A Meta-Analytic Review of Interventions That Promote Meaning in Life

Meaning in Life as a Potential Protective Factor for Tobacco Abstinence Among Adult Rural Residents: A Pilot Study in Alabama

U.S. rural counties have been shown to demonstrate higher rates of tobacco use, however, there is limited understanding concerning protective factors that may decrease the likelihood of tobacco use in these settings. The increased presence of the sense that one's life is meaningful has been found to be associated with engagement in health behaviors, including refraining from tobacco use. However, comprehensive population-based assessments are required to examine the association between meaning in life and tobacco abstinence. This is especially pertinent among sub-populations that are underrepresented in research, including Black and White rural residents. The purpose of this study was to examine if increased meaning in life would be associated with current tobacco abstinence among residents of rural Alabama. A population-based in-person survey was administered to 268 adults representing all census tracts within a rural Alabama county. Participants were provided a comprehensive list of tobacco products with product photos and queried about use, including use within the previous 30 days. Meaning in life was measured using the 10-item Meaning in Life Questionnaire. Increased meaning in life was associated with a greater likelihood of current abstinence from tobacco products while controlling for multiple demographic variables including sex, age, race, and educational attainment. This study identified meaning in life as a potential protective factor against current tobacco use that may generalize beyond rural settings. This finding has relevant research and public health implications within rural settings, providing preliminary evidence that this understudied construct may play an important role in protecting rural residents from engagement in an addictive behavior. Further research is needed to elucidate mechanisms that may underlie the protective capacity of meaning in life to inform interventions to boost this construct.

Purpose in life and lung function: an individual-participant meta-analysis of six cohort studies

BACKGROUND

Purpose in life is a psychological resource associated with better health outcomes across adulthood. It is unknown whether it is related to lung function, a key marker of health and longevity. We evaluate the replicability and generalizability of the cross-sectional association between purpose in life and lung function and whether purpose in life is associated with lower risk of developing poor lung function over time.

METHODS

Participants were from six cohort studies with public data: Health and Retirement Study, Midlife in the United States study, Wisconsin Longitudinal Study, National Health and Aging Trends Study, English Longitudinal Study of Ageing, and Survey of Health, Ageing and Retirement in Europe (total N = 85,190). Participants reported on their purpose in life, and staff measured their peak expiratory flow with either a peak flow meter or a spirometer. Four cohorts (N = 11,595) had longitudinal assessments of lung function over up to 12 years. Linear regression was used to test the cross-sectional association between purpose and continuous lung function. Cox regression was used to test the association between purpose and risk of developing predicted lung function < 80% over time, a dichotomous outcome that categorized lung function into performance less than 80% of predicted function (= 1) and at least 80% of predicted function (= 0).

RESULTS

In each cohort and aggregated in a random-effects meta-analysis, higher purpose in life was associated with better peak expiratory flow (meta-analytic effect = 0.07, p <.001). The association was generally similar across sociodemographic groups (e.g., age, sex). Every standard deviation higher purpose in life was associated with a 10% reduced risk of developing poor lung function over time (meta-analytic hazard ratio = 0.91, 95% confidence interval = 0.88, 0.94, p <.001). These associations were attenuated but remained significant accounting for behavioral and clinical risk factors.

CONCLUSIONS

Purpose in life is associated with healthier lung function, with evidence of replicability and generalizability, and with lower risk of developing poor lung function over time. Lung function may be one mechanism between purpose in life and healthier outcomes in older adulthood.

CLINICAL TRIAL NUMBER

Not applicable.

Down the Digital Rabbit Hole: Objectification Increases Problematic Gaming

Objectification, being perceived and treated merely as an object with a denial of one's humanness, has been linked to numerous adverse outcomes in daily life. Despite this, its influence on online behaviors, particularly problematic gaming, remains underexplored. The current research (total N = 1,000) extends the literature on objectification by investigating the effect of objectification on problematic gaming. Study 1, with a correlational design (N = 300), established a significant association between objectification and problematic gaming. Subsequent experimental studies (Studies 2 and 3) demonstrated that objectification directly contributes to increased problematic gaming intentions. Study 2, with a measurement-of-mediation design (N = 300), also identified escapism as a mediating factor, suggesting that objectification intensifies the motive to escape from reality, thereby increasing problematic gaming intentions. Furthermore, Study 3, with a moderation design (N = 400), revealed that perceived meaning in life could mitigate the negative impact of objectification on problematic gaming intentions. Collectively, these findings advance our understanding of the detrimental effects of objectification, highlighting its role in problematic gaming and identifying the potential intervention.

The Role of Resilience Portfolios in Overcoming Trauma

This special issue offers a series of papers that use the resilience portfolio model (RPM) to explore multidimensional, strength-based approaches to resilience in a wide variety of communities. The field is urgently in need of research that helps identify the factors that help people thrive despite exposure to violence and other trauma. We need to know how people typically overcome victimization and other adverse experiences if we are going to improve intervention and minimize the global burden of trauma. The series of papers in this issue consider resilience portfolios across geographic locations, forms of violence and trauma, communities, and age groups. In this introduction, we synthesize key themes in four RPM domains: meaning making, regulatory, interpersonal, and environmental. We use these themes to describe a revised RPM and implications for future research and practices.

