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Does Recognition of Meaning in Life Confer Resiliency to Suicide Ideation Among Community-Residing Older Adults? A Longitudinal Investigation
Abstract
Objective:
To test a theoretical model of the onset and/or exacerbation of late-life suicide ideation, incorporating consideration of risk, resiliency, and precipitating factors.
Design:
A longitudinal study investigating whether recognition of meaning in life (MIL) at baseline confers resiliency to the onset and/or exacerbation of suicide ideation over a 6- to 22-month period of follow-up, controlling for baseline depression, self-rated health, and physical functioning, and for frequency and intensity of intervening daily hassles.
Setting:
Mental health research offices in an urban academic health sciences center.
Participants:
173 community-residing older adults (mean: 73.9 years, SD: 6.1 years, range: 65-93 years) recruited from health, wellness, and interest programs, and from newspaper ads and flyers posted in London, Ontario, a mid-sized Canadian city. A total of 126 (73%) completed follow-up assessments.
Measurements:
Participants completed a demographics form, a cognitive screen, and measures of suicide ideation and of risk (depressive symptom severity, self-rated health problems, and physical functioning) and potential resiliency (recognition of MIL) factors at baseline and follow-up assessment points, and a measure of intervening daily hassles.
Results:
MIL at baseline was negatively associated with the onset and/or exacerbation of suicide ideation over time, controlling for risk factors and intervening precipitating factors. The extent and relative significance of this finding differed with the manner in which MIL and suicide ideation were operationalized.
Conclusions:
Study findings add to a growing body of knowledge suggesting that MIL may play an important role in promoting mental health and well-being and potentially conferring resiliency to contemplations of suicide in later life.
... Participants who were 60 years and older were recruited among community-dwelling older adults with the mean age being 70.4 (Cheavens et al., 2016). Similarly to Heisel and Flett (2016), data collection occurred at a university research setting (Cheavens et al., 2016). This cross-sectional study used the terms selfforgiveness and hope to measure resilience, which were incorporated into the model of ITPS as its theoretical framework (Cheavens et al., 2016). ...
... The results reflected suicide ideation being positively associated with depression and with a number of selfreported physical health problems, and negatively with parts of psychological well-being including positive connection with others and acceptance of self, with perceived meaning in life. Heisel and Flett (2016) conducted their study in Canada and examined whether recognizing meaning in life at baseline presents a resiliency to the development of increased suicidal ideation in the span of 6-22 months. All participants were community-dwelling older adults over the age of 65 with the mean age of 73.9 (Heisel & Flett, 2016). ...
... Heisel and Flett (2016) conducted their study in Canada and examined whether recognizing meaning in life at baseline presents a resiliency to the development of increased suicidal ideation in the span of 6-22 months. All participants were community-dwelling older adults over the age of 65 with the mean age of 73.9 (Heisel & Flett, 2016). The study used a longitudinal design and used the Experienced Meaning in Life Scale (Heisel, 2009) to measure meaning in life and Geriatric Suicide Ideation Scale (Heisel & Flett, 2006) to measure suicidal ideation. ...
Nearly 700,000 suicide deaths occur each year. One in every five suicide death occurs among adults over 60 years of age or older. As the aging population increases rapidly, there is a need to understand protective factors to prevent older adult suicide. This study used the rapid review methodology to search literature from 1997 to 2022, examining whether resilience was a protective factor. The literature search was conducted over the following six databases for peer-reviewed journals and gray literature including Abstracts in Social Gerontology, Academic Search Premier, APA PsycInfo, CINAHL Complete, MEDLINE, and SocINDEX with Full Text. A total of six peer-reviewed journal articles met the inclusion criteria. The conclusion of the articles suggested resilience may be a protective factor in older adult suicide. Despite its underpinning, resilience in suicide prevention literature is lacking. More studies should examine resilience and its constructs as part of the effort to prevent older adult suicide.
... In a trial of Interpersonal Psychotherapy (IPT) adapted for suicidal older adults, MIL improved significantly with the reduction or resolution of depression and suicide ideation (Heisel et al., 2015). MIL has been shown to be negatively associated with the presence and severity of suicide ideation (Heisel, Neufeld, & Flett, 2016), to confer resiliency to the onset or exacerbation of suicide ideation in a general community sample of older adults over 1-2-years of follow-up, controlling for depression and daily hassles (Heisel & Flett, 2016a), and to mediate the negative association of Reasons for Living with suicide ideation . Meaning-centered therapeutic interventions have been hypothesized to promote psychological well-being and prevent the onset or reduce the severity of suicide ideation in the face of loss and other difficult life transitions, including retirement (Heisel & Flett, 2016a). ...
... MIL has been shown to be negatively associated with the presence and severity of suicide ideation (Heisel, Neufeld, & Flett, 2016), to confer resiliency to the onset or exacerbation of suicide ideation in a general community sample of older adults over 1-2-years of follow-up, controlling for depression and daily hassles (Heisel & Flett, 2016a), and to mediate the negative association of Reasons for Living with suicide ideation . Meaning-centered therapeutic interventions have been hypothesized to promote psychological well-being and prevent the onset or reduce the severity of suicide ideation in the face of loss and other difficult life transitions, including retirement (Heisel & Flett, 2016a). Our overall study thus aimed to iteratively develop, refine, test, and disseminate MCMG for men concerned about or struggling to transition to retirement. ...
... Physical Functioning was assessed with the 8item Instrumental Activities of Daily Living (IADL; Lawton & Brody, 1988a) and the 6-item Physical Self-Maintenance Scales (PSMS; Lawton & Brody, 1988b), assessing their ability to complete instrumental (e.g., use the phone, shop, prepare food, and handle finances) and basic activities of daily living (e.g., toileting, feeding, ambulating, and grooming). These measures have shown strong psychometric properties with older adults, including associations between IADL scores and suicide ideation (Heisel & Flett, 2016a). IADL scores potentially range from 0 to 24 and scores on the PSMS range from 0 to 24; higher scores reflect higher levels of functional impairment. ...
Objectives: To assess the preliminary effectiveness of Meaning-Centered Men’s Groups (MCMG), a 12-session existentially-oriented, community-based, psychological group intervention designed to enhance psychological resiliency and prevent the onset or exacerbation of suicide ideation among men who are concerned about or struggling with the transition to retirement.
Methods: We recruited 30 men (n= 10 per group), 55 years and older (M= 63.7, SD= 4.1) from community settings to participate in a course of MCMG to be delivered in a community center. Participants completed eligibility, pre-, mid-, and post-group assessments of suicide ideation and psychological risk and resiliency factors.
Results: Participants experienced significant increases in attitudinal sources of meaning in life, psychological well-being, life satisfaction, retirement satisfaction, and general health, and decreases in depression, hopelessness, loneliness, and suicide ideation.
Conclusions: Preliminary findings suggest that MCMG is a novel men’s mental health intervention that may help to enhance psychological well-being and potentially reduce the severity or prevent the onset of symptoms of depression, hopelessness, and suicide ideation.
Clinical Implications: Upstream psychological interventions may serve an important role in mental health promotion and suicide prevention with potentially vulnerable individuals facing challenging life transitions.
... The body of empirical literature on late-life suicide prevention is growing. Yet, few researchers have investigated positive psychological factors that may help reduce suicide vulnerability, despite a growing focus on positive factors in Suicidology (see Hirsch, Rabon, & Chang, 2018), and despite calls for an increased focus on psychological resiliency to suicide thoughts and behavior in later life (e.g., CCSMH, 2006;Heisel & Flett, 2006, 2016a, 2016b. Psychological resiliency has been conceptualized variably as something that one has, such as "hardiness" (e.g., Abdollahi, Talib, Yaacob, & Ismail, 2015); something that one develops, such as "post-traumatic growth" (e.g., Bush, Skopp, McCann, & Luxton, 2011); or something that one uses, such as "grit" (e.g., Kleiman, Adams, Kashdan, & Riskind, 2013) or "emotional intelligence" (e.g., Cha & Nock, 2009), to promote or enhance mental health and well-being. ...
... Considerable research has since been conducted on the RFL construct across demographic groups and clinical settings; a recent systematic review of the literature on RFL and suicide variables has demonstrated strong negative associations between the presence of reasons for living and both suicide ideation and behavior (Bakhiyi, Calati, Guillaume, & Courtet, 2016). Late-life suicide prevention researchers have found that RFLs and other positive psychological factors, including perceptions of meaning and purpose in life, future orientation, psychological well-being, life satisfaction, and perceptions of social support, are negatively associated with the presence of suicide ideation among older adults (e.g., Heisel & Flett, 2006, 2016aHirsch et al., 2006Hirsch et al., , 2007Marty, Segal, & Coolidge, 2010;Purcell et al., 2012;Rowe, Conwell, Schulberg, & Bruce, 2006;Segal, Marty, Meyer, & Coolidge, 2012). In a longitudinal study of the onset or exacerbation of suicide ideation among community-residing older adults, participants who endorsed higher levels of meaning in life were protected against the onset or exacerbation of suicide ideation over a 1-2 year period, controlling for depressive symptom severity and life stressors (Heisel & Flett, 2016a). ...
... Late-life suicide prevention researchers have found that RFLs and other positive psychological factors, including perceptions of meaning and purpose in life, future orientation, psychological well-being, life satisfaction, and perceptions of social support, are negatively associated with the presence of suicide ideation among older adults (e.g., Heisel & Flett, 2006, 2016aHirsch et al., 2006Hirsch et al., , 2007Marty, Segal, & Coolidge, 2010;Purcell et al., 2012;Rowe, Conwell, Schulberg, & Bruce, 2006;Segal, Marty, Meyer, & Coolidge, 2012). In a longitudinal study of the onset or exacerbation of suicide ideation among community-residing older adults, participants who endorsed higher levels of meaning in life were protected against the onset or exacerbation of suicide ideation over a 1-2 year period, controlling for depressive symptom severity and life stressors (Heisel & Flett, 2016a). Meaning in life additionally mediated the association between RFL and suicide ideation (Heisel, Neufeld, & Flett, 2016), suggesting a process by which RFLs might protect against suicide risk in later life, and further supporting the assessment of RFLs when seeking to identify the presence or severity of suicide risk among older adults. ...
