Making sense of loss and benefiting from the experience: two construals of meaning

"Fighting demons": Stigma and shifting norms in explicit mention of overdose in obituaries, 2010-2019

Obituaries are often the only published record of an individual's life and elicit community reactions, including stigmatization. Because obituaries are typically written by the bereaved, their content reflects the writer's perceptions of mores governing the social context of the next-of-kin and decedent. When a cause of death is stigmatized, it can influence the way the bereaved write the obituary. However, what constitutes a stigmatized cause of death may change as larger societal discourses of morality shift and conditions or events become framed differently. Using a sample of obituaries (N = 210) from obituary aggregator Legacy.com of "off-time," or premature, deaths in West Virginia from 2010, 2015, 2017, and 2019, this article explores whether the presentation of overdose deaths in obituaries changes alongside the shift in the public framing of the opioid crisis as medical rather than criminal. I find obituaries including terms associated with drug use and overdose become both more common and explicit over the course of the study period. This suggests that the shift in public framing of the opioid crisis from criminalization to medicalization corresponds with a decrease in drug stigmatization in obituaries. Obituary analysis can be a useful means of exploring the stigmatization of other controversial causes of death, such as suicide, cirrhosis, and lung cancer.

Promoting post-traumatic growth in cancer patients: a randomized controlled trial of guided written disclosure

Background

Cancer is a life-threatening disease that triggers not only vulnerability to distressing symptoms but also a meaning-making process that may lead to post-traumatic growth. As people often struggle to integrate cancer illness into their meaning system to reach an adaptive meaning, psychological interventions focused on a reappraisal of the illness experience can facilitate this process. This multicenter randomized controlled trial (RCT) was primarily aimed at assessing the efficacy of a writing intervention known as a guided disclosure protocol (GDP), compared to a generic writing intervention, in promoting post-traumatic growth in stage I-III breast and colon cancer patients at the end of their adjuvant chemotherapy.

Methods

Between January 2016 and August 2020 recruitment of eligible subjects took place during follow-up clinical consultations. Assessment occurred at baseline (T0), after the intervention (T1, 3 months from baseline), and at 6 months from baseline (T2). Both interventions consisted of three 20-min writing sessions to be performed once every two weeks. Change in post-traumatic growth was assessed using the Posttraumatic Growth Inventory, meaning with the Constructed Meaning Scale, and psychological distress with the Impact of Event Scale and the Hospital Anxiety and Depression Scale.

Results

In the five participating centers, 102 eligible patients were randomized and 72 participants completed follow-up evaluation. Most patients were women (79.4%), had breast cancer (68.6%), and stage I (27.5%), or stage II (44.1%) disease. Mean differences did not reach statistical significance for any of the dependent variables. However, an effect of the GDP, although not statistically relevant, was observed after the intervention in terms of enhanced post-traumatic growth and increased distress measured with the Impact of Event Scale.

Conclusion

This is the first RCT investigating the efficacy of a GDP in cancer patients having post-traumatic growth as the primary aim. Though GDP is a promising intervention in promoting post-traumatic growth, the lack of statistical significance of our findings may be due to the study being underpowered, hence this trial should be replicated with an adequate sample size, paying attention to supporting recruitment.

Clinical trial registration: ClinicalTrials.gov, identifier: 2015/0024360.

Path analysis of the role of coping strategies between emotional intelligence and lifestyle habits during COVID-19 lockdown

The relationship between Emotional Intelligence (EI) and lifestyle choices during the COVID-19 pandemic is obscure and not very well understood. To clarify the mechanisms underlying this relationship, we proposed to test the hypothesis that different coping styles (avoidant and approach) have an indirect effect on the association between EI and many types of lifestyle habits. A cross-sectional study was conducted between December 2020 and January 2021. Our target sample consisted of Lebanese adults from the general population. In path analysis, approach coping mediated the association between EI and different lifestyle habits (rest, nutrition, general physical conditions), but not exercise. Furthermore, avoidant coping did mediate the association between EI and general physical conditions, but not between EI and other lifestyle choices (namely rest, exercise, and nutrition). To conclude, individuals with high EI, and that are users of approach coping strategies to deal with stressors, have increased rest time, healthy nutrition and general physical conditions. This cautiously implies that fostering approach coping may help improve the positive effects of EI on healthy lifestyles during crises such as this pandemic.

Exploring the Lived Experiences of Caregiving for Older Family Members by Young Caregivers in Singapore: Transition, Trials, and Tribulations

Amidst population ageing trends and epidemiological transitions, there has been a growing emergence of young family caregivers, about whom most studies have been conducted in Western countries. Their subjective experiences and perceptions toward caregiving remain underexplored in Asia. This qualitative study explored the lived experiences of caregiving for older family members by young caregivers in Singapore. Interpretative phenomenological analysis was employed to collect and analyse data from semi-structured, in-depth interviews with six young adult caregivers aged between 23 and 29. Interviews were supplemented with photo-elicitation techniques to deepen interview discussions and uncover experiential significance. Findings illustrated transitions into caregiving, challenges across role conflicts and expectations amidst developmental tasks and transitions, and navigation of intergenerational conflicts and ambivalence. Although no definitive conclusions can be reached from this small-scale study, the findings offer important insights into the convergence and intensity of young caregivers' experiences. Given that caregiving challenges are likely to continue amidst Singapore's rapidly ageing population, these necessitate further in-depth research efforts. Implications for policy and practice across multiple stakeholders interfacing with youth and older adults are presented. A whole-of-society approach is called for to enable young caregivers to realise their full potential while contributing to their ageing families and nation.

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.

Post-traumatic stress symptoms and benefit finding: a longitudinal study among Italian health workers during the COVID-19 pandemic

PURPOSE

Research has highlighted that the exposure of healthcare professionals to the COVID-19 pandemic for over two years can lead to the development and persistence of symptoms characteristic of Post-Traumatic Stress Disorder (PTSD), with serious consequences on both the individual well-being and the quality of care provided. The present study was aimed at investigating the role of benefit finding in moderating post-traumatic stress symptoms (PTSS) over time.

METHODS

The longitudinal study, conducted between April and October 2020, involved 226 Italian health workers (44.7% nurses and midwives, 35% doctors, 20.3% technical and rehabilitation professionals), who filled out an online survey at the beginning of the study (T1), after three months (T2), and after six months (T3). Participants (77.4% women; mean age = 41.93, SD = 12.06) completed the PTSD Checklist for DSM-5 (PCL-5) and Benefit Finding, a 17-item questionnaire measuring the perceived level of positive consequences derived from stressful experiences. A hierarchical regression analysis highlighted the moderating effect of benefit finding (T2) on the association between PTSS values at T1 and T3.

