A Dissertation Study on Prolonged Grief Disorder and Mourning via Social Media

I grew up in a time when social media was gaining popularity and spreading into several different platforms. As a doctoral student in a PsyD program at California Northstate University, I have gained an appreciation for research seeking to understand the intersection of social media and mental health. My dissertation chair, Dr. Craig Wetterer, and I decided to focus my dissertation study on understanding how people use social media as a form of mourning practice. I came to find that while I was not alone in my interest in this topic, social media and mourning is a relatively new area of interest in psychology with plenty of room for new research to better understand these concepts. More specifically for my study, I chose to focus on social media use related to mourning in the first month after a loss to better understand factors that may contribute to the subsequent development of Prolonged Grief Disorder. The following is a summary of what I have learned so far, more information on my study, and how you can participate.

Prolonged Grief Disorder and Current Research

Grief has been defined by the American Psychological Association (APA; n.d.) as, “the anguish experienced after significant loss, usually the death of a beloved person” (para. 1). Grief is a common experience and often involves distress; however, it is also an experience that is personalized and unique to an individual based on both cultural and personal factors. Despite variations in how individuals grieve, the intensity of one’s grief tends to diminish over time (Shear, 2015). However, for approximately 13% of grievers worldwide, the intensity of grief does not diminish over time and clinical intervention may be necessary (Comtesse et al., 2024).

Prolonged grief disorder (PGD) is a newer diagnosis that was added to the 5th edition text-revision of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR) in 2022 to help explain the symptomatology for individuals experiencing a grief response requiring intervention. To meet the criteria for PGD, the following symptoms must be met:

(A) the death of an individual close to the bereaved at least 12 months ago in adults, (B) intense yearning for the deceased and/or preoccupation with memories of the deceased most days, (C) at least three of the following symptoms experienced most days for at least one month: identity disruption, disbelief about the death, avoidance of reminders that the deceased has passed, intense emotional pain, difficulty reintegrating into relationships and/or activities, feelings of numbness, feelings of life as meaningless, loneliness, (D) clinically significant distress, (E) a grief response that exceeds the norms of one’s culture, and (F) the symptoms are not better explained by another disorder. (American Psychiatric Association, 2022, pp. 322-323)

Several risk factors have been identified through research to better understand why some people may develop PGD after a loss. A systematic review and meta-analysis conducted by Burr and colleagues (2024) examined 120 studies published between 1989 and 2023 that looked at risk factors for PGD. The results identified the following as statistically significant risk factors for this disorder: pre-loss grief symptoms, pre-loss depressive symptoms, loss of a child, loss of a partner, attachment anxiety, income, violent/unnatural death, education level, gender of the bereaved, the death being unexpected, the bereaved being single, and the number of losses. Identifying risk factors for the development of PGD informs researchers about different courses of grief and may help identify individuals who would benefit from early intervention.

Mourning Practices

Mourning and grief are often used interchangeably although they are distinct constructs. The American Psychological Association (n.d.) has defined mourning as, “the process of feeling or expressing grief following the death of a loved one, or the period during which this occurs” (para. 1). Due to mourning being an expression of grief rather than an internal experience, it may be easier to observe than grief. Mourning behaviors include outbursts of anger or social withdrawal.

Mourning practices are culturally bound and reflect the traditions of a given community; however, many cultures include grief rituals as a form of mourning practice to help exert social control over a loss (Silverman et al., 2021). In a scoping review of cross-cultural mourning practices, Goodwyn (2015) identified eight themes commonly found in grief rituals: (1) containment of emotions experienced as part of grief within a cultural context, (2) acceptance of the loss gained through close contact between the deceased and the bereaved, (3) tasks that help the deceased transition to the afterlife, (4) recognition of the vulnerability of the bereaved and their community after a loss, (5) recognition of the vulnerable state of the bereaved after a violent loss, (6) a framework to reorganize the relationship between the deceased and the bereaved, (7) culturally bound methods to express emotions, and, (8) ways to integrate knowledge of the death into belief systems.

