Prospective Risk Factors for Intense Grief in Family Members of Veterans Who Died of Terminal Illness

Many bereavement researchers focus on predicting and preventing complicated grief, a psychologically crippling, sometimes life-threatening response to loss that persists for lengthy periods, often with serious health consequences. Reviews of studies have identified specific risk factors (e.g., low social support, insecure attachment style) that predict high levels of complicated grief symptomatology. However, studies rarely investigate multiple risk factors in combination, and still more rarely trace factors observable during the end-of-life period and their predictive power for identifying intense grief in family members following the death. We therefore investigated several pre-loss risk factors for post-loss bereavement distress in 35 family members of Veterans who died of a terminal illness after receiving palliative care. Results revealed that being female, Caucasian, losing a spouse, and experiencing high anticipatory grief prior to the death, all predicted high levels of grief 6 to 10 weeks following the death. Moreover, psychosocial factors such as being highly dependent upon the Veteran, displaying high neuroticism, reporting low levels of social support, and being unable to make sense of the prognosis or death predicted more intense post-loss grief reactions