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European Journal of Psychotraumatology logoLink to European Journal of Psychotraumatology
. 2025 Jul 7;16(1):2523080. doi: 10.1080/20008066.2025.2523080

Unfinished business, continuing bonds and bereaved college students’ grief: a three-wave longitudinal study

Asuntos no resueltos, lazos continuos y duelo en estudiantes universitarios en situación de pérdida: un estudio longitudinal en tres momentos

Jingjing Huang a, Wanyue Jiang a, Xinyi Yu a, Suqin Tang b, Renzhihui Tang a, Xiaoyan Liu c, Wenli Qian a, Lin Jiang a, Zhongfang Fu d, Jianping Wang a,CONTACT
PMCID: PMC12239121  PMID: 40622762

ABSTRACT

Background: Bereavement is one of the major stressors for college students and triggers grief.

Objective: Based on the integrative risk factor framework for the prediction of bereavement outcome, this study used a three-wave longitudinal design with 3-month intervals to explore the relationships between unfinished business and grief among bereaved college students and the role of continuing bonds (CBs), including internalized continuing bonds (ICBs) and externalized continuing bonds (ECBs).

Method: Bereaved college students who lost a loved one within the past 3 years participated in the longitudinal study (T1-T3), completing the Basic Information Questionnaire, Unfinished Business in Bereavement Scale, Continuing Bonds Scale, and Prolonged Grief Disorder-Revised Scale. Valid responses were obtained from 538 participants at T1 (100.0%), 363 at T2 (67.5%), and 320 at T3 (59.5%). The final valid sample comprised 320 participants (Mage = 21.64 years, 56.56% female) who completed all three waves.

Results: Unfinished business consistently and positively predicted grief over time. Furthermore, T1 unfinished business positively predicted T2 ICBs, while T1 ICBs negatively predicted T2 grief. In contrast, T1 ECBs positively predicted T2 grief. However, the mediating roles of T2 ICBs and T2 ECBs in the relationship between T1 unfinished business and T3 grief were not significant.

Conclusion: Unfinished business played a critical role in college students’ bereavement adjustment. Besides, in grief counselling for bereaved college students struggling with unfinished business, it may be particularly important to focus on fostering ICBs with the deceased, helping them gradually reintegrate into daily life more effectively.

KEYWORDS: Bereavement, grief, unfinished business, continuing bonds, college student

HIGHLIGHTS

  • Unfinished business consistently and positively predicted grief over time.

  • Unfinished business positively predicted internalized continuing bonds three months later.

  • Internalized continuing bonds had a negative predictive effect on grief three months later, but externalized continuing bonds had a positive predictive effect on grief three months later.

1. Introduction

Bereavement (i.e. experiencing the death of someone they love) can be a significant life challenge for college students (Keyes et al., 2014; Neimeyer et al., 2008). Studies have shown that 60% of college seniors have experienced at least one bereavement since their first year, and nearly 25% have experienced multiple bereavements (Cox & Kowalski, 2015; Plocha et al., 2023). Furthermore, the developmental stage and campus environment increase the difficulty of coping with grief for college students. In emerging adulthood, college students’ self-identity is still unstable, which may make them more vulnerable to adverse life events (e.g. bereavement) and prone to psychological problems (Arnett, 2014). Within the campus environment, the combined influence of academic pressures and social demands can make it challenging for them to devote time and energy to processing their grief, and may also intensify feelings of loneliness and alienation (Bakelants et al., 2023; Servaty-Seib & Fajgenbaum, 2015; Spiccia et al., 2023; Valentine & Woodthorpe, 2020). Additionally, the lack of comprehensive assistance policies for bereavement in many universities may leave students feeling confused, helpless, or even neglected (Cupit et al., 2021; Elsner et al., 2022; Servaty-Seib & Liew, 2019).

The impact of bereavement on college students manifests in various aspects (Balk et al., 2010), among which grief is one of the most immediate, natural, and noteworthy consequences following the loss. Grief involves changes in multiple domains, including physiological, emotional, cognitive, and behavioural aspects, such as intense longing and yearning for the deceased, dwelling on thoughts or memories related to the deceased, and experiencing feelings of guilt and regret (Shear, 2015). For most bereaved individuals, grief gradually decreases over time; however, if severe grief persists for more than 6 or 12 months and significantly impairs daily functioning, it may develop into prolonged grief disorder (Prigerson et al., 2021; World Health Organization, 2018). To better understand the process of grief formation and explore methods to prevent prolonged grief disorder, researchers have been dedicated to exploring the factors that influence grief and have developed various psychopathological models. Among these, the Integrative Risk Factor Framework for the Prediction of Bereavement Outcome is one of the most comprehensive models (Stroebe et al., 2006). This model states that bereavement brings loss-oriented (e.g. the quality of the relationship with the deceased) and restoration-oriented stressors (e.g. caregiver burden) to the bereaved. These stressors may influence the bereavement outcomes (e.g. grief) through the individual’s appraisals and coping strategies. Additionally, both interpersonal and intrapersonal factors may either heighten risk or offer protection throughout this process.

