A Network Approach to Understanding Quality of Life Impairments in Prolonged Grief Disorder

Prolonged grief (PGD) is a potentially debilitating consequence of bereavement that is experienced by 7%-10% of bereaved individuals. In recent years, PGD has been the focus of increasing interest as it is associated with a range of significant negative physical and mental health outcomes. To date, however, there is little understanding of how impairment is associated with individual PGD symptom interactions. Network analysis is an innovative statistical approach that has been productively applied to examine how symptoms of psychopathology influence and reinforce each other. In this study, we examined the association between PGD symptoms and quality of life (QoL) impairments. Data from 215 bereaved individuals were used to construct networks comprising PGD symptoms and different facets of QoL. The results showed that PGD symptoms of meaninglessness and role confusion were linked with reduced psychological QoL, trust difficulties were linked with reduced social QoL, and bitterness was linked with reduced environmental QoL. These results are consistent with models that highlight the importance of self-identity and loss of meaning in PGD. By elucidating pathways of dysfunction, these findings offer clinical implications that may help to improve outcomes for persons with PGD.