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Post-traumatic distress and the presence of post-traumatic growth and meaning in life Experiential avoidance as a moderator

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Abstract

Existing models of trauma suggest that for recovery to occur, trauma related cues and emotions require awareness and openness while survivors continue committing action toward valued life aims (other than regulating emotions). Based on this theoretical framework, an unwillingness to be in contact with distressing thoughts and feelings (experiential avoidance) might operate together with posttraumatic distress to predict when people find benefits and meaning in the aftermath of trauma. We hypothesized that people reporting posttraumatic distress and less reliance on experiential avoidance would report greater posttraumatic growth and meaning in life compared with other trauma survivors. We administered questionnaires to 176 college students reporting at least one traumatic event. Results supported these moderation models. This is the fourth study (with different samples, measures, and methodologies) to provide evidence that a combination of excessive anxiety and a heavy reliance on experiential avoidance leads to attenuated well-being. We discuss the implications for understanding heterogeneous trauma reactions.

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... r = 0.13). We followed the rationale of Kashdan and Kane [21] in that unwillingness to be in contact with distressing thoughts and feelings-i.e. experiential avoidance-would moderate the relation between Post-Traumatic Stress Disorder (PTSD) and growth. ...
... The assumption made about the moderating effect of experiential avoidance on the relationship between PTSD symptomatology and both perceived and actual growth con rms the study of Kashdan and Kane [21] for perceived growth only. For actual growth, this con rms the meta-analysis of Mangelsdorf et al. [13], who concluded that there is "no general evidence for the widespread conviction that negative life events have a stronger effect than positive ones". ...
... Therefore, the direct confrontation with the source of distress does not allow for actual growth, it is rather its acceptance and lack of over-judging that seems important. On the other hand, as for Kashdan and Kane [21], this direct confrontation seems to be associated with perceived growth. This may once again depict the interpretive activity of lived experience. ...
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Background. This prospective longitudinal study examined perceived and actual changes in post-traumatic growth following Hematopoietic Stem-Cell Transplantation (HSCT) and their relationships with mental health and psychological disposition. We also tested the hypothesis that unwillingness to be in contact with distressing thoughts and feelings—i.e. experiential avoidance—would moderate the relationship between Post-Traumatic Stress Disorder (PTSD) and growth. Methods. This study was carried out with 187 patients. All patients completed the Post-Traumatic Growth Inventory (PTGI) five months after HSCT and also scales tapping into the five domains of PTGI during and 5 months after HSCT. Mental health and psychological disposition were also assessed prior to hospitalization. A PTSD scale was administrated at the five-month follow-up. Results. Perceived and actual change were weakly correlated. Bayesian pre/post-HSCT comparisons in actual growth revealed substantial to very strong decline in four of the five dimensions assessed. Overall, RCI indicated a reliable increase for 5.6% of patients and a reliable decrease for 40.8% of patients. Confirming that perceived and actual growth reflect different processes, they were not related to the same mental health and psychological disposition variables. Moreover, the hypothesis that acquiring positive outcomes from a traumatic event, such as HSCT, requires direct confrontation with the source of distress that was supported in the case of perceived growth but not in the case of actual growth. Conclusions. Retrospective measures such as the PTGI do not appear to assess actual pre- to post-HSCT change. HSCT seems more linked to psychological decline than to growth.
... In support of the role of psychological flexibility in fostering PTG, one study highlighted that in the aftermath of trauma, experiential avoidance (the core process in psychological inflexibility operationalized in this study as a lack of psychological flexibility), moderated the link between PTS and PTG (Kashdan & Kane, 2011). That is, consistent with post-trauma processing theories and the inverse of the psychological flexibility model, people with higher PTS and greater avoidance of aversive trauma-related thoughts, feelings, and images, reported the lowest levels of PTG and meaning in life (Kashdan & Kane, 2011). ...
... In support of the role of psychological flexibility in fostering PTG, one study highlighted that in the aftermath of trauma, experiential avoidance (the core process in psychological inflexibility operationalized in this study as a lack of psychological flexibility), moderated the link between PTS and PTG (Kashdan & Kane, 2011). That is, consistent with post-trauma processing theories and the inverse of the psychological flexibility model, people with higher PTS and greater avoidance of aversive trauma-related thoughts, feelings, and images, reported the lowest levels of PTG and meaning in life (Kashdan & Kane, 2011). Only two studies have examined the relationship between psychological inflexibility and PTG during the pandemic (Bruno et al., 2022;Yildiz, 2021). ...
... This is likely to be due to a greater reliance on strategies that involve avoidance of trauma-related inner experiencing. Supporting this view is evidence showing that lower scores on the psychological flexibility processes are related to higher experiential avoidance (Rolffs et al., 2018), which in turn plays a key role in the development and maintenance of PTS , and reduces the potential for finding positives in adversity (Kashdan & Kane, 2011). ...
Article
The COVID-19 pandemic evokes high levels of post-traumatic stress (PTS) in some people as well as positive personal changes, a phenomenon known as post-traumatic growth (PTG). Experiencing an adverse event as traumatic is crucial for triggering PTG, therefore higher PTS is often associated with higher PTG. This longitudinal study examined the protective role of psychological flexibility in fostering PTG in a group of people reporting high PTS related to COVID-19 as compared to those with low PTS. We hypothesized that higher psychological flexibility will be associated with higher PTG in those with high PTS and that psychological flexibility would be unrelated to PTG in those with low PTS. Secondary data analysis was conducted on data from a larger project investigating the psychological impacts of COVID-19. Adult Italians (N = 382) completed online surveys at Time 1 (three months after the first national lockdown, July 2020) and Time 2 (three months later when the number of COVID-19 cases increased, October 2020). Based on the Impact of Event Scale–Revised cut-off score, two PTS groups were identified at Time 2: low PTS (below cut-off) and high PTS (above cut-off). As predicted, moderation analyses showed that after controlling for Time 1 PTS and PTG and confounding variables, Time 1 psychological flexibility was associated with higher Time 2 PTG in the high PTS group, whereas psychological flexibility was unrelated to PTG in the low PTS group. Four psychological flexibility sub-processes (present moment awareness, defusion, values, committed action) at Time 1 were related to higher Time 2 PTG in only the high PTS group. Findings advance understanding of the role of psychological flexibility in trauma reactions and pandemic mental health adjustment. Evidence-based approaches that target psychological flexibility, like Acceptance and Commitment Therapy, are likely to foster PTG and ultimately adjustment in people with high PTS during and after the pandemic.
... As for positive moments, it has been shown that sharing and intensely focusing on (savoring) positive events is related to higher momentary happiness (Jose et al. 2012). Highs and lows can also respectively catalyze post-ecstatic and post-traumatic growth, especially in terms of self-esteem, positive relations, and sense of mastery (Mangelsdorf et al. 2019); however, coping strategies, beliefs, and dispositions affect whether and how growth arises (Kashdan and Kane 2011). Importantly, highs and lows can be both represented as singular, self-relevant, impactful positive and negative events (Mangelsdorf et al. 2019), and as cumulated positive or cumulated negative events in a period, i.e., positive and negative events happening more than usual (Zautra et al. 2005). ...
... As reactions to events may have different relationships with hedonic and eudaimonic well-being, especially for what concerns negative events (e.g., Charles et al. 2013;Kashdan and Kane 2011), we also considered hedonism and eudaimonism, respectively defined as a dispositional focus on pleasure (orientation to pleasure) and a dispositional focus on meaning and purpose (orientation to meaning) in people's route to happiness (Huta and Waterman 2014). Both hedonism and eudaimonism were shown to be positively associated with life satisfaction and positive affect, and negatively associated with negative affect, with slightly stronger relationships for eudaimonism (Schueller and Seligman 2010). ...
... This suggests that bad events stimulate growth especially in individuals oriented toward the search for meaning in life, a finding consistent with Viktor Frankl's (1959) hypothesis that searching for meaning can help endure suffering. From our findings, it seems that a focus on meaning and meaningful experiences may help individuals learn from and relate to negative events; this would also be consistent with Kashdan and Kane's (2011) finding that people willing to be in contact with distressing thoughts and feelings related to a trauma report greater posttraumatic growth and meaning, compared to other people with the same level of posttraumatic distress. ...