Although some studies have preliminarily explored grief among bereaved college students and identified certain influencing factors, further research is needed to address their unique developmental stage. This includes a deeper investigation into their grief experiences, risk factors, and underlying mechanisms (Servaty-Seib & Taub, 2010).

1.1. Unfinished business and grief

Unfinished business (UB) refers to incomplete, unexpressed, or unresolved relational issues between the bereaved and the deceased that characterize their past relationship, which could be a loss-oriented stressor (Ho, 2007; Holland et al., 2014; Klingspon et al., 2015; Lee et al., 2022). For college students, online communication is their primary way to connect with their family and friends as their studies and lives are mainly conducted on campus (Lipp & O’Brien, 2022). Therefore, they are more likely to be passive recipients of information about a deceased person’s severe illness or passing, and the timing and manner in which they receive the information depend largely on the informant (Deatherage, 2014). In addition, for many college students, bereavement marks their first encounter with the loss of a loved one while possessing a clear understanding of death (Balk et al., 2010). As a result, they often lack experience in handling end-of-life situations and navigating the bereavement process (Servaty-Seib & Taub, 2010; Thai & Moore, 2018). Therefore, bereaved college students are likely to leave behind unfinished business with the deceased. Empirical studies have found that unfinished business is positively related to grief (Klingspon et al., 2015), and it can positively predict concurrent grief after controlling for demographic and loss-related variables (Holland et al., 2020a, 2020b; Lee et al., 2022). However, no study has yet to explore the long-term effects of unfinished business on grief, and the mechanisms underlying this effect have yet to be elucidated.

1.2. The role of continuing bonds

Continuing bonds (CBs) refer to an intrinsic relationship that continues to develop between the bereaved and the deceased, which occurs across cultures and bereavement groups (Currier et al., 2015; Klass et al., 1996). According to attachment-based model of grief, bereavement involves the loss of an attachment figure, which activates and prompts bereaved individuals to update their internal working models of attachment (Shear & Shair, 2005). Driven by the innate desire to maintain the bond, bereaved individuals often experience longing and yearning for the deceased and attempt to ‘reconnect’ with them through various means – keeping the deceased’s belongings at home, visiting the cemetery, and confiding in the deceased (Field et al., 2013; Shear & Shair, 2005).

1.2.1. Continuing bonds and grief

Early studies have suggested that different types of CBs may have distinct psychological impacts on grief responses (e.g. Boelen et al., 2006a, 2006b). Building on this, Field and Filanosky (2009) proposed a widely adopted typology that categorizes CBs into Externalized Continuing Bonds (ECBs) and Internalized Continuing Bonds (ICBs), a classification that has since been employed in numerous studies (Albuquerque et al., 2020; De Luca et al., 2016; Ho et al., 2013).

If bereaved individuals form ECBs with the deceased, they may perceive the deceased’s ‘presence’ and experience hallucinations or illusions, which can hinder their ability to fully accept the loss (Field & Filanosky, 2009). Thus, ECBs may cause bereaved individuals to experience a strong conflict between reality and their wishes, further exacerbating their grief (Field & Filanosky, 2009). Empirical studies have also consistently shown that ECBs positively predicts concurrent grief (Field & Filanosky, 2009; Hopf et al., 2024; Keser & Işıklı, 2022; Lipp & O’Brien, 2022; Yu et al., 2016a, 2016b).

If the bereaved develop ICBs with the deceased, they may view the deceased as a secure internal representation, seeking comfort or support from them during times of stress or difficulty, or take the deceased as a guide for their thoughts and actions (Field & Filanosky, 2009). Thus, ICBs facilitate the successful integration of bereavement into individuals’ self-narratives (Field & Filanosky, 2009). Interestingly, despite theoretical expectations, many empirical studies have demonstrated a positive correlation between ICBs and grief (Ho et al., 2013; Hopf et al., 2024; Keser & Işıklı, 2022; Lipp & O’Brien, 2022). Furthermore, ICBs have been found to positively predict (Field & Filanosky, 2009), negatively predict (Scholtes & Browne, 2015), or fail to predict concurrent grief (Yu et al., 2016a).

Some studies have also suggested that the relationship between CBs and grief may be influenced by other factors, such as attachment style (Currier et al., 2015), meaning-making (Neimeyer et al., 2006), and the bereaved individuals’ subjective perceptions of CBs (Packman et al., 2011). However, there is still debate regarding the functional roles of these factors (i.e. as mediators or moderators) in this relationship (e.g. attachment style, Currier et al., 2015; Yu et al., 2016b). Notably, existing research on potential moderators has rarely been conducted based on a classification of CBs. We argue that classifying CBs is necessary, and that the classical dichotomous approach – dividing CBs into ICBs and ECBs – has both theoretical grounding and empirical support. Therefore, the present study aims to investigate the relationship between dichotomously classified CBs and grief, using the Continuing Bonds Scale (CBS-16; Field & Filanosky, 2009).