Objectives: To derive a brief late-life suicide resiliency scale from the 69-item Reasons for Living Scale-Older Adult version (RFL-OA).
Methods: We conducted a series of secondary analyses of RFL-OA data (N = 204) from a dataset combining: 1. A follow-up assessment of nursing home residents in the Geriatric Suicide Ideation Scale (GSIS) development study; 2. A trial of Interpersonal Psychotherapy (IPT) with suicidal older adults; 3. A longitudinal study of risk and resiliency to late-life suicide ideation. We specifically assessed the distributions of RFL-OA items and their associations with suicide ideation and behavior to create an RFL-Suicide Resiliency subscale (RFL-SR); we then tested the psychometric properties of this measure’s items drawn from the larger RFL-OA.
Results: Nine RFL-OA items were significantly associated with suicide ideation and history of suicide behavior and were not highly correlated with social desirability. Psychometric analyses supported the internal consistency, test–retest reliability, and construct validity of this scale.
Conclusions: The items of the RFL-SR demonstrated strong psychometric properties with older adults in clinical and community settings.
Clinical Implications: The RFL-SR may make a useful addition to suicide risk assessment in gerontological research and clinical practice.
... Commonalties across these theories, particularly prevailing ones, promote an ecological-systems and biopsychosocial understanding. Several theories such as Durkheim (1951), Shulman (1978), Williams and Williams (1997), Joiner (2005), and Mann and colleagues (2005), and Heisel and Flett (2016) offer up a social or interpersonal explanation whereby life stressors such as loss (Heisel & Flett, 2016;Shulman, 1978), adverse childhood events (Mann et al., 2005), thwarted belongingness (Joiner, 2005), social environment factors (Williams and Williams, 1997), or poor social integration (Durkheim, 1951) contribute to suicidality, all of which indirectly implicate family functioning. ...
... Commonalties across these theories, particularly prevailing ones, promote an ecological-systems and biopsychosocial understanding. Several theories such as Durkheim (1951), Shulman (1978), Williams and Williams (1997), Joiner (2005), and Mann and colleagues (2005), and Heisel and Flett (2016) offer up a social or interpersonal explanation whereby life stressors such as loss (Heisel & Flett, 2016;Shulman, 1978), adverse childhood events (Mann et al., 2005), thwarted belongingness (Joiner, 2005), social environment factors (Williams and Williams, 1997), or poor social integration (Durkheim, 1951) contribute to suicidality, all of which indirectly implicate family functioning. ...
The impacts of suicidality on families are well known, which is particularly relevant in at-risk populations, such as active duty military personnel and Veteran communities. This scoping review describes how military and Veteran families have been conceptualized within suicide prevention research. A systematic, multi-database search was conducted, and 4,835 studies were screened. All included studies underwent quality assessment. Bibliographic, participant, methodological, and family-relevant data was extracted and descriptively analyzed into Factors, Actors, and Impacts. In total, 51 studies (2007 - 2021) were included. Most studies focused on suicidality rather than suicide prevention. Factor studies described family constructs as a suicidality risk or protective factor for military personnel or Veterans. Actor studies described families' roles or responsibilities to act in relation to the suicidality of military personnel or Veterans. Impacts studies described the impacts of suicidality on military and Veteran family members. The search was limited to English language studies. There were few studies on suicide prevention interventions for or including military and Veteran family members. Family was typically considered peripheral to the military personnel or Veteran experiencing suicidality. However, there was also emerging evidence of suicidality and its consequences in military-connected family members.
... Paralleling this claim, Shneidman (1981) asserted that intense mental pain is related to suicide. People who fail to discover meaning in life may be prone to existential despair and suicide risk (Heisel & Flett, 2016), and human life without existential meaning can result in major depression. Meaning in life and optimism are the polar opposites of suicidality and hopelessness (Orbach et al., 2003). ...
... Individuals who discover a meaning through creative acts, life experiences, and attitudes toward life's challenges and successes may develop protection against despair (Frankl, 1988). Although it seems that elderly people have be more able to discover a meaning in life, younger (Heisel & Flett, 2016) and the middle-aged adults (van Selm & Dittmann-Kohli, 1998) can be helped to use logo therapy (Frankl, 2006) to reduce depression symptoms and increasing meaning in life. Since existential therapy deals with concerns such as isolation and meaninglessness and tries to make confronting these concerns tolerable for the individual, this treatment can help suicidal clients to cope with the crisis. ...
Suicide is a worldwide public health issue and concerns about rising suicide rates are growing significantly in many countries. Psychotherapy is often expected to address this problem in clients. Existential therapy may be a particularly effective prevention technique to address suicide related concerns. Existential concerns common among suicidal patients include meaninglessness, isolation, freedom and responsibility. Previous work in existential therapy has given considerable attention to meaninglessness and meaning in life, but discussions on other existential concerns have been limited. This article presents a case for the relevance of existential therapy for working with people presenting with issues relating to suicidality and offers recommendations for clinicians hoping to foster discussions with clients pertaining to existential concerns.
... The main antecedent of suicide resilience is the events that may place an individual at high risk of suicide. It may be adversity such as the coming-out process, stressful life events, combat distress, posttraumatic stress symptoms linked to sexual assault or childhood abuse, being in late life, depressive symptoms, and a diagnosis of schizophrenia (28,34,42,44,50,64,66,67). This adversity also includes events directly relating to suicide, which are the strongest predictors of future suicide, such as suicide ideation or suicide attempt (71, 72). ...
... Meaning in life is linked to suicide resilience with a total of 16 articles mentioned(15, 36,42,67,68). It is a strong protective factor against suicide. ...
Objective
Suicide resilience is gaining increasing attention from researchers because of its potential role in preventing suicide. However, it has not been clearly analyzed, and there are various meanings and terms regarding this issue. The purpose of this analysis, therefore, was to conceptualize the concept of suicide resilience.Methods
Walker and Avant's method of concept analysis was used to identify the antecedents, attributes, and consequences of suicide resilience. The literature was searched using PubMed, PsychINFO, Embase, Web of Science, CINAHL, CNKI, and WanFang databases with no limitation on publication date. The search included peer-reviewed journal articles and dissertations related to suicide resilience published in English or Chinese.Results52 articles were identified to provide information for this concept analysis. Five defining attributes of suicide resilience were identified: social support, coping strategies, psychological capital, meaning in life, and sense of responsibility. Antecedents of suicide resilience were high suicide risk events, and consequences of suicide resilience were keeping vulnerable individuals stay away from or overcoming suicidality.Conclusions
The result of the analysis provided a more clear definition of suicide resilience. The identified defining attributes, antecedents, and consequences can be further tested and used to develop potential interventions. Future research is needed and will help to advance our understanding of the scope.
... In this older adult primary care sample, for every lifetime trauma reported there was a 16% increase in the odds of also reporting suicidal ideation. This was similarly observed in a small convenience sample of community living older adults in Canada which showed that the frequency of daily hassles was associated with onset and exacerbation of suicidal ideation (Heisel and Flett, 2016). The overall path analysis showed that exposure to sexual assault was directly associated with suicidal ideation and indirectly through the presence of PTSS. ...
... The direct association between daily hassles and suicidal ideation as well as an indirect association through the mediating effect of depression was similarly reported in African women (Lamis and Kaslow, 2014). In a small community sample of older adults, daily hassles predicted the onset and exacerbation of suicidal ideation (Heisel and Flett, 2016). These studies highlight the importance of day-to-day stressors in predicting suicidal ideation in primary care older adults and the potential for clinicians to also focus on these risk factors when ascertaining the presence of anxio-depressive disorders and PTSS. ...
Objectives
Examine the association between trauma and daily stressors, post-traumatic stress syndrome (PTSS), anxio-depressive disorders, and suicidal ideation in older adults.
Design
A cross-sectional study.
Setting and Participants
This study included 1446 older adults recruited in primary care practices (2011–2013) and participating in Quebec’s longitudinal study on health services in the elderly.
Measurements
Lifetime trauma and PTSS was assessed using the validated PTSS scale for older adults based on scores from the Impact of Events Scale-Revised, number of lifetime traumatic events and interference with daily activities. The presence of an anxio-depressive disorder was based on physician diagnoses. Path analyses were conducted to determine the pathways between trauma, daily stressors, PTSS and anxio-depressive disorders and SI. Analyses were conducted on the overall sample and by sex.
Results
Seven percent and 12% reported SI and PTSS. In males, traumas of sexual assault, violence/stalked, war/combat/imprisonment and daily hassles were directly associated with SI. In females, daily hassles were directly associated with SI. In males, a number of traumas were associated with SI through the mediating effect of PTSS and anxio-depressive disorders. In females, PTSS but not anxio-depressive disorders mediated the relationship between traumas and daily stressors, and suicidal ideation.
Conclusions
The effects of lifetime traumas persist well into older age. Traumas leading to SI differ between males and females as do the pathways and comorbidity with PTSS and anxio-depressive disorders. This highlights differences in etiologic patterns, which may be used in primary care practice to identify symptom profiles of older persons at risk of suicidal ideation.
... Higher scores on the GSIS reflect more severe suicide ideation. The GSIS has shown strong psychometric properties with older adults across community, residential, and clinical settings, including internal consistency, longer-and shorter-term test-retest reliability, criterion validity by differentiating respondents who endorsed or denied having attempted suicide, construct validity by way of positive associations with alternate measures of suicide ideation and with depression and hopelessness, and negative associations with psychological well-being variables (Cukrowicz, Cheavens, Van Orden, Ragain, & Cook, 2011;Heisel & Flett, 2006, 2016a, 2016bJahn, Cukrowicz, Litton, & Prabhu, 2011;Jahn, Poindexter, Graham, & Cukrowicz, 2012;Nadorff, Fiske, Sperry, Petts, & Gregg, 2013;Neufeld, O'Rourke, & Donnelly, 2010;O'Rourke, Heisel, Canham, & Sixsmith, 2017;O'Rourke et al., 2018;Segal, Marty, Meyer, & Coolidge, 2012;Segal, Gottschling, Marty, Meyer, & Coolidge, 2015). ...
