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Complicated Grief and Depression in Young Adults: Personality and Relationship Quality

Mash, Holly B. Herberman PhD*; Fullerton, Carol S. PhD*; Shear, M. Katherine MD; Ursano, Robert J. MD*

The Journal of Nervous and Mental Disease: July 2014 - Volume 202 - Issue 7 - p 539–543
doi: 10.1097/NMD.0000000000000155
Original Articles

Young adults experience problematic responses to loss more often than is commonly recognized. Few empirical studies have examined the contribution of intrapersonal and interpersonal characteristics to grief and depression in bereaved young adults. This study investigated the association of dependency and quality of the relationship with the deceased (i.e., depth and conflict) with complicated grief (CG) and depression. Participants were 157 young adults aged 17 to 29 years who experienced loss of a family member or close friend within the past 3 years (mean = 1.74 years). Participants completed the Inventory of Complicated Grief, Beck Depression Inventory, Depth and Conflict subscales of the Quality of Relationships Inventory, and the Dependency subscale of the Depressive Experiences Questionnaire. Relationships among dependency and interpersonal depth and conflict and CG and depression were examined through analyses of covariance. Sixteen percent of participants met criteria for CG and 34% had mild to severe depression. Dependency and depth were independently related to CG and dependency was related to depression, but the pattern of associations was somewhat different for each outcome. Greater depth was associated with CG, at both high and low levels of dependency. High levels of dependency were related to more depressive symptoms. Interpretation of the findings is limited by the relatively small sample size and cross-sectional design. CG and depression are related but distinct responses to loss. Although dependency is associated with both CG and depression after loss, relationships between the bereaved and deceased that are characterized by high levels of depth are particularly related to the development of CG symptoms.

*Center for the Study of Traumatic Stress, Department of Psychiatry, Uniformed Services University of the Health Sciences, Bethesda, MD; and †Columbia University School of Social Work, Columbia University College of Physicians and Surgeons, New York, NY.

M. Katherine Shear, MD received funding from the National Institute of Mental Health - Grant Nos. R01MH070741 and R01MH060783.

Send reprint requests to Holly B. Herberman Mash, PhD, Uniformed Services University of the Health Sciences, Department of Psychiatry, 4301 Jones Bridge Road, Bethesda, MD 20814. E-mail:

© 2014 by Lippincott Williams & Wilkins