The protective role of positive mental health on prolonged grief disorder, anxiety and depression among bereaved refugees: cross-sectional mediation models

Abstract

Grief is a common reaction to loss; however, its persistence is subject to specific mechanisms related to the context of death, comorbidities with other mental health disorders, and individual coping status. The current study aimed to investigate the cross-sectional link between refugees’ positive mental health (PMH) and reduced prolonged grief disorder (PGD) mediated by changes in anxiety and depression and, conversely, between PMH and reduced anxiety and depression symptoms mediated by changes in prolonged grief symptoms. The present cross-sectional study involved 385 bereaved adult Arabic-speaking refugees. Data were collected via an online survey. All participants experienced prolonged grief symptoms a minimum of 6 months from the death event. The parallel mediation model showed that PMH is indirectly linked to PGD, and the significant mediation of anxiety and depression could explain this relationship. Furthermore, two simple mediation models showed that PMH is indirectly linked to anxiety and depression, and the significant mediating effect of PGD could explain this relationship. The current results confirm the role of PMH as a predisposed coping status that could reduce the risk for PGD. Increasing the level of PMH can be considered a protective factor against challenging life events such as persistent grief and related disorders.