Assessing Disruptions in Meaning: Development of the Global Meaning Violation Scale

Families of organ donors between Jews and Arabs in Israel during a military operation: Constructing meaning through participation in an epistemic Community - Media analysis of two cases

This study explores how bereaved families of organ donors become participants in an 'imagined epistemic community' of organ donor families, amidst a national conflict between Jews and Arabs in Israel. Utilizing a media case study approach, we identified factors contributing to the creation of this bi-national community and examined what the families received in return for their part. Additionally, we explored the reasons behind the community splitting into two separate entities. Based on the media reports, we suggest that entry into the community is conditional on donating organs during wartime, granting these families a special moral status in return, resonating messages of altruism, solidarity and coexistence. Further to this, we propose that when the Arab family felt they did not receive the expected recognition, they withdrew from the common community in favor of a separate national community.

The role of spirituality and identity formation in personal recovery from traumatic brain injury: A qualitative analysis through the personal experiences of survivors

Traumatic brain injury (TBI) is a type of acquired brain injury (ABI) that happens when a sudden, external, physical assault damages the brain. TBI can cause long-term cognitive impairments and other lifestyle changes that may affect psychological wellbeing. Among the psychological challenges people recovering from TBI often face is the subjective loss of their pre-injury identity. Quantitative and qualitative research suggests that spirituality can play a positive role in recovery from TBI, increasing the quality of life and overall mental health. However, thus far, the research into this topic has not directly addressed the relationship between identity and spirituality after TBI. The present study sought to do this by thematically analyzing 22 public podcasts featuring interviews of people recovering from TBI telling their stories. The authors review the spiritual themes discussed in the podcasts and then propose a hypothesis about how, through a sense of connection to something self-transcendent, spirituality may enable people to test new meanings and identities, relatively free from the consequences of discrepancy in meaning and identity after TBI.

Meaning in Life and Coping With Everyday Stressors

Meaning in life (MIL) has been proposed to improve coping and resilience. Yet MIL's association with coping has primarily been investigated in the context of extreme stressors and trauma, often using varied measures of MIL. Is MIL associated with varied coping strategies, coping self-efficacy, and distress in relation to commonly experienced, everyday challenges? Using diverse methodological designs, five studies (total N = 1,646) investigated the association between MIL and coping strategies/appraisals pertaining to varied challenging, stressful events. Across recalled (Studies 1 and 2), anticipated (Study 3), and experienced stressors (Studies 3-5), MIL was consistently associated with positive reinterpretation, proactive planning, coping self-efficacy, and stress. MIL was inconsistently related to threat/emotion-coping.

Effects of positive reappraisal and self-distancing on the meaningfulness of everyday negative events

Current work on meaning-making has primarily focused on major negative life events such as trauma and loss, leaving common daily adversities unexplored. This study aimed to examine how utilizing meaning-making strategies such as positive reappraisal and self-distancing (in isolation or in combination) can facilitate an adaptive processing of these daily negative experiences. Overall meaning and facets of meaning (coherence, purpose, and significance/mattering) were assessed at both global and situational levels. Results suggested that positive reappraisal was generally effective for enhancing situational meaning but not under all conditions. Specifically, when negative experiences were high on emotional intensity, reflecting on the experience from a distanced (third-person) perspective enhanced coherence and existential mattering more than engaging in positive reappraisal. However, when negative experiences were low on intensity, distanced reflection led to less coherence and mattering than positive reappraisal. The findings of this study elucidated the importance of examining the multidimensional construct of meaning at the facet level and highlighted the importance of applying different coping strategies to effectively make meaning out of daily negative experiences.

