The disappearance of a significant other: Consequences and care

This dissertation provides insights in consequences of, and psychological care after the disappearance of a significant other. In contrast with previous research on this topic, we focused on disappearances outside the context of armed conflict. A survey-study among 137 Dutch and Belgian people showed that 58% passed clinically relevant thresholds for prolonged grief disorder, posttraumatic stress disorder, and/or depression, on average 15 years post-disappearance. In contrast with an assumption that the disappearance of a significant other is the most traumatic loss, a comparative study showed that prolonged grief and posttraumatic stress levels were significantly higher in homicidally bereaved individuals than in relatives of long-term missing persons. Findings from three correlational survey-studies indicated that, similar to bereaved individuals, relatives of missing persons who experience more negative cognitions, and engage in more avoidance behaviors and ruminative thinking are more likely to experience elevated distress. Our findings also suggested that enhancing positive affect and being more self-compassionate are potential protective factors for experiencing distress post-disappearance. An interview-study among 23 people indicated that, according to relatives with little to no symptoms looking back on responses to the disappearance, learning to tolerate uncertainty is of utmost importance. These findings offer tentative support for our efforts to develop and evaluate the feasibility and potential effectiveness of cognitive behavioural therapy with elements of mindfulness (CBT+M) for relatives of missing persons with elevated distress-levels. Based on a pilot study among 17 people we concluded that CBT+M yields promising effects and that more research on this approach is justified.