Searching for and finding meaning in collective trauma: Results from a national longitudinal study of the 9/11 terrorist attacks.

The ability to make sense of events in one's life has held a central role in theories of adaptation to adversity. However, there are few rigorous studies on the role of meaning in adjustment, and those that have been conducted have focused predominantly on direct personal trauma. The authors examined the predictors and long-term consequences of Americans' searching for and finding meaning in a widespread cultural upheaval-the terrorist attacks of September 11, 2001-among a national probability sample of U.S. adults (N = 931). Searching for meaning at 2 months post-9/11 was predicted by demographics and high acute stress response. In contrast, finding meaning was predicted primarily by demographics and specific early coping strategies. Whereas searching for meaning predicted greater posttraumatic stress (PTS) symptoms across the following 2 years, finding meaning predicted lower PTS symptoms, even after controlling for pre-9/11 mental health, exposure to 9/11, and acute stress response. Mediation analyses suggest that finding meaning supported adjustment by reducing fears of future terrorism. Results highlight the role of meaning in adjustment following collective traumas that shatter people's fundamental assumptions about security and invulnerability. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Religion's role in adjustment to a negative life event: Coping with the loss of a child.

Parents (N?=?124) who had lost an infant to sudden infant death syndrome were interviewed 3 wks and 18 mo postloss. Two components of religion (religious participation and religious importance) were assessed, and their relations with 3 coping-process variables (perceived social support, cognitive processing of the loss, and finding meaning in the death) were examined. Greater religious participation was related to increased perception of social support and greater meaning found in the loss. Importance of religion was positively related to cognitive processing and finding meaning in the death. Furthermore, through these coping-process variables, religious participation and importance were indirectly related to greater well-being and less distress among parents 18 mo after their infants' deaths. Results suggest that further study of the social and cognitive aspects of religion would be profitable. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Finding meaning, perceiving growth, and acceptance of tinnitus.

Objectives: The authors test hypotheses derived from current models of growth following adversity in a sample of people with tinnitus. These models assume a process whereby adversity or trauma threatens major assumptions, which, in turn, promotes a search for meaning in the adversity and subsequently growth. Method: Data from a sample of 315 people with tinnitus who completed an online survey were used to assess the relations of reports of negative changes to asking "Why me?" and answering the Why me? question with reports of growth, acceptance, and well-being. Results: indicate that reports of negative changes in goals and philosophy of life predict a search for meaning and that finding meaning is associated with perceived growth. Those who report never searching for meaning are less likely to report growth but report better adjustment and acceptance of their tinnitus than those who have searched for meaning. Discussion: The data are consistent with models of growth that give a central role to meaning-making processes, but they also suggest that a significant minority of people with tinnitus do not report searching for meaning or perceiving growth--yet appear to be coping well. Acceptance of tinnitus is identified as a key construct for future research. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Benefit finding, affective reactions to diabetes stress, and diabetes management among early adolescents.

Objective: To examine whether benefit finding was associated with better adjustment among adolescents with diabetes by buffering negative affective reactions to diabetes stress and by promoting positive affective reactions. Design: Early adolescents aged 10–14 with Type 1 diabetes (n = 252) described recent diabetes stressors, affective reactions, and perceived coping effectiveness. They also completed measures of benefit finding, depressive symptoms, and adherence. Metabolic control (i.e., HbA1c) was obtained from medical records. Main Outcome Measures: The main outcome measures were perceived coping effectiveness, depressive symptoms, adherence, and HbA1c. Results: Benefit finding was associated with lower depressive symptoms, higher perceived coping effectiveness and better adherence, and with higher positive as well as negative affective reactions to diabetes stress. Benefit finding interacted with negative affective reactions to predict depressive symptoms and HbA1c. Negative affective reactions to stress were associated with poorer adjustment among those with low benefit finding, but were unrelated or more weakly related to poor adjustment among those with high benefit finding. Positive affective reactions did not mediate associations between benefit finding and any outcome. Conclusions: Consistent with a stress-buffering process, benefit finding may be a resource that buffers the disruptive aspects of negative affective reactions to stress for adolescents' diabetes management. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

The relation of continuing attachment to adjustment in conjugal bereavement.