Article
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In a four-wave, longitudinal study (N = 323), we tested the relationships between five positive dispositions—mindfulness, self-compassion, gratitude, hedonism, and eudaimonism—and time-varying negative affect, positive affect, life satisfaction, and meaning in life. These relationships were tested while controlling for the ups and downs in life across three months, operationalized as the effects, for a respondent, of having experienced more frequent and intense positive and negative events compared to other individuals in the sample (inter-individual variation) and of having experienced more frequent and intense positive and negative events than usual for that person (intra-individual variation). We also tested the interactive effects between each disposition and intra-individual variation in the frequency and intensity of negative and positive events on well-being variables. Results, obtained through multilevel models with repeated observations nested in individuals, showed that each disposition had specific associations with well-being indicators, although stronger effects were detected for eudaimonism and, especially, self-compassion. Moderation analyses showed that: mindfulness and self-compassion buffered intra-individual variation in negative events; people scoring higher on hedonism, eudaimonism, and self-compassion showed less need to rely on positive events to experience positive emotions; experiencing a negative event that was more intense than usual was associated with higher meaning in life for people with high levels of eudaimonism. Overall, findings suggest that mindfulness, self-compassion, gratitude, hedonism, and eudaimonism build well-being through different channels. Positive interventions could benefit from mixing these healthy functioning strategies and considering their roles in reactions to events.
... r = 0.13). We followed the rationale of Kashdan and Kane [22] in that unwillingness to be in contact with distressing thoughts and feelings-i.e. experiential avoidance-would moderate the relationship between Post-Traumatic Stress Disorder (PTSD) and growth. ...
... The assumption made about the moderating effect of experiential avoidance on the relationship between PTSD and both measures of growth confirms the study of Kashdan and Kane [22] for retrospective measure of growth only. For the prospective measure of growth, this confirms the meta-analysis of Mangelsdorf et al. [13], who concluded that there is 'no general evidence for the widespread conviction that negative life events have a stronger effect than positive ones. ...
... Therefore, a direct confrontation with the source of distress does not allow for actual growth: it is rather its acceptance and lack of over-judging that seems important. On the other hand, as for Kashdan and Kane [22], this direct confrontation seems to be associated with retrospective perception of growth. This may once again depict the interpretive activity of lived experience. ...
Article
Full-text available
Background. This prospective longitudinal study examined and compared two measures (prospective and retrospective ones) of post-traumatic growth (PTG) following Hematopoietic Stem-Cell Transplantation (HSCT) and their respective relationships with mental health and psychological disposition. We also tested the hypothesis that unwillingness to be in contact with distressing thoughts and feelings—i.e. experiential avoidance—would moderate the relationship between Post-Traumatic Stress Disorder (PTSD) and growth. Methods. This study was carried out with 187 patients. Patients completed the Post-Traumatic Growth Inventory (PTGI) 5 months after HSCT and scales tapping into the five domains of PTGI during hospitalisation and 5 months after HSCT. Mental health and psychological disposition were also assessed prior to hospitalisation. A PTSD scale was administered at the five-month follow-up. Results. Prospective and retrospective measures of PTG were weakly correlated. Bayesian pre/post-HSCT comparisons in the prospective measure of PTG revealed substantial to very strong decline in four of the five dimensions assessed. Overall, RCI indicated a reliable increase for 5.6% of patients and a reliable decrease for 40.8% of patients. Confirming that retrospective and prospective measures of PTG reflect different processes, they were not related to the same mental health and psychological disposition variables. Moreover, the hypothesis that acquiring positive outcomes from a potentially traumatic experience, such as HSCT, requires direct confrontation with the source of distress was supported in the case of the retrospective measure of growth but not in the case of the prospective measure growth. Conclusions. Retrospective measures such as the PTGI do not appear to assess actual pre- to post-HSCT change. HSCT seems more linked to psychological decline than to growth.
... r = 0.13). We followed the rationale of Kashdan and Kane [22] in that unwillingness to be in contact with distressing thoughts and feelings-i.e. experiential avoidance-would moderate the relationship between Post-Traumatic Stress Disorder (PTSD) and growth. ...
... The assumption made about the moderating effect of experiential avoidance on the relationship between PTSD and both measures of growth con rms the study of Kashdan and Kane [22] for retrospective measure of growth only. For the prospective measure of growth, this con rms the meta-analysis of Mangelsdorf et al. [13], who concluded that there is 'no general evidence for the widespread conviction that negative life events have a stronger effect than positive ones. ...
... Therefore, a direct confrontation with the source of distress does not allow for actual growth: it is rather its acceptance and lack of over-judging that seems important. On the other hand, as for Kashdan and Kane [22], this direct confrontation seems to be associated with retrospective perception of growth. This may once again depict the interpretive activity of lived experience. ...
Preprint
Full-text available
Objective. This prospective longitudinal study examined and compared two measures (prospective and retrospective ones) of post-traumatic growth (PTG) following Hematopoietic Stem-Cell Transplantation (HSCT) and their respective relationships with mental health and psychological disposition. We also tested the hypothesis that unwillingness to be in contact with distressing thoughts and feelings—i.e. experiential avoidance—would moderate the relationship between Post-Traumatic Stress Disorder (PTSD) and growth. Methods. This study was carried out with 187 patients. Patients completed the Post-Traumatic Growth Inventory (PTGI) five months after HSCT and scales tapping into the five domains of PTGI during hospitalization and five months after HSCT. Mental health and psychological disposition were also assessed prior to hospitalization. A PTSD scale was administered at the five-month follow-up. Results. Prospective and retrospective measures of PTG were weakly correlated. Bayesian pre/post-HSCT comparisons in the prospective measure of PTG revealed substantial to very strong decline in four of the five dimensions assessed. Overall, RCI indicated a reliable increase for 5.6% of patients and a reliable decrease for 40.8% of patients. Confirming that retrospective and prospective measures of PTG reflect different processes, they were not related to the same mental health and psychological disposition variables. Moreover, the hypothesis that acquiring positive outcomes from a potentially traumatic experience, such as HSCT, requires direct confrontation with the source of distress was supported in the case of the retrospective measure of growth but not in the case of the prospective measure growth. Conclusions. Retrospective measures such as the PTGI do not appear to assess actual pre- to post-HSCT change. HSCT seems more linked to psychological decline than to growth.
... r = 0.13). We followed the rationale of Kashdan and Kane [22] in that unwillingness to be in contact with distressing thoughts and feelingsi.e. experiential avoidance-would moderate the relationship between Post-Traumatic Stress Disorder (PTSD) and growth. ...
... The assumption made about the moderating effect of experiential avoidance on the relationship between PTSD and both measures of growth con rms the study of Kashdan and Kane [22] for retrospective measure of growth only. For the prospective measure of growth, this con rms the meta-analysis of Mangelsdorf et al. [13], who concluded that there is 'no general evidence for the widespread conviction that negative life events have a stronger effect than positive ones. ...
... Therefore, a direct confrontation with the source of distress does not allow for actual growth: it is rather its acceptance and lack of over-judging that seems important. On the other hand, as for Kashdan and Kane [22], this direct confrontation seems to be associated with retrospective perception of growth. This may once again depict the interpretive activity of lived experience. ...
Preprint
Full-text available
Background. This prospective longitudinal study examined and compared two measures (prospective and retrospective ones) of post-traumatic growth (PTG) following Hematopoietic Stem-Cell Transplantation (HSCT) and their respective relationships with mental health and psychological disposition. We also tested the hypothesis that unwillingness to be in contact with distressing thoughts and feelings—i.e. experiential avoidance—would moderate the relationship between Post-Traumatic Stress Disorder (PTSD) and growth. Methods. This study was carried out with 187 patients. Patients completed the Post-Traumatic Growth Inventory (PTGI) five months after HSCT and scales tapping into the five domains of PTGI during hospitalisation and five months after HSCT. Mental health and psychological disposition were also assessed prior to hospitalisation. A PTSD scale was administered at the five-month follow-up. Results. Prospective and retrospective measures of PTG were weakly correlated. Bayesian pre/post-HSCT comparisons in the prospective measure of PTG revealed substantial to very strong decline in four of the five dimensions assessed. Overall, RCI indicated a reliable increase for 5.6% of patients and a reliable decrease for 40.8% of patients. Confirming that retrospective and prospective measures of PTG reflect different processes, they were not related to the same mental health and psychological disposition variables. Moreover, the hypothesis that acquiring positive outcomes from a potentially traumatic experience, such as HSCT, requires direct confrontation with the source of distress was supported in the case of the retrospective measure of growth but not in the case of the prospective measure growth. Conclusions. Retrospective measures such as the PTGI do not appear to assess actual pre- to post-HSCT change. HSCT seems more linked to psychological decline than to growth.