Meaning in life: bidirectional relationship with depression, anxiety, and loneliness in a longitudinal cohort of older primary care patients with multimorbidity

BACKGROUND

Depression, anxiety and loneliness are common among older patients. As a potential psychological buffer against these challenges, meaning in life (MIL) remains underexplored in longitudinal studies within this population. This study aims to examine the longitudinal relationship of MIL with depression, anxiety, and loneliness among older adults with multimorbidity in Hong Kong.

METHODS

In a prospective cohort of 1077 primary care patients aged 60 or above with multimorbidity in Hong Kong, MIL was assessed using an item from the Chinese Purpose in Life test at baseline, the 1st follow-up (median: 1.3 years), and the 2nd follow-up (median: 3.1 years). Depression, anxiety, and loneliness were assessed using the Patient Health Questionnaire, Generalized Anxiety Disorder, and De Jong Gierveld Loneliness scales, respectively, at each time point. Cross-lagged relationships between MIL and these measures were examined using cross-lagged panel models.

RESULTS

Participants had an average age of 70.0 years, with 70.1% being female. Higher MIL predicted lower depression (β = -0.15), anxiety (β = -0.13), overall loneliness (β = -0.18), emotional loneliness (β = -0.15), and social loneliness (β = -0.16) at the 1st follow-up. Additionally, higher MIL predicted lower overall loneliness (β = -0.12), emotional loneliness (β = -0.11), and social loneliness (β = -0.10) at the 2nd follow-up. At baseline, higher depression (β = -0.21), overall loneliness (β = -0.15), emotional loneliness (β = -0.11), and social loneliness (β = -0.11), but not anxiety, predicted lower MIL at the 1st follow-up. At the 1st follow-up, depression (β = -0.23), anxiety (β = -0.16), overall loneliness (β = -0.10), and emotional loneliness (β = -0.11), but not social loneliness, predicted lower MIL at the 2nd follow-up.

CONCLUSIONS

The findings suggest a bidirectional relationship between MIL and mental health outcomes in older patients with multimorbidity in Hong Kong. Emotional loneliness demonstrated a more consistent bidirectional association with MIL than social loneliness. Further research is needed to understand the underlying mechanisms and develop targeted interventions addressing both MIL and mental health problems.

Purpose in Life After Brain Injury: Expanding the Focus and Impact of Interdisciplinary Rehabilitation

PURPOSE

Traumatic brain injury (TBI) is a life-altering event that can abruptly and drastically derail an individual's expected life trajectory. While some adults who have sustained a TBI go on to make a full recovery, many live with persisting disability many years postinjury. Helping patients adjust to and flourish with disability that may persist should be as much a part of rehabilitative practice as addressing impairment, activity, and participation-level changes after TBI. Living with a sense of purpose in daily life has been shown to provide numerous health and psychological benefits in the general population, especially in the face of major life transitions. In this article, we argue that rehabilitative professionals across disciplines can fruitfully leverage the construct of purpose in life to lend structure, meaning, and intrinsic motivation to TBI rehabilitation and to the recrafting of lives in the aftermath of unexpected change.

METHOD

We provide a narrative review of the literature relevant to recovery and long-term well-being after TBI and of the role of purpose in daily life in promoting well-being in the general population. We then outline avenues for, and potential benefits of, incorporating a focus on purpose in life into TBI rehabilitation and discuss future directions in purpose-in-life rehabilitation research.

CONCLUSION

We propose that an overarching rehabilitative focus on purpose in daily life could improve well-being after TBI by grounding therapeutic services in a construct that meaningfully connects traditional rehabilitation targets to patients' broader lives, while concurrently addressing injury-related purpose disruption, in order to promote flourishing after brain injury irrespective of a person's degree of functional recovery.

Meaning in life and neurobiomarkers of brain health in the UK Biobank

This study examines meaning in life and four neurobiomarkers implicated in dementia risk: amyloid-β 42 to 40 ratio, phosphorylated tau-181, neurofilament light, and glial fibrillary acidic protein. Adults without dementia (N = 1150; Mage = 59.89) from the UK Biobank reported their meaning in life; neurobiomarkers were assayed twice. Meaning in life was unrelated to the biomarkers at either assessment (βs range -0.03-0.02). No association was moderated by age. These findings do not support the hypothesis that meaning in life is associated with neurobiomarkers in adults without dementia. The relation between meaning and cognition may be through other pathways, such as resilience to neuropathology.

