Loss of Meaning as a Predictor of Distress in Prison

Religion and Rehabilitation as Moral Reform: Conceptualization and Preliminary Evidence

We examine how religion contributes to rehabilitation, which we conceptualize as moral reform and operationalize in terms of self-identity, existential belief, and character. We hypothesize that religion contributes to identity transformation, a sense of meaning and purpose in life, and virtue development. We also hypothesize that faith-based rehabilitation reduces negative emotions and the risk of interpersonal aggression. We conducted a quasi-experiment on a faith-based program in a state jail and a maximum-security prison in Texas, using a convenience sample of male inmates. To test our hypotheses, we compare inmates who graduated the program with those who did not and applied manifest-variable structural equation modeling to analyze data from pretest and posttest surveys. Program participation was linked to an increase in religiosity, which contributed to identity transformation (cognitive and emotional transformations and crystallization of discontent), the perceived presence of meaning and purpose in life, and virtues (including self-control, compassion, and forgiveness). Faith-based rehabilitation in turn reduced state depression and anxiety and the probability of engaging in aggression toward another inmate. This study provides preliminary evidence of religion's rehabilitative effect on offenders; findings which hold promise for prison administrators looking for creative ways to support evidence-based and cost-effective approaches to rehabilitation within the correctional system.

Supplementary Information

The online version contains supplementary material available at 10.1007/s12103-022-09707-3.

Mental state of demoralisation across diverse clinical settings: A systematic review, meta-analysis and proposal for its use as a 'specifier' in mental illness

OBJECTIVE

Demoralisation is a state of poor coping characterised by low morale, hopelessness, subjective incompetence, and loss of meaning and purpose in life. While studied extensively in oncology and palliative care, there has been recent exploration in broader medical and mental health settings. The aim was to investigate the prevalence of demoralisation and associated sociodemographic and psychological factors across these clinical settings.

METHOD

Six electronic databases were used to locate articles from January 2014 to March 2020. A pre-publication update of non-oncology populations was completed in September 2021. The review has been reported following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Pooled prevalence of demoralisation was determined through % prevalence and mean demoralisation score; this was synthesised through meta-analysis of single means to determine pooled mean prevalence of Demoralisation Scale scores using the 'R' statistical software.

RESULTS

Demoralisation has been examined in 52 studies (n = 11,670) and found to be prevalent in 24-35% of oncology and non-oncology, including mental health, populations. The mean score on the Demoralisation Scale was 24.3 (95% confidence interval, CI = [21.3, 27.3]). There was evidence of divergent validity in addition to significant comorbidity between depression, demoralisation and suicidal ideation. Burdensome physical symptoms, and psychological and demographic factors are strongly correlated with demoralisation.

CONCLUSION

There remains a need to recognise demoralisation in various clinical and cultural settings and to strongly consider its inclusion as a 'specifier' within formal nosological systems for adjustment and depressive disorders. This is important to initiate targeted interventions and prevent significant morbidity.

Depression and Suicidal Behaviors Among HIV-Infected Inmates in Lesotho: Prevalence, Associated Factors and a Moderated Mediation Model

Depression and suicidal behaviors are two common psychiatric problems observed among people living with HIV. The situation is worse among HIV-infected inmates. The present study aimed to assess the prevalence and associated factors of depression and suicidal behaviors among HIV-infected inmates, and to clarify the mechanisms underlying the impact of HIV-related stigma on suicidal behaviors. The data from 402 HIV-infected inmates in Lesotho showed the prevalence of depression and suicidal behaviors was 53.0% and 8.2%. Female and institution maladaptation were risk factors for depression, and the risk factor for suicidal behaviors was non-participation of institution activities. Moreover, HIV-related stigma indirectly increased inmates' suicidal behaviors through elevated depression. Such indirect effect was stronger for inmates with a lower level of meaning in life. These findings indicate more concern should be given to high-risk subgroups, and both depression and meaning in life are intervention targets for suicide prevention among HIV-infected inmates.

