Unforgiveness, depression, and health in later life: the protective factor of forgivingness

Inner Peace needs of male psychiatric patients in post-war Croatia are associated with their needs to clarify open issues in their life and their needs for forgiveness

Background

More than 25 years after the end of the Balkan war, many people belonging to the post-war population are still traumatized by the war events and have been treated for post-traumatic stress disorder or other psychiatric diagnoses. We were interested in their Inner Peace needs, how these relate to indicators of mental health, and their needs to clarify open processes in their lives and to forgive and be forgiven.

Materials and methods

In a cross-sectional survey with standardized questionnaires (i.e., SpNQ, PCL-M, HADS, and BMLSS), 638 male patients who were treated in seven psychiatric centers in Croatia were enrolled. 68% were diagnosed with PTSD and 32% had other psychiatric diagnoses. Most had actively participated in the Balkan war (79%), and 60% for the whole war period.

Results

Strong needs to "immerse into beauty of nature" were stated by 47%, to "dwell at a place of quietness and peace" by 66%, and to "find inner peace" by 57%. These Inner Peace needs were highest in men treated with PTSD diagnoses as compared to men with other psychiatric diagnoses and were slightly lower in men who were active during the whole war period as compared to shorter phases of war participation. Regression analyses with Inner Peace needs as a dependent variable revealed that Clarification/Forgiveness needs were the best predictor, with further influences of PTSD symptoms and life satisfaction, explaining altogether 49% of the variance. The best predictors of their PTSD symptoms were life satisfaction, perceived burden, depressive symptoms, Inner Peace needs, religious trust, and duration of war participation, explaining 60% of the variance.

Conclusion

In Croatian male war participants in clinical treatment decades after the war, Inner Peace needs indicate their ongoing intention to let go of their disturbing experiences and to find states of inner peace, particularly at specific places of quietness and peace. These needs can be considered metaphors for longing for wholeness, integrity, and safety, in contrast to the ongoing impact of unresolved issues. Thus, apart from psychotherapeutic treatment, sheltered places of nature, inspiration, and reconciliation might be elements to improve the difficult situation of post-war victims still suffering from their experiences.

Associations of dispositional forgivingness with facets of well-being among Colombian adults: A longitudinal outcome-wide analysis

Many studies have reported evidence suggesting that dispositional forgivingness has positive implications for different domains of well-being. However, relatively few methodologically rigorous studies have been conducted in the Global South, particularly in post-conflict settings where forgiveness could play an important role in supporting individual well-being. In this three-wave cohort study of predominantly young adult Colombians (n = 1575), we examined the associations of dispositional forgivingness with 20 well-being outcomes across several domains of well-being: psychological distress, psychological well-being, physical health, social well-being, and character strengths/virtues. Using an outcome-wide analytic design that included extensive control for potential confounding and reverse causation by adjusting for a range of covariates assessed in Wave 1 (2017), we found that dispositional forgivingness assessed in Wave 2 (2018) was at least modestly associated with improvements in one or more facet of each well-being domain assessed approximately 1 year later in Wave 3 (2019). Associations tended to be stronger for outcomes in the domains of psychological distress, psychological well-being, social well-being, and character strengths/virtues compared to the physical health domain. These longitudinal findings suggest that dispositional forgivingness might promote individual well-being in societies with a long history of ongoing civil unrest, conflict, and war.

A hypothetic model for examining the relationship between happiness, forgiveness, emotional reactivity and emotional security

The ultimate goal of life is happiness, according to Plato. Perhaps the most critical questions in the life of human beings have been on happiness and processes that affect happiness. The present study was planned during the COVID-19 pandemic; perhaps human beings are most needed for happiness. The original hypothetical model and the findings constitute the powerful and different aspects of the present study. This study determined a hypothetical model to examine the relationships among happiness, forgiveness, emotional reactivity, and emotional security. The participant group of the study consists of a total of 916 individuals from Turkey, 617 women, and 299 men. The age scale of the participants is between 18-25. Participants completed the Heartland Forgiveness Scale, the Emotional Security Scale, the Emotional Reactivity Scale, and the Oxford Happiness Scale. Mediation analysis was conducted using Hayes' (2017) process macro. According to the proposed model in the study, emotional reactivity mediates the relationship between forgiveness and happiness. As the individual's forgiveness increases, their emotional reactivity decreases, and as the emotional reactivity decreases, the individual's level of happiness increases.