Happiness in US military veterans: Results from a nationally representative study

In line with the US Department of Veterans Affairs' adoption of a Whole Health approach to healthcare, there has been growing interest in factors linked to veterans' perceptions of well-being. To date, no known study has examined levels and correlates of perceived happiness in this population. To examine this question, we analyzed data from the National Health and Resilience in Veterans Study, which surveyed a nationally representative sample of 4,069 US military veterans. Overall, veterans reported mean happiness scores of 5.41 out of 7. Greater purpose in life was the strongest correlate of happiness, followed by lower severity of depressive symptoms, and higher optimism, emotional stability, and resilience. Among veterans who screened positive for depression, those who scored higher on measures of optimism, emotional stability, and resilience reported greater happiness. Interventions to leverage these modifiable psychosocial characteristics may help promote happiness and subjective well-being in this population.

Exploring meaning in life as a potential target for early intervention - results from a randomized trauma analogue study

Background: Previous studies in individuals exposed to stressors, including traumatic ones, have shown inverse relations between life meaning and distress. Furthermore, meaning-related treatments can benefit (traumatic) stressor-exposed individuals. However, the evidence regarding the effect of life meaning interventions on PTSD symptoms is limited. Moreover, early post-stressor interventions preventing distress are needed. This study investigated the effects of a short, online life meaning intervention after an analogue traumatic stressor on intrusions and anxiety following the intervention, intrusions over a week, and explored distress and life meaning differences after a week.Method: Following an analogue traumatic stressor (i.e. an aversive film), N = 237 participants were randomized to a life meaning intervention, an active or inactive control condition. Participants completed questionnaires in the laboratory, in an online seven-day diary, and at one-week follow-up.Results: The intervention resulted in significantly lower post-intervention state anxiety and higher life meaning, but not significantly less severe wait-period intrusions than the control conditions. Intrusions in the subsequent week as well as depression, anxiety, PTSD, and life meaning after a week did not significantly differ between the conditions.Conclusion: This intervention showed promising temporary effects on anxiety and life meaning after a trauma analogue, but no significant longer-term effects and no effects on PTSD symptoms including intrusions. Meaning-related interventions for PTSD target stressor-related meaning-making rather than life meaning. Thus, future studies may benefit from implementing more intense interventions to extend effects on general distress, as well as stressor-addressing meaning interventions to elicit stressor-related meaning-making.

Resilient Responses to Victimization and Other Trauma: Positive Emotion Regulation and Other Understudied Psychosocial Strengths

Although many psychosocial strengths have been explored, there remains a need to identify under-appreciated strengths that help people overcome trauma. The objective of this study was to explore the resilience potential of 16 psychosocial strengths-including 4 understudied strengths (positive emotion regulation, self-reliance, relational motivation, and group connectedness)-for helping people overcome trauma. The understudied strengths were identified in previous qualitative work as salient in the southeastern communities where the study took place. The sample was comprised of 357 adults recruited from community events in Tennessee. Their average age was 37.6 years (SD 15.6), and the sample was 65.8% female. They completed a survey with measures of 16 psychosocial strengths, polyvictimization, and a range of outcomes. Blockwise logistic regressions were conducted using subjective well-being and trauma symptoms as the outcome. Results indicated that positive emotion regulation was the best predictor of positive functioning after experiencing trauma. Polystrengths (an indicator of the breadth of a person's resilience portfolios), a sense of purpose, and social support received were also associated with better functioning after controlling for polyvictimization, other adversities, and demographics. In multivariate analyses, religious meaning-making and relational motivation were unexpectedly associated with worse outcomes. Most studies of emotion regulation only explore the regulation of negative emotions, such as distress and anger, but the capacity to regulate positive emotions shows promise for helping people overcome trauma. The support for polystrengths, despite mixed findings for some strengths, points to the urgent need to identify the most helpful elements of resilience portfolios.

Effect of Meaning-in-Life Interventions for Advanced Cancer Patients: A Systematic Review and Meta-Analysis

This study aimed to explore the effects of meaning-in-life intervention on meaning in life, quality of life, spiritual well-being, anxiety, and depression in advanced cancer patients. Databases, including Ovid Medline, Cochrane, PsycINFO, CINAHL, and Embase, were searched to identify relevant randomized controlled trials based on predefined criteria. Seven studies were included. Meta-analysis was performed for five studies, involving 718 patients with advanced cancer. The meta-analysis revealed no significant effects of the meaning-in-life intervention on spiritual well-being, depression, and anxiety of advanced cancer patients. The insufficient number of studies and risk of bias limit the strength of the conclusions. Therefore, further studies with larger sample sizes and methodologically rigorous designs are required to evaluate the effects of meaning-in-life interventions for advanced cancer patients. Our findings can support a better understanding of the need to study meaning-in-life interventions in advanced cancer patients and foster sustained attention to recognize meaning-in-life interventions as an effective method in healthcare.

