Meaning in life as a protective factor against suicidal tendencies in Chinese University students

"Meaning in Life" Mediates the Relationship between Loneliness and Depressive Symptoms among Older Adults during the COVID-19 Pandemic

BACKGROUND

Loneliness was found to be a commonly experienced feeling among older adults during the COVID-19 pandemic and is considered to be a high-risk factor for depressive symptoms. Maintaining meaning in life has been found to be a protective resource for mental health among older adults. The purpose of this study was to examine the mediating effects of an individual's meaning in life in the relationship between loneliness and depressive symptoms among older Korean adults.

METHODS

The data were obtained from a sample of 213 community-dwelling older adults aged over 65. The instruments were the UCLA Loneliness Scale, the Center for Epidemiologic Studies Depression Scale, and the Meaning in Life Questionnaire.

RESULTS

Loneliness was positively associated with depressive symptoms and negatively associated with the presence of and search for meaning among older adults. The presence of meaning mediated the relationship between loneliness and depressive symptoms but the search for meaning did not. The search for meaning mediated the relationship between loneliness and depressive symptoms through the presence of meaning.

CONCLUSIONS

Our study findings suggest that efforts to reduce loneliness and improve meaning in life should be undertaken to prevent depressive symptoms among older adults.

Why emotional neglect brings suicidal ideation? The mediating effect of meaning in life and the moderating effect of post-stress growth

BACKGROUND

Emotional neglect during childhood has long-lasting negative effects on individuals, and it is often hidden and unrecognized. Previous research has not fully understood its unique effects on mental health outcomes, especially when considering the co-occurrence with other forms of maltreatment. The meaning-making coping and growth model suggests that individuals achieve positive psychological outcomes by constructively integrating negative experiences into their self-concept, which may be a protective mechanism against the detrimental effects of emotional neglect.

OBJECTIVE

This study aimed to examine the relationship between emotional neglect and suicidal ideation among undergraduates, accounting for the presence of emotional abuse and physical neglect, and to investigate the mediating role of meaning in life and the moderating role of post-stress growth in this relationship.

METHODS

A self-reported survey was conducted with 3132 undergraduate students from a university in South China. The survey assessed emotional neglect, emotional abuse, physical neglect, suicidal ideation, post-stress growth, and meaning in life.

RESULTS

Meaning in life partially mediated the relationship between emotional neglect and suicidal ideation. Post-stress growth moderated the association between emotional neglect and the sense of meaning in life, in particular the moderation effect was stronger when emotional abuse was weaker.

CONCLUSIONS

Meaning in life mediated the relationship between emotional neglect and suicide ideation. Post-stress growth moderated the mediation effect such that it was weakened among individual with a higher level of post-stress growth. This study contributes to the understanding of the psychopathological processes following emotional neglect and the development of positive personal changes thereafter.

Risk and protective factors of suicidal tendencies among freshmen in China revealed by a hierarchical regression model

This study aimed to identify risk and protective factors for suicidal tendencies among college students by exploring current mental health, personal experiences, family environment, and school adaptation. A total of 11,504 freshmen in China were recruited. Suicidal tendencies were assessed using the Adolescents Suicidal Tendencies Scale (ASTS), while explored risk and protective factors included mental health assessed by the Symptom Checklist-90 (SCL-90), campus adaptation using the College Student School Adaptation Scale, and Personal Situation Survey. Single-factor Logistic regression analysis, correlation analysis, and hierarchical regression analysis were used to analyze the risk and protective factors affecting suicidal tendencies. The results showed that in terms of personal experience, self-injury behavior (OR = 3.522, 95% CI [3.256, 3.811]), sexual assault experience (OR = 2.603, 95% CI [2.374, 2.855]) and lack of friendship relationship (OR = 2.249, 95% CI [2.076, 2.436]) were the most significant risk factors. Regarding family environment, parenting style (OR = 2.455, 95% CI [2.272, 2.652]), parent-child relationship (OR = 2.255, 95% CI [2.092, 2.429]) and violent conflict (OR = 2.164, 95% CI [2.015, 2.324]) were the most prominent risk factors. For protective factors, life satisfaction (OR = 0.330, 95% CI [0.304, 0.359]) and rest quality (OR = 0.415, 95% CI [0.386, 0.447]) were the most significant protective factors. In addition, Symptom Checklist-90 was positively correlated with suicidal tendencies (r = 0.541, 95% CI [0.522, 0.560], p < 0.001), while school adaptation was negatively correlated with suicidal tendencies (r = - 0.590, 95% CI [- 0.579, - 0.601], p < 0.001). After considering demographic variables, psychological symptoms, school adaptation and other risk and protective factors, the hierarchical regression model could explain 48.9% of the variance of suicidal tendencies. The study emphasizes a range of multidimensional risk and protective factors for suicidal tendencies. This enhanced understanding is crucial in aiding the design of future intervention studies targeted at improving the mental health of college students.

