Psychological distress among adults from the urban and rural areas affected by the Ebola virus disease in the Democratic Republic of the Congo.

PURPOSE: Ebola virus disease (EVD) is associated with high anxiety and multiple bereavement that can induce severe psychological distress (SPD) in individuals living in affected communities. Using data from the EVD and Mental Health project (EboMH), this study assessed the prevalence and determinants of SPD symptoms in a representative sample of adults in communities affected by EVD. METHODS: A representative sample of 1614 adults (50% women) aged 18-85 years completed measures assessing exposure level to EVD, stigmatization related to EVD, and psychological distress. RESULTS: In total, 45.58% of individuals from the cities and villages affected by EVD reported SPD. Results showed significant differences for residence area, employment, age, education level, and religion, but not for gender. Exposure level to EVD (ß = 0.11, p < 0.001; OR = 1.12, 95% CI [1.08-1.16]), stigmatization related to EVD (ß = 0.06, p < 0.001; OR = 1.06, 95% CI [1.05-1.07]), and living in rural areas (ß = 0.67, p < 0.001; OR = .51, 95% CI [.36-.72]) predicted SPD symptoms. CONCLUSIONS: Evidence-based global mental health programs in high-risk mortality epidemic contexts should take into account the high psychological distress in the affected areas.

Sexual victimization, PTSD, depression, and social support among women survivors of the 2010 earthquake in Haiti: a moderated moderation model.

BACKGROUND: In 2010, an important earthquake devastated Haiti and caused thousands of deaths. In a social context where women are particularly vulnerable, this cross-sectional study examined the associations between sexual assaults experienced by women before the earthquake, the earthquake exposure, the traumatic consequences, and their satisfaction of social support received. METHODS: A total of 660 women aged 18 to 86 completed questionnaires assessing exposure to the earthquake, sexual assault victimization, peritraumatic distress, Posttraumatic stress disorder (PTSD), depression, and social support. A moderated moderation model was computed to examine associations between exposure to the earthquake, sexual assault, social support, and traumatic consequences. RESULTS: Results showed that 31.06% of women were victims of sexual assault before the earthquake. They presented higher prevalence of peritraumatic distress, PTSD, and depression symptoms, compared to non-victims. The moderated-moderation model showed that sexual assault and exposure to the earthquake were positively associated with traumatic consequences (respectively, B = 0.560, p < 0.001; B = 0.196, p < 0.001), while social support was negatively associated with them (B = -0.095, p < 0.05). Results showed a triple interaction: women victim of sexual assault who were satisfied with received social support are less likely to develop traumatic consequences after being exposed to the earthquake(B = -0.141, p < 0.01). CONCLUSIONS: By demonstrating the role of sexual assault in the development of mental health problems after the Haitian earthquake, this study shows the importance for clinicians to investigate interpersonal trauma experienced before or following natural disasters among survivors. Results also indicate the key role of family and communities to help survivors build resilience and coping strategies with their social support.

The mental health professional at the feet of the Ebola virus: individual treatment and global mental challenges.

SummaryMental health professionals form an important component of the response teams currently working in the Democratic Republic of the Congo to treat what is historically the second-largest Ebola outbreak. They provide psychological treatment to patients under extraordinary conditions, helping them cope with anxiety and the daily death of other patients.Declaration of interestNone.

Long-term outcomes among child and adolescent survivors of the 2010 Haitian earthquake.

BACKGROUND: We examined the prevalence and predictive factors of PTSD and depression in relation with peritraumatic distress, trauma exposure, and sociodemographic characteristics among children and adolescent who survived the 2010 Haiti's earthquake. METHODS: We analyzed data collected between June and July 2012 from a sample of 872 participants aged 7 to 17 in 12 schools, door-to-door canvassing and two centers for street children at Port-au-Prince. Participants completed the Impact of Event Scale Revised (IES-R), Peritraumatic Distress Inventory, Child Depression Inventory 2 (CDI), and sociodemographic and traumatic exposure questionnaires. RESULTS: Of 872 participants, respectively 322 (36.93%); and 403 (46.21%) reported a clinically significant symptoms of PTSD and depression, which were significantly higher among girls. The best predictive variables are peritraumatic distress for PTSD (ß=0.53,P<.0001) a traumatic exposure for depression (ß=0.23,P<.0001). The comorbidity between PTSD and depression symptoms is 22.25%. CONCLUSIONS: This first study in children on the prevalence of PTSD and depression resulting from the 2010 Haiti earthquake demonstrates a need for improvement in treatment aimed at reducing PTSD and depression. Such treatment should be geared primarily toward girls, adolescents between the ages of 14 and 17 and those children and adolescents who have lost a family member in the earthquake.