RESULTS

A buffering effect was observed, with higher benefit finding levels reducing the magnitude of the bivariate association between PTSS assessed at the beginning and at the end of the study.

CONCLUSION

Findings suggest the potential mental health related benefits of interventions allowing health professionals to identify positive aspects in the experience of working under prolonged emergency circumstances, such as the pandemic ones.

Pre-pandemic mental health and coping strategy usage during the COVID-19 pandemic: a cross-sectional analysis of the Southern Cities Study

BACKGROUND

Little is known about the usage of coping strategies recommended by the World Health Organization and the Centers for Disease Control and Prevention during the COVID-19 pandemic and whether coping strategy usage varies by pre-pandemic mental health. This study examined the prevalence of different coping strategies and associations of their usage with pre-pandemic mental health.

METHODS

Data were collected from adults residing in metropolitan areas of the U.S. South in May/June 2020 using random-digit-dialing and web-based surveys (n = 1,644). We estimated the prevalence of each coping strategy: (1) keeping up-to-date about COVID-19; (2) taking breaks from the news or social media; (3) taking care of physical health; (4) engaging in relaxing activities; (5) reaching out to and spending time with others; and (6) trying to find comfort in religious or spiritual beliefs. We examined the association between the use of each strategy and pre-pandemic mental health using modified Poisson regression, adjusting for covariates. We also analyzed the association between pre-pandemic mental health and the number of coping strategies employed using ordered logistic regression.

RESULTS

The most prevalent strategies were: "keeping up-to-date about COVID-19" (53%), "taking care of physical health" (52%), and "reaching out to and spending time with others" (52%). Good pre-pandemic mental health was associated with an increased prevalence of "reaching out to and spending time with others" (adjusted prevalence ratio, 1.43; 95% confidence interval, 1.07-1.91). The use of other coping strategies and the number of coping strategies used during the pandemic did not vary by pre-pandemic mental health.

CONCLUSIONS

Our findings suggest that people who had good pre-pandemic mental health were more likely to connect with other people during the COVID-19 pandemic. Given the well-documented impact of social support on mental health in disaster contexts, efforts to promote safe social connections for those with pre-existing mental health concerns are needed.

The impact of COVID-19 on mental health and posttraumatic growth of Korean college students: a mixed method study examining the moderating role of coping flexibility and sense of community

Introduction

In the context of the COVID-19 pandemic, which has led to complex psychological problems, it is important to examine the effect of coping flexibility and sense of community, because relying solely on specific coping strategies is ineffective, and the pandemic necessitates social cooperation.

Methods

This study was divided into two parts. The first study used a quantitative research method(i.e., structural equation modeling) to test if coping flexibility and sense of community moderated the impact of COVID-19-related concerns on mental health (i.e., depression and anxiety) and posttraumatic growth among Korean college students. The second study used a qualitative research method for an in-depth examination of how Korean college students coped with the COVID-19 pandemic and if they achieved any positive change or growth. Given that the COVID-19 pandemic represents a situation distinct from what people have previously encountered, Study II was designed to examine the experiences of individuals during this exceptional period.

Results

In the first study (Study I), coping flexibility was found to increase the impact of COVID-19-related concerns and difficulties on depression and anxiety. Conversely, a sense of community reduced the consequences of these overwhelming worries on depression and anxiety, while also expanding the impact of COVID-19-related disorders on posttraumatic growth. In the second study (Study II), the findings showed that the participants experienced various psychological consequences, including depression and anxiety, and distress in other aspects of their life, including disruptions in interpersonal relationships and college life. Nonetheless, the participants made efforts to cope with such difficulties and overcome the challenges together with the community. In fact, the pandemic improved their coping skills and expanded their value system and worldview.

Conclusion

The study findings suggest that given the unique situation presented by the COVID-19 pandemic, a sense of community protected the mental well-being of Korean college students and facilitated their growth. This study emphasizes the necessity of promoting SOC to effectively cope with disaster situations.

Finding Strength in Times of Crisis? Post-Traumatic Growth During the Covid-19 Pandemic: A Saudi Arabian Perspective

This paper contributes to the Covid-19 literature by exploring the concept of post-traumatic growth (PTG) utilizing a mixed methods approach. The study examines to what extent the participants experienced positive growth and renewal arising from the prolonged period of lockdowns and emergency online learning. Exploring the experiences of 552 female undergraduate students in a private Saudi Arabian university, an online survey was utilized to gather the data. All the students had experienced online education as a result of the pandemic. The findings indicate the participants underwent a diversity of personal growth experiences. In addition, they also developed different coping mechanisms. The study provides insights into the responses of the students to the issues they were facing during the pandemic. It identifies ways in which participants experienced personal growth as well as a shift in perspective about their lives. There are implications for educators, counselors and policymakers emerging from this study.

Associations of the perceived benefits and harms of COVID-19 with confidence in coping with the pandemic and mental health symptoms: a population-based survey in Hong Kong

Introduction

Both perceived benefits and harms of COVID-19 have been reported, but whether they affect confidence in coping with the pandemic and mental health remains uncertain.

Objective

To examine the association of perceived benefits and harms of COVID-19 with confidence in coping with the pandemic and mental health symptoms.

Methods

A population-based survey was conducted on 7,535 Hong Kong adults from 22 February to 23 March 2021, when the 4^th wave of COVID-19 was under control. Information on sociodemographic characteristics, perceived benefits (10 options) and harms (12 options) of COVID-19, confidence in coping with the pandemic (range 0-10), loneliness (range 0-4), anxiety (General Anxiety Disorders-2, range 0-6) and depression (Patient Health Questionnaire-2, range 0-6) was collected. Latent profile analysis was used to identify the combined patterns of perceived benefits and harms of COVID-19. The associations of combined patterns with confidence in coping with COVID-19, loneliness, anxiety, and depression were examined using linear regression (β coefficient) adjusting for sociodemographic characteristics.