... r = 0.13). We followed the rationale of Kashdan and Kane [22] in that unwillingness to be in contact with distressing thoughts and feelings-i.e. experiential avoidance-would moderate the relationship between Post-Traumatic Stress Disorder (PTSD) and growth. ...
... The assumption made about the moderating effect of experiential avoidance on the relationship between PTSD and both measures of growth con rms the study of Kashdan and Kane [22] for retrospective measure of growth only. For the prospective measure of growth, this con rms the meta-analysis of Mangelsdorf et al. [13], who concluded that there is 'no general evidence for the widespread conviction that negative life events have a stronger effect than positive ones. ...
... Therefore, a direct confrontation with the source of distress does not allow for actual growth: it is rather its acceptance and lack of over-judging that seems important. On the other hand, as for Kashdan and Kane [22], this direct confrontation seems to be associated with retrospective perception of growth. This may once again depict the interpretive activity of lived experience. ...
Preprint
Full-text available
Background. This prospective longitudinal study examined and compared two measures (prospective and retrospective ones) of post-traumatic growth (PTG) following Hematopoietic Stem-Cell Transplantation (HSCT) and their respective relationships with mental health and psychological disposition. We also tested the hypothesis that unwillingness to be in contact with distressing thoughts and feelings—i.e. experiential avoidance—would moderate the relationship between Post-Traumatic Stress Disorder (PTSD) and growth. Methods. This study was carried out with 187 patients. Patients completed the Post-Traumatic Growth Inventory (PTGI) five months after HSCT and scales tapping into the five domains of PTGI during hospitalisation and five months after HSCT. Mental health and psychological disposition were also assessed prior to hospitalisation. A PTSD scale was administered at the five-month follow-up. Results. Prospective and retrospective measures of PTG were weakly correlated. Bayesian pre/post-HSCT comparisons in the prospective measure of PTG revealed substantial to very strong decline in four of the five dimensions assessed. Overall, RCI indicated a reliable increase for 5.6% of patients and a reliable decrease for 40.8% of patients. Confirming that retrospective and prospective measures of PTG reflect different processes, they were not related to the same mental health and psychological disposition variables. Moreover, the hypothesis that acquiring positive outcomes from a potentially traumatic experience, such as HSCT, requires direct confrontation with the source of distress was supported in the case of the retrospective measure of growth but not in the case of the prospective measure growth. Conclusions. Retrospective measures such as the PTGI do not appear to assess actual pre- to post-HSCT change. HSCT seems more linked to psychological decline than to growth.
... Prior research has established the role of meaning in life in the perception of positive changes and life satisfaction. A positive relationship was found between the presence of meaning in life and PTG (Kashdan & Kane, 2011;Linley & Joseph, 2011;Triplett et al., 2012). Moreover, even if the search for meaning was not related to positive changes following adversity, it is believed to be vital for the development of positive outcomes (Linley & Joseph, 2011). ...
... Consistent with our hypothesis, the results indicate a positive association between PTG and the presence of meaning. Our results are in line with previous findings that established a positive correlation between general positive changes or its domains with the presence of meaning in life among student samples, tornado survivors, churchgoers, the general population and funeral directors (Kashdan & Kane, 2011;Lancaster & Carlson, 2014;Linley & Jospeh, 2011;Triplett et al., 2012;Weber et al., 2019). These results suggest that people who experienced more PTG might see their lives as more purposeful and meaningful, which can contribute to narratives about the lives of survivors in general. ...
Article
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Although it is known that facing cancer may be accompanied by a range of chronic and acute stress reactions, it can also contribute to positive psychological changes and influence one's life perception. The aim of this cross-sectional study was to investigate relationship between posttraumatic growth (PTG), meaning in life and life satisfaction to determine whether the presence of meaning or the search for meaning mediated the relationship between PTG and life satisfaction. The study was conducted with 149 cancer survivors who were at least one-month post-completion of all medical cancer therapy. The results indicate positive associations between PTG, the presence of meaning in life, the search for meaning and life satisfaction. Moreover, the relationship between PTG and life satisfaction could be explained by the mediating effect of the presence of meaning in life. Thus, it is important for clinicians to systematically facilitate PTG, meaning in life and life satisfaction as protective factors to one's daily functioning.
... For example, lower levels of EA protected against the detrimental influence of ostracism on eudaimonic well-being (Waldeck et al., 2020). In contrast, when EA was high, greater use of dysfunctional emotion regulation strategies predicted greater negative emotion (Fitzpatrick et al., 2019), whereas greater distress predicted lower MIL, when EA was high (Kashdan & Kane, 2011). distinct dimensions of well-being, with joy as an indicator of subjective well-being, and presence of MIL as an indicator of eudaimonic well-being (Huta & Waterman, 2014). ...
... We examined these associations using a panel model with three time points (Newsom, 2015;Selig & Preacher, 2009). R/S exploration can exert a risk influence on well-being (e.g., Cook et al., 2014;Francis & Crea, 2016), thus we explored the influence of EA as a moderator of the exploration -well-being association given prior use of EA as a moderator of predictors of well-being (e.g., Fitzpatrick et al., 2019;Kashdan & Kane, 2011). Further, since humility and patience tend to exert a salutary influence on well-being (e.g., Krause et al., 2016;Schnitker, 2012), we modeled humility and patience as additional moderators potentially buffering the potential negative influence for EA on well-being. ...
Article
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Prior research on the religiousness/spirituality—well-being association has largely neglected the dimension of religious/spiritual exploration, and the recent trend examining virtues, religiousness/spirituality, and well-being has predominantly involved cross-sectional data. We expanded prior research by analyzing a longitudinal model consisting of three waves of data, approximately 6 months between waves, that explored the associations between experiential avoidance, humility, patience, religious/spiritual exploration, and distinct dimensions of well-being. We used joy as an indicator of the positive emotion dimension of subjective well-being, and presence of meaning in life as an indicator of eudaimonic well-being. We used a diverse sample of emerging religious leaders attending 18 graduate theological schools across North America (N = 283; Mage = 29.81; SD = 0.51; range = 19–62; 47.7% female; 61.8% White). We observed a negative influence for initial levels of exploration on later joy and meaning in life, when initial levels of experiential avoidance were high and humility was low. In contrast, we found a positive influence for initial levels of exploration on later joy and meaning in life, when initial levels of experiential avoidance remained high and humility was high. Initial levels of patience exhibited a positive influence on meaning in life 1 year later, indirectly via greater levels of exploration at time 2. Practical implications centered on providing opportunities for individuals to explore alternative beliefs, practices and experiences, and encouraging engagement in humility and patience self-cultivation practices, each of which could move them toward greater well-being.
... In contrast, higher psychological inflexibility is related to psychopathology (Hayes et al., 2006;Kashdan & Rottenberg, 2010;Stabbe et al., 2019). In particular, higher psychological inflexibility has been found to predict trauma and mental health problems in the context of violent crimes (Gold, Marx, & Lexington, 2007), school shootings (Kumpula, Orcutt, Bardeen, & Varkovitzky, 2011), and death of a loved one, motor vehicle accidents and witnessing violence in the home or natural disasters (Kashdan & Kane, 2011). ...
... Results from the present study that show higher psychological inflexibility exacerbates the adverse effects of COVID-19 pandemic and lockdown risk factors on mental health are aligned with findings from research indicating that higher psychological inflexibility predicts psychopathology in a variety of contexts including community disasters (e. g., Gold et al., 2007;Kashdan & Kane, 2011;Kumpula et al., 2011). ...
Article
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The Moderating Roles of Psychological Flexibility and Inflexibility on the Mental Health Impacts of COVID-19 Pandemic and Lockdown in Italy. Preliminary data suggest the COVID-19 pandemic has adverse effects on mental health in approximately a quarter of the general population. Few prior studies have identified contextual risk factors and no published study has explored factors that might moderate their adverse effects on mental health. Psychological flexibility is the cornerstone of psychological health and resiliency. This study investigated the roles of psychological flexibility and inflexibility in moderating the effects of COVID-19 risk factors on three mental health outcomes: COVID-19 peritraumatic distress, anxiety, depression. We hypothesized that psychological flexibility would mitigate and psychological inflexibility would exacerbate the adverse effects of COVID-19 risk factors on mental health. During the Italian national lockdown (M=39.29 days, SD=11.26), 1,035 adults (79% female, M=37.5 years, SD=12.3) completed an online survey. Twelve COVID-19 risk factors were identified (e.g. lockdown duration, family infected by COVID-19, increase in domestic violence and in unhealthy lifestyle behaviours) and constituted a COVID-19 Lockdown Index. As predicted, results showed that after controlling for sociodemographic variables, global psychological flexibility and four of its sub-processes (self-as context, defusion, values, committed action), mitigated the detrimental impacts of COVID-19 risk factors on mental health. In contrast and as expected, global psychological inflexibility and four of its sub-processes (lack of contact with present moment, fusion, self-as-content, lack of contact with personal values) exacerbated the detrimental impacts of COVID-19 risk factors on mental health. Findings converge with those from the broader psychological flexibility literature providing robust support for the use of ACT-based interventions to promote psychological flexibility and mental health during the COVID-19 pandemic.