In addition, previous studies on dichotomous classification of CBs rely on cross-sectional designs, which primarily reveal concurrent associations with grief. Notably, an early prospective study found that, although the results did not reach statistical significance, after controlling for baseline grief severity, feeling guided by the deceased (can be regarded as ICB) was negatively associated with grief severity at 9-month follow-up, while cherishing the deceased’s belongings (closer to ECB) was positively associated with grief severity at 9-month follow-up (Boelen et al., 2006a, 2006b). Another study comparing widowed individuals 4 months post-loss and more than 2 years post-loss suggested that the role of CBs may vary depending on time since loss (Field & Friedrichs, 2004). Therefore, the present study will employ a multi-wave longitudinal design to further examine the long-term effects of ICBs and ECBs on grief.

1.2.2. Continuing bonds and unfinished business

CBs is also strongly associated with unfinished business. Unfinished business may create a psychological tension within the individual that persists until the individual is satisfied with completing the business (Zeigarnik, 1938). Therefore, bereaved individuals who perceive unfinished business with the deceased often remain motivated to ‘complete’ these matters in order to achieve a sense of closure. Previous research has also shown that bereaved individuals who perceive unfinished business will place a high value on improving their relationship with the deceased, such as expressing a strong desire to convey apologies (Yamashita et al., 2017).

Greenberg and Paivio (1997) proposed that, from the perspective of emotional processing, unfinished business represents a form of maladaptive emotional memory. van der Kolk (1996) further argued that opportunities to express previously suppressed emotions may facilitate the retrieval and reprocessing of such memories, thereby aiding in the resolution of unfinished business. Clinical interventions targeting unfinished business often underscore the importance of emotional expression and the reconstruction or redefinition of the bereaved individual’s relationship with the deceased (Neimeyer, 2012; Shear, 2015). In this regard, CBs offer a meaningful channel through which this process can unfold.

A qualitative study found that bereaved individuals often perceive hallucinations or dreams involving the deceased (such as seeing, hearing, or reuniting with them in dreams) as opportunities to process unfinished business (Chan et al., 2005). Maintaining CBs with the deceased also facilitates self-forgiveness or forgiveness of the deceased for past wrongs (Suhail et al., 2011; Woo & Chan, 2010). Thus, one of the primary functions of CBs is to assist bereaved individuals in resolving unfinished business and addressing relational issues with the deceased (Hewson et al., 2023). Additionally, quantitative research also provided preliminary evidence that the level of distress triggered by unfinished business is positively correlated with bereaved people’s level of CBs (Klingspon et al., 2015).

Currently, the relationship between distressing emotions that may result from unfinished business (e.g. guilt, regret, self-blame, etc.) and CBs has received attention from researchers. For example, bereaved individuals’ guilt has been found to be positively correlated with both ICBs and ECBs (Li et al., 2021); it has also been found that regret or self-blame is positively correlated with ECBs but not significantly correlated with ICBs (Black et al., 2022). The inconsistency of the findings makes it challenging to clarify the specific relationship between unfinished business and different types of CBs, indicating that further empirical research is needed.

1.2.3. The mediating role of continuing bonds

According to the Integrative Risk Factor Framework for the Prediction of Bereavement Outcome, loss-oriented stressors may influence grief reactions through the bereaved individual’s coping strategies (Stroebe et al., 2006). CBs can be conceptualized as a grief-specific coping strategy (Root & Exline, 2014; Stroebe & Schut, 2005). In addition, several empirical studies have shown that both ICBs and ECBs can mediate the relationship between loss-oriented stressors (e.g. closeness to the deceased) and grief (Field & Filanosky, 2009; Sekowski & Prigerson, 2022; Yu et al., 2016b). Therefore, CBs (including ICBs and ECBs) may also serve as a mediator in the relationship between unfinished business and grief.

1.3. Aims of the present study

Previous studies have suggested that unfinished business, continuing bonds, and grief reactions may be closely related. However, most of the existing research has employed cross-sectional designs, which limit the ability to infer causal relationships among these variables (Kraemer et al., 2000). Although some studies have used longitudinal designs to examine the predictive effects of baseline risk factors on subsequent grief reactions while controlling for baseline grief levels (Boelen et al., 2006a, 2006b; Janshen et al., 2024; Thimm et al., 2024), they have not fully captured the dynamic associations among variables – particularly when the risk factors themselves are subject to change over time.

