Temporal associations between meaning in life, ultimate meaning struggles, and mental health outcomes in a spiritually integrated inpatient program

BACKGROUND

Meaning in life is a benchmark indicator of flourishing that can likely mitigate the severity of depression symptoms among persons seeking mental healthcare. However, patients contending with serious mental health difficulties often experience a painful void or absence of ultimate meaning in their lives that might hinder recovery. This two-wave longitudinal study examined temporal associations between perceived presence of meaning in life, struggles with ultimate meaning, flourishing, and depression symptoms among adults in a spiritually integrated inpatient treatment program.

METHODS

Of the 242 patients assessed at intake, 90% (N = 218; 40% Cisgender male; 57% Cisgender female; 3.0% nonbinary) completed validated measures of these meaning-related factors and mental health outcomes at discharge.

RESULTS

Cross-sectional analyses revealed perceptions of meaning in life and ultimate meaning struggles were inversely linked with one another along with being associated with indices of positive and negative mental health in varying ways at the start and end of treatment. Drawing upon a two-wave cross-lagged panel design, longitudinal structural equation modeling analyses supported a Primary Meaning Model whereby having a subjective sense of meaning in life at intake was prospectively linked with lower levels of ultimate meaning struggles and greater flourishing at discharge. However, baseline levels of mental health outcomes were not predictive of the meaning-related factors in this sample.

CONCLUSION

Findings highlight the utility of assessing patients' perceived meaning in life and ultimate meaning struggles in spiritually integrated programs and for clinicians to be prepared to possibly address these meaning-related concerns in the treatment process.

Virtue in Pursuit of Goals: A Goals-Based Approach to Patience Measurement

In this paper, we provide a contextualized assessment of virtue through validation of a goals-based approach to measuring patience, the Goals-Based Virtue-Patience Scale (GBV-P). To assess virtue in a way congruent with its definition requires consideration of situational and contextual factors; however, most extant measures of virtue instead assess virtue at a decontextualized, global level (Ng & Tay, 2020). As such, we developed a contextualized and motivationally attuned goals-based assessment of the virtue of patience, the ability to remain calm in the face of frustration, suffering, or delay in goal pursuit. We engaged multilevel structural equation modeling to validate a new measure of patience in pursuit of goals nested within people. Across three studies (N = 798) assessing the GBV-P, data were consistent with reliability and structural validity tests, and associations of the new measure with other regulatory virtues or constructs (e.g., global patience, self-control, conscientiousness, perseverance, emotion regulation) as well as well-being (e.g., life satisfaction, goal orientation, meaning) and ill-being outcomes (e.g., depression and anxiety symptoms, loneliness, stress) provided evidence of convergent validity. Likewise, patience was differentially engaged depending on the goal domain and type; approach (vs. avoidance), interpersonal (vs. intrapersonal), and generativity goals were pursued with more patience.

Attachment to God, Contingent Self-Worth, and Mental Health Outcomes in U.S. Collegiate Athletes

Scholars and practitioners have recently devoted increased attention to the psychological well-being of student-athletes. However, sparse research has examined the role of religion/spirituality in well-being in athletic populations. In a sample of U.S. collegiate athletes (N = 415), the present study assessed how the divine relationship, measured by attachment style to God, associates with depressive and anxiety symptoms in a sample of collegiate student-athletes, as well as the mediating role of contingent self-worth based on the approval of others in this process. Results show that secure attachment to God is associated with fewer mental illness symptoms, whereas avoidant and anxious attachment to God are associated with greater mental illness symptoms. Contingent self-worth based on others' approval partially mediates each of these associations. Implications for the religion and health literature and sport practitioners are discussed.

Perceptions of Divine Forgiveness, Religious Comfort, and Depression in Psychiatric Inpatients: A Mixed Methods Study

Understanding how forgiveness relates to mental health outcomes may improve clinical care. This study assessed 248 adult psychiatric inpatients, testing associations of forgiveness, religious comfort (RC), religious strain (RS), and changes in depressive symptomatology from admission to discharge. Experiencing divine forgiveness and self-forgiveness was both directly associated with RC and inversely associated with RS. Using structural equation modeling, the path from divine forgiveness to depression through RC was significant, β =  - .106, SE = .046, z =  - 2.290, p = .022, bootstrapped 95% CI =  - .196 to - .015. Qualitative findings illustrated patients' changed perspectives on divine forgiveness during hospitalization.

