Prolonged Grief Disorder Gets Its Spanish-Language Tool: Mexican PG-13-R Validation

Prolonged Grief Disorder entered DSM-5-TR in 2022 and ICD-11 before that. The diagnostic criteria are established. The screening tools exist — for English-speaking populations. For the ~580 million Spanish speakers worldwide, including ~130 million in Mexico alone, validated assessment has been lagging. This UNAM/INCMNSZ collaboration closes that gap for Mexican Spanish — and by extension provides a starting point for Latin American populations more broadly.

Why cultural adaptation matters for grief scales

Grief is universal but its expression is culturally shaped. Mexican mourning practices include specific rituals — novenario (9 days of prayer), day-of-the-dead traditions, shared family bereavement that is more collective than Anglo-American individualized grieving. A grief assessment tool must capture the same underlying construct (impairing, prolonged yearning) without mistaking culturally-typical expressions for pathology, or missing pathology because it manifests differently.

The Mexican PG-13-R went through translation, back-translation, expert review, and cognitive debriefing with Mexican participants. The CFA confirmed that the same 1-factor structure from the English original holds in this sample — prolonged grief is, at its core, the same phenomenon.

The sample and validation approach

397 participants were recruited from two sources:

• Cancer bereavement: family members of patients who died under care at a supportive care navigation program at a public hospital in Mexico City (Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán)
• Community sample: individuals recruited via social media (X, Facebook)

This dual-source approach is methodologically strong: the cancer sample provides a clinically-relevant bereavement population, while the community sample tests the scale across broader loss types and non-medical contexts.

The convergent validity finding

The Mexican PG-13-R correlated significantly with depression (PHQ-9) and anxiety (GAD-7) scores — but not so strongly as to suggest it was measuring the same thing. This is the test of discriminant validity: prolonged grief is related to depression and anxiety (comorbidity is high) but remains a distinct construct with its own symptom structure. The Mexican version preserves this distinction.

For your practice

For Spanish-speaking clinicians: the Mexican PG-13-R is now available and psychometrically validated. Use it in primary care, palliative care follow-up, and any setting that serves bereaved Spanish-speaking patients. For international clinicians: working with Spanish-speaking patients from Mexico or broader Latin America — this version is more culturally appropriate than a direct translation of the English original. For researchers: this validation enables cross-cultural prolonged grief research in Latin American populations, which have been systematically understudied in the bereavement literature.