Results

The combined patterns of perceived benefits and harms were classified into benefit (n = 4,338, 59.3%), harm (n = 995, 14.0%), and ambivalent (n = 2,202, 26.7%) groups. Compared with the ambivalent group, the benefit group had a significantly higher level of confidence (adjusted β 0.46, 95% CI 0.33 to 0.58), and lower levels of loneliness (-0.35, -0.40 to-0.29), anxiety (-0.67, 0.76 to-0.59), and depression (-0.65, -0.73 to-0.57). The harm group had a significantly lower level of confidence (-0.35, -0.53 to-0.16), and higher levels of loneliness (0.38, 0.30 to 0.45), anxiety (0.84, 0.73 to 0.96), and depression (0.95, 0.84 to 1.07).

Conclusion

Perceived greater benefit from COVID-19 was associated with better mental health and stronger confidence in coping with the pandemic.

Meaning-making following loss among bereaved spouses during the COVID-19 pandemic (the CO-LIVE study)

This study investigates how individuals construe, understand, and make sense of experiences during the first wave of the COVID-19 pandemic. Seventeen semi-structured interviews were conducted with bereaved spouses focusing on meaning attribution to the death of their partner. The interviewees were lacking adequate information, personalized care, and physical or emotional proximity; these challenges complicated their experience of a meaningful death of their partner. Concomitantly, many interviewees appreciated the exchange of experiences with others and any last moments together with their partner. Bereaved spouses actively sought valuable moments, during and after bereavement, that contributed to the perceived meaning.

Predictors of Post-Traumatic Growth in a Sample of United Kingdom Mental and Community Healthcare Workers during the COVID-19 Pandemic

Experiences of adversity can generate positive psychological effects alongside negative impacts. Little research to date has evaluated predictors of post-traumatic growth in mental or community healthcare workers during the COVID-19 pandemic. Following a survey of 854 community and mental healthcare staff in the United Kingdom in July to September 2020, multiple linear regression was used to determine the association between hypothesised risk and protective factors (personal, organisational and environmental variables) and total scores on the Post-traumatic Growth Inventory-Short Version. Positive self-reflection activities, black and minority ethnic status, developing new healthcare knowledge and skills, connecting with friends and family, feeling supported by senior management, feeling supported by the UK people, and anxiety about the personal and work-related consequences of COVID-19 each significantly independently predicted greater post-traumatic growth. Working in a clinical role and in mental healthcare or community physical healthcare predicted lower post-traumatic growth. Our research supports the value of taking an organisational growth-focused approach to occupational health during times of adversity, by supporting staff to embrace opportunities for personal growth. Valuing staff's cultural and religious identity and encouraging self-reflective activities, such as mindfulness and meditation, may help to promote post-traumatic growth.

Suffering, authenticity, and meaning in life: Toward an integrated conceptualization of well-being

Most conceptions of well-being either ignore suffering or assume an ideal version of human life in which suffering would be eliminated. This trend is especially emblematic of positive psychology. Recent research on well-being indicates a mediating function of meaning in life between suffering and well-being demonstrating that making sense of past experiences is significantly correlated with high presence of meaning in life. Hence, meaning-making serves the role of an active coping mechanism that alleviates suffering. This and related strategies of defining, measuring, and augmenting well-being however overlook a form of suffering that is ineliminable and in fact essential to personal growth. In this paper the insights of the existentialist philosopher Søren Kierkegaard are developed to formulate an integrated conceptualization of well-being that regards "negative" affects as crucial for a rich and complete life. The complexity of the relationship between meaning in life, suffering, and authenticity concerning well-being are discussed. A synthetic perspective on the subjective dimension of the experience of suffering and on the objective nature of human limitations that often cause suffering is discussed in relation to the notions of meaning in life and authenticity. Finally, an integrated conceptualization of well-being is posited. It entails suffering as constitutive of meaning in life and authenticity, which are key components of a well-lived life.

"I Do Not Think She Will Understand, This is Not a Situation for a Girl Like Her:" Disenfranchised Grief Among Adults with Intellectual and Developmental Disabilities in the Ultra-orthodox Jewish Society

This article examines the experience of aging ultra-Orthodox families alongside a person with intellectual and developmental disabilities (IDD) in relation to parents' illness and death, followed by grief. In-depth interviews were conducted with 14 family units. Each family unit included the person with IDD, a parent, and a sibling-a total of 43 participants. Three main themes emerged: A. The difficulty in confronting illness and dying of parents alongside a family member with IDD in an Ultra-Orthodox Context. B. Exclusion of the person with IDD from parents' memorial events. C. Religious ceremonies as a strategy for coping with mourning among persons with IDD. The discussion focuses on the concept of disenfranchised grief in a religious context and its impact on the family support system. Culturally sensitive therapeutic recommendations are made for professionals working with older ultra-Orthodox Jewish families alongside a person with IDD in the context of the subject.

COVID-19 in Memes: The Adaptive Response of Societies to the Pandemic?

COVID-19 expanded rapidly throughout the world, with enormous health, social, and economic consequences. Mental health is the most affected by extreme negative emotions and stress, but it has been an underestimated part of human life during the pandemic. We hypothesized that people may have responded to the pandemic spontaneously with increased interest in and creation of funny internet memes. Using Google and Google Trends, we revealed that the number of and interest in funny internet memes related to COVID-19 exploded during the spring 2020 lockdown. The interest in coronavirus memes was positively correlated with interest in mortality due to COVID-19 on a global scale, and positively associated with the real number of deaths and cases reported in different countries. We compared content of a random sample of 200 coronavirus memes with a random sample of 200 non-coronavirus memes found on the Internet. The sentiment analysis showed that coronavirus memes had a similar proportion of positive and negative words compared to non-coronavirus memes. However, an internet questionnaire revealed that coronavirus memes gained higher funniness scores than a random sample of non-coronavirus memes. Our results confirm that societies may have turned to humor to cope with the threat of SARS-CoV-2.

Optimism and symptoms of anxiety and depression among Chinese women with breast cancer: the serial mediating effect of perceived social support and benefit finding

OBJECTIVE

This research examines the direct and indirect relationships between optimism, perceived social support (PSS), benefit finding (BF), and anxiety and depressive symptoms among Chinese women with breast cancer (BC).

METHODS

We recruited 512 patients, aged averagely 47.46(SD = 8.51) years from two hospitals located in Hunan province, China. The variables were assessed using the Optimism-Pessimism Scale (OPS), the Multidimensional Scale of Perceived Social Support (MSPSS), the Benefit Finding Scale (BFS), and the Hospital Anxiety and Depression Scale (HADS). Path analyses were conducted by Amos version 24.0 for Windows to test the hypothesized serial mediation model.

