Distinguishing prolonged grief and mental well-being after homicidal loss: a longitudinal factor analytic study in the context of a criminal trial

Abstract

ABSTRACT Background: As per the dual-continua model, mental illness and mental well-being are related, distinct continua of mental health. Whether this association generalises to bereaved people and is stable over time remains uncertain. Moreover, criminal justice system (CJS) involvement may pose a risk to the different continua of mental health of bereaved people. Objectives: We investigated (1) whether the factor structure of prolonged grief disorder (PGD) and well-being remains stable over time, and (2) whether aspects of CJS involvement are related to latent PGD and well-being levels reported after the criminal trial. Method: In a sample of MH17-bereaved people (N = 237), we used (longitudinal) confirmatory factor analysis to examine the factor structure of PGD and well-being over time. To examine whether aspects of CJS involvement are associated with PGD and well-being levels, we regressed PGD and well-being levels on aspects of CJS involvement in a structural model. Results: Regarding the first objective, PGD and well-being were distinct, negatively related, constructs among people bereaved by the MH17 plane disaster. This association appears stable over time. Regarding the second objective, no aspects of CJS involvement were related to PGD and well-being levels reported after the trial, while accounting for levels before the criminal trial. Conclusions: Mental healthcare professionals may want to assess and treat well-being levels in addition to PGD levels, to determine whether targeting well-being in treatment may be a fruitful avenue to pursue. Future studies might want to examine which positive psychology interventions would work well in conjunction with existing grief therapies for people experiencing clinically relevant PGD levels with below-average well-being levels. Also, if replicated, the findings indicate that CJS involvement may not significantly affect the mental health of bereaved people, raising questions about the generalizability of the framework of therapeutic jurisprudence and justice theories to this population.