Posttraumatic Growth Among Suicide-Loss Survivors: Protocol for an Updated Systematic Review and Meta-Analysis
Authors: Whittaker Spence , Rasmussen Susan , Cogan Nicola , Tse Dwight , Martin Bethany , Andriessen Karl , Shiramizu Victor , Krysinska Karolina , Levi-Belz Yossi 
Published: February 2025

Background
Losing a loved one to suicide is an event that can have strong and potentially traumatic impacts on the lives of the bereaved survivors, especially regarding their grief, which can be complicated. These bereaved individuals are also less likely to receive social support following their bereavement. However, besides these adverse impacts, growing evidence supports the concept of posttraumatic growth following suicide bereavement. Posttraumatic growth is the personal improvement that occurs as a consequence of experiencing a traumatic or extremely challenging event or crisis. Only 1 systematic review and meta-analysis on posttraumatic growth following suicide bereavement has been conducted; this protocol is for the planned systematic review and meta-analysis update of the original systematic review and meta-analysis, as the original review collected its data in 2018.

Objective
This review aims to investigate demographic characteristics, correlational relationships, and facilitative factors of posttraumatic growth in individuals bereaved by suicide. In addition, as this is an update of a previous systematic review and meta-analysis, we aim to compare our findings with the original review and to identify any similarities or differences.

Methods
This protocol outlines the planned procedures of the updated systematic review and meta-analysis. MEDLINE, PsycINFO, Embase, CINAHL, Scopus, and Web of Science (Core Collection) were examined, and the search results were imported to Covidence, where title and abstract screenings and full-text screenings occurred. The inclusion and exclusion criteria for this updated review match those in the original review: (1) the study population must contain participants bereaved by suicide, (2) the study data must be quantitative, and (3) the study must report data on posttraumatic or stress-related growth. The original review conducted its search before 2019; thus, this updated review searched databases for the timeframe of January 2019 to January 2024. The updated meta-analysis will synthesize data from both the original and updated reviews to examine trends over time. The Newcastle-Ottawa Scale (NOS) will be used to assess publication quality. Random-effects meta-analyses will be conducted using RStudio (R Foundation for Statistical Computing).

Results
The review was funded in October 2023 and is currently in progress. Results are expected to be finalized in October 2024. There are 21 articles that have been included in the review and are being analyzed at this time. We aim to submit the full article for publication in December 2024.

Conclusions
The results of this updated systematic review and meta-analysis will be used to examine key relationships and findings regarding posttraumatic growth in individuals bereaved by suicide. The discussion will also investigate the findings of this updated review in comparison to the findings of the original review. Any differences would be highlighted. Limitations of the current review will be discussed, such as the quality of the articles included.

Trial Registration
PROSPERO CRD42024485421; https://tinyurl.com/3hzpnzr3

International Registered Report Identifier (IRRID)
DERR1-10.2196/64615