Study Description and Background

Losing a close friend or family member to death can be an incredibly painful and stressful occurrence. Some bereaved persons may experience additional symptoms associated with a severe and unending type of grief now referred to as prolonged grief (PG).

Among bereaved persons, PG can lead to worsening mental health functioning – possibly more so than either posttraumatic stress disorder (PTSD) or depression. For Veterans, treating PG may be just as crucial as treating PTSD. Some studies suggest that although grieving a death may lead to thoughts of suicide, those with PG symptoms may be more likely to make a suicide attempt. Despite this, the connection between PG and suicide among Veterans has not been studied, even though Veterans already are at a higher risk for suicide than are other groups.

This is an observational study. Participants will be recruited from those receiving outpatient mental health services (MHS) at the ECHCS/Denver VAMC. Both the consent process and testing will take place during a single 60 to 90 minute visit. There are no laboratory studies or follow up visits.

After informed consent is obtained, participants will complete five questionnaires assessing symptoms of grief, PTSD, depression, and thoughts of suicide, as well as one computer test assessing some types of brain activity. Participants will be monetarily compensated at the end. To address the study aims, the investigators then will examine the relationships between variables collected from the questionnaires.

Hypotheses, Study Aims, and Short-term Goals

The primary aims of this study are to:

1. examine the rate at which prolonged grief (PG) and its various related symptoms occur among a sample of Veteran Mental Health Services (MHS) patients
2. examine the frequency with which PG co-occurs with PTSD and depression among this group; and
3. assess the degree to which, if any, PG is related to suicidal ideation

Long-term Goals:
Putting Research into Practice

Without examining the potential impact of prolonged grief (PG) among Veterans, we may be overlooking an important factor contributing to Veteran suicide. For accuracy’s sake, PG among Veterans should be assessed more immediately upon return from theater in order to gain a better understanding of its prevalence.

Also, addressing PG now among OEF/OIF Veterans could help to reduce long-term mental health and medical difficulties related to PG. This could result in a much-improved quality of life for many of our Veterans.

This study’s findings may provide initial support for the presence of PG among Veterans. Findings also could suggest that PG is associated with increased thoughts of suicide among some Veterans.

If so, one next step would be to assess for both PG and suicidal thinking among a larger, more representative Veteran sample to help gauge PG's actual prevalence among the Veteran population as well as its relationship to suicidal thinking. Because having a VA service connection ultimately may be a protective factor for suicide (Zivin et al., 2007), this future study would aim to assess such conditions among both service-connected and non-service connected Veterans.

Research Team

Principal Investigator:

Jeffrey Rings, Ph.D.

Co-Investigators:

Peter Gutierrez, Ph.D.

Jeri E Forster, Ph.D.

Research Coordinator:

Rebecca Leitner, B.A.
rebecca.leitner@va.gov
CONTACT PHONE: 303.399.8020 x 2404