Psychological Factors Explaining the COVID-19 Pandemic Impact on Mental Health: The Role of Meaning, Beliefs, and Perceptions of Vulnerability and Mortality

This study tested an expanded version of the explanatory model of the negative impact of the COVID-19 pandemic on mental health proposed by Milman and colleagues. Participants (N = 680) completed an online survey on demographic variables associated with poor pandemic mental health, COVID-19 stressors, mental health symptoms, and pandemic-related psychological processes we hypothesized as mediating mechanisms explaining the negative mental health effects of the COVID-19 stressors. Results indicated that these psychological processes (core belief violation, meaning made of the pandemic, vulnerability, and mortality perception) explained the severity of mental health symptoms to a far greater extent than COVID-19 stressors and demographics combined. In addition, these psychological processes mediated the impact of COVID-19 stressors on all mental health outcomes. Specifically, COVID-19 stressors were associated with increased core belief violation, decreased meaning making, and more intense perceived vulnerability and mortality. In turn, those whose core beliefs were more violated by the pandemic, who made less meaning of the pandemic, and who perceived a more pronounced vulnerability and mortality experienced a worse mental health condition. This study's results suggest some possible ways of intervention in pandemic-like events useful for limiting such impact at the individual, group, social and political levels.

"I'm Going to Tell You Something I Never Told Anyone": Ethics- and Trauma-Informed Challenges of Implementing a Research Protocol with Syrian Refugees

As research subjects, refugees have numerous potential vulnerabilities. This study aimed to examine the ethics- and trauma-informed challenges of implementing a mental health research protocol with Syrian refugees living in Portugal. Guided by the integrated meaning-making model, the research project "Journeys in Meaning" employed a mixed-methods cross-sectional design to explore posttraumatic cognitive processing in refugees using two phases of data collection: two focus groups (Phase 1) to test the protocol and 39 in-depth individual interviews (Phase 2) to implement the protocol. Results examine the strategies used to address the following: methodological challenges related to protocol design, participant recruitment, and language; ethics- and trauma-informed challenges aimed at minimizing harm and maximizing benefit to participants that followed social justice principles; and perceived compassion fatigue on the part of the researcher following repeated empathetic exposure to traumatic content. Findings suggest the need for adaptive approaches to research with refugee populations that challenge strict compliance with the traditional principles of "do no harm" and researcher neutrality, and that accommodate individual and community complexities.

The role of psychological flexibility in the meaning-reconstruction process in cancer: The intensive longitudinal study protocol

OBJECTIVES

Meaning-making is an important element of adapting to disease. However, this process is still poorly understood and the theoretical model has not been comprehensively verified yet, particularly in terms of complexity, dynamics, and intraindividual variability. The aim of this study is a deeper understanding of the meaning-reconstruction process in cancer and empirical verification of the integrative meaning-making model of coping extended by the psychological flexibility model. We postulate that psychological flexibility can foster the meaning-making in cancer by building more flexible and workable meaning-making explanations of disease.

DESIGN

A daily-diary study conducted for 14 days in patients following the first autologous or allogeneic hematopoietic cell transplantation (HCT).

METHODS

Participants (at least 150) will be requested to complete the daily-diary related to daily situational meaning, meaning-related distress, meaning-making, psychological flexibility, meanings made, and wellbeing for 14 days after hospital discharge following HCT. Also, baseline and follow-up assessment of global meaning, wellbeing, and meanings made will be performed. Statistical analysis of the data will be conducted using the multilevel and dynamic structural equation modeling.

CONCLUSIONS

The study will fill in the gaps in health psychology in the understanding of the meaning-reconstruction process in cancer by within- and between-person verification of the integrative meaning-making model and its extension by the psychological flexibility model. The data obtained will be used in further research on the development of meaning-making by means of interventions based on psychological flexibility.

Assessing meaning violations in Syrian refugees: A mixed-methods cross-cultural adaptation of the Global Meaning Violations Scale-ArabV