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.

Meaning in life as a protective factor against depression

The main objective of this study was to analyze the mediating role that meaning in life has between emotion dysregulation and depressive symptomatology in Spanish university students. Five hundred and sixty-six Spanish university students participated in the study. All of them completed the Difficulties in Emotion Regulation Scale (DERS), the Patient Health Questionnaire (PHQ-9) and the Purpose in Life Test (PIL-10). A mediation model was performed to test the hypothesis that meaning in life mediates the effect of emotional dysregulation on depressive symptomatology in college students. The results show a positive, moderate, and statistically significant correlation between depression and emotional dysregulation. In addition, a negative, moderate, and statistically significant correlation was found between depression and meaning in life, and a negative, small, and statistically significant correlation between emotional dysregulation and meaning in life. Finally, the results of the mediation model evidence the role of meaning in life in different emotional dysregulation strategies and depressive symptomatology. These findings suggest the importance of incorporating the meaning in life variable in the development and implementation of prevention and treatment programs for psychological disorders.

Meaning in Life, Social Axioms, and Emotional Outcomes during the First Outbreak of COVID-19 in Hong Kong

Social unrest, coupled with the outbreak of COVID-19, was a double-hit for Hong Kong in early 2020. Those stressful societal situations not only trigger negative emotions, such as anxiety and/or depression, but also consolidate a person's belief towards oneself (i.e., meaning in life) and society (i.e., social axioms). The study included 2031 participants from the Formation and Transformation of Beliefs in Chinese (FTBC) project dataset. The data were collected in Hong Kong from February 2020 to March 2020 (double-hit). Path analysis and multiple regression were used to examine the mediating and moderating effects of the presence subscale (P) of the Meaning in Life Questionnaire (MLQ) on the relations between social axioms and negative emotions. Results showed that low MLQ-P mediated the associations between cynicism and negative emotions and between low religiosity and negative emotions and moderated the relation between social cynicism and emotional outcomes. Exploratory analyses showed that MLQ-Search (S) mediated the relations between reward for application and negative emotions, between social complexity and negative emotions, and between fate control and negative emotions, and moderated the relation between religiosity and stress. As far as we know, this study reported the first evidence of the role of meaning in life in explaining and modifying the associations between social axioms and mood states. The presence of and search for meaning in life seem to work differently with respect to the relations between social axioms and negative emotions, with important implications for understanding the dynamics of social and personal beliefs in affecting mental health in times of large-scale public crisis.

Stigma and Suicide From the Perspective of Balinese Adults

Research on stigma toward suicide has grown dramatically but limited is studying in Bali, Indonesia. This qualitative research conducted to explore the stigma and suicide from Balinese perspective. Eighty-four Balinese Hindus participated in this study, which 27.38% of them had a history of suicidal thoughts or attempted suicide. Our research found that the cultural belief of Balinese view suicide as an act of ulah pati, which means taking death inappropriately and for an inappropriate reason, which carries the consequence that the suicidal person and the family will incur bad karma. Public stigma and self-stigma toward suicide exist among Balinese, i.e. the act of suicide due to a mental disorder and people who die by suicide are weak. The findings of this study suggest mental health professionals and local governments to pay attention to Balinese cultural belief and Hinduism religious teaching to prevent suicide.

