A comparison of prevalence and risk factor profiles of prolonged grief disorder among French and Togolese bereaved adults

Abstract

Background With the introduction of the prolonged grief disorder (PGD) in the ICD-11 and most likely in the future DSM-5-TR, there is clinical need to examine cultural variations in grief phenomenon. We tested whether grief symptoms differ cross-culturally by examining the prevalence rates and predictors of PGD among French and Togolese bereaved individuals. Methods The sample comprised 235 widowed persons (73 French and 162 Togolese participants). They all completed the Prolonged Grief Scale-11 items. There were no statistically significant differences between both groups in terms of sociodemographic information (except for education). However, they differed on loss-related characteristics. We used two different symptom-diagnostic tests to estimate the prevalence rates. Results We found that French and Togolese bereavers reported almost similar PGD prevalence rates (21.9% [95% CI 0.13, 0.36] and 15.4% [95% CI 0.10, 0.23], respectively for the first test, 26% [95% CI 0.16, 0.41] and 17.3% [95% CI 0.12, 0.25], respectively for the second test). Through regression analyses, PGD severity was predicted by low education, being unemployed, long duration of a marital relationship, and traumatic death in the French sample, whereas it was predicted by being male and highly educated in the Togolese sample. Both groups only shared a recent bereavement period as a common risk factor. Conclusions Even though French and Togolese widowed persons reported almost similar prevalence rates of PGD, etiology, risk, and protective factors are culturally distinctive. It is critical to consider cultural and individual differences when conducting research on diagnosis and intervention in cases of prolonged grief.

Prolonged grief and depression: A latent class analysis

“…Further, what seems perhaps little surprising was the high prevalence of both symptomatic classes (44.7% for the predominantly PGD class and 34.7% for the combined PGD and Depression class) when compared to previous LCA research. Also, the prevalence of the predominantly PGD class was two time higher than that reported in Togolese widowed persons (Kokou-Kpolou et al, 2020b). With respect to our sample characteristics, the relatively short bereavement-period set as a criterion for participation (i.e., a maximum of 5 year post-loss) may explain the elevated prevalence rates of the predominantly PGD class.…”

Social Support Experiences of Spousally Bereaved Individuals in a South African Township Community: The Botho/Ubuntu Perspective

“…As with this study participant, Daggett (2002) found that the support that spousally bereaved men received was generally short-lived. Implications of the current study finding are especially concerning, considering Kokou-Kpolou et al ' s (2020) finding that bereaved male Togolese participants were at a higher risk of experiencing prolonged grief disorder, compared to spousally bereaved women. However, the current study participant's receipt of emotional support from his daughter only might have coincided with the fact that she was the only one residing with the participant at the time, thereby automatically assuming the dual role of providing structural and emotional support.…”

“…Therefore, bereaved persons engage in adaptive grieving by oscillating between confronting and avoiding the loss through either focusing on the loss or "get[ting] on with other things" (Stroebe et al, 2005, p. 52) at different points of the grieving period. The role of distraction as a coping mechanism by bereaved spouses within the dual-process model has been acknowledged by Kokou-Kpolou et al (2020) in a study on a Togolese and French sample. Along with the current participants' reports, these observations illustrate the importance of the support or distraction from the loss that bereaved spouses can access outside the home, which they are systematically barred from seeking out during the traditional mourning period in the study context.…”

COVID-19 and Disenfranchised Grief

“…The deaths framed as statistic also leaves the bereaved individuals feeling that the pain of their loss in undervalued. In addition, not only can grief be overlooked by society but patients and their families can also experience social stigma regarding COVID-19 losses (17).…”