Cluster analysis of prolonged grief, posttraumatic stress, and depression symptoms in bereaved asylum seekers and refugees

Abstract

Background: Refugees and asylum seekers are frequently exposed to loss in addition to a variety of other stressors and often display high levels of various psychological symptoms. Objective: It was the aim of this study to determine clusters of prolonged grief disorder (PGD), posttraumatic stress disorder (PTSD), and depression symptoms in bereaved refugees and asylum seekers and identify predictors of cluster membership. Method: Bereaved refugees and asylum seekers in Germany (N = 92) were assessed with interview-based questionnaires for PGD, PTSD, and depressive symptoms. We used cluster analysis to distinguish symptom profiles and logistic regression analyses to identify predictors of cluster membership.Results: We found a three-cluster-solution. The PGD-cluster (30%) was characterized predominantly by PGD symptoms, while the PGD/PTSD-cluster (32%) had high PGD and PTSD and moderate depressive symptoms. The resilient cluster (38%) showed low symptoms overall. Insecure residence status predicted membership in the PGD and PGD/PTSD clusters relative to the resilient cluster, whilst higher attachment anxiety and a longer duration of stay was more often experienced by members of the PGD/PTSD cluster. Conclusion: Findings extend the current evidence to support different symptom profiles among bereaved refugees and asylum seekers in Europe. Attachment- and migration-related variables can distinguish between these profiles.