Psychometric properties of the Haitian Creole version of the Resilience Scale with a sample of adult survivors of the 2010 earthquake.

BACKGROUND: Resilience is defined as the ability of people to cope with disasters and significant life adversities. The present paper aims to investigate the underlying structure of the Creole version of the Resilience Scale and its psychometric properties using a sample of adult survivors of the 2010 earthquake. METHODS: A parallel analysis was conducted to determine the number of factors to extract and confirmatory factor analysis was performed using a sample of 1355 adult survivors of the 2010 earthquake from people of specific places where earthquake occurred with an average age of 31.57 (SD=14.42). All participants completed the Creole version of Resilience Scale (RS), the Impact of Event Scale Revised (IES-R), the Beck Depression Inventory (BDI) and the Social Support Questionnaire (SQQ-6). To facilitate exploratory (EFA) and confirmatory factor analysis (CFA), the sample was divided into two subsamples (subsample 1 for EFA and subsample 2 for CFA). RESULTS: Parallel analysis and confirmatory factor analysis results showed a good-fit 3-factor structure. The Cronbach α coefficient was .79, .74 and .72 respectively for the factor 1, 2 and 3 and correlated to each other. Construct validity of the Resilience scale was provided by significant correlation with measures of depression and social support satisfaction, but no correlation was found with posttraumatic stress disorder measure, except for factor 2. CONCLUSIONS: The results reveal a different factorial structure including 25 items of the RS. However, the Haitian Creole version of RS is a valid and reliable measure for assessing resilience for adults in Haiti.

Psychometric properties of the Creole Haitian version of the Resilience Scale amongst child and adolescent survivors of the 2010 earthquake.

Resilience is defined as the capacity of human beings to deal with and adapt to adversity, suffering, tragedy or other traumatic event. This study aims to investigate psychometric properties and the underlying structure of the Creole version of the RS among children and adolescents survivors to the 2010 Haitian earthquake. A total of 872 children and adolescents exposed to the earthquake with an average age of 14.91 (SD=1.94) completed the Creole version of RS, the Impact Event Scale-Revised, the Children Depression Inventory and the Social Support Questionnaire-6. The current validity of RS and the internal consistency were investigated; sex, age, religion and others socio-demographic variables differences were also analysed. Cronbach's alpha coefficient for the RS was .77; the split-half coefficient was .72. The goodness-of-fit for the 5-factor model presents the best adjusted indices. The total resilience score was correlated positively with social support (r=.42, p<.01). Mean score of the RS was 131.46 (SD=21.01). No significant differences were observed about sex, age and residential municipality. The results showed that the Haitian Creole version of RS is a valid and reliable measure in assessing resilience for the children and adolescent survivors to the 2010's earthquake.

Multi-natural disasters in Gonaïves Haiti: long-term outcomes among child and adolescents and social support.

In this article, we posit the hypothesis that the January 2010 earthquake in Port-au-Prince reawakened a number of traumas linked to the natural disasters that struck Gonaives in 2004 and 2008. The study set out to evaluate the PTSD and social support in the affected areas in Gonaives seven years after the disasters. The study covered a sample of 917 participants, of whom 534 (58.23%) were females, aged between 10 and 23 with an average age of 16.03 (SD = 2.65). A variety of scales were used: the Clinician Administered PTSD Scale (CAPS-1); the Traumatic Exposure Severity Scale (TESS); the PTSD Check-List Civilian version (PCL-C); the Impact of Event Scale Revised (IES-R) and the Social Support Questionnaire (SSQ). The results reveal a higher rate of PTSD among the oldest participants, a similarly higher rate of social support among Catholics than among Protestants, a more severe rate of PTSD among school going children and a positive correlation between social support and PTSD.

Prevalence and Factors Related to Post-traumatic Stress Disorder and Depression Symptoms Among Children and Adolescents Survivors and Orphans of Ebola Virus Disease in Democratic Republic of the Congo Eastern Regions During the COVID-19 Pandemic.