Well-being domains in U.S. military veterans: identifying modifiable factors to promote whole health

The U.S. Department of Veterans Affairs is actively transitioning away from a disease-centric model of healthcare to one that prioritizes disease prevention and the promotion of overall health and well-being. Described as Whole Health, this initiative aims to provide personalized, values-centered care that optimizes physical, behavioral, spiritual, and socioeconomic well-being. To inform this initiative, we analyzed cross-sectional data from a nationally representative sample of primarily older U.S. military veterans to estimate levels of well-being across these domains, and identify sociodemographic, military, and potentially modifiable health and psychosocial correlates of them. Results revealed that, overall, veterans reported high domain-specific well-being (average scores ranging from 6.7 to 8.3 out of 10), with the highest levels in the socioeconomic domain and lowest in the physical domain. Several modifiable factors, including purpose in life, resilience, and social support, were strongly associated with the examined well-being domains. Interventions targeting these constructs may help promote well-being among U.S. veterans.

The Relationship between Meaning in Life and Mental Health in Chinese Undergraduates: The Mediating Roles of Self-Esteem and Interpersonal Trust

To explore the association and the underlying process between meaning in life and psychological health, a stratified random sampling was conducted on undergraduate students from five universities in Fujian Province from March to April 2022, with the Meaning in Life Questionnaire, the Self-Esteem Scale, the Interpersonal Trust Scale, and the Kessler10 Scale. The results indicated that 34.5% of Chinese undergraduates were in poor or worse mental health. There were significant positive correlations among meaning in life, self-esteem, and interpersonal trust; meaning in life, self-esteem, and interpersonal trust were all significantly and positively correlated with mental health. Self-esteem and interpersonal trust played a chain mediating role between meaning in life and mental health. Schools and families should conduct appropriate activities to help them enhance meaning in life so as to improve the level of mental health.

Exploring Resilience and Post-traumatic Growth Among Bereaved Adults in Kosovo

The study explores resilience and posttraumatic growth in adults in Kosovo who have experienced grief, using the Resilience Portfolio Model as a guiding framework. Twelve participants shared their experiences through semi-structured interviews, aiming to capture detailed personal narratives and insights into coping with loss. Thematic analysis of the data revealed three main themes: "Reaction to Loss," "Navigating through Loss and Embracing Adaptations," and "Resilience and Posttraumatic Growth." The findings highlight the transformative experiences contributing to personal development and resilience, emphasizing the significant role of cultural dimensions in shaping resilience and posttraumatic growth. The study underscores the importance of considering cultural context in therapeutic approaches to better support individuals in their recovery and growth from experiences of loss.

Caregiver interactions, perceived control, and meaning in life of elderly: the moderating effect of the elderly-to-social worker ratio

BACKGROUND

Meaning in life is a widely accepted aim in promoting psychosocial health in institutional care. However, how caregiver interaction and perceived control impact meaning in life among the elderly remains unclear. This study explores the effect of institutional caregiver interaction, family caregiver interaction, and perceived control on meaning in life among elderly residents in China, and the potential moderating effect of elderly-to-social worker ratio in these associations.

METHODS

Multistage random sampling was used to recruit a sample of 452 elderly residents from 4 elderly care homes in urban China. A structural equation model was used to test the study hypothesis.

RESULTS

Institutional caregiver interaction is positively related to meaning in life, and perceived control among elderly residents has a positive impact on meaning in life. Moreover, the elderly-to-social worker ratio moderated the relationship between institutional caregiver interaction and meaning in life, as well as between family caregiver interaction and meaning in life.

CONCLUSIONS

Increase elderly's meaning in life is an important service target for the caring professions in institutional care. Social workers affect the effectiveness of interventions on elderly's meaning in life in institutional care. A higher elderly-to-social worker ratio could improve the effectiveness of interventions on meaning in life for elderly residents.

The effects of loving-kindness meditation on doctors' communication anxiety, trust, calling and defensive medicine practice

OBJECTIVE

The study investigated the effects of loving-kindness meditation (LKM) on doctors' communication anxiety, trust, calling, and defensive medicine practice.

METHODS

This study recruited 94 doctors from a hospital in China, randomized them to an LKM group (n = 47), and waited for the control group (n = 47). The experimental group accepted an 8-week LKM interference while the waiting for the control group underwent no interference. Researchers measured four major variable factors (communication anxiety, trust, calling, and defensive medicine practice) before and after the LKM intervention.

RESULTS

In the experimental group, trust, and calling were significantly higher, and communication anxiety, and defensive medicine practice were significantly lower than in the control group. In the control group, there were no noticeable differences in any of the four variables between the pre-test and post-test.

CONCLUSIONS

The results of this study demonstrate that LKM may help to improve trust, and calling, and reduce communication anxiety and defensive medicine practice. The finding of LKM's effect extends the understanding of the integrative effects of positive psychology on the decrease of defensive medicine practice.

TRIAL REGISTRATION

ChiCTR2300074568. Registered in Chinese Clinical Trial Registry (ChiCTR), 9 August, 2023.

Longitudinal processes among humility, social justice activism, transcendence, and well-being

Introduction

Existing research shows positive associations between humility and well-being, and between civic engagement and well-being. Rarely have humility, civic engagement, and well-being been examined together. We build off of previous cross-sectional findings and a prior longitudinal study that used three waves of data and found significant positive bivariate correlations between humility and the presence of life purpose across time points.

