The relationship between guilt, depression, prolonged grief, and posttraumatic stress symptoms after suicide bereavement

Abstract

Objective: A profound feeling of guilt and its role in complicating psychological reactions are accepted as central issues in suicide bereavement. However, research examining the relationship of guilt with mental disorders commonly following suicide bereavement is still lacking.This study aimed to examine the association between guilt and symptoms of depression, prolonged grief disorder, and posttraumatic stress disorder (PTSD) after suicide bereavement, as well as its moderating role in the association between the time which elapsed since bereavement and psychopathological symptoms.Methods: 154 self-selected adult German participants bereaved by suicide completed online questionnaires assessing sociodemographics, characteristics related to the loss, guilt, depression, prolonged grief, and PTSD.Results: Significant positive correlations were found between guilt and all assessed psychopathological symptoms.Further, guilt was a significant correlate with symptoms of depression, prolonged grief, PTSD over and above sociodemographic factors, and time that elapsed since the loss. Guilt furthermore moderated the link between the timeThis is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

Prolonged Grief Symptoms among Suicide-Loss Survivors: The Contribution of Intrapersonal and Interpersonal Characteristics

“…Our results indicated that guilt and depression are critical contributors to the level of PGS beyond sociodemographic and loss-related factors. These findings align with several studies that have highlighted the importance of guilt as a significant predictor of the development or progression of psychopathological symptoms in grief following suicide loss [ 19 , 30 ] and grief in general [ 53 , 54 , 55 ]. Other studies have suggested that feelings of guilt are longer lasting and more intense in suicide grief than in other forms of grief [ 56 , 57 ].…”

“…Thus, our results suggest that the SLSs’ devastating feelings of lack of belonging, isolation, being a burden to their surroundings, and difficulty disclosing intimate feelings and thoughts may contribute to PGS. This finding aligns with several cross-sectional and longitudinal studies that highlight the critical role of these variables in maladaptive grief response [ 22 , 30 , 58 , 59 ].…”

“…As a result, many SLSs are disinclined to share their thoughts and feelings with others [ 28 , 29 ]. This aversion to sharing can undermine the foundation of SLSs’ interpersonal relationships [ 18 ], promote loneliness and withdrawal, and exacerbate adverse psychological outcomes such as depression, anxiety [ 1 ], and hopelessness [ 30 ]. Recently, Feigelman and Cerel [ 25 ] showed that feelings of blameworthiness (a factor closely related to guilt) are associated with grief difficulties among bereaved parents of children who died by suicide.…”

Conflicted or close: Which relationships to the deceased are associated with loss‐related psychopathology?

“…There is a need to look for additional mediators of the relationships between closeness and/or conflict with the deceased and poor adjustment to loss. In the future, it should be tested whether the relationship between past conflict and depression and prolonged grief symptoms can be also mediated for example by ‘unfinished businesses’ (Holland et al., 2020; Klingspon et al., 2015), the deceased‐related self‐blame and guilt (see Glickman et al., 2017; Wagner et al., 2021), and/or suppression of anger (see Meyrueix et al., 2015; Sahu et al., 2014). Regarding the mediating role of CB in the relationship between pre‐loss closeness and post‐loss pathological symptoms, it seems that these indirect relationships could be moderated by other variables, for example, loss‐centrality, self‐clarity (see Boelen, 2017), or pre‐loss attachment to the deceased (see Smigelsky et al., 2020).…”

Prolonged grief disorder in Arabic-speaking treatment-seeking populations: Relationship with socio-demographic aspects, loss- and trauma-related characteristics, and mental health support

“…Even though 40% of the variance in the present study was already explained by the examined associated factors, it is crucial to ascertain whether there may be additional influences, for example feelings of guilt (44) or unresolved conflicts (45).…”