... Hence, it is reasonable to assume that presence of meaning is central to understanding positive change, posttraumatic growth in particular. And indeed, there is evidence to suggest that higher meaning in life is tied to greater PTG (e.g., Kashdan and Kane 2011;Linley and Joseph 2011) and other forms of positive changes following a trauma (Steger et al. 2008). ...
... Second, the three potential mediators tested in the current investigation were positively linked to PTG. This finding is largely consistent with previous findings linking meaning in life (e.g., Kashdan and Kane 2011;Linley and Joseph 2011) and social support (e.g., Nenova et al. 2013;Prati and Pietrantoni 2009) to PTG, and is in line with our theoretical speculation that self-control might be a significant predictor of PTG, and with findings of a few studies linking internal locus of control (Zarin et al., 2017) and self-efficacy (Cummings and Swickert 2010) to PTG. The finding that self-control was strongly and positively correlated with PTG is worth stressing here as this is the first study to test the link between these two constructs. ...
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This study applied a cross-sectional design and used a sample of 204 Muslim parents who lost their children due to traffic accidents, to answer two questions: (1) do positive religious coping (PRC) and negative religious coping (NRC) predict posttraumatic growth (PTG) among Muslims?; (2) are the links between the two types of religious coping and PTG direct or indirect? Three potential mediators between religious coping and PTG were examined: meaning in life, self-control, and social support. Analyses showed that: (1) a direct, moderate positive link existed between PRC and PTG, and; (2) the link between NRC and PTG was indirect and mediated by meaning in life and self-control. Specifically, higher levels of NRC were linked to lower levels of both meaning in life and self-control, which in turn were linked to lower levels of PTG. The findings suggest that in contrast to PRC that is likely to be inherently linked to PTG, there is nothing inherent in NRC that corresponds to PTG.
... This is consistent with the results of previous studies examining traumatic events. For instance, in some studies, if a person experiencing a traumatic event does not find a sense of meaning despite searching for it, the negative psychological symptoms, such as depressive symptoms, are exacerbated; however, PML reduced the harmful effects of SML (Kashdan & Kane, 2011;Linley & Joseph, 2011). The results of this study are consistent with the results of those showing positive correlations between SML and PML, which are more common in interdependent cultures; on the contrary, SML and PML are more often negatively correlated in past research using Western samples (Steger, Kawabata, Shimai, & Otake, 2008). ...
Article
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Background : Meaning in life has been associated with greater mental health. However, previous findings are inconsistent regarding how the search for meaning in life (SML) is related to mental health issues such as symptoms of depression and anxiety. This study proposed and tested a new model to explain how the relationship between SML and symptoms of depression as well as anxiety can be moderated by life events and mediated by the presence of meaning in life (PML). Methods : Middle and high school students (N = 1,705, 836 girls and 869 boys; Mage = 14.37, SD = 1.70) were administrated the Meaning in Life Questionnaire, Adolescent Self-Rating Life Events Checklist, Center for Epidemiologic Studies Depression Scale, and the State Anxiety Inventory. Results : Results showed that the relationship between SML and symptoms of depression (or anxiety) depended on the impact of the life events experienced by the individual. In general, SML served as a beneficial or unrelated factor for those experiencing low impactful life events, but as a harmful factor for those experiencing high impactful life events. For those experiencing middle impactful life events, SML had a positive direct effect, but a negative indirect effect (through PML) on symptoms of depression (or anxiety). Limitations : Data are cross-sectional, and the present study examined only middle school students, which may limit generalizability. Conclusions : The findings indicate a complex relationship between SML and mental health. Symptoms of depression, anxiety, and other related problems may be diminished by applying training programs and policies aimed at increasing PML and reducing negative life events.
... These findings could be interpreted in light of recent theoretical conceptualization of EA as a generalized form of psychological vulnerability and an integrative explanatory construct in psychopathology (Chawla & Ostafin, 2007;Kashdan et al., 2006). On the other hand, it is possible that particularly in cases of traumatic experience EA, and not CR or ES, is a better correlate of PTSS outcome (Kashdan & Kane, 2011) or a key facilitator of coping-oriented alcohol use (DeMartini & Carey, 2011). Therefore, future research should further explore the unique contribution and inter-correlation of EA, ER and CS in moderating the PTSS AUD association. ...
Article
Introduction the association between Posttraumatic Stress symptoms (PTSS) and Alcohol Use Disorder (AUD) among combat veterans is well established. However, little is known concerning the intertwining effect of distress oriented coping mechanisms on this association. In this study, we sought to explore the moderating role of experiential avoidance (EA), cognitive reappraisal (CR) and expressive suppression (ES) on the association between PTSS and AUD among Israeli combat veterans. Method Participants were 189 Israel Defense Forces (IDF) male combat veterans (mean age = 30.03) who completed a set of validated self-report questionnaires assessing PTSS, AUD, EA, CR and ES. Moderation analyses were conducted using a four-step hierarchical regression analysis and an ordinary least squares regression analysis. Results Analyses indicated that individuals with average or high levels of EA or ES exhibited significant positive association between PTSS and AUD, yet those with low levels of EA or ES exhibited no significant association between PTSS and AUD (b = 0.14,Confidence Interval (CI)[0.06, 0.22, SE = 0.04, t = 3.65, p = .000, 95%] for EA and b = 0.17, CI[0.07, 0.25, SE = 0.04, t = 3.69, p = .000, 95%] for ES). In addition, CR moderated the association between PTSS and AUD (b = 0.18, CI[0.07, 0.29, SE = 0.06, t = 3.24, p = .001, 95%]), so that the association between PTSS and AUD is positive and stronger for higher levels of CR. Conclusions Our findings imply that EA, ES and CR and emotion regulation may be major facilitators of the association between PTSS and AUD among combat veterans. These findings are discussed in the Israeli context as well as in light of a general psychological perspective.
... This literature indicates that whilst the majority of exposed individuals will express symptoms of distress in the immediate aftermath of an event, these will wane over time. This natural recovery means that up to 80% of these exposed to a traumatic event will not develop PTSD (Kashdan and Kane, 2011). ...
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Introduction: Research examining the prevention of Posttraumatic Stress Disorder (PTSD) has shown that selective treatments to those with high symptom levels, using trauma focused CBT are relatively successful in reducing symptoms and preventing chronic PTSD. However, uptake of these early treatments is often low. This study aimed to provide an internet based Virtual Reality treatment to overcome some of these barriers to early treatment. Method: The study received IRB approval from Hadassah Hospital (HMO 0056-013); its ClinicalTrials.gov identifier is NCT01760213. Recent survivors of motor vehicle accidents (N = 1,500) were assessed by telephone and online questionnaires. Patients meeting study criteria were randomly assigned to a Virtual Reality internet-based trauma-focused cognitive behavioral therapy (CBT) or waitlist control. Results: the majority of subjects recruited did not meet study criteria or were unwilling to participate. 14 subjects were randomly assigned to treatment or waitlist control. Results indicate that both groups show a decline in PTSD symptoms at follow up, with no significant differences between groups. Discussion: prevention of PTSD is a challenging goal, and internet-based interventions may play a role in this. The current study was not able to recruit sufficient participants to draw conclusions regarding the efficacy of the treatment. Proving services via the internet may not reduce barriers to care in this population. Clinical Trial Registration: https://clinicaltrials.gov/ct2/show/NCT01760213?term=Freedman&cond=PTSD&cntry=IL&draw=2&rank=2 , identifier NCT01760213.
... Reliance on avoidance coping following ABI has been recognised elsewhere within the qualitative ABI literature [24]. Gracey et al. [28] argued that while avoidance coping may reduce distress in the short term, it ultimately limits opportunities for closing the gap between the pre and post-injury self and may detract from the possibility of gaining meaning from traumatic experiences [86]. Perceptions of powerlessness may cause individuals to underestimate their ability to cope with distressing emotions [87] and limit effective coping [88]. ...
