The dual role of grief rumination in prolonged grief disorder among Chinese Shidu parents: A qualitative study.

BACKGROUND

Chinese parents who have lost their only child, commonly referred to as Shidu parents, are at heightened risk for prolonged grief disorder (PGD). Rumination has been identified as a potential mechanism underlying PGD, yet its content and functions in this population remain poorly understood. This study aimed to explore the dimensions and effects of grief rumination among Shidu parents through a qualitative interview design.

METHODS

Semi-structured interviews were conducted with 11 Shidu parents, and the data were analyzed using reflexive thematic analysis.

RESULTS

Five dimensions of grief rumination were identified: meaning, relationships, counterfactuals, injustice, and reactions. Across these dimensions, rumination emerged as a double-edged process. On the one hand, it often intensified emotional suffering, worries about the future, avoidant coping, social withdrawal due to stigma, negative self-evaluation, and fear of losing mental control. On the other hand, it could also open up space for cognitive reappraisal, reconstruction of life meaning, recognition of remaining social resources, more bearable acceptance of the loss, future-oriented reorientation, and greater self-understanding. Throughout these dimensions, the content and effects of rumination were shaped by culturally embedded meanings, particularly bloodline continuity, filial obligations, collectivism, and fate or destiny.

LIMITATIONS: The purposive, non-random sampling and potential self-selection bias may limit the transferability of the results.

CONCLUSIONS

Grief rumination among Shidu parents is a complex, culturally situated phenomenon that can both exacerbate distress and facilitate adaptation. The study highlights the importance of culturally sensitive assessment and intervention for Shidu parents in the Chinese context.