... Physical functioning was assessed at T1 using the eight-item Instrumental Activities of Daily Living scale (IADL; Lawton & Brody, 1988a) and six-item Physical Self-Maintenance Scale (PSMS; Lawton & Brody, 1988b), interviewer-rated measures of the ability to complete instrumental (e.g., shopping, preparing food) and basic (e.g., toileting, self-grooming) activities of daily living. The IADL and PSMS have demonstrated strong psychometric properties with older adults, including associations between the IADL and suicide ideation (Heisel & Flett, 2016a;Hirsch et al., 2007). IADL scores potentially range from 0 to 24 and scores on the PSMS range from 0 to 24; higher scores on both scales indicate higher levels of functional impairment. ...
Objectives. To investigate the psychometric properties of the five-item Suicidal Behaviors Questionnaire (SBQ-5) and the Geriatric Suicide Ideation Scale-Screen (GSIS-Screen, submitted) among community-residing middle-aged and older men.
Methods. The SBQ-5 and GSIS-Screen were administered to 93 men, 55 years or older, who participated in an eligibility assessment (Time 1) for an upstream psychological intervention study to prevent the onset of suicide ideation among men struggling to transition to retirement. Eligible participants later completed the full GSIS and measures of depression and hopelessness at a pre-group assessment (Time 2).
Results. The SBQ-5 was positively associated with the GSIS-Screen at the eligibility assessment. Internal consistency for both measures was low but acceptable. Time 1 scores on both screens predicted suicide ideation at Time 2, controlling for the intervening time lag and for baseline cognitive and physical functioning. Only the GSIS-Screen uniquely predicted future depression and hopelessness ratings.
Conclusions. The SBQ-5 and the GSIS-Screen have acceptable psychometric properties among middle-aged and older community-residing men; the GSIS-Screen is more closely associated with later-life suicide risk factors.
Clinical Implications. Brief screening tools may be of use in effectively identifying suicide ideation in community-residing middle-aged and older men.
... 12,22,23,26,32 Social identity has profound implications for well-being in multiple domains including physical and mental health, suicide prevention, security, sense of purpose, sense of belonging and access to resources like social support, employment, finances, housing, and services. 22,23,27,33,34 Depression and suicide have been linked to social identity disruption. 2,7,12,23 Achievement of post-military social identities that confer good well-being therefore is viewed as a key issue in military-civilian transition. ...
... 25,50 Th ere is longitudinal evidence for managing depression by encouraging people to join positive social groups, and the development of meaning and purpose in life in mitigating suicidal ideation. 22,23,34 To support well-being in transition, Demers recommended support groups for Veterans, transition groups for families and friends, and military cultural competence training for health practitioners. 6 Boerstler described a system for promoting Veteran-friendly communities in Houston, Texas. ...
Introduction: Suicide risk is higher in Canadian Armed Forces (CAF) Veterans than the Canadian general population (CGP). Suicidality is understood to be caused by incompletely clarified, complex interacting combinations of multiple factors. One of the precipitating factors for suicide is thought to be the social identity challenges known to occur in major life transitions.
Methods: The 2016 Life After Service Studies survey representatively sampled Regular Force Veterans stratified by two release groups: earlier in 1998 to August 2012 (n = 1,575) and more recently in September 2012 to 2015 (n = 1,180). The linked dataset included socioeconomic and military characteristics and well-being indicators in multiple domains. Weak group identity was indicated by weak sense of local community belonging and/or not feeling part of a group with shared attitudes and beliefs. Associations were evaluated with multiple logistic regression.
Results: Suicidal ideation, weak community belonging, and perceived difficult adjustment to civilian life were more prevalent in Veterans soon after release (September 2012 to 2015) than in Veterans released earlier (1998 to August 2012). Suicidal ideation and weak community belonging were more prevalent in the Veterans than in the CGP. In the more recently released Veterans, weak group identity was endorsed by the majority with suicidal ideation (93.3%). In adjusted regression models, mental health problems had the strongest association with suicidal ideation (adjusted odds ratio [AOR] = 13.4–79.3); however, weak group identity was moderately strongly associated with both difficult adjustment (AOR = 2.4–4.1) and particularly suicidal ideation (AOR = 3.8–9.0), independently of mental health problems.
Discussion: Weak group identity was associated with difficult adjustment to civilian life and suicidal ideation in CAF Regular Force Veterans within 3.6 years after military release. These findings indicate the importance in suicide prevention of attending to social identity during transition to post-military life.
... In the second half of the mediating path, the presence of meaning is significantly associated with depressive symptoms, which is supported by previous research [24,47,52]. This is also in line with prior studies that have found that loss of meaning has been consistently reported as leading to negative psychological outcomes, including suicidal ideation and behavior [53][54][55][56][57] and anxiety [22,24,47]. However, a sense of meaning in life is a beneficial psychological resource that promotes psychological well-being [32,52,58,59]. ...
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.
... In addition, they showed that the meaning in life is responsible for promoting mental health and well-being and potentially creating resilience to suicidal thoughts in the future. 27 Kleiman and Beaver conducted a study to define life as a suicidal resilience factor. They concluded that the search for meaning in life, but not its existence, mediated the relationship between interpersonal psychological theory variables and suicidal thoughts. ...
Background: Suicide is a serious public health problem, and suicide attempt is defined as one of the important indicators of mental health in a society. The present study investigated the relationship between resilience and suicidal thoughts in Rafsanjani youth. Methods: This cross-sectional descriptive study examined 3006 young people aged 15-35 who referred to Rafsanjan Cohort Study (RCS). Connor and Davidson’s questionnaire was used to measure resilience. The data, including demographic characteristics and cases related to suicide, were extracted from the computer system, which is part of the Rafsanjan Youth Cohort Program. Independent t-test, one-way analysis of variance, Tukey’s post-hoc test, Pearson’s correlation coefficient and multiple linear regression model were used to analyze the data. Results: A total of 3006 individuals were studied, of whom 1685 (56.1%) were women, and 1321 (43.9%) were men. The average age of the participants was 25.75±6.09 years. Men had a significantly higher average score of resilience (P<0.001) and suicidal thoughts (P=0.002) than women. In addition, the average score of suicidal thoughts in divorced and widowed people was significantly higher than single and married people (P=0.029). It was shown that older age groups had higher average resilience (P<0.001) and fewer suicidal thoughts (P=0.003), and people over 30 years had the lowest average suicidal thoughts. Conclusion: The results indicate an inverse and significant relationship between resilience and suicidal thoughts in both men and women. Therefore, more evaluations are necessary to investigate the factors affecting resilience and take measures to improve it among young people.
... Some studies indicated no significant association between marital status and suicidal behaviors, 23 whereas a statistically significant negative association has been documented in some other studies. 24 These interesting findings, once again, remind us that the risk factors and patterns of suicidality vary significantly from east to west and from one culture to another one. ...
Background and aims: This study aimed to determine the prevalence of morbid thoughts and suicide attempts as well as their relationship with perceived health status, quality of life, and happiness in five low-middle-income countries. Methods: Data on 3373 men and women aged 40 years and above were collected from the World Health Organization’s (WHO’s) study on global AGEing and adult health (SAGE) survey on five countries: China (830), Ghana (438), India (1602), Russia (175), and South Africa (830). Outcome variables were morbid thoughts and suicide attempts, and the main explanatory variables were health status, quality of life, and happiness. Results: The findings indicated that among the five countries, India had the highest prevalence of both morbid thoughts 79.5% (95% CI: 73.4-84.5) and suicide attempts 75.4% (95% CI: 61.0-85.7), while Ghana had the lowest prevalence of both morbid thoughts 1.9% (95% CI: 1.3-2.7) and suicide attempts 2.5% (95% CI: 1.1-5.5). Furthermore, regression analysis revealed a significant association between perceived health, quality of life, and happiness with morbid thoughts and suicide attempts. However, the association between perceived health and happiness was significant only among women. Men and women reporting dissatisfaction with the quality of life had 1.521 times (95% CI: 1.126-2.056) and 1.762 times (95% CI: 1.406-2.209) higher odds of morbid thoughts compared with those who reported satisfaction with the quality of life. Conclusion: Perceived poor health, quality of life, and happiness are significantly associated with higher odds of morbid thoughts of suicidal ideation, especially among women. In line with the past findings, these findings support the importance of focusing on these perceived constructs of health and life for mental health promotion and suicide prevention programs.
... A previous study found that among Downloaded from https://academic.oup.com/innovateage/advance-article/doi/10.1093/geroni/igad073/7220678 by guest on 06 August 2023 A c c e p t e d M a n u s c r i p t decedents younger than age 65 with PH, the likelihood of suicide is elevated in states with limited health care access and weaker gun control laws (Phillips & Hempstead, 2022). Research has also shown the importance of cultivating and maintaining meaning in life in promoting positive psychological factors, potentially conferring resilience, and reducing suicidal ideation especially among those with chronic illnesses (Heisel & Flett, 2016;Lutzman & Sommerfeld, 2023). ...
Background and Objectives
Physical health problems are a significant late-life suicide precipitant. This study’s purpose was to examine differences in (1) other suicide precipitants and psychiatric/substance use problems, and (2) suicide methods (firearms, hanging/suffocation, and poisoning) in three age groups (55-64, 65-74, and 75+) of older suicide decedents who had physical health problems as a suicide precipitant.
Research Design and Methods
Data came from the 2017-2019 U.S. National Violent Death Reporting System (N=34,912; 27,761 males [79.5%] and 7,151 females [20.5%]). Generalized linear models for a Poisson distribution with a log link were used to examine the study questions.
Results
Physical health problems were a suicide precipitant for 25.8%, 41.9%, and 57.7% of the 55-64, 65-74, and 75+ age groups, respectively, and were associated with a higher likelihood of having had depressed mood (IRR=1.38, 95% CI=1.33-1.43) and other substance use problems (IRR=1.22, 95% CI=1.13-1.31). Interaction effects showed that when job/finance/housing problems, depressed mood, or any psychiatric disorders were co-present with physical health problems, the age group differences in the predicted rates of physical health problems were diminished. Physical health problems were also positively associated with firearm and poisoning use, but negatively associated with hanging/suffocation. Interaction effects indicated that the predicted rates of firearm and poisoning uses significantly increased among those age 55-64 with than without physical health problems.
Discussion and Implications
In all three age groups of older suicide decedents, physical health problems were the predominant suicide precipitant, and those with physical health problems had elevated depressed mood. Assessment of suicide risk, affordable and accessible health and mental health services, restriction of access to lethal suicide methods, and policy-based suicide prevention approaches for older adults with physical health problems are needed.
