Boelen, P. A., Keijser, J. de, & Smid, G. (in press). Cognitive behavioural variables mediate the impact of violent loss on post-loss psychopathology. Psychological Trauma: Theory, Research, Practice, and Policy.


Research has shown that violent losses lead to more severe emotional distress than do nonviolent losses. Little is known about the psychological mechanisms underlying the debilitating impact of violent loss. In the current study, the authors used self-reported data of 496 bereaved individuals, bereaved in the last 3 years, to examine the role of seven cognitive– behavioral variables in mediating the impact of violent loss: (a) a sense of “unrealness” about the irreversibility of the separation, negative cognitions about (b) the self, (c) life, (d) the future, and (e) catastrophic misinterpretations of grief-reactions, and indices of (f) anxious avoidance and (g) depressive avoidance behavior. Outcomes showed that people bereaved by violent losses (due to homicide, suicide, or accident) had significantly higher symptom-levels of Prolonged Grief Disorder (PGD), posttraumatic stress disorder (PTSD), and depression than persons bereaved by nonviolent losses. Indices of unrealness, negative cognitions about the self, the future, catastrophic misinterpretations, and depressive avoidance were all significant independent mediators of the linkages between violent loss and symptom-levels of PGD and depression. Negative cognitions about the future, catastrophic misinterpretations, and depressive and anxious avoidance emerged as unique mediators of the association between violent loss and elevated PTSD severity. Findings underscore that cognitive– behavioral variables are a critical component of elevated emotional distress following violent loss.