An everlasting love: The relationship of happiness and meaning

Happiness is of great importance to people. Although happiness constitutes a central theme in psychology, the absence of a unifying theory and inconsistent terminology undermine scientific progress. The present article goes beyond attempting to define “types of happiness” or its contributing factors and addresses the role of happiness (i.e., embodied positive emotional patterns) as a function of a dynamic multisystem (i.e., an individual) and its relationship to meaning (i.e., ongoing bidirectional cognitive processes). As a dynamic multisystem, a person strives for stability as they move in physical space, and during their development, across time (i.e., dynamic balance). A primary requirement for dynamic balance is maintaining consistency by connecting the cognitive system to behavior. In psychological terms, such a connection is facilitated by meaning. The model suggests that happiness serves as a marker of a person’s consistency and meaningful interpretations of their lived experience. The model points to a new research direction.

The Near-Death Experience and Suicidal Ideation

The near-death experience (NDE) most generally refers to a state of altered consciousness with various features that can occur during real or presumed near-death circumstances and/or life-threatening incidents. Some NDEs are associated with a nonfatal suicide attempt. This paper discusses how a belief by suicide attempters that their NDEs are a true portrayal of objective spiritual reality can at least in some cases be positively associated with a persistence or increase of suicidal ideation and on occasion lead to further suicide attempts, while also exploring why at other times such a belief may reduce the risk of suicide. The formulation of suicidal ideation associated with NDEs among some of those who did not initially try to kill themselves is also explored. Various examples related to NDEs and suicidal ideation are provided and discussed. Furthermore, this paper also offers some theoretical insights related to this matter and points out some specific therapeutic concerns based on this discussion.

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.

Perceived stress from interpersonal relations predicts suicidal ideation in Chinese university students: Roles of meaning in life and coping humor

Existing studies emphasize that interpersonal relationships are closely associated with the increased risk of suicidal ideation (SI). However, the mechanism underlying this association remains poorly understood. In this study, we investigated how and under what conditions the perceived stress from interpersonal relations links to SI. Also we explored the possible important roles of meaning in life and coping humor. A total of 1472 Chinese freshmen completed self-reported questionnaires of thwarted belongingness (TB), fear of negative evaluation (FNE), meaning in life, coping humor, and SI. Our results showed that SI was associated with more TB and FNE, and it was linked to less meaning in life and coping humor. Importantly, two dimensions of meaning in life mediated the associations between TB, FNE, and SI. Specifically, TB increased SI by destroying both presence of meaning and search for meaning while FNE increased SI by destroying presence of meaning, but not by search for meaning. Additionally, coping humor attenuated the effect of FNE on SI. Our findings highlight the protective roles of meaning in life and coping humor in the link between perceived stress from interpersonal relations and SI among Chinese university students. These results provide feasible advices for practitioners to carry out suicide prevention and intervention.

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.

An examination of theory-based suicidal ideation risk factors in college students with multiple marginalized identities

Social marginalization increases the risk of suicidal ideation (SI) among individuals with diverse identities, yet research examining the effects of marginalization has focused on one identity. Emerging adulthood is a critical period of identity development and the age group with the highest rates of SI. Considering the challenges of living in potentially heterosexist, cissexist, racist, and sizeist environments, we tested whether possessing multiple marginalized identities was associated with severity of SI through factors proposed in the interpersonal-psychological theory (IPT) and the three-step theory (3ST) of suicide and if mediation paths were moderated by sex. A sample of 265 college students completed a cross-sectional online survey assessing SI and constructs related to IPT and 3ST. The number of marginalized identities was generated by adding minoritized sexual orientation, race/ethnicity other than non-Hispanic White, body mass index >25 kg/m2, sexual attraction to same sex but identified as heterosexual, and gender-fluid identity. In IPT multiple mediation analyses, possessing more marginalized identities was associated with SI severity through burdensomeness and hopelessness, but not belonging. Indirect paths through burdensomeness and belonging were moderated by sex. For 3ST, possessing more marginalized identities was associated with SI severity through hopelessness and psychological pain, but not social connection or meaning in life. Future research should consider intersecting social identities and test mechanisms by which multiply marginalized college students develop resilience to SI risk factors, such as support within their marginalized groups, to inform suicide assessment and intervention efforts on college campuses. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

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 fear of COVID-19 and flourishing: the mediating role of search for meaning and presence of meaning

