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Prolonged Grief in Cambodian Refugees Following Genocide: Rebirth Concerns and Avoidance of Reminders

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This study investigated whether prolonged grief (PG) forms a coherent syndrome that is discrete from posttraumatic stress disorder (PTSD) in a Cambodian refugee population and examined the relative centrality to PG of “avoidance of reminders of the deceased” as compared to “rebirth concerns” in the group. The Prolonged Grief 13 (PG-13) scale significantly explained variance over and beyond PTSD in regression analyses of severity of bereavement, as assessed by a culturally sensitive measure of grief (CSM-G) and by the presence of grief-related functional impairment. Rebirth concerns were significantly more correlated than avoidance of reminders to the PG-13 and CSM-G. In an item analysis of the PG-13 and its addendum item (rebirth concerns) to determine predictive power in respect to presence of grief-related functional impairment, the avoidance item performed very poorly and the rebirth item very well (as did the bitterness item). These findings point to the applicability of the prolonged grief disorder construct to the Cambodian experience of loss, yet indicate the poor performance of the avoidance item and the centrality of rebirth issues in this group.
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Keywords: Cambodian refugees; PTSD; culture; functional impairment; prolonged grief; rebirth concerns

Document Type: Research Article

Affiliations: 1: Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts 2: School of Psychology, University of New South Wales, Sydney, Australia

Publication date: September 1, 2013

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