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Crystal L. Park - One of the best experts on this subject based on the ideXlab platform.
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Religiousness and Meaning making following stressful life events
The Science of Religion Spirituality and Existentialism, 2020Co-Authors: Crystal L. ParkAbstract:Abstract This chapter focuses on the role of religiousness in Meaning making following stressful life events. First, we discuss the components of the Meaning making model, including both Global (broad beliefs and general goals and values) and situational (appraisals of a specific instance) levels of Meaning. Stressful life events occur when people appraise the Meaning of a particular situation (e.g., diagnosis of serious illness) as discrepant with their Global Meaning system (e.g., that God is loving and protective). Discrepancies represent threats to one’s Global Meaning system, which creates distress. Distress, in turn, motivates efforts to reduce discrepancy, a process of Meaning making. Meaning making efforts are often of a religious or spiritual nature and involve changing one’s understood-Meaning of the stressor to assimilate it into one’s Global Meaning system (e.g., appraising it as a test of one’s devotion) or changing one’s Global Meaning system to improve its fit with the specific stressor (e.g., revising one’s image of God). This process of making Meaning can lead to Meaning made, which are changes in either (or both) appraised Meaning of the stressor or changes in one’s beliefs and goals. Meaning making can lead to better adjustment to the stressor when coherence in Meaning systems is restored, but protracted Meaning making efforts can devolve into maladaptive rumination with poor outlooks for physical health and psychological well-being.
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Resilience and Recovery Following Disasters: The Meaning Making Model
Positive Psychological Approaches to Disaster, 2020Co-Authors: Crystal L. Park, Erin C. BlakeAbstract:In this chapter, we use Park’s (Park’s (2010) Meaning making model as a framework for organizing current knowledge of how people recover from disasters, highly stressful events that can severely violate people’s Meaning systems. First, we review the main components of the Meaning making model, then review how both Global Meaning (Global beliefs and goals) and situational Meaning (appraisals, Meaning making and Meanings made) are implicated in recovery following disasters. We highlight the central role that religiousness and spirituality often play in these Meaning-related recovery processes. We conclude with limitations of current research and directions for future research.
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Meaning Violations, Religious/Spiritual Struggles, and Meaning in Life in the Face of Stressful Life Events
International Journal for the Psychology of Religion, 2019Co-Authors: J.e. Appel, Crystal L. Park, Jennifer H. Wortmann, H.t. Van SchieAbstract:Both Meaning violations (i.e., discrepancies between individuals’ Global Meaning system and appraised Meaning of events) and religious/spiritual (r/s) struggles (i.e., spiritual tensions often aris...
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Assessing Disruptions in Meaning: Development of the Global Meaning Violation Scale
Cognitive Therapy and Research, 2016Co-Authors: Crystal L. Park, Kristen E. Riley, Login S. George, Ian A. Gutierrez, Amy E. Hale, Dalnim Cho, Tosca D. BraunAbstract:Models of Meaning making following stressful events are based on the notion that individuals’ appraisals of events (i.e., their situational Meaning) can violate their goals and beliefs (i.e., Global Meaning), and that resulting discrepancies between situational Meaning and Global Meaning negatively affect their psychological adjustment. To date, research has relied primarily on indirect measures of Meaning violation. We describe the development of a new instrument, the Global Meaning Violation Scale (GMVS), for directly assessing belief and goal violations. We establish the psychometric integrity of the GMVS across three studies. In Study 1, we identify and replicate a factor structure consisting of three subscales: belief violation, intrinsic goal violation, and extrinsic goal violation. In Study 2, we provide evidence for the reliability and validity of the GMVS. In Study 3, we test the predictive validity of the GMVS in a sample of undergraduates reporting on the most stressful experiences of their lives. Our findings indicate that the GMVS is a reliable and valid tool for directly examining Global Meaning violation. We anticipate that the GMVS will advance research on stress, trauma, and coping by giving researchers a tool to directly explore the role of violations in Meaning making processes.