The role of continuing attachment in adjustment to conjugal loss was examined. At 6 months postloss, 70 midlife bereaved participants were interviewed to assess different forms of continuing attachment. They also engaged in a monologue role-play with their deceased spouse, providing a behavioral measure of grief-related distress. In addition, they completed general and grief-specific symptom inventories at 6 months and again at 14 and 25 months postloss. The results indicated that use of the deceased's possessions to gain comfort was positively correlated with concurrent distress in the role-play and predictive of less of a decrease in grief-specific symptoms over time in a growth curve analysis. In contrast, attachment through fond memories was related to less distress in the role-play. The results, therefore, suggest that whether continuing attachment is adaptive or not depends on its form. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Positive Aspects of Caregiving and Adaptation to Bereavement.

This study examined how positive aspects of caregiving affect adaptation to bereavement among older adults who cared for a family member with dementia. The sample consisted of 217 caregivers who were part of the Resources for Enhancing Alzheimer's Caregiver Health Study. Using pre- and postloss data, hierarchical regressions were carried out to examine the effects of positive aspects of caregiving (caregiving benefit) on postloss depression and grief. Findings show that preloss caregiving benefit was associated with higher levels of postloss depression and grief, even after controlling for caregiver demographic characteristics, contextual factors, and caregiving burden. This effect was particularly strong for the relation between benefit and grief. Results demonstrate the importance of studying both positive and negative aspects of caregiving and their relation to bereavement outcomes. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

When distress does not become depression: Emotion context sensitivity and adjustment to bereavement.

Recent evidence suggests that the sensitivity of emotion responses to changing context may be a key element of psychological adjustment and psychopathology (Bonanno et al., 2007; Rottenberg, Kasch, Gross, & Gotlib, 2002). However, there have been no previous investigations to examine emotion context sensitivity and adjustment following stressful life events. This investigation addressed this deficit in a sample of middle-aged bereaved adults (N = 48) whose emotion responses were measured as they described loss and non-loss-related events during a laboratory interview 4 months after the death of their spouse or child. Symptoms of depression were assessed using structured clinical interviews at 4 and 18 months postloss. Although positive emotions were beneficial regardless of context, context sensitivity for negative emotions at 4 months predicted fewer depression symptoms at 18 months. These findings suggest that the capacity to shift negative emotion responses according to changing context may differentiate those individuals who will show improvements in depression symptoms over time from those who will show chronic impairments. Implications for future research and clinical intervention are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Cognitive processing, discovery of meaning, CD4 decline, and AIDS-related mortality among bereaved HIV-seropositive men

This study investigated whether finding meaning in response to an HIV-related stressor was associated with changes in immune status and health. Forty HIV-seropositive men who had recently experienced an AIDS-related bereavement completed interviews assessing cognitive processing and finding meaning after the loss and provided blood samples for a 2- to 3-year follow-up. AIDS-related mortality over an extended follow-up was determined from death certificates. As predicted, men who engaged in cognitive processing were more likely to find meaning from the loss. Furthermore, men who found meaning showed less rapid declines in CD4 T cell levels and lower rates of AIDS-related mortality (all ps < .05), independent of health status at baseline, health behaviors, and other potential confounds. These results suggest that positive responses to stressful events, specifically the discovery of meaning, may be linked to positive immunologic and health outcomes.     

The past makes the present meaningful: Nostalgia as an existential resource.

The present research tested the proposition that nostalgia serves an existential function by bolstering a sense of meaning in life. Study 1 found that nostalgia was positively associated with a sense of meaning in life. Study 2 experimentally demonstrated that nostalgia increases a sense of meaning in life. In both studies, the link between nostalgia and increased meaning in life was mediated by feelings of social connectedness. Study 3 evidenced that threatened meaning increases nostalgia. Study 4 illustrated that nostalgia, in turn, reduces defensiveness following a meaning threat. Finally, Studies 5 and 6 showed that nostalgia disrupts the link between meaning deficits and compromised psychological well-being. Collectively, these findings indicate that the provision of existential meaning is a pivotal function of nostalgia. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Meaning making and psychological adjustment following cancer: The mediating roles of growth, life meaning, and restored just-world beliefs.