Past researches have found that sense of control and meaning in life can act as a protective factor against fear of COVID-19 pandemic. The current study examined whether the search for meaning and the presence of meaning could mediate the link between fear of COVID-19 and flourishing. A total of 312 Iranians who were identified by snowball sampling were recruited as the subjects of the cross-sectional study. The participants gave their consent to complete the Meaning in Life Scale, Flourishing Scale, and Fear of COVID-19 Scale. The findings demonstrated that fear of COVID-19 had a significant direct effect on flourishing. The presence meaning was positively and significantly connected with flourishing and the search for meaning. Both the search for - and the presence - of meaning were negatively and significantly linked with fear of COVID-19. Mediation analysis demonstrated that a presence of meaning is a protective factor for flourishing, but the search for meaning can be detrimental to flourishing. As a result, it may be worthwhile to conduct longitudinal research to track how the effects of the presence of meaning and the search for meaning vary over time. The study calls on mental health providers to take into account how the presence of meaning might lessen the negative impacts of fear in crisis situations and promote flourishing.

Meaning of life as a resource for coping with psychological crisis: Comparisons of suicidal and non-suicidal patients

Introduction

Meaning is an important psychological resource both in situations of accomplishment and in situations of ongoing adversity and psychological crisis. Meaning in life underlies the reasons for staying alive both in everyday and in critical circumstances, fulfilling a buffering function with respect to life adversities.

Aim

The aim of the present study was to reveal the role of both meaningfulness, including specific sources of meaning and reasons for living, and meaninglessness (alienation) in patients suffering from profound crisis situations with or without suicidal intentions and behavior.

Methods

The sample included 148 patients (all Caucasian) who were referred to a crisis center in Moscow, Russia. Seventy-seven patients (54 females, mean age 32.00 ± 11.98 years) reported a current crisis situation in their life but denied suicidal thoughts or behavior. Twenty-nine patients (21 females, mean age 31.55 ± 13.76 years) reported suicidal ideations but denied suicidal attempts or self-harming behavior. Forty-two patients (31 females, mean age 30.64 ± 11.38 years) had episodes of suicidal attempts or self-harming behavior accompanied by suicidal intentions. There were no significant gender or age differences between groups.

Participants completed a number of measures of different aspects of meaning and meaninglessness, well-being, ill-being and psychological resources. For some patients (N = 74), a clinical checklist was completed by their doctors assessing 28 various characteristics associated with the patient’s clinical status.

Results and discussion

Meaningfulness and reasons for living were more helpful in distinguishing between reactions to profound crisis situations (suicidal intentions versus non-suicidal behavior) than were measures of well-being, ill-being, meaning crisis or personality resources. In both suicidal and non-suicidal crisis patients meaningfulness predicted more positive reasons for living. The relationship between meaningfulness and most reasons for living remained significant after controlling for clinically appraised suicidal “readiness,” acute stress and lack of social support. Self-transcendence was the major specific source of meaning predicting higher reasons for living after adjusting for general meaningfulness.

Conclusion

The data cast some light on the psychological meaning of suicide. It follows that prevention efforts are to be focused not on eliminating the factors “pushing” one to suicidal behavior, but rather on supporting inner strengths conducive of a positive decision, to be, through enhancing meaningfulness and reasons for living.

Cross-cultural measurement invariance of the purpose in life test - Short form (PIL-SF) in seven Latin American countries

The aim was to test the cross-cultural measurement invariance of the PIL-SF in a sample of people from seven Latin American countries. Additionally, the characteristics of the PIL-SF items were evaluated and to assess the relationship between purpose in life, as measured by the PIL-SF, and fear of COVID-19. A total of 4306 people from seven Latin American countries participated in the study. The results indicated that the PIL-SF is invariant in the seven participating countries and, therefore, there is evidence that the items reflect the purpose of life in the same way in all countries. This allows comparisons of purpose in life between countries that are free of bias, reflecting the true differences in how countries respond to items. From IRT, the discrimination parameters are adequate and indicate that the items cover a wide range of the purpose in life construct. The difficulty parameters are adequate and increase monotonically. This indicates that people would need a higher level of purpose in life to respond to the higher response categories. Thus, the PIL-SF items would be useful in determining people with a relatively high degree of purpose in life. Identifying people with different levels of purpose in life would allow them to be part of intervention programs, either to support those with low levels or to maintain and reinforce their purpose in life. The evidence of cross-country measurement invariance of the PIL-SF provides a measure to be used in cross-cultural studies about the meaning of life.