RESULTS

Path analyses suggest a significant negative association between optimism and symptoms of anxiety and depression. The relationship was mediated by BF (β = -0.085, SE = 0.015, 95% CI [-0.126, -0.055]), and by BF together with PSS (β = -0.027, SE = 0.007, 95% CI [-0.047, -0.017]). The difference comparison between the two indirect effects was significant (β = 0.057, SE = 0.015, 95% CI [0.034,0.101]).

CONCLUSIONS

Our findings suggest that PSS, and BF are important mediators through which optimism may buffer symptoms of anxiety and depression among Chinese BC patients. Clinicians and healthcare practitioners should be aware of the importance of patients' emotional health and endeavor to offer emotional support, facilitate their capacity to improve their quality of life.

Patterns in older adults' perceived chronic stressor types and cognitive functioning trajectories: Are perceived chronic stressors always bad?

PURPOSE

Previous studies have linked levels of perceived chronic stress to older adults' cognitive functioning, but few have focused on the impact of chronic stressor types. Thus, this study aimed to (1) identify patterns of chronic stressor types and (2) examine the effects of these patterns on cognitive functioning trajectories among older adults.

METHODS

Two longitudinal studies were conducted separately to test the study aims and ensure replicability across samples and time points. Both used three timepoints (Study 1: 2006, 2008, and 2010, n = 6974; Study 2: 2012, 2014, and 2016, n = 6604) collected from older Americans in the Health and Retirement Study. Participants did not overlap between the two studies. Latent class analyses were conducted to identify chronic stressor-type patterns. Latent growth curve models were used to test the effects of chronic stressor-type patterns on cognitive functioning trajectories.

RESULTS

Three latent classes of stressor types were identified in both studies: egocentric (4.56%; 5.85%), nonegocentric (8.58%; 10.03%), and low stressor (86.86%; 84.12%). In both studies, compared to the low stressor class, the egocentric stressor class had significantly lower initial cognitive scores (B = -0.72, ρ < 0.001; B = -0.46, ρ < 0.05), while the nonegocentric stressor class did not have significantly different initial scores, with covariates controlled. Additionally, in Study 1, the nonegocentric stressor class had significantly slower cognitive decline rates than the low stressor class (B = 0.11, ρ < 0.05).

CONCLUSIONS

Findings suggested that nonegocentric stressors are an important stressor source in late adulthood but are less detrimental to cognitive functioning than egocentric stressors. Health management interventions may reduce older adults' cognitive health disparities caused by self-health and financial stressors. More support, including financial subsidies, caregiver stress management training, or support groups, should be provided to older caregivers, especially those with few resources.

Predictors of mental health in aid workers: meaning, resilience, and psychological flexibility as personal resources for increased well-being and reduced distress

Aid workers operate in stressful environments and tend to experience high psychological distress, yet not enough is known about their well-being and how to improve their mental health. This research project surveyed 243 aid workers in 77 countries undertaking humanitarian and development work who reported lower well-being and higher psychological distress than the general population. Well-being and distress emerged as two related but distinct mental health outcomes, encouraging further research on well-being in the sector. Better mental health outcomes were predicted by the presence of meaning, psychological flexibility, and resilience. Presence of meaning was the strongest predictor, whereas resilience was the weakest. Meaning was a stronger predictor of good mental health among national workers, whereas psychological flexibility was a stronger predictor among female, older, and international workers. These results can support evidence-based approaches to staff care and mental health interventions for aid workers, expanding the current focus on resilience to include meaning and psychological flexibility.

Understanding the Motives for Terrorism-Does it Have an Effect on Psychological Reactions? A Replication and Extension

The collective communication model of terrorism (CCMT) proposes that understanding terrorists' motives influences appraisal (threat perception and emotional well-being) and reaction to terrorism (intention to retaliate). Fischer et al. (2011) presented evidence from two experiments for the assumption that understanding motives of terrorism influences appraisal. The present preregistered experiment aimed to replicate their second experiment, validate the measures they used, and also test the second proposition of the CCMT. Ensuring sufficient power for multiple tests and the given effect size, we collected data from 188 participants. The findings by Fischer et al. (2011) were partly replicated, but the comparison of the original effect sizes and the effect sizes from the replication attempt does not provide convincing evidence for the hypothesis that understanding the motives for terrorism reduces the perceived threat or negative emotional impact of acts of terrorism. Correlations with other risk-perception measures call into question the validity of the items used to assess perceived threat. Results suggest that understanding the motives for terrorism may influence whether the targeted populations want to retaliate.

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.

The silver lining behind the dark cloud: Exploring the psycho-social factors impacting successful adaptation during the COVID-19 pandemic

While most studies have been reporting the psychological issues being faced by the public due to the global spread of coronavirus and sudden restrictions and changes accompanying it, the present study attempted to explore dynamic human experiences during the COVID-19 pandemic and resultant lockdown, so as to understand the psycho-social factors that acted as adaptive resources or as buffers to maintain a stable mental state amidst this crisis. In-depth telephonic interviews with 30 participants were conducted to explore their experiences in dealing with the COVID-19 pandemic and the lockdown. Thematic analysis performed to identify the positive and protective factors that helped people adapt in a healthy way revealed that although the initial response of the participants to the pandemic was “optimistic bias” followed by downplaying the seriousness of the issue, later they demonstrated increased realization and acceptance to the seriousness of the situation. Upon realizing the situation, their positive psychological resources acted as a buffer against the ill effects of the pandemic, and they used both cognitive and behavioral coping. The study clearly demonstrates that crisis in life is not just a source of stress, anxiety, and uncertainty but also an opportunity to test one’s psychological resources to learn and grow.

Characteristics of alcohol recovery narratives: Systematic review and narrative synthesis

BACKGROUND AND AIMS

Narratives of recovery from alcohol misuse have been analysed in a range of research studies. This paper aims to produce a conceptual framework describing the characteristics of alcohol misuse recovery narratives that are in the research literature, to inform the development of research, policy, and practice.

METHODS

Systematic review was conducted following PRISMA guidelines. Electronic searches of databases (Ovid MEDLINE, EMBASE, CINHAL, PsychInfo, AMED and SCOPUS), grey literature, and citation searches for included studies were conducted. Alcohol recovery narratives were defined as "first-person lived experience accounts, which includes elements of adversity, struggle, strength, success, and survival related to alcohol misuse, and refer to events or actions over a period of time". Frameworks were synthesised using a three-stage process. Sub-group analyses were conducted on studies presenting analyses of narratives with specific genders, ages, sexualities, ethnicities, and dual diagnosis. The review was prospectively registered (PROSPERO CRD42021235176).