... It is a kind of high-level psychological feeling, including two independent and complementary dimensions: the sense of having meaning and the sense of seeking meaning (Tang, 2008). It is found that the meaning in life may be an important factor in preventing suicidal ideation, and there is a significant negative correlation between the meaning in life and suicidal ideation in college students (Heisel and Flett, 2016;. The meaning in life can negatively predict suicidal ideation, and improving the meaning in life may help alleviate suicidal ideation (Jose and Angelina, 2019). ...
Objective
The purpose of this study was to explore the relationship between exercise adherence and suicidal ideation in college students, as well as the mediating role of meaning in life and internet addiction.
Methods
A total of 1925 college students (Mage = 19.51 years, SDage = 2.393 years) were recruited by stratified cluster sampling method in Zhaoqing University, among which 890 were males and 1,035 were females. Exercise adherence, meaning in life, internet addiction and suicidal ideation were assessed by using standard scales. Data were analyzed by Pearson Correlation Analysis, and bias-correction percentile Bootstrap method.
Results
(1) There is a significant correlation between exercise adherence, meaning in life, internet addiction and suicide ideation; (2) meaning in life plays a significant mediating role between exercise adherence and suicidal ideation; internet addiction plays a significant mediating role between exercise adherence and suicidal ideation; meaning in life and internet addiction play a chain mediating role between exercise adherence and suicide ideation.
Conclusion
Exercise adherence can not only directly predict college students’ suicidal ideation, but also indirectly predict college students’ suicidal ideation through the independent mediation and chain mediation of meaning in life and internet addiction.
... Third, the present study focused only on young adults and our results may not be generalized to other age groups. Future studies are needed to elucidate the potential protective role of MIL as a resiliency factor to SI among older adults as in Beach et al. (59) and Heisel et al. (60). ...
Background
Young adults in Hong Kong are subject to elevated psychological distress given the societal stressors such as civil unrest and COVID-19 pandemic and suicide is a leading cause of death among them. The present study aimed to evaluate the psychometric properties and measurement invariance of the 4-item Patient Health Questionnaire-4 (PHQ-4) as a brief measure of psychological distress and its associations with meaning in life and suicidal ideation (SI) in young adults.Materials and methodsA mobile survey recruited a large and random sample of 1,472 young adults (Mean age = 26.3 years, 51.8% males) in Hong Kong in 2021. The participants completed the PHQ-4 and Meaning in Life Questionnaire–short form (MLQ-SF) for presence of meaning in life (MIL), SI, COVID-19 impact, and exposure to suicide. Confirmatory factor analysis was conducted to examine the factorial validity, reliability, and measurement invariance of PHQ-4 and MLQ-SF across gender, age, and distress subgroups. Multigroup structural equation model evaluated and compared the direct and indirect effects of latent MIL factor on SI via latent PHQ-4 factor across distress groups.ResultsBoth MIL and PHQ-4 supported a 1-factor model with good composite reliability (Ω = 0.80–0.86) and strong factor loadings (λ = 0.65–0.88). Both factors showed scalar invariance across gender, age, and distress groups. MIL showed significant and negative indirect effects (αβ = −0.196, 95% CI = −0.254 to −0.144) on SI via PHQ-4. PHQ-4 showed a stronger mediating role between MIL and SI in the distress group (Δ = −0.146, 95% CI = −0.252 to −0.049) than the non-distress group. Higher MIL predicted higher likelihoods of help-seeking (Odds ratios = 1.46, 95% CI = 1.14–1.88).Conclusion
The present results support adequate psychometric properties in terms of factorial validity, reliability, convergent validity, and measurement invariance for the PHQ-4 in young adults in Hong Kong. The PHQ-4 demonstrated a substantial mediating role in the relationship between meaning in life and SI in the distress group. These findings support clinical relevance for using the PHQ-4 as a brief and valid measure of psychological distress in the Chinese context.
... It means that being excluded or isolated by others can erode a decreased perception of one's worth, resulting in the decline of life meaning [50]. The current study also underlined the importance of meaning in life since it could protect against suicide risk by mitigating the negative effects of emotional, interpersonal, and situational challenges [51]. ...
Existing studies emphasize that interpersonal relationships are closely associated with the increased risk of suicidal ideation (SI). However, the mechanism underlying this association remains poorly understood. In this study, we investigated how and under what conditions the perceived stress from interpersonal relations links to SI. Also we explored the possible important roles of meaning in life and coping humor. A total of 1472 Chinese freshmen completed self-reported questionnaires of thwarted belongingness (TB), fear of negative evaluation (FNE), meaning in life, coping humor, and SI. Our results showed that SI was associated with more TB and FNE, and it was linked to less meaning in life and coping humor. Importantly, two dimensions of meaning in life mediated the associations between TB, FNE, and SI. Specifically, TB increased SI by destroying both presence of meaning and search for meaning while FNE increased SI by destroying presence of meaning, but not by search for meaning. Additionally, coping humor attenuated the effect of FNE on SI. Our findings highlight the protective roles of meaning in life and coping humor in the link between perceived stress from interpersonal relations and SI among Chinese university students. These results provide feasible advices for practitioners to carry out suicide prevention and intervention.
... In addition to well-being, Heisel and Flett (2016) observed that low levels of MIL predicted onset of suicide ideation in their longitudinal study. Pot et al. (2010) used a randomized controlled trial to examine causal relationships between MIL and depression, comparing 88 middle-aged and older adults in a control group to 83 participants aged 50 years or older who participated in the life review-based prevention course called "Looking for Meaning." ...
Identifying predictors of meaning in life (MIL) among middle-aged adults is important to promote their well-being. To inform efforts to foster well-being for middle-aged adults, the purpose of this study was to examine whether transcendent experiences mediate the relationships between two types of leisure social support (leisure instrumental support and leisure emotional support) and MIL in this population. In total, 236 middle-aged adults participated in the study. We used in-person surveys to collect data on leisure instrumental support, leisure emotional support, transcendent experiences, and MIL as well as analyzed data conducting structural equation modeling. Results indicated that high levels of leisure instrumental support predicted high levels of transcendent experiences; high levels of transcendent experiences predicted high levels of MIL; and high levels of leisure instrumental support and leisure emotional support predicted high levels of MIL. We discuss implications of these results in terms of facilitating MIL experienced by middle-aged adults.
... Risk of attempt for suicide and completed death by suicide was also found in one review as being at least doubled for those suffering from chronic pain conditions when compared to the general population (Hitchcock et al., 1994;Magni et al., 1998;Tang & Crane, 2006). A recent study (Costanza et al., 2021) involving a cohort of chronic pain patients within a pain center in Switzerland found that a described psychological construct used in assessing risk for suicide, known as "meaning in life (MiL)" (Frankl, 1985;Heisel & Flett, 2016), may be eroded in individuals experiencing chronic pain. Other epidemiological studies have found that even after factoring in affecting variables such as sociodemographic characteristics or previously diagnosed psychiatric disorders, that there is a substantial increase in those suffering from chronic pain conditions and their risk of suicidal ideation or attempt (Braden & Sullivan, 2008;Racine, 2018;Ratcliffe et al., 2008). ...
Abnormal pain affects ~50 million adults nationwide. With many of the current treatment options for chronic pain, such as opioid analgesics, carrying side effects such as the threat for addiction, research into safer and more effective options for chronic pain relief is crucial. Abnormal alterations in nociceptive sensitivity, which is the sensitivity of peripheral sensory neurons that detect noxious stimuli, can underlie, and perpetuate chronic pain. However, much is still unknown about the mechanism of how these abnormal alterations in sensitivity occur. To help elucidate genetic components controlling nociceptive sensitivity, the Drosophila melanogaster larval nociception model has been used to characterize well-conserved pathways through the use of genetic modification and/or ultraviolet (UV) irradiation injury to alter the sensitivity of experimental animals. We have continued to build upon this knowledge to reveal a more complete system for how nociceptive sensitivity can be altered, even without injury, by investigation into the potential roles of other novel genes/signaling pathways including, Arm, a component within the Wnt/Wg signaling pathway. Our findings indicate Arm to be a facilitator in controlling nociceptive sensitivity in the absence of injury, by maintaining baseline sensitivity. In an effort to also explore the mechanisms of the primary nociceptors (nociceptors which directly detect noxious stimuli), we conducted bioinformatic analysis of RNA transcripts derived specifically from the nociceptors of larvae after UV injury. Results from this effort led to the discovery of a downregulation in serine proteases during peak allodynia (when something not normally noxious becomes so) development. Results also led to the hypothesis that upregulated Rgk1 and AnxB11 were involved in recovery of the nociceptor from hyperalgesia. This was supported by the knockdown of Rgk1 and AnxB11 having led to nociceptor hypersensitivity in larvae. And in an effort to move the methodology of our field forward, and because the larval stages of fruit fly development are relatively brief, we developed a methodology that allows longer term experimentation of nociceptive sensitization after injury in adult fruit flies. Ultimately, our research uncovered components involved in nociceptive sensitivity, which will hopefully lead to uncovering better treatment options for abnormal pain in the future.
... People who find more meaning in life are in better mental health (Halama & Dědová, 2007), are more satisfied with their lives (Ang & O, 2012;Nell, 2014); they experience more well-being, feeling more optimistic about the future (Dezutter et al., 2013;Ho et al., 2010;Yalçın & Malkoç, 2015), and display better life adjustment (Cho et al., 2014). Conversely, finding less meaning in life is related to serious depression (Bamonti et al., 2016), more suicidal ideation (Bryan et al., 2013;Heisel & Flett, 2004), and higher suicide risk (Heisel & Flett, 2016;Kleiman & Beaver, 2013). Researchers find that meaning in life is a suicide resiliency factor (Gallagher & Miller, 2018;Zhang et al., 2021). ...
Although many studies have found the effect of group counseling on enhancement of meaning in life, few studies have employed the class group counseling in life education. The present study assessed the effect of class group counseling on life education for undergraduate students. Two classes from a Chinese university were randomly allocated into the intervention and control groups. The intervention group received class group counseling for 1.5 months. The intervention and control groups completed the meaning in life questionnaire (MLQ), the satisfaction with life scale (SWLS), and the positive affect and negative affect scales (PANAS) before and after the intervention. The results showed that the intervention improved students’ life satisfaction, positive affect, and presence of meaning, and decreased negative affect. These findings indicated that class group counseling could play an important role in the life education of undergraduate students. The current study extends our understanding of improving mental health and preventing suicide for undergraduate students.
