Prolonged grief symptomatology following violent loss: the mediating role of meaning

Abstract

Background: Prolonged Grief Disorder (PGD) is over-represented among those who have lost loved ones to violent causes. To tailor PGD interventions for this vulnerable population it is critical to examine the aetiology of PGD specifically in the context of violent death bereavement. Previous studies have suggested that violent loss increases symptoms of PGD by hindering the mourner’s ability to make meaning of the death or its aftermath. However, these studies have relied on cross sectional data that preclude genuine prediction and have not differentiated among specific themes of meaning. Objective: This study aimed to identify specific themes of meaning that mediate the detrimental impact of violent loss on subsequent emergence of PGD symptomatology among the violently bereft. Method: A longitudinal, prospective design (N = 171) was used to assess violent loss and themes of meaning an average of six months post-loss allowing for prediction of PGD symptoms an average of eight months later. Results: Violent loss had a significant indirect effect on PGD symptomatology when meaning themes focusing on sense of peace and continuing bonds served as mediators. Conclusions: This study demonstrates the mediating role that specific meaning themes play in the development of PGD symptomatology following violent loss. These findings highlight the potential benefits of applying a meaning-based intervention approach with the violently bereft.

Traumatic loss: Mental health consequences and implications for treatment and prevention

“…Milman et al ( 2018 ) examined whether violent loss increases symptoms of PGD by hindering the bereaved person’s ability to make meaning of the death. In a prospective, longitudinal sample of 171 violently bereft persons, sense of peace and continuing bonds served as mediators.…”

Rumination moderates the role of meaning in the development of prolonged grief symptomatology

“…Building on previous research that demonstrated the mediating role of meaning‐making in the etiology of PGD (Currier, Holland, & Neimeyer, ; Milman et al, ; Rozalski et al, ), the present study is the first to provide evidence indicating that rumination moderates this mediating pathway. Among participants who reported higher levels of rumination, the degree of meaning made early in grief predicted symptoms of PGD more strongly 7–10 months later.…”

“…Previous research has made a compelling case for the central role of meaning in the etiology of PGD symptomatology, suggesting that risk factors increase symptoms of PGD by hindering meaning making such that the bereft are unable to “make sense” of the death or its aftermath in their ongoing lives (Currier, Holland, Coleman, & Neimeyer, ; Lichtenthal, Neimeyer, Currier, Roberts, & Jordan, ; Milman et al, ; Rozalski, Holland, & Neimeyer, ). Such research provides an empirical basis for facilitating meaning making among at‐risk grievers as a clinical approach for effectively intervening in the development of PGD.…”

“…The first manuscript, currently under review, establishes meaning made as a mediator of PGD symptomatology. The second manuscript (Milman et al, ), examines which specific themes of meaning mediate the relationship between violent loss and PGD symptomatology. Finally, the current manuscript describes a detrimental relationship between rumination and meaning‐making following bereavement.…”

A qualitative analysis of psychosocial needs and support impacts in families affected by young sudden cardiac death: The role of community and peer support

“… 22 An expansive understanding of what sense-making entails links with research on the significance of meaning as a mediator for complicated or prolonged grief. 23 This may partially answer concerns expressed by Christiaans, 24 who drew attention to the lack of understanding of the cause of death in surviving relatives even in the face of an established cause, which undermined uptake of genetic counselling by some family members. For family members in our study, meaning-making included understanding the impact of the death on their sense of self and their place in the world.…”