Methods

Extending these previous findings, we used six waves of data obtained from graduate students at 18 seminaries across North America (N = 574; Mage = 31.54; 46.7% female; 65.3% White) to explore the dynamic associations among humility and life purpose, along with horizontal transcendence (an indicator of the attitudinal dimension of civic engagement) and social justice activism (an indicator for the behavioral dimension). We explored reciprocal short-run processes and dynamic long-run effects using a general cross-lagged panel model.

Results and discussion

We found robust evidence for a reciprocal influence between the presence of life purpose and horizontal transcendence, and long-run effects for initial levels of life purpose to influence later levels of horizontal transcendence. We also found long-run effects for the influence of initial levels of life purpose on later levels of humility, and initial levels of social justice activism on later levels of horizontal transcendence. Implications center on the use of the findings for planning future one-time life purpose and social justice interventions to affect changes in humility and horizontal transcendence.

"Meaning in Life" Mediates the Relationship between Loneliness and Depressive Symptoms among Older Adults during the COVID-19 Pandemic

BACKGROUND

Loneliness was found to be a commonly experienced feeling among older adults during the COVID-19 pandemic and is considered to be a high-risk factor for depressive symptoms. Maintaining meaning in life has been found to be a protective resource for mental health among older adults. The purpose of this study was to examine the mediating effects of an individual's meaning in life in the relationship between loneliness and depressive symptoms among older Korean adults.

METHODS

The data were obtained from a sample of 213 community-dwelling older adults aged over 65. The instruments were the UCLA Loneliness Scale, the Center for Epidemiologic Studies Depression Scale, and the Meaning in Life Questionnaire.

RESULTS

Loneliness was positively associated with depressive symptoms and negatively associated with the presence of and search for meaning among older adults. The presence of meaning mediated the relationship between loneliness and depressive symptoms but the search for meaning did not. The search for meaning mediated the relationship between loneliness and depressive symptoms through the presence of meaning.

CONCLUSIONS

Our study findings suggest that efforts to reduce loneliness and improve meaning in life should be undertaken to prevent depressive symptoms among older adults.

Exploring strengths, psychological functioning and youth victimization among American Indians and Alaska Natives in four southern states

BACKGROUND

Identifying factors that support healthy psychological functioning after experiencing violence or other adversities in youth can lead to better prevention and intervention efforts. This is particularly important among communities with disproportionately high rates of adversity resulting from legacies of social and political injustices, such as American Indian and Alaska Native populations.

METHODS

Data were pooled from four studies in the southern U.S. to examine a subsample of American Indian/Alaska Native participants (N = 147; mean age 28.54 years, SD = 16.3). Using the resilience portfolio model, we investigate the impact of three categories of psychosocial strengths (regulatory, meaning making, and interpersonal) on psychological functioning (subjective well-being and trauma symptoms), controlling for youth victimization, lifetime adversities, age, and gender.

RESULTS

In examining subjective well-being, the full model accounted for 52 % of the variance, with strengths explaining more variance than adversities (45 % vs 6 %). For trauma symptoms, the full model accounted for 28 % of the variance, with strengths and adversities accounting nearly equally for the variance (14 % and 13 %).

DISCUSSION

Psychological endurance and sense of purpose showed the most promise for bolstering subjective well-being while poly-strengths (having a diversity of multiple strengths) was most predictive of fewer trauma symptoms. Building psychosocial strengths offers promising strategies for prevention and intervention in Native nations and communities.

Well-Being of US Military Veterans

This survey study analyzed data from a nationally representative sample of US veterans to examine ratings and correlates of well-being.

Healthy Eating as Potential Mediator of Inverse Association between Purpose in Life and Waist Circumference: Emerging Evidence from US and Chilean Cohorts

High sense of purpose in life, a fundamental domain of eudaimonic well-being, has been consistently associated with lower risk for various obesity-related chronic diseases. Although this psychological feature correlates with some health behaviors as potential mediators, its association with healthy eating remains less explored. In addition, studies of these psycho-behavioral and health relationships in the South American population are lacking. This research sought to assess: (1) the cross-sectional association between self-reported purpose in life and overall healthy eating patterns, and (2) healthy food intake as a potential mediator of the inverse relationship between purpose in life and waist circumference. Data collected of 2060 US adults from the MIDUS study (5 ± 12 years, 55% women, mostly white people, and 42.5% obese) and 223 Chilean adults from the CHILEMED study (46.6 ± 9 years, 58.3% women, and 71.3% obese) were used. Anthropometric and sociodemographic variables were collected. Sense of purpose was assessed using the purpose in life subscale of the Ryff's psychological well-being questionnaire. Diet quality was evaluated using healthy eating or low-fat diet indexes, according to extant food intake data in each cohort. The relationship between these variables was estimated by bivariate and multivariate linear regressions with appropriate adjustments. To establish whether a better diet quality could mediate a link of purpose in life and improved nutritional status (assessed by waist circumference), the association between these three variables was tested by bootstrapping-based mediation analysis. Our results show significant associations of sense of purpose with healthy eating and low-fat dietary patterns in both US and Chilean cohorts, respectively, even after adjusting for sociodemographic variables. According to the mediation analysis, the relationship between sense of purpose and waist circumference, as an indicator of abdominal obesity, appears to be partially mediated by healthier food intake in both samples. In conclusion, our findings suggest a plausible mechanism underlying the favorable impact of this well-being dimension on physical health. Given its protective effects, interventions aimed at increasing purpose in life may facilitate adherence to better dietary patterns, which, in turn, will reduce the risk for obesity-related chronic diseases.