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Distinctions to Promote an Integrated Perspective on Meaning: Global Meaning and Meaning-Making Processes
Journal of Constructivist Psychology, 2016Co-Authors: Crystal L. ParkAbstract:This article continues the dialogue begun during the First Congress on the Construction of Personal Meaning by addressing specific questions generated at the Congress. I argue that it is desirable to move toward consensus in understanding existential Meaning, that it is useful to reframe the human “need for Meaning” as the “need for a functional Meaning system,” and that it is important to consider the functionality of individuals’ Meaning systems as determining when and how they may change. I describe a model of Global Meaning as comprising beliefs (cognitions), goals (motivation), and a subjective sense of Meaning (emotion); and Meaning making as aligning one's appraisals of situations with one's Global Meaning. I highlight the unique role that spirituality plays in the Meaning systems of many people. I conclude by strongly encouraging future researchers to develop and use strong measures of Meaning-related constructs. My aim in this article is to help foster consensus and advance the science of human m...
Anja Mehnert - One of the best experts on this subject based on the ideXlab platform.
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sources of Meaning in cancer patients influences on Global Meaning anxiety and depression in a longitudinal study
European Journal of Cancer Care, 2014Co-Authors: Katharina Scheffold, Uwe Koch, Anja Mehnert, Volkmar Müller, Martin Härter, Sigrun VehlingAbstract:Although existential needs are highly prevalent in patients with cancer, specific sources of Meaning have been little explored. We investigated whether specific sources of Meaning predict Global Meaning and psychological distress. N = 258 patients with breast (45%), lung (39%) and gynaecological cancer (16%) completed a battery of validated questionnaires at T1. Six months later (T2), n = 183 (78%) patients participated again. The primary outcomes – sources of Meaning, Global Meaning and psychosocial distress – were measured with the Sources of Meaning Profile-Revised (SOMP-R), Life Attitude Profile-Revised (LAP-R) and modules for depression and anxiety of the Patient Health Questionnaire (PHQ-9, GAD-7). Most important sources of Meaning were ‘engaging in personal relationships’, ‘preserving human values and ideals’ and ‘feeling financially secure’. Stepwise multivariate regression analyses controlling for demographic and medical factors revealed that ‘engaging in personal relationships’, ‘preservation of culture and tradition’ and ‘interest in social and/or political causes’ predicted lower depression. ‘Leaving a legacy for the next generation’ and ‘feeling financially secure’ predicted both higher depression and anxiety. The findings highlight the relevance of sources of Meaning for the psychological well-being of cancer patients and point towards specific sources of Meaning that should be focused in psychosocial interventions.
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Sources of Meaning in cancer patients – influences on Global Meaning, anxiety and depression in a longitudinal study
European Journal of Cancer Care, 2013Co-Authors: Katharina Scheffold, Uwe Koch, Anja Mehnert, Volkmar Müller, Martin Härter, Sigrun VehlingAbstract:Although existential needs are highly prevalent in patients with cancer, specific sources of Meaning have been little explored. We investigated whether specific sources of Meaning predict Global Meaning and psychological distress. N = 258 patients with breast (45%), lung (39%) and gynaecological cancer (16%) completed a battery of validated questionnaires at T1. Six months later (T2), n = 183 (78%) patients participated again. The primary outcomes – sources of Meaning, Global Meaning and psychosocial distress – were measured with the Sources of Meaning Profile-Revised (SOMP-R), Life Attitude Profile-Revised (LAP-R) and modules for depression and anxiety of the Patient Health Questionnaire (PHQ-9, GAD-7). Most important sources of Meaning were ‘engaging in personal relationships’, ‘preserving human values and ideals’ and ‘feeling financially secure’. Stepwise multivariate regression analyses controlling for demographic and medical factors revealed that ‘engaging in personal relationships’, ‘preservation of culture and tradition’ and ‘interest in social and/or political causes’ predicted lower depression. ‘Leaving a legacy for the next generation’ and ‘feeling financially secure’ predicted both higher depression and anxiety. The findings highlight the relevance of sources of Meaning for the psychological well-being of cancer patients and point towards specific sources of Meaning that should be focused in psychosocial interventions.