University students' mental well-being during COVID-19 pandemic: The mediating role of resilience between meaning in life and mental well-being

The current study aims to examine (a) the mental well-being of university students, who were taking online classes, and (b) and test whether resilience would mediate the relationship between meaning in life and mental well-being. The sample of 302 university students (M_age = 20.25 years; 36.1% men, 63.9% women) was taken from the universities of Punjab, Pakistan. The participants were recruited online and they completed a cross-sectional survey comprising the scales of meaning in life, resilience, and mental well-being during COVID-19. Findings from the study indicated that participants had a normal to a satisfactory level of overall mental wellbeing during COVID-19. Resilience acted as a mediator for both the presence of meaning in life, the search for meaning in life, and mental well-being. Demographic variables including family size were significantly and positively related to resilience while the availability of personal room showed a significant positive relationship with mental well-being. These findings suggest that meaning in life and resilience supports mental well-being during the COVID-19 pandemic and that effective steps should be taken to make the lives of university students more meaningful and resilient.

Promotion of Meaning in Life and Wellbeing Among University Students During the COVID-19 Pandemic via a Service-Learning Subject

Utilizing the principle of “learning by doing,” service-learning (SL) course provides a platform for university students to apply academic knowledge in serving the community, reflecting on the serving experiences, deepening their understanding of the knowledge, and further improving their competence, responsibility, wellbeing, and meaning in life (MIL). This study reported university students' changes in psychological wellbeing (positive youth development attributes), subjective wellbeing (life satisfaction), and MIL after taking a SL subject during the COVID-19 pandemic through a one-group pretest-posttest design. Based on the data collected from 229 students (mean age = 20.86 ± 1.56 years, 48.0% females), repeated-measures multivariate general linear model (GLM) analyses revealed that students showed significant positive changes in wellbeing and MIL. In addition, pretest MIL scores positively predicted posttest scores of the two wellbeing measures but not vice versa. As predicted, improvement in MIL among students was closely associated with the positive changes in both psychological and subjective wellbeing measures. These findings suggest that SL participation during the pandemic may promote students' life meaning and foster their wellbeing. Furthermore, MIL and wellbeing may improve simultaneously, and MIL enhancement may further contribute to improvement in psychological and subjective wellbeing. The findings further prove that SL is an effective pedagogy in higher education settings in promoting youth positive development.

Identity Processing Style and Meaning in Life among Emerging Adults: Mediational Role of Commitment

Building one’s own identity and finding meaning in life are important tasks for emerging adults. Although many agree that both are essential in terms of the well-being and proper functioning of an individual, there is little empirical data concerning the relationship between the way young people process information about themselves and the feeling that their life has a purpose and value. Therefore, the aim of this study was to explore how identity processing styles (normative, diffuse-avoidant and informational) and two dimensions of meaning of life (presence and the search for meaning) are related. It was also assumed that identity commitment could play a mediating role between those variables. 183 emerging adults who participated in the study completed Identity Style Inventory (ISI-5) and Meaning in Life Questionnaire. The cross-sectional study design was used. Using Structural Equation Modeling revealed that commitment mediated the relationship between two of three identity styles (diffuse-avoidant and informational) and presence, but not search for or meaning in life. Normative identity style also negatively predicted the search for meaning in life. It seems that commitment might play an important role in meaning-making process, and as such, should be strengthened and encouraged when working with individuals at this stage in life.