Positive exchanges buffer negative exchanges: Associations with marital satisfaction among U.S. mixed-sex couples

Perceived positive and negative exchanges in relationships contribute to marital satisfaction in qualitatively distinct manners. However, the nature of these associations is unclear with some studies demonstrating curvilinear relationships and some literature suggesting interaction effects of positive and negative exchanges on marital satisfaction. Extant work has not compared curvilinear and interactive models to address this discrepancy. The present study clarifies these associations by comparing multiple models. Based on cross-sectional data from 886 mixed-sex married couples from across the U.S., we found that marital satisfaction was associated with greater positive exchanges and lower negative exchanges. In addition, the data support interaction effects of positive and negative exchanges on marital satisfaction, but not curvilinear effects. Specifically, high positive exchanges may buffer the impact of negative exchanges on relational satisfaction. Gender differences in effects were not supported. These findings confirm that positive and negative exchanges are distinct constructs and demonstrate how relationship satisfaction scores suffer from issues of equifinality by failing to distinguish between very different qualitative relational experiences. We suggest that curvilinear, plateauing effects may be an artifact of data loss when analyzing individuals in relationships rather than whole dyads, and suggest that scholars study positive and negative exchanges with both members of a dyad moving forward. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Closeness to God, Spiritual Struggles, and Wellbeing in the First Year of College

Spirituality is an important, but oft-overlooked, aspect of the self that may affect college students’ wellbeing and belonging. Few studies have systematically examined closeness to God and spiritual struggles as predictors of college student wellbeing during early college, which is a critical window for identity development. Moreover, research exploring interactions between spiritual struggles and closeness to God in predicting wellbeing outcomes is scarce. We address these gaps in the literature with an analytic sample comprised of 839 first-year college participants who identify as religious. The results of correlational analyses and linear mixed effect models are presented. Closeness to God was associated with greater wellbeing and belonging, and spiritual struggles were associated with lower wellbeing and belonging. In exploratory analyses, a moderating effect of closeness to God on the relation between spiritual struggles and negative outcomes was observed. Implications for higher education and college student development are discussed.

Mindset as Characteristic Adaptations: Using Response Surface Analysis to Assess Mindset in the Personality System

This study aimed to assess the congruencies and discrepancies between mindset domains in relation to well-being and sought to demonstrate that mindset falls into the characteristic adaptation level of personality. Data (N = 618, M age = 16.07, SD age = 0.99) from Wave 1 of a longitudinal study on primarily ethnic-minority adolescents were used in response surface analyses to examine the effects of (in)congruence on well-being. The response surface analyses suggested no overall congruence effect between moral and ability mindsets. However, two-thirds of the participants demonstrated differing levels of mindsets, highlighting the domain specificity of mindsets. Results suggest that mindsets are contextual, domain-specific constructs, suiting the characteristic adaptation level of personality. Congruence for moral and ability mindset does not affect adolescent well-being.

Mixed Results on the Efficacy of the CharacterMe Smartphone App to Improve Self-Control, Patience, and Emotional Regulation Competencies in Adolescents

Unprecedented levels of access to adolescents' time and attention provide opportunities to convert traditional character and socioemotional competencies interventions into behavioral intervention technologies. However, these new tools must be evaluated rather than assuming previously validated activities will be efficacious when converted to a mobile platform. Thus, we sought to design and provide initial data on the effectiveness of the CharacterMe smartphone app to build self-control and patience, which are built on underlying social-emotional regulation competencies, in a sample of 618 adolescents (M_age = 16.07, Female = 56.6%). We also sought to examine whether framing the app activities as having a transcendent (spiritual connection or moral/prosocial) rather than instrumental purpose would increase engagement and change in self-control, patience, and emotion regulation. Finally, we tested the impact of framing activities as building strengths vs. fixing weaknesses. Results highlight the difficulty of translating psychological interventions to behavioral intervention technologies. Overall, the CharacterMe smartphone app was unsuccessful in increasing self-control, patience, or emotion regulation in adolescents, with analyses showing no significant mean changes over time. Framing conditions and user engagement were largely not significant predictors of change in self-control, patience, and emotion regulation.

Gratitude and patience moderate meaning struggles and suicidal risk in a cross-sectional study of inpatients at a Christian psychiatric hospital

OBJECTIVE

Suicidal behavior is a leading cause of injury and death, so research identifying protective factors is essential. Research suggests gratitude and life hardships patience are character strengths that might protect against the deleterious association of struggles with ultimate meaning and suicide risk. However, no studies have evaluated their utility among people experiencing acute/severe mental health concerns.

METHOD

We tested the protective function of gratitude and life hardships patience with cross-sectional data from adults (M_age  = 31.83 years; SD = 14.84; range = 18-82) hospitalized in a Christian psychiatric inpatient facility (M_stay  = 6.37 days, SD = 4.64).

RESULTS

Gratitude and life hardships patience moderated the positive relation between meaning struggles and suicide risk. Specifically, gratitude and life hardships patience protected against meaning struggles as a risk factor for suicide through mechanisms separate from ameliorating depressive symptoms.

CONCLUSIONS

Findings provide initial support for gratitude and patience interventions as an adjunct to standard psychiatric treatment for minimizing suicide risk.