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is advanced cancer associated with demoralization and lower Global Meaning the role of tumor stage and physical problems in explaining existential distress in cancer patients
Psycho-oncology, 2012Co-Authors: Sigrun Vehling, Claudia Lehmann, Karin Oechsle, Carsten Bokemeyer, Andreas Krull, Uwe Koch, Anja MehnertAbstract:Objective: This longitudinal study examines the extent to which Global Meaning, existential distress in terms of demoralization, and depression are predicted by tumor stage (UICC stages 0–II vs III/IV), palliative treatment, and physical problems in cancer patients. Methods: N = 270 cancer patients were studied at baseline (T1, response rate: 41%) and after 3 months (T2) (N = 178, 72%). The following standardized self-report measures were used: Demoralization Scale, Life Attitude Profile—Revised, Hospital Anxiety and Depression Scale, NCCN DT (physical problems list). Results: Multivariate regression analyses controlling for sociodemographic variables showed the number of physical problems significantly predicting higher demoralization (β = 0.42, p<0.001) and depression (β = 0.34, p<0.001), but not Global Meaning. While palliative treatment intention was related to higher depression (β = 0.21, p = 0.03) and higher demoralization (ns), there was no effect of tumor stage on dependent variables. The hypothesized moderating effect of Global Meaning on the relation between physical problems and depression or demoralization, respectively, was not found. Conclusions: Results indicate a risk of existential distress in cancer patients across all disease stages, possibly due to confrontation with, albeit different, existential stressors throughout the illness. The general protective effect of Global Meaning against distress, independent of the number of physical problems, underscores the notion of existential concerns being relevant to cancer patients more generally, rather than just to a subgroup. However, physical problems might play a central role in the process of becoming demoralized through impairing the sense of mastery and competence. Findings finally strengthen the difference between the concepts of demoralization and Global Meaning. Copyright © 2010 John Wiley & Sons, Ltd.
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Is advanced cancer associated with demoralization and lower Global Meaning? The role of tumor stage and physical problems in explaining existential distress in cancer patients.
Psycho-oncology, 2010Co-Authors: Sigrun Vehling, Claudia Lehmann, Karin Oechsle, Carsten Bokemeyer, Andreas Krull, Uwe Koch, Anja MehnertAbstract:Objective: This longitudinal study examines the extent to which Global Meaning, existential distress in terms of demoralization, and depression are predicted by tumor stage (UICC stages 0–II vs III/IV), palliative treatment, and physical problems in cancer patients. Methods: N = 270 cancer patients were studied at baseline (T1, response rate: 41%) and after 3 months (T2) (N = 178, 72%). The following standardized self-report measures were used: Demoralization Scale, Life Attitude Profile—Revised, Hospital Anxiety and Depression Scale, NCCN DT (physical problems list). Results: Multivariate regression analyses controlling for sociodemographic variables showed the number of physical problems significantly predicting higher demoralization (β = 0.42, p
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Global Meaning and Meaning-related life attitudes: exploring their role in predicting depression, anxiety, and demoralization in cancer patients.
Supportive Care in Cancer, 2010Co-Authors: Sigrun Vehling, Claudia Lehmann, Karin Oechsle, Carsten Bokemeyer, Andreas Krull, Uwe Koch, Anja MehnertAbstract:Goal of work While significance of the concept of Meaning in understanding adaptation to cancer is widely accepted, it has been little studied, especially in longitudinal data. This study aims to clarify the role of Global Meaning and Meaning-related life attitudes (death acceptance and goal seeking) in predicting different aspects of psychological and existential distress by reference to a specified research model.
Joost Dekker - One of the best experts on this subject based on the ideXlab platform.
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Inner posture as aspect of Global Meaning in healthcare: a conceptual analysis
Medicine Health Care and Philosophy, 2018Co-Authors: Elsbeth Littooij, Carlo Leget, Guy Widdershoven, Joost DekkerAbstract:Based on our empirical research on Global Meaning in people with spinal cord injury and people with stroke, we formulated ‘inner posture’ as a concept in rehabilitation. Inner posture, as we concluded from our empirical data, refers to the way in which people bear what cannot be changed. It helps them to live with their injury. Considering that much has already been written about Meaning from a variety of disciplines, the question arises whether the concept of inner posture adds something new to the existing literature, or is just another name for a phenomenon that has already been described before in different terms. In this paper, we aim to investigate this and to clarify our conceptualization, by comparing the concept of inner posture with influential concepts in healthcare literature which seem to be more or less related. In the work of Puchalski regarding spirituality, Pargament regarding religion, Eliott regarding hope and Frankl regarding attitude, we found definitions and descriptions that seemed to come close to the phenomenon we refer to as inner posture. Because these concepts have various theoretical backgrounds, the comparison can help to better understand our concept of inner posture, through a process of dialogue between traditions, following Gadamer’s notion of dialogue as fusion of horizons of understanding. We conclude that inner posture differs from the other concepts in several ways. Some of these differences are more fundamental, other are partial. This suggests that we identified a new perspective on a phenomenon partially described earlier. The comparison also inspired us to slightly adjust our definition and to formulate new research questions.
