Persistent Complex Bereavement Disorder and culture: Early and prolonged grief in Nepali widows

Kim J, Tol WA, Shrestha A, Kafle HM, Rayamajhi R, Luitel NP, Thapa L, Surkan PJ

Psychiatry

Published on: 14 April 2017

Objective: Persistent complex bereavement disorder (PCBD) in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), has not been well studied in socio-culturally diverse populations. Thus, this qualitative study examined (a) how widows in Nepal understand grief, (b) whether a local construct of PCBD exists, and (c) its comparability with the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), terminology.

Methods: Using an adapted Explanatory Model Interview Catalogue (EMIC) framework, semi-structured interviews with 25 widows and 12 key informants, as well as three focus-group discussions (n = 20), were conducted between October 2014 and April 2015. Through an inductive grounded theory–based approach, we used the constant comparative method, iteratively coding transcripts to identify themes and patterns in the data. Also, we created two lists of grief responses, one of early reactions and another all reactions to grief, based on the frequency of mention.

Results: No single term for grief was reported. Widows reported a local construct of PCBD, which was broadly compatible with DSM-5 terminology but with important variation reflecting societal influence. Surviving torture during conflict, economic and family stressors, and discrimination were mentioned as important determinants that prolong and complicate grief. Suicidal ideation was common, with about 31% and 62% of widows reporting past-year and lifetime suicidality, respectively. Findings may not be generalizable to all Nepali widows; participants were recruited from a non-governmental organization, from Kathmandu and its neighboring districts, and were primarily of reproductive age.

Conclusions: While PCBD symptoms proposed in DSM-5 were mentioned as relevant by study participants, some components may need adaptation for use in non-Western settings, such as Nepal.

https://doi.org/10.1080/00332747.2016.1213560

Head Office
  • Baluwatar, Kathmandu, Nepal
  • G.P.O Box 8974/C.P.C. Box 612
  • +977-01-4537124/4524082
  • [email protected]
Toll Free Number
1660 010 2005
हरेक दिन बिहान ८ बजे देखि साझ ६ बजे सम्म !! COVID-19 को मनोसामाजिक प्रभाव !!

यदि मनसँग सम्बन्धित समस्या भएमा मनोसामाजिक सहयोग तथा परामर्शका लागि यो नम्बरमा सम्पर्क गर्न सक्नुहुनेछ। NTC बाट यस नम्बरमा फोन गर्दा कुनै शुल्क लाग्दैन।

Every Day From 8 AM to 6 PM COVID-19, Psychosocial Impact !!

Please call this number for psychosocial support and counseling/consultation. You can call this number free of cost from Nepal Telecom network.

Subscribe Us




    Connect With Us