Adolescents' needs for information and psychosocial support during their mother's breast cancer trajectory: A systematic review

OBJECTIVE

Breast cancer is the most common cancer diagnosis among women. The acute crisis and uncertainty that often follow diagnosis put the family at risk of exhaustion and dysfunction. Adolescents have been identified as a particularly vulnerable group of relatives. To investigate how to prevent distress in this group, we systematically reviewed research on adolescents' (11-21 years) needs for information and psycho-social support during their mothers' breast cancer trajectory.

METHOD

Systematic searches were conducted in five bibliometric databases. Peer-reviewed, original research of adolescents aged 11-21 with a mother diagnosed with breast cancer was included. Two researchers conducted screening, quality assessment, and data extraction independently. Thematic synthesis was applied to the included studies.

RESULTS

A total of 8066 studies were screened, and five quantitative and six qualitative studies were included. The results indicated that adolescents' information and psycho-social support needs were poorly met. Many were reluctant to share feelings with family and peers and experienced abandonment during the crisis. Adolescents who were not well informed experienced distress. Poor family functioning increased the level of adolescents' distress.

CONCLUSIONS

Despite limitations regarding heterogeneity among the studies, eligibility criteria, and quality assessment, this review provides clear clinical implications. Encounter groups may support adolescents during their mother's breast cancer trajectory. Furthermore, healthcare professionals could provide more indirect support to adolescents by providing support and clearer guidelines to parents. Finally, adolescents from poor-functioning families need extra attention.

The Experiences of Post-ICU COVID-19 Survivors: An Existential Perspective using Interpretative Phenomenological Analysis

COVID-19 has highlighted the vulnerability of intensive care unit (ICU) patients and the negative sequelae associated with ICU treatment. While the potentially traumatic impact of ICU is well documented, less is known about the ICU survivor's subjective experience and how it influences life post-discharge. Existential psychology addresses the universal concerns of existence, including death, isolation, and meaninglessness, and offers a holistic view of human experience beyond diagnostic categories. An existential psychological understanding of ICU COVID-19 survivorship may therefore provide a rich account of what it means to be among the worst affected by a global existential crisis. This study employed interpretive phenomenological analysis of qualitative interviews with 10 post-ICU COVID-19 survivors (aged 18-78). Interviews were structured on existential psychology's 'Four Worlds' model that explores the physical, social, personal, and spiritual dimensions of human experience. The essential meaning of ICU COVID-19 survival was conceptualised as 'Trying to Reconnect with a Changed Reality' and consisted of four themes. The first, Between Shifting Realities in ICU, described the liminal nature of ICU and the need to ground oneself. The second, What it Means to Care and Be Cared For, captured the emotive nature of personal interdependence and reciprocity. The third, The Self is Different, described survivors' struggle to reconcile old and new selves. The fourth, A New Relationship with Life, outlined how survivors' experiences shaped their new worldviews. Findings evidence the value of holistic, existentially informed psychological support for ICU survivors.

How I Learned to Stop Worrying and Love the Eco-Apocalypse: An Existential Approach to Accepting Eco-Anxiety

Climate crisis presents a near-term existential threat to the human species, one that society has neither the physical nor psychological infrastructure to manage. Eco-anxiety increases as awareness about climate crisis spreads. Despite an urgent need for resources on how to help people cope with the psychological ramifications of climate crisis, there is little literature that both addresses people's apocalyptic fears and takes the scientific bases of those fears seriously. In this article, I synthesize research on existential psychology, Acceptance and Commitment Therapy, grief, and end-of-life care to present an original perspective on how people, individually and collectively, can become psychologically resilient to climate crisis. First, I establish that death anxiety underlies eco-anxiety. Second, I demonstrate that preparing psychologically for eco-apocalypse requires people to cultivate death acceptance. Finally, I illustrate how commitment to palliative values can enable people to live rich and meaningful lives despite their most likely imminent end.