Some Molecular and Cellular Stress Mechanisms Associated with Neurodegenerative Diseases and Atherosclerosis

Chronic stress is a combination of nonspecific adaptive reactions of the body to the influence of various adverse stress factors which disrupt its homeostasis, and it is also a corresponding state of the organism's nervous system (or the body in general). We hypothesized that chronic stress may be one of the causes occurence of several molecular and cellular types of stress. We analyzed literary sources and considered most of these types of stress in our review article. We examined genes and mutations of nuclear and mitochondrial genomes and also molecular variants which lead to various types of stress. The end result of chronic stress can be metabolic disturbance in humans and animals, leading to accumulation of reactive oxygen species (ROS), oxidative stress, energy deficiency in cells (due to a decrease in ATP synthesis) and mitochondrial dysfunction. These changes can last for the lifetime and lead to severe pathologies, including neurodegenerative diseases and atherosclerosis. The analysis of literature allowed us to conclude that under the influence of chronic stress, metabolism in the human body can be disrupted, mutations of the mitochondrial and nuclear genome and dysfunction of cells and their compartments can occur. As a result of these processes, oxidative, genotoxic, and cellular stress can occur. Therefore, chronic stress can be one of the causes forthe occurrence and development of neurodegenerative diseases and atherosclerosis. In particular, chronic stress can play a large role in the occurrence and development of oxidative, genotoxic, and cellular types of stress.

Six-Month Emergency Department Use among Older Adults Following Jail Incarceration

Although the number of older adults who are arrested and subject to incarceration in jail is rising dramatically, little is known about their emergency department (ED) use or the factors associated with that use. This lack of knowledge impairs the ability to design evidence-based approaches to care that would meet the needs of this population. This 6-month longitudinal study aimed to determine the frequency of 6-month ED use among 101 adults aged 55 or older enrolled while in jail and to identify factors associated with that use. The primary outcome was self-reported emergency department use within 6 months from baseline. Additional measures included baseline socio-demographics, physical and mental health conditions, geriatric factors (e.g., recent falls, incontinence, functional impairment, concern about post-release safety), symptoms (pain and other symptoms), and behavioral and social health risk factors (e.g., substance use disorders, recent homelessness). Chi-square tests were used to identify baseline factors associated with ED use over 6 months. Participants (average age 60) reported high rates of multimorbidity (61%), functional impairment (57%), pain (52%), serious mental illness (44%), recent homelessness (54%), and/or substance use disorders (69%). At 6 months, 46% had visited the ED at least once; 21% visited multiple times. Factors associated with ED use included multimorbidity (p = 0.01), functional impairment (p = 0.02), hepatitis C infection (p = 0.01), a recent fall (p = 0.03), pain (p < 0.001), loneliness (p = 0.04), and safety concerns (p = 0.01). In this population of older adults in a county jail, geriatric conditions and distressing symptoms were common and associated with 6-month community ED use. Jail is an important setting to develop geriatric care paradigms aimed at addressing comorbid medical, functional, and behavioral health needs and symptomatology in an effort to improve care and decrease ED use in the growing population of criminal justice-involved older adults.

The Relation Between a Sense of Meaning in Life and Suicide Potential Among Disadvantaged Adolescent Girls

The study examines the influence of the sense of meaning in life, or its absence, on the suicide potential of disadvantaged adolescent girls in Israel who reside in boarding school ( n = 50) compared with adolescent girls in a rehabilitation project ( n = 31), and between them and normative adolescent girls ( n = 128). The research findings indicate a negative relation between meaning in life and suicide potential, which exists only among the normative adolescent girls and the disadvantaged adolescent girls residing in the boarding school. This relation does not exist among the disadvantaged adolescent girls in the rehabilitation project. The explanation for this unusual finding is, apparently, the early stage of rehabilitation at which the adolescent girls are found. In conclusion, this study joins previous studies that propose prevention, intervention, and therapy programs based on increasing adolescent (disadvantaged and not disadvantaged) strength factors by finding meaning to their lives.