RESULTS

32 studies were included (29 qualitative, 3 mixed-methods, 1055 participants, age range 17-82years, 52.6% male, 46.4% female). Most were conducted in the United States (n = 15) and Europe (n = 11). No included studies analysed recovery narratives from lower income countries. Treatment settings included Alcoholic Anonymous (n = 12 studies), other formal treatment, and 'natural recovery'. Eight principle narrative dimensions were identified (genre, identity, recovery setting, drinking trajectory, drinking behaviours, stages, spirituality and religion, and recovery experience) each with types and subtypes. All dimensions were present in most subgroups. Shame was a prominent theme for female narrators, lack of sense of belonging and spirituality were prominent for LGBTQ+ narrators, and alienation and inequality were prominent for indigenous narrators.

CONCLUSIONS

Review provides characteristics of alcohol recovery narratives, with implications for both research and healthcare practice. It demonstrated knowledge gaps in relation to alcohol recovery narratives of people living in lower income countries, or those who recovered outside of mainstream services.

PROTOCOL REGISTRATION

Prospero registration number: CRD42020164185.

Mediating Role of Entrepreneurial Self-Efficacy and Prosocial Tendency in the Relation Between College Students' Post-traumatic Growth and Entrepreneurial Intention in the Post-COVID-19 Era

In this study, we explore the psychological mechanisms underlying the relation between college students' post-traumatic growth and their entrepreneurial intentions in the post-COVID-19 era. Using the post-traumatic growth, entrepreneurial self-efficacy, prosocial tendency, and entrepreneurial intention scales, we tested 690 valid samples of Chinese undergraduates (including 445 men and 245 women). The results revealed that post-traumatic growth of college students in the post-COVID-19 era will have a significant and positive effect on their entrepreneurial intentions. Additionally, the results indicated that students' entrepreneurial self-efficacy and prosocial tendencies play a partial mediation role between post-traumatic growth and entrepreneurial intentions in the post-COVID-19 era and that there is a chain mediating effect between students' entrepreneurial self-efficacy and prosocial tendencies. This study provides valuable insights into the influence of post-traumatic growth on entrepreneurial intentions among college students in the post-COVID-19 era and suggests that colleges and universities can improve students' entrepreneurial intentions by adopting measures to foster their post-traumatic growth, entrepreneurial self-efficacy, and prosocial tendencies.

Longitudinal Intercorrelations between Complicated Grief and Posttraumatic Growth among Suicide Survivors

BACKGROUND

Suicide survivors are prone to elevated risk for several psychiatric and somatic complications, including complicated grief (CG) and depression. Recent studies have highlighted the possibility of posttraumatic growth (PTG) among suicide survivors. However, to date, no longitudinal study has focused on the relationships between CG and PTG among suicide survivors.

AIMS

In this 18-month longitudinal design study, our goal was to investigate the longitudinal bidirectional associations between PTG and CG, as well as between PTG and depression among suicide survivors.

METHOD

Participants were156 suicide-loss survivors, aged 18-70, who completed questionnaires tapping the CG and PTG at T1 and again after 18 months (T2). Depression was measured only at T2.

RESULTS

The integrated model showed that CG-T1 predicts a reduction in PTG-T2 levels, beyond the trajectory of PTG. Whereas PTG-T1 was negatively correlated with CG-T2 and with depression at T2, this path was only marginally significant in the model.

LIMITATIONS

Voluntary nature of the participants; self-report measures; lack of pre-suicide-loss assessment.

CONCLUSION

The study's findings suggest that CG levels play an important role in facilitating PTG among suicide survivors, with high CG levels impeding the possibility of growth. PTG did not act as a coping strategy to reduce CG. Clinical and research implications are discussed.

The relationship between posttraumatic stress disorder, posttraumatic growth, and rumination in adolescents after earthquake: A systematic review

PURPOSE

This systematic review aims to examine, from an interdisciplinary perspective, the relationship between posttraumatic stress disorder (PTSD), posttraumatic growth (PTG), and rumination in adolescents after an earthquake. The aim of the review is to provide high-quality, evidence-based recommendations that contribute to the roles of psychiatric nurses and the development of psychosocial support systems.

DESIGN AND METHODS

This study has been conducted in line with the Centres for Reviews and Dissemination (CRD) guideline which guides preparation for transparent reporting of meta-analysis and systematic reviews.

FINDINGS

Despite the limited evidence, it was concluded that it is important to identify the psychological processes that lead to PTG and reduce the incidence of PTSD in earthquake-affected adolescents.

PRACTICAL IMPLICATIONS

This evidence shows how important it is to raise the awareness of healthcare providers in different disciplines, including psychiatric nurses, around the need for psychosocial support interventions following a natural disaster.

Abusive leadership and proactive behaviours: Role of family motivation as a moderator

BACKGROUND: Negative impact of abusive leadership has always been the focus of attention for researchers, however, the asymmetrical relationship of abuse with its outcomes has never been studied. OBJECTIVE: Drawing on Affective Events Theory (AET), this study investigates the moderating role of family motivation (FM), a prosocial intent, in yielding positive behavioural reactions among individuals facing workplace abuse. Negative emotions (NE) are taken as a unique mediating factor between abusive leadership (AL) and proactive behaviours (PB). METHODS: Data were collected from 309 employees of Pakistani manufacturing organizations. SEM is used for studying the proposed relationships and Smart PLS is used for data analysis. RESULTS: Results of the study suggest that negative emotions mediate the indirect relationship between abusive leadership and proactive behaviours. Family motivation strongly moderates and strengthens the positive direct relationship of negative emotions and proactive behaviours, concluding that it has a strong influence in altering behavioural reactions in response to negative triggers. CONCLUSIONS: This research study adds to the body of knowledge in suggesting FM as a strong intrinsic factor to be considered while creating synergy between organizational and human resource strategies.

Una aproximación al significado del amor en una población infantil en Lima, Perú

El presente estudio tuvo como objetivo aproximarse al significado del amor, a través de su expresión escrita, en una muestra de niños y niñas de Lima Metropolitana de Perú, y examinar sus diferencias según sexo y edad. En total, se contó con la participación de 289 individuos divididos en dos muestras: una muestra exploratoria (n = 50) y otra de confirmación (n = 239). El estudio siguió una metodología mixta, a partir del análisis temático como técnica cualitativa para identificar códigos subyacentes a la definición de amor de los niños, y del análisis clúster jerárquico como técnica cuantitativa para generar un dendrograma. Los resultados revelaron la presencia de seis categorías centrales: relación con otros significativos cercanos, romanticismo y amor propio, relación característica entre adultos, estado positivo, afectividad, y apoyo incondicional. A partir de ello, se concluye que el concepto de amor durante la niñez integra tres categorías del esquema interpretativo de las emociones: contextual o elicitador, experiencia subjetiva, y tendencia expresiva/motivacional.

