The interlink between bereavement guilt and prolonged grief disorder: A cross-lagged panel network analysis

Bereavement guilt is closely linked to prolonged grief disorder (PGD), yet the symptom-level dynamics underlying this association remain unclear. Bereaved Chinese adults completed the Bereavement Guilt Scale and Inventory of Complicated Grief in a cross-sectional survey (N = 1,340) and a longitudinal follow-up (N = 194). Cross-sectional network analysis examined symptom associations, and cross-lagged panel network analysis tested potential causal relationships. Global connectivity remained stable across two time points; BGS11 (Guilt-related pain) and ICG13 (Feeling life is meaningless) consistently displayed the highest centrality. Cross-lagged analysis further revealed that ICG4 (Yearning for the deceased) had the highest out-expected influence, while BGS11 (Guilt-related pain) had the highest in-expected influence. BGS2 (Guilt over happiness after death) demonstrated the highest bridge expected influence, indicating survivor-guilt symptoms are key connectors between guilt and PGD. This study highlights yearning and survivor guilt as central intervention targets to facilitate adaptive adjustment.