Trajectories of grief following bereavement: a systematic review

Following bereavement, a minority experiences severe, persistent, and disabling grief, termed prolonged grief disorder (PGD). Establishing individual differences in how grief develops over time can guide clinical decision-making, yet has only recently received empirical scrutiny. The present review synthesizes results from grief trajectory studies.

Systematic review (PROSPERO registration number: CRD42024601883).

We included peer-reviewed, longitudinal, quantitative studies that identify grief trajectories in bereaved adults. Searches of Web of Science, PsycINFO, and PubMed (October 18, 2024) identified 272 potentially relevant papers. Thirteen articles, reporting on 12 studies and 14 trajectory analyses, were selected.

Latent growth mixture modeling (and similar approaches) identified two to five trajectories. On average, chronic grief was identified in 10% of participants (in 13 analyses), recovery in 33% of participants (in 12 analyses), and resilience in 55% of participants (in 13 analyses). Most consistent correlates of more severe grief trajectories were younger age, lower education levels, and the death of a child/partner.

Recovery appears more common and resilience less common after bereavement than after other stressful life-events. There is limited evidence for a delayed grief trajectory. Younger adults with lower education levels who lost a child/partner appear at risk for chronic grief.