A Survey Study of Spiritual Change and Related Factors Among the Surviving Loved Ones of Homicide Victims

A survey study was conducted as the second phase of a sequential mixed-methods study of spiritual change after the homicide of a loved one. The purpose of the study was to test the Theory of Post-Homicide Spiritual Change (Theory of PHSC), which emerged in Phase 1 of the larger study. The formulation of survey research questions and hypotheses was guided by the emerging theory. Data were collected online using Qualtrics. Respondents (N = 112) completed a demographic and background questionnaire that was devised for the study based on a review of important factors in homicidal bereavement. They also responded to established measures, including a modified version of the Posttraumatic Growth Inventory, the Integration of Stressful Life Experiences Scale (ISLES), and the Perceived Justice Scale. The ISLES was comprised of two subscales-Comprehensibility and Footing in the World. Significant findings revealed that posttraumatic growth (PTG) was higher among those for whom 3 or more years had passed since the murder, as compared with those for whom fewer than 3 years had passed. The age of the victim was positively correlated with integration of loss. Christian respondents reported higher levels of integration of loss and PTG, as compared with non-Christian respondents. Integration of loss was a mediator of the relationship between perceived justice and integration of loss, while footing in the world was a mediator of the relationship between comprehensibility and PTG. Contrary to hypotheses, integration of loss did not differ by time since murder. This finding is interpreted in terms of the limitations of the study sample and in terms of future research directions in this area. The results of this study yield important insight into spiritual change and related factors that can be used to guide service provision with the homicide survivor population.

Meaning Reflectivity in Later Life: The Relationship Between Reflecting on Meaning in Life, Presence and Search for Meaning, and Depressive Symptoms in Older Adults Over the Age of 75

Background: Over the last decades, there is growing attention for the importance of meaning in life for older adults. However, there is virtually no insight into the mental processes that contribute to this experience. Some scholars recently called for an investigation of meaning reflectivity, or the process of reflecting on issues specifically related to meaning in life. In this study, we explored to what extent older adults talk and think about issues of meaning in life, and how this meaning reflectivity is related to the search for and presence of meaning in life, and to depressive symptoms.

Method: In this cross-sectional observational study, 282 community-residing older adults (75 or older) in Belgium filled in paper questionnaires on meaning in life (presence and search), depressive symptoms, and meaning reflectivity (categorical item). ANOVA analyses were used to explore differences in meaning in life and depressive symptoms across the meaning reflectivity categories. Regression and negative binomial models investigated the association between meaning reflectivity and presence, search and depressive symptoms. Finally, an exploratory structural equation model examined whether presence of meaning statistically mediated the relationship between meaning reflectivity and depressive symptoms.

Results: The majority of participants (42.4%) indicated that they had thought about meaning in life before, 23.2% indicated that they had talked about it before, 18% indicated that they hadn’t thought about it before but found it interesting, and 16.4% indicated that they were indifferent/unconcerned about meaning in life. The latter group reported lower levels of presence of meaning and search for meaning and higher levels of depressive symptoms. Belonging to this category was also associated with lower presence and search in regression analyses, but not with depressive symptoms above the effect of presence of meaning. Exploratory mediation analyses suggested that presence of meaning may be a mediator between meaning reflectivity and depressive symptoms.

Conclusion: Meaning reflectivity is an important process to consider in the context of the experience of meaning in life for older adults. Those older adults who are indifferent about issues of meaning in life might be more vulnerable to experience a lack of meaning and depressive symptoms.

The Impact of Different Coping Styles on Psychological Distress during the COVID-19: The Mediating Role of Perceived Stress

The present study aimed to understand the impact of different coping methods endorsed by Chinese college students during COVID-19 through the examination of the mediating role of perceived stress. We recruited a total of 492 undergraduate students to complete an online survey from May to June 2020. The results of structural equation modeling indicated that perceived stress was a significant mediator in the association between different coping styles and psychological distress. Three coping styles, including problem-focused, adaptive emotion-focused, and maladaptive emotion-focused coping styles were all significantly correlated with psychological distress. Perceived stress significantly mediated the association between the three coping styles and psychological distress. The results indicated a full mediation model in which problem-focused coping and adaptive emotion-focused coping affected psychological distress entirely through the mediation of perceived stress. Maladaptive emotion-focused coping positively predicted perceived stress, which in turn positively predicted psychological distress through a partial mediation model. We discuss the implications of these findings and offer suggestions for future research.

Perception of grief responses: Are maladaptive grief responses and the stages of grief considered normal?

Literature indicates laypeople hold strong opinions about how persons should grieve. This study examined how individuals perceive normal grief. Participants across two distinct samples (Study 1: N = 510 via MTurk; Study 2: N = 210 via Qualtrics panels) completed the Perception of Grief Scale and Grief Expectations Questionnaire. Findings indicated participants endorsed maladaptive grief responses as normal relative to other responses to loss. Endorsement of maladaptive grief responses as normal predicted endorsement of grief work beliefs. If social expectations deem maladaptive grief to be normal, as this study suggests, bereaved individuals might implicitly push themselves to grieve maladaptively.

Prolonged grief and posttraumatic growth among middle-aged and older widowed persons: A latent class analysis and testing for the role of social support

Evidence has shown that symptoms of grief co-occur with posttraumatic growth following loss. Using latent class analysis among a Togolese sample of middle-aged/older widowed persons, we identified three classes along their experiences of grief-growth interaction (combined grief/growth, predominantly growth, and low-medium growth classes). The combined grief/growth class members were more likely to have lost their spouses recently and to report greater marital relationship satisfaction with their spouse before their death. The perceived social support from family was predictive of the predominantly growth class membership. The findings provide a nuanced understanding of grief, which is dominated by psychopathology and negative outcomes.

