The grieving process is typically expected to resolve within six months after bereavement, allowing the bereaved individual to regain functional adaptation. However, some people experience prolonged psychological difficulties, including Prolonged Grief Disorder (PGD), Depression, and Post-Traumatic Stress Disorder (PTSD), which may co-occur following loss. The present study aimed to identify distinct symptom trajectories across these conditions and to examine risk factors predicting class membership.
Participants were 1,060 bereaved adults aged 18 and above who had lost a loved one. Symptom clusters were identified through Latent Class Analysis (LCA), while risk factors for class membership were examined using Multinomial Logistic Regression. Predictor variables included socio-demographic characteristics, loss-related factors, relational processes, and meaning-related measures.
Results revealed a four-class solution: a resilient group, a high-symptom comorbid group, a PGD-dominant group, and a depression-dominant group. Systematic predictors of resilience included being male, higher perceived social support, fewer unfulfilled wishes and unresolved conflicts (unfinished business), and lower attachment anxiety. In contrast, high-symptom membership was predicted by elevated unfinished business and impaired meaning reconstruction. Prolonged grief was specifically associated with attachment anxiety, while depression was predicted solely by inadequate meaning reconstruction. Additional predictors such as time since loss, kinship (spousal or child loss), age of the deceased, and longer caregiving duration were also linked to adverse trajectories.
These findings highlight the multifaceted nature of bereavement risk, emphasizing the critical role of relational vulnerabilities (attachment anxiety, unfinished business, continuing bonds), contextual stressors (unexpected or close kin losses, caregiving strain), and protective factors (social support, meaning-making). Recognizing these predictors provides a framework for developing targeted, dimensional interventions that address the unique needs of bereaved individuals and mitigate the risk of persistent psychopathology.