Research has also explored how grief rituals can be utilized in psychotherapeutic treatment. Sas and Coman (2016) interviewed 10 therapists (six from the United Kingdom and four from the United States) with expertise in grief rituals and grief therapy to determine the main types of grief rituals and their functions. The authors found three types of rituals: honoring rituals, which are meant to celebrate the bond between the living and the deceased; rituals of releasing negative emotions associated with the loss; and, rituals of self-transformation in which clients will evaluate where they are in their lives, what they need to process, and their goals for the future. Wojtkowiak and colleagues (2021) extended the literature on the use of rituals in grief therapy by conducting a scoping review of studies that used grief rituals in outpatient therapy for PGD. They identified 22 studies published between 2009 and 2019 conducted throughout various countries, including the United States, the Netherlands, Portugal, Rwanda, Germany, India, Japan, Denmark, and Iran. Nineteen of the studies reported significant symptom reduction on measurements of different symptoms, including grief, depression, post-traumatic stress, distress, despair, intrusions and avoidance, emotional loneliness, and emotional numbing. All 22 identified studies included some kind of ritual, such as meditation, symbolic communication with the deceased or with an imaginary friend, writing assignments, use of religious texts, having a commemorative or drumming ceremony, visiting the funeral with the therapist, visiting the gravesite, and having a dialogue with the deceased (Wojtkowiak et al., 2021).

Mourning Through Social Media

Mourning via social media shares elements with other types of mourning rituals, such as revisiting pictures and memories of the deceased (Kakar & Oberoi, 2016). However, mourning through social media can change the visibility of one’s grief, creating a unique context for one’s mourning process (Morehouse & Crandall, 2014). In some ways, social media has also changed the cultural norms for mourning. In a qualitative study on social media posts (primarily Instagram), Khumairoh (2023) examined the cultural impact of grieving in Indonesia after the invention and widespread use of social media. They found that prior to widespread social media use, many Indonesian mourning practices were strictly enforced; however, social media forced a “cultural expansion” such that previous norms unique to a single culture blended with other norms seen online (Khumairoh, 2023, p. 84).

Communicating About Grief Through Social Media

Research indicates that individuals use social media to communicate about their grief in a variety of ways. In an interview study of adults aged 22 to 60 in the United States who lost a loved one, Moore and colleagues (2019) identified three different types of communication used on social media regarding grief: (1) one-way communication, (2) two-way communication, and (3) immortality communication. Participants reported that one-way communication via social media, like sharing information with others about their loss, was beneficial as it helped alleviate the pain of discussing the death repeatedly with others. Motivations for using social media to engage in two-way communication included discussing the death with others and creating a community where people could mourn together. However, participants expressed concerns about their privacy when using social media for two-way communication. Immortality communication involved using social media to commemorate and continue a connection with the deceased (Moore et al., 2019).

Research on communicating about grief via social media has also investigated various platforms used and the frequency of posts on these platforms.  Facebook has been identified as the most used social media platform for expressing grief; however, some individuals indicated Facebook was better for engaging with family members while Instagram was preferred for engaging with friends (King & Carter, 2022). According to one study, posts about loss and grief experiences tended to be most frequent in the first 10 days following the loss, but engagement was still common in the first month post-loss (Brubaker & Hayes, 2011). Some mourning behaviors on social media, however, were found to persist throughout this three-year study, including sharing memories of the deceased, posting updates about one’s own life, and maintaining a connection with the deceased (Brubaker & Hayes, 2011).

Motivations for Social Media Use in Mourning

Several research studies have examined motivations for why people use social media as a platform for mourning (King & Carter, 2022; Rossetto et al., 2015; Varga & Varga, 2021; Willis & Ferrucci, 2017) and the following have been identified:

• Sharing news about the death
• Seeking support
• Emotional release
• Continuing a bond with the deceased
• Creating an online memorial for the deceased
• Social norms to post about a death

Advocacy Understanding why social media is used in mourning is helpful for contextualizing grief in the digital age. Motivations also highlight the needs of grievers throughout the mourning process and can serve as a guide for those seeking to provide support.

The Current Study

My study seeks to answer how social media use related to mourning in the first month post-loss might impact the development of PGD. The study will consist of a series of surveys and should take approximately 30 minutes. There will be an option to enter into a gift card raffle where I will be giving away five $25 Amazon gift cards.

Requirements to participate

• At least 18 years of age
• Loss of a loved one at least 1 year ago
• Have at least 1 social media account
• Ability to read English

To learn more and access the study, please click here.