Article
Objective To explore the experience of living with an Acquired Brain Injury (ABI) in individuals who report higher or lower posttraumatic growth (PTG). Method A multi-method design was employed. Participant scores on the Posttraumatic Growth Inventory (PTGI) were used to identify groups for qualitative comparative analysis. Individual semi-structured interviews were conducted with fourteen individuals with ABI. Data were analysed thematically. Results Four themes emerged. The first two themes: “In my mind I was fine” surviving in aftermath of acquiring a brain injury and The everyday as “derailing” capture the transition process from an initial rehabilitation state characterised by neuropsychological and avoidance coping, towards active rebuilding for PTG. Internal building blocks for PTG and Growing in the social world: “you need to have that social connection” elaborate on the internal (e.g., acceptance, integration of the pre and post-injury self) and external (e.g., social relationships) factors seen to facilitate or obstruct PTG. Conclusions Under certain conditions, individuals living with ABI may construe positive growth from their experiences. Practitioners can support PTG development by providing individual and family-based supports aimed at increasing acceptance, the integration of self, and social connection throughout all stages of ABI rehabilitation. • IMPLICATIONS FOR REHABILITATION • Internal factors such as having a flexible and positive mindset and external factors such as one’s social environment can affect how individuals living with an ABI construe positive growth. • Individuals with ABI and their families require access to individualised longitudinal support for neuropsychological and social challenges that can result in increased distress and obstruct the development of PTG. • Efforts to facilitate acceptance and support the integration of the pre and post-injury self through recognition of continuity of self and processing of new schematic beliefs can benefit PTG development. • Rehabilitation providers should support individuals with ABI to develop or maintain a positive social identity within new or existing social groups.
... Psychological flexibility is related to lower psychopathology (Fischer, Smout, & Delfabbro, 2016), emotion regulation (Biron & Van Veldhoven, 2012) and predictor to psychological health (Masuda, Price, Anderson, Schmertz, & Calamaras, 2009). In several studies, psychological flexibility is considered as moderator to the outcome of ACT (Kashdan & Kane, 2011;Palm & Follette, 2011;Probst, Baumeister, McCracken, & Lin, 2019). In this study psychological flexibility is employed as a control variable for counselling outcome. ...
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Wellness is believed to be a precondition for students’ success in university. Therefore, many higher education institutions are committed to enhancing student wellness through psychoeducation and counselling program. The present study aimed to test the efficacy of Acceptance and Commitment Therapy (ACT) in enhancing the level of wellness among first-year university students. An experimental study was conducted over six months by implementing a pre-post control group design to measure the benefits of ACT for first-year university students. Exactly 58 students voluntarily participated in serial group counselling, with participants distributed equally between the experimental and control groups. The Five Factor Wellness Inventory, the Acceptance and Action Questionnaire and Client Satisfaction Questionnaire were used as measurement tools. Six core ACT processes were applied over 10 treatment sessions. Comparison of the statistical results for pre- and post-test showed that the wellness score of experimental group was higher than control groups (F=1325.559; p<0.005). This study asserts that ACT is a feasible and practical way to enhance students’ wellness.
... The AAQ-II has also been criticized for not making a clear enough distinction between EA and perceived stress or psychological distress (Chawla & Ostafin, 2007;Batten, Follette & Aban, 2002;Marx & Sloan, 2005;Karekla & Panayiotou, 2011;Kashdan & Kane, 2011;Bardeen, Fergus & Orcutt, 2013). In the current study, AAQ-II scores had a stronger positive relationship with perceived stress than MEAQ total scores. ...
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Background Current psychotherapies seek to reduce experiential avoidance (EA) which has also been put forth as a risk factor for anxiety disorders, depression, and post-traumatic stress disorder. EA is a potentially maladaptive self-regulatory tendency to avoid negative thoughts, feelings, memories, physical sensations, and other internal experiences. One unresolved issue with the most commonly used measures of EA, the Acceptance and Action Questionnaire-II (AAQ-II) which measures EA as a single factor and the Multidimensional Experiential Avoidance Questionnaire (MEAQ) which measures EA as six subdimensions, is what exactly is being measured. The AAQ-II appears to measure negative affect (NA), some aspects of avoidant coping, and psychological distress. In addition, the relationships of all the MEAQ subscales have not been thoroughly examined with these other constructs. In the current study, the relationships of AAQ-II and MEAQ scores with NA, avoidant coping styles, and perceived stress were examined. Methods Two-hundred undergraduates (154 females and 46 males) completed the AAQ-II and MEAQ, the Distressed Type D Personality Scale (DS-14) which includes a measure of NA, the Brief COPE which measures coping styles, and the Perceived Stress Scale. Results Scores on the AAQ-II had moderate positive relationships with the MEAQ total score and all MEAQ subscales with the exception of distress endurance which had a moderate negative relationship. The AAQ-II had a stronger relationship with NA, avoidant coping, and perceived stress than did the MEAQ. All MEAQ subscales had a positive relationship to NA, avoidant coping, and perceived stress with the exception of distress endurance which had a negative relationship with these constructs. While the AAQ-II is limited as a unitary measure of EA the multiple dimensions of the MEAQ may involve an extraneous factor of distress endurance. Future work should examine the relationships of the MEAQ with NA, avoidant coping and perceived stress with clinical populations.
... By contrast, CR is strongly associated with avoidance of elicited aversive emotions (Wolgast et al., 2011), which might predict difficulty in processing stressful events in the long term. Accordingly, college students with higher clinical distress and lower experiential avoidance reported the greatest post-traumatic personal growth after traumatic events (Kashdan & Kane, 2011). Therefore, it would be worthwhile to examine the additional benefit of a stepped-care approach: CR is presumably an effective ER strategy for all stressed parents during an acute stage of pandemic stress. ...
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Objective. Parenting during pandemic restrictions places extreme demands on everyday family life, leading to increased stress levels for parents and distressed parent-child interactions. This RCT aimed to investigate whether cognitive reappraisal and self-compassion are helpful emotion regulation (ER) strategies to reduce individual and parental stress during the COVID-19 pandemic. Method. An online intervention for parents was developed focusing on the application of ER strategies to pandemic requirements of families. A sample of 265 parents were randomly assigned to either cognitive reappraisal (CR; n = 88), self-compassion (SC; n = 90) or wait-list control (WLC; n = 87) group. Interventions included two video sessions (day 1 and day 3) and three email reminders to transfer the application of ER strategies to daily family life (days 2, 4, 5). Parents’ perceived individual stress and parental stress were assessed at baseline (T0), at T1 prior to the booster session on day 3, and at T2 (7 days after baseline). Results. Significant decreases from T0 to T2 emerged for both primary stress outcomes in both intervention groups. Individual stress significantly decreased in CR compared to WLC at T2, but not compared to SC. No time × group interactions for parental stress were found. However, mediation analyses suggested that parental stress was indirectly decreased via reductions in individual stress for CR compared to WLC at both time points. Conclusions. COVID-19 will not be the last pandemic to affect family life. Cognitive reappraisal as a brief online intervention can ease acute stress and strengthen the mental health of parents in acute crises.
... Shenk et al. (2012) also exhibited the crucial role of experiential avoidance in developing PTSD symptoms. Investigations also showed that experiential avoidance is significantly associated with PTSD symptoms in women (Kashdan & Kane, 2011;Palm & Follette, 2011). Boeschen et al. (2001) argued that experiential avoidance acts as a cognitive coping strategy in women suffering from PTSD, and those with higher experiential avoidance made greater efforts to suppress their traumatic memory or to minimize it. ...
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The current study was carried out to investigate the effects of compassion-focused therapy (CFT) on experiential avoidance, meaning-in-life, and sense of coherence (SoC) in women suffering from post-traumatic stress disorder (PTSD) due to the intimate partner violence (IPV). 42 women suffering from PTSD due to the IPV exposure were randomized to the two groups of experimental and control (21 per group). All participants completed the questionnaires of experiential avoidance, meaning-in-life, and SoC as pre-test measures. The experimental group received eight sessions of CFT, while the controls did not receive any treatment. After that, all subjects responded to the questionnaires of experiential avoidance, meaning-in-life, and SoC as the post-test measures. Data were analyzed using one-way repeated measures MANOVA. Subjects of the experimental group indicated a greater reduction in post-test scores of experiential avoidance, and a significant rise in the level of meaning-in-life and its subscales including the presence of meaning-in-life and search for meaning-in-life when compared to the controls. Nevertheless, there was no change in the level of SoC as a function of CFT. Applying CFT can result in reducing experiential avoidance and raising the meaning of life in women with PTSD due to IPV exposure. CFT is highly recommended to strengthen the well-being of patients with PTSD and reduce the PTSD symptoms.