Counterfactual Thinking Among Victims of Sexual Assault: Relationships With Posttraumatic Stress and Posttraumatic Growth

Counterfactual thinking is thinking of alternatives to events that have already occurred. The purpose of this quantitative study was to investigate the relationships between counterfactual thinking and both posttraumatic stress and posttraumatic growth among undergraduate women who identified as having been sexually assaulted (N = 199). Participants who identified as sexual assault victims completed measures of posttraumatic stress, posttraumatic growth, and counterfactual thinking online. Upward counterfactual thinking-that is, thinking of preferable alternative outcomes-specific to sexual assault was associated with greater posttraumatic stress and greater posttraumatic growth, while downward counterfactual thinking-that is, thinking how things could have been worse-was associated with lower posttraumatic stress. Women endorsed approximately equal levels of upward and downward counterfactual thinking. The results suggest that the way individuals cognitively process sexual assault may play a role in long-term trauma and recovery.

A Struggle for Survival: Meaning of Late Life in a Rural District in Uganda: A Qualitative Study

Background: Between 2015 and 2050, the aging population of Uganda (aged 50 years and older) will be nearly doubled. Therefore, later-life problems have become an area of increasing research and policy interest. This study aimed at exploring how aging people living in extreme poverty in a low-income country experience their everyday life and what kind of meaning systems employed by them to understand and cope with their living conditions. Methods: We conducted a qualitative interview with 14 participants in the Buikwe district. In this interview, 11 women and 3 men were included, and a thematic analysis was employed for data processing and analysis. Results: Unanimously, all participants reported their condition as extreme poverty. The key informants (KIs) emphasized respect from descendants and the community as a foundation for a meaningful later life. In contrast, this aspect has been ever mentioned by no caregivers but by only one care-receiver. The willingness/ability of children to support the elderly who are in need of support formed a major part of the reflections of care-receivers, which would be decisive for their position in the society and the respect they would receive. In addition, both Christianity and traditional beliefs as well as beliefs in witchcraft and ancestral spirits were employed as a basis for actions and reflections. Discussion: The question arises whether life in extreme poverty conditions can be perceived as meaningful. Respect was mentioned as fundamental by the KIs, thereby giving priority to social relations as the most meaningful factor for living a meaningful life. The ability and willingness of the possible descendants for support as the focus of care-receivers might be a more down-to-earth description of this aspect but without using the same level of abstraction. For the majority, due to their belief system did not serve as a source of consolation their main focus was on social relationships for support. To improve the wellbeing of the old people, their sense of meaning must be restored through a system, guaranteeing the coverage of basic needs and measures to restore dignity through a reintegration in both community and congregations. Social service agencies who are targeting the elderly people need to work toward this objective.

Truth is its own reward: Completeness of information, the feeling of truth knowing, and victims' closure

Victims of crime often want the truth about what happened. Yet, how exactly is truth valuable? Commonly, truth is thought to be instrumentally valuable by providing useful knowledge. Truth would be beneficial for victims because specific information may afford re-appraisals or greater understanding. The present research shows that truth may have inherent value independent from information content by providing truth knowing, a subjective sense of having the complete account, which facilitates closure. In Study 1 (n = 200) and Study 2 (n = 195), participants imagined themselves as victims of crime and were presented with one of two reports identical in content but designed to appear either complete or incomplete. As predicted, the complete report increased truth knowing and not understanding. Truth knowing was associated with greater closure, reduced affect, and greater forgiveness. In Study 3 (n = 157), real crime victims responded to one of two question sets making salient either the completeness or incompleteness of the information available about the crime. Salience of the completeness of information increased truth knowing, increased closure, reduced anger, and was associated with greater forgiveness. Findings suggest that truth knowing may facilitate the recovery of victims independently from instrumental value derived from content.

Meaning-Making, Psychological Distress, and the Experience of Meaning in Life Following a Natural Disaster

The purpose of this study was to examine the role of meaning-making in response to collective trauma. In the aftermath of Hurricane Harvey, we recruited participants ( N = 570) to test the hypothesis that searching for meaning (vs. finding meaning) in the event would be associated with greater (vs. lower) levels of acute and post-traumatic stress symptoms. We further hypothesized that searching for (and finding) meaning in the event would predict global search for (and presence of) meaning in life (MIL). Consistent with our hypotheses, we found that searching for meaning in the event was associated with greater psychological distress at both time points and predicted global search for MIL at one of the time points. Finding meaning in the event was unexpectedly not consistently associated with lower levels of stress; however, across analyses, finding meaning in Hurricane Harvey was associated with greater levels of MIL. Implications and possible explanations for these unexpected results are discussed.

Upward and Downward Counterfactual Thought After Loss: A Multiwave Controlled Longitudinal Study

Counterfactual thoughts, mental simulations about how a situation may have turned out differently (i.e., "if only …, then …"), can reduce mental health after stressful life-events. However, how specific counterfactual thought types relate to post-loss mental health problems is unclear. We hypothesized that self-referenced upward counterfactuals (i.e., "If only I had done …, then the current situation would be better") may serve as cognitive avoidance, thereby perpetuating loss-related distress. Conversely, downward counterfactuals (i.e., "If … had happened, then the current situation could have been [even] worse") may facilitate benefit finding, thereby reducing distress. In a longitudinal survey, self-referent, other-referent, and nonreferent upward counterfactuals, and nonreferent downward counterfactuals were assessed at baseline. Prolonged grief and depression symptoms were assessed at baseline, and 6- and 12-month follow-ups. Multiple regression analyses assessed associations between counterfactual thoughts and symptom levels in 65 recently bereaved people who generated counterfactual thoughts about the loss-event. Moderator analyses assessed the unicity of significant effects in the previous step, by comparing these effects in 59 people generating loss-related counterfactuals with those in 59 propensity-score matched participants generating counterfactuals about other negative life-events. Multivariate analyses showed that nonreferent upward counterfactuals were uniquely strongly positively associated with prolonged grief and depression symptoms concurrently. Self-referent upward counterfactuals were uniquely positively associated with prolonged grief and depression symptoms longitudinally. Moderator analyses confirmed that thinking about how one's (in)actions could prevent a death uniquely exacerbated prolonged grief and depression severity. Prolonged grief treatment may be improved by targeting self-blame and guilt.

Retrospective and prospective measures of post-traumatic growth reflect different processes: longitudinal evidence of greater decline than growth following a hematopoietic stem-cell transplantation

BACKGROUND

This prospective longitudinal study examined and compared two measures (prospective and retrospective ones) of post-traumatic growth (PTG) following Hematopoietic Stem-Cell Transplantation (HSCT) and their respective relationships with mental health and psychological disposition. We also tested the hypothesis that unwillingness to be in contact with distressing thoughts and feelings-i.e. experiential avoidance-would moderate the relationship between Post-Traumatic Stress Disorder (PTSD) and growth.

