Background and Scope of the Problem. High prevalence rates of deaths by
accidents, suicides, and homicides, coupled with expanding social networks, place
adolescents at significant risk for traumatic bereavement occasioned by the traumatic deaths
of their friends, romantic partners, and family members.
Conceptual Analysis. This conceptual paper focuses on the interplay between posttraumatic
stress symptoms and grief reactions that can arise following traumatic bereavement in
adolescence. We begin with a review of “building block” key concepts needed to construct a
scientifically sound and clinically useful theory of traumatic bereavement in adolescence.
We briefly review earlier conceptual contributions and discuss the utility of unpacking and
distinguishing between trauma exposure and bereavement as theorized causal risk factors,
and posttraumatic stress reactions and grief reactions as their respective primary causal
Multidimensional Grief Theory. We introduce multidimensional grief theory as a useful
framework for conceptualizing a broad range of grief reactions, both adaptive and
maladaptive, in traumatically bereaved adolescents. We use the theory to explore the
interplay between posttraumatic stress and grief reactions, including ways in which each set
of reactions may exacerbate the other and contribute to adverse outcomes.
Implications for Evidence-based Assessment. We conclude with recommendations for
trauma- and bereavement-informed risk screening, clinical assessment, and case formulation
of potential consequences of traumatic bereavement in adolescence across multiple
psychosocial domains. These domains include posttraumatic stress and grief reactions,
school functioning, suicide ideation and behavior, risk-taking behavior, and developmental