Resilience After Trauma in Kosovo and Southeastern Europe: A Scoping Review

Most people who experience trauma want to thrive and often find paths to well-being and healthy functioning. This scoping review explores the existing evidence on adversity and resilience in southeastern European countries, focusing on Kosovo. There is a lack of research on trauma and resilience in cultures outside the US and Western Europe. The paper provides a brief cultural and historical overview of this region and the collectivist cultures found there. We draw from a range of interdisciplinary literatures to identify key strengths that have the potential to improve health outcomes for trauma victims in this region. Overall, 42 papers from PsycInfo and PubMed were identified, using keywords such as "resilience" or "health" and "Kosovo," "Balkans," and "Southeastern Europe." Findings from this scoping review show that different cultural values, norms, and societal ecologies impact resilience within these societies. Some strengths, such as social support and sense of purpose, echoed similar research in the US and Western Europe. There was also evidence that factors such as dignity, family solidarity, social activism, and nationwide meaning-making are strengths associated with resilience for these collectivist societies of southeastern Europe. We also consider the implications of the results for other post-conflict societies. Finally, findings from this review call for culturally sensitive strength-based perspectives in promoting health and well-being after the high dosages of trauma common in this region.

Does childhood psychological maltreatment encourage you to become a cyberbullying perpetrator? The mediating role of negative affect and the moderating role of meaning in life

Objective

With the development of information and communication technology, cyberbullying among Chinese college students has become more frequent, bringing many negative consequences to both society and students themselves. Childhood psychological maltreatment may be one of the influencing factors of cyberbullying, but its internal mechanism remains poorly understood. This study aimed to explore the relationship between childhood psychological maltreatment and cyberbullying among college students and to further explore the mediating effect of negative emotion and the moderating effect of meaning in life.

Methods

In this study, 656 college students (48.7% males) were recruited to complete anonymous questionnaires assessing their perceptions of child psychological maltreatment, negative affect, meaning in life and cyberbullying. SPSS23.0 and Hayes PROCESS macro for SPSS were used to conduct statistical analysis.

Results

(1) Childhood psychological maltreatment was significantly positively associated with cyberbullying; (2) Negative affect played a partially mediating role between childhood psychological maltreatment and cyberbullying; and (3) Meaning in life moderated the direct association between childhood psychological maltreatment and cyberbullying and moderated the association between negative affect and cyberbullying.

Conclusion

In this study, a moderated mediation model was constructed and the internal mechanism of childhood psychological maltreatment and cyberbullying among college students was found. The results provided both theoretical contributions and practical suggestions for preventing cyberbullying.

Longitudinal Trends in Suicidal Thoughts and Behaviors Among US Military Veterans During the COVID-19 Pandemic

Importance

Concerns have been raised since the onset of the COVID-19 pandemic that vulnerable populations, such as military veterans, may be at increased risk of suicidal thoughts and behaviors (STBs).

Objective

To examine longitudinal trends in STBs in US military veterans during the first 3 years of the COVID-19 pandemic.

Design, Setting, and Participants

This cohort study is a population-based longitudinal study including US military veterans that used 3 surveys from the National Health and Resilience in Veterans Study. Median dates of data collection were November 21, 2019 (prepandemic); November 14, 2020; and August 18, 2022.

Main Outcomes and Measures

Lifetime and past-year suicidal ideation, suicide planning, and suicide attempt.

Results

In this longitudinal study including 2441 veterans (mean [SD] age, 63.2 years [14.0]; 2182 [92.1%] male), past-year suicidal ideation decreased from 9.3% prepandemic (95% CI, 8.2%-10.6%) to 6.8% a year later (95% CI%, 5.8-7.9%) and then slightly increased to 7.7% (95% CI, 6.7%-8.9%) 2 years later. In total, 9 veterans (0.4%) reported attempting suicide at least once during the follow-up period, while 100 (3.8%) developed new-onset suicidal ideation and 28 (1.2%) developed new-onset suicide planning. After adjusting for sociodemographic and military characteristics, factors strongly associated with new-onset suicidal ideation included higher education (odds ratio [OR], 3.27; 95% CI, 1.95-5.46), lifetime substance use disorder (OR, 2.07; 95% CI, 1.23-3.46), prepandemic loneliness (OR, 1.28; 95% CI, 1.09-1.49), and lower prepandemic purpose in life (OR, 0.92; 95% CI, 0.86-0.97). Factors associated with new-onset suicide planning included lifetime substance use disorder (OR, 3.03; 95% CI, 1.22-7.55), higher prepandemic psychiatric distress (OR, 1.52; 95% CI, 1.06-2.18), and lower prepandemic purpose in life (OR, 0.88; 95% CI, 0.81-0.95).