In contrast, the cross-lagged panel model (CLPM) offers significant advantages. This approach not only accounts for the temporal stability of variables but also allows for more accurate estimation of reciprocal influences and temporal ordering, thereby strengthening causal inference (Cole & Maxwell, 2003). Therefore, the present study adopted a three-wave longitudinal design and applied a cross-lagged panel model to examine following hypotheses: (1) Unfinished business will positively predict grief reactions over time; (2) Unfinished business will positively predict both ICBs and ECBs over time; (3) ICBs will negatively predict grief over time; (4) ECBs will positively predict grief over time; (5) ICBs and ECBs will longitudinally mediate the relationship between unfinished business and grief.

In this study, we chose a 3-month interval between measurement waves, a decision based on both theoretical and practical considerations. Bereavement-related psychological responses often fluctuate significantly over relatively short periods (e.g. Smith & Ehlers, 2020). Therefore, using a shorter interval allows us to better capture the dynamic nature of the variables and accurately examine their associations. Moreover, previous longitudinal studies involving college student samples in various psychological domains have also commonly adopted a 3-month interval (e.g. Chang et al., 2022; Henderson et al., 2023), providing empirical support for the feasibility and appropriateness of this design.

2. Method

2.1. Participants

The inclusion criteria for participants were as follows: (1) have lost a loved one during college; (2) bereavement was within 3 years at T1; (3) self-reported absence of serious mental disorders (e.g. bipolar disorder, schizophrenia); and (4) no newly encountered bereavement experiences throughout the survey period. Ultimately, a total of 538 valid participants completed the baseline survey (T1; 100%), with 363 remaining at T2 (67.5%) and 320 at T3 (59.5%), yielding an overall dropout rate of 40.5%.

2.2. Procedures

This study was part of a project on the mental health status and influencing factors of bereaved college students and was approved by Institutional Review Board of the researcher’s institution (BNU202303170056). A convenience sampling method was used to recruit participants through posters posted on online social media platforms (e.g. WeChat Moments, WeChat groups), which are easy to reach real college students, and data were collected using the Qualtrics online survey platform system. Participants completed an informed consent form and then three surveys in March (T1), June-July (T2), and October 2023 (T3). Since each survey wave allowed approximately two weeks for participants to complete the questionnaires, the actual data collection period spanned roughly seven months. Based on the personal information provided by participants at the end of each survey (which was kept strictly confidential and removed during data analysis), the researchers were able to verify their identity, and compensated them with ¥15, ¥20, and ¥25 for each survey, as well as a grief self-help booklet upon completion of all surveys.

2.3. Measures

2.3.1. Demographic and loss-related information

Demographic information included age, gender, and education level of the bereaved. Loss-related information included the deceased’s age, gender, time since loss (months), relationship with the deceased (e.g. parent, grandparent), and cause of death. Cause of death was categorized as either natural or unnatural. Unnatural deaths included those resulting from accidents, suicides, homicides, disasters, terrorism, or war (Djelantik et al., 2020; Eisma et al., 2021; Lenferink & Boelen, 2023), whereas natural deaths were due to aging or illness.

2.3.2. Unfinished business in bereavement scale

The 28-item Unfinished Business in Bereavement Scale (UBBS) developed by Holland et al. (2020a, 2020b) was used. Participants assessed the distress related to each statement over the past month on a Likert-5 scale (1 = not at all distressed, 5 = extremely distressed), with a higher total score representing a higher level of distress triggered by unfinished business. The scale has been validated among Chinese bereaved college students (Huang et al., 2024). In this study, the Cronbach’α coefficients of UBBS at three time points were .94 (T1), .95 (T2), and .96 (T3), respectively.

2.3.3. Continuing bonds scale

The Continuing Bonds Scale (CBS) developed by Field and Filanosky (2009) was used, consisting of 16 items in two dimensions: ICBs (10 items) and ECBs (6 items). Participants assessed the extent to which each statement corresponded to the actual situation in the past month on a Likert-5 scale (1 = strongly disagree, 5 = strongly agree). Total scores were calculated for each dimension, with a higher score indicating a higher degree of ICBs and ECBs. The scale showed good reliability and validity among Chinese bereaved parents (Li et al., 2015). In this study, the Cronbach’α coefficients of CBS at three time points were .87 (T1), .87 (T2), and .90 (T3) for ICBs and .89 (T1), .91 (T2), and .89 (T3) for ECBs.

2.3.4. Prolonged grief disorder-revised scale

The Prolonged Grief Disorder Revised Scale (PG-13-R) developed by Prigerson et al. was used (Prigerson et al., 2009; Prigerson et al., 2021). The scale consists of 13 items, 10 of which were selected for this study as reflecting different performances of grief. Participants assessed the frequency of these items in the past month on a Likert-5 scale (1 = never, 5 = always), and a higher total score indicated severer grief. The scale shows good reliability and validity among Chinese bereaved people (Zou, 2022). In this study, the Cronbach’α coefficients of PG-13-R were .89 (T1), .91 (T2), and .89 (T3).