... Moreover, greater meaning coincided with lower anxiety in cancer patients (Gravier et al., 2019;Jaarsma et al., 2007), participants in a smoking cessation program (Steger et al., 2009), and during the pandemic (Schnell & Krampe, 2020). Similarly, meaning was inversely related with PTSD symptoms in earthquake survivors (Feder et al., 2013), trauma-exposed students (Kashdan & Kane, 2011), and veterans (Blackburn & Owens, 2015). ...
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ABSTRACT Background/Objective: Meaning in life may function as a protective factor in the context of potentially traumatic experiences, such as the COVID-19 pandemic. We investigated the associations between meaning and psychological distress (i.e., depression, anxiety, COVID-19-related PTSD) prospectively and cross-sectionally. We hypothesized that meaning inversely predicts peri-pandemic distress and that meaning moderates the association between being negatively affected by the pandemic and distress. We additionally explored cross-sectional associations between meaning subcomponents and distress and a meaning violations perspective. Methods: Undergraduate students (N = 109) completed questionnaires before (October 2019 to March 2020; meaning, anxiety) and during the pandemic (April to June 2020; meaning, meaning subcomponents, depression, anxiety, PTSD). Results: Correcting for family-wise errors, meaning prospectively predicted less depression and anxiety, but not PTSD. Correcting for family-wise errors, peri-pandemic meaning was consistently related with peri-pandemic distress. Meaning did not moderate the link between being affected by the pandemic and distress. The meaning subcomponent comprehension was most strongly related with distress and a meaning violations perspective was partly supported. Conclusion: Meaning emerged as a significant correlate of peri-pandemic distress. Current findings should be replicated longitudinally and experimentally to establish their robustness and to examine the causal influence of meaning on distress.
... The affective blunder of the stressful event, rather than the event alone, motivates constructive cognitive processing. In turn, such cognitive processing may lead to a change in perspectives about oneself, the event, and the world around (Kashdan and Kane, 2011;Park et al., 2012;First et al., 2018). In other words, the struggle to make sense of and attain meaning from the distressing situation is where the growth emerges. ...
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Post-traumatic growth (PTG) emerges from highly stressful situations. The coronavirus (COVID) pandemic may qualify as one. This study investigated the PTG among Hong Kong citizens during the first outbreak in spring 2020, shortly after a large-scale social movement subsided. A longitudinal online survey was launched during the peak (Time 1) and the palliation (Time 2) of the outbreak. Among the 327 participants who completed both waves, 28.4% exhibited probable post-traumatic stress disorder (PTSD) in Time 1, while 18.0% reported significant PTG in at least one domain in Time 2. The interaction between the sense of coherence (SOC) and post-traumatic stress mediated the relationship between Time 1 perceived outbreak severity and Time 2 PTG, such that PTG was more likely among participants with higher post-traumatic stress and SOC. PTG was also associated with a weaker contingency between Time 1 and Time 2 perceived outbreak severity. Echoing the transformational model, our findings show that both experienced stress and coping resources are essential for PTG to emerge. We also demonstrated how PTG might lead to more flexible risk perceptions according to the development of the outbreak.
... Triplett, Tedeschi, Cann, Calhoun and Reeve (2012) demonstrated that meaning in life was positively associated with PTG among people who had experienced death of a loved one, serious illness of a loved one, divorce, or physical or sexual injury in the last two and a half years. A higher level of meaning in life was also associated with a higher level of positive changes after trauma in a study conducted by Kane and Kashdan (2011), in which the majority of the respondents were people who had experienced the death of a loved one. The relationship between meaning in life and PTG was also verified in people who had lost a loved one in the period from half a year to six years prior to the study as a result of an unpredictable death (Ogińska-Bulik, 2013a, 2013b). ...
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We analyzed the relationship between post-critical beliefs and the quality and stability of marriage, taking into account the mediating function of attitude and the tendency to forgive. The sample consisted of 122 predominantly Roman Catholic respondents. We used the Marriage Quality and Stability Scale, the Post-Critical Belief Scale and the Attitude and Tendency to Forgive Scale. Correlation analysis showed a significant positive relationship between Symbolic Affirmation and stability of marriage. Mediation analysis demonstrated that the relationship between Symbolic Affirmation and stability of marriage was mediated by attitude toward forgiveness. The results suggest that religiousness plays a role in predicting stability of marriage and that attitude towards forgiveness is a mediator explaining the mechanism of this relationship.
... Of course, this requires victims of trauma to acknowledge that they have been affected by what they have experienced. Individuals who suppress traumatic memories, hide their emotions from others, and try to manage their symptoms on their own are far less likely to return to baseline levels of functioning, let alone experience post-traumatic growth (Ehlers & Clark, 2000;Kashdan et al., 2010;Kashdan & Kane, 2011). ...
Article
Victims of trauma who experience post-traumatic stress disorder are often able to reframe the tragedies that they have been through in a way that gives them new-found purpose in life and a sense of empowerment. When they do so, they are enacting the phenomenon of post-traumatic growth. There are several empirically supported predictors of post-traumatic growth, including a person’s level of optimism and extroversion, the amount they socialize with friends and others who have experienced similar traumas, and their level of self-confidence and ability to be open to new ideas. These predictors of PTG may be at a disadvantage of being realized in light of modern-day trends of isolation, depression, low self-esteem, and inactivity. In order for trauma clinicians to be maximally effective with the clients that they treat in today’s social and cultural climate, these trends must be accounted for in treatment plans for individuals with PTSD. This article recommends a combination of activating one’s social network, utilizing modalities that specifically target depression and trauma-processing such as Behavioral Activation and EMDR, participation in team sports, and widespread psychoeducation regarding trauma symptoms in an effort to normalize presentation and fight against stigma.
... Podľa výskumov Kashdana a Kaneovej už len otvorenosť voči vlastnému prežívaniu (v protiklade k vyhýbaniu sa) stresujúcich myšlienok a pocitov vedie ku zvýšenému posttraumatickému rastu. 30 Popri informovanosti, celkovom (trénovanom) povahovom optimizme a otvorenosti, existujú aj niektoré ďalšie aspekty, ktoré zohrávajú dôležitú úlohu v posttraumatickom raste. O'Rourke, Tallman a Altmaier vo svojej štúdii objasňujú silný pozitívny vzťah medzi posttraumatickým rastom a spiritualitou. ...
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ROJKA, Ľ., HALAMOVÁ, J.: Why God Created the World so Badly. Studia Aloisiana, 5, 2013, 1, s. 17–30. The so called problem of evil, in which the existence of physical and psychological suffering discredits that the world was created by an omnipotent, omniscient, and perfectly good God, and disruptes the overall Christian conception of human life. The goal of the paper is to show in what way the existence of evil does not contradict the theistic conception of the world. On the contrary, evil in the world can play an important role in the development of the universe and in the ethical and moral development of humans. The most recent psychological studies show that difficult situations, with a training and thanks to empathy and support from loved ones, can be transformed into a post-traumatic growth, which consists in a discovery of new opportunities, development of new skills, courage, self-confi dence, a deeper perception of the meaning of life, more valuable and more honest interpersonal relationships, and closer relationship with God.
... In turn, emotional clarity is associated positively with presence of meaning in life, thus having a strong sense of meaning may provide people with a framework from which to understand and make sense of their emotional experiences (Abeyta et al., 2015). Further support of this connection between presence of meaning in life and emotion regulation comes from a study that found that after experiencing a trauma, people who engage in less experiential avoidance find more meaning in the aftermath (Kashdan & Kane, 2011). Thus, high levels of presence of meaning in life are associated with high levels of emotional clarity and regulation and low levels of experiential avoidance, all of which predict reduced engagement in NSSI and suicidal ideation. ...
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Previous research indicates that sensation seeking, emotion dysregulation, and impulsivity are predictive of non-suicidal self-injury (NSSI). A body of research supports that meaning in life predicts improved mental health and well-being, including fewer suicidal thoughts and attempts, yet no research has examined the moderating effects of meaning in life on the relations between personality and temperament and NSSI. Given the growing incidence rates of NSSI among adolescents and the potential lifelong consequences of NSSI, it is imperative to better understand the factors that reduce the rates at which adolescents in a clinical sample engage in NSSI. The present study investigates if the protective factors of meaning in life moderate the relation between personality and temperament variables and NSSI among 126 adolescents (71% female, Mage = 16.1, SD = 1.1, range 13–18, 80% White) residing in an inpatient psychiatric hospital who endorsed NSSI in the last 12 months. Results from hurdle modeling indicate that two subtypes of meaning in life, presence of meaning in life and search for meaning of life, may serve as robust protective factors against engagement in NSSI among a clinical sample of adolescents. Additionally, results suggest that search for meaning, but not presence of meaning in life, variables moderate the relations between personality and temperament and NSSI. Results provide evidence that meaning in life is an understudied variable of importance in understanding how to prevent or treat NSSI. It also underscores the need to develop, refine, and test meaning-making interventions.
