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Cross-cultural generalizability of the ICD-11 PGD symptom network: Identification of central symptoms and culturally specific items across German-speaking and Chinese bereaved.

Authors
  • Stelzer, Eva-Maria1
  • Höltge, Jan2
  • Zhou, Ningning3
  • Maercker, Andreas4
  • Killikelly, Clare4
  • 1 Department of Psychology, University of Zurich, Binzmuehlestrasse 14/17, CH-8050 Zurich, Switzerland; Department of Psychology, University of Arizona, 1503 E. University Blvd, Tucson, AZ 85721, United States. Electronic address: [email protected] , (Switzerland)
  • 2 Resilience Research Centre, Dalhousie University, Halifax, Canada. , (Canada)
  • 3 Department of Psychology, University of Zurich, Binzmuehlestrasse 14/17, CH-8050 Zurich, Switzerland; The School of Psychology and Cognitive Science, East China Normal University, Shanghai 200062, PR China. , (Switzerland)
  • 4 Department of Psychology, University of Zurich, Binzmuehlestrasse 14/17, CH-8050 Zurich, Switzerland. , (Switzerland)
Type
Published Article
Journal
Comprehensive psychiatry
Publication Date
Nov 01, 2020
Volume
103
Pages
152211–152211
Identifiers
DOI: 10.1016/j.comppsych.2020.152211
PMID: 33049644
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

Prolonged grief disorder (PGD) is a newcomer to psychopathology and the new ICD-11 diagnostic criteria are conceptualized with an eye towards global applicability. Yet, previous network studies have not used official ICD-11 criteria nor tested whether network structures generalize across cultural groups even though much current research relies on ICD-11 PGD criteria. To overcome these limitations, the present study used data from 539 German-speaking (n = 214) and Chinese (n = 325) bereaved individuals to investigate similarities and differences in network structures of ICD-11 PGD criteria. In addition, network structures were investigated for an expanded supplementary questionnaire of culturally-bound grief symptoms hypothesized to be of relevance in each cultural context. Results suggested both similarities and differences in network structures between the two samples. Across cultural groups, intense feelings of sorrow and inability to experience joy or satisfaction since the death emerged as most central symptoms. Compared to the standard PGD network, the expanded network showed a better average predictability for Chinese participants, but no improvement for the German-speaking context. Unhealthy behavior change was the most central symptom for Chinese bereaved when additional grief symptoms were included. Results of the present study suggest there are culturally-bound symptoms of grief which are not included in the current ICD-11 PGD criteria. These findings provide areas of special clinical attention concerning screening and treatment and present a first step towards a more cultural-sensitive understanding of grief. NCT03568955. Copyright © 2020 The Authors. Published by Elsevier Inc. All rights reserved.

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