Age Progression in the Treatment of Suicidal Patients

Suicide is a very distressing but preventable phenomenon; it is also the most profound and serious outcome for patients and healthcare professionals. Suicidal ideations and hopelessness are a high-risk predictor for suicide attempts and death by suicide. The proper therapeutic management of suicidal patients continues to be an important challenge to all practicing clinicians. This article provides a review of age progression and specific information on the value and use of hypnotically mediated age progression as a therapeutic tool in the effective clinical management of patients with suicidal thoughts and behaviors. Case examples are provided to illustrate the use of age progression in clinical practice. The literature that explores a future-oriented strategy in the treatment of suicidal patients is reviewed. Moreover, information on a method of enhancing a future oriented strategy with hypnotically mediated age progression interventions is provided. The goal is to improve therapeutic results and reducing the risk of suicide attempts and death by suicide.

Meaning in life as a mediator of the associations among depression, hopelessness and suicidal ideation: A path analysis

WHAT IS KNOWN ON THE SUBJECT

The meaning in life consists of an individual's values, experiences, goals and beliefs. It has been shown to be negatively associated with depression, hopelessness and suicidal ideation. Depression and hopelessness are related to increased suicidal ideation. Meaning in life has been shown to be a protective factor against depression, hopelessness and suicidal ideation.

WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE

A path model was developed to clarify the associations among meaning in life, depression, hopelessness and suicidal ideation. For clarity, the outcomes were depression and suicidal ideation, the independent variable was hopelessness, and the mediator was meaning in life. Hopelessness had a direct association with meaning in life, and meaning in life had a direct association with depression, supporting the mediating effect of meaning in life from hopelessness to depression. Meaning in life had the strongest association with depression, and depression had the strongest association with suicidal ideation. Meaning in life did not have a significant direct association with suicidal ideation; it did have an indirect association with suicidal ideation through depression. This study estimated that one-point increase in meaning in life score was associated with 0.47-point decrease in depression score and 0.13-point decrease in suicidal ideation score, respectively.

WHAT ARE THE IMPLICATIONS FOR PRACTICE

Logotherapy is a meaning-centred therapy to find meaning in life. This study reveals that increased levels of meaning in life are associated with decreasing degrees of depression. Mental health nurses could help patients to find meaning in life by logotherapy and thus associated with reductions in depression. Mental health nurses could help patients to find hope by exploring meaning in life and promoting positive attitudes towards life from meaningless life to meaningful life, there is a reduction in depression, which in turn reduces suicidal ideation indirectly.

ABSTRACT

Introduction Meaning in life can be good protective factor against depression, hopelessness and suicidal ideation. Aim To analyse the mediating effect of meaning in life on the associations among hopelessness, depression and suicidal ideation. Method A cross-sectional study was conducted among 90 patients diagnosed with depression. A structural equation modelling approach was applied for this path analysis to examine the mediating effect of meaning in life on the association among hopelessness, depression and suicidal ideation. Results The results showed that meaning in life mediated the association between hopelessness and depression. Hopelessness had a direct positive association with depression (β = 0.23, p < .03), and meaning in life had a direct negative association with depression (β = -0.51, p < .01) and indirect association with suicidal ideation through depression; this indirect association was -0.21 (p < .01). Discussion Meaning in life revealed strong mediating association with the relationship between hopelessness and depression. By reducing the level of depression, meaning in life demonstrated its mediator association with suicidal ideation. Implications for Practice Logotherapy is a meaning-centred therapy to find meaning in life. Mental health nurses could help patients to manage their depression through logotherapy, thus leading to reductions in suicidal ideation.

Enhancing Meaning in Life and Psychological Well-Being Among a European Cohort of Young Adults via a Gratitude Intervention

Background: Strengthening the sense of meaning in life and psychological well-being brings benefits for mental health. The group particularly vulnerable to mental problems are young adults, therefore the aim of our research was to explore how a gratitude intervention will affect the sense of meaning in life, psychological well-being, general health and perceived stress among them. The research also took into account the issue of expressing gratitude.

Method: The study involved 80 young adults (58 women and 22 men) who were randomly assigned to the experimental group that filled out the specially prepared diaries for a week (participants were asked to list three things for which they feel grateful, to whom they are grateful and if and how they expressed their gratitude) or the control group. Participants completed the Meaning in Life Questionnaire (MLQ), the General Health Questionnaire – 28 (GHQ-28), the Perceived Stress Scale (PSS), and the Ryff Scales of Psychological Well-Being (PWBS) twice (before and after intervention).