Conclusions and Relevance

Contrary to expectations, the prevalence of STBs did not increase for most US veterans during the COVID-19 pandemic. However, veterans with preexisting loneliness, psychiatric distress, and lower purpose in life were at heightened risk of developing new-onset suicidal ideation and suicide planning during the pandemic. Evidence-based prevention and intervention efforts that target these factors may help mitigate suicide risk in this population.

Meaning in challenging times: Sense of meaning supports wellbeing despite pandemic stresses

The COVID-19 pandemic created stress and trauma for many individuals. Traumatic experiences often trigger reflection on meaning in life, with subsequent growth or despair. This study evaluates the role of meaning in life in buffering stressors in the early stages of the COVID-19 pandemic. The purpose of this study was to determine the extent to which the negative effects of COVID-19 stressors (self-perceived stress, emotional state, and cognitive adaptation to stress in the pandemic) are influenced by meaning in life in the context of the early stages of the pandemic. Further, this study described differences in meaning in life observed across demographic groups. Web-based surveys were completed by 831 Slovenian participants in April of 2020. Demographic data; perceptions of stressors related to lacking necessities, movement restrictions, and concerns at home; meaning in life; perceived overall health status; anxiety; emotional state; and perceived stress were measured. A moderately strong sense of meaning in life (M = 5.0, SD = 0.74, range 1-7) was reported by participants, and meaning in life was associated with enhanced wellbeing (B = 0.06-.28, p < .01). Both direct and indirect relationships were observed between stressors and wellbeing outcomes. The indirect effects of meaning in life were especially prominent in the relationship between stressors related to lacking necessities and concerns at home and outcomes of anxiety, perceived stress, and negative emotions, contributing 13-27% of the total observed effects. Increased meaning in life was observed across older age groups (F(5, 825) = 4.8, p < .001) and for those in partnered relationships (t(829) = -3.397, p <.001). A strong sense of meaning in life was associated with improved well-being, even for individuals who experienced pandemic-related stressors. Public health initiatives and media may help improve resilience to pandemic trauma by emphasizing the collective meaning in challenging situations.

Health-Related Quality of Life among American Indian and Alaska Native People: Exploring Associations with Adversities and Psychosocial Strengths

Identifying psychosocial strengths that support physical health can lead to better pathways to prevention and intervention. Relying on the resilience portfolio model as a conceptual framework, this study explores strengths in three domains (regulation, meaning making, and interpersonal) to identify promising protective factors to support physical health-related quality of life (P-HRQOL), controlling for prior exposure to adversity, age, and gender. This study uses data from four resilience portfolio model studies collected in the southern United States, combined to increase the number of people who identified as American Indian/Alaska Native. The sample included 147 people (M age = 28.5 years; SD = 16.26), of which 57 percent are female. The surveys collected data on adversities (polyvictimization, other adversities, county poverty), psychosocial strengths (psychological endurance, sense of purpose, religious meaning making, compassion, and community support), and P-HRQOL. The full model accounted for 24 percent of the variance in P-HRQOL, with strengths explaining more than twice as much variance as adversities (13 percent versus 6 percent). A sense of purpose showed the most promise for supporting P-HRQOL. Regarding implications, authors recommend exploring a wider range of protective factors that might improve resilience in Native communities. Several evidence-based pathways to meaning making, such as narrative and mindfulness, may improve health outcomes for Native people.

Development of a Three-Stage Strength-Based Meaning Intervention to Promote Mental Health Among Individuals with Physical Disabilities in Disadvantaged Communities: A Randomized Controlled Trial

A three-stage strength-based meaning intervention (SMI) was developed in the present study, and its utility in facilitating the mental health of individuals with physical disabilities in low-income communities was tested. A randomized controlled and single-blind trial was adopted. A total of 50 qualified participants (mean age = 42.12, standard deviation = 8.68; 48% males; 26 for the intervention group, 24 for the control group) completed the pre-intervention test, post-intervention test, and three-month follow-up test. No significant difference was observed between the two groups at pre-intervention assessment . After intervention, the results in terms of strength knowledge, strength use, sense of meaning in life and mental health showed a significant improvement in the intervention group, with the changes maintained over three months except mental health. The differences in mental health between the post-intervention test and the three-month follow-up test were not significant in the intervention group. The results imply that the SMI model is a promising approach in promoting the mental health of individuals with physical disabilities in low-income communities as it promotes improved knowledge and use of strength and sense of meaning in life.