Cancer survivors' efforts at meaning making may influence the extent to which they successfully make meaning from their experience (i.e., experience posttraumatic growth, find life meaningful, and restore beliefs in a just world), which may, in turn, influence their psychological adjustment. Previous research regarding both meaning making processes and meanings made as determinants of adjustment has shown inconsistent effects, partly because of the lack of clearly articulated theoretical frameworks and problematic research strategies. In a 1-year longitudinal study, the authors distinguished the meaning making process from the outcomes of that process (meanings made), employing specific measures of both. The authors tested pathways through which meaning making efforts led to 3 different meanings made (growth, life meaning, and restored just-world belief) in a sample of 172 young to middle-age adult cancer survivors, and they explored whether those meanings made mediated the effect of meaning making efforts on psychological adjustment. Cross-sectional and longitudinal path models of the meaning making process indicate that meaning making efforts are related to better adjustment through the successful creation of adaptive meanings made from the cancer experience. The authors conclude with clinical implications and suggestions for future research. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Continuing bonds and adjustment at 5 years after the death of a spouse.

Thirty-nine bereaved individuals completed the Continuing Bonds Scale (CBS), assessing various aspects of the ongoing attachment to the deceased, at 60 months postloss in a longitudinal conjugal bereavement study. They also completed symptom measures at 6, 14, 25, and 60 months postloss. Higher CBS scores were associated with a more elevated grief-specific symptom pattern over the 5-year postloss period. Moreover, those who expressed greater helplessness and less blame toward the deceased during a monologue role-play involving their deceased spouse at 6 months postloss had higher CBS scores. Finally, greater satisfaction in the past relationship with the spouse was predictive of higher CBS scores. The results were discussed in relation to existing literature on the adaptiveness of continuing bonds. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Well-being following amputation: Salutary effects of positive meaning, optimism, and control.

Examined the salutary effects of finding positive meaning in a disabling experience, being an optimist, and perceiving control over disability on 2 criterion variables of psychological well-being: depression and self-esteem. A mail-in survey on psychosocial adjustment to limb amputation was completed by 138 persons (aged 19–78.6 yrs) with amputations. Regression analyses revealed that finding meaning following amputation was linked to lower levels of depressive symptomatology but not to self-esteem. Both dispositional optimism and perceived control over disability were predictive of lower scores on the Center for Epidemiological Studies Depression Scale and higher scores on the Rosenberg Self-Esteem Scale. Implications for rehabilitation are discussed, and it is recommended that future research consider salutary effects from a reality negotiation perspective. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Goal instability and adjustment to physical disability.

Few studies have examined psychoanalytic constructs in the adjustment of individuals who incur physical disability. According to H. Kohut (1977), optimal adjustment during life transitions is contingent on the individual's capacity for maintaining and pursuing meaningful goals, which reflects a stable sense of self. A series of studies was conducted to determine if goal instability would predict adjustment and health following disability. Goal instability was predictive at depressive behavior and acceptance of disability among individuals with recent-onset disability. Goal instability predicted subjective well-being 1 year later. Among community residents with a disability, goal instability was associated with life satisfaction; this relationship was not mediated by perceived stigma or community mobility. These findings indicate that a flexible yet durable goal orientation is associated with optimal psychological adjustment among individuals with a physical disability. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Reconsidering the attribution-adjustment relation following a major negative event: Coping with the loss of a child.

Field studies have not yet conclusively established how attributions affect adjustment to unanticipated traumatic events. This may be due, in part, to the adoption of several untested assumptions in most prior research. It has usually been assumed that attributional issues are important to people who experience a traumatic event, that such concern is adaptive, and that specific attributions (e.g., self-blame) influence subsequent adjustment. These assumptions were tested with longitudinal data collected over 18 mo from 124 parents whose children died of Sudden Infant Death Syndrome. By 3 wks postloss, 45% of parents were not concerned with attributional issues. These parents were less distressed and less likely to blame themselves or others for the death. Longitudinal analyses did not support the assumption that attributions influence subsequent adjustment. Rather, attributions to oneself or others appear to be symptomatic of distress. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Regret resolution, aging, and adapting to loss.

Both theory and empirical evidence suggest that people who have unresolved regrets experience lower levels of well-being than do those who resolve their regrets. In this study, the authors examined the role of regret resolution during bereavement by assessing whether (a) regret resolution would aid in adapting to the death of a loved one and (b) older adults would be more successful at resolving their bereavement-related regrets than would younger adults. Mixed models were run with longitudinal data from an age-heterogeneous sample of 147 men and women who were eventually bereaved after providing care for a loved one through a hospice. As expected, regret resolution contributed to adjustment as indicated by postloss patterns of depressive symptoms, well-being, and rumination; further, older adults were more likely to resolve their regrets than were younger adults. Implications for encouraging regret resolution early in bereavement are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Factorial validity of the Texas Revised Inventory of Grief—Present scale among bereaved older adults.

