Profiles of fluctuating prolonged grief disorder reactions using experience sampling data

BACKGROUND: The death of a significant other can lead to prolonged grief disorder (PGD), characterized by intense grief reactions interfering with daily life. This study aims to identify latent profiles, and predictors thereof, of severity and fluctuation indices in PGD using experience sampling methodology (ESM) data from a novel Findable, Accessible, Interoperable, and Reusable (FAIR) data-archive.

METHODS: Bereaved adults (N = 228) completed PGD items five times per day for two weeks using ESM. Latent profile analyses were run to identify profiles of fluctuating PGD reactions using four person-specific indicators derived from ESM-PGD items: mean, standard deviation, autocorrelation indicating inertia, and the root mean square of successive differences indicating instability. Background, loss-related characteristics, and psychopathology levels assessed before the ESM period were explored as potential predictors of profile membership.

RESULTS: Five distinct profiles were identified: moderate PGD/low inertia/moderate fluctuation (46 %), moderate PGD/low inertia/high fluctuation (20 %), low PGD/low inertia/low fluctuation (19 %), high PGD/low inertia/low fluctuation (8 %), and low PGD/high inertia/low fluctuation (7 %). The most consistent differentiating predictors of profiles were gender, time since loss, and baseline psychopathology levels.

CONCLUSIONS: We found that at comparable levels of PGD severity, different fluctuation profiles exist in daily life of bereaved people suggesting that ESM may be an important tool for understanding the dynamic nature of PGD. Identifying these profiles enhances our understanding of individual differences in response to loss and could help to personalize bereavement care.