Not all dogs (and goals) were created equal: an existential perspective on helplessness

Building on the framework of learned helplessness, and applying a behavioural perspective, Boddez et al. theorise that consecutive failures in various life domains might be generalised and cause a general sense of helplessness, which leads to, and can be conceptualised as, human suffering. We argue that this perspective fails to address the complexities of human suffering and the motivational sources of feelings of helplessness. We provide an existential-social psychological perspective on helplessness, highlighting the need for psychological protection and the mechanisms by which it is achieved. We draw upon attachment, terror management, and motivated helplessness theories in order to demonstrate the anxiety-buffering function of goal attainment in major life domains (e.g. self-esteem and close relationships) and its influence on helplessness and suffering.

Existential Well-being, Mental Health, and COVID-19: Reconsidering the Impact of Lockdown Stressors in Moscow

Background

Initial psychological papers on COVID-19, mental health and wellbeing mostly focus on the aftermath lockdown-related stress and stress related to the disease itself. Still, we presume that personal well-being can be resistant to stressors depending on the way the person is settled in their life.

Objective

We seek to reconsider the contribution of lockdown-related stressors to existential well-being, to assess existential well-being during the outbreak and to compare the contribution of living conditions and COVID-19-related factors on well-being.

Design

An online survey was conducted during the peak of the outbreak in Moscow (April-May 2020) (N=880). The data was obtained using the "Test of Existential Motivations" questionnaire and a series of questions addressing (1) living conditions - mental and physical health, employment, and social distancing; (2) COVID-19-related stressors - non-chronic illness, financial losses, and unavailability of goods or services; (3) sociodemographic indicators - age, gender, and income. Data analysis included hierarchical multiple regression, one-sample t-test, and analysis of variance.

Results

Surprisingly, the existential well-being of Moscow citizens during the research period was moderate. Each of the three groups of factors predicted a similar proportion of the variance of well-being (3-3,9%). The strongest predictors of well-being were long-term mental health status and financial stability. The effect of COVID-19-related stressors was most pronounced when they co-occur.

Conclusion

The negative association between lockdown-related stressors and poor well-being is not universal. It is necessary to study the effect of COVID-19-related stressors in combination with individual living conditions and region-specific factors and to focus on the prevention of the occurrence of stressors.

A Journey Towards Meaning: An Existential Psychobiography of Maya Angelou

This psychobiography focuses on meaning making in the early life and young adulthood of acclaimed African American author Maya Angelou (1928-2014) through the lens of Frankl’s existential psychology with a specific focus on the tri-dimensional nature of human beings and the fundamental triad. The primary data source was Angelou’s own published autobiographies, which contain an in-depth narrative of her early life and young adulthood. Data was extracted, organised and analysed according to established qualitative research methods as well as through the identification of psychological saliences. The search for meaning within Angelou’s own narrative of her life was clearly apparent in the thematic analysis. Angelou’s narrative of her journey through the physical (childhood and adolescence), psychological (travelling and searching years) and spiritual (sensemaking years) dimensions was core to her meaning making. The three tiers of the fundamental triad (awareness of meaning, will to meaning, freedom of will) were present in various aspects of Angelou’s existential journey, manifesting as a focus on choice, responsibility, purpose, and acceptance. This study provides a more in-depth understanding of meaning making processes in the lives of extraordinary individuals, as well as contributing to the development of the research method of psychobiography, with a specific focus on meaning making.

Review: Ecological awareness, anxiety, and actions among youth and their parents - a qualitative study of newspaper narratives

BACKGROUND

Despite the growing impact of climate change on mental health, there have been few studies to date investigating how children and teenagers manage their ecological grief and eco-anxiety and how they can leverage it into environmental action. In this scoping review, we analyze lay press narratives about how youth respond to climate change to examine the dynamics between minors and adults around the evolving climate crisis.

