# International Prolonged Grief Disorder Scale Addendum for Refugees and Displaced People (IPGDS-ARD): A Study of Arabic-Speaking Bereaved Refugees

## TL;DR

This study adapts a grief disorder scale for Arabic-speaking refugees by adding culturally relevant items to improve treatment planning.

## Contribution

The study introduces a new addendum to the IPGDS with three scales tailored for refugees and displaced people.

## Key findings

- The IPGDS-ARD addendum includes 42 items addressing ambiguous loss and adjustment to host countries.
- Qualitative methods were used to ensure cultural relevance and clinical utility of the new scales.
- The study provides a detailed process for culturally adapting diagnostic tools for bereaved refugees.

## Abstract

Prolonged grief disorder (PGD) is a new and significant addition to the ICD-11 WHO disease classification system and the DSM 5-TR. As a new disorder, it stands to improve diagnostic precision, enhance communication among health professionals and patients, provide better access to care and lead to effective treatments and intervention. However, it remains to be determined if the new diagnostic criteria for PGD are applicable to different cultural groups.

Here we sought to adapt the International Prolonged Grief Disorder Scale for refugees and displaced people. We conducted two focus groups with clinicians and health care workers and six cognitive interviews with bereaved Arabic-speaking refugees.

This formative research resulted in an addendum (comprised of three new scales) to the IPGDS aimed to aid with treatment planning: the 42 item Addendum for Refugees and Displaced people (IPGDS-ARD). Here we present the steps for scale augmentation based on cultural considerations, a detailed description of clinical utility, feasibility and content validity established at each step, and an analysis of the percent of change in content at each step.

We conclude that the presented method of scale augmentation is a feasible and efficient approach that led to a culturally relevant, clinically useful addendum to an existing PGD questionnaire.

This study is one of the first formative research studies on culturally relevant items for treatment planning with bereaved refugees.The additional scales developed seek to unpick the complex experiences of ambiguous loss, adjustment to host country and grief.With this work we present a detailed description of qualitative research methods for scale augmentation for bereaved refugees.

This study is one of the first formative research studies on culturally relevant items for treatment planning with bereaved refugees.

The additional scales developed seek to unpick the complex experiences of ambiguous loss, adjustment to host country and grief.

With this work we present a detailed description of qualitative research methods for scale augmentation for bereaved refugees.