A meaningful life is worth living: meaning in life as a suicide resiliency factor

Emerging adults' financial stress and self-rated health: Meaning in life as a moderator

Objective: The primary objective of the study was to examine associations between financial stress and self-rated health (mental and physical), with presence of and search for meaning in life as moderator variables. The secondary objective was to examine the association between presence of meaning and self-rated health, with search for meaning as a moderator. Participants and methods: The sample included 166 emerging adults (ages 18-32, mean age 22.55) recruited from a university setting (n = 87) and online platform (n = 79). To examine the proposed moderating effects, two hierarchical multiple regression models were conducted using secondary data. Results: For the primary objective, presence of meaning did not moderate the association between financial stress and self-rated health (mental or physical). Search for meaning strengthened the negative association between financial stress and physical health, exacerbating the negative health impacts associated with financial stress. However, search for meaning did not moderate the association between financial stress and mental health. For the secondary objective, search for meaning moderated the association between presence of meaning and physical health such that a negative presence-physical health association emerged at high levels of search, and a positive presence-physical health association emerged at low levels of search. Conclusion: Presence of meaning was not a protective factor in the association between financial stress and self-rated health, perhaps because average presence of meaning was lower than average search for meaning in this sample. Search for meaning was a risk factor for adverse physical health when financial stress was high or presence of meaning was low. Future research should examine in which contexts (e.g., different stressors, cultures) meaning in life dimensions emerge as risk versus protective factors.

Meaning in life and all-cause and cause-specific mortality in the UK Biobank

OBJECTIVE

To determine the association between meaning in life and all-cause and cause-specific mortality, and whether associations vary by depression or sociodemographic factors.

METHODS

Participants were UK Biobank cohort members who reported on their meaning in life in the mental health assessment from October 2016 to July 2017 (N = 153,505). All-cause mortality and cause-specific mortality were identified from ICD-10 codes from national death registries through December 2022.

RESULTS

Over the up to six-year follow-up, every standard deviation higher in meaning in life was associated with a 15 % decreased risk of death from any cause (HR = 0.87, 95 % CI = 0.85-0.90, p < .001). The association was attenuated but remained significant accounting for socioeconomic, clinical, and behavioral risk factors (HR = 0.91, 95 % CI = 0.88-0.94, p < .001). Meaning in life was associated with reduced risk of death from 7 of the 8 cause-specific deaths examined: external cause (47 %), respiratory (41 %), nervous (32 %), digestive (25 %), or circulatory (15 %) systems, COVID-19 (28 %), and cancer (8 %). Depression concurrent with the meaning assessment did not explain or moderate these associations, which indicated that meaning was similarly protective when concurrently experiencing psychological distress. The association between meaning and all-cause mortality was similar across age, ethnicity, and socioeconomic status but slightly stronger among female than male participants.

CONCLUSION

Feeling that one's life has meaning is associated with lower risk of mortality, particularly causes of death due to the respiratory system, nervous system, or COVID-19. Given that meaning in life can be modified through intervention, future research could address whether it could be a useful target of intervention.

Stress and hope distinguish individuals with suicidal plan from suicide ideators among Chinese college students

Background

Suicide among college students is a significant public health concern in China. While suicidal ideation serves as a crucial predictor of subsequent suicidal plans and behaviors, it is important to recognize that most instances of suicidal ideation may only be fleeting thoughts that do not progress to an actual plan. Therefore, it is imperative to identify the factors associated with the transition from suicidal ideation to a concrete plan. Consequently, this study aims to investigate whether certain frequently cited factors can differentiate individuals who have formulated a specific suicidal plan from those who have experienced suicidal thoughts without planning, based on data obtained through a cross-sectional survey.

Materials and methods

This survey was conducted as part of routine mental health assessments among second-year college students in October 2023. Data from a total of 4,858 second-year college students were utilized for the final analyses. Two survey questions were employed to identify past-year suicidal ideation and past-year suicidal plan. All participants were required to complete various assessments, including the Chinese version of Depression Anxiety Stress Scale 21 items (DASS-21), the Chinese version of Gratitude Questionnaire-six items (GQ-6), the Chinese version of Meaning in Life Questionnaire (MLQ), and the Chinese version of State Hope Scale (SHS).

Results

Among 4,858 participants, a total of 134 individuals (2.8%) were confirmed to have experienced past-year suicidal ideation. Out of these, 53 (1.1% overall) reported having a past-year suicidal plan, accounting for approximately 39.6% of those with suicidal ideation. Logistic regression analyses revealed that while most potential variables differentiated between students with and without suicidal ideation, only two factors stood out in distinguishing individuals with a suicidal plan from those who had not made such plans despite experiencing suicidal thoughts-presence of stress (OR=2.49, 95% CI: 1.04-5.96) and lower scores of hope agency (OR=0.84, 95% CI: 0.72-0.98).

Conclusion

These findings suggest that the stress may contribute to susceptibility for transitioning from mere thoughts to actual planning regarding suicide; conversely, hope agency appears to offer protection against this transition process. Therefore, we advocate for targeted interventions aimed at fostering hope among individuals who have encountered adverse and stressful life events.

Voices Unheard: A Reflective Lifeworld Research Study of Older Arabic-Speaking Female Migrants and Their Experience of Existential Loneliness

INTRODUCTION

Existential loneliness (EL) is an unavoidable, deeper sense of loneliness. EL has been described as disconnection from life and the universe, experienced even in the presence of family and friends. Meaninglessness, loss of health and significant others seem to trigger older persons EL. Older Arabic-speaking women are a large migrant group in Sweden and there is a lack in knowledge about their experience of EL. Therefore, this study aimed to describe the phenomenon of EL as experienced by older Arabic-speaking female migrants.

METHODS

This study was based on a phenomenological approach known as reflective lifeworld research (RLR). Ten older migrated Arabic-speaking women were included in the study. Lifeworld interviews were conducted to collect data. The data were analysed in accordance with the phenomenological RLR principles of openness, flexibility and bridling.

RESULTS

This study shows that EL is experienced when there is a lack of attachment to place and people. EL is experienced more distinctively in the beginning of the migration process. It was difficult sharing feelings of EL with anyone. Feelings of meaninglessness occurred when entering a new lifeworld and triggered EL. EL was however attenuated when being able to practise their religion.

CONCLUSION

Lack of attachment to place and people as well as feelings of meaninglessness brought existential loneliness to the fore for the older Arabic-speaking female migrants. There was a collision of lifeworlds not at least by the fact moving as a Muslim woman to one of the most secular countries in the world. Practising their religion attenuated their EL. To promote better health for this group of women, it is of importance to be aware of EL and its mode of expression.

IMPLICATIONS FOR PRACTICE

It is crucial to let the voice of older Arabic-speaking female migrants be heard and to be aware of their experience of EL and its mode of expression in order to promote better health. Further, educational training for nursing professionals and nursing students needs to be provided to develop skills how to be aware of and address EL.