METHODS

We included articles published between 2018 and 2021 in six of the top ten American newspapers by circulation about young people during the climate crisis. The 131 articles we selected addressed the attitudes of children, adolescents, and parents toward the climate crisis. We conducted a qualitative analysis based on discourse analysis aided by NVivo software.

RESULTS

Newspaper articles commonly categorized children, adolescents, and their respective perspectives and experiences around climate change along four patterns of discourse: (a) fierce young activists; (b) adultified children; (c) innocent victims; and/or (d) ultimate saviors. In turn, articles considered parents and adults in one of four paradigmatic ways: (a) experiencing eco-anxiety through parenthood; (b) taming children's eco-anxiety; (c) criticizing youth-led activism; and/or (d) reimagining climate action as a source of meaning in the lives of young people.

CONCLUSION

Through the framework of childism, or prejudice against children, we conceptualize immature ways for adults to respond to youths' concerns as a defensive stance against overwhelming climate change anxiety. Alternatively, principles of existential psychology can help inform healthier and more productive responses from parents, clinicians, educators, and public health officials as they seek truthful yet supportive responses to address legitimate ecological threats that will disproportionately affect generations to come.

Understanding Wildlife Crime from Eco-Existential and African Perspectives: A Psycho-Philosophical Investigation

Wildlife crime has huge consequences regarding global environmental changes to animals, plants and the entire ecosystem. Combatting wildlife crime effectively requires a deep understanding of human-wildlife interactions and an analysis of the influencing factors. Conservation and green criminology are important in reducing wildlife crime, protecting wildlife and the ecosystem and informing policy-makers about best practices and strategies. However, the past years have shown that wildlife crime is not easy to combat and it is argued in this article that there are underlying existential "givens" and culture-specific aspects that need to be investigated to understand why wildlife crime is still on the rise. This theoretical article explores (eco-)existential perspectives, Greening's four givens and selected African philosophical concepts, aiming to understand the complexities behind the prevalence of wildlife crime within global and African contexts.

A Randomized controlled trial of the Sources of Meaning Card Method: A new meaning-oriented approach predicts depression, anxiety, pain acceptance, and crisis of meaning in chronic pain patients

OBJECTIVE

Although considered the first-line psychological treatment of chronic pain, cognitive behavioural therapy has recently been criticized as being too limited, insufficient, and sometimes ineffective in the treatment of chronic pain patients. Moreover, important existential perspectives are sparsely or not at all integrated into CBT. We therefore propose to complement chronic pain treatment with a meaning-based intervention, the Sources of Meaning Card Method (SoMeCaM). This study tested its efficacy.

DESIGN

A randomized controlled trial was conducted with 42 chronic pain patients, comparing an intervention group (standard care and participation in the SoMeCaM, a meaning-oriented approach) with a control group (standard care). We evaluated both groups at baseline, 1 (t1) and 2 months (t2) after the intervention. The primary outcome assessed was pain acceptance, while depression, anxiety, pain intensity, pain medication, satisfaction with life, meaningfulness, and crisis of meaning were examined as secondary outcomes.

RESULTS

Comparisons within and between groups showed significant treatment effects at t1. Higher increases in pain acceptance and decreases in anxiety, depression and crisis of meaning were observed in the intervention group. Improvements in pain acceptance and anxiety persisted until t2, when pain intensity was also lower. Effect sizes at t2 were medium to large.

CONCLUSION

Our preliminary work demonstrates the importance of the existential perspective in chronic pain therapy.

