The effect of bereavement and prolonged grief on anger and physical aggression in parentally bereaved adolescents

Background: Parental bereavement is associated with adverse mental health and behavioral outcomes, yet its effects on anger and physical aggression remain unclear. This study examined the cross-sectional and longitudinal associations of parental bereavement and prolonged grief with anger and physical aggression.Methods: Participants included 380 adolescents and young adults (mean age = 13.3 years, 49.2% female), comprising 206 parentally bereaved and 174 nonbereaved controls. Participants and their caregivers completed clinical assessments at baseline (approximately 9 months after parental death) and four follow-ups at approximately 21, 33, 62, and 84 months after death. Results: After adjustment for covariates, bereavement was not significantly associated with anger at baseline (β = 0.151, SE = 0.099, p = 0.127), and changes in anger over time did not differ between bereaved and nonbereaved participants (β = 0.001, SE = 0.001, p = 0.348). Bereavement was not significantly associated with physical aggression. Among bereaved participants, clinical prolonged grief was associated with higher anger at baseline (β = 0.516, SE = 0.163, p = 0.002) and greater increases in anger over time (β = 0.009, SE = 0.004, p = 0.038), but not with physical aggression. Physical aggression increased more steeply following sudden natural parental death than parental suicide (β = −0.187, SE = 0.081, p = 0.022).Conclusions: Clinical prolonged grief, rather than bereavement alone, was associated with greater anger, whereas parental cause of death was associated with changes in physical aggression. These findings highlight the importance of distinguishing emotional and behavioral expressions of aggression and assessing prolonged grief and family functioning following parental death.