People who experience PTSD after surviving a traumatic event that claimed the life of a loved one may be more likely to suffer from a sense of persistent sadness and an inability to cope years later, according to a new study.
While the sensation of sorrow that follows loss typically fades with time, research, published in the journal Psychological Trauma: Theory, Research, Practice and Policy, found the symptoms of this more complicated grief can intensify over time and even prevent survivors from leading normal lives.
“Grief is a normal response to the loss of someone close, but traumatic losses may severely harm survivors for years,” said Kristin Alve Glad, lead author of the study and a researcher at the Norwegian Centre for Violence and Traumatic Stress Studies.
“Our findings suggest that when treating trauma survivors, targeting symptoms of PTSD early might help them avoid complicated grief later on. Complicated grief has been defined as a persistent, intense yearning, longing and sadness, usually accompanied by insistent thoughts or images of the deceased and a sense of disbelief or an inability to accept the painful reality of the person’s death.”
The study focused on survivors from the 2011 terror attack that killed a total of 77 people in Oslo, Norway, and on the nearby island of Utøya. The combined bombing and shooting spree was the deadliest attack in the country since the Second World War. Of the 275 people interviewed by researchers, 256 lost a close friend, six lost a family member and 13 lost a close friend and family member/partner.
The face-to-face interviews were conducted by experienced healthcare professionals on three separate occasions following the attack: five months later, 15 months later and 30 months later. Participants were asked questions about symptoms of post-traumatic stress syndrome and others intended to reveal feelings of complicated grief, such as those related to difficulty accepting the loss, managing intense grief and coping with thoughts surrounding death.
They found that people who reported symptoms of PTSD were significantly more likely to also relay feelings of complicated grief, with those who still felt the effects of PTSD one year after the attack struggling with the most intense symptoms of this form of grief.
“The fact that we found that PTSD symptoms predicted complicated grief reactions at a subsequent time point, but complicated grief did not predict the development of PTSD, is interesting because it suggests that targeting PTSD symptoms may hinder later development of complicated grief,” Glad said. “This may have important implications for clinicians working with bereaved trauma survivors.”
The terrorist attack took a particularly heavy toll on survivors because — in addition to losing loved ones — they were a part of the traumatic event, researchers said. The “dual burden” of unexpected loss combined with high exposure to the event itself may steer PTSD symptoms toward complicated grief in a manner not seen in people who were removed from the violence.
The team hopes this better understanding of the relationship between PTSD and complicated grief will be used to help develop targeted therapies for survivors who lost loved ones to unexpected trauma.
Dave Yasvinski is a writer with Healthing.ca