Latent classes of acute grief reactions in the shadow of collective trauma and its predictors in bereaved adults

The current study explored grief reaction profiles after the October 7th, 2023, Israeli massacre regarding the loss of significant others. It investigated factors worsening pre-existing grief in 2,028 adult civilians, with 1,263 reporting pre- or post-massacre loss. Participants completed self-reports on prolonged grief disorder (PGD), post-traumatic stress disorder (PTSD), complex PTSD (CPTSD), cognitive emotional regulation (CER), and assumptive worldviews. Latent class analysis identified four classes of probable PGD among those with lifetime loss: "high PGD-both core and emotional pain" (35.9 %); "Medium PGD-emotional pain" (6.9 %); "medium to high PGD-high core, medium emotional pain" (23 %); and "low PGD-both core and emotional pain" (34.5 %). The subsample analysis of individuals experiencing lifetime loss with concurrent October 7th loss indicated three classes of probable PGD: "high PGD symptoms" (47.9 %), "high to medium PGD-high core with medium emotional pain symptoms" (15.9 %), and "low PGD symptoms" (36.2 %). The subsample analysis of those who experienced concurrent recent loss related to the October 7th attack showed two classes related to indicative of acute grief: "high PGD symptoms" (69 %), and "low PGD symptoms" (31 %). Negative CER coping strategies were associated significantly with the high PGD in all three groups, and with increased risk of PTSD and CPTSD symptoms compared to the "low PGD symptoms" group. Collective bereavement amid collective trauma can activate prior individual grief reactions, even without current losses from the traumatic event. Those experiencing loss tied to severe traumatic events may face higher susceptibility to developing pathological grief.