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Global Meaning and Rehabilitation in People with Stroke
Brain Impairment, 2018Co-Authors: Elsbeth Littooij, Joost Dekker, Judith Vloothuis, Guy Widdershoven, Carlo LegetAbstract:A stroke can have implications for all areas of a person's life. In research on adaptation to stroke, finding Meaning is associated with better adaptation. This study focuses on one of the driving principles behind Meaning-making processes: Global Meaning. The aim of this study was to explore whether Global Meaning (i.e., fundamental beliefs and life goals concerning core values, relationships, worldview, identity and inner posture) is associated with processes and outcomes of rehabilitation, as experienced by people with stroke. In-depth, semi-structured interviews were conducted, and analysed using qualitative research methods. Aspects of Global Meaning were associated with the following elements of process and outcome of rehabilitation: motivation, handling stress and emotions, physical functioning and acceptance. The influence was mostly positive. If rehabilitation professionals took Global Meaning into account, respondents tended to associate this with better or faster recovery.
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Global Meaning in people with stroke: Content and changes.
Health psychology open, 2016Co-Authors: Elsbeth Littooij, Joost Dekker, Judith Vloothuis, Carlo Leget, Guy WiddershovenAbstract:After a traumatic event like a stroke, people need to find Meaning and control again. This study enhances knowledge on one of the driving principles behind Meaning-making processes: Global Meaning. Global Meaning refers to individuals’ general orienting systems, comprising fundamental beliefs and life goals. Little is known about Global Meaning in people with stroke and whether Global Meaning changes after stroke. In this qualitative study, five aspects of Global Meaning were found: core values, relationships, worldview, identity and inner posture. Continuity in all aspects was reported, but worldview, identity and inner posture were also subjected to change.
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The importance of 'Global Meaning' for people rehabilitating from spinal cord injury.
Spinal Cord, 2016Co-Authors: Elsbeth Littooij, Carlo Leget, Guy Widdershoven, Janneke M. Stolwijk-swuste, Suzan Doodeman, Joost DekkerAbstract:STUDY DESIGN Qualitative study. OBJECTIVES To explore whether aspects of Global Meaning (that is, fundamental beliefs and life goals concerning core values, relationships, worldview, identity and inner posture) are associated with processes and outcomes in rehabilitation, as experienced by people with spinal cord injury (SCI). SETTING People living in the community receiving outpatient rehabilitation in a Dutch rehabilitation center. METHODS In-depth semi-structured interviews were conducted with 16 people with SCI. Interviews were analyzed using qualitative research methods: structural and provisional coding. RESULTS Core values, relationships, worldview, identity and inner posture (that is, the way in which people relate to the facts of life) were associated with various processes and outcomes of rehabilitation. Elements of the rehabilitation process included motivation, regulation of emotion, making decisions and handling stress. Elements of the outcome of rehabilitation included physical functioning, emotional functioning, social functioning and subjective sense of Meaning. The influence was positive, with the exception of one case in which worldview and inner posture were negatively associated with motivation. Besides that, respondents emphasized the importance of rehabilitation professionals attuning to their Global Meaning. CONCLUSION All aspects of Global Meaning were positively associated with various processes and outcomes of rehabilitation. It is recommended that rehabilitation professionals are aware of the importance of Global Meaning to people with SCI and that they take people's fundamental beliefs and life goals into account.
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Global Meaning in people with spinal cord injury: Content and changes
Journal of Spinal Cord Medicine, 2016Co-Authors: Elsbeth Littooij, Carlo Leget, Guy Widdershoven, Janneke M. Stolwijk-swuste, Suzan Doodeman, Joost DekkerAbstract:Background: After spinal cord injury (SCI), people are confronted with abrupt discontinuity in almost all areas of life, leading to questions on how to live a Meaningful life again. Global Meaning refers to basic ideas and goals that guide people in giving Meaning to their lives, in specific situations. Little is known about Global Meaning relating to SCI and whether Global Meaning changes after SCI.Purpose: The purpose of this study was twofold: (i) to explore the content of Global Meaning of people with SCI, and (ii) to explore whether or not Global Meaning changes after SCI.Methods: In-depth semi-structured interviews were conducted with 16 people with SCI. Interviews were analyzed according to the method of grounded theory.Results: (i) Five aspects of Global Meaning were found: core values, relationships, worldview, identity and inner posture. (ii) Overall, little change in the content of Global Meaning was found after SCI; specific aspects of Global Meaning were foregrounded after SCI.Conclusion: Fiv...
