Journal Article

Grief, depression and psychotic-like experiences among bereaved college students: the predictive role of attitudes towards death

Hu, Po, Wen, Jun, Xu, Xin, Qian, Wenli, Liu, Nannan, Xi, Chang

2025

Overview

Bereavement may lead to heterogeneous psychological responses, including prolonged grief disorder (PGD), depression, and psychotic-like experiences (PLEs). Individuals' attitudes toward death may play a significant role in bereavement adjustment. This study aimed to identify latent subgroups of bereaved Chinese college students based on their symptom endorsement of PGD, depression, and PLEs, and to examine the predictive role of five specific death attitudes - fear of death, death avoidance, neutral acceptance, approach acceptance, and escape acceptance - on class membership over time. At baseline, 366 bereaved college students completed measures of PGD, depression, PLEs, and death attitudes. Of these, 159 (43.4%) completed the six-month follow-up survey. Latent class analysis was conducted to identify subgroups, and multinomial logistic regression was used to explore predictors of class membership at follow-up. A three-class solution was identified as optimal among the retained participants: a Resilient class, a Moderate Symptoms with Elevated Delusions Class and a High Symptom Class. Compared to those in the High Symptom Class, students in the Resilient Class were more likely to report better physical health and to have experienced a non-violent loss. Furthermore, higher levels of fear of death and escape acceptance at baseline significantly predicted membership in High Symptom Class six months later. Bereaved college students exhibited distinct symptom profiles, with a small subgroup experiencing severe comorbid symptoms of grief, depression, and PLEs. Death attitudes were important predictors of class membership. Although the high attrition rate and differences between retained participants and dropouts warrant caution in generalising the findings, the results underscore the importance of early identification and tailored interventions for bereaved college students. Interventions targeting maladaptive death attitudes, particularly fear of death and escape acceptance, may represent an effective strategy to promote adaptive bereavement adjustment.

• Publisher: Taylor & Francis Ltd,Taylor & Francis,Taylor & Francis Group
• Subject: Adolescent / Adult / Attitude to Death / Attitudes / Basic / bereaved college students / Bereavement / China / College students / Colleges & universities / death attitudes / depression / Depression - psychology / Experimental psychology / Female / Grief / Humans / Male / Nonviolence / Prolonged grief disorder / Psychosis / Psychotic Disorders - psychology / psychotic-like experiences / Students - psychology / Surveys and Questionnaires / Teacher education / Trastorno de duelo prolongado / Universities / Young Adult / Young adults