PURPOSE: Although previous studies have shown a high prevalence of mental health problems among adult Ebola virus disease survivors, no studies have yet been conducted on mental health problems among children and adolescents in affected regions. Consequently, the current study aimed to examine the prevalence and factors associated with depression and post-traumatic stress disorder (PTSD) among children and adolescent survivors and orphans by utilizing a cross-sectional survey following the 2018-2020 epidemic in Eastern Democratic Republic of the Congo. METHODS: A total of 146 survivors (mean age = 13.62, standard deviation [SD] = 2.50, 49.32% female), 233 orphans (mean age = 13.18, SD = 2.96, 53.32% female), and 34 orphan-survivor participants (mean age = 13.39, SD = 2.87, 44.12% female) were recruited. Participants completed measures assessing depression and PTSD symptoms, traumatic experiences, and stigma related to Ebola and COVID-19. RESULTS: The prevalence of depression and PTSD symptoms was 87.32% and 44.42%, respectively. Results showed significant differences in depression and PTSD symptoms between orphan-survivors (100% and 97.06%), survivors (90.21% and 75.86%), and orphans (83.48% and 16.52%; χ2(2) = 9.02; p = .011 and χ2(2) = 168.85; p < .001). Experience of traumatic events, Ebola stigmatization, and COVID-19 stigmatization positively predicted depression and PTSD symptoms. The regression models explained 61%-72% of the variance of depression and PTSD. DISCUSSION: The results reveal that the Ebola virus disease and its associated grief severely jeopardize the mental health of children and adolescents in affected regions. Despite the relative paucity of resources, intervention programs may be helpful to minimize associated stigma and promote psychological support.

Prevalence and determinants of anxiety, depression and comorbid anxiety-depression symptoms among adolescents in Ebola-affected zones.

BACKGROUND: Ebola virus disease (EVD) has been shown to be associated with poor mental health in affected zones. However, no study has yet explored its impact on adolescents' mental health. AIMS: This study aimed to assess the prevalence and risk factors associated with depression and anxiety symptoms among adolescents in EVD-affected areas in the Equateur Province of the Democratic Republic of the Congo during the COVID-19 pandemic. METHOD: A provincial sample of adolescents aged 12-17 years (M = 14.84, s.d. = 1.49) living in the 18 urban and rural areas affected by the 2018 EVD outbreak completed a two-wave longitudinal survey. Surveys assessed symptoms of depression and anxiety, exposure to Ebola, social support and sociodemographic information. RESULTS: A total of 490 participants completed the baseline and follow-up surveys, 50% of whom were female. Elevated and worsened depressive symptoms were observed among participants from the baseline (56.94%) to the follow-up (91.43%; z = -11.37, P < 0.001), whereas anxiety symptoms decreased from the baseline (36.33%) to follow-up (24.90%; z = 4.06, P < 0.001). The final generalised estimating equation model showed that anxiety symptoms decreased over time (B = -3.92, P < 0.001), while depression symptoms increased (B = 4.79, P < 0.001). Stigmatisation related to Ebola positively predicted anxiety (B = 5.41, P < 0.001) and depression symptoms (B = 0.4452, P = 0.009). Social support negatively predicted anxiety (B = -1.13, P = 0.004) and depression (B = -0.98, P < 0.001) symptoms but only moderated the association between stigmatisation and depression symptoms (B = -0.67, P < 0.001). CONCLUSIONS: Most adolescents living in EVD-affected areas experience mental health issues. Stigmatisation related to EVD and living in urban areas are the most consistent predictors of mental health problems. Nevertheless, social support remains a protective factor for depression and anxiety symptoms and a necessary resource for building resilience.

Migration experience and mental health: A qualitative study in France and Brazil.

BACKGROUND: The relationship between migration and mental health is complex and involves factors at different levels, as the individual history of the migrant, the collective history of their home country, the host society's and their mutual past history. Even though the migratory scenario of France and Brazil has changed over the years, both countries currently host an important number of immigrants. AIM: The main objective of the present study was to describe and analyze the impacts of the migratory experience on mental health of migrants with different migration experiences and living in two countries: France and Brazil. METHOD: Semi-structured interviews were conducted with 13 participants, six in France and seven in Brazil. A thematic qualitative analysis of the data was performed using the ATLAS.TI software. Three themes were created based on the different times of the migration experience: before migration, during migration and after migration. All codes of these three bigger themes were organized in sub-themes for the samples in France and Brazil. RESULTS: Participants in France described an important exposure to traumatic events before and during migration. In Brazil, the migration experiences were multiple, in some cases presenting a traumatic history, but in most cases migration was seen as an opportunity to have access to better life conditions. In both countries, participants reported a great level of psychological distress associated to post-migratory difficulties (e.g. unemployment, learning a new language, or facing a new cultural environment). CONCLUSIONS: Our results suggest that multidisciplinary interventions, with focus on skills development, such as language and work-related skills, and on access to basic needs may be essential for both voluntary and involuntary migrants. In addition to these interventions, some individuals may need specialized mental health intervention, focusing in past traumatic exposure and in the current acculturation process.