Self-Transcendence as a Buffer Against COVID-19 Suffering: The Development and Validation of the Self-Transcendence Measure-B

The age of COVID-19 calls for a different approach toward global well-being and flourishing through the transcendence suffering as advocated by existential positive psychology. In the present study, we primarily explained what self-transcendence is and why it represents the most promising path for human beings to flourish through the transformation of suffering in a difficult and uncertain world. After reviewing the literature on self-transcendence experiences, we concluded that the model of self-transcendence presented by Frankl is able to integrate both of the characteristics associated with self-transcendence. Afterward, we discussed how the self-transcendence paradigm proposed by Wong, an extension of the model by Frankl, may help awaken our innate capacity for connections with the true self, with others, and with God or something larger than oneself. We presented self-transcendence as a less-traveled but more promising route to achieve personal growth and mental health in troubled times. Finally, we presented the history of the development and psychometrics of the Self-Transcendence Measure-Brief (STM-B) and reported the empirical evidence that self-transcendence served as a buffer against COVID-19 suffering. The presented data in the current study suggested that the best way to overcome pandemic suffering and mental health crises is to cultivate self-transcendence.

Finding Meaning Amidst COVID-19: An Existential Positive Psychology Model of Suffering

The global COVID-19 pandemic has created a crisis of suffering. We conceptualize suffering as a deeply existential issue that fundamentally changes people indelible ways and for which there are no easy solutions. To better understand its effects and how people can flourish in the midst of this crisis, we formally introduce and elaborate on an Existential Positive Psychology Model of Suffering (EPPMS) and apply that to the COVID-19 global pandemic. Our model has three core propositions: (a) suffering reveals existential concerns, (b) existential anxiety impairs one's ability to find meaning, and (c) cultivating meaning is the primary way to address suffering and allay existential anxiety, eventually leading to flourishing (and potentially growth). We apply this model to the COVID-19 pandemic, including how to build meaning, and discuss clinical implications.

Terror Management Theory and the COVID-19 Pandemic

Terror management theory is focused on the role that awareness of death plays in diverse aspects of life. Here, we discuss the theory's implications for understanding the widely varying ways in which people have responded to the COVID-19 pandemic. We argue that regardless of whether one consciously believes that the virus is a major threat to life or only a minor inconvenience, fear of death plays an important role in driving one's attitudes and behavior related to the virus. We focus on the terror management theory distinction between proximal defenses, which are activated when thoughts of death are in current focal attention and are logically related to the threat at hand, and distal defenses, which are activated when thoughts of death are on the fringes of one's consciousness and entail the pursuit of meaning, personal value, and close relationships. We use this framework to discuss the many ways in which COVID-19 undermines psychological equanimity, the diverse ways people have responded to this threat, and the role of ineffective terror management in psychological distress and disorder that may emerge in response to the virus.

Existential positive psychology and integrative meaning therapy

The unprecedented changes in our society because of COVID-19 and the fourth industrial revolution (4IR) shows that our healthcare system and the medical approach to psychotherapy can no longer meet the mental health needs of society. This paper first described the negative impact of COVID-19 and 4IR on our mental health. Then, following a brief critique of the medical model, this paper proposes that the future of psychotherapy needs to be based on the more inclusive and integrative framework of existential positive psychology (PP 2.0), which emphasizes flourishing through suffering. Finally, the paper emphasizes Viktor Frankl's cure and Wong's integrative meaning therapy. It concludes that integrative meaning therapy represents the future of psychotherapy, because it is situated in the area of interactions of at least three traditions: Clinical psychology, existential psychology, and positive psychology. This integrative model is holistic, recognising humans as bio-psycho-social-spiritual beings and considers several theoretical perspectives in both diagnosis and treatment.

The Science of Meaning in Life

Meaning in life has long been a mystery of human existence. In this review, we seek to demystify this construct. Focusing on the subjective experience of meaning in life, we review how it has been measured and briefly describe its correlates. Then we review evidence that meaning in life, for all its mystery, is a rather commonplace experience. We then define the construct and review its constituent facets: comprehension/coherence, purpose, and existential mattering/significance. We review the many experiences that have been shown to enhance meaning in life and close by considering important remaining research questions about this fascinating topic.

Mortality salience leads to greater consumption of an ostensibly alcoholic beverage on Friday versus other weekdays

OBJECTIVES

We build on findings from terror management theory to examine how non-conscious mortality concerns may lead individuals to adhere to cultural meanings yoked to discrete time periods, in this case influencing consumption of an ostensibly alcoholic beverage.

