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Background: Violent loss (i.e. loss through homicide, suicide, or accident) is associated with high levels of prolonged grief disorder (PGD). Objective: The current meta-analysis aims at identifying correlates of PGD in adults exposed to violent loss. Method: We conducted a systematic literature search in PsycINFO, PsycARTICLES, PubMed, Web of Science, and Scopus. We used the Pearson correlation coefficient r as an effect size measure and a random effects model was applied to calculate effect sizes. Results: Thirty-seven eligible studies published between 2003 and 2017 (N = 5911) revealed 29 potential correlates. Most studies used a cross-sectional design. Analyses revealed large significant effect sizes for comorbid psychopathology (r = .50-.59), suicidality (r = .41, 95% confidence interval [CI] [.30; .52]), and rumination (r = .42, 95% CI [.31; .52]), while medium effect sizes were found for exposure to traumatic events and factors concerning the relationship to the deceased. Small effect sizes emerged for sociodemographic characteristics, multiple loss, physical symptoms, and religious beliefs. Ten variables did not show a significant association with PGD. Heterogeneity and a small number of studies assessing certain correlates were observed. Conclusions: The associations with psychological disorders may indicate shared mechanisms of psychopathology. Moreover, we recommend that clinicians carefully assess suicidal ideation among individuals with PGD who have been exposed to violent loss. Further research is warranted using longitudinal study designs with large sample sizes to understand the relevance of these factors for the development of PGD.

Background: Prolonged Grief Disorder (PGD) is over-represented among those who have lost loved ones to violent causes. To tailor PGD interventions for this vulnerable population it is critical to examine the aetiology of PGD specifically in the context of violent death bereavement. Previous studies have suggested that violent loss increases symptoms of PGD by hindering the mourner's ability to make meaning of the death or its aftermath. However, these studies have relied on cross sectional data that preclude genuine prediction and have not differentiated among specific themes of meaning. Objective: This study aimed to identify specific themes of meaning that mediate the detrimental impact of violent loss on subsequent emergence of PGD symptomatology among the violently bereft. Method: A longitudinal, prospective design (N = 171) was used to assess violent loss and themes of meaning an average of six months post-loss allowing for prediction of PGD symptoms an average of eight months later. Results: Violent loss had a significant indirect effect on PGD symptomatology when meaning themes focusing on sense of peace and continuing bonds served as mediators. Conclusions: This study demonstrates the mediating role that specific meaning themes play in the development of PGD symptomatology following violent loss. These findings highlight the potential benefits of applying a meaning-based intervention approach with the violently bereft.

La cantidad de muertes violentas en México ha venido creciendo durante los últimos años, lo que ha ocasionado enormes retos en las políticas públicas, específicamente en las relacionadas con la seguridad pública, los servicios de salud y las aseguradoras. En general, una muerte violenta es una tragedia que, con frecuencia, puede ser evitada. Además, dicha pérdida no sólo afecta a la víctima y a sus familiares, ya que repercute en toda la sociedad. En efecto, al considerar esta problemática, y utilizando las ecuaciones de ingreso de Mincer, observamos que se han perdido cuantiosas vidas de trabajadores (potenciales o en activo), por lo que la sociedad ha perdido el ingreso y el consumo potenciales de las personas fallecidas. Por tal razón, en este artículo estimamos las pérdidas económicas causadas por las muertes violentas, esperando coadyuvar a aumentar la conciencia sobre la urgencia de delinear e instrumentar políticas públicas que disminuyan este tipo de fallecimientos que, insistimos, son evitables. The number of violent deaths in Mexico has been increasing in recent years. This has brought a great challenge to public policies, specifically those related to public safety, health services, Tand insurance. A violent death is a senseless tragedy that could be avoided, and it is incorrect to think that this death exclusively affects the victim and their family members. In reality, it affects the whole of society. When considering this problem using Mincer's income equations, we observe that the lives of workers (potential or active) have been lost and that society has lost the income and potential consumption of the deceased. For this reason, in this article we intend to assess the economic losses caused by violent demises, hoping to help increase awareness that public policies are urgently needed to reduce these types of preventable deaths.