Cross-Lagged Analyses of Prolonged Grief and Depression Symptoms With Insomnia Symptoms

•Insomnia symptoms predicted future prolonged grief symptoms but not vice versa.•Insomnia symptoms and symptoms of depression showed a reciprocal relationship.•Targeting insomnia symptoms seems a promising avenue for prolonged grief treatment. Prolonged grief disorder, characterized by severe, persi...

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Bibliographic Details
Published in:Behavior therapy 2023-05, Vol.54 (3), p.510-523
Main Authors: de Lang, Thomas A., Buyukcan-Tetik, Asuman, de Jong, Peter J., Lancel, Marike, Eisma, Maarten C.
Format: Article
Language:English
Subjects:
Adult
Bereavement
complicated grief
Depression
Female
Grief
Humans
insomnia
Male
prolonged grief disorder
random intercept cross-lagged panel model
Sleep Initiation and Maintenance Disorders
Surveys and Questionnaires
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Summary:•Insomnia symptoms predicted future prolonged grief symptoms but not vice versa.•Insomnia symptoms and symptoms of depression showed a reciprocal relationship.•Targeting insomnia symptoms seems a promising avenue for prolonged grief treatment. Prolonged grief disorder, characterized by severe, persistent and disabling grief, has recently been added to the DSM-5-TR and ICD-11. Treatment for prolonged grief symptoms shows limited effectiveness. It has been suggested that prolonged grief symptoms exacerbate insomnia symptoms, whereas insomnia symptoms, in turn, may fuel prolonged grief symptoms. To help clarify if treating sleep disturbances may be a viable treatment option for prolonged grief disorder, we examined the proposed reciprocal relationship between symptoms of prolonged grief and insomnia. On three time points across 6-month intervals, 343 bereaved adults (88% female) completed questionnaires to assess prolonged grief, depression, and insomnia symptoms. We applied random intercept cross-lagged panel models (RICLPMs) to assess reciprocal within-person effects between prolonged grief and insomnia symptoms and, as a secondary aim, between depression and insomnia symptoms. Changes in insomnia symptoms predicted changes in prolonged grief symptoms but not vice versa. Additionally, changes in depression and insomnia symptoms showed a reciprocal relationship. Our results suggest that targeting insomnia symptoms after bereavement is a viable option for improving current treatments for prolonged grief disorder.
ISSN:0005-7894
1878-1888
DOI:10.1016/j.beth.2022.12.004