Abstract

BackgroundDuring the Khmer Rouge regime in Cambodia, about a quarter of the population died, resulting in many individuals losing close relatives. Still today, many individuals are suffering from the psychological consequences of these losses, which might also affect the process of reconciliation within the Cambodian society. The aim of this paper is therefore to investigate the association between symptoms of prolonged grief and attitudes toward reconciliation.MethodsA sample of 775 survivors of the Khmer Rouge regime who lost relatives during the conflict were interviewed about their losses and traumatic events, prolonged grief (PG; Complicated Grief Assessment Self-Report, CGA-SR), posttraumatic stress disorder (PTSD Checklist - Civilian Version) and attitudes toward reconciliation (Readiness to Reconcile Inventory, RRI).ResultsA higher symptom severity of PG was significantly associated with readiness to reconcile even when controlling for other relevant variables (β = −0.22; p <.001). Persons who met caseness criteria for PG were significantly less ready to reconcile, t(773) = 5.47, p <.001, than persons who did not meet caseness for PG.ConclusionPG seems to be a relevant mental health correlate of attitudes toward reconciliation. The results of the current study underline the importance of also considering PG with regard to the reconciliation process in Cambodia and possibly also in other post-conflict regions.

Highlights

  • During the Khmer Rouge (KR) regime from 1975 to 1979, millions of Cambodians suffered grave human rights violations, including mass executions, forced labor, torture and starvation

  • Over the last decades of research, this pathological form of grief has been given a variety of labels (e.g., “complicated grief”, “disturbed grief”, and “pathological grief”), and was included as “prolonged grief disorder” (PGD) in the 11th edition of the International Classification of Diseases (ICD-11; 6) in a new category for stress-related disorders

  • The present study examined associations of PG with attitudes toward reconciliation 30 years post loss in a sample of bereaved survivors of the KR regime who had lost at least one family member during the KR regime

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Summary

Introduction

During the Khmer Rouge (KR) regime from 1975 to 1979, millions of Cambodians suffered grave human rights violations, including mass executions, forced labor, torture and starvation. The ICD-11 and DSM-5 definitions of the disorder differ from each other in terms of symptoms and symptom duration requirement (6 vs 12 months, respectively) This represents a significant challenge, as the use of diverse scales to assess PG has been shown to result in different prevalence rates [8]. The current study is based on the criteria provided by Prigerson and colleagues [10] These authors originally introduced the term “prolonged grief disorder”, which represents the most widely used term in the literature. As the applied criteria differ slightly from the current PGD ICD-11 definition, we will use the term “prolonged grief (PG)” when describing the results of our study to avoid confusion with the current ICD-11 definition. The aim of this paper is to investigate the association between symptoms of prolonged grief and attitudes toward reconciliation

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