METHODS

This study was carried out with 187 patients. Patients completed the Post-Traumatic Growth Inventory (PTGI) 5 months after HSCT and scales tapping into the five domains of PTGI during hospitalisation and 5 months after HSCT. Mental health and psychological disposition were also assessed prior to hospitalisation. A PTSD scale was administered at the five-month follow-up.

RESULTS

Prospective and retrospective measures of PTG were weakly correlated. Bayesian pre/post-HSCT comparisons in the prospective measure of PTG revealed substantial to very strong decline in four of the five dimensions assessed. Overall, RCI indicated a reliable increase for 5.6% of patients and a reliable decrease for 40.8% of patients. Confirming that retrospective and prospective measures of PTG reflect different processes, they were not related to the same mental health and psychological disposition variables. Moreover, the hypothesis that acquiring positive outcomes from a potentially traumatic experience, such as HSCT, requires direct confrontation with the source of distress was supported in the case of the retrospective measure of growth but not in the case of the prospective measure growth.

CONCLUSIONS

Retrospective measures such as the PTGI do not appear to assess actual pre- to post-HSCT change. HSCT seems more linked to psychological decline than to growth.

The relationship between meaning in life and post-traumatic stress symptoms in US military personnel: A meta-analysis

BACKGROUND

Subjective meaning in life has been theorized to play a critical role in the adjustment to traumatic events. However, its association with post-traumatic stress symptoms has not been quantitatively reviewed.

METHODS

Informed by Park's integrated meaning-making model and evidenced-based psychological treatments for post-traumatic stress disorder, the goals of this meta-analysis were to: (1) to determine the direction and magnitude of the association between meaning in life and post-traumatic stress symptoms; and (2) to examine potential moderators of this association (i.e., age, sex, race, marital status, type of trauma, and meaning in life conceptualization). CINAHL, Embase, PILOT, PsycINFO, PubMed, and Web of Science core collection databases were searched.

RESULTS

A random-effects meta-analysis was conducted on 26 associations (N = 9,751). A significant, moderate, negative relationship was found between meaning in life and post-traumatic stress symptoms (r = -0.41; 95% CI: -0.47 to -0.35, k = 25). No significant moderators were detected.

CONCLUSIONS

Findings suggest that meaning in life plays a crucial role in adjustment to traumatic events. Development and testing of randomized controlled trials to determine whether increases in meaning in life result in reductions of post-traumatic stress in US military personnel may facilitate ongoing efforts aimed at recovery from trauma.

A Mixed Methods Approach of End-of-Life Care, Social Rites, and Bereavement Outcomes: A Transnational Perspective

The current article focused on examining the potential benefits of the End-of-Life (EoL) informal caregiving, communication, and ritualistic behaviors in adaptation to the conjugal bereavement across two different cultural-background contexts: France and Togo, West Africa. The investigation adopted a transnational approach including a total of 235 bereaved spouses. Despite the variation in the length of time since death, no significant difference was found between the Togolese and French bereaved with respect to the level of complicated grief symptoms. However, the Togolese bereaved perceived a significant postloss growth, fostered by EoL communication with the dying and the performance of ritualistic behaviors. In the French sample, bereaved individuals who had experienced more intimate communication with their dying spouse reported a high level of postloss growth. Moreover, findings showed that EoL caregiving without ritualistic support or communication is associated with poor postbereavement outcomes. These findings suggest a clinical need to promote informal caregiving to the dying, communication with the dying, and ritualistic support during the process of dying as entangled components of EoL care.

A qualitative analysis of psychosocial needs and support impacts in families affected by young sudden cardiac death: The role of community and peer support

BACKGROUND

Young sudden cardiac death (YSCD), often occurring in previously healthy individuals, is a tragic event with devastating impact on affected families, who are at heightened risk of posttraumatic stress and prolonged grief and may themselves be at risk of YSCD. Previous research suggests that surviving family members' psychosocial support needs are often unmet.

PURPOSE

This study sought to identify how YSCD-affected families experience dedicated community and peer support in light of their psychosocial support needs.

METHODS

The study used a qualitative design, employing a thematic analysis of focus group and interview data. Three focus groups and five individual interviews were conducted with affected family members (N = 19). The sample was drawn from a UK-based charity, Cardiac Risk in the Young. Audio-recordings of the focus groups and interviews were transcribed and subjected to thematic analysis.

RESULTS

Three super-ordinate themes were identified: 1. YSCD community support as offering a place of safety, 2. YSCD community support as fostering sense-making, 3. YSCD community support as facilitating finding new meaning.

CONCLUSIONS

YSCD-affected families can benefit from access to dedicated community and peer support that offers a safe environment, provides affiliation, understanding and normalisation and enables sense-making and the rebuilding of a sense of self. Dedicated community support can facilitate meaningful re-engagement with life through helping prevent YSCD and through memorialisation and legacy-building to maintain a continuing bond with the deceased. Clinicians need to be aware of the need to incorporate available community and peer support into patient pathways.

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.

Identifying Positive Features of the Sadness Prototype

Sadness, an emotional experience of daily life, is typically associated with negative experiences such as the loss of a loved one. However, sadness also has an adaptive function, as it can help us respond appropriately to environmental demands. While previous research has revealed positive functions of sadness, it is unclear whether laypeople recognize any positive aspects of sadness. In the present three-part study, we aimed to identify whether laypeople conceptualize any positive features of sadness. In Part 1, we asked Japanese participants (n = 122) to describe the features of "sadness," and their responses revealed 37 different sadness features, some of which were assumed to be positive aspects (e.g., meaning making). In Part 2, we asked a second group of Japanese participants (n = 140) to rate the centrality of each previously named feature, and we then classified the features into either central or peripheral sadness features. At this point, participants reported positive aspects of sadness (e.g., co-occurrence of positive emotion). To confirm the differences between central and peripheral features, in Part 3 we examined automatic responses toward these features from a third group of Japanese participants (n = 91) and demonstrated the relationship between the concept of sadness and its characteristic features. We presented these participants with a subset of the features of sadness and then asked them to complete a recall and recognition task. As expected, they recalled central features more often than peripheral features of sadness, and they generated false recognitions to central features. In conclusion, this three-part study indicated that there are positive features related to the function of sadness that laypeople can identify in their mental lexicon.