Exploring suicide resilience experiences in Chinese youth after self-poisoning: A qualitative study

OBJECTIVE

This inquiry probes the suicide resilience experiences in suicide attempts by self-poisoning among Chinese youth. The study's goal is to provide healthcare professionals with critical insights to develop effective interventions that enhance suicide prevention measures and diminish the likelihood of subsequent attempts.

METHODS

Utilizing a qualitative phenomenological approach, we conducted semi-structured interviews with 12 youths (Mean age = 21.1 ± 2.8 years; n = 7 females) who survived suicide attempts by self-poisoning. Data analysis was performed using Colaizzi's seven-step method, a rigorous method entailing iterative reading for the extraction of key statements and the distillation of thematic essence.

RESULTS

Four primary themes with ten sub-themes were extracted: (1) New understanding of life (cherish life, and meaning of life), (2) Self-Reconciliation (self-acceptance, self-understanding, and self-openness), (3) Personal empowerment (increased self-reliance, increased responsibility, and increased emotional regulation), and (4) Life redesigning (faith in the future, and plan for the future).

CONCLUSIONS

The findings reveal a potential for psychological growth and beneficial transformation in youth following suicide attempts by self-poisoning. These insights advocate for the integration of positive psychology principles in therapeutic interventions for this demographic.

Bored to death: Artificial Intelligence research reveals the role of boredom in suicide behavior

Background

Recent advancements in Artificial Intelligence (AI) contributed significantly to suicide assessment, however, our theoretical understanding of this complex behavior is still limited.

Objective

This study aimed to harness AI methodologies to uncover hidden risk factors that trigger or aggravate suicide behaviors.

Methods

The primary dataset included 228,052 Facebook postings by 1,006 users who completed the gold-standard Columbia Suicide Severity Rating Scale. This dataset was analyzed using a bottom-up research pipeline without a-priory hypotheses and its findings were validated using a top-down analysis of a new dataset. This secondary dataset included responses by 1,062 participants to the same suicide scale as well as to well-validated scales measuring depression and boredom.

Results

An almost fully automated, AI-guided research pipeline resulted in four Facebook topics that predicted the risk of suicide, of which the strongest predictor was boredom. A comprehensive literature review using APA PsycInfo revealed that boredom is rarely perceived as a unique risk factor of suicide. A complementing top-down path analysis of the secondary dataset uncovered an indirect relationship between boredom and suicide, which was mediated by depression. An equivalent mediated relationship was observed in the primary Facebook dataset as well. However, here, a direct relationship between boredom and suicide risk was also observed.

Conclusion

Integrating AI methods allowed the discovery of an under-researched risk factor of suicide. The study signals boredom as a maladaptive 'ingredient' that might trigger suicide behaviors, regardless of depression. Further studies are recommended to direct clinicians' attention to this burdening, and sometimes existential experience.

Pandemic Grief and Suicidal Ideation in Latin American Countries: A Network Analysis

This study aimed to characterize the network structure of pandemic grief symptoms and suicidal ideation in 2174 people from eight Latin American countries. Pandemic grief and suicidal ideation were measured using the Pandemic Grief Scale and a single item, respectively. Network analysis provides an in-depth characterization of symptom-symptom interactions within mental disorders. The results indicated that, "desire to die," "apathy" and "absence of sense of life" are the most central symptoms in a pandemic grief symptom network; therefore, these symptoms could be focal elements for preventive and treatment efforts. Suicidal ideation, the wish to die, and the absence of meaning in life had the strongest relationship. In general, the network structure did not differ among the participating countries. It identifies specific symptoms within the network that may increase the likelihood of their co-occurrence and is useful at the therapeutic level.

Assessment of psychometric properties of the Huaxi Emotional-distress Index questionnaire (HEI)in a large sample of general hospital inpatients

OBJECTIVES

Huaxi Emotional-distress Index questionnaire (HEI) is a 9-item questionnaire designed to measure psychological distress. The present study aimed to validate the factor structure of the HEI and its reliability and validity using a large sample from inpatients of West China Hospital.

METHODS

HEI data were collected from inpatients of various departments at West China Hospital in 2019 through the hospital's data management platform (total sample, N = 55,396). The internal consistency reliability of the HEI was examined. Exploratory factor analysis (N = 27,696) and confirmatory factor analysis(N = 27,700) were conducted to validate the construct validity.

RESULTS

Three factors, namely depression (DEP), anxiety (ANX), and suicidal risk (SR), were extracted through exploratory factor analysis, which accounted for 79.55% of the total variance.The results of confirmatory factor analysis supported the fit for the three-component model oblique model as the best-fitting model compared with one-component model and two-component model. The internal consistency of the HEI was α =0.918. The internal consistencyα of ANX, DEP and SR is 0.87,0.814,0.843 respectively.

CONCLUSIONS

HEI is a validated and concise tool that serves a dual purpose of screening for mood disorders and assessing depressive and anxiety symptoms as well as suicidal risk among inpatients in Chinese general hospitals.

Moderating effects of suicide resilience and meaning in life on the association between entrapment and suicidal ideation in Chinese patients with ovarian cancer: a cross-sectional study

BACKGROUND

Numerous studies have confirmed that patients with ovarian cancer have a relatively high risk of suicidality. Early identification of psychological factors related to suicidal ideation in patients with ovarian cancer may provide effective information for suicide prevention strategies. This study aimed to investigate whether and how suicide resilience and meaning in life moderate the relationship between entrapment and suicidal ideation in patients with ovarian cancer.

METHODS

This was a cross-sectional investigation was conducted in 505 Chinese patients with ovarian cancer. Patients completed a battery of self-reported questionnaires that included the General Information Questionnaire, and Chinese versions of the Entrapment Scale, Scale for Suicidal Ideation, Suicide Resilience Inventory-25, and Meaning in Life Scale. Descriptive statistics, Pearson' s chi-square, Pearson' s correlation, and hierarchical multiple linear regression analysis were performed.

RESULTS

In this study, the prevalence of suicidal ideation reported by patients with ovarian cancer was 32.07%. Patients' suicidal ideation could be explained by the following three predictors: entrapment × suicide resilience × meaning in life (β = -0.169, p < 0.001), entrapment × suicide resilience (β = -0.148, p < 0.001), and entrapment × meaning in life (β = -0.107, p = 0.005).

CONCLUSION

These findings suggest that ovarian cancer patients are prone to suicidal ideation when they feel a sense of entrapment. Enhancing patients' suicide resilience and meaning in life may be two targeted interventions to reduce suicidal ideation in ovarian cancer patients. In particular, considering both the protective effects of suicide resilience and meaning in life may yield better suicide prevention outcomes than considering only one of these factors.