... Previous research demonstrates that the female gender is a significant predictor of PTG in parents of critically ill children (Hungerbuehler et al., 2011). However, whether the reason for this lies within the maternal parenting role, or the willingness to be in contact with distressing thoughts, feelings and images, which Kashdan and Kane (2011) posit serves as a catalyst for the development of PTG, warrants further examination. It must also be noted that most studies in the present review examined maternal PTG. ...
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This systematic review aims to identify the demographic, clinical and psychological factors associated with post-traumatic growth (PTG) in parents following their child’s admission to the intensive care unit (ICU). Papers published up to September 2021 were identified following a search of electronic databases (PubMed, Medline, Web of Science, PsycINFO, CINAHL, PTSDpubs and EMBASE). Studies were included if they involved a sample of parents whose children were previously admitted to ICU and reported correlational data. 1777 papers were reviewed. Fourteen studies were eligible for inclusion; four were deemed to be of good methodological quality, two were poor, and the remaining eight studies were fair. Factors associated with PTG were identified. Mothers, and parents of older children, experienced greater PTG. Parents who perceived their child’s illness as more severe had greater PTG. Strong associations were uncovered between PTG and post-traumatic stress, psychological well-being and coping. PTG is commonly experienced by this population. Psychological factors are more commonly associated with PTG in comparison with demographic and clinical factors, suggesting that parents’ subjective ICU experience may be greater associated with PTG than the objective reality.
... According to the literature, the confrontation of an individual with stressful life events accompanied by various losses poses a challenge to the desire to perceive the world as meaningful and predictable, and thus may contribute to a search for meaning [62]. Earlier studies have shown a positive relationship between the presence of meaning in life and PTG [63,64]. Our research confirmed this fact, which showed a positive relationship between the search for meaning in life and a positive and negative relationship between the negative perception of the consequences of the COVID-19 pandemic. ...
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It is common knowledge that COVID-19 affects physiopathological changes in all systems of the human body. On the other hand, events related to the COVID-19 pandemic also have a significant impact on the social and mental sphere of human functioning. The aim of this study is to determine the relationship between selected sociodemographic variables and selected subjective cognitive resources, and the positive and negative perception of the consequences of the COVID-19 pandemic in a group of nurses working in Poland. The computer-assisted web interviewing method was conducted between 1 and 15 May 2020. Participants were requested to complete the following questionnaires: The Changes in Outlook Questionnaire (CIOQ), The Impact Event Scale-Revised (IES-R), The Multidimensional Scale of Perceived Social Support (MSPSS), The Safety Experience Questionnaire (SEQ), and The Meaning in Life Questionnaire (MLQ). Three-hundred and twenty fivenurses working all over Poland participated in the study. Their mean age was 39.18 ± 11.16 years. A higher average level was noted among the surveyed nurses in the Positive Change subscale (18.56 ± 4.04). In a multivariate model, taking into account both sociodemographic and cognitive variables, the level of perceived traumatic stress, the level of social support, a sense of security, reflection on safety and a sense of meaning and meaning in life were independent predictors of a positive perception of the consequences of the COVID-19 pandemic. Those variables explained as much as 37% of the dependent variable, and the nature of the relationship was positive. While we are still a long way from understanding the full range of the long-term impact of the COVID-19 pandemic on mental health and psychosocial well-being, it is possible that in this challenging context there are many individual resources available to perceive the effects of the current pandemic positively. Therefore, they should be strengthened through the development and implementation of intervention programs to improve the mental state of nurses.
... 30 Our findings suggested possible gender differences which have not been consistently demonstrated or examined within other college samples. 47,65,66 Perceived stress was found to be an intervening variable in the relationship between COVID-19 stressors and student outcomes. This finding was robust and applied to both mental health and purpose outcomes. ...
Article
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Background: The COVID-19 pandemic is a disaster event associated with negative social, mental health, financial, and academic outcomes for college students. However, there is limited evidence to guide efforts to help support college students during the crisis. This study used a disaster conceptual model to evaluate the relationship between COVID-19 stressors and mental health and purpose in college students in the United States.Methods: Cross-sectional data were collected from 251 undergraduates through an online survey between April and May 2020.Results: Students were exposed to multiple COVID-19 stressors (M = 8.14, SD = 3.02). Overall, 53.0 percent reported moderate to severe levels of depression, 40.7 percent reported moderate to severe levels of anxiety, and 39.4 percent endorsed having a clear sense of purpose in life. A disaster conceptual model fit the data well (c2 [30] = 31.93, p = .37, CFI = 0.995, RMSEA = 0.02, SRMR = 0.04). COVID-19 stressors were directly associated with depression and anxiety, and inversely associated with purpose. Perceived stress was an intervening variable in this relationship.Conclusion: Findings highlight the relationship between COVID-19 disaster stressors and mental health and purpose outcomes and provide evidence which may help guide recovery efforts.
... Attempts to suppress one's unwanted thoughts (e.g., attempting to alter the frequency or form of one's thoughts associated with ostracism) has been demonstrated to paradoxically increase the frequency and intensity of those thoughts (Wenzlaff & Wegner, 2000). Moreover, researchers have consistently shown that experiential avoidance can be a moderator or mediator of psychological distress (e.g., Bardeen, 2015;Bardeen, Fergus, & Orcutt, 2013;Kashdan & Kane, 2011;Pickett, Bardeen, & Orcutt, 2011;Roush, Brown, Mitchell, & Cukrowicz, 2019;Spinhoven, Drost, de Rooij, van Hemert, & Pennix, 2014). Tyndall et al. (2018) found that experiential avoidance appeared to moderate the relationship between perceived ostracism and psychological distress. ...
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Previous research suggests that longer‐term perceived ostracism is related to poor sleep quality. In this study, we investigated the mediating effect of cognitive arousal on the perceived ostracism‐sleep quality relationship. We also investigated whether experiential avoidance was a moderator of the cognitive arousal‐sleep quality relationship. Participants (N = 251) were recruited through online research portals to take part in an online survey. A path analysis was used to test a moderated mediation effect between variables. It was found that cognitive arousal mediated the perceived ostracism‐sleep quality relationship, however, experiential avoidance was not a significant moderator. These findings suggest that further research needs to be conducted to elucidate the mechanism of experiential avoidance to account for when it may impact sleep quality. Moreover, treatment interventions targeted at reducing cognitive arousal (e.g., cognitive behavioral therapy) prior to sleep are likely to bear some fruit. This article is protected by copyright. All rights reserved.
... In the end, it should be noted that not all traumas and PTGs are transformative: when they lead individuals to a relevant and permanent psychological transformation, they could be considered as TEs. Research on traumatic and stressful events has generally focused on individuals' transformation related to suffering and turmoil events (Kesimci et al., 2005;Kashdan and Kane, 2011), thus excluding perceived positive events as potential triggers of transformative growth. ...
Article
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The concept of transformative experience (TE) has been widely explored by several disciplines from philosophy to neurobiology, and in different domains, from the spiritual to the educational one. This attitude has engendered heterogeneous models to explain this phenomenon. However, a consistent and clear understanding of this construct remains elusive. The aim of this work is to provide an initial comprehensive interdisciplinary, cross-domain, up-to-date, and integrated overview on the concept of TEs. Firstly, all the models and theories on TEs were reviewed to extract and analyze TEs’ main components emerging from different disciplines. Then, this preliminary analysis was integrated with an in-depth examination of redundancies and particularities across domains and disciplines, to provide an integrated theoretical framework of TEs and a preliminary interdisciplinary operational definition of TEs. This examination, in turn, can help organize current research and theories, thus providing suggestions for operationalizing TEs as well as encouraging new interdisciplinary research endeavors.
... Some findings appear to grant plausibility to this suggestion. Negative relationships between purpose or meaning in life and experiential avoidance have already been reported (Gámez et al., 2014;Kashdan & Kane, 2011). ...
