Grief, posttraumatic stress, and depression following MH17 plane disaster: A four-wave longitudinal study

Background: Knowledge on the course of persistent complex bereavement disorder (PCBD), posttraumatic stress disorder (PTSD) and depression among
disaster-bereaved people enhances our understanding of the aetiology and treatment of traumatic grief.

Objective: To identify trajectories of PCBD, PTSD and depression in disaster-bereaved people (study 1) and to examine temporal associations between PCBD,
PTSD and depression symptoms (study 2).

Method:
People (N = 172) whose significant other(s) died in MH17 flight completed PCBD, PTSD and depression questionnaires 11, 22, 31 and 42 months post-loss. In
study 1, distress-trajectories were identified using latent class growth modelling. In study 2, the same data were used to examine temporal associations between symptoms, using cross-lagged analysis.

Results: In study 1, a Mild (81.8%) and Chronic (18.2%) PCBD class emerged. For PTSD and depression we found a Mild (85.2 and 85.6%), Recovered (4.4 and 8.2%) and Chronic trajectory (10.3 and 6.2%). In study 2, changes in PCBD symptoms had a greater impact on changes in PTSD and depression symptoms than vice versa.

Conclusions:
Findings from study 1 indicate that different symptom-profiles post-loss may need different treatment. Study 2’s findings run counter to the notion that
PTSD and depression symptoms should be treated before grief. We suggest that early screening and treatment of elevated grief is pivotal in preventing
long-lasting distress.