Enacted Ebola Stigma and Health-related Quality of Life in Post Ebola Epidemic: A Psychosocial Mediation Framework Through Social Support, Self-Efficacy, and Coping.

On-site experiences and reports have shown that the multiple outbreaks of Ebola virus disease (EVD) in the Democratic Republic of the Congo (DRC) resulted in pervasive experience of stigma against many people who have recovered from EVD as well as their families and close relatives. Three evidence-based protective factors which are supposed to mitigate the impact of enacted Ebola stigma on health-related quality of life (HRQoL) of individuals in this epidemic context were identified. We expected that positive religious coping, perceived social support, and general self-efficacy would mediate the relationship between enacted Ebola stigma and HRQoL. These hypotheses were tested through multiple mediation model using the structural equation modeling among a large sample of adult populations (N = 1614; 50% women) in the province of Equateur in the DRC, in the aftermath of the 9th Ebola outbreak. The mediation model yielded adequate fit statistics and the results provided strong evidence that higher levels of enacted Ebola stigma were associated with lower HRQoL. They confirmed the synergetic mediating effects of positive religious coping, perceived social support from family (but not from others sources) and general self-efficacy. Futher exploratory findings revealed that the perceived social support from family buffered the impact of enacted Ebola stigma on HRQoL. If replicated by a longitudinal study, our findings lay a solid foundation for empirical-based community mental health interventions for reducing enacted Ebola stigma and promoting HRQoL during epidemics, especially in the DRC.

Prevalence and risk factors of depression symptoms among rural and urban populations affected by Ebola virus disease in the Democratic Republic of the Congo: a representative cross-sectional study.

OBJECTIVES: High mortality rates, anxiety and distress associated with Ebola virus disease (EVD) are risk factors for mood disorders in affected communities. This study aims to document the prevalence and risk factors associated with depressive symptoms among a representative sample of individuals affected by EVD. DESIGN: Cross-sectional study. SETTING: The current study was conducted 7 months (March 11, 2019 to April 23, 2019) after the end of the ninth outbreak of EVD in the province of Equateur in the Democratic Republic of the Congo (DRC). PARTICIPANTS: A large population-based sample of 1614 adults (50% women, Mage=34.05; SD=12.55) in health zones affected by the ninth outbreak in DRC. PRIMARY AND SECONDARY OUTCOME MEASURES: Participants completed questionnaires assessing EVD exposure level, stigmatisation related to EVD and depressive symptoms. The ORs associated with sociodemographic data, EVD exposure level and stigmatisation were analysed through logistic regressions. RESULTS: Overall, 62.03% (95% CI 59.66% to 64.40%) of individuals living in areas affected by EVD were categorised as having severe depressive symptoms. The multivariable logistic regression analyses showed that adults in the two higher score categories of exposure to EVD were at two times higher risk of developing severe depressive symptoms (respectively, OR 1.94 (95% CI 1.22 to 3.09); OR 2.34 (95% CI 1.26 to 4.34)). Individuals in the two higher categories of stigmatisation were two to four times more at risk (respectively, OR 2.42 (95% CI 1.53 to 3.83); OR 4.73 (95% CI 2.34 to 9.56)). Living in rural areas (OR 0.19 (95% CI 0.09 to 0.38)) and being unemployed (OR 0.68 (95% CI 0.50 to 0.93)) increased the likelihood of having severe depressive symptoms. CONCLUSIONS: Results indicate that depressive symptoms in EVD affected populations is a major public health problem that must be addressed through culturally adapted mental health programs.

Mental distress before and during the COVID-19 pandemic: A longitudinal study among communities affected by Ebola virus disease in the DR Congo.

