Publication year
2018
Citation Title
Complicated grief among military service members and veterans who served after September 11, 2001.
Journal Name
Journal of Traumatic Stress
Journal Volume
31
Issue Number
1
Page Numbers
157-162
DOI
10.1002/jts.22254
Summary
Service members and Veterans are at risk for complicated grief (i.e., having intense grief symptoms such as nonacceptance of the death and preoccupation about the deceased). This study had 468 mental health treatment-seeking Service members and Veterans complete questionnaires regarding their complicated grief symptoms, mental health symptoms, and quality of life. Results indicated that the prevalence of complicated grief was high among participants and that complicated grief was associated with a number of mental health symptoms.
Key Findings
Approximately one third (30%) of participants met diagnostic criteria of complicated grief.
The presence of complicated grief was associated with symptoms of posttraumatic stress disorder (PTSD), depression, anxiety, and stress.
Participants who met diagnostic criteria of complicated grief were less likely to have high quality of life compared to participants who did not have complicated grief.
Implications for Program Leaders
Offer support groups for Service members and military spouses who are in complicated grief
Disseminate information regarding available resources on military bases for Service members who lost a family member or close friend
Educate military families on useful methods to cope with grief
Implications for Policy Makers
Raise awareness regarding the negative effects of complicated grief on Service members' mental health and quality of life
Recommend regular screening of complicated grief among Service members who are in bereavement
Support the development of programs that treat complicated grief in Service members
Methods
Participants were recruited from a mental health clinic, and had to be a Service member or a Veteran to be eligible for the study.
Participants completed questionnaires regarding their complicated grief symptoms, PTSD, depression, anxiety, stress symptoms, and quality of life.
Data were analyzed to examine the rate of complicated grief among participants as well as characteristics that are associated with complicated grief.
Participants
Participants were 468 Service members or Veterans; the average age of the participants was 33.98 years (SD = 8.69) and the majority of them were male (91%).
The race/ethnicity of the participants was not reported.
The military branches of the participants were Army (35%), Marine Corps (21%), National Guard (21%), and other (23%).
Limitations
All participants were seeking treatment at a mental health clinic; therefore, they may show more symptoms than the general population and these findings may not generalize to non-clinical populations.
Only self-report data were used in the study, so the findings may be subject to memory bias and social desirability bias.
The cross-sectional design of the study made it impossible to examine the causal relationship between complicated grief and mental health symptoms.
Avenues for Future Research
Recruit participants of different mental health status and from various race/ethnicity backgrounds so that the study can be better generalized
Use both subjective and objective data to increase the reliability of the study
Conduct longitudinal studies to examine the causal relationship between complicated grief and mental health symptoms
Focus
Multiple Branches
Target Population
Population Focus
Military Component
Abstract
Minimal research is available on the prevalence and impact of complicated grief (CG) in military service members and veterans, despite high reported rates of loss in this population. The present study aimed to examine prevalence rates of CG in a sample of treatment-seeking military service and members and veterans who served after September 11, 2001. Additionally, the study aimed to examine characteristics associated with CG as well as the association between CG and quality of life. In a sample of 622 military service members and veterans who served after September 11, 2001, 502 reported a significant loss (80.7%). Usable data were available for a total of 468 participants. Of these 468 participants, 30.3% (n = 142) met diagnostic criteria for CG, as defined by a score of 30 or more on the Inventory of Complicated Grief (ICG; Prigerson et al., 1995). We conducted a series of t tests and chi-square tests to examine the differences between individuals who met criteria for CG and those who did not. The presence of CG was associated with worse PTSD, d = 0.68, p < .001; depression, d = -1.10, p < .001; anxiety, d = -1.02, p < .001; stress, d = 0.99, p < .001; and quality of life, d = 0.76, p < .001. Multiple regression analyses examined the independent impact of CG on quality of life. Complicated grief was associated with poorer quality of life above and beyond PTSD, β = -.12, p = .017. In addition, in a separate regression, CG was associated with poorer quality of life above and beyond depression, β = -.13, p < .001. Overall, our findings highlight the impact of CG on this population, and have implications for assessment and treatment.
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