Complicated Grief in the Aftermath of Homicide: Spiritual Crisis and Distress in an African American Sample

Abstract

Both grieving the loss of a loved one and using spirituality or religion as an aid in doing so are common behaviors in the wake of death. This longitudinal examination of 46 African American homicide survivors follows up on our earlier study that established the relation between positive and negative religious coping on the one hand and complicated grief (CG) on the other. In the current report, we broadened this focus to determine the relation between religious coping and other bereavement outcomes, including posttraumatic stress disorder (PTSD) and depression, to establish whether religious coping more strongly predicted bereavement distress or vice versa. We also sought to determine if the predictive power of CG in terms of religious coping over time exceeded that of PTSD and depression. Our results suggested a link between negative religious coping (NRC) and all forms of bereavement distress, whereas no such link was found between positive religious coping (PRC) and bereavement outcomes in our final analyses. Significantly, only CG prospectively predicted high levels of spiritual struggle six months later. Clinical implications regarding spiritually sensitive interventions are noted.

Spiritual Distress in Bereavement: Evolution of a Research Program

“…Still, this explanation alone is insufficient, as CSG scores in our sample were equally skewed, and yet were robust in their association with difficulty making meaning of the loss. Notably, our results are congruent with our previous findings [26], where we observed that CSG but not PRC was associated with CG; and, similarly, that PRC was not associated with PTSD or depression [62].…”

“…Consistent with previous studies [26,62,65], we found that two forms of spiritual responses, PRC and CSG-one characteristically considered positive and one negative-related quite differently to bereavement outcome. On the one hand, in this study, use of religion as a positive resource in coping proved unrelated to adjustment to loss, whereas maladaptive religious coping was consistently related to elevated grief, replicating our previous findings [26] with a sample of homicide survivors.…”

“…Consistent with previous studies linking CSG with CG [26,62,70] our findings revealed that bereaved individuals in our sample who scored highly on general measures of spiritual struggle and who were highly distressed over the loss of their loved one likewise scored high on the ICSG. Interesting patterns also emerged from analyses of both samples in terms of associations between ICSG subscales and other measures used to test convergent validity.…”

“…Rather, specialized psychotherapy interventions targeting CSG symptoms are likely necessary for some grievers, especially for spiritually inclined survivors of violent death. [62] Logically, our next step was to conduct a follow-up study with the same sample of homicidally bereaved African American adults, examining the relation between psychological distress (in the form of CG, PTSD, and depression) and positive-and negative religious coping to establish if psychological distress more strongly predicted religious coping or vice versa in the same sample (46 African American homicide survivors). Although CG is a distinct and highly concerning form of bereavement outcome, we also recognized that PTSD and depression are worthy of attention in the context of homicide loss.…”

The Inventory of Complicated Spiritual Grief: Assessing Spiritual Crisis Following Loss

“…In the context of bereavement, prolonged and debilitating spiritual distress of this sort, which includes the collapse or erosion of the griever's sense of relationship to God and/or their faith community, has been termed complicated spiritual grief (CSG) [8,9] and has shown an empirically consistent association with CG [7,[10][11][12][13].…”