Mediators of the Relationship Between Adverse Childhood Experiences (ACEs) and Symptoms of Anxiety, Depression, and Suicidality among Adults

Adverse childhood experiences (ACEs) are consistently found to be negatively associated with physical, psychological, and psychosocial well-being throughout the lifespan. While previous research has established risk factors and noxious outcomes arising post-ACEs, less attention has been given to factors such as resilience, perceived social support, and subjective well-being that may help explain the relationship between ACEs and psychopathology. Hence, the objectives of this study are to examine: (1) the relationships among ACEs and symptoms of anxiety, depression, and suicidality in adulthood, and (2) whether resilience, social support, and subjective well-being mediate the relationship between ACEs and psychopathological symptoms. Cross-sectional data on ACEs, psychological factors, potential mediating variables, and sociodemographic factors were collected from a community sample of adults aged 18-81 (N = 296) via an on-line survey. Endorsing ACEs was significantly and positively correlated with symptoms of anxiety, depression, and suicidality. Results of parallel mediation analyses showed that social support, negative affect, and life satisfaction statistically mediated the relationships between ACEs and psychopathological outcomes in adulthood. These results highlight the importance of identifying potential mediators of the ACEs-psychopathological symptoms relationship to aid in the development of screening and intervention practices that could bolster developmental outcomes following traumatic childhood experiences.

The Importance of Timing, Fundamental Attitudes, and Appropriate Interventions as Key Aspects of Chaplain Suicide Prevention: A European Expert Panel of Mental Health Chaplains

An expert panel consisting of six mental health chaplains from several European countries was convened to ascertain the specific contribution of mental health chaplains to suicide prevention, and to generate good practices for suicide prevention. Three themes emerged: (1) the importance of timing; (2) fundamental attitudes of the chaplain towards the patient, and (3) appropriate interventions.

Experiences that matter in bipolar disorder: a qualitative study using the capability, comfort and calm framework

BACKGROUND

When assessing the value of an intervention in bipolar disorder, researchers and clinicians often focus on metrics that quantify improvements to core diagnostic symptoms (e.g., mania). Providers often overlook or misunderstand the impact of treatment on life quality and function. We wanted to better characterize the shared experiences and obstacles of bipolar disorder within the United States from the patient's perspective.

METHODS

We recruited 24 individuals diagnosed with bipolar disorder and six caretakers supporting someone with the condition. Participants were involved in treatment or support services for bipolar disorder in central Texas. As part of this qualitative study, participants discussed their everyday successes and obstacles related to living with bipolar disorder during personalized, open-ended interviews. Audio files were transcribed, and Nvivo software processed an initial thematic analysis. We then categorized themes into bipolar disorder-related obstacles that limit the patient's capability (i.e., function), comfort (i.e., relief from suffering) and calm (i.e., life disruption) (Liu et al., FebClin Orthop 475:315-317, 2017; Teisberg et al., MayAcad Med 95:682-685, 2020). We then discuss themes and suggest practical strategies that might improve the value of care for patients and their families.

RESULTS

Issues regarding capability included the struggle to maintain identity, disruptions to meaningful employment, relationship loss and the unpredictable nature of bipolar disorder. Comfort related themes included the personal perception of diagnosis, social stigma and medication issues. Calm themes included managing dismissive doctors, finding the right psychotherapist and navigating financial burdens.

CONCLUSIONS

Qualitative data from patients with bipolar disorder helps identify gaps in care or practical limitations to treatment. When we listen to these individuals, it is clear that treatments must also address the unmet psychosocial impacts of the condition to improve patient care, capability and calm.

An investigation of the relationships between suicidal ideation, psychache, and meaning in life using network analysis

BACKGROUND

Previous studies have investigated the relationships between psychache or meaning in life and suicidal ideation based on sum score of corresponding scale. However, this practice has hampered the fine-grained understanding of their relationships. This network analysis study aimed to conduct a dimension-level analysis of these constructs and the relationships among them in a joint framework, and identify potential intervention targets to address suicidal ideation.

METHODS

Suicidal ideation, psychache, and meaning in life were measured using self-rating scales among 738 adults. A network of suicidal ideation, psychache, and meaning in life was constructed to investigate the connections between dimensions and calculate the expected influence and bridge expected influence of each node.

RESULTS

"Psychache" was positively linked to "sleep" and "despair", while "presence of meaning in life" had negative associations with "psychache", "despair", and "pessimism". The most important central nodes were "sleep" and "despair", and the critical bridge nodes were "presence of meaning in life" and "psychache".

CONCLUSION

These preliminary findings uncover the pathological pathways underlying the relationships between psychache, meaning in life, and suicidal ideation. The central nodes and bridge nodes identified may be potential targets for effectively preventing and intervening against the development and maintenance of suicidal ideation.

Integrating the interpersonal theory of suicide and the dualistic model of passion among adults at risk for suicide

The dualistic model of passion proposes two passion types, harmonious and obsessive, representing adaptive and maladaptive passion, respectively. Studies suggest interpersonal experiences explain harmonious passion benefits and obsessive passion negative consequences. However, research has not examined passion among individuals with clinically elevated suicide risk, nor the associations between passion types and suicide-related outcomes. The present study presents a conceptual model linking the dualistic model of passion and the interpersonal theory of suicide constructs [specifically, thwarted belongingness (TB) and perceived burdensomeness (PB)]. U.S. adults with clinically elevated suicide risk (N = 484) completed online, cross-sectional assessments of harmonious and obsessive passion, TB, PB, and future dispositions (i.e., positive focus, negative focus, and suicide orientation). A mediation model indicated the effects of harmonious and obsessive passion on positive and negative focus and suicide orientation were largely explained by TB and PB. The present findings suggest engaging in a passion activity may be meaningfully related to suicide-related interpersonal perceptions (i.e., TB and PB).

Psychometric properties of the Patient Health Questionnaire-4 among Hong Kong young adults in 2021: Associations with meaning in life and suicidal ideation

Background

Young adults in Hong Kong are subject to elevated psychological distress given the societal stressors such as civil unrest and COVID-19 pandemic and suicide is a leading cause of death among them. The present study aimed to evaluate the psychometric properties and measurement invariance of the 4-item Patient Health Questionnaire-4 (PHQ-4) as a brief measure of psychological distress and its associations with meaning in life and suicidal ideation (SI) in young adults.

Materials and methods

A mobile survey recruited a large and random sample of 1,472 young adults (Mean age = 26.3 years, 51.8% males) in Hong Kong in 2021. The participants completed the PHQ-4 and Meaning in Life Questionnaire–short form (MLQ-SF) for presence of meaning in life (MIL), SI, COVID-19 impact, and exposure to suicide. Confirmatory factor analysis was conducted to examine the factorial validity, reliability, and measurement invariance of PHQ-4 and MLQ-SF across gender, age, and distress subgroups. Multigroup structural equation model evaluated and compared the direct and indirect effects of latent MIL factor on SI via latent PHQ-4 factor across distress groups.