DESIGN

The study took the form of a 2 (death vs. uncertainty reminder) × 3 (Monday vs. Wednesday vs. Friday) between-subjects laboratory-based quasi-experimental design.

METHODS

A total of 210 participants (age: M = 21.92 years, SD = 5.33; 103 males and 107 females) recruited from a UK university answered either an open-ended question to prime mortality or uncertainty cognition on either a Monday, Wednesday, or Friday. As part of an ostensible taste test, they then consumed as much or as little of a purportedly alcoholic drink as they desired.

RESULTS

Death reminders (vs. control topic) were found to result in more consumption of the beverage on a Friday, less consumption on a Monday, and no difference in consumption on a Wednesday.

CONCLUSIONS

Findings point to the flexible, time-contingent nature of culture-oriented defences against mortality concerns with potential implications for the efficacy of alcohol health warnings featuring mortality-related stimuli. Statement of contribution What is already known on this subject? Death reminders can spur people to adhere to cultural scripts for behaviour in the service of maintaining existential security. Death reminders can lead people to consume alcohol (particularly for those who are low in self-esteem). What does this study add? Death reminders may lead people to adhere to temporally yoked scripts related to drinking behaviour. Specifically, death reminders led to more positive drinking attitudes and more alcohol consumed on Friday compared to Monday or Wednesday. Cultural script following may be specifically tied to non-conscious mortality awareness.

Work, love, and death-thought accessibility: A terror management investigation

Terror management theory suggests that following culturally derived scripts for valued behaviour protects people from death concerns, and conversely, not meeting standards for cultural value can weaken this protection, heightening mortality concerns. Using this conceptual framework, we examine (1) how considerations of loss of employment, a source of cultural value for many, relates to the accessibility of death-related cognition, and (2) the moderating role of job market health, and (3) involvement in close relationships. Study 1 found that writing about being unemployed (vs. a control topic) led to greater mortality-related cognition. Study 2 found that considering unemployment heightened death cognition, but only when participants were led to perceive the job market as unhealthy. Finally, Study 3 found that considering unemployment led to greater death cognition, but not for those involved in a close relationship. Findings offer insight into a previously overlooked consequence of unemployment, and factors that may serve a protective function.

'You only have one chance to get it right': A qualitative study of relatives' experiences of caring at home for a family member with terminal cancer

BACKGROUND

Relatives looking after a terminally ill family member at home face numerous challenges. Studies into relatives' experiences of home caregiving have been criticised for their descriptive nature and lack of theoretical underpinnings.

AIM

To explore the emotional challenges faced by home caregivers, and their experiences of healthcare professionals, from the perspective of existential psychology.

DESIGN

A qualitative study using semi-structured interviews. Transcripts were analysed thematically using the Framework approach.

SETTING/PARTICIPANTS

The study took place within an inner-city London hospice. Participants (n = 15) were recently bereaved adult relatives of cancer patients who cared for their family member at home.

RESULTS

Participants' experiences of being a caregiver and of professional support were highly varied. The analysis generated 15 themes which were organised into a framework based on Yalom's four 'existential conditions': responsibility (e.g. 'being the linchpin of care'; 'you only have one chance to get it right'), isolation (e.g. 'being on my own', 'being held in mind'), death (e.g. 'knowing but not knowing') and meaningfulness (e.g. 'giving something back', 'acceptance and gratitude'). Healthcare professionals were perceived as influential in both helping and hindering relatives in meeting the challenges they faced.

CONCLUSION

Existential psychology provides a theoretical perspective from which to understand the psychological complexity of the emotional challenges home caregivers face and a framework which may usefully inform research and clinical practice. Professionals' attentiveness to caregivers' needs can have powerful effects in assuaging anxiety, reducing isolation and enabling relatives to connect with the meaningfulness of caregiving.