... Social isolation and loneliness among older adults are critical public health concerns associated with cognitive decline, comorbid conditions, depression, suicide ideation, and mortality (Beller & Wagner, 2018;Courtin & Knapp 2017;Heisel & Flett, 2016;James et al., 2011;Sakurai et al., 2019;Wilson et al., 2007). In addition to these health impacts, isolation and loneliness are associated with greater health care utilization and spending among older adults (AARP Public Policy Institute, 2017;Gerst-Emerson & Jayawardhana, 2015;Valtorta et al., 2018). ...
Background and Objectives
Social isolation and loneliness are common among older adults and associated with negative health outcomes including cognitive decline, depression, suicide ideation, and mortality. Information and communication technology interventions are often used to combat loneliness and social isolation; however, homebound older adults face barriers to access. This study reports findings from a novel pilot intervention, called Talking Tech, designed to reduce loneliness and social isolation in homebound older adults by providing one-on-one, in-home technology training, a tablet, and the internet, to promote digital literacy and participation in a virtual senior center.
Research Design and Methods
21 homebound older adults participated in this 14-week, volunteer-delivered program. We used qualitative interviews with participants, volunteers, and program staff, weekly progress reports from volunteers, and quantitative pre- and post-intervention surveys with participants to examine experiences and to evaluate the impact of the intervention on loneliness and social isolation. Qualitative data were analyzed using content analysis and pre- and post-intervention survey data were compared.
Results
Participants reported increased technological literacy and use, increased access to online activities, and improved facilitation of social connections to existing and new networks. Additionally, during interviews, many participants reported that participating in Talking Tech alleviated their loneliness. While not statistically significant, our quantitative analysis revealed trends towards decreased participant feelings of loneliness and increased technology use. Additionally, intervention adoption and retention were high, with only one participant withdrawing from the intervention.
Discussion and Implications
This evaluation of the novel Talking Tech pilot intervention provides critical insights into strategies to reduce loneliness and isolation for older adults, with implications for future research, policy, and practice. Findings demonstrate that individualized technology training may be an acceptable way to improve well-being for homebound older adults.
... Among middle-aged and older adults, recent evidence suggests that purpose in life is associated with lower mortality risk (Boyle et al., 2009;Shiba et al., 2021), a reduced incidence of stroke (Kim, Sun, Park, & Peterson, 2013), fewer sleep disturbances (Kim et al., 2015), reduced risk for myocardial infarction (Kim, Sun, Park, Kubzansky et al., 2013), and better maintenance of physical functioning over time (Kim et al., 2017). Regarding mental health, a higher sense of purpose or meaning in life also protects against cognitive decline (Kim et al., 2019) and suicidal ideation (Heisel & Flett, 2016) among older adults, and reduces negative affect and symptoms of depression and anxiety in adults of all ages (Crego et al., 2019(Crego et al., , 2021. ...
Objective: We assessed the effects of hope, purpose in life, and religiosity on trajectories of depressive symptoms among middle-aged and older Blacks, with a focus on age differences in these associations. Methods: Data come from 1906 respondents from the 2006-2016 Health and Retirement Study. Linear mixed models were estimated and included interactions between age and time and between age and each psychosocial resource. Results: Depressive symptoms decreased for Blacks ages 51-64, did not change for those 65-74, and increased among Blacks age 75+. Hope and purpose in life were inversely associated with symptom levels but were not associated with change over time in symptomology. Associations were stronger among the youngest age group and weakest among the oldest. Religiosity was unrelated to depressive symptoms. Discussion: Psychosocial resources protect against depressive symptoms in age-dependent ways among middle-aged and older Blacks. Differences in these effects may be related to aging, cohort, and selection effects.
... 27 Previous studies have indicated the effectiveness of interventions that increasing the meaning of life for older adults can reduce suicidal ideations, as it improved the determination and resilience when suicidal ideators met obstacles. 28,29 Second, we identify nursing home older adults' negative life experiences not only in individual aspects but also in institutional aspects, which has been overlooked in previous studies. 30 In this study, the low perceived quality of services is reflected in the following four aspects: poor basic services (living conditions, hygiene conditions, catering, and daily living care), a lack of medical and health facilities, insufficient leisure activities, and the poor attitudes of the nursing staff. ...
Globally, older adults, especially nursing home residents, are at a higher risk of suicide. This study examined the life of nursing home residents with suicidal ideations and their help-seeking experiences. A qualitative analysis of 19 semi-structured interviews was conducted. Results indicate that suicidal ideations among nursing home residents correlates with their negative life experiences, both personally and institutionally. In terms of their life experiences, themes included the desire for death, emotional loneliness, a state of discomfort arising from incapacity, feeling like a burden on children, and dealing with the low-quality service. Older adults’ negative attitudes toward seeking assistance as well as limited resort resources and ineffective help-seeking hinder them from finding more support or treatment. This study adds to a growing body of research on late-life suicide in institutional settings, and relevant findings can serve as references in improving nursing home residents’ life quality and developing suicide-prevention strategies.
... Prior research shows that when caring behaviour is intrinsically motivated and there are explicit, overt cognitive associations made, meaning and purpose are developed (Han, 2015). This may be associated with improved mental health (Heisel & Flett, 2016;Landstedt et al., 2016;Zechmann & Paul, 2019). Frankl (1988) argued that meaning and purpose are found in caring values and actions beyond self-interest. ...
This study examined associations between school sector (Government, Catholic or Independent) and depressive symptomology over the secondary school years. Six waves of data collected annually from a representative Australian sample were examined. Multilevel piecewise linear and logistic regression controlling for a variety of demographic variables and protective factors was undertaken. In all sectors, depressive symptomology decreased between 10 and 13 years of age, but significantly increased for girls at age 13. Adolescents in Catholic schools reported significantly fewer symptoms of depression compared to those in Government and Independent schools. Adolescents in Catholic schools were less likely to report clinical levels of depressed mood compared to adolescents in Government schools.
... Many studies also demonstrate that MIL relates to psychological variables, such as increases in global life satisfaction and self-esteem (Hallford et al., 2018), positive affect (Steger et al., 2009), and subjective vitality (Ju, 2017) as well as decreases in anxiety (Korte et al., 2012) and negative affect (Steger et al., 2009). In a longitudinal study, Heisel and Flett (2016) observed that low levels of MIL predicted onset of suicide ideation among older adults. In addition, Pot et al. (2010) used a randomized controlled trial to determine effects of meaning on depression, comparing 83 older adults who participated in the life review-based prevention course called 'Looking for Meaning' to 88 participants in a control group. ...
Identifying predictors of meaning in life (MIL) among older adults is important to promote their well-being. Therefore, to provide practitioners with information to help older adults enhance well-being, we examined a mediated model in which singing commitment is predictive of flow, and flow is predictive of MIL. A total of 305 older adults participated in our study. Participants completed an in-person survey including singing commitment, flow, and MIL scales. We analysed data using structural equation modeling. Results indicated that high levels of singing commitment predicted high levels of flow, and high levels of flow predicted high levels of MIL. The relationship between singing commitment and MIL was fully mediated by flow, and there were no residual direct effects. We discuss implications of these results in terms of increasing meaning in later life, in particular, facilitating flow through singing commitment among older adults who do not have high levels of singing skills.
... Therefore, how people interpret and make meaning of stressors can greatly affect individuals' mental health in a positive or negative way. For example, a greater level of meaning in life has been linked with a decreased risk of depression, anxiety, (Bamonti et al., 2016;Blackburn & Owens, 2015;Chen et al., 2021;Steger et al., 2009) suicidal behavior, and post-traumatic stress disorder symptoms (Braden et al., 2015;Bryan et al., 2013;Heisel & Flett, 2016;Kleiman & Beaver, 2013) and less a diminished sense of meaning in life threatens mental health outcomes (Brassai et al., 2010;Chen et al., 2021). Similarly, previous research has found that greater meaning in life is linked with a higher level of life satisfaction, psychological well-being, improved quality of life, and the presence of adaptive coping strategies (Arslan et al., 2020;Heintzelman & King, 2014;Park, et al., 2008;Steger et al., 2006Steger et al., , 2015Sherman et al., 2010). ...
Young adults with psychological problems are at risk for experiencing personal, social, and economic difficulties, such as educational problems, poverty, social difficulties, and unemployment. Therefore, understanding the risks and protective factors of psychological health problems is a critical step in designing preventative approaches and interventions to foster young adults’ mental health and well-being. This study aims to examine the mediating role of meaning in life, positive emotions, and negative emotions in the relationship between psychological maltreatment and psychological health problems among Turkish young adults. The study included 381 young adults. Participants were 33% male and 67% female and ranged in age from 18 to 41 years (M = 20.73, SD = 3.36). Structural equation modelling indicated that psychological maltreatment had significant predictive effects on positive and negative emotions and meaning in life among young adults. Psychological maltreatment was also predictive of emotions and psychological health problems through meaning in life, and meaning in life mitigate the negative effect of maltreatment on well-being and psychological health. Similarly, both negative and positive emotions mediated the effect of psychological maltreatment on young adults’ psychological health problems. In these results indicate that psychological maltreatment’s effect on psychological health can be mitigated through cultivating meaning in life and positive emotions and striving to manage negative emotions.
... 65 Thus, a sense of M&P may serve as a resiliency factor for suicide in people with the HD gene mutation in that it can impact factors associated with suicidal ideation (e.g., depression, anxiety) as well as suicidal behaviors (e.g., impulsivity and anger). 66 In conclusion, this study provides a generalization on the value of M&P to people with the HD gene mutation, and future efforts are warranted to adapt and develop meaning-and palliative-centered interventions to this population. 13 Paulsen receives support from the NINDS and NIBIB and has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring Board for Wave Life Sciences, has received personal compensation in the range of $0-$499 for serving on a Speakers Bureau for HDSA, and has received personal compensation in the range of $0-$499 for serving as a consultant with Acadia. ...