2.4. Data analysis

Data organization, descriptive statistics, correlation analysis, independent samples t-tests, Chi-square test, and repeated measures analysis of variance (ANOVA) were conducted using SPSS 26.0, while longitudinal mediation analysis was performed in Mplus 8.7 by constructing cross-lagged models.

First, the data from multiple surveys of the same participants were matched based on the personal information provided at the end of each survey. This resulted in the final sample and dropout sample, and descriptive statistics were performed to examine the demographic and loss-related information. Next, independent samples t-tests and Chi-square test were conducted to compare whether there were any significant differences between the final sample and the dropout sample in terms of demographic and loss-related variables, as well as the key variables at T1. Third, descriptive statistics and correlation analyses were performed for key variables. Additionally, repeated measures ANOVA was used to test the group-level differences of key variables at different time points.

Finally, a first-order CLPM was constructed in Mplus 8.3 using the method of maximum likelihood (ML) to examine the concurrent and prospective relationships between unfinished business, ICBs, ECBs, and grief. The bereaved’s gender, the deceased’s gender, education level, relationship with the deceased, and cause of death were dummy coded. All demographic and loss-related information was included as covariates, given prior research indicating significant associations between these factors and the key study variables (e.g. Buur et al., 2024; Field & Filanosky, 2009; Holland et al., 2020a, 2020b). The analysis code is available at: https://osf.io/z65mx/?view_only=87ef4b7f443243f790f2f0ae94d5f4ed.

Model fit was determined by the Comparative Fit Index (CFI) and Tucker Lewis Index (TLI), Root Mean Square Error of Approximation (RMSEA), and Standardized Root Mean Square Residual (SRMR) metrics. Acceptable model fit was indicated when CFI > .90, TLI > .90, RMSEA < .08 and SRMR < .08 (Hu & Bentler, 1999; Schermelleh-Engel et al., 2003). In addition, we further tested the mediating role of ICBs and ECBs. Using a repeated random sampling method (Bootstrap method), the sample size was set to 1000, and a bias-corrected 95% confidence interval that did not contain zero was determined to indicate a significant mediating effect (Hayes, 2017).

3. Results

3.1. Sample characteristics

Table 1 presents the basic information and between-group comparisons for the the final sample (N = 320) and the dropout samaple (N = 218). The final sample included 320 bereaved students, with a mean age of 21.64 years, of which 56.56% were female. Differences between the final sample (N = 320) and the dropout samaple (N = 218) in terms of gender, age of the deceased, T1 unfinished business, and T1 ECBs were significant, but not on other demographic and loss-related variables, T1 ICBs and T1 grief.

Table 1.

The basic information and between-group comparisons for the final sample (N = 320) and the dropout samaple (N = 218).

Variables Final sample (N = 320) Dropout sample (N = 218) χ2 / t p
N (%) / M ± SD N (%) / M ± SD
Demographic variables        
Age at T1 21.64 ± 1.93 21.41 ± 2.03 1.34 .180
Gender        
 Male 139 (43.44%) 126 (57.80%) – 10.70 .001
 Female 181 (56.56%) 92 (42.2%)
Educational level        
 Undergraduate 248 (77.50%) 183 (83.94%) – 3.38 .066
 Graduate 72 (22.50%) 35 (16.06%)
Loss-related variables        
Age of deceased 67.56 ± 19.29 63.02 ± 20.33 2.60 .010
Gender of the deceased        
 Male 172 (53.75%) 122 (55.96%) – 0.26 .613
 Female 148 (46.25%) 96 (44.04%)
Time since loss (months) at T1 12.39 ± 9.43 13.12 ± 10.23 – 0.86 .393
Relationship with deceased        
 Parents 36 (11.25%) 27 (12.39%) – 8.03 .155
 Grandparent 239 (74.69%) 146 (66.97%)
 Partner 5 (1.56%) 2 (0.92%)
 Sibling 10 (3.13%) 6 (2.75%)
 Friend 20 (6.25%) 27 (12.39%)
 Other relatives 10 (3.13%) 10 (4.59%)
Cause of death        
 Natural death (e.g. illness) 280 (87.50%) 179 (82.11%) – 3.01 .083
 Unnatural death (e.g. accident) 40 (12.50%) 39 (17.89%)
T1 UB 3.48 ± 0.70 3.62 ± 0.67 – 2.29 .022
T1 ICBs 3.65 ± 0.77 3.54 ± 0.74 1.63 .103
T1 ECBs 2.57 ± 1.01 2.81 ± 0.86 – 3.02 .003
T1 PG 2.84 ± 0.80 2.96 ± 0.79 – 1.74 .082
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3.2. Preliminary analysis of key variables at each time point

The results of the descriptive statistics and correlation analyses are presented in Table 2. Unfinished business of bereaved college students was moderately high. Significant positive correlations (ps < .001) were found between unfinished business, ICBs, ECBs, and grief at all time points. In addition, repeated measures ANOVA showed a decreasing trend in unfinished business and grief over time (ps < .001) but a decreasing and then unchanging trend in ICBs and ECBs (T1 vs. T2: ps < .001; T2 vs. T3: ps > .05).