Results

Both MIL and PHQ-4 supported a 1-factor model with good composite reliability (Ω = 0.80–0.86) and strong factor loadings (λ = 0.65–0.88). Both factors showed scalar invariance across gender, age, and distress groups. MIL showed significant and negative indirect effects (αβ = −0.196, 95% CI = −0.254 to −0.144) on SI via PHQ-4. PHQ-4 showed a stronger mediating role between MIL and SI in the distress group (Δ = −0.146, 95% CI = −0.252 to −0.049) than the non-distress group. Higher MIL predicted higher likelihoods of help-seeking (Odds ratios = 1.46, 95% CI = 1.14–1.88).

Conclusion

The present results support adequate psychometric properties in terms of factorial validity, reliability, convergent validity, and measurement invariance for the PHQ-4 in young adults in Hong Kong. The PHQ-4 demonstrated a substantial mediating role in the relationship between meaning in life and SI in the distress group. These findings support clinical relevance for using the PHQ-4 as a brief and valid measure of psychological distress in the Chinese context.

The Relationships Between Suicidal Ideation, Meaning in Life, and Affect: a Network Analysis

Transitioning from holistic analysis to a fine-grained level analysis may provide further understanding of psychopathology. This study aimed to explore dimension-level relationships between suicidal ideation, meaning in life, and affect in a joint framework using network analysis and to identify potential prevention and intervention targets to address suicidal ideation. A total of 852 healthy adults aged 18-35 years completed self-report scales to assess suicidal ideation, meaning in life, and affect. A regularized partial correlation network was then built to examine the links between these dimensions. Expected influence and bridge expected influence values were calculated for each node. The prevalence of suicidal ideation was 4.2%. The search for and presence of meaning in life and positive and negative affect exhibited distinct and complex links to the three dimensions of suicidal ideation (pessimism, sleep, and despair). The important central nodes were search for meaning in life, sleep, despair, and positive affect, while the critical bridge nodes were positive affect, negative affect, and presence of meaning in life. These findings provide further understanding of the specific roles of meaning in life and affect in suicidal ideation. The identified nodes may be promising targets for prevention and intervention for suicidal ideation.

Protective factors against suicide attempt in Iranian Kurdish women: a qualitative content analysis

BACKGROUND

A proper understanding of the protective factors against suicide attempt can provide the basis for planning preventive interventions. This study aimed to identify protective factors against suicide attempt among women.

METHODS

This qualitative study was conducted in Kermanshah, Iran between January and May 2021. Participants were 20 Kurdish women, survivors of suicide attempt, selected by purposive sampling method. The data collection method was face-to face and audio-recorded semi-structured interview. Qualitative data analysis was done according to Diekelmann 7-step approach.

FINDINGS

According to the results, the main topic was protective factors against suicide attempt in women, with two categories; "Individual factors" and "Social factors". "Individual factors" had five subcategories including coping strategies, reasons for living, resilience, religious beliefs, and fear of death, and "social factors" had two subcategories including social support and effective communication.

CONCLUSION

This study showed that women who intend to commit suicide may encounter some individual and social factors that play a protective role against suicide. It is recommended to identify and strengthen these protective factors for the effectiveness of suicide prevention interventions.

Self-leadership as an attribute of service leadership: Its relationship to well-being among university students in Hong Kong

Introduction

In the scientific literature, although conceptual models and empirical evidence have shown that leadership attributes are intimately linked to the well-being of followers, there is a lack of studies focusing on leadership in the service economy. According to the Service Leadership Theory, service leadership is a process that satisfies the needs of self, others, and systems (teams, organizations, communities, and societies) in ethical ways that is characterized by leadership competence, character, and care. With specific reference to self-leadership emphasized in service leadership, higher levels of service leadership attributes should promote personal well-being. However, the relationships between "service leadership attributes" and "well-being" in leaders at the intrapersonal level in leadership education among Chinese university students are rarely examined.

Methods

In this study, we collected data from 198 students to understand the linkages between "service leadership attributes" and "well-being" in university students taking a course on service leadership. For tracking changes in students, we collected both pretest and posttest data on validated measures of "service leadership attributes" (i.e., "knowledge," "attitude," and "behavior") and "well-being" (i.e., "positive youth development attributes" and "life satisfaction").

Results

Results showed that the posttest scores on all three domains of "service leadership attributes" as well as two dimensions of "well-being" encompassing life satisfaction and positive youth development attributes were higher than the respective pretest scores, suggesting that students experienced a shift in a positive direction after taking the course. Cross-lagged analyses showed that pretest service leadership attitude and behavior predicted posttest positive youth development attributes; pretest service leadership behavior predicted posttest life satisfaction. Pretest life satisfaction also predicted posttest service leadership behavior.

Discussion

Findings suggest that there is an intimate relationship between "service leadership attributes" and "well-being" in the "pre-work" context among university students.

Resilience in adults with colorectal cancer: Refining a conceptual model using a descriptive qualitative approach

AIMS

To examine and refine a conceptual model of resilience in adult cancer care based on the perspectives and experiences of resilience in adults with colorectal cancer.

DESIGN

A descriptive qualitative study was performed.

METHODS

Twelve participants diagnosed with colorectal cancer that had completed cancer treatment with curative intent were recruited from a tertiary hospital in Australia from July to December 2019. The meaning of individual resilience was explored using in-depth individual interviews. Data were analysed using inductive thematic analysis. Following data analysis, the elements of the conceptual model of resilience were mapped against the themes and subthemes to refine the model.

RESULTS

Five themes were identified as key elements of individual resilience in adults with colorectal cancer: (1) seeking motivations to move forward; (2) striving for normality; (3) adapting and managing self; (4) drawing on external supports; (5) redefining self. A refined conceptual model of individual resilience in adults with colorectal cancer was developed based on the integration of the themes and the elements of the conceptual model of individual resilience.

CONCLUSIONS

Our refined conceptual model of individual resilience in adults with colorectal cancer could facilitate nurses' and other health professionals' understanding of the process of how resilient individuals with colorectal cancer overcome their illness-related adversity. This refined model may be used to further develop and test cancer-specific resilience measures and develop interventions to facilitate resilience in people living with colorectal cancer.

IMPACT

This research identified five features of resilience in adults with colorectal cancer and refined a conceptual model of resilience in adults with colorectal cancer. The findings could help nurses and other health professionals with identifying individuals who are at risk of adaptation difficulties and contribute to an early referral to psychosocial support services.

Impact of death anxiety on mental health during COVID-19: The mediating role of the meaning in life

The aim of this article is to explore whether COVID-19 aroused an awareness of death, inflamed death anxiety, and affected mental health and to assess the degree that meaning in life played in the relationship between death anxiety and general mental health. A total of 197 participants were recruited using convenience sampling and were divided into an experimental group ( n = 100) and a control group ( n = 97). All participants completed the Death Anxiety Scale (DA), the Meaning in Life Questionnaire (MLQ), and the General Health Questionnaire (GHQ-12). Death anxiety had a significant positive predictive effect on general mental health and meaning in life. When death anxiety and meaning in life were included in the regression equation, death anxiety still had a significant positive predictive effect on general mental health, and meaning in life had a significant positive predictive effect on general mental health. These results indicated that meaning in life played a partially mediating role in the influence of death anxiety on general mental health. In the COVID-19 context, death information was found to arouse awareness of death and death anxiety, which adversely affected mental health, and it was also confirmed that meaning in life played a partially mediating role between death anxiety and general mental health, which suggested that mental health problems could be alleviated in the future by helping people find meaning and value in their lives and cope more positively with death.

