Trajectories of children's intrusive grief and association with baseline family and child factors and long-term outcomes in young adulthood.

This study reports on the description of children's distinct trajectories of intrusive grief, baseline predictors of grief trajectories, and the association of grief trajectories with mental health, substantive abuse and disordered grief six and fifteen years following baseline assessment. The study uses data on 244 parentally-bereaved children ages 8-16 at baseline. Four distinct trajectories were identified using Growth Mixture Modeling over four waves of assessment across 6 years. The trajectories were labeled high chronic grief, moderate chronic grief, grief recovery (starts high but decreases over 6 years of assessment) and grief resilience (chronic low grief). Baseline factors associated with chronic high or moderate chronic levels of grief included depression, traumatic cause of death (homicide or suicide), active inhibition of emotional expression, active coping, child age and gender. At the six-year assessment, trajectories were associated with internalizing mental health problems, higher level of traumatic grief, and aversive views of the self. At the fifteen-year assessment, trajectories were associated with intrusive grief. The results are interpreted in terms of consistency with prior evidence of children's long-term grief, theoretical processes that may account for chronic grief and implications for the development of preventive and treatment interventions.