1 - (SYM 49) The Behavior of Grief: Investigating the Dynamics and Emotional Correlates of Grief-related Approach and Avoidance Behavior

Prolonged Grief Disorder (PGD) is a trauma and stressor-related disorder characterized by persistent, distressing, and impairing grief. Grief-related approach behavior (e.g., spending time with things that remind one of their deceased loved one) and avoidance behaviors (e.g., avoiding situations that remind one of the deceased) feature prominently in PGD. Yet, we have little insight into how these behaviors unfold in daily life or how grief-related emotions relate to those behaviors. To address this need, we used ecological momentary assessment to evaluate the dynamics of approach and avoidance behaviors and the relationships among these behaviors and grief-related emotions. Bereaved adults (n=136) completed six 12-item surveys per day for 17 days (102 total surveys). Items assessed PGD symptoms on a 0-100 scale. We found that approach behavior is engaged in more frequently (M=44% of responses, Mdn=34%) than avoidance behavior (M=26% of responses, Mdn=7%). Frequency, intensity, and variability of approach and avoidance behavior were each positively correlated with PGD symptoms, though correlations were higher for avoidance dynamics. In a mixed effects model, we found between-person (b=0.58, p < .001) and within-person effects (b=0.06, p< .001) of approach behavior as a predictor of avoidance behavior. In separate models investigating emotional correlates of grief-related behavior, between-person emotional pain was a significant predictor of avoidance behavior (b=0.44, p=0.0015), but between-persons yearning was not (b=-0.029, p=0.82). Conversely, between-person yearning was a significant predictor of approach behavior (b=0.51,p< .001), but between-person emotional pain was not (b=0.07, p=0.51). In these models, within-person effects of yearning and emotional pain were significant predictors of both approach and avoidance behavior. These findings suggest approach behavior is more common than avoidance, and avoidance behavior is more strongly associated with PGD symptoms. Despite appearing to reflect opposing motivations, we found that even at the within-person level, approach and avoidance behavior were positively associated, suggesting they are commonly engaged in concurrently. We also found that emotional pain may be more implicated in avoidance behavior while yearning may be more implicated in approach behavior. Future research should explore if approach and avoidance behaviors may sometimes share a similar function (e.g., avoiding the reality of one’s loss).