The Older, the More Forgiving? Characteristics of Forgiveness of Chinese Older Adults

This study explores the characteristics of forgiveness in the aging cohorts, which is regarded to be associated with healthy outcomes. Data were drawn from a sample of 308 older adults (aged from 60 to 98 years) who completed the forgiveness questionnaire: forgiving others of The Heartland Forgiveness Scale (HFS) to examine explicit forgiveness, and among the participants, 44 older adults were administrated on the variant single category of implicit association test (SC-IAT) to examine the implicit forgiveness. The results revealed that (1) there is no correlation between explicit forgiveness and implicit forgiveness of older adults. (2) The result of explicit forgiveness is relatively high while that of implicit forgiveness is relatively low. (3) There was no significant correlation between explicit forgiveness and age, but there was significant difference between age groups, as forgiveness tendency of the elderly had a trough in the age group of 70–79 and then rebounded. (4) Implicit forgiveness was significantly correlated with age, and the difference between age groups was marginal. The forgiveness tendency of the elderly over 80 years old was significantly higher than that of the other two age groups. (5) Gender differences are found in both explicit and implicit forgiveness. The findings indicated that (1) explicit and implicit measures in this study have assessed independent and complementary aspects of forgiveness tendency in older adults. (2) Implicit forgiveness falls behind explicit forgiveness, and true internal forgiveness is difficult and rare in older adults according to data analysis. (3) The trend of explicit forgiveness with age is not obvious, because explicit forgiveness in the middle old age group presents an inflection point. However, implicit forgiveness increases slowly with age. (4) Women excel men in scores obtained with both explicit and implicit measures for forgiveness.

Autobiographical Memory, Gratitude, Forgiveness and Sense of Humor: An Intervention in Older Adults

Research has shown that happiness and well-being play a fundamental role in the health of older adults. For this reason, programs based on Positive Psychology seek to improve quality of life, preventing and reducing the appearance of emotional disorders. The objective of this study was to verify whether an intervention based on Autobiographical Memory, Forgiveness, Gratitude, and Sense of humor would increase quality of life in institutionalized older adults. We used a quasi-experimental design with pre- and post-intervention measures and follow-on measures at 3, 6, and 12 months. A total of 111 institutionalized older adults participated in the study and were randomly assigned to one of three groups: experimental (n = 36), placebo (n = 39), and control (n = 36). Measurements were taken of depression, subjective happiness, satisfaction with life, psychological well-being, and specific memories. Program duration was 11 weeks, followed by refresher sessions of the activities that had been conducted. The results showed that the intervention was effective, producing lasting increase in the participating adults' well-being, maintained for the following 12 months, in contrast to the other two groups. In conclusion, the proposed intervention proved to be a novel tool that was effective, easily applied, and able to improve quality of life and emotional disorders in older adults.

Different Routes, Same Effects

Abstract. In the field of forgiveness interventions, little research has been done on the comparative effects of learning-oriented versus action-oriented routes in managing unresolved interpersonal transgressions. In this study, 73 older adults ( M = 68.8 years) were randomized to either a learning-oriented group intervention condition that emphasized learning factors by helping older adults to understand the transgression in a more adaptive way; or to an action-oriented group intervention condition that emphasized action factors by helping older adults to practice new behaviors and skills to manage the transgression. The findings indicated that both conditions resulted in decreases in revenge, transgression-related thoughts and feelings, negative affect, and psychological distress as well as increases in life satisfaction. We were able to demonstrate that both routes are equally effective in reducing negative states and producing positive states.

Cross-cultural adaptation and validation of the European Portuguese version of the heartland forgiveness scale

Background

Forgiveness is linked with well-being, and social and health research has focused on the role and aspects of forgiveness that has been recently suggested as a phenomenon of public health importance. The Heartland Forgiveness Scale (HFS) was developed gathering three subscales to assess the forgiveness of others, forgiveness of self, and forgiveness of situation. The present study aimed to adapt the HFS into European Portuguese, and investigate its reliability and validity.

Methods

Translation and cross-cultural adaptation were conducted using a multistep forward-back translation process. Internal consistency was assessed by Cronbach’s alpha. Confirmatory factor analysis was conducted to verify that the factor structure is the same as in the original HFS. The short version of the Ruminative Response Scale (RRS) and the Satisfaction with Life Scale (SWLS) were used to examine convergent validity.

Results

A sample of 222 university students, selected through convenience sampling, was used to access the validity of the European Portuguese version of the HFS (EPHFS). Cronbach’s alpha for the European Portuguese HFS subscales were 0.777, 0.814 and 0.816 for Self, Others and Situation, respectively, indicating acceptable reliability. The 3-factor model of the original HFS was replicated in confirmatory factor analysis. As expected by evidence in the literature, positive and statistically significant correlations were found between SWLS and HFS and subscales. RRS showed negative and statistically significant correlations with HFS and subscales.