Religiousness, meaning, and quality of life: Test of a mediational model among adults seeking a spiritually integrated inpatient program

OBJECTIVE

Religious beliefs and practices may augment a sense of meaning in life that could support quality of life (QOL) in physical, social, and emotional domains amid mental health crises. However, these associations have not been thoroughly tested among persons with serious mental illness (SMI).

METHODS

Focusing on 248 adults who had recently enrolled in a spiritually integrated acute psychiatric hospitalization program, we incorporated structural equation modeling to examine whether (1) religiousness would be associated with better overall QOL; and (2) inpatients' sense of meaning in life would at least partially account for the religiousness-QOL link.

RESULTS

Religiousness was linked indirectly with QOL at the time of admission: religiousness was associated with greater meaning in life, and a higher degree of meaning in life was associated with QOL.

CONCLUSIONS

Findings underscore the crucial role of religiousness for meaning and wellness among many individuals with SMI who seek stabilization and healing.

Religiosity in adolescence

Person-centered approaches to religious development across adolescence reveal diverse trajectories of change, which are differentially subject to environmental and genetic influences. Studies support the robust protective effects of religiosity on adolescent internalizing and externalizing symptoms. However, some specific religious beliefs may predict poor adjustment. Evidence also suggests adolescent religiosity may exacerbate sexual identity conflicts and increase prejudice toward proscribed outgroups. Researchers demonstrate robust mediating effects of effortful control for explaining religiosity's influence on outcomes, and approaches to establish mediation through assessment intraindividual variability in the daily dynamics of religiosity and positive outcomes are promising. Inclusion of non-Western, non-Christian samples has allowed scholars to begin identifying the universal versus culturally specific elements of religiosity trajectories and processes in adolescence.

Religion, Spirituality, and Thriving: Transcendent Narrative, Virtue, and Telos

A theory is proposed to explain how religion/spirituality (R/S) is related to positive youth development and thriving. The concept of telos is employed to define thriving as continued growth through strength-based living that leads to contributing to one's communities and living out one's ethical ideals. Virtue development is proposed as a primary process by which R/S promotes thriving. Virtues are defined as hybrid personality units emerging when characteristic adaptations are given meaning by a transcendent narrative identity. R/S contributes to virtue formation through the ideological, social, and transcendent contexts embedded within religion by providing opportunities to grow both the characteristic adaptations and transcendent narrative identities necessary for virtue formation in youth and, ultimately, thriving. Implications for future research are discussed.

Transcendent motivations and virtue development in adolescent marathon runners

OBJECTIVE

To understand how health, prosocial, and spiritual motivations correspond to changes in the virtues of self-control, patience, and interpersonal generosity among adolescents and emerging adults.

METHOD

Participants included adolescent and emerging adult athletes (N = 396; 12-22 years, M = 18.42, SD = 2.03) on marathon training teams fundraising for a faith-based charity. Participants completed self-report questionnaires four times over six months. Participants were 63% female and identified as 61% Caucasian, 17% Latino/a, 10% African American, 6% Asian American, and 6% other.

RESULTS

Bivariate latent growth curve models showed positive relations between baseline levels of transcendent motivations (spiritual, prosocial) and all three virtues (self-control, patience, interpersonal generosity) as well as baseline health motivation and self-control. Linear slopes in all three motivations were positively correlated with change in patience, and greater decreases in these motivations from wave 1 to wave 2 before recovering motivation in subsequent waves correlated with less change in patience. Only the linear slope in prosocial motivation positively correlated with change in generosity. None of the motivation slopes correlated with change in self-control.

CONCLUSIONS

More than just sport participation is required to cultivate virtue in adolescents; instead, transcendent and non-transcendent motivations are concurrently developing for athletes who increase in prosocial virtues.

God imagery and affective outcomes in a spiritually integrative inpatient program

Religion and/or spirituality (R/S) can play a vital, multifaceted role in mental health. While beliefs about God represent the core of many psychiatric patients' meaning systems, research has not examined how internalized images of the divine might contribute to outcomes in treatment programs/settings that emphasize multicultural sensitivity with R/S. Drawing on a combination of qualitative and quantitative information with a religiously heterogeneous sample of 241 adults who completed a spiritually integrative inpatient program over a two-year period, this study tested direct/indirect associations between imagery of how God views oneself, religious comforts and strains, and affective outcomes (positive and negative). When accounting for patients' demographic and religious backgrounds, structural equation modeling results revealed: (1) overall effects for God imagery at pre-treatment on post-treatment levels of both positive and negative affect; and (2) religious comforts and strains fully mediated these links. Secondary analyses also revealed that patients' generally experienced reductions in negative emotion in God imagery over the course of their admission. These findings support attachment models of the R/S-mental health link and suggest that religious comforts and strains represent distinct pathways to positive and negative domains of affect for psychiatric patients with varying experiences of God.