The Associations of Complicated Grief, Depression, Posttraumatic Grief and Hope Among Bereaved Youth

Background and purpose: Research on the association of complicated grief (CG) and hope and posttraumatic grief growth (PTG) among bereaved youth is limited.  The aims of this study are to examine 1) differences and associations between CG and depression, PTG and hope between demographics (age and gender), type of death, relationship to the deceased and time since death; 2) associations between CG and depression, PTG and hope; and 3) CG and hope as predictors of depression and PTG as well as the moderating role of hope.  

Methods: Assessments were conducted at ten schools in Texas. Teachers and counselor identified youth  who were known to have someone close die. Measures of CG, depression, hope and PTG were completed by 85 youth (7-18).

Results: Gender, age, type of death, relationship to the deceased, and time since death were not significantly associated with CG, depression (mood and feeling questionnaire short version MFQS), PTG or hope. There was a strong correlation between CG and depression and there was an inverse relationship between hope and depressive symptoms, and a moderate positive relationship between hope and PTG.  Predictors of depression on MFQS . Hierarchical regression model containing CG and hope was significant, F(2,82) = 44.33, p < .001, and explained 52% of the variance in depressive symptoms. Higher levels of CG and lower levels of hope independently predicted greater depressive symptoms (β = .66, p < .001 and β = -.27, p = .001 respectively). There was no evidence of moderation, given that a model that included the interaction between CG and hope did not significantly improve the amount of variance explained (ΔR² = .01, p = .353). Predictors of posttraumatic growth. The regression model containing CG and hope was significant, F(2,82) = 6.94, p = .002, and explained 14.5% of the variance in posttraumatic growth. Increased levels of hope predicted higher levels of PTG (β = .38, p < .001). Complicated grief symptoms did not predict PTG (β = .08, p = .437). There was no evidence that hope moderated the effect between CG and PTG (β = .19, p = .073), and adding this interaction to the model did not significantly improve the prediction of PTG (ΔR² = .03, p= .073).  

Conclusion and implications: While there are several limitations of the current study, the strong association between CG and depression suggest that when working with bereaved youth, both CG and depression should be assessed. Since CG and hope were independent predictors of depression, the role of CG and hope in contributing to and/or maintaining depressive symptoms in youth needs to be assessed as well. To our knowledge, there has not been an investigation of CG and PTG among youth. A better understanding of PTG in relation to CG is important to understanding the process of meaning and adjustment after bereavement and additional research is warranted.