Mapping the Temporal Dynamics of Prolonged Grief Symptoms: A Cross-Lagged Panel Network Analysis in Chinese and U.S. Samples

BackgroundThe culturally specific nature of grief highlights potential cultural-bounded symptom dynamics. This study first aimed to explore the temporal dynamics of PG symptoms and to identify central nodes in longitudinal symptom networks to inform targeted clinical interventions. A second aim was to examine cross-cultural similarities and differences in these networks over time, providing empirical foundations for culturally tailored grief interventions.MethodsThe present study applied contemporaneous and cross-lagged panel network (CLPN) analyses to one-year longitudinal data from Chinese (N = 286) and U.S. (N = 267) community samples to examine the dynamic associations of Prolonged Grief (PG) symptoms. ResultsContemporaneous network analyses revealed that disbelief about the death demonstrated high centrality across both cultural groups and time points. No significant differences were found in the network structure and global strength between the two time points in either sample. Results from CLPNs showed that emotional pain exhibited strong and consistent influence (i.e., high out-prediction) across cultures. In the Chinese sample, identity disruption emerged as a culturally specific driving symptom, while in the U.S. sample, reintegration-related symptoms (i.e., difficulty reintegrating new life and preoccupation) demonstrated greater predictive influence. Additionally, loneliness showed high cross-cultural predictability over time (i.e., high in-prediction). ConclusionsThese findings provide important insights into the temporal dynamics of PG symptoms and suggest a two-step, culturally responsive care pathway, with early emotion regulation strategies plus culturally tuned identity or reintegration focused approaches. Integrating such care into primary bereavement services has the potential to enhance grief-informed clinical practice.