Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Dec;16(1):2515705.
doi: 10.1080/20008066.2025.2515705. Epub 2025 Jun 23.

The association between one's social life and symptoms of prolonged grief following a traumatic loss: an ecological momentary assessment study

Philippa Specker  1 , Justina Pociūnaitė-Ott  2 , Ariela Lev Rosenblum  3   4 , Sofia Marcolini  5 , Pascale Waschnig  6 , Christopher Magoon  7 , Annie-Lori Joseph  8 , Lieke C J Nijborg  2 , Xi Pan  9 , Lonneke I M Lenferink  2   10   11
Affiliations

The association between one's social life and symptoms of prolonged grief following a traumatic loss: an ecological momentary assessment study

Philippa Specker et al. Eur J Psychotraumatol. 2025 Dec.

Abstract
in English, Spanish

Background: A strong social safety net may play a key role in protecting people from developing prolonged grief disorder (PGD) after a traumatic loss. This has mainly been investigated cross-sectionally, whereby people usually report on their social life and PGD reactions during the past month. However, retrospectively recalling experiences is prone to recall bias.Objective: As such, we investigated the associations between pleasantness of social interactions and PGD reactions in traumatically bereaved people using Ecological Momentary Assessment (EMA).Methods: People whose loved one died due to homicide, suicide, or accident at least 12 months earlier (N = 36, 78% women, Mage = 56, 47% met PGD criteria) received smartphone-based surveys five times per day for two weeks. Surveys included questions about PGD intensity (e.g. 'In the past 3 hours, did you yearn for your loved one?' 0 = not at all, 6 = extremely) and their quality of social life (e.g. 'In the past 3 hours, how did you find being with others?' 0 = very unpleasant, 6 = very pleasant). Linear mixed models were used.Results: Based on 2520 measurement occasions, we found that when a person enjoyed their social life more than usual, they grieved less (B = -0.141, SE = 0.020, p < .001). However, whether a person's social life was more or less pleasant than their peers was not related to their PGD levels.Conclusions: This EMA study highlights the importance of accounting for individual variability in grief reactions after loss and highlights the potential utility of strengthening one's social safety net as a way to reduce the burden of PGD.

Antecedentes: Una sólida red de seguridad social puede desempeñar un papel clave en la protección de las personas contra el desarrollo del trastorno de duelo prolongado (TDP) tras una pérdida traumática. Esto ha sido investigado principalmente de forma transversal, donde las personas suelen informar sobre su vida social y reacciones al TDP durante el último mes. Sin embargo, el recuerdo retrospectivo de experiencias es propenso a sesgos de recuerdo.

Objetivo: Por lo tanto, investigamos las asociaciones entre la satisfacción de las interacciones sociales y las reacciones al TDP en personas en duelo traumático mediante la Evaluación Ecológica Momentánea (EEM).

Métodos: Personas cuyo ser querido falleció por homicidio, suicidio o accidente al menos 12 meses antes (N=36, 78% mujeres, Edad media=56, 47% cumpliendo criterios de TDP) recibieron encuestas a través de teléfonos inteligentes cinco veces al día durante dos semanas. Las encuestas incluyeron preguntas sobre la intensidad del TDP (p. ej., ¿extrañó a su ser querido en las últimas 3 horas? 0=nada, 6=extremadamente) y su calidad de vida social (p. ej., ¿cómo encontró el estar con otras personas en las últimas 3 horas? 0=muy desagradable, 6=muy agradable). Se utilizaron modelos lineales mixtos.

Resultados: Con base en 2.520 mediciones, observamos que cuando una persona disfrutaba de su vida social más de lo habitual, experimentaba menos duelo (B=−0,141, EE=0,020, p <0,001). Sin embargo, el hecho de que la vida social de una persona fuera más o menos placentera que la de sus compañeros no se relacionó con sus niveles de TDP.

Conclusiones: Este estudio de EEM destaca la importancia de tener en cuenta la variabilidad individual en las reacciones de duelo tras una pérdida y destaca la potencial utilidad de fortalecer la red de seguridad social para reducir la carga del TDP.

Keywords: Duelo; Ecological Momentary Assessment; Grief; bereavement; evaluación ecológica momentánea; experience sampling; loss; luto; muestreo de experiencias; pérdida; social; trauma.

Plain language summary

The link between one’s social life and prolonged grief reactions was examined using ecological momentary assessment in traumatically bereaved people.We found that when people perceived their social interactions or time spent alone to be more pleasant than usual, they grieved less.Also, when people were in the presence of others, they grieved less.Strengthening one’s social safety net after traumatic loss seems clinically useful.

PubMed Disclaimer

Conflict of interest statement

No potential conflict of interest was reported by the authors.

Figures

Figure 1.
Figure 1.
Flowchart depicting participant exclusions during the recruitment, screening and data collection phases of the study.
See this image and copyright information in PMC

References

    1. Aeschlimann, A., Gordillo, N., Ueno, T., Maercker, A., & Killikelly, C. (2024). Feasibility and acceptability of a mobile app for prolonged grief disorder symptoms. Clinical Psychology in Europe, 6(1), 1–23. 10.32872/cpe.10881 - DOI - PMC - PubMed
    1. Alisic, E., Gunaratnam, S., Barrett, A., Conroy, R., Jowett, H., Bressan, S., Babl, F. E., McClure, R., Anderson, V., & Mehl, M. R. (2017). Injury talk: Spontaneous parent-child conversations in the aftermath of a potentially traumatic event. Evidence Based Mental Health, 20(4), e19–e20. 10.1136/eb-2017-102736 - DOI - PMC - PubMed
    1. American Psychiatric Association . (2022). Diagnostic and statistical manual of mental disorders (DSM-5-TR). American Psychiatric Association Publishing. 10.1176/appi.books.9780890425787. - DOI
    1. Bastiaansen, J. A., Meurs, M., Stelwagen, R., Wunderink, L., Schoevers, R. A., Wichers, M., & Oldehinkel, A. J. (2018). Self-monitoring and personalized feedback based on the experiencing sampling method as a tool to boost depression treatment: A protocol of a pragmatic randomized controlled trial (ZELF-i). BMC Psychiatry, 18(1), 1–11. 10.1186/s12888-018-1847-z - DOI - PMC - PubMed
    1. Bates, D., Meachler, M., Bolker, B., & Walker, S. (2015). Fitting linear mixed-effects models using lme4. Journal of Statistical Software, 67(1), 1–48. 10.18637/jss.v067.i01 - DOI