Elsbeth Littooij - One of the best experts on this subject based on the ideXlab platform.
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Inner posture as aspect of Global Meaning in healthcare: a conceptual analysis
Medicine Health Care and Philosophy, 2018Co-Authors: Elsbeth Littooij, Carlo Leget, Guy Widdershoven, Joost DekkerAbstract:Based on our empirical research on Global Meaning in people with spinal cord injury and people with stroke, we formulated ‘inner posture’ as a concept in rehabilitation. Inner posture, as we concluded from our empirical data, refers to the way in which people bear what cannot be changed. It helps them to live with their injury. Considering that much has already been written about Meaning from a variety of disciplines, the question arises whether the concept of inner posture adds something new to the existing literature, or is just another name for a phenomenon that has already been described before in different terms. In this paper, we aim to investigate this and to clarify our conceptualization, by comparing the concept of inner posture with influential concepts in healthcare literature which seem to be more or less related. In the work of Puchalski regarding spirituality, Pargament regarding religion, Eliott regarding hope and Frankl regarding attitude, we found definitions and descriptions that seemed to come close to the phenomenon we refer to as inner posture. Because these concepts have various theoretical backgrounds, the comparison can help to better understand our concept of inner posture, through a process of dialogue between traditions, following Gadamer’s notion of dialogue as fusion of horizons of understanding. We conclude that inner posture differs from the other concepts in several ways. Some of these differences are more fundamental, other are partial. This suggests that we identified a new perspective on a phenomenon partially described earlier. The comparison also inspired us to slightly adjust our definition and to formulate new research questions.
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Global Meaning and Rehabilitation in People with Stroke
Brain Impairment, 2018Co-Authors: Elsbeth Littooij, Joost Dekker, Judith Vloothuis, Guy Widdershoven, Carlo LegetAbstract:A stroke can have implications for all areas of a person's life. In research on adaptation to stroke, finding Meaning is associated with better adaptation. This study focuses on one of the driving principles behind Meaning-making processes: Global Meaning. The aim of this study was to explore whether Global Meaning (i.e., fundamental beliefs and life goals concerning core values, relationships, worldview, identity and inner posture) is associated with processes and outcomes of rehabilitation, as experienced by people with stroke. In-depth, semi-structured interviews were conducted, and analysed using qualitative research methods. Aspects of Global Meaning were associated with the following elements of process and outcome of rehabilitation: motivation, handling stress and emotions, physical functioning and acceptance. The influence was mostly positive. If rehabilitation professionals took Global Meaning into account, respondents tended to associate this with better or faster recovery.
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Global Meaning in people with stroke: Content and changes.
Health psychology open, 2016Co-Authors: Elsbeth Littooij, Joost Dekker, Judith Vloothuis, Carlo Leget, Guy WiddershovenAbstract:After a traumatic event like a stroke, people need to find Meaning and control again. This study enhances knowledge on one of the driving principles behind Meaning-making processes: Global Meaning. Global Meaning refers to individuals’ general orienting systems, comprising fundamental beliefs and life goals. Little is known about Global Meaning in people with stroke and whether Global Meaning changes after stroke. In this qualitative study, five aspects of Global Meaning were found: core values, relationships, worldview, identity and inner posture. Continuity in all aspects was reported, but worldview, identity and inner posture were also subjected to change.
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The importance of 'Global Meaning' for people rehabilitating from spinal cord injury.
