Cited by 77Grief, Bereavement, and Mental HealthMigration, Health and TraumaPosttraumatic Stress Disorder Research

Factorial structure of complicated grief: associations with loss-related traumatic events and psychosocial impacts of mass conflict amongst West papuan refugees.

Tay, Alvin Kuowei, Rees, Susan, Chen, Jack, Kareth, Moses, Silove, Derrick·2016·Social Psychiatry and Psychiatric Epidemiology

Abstract

Introduction Definitions of complicated grief vary across diagnostic systems, being represented as persistent complex bereavement (PCB) in DSM-5 and prolonged grief disorder (PGD) in the proposed revision of the ICD system. A past study in a high-income country has identified a six-factor structure for complicated grief, but there are no data testing this or any other model across cultures. The present study reports findings from a survey amongst West Papuan refugees (n = 230, response rate = 92 %) residing in Port Moresby, Papua New Guinea.Materials and methods We applied culturally adapted measures of conflict-related traumatic event (TEs) (drawing specifically on domains of conflict and loss), symptoms of complicated grief adapted and modified to the culture, and a multidimensional psychosocial index of the broader effects of conflict and displacement.Results Confirmatory factor analysis yielded a single higher order construct of complicated grief comprising six factors of yearning/preoccupation; shock/disbelief; anger/negative appraisal; behavioural change; estrangement from others/impairment; and a novel dimension of confusion/diminished identity. In contrast, our analysis failed to support DSM or ICD models of PCB or PGD. A Multiple Indicators Multiple Causes (MIMIC) model revealed that traumatic loss and the sense of injustice each were associated with the unitary construct of complicated grief and its subdomains of yearning/preoccupation; shock/disbelief; anger/negative appraisal (exclusive to injustice); and estrangement from others/social impairment (exclusive to TE domain of conflict and loss).Conclusions Conflict and loss associated with feelings of injustice may be especially pathogenic in generating the anger/negative appraisal component of complicated grief amongst refugees.

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Crossref · 10.1007/s00127-015-1099-x

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Authors
Tay, A. K., Rees, S., Chen, J., Kareth, M., & Silove, D.
Affiliations
  • Liverpool Hospital (AU)
  • UNSW Sydney (AU)
Corresponding author
Tay, Alvin Kuowei
Venue
Social Psychiatry and Psychiatric Epidemiology
Published
2015-07-31
Volume
51
Issue
3
Pages
395-406
ISSN
  • 0933-7954 (ISSN-L)
  • 1433-9285
OpenAlex
W1007972329
Cited by
77
References
44
Citations by year
2026: 2 · 2025: 1 · 2024: 6 · 2023: 7 · 2022: 18 · 2021: 6 · 2020: 10 · 2019: 13 · 2018: 8 · 2017: 3 · 2016: 3
FWCI
5.80
Type
journal article
Language
en
Open access
closed
Locations
  • Social Psychiatry and Psychiatric Epidemiology (publishedVersion)
  • PubMed (publishedVersion)
Funders
National Health and Medical Research Council (RM08333)
Topics
  • Social Sciences › Psychology › Clinical Psychology › Grief, Bereavement, and Mental Health
  • Social Sciences › Psychology › Clinical Psychology › Migration, Health and Trauma
  • Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
Keywords
complicated grief, prolonged grief disorder, sense of injustice, social dysfunction, displacement, Port Moresby
MeSH terms
Adult, Cultural Characteristics, Factor Analysis, Statistical, Female, Grief, Humans, Male, Middle Aged, Papua New Guinea, Surveys and Questionnaires, Refugees, Stress Disorders, Post-Traumatic, Warfare, Reproducibility of Results, International Classification of Diseases, Diagnostic and Statistical Manual of Mental Disorders

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