Table 2.

Descriptive statistics and correlation matrix for key variables at each time point (N = 320).

  M SD 1 2 3 4 5 6 7 8 9 10 11
1. T1 UB 3.48 0.70                      
2. T2 UB 3.31 0.75 .67***                    
3. T3 UB 3.21 0.81 .65*** .74***                  
4. T1 ICBs 3.65 0.77 .42*** .26*** .25***                
5. T2 ICBs 3.35 0.81 .38*** .54*** .42*** .58***              
6. T3 ICBs 3.33 0.85 .38*** .49*** .51*** .54*** .74***            
7. T1 ECBs 2.57 1.01 .52*** .45*** .43*** .46*** .43*** .42***          
8. T2 ECBs 2.28 0.93 .39*** .52*** .48*** .26*** .47*** .47*** .66***        
9. T3 ECBs 2.20 0.97 .37*** .48*** .54*** .22*** .37*** .50*** .66*** .79***      
10. T1 grief 2.84 0.80 .55*** .48*** .47*** .35*** .30*** .34*** .57*** .41*** .45***    
11. T2 grief 2.45 0.77 .42*** .54*** .50*** .15*** .27*** .33*** .44*** .59*** .54*** .60***  
12. T3 grief 2.24 0.72 .41*** .53*** .58*** .17*** .25*** .35*** .44*** .51*** .57*** .54*** .74***
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Note: *p < .05, **p < .01, ***p < .001. UB = unfinished business, ICBs = internalized continuing bonds, ECBs = externalized continuing bonds.

3.3. Cross-lagged panel model

After controlling for the bereaved’s gender (male = 0, female = 1) and T1 age, the deceased’s gender (male = 0, female = 1) and age, time since loss at T1, relationship with the deceased (using parent as the reference group, with five dummy variables), and cause of death (natural = 0, unnatural = 1), a three-wave cross-lagged panel model was constructed to examine unfinished business, ICBs, ECBs, and grief. The results indicated that the model fit well: χ²/df = 1.50, RMSEA = .040, CFI = .997, TLI = .961, SRMR = .014.

Significant positive concurrent relationships (r = .12 ∼ .54, ps < .05) existed within each time point between unfinished business, ICBs, ECBs, and grief. The first-order autoregressive coefficients indicated that the level of unfinished business, ICBs, ECBs, and grief were all stable (β = .44 ∼ .59, ps < .001). Regression coefficients indicated that T1 unfinished business positively predicted T2 grief and T2 unfinished business positively predicted T3 grief (β = 0.13, p = .033; β = 0.16, p = .001). T1 unfinished business positively predict T2 ICBs (β = 0.14, p = .044). Meanwhile, T1 ICBs had a negative predictive effect on T2 grief (β =  – 0.12, p = .013), and T1 ECBs had a positive predictive effect on T2 grief (β = 0.15, p = .009). Figure 1 illustrates the estimated autoregressive and cross-lagged paths in the cross-lagged panel model.

Figure 1.

Figure 1.

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Cross-lagged model of UB, ICBs, ECBs, and grief.

Note: *p< .05, **p<.01, ***p<.001; UB = unfinished business, ICBs = internalized continuing bonds, ECBs = externalized continuing bonds. Dashed line indicated that the path coefficient is not significant. Standardized coefficients were displayed. For simplicity, the predictive effect of covariates and the correlations among variables within each time point are omitted.

The bootstrap results of 1000 resamples showed that the 95% confidence intervals for the mediating effects of both T2 ICBs and T2 ECBs contained 0, indicating that none of the mediating effects were significant (see Table 3).

Table 3.

Results of the longitudinal mediation effect test (N = 320).

Paths Standardized estimates Boot SE 95% CI
T1 UB → T2 ICBs → T3 grief – 0.009 0.008 [ – 0.033, 0.001]
T1 UB → T2 ECBs → T3 grief 0.006 0.007 [ – 0.002, 0.028]
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Note: *p < .05, **p < .01, ***p < .001. UB = unfinished business, ICBs = internalized continuing bonds, ECBs = externalized continuing bonds.

4. Discussion

For bereaved college students, the challenges of emerging adulthood and the campus environment may heighten their risk for severe grief and PGD, with unfinished business emerging as a key risk factor. However, few studies have examined the prospective predictive role of unfinished business on grief and the mechanisms involved. Therefore, the present study employed a three-wave longitudinal design to examine the prospective predictive role of unfinished business on bereaved college students’ grief and the mediating role of CBs. The results indicated that unfinished business had a stable, positive prospective predictive effect on grief. T1 unfinished business had a positive prospective predictive effect on T2 ICBs; and long-term effects between ICBs, ECBs, and grief were also identified. However, neither T2 ICBs nor T2 ECBs mediated between T1 unfinished business and T3 grief.

