Are ‘time’ and ‘culture’ useful and necessary diagnostic criteria for ICD-11 Prolonged Grief Disorder? A Cross-national study.

ICD-11 PGD can only be diagnosed if symptoms persist beyond 6 months after bereavement and for longer than would be expected from societal, cultural, or religious norms. This study examined the validity and utility of these diagnostic requirements using self-report cross-sectional data from samples of bereaved adults from the United Kingdom (UK; n = 1,012), Ireland (Ireland; n = 1,011), and Ontario (n = 1,167). PGD symptoms and rates of probable PGD were not markedly higher in those bereaved within the last 6 months, and participants didn’t view 6 months as the normative timeframe to come to terms with a bereavement. Approximately a quarter of those meeting symptom and impairment requirements couldn't determine if their grief exceeded cultural norms. Applying time and cultural requirements significantly reduced diagnosis rates. We argue that these findings may undermine the validity and clinical utility of these diagnostic requirements.