Conclusions

The European Portuguese version of the HFS presented acceptable internal consistency, construct validity and confirmed the three-factor structure of the original HFS.

Reliability and Validity of the Center for Epidemiologic Studies Depression Scale in a Population-Based Cohort of Middle-Aged U.S. Adults

BACKGROUND AND PURPOSE

Globally, depressive symptoms are a leading contributor to years lived with disability. The Center for Epidemiological Studies-Depression (CES-D) scale has been used extensively to quantify depression; yet, its psychometric properties remain contentious. This study examined the reliability and factor structure of the CES-D in the MacArthur Foundation's Midlife in the United States Study (MIDUS), a nationally representative cohort study of noninstitutionalized, English-speaking adults aged 24-74 years.

METHODS

Internal consistency (Cronbach's alpha) and confirmatory factor analysis (CFA) were used to examine the reliability and factor structure of the CES-D.

RESULTS

There were 1,233 participants who were included in the analysis (mean age = 57.3 years [SD = 11.5], 56.7% female). Cronbach's alpha of .90 was observed. The 4-factor model had the best model fit.

CONCLUSIONS

High internal consistency was demonstrated alongside a replication of the original 4-factor structure. Continued use of the CES-D in noninstitutionalized populations is warranted.

The cross-lagged relationship between interpersonal forgiveness and depression symptoms in China

This study investigated the relationship between the process of forgiveness and depressive symptoms in China. A total of 116 college students who had experienced an interpersonal transgression "within the past week" were selected to perform the tracking measurements at 2-week intervals. Cross-lagged models showed that the victim's depressive symptoms were related to increasing revenge and avoidance motivations as well as decreased benevolence motivation; however, the revenge, avoidance, and benevolence motivations of the victims did not predict subsequent changes in depressive symptoms. These results confirm that the presence of depressive symptoms is a predictor of the reduced interpersonal forgiveness, and the alleviation of individuals' depressive symptoms plays a protective role in the adaptive process of interpersonal relationships.

Forgiveness and late life functioning: the mediating role of finding ego-integrity

OBJECTIVES

This study seeks (1) to replicate previous findings on the mediating effect of integrity/despair in the relation between forgiveness and depression in an elderly population and (2) to extend these findings to other aspects of functioning, namely life satisfaction and subjective health. Both aims were studied in a sample of residential elderly.

METHODS

Residential elderly (n = 329, M = 87 years) filled out questionnaires on forgivingness, depressive symptoms, life satisfaction, subjective health and the developmental task of integrity/despair. Structural equation modeling was used to test the mediational role of integrity-despair in the relation between forgivingness and the aspects of functioning. Direct and indirect effects are tested.

RESULTS

The results confirmed earlier findings stating that forgivingness and depression are negatively associated in residential elderly and that the developmental task of finding integrity and avoiding despair is significant mediator in this relationship. A similar pattern of mediational associations was found for life satisfaction. However, for subjective health only a direct effect between forgiveness and subjective health was found, whereas the developmental task of integrity and despair did not function as an underlying mechanism.

DISCUSSION

Framed within a life span perspective, we showed that the developmental task of finding a balance between integrity and despair is an important intrapersonal mechanism through which forgivingness is related with depressed feelings and life satisfaction for residential elderly. A different mechanism might explain the direct effect between forgiveness and subjective health.

The Gender Difference in Depression: Are Elderly Women at Greater Risk for Depression Than Elderly Men?

Numerous epidemiological reports have found that adolescent, young adult, and middle-aged adult girls and women are more likely to be diagnosed with unipolar depression and report greater symptoms of depression when compared to boys and men of similar ages. What is less well-known is whether this gender difference persists into late life. This literature review examines whether the well-known gender difference in unipolar depression continues into old age, and, if it does, whether the variables that are known to contribute to the gender difference in unipolar depression from adolescence through adulthood continue to contribute to the gender difference in the elderly, and/or whether there are new variables that arise in old age and contribute to the gender difference in the elderly. In this review of 85 empirical studies from every continent except for Antarctica, we find substantial support for the gender difference in depression in individuals who are 60 and older. More research is necessary to determine which factors are the strongest predictors of the gender difference in depression in late life, and particularly whether the factors that seem to be responsible for the gender difference in depression in earlier life stages continue to predict the gender difference in the elderly, and/or whether new factors come into play in late life. Longitudinal research, meta-analyses, and model-based investigations of predictors of the gender difference in depression are needed to provide insights into how and why the gender difference in depression persists in older age.