Refugees are disproportionately affected by extreme traumatic events that can violate core beliefs and life goals (i.e., global meaning) and cause significant distress. This mixed-methods study used an exploratory sequential design to assess meaning violations in a sample of Syrian refugees living in Portugal. For this purpose, we cross-culturally adapted the Global Meaning Violations Scale (GMVS) for use with Arabic-speaking refugees. In total, 43 war-affected Syrian adults participated in the two-phase study. Participants completed measures of trauma and narrated violations as they filled out the newly adapted GMVS-ArabV. GMVS-ArabV validity evidence based on response processes was investigated through Phase 1 focus groups (FGs; n = 2), whereas data from Phase 2 cognitive interviews (n = 38) were used to preliminarily explore the measure's internal structure through descriptive statistics as well as culture- and trauma-informed content evidence through thematic analysis. The results suggested highest goal (M = 3.51, SD = 1.46) and lowest belief (M = 2.38, SD = 1.59) violations of educational goals and religious beliefs, respectively. Themes related to stressors, item formulation, response scale, and the global meaning construct suggested that (a) beliefs and goals can be differentially violated by different stressors; (b) much like war trauma, including torture, daily stressors can additionally shatter pretrauma global meaning; and (c) refugees reappraise meaning and suffer violations anew throughout their migration journeys. The GMVS-ArabV offers a promising tool for exploring shattered cognitions in refugees and informs evidence-based approaches to trauma recovery and psychological adjustment in postmigration settings (the Arabic abstract and keywords are available in the Supplementary Materials).

Adjustment to the COVID-19 pandemic: associations with global and situational meaning

COVID-19 has created pervasive upheaval and uncertainty in communities around the world. This investigation evaluated associations between discrete dimensions of personal meaning and psychological adjustment to the pandemic among community residents in a southern US state. In this cross-sectional study, 544 respondents were assessed during a period of reopening but accelerating infection rates. Validated measures were used to evaluate theoretically distinct dimensions of perceived global meaning (Meaning-in-Life Questionnaire) and pandemic-specific meaning (Meaning in Illness Scale). Adjustment outcomes included perceived stress, pandemic-related helplessness, and acceptance of the pandemic. In multivariate models that controlled for demographic and pandemic-related factors, stronger attained global meaning (i.e., perceptions that life is generally meaningful) and attained situational meaning (i.e., perceptions that the pandemic experience was comprehensible) were related to better adjustment on all three outcomes (all p's < .001). In contrast, seeking situational meaning (i.e., ongoing efforts to find coherence in the situation) was associated with poorer adjustment on all indices (all p's < .001). Results offer novel information regarding theoretically salient dimensions of meaning, which may have direct relevance for understanding how community residents adapt to the challenges of a major public health crisis.

Cognitive Coping Reduces Posttraumatic Stress Symptoms, Especially in the Context of Self-Blame

Following a traumatic event, coping strategies may affect the natural course of posttraumatic stress symptoms (PTSS). In particular, cognitive coping strategies (how one thinks about stressors) may reduce PTSS by increasing individuals' perceived control over events, appraising them as less threatening, particularly for individuals who experience self-blame after trauma. Individuals who experience a traumatic event (n =344) completed assessments at baseline (T1), one month (T2), and two months (T3). We tested whether T1 cognitive coping strategies (positive reinterpretation, acceptance, religious coping) predicted reduced T3 PTSS and whether this reduction was mediated by increased perceived control at T2. We tested whether this effect was particularly strong for individuals experiencing self-blame. Positive reinterpretation predicted decreases in, religious coping predicted increases in, and acceptance had no direct effect on PTSS. Overall, acceptance showed the greatest potential for reducing PTSS through increased perceived control over one's life. In a fully moderated mediation model, positive reinterpretation significantly interacted and acceptance marginally interacted with self-blame to predict increased perceived control and, subsequently, decreased T3 PTSS. Specifically, acceptance and positive reinterpretation were most helpful for those with higher levels of self-blame. Religious coping interacted with self-blame to predict decreased perceived control and subsequent increased PTSS. For trauma survivors experiencing self-blame, cognitive coping strategies that utilize compassionate self-talk, such as positive reinterpretation and acceptance, may be particularly helpful at increasing perceived control after trauma, while religious coping may have deleterious effects.