Results: In the experimental group significant increases were observed in three areas of psychological well-being: environmental mastery, relationships with others and purpose in life. The significant decrease was also noted in anxiety/insomnia and depression symptoms as well as in perceived stress. There were no differences in the level of meaning in life. There was a positive relationship between expressing gratitude and meaning in life and psychological well-being.

Conclusion: Proposed gratitude intervention has the potential to enhance psychological well-being among young adults, however, it may not be effective in enhancing meaning in life.

Mental health issues among international touring professionals in the music industry

Music industry touring professionals are generally assumed to be at elevated risk for mental health issues, highlighted by numerous high-profile suicides in recent years. Few studies have explored the prevalence of depression, suicidality and associated factors within this population. This study aims to gain an empirical understanding of the mental health issues among international touring professionals, with a particular focus on risk for depression and suicidality, and to identify potential protective factors. Data were collected between February-March 2020 as part of the Tour Health Research Initiative's Touring Health and Wellness Survey 2020. Using a multidimensional questionnaire with a sample of 1154 international touring professionals (artists and crew members), participants who completed all psychosocial measures (n = 508) demonstrated elevated levels of suicidality, risk for clinical depression, stress, anxiety and burnout. The median depression score for completers matched the recommended cutoff score of 20, which qualified 254 participants as high risk for clinical depression, while 200 (39.4%) demonstrated high scores for suicidality. In ROC curve analyses, all psychosocial measures were significant predictors of high suicidality, with a combined emotional and social measure yielding the highest classification accuracy (80%). Moderate strength linear relations were observed for all pairs of measures. Positive correlations were found among all risk factors (depression, anxiety, stress, and burnout) and these measures yielded negative correlations with the protective factors (mindfulness and the emotional/social measure). Findings suggest that interventions enhancing mindfulness and emotional/social well-being may serve as valuable treatment components for this population.

A Generalizability Analysis of the Meaning in Life Questionnaire for Chinese Adolescents

The level of meaning in life not only affects the physical health of individuals, but also is closely related to their mental health. At present, many self-reported questionnaires are being used to measure the meaning in life of Chinese adolescents. Using the multivariate generalizability theory, this study investigated the psychometric properties and the internal structure of the Meaning in Life Questionnaires (MLQs), the most widely used questionnaire for assessing the level of meaning in life of Chinese adolescents. The data were sample of 1,951 junior high school students from Guizhou, China. Multivariate random measurement mode p × i° is the primary analytic approach. Results showed that the generalizability coefficient and dependability index of the scale were 0.86 and 0.85, respectively. The generalizability coefficients of presence of meaning and search for meaning were 0.76 and 0.85, respectively, and the dependability indexes were 0.75 and 0.85 for MLQ-P and MLQ-S, respectively. The design of each factor for MLQ is reasonable in terms of score ratio and the number of projects. In brief, the reliability and factor structure of the scale are satisfactory.

Grit and Meaning in Life of Chinese Nurses: The Chain Mediating Effect of Social Support and Hope

Grit is defined as perseverance and passion for long-term goals, and it may affect the stability of the nursing workforce and the physical and mental health of nurses continuously. Meaning in life has received considerable attention from scholars, which is an important component in positive psychology. This study aimed to delve into the relationship between grit and the meaning in life of Chinese nurses. Additionally, we also sought to prove the chain mediating effect of social support and hope on this relationship. An online questionnaire survey was used to collect data from 704 Chinese nurses using the self-made demographic questionnaire with Short Grit Scale (Grit-S), the Perceived Social Support Scale (PSSS), Adult Dispositional Hope Scale (ADHS), and Meaning in Life Questionnaire (MLQ). Moreover, Process version 3.3 plug-in SPSS 25 was used to test the mediation effect between variables. The results showed a strong positive relationship between grit and meaning in life and verified the mediating effect of social support and hope on grit and meaning in life. The results also confirmed the chain mediating model between grit, social support, hope, and meaning in life.