Bullying Victimization, Future Orientation, and Suicidal Ideation of African American Youth in an Under-Resourced Community: A Moderated-Mediation Approach

African American youth living in low-resourced communities are at high risk for bullying victimization which is positively associated with suicidal ideation. This study explored whether positive future orientation mediated the relationship between bullying victimization and suicidal ideation. This study engaged 627 African American adolescents and measured bullying victimization, internalizing problems, suicidal ideation, future orientation, and several covariates. Major findings indicated that controlling for gender, socioeconomic status, school motivation, and perceived teacher support, internalizing problems mediated the relationship between bullying victimization and suicidal ideation. Furthermore, both the effect of bullying victimization on suicidal ideation and the mediating effect of internalizing problems were moderated by future orientation. The effects were weakened when the level of future orientation increased. The implications for future research and supporting resiliency are discussed based on these findings.

Erfüllte Gegenwart und Rhythmus des Lebens

Der Zusammenhang von Zeit und gutem Leben wurde bereits für eine Reihe medizinischer Disziplinen und Praktiken herausgearbeitet. Doch welche Rolle spielt die Zeitlichkeit des guten Lebens für die Medizin insgesamt? Das ist die leitende Frage dieses Artikels. Dabei wird das gute Leben als sinnvolles Leben verstanden. In diesem Sinne wird für eine zweifache medizinische Relevanz der Zeitlichkeit des guten Lebens argumentiert: Erstens besteht der Sinn medizinischer Behandlungen in der Ermöglichung erfüllter Gegenwart. Zweitens kann und sollte ebendies u. a. durch die Wahrung und Wiederherstellung der chronobiologischen Rhythmen geschehen.

The Relationship of Family Functioning and Suicidal Ideation among Adolescents: The Mediating Role of Defeat and the Moderating Role of Meaning in Life

OBJECTIVE

To investigate the relationship between family functioning and suicidal ideation among adolescents.

METHOD

A total of 4515 junior and senior high school students were assessed using the Family APGAR, the Depressive Symptom Index-Suicidality Subscale, the Defeat Scale, and the Chinese Meaning in Life Questionnaire.

RESULTS

This study found pairwise correlations between suicidal ideation, family functioning, defeat, and meaning in life. Specifically, family functioning was an influencing factor of adolescent suicidal ideation, and defeat was a mediator of the relationship between family functioning and adolescent suicidal ideation; meaning in life was found to be a moderator of the first half of the mediation process by defeat, that is, it moderated the influence of family functioning on adolescent defeat.

CONCLUSIONS

This study demonstrated that the relationship between family functioning and adolescent suicidal ideation, as well as the influence of defeat and meaning in life on this relationship, constituted a moderated intermediary model. This finding has both theoretical and practical value for the implementation of a psychosocial model of adolescent suicide prevention and intervention.

Examining the Interrelationships Among Suicide Cognitions, Suicidal Ideation, and Theoretically Derived Protective Factors

INTRODUCTION

Several protective factors for mitigating suicidal ideation (SI) such as positive affect, reasons for living, purpose in life, meaning in life, gratitude, grit, optimism, social support, and hope have been identified and received empirical support. However, few studies have examined the interrelationships of these protective factors and the identification of protective factors most closely linked to lower levels of SI may be useful for both theory-building initiatives and improvement of suicide-specific interventions. Network analysis offers an approach for testing the relation among these constructs, SI, and suicide risk factors.

METHODS

A sample N = 557 undergraduate students oversampled for lifetime SI completed a cross-sectional, online survey. The data was used to estimate an undirected, cross-sectional network of the aforementioned protective factors.

RESULTS

The resulting inferred network implicates strong negative influence of suicide cognitions, but not recent SI, and the strong positive influence of presence of meaning in life, trait hope, and low negative affect.

CONCLUSIONS

Implications for dimensionality of SI versus suicide cognitions, targeting presence of meaning in life, trait hope, and negative affect in treatment, and cross-cultural variations in reasons for living are discussed. The study is limited by the cross-sectional and convenience sampling methodology.HighlightsProtective factors may have less direct influence on suicidal ideationSuicide cognitions and the suicidal mode may be of phenomenological importancePresence of meaning and trait hope may be primary targets for suicide interventions.

Possible Contribution of Meaning in Life in Patients With Chronic Pain and Suicidal Ideation: Observational Study

Background

Chronic pain is associated with an elevated risk of suicidal ideation (SI).

Objective

We aimed to examine if the presence or the search for Meaning in Life (MiL) are associated with less SI and explore whether MiL profiles emerge in our cohort. These profiles can be described as high presence–high search, high presence–low search, low presence–low search, and low presence–high search.

Methods

In this observational study, we recruited 70 patients who were referred to the Multidisciplinary Pain Center of the Geneva University Hospitals and who answered positively to question 9 on the Beck Depression Inventory, 2nd Edition, investigating SI. Patients who agreed to participate in the study were further investigated; they participated in a structured diagnostic interview to screen for psychiatric diagnoses. During this interview, they completed the Meaning in Life Questionnaire and the semistructured Scale for Suicide Ideation (SSI) to assess the characteristics and severity of SI.

Results

There was a statistically significant correlation between the presence of MiL subscale and the SSI. These 2 scales had a negative and statistically highly significant correlation (R=–.667; P<.001). The results also showed a negative and statistically highly significant correlation between the score of the search for MiL and the SSI (R=–.456; P<.001). The results thus pointed to the presence of MiL as a potential protective factor against the severity of SI, while the search for MiL is also a possible resiliency factor, although to a lesser extent. The profile low presence–low search grouped the vast majority (47%) of the patients; in these patients, the mean SSI score was 14.36 (SD 5.86), much higher compared with that of the other subgroups.

Conclusions

This study’s results point to MiL as a concept of interest regarding devising psychotherapeutic interventions for chronic pain patients in order to reduce the suicidal risk and more accurately determine patients’ suffering.

Participation Mediates the Relationship Between Postconcussive Symptoms and Suicidal Ideation Among Veterans

IMPORTANCE

Veterans with mild traumatic brain injury (mTBI) and associated symptoms are at risk for suicide. Postconcussive symptoms (PCS) may heighten risk for suicidal thoughts by limiting veterans' participation.

OBJECTIVE

To investigate whether participation mediates the relationship between PCS and suicidal ideation.

DESIGN

Cross-sectional, exploratory design. Structural equation models were used to investigate whether participation mediated the relationship between PCS and suicidal ideation.

