Abstract

The purpose of this study was to examine changes in PGD symptoms over time and to identify internal and external factors influencing PGD at each time point among 441 adults who experienced bereavement. To achieve this, longitudinal data were collected at two time points with a 15-month interval. The results were as follows: First, PGD symptoms tended to intensify over time rather than naturally subside. Second, cross-sectional hierarchical regression analysis revealed that being female, living alone, being older at the time of bereavement, not relatives but having a more intimate relationship with the deceased compared to a third-degree relative, experiencing an unexpected loss, reporting lower levels of meaning integration, and higher levels of social meaning-making (social validation) were associated with higher PGD symptoms. Third, longitudinal hierarchical regression analysis showed that being female, having lower levels of meaning integration, and having lower levels of social meaning-making (social invalidation- recognition for others) were significantly associated with higher PGD symptoms over time. These findings suggest that PGD is not merely an emotional reaction but a condition influenced by multiple contextual and interpersonal factors. In particular, it may result from the failure of cognitive and emotional integration, such as difficulty in meaning-making after loss and perceiving supportive social responses. These findings showed that PGD is influenced by several contexts, environments, and can be derived from failure of cognitive and emotional integration, such as failure to make meaningful bereavement, and recognition of social reaction over simple emotional reaction. This study provides valuable insights for developing preventive interventions and personalized psychological support for individuals experiencing bereavement.