Risk of prolonged grief disorder when significant other goes missing probably five times greater than after a natural death

When a loved one goes missing, almost half of those remaining behind experience long-term psychological problems. The risk of developing prolonged grief disorder appears to be five times greater than after the natural death of a loved one. The constant uncertainty seems to be the determining factor. These are the findings from research carried out by PhD student Lonneke Lenferink, funded by the Dutch Victim Support Fund.

Lenferink studied the psychological effects on 137 people in the Netherlands and Belgium who had to deal with the disappearance of a significant other. This is the first large-scale study of the psychological impact of people going missing outside of war or political repression. Lenferink will be awarded a PhD by the University of Groningen on 24 May.

An effect that is difficult to measure

In the Netherlands, an average of eighty people are reported missing every day. The majority of these cases are solved within 48 hours, but approximately one hundred cases a year remain unsolved with no clear explanation. The police do not always set up an investigation. This includes cases where people disappear of their own accord, for example. Lenferink: ‘We don’t know exactly how many people are missing long-term because of the way our systems record missing persons.’

No solace for those remaining behind

The number of people left to cope with this situation is much larger than the number of people missing. According to Lenferink, there is no solace for this forgotten group. She points out the difficulty of even finding a term to describe the people who are left behind. ‘You can't refer to them as bereaved, because this implies that the fate of their loved one is known. Not only do the people left behind have to deal with the emotional impact of their loss, many also face financial or legal problems resulting from the disappearance.’

Treating ambiguous loss

Lenferink first examined the impact of ambiguous loss: a significant other who is physically absent, but mentally very much present. She then identified factors that correlate with the way in which the people left behind deal with the disappearance and their suitability for therapy, for example. Finally, she carried out a pilot study to ascertain the feasibility and possible effectiveness of cognitive behavioural therapy combined with elements of mindfulness for reducing psychological problems.

Risk of prolonged grief disorder

There seems to be evidence that when someone goes missing, the grieving process is different from the process of grieving after the death of a loved one, says Lenferink. Symptoms such as worrying or depression can go on for prolonged periods if those left behind are unable to let go of the circumstances in which someone probably went missing. An interview study of people left behind who did not have long-term psychological problems underlines the importance of finding an effective way of dealing with the constant uncertainty.

Treatment suggestions

On the basis of her research, Lenferink helped to develop methods for treating prolonged symptoms of grief. Examples include cognitive behavioural therapy in combination with elements of mindfulness. Lenferink emphasizes that very little research has been conducted into this area, and that more international research is needed before we can make any definite claims about the effectiveness of methods for treating those left behind when a significant other goes missing.

Additional information

Psychologist Lonneke Lenferink will be awarded a PhD on 24 May for a thesis entitled The disappearance of a significant other: Consequences and care . Her supervisors are Prof. Jos de Keijser (University of Groningen), Prof. Paul Boelen (Utrecht University and Arq Pschotrauma Expert Groep) and Dr Ineke Wessel (University of Groningen).