Exploring prolonged grief disorder through Iranian cultural beliefs: a qualitative thematic analysis

Background: Prolonged Grief Disorder (PGD), recently recognized in the DSM-5-TR and ICD-11, manifests differently across cultural contexts. Although grief is a universal human response to loss, its expression and interpretation are shaped by culturally specific moral and social norms. With limited research on Iranian cultural influences on prolonged grief symptoms, this study examined how culturally embedded beliefs shape the moral meanings and social expectations of grief among individuals meeting PGD screening criteria in Iran.Methods: Semi-structured interviews were conducted with seventeen bereaved adults in Tehran (aged 21-59 years) who met PGD screening criteria based on the PG-13-R and the International Prolonged Grief Disorder Scale (IPGDS). Data were analyzed inductively using reflexive thematic analysis to capture culturally grounded meanings shaping prolonged grief experiences.Results: Five interrelated themes were identified: (1) causal attributions, (2) cultural mourning symbols, (3) paradoxical expectations surrounding mourning, (4) distressing religious beliefs, and (5) harmful cultural clichés. Participants linked these thematic patterns to guilt, social pressure, and spiritual conflict, and described them as relevant to their PGD symptom experiences.Conclusions: Findings suggest that participants described their PGD-related distress as shaped by culturally salient meanings and social evaluations of grief. These results underscore the need for culturally attuned assessment and intervention strategies that address moral and social narratives surrounding mourning.