Pathological Grief: The Role of Cause and Unexpectedness of Death

Abstract

Background. A minority of those bereaved develops a set of dysfunctional grief symptoms, referred to as Pathological Grief (PG). Two constructs, cause of death (natural versus unnatural) and perceived unexpectedness of death, have been suggested to predict PG. However, no earlier studies used clinical interviews in the assessment of PG. The aim of the current study was to investigate the association between cause and perceived unexpectedness of death with PG symptoms using clinical interviews, while controlling for background characteristics (gender, educational level, time since loss and relationship to deceased). Methods. Participants (N = 248) were interviewed by telephone. PG was assessed via the Traumatic Grief Inventory – Clinician Administered (TGI-CA). Two hierarchical regression analyses were conducted. Results. Background characteristics explained 24.8% of the variance in TGI-CA scores (p < .001), cause of death explained an additional 3.8% (p < .001) in one analysis and perceived unexpectedness of death an additional 2.3% (p < .01) in the other. Two post-hoc hierarchical regression analyses showed 1) cause of death explained 2.7% (p = .003) of the variance in TGI-CA scores over and above background characteristics and perceived unexpectedness, and 2) perceived unexpectedness explained 1.2% (p = .048) of the variance in TGI-CA scores over and above background characteristics and cause of death. Discussion. Findings provide support for both cause and perceived unexpectedness of death as correlates of PG. Furthermore, cause of death and perceived unexpectedness are found to both explain unique variances in PG symptoms, independent of one another.