Grieving Suicide: Clinical Aspects and Neural Circuitry

Losing a loved one sets off a process of grief. Some wonder if losing a loved one to suicide generates a unique bereavement process and little is known about the difference between suicide related grief and nonsuicide related grief. Using fMRI to measure brain activity, 30 people with a suicide related grief (SRG) and 15 people with a nonsuicide related grief (nSRG) will engage in a behavioral task that measures emotional attachment and evokes avoidance and yearning related neural activity. Participants will also be asked to complete self-report measures of emotional attachment, avoidance in addressing the loss, and yearning for the deceased. The baseline assessment will take place 8-12 weeks after the death of a loved one, and participants will complete the self-report measures, including an assessment of complicated grief, again six months later. The investigators hypothesize that suicide related grief will be associated with greater emotional attachment and activation of avoidance and yearning related neural circuitry compared to those with nonsuicide related grief. They further hypothesize that greater activation of avoidance and yearning neural circuitry will predict higher levels of complicated grief six months after scanning. Based on prior research they expect that avoidance/acceptance will be measured by activation of the anterior cingulate cortex, dorsolateral prefrontal cortex, and anterior cingulate cortex parts of the brain; while yearning will be measured by activation of ventral tegmental area and nucleus accumbens. Avoidance circuitry and yearning circuitry will be used to predict complicated grief outcomes at a six‐month follow-up. They also expect that greater avoidance and yearning will predict higher levels of complicated grief.