SETTING

Community.

PARTICIPANTS

Veterans with mTBI (N = 145).

OUTCOMES AND MEASURES

The Ohio State University TBI Identification Method was used to establish mTBI diagnosis. We identified latent variables for PCS and participation using the Neurobehavioral Symptom Inventory and select domains of the Medical Outcomes Study Short Form-36, respectively. We used the Beck Scale for Suicide Ideation to measure the presence of suicidal ideation.

RESULTS

Participation mediated the relationship between PCS and the presence of suicidal ideation (odds ratio [OR] = 1.09, p = .011). More severe PCS were associated with lesser participation (β = -.86, p < .001); greater participation was associated with lower odds of suicidal ideation (OR = 0.92, p = .007).

CONCLUSIONS AND RELEVANCE

PCS may heighten risk for suicidal thoughts among veterans by limiting successful participation, a primary target of occupational therapy intervention. Thus, the results suggest that occupational therapy practitioners can play a substantial role in suicide prevention services for veterans with mTBI. Preventive services could mitigate suicide risk among veterans with mTBI by enabling sustained engagement in meaningful and health-promoting activity (e.g., reasons for living) and targeting PCS. What This Article Adds: Researchers have proposed that occupational therapy practitioners can help prevent veteran suicide by supporting their engagement in meaningful, health-promoting activity and by targeting suicide risk factors within their scope of practice. To the best of our knowledge, this is the first study to offer empirical support for such proposed suicide prevention efforts. Although additional research is needed, these results are promising and highlight a distinct role for occupational therapy in suicide prevention.

Meaning in Life Moderates Relations between Personality and Temperament and Nonsuicidal Self-Injury in Hospitalized Adolescents

Previous research indicates that sensation seeking, emotion dysregulation, and impulsivity are predictive of non-suicidal self-injury (NSSI). A body of research supports that meaning in life predicts improved mental health and well-being, including fewer suicidal thoughts and attempts, yet no research has examined the moderating effects of meaning in life on the relations between personality and temperament and NSSI. Given the growing incidence rates of NSSI among adolescents and the potential lifelong consequences of NSSI, it is imperative to better understand the factors that reduce the rates at which adolescents in a clinical sample engage in NSSI. The present study investigates if the protective factors of meaning in life moderate the relation between personality and temperament variables and NSSI among 126 adolescents (71% female, Mage = 16.1, SD = 1.1, range 13-18, 80% White) residing in an inpatient psychiatric hospital who endorsed NSSI in the last 12 months. Results from hurdle modeling indicate that two subtypes of meaning in life, presence of meaning in life and search for meaning of life, may serve as robust protective factors against engagement in NSSI among a clinical sample of adolescents. Additionally, results suggest that search for meaning, but not presence of meaning in life, variables moderate the relations between personality and temperament and NSSI. Results provide evidence that meaning in life is an understudied variable of importance in understanding how to prevent or treat NSSI. It also underscores the need to develop, refine, and test meaning-making interventions.

What predicts suicidality among psychologists? An examination of risk and resilience

Psychologists may have a uniquely high risk for suicide. We examined whether, among 172 psychologists, factors predicting suicide risk among the general population (e.g., gender and mental illness), occupational factors (e.g., burnout and secondary traumatic stress), and past trauma predicted suicidality. We also tested whether resilience and meaning in life were negatively related to suicidality and whether resilience buffered relationships between risk factors and suicidality. Family history of mental illness, number of traumas, and lifetime depression/anxiety predicted higher suicidality, whereas resilience predicted lower suicidality. At higher levels of resilience, the relationship between family history of suicide and suicidality was stronger.

Validating the Suicide Behavior Questionnaire-Revised among Filipino adults during the COVID-19 pandemic

The study aimed to examine the validity of the Suicide Behavior Questionnaire-Revised (SBQ-R) among adult Filipinos experiencing severe depression symptoms during the COVID-19-related lockdowns in 2020. Results support SBQ-R's internal reliability. Confirmatory factor analyses supported SBQ-R's one-factor structure and its measurement invariance across gender and age. The SBQ-R's positive relationship with negative affect and its negative relationships with positive affect and family support demonstrate the questionnaire's criterion-related validity. The SBQ-R's cutoff of ≥8 shows that 78% of the sample were at-risk for suicide. The SBQ-R is valid in assessing suicide risk among severely depressed adults during the COVID-19 pandemic.

Entrapment and suicidal ideation: The protective roles of presence of life meaning and reasons for living

OBJECTIVE

The integrated motivational-volitional model of suicide proposes that feelings of entrapment play a key role in the development of suicidal ideation. The model also posits a set of motivational moderators which either facilitate or hinder the development of suicidal thinking when entrapment is present. These motivational moderators include factors such as attitudes, future goals, thwarted belongingness, and social support. Two previously studied protective factors against suicide, reasons for living and life meaning, have received support in suicidology and might serve as motivational moderators in this model.

METHODS

The current cross-sectional study included college students (N=195) oversampled for recent suicidal ideation who took a series of self-report questionnaires online.

RESULTS

Our findings demonstrated that both reasons for living and life meaning are protective against the relation between entrapment and suicidal ideation, especially when presence of life meaning and reasons for living of high. Search for life meaning was found demonstrated a less protective relation with SI severity, particularly when reasons for living were low.

CONCLUSION

Both motivational moderators demonstrated protective relationships with suicidal ideation and may be relevant to suicide prevention strategies. Limitations and future directions are discussed.

Screening for suicide risk among older adults: assessing preliminary psychometric properties of the Brief Geriatric Suicide Ideation Scale (BGSIS) and the GSIS-Screen

OBJECTIVES

To initially assess psychometric properties of two abbreviated versions of the Geriatric Suicide Ideation Scale (GSIS): a 10-item Brief Geriatric Suicide Ideation Scale (BGSIS), and a 5-item Geriatric Suicide Ideation Scale-Screen (GSIS-Screen).

METHODS

A series of psychometric analyses was conducted, assessing the internal consistency, test-retest reliability, construct and predictive validity of the abbreviated GSIS scales. This was done by selecting-out GSIS items from a combined dataset of studies on suicide ideation in older adults: 1) The GSIS scale development study (n = 107); 2) A clinical trial of Interpersonal Psychotherapy (IPT) modified for suicidal older adults(n = 25); 3) A longitudinal study of risk and resiliency to suicide ideation in community-residing older adults (n = 173).

RESULTS

Overall findings demonstrated strong internal consistency, test-retest reliability, concurrent and predictive validity for the BGSIS and GSIS-Screen with older adults across community, clinical, and residential settings.

CONCLUSION

Study findings support the use of the abbreviated GSIS scales when conducting research on suicide risk identification among older adults. Future research is recommended testing these scales prospectively in public health, residential, and clinical settings, in research and healthcare delivery contexts.

