{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T16:33:22Z","timestamp":1790786002807,"version":"4.1.0"},"reference-count":61,"publisher":"MDPI AG","issue":"23","license":[{"start":{"date-parts":[[2025,12,3]],"date-time":"2025-12-03T00:00:00Z","timestamp":1764720000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Funda\u00e7\u00e3o para a Ci\u00eancia e Tecnologia","award":["UIDB\/05380\/2020,"],"award-info":[{"award-number":["UIDB\/05380\/2020,"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Bereavement often elicits complex emotional and cognitive reactions, including guilt, unresolved relational concerns, and repetitive negative thinking. Although grief-specific rumination is recognized as a key process that can intensify prolonged grief and trauma-related responses, longitudinal evidence clarifying its mediating role remains limited. This study examines whether grief-specific rumination explains how guilt and unfinished business contribute to prolonged grief and PTSD symptoms over time. Methods: A two-wave longitudinal design was used to assess bereaved adults several months after loss and again at follow-up. Measures included guilt, unfinished business, grief-specific rumination, prolonged grief symptoms, and PTSD symptoms. Mediation analyses tested whether rumination accounted for associations between early loss-related responses (guilt and unfinished business) and psychological outcomes at follow-up. Results: Grief-specific rumination consistently emerged as the mechanism linking guilt and unfinished business with both prolonged grief and PTSD symptoms. These findings suggest that the impact of these early loss-related responses operates primarily through persistent and repetitive cognitive engagement with the loss. Conclusions: Rumination emerged as a central mechanism through which guilt and unfinished business shape bereavement-related distress. These findings highlight the importance of interventions that directly target repetitive negative thinking to promote healthier adjustment following loss.<\/jats:p>","DOI":"10.3390\/jcm14238582","type":"journal-article","created":{"date-parts":[[2025,12,8]],"date-time":"2025-12-08T16:20:29Z","timestamp":1765210829000},"page":"8582","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Guilt and Unfinished Business in Bereavement: Rumination as a Pathway to Prolonged Grief and Trauma"],"prefix":"10.3390","volume":"14","author":[{"given":"Sara","family":"Albuquerque","sequence":"first","affiliation":[{"name":"HEI-Lab: Digital Human-Environment Interaction Labs, Lus\u00f3fona University, Campo Grande 376, 1749-024 Lisboa, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beatriz Barbas","family":"Pereira","sequence":"additional","affiliation":[{"name":"Academia Transformar, Av. Ant\u00f3nio Augusto de Aguiar 17 5th Floor, 1050-012 Lisboa, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2883-415X","authenticated-orcid":false,"given":"Alexandra","family":"Coelho","sequence":"additional","affiliation":[{"name":"ISPA\u2014Instituto Universit\u00e1rio de Ci\u00eancias Psicol\u00f3gicas, Sociais e da Vida, R. do Jardim do Tabaco 34, 1149-041 Lisboa, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7952-6296","authenticated-orcid":false,"given":"Ricardo","family":"Pinto","sequence":"additional","affiliation":[{"name":"HEI-Lab: Digital Human-Environment Interaction Labs, Lus\u00f3fona University, Campo Grande 376, 1749-024 Lisboa, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,12,3]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1960","DOI":"10.1016\/S0140-6736(07)61816-9","article-title":"Health outcomes of bereavement","volume":"370","author":"Stroebe","year":"2007","journal-title":"Lancet"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1150","DOI":"10.1037\/0022-3514.83.5.1150","article-title":"Resilience to loss and chronic grief: A prospective study from preloss to 18-months postloss","volume":"83","author":"Bonanno","year":"2002","journal-title":"J. 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