The heterogeneity of long-term grief reactions.

BACKGROUND: Individuals experience the loss of a spouse in varied ways. There is growing recognition of major depressive disorder and complicated grief as distinct post-bereavement disorders. However, most studies focusing on these different courses of functioning have not examined pre-loss functioning. METHODS: We used data from a prospective population based study to examine depression and grief among conjugally bereaved older adults. We compared latent trajectories of grief and depression symptoms based on data from pre-loss and 6, 18, and 48 months post-loss, and examined a number of pre- and post-loss predictor variables. RESULTS: The chronic grief and chronic depression trajectories did not differ in grief symptoms at any post-loss time point. However, a number of pre- and post-loss variables uniquely differentiated these two distinct trajectories. LIMITATIONS: Measures used in the current study were based on self-report and compared only two trajectories. Additionally, the sample was restricted to older adults (M age=72) and thus our findings may not generalize to younger populations. CONCLUSIONS: These two distinct trajectories--chronic grief and chronic depression--may appear similar when examining grief symptoms alone, though it is apparent that they have different long-term courses of functioning. It is important to understand pre-loss functioning as well as variables associated with each group in order to appropriately target treatment.