Objective:
Previous work in Huntington's disease (HD) has shown that a sense of meaning and purpose (M&P) is positively associated with positive affect and well-being (PAW); however, it was unknown whether HD-validated patient-reported outcomes (PROs) influence this association and how M&P impacts PROs in the future. Our study was designed to examine if HD-validated PROs moderate the relationship between M&P and PAW and to evaluate if baseline M&P predicts 12- and 24-month changes in HD-validated PROs.
Methods:
This was a longitudinal, multicenter study to develop several PROs (e.g., specific for the physical, emotional, cognitive, and social domains) for people with HD (HDQLIFE). The sample consisted of 322 people with HD (n = 50 prodromal, n = 171 early-stage manifest, and n = 101 late-stage manifest HD). A single, multivariate linear mixed-effects model was performed with PAW as the outcome predicted by main effects for M&P and several moderators (i.e., an HD-validated PRO) and interactions between M&P and a given PRO. Linear-mixed models were also used to assess if baseline M&P predicted HD-validated PROs at 12 and 24 months.
Results:
Higher M&P was positively associated with higher PAW regardless of the magnitude of symptom burden, as represented by HD-validated PROs, and independent of disease stage. In our primary analysis, baseline M&P predicted increased PAW and decreased depression, anxiety, anger, emotional/behavioral disruptions, and cognitive decline at 12 and 24 months across all disease stages.
Interpretation:
These findings parallel those seen in the oncology population and have implications for adapting and developing psychotherapeutic and palliative HD interventions.
... Esses dados também foram destacados nos estudos de Luo, Wang, Wang e Cai (2016) no qual as razões para viver e a esperança foram importantes redutores da tentativa de suicídio e de Sedivy, Podlogar, Kerr e Leo (2017) que deram ênfase para o suporte social como um fator de proteção. A religiosidade e espiritualidade e o significado de vida são outros aspectos que tem recebido atenção especial nos estudos devido às importantes contribuições para a proteção e diminuição dos riscos (Bamonti, Lombardi, Duberstein, King, & Orden, 2015;Heisel & Flett, 2016). Porém, os aspetos protetivos ainda são pouco estudados, havendo a necessidade de melhores investigações. ...
... Several studies have identified meaning in life as an important dimension of resilience in older populations (Resnick, Gwyther, & Roberto, 2018). Perceived meaning in life was found to be related to resilience and promotion of well-being and mental health in older adults (Heisel & Flett, 2016). Resilience was one of the strongest characteristics in older adults with moderate and high levels of purpose in life, and was found to be strongly associated with improved mental and physical health outcomes (Musich, Wang, Kraemer, Hawkins, & Wicker, 2018). ...
Objectives
Older adults are more likely to encounter adverse life events and have protective factors that are different from other populations. Currently, there is no resilience scale designed exclusively for older adults. This study aims at developing a new measurement scale for assessing resilience of older adults.
Methods
Items of Resilience Scale for Older Adults (RSOA) was generated from thorough literature review. A multiple stage method was applied to examine the psychometric properties of the scale. In pretesting, items that did not meet the psychometric criteria were removed. A sample of 368 older adults was collected in the main survey to perform preliminary item selection and removal, reliability and construct validity analyses. Another survey on 76 samples was then conducted to assess test-retest reliability of the scale.
Results
RSOA that comprised four constructs (personal strength, meaning and purpose of life, family support, and social support) with a total of 15 items was developed with good reliability and validity. Cronbach’s α of the scale was 0.882. All the four constructs were found significantly correlated with life satisfaction of older adults.
Conclusions
The RSOA is a reliable means of assessing psychological and physical resilience of older people as well as predicting their satisfaction with life. The study may also provide important information about elderly coping with adversity.
... Meaning making as a life narrative construct is defined as the extent of learning from an adverse experience (McAdams and McLean 2013). In a longitudinal study investigating whether recognition of meaning in life is related to resilience to suicide, Heisel and Flett (2016) identified perceived meaning in life as an important factor, as did Edward et al. (2009) whose work focused on how adult patients of mental health services who have experienced mental illness describe the phenomenon of resilience. Theron and Theron (2014), also studied meaning making processes among black South African students in a broader pursuit of resiliencepromoting processes. ...
How do residents of small towns that depend on oil and gas extraction or processing industries withstand economic boom and bust cycles? To answer this question, this article reports on a narrative analysis of residents’ life stories gathered from 37 adults of a small town on the Canadian prairies dependent on the oil and gas industry, employing the theories of narra- tive inquiry and narrative identity. Participants aged 30 to 76 were interviewed and their experiences of living in an unstable economy that is dependent mostly on a single resource extraction industry were explored. Specifically, we asked participants about the effect of economic change on factors related to resilience like family interactions, work choices, educational path- ways, and the quality of their social lives. Our analysis of adult narratives looked for patterns in the relationship between risk exposure, promotive and protective factors at multiple systemic levels (individual, relational, cultural), and functional outcomes such as individual coping, community cohesion, and social and economic sustainability. Results show that a strong identity, in particular expressions of personal agency, communion, and engagement in meaning making are contributing factors to adult resilience in a context of economic change. Our results also highlight how positive attitudes towards a better future may inadvertently undermine the need for residents of oil and gas-dependent towns to commit to economic diversi- fication and other potential resilience-promoting strategies.
... Pulling together at scale, if actually present, would indeed be expected to moderate the negative psychosocial impact of COVID-19, including on suicide-related outcomes. Theory and research similarly support the role of enhancing social outreach, connection, support, and perceptions of meaning in life and of mattering to others when seeking to reduce risk for suicide ideation and behavior among older adults (Heisel & Flett, 2016;Van Orden et al., 2010); such efforts (e.g., telephone support, older befriending programs, and meaning-centered psychosocial groups) may be especially needed to help counteract the potentially negative impact of epidemics on suicide risk in later life (De Leo et al., 2002;Heisel et al., 2020). ...
Background: Infectious disease-related public health emergencies (epidemics) may increase suicide risk, and high-quality evidence is needed to guide an international response. Aims: We investigated the potential impacts of epidemics on suicide-related outcomes. Method: We searched MEDLINE, EMBASE, PsycInfo, CINAHL, Scopus, Web of Science, PsyArXiv, medRxiv, and bioRxiv from inception to May 13-16, 2020. Inclusion criteria: primary studies, reviews, and meta-analyses; reporting the impact of epidemics; with a primary outcome of suicide, suicidal behavior, suicidal ideation, and/or self-harm. Exclusion criteria: not concerned with suicide-related outcomes; not suitable for data extraction. PROSPERO registration: #CRD42020187013. Results: Eight primary papers were included, examining the effects of five epidemics on suicide-related outcomes. There was evidence of increased suicide rates among older adults during SARS and in the year following the epidemic (possibly motivated by social disconnectedness, fears of virus infection, and concern about burdening others) and associations between SARS/ Ebola exposure and increased suicide attempts. A preprint study reported associations between COVID-19 distress and past-month suicidal ideation. Limitations: Few studies have investigated the topic; these are of relatively low methodological quality. Conclusion: Findings support an association between previous epidemics and increased risk of suicide-related outcomes. Research is needed to investigate the impact of COVID-19 on suicide outcomes.
... Similar to previous studies (e.g. Heisel and Flett, 2016), participants were recruited through advertisements on social network sites, official requests to managers of organizations for the elderly, and snowball method, in which the recruited participants refer to potential others. This sampling method is considered to be appropriate for studying hard-toreach populations (Biernacki and Waldorf, 1981;Heckathorn, 2011). ...
Objectives
Suicide in the elderly is a complex and significant public health problem. The purpose of our study was to examine the role of loneliness and social integration as potential mediators in the relationship between physical pain and suicidal ideation in the elderly.
Design
Descriptive, bivariate correlations, and moderated mediation analyses were performed.
Setting
Personal meetings were held with participants in their homes.
Participants
A total of 198 elderly men aged 65 and over.
Measurements
Self-report measures: Beck Scale for Suicidal Ideation, Physical pain subscale, Multidimensional Social Integration in Later Life Scale, and University of California, Los Angeles (UCLA) Loneliness Scale (Version 3).
Results
Our findings showed that the association between physical pain and suicidal ideation was mediated by loneliness and social integration. Further analyses revealed that this mediation model was significant among single, but not married, men.
Conclusions
Physical pain and social factors are both important in understanding suicidality in late life. Elderly single men who experience physical pain may be lonelier and less socially integrated, and these factors may contribute to higher risk of suicidal ideation.
... A famous clinical work conducted by Jung and colleagues has reported that the pathology of some mental diseases results from the failure to find life meaning, while regaining life meaning is the key to curing these diseases (Yalom 1980). Further empirical research has manifested that lack of life meaning can lead to negative mental outcomes such as suicide ideation and depression (Heisel and Flett 2016;Huo et al. 2019). Accordingly, we propose that meaning in life is positively associated with life satisfaction. ...
With the rapid increase in the aged population, life satisfaction among old people has become a hot topic for both discussion and research. However, the antecedents of old people’s life satisfaction still need to be further excavated. Moreover, although aging of population is the furthest advanced in Japan, the Japanese sample has received relatively little research attention. Accordingly, the purpose of this study is to identify the factors influencing life satisfaction among Japanese elderly. Data are obtained from the Survey of Attitudes among the Elderly toward Daily Life in 2014. With the sample of 3893 elderly Japanese, our findings reveal that Internet use and appearance management helps to add meaning into the elderly’s lives, which in turn contributes to enhanced life satisfaction. Moreover, we find that the positive relationship between appearance management and meaning in life, as well as the mediating effect of meaning in life on the relationship between appearance management and life satisfaction are stronger among elderly females than that of elderly males. Finally, theoretical contributions, practical implications, limitations and future research directions are detailed.
... Annals of General Psychiatry 19:4 protective factors against suicide [7]. Suicide is undesirable resistive response to stress and hardships felt by the individual. ...
Background:
The rate of attempting suicide is growing due to the increasing social and economic problems and a variety of stresses taken by individuals in their lives. Helping people, boosting hope, and improving resilience to life hardships might be helpful in this area. This paper is an attempt to determine the effects of group reminiscence on hope and resilience in care-seekers who have attempted suicide.