4.1. Unfinished business and its relationship with grief

The unfinished business of Chinese bereaved college students is in the middle to high range (MT1 = 3.48; MT2 = 3.31; MT3 = 3.21), much higher than those reported in two samples of American bereaved college students (M = 1.71, 1.57, respectively, Holland et al., 2020), Turkish bereaved adults (M = 2.17; Keser et al., 2022) and Dutch bereaved adults who lost someone during the first wave of the COVID-19 pandemic (M = 1.72; Becqué et al., 2024). This difference may be related to loss-related characteristics of the sample. The sample in this study consisted only of college students who had a close relationship with the deceased, with a relatively short time since the loss. In addition, the emphasis on familial bonds and ‘good death’ in Chinese culture may heighten bereaved individuals’ sensitivity to unfinished business with the deceased. Future research could further compare UB levels between college students and other bereaved populations to examine whether college students exhibit higher levels of unfinished business due to their developmental stage and campus environment.

The present study found that the level of distress caused by unfinished business was a prospective predictor of bereaved college students’ grief, which confirms and further extends the findings of previous studies (Field & Horowitz, 1998; Holland et al., 2020a, 2020b; Keser et al., 2022). When bereaved people perceive that there are some unfinished businesses between them and the deceased, they may feel that certain fundamental psychological needs remain unmet, leading these unmet needs to dominate their current lives (Polster & Polster, 1973). To resolve these issues, their thoughts often remain fixated on the deceased, frequently recalling memories and events related to the deceased or the death itself (Root, 2012), as well as their loss-related feelings and behaviours. These recurrent thoughts may increase the bereaved person’s negative perceptions and emotions about the bereavement event, preventing the individual from processing the loss event and integrating it into autobiographical memory, and accepting the fact of the deceased’s death, thereby perpetuating bereavement-related distress (Stroebe et al., 2007). In addition, the nature of unfinished business is the bereaved person’s past memories about the deceased; however, if the bereaved person keeps focusing on the past, they may neglect real life and not have enough time and energy to participate in social activities, learn new skills and hobbies, etc. They will have difficulty rebuilding their daily life and adapting to bereavement (Stroebe & Schut, 2010). Therefore, the greater the distress caused by unresolved issues, the more intense the grief experienced by bereaved college students will be.

4.2. Relationships among continuing bonds, unfinished business and grief

The present study, using the cross-lagged model, revealed prospective predictive roles for CBs, unfinished business, and grief.

First, T1 unfinished business positively predicted T2 ICBs, but not ECBs prospectively. This may be because the nature of the prior relationship with the deceased may shape and influence the forms and feelings of the bereaved college student’s ongoing bonds with the deceased in the present (Hayes & Leudar, 2016; Sekowski & Prigerson, 2022). On the one hand, unfinished business may often cause the bereaved to experience feelings of guilt and regret and also blame themselves (Holland et al., 2014). These emotions, tied to moral codes and self-expectations, may drive the bereaved to miss the deceased more, seek to make amends for past actions, and place greater value on the deceased’s impact on their lives (Camacho et al., 2018; Li et al., 2021). At this point, the bereaved are more likely to engage in ICBs and work toward resolving unfinished business within these bonds, leading to increased comfort and reduced pain (Black et al., 2022; Parker, 2005). The positive feelings associated with ICBs may motivate the bereaved to continue using them subsequently, and thus unfinished business can increase the degree of ICBs over time. On the other hand, if unfinished business involves conflicts, secrets, or problems with the deceased, it may lead the bereaved to feel ambivalence toward the deceased, often generating emotions like anger. In this case, the bereaved are more likely to maintain the conflicted relationship through ECBs, feeling a lack of autonomy and control in managing the relationship, memories, and emotional distress of bereavement. This leaves the bereaved feeling uncertain about how to resolve the conflict and move forward (Hewson et al., 2023; Packman et al., 2006). In such cases, ECBs may not help resolve unfinished business, which discourages the bereaved from choosing to continue using ECBs.

Second, T1 ICBs negatively predicted T2 grief, while T1 ECBs positively predicted T2 grief. This is supported by some previous cross-sectional studies (Field & Filanosky, 2009; Lipp & O’Brien, 2022; Scholtes & Browne, 2015). However, a previous longitudinal cross-cultural study found that the more CBs Chinese bereaved had at 4 months post-bereavement, the less psychological distress they experienced at 18 months post-bereavement (Lalande & Bonanno, 2006). The present study’s results may suggest that CBs’s effect on Chinese bereavement adaptation varies by type. ICBs not only helps the bereaved to obtain more guidance and support from the deceased, and thus have the strength to face many real-life problems, but also motivates the bereaved to actively engage in post-bereavement meaning-making, all of which may help individuals to alleviate grief (Neimeyer et al., 2006), and thus may play a protective role in long-term bereavement adaptation. ECBs, on the other hand, is a risk factor in long-term bereavement adaptation, as it tends to make bereaved individuals experience a deep sense of ‘absence of the deceased’, which is psychologically shocking and intensely distressing (Field et al., 2013; Sabucedo et al., 2021), making it difficult for them to accept the fact of bereavement, thus exacerbating the grief after a period of time.