Toward a Unified Framework for Positive Psychology Interventions: Evidence-Based Processes of Change in Coaching, Prevention, and Training

Since 2000, research within positive psychology has exploded, as reflected in dozens of meta-analyses of different interventions and targeted processes, including strength spotting, positive affect, meaning in life, mindfulness, gratitude, hope, and passion. Frequently, researchers treat positive psychology processes of change as distinct from each other and unrelated to processes in clinical psychology. This paper presents a comprehensive framework for positive psychology processes that crosses theoretical orientation, links coherently to clinical psychology and its more dominantly "negative" processes, and supports practitioners in their efforts to personalize positive psychological interventions. We argue that a multi-dimensional and multi-level extended evolutionary approach can organize effective processes of change in psychosocial interventions, by focusing interventions on context-appropriate variation, selection, and retention of processes, arranged in terms of key biopsychosocial dimensions across psychological, biophysiological, and sociocultural levels of analysis. We review widely studied positive psychology constructs and programs and show how this evolutionary approach can readily accommodate them and provide a common language and framework for improving human and community flourishing. We conclude that Interventions should start with the person, not the protocol.

Latinx Undergraduates’ Navigation in the Context of COVID 19 and Racial Injustice

Six self-identified, first generation, Latinx, undergraduates from west coast public institutions were recruited via social media to participate in individual, semi-structured, qualitative interviews about their experiences with COVID-19 and racial injustice during the summer and fall of 2020. Interviews explored challenges and meaning-making around what had been happening in their lives and how they experienced and made sense of those events. Interpretative Phenomenological Analysis (IPA; Smith et al., 2009) was used to identify emergent themes that fell into two main categories: a) Adversities and b) Ways of Overcoming. Several subthemes also emerged in each category and will be discussed. Emergent themes indicated various ways of facing the adversities, including reliance on family and friends and highlighting the need for further resources for these students during this time. Limitations and future directions, as well as implications for counseling psychology researchers, educators, and practitioners are discussed.

Narrative messages, information seeking and COVID-19 vaccine intention: The moderating role of perceived behavioral control

Purpose

The main purposes of the current study are to examine 1) the influence of narrative vs statistics messages on COVID-19 related information seeking and COVID-19 vaccine intention and 2) the moderating role of perceived behavioral control (PBC).

Design

Data for a between-subject randomized experiment were collected online. The manipulation messages were presented as screenshots from the CDC’s Facebook page.

Setting

The participants were recruited from Amazon MTurk.

Subjects

A total of 300 subjects participated in the study, who were 18 years and above (M = 38.40).

Measures

Intention to seek information, COVID-19 vaccine intention, and PBC.

Analysis

To test the hypotheses, we utilized Hayes’s (2014) PROCESS for SPSS (Model 1). For intention to seek information, the main effect of the message manipulation (narrative vs statistics) [b = −2.10, t (300) = −4.14, P < .001] and the interaction [b = .41, t (300) = 3.88, P < .001] were significant. For vaccine intention, the main effects of message manipulation [b = 1.64, t (300) = −2.61, P < .005] and the interaction [b = .34, t (300) = 2.64, P < .005] were significant.

Results

Our research found that narrative messages were more persuasive for both information seeking and vaccine intention. But this was true only in the case of individuals whose PBC was low.

Conclusions

Our findings have critical implications for vaccine promotion research.

Meaning in Life Buffers the Association between Perceived Burdensomeness, Thwarted Belongingness, and Frequency of Non-Suicidal Self-Injuries in Spanish Adolescents

BACKGROUND

Adolescence is a developmental stage when there is a high risk of engaging in non-suicidal self-injury (NSSI). There is recent interest in the study of thwarted belongingness and perceived burdensome as variables associated with the frequency of NSSI in adolescents. Meaning in life (MIL) might be negatively associated with thwarted belongingness and perceived burdensomeness. To date, no studies have analyzed the buffering role of MIL in the association between thwarted belongingness and perceived burdensomeness and the frequency of lifetime NSSI in Spanish adolescents.

AIMS

(a) To test whether thwarted belongingness and perceived burdensomeness are associated with frequency of lifetime NSSI; (b) to test whether MIL moderates the association between thwarted belongingness and frequency of lifetime NSSI; and (c) to test whether MIL moderates the association between perceived burdensomeness and frequency of lifetime NSSI.

METHOD

The sample consisted of N = 1531 participants (n = 736, 48.1%, were men, and n = 795, 51.9%, were women) between 12 and 18 years old from Spain. The participants filled out the Inventory of Statements about Self-Injury, Purpose-In-Life Test-Adolescent Version, and Interpersonal Needs Questionnaire. Moderation analyses were performed.

RESULTS

No statistically significant differences were found in the frequency of lifetime NSSI in the adolescents based on gender. Thwarted belongingness and perceived burdensomeness were positively associated with the frequency of lifetime NSSI in Spanish adolescents. MIL was a moderating variable between thwarted belongingness and the frequency of lifetime NSSI, and between perceived burdensomeness and the frequency of lifetime NSSI.

CONCLUSIONS

Thwarted belongingness and perceived burdensomeness might be positively associated with the frequency of lifetime NSSI, and MIL might be negatively associated with the frequency of lifetime NSSI. Thus, adding these variables to current descriptive theories of NSSI in adolescents would allow us to improve assessment and treatment protocols for adolescents with NSSI.