Method:
The study was carried out as a quasi-experimental interventional study. The participants were 57 care-seekers with a history of attempting suicide who met the inclusion criteria. The sampling was done through convenience sampling and the participants were grouped into control (n = 29) and experimental (n = 28) groups randomly. The experimental group received integrated reminiscence sessions (eight sessions; 60-90 min). Hope and resilience of the subjects were measured using Schneider's Hope Scale and Connor and Davidson's Resilience Scale. The scales were filled out by the subjects before, immediately after, and 4 weeks after the intervention.
Results:
The mean scores of hope in the experimental and control groups were 34.60 and 38.04, respectively, before the intervention. These figures immediately after the intervention were 44.07 and 35.96 in the experimental and control groups, respectively. 4 weeks after the intervention, the mean scores of hope in the experimental and control groups were 44.39 and 35.79, respectively, which is a statistically significant difference (p < 0.05). In terms of resilience, the mean scores in the experimental and control groups before the intervention were 48.17 and 57.51, respectively; and immediately after the intervention, these figures were 67.71 and 52.75, respectively. 4 weeks of the intervention, the mean scores of resilience were 59.17 and 52.24, respectively, which is a statistically significant difference (p < 0.05).
Conclusion:
Group reminiscence has a positive effect on boosting hope and resilience in care-seekers who have attempted suicide.
... Most studies investigated the impact of MiL on SI, and an inverse association was reported as direct [22,27,29,34,36,39,[41][42][43]45,48,50,53] and/or through mediation and moderation models. MiL was found to mediate the relationships between SI and a variety of factors: stress/coping (via an inverse effect on depression) [1], "Reason for Living" [35], psychological strain [40], and satisfaction in life [43]. ...
Background and Objectives: Research on suicidal behavior (SB) has frequently focused more on risk factors than protective factors. Since the historic works of Viktor E. Frankl, who inquired how some Nazi concentration camps prisoners maintained their will to live though confronted with pervasive absurdity, Meaning in Life (MiL) has been interpreted as a potent resiliency factor. MiL then declined along a multitude of theoretical perspectives and was associated with various functioning domains of the individual. Surprising, few studies investigated the role of MiL on SB. We aimed to review and synthetize current literature on possible associations between MiL and SB, which included suicidal ideation (SI), suicidal attempts (SA), and completed suicide, focusing on two MiL constructs (the presence of MiL and search for MiL) from Michael F. Steger’s recent conceptualization. Material and Methods: A systematic strategy following PRISMA guidelines was used to search for relevant articles in Pubmed/MEDLINE, Scopus, PsycINFO, and ScienceDirect (January 1980–February 2019) and yielded 172 articles, 37 of which met our inclusion criteria. Results: MiL emerged as a protective factor against SI, SA, and completed suicides, directly or through mediation/moderation models with other SB-related variables. When distinguishing the presence of MiL and the search for MiL, a consensual protective impact was described for the former. Data for the latter were less consistent but rather oriented towards a non-protective impact Conclusions: These findings could have clinical repercussions for SB prevention, in both suicide risk assessment refinement and psychotherapeutic interventions. Further research is needed to examine dynamic interplay of the two constructs.
Background
Research on suicide rarely focuses on protective factors. The goal of this systematic review was to assess the evidence of the associations between protective factors and reduced suicidality among older adults.
Method
First, a scoping review was conducted to identify pertinent terms that refer to various protective factors against suicidality. A systematic review, following the PRISMA guidelines, was then conducted on a selection of 15 protective factors (e.g., perceived control, well-being and quality of life, life satisfaction, purpose-in-life, resilience, coping, religiosity, hope, self-regulation, sense of belonging, mattering, positive relationship, social support, social connectedness, and social participation), with separate searches performed on each factor in five databases. Empirical studies were eligible if participants were adults aged 60 years and over, and if the studies reported predictive statistical analysis.
Results
A total of 70 studies were retained for the review. Suicidal ideation was the main outcome measure (91%). Significant associations were consistently observed between all protective factors and reduced suicidal ideations or behaviors, particularly for purpose-in-life, resilience, and positive relationships, indicating that these are solid components for suicide prevention. Using scales, instead of a single item, to measure protective factors (e.g. life satisfaction) was more efficient to capture the associations. On the other hand, results were similar whether studies used subjective (e.g., sense of belonging) or objective (e.g., social connectedness) measures.
Conclusion
Protective factors were inversely associated with suicidal ideation. Improving protective factors is essential for the development of late-life suicide prevention and interventions, instead of merely focusing on risk factors.
Objectives:
To determine the incidence of suicidal ideation and suicide attempts (STBs) in veterans without an endorsed history of STBs and identify baseline predictors of these outcomes over a 10-year period.
Methods:
Population-based prospective cohort study of 2307 US military veterans using five waves of the 2011-2021 National Health and Resilience in Veterans Study. Baseline data were collected in 2011, with follow-up assessments conducted 2-(2013), 4-(2015), 7-(2018), and 10-years (2021) later.
Results:
In total, 10.1 % (N = 203) of veterans endorsed incident suicidal ideation (SI) over the 10-year period and 3.0 % (N = 55) endorsed an incident suicide attempt (SA). Multivariable regression analyses revealed the following baseline predictors of incident SI: lower annual household income, current posttraumatic stress disorder, current alcohol use disorder (AUD), disability with activities of daily living (i.e., ADLs) or instrumental activities of daily living (i.e., IADLs), lower perceived social support, lower community integration, and lower purpose in life. Current AUD, greater cumulative trauma burden, and lower purpose in life at baseline were predictive of incident SA. Relative importance analyses revealed that lower purpose in life was the strongest predictor of both incident SI and SA.
Conclusions:
Psychosocial determinants of health, such as purpose in life, may be more reliable predictors of incident suicidal thoughts and behaviors than traditional risk factors (e.g., psychiatric distress; history of SA) in those without a history of STBs. Evidence-based interventions that facilitate purpose in life and feelings of connectedness and belonging should be examined as possible treatments for STBs.
Background:
A growing body of literature has shown a higher risk of suicide in cancer patients compared with the general population. Early detection of factors related to suicide resilience in cancer patients could prevent loss of life.
Objective:
The study aimed to investigate the serial-multiple mediation of self-care self-efficacy and meaning in life in the relationship between social support and suicide resilience among Chinese cancer patients.
Methods:
A cross-sectional investigation of 287 cancer patients using a battery of self-reported questionnaires was performed. For preliminary analyses, descriptive, univariate, and Pearson correlation analyses were performed. Mediation analyses were tested using a serial-multiple mediation model (PROCESS model 6).
Results:
Mediation analysis indicated the indirect effects of social support on suicide resilience mediated solely by either self-care self-efficacy (point estimate = 0.20; 95% confidence interval [CI], 0.12-0.30), or by meaning in life (point estimate = 0.06; 95% CI, 0.01-0.12), or by the multiple mediation of self-care self-efficacy to meaning in life (point estimate = 0.03; 95% CI, 0.01-0.06).
Conclusions:
The findings demonstrated the crucial direct or indirect effects of social support, self-care self-efficacy, and meaning in life on facilitating cancer patients' suicide resilience.
Implications for practice:
Oncology nurses, as 24-hour care providers for cancer patients, may interact with and be important sources for the psychosocial care of cancer patients at risk of suicide. Prevention and intervention efforts must be directed at assisting cancer patients, improving self-care self-efficacy, and finding meaning in life after a cancer diagnosis.
A wide body of psychological research corroborates the claim that whether one’s life is (or will be) meaningful appears relevant to whether it is rational to continue living. This chapter advances conceptions of life’s meaningfulness and of suicidal choice with an eye to ascertaining how the former might provide justificatory reasons relevant to the latter. Drawing upon the recent theory of meaningfulness defended by Cheshire Calhoun, the decision to engage in suicide can be understood as a choice related to life’s meaningfulness insofar as an individual can see no point in investing her agency in her anticipated future. These meaning-based reasons relevant to suicidal choice either cannot be reduced to the reasons of well-being that philosophers have typically used to analyse suicide decisions or at least forms a distinct class of reasons within those that contribute to well-being.
Objective
Suicide is a complex multifactorial process influenced by a variety of biological, psychological, and social stressors. Many older adults face a characteristic set of challenges that predispose them to suicidal ideation, suicide-related behavior, and death by suicide. This study explored the subjective experience of suicidality through the analysis of suicide notes from older adults.
Design
Qualitative study analyzing written suicide notes.
Setting
Written notes for suicide deaths in Toronto, Canada, between 2003 and 2009 were obtained from the Office of the Chief Coroner for Ontario.
Participants
The analysis comprised 29 suicide notes (mean words per note: 221; range: 6-1095) written by individuals 65 years and older (mean ± SD age: 76.2 ± 8.3).
Measurements
We employed a constructivist grounded theory framework for the analysis, conducted through line-by-line open coding, axial coding, and theorizing of data to establish themes.
Results
Suicide notes elucidated the writers’ conception of suicide and their emotional responses to stressors. Expressed narratives contributing to suicide centered on burdensomeness or guilt, experiences of mental illness, loneliness or isolation, and poor physical health or disability. Terms related to pain, poor sleep, apology, and inability to go on were recurrent.
Conclusions
Suicide notes enrich our understanding of the thoughts and emotions of those at highest risk of suicide, and they inform potential interventions for reducing suicide risk in older adults.
Objective:
Many people who die by suicide experience major depressive disorder (MDD), but most people with MDD do not die by suicide and many do not report thoughts of death or suicide. This cross-sectional study examined the potential of personal growth initiative (PGI) skills to protect against suicide ideation among adult psychotherapy outpatients.
Method:
Adult outpatients (N = 178) completed measures of suicide ideation severity (SI), depressive symptom severity (DEP), and PGI skills (PGI) at intake.
Results:
Although higher DEP significantly correlated with higher suicide ideation, a significant DEP × PGI interaction, indicated significant positive relations between DEP and SI only when PGI was at or below the mean for this sample.
Conclusions:
PGI skills may function as a protective factor against the development of suicide ideation even in the presence of severe depressive symptoms. This suggests that training PGI skills might prevent or reduce suicide ideation among depressed patients.
