Different Trajectories of Prolonged Grief in Bereaved Family Members After Terror

Introduction: The loss of a loved one in a terror incident is associated with elevated risk for mental health disorders such as prolonged grief disorder (PGD) and posttraumatic stress disorder (PTSD), but the long- term adaptation after such losses are not well understood. This study aims to explore the trajectories of PGD among parents and siblings (n = 129) after the 2011 terror attack on Utøya Island, Norway. Methods: The 19-item Inventory of Complicated grief (ICG) was used to measure PGD at 18, 28, and 40 months post-loss. Latent class growth analysis (LCGA) was used to identify trajectories of grief and a multinomial regression analysis was conducted to examine predictors of class membership. Results: The analysis identified three grief trajectories; moderate/decreasing class (23%), high/slow decreasing class (64%), and a high/chronic class (13%). Predictors of high/slow recovery or chronic grief was female gender, previous depressive symptoms, and intrusion and avoidance symptoms. Conclusion: The findings highlights the difficult grief process and slow recovery that characterizes the majority of close family members bereaved by a terror-incident. Community mental health programs should strive for both early outreach and long-term follow-up after such incidents.