Patterns and predictive value of acute prolonged grief and posttraumatic stress in youngsters confronted with traumatic loss : A latent class analysis

Deaths of relatives and peers in potentially traumatizing circumstances may lead to symptoms of prolonged grief (PG, e.g.,yearning, preoccupation) and posttraumatic stress (PTS, e.g., re-experiencing, hypervigilance). There is limited knowledge about how symptoms of PG and PTS co-occur following such events. The current study aimed to identify patterns of DSM-5-TR defined PG symptomatology and PTS in a sample of 213 youngsters, involved in a school bus accident killing seven peers 2 months earlier. Using latent class analysis, three groups were identified evidencing moderate endorsement of most symptoms (Class 1), high endorsement of almost all but the avoidance symptoms (Class 2), and high endorsement of almost all symptoms (Class 3), respectively. Classes differed in terms of levels of grief, PTS, and depression, assessed concurrently, and—in a subgroup of n=137 participants—assessed at 16 month follow-up. E.g., Class 3 membership was associated with a greater likelihood of meeting criteria for DSM-5-TR defined prolonged grief disorder at follow-up. Gender (fewer females in Class 1) but not age and proximity to the accident were associated with class membership. Findings indicate that it is important to identify groups with elevated PG and PTS early after traumatic bereavement who may be en route to persistent mental health problems.

Highlights

·  In youngsters, traumatic loss may be associated with different patterns of prolonged grief (PG) and posttraumatic stress (PTS).

·  In 213 youngsters confronted with traumatic losses two months earlier, we identified latent classes with moderate PG and PTS (Class 1, 33.3%), high PG and PTS with low avoidance (Class 2, 22.5%), and high PT and PGD with high avoidance (Class 3, 44.1%).

·  Class 3 membership increased the likelihood of meeting criteria for prolonged grief disorder at 16 months follow-up.

·  Females had a greater likelihood of membership of Class 2 and Class 3.