Reciprocal relations between prolonged grief and anger in homicidally bereaved people involved in a criminal trial: a four-wave cross-lagged panel model.

Background: Anger may increase the risk for prolonged grief disorder (PGD) after violent loss. A source of anger for violently bereaved people can be the criminal proceedings that ensue following the loss. The present study explored the reciprocal associations between PGD and state anger and whether aspects of involvement in the criminal justice system (CJS) relate to PGD and state anger.

Methods: We analyzed data of 237 MH17-bereaved people collected 67, 79, 88, and 103 months after the loss. Cross-lagged panel modeling was employed to examine the reciprocal associations between PGD and state anger. In the optimal model, we regressed PGD and state anger levels on different aspects of CJS involvement.

Results: Higher PGD levels significantly predicted higher state anger levels at each wave (β = .112-.130) but not the other way around. This was found while constraining autoregressive and cross-lagged paths. When adding predictors and covariates to the model, PGD levels still consistently predicted state anger levels over time (β = .107-.121), with state anger levels predicting PGD levels to a lesser extent (β = .064-.070). None of the aspects of CJS involvement were related to either PGD or state anger levels.

Conclusions: If replicated, a clinical implication could be that targeting PGD levels in treatment may reduce state anger levels and, to a lesser extent, vice versa. Also, CJS involvement does not seem to have an impact on PGD and state anger in people confronted with violent loss.