The traumatic grief inventory self report: validation in the balinese population

Background The Traumatic Grief Inventory Self-Report version (TGI-SR) is a well-known and validated 18-item self-report measure to assess symptoms of Prolonged Grief Disorder (PGD; ICD-11 and DSM-5TR). No validation study has yet been performed in the Balinese population.Methods This study determined the 1) factor structure 2) content validity 3) construct validity, 4) discriminant validity, and 4) a symptom-level investigation of the construct of grief disorder measured in the TGI-SR in a sample of 301 bereaved family members of traffic accidents from Bali, Indonesia.Results We found a 3-factor structure for the TGI-SR, namely 1) emotional pain, 2) confusion/preoccupation with loss, and 3) avoidance and anger. Construct, discriminant validity and reliability were good. An association was found between 3-factor structure with gender, professional situation, main income earner, relation to the victim, and level of education. Certain symptoms, such as “a desire to die” or “feeling disconnected to others” were not endorsed.Conclusions Results indicate that the TGI-SR is a reliable and valid tool to measure prolonged grief symptoms in the Balinese population. However, the three-factor structure we found diverges from western models and the symptoms “desire to die in order to be with the deceased”, “feeling alone or detached from other people” and “difficulty with positive reminiscing about the deceased” were less important symptoms compared to prior research results in other parts of the world. This could be explained by Balinese cultural beliefs around life and death and gives us an insight in how cultural aspects may influence the way people experience grief.