically most common. Moreover, PG and well-being appeared to lie on opposite ends of a single continuum rather than functioning as distinct dimensions, providing limited support for the dual-continua model. This pattern suggests that Ukrainians may be facing unique challenges due to ongoing war-related stressors. Identifying those most in need of support and highlighting potential intervention targets are particularly important in under-resourced populations where access to care is limited.

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.

Background: A strong social safety net may play a key role in protecting people from developing prolonged grief disorder (PGD) after a traumatic loss. This has mainly been investigated cross-sectionally, whereby people usually report on their social life and PGD reactions during the past month. However, retrospectively recalling experiences is prone to recall bias. Objective: As such, we investigated the associations between pleasantness of social interactions and PGD reactions in traumatically bereaved people using Ecological Momentary Assessment (EMA). Methods: People whose loved one died due to homicide, suicide, or accident at least 12 months earlier (N = 36, 78% women, Mage = 56, 47% met PGD criteria) received smartphone-based surveys five times per day for two weeks. Surveys included questions about PGD intensity (e.g. ‘In the past 3 hours, did you yearn for your loved one?’ 0 = not at all, 6 = extremely) and their quality of social life (e.g. ‘In the past 3 hours, how did you find being with others?’ 0 = very unpleasant, 6 = very pleasant). Linear mixed models were used. Results: Based on 2520 measurement occasions, we found that when a person enjoyed their social life more than usual, they grieved less (B = −0.141, SE = 0.020, p <.001). However, whether a person’s social life was more or less pleasant than their peers was not related to their PGD levels. Conclusions: This EMA study highlights the importance of accounting for individual variability in grief reactions after loss and highlights the potential utility of strengthening one’s social safety net as a way to reduce the burden of PGD.

Introduction: The Centrality of Event Scale (CES) has frequently been used to measure the degree to which positive and negative life events are perceived central to a person's identity and life story; and previous research suggests that individuals rate their most positive memory as more central compared to their most negative one. When comparing the centrality of two (or more) memories within individuals, one needs to ensure that the CES (or its short form) is equally valid for different types of events (i.e., positive and negative) as well as on different levels of analyses (i.e., on the between-person and the within-person level), pointing to the issue of measurement invariance. Methods: Three-hundred sixty-five adults (18–89 years of age) reported up to ten positive and up to ten negative autobiographical memories. For each memory reported, participants completed the seven-item short form of the CES, which measures three different components of centrality: Events can form a central component of identity (two items), a turning point in the life story (three items), and a reference point for everyday inferences (two items). Results: Based on exploratory and confirmatory factor analyses, we found a two-factor structure (Self-Perception and Life-Course) to fit the data best at both levels of analyses and for both positive and negative events. Strict measurement invariance could be applied for positive and negative events at between-person level and at within-person level. The two factors, which measure the impact of an event on either a person's self-perception or their (future) life course, were rated higher for positive compared to negative memories. This difference, however, was stronger for the self-perception factor. Discussion: The present study provides a first examination of the factorial structure of the CES short form on two levels (within and between persons) as well as for two types of life events (positive and negative). Whereas, a unidimensional scale might be sufficient to measure the centrality of stressful or traumatic life events, a more fine-graded measure seems better suited to understand the different roles of positive and negative life events for a person's identity and life story.

Objectives: Personal reminiscence styles are known to influence a person’s well-being, but research regarding their impact on bereavement outcomes is limited. Based on previous findings, we assumed ruminative and reflective reminiscence styles to be associated with feelings of grief and personal growth, and that meaning-making efforts and the degree of having meaning-made of losing a loved one potentially mediate these relationships. Methods: The final study sample consisted of 198 participants aged between18 and 75 years (Mage = 40.58, SD = 39.0), 83.3% were female. In a first step, we ran separate mediation models to examine the associations between reminiscence styles, processes of making meaning of the loss and bereavement. Based on these results, we build a parsimonious, inclusive pathway model. Results: Our findings indicate that a ruminative reminiscence style is related to feelings of grief and personal growth through its associations with meaning-made. A reflective reminiscence style, in contrast, is associated with feelings of grief through its relation to meaning-making efforts. Moreover, a reflective reminiscence style is directly related to personal growth. Conclusion: Findings are discussed regarding their implications for both areas of research — autobiographical remembering and adaptation to bereavement, as well as their applicability in clinical settings.

Remembering the lost loved one is an integral part of bereavement process. While we know from prior research that memories in general are used for specific reasons (e.g., for identity processes or within social relationships), it is unclear for what reasons people remember their lost loved ones. Based on previous literature, we assumed that memory emotionality and bereavement reaction are associated with why people reminisce about their lost loved ones. In total, 100 adults reported up to 10 of their most important memories about a lost loved one and rated them regarding emotional valence, intensity and different types of memory use. Participants also rated their feelings of grief and personal growth post‐loss. Findings demonstrate that memories about lost loved ones are used in ways considered adaptive and maladaptive. Importantly, the reasons for remembering lost loved ones are strongly associated with emotional qualities of memories and the individual bereavement reaction.