Spinal Cord, 2016Co-Authors: Elsbeth Littooij, Carlo Leget, Guy Widdershoven, Janneke M. Stolwijk-swuste, Suzan Doodeman, Joost DekkerAbstract:STUDY DESIGN Qualitative study. OBJECTIVES To explore whether aspects of Global Meaning (that is, fundamental beliefs and life goals concerning core values, relationships, worldview, identity and inner posture) are associated with processes and outcomes in rehabilitation, as experienced by people with spinal cord injury (SCI). SETTING People living in the community receiving outpatient rehabilitation in a Dutch rehabilitation center. METHODS In-depth semi-structured interviews were conducted with 16 people with SCI. Interviews were analyzed using qualitative research methods: structural and provisional coding. RESULTS Core values, relationships, worldview, identity and inner posture (that is, the way in which people relate to the facts of life) were associated with various processes and outcomes of rehabilitation. Elements of the rehabilitation process included motivation, regulation of emotion, making decisions and handling stress. Elements of the outcome of rehabilitation included physical functioning, emotional functioning, social functioning and subjective sense of Meaning. The influence was positive, with the exception of one case in which worldview and inner posture were negatively associated with motivation. Besides that, respondents emphasized the importance of rehabilitation professionals attuning to their Global Meaning. CONCLUSION All aspects of Global Meaning were positively associated with various processes and outcomes of rehabilitation. It is recommended that rehabilitation professionals are aware of the importance of Global Meaning to people with SCI and that they take people's fundamental beliefs and life goals into account.
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Global Meaning in people with spinal cord injury: Content and changes
Journal of Spinal Cord Medicine, 2016Co-Authors: Elsbeth Littooij, Carlo Leget, Guy Widdershoven, Janneke M. Stolwijk-swuste, Suzan Doodeman, Joost DekkerAbstract:Background: After spinal cord injury (SCI), people are confronted with abrupt discontinuity in almost all areas of life, leading to questions on how to live a Meaningful life again. Global Meaning refers to basic ideas and goals that guide people in giving Meaning to their lives, in specific situations. Little is known about Global Meaning relating to SCI and whether Global Meaning changes after SCI.Purpose: The purpose of this study was twofold: (i) to explore the content of Global Meaning of people with SCI, and (ii) to explore whether or not Global Meaning changes after SCI.Methods: In-depth semi-structured interviews were conducted with 16 people with SCI. Interviews were analyzed according to the method of grounded theory.Results: (i) Five aspects of Global Meaning were found: core values, relationships, worldview, identity and inner posture. (ii) Overall, little change in the content of Global Meaning was found after SCI; specific aspects of Global Meaning were foregrounded after SCI.Conclusion: Fiv...
Sigrun Vehling - One of the best experts on this subject based on the ideXlab platform.
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sources of Meaning in cancer patients influences on Global Meaning anxiety and depression in a longitudinal study
European Journal of Cancer Care, 2014Co-Authors: Katharina Scheffold, Uwe Koch, Anja Mehnert, Volkmar Müller, Martin Härter, Sigrun VehlingAbstract:Although existential needs are highly prevalent in patients with cancer, specific sources of Meaning have been little explored. We investigated whether specific sources of Meaning predict Global Meaning and psychological distress. N = 258 patients with breast (45%), lung (39%) and gynaecological cancer (16%) completed a battery of validated questionnaires at T1. Six months later (T2), n = 183 (78%) patients participated again. The primary outcomes – sources of Meaning, Global Meaning and psychosocial distress – were measured with the Sources of Meaning Profile-Revised (SOMP-R), Life Attitude Profile-Revised (LAP-R) and modules for depression and anxiety of the Patient Health Questionnaire (PHQ-9, GAD-7). Most important sources of Meaning were ‘engaging in personal relationships’, ‘preserving human values and ideals’ and ‘feeling financially secure’. Stepwise multivariate regression analyses controlling for demographic and medical factors revealed that ‘engaging in personal relationships’, ‘preservation of culture and tradition’ and ‘interest in social and/or political causes’ predicted lower depression. ‘Leaving a legacy for the next generation’ and ‘feeling financially secure’ predicted both higher depression and anxiety. The findings highlight the relevance of sources of Meaning for the psychological well-being of cancer patients and point towards specific sources of Meaning that should be focused in psychosocial interventions.