Psychological Strain and Suicidal Behaviors Among Medical Students in Northwest, China: The Mediating Effect of Psychological Distress and Hopelessness

ABSTRACT

Although most studies have shown the psychological strains associated with increased risk of suicidal behaviors, how psychological strains are linked to suicidal behaviors is still unclear. The current study examines the possible mediation effect of psychological distress and hopelessness on the relationship between psychological strains and suicidal behaviors among Chinese medical college students. A cross-sectional survey was conducted from November 2017 to March 2018 involving 5703 medical college students, and the 12-month prevalence of suicidal behaviors was 12.89%. Psychological strains significantly associated with suicidal behaviors, and psychological distress and hopelessness partially explained this relationship. A positive psychological intervention program is needed to buffer the psychological strains, which is a crucial predictor for suicidal behaviors among Chinese medical college students.

A qualitative exploration of young people's experiences of attempted suicide in the context of alcohol and substance use

The aim of this study was to explore young people’s experiences of the role and the processes underpinning the use of alcohol and/or other substances in attempts to end their life. Seven young people, aged 16–25 years old, were interviewed using in-depth, semi-structured interviews. Interpretative Phenomenological Analysis was used to analyse these interviews and develop an understanding of how young people understand their attempted suicide in the context of alcohol and/or other substance use. The analysis identified four superordinate themes reflecting young people’s experiences across the seven interviews. Superordinate themes included: i) The complexity of relationships; ii) The double-edged sword of alcohol and substance use; iii) The straw that broke the camel’s back; and iv) Reflecting on the on-going processes of recovery. The results of this study highlight the complex and multifaceted functions of the consumption of alcohol, and other drugs, in the experiences of young people attempting suicide. Young people described a number of inter and intrapersonal factors which impact upon their suicidal experiences including suicidal ideation and attempts. Participants reported using alcohol and substances as methods of coping with distress, low mood, hearing voices, anxiety and mania. However they also reflected on the impact that this has on their own suicidal ideation and attempts.

Investigating prolonged social withdrawal behaviour as a risk factor for self-harm and suicidal behaviours

BACKGROUND

Self-harm and suicidal behaviour are recognised as public health concerns. Prolonged social withdrawal behaviour, or hikikomori, is reported as a risk factor for suicidal behaviour.

AIMS

To examine the occurrence and additional risk of prolonged social withdrawal behaviour on self-harm and suicidal behaviour among Chinese university students.

METHOD

A cross-sectional online survey was conducted with three universities in southern China. A two-stage random sampling was adopted for recruitment, with students in different years of study, in different departments of each participating university. Hierarchical logistic regression analyses were conducted to investigate the sociodemographic and psychological correlates of self-harm and suicidal behaviours among male and female participants with hikikomori status.

RESULTS

Of the students who completed the online survey, 1735 (72.23%) were included in the analysis; 11.5% (n = 200) reported self-harm behaviour and 11.8% (n = 204) reported suicidal behaviours in the past 12 months. Men showed a higher prevalence rate of self-harm than women (14.7% v. 10.8%, P = 0.048), but a similar rate of suicidal behaviours (11.9% v. 11.3%, P = 0.78). The overall prevalence rate of social withdrawal behaviour was 3.2% (7.0% for men and 2.3% for women, P < 0.001). Prolonged social withdrawal behaviour status was significantly associated with self-harm (odds ratio 2.00, 95% CI 1.22-3.29) and suicidal behaviour (odds ratio 2.35, 95% CI 1.45-3.81). However, the associations became statistically insignificant after adjustment for psychological factors in the final models in the logistic regression analyses.

CONCLUSIONS

Prolonged social withdrawal behaviour appears to be associated with self-harm and suicidal behaviour, but psychological factors have stronger links with suicidality.

COVID-19 among Chinese high school graduates: Psychological distress, growth, meaning in life and resilience

This study examined perceived impact of COVID-19 (PIC) on mental health outcomes (anxiety, depression, and posttraumatic growth) and roles of resilience and meaning in life. In October 2020, 430 Chinese high school graduates completed self-report measures. Results showed that 4.4% and 5.8% participants had anxiety and depression symptoms (⩾10), respectively, while 13.3% developed posttraumatic growth (⩾37.5). Resilience and meaning in life mediated the relationships between PIC and mental health outcomes. These findings underline psychological distress and growth coexisted in COVID-19, while resilience and meaning in life served as important protective factors of mental health.