Grief, posttraumatic stress, and depression following MH17 plane disaster:A four-wave longitudinal study

Background Knowledge on the course of persistent complex bereavement disorder (PCBD), posttraumatic stress disorder (PTSD), and depression among disaster-bereaved people enhances our understanding of the aetiology and treatment of traumatic grief.Objective To identify (predictors of) trajectories of PCBD, PTSD, and depression in disaster-bereaved people (study 1) and to examine temporal associations between PCBD, PTSD, and depression symptoms (study 2).MethodIn study 1, distress-trajectories were identified using latent class growth modelling. People (N = 172) whose significant other died due to MH17 disaster completed PCBD, PTSD, and depression questionnaires 11, 22, 31, and 42 months after the disaster. Predictors of trajectories were examined with logistic regression. In study 2, the same data were used to examine temporal associations between symptoms, using cross-lagged analysis.ResultsIn study 1, a Mild (81.8%) and Chronic (18.2%) PCBD class emerged. For PTSD and depression we found a Mild (85.2% and 85.6%), Recovered (4.4% and 8.2%), and Chronic trajectory (10.3% and 6.2%). A lower educational level predicted chronic trajectories. In study 2, changes in PCBD symptoms had a greater impact on changes in PTSD and depression symptoms than vice versa.ConclusionsIn Study 1 we found support for differential trajectories and predictors across the outcomes, suggesting that different symptom-profiles post-loss may need different treatment approaches. Study 2’s findings run counter to the notion that PTSD and depression symptoms should be addressed before grief in treatment. We suggest that early screening and treatment of elevated grief is pivotal in preventing long-lasting distress