Complex Moral Injury: Shattered Moral Assumptions

An infographic model of moral injury (MI) is introduced in this conceptual paper that distinguishes the development of a worldview discrepancy-induced genus of MI, called complex moral injury (C-MI), from a standard expression of moral injury (S-MI), clearly delineated as perpetration-focused and a violation of moral belief in the contemporary view. It builds upon a previous essay that examined the potential of paradoxical circumstance (e.g., clashes of value, competing moral expectations, and moral paradox) to inflict MI among military personnel during wartime (Fleming in J Relig Health 60(5):3012-3033, 2021). Accordingly, it heeds Litz et al.'s recommendation to expand the research of MI beyond the effects of perpetration and investigate the impact of morally injurious events that shake one's core moral beliefs about the world and self (Litz et al. in Clin Psychol Rev 29(8):695-706, 2009). A review of definitional, scale, and qualitative studies shows evidence of a nuanced and complex form of MI that presents as moral disorientation and is a response to a disruption and subsequent failure of foundational moral beliefs to adequately appraise ethical problems and inform moral identity. Interrelations between MI, assumptive world, and meaning theories suggest the mechanism of C-MI and potential therapies. Case studies from a Veterans Administration hospital in the United States and a walk through the diagram will help illustrate the model. Clinical implications of a definition that includes morally injurious events that shatter fundamental moral assumptions are discussed. The role of chaplains in facilitating acceptance and meaning-making processes is recommended for C-MI recovery. Acknowledging the model's need for empirical support, a plausible scale is discussed for future research.

When Good People Break Bad: Moral Impression Violations in Everyday Life

The present research investigated the emotional, interpersonal, and impression-updating consequences of witnessing events that violate the moral character impressions people hold of others. Across three studies, moral character violations predicted broad disruptions to participants’ sense of meaning, confidence judging moral character, and expectations of others’ moral characters. Participants who were in real life closer to perpetrators, directly victimized, and higher in preferences for closure and behavioral stability reported more negative outcomes. Moreover, experimental manipulations showed that character violations lead to worse outcomes than the comparable experience of encountering consistently immoral others. The authors discuss implications for research on moral perception and meaning, as well as on understanding responses to everyday revelations about people’s characters.

Existential Meaning-Making Coping in Iran: A Qualitative Study among Patients with Cancer

This article is written on the basis of a study on meaning-making coping in Iran. The study is a part of an international project in 10 countries with different religious and cultural backgrounds. This article aims to discuss the secular existential meaning-making coping methods employed by Iranian cancer patients. Interviews were conducted with 27 participants with various kinds of cancer. Nine secular existential meaning-making coping strategies emerged from the analyses of the qualitative interviews. These coping methods are as follows: Ignoring the illness, Distraction, Altruism, Encounter with others, Nature, Discourse of the self, Visualization, Positive solitude, and Positive thinking and transformational orientation. It seems that, using these strategies, our sample of Iranian cancer patients/survivors have been denying/ignoring their illness, and/or empowering themselves. We discuss the results, considering the potential influence of cultural elements, including Iranian Islam, Persian mysticism, and Persian literature, on the selection of the coping strategies. The study contributes to our understanding of coping via elucidating how seriously ill individuals in Iran try to manage the challenges caused by a health crisis.

The Meaning Making Model Applied to Community-Dwelling Adults with Chronic Pain

PURPOSE

Chronic pain is a multidimensional experience that is influenced by biological, psychological, social, and spiritual factors. The Meaning Making Model is a recent cognitive behavioral model that has been developed to understand how psychosocial factors influence adjustment to stressful events, such as having a chronic illness. This qualitative study aims to understand the potential utility of this model for understanding the role of meaning making in adjustment to chronic pain.

MATERIALS AND METHODS

Eighteen community-dwelling adults with chronic low back pain or chronic pain due to osteoarthritis participated in four focus groups. Participants were asked open-ended questions about their pain experience, pain-related beliefs, meaning of pain, and the perceived association between pain and their meaning in life and sense of purpose. Data were submitted to thematic analysis and the identified themes were considered in light of the Meaning Making Model.

RESULTS

Three overarching themes emerged, each of which included two themes. The first overarching theme - "appraised meaning of pain" - included the themes "causal attributions" and "primary appraisals." The second - "meaning making processes" - included the themes "assimilation" and "accommodation." The third - "meanings made" - included the themes "pain as an opportunity" and "acceptance."