The role of personality traits and social support in relations of health-related behaviours and depressive symptoms

BACKGROUND

Previous evidence has suggested that physically inactive individuals and extensive media users are at high risk for experiencing depressive symptoms. We examined personality traits and perceived social support as potential moderators of this association. Personality and perceived social support were included as two of the most frequently considered variables when determining predispositioning factors for media use phenomena also discussed in relation to physical activity.

METHODS

We analysed cross-sectional data from 1402 adults (18-31 years old) who participated in a national health survey in Germany (KiGGS, Study on the health of children and adolescents in Germany, wave 2). The data included one-week accelerometer assessments as objective indicators of physical activity, self-reported media use, depressive symptoms, perceived social support and Big 5 personality traits. An elastic net regression model was fit with depressive symptoms as outcome. Ten-fold cross-validation was implemented.

RESULTS

Amongst the main effects, we found that high media use was positively correlated with depressive symptoms, whereas physical activity was not correlated. Looking at support and individual differences as moderators, revealed that PC use was more strongly correlated with depressive symptoms in cases of low levels of perceived social support. Positive associations of social media use with depressive symptoms were more pronounced, whereas negative associations of moderate to vigorous physical activity with depressive symptoms were less pronounced in extraverts than they were in introverts.

CONCLUSIONS

Results highlight the importance of considering individual factors for deriving more valid recommendations on protective health behaviours.

Suicide resilience: A concept analysis

OBJECTIVE

Suicide resilience is gaining increasing attention from researchers because of its potential role in preventing suicide. However, it has not been clearly analyzed, and there are various meanings and terms regarding this issue. The purpose of this analysis, therefore, was to conceptualize the concept of suicide resilience.

METHODS

Walker and Avant's method of concept analysis was used to identify the antecedents, attributes, and consequences of suicide resilience. The literature was searched using PubMed, PsychINFO, Embase, Web of Science, CINAHL, CNKI, and WanFang databases with no limitation on publication date. The search included peer-reviewed journal articles and dissertations related to suicide resilience published in English or Chinese.

RESULTS

52 articles were identified to provide information for this concept analysis. Five defining attributes of suicide resilience were identified: social support, coping strategies, psychological capital, meaning in life, and sense of responsibility. Antecedents of suicide resilience were high suicide risk events, and consequences of suicide resilience were keeping vulnerable individuals stay away from or overcoming suicidality.

CONCLUSIONS

The result of the analysis provided a more clear definition of suicide resilience. The identified defining attributes, antecedents, and consequences can be further tested and used to develop potential interventions. Future research is needed and will help to advance our understanding of the scope.

The three-step theory of suicide: Description, evidence, and some useful points of clarification

There has been considerable uptake of the Three-Step Theory (3ST) of suicide since its publication in 2015. The 3ST is a concise, evidence-based, and actionable theory that explains suicide in terms of four factors: pain, hopelessness, connection, and capability for suicide. The 3ST has not only been cited in hundreds of scientific papers, but incorporated into continuing education programs, gatekeeper training, and self-help resources. In this context, it is useful to clarify the theory's content and review its scientific support. Thus, the present article describes the 3ST, provides an updated evidence review for each of its premises, and offers several points of clarification so that the claims of the 3ST may be better understood, evaluated, and applied. To date, research (including research on correlates, risk factors, motivations, warning signs, and means-safety interventions) supports the 3ST. At the same time, there are aspects of the theory that are challenging to operationalize and that require further testing.

The role of meaning in life as a protective factor in suicidal ideation among elderly men with physical illnesses

The highest suicide rates are among elderly men. The aim of the present study is to extend previous findings by focusing on meaning in life as a protective factor for suicidal ideation among elderly men. Self-report measures were administered to 170 elderly men aged 65 and over in community. Meaning in life and physical illness predicted suicidal ideation among elderly men. Physical illness moderated the association between meaning in life and suicidal ideation. In the young-old group (ages 65-74), meaning in life predicted suicidal ideation among those who reported higher rates of physical illness. This moderation effect was not found among the older group (aged 75 years and older). The findings of this study highlight the importance of age-differences in studying suicidal ideation among elderly men. Our findings emphasize the importance of cultivating and maintaining meaning in life when coping with chronic illnesses and point at meaning in life as a goal in therapeutic interventions designed to reduce suicidal ideation among elderly.

Depression and Suicidal Behaviors Among HIV-Infected Inmates in Lesotho: Prevalence, Associated Factors and a Moderated Mediation Model

Depression and suicidal behaviors are two common psychiatric problems observed among people living with HIV. The situation is worse among HIV-infected inmates. The present study aimed to assess the prevalence and associated factors of depression and suicidal behaviors among HIV-infected inmates, and to clarify the mechanisms underlying the impact of HIV-related stigma on suicidal behaviors. The data from 402 HIV-infected inmates in Lesotho showed the prevalence of depression and suicidal behaviors was 53.0% and 8.2%. Female and institution maladaptation were risk factors for depression, and the risk factor for suicidal behaviors was non-participation of institution activities. Moreover, HIV-related stigma indirectly increased inmates' suicidal behaviors through elevated depression. Such indirect effect was stronger for inmates with a lower level of meaning in life. These findings indicate more concern should be given to high-risk subgroups, and both depression and meaning in life are intervention targets for suicide prevention among HIV-infected inmates.

Relationships between Cultural Adaptation and Immigrants’ Well-Being

Abstract The present study aimed to evaluate the predictive relationship of socio-demographic variables, cultural adaptation and hope on general well-being (GWB), subjective (SWB), social (SoWB) and psychological (PWB) and in the meaning of life. The participants consisted of 108 immigrants. The instruments used were: bio sociodemographic questionnaire, Mental Health Continuum - Short Form, Dispositional Hope Scale, Acculturation Measures and Meaning of Life Questionnaire. In general, only sociocultural adaptation showed a positive predictive relationship with all types of well-being studied, nonetheless this measure presented a negative predictive relationship regarding the presence of meaning in life. Psychological adaptation was predictively and positively related only to SWB. The perception of cultural distance negatively affected SoWB. The presence of meaning was also negatively predicted by the type of immigration and age. The search for meaning was negatively predicted only by income. The results are important for a better understanding of factors that influence the experience of immigrants in Brazil.

Examining the relations between hopelessness, thwarted interpersonal needs, and passive suicide ideation among older adults: does meaning in life matter?

Older adults are at an elevated risk for passive suicide ideation. The interpersonal theory of suicide and the 3-step theory may provide a framework to better understand factors that contribute to passive suicide ideation among older adults. Specifically, this study aimed to test components of prominent suicide theories and examine the role of meaning in life in the associations between hopelessness, thwarted belongingness, perceived burdensomeness and passive suicide ideation among older adults. Participants were 243 adults aged 60 and older recruited from primary care settings in the southwest United States. We hypothesized that high meaning in life would weaken the associations between hopelessness, thwarted belongingness, perceived burdensomeness and passive suicide ideation. Results from moderation analyses indicate that meaning in life was a significant moderator of the associations between hopelessness and passive suicide ideation, thwarted belongingness and passive suicide ideation, and perceived burdensomeness and passive suicide ideation. These findings suggest that when meaning in life is low there are significant negative associations between hopelessness, thwarted belongingness, perceived burdensomeness and passive suicide ideation among older adults. Implications, limitations, and future directions are discussed.