BACKGROUND: Associated with high mortality rate, fear, and anxiety, Ebola Virus Disease (EVD) is a significant risk factor for mental distress. This longitudinal study aims to investigate the prevalence and predictors associated with mental distress among populations affected by EVD outbreaks in the Province of Equateur in DR Congo. METHODS: Surveys were administered in zones affected by the 2018 EVD outbreak in Equateur Province with a 16-month interval. Measures assessed sociodemographic characteristics, mental distress (GHQ-12), COVID-19 and EVD exposure and related stigmatization, and Resilience. Models of logistic regression and path analysis were used to estimate factors related to mental distress outcomes. RESULTS: Prevalence of mental distress decreased from Wave 1 to Wave 2 (Mental distressT1= 57.04%, Mental distressT2= 40.29%, x2= 23.981, p<.001). Clinical mental distress score at follow-up was predicted by greater levels of exposure to Ebola at baseline (B= .412, p<.001) and at Wave 2 (B= .453, p<.001) as well as Ebola stigmatization at baseline (B= .752, p<.001), and Protestant religion (B= .474, p=.038). Clinical mental distress score at follow-up was significantly associated with higher levels of exposure to COVID-19 (B= .389, p=.002) and COVID-19 related stigmatization (B= .480, p<.001). COVID-19 related stigmatization partially mediated the association between exposure to EVD (Time 1) and mental distress (B= .409, p<.001). CONCLUSIONS: Although a decrease in mental distress symptoms was observed, its prevalence remains high. The results show that mental health programs need to develop better health and education communication strategies to reduce stigmatization.

Polyvictimization and Cybervictimization Among College Students From France: The Mediation Role of Psychological Distress and Resilience.

Few studies have explored potential associations between polyvictimization and cybervictimization and even fewer have involved in college-age sample. As it has been shown in the literature, polyvictimization is associated with higher psychological distress and lower resilience. This study is aimed to model the association between polyvictimization and cybervictimization by testing the mediating role of psychological distress and resilience. The sample included 4,626 undergraduates from France. Participants completed questionnaires assessing cybervictimization, polyvictimization (emotional abuse from parents, exposure to interparental violence, parental neglect, unwanted sexual touching, and unwanted sexual intercourse), psychological distress, and resilience. Results show that each form of victimization considered was significantly associated with cybervictimization. Also, polyvictimized participants presented higher prevalence of cybervictimization. The association between polyvictimization and cybervictimization was partially mediated positively by psychological distress and negatively by resilience. In fact, more cybervictimization was observed among polyvictimized participants with a high score of psychological distress, whereas fewer cybervictimization was observed in those with a high score of resilience. This study provides a new understanding of the mechanisms involved in cybervictimization that can help to better prevent and intervene with victims. Our results suggest that mental health professionals should assess childhood experiences of victimization when they are working with cybervictims. They also suggest the need for mental health professionals to help both polyvictimized and cybervictimized youth to develop resilience skills and coping strategies.

Corrigendum: The Transcultural Community Resilience Scale: Psychometric Properties and Multinational Validity in the Context of the COVID-19 Pandemic.

[This corrects the article DOI: 10.3389/fpsyg.2021.713477.].

The Transcultural Community Resilience Scale: Psychometric Properties and Multinational Validity in the Context of the COVID-19 Pandemic.

Few instruments assess community resilience. In the midst of the COVID-19 pandemic, the capacity of communities to support resilience of members deserves to be assessed to develop programs for improving mental health of affected populations. This article presents the development of the Ottawa-Community Resilience Scale (O-CRS), its underlying factorial structure and transcultural validity with a multilingual (English, French, Creole, Kinyarwanda), multinational (DR Congo, Haiti, Rwanda, Togo) and multicultural sample affected by this pandemic. A sample of 1,267 participants (40.9% women) were recruited in the four countries: DRC (n = 626, 43.4% women), Haiti (n = 225, 42.0% women), Rwanda (n = 174, 40.5% women), and Togo (n = 242, 33.2% women), with a mean age of 32 (SD = 10.1). They completed measures assessing individual resilience, depression and the O-CRS. Exploratory and confirmatory Factor Analyses, Cronbach alpha, coefficient H and the McDonald's Omega, and bivariate regression were used to estimate the underlying components of the O-CRS, its internal consistency and concurrent validity. Parallel factorial analysis and confirmatory factor analysis results revealed an excellent fit 3-factor structure. Internal consistency coefficients varied between 0.82 and 0.95. The O-CRS showed a good construct validity with a positive association with individual resilience and negative association with depression score. Developed with a collaborative approach involving researchers, practitioners, and clients/patients, the O-CRS and its three factors (community strengths and support, community trust and faith, and community values) demonstrated excellent psychometric properties for assessing community resilience among adults during the COVID-19 pandemic.