The Texas Revised Inventory of Grief—Present scale (TRIG–Present) is one of the most widely used grief measures; however, researchers have only empirically examined the validity and underlying factor structure of TRIG–Present scores in a few studies. Hence, in the present investigation, we sought to examine the factorial validity of the TRIG–Present (those scores that index current grief) among 2 samples of bereaved older adults—a community-dwelling sample of 162 individuals who experienced a diverse set of losses in terms of relationship to the deceased and time since loss, and a recently widowed sample of 212 individuals who were assessed at 2-months and 12-months postloss. Across both samples, we found support for a 3-factor model, composed of clusters of items representing Emotional Response, Thoughts, and Nonacceptance regarding a loss. Additionally, this 3-factor model exhibited significant invariance from 2-months to 12-months postloss in the recently widowed sample. Analyses examining the convergent validity of these 3 factors also suggest that this conceptualization of the TRIG–Present could have practical advantages and potentially influence the way in which clinicians and/or researchers assess grief and evaluate bereavement interventions. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Couples at Risk Following the Death of Their Child: Predictors of Grief Versus Depression.

This longitudinal study examined the relative impact of major variables for predicting adjustment (in terms of both grief and depression) among bereaved parents following the death of their child. Couples (N = 219) participated 6, 13, and 20 months postloss. Use of multilevel regression analyses enabled assessment of the impact of several predictors and facilitated analysis of factors that were either shared by parents or individual. Grief was predicted mainly by shared parent factors: child's age, cause and unexpectedness of death, and number of remaining children. By contrast, depression was predicted by individual parent factors: gender, religious affiliation, and professional help seeking. Theoretical implications of these findings are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychological well-being after spinal cord injury: Perception of loss and meaning making.

Objective: This study examined the influence of medical injury severity, perceived loss of physical functioning (conceptualized as physical resource loss), and global meaning making on psychological well-being among 79 veterans living with a spinal cord injury. Measures: Structured interviews were completed to assess perceived loss of physical abilities using the Conservation of Resources—Evaluation and SF-36 Health Survey, global meaning making (Purpose in Life scale), and psychological well-being (Sense of Well-Being Inventory). Medical injury severity was calculated from medical records. Results: Medical injury severity was not related to psychological well-being, whereas perceived loss of physical functioning was inversely associated. Global meaning making was significantly related to and accounted for a large portion of the variance in psychological well-being. Results suggest that global meaning making partially mediates perceived loss of physical resources and psychological well-being. Conclusion: The perceived loss of physical abilities and the generation of meaning and purpose in life are important variables that relate to positive adaptation following spinal cord injury. Treatment implications related to factors that increase quality of life following spinal cord injury are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Grandparents' psychological well-being after loss of contact with their grandchildren.

This study examined how loss of contact with grandchildren due to parental separation or divorce, family feud, or a sudden event, such as relocation, affected the emotional well-being of grandparents (N = 442). Using data from the Longitudinal Study of Generations, the depressive symptoms of grandparents were tracked over 15 years. Growth curve analysis was used to compare grandparents who had lost contact with their grandchildren with those who had not and to examine preloss to postloss change in depressive symptoms. Grandparents who lost contact with their grandchildren experienced a steeper increase in depressive symptoms as they aged compared with other grandparents. Depressive symptoms of grandparents who lost contact because of a sudden event increased up to 3 years following the loss but returned to equilibrium thereafter. The authors conclude that grandparents who lost contact with their grandchildren experienced a negative impact on their emotional health. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Strategies used in coping with a cancer diagnosis predict meaning in life for survivors.

The search for meaning in life is part of the human experience. A negative life event may threaten perceptions about meaning in life, such as the benevolence of the world and one's sense of harmony and peace. The authors examined the longitudinal relationship between women's coping with a diagnosis of breast cancer and their self-reported meaning in life 2 years later. Multiple regression analyses revealed that positive strategies for coping predicted significant variance in the sense of meaning in life--feelings of inner peace, satisfaction with one's current life and the future, and spirituality and faith--and the absence of such strategies predicted reports of loss of meaning and confusion (ps