CONCLUSION

The key themes that emerged as individuals with chronic pain discussed pain and its impact are consistent with those that would be hypothesized as important from the Meaning Making Model, providing preliminary support for the utility of this model in the context of chronic pain. People with chronic pain appear to appraise pain in terms of its cause, controllability, threat, loss, or challenge. When a discrepancy between the appraised meaning of pain and one's global meaning emerged, participants engaged in meaning making processes (accommodation and assimilation), resulting in meanings made, such as a reappraised meaning of pain, perceptions of growth, and acceptance.

Modeling pandemic depression and anxiety: The mediational role of core beliefs and meaning making

Background

Methods

Limitations

Conclusions

Stress, savouring, and coping: The role of savouring in psychological adjustment following a stressful life event

There is increasing research on the role of savouring positive emotional experience in the context of stress. As such, we need a better understanding of how savouring and coping relate to each other and to psychological adjustment outcomes following a stressful life event. In particular, this study seeks to understand whether savouring is better conceptualized as a coping resource or a coping response. Three hundred people who experienced a highly stressful event in the past year completed measures of impact of event, savouring, coping, positive emotions, depression, anxiety, and life satisfaction. Results of bivariate correlations showed that savouring is positively correlated with positive coping (i.e., mastery and meaning-based coping) and socially-supported coping (i.e., using emotional and instrumental support) and negatively correlated with negative coping (i.e., self-judgement and avoidance coping). The results of path analyses support a model that positions savouring as a coping response that relates to other coping responses and indirectly relates to better psychological adjustment through positive emotions (when psychological adjustment is conceptualized as depression or life satisfaction but not anxiety). Findings provide preliminary support for conceptualizing savouring as a coping response; future research should consider measuring savouring as a coping response to further our understanding of savouring following a stressful life event.

Event centrality influences posttraumatic stress disorder symptoms via core beliefs in internally displaced older adults

OBJECTIVES

There is substantial evidence regarding the role of event centrality (EC) in posttraumatic stress disorder (PTSD) symptoms, but little research has examined the explanatory pathways linking EC with PTSD symptoms severity. The present study examined whether core beliefs (CB) mediates the relationship between EC and PTSD symptoms in internally displaced older adults.

METHOD

Internally displaced older adults (N = 279; mean age = 62 years) sheltered in two camps located in north-central Nigeria, completed Tiv language versions of self-report measures, namely, the Harvard Trauma Questionnaire, the Centrality of Event Scale, Core Beliefs Inventory, and provided relevant demographic information.

RESULTS

Analysis indicated that EC and CB were linked to greater PTSD symptoms as well as re-experiencing/intrusion, avoidance and hyperarousal symptoms severity. The mediator path was significant which implies that CB was a pathway through which EC influences PTSD symptoms clusters and overall PTSD symptomatology.

CONCLUSION

A traumatic event becoming more central in a person's identity and life story distorts entrenched beliefs about oneself, others and the world, thereby resulting in greater PTSD symptoms. Our findings suggest that considerations of disrupted world assumptions may be a salient target for prevention and treatment efforts.

Lab- and Field-Based Approaches to Meaning Threats and Restoration: Convergences and Divergences

Two distinct approaches to meaning—experimental lab-based research on meaning and its maintenance in response to situational cues and observational field research on meaning-focused coping following highly stressful or traumatic situations—have both produced important insights into the mechanics underlying responses to meaning-relevant threats. It has been suggested that although these 2 approaches focus on different, specific aspects of meaning, they converge on common underlying phenomena. The present article considers how lab-based and field-based approaches align and diverge on their answers to 4 questions: (1) How is meaning defined in the context of meaning violation and restoration? (2) What are threats to meaning? (3) How do people respond to these threats? and (4) Why does meaning restoration matter? Our comparison of these lab- and field-based approaches suggests that they share considerable commonalities in conceptualization, but they diverge in important ways in terms of emphasis and empirical considerations. We conclude that lab- and field-based approaches to meaning violation and restoration may be focusing on the same phenomena studied at different levels, but with some qualitative differences, and we offer suggestions for how lab- and field-based approaches can better inform one another. Considering these two approaches conjointly provides a more holistic and comprehensive understanding of the fundamental phenomena of meaning threat and restoration.