The co-occurrence of symptoms of prolonged grief and dissociation: Could there be a dissociative prolonged grief disorder subtype?

Abstract

Background The co-occurrence of symptoms of prolonged grief (PG) and dissociation is largely unexplored. Studying heterogeneity in patterns of PG and dissociative symptoms is important to inform theorizing about, and treatment of, post-loss psychopathology. The present research aimed to examine if, among bereaved people, subgroups could be distinguished in terms of the endorsement of PG and dissociative phenomena. Method We performed three studies. In Study 1 (N = 476) and Study 2 (N = 141), we examined the co-occurrence of PG and peri‑loss dissociation (experienced shortly after the death) in relatively recently (≤6 months) bereaved people. In Study 3 (N = 258), we examined PG and trait-like dissociation among more remotely bereaved people. Latent profile analysis was used to identify subgroups. Our aims were to identify profiles of PG and dissociation and to examine associations of emerging profiles with loss-related emotional distress, and with socio-demographic and loss-related characteristics. Results In Study 1 and 3, profiles were identified characterized by low, average, and high PG and dissociation. In Study 2, profiles emerged characterized by low PG and low dissociation, average PG and low dissociation, and high PG and high dissociation. Across studies, people in the most pervasive PG and dissociation profiles reported the most severe concurrent (Studies 1, 2, and 3) and prospective (Studies 1 and 2) emotional distress. People confronted with losses of partners or children and with unexpected deaths were more likely to evidence pervasive PG and dissociation. Conclusion PG and dissociation appear to increase and decrease in parallel. No evidence was found that subgroups existed with severe PG and no dissociation vs. severe PG and high dissociation. This runs counter to the existence of a possible “dissociative prolonged grief disorder subtype.” Nonetheless, dissociation may be a target of treatment for more severely distressed mourners.