The Loss Of A Fellow Service Member: Complicated Grief In Post-9/11 Service Members and Veterans With Combat-Related Posttraumatic Stress Disorder

Bereavement is a potent and highly prevalent stressor among service members and veterans.
However, the psychological consequences of bereavement, including complicated grief (CG), have
been minimally examined. Loss was assessed in 204 post-9/11, when service members and veterans
with combat-related posttraumatic stress disorder (PTSD) took part in a multicenter treatment
study. Those who reported the loss of an important person completed the inventory of complicated
grief (ICG; n5160). Over three quarters (79.41%) of the sample reported an important
lifetime loss, with close to half (47.06%) reporting the loss of a fellow service member (FSM). The
prevalence of CG was 24.75% overall, and nearly one third (31.25%) among the bereaved. CG was
more prevalent among veterans who lost a fellow service member (FSM) (41.05%, n539) compared
to those bereaved who did not (16.92%, n511; OR53.41, 95% CI: 1.59, 7.36). CG was
associated with significantly greater PTSD severity, functional impairment, trauma-related guilt,
and lifetime suicide attempts. Complicated grief was prevalent and associated with adverse psychosocial
outcomes in veterans and service members with combat-related PTSD. Clinicians
working with this population should inquire about bereavement, including loss of a FSM, and
screen for CG. Additional research examining CG in this population is needed.