Development and Effect of a Salutogenic Program for Rural Elderly Women on Depression and Suicidal Ideation

This study aimed to develop and evaluate the effects of a Salutogenic program on sense of coherence, depression, and suicidal ideation among rural older adults. Quasi-experimental, nonequivalent control group pretest-posttest design was used. Participants were female, aged 65 years and older from G and O province, South Korea. The experimental group (n = 22) received a 12-session Salutogenic program for 6 weeks, twice a week. The control group (n = 19) was put on a waiting list to receive the intervention after completing the study. Collected data were analyzed using descriptive statistics, a χ² test, independent t-test, and repeated measure ANOVA with SPSS WIN 26.0. There were significant differences in sense of coherence (F = 19.34, p < .001), depression (F = 12.93, p < .001), and suicidal ideation (F = 4.40, p = .027) over time pretest, posttest, and follow-up test after intervention between two groups. The study discussed the effect of Salutogenic program on sense of coherence, depression, and suicidal ideation, and considered its benefits in suicide prevention for elderly women. The Salutogenic program can be recommended as useful strategies to enhance sense of coherence and to reduce depression and suicidal ideation of elderly women in community.

Meaning and purpose in Huntington's disease: a longitudinal study of its impact on quality of life

Objective

Previous work in Huntington’s disease (HD) has shown that a sense of meaning and purpose (M&P) is positively associated with positive affect and well‐being (PAW); however, it was unknown whether HD‐validated patient‐reported outcomes (PROs) influence this association and how M&P impacts PROs in the future. Our study was designed to examine if HD‐validated PROs moderate the relationship between M&P and PAW and to evaluate if baseline M&P predicts 12‐ and 24‐month changes in HD‐validated PROs.

Methods

This was a longitudinal, multicenter study to develop several PROs (e.g., specific for the physical, emotional, cognitive, and social domains) for people with HD (HDQLIFE). The sample consisted of 322 people with HD (n = 50 prodromal, n = 171 early‐stage manifest, and n = 101 late‐stage manifest HD). A single, multivariate linear mixed‐effects model was performed with PAW as the outcome predicted by main effects for M&P and several moderators (i.e., an HD‐validated PRO) and interactions between M&P and a given PRO. Linear‐mixed models were also used to assess if baseline M&P predicted HD‐validated PROs at 12 and 24 months.

Results

Higher M&P was positively associated with higher PAW regardless of the magnitude of symptom burden, as represented by HD‐validated PROs, and independent of disease stage. In our primary analysis, baseline M&P predicted increased PAW and decreased depression, anxiety, anger, emotional/behavioral disruptions, and cognitive decline at 12 and 24 months across all disease stages.

Interpretation

These findings parallel those seen in the oncology population and have implications for adapting and developing psychotherapeutic and palliative HD interventions.

Does meaning protect against loneliness? Exploring empirical studies and theory

Research indicates that meaning in life is a protective factor for physical and mental health. Although loneliness is increasingly recognized as an important public health concern, no studies have investigated the potential of meaning in life to protect against loneliness. Based on an explorative interdisciplinary research strategy that comprises data from a cohort study, a strategic review of empirical literature and a conceptual analysis of the concept of meaning in life we explore the support for potential links between meaning in life and the protection against loneliness. We propose three different explanatory mechanisms; (i) that meaning in life promotes a positive orientation toward others, (ii) that meaning in life enhances interpersonal appeal and (iii) that meaning in life promotes a better ability to cope with loneliness. Theoretically, we explore the idea that the value of meaning in life ultimately concerns a social need to contribute to the realization of value that, at least in principle, can be shared and recognized by others. When people realize the value of meaning in life, they partake in a community of shared values, which links them to a social world in a way that may protect against the feeling of loneliness. Jointly the analyses point to the need for prospective studies on the role of meaning in life as a protective factor against loneliness and a potential novel focus for loneliness interventions.

Almost Everyone Loses Meaning in Life From Social Exclusion, but Some More Than the Others: A Comparison Among Victims, Voluntary, and Forced Rejecters

Social exclusion has been a major societal concern because it hinders the attainment of needs for belonging and relationship. While we know much about the effects of social exclusion on victims and perpetrators, there is limited insight regarding how different types of rejecters (voluntary vs. forced) might affect important outcomes. The purpose of this study is to bridge this gap and to examine how different types of social exclusion (forced and voluntary) influence meaning in the life of participants. To this end, we conducted two experiments using two social exclusion paradigms: the recall paradigm and the Cyberball game. The results of the two experiments were consistent. Both experiments revealed that (1) the meaning in the life of the victim group and the forced rejecter group (i.e., those who were forced to exclude others) was significantly lower than this of the control group and the voluntary rejecter group (i.e., those choosing to exclude others). There were no significant differences between the victim group and the forced rejecter group, and there were no significant differences between the voluntary rejecter group and the control group. These results reveal that social exclusion not only negatively affects the victims of exclusion but also reduces the meaning in the life of forced rejecters. These findings are specific, and they show that the types of will in exclusion can create differences in the effects of social exclusion on the rejecters.

Suicidal ideation predicted by changes experienced from pre-treatment to 3-month postdischarge from residential substance use disorder treatment

PURPOSE

Individuals with substance use disorders (SUD) are at an elevated risk for suicide. Abstinence and drug-related treatment outcomes remain integral to SUD treatment, but recovery incorporates more than just the absence of substance use or mental illness and including positive mental health indices in assessment and treatment of suicidality is needed.

AIMS

The current study investigates the role of traditional indicators of recovery, as well as positive psychology constructs, in predicting suicidal ideation following residential SUD treatment.

METHOD

The study utilized a longitudinal design with baseline and 3-month postdischarge follow-up assessments of 791 individuals who attended residential SUD treatment in Australia.

RESULTS

Rates of suicidal ideation decreased from baseline to follow-up, and the magnitude of change in most indices was associated with suicidal ideation at follow-up assessment. In a hierarchical logistic regression, baseline suicidal ideation, as well as a reduction in psychological distress, increase in refusal self-efficacy, and increase in self-forgiveness, emerged as significant predictors of follow-up suicidal ideation. The final model correctly classified 98.8% of participants as not experiencing SI, and 8.7% of participants as experiencing SI at follow-up, resulting in a total predictive accuracy of 86.9%.

CONCLUSIONS

The results suggested that changes in traditional recovery indices may facilitate reductions in suicidality. As a whole, changes in positive psychology indices did not add to the ability to predict suicidal ideation once traditional indices had been accounted for, but this does not preclude the importance of these indices to SUD treatment and suicide prevention efforts.