Belief in a just world and prolonged grief disorder among individuals bereaved by 9/11

Background: Belief in a just world is the conviction that the world is fundamentally fair and that people deserve to be rewarded for admirable actions and punished for unjust actions. However, these beliefs can be challenged by a traumatic event, especially bereavement by a sudden and violent death, increasing the risk for Prolonged Grief Disorder (PGD). This study examined the association between belief in a just world and PGD among family members bereaved by the September 11, 2001 terrorist attacks. Methods: 380 bereaved family members provided responses on a cross-sectional survey that included the Inventory of Complicated Grief (ICG) and the Global Belief in a Just World (BJW). Multivariable logistic regressions were used to examine associations between endorsed BJW items and meeting threshold for PGD. An interaction between BJW and relationship type to the deceased was also evaluated. Results: A weaker belief in a just world (as indicated by higher scores) was associated with an increased risk of meeting the threshold for PGD among bereaved parents, but not among other relationships to the deceased. Conclusions: The death of a family member due to sudden and violent causes, especially when the decedent is a child, increases the risk for PGD. However, a stronger belief in a just world can potentially buffer against PGD. These findings highlight the need to incorporate perceptions of justice within the world as a potential therapeutic target for grief support.