Knowledge and misconceptions related to the Ebola Virus Disease among adults in the Democratic Republic of the Congo: The venomous snake under the table of prevention.

Objectives: On July 24, the Ministry of Health of the Democratic Republic of the Congo declared the end of the 2018 Ebola Virus Disease (EVD) outbreak in the Equateur Province. Conducted seven months after, this study aimed to examine knowledge and misconceptions related to EVD in a representative sample of affected communities in order to develop evidence-based prevention programs. Study design: Cross-sectional study with a two-stratified representative sample. Methods: A sample of 1,614 participants (50% of women) was recruited between March and April 2019 in the three affected health zones. Participants completed a questionnaire assessing knowledge, perception, practices and misconceptions related to EVD. Results: One-third of the 1,614 participants did not know that EVD is transmitted through bodily fluids of infected people. Only 39.85% and 45.99% were aware that EVD cannot be transmitted through air and mosquitoes. Only 44.93% declared a salty and hot bath cannot prevent EVD; and only 43.78% answered that spiritual or traditional healers cannot cure EVD. Results also indicated that although participants with high levels of education had more knowledge of EVD, they did not differ significantly from less educated ones for misconceptions. Hierarchical linear regression models showed interactions of sociodemographic characteristics that predicted EVD knowledge. Conclusions: The pervasive lack of knowledge, misconceptions and attitudes related to EVD constitute a major concern for prevention. Instead of basing awareness programs on the fear of EVD, health authorities, World Health Organization and NGOs should co-develop culturally sensitive and inclusive community evidence-based programs to educate the populations.

Prevalence and associated mental health outcomes of child sexual abuse in youth in France: Observations from a convenience sample.

CONTEXT: Child sexual abuse (CSA) is an important public health problem associated with an array of negative consequences. Although prevalence rates are well established from North America, few studies have focused on the extent of CSA and associated outcomes in youth from France. OBJECTIVES: This study aimed to: 1) estimate the prevalence of CSA, 2) assess the associations between CSA and health outcomes while exploring possible gender specificities and 3) document the contribution of revictimization on symptom complexity. METHOD: The sample involved 2309 participants aged between 14 and 23 years old (M = 19.55). Measures assessing CSA, other forms of child maltreatment and mental health problems were administered. Sexual revictimization and a host of protective factors (resilience, coping strategies, parental support) were also assessed. RESULTS: CSA was reported by 13.1% of girls and 4.2% of boys. Regression analyses revealed that CSA was associated with all mental health outcomes except alcohol and drug use (other than cannabis) after controlling for sociodemographics and other forms of child maltreatment. Sexual revictimization was associated with symptom complexity. Emotion-centered and avoidance coping predicted symptom complexity while resilience and paternal support acted as protective factors. LIMITATIONS: The study relied on a cross-sectional design with a convenience sample, which limits the generalizability of results. The small number of boys reporting CSA precludes drawing firm conclusions as to the gender specificities in the outcomes associated with CSA. CONCLUSIONS: Findings underscore the relevance of developing efficient prevention programs as CSA is linked to a host of negative outcomes.

Prolonged grief and depression: A latent class analysis.

Recent trends in grief research have been exploring how symptoms of prolonged grief disorder (PGD) and depression co-occur in bereaved individuals using Latent Class Analysis (LCA). However, the PGD criteria have kept undergoing changes and the newest DSM-5 PGD criteria have not been captured in these studies. Also, previous LCA-grief studies have been conducted in Western cultures, focusing more on bereaved adult populations. In this study, we applied LCA on a non-Western sample of bereaved young and middle-aged adults to examine whether the consistently observed 3 latent classes will emerge. We explored if the socio-demographic, loss-related factors, religiousness, spirituality, and continuing bond to the deceased, differentiated the latent classes. We confirmed the 3 latent classes comprising the Resilient class (20.6%), the predominantly PGD class (44.7%), and the combined PGD and Depression class (34.7%). Age, time elapsed since the loss, continuing bond and relationship with the deceased as well as spiritual beliefs were the differential predictors of class membership. This study increases our conceptual and clinical understanding of the predictability of PGD symptomology outcome, according to the newest DSM-5 criteria following bereavement in a non-Western sample. In addition to the continuing bond which was the strongest correlate, attention should be paid to important sociocultural frameworks in grief management.