Bereavement by Traumatic Means: The Complex Synergy of Trauma and Grief

Abstract

When people lose intimates unexpectedly, in particular from malicious acts of violence, they are at risk for chronic grief reactions. The phenomenology, clinical symptoms, clinical needs, and risk factors associated with loss by traumatic means and the combined influences of loss and trauma exposure are yet to be systematically studied. We review the complex interplay between trauma and loss by traumatic means. The distinctions between normal and traumatic loss, and complicated and traumatic grief, are contrasted with the traditional conceptualization of posttraumatic stress disorder. The role of various mediators such as concurrent or life-span trauma exposure and interpersonal factors, particularly the degree of attachment to the individual or group traumatically lost, is discussed. We offer a more integrated and focused view of traumatic grief, its predictors, and future directions for the integrative study of trauma and loss outcomes.

The Mental Health Consequences of Disaster-Related Loss: Findings from Primary Care One Year After the 9/11 Terrorist Attacks

“…Second, this study did not include a specific measure of complicated grief. It is likely that in addition to the DSM-IV disorders studied here, some patients developed specific grief reactions associated with post-trauma psychopathology (Neria & Litz, 2004, Neria et al, 2007. Third, because the study was undertaken in an urban general medical practice serving a low-income population, the results may not generalize to primary care settings with different populations (Bruce, Takeuchi, & Leaf, 1991).…”

Psychosocial functioning after losing a close friend in an extreme terror incident

“…Both clinical experience and research have identified problems related to the interplay between trauma and grief, and if a person is present and witness to a death, or the traumatic circumstances surrounding the death easily gives rise to inner images of what happened, it may be very difficult to think of memories of that person without the «traumatic» circumstances invading their thoughts (Neria & Litz, 2004). Bereavement after the unexpected loss of a loved one is associated with elevated risk for an onset of PTSD, panic disorder, depressive episodes, and multiple psychiatric disorders like mood and anxiety disorders (Keyes et al, 2014).…”

Trauma Experience, Identity, and Narratives

“…Loss of this kind can be conceptualized as a trauma stressor that can lead to traumatic stress. Therefore, there is a great deal of intersection between trauma loss and trauma stress, both in event dimensions and psychological outcome (Neria & Litz, 2004). In trauma loss, a person is forcefully separated from his or her family member or close friends by death or other reasons.…”