Finally, it is worth noting that the predictive effects of unfinished business on ICBs, as well as ICBs and ECBs on grief, were only present between T1 and T2 and were not significant between T2 and T3. This also makes the present study fail to find the mediating roles of ICBs and ECBs. On the one hand, this may be related to time since the loss of the participants in this study. The average time since loss for the participants in this study had reached 18–19 months at T3, and although the level of unfinished business and grief were still decreasing from T2 to T3, both ICBs and ECBs had been maintained relatively stable. Thus, the level of associations might not be able to be easily affected by other factors or influence bereavement outcomes any longer. This also implies that the role of unfinished business on the two types of CBs, and the role of CBs on grief, may be more pronounced in the early stages following bereavement.

4.3. Implications

First, this study found that unfinished business is a robust risk factor for grief among bereaved college students. Previous research has also highlighted that addressing unfinished business can help alleviate psychological distress, including grief (Yamashita et al., 2017). This suggests that, on the one hand, mental health education can be provided to college students to raise their awareness of the importance of unfinished business in order to minimize unfinished business. On the other hand, universities and academic institutions could implement bereavement policies to support students in better navigating end-of-life and post-death matters (Cupit et al., 2021).

Second, the present study found that ICBs negatively predicted grief prospectively, while ECBs positively predicted grief in the early stages of bereavement. This supports the categorization of CBs and provides additional empirical evidence. At the same time, it suggests that effective grief interventions need to focus specifically on facilitating the establishment of ICBs with the deceased. Specific approaches may include using constructivist or narrative therapy techniques of writing letters to the deceased or employing the empty chair technique of Gestalt therapy to engage in imaginative conversations with the deceased (Neimeyer, 2012; Shear, 2015).

4.4. Limitations

Although this study explored the relationship between unfinished business and grief among bereaved college students and the role of CBs, the following limitations still need to be considered.

First, the participants were recruited through online platforms, which forms a convenience sample. Bereaved college students who had lower severity of grief may be more willing to disclose their grief authentically and more willing to use online and social platforms to participate in this study. Future studies could conduct offline hierarchical random sampling at multiple colleges in multiple regions, which would cover a broader group of college students and further improve the generalizability of the findings.

Second, the relatively high dropout rate in this study may be due to limitations in tracking technology in this study and the challenges of conducting bereavement research in China. Due to differences in some baseline characteristics, T1 unfinished business and T1 ECBs between the dropout sample and the final sample, the final sample’s representativeness may have been somewhat reduced. This discrepancy may have led to an underestimation of the predictive effects of UB and ECBs, thus limiting the generalizability of the study’s findings.

Third, the range of bereavement duration for the current sample was limited to 3 years, while grief changes rapidly right after the loss. Future research may benefit from recruiting bereaved college students with a shorter time since the loss (e.g. within one year) for a long-term follow-up study and increasing the number of time points measured (i.e. three and above). Additionally, CBs, a coping style specific to post-bereavement, may change dynamically with daily life contexts, so future studies may also consider using ecological momentary assessments to improve the ecological validity of the study.

Finally, although the results of this study provide empirical support for the validity of the dichotomous classification of Cbs to some extent, future research could further build on this foundation by exploring the roles of other potential influencing factors in the relationship between different types of CBs and grief, thereby offering a more comprehensive understanding of the mechanisms underlying the dichotomous classification of CBs.

5. Conclusion

For college students at a critical stage of life, bereavement, as a significant adverse life event, can be overwhelming and lead to maladaptive grief, hindering their personal growth and future development. The present study found that (1) bereaved college students’ unfinished business, ICBs, ECBs, and grief were positively correlated; (2) unfinished business was a prospective positive predictor of grief; and (3) between T1 and T2, unfinished business was a prospective positive predictor of ICBs, and ICBs further negatively predicted grief, while ECBs shows a prospective positive effect on grief.

Acknowledgements

We gratefully acknowledged the contribution of all participants of the present research.

Funding Statement

This work was supported by the Chen Zhonggeng Clinical and Counseling Psychology Development Fund, School of Psychology and Cognitive Sciences, Peking University [Grant Number 2022YJ001(JD)].

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

The data that support the findings of this study are available from the corresponding author, upon reasonable request.

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Data Availability Statement

The data that support the findings of this study are available from the corresponding author, upon reasonable request.

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