Background: High levels of both prolonged grief symptoms (PGS) and posttraumatic stress symptoms (PTSS) are relatively common following bereavement, and the two types of bereavement complications share some of the same features. Little research has studied which of the two precedes the other following the death of a loved one. The purpose of this study was to examine the temporal relationship between change in high levels of PGS and PTSS during the first four years following old age spousal loss. Methods: Participants were 237 Danes (40% male; mean age = 73 years, SD = 4.4; range 65-81) who during the year of 2006 lost their spouse. Participants completed self-report questionnaires at six months (n = 237), 13 months (n = 198), 18 months (n = 192), and 48 months (n = 213) post-loss. Main outcome measures were Inventory of Complicated Grief–Revised and the Harvard Trauma Questionnaire. Results: Lower-level mediation analyses wereas performed. Results indicated that PGS mediated 83% of the relationship between time and PTSS, while PTSS only mediated 17% of the relationship between time and PGS. These results suggest that changes in PGS mediated changes in PTSS following spousal bereavement to a greater extent than vice versa. Conclusions: The findings in the present study indicate that changes in PGS may precede and potentially directly impact changes in PTSS following bereavement. This tentative conclusion points to the potential value of targeting PGS in psychological interventions at an early point in the long term perspective following old age spousal bereavement.
Depression and Anxiety (hoboken), 2015, Vol 32, Issue 5, p. 335-340