The highest suicide rates are among elderly men. The aim of the present study is to extend previous findings by focusing on meaning in life as a protective factor for suicidal ideation among elderly men. Self-report measures were administered to 170 elderly men aged 65 and over in community. Meaning in life and physical illness predicted suicidal ideation among elderly men. Physical illness moderated the association between meaning in life and suicidal ideation. In the young-old group (ages 65–74), meaning in life predicted suicidal ideation among those who reported higher rates of physical illness. This moderation effect was not found among the older group (aged 75 years and older). The findings of this study highlight the importance of age-differences in studying suicidal ideation among elderly men. Our findings emphasize the importance of cultivating and maintaining meaning in life when coping with chronic illnesses and point at meaning in life as a goal in therapeutic interventions designed to reduce suicidal ideation among elderly.
Background
: Older adults with bipolar disorder (BD) commonly present with cognitive deficits (e.g., attention, memory, verbal fluency). Concomitantly, older adults with BD commonly report subjective or perceived cognitive failures. For this study, we confirmed a 3-factor model of cognitive failures first validated with older adults free of mental illness (i.e., forgetfulness, distractibility, false triggering). We then computed a structural equation model (SEM) demonstrating the construct validity of perceived cognitive errors in relation to quality of life with BD. Use of SEM enabled us to measure quality of life broadly and germane to BD (i.e., well-being, life satisfaction, alcohol misuse, sleep quality).
Methods
: We obtained responses from an international sample of 350 older adults with BD (M = 61.26 years of age, range 50-87), recruited via micro-targeted social media advertising. Most lived in Canada, the U.S., U.K., Ireland, Australia and South Africa.
Results
: As hypothesized, perceived cognitive failures were predicted by BD symptoms (depression and hypo/mania). And cognitive failures directly and indirectly predicted quality of life.
Limitations
: Future research is needed to replicate this QoL model over time with younger patients and those recruited using more traditional methods.
Conclusions
: Perceived cognitive failures may not be strongly correlated with objective indices of cognitive deficits; nonetheless perceived cognitive failures are significantly associated with quality of life for older adults with BD. For both cognitive errors and BD symptoms, their indirect effect on quality of life (via suicide ideation) is greater than the direct effect.
Objectives
To initially assess psychometric properties of two abbreviated versions of the Geriatric Suicide Ideation Scale (GSIS): a 10-item Brief Geriatric Suicide Ideation Scale (BGSIS), and a 5-item Geriatric Suicide Ideation Scale-Screen (GSIS-Screen).
Methods
A series of psychometric analyses was conducted, assessing the internal consistency, test–retest reliability, construct and predictive validity of the abbreviated GSIS scales. This was done by selecting-out GSIS items from a combined dataset of studies on suicide ideation in older adults: 1) The GSIS scale development study (n = 107); 2) A clinical trial of Interpersonal Psychotherapy (IPT) modified for suicidal older adults(n = 25); 3) A longitudinal study of risk and resiliency to suicide ideation in community-residing older adults (n = 173).
Results
Overall findings demonstrated strong internal consistency, test–retest reliability, concurrent and predictive validity for the BGSIS and GSIS-Screen with older adults across community, clinical, and residential settings.
Conclusion
Study findings support the use of the abbreviated GSIS scales when conducting research on suicide risk identification among older adults. Future research is recommended testing these scales prospectively in public health, residential, and clinical settings, in research and healthcare delivery contexts.
Purpose
This mixed‐methods study evaluated a group logotherapy program's efficacy on Korean older adults with depressive symptoms.
Design and Methods
An intervention group (n = 23) participated in eight sessions of group logotherapy; a control group (n = 21) received the usual care. Participants completed the pretest, posttest, and 4‐week follow‐up questionnaires. Ten participants also had focus group or individual interviews.
Findings
A linear mixed model showed significant differences between groups in terms of changes in purpose in life, depression, self‐esteem, and quality of life over time. These quantitative findings were supported and enriched by qualitative data.
The current commentary and review examines the potentially protective role of feelings of mattering among elderly people during typical times and the current atypical times associated with the COVID-19 global pandemic. Mattering is the feeling of being important to others in ways that give people the sense that they are valued and other people care about them. We contrast this feeling with messages of not mattering and being expendable and disposable due to ageism, gaps in the provision of care, and apparently economically focused positions taken during the pandemic that disrespect the value, worth, and merits of older persons. We provide a comprehensive review of past research on individual differences in mattering among older adults and illustrate the unique role of mattering in potentially protecting older adults from mental health problems. Mattering is also discussed in terms of its links with loneliness and physical health. This article concludes with a discussion of initiatives and interventions that can be modified and enhanced to instill a sense of mattering among older adults. Key directions for future research are also highlighted along with ways to expand the mattering concept to more fully understand and appreciate the relevance of mattering among older adults.
Today, in many countries, elderly suicide is considered as an important issue in public health. The present study aimed to predict suicidal ideation based on interpersonal cognitive distortions, positive and negative affect, perceived social support and meaning in life in the elderly without a spouse. It was a correlational descriptive study. The statistical population of the study included all elderly attending nursing homes in Ardabil in 2019 among whom 111 were selected by convenience sampling method. Beck Scale for Suicidal Ideation, Hamamci and Buyukozturk Scale for Interpersonal Cognitive Distortions, Watson and Clark Questionnaire for Positive and Negative Affect, Zimet Multiple Scale for Perceived Social Support and Steger Questionnaire for Meaning in Life were used to collect the required data. Data were analyzed using Pearson correlation coefficient and regression analysis in SPSS version 23 software. The results showed a significant positive correlation between interpersonal cognitive distortions and negative affect with suicidal ideation of the elderly (P<0/01). In addition, there was a significant negative correlation between positive affect and perceived social support with suicidal ideation of elderly (P<0/01). However, results suggested no significant correlation between meaning in life and suicidal ideation of elderly. In addition, the results of regression analysis revealed that approximately 48% of the total variance of suicidal ideation was predicted based on cognitive distortions, positive and negative affect and perceived social support (P<0/01). In general, according to the findings of the study and in order to prevent the occurrence of suicidal ideation in elderly without a spouse, it was recommended to pay attention to dimension such as interpersonal cognitive distortions, positive and negative affect and perceived social support.
Objectives:
Prior research has found that insomnia symptoms and nightmares are associated with suicidal ideation, suicide attempts, and death by suicide. However, to the best of our knowledge, no research has examined the relation between insomnia symptoms, nightmares, and suicidal ideation in older adults. The current project aimed to fill this void by investigating the relation between insomnia symptoms, nightmares, and suicidal ideation in an older adult sample.
Method:
The study utilized a cross-sectional design. The sample consisted of 81 older adult patients (age ≥ 65 years) recruited from a family medicine clinic. The participants were asked to complete surveys about their sleep, symptoms of depression, and suicidal ideation.
Results:
Insomnia symptoms, but not nightmares, were significantly related to suicidal ideation. In addition, insomnia symptoms were related to suicidal ideation independent of nightmares. Furthermore, the relation between insomnia symptoms and suicidal ideation was mediated by depressive symptoms.
Discussion:
These findings have implications for the identification and treatment of suicidal ideation in older adults.
Functional impairment might amplify suicide risk in later life. A positive view of the future may reduce this risk. We tested the hypothesis that hopelessness and positive future orientation moderate the association between functional status and suicide ideation in a sample of 136 patients, 55 years of age or older, in treatment for depression. Future orientation moderated the association between functional status and suicide ideation; hopelessness did not. Although prospective research is needed to test more rigorously the hypothesized protective role of positive future orientation, our data suggest that treatments designed to enhance future orientation might decrease suicide risk.
The goal of the current study was to investigate psychological resilience in the older adults (>64 years) compared with that of the young ones (<26 years).
Questionnaire measures of depression, hopelessness, general health and resilience were administered to the participants. The resilience measure comprised three sub-scales of social support, emotional regulation and problem solving.
The older adults were the more resilient group especially with respect to emotional regulation ability and problem solving. The young ones had more resilience related to social support. Poor perceptions of general health and low energy levels predicted low levels of resilience regardless of age. Low hopelessness scores also predicted greater resilience in both groups. Experiencing higher levels of mental illness and physical dysfunction predicted high resilience scores especially for the social support resilience scale in the older adults. The negative effects of depression on resilience related to emotional regulation were countered by low hopelessness but only in the young adults.
These results highlight the importance of maintaining resilience-related coping skills in both young and older adults but indicate that different psychological processes underlie resilience across the lifespan.
An increasingly important concern for clinicians who care for patients at the end of life is their spiritual well-being and sense of meaning and purpose in life. In response to the need for short-term interventions to address spiritual well-being, we developed Meaning Centered Group Psychotherapy (MCGP) to help patients with advanced cancer sustain or enhance a sense of meaning, peace and purpose in their lives, even as they approach the end of life.
Patients with advanced (stage III or IV) solid tumor cancers (N=90) were randomly assigned to either MCGP or a supportive group psychotherapy (SGP). Patients were assessed before and after completing the 8-week intervention, and again 2 months after completion. Outcome assessment included measures of spiritual well-being, meaning, hopelessness, desire for death, optimism/pessimism, anxiety, depression and overall quality of life.
MCGP resulted in significantly greater improvements in spiritual well-being and a sense of meaning. Treatment gains were even more substantial (based on effect size estimates) at the second follow-up assessment. Improvements in anxiety and desire for death were also significant (and increased over time). There was no significant improvement on any of these variables for patients participating in SGP.
MCGP appears to be a potentially beneficial intervention for patients' emotional and spiritual suffering at the end of life. Further research, with larger samples, is clearly needed to better understand the potential benefits of this novel intervention.
The standard life events methodology for the prediction of psychological symptoms was compared with one focusing on relatively minor events, namely, the hassles and uplifts of everyday life. Hassles and Uplifts Scales were constructed and administered once a month for 10 consecutive months to a community sample of middle-aged adults. It was found that the Hassles Scale was a better predictor of concurrent and subsequent psychological symptoms than were the life events scores, and that the scale shared most of the variance in symptoms accounted for by life events. When the effects of life events scores were removed, hassles and symptoms remained significantly correlated. Uplifts were positively related to symptoms for women but not for men. Hassles and uplifts were also shown to be related, although only modestly so, to positive and negative affect, thus providing discriminate validation for hassles and uplifts in comparison to measures of emotion. It was concluded that the assessment of daily hassles and uplifts may be a better approach to the prediction of adaptational outcomes than the usual life events approach.