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Sources of Meaning in cancer patients – influences on Global Meaning, anxiety and depression in a longitudinal study
European Journal of Cancer Care, 2013Co-Authors: Katharina Scheffold, Uwe Koch, Anja Mehnert, Volkmar Müller, Martin Härter, Sigrun VehlingAbstract:Although existential needs are highly prevalent in patients with cancer, specific sources of Meaning have been little explored. We investigated whether specific sources of Meaning predict Global Meaning and psychological distress. N = 258 patients with breast (45%), lung (39%) and gynaecological cancer (16%) completed a battery of validated questionnaires at T1. Six months later (T2), n = 183 (78%) patients participated again. The primary outcomes – sources of Meaning, Global Meaning and psychosocial distress – were measured with the Sources of Meaning Profile-Revised (SOMP-R), Life Attitude Profile-Revised (LAP-R) and modules for depression and anxiety of the Patient Health Questionnaire (PHQ-9, GAD-7). Most important sources of Meaning were ‘engaging in personal relationships’, ‘preserving human values and ideals’ and ‘feeling financially secure’. Stepwise multivariate regression analyses controlling for demographic and medical factors revealed that ‘engaging in personal relationships’, ‘preservation of culture and tradition’ and ‘interest in social and/or political causes’ predicted lower depression. ‘Leaving a legacy for the next generation’ and ‘feeling financially secure’ predicted both higher depression and anxiety. The findings highlight the relevance of sources of Meaning for the psychological well-being of cancer patients and point towards specific sources of Meaning that should be focused in psychosocial interventions.
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is advanced cancer associated with demoralization and lower Global Meaning the role of tumor stage and physical problems in explaining existential distress in cancer patients
Psycho-oncology, 2012Co-Authors: Sigrun Vehling, Claudia Lehmann, Karin Oechsle, Carsten Bokemeyer, Andreas Krull, Uwe Koch, Anja MehnertAbstract:Objective: This longitudinal study examines the extent to which Global Meaning, existential distress in terms of demoralization, and depression are predicted by tumor stage (UICC stages 0–II vs III/IV), palliative treatment, and physical problems in cancer patients. Methods: N = 270 cancer patients were studied at baseline (T1, response rate: 41%) and after 3 months (T2) (N = 178, 72%). The following standardized self-report measures were used: Demoralization Scale, Life Attitude Profile—Revised, Hospital Anxiety and Depression Scale, NCCN DT (physical problems list). Results: Multivariate regression analyses controlling for sociodemographic variables showed the number of physical problems significantly predicting higher demoralization (β = 0.42, p<0.001) and depression (β = 0.34, p<0.001), but not Global Meaning. While palliative treatment intention was related to higher depression (β = 0.21, p = 0.03) and higher demoralization (ns), there was no effect of tumor stage on dependent variables. The hypothesized moderating effect of Global Meaning on the relation between physical problems and depression or demoralization, respectively, was not found. Conclusions: Results indicate a risk of existential distress in cancer patients across all disease stages, possibly due to confrontation with, albeit different, existential stressors throughout the illness. The general protective effect of Global Meaning against distress, independent of the number of physical problems, underscores the notion of existential concerns being relevant to cancer patients more generally, rather than just to a subgroup. However, physical problems might play a central role in the process of becoming demoralized through impairing the sense of mastery and competence. Findings finally strengthen the difference between the concepts of demoralization and Global Meaning. Copyright © 2010 John Wiley & Sons, Ltd.
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Is advanced cancer associated with demoralization and lower Global Meaning? The role of tumor stage and physical problems in explaining existential distress in cancer patients.
Psycho-oncology, 2010Co-Authors: Sigrun Vehling, Claudia Lehmann, Karin Oechsle, Carsten Bokemeyer, Andreas Krull, Uwe Koch, Anja MehnertAbstract:Objective: This longitudinal study examines the extent to which Global Meaning, existential distress in terms of demoralization, and depression are predicted by tumor stage (UICC stages 0–II vs III/IV), palliative treatment, and physical problems in cancer patients. Methods: N = 270 cancer patients were studied at baseline (T1, response rate: 41%) and after 3 months (T2) (N = 178, 72%). The following standardized self-report measures were used: Demoralization Scale, Life Attitude Profile—Revised, Hospital Anxiety and Depression Scale, NCCN DT (physical problems list). Results: Multivariate regression analyses controlling for sociodemographic variables showed the number of physical problems significantly predicting higher demoralization (β = 0.42, p
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Global Meaning and Meaning-related life attitudes: exploring their role in predicting depression, anxiety, and demoralization in cancer patients.
Supportive Care in Cancer, 2010Co-Authors: Sigrun Vehling, Claudia Lehmann, Karin Oechsle, Carsten Bokemeyer, Andreas Krull, Uwe Koch, Anja MehnertAbstract:Goal of work While significance of the concept of Meaning in understanding adaptation to cancer is widely accepted, it has been little studied, especially in longitudinal data. This study aims to clarify the role of Global Meaning and Meaning-related life attitudes (death acceptance and goal seeking) in predicting different aspects of psychological and existential distress by reference to a specified research model.