Article
Objective: Despite consistent evidence for the beneficial effects of meditation on mental health, little is known about the mechanisms that make mindfulness meditation effective. Method: The levels of mental health, self-compassion, presence of meaning in life, and experiential avoidance of meditators (n = 414) and nonmeditators (n = 414) were measured and compared. Bootstrap-based structural equation modeling (SEM) modeling analyses were used to test multiple-step multiple-mediator models. Results: Meditation was positively associated with mental health, although the regularity of practice was an influential element to be considered. Significant indirect effects of meditation on mental health through self-compassion, meaning in life, and experiential avoidance were found. SEM models were able to account for 58% of the variance in mental health scores. Conclusions: Self-compassion, presence of meaning in life, and reduced experiential avoidance may be active components of healthy meditation practices. Identifying the mechanisms involved in effective meditation practices has relevant implications for well-being and mental health-promoting interventions.
... 이는 상실 사 건에 대해 생각하는 것, 상실에 대한 사실과 감정을 표현 하는 것, 상실 경험과 관련된 행동을 피하는 등 상실 사건 이 떠오르는 것으로부터 적극적으로 떨어져 있으려 하고 그 사건에 대해 생각하는 것을 피하려 하는 의식적인 노력 이다 (Hogan et al., 2002;Bonanno et al., 2005). 이 러한 애도 회피는 삶의 만족도와 정서적 행복을 저하시키 며 (Hahn et al., 2003), 상실로부터의 회복에서 중요한 상실에 대한 의미를 찾고, 삶을 긍정적으로 변화시키는 것 을 방해한다 (Bonanno et al., 2005;Kashdan et al., 2011;Cho et al., 2015). 일찍이 상실에 직면하고 감정 을 억압하지 않으며 표현하도록 하는 것이 중요함이 강조 되어 왔던 만큼 (Shepherd, 2003) (Clen et al., 2011;Jung, 2015). ...
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This study examined parental coping with grief and identified protective factors for better coping among parents who suffered the loss of a child during military service in Israel. Coping indicators included complicated grief, functioning in life tasks, succeeding in living meaningful lives, and personal growth. Participants were 164 parents who had lost children 5-16 years previously. We found strong associations between parents' decision to continue life despite traumatic loss and several indicators of coping. Meaning-making was associated with better functioning and greater personal growth. Practitioners should explore with parents the internal struggles about deciding whether to continue in life.
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While many veterans face physical, psychological, and spiritual difficulties, research suggests that the reintegration process from military service to civilian life, is a complex one. Our study focused on the role of moral injury and the disclosure of military experience in this transition, and how they might combine to affect veterans’ life satisfaction. We gave a battery of surveys to a large and diverse sample of veterans, measuring aspects of military culture and service, the moral ramifications of military experiences and attitudes and experiences with disclosing these experiences to civilians. Most important, we found that greater moral injury was associated with greater concerns about disclosure. Greater disclosure concerns were associated with lower perceptions of disclosure support, which in turn was associated with lower life satisfaction. We conclude that these findings suggest that a more nuanced account is required to fully understand the relationship between moral injury, disclosure attitudes, and life satisfaction. For promoting healthy reintegration and greater satisfaction with life, and we discuss several possibilities for future research.
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The concept of posttraumatic growth appears frequently in the psychology literature. However, there is no clear definition of it. The purpose of this study was to determine its attributes, antecedents, and consequents. Rodgers’ evolutionary concept analysis method was used. Data analysis was implemented using thematic analysis. The results showed that posttraumatic growth is a complex concept with four main attributes including spiritual changes, compassion toward others, appreciation of life, and improved self-understanding. Clarifying the concept of posttraumatic growth and identifying its features can be used to design nursing interventions to develop posttraumatic growth.
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Objective: The purpose of this study was to investigate how locus of control, coping strategies, emotion regulation strategies and social support affect posttraumatic growth. Methods: A cross-sectional study design was adopted. A convenience sample of 540 patients with lung cancer was recruited from November 2016 to July 2017 at two tertiary grade A hospitals in China. The participants completed a series of questionnaires. Structural equation modelling was used to explore the effects of psychosocial factors on posttraumatic growth. Results: Social support had a direct positive effect on posttraumatic growth (β = 0.318, SE = 0.071, BC 95% CI = 0.252/0.390), and it also had indirect effects on posttraumatic growth (β = 0.112, SE = 0.023, BC 95%CI = 0.088/0.135) through mediating psychological factors. Coping strategies and the cognitive reappraisal emotion regulation strategy were the main mediating variables, explaining approximately 73.1% of the indirect effect between social support and posttraumatic growth. Conclusions: Our study suggests that Chinese lung cancer survivors can show relatively high posttraumatic growth. There are many mediating paths between social support and posttraumatic growth. These results may help healthcare professionals to identify the psychosocial factors that may benefit lung cancer patients and develop interventions to promote posttraumatic growth.
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Objective Parenting during pandemic restrictions places extreme demands on everyday family life, leading to increased stress levels for parents and distressed parent-child interactions. This RCT aimed to investigate whether cognitive reappraisal and self-compassion are helpful emotion regulation (ER) strategies to reduce individual and parental stress during the COVID-19 pandemic. Method An online intervention for parents was developed focusing on the application of ER strategies to pandemic requirements of families. A sample of 265 parents were randomly assigned to either cognitive reappraisal (CR; n = 88), self-compassion (SC; n = 90) or wait-list control (WLC; n = 87) group. Interventions included two video sessions (day 1 and day 3) and three email reminders to transfer the application of ER strategies to daily family life (days 2, 4, 5). Parents’ perceived individual stress and parental stress were assessed at baseline (T0), at T1 prior to the booster session on day 3, and at T2 (7 days after baseline). Results Significant decreases from T0 to T2 emerged for both primary stress outcomes in both intervention groups. Individual stress significantly decreased in CR compared to WLC at T2, but not compared to SC. No time × group interactions for parental stress were found. However, mediation analyses suggested that parental stress was indirectly decreased via reductions in individual stress for CR compared to WLC at both time points. Conclusions COVID-19 will not be the last pandemic to affect family life. Cognitive reappraisal as a brief online intervention can ease acute stress and strengthen the mental health of parents in acute crises.
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Background Individuals differ in how they react to stress or trauma through different coping styles in which they may deal directly with a stressor by adopting approach coping styles or disengage with a stressor by utilizing avoidant coping styles. Avoidant coping styles have been linked to adverse outcomes including psychological distress, anxiety disorders, and post-traumatic stress disorder (PTSD). Recently, avoidance coping styles as measured by a subset of items on the Brief COPE were found to have a weak positive relationship with performance on a computer-based avatar task which is related to avoidant personality temperaments. This avatar task was developed as an alternative for paper and pencil self-report inventories for measuring avoidant tendencies based on possible response biases of avoidant individuals. In the current study, avoidance and approach coping styles as measured by the Brief Approach/Avoidance Coping Questionnaire (BACQ) were compared to avoidant coping as measured by the Brief COPE and performance on the avatar task. In addition to approach and avoidance coping, the BACQ also measures active avoidance coping (i.e., diversion) and passive avoidance coping (i.e., resignation and withdrawal). The relationships between approach and avoidance coping and performance on the avatar task were also analyzed with the outcome of perceived stress as measured by the Perceived Stress Scale (PSS). Methods One hundred undergraduates voluntarily completed the BACQ, the Brief COPE, and the PSS. Participants also completed a computer-based task in which they guided an avatar through a series of social situations where they indicated how they would interact with or avoid interacting with strangers. Results Approach coping had a weak negative relationship to avoidance coping as measured by the BACQ and the Brief COPE. Performance on the avatar task had a moderate positive relationship with avoidance coping (diversion as well as resignation and withdrawal) as measured by the BACQ and a moderate negative relationship with approach coping as measured by the BACQ. A model including only approach, diversion, and resignation and withdrawal coping best predicted performance on the avatar task in a linear regression model. While resignation and withdrawal coping and diversion coping had moderate positive relationships to avatar task scores, only resignation and withdrawal had a strong positive relationship to perceived stress. A model than included only resignation and withdrawal coping best predicted perceived stress in a linear regression model. Overall, passive avoidant coping styles (i.e., resignation and withdrawal), but not active avoidant coping style (i.e., diversion), were related to perceived stress. These results support the continued study of multiple aspects of avoidant coping styles as well as the avatar task to increase our understanding of the maladaptive effects of excessive avoidance in the face of stress.
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Background There is considerable evidence of widespread emotional distress associated with the COVID-19 pandemic. A growing number of studies have assessed posttraumatic growth related to the current pandemic; but, none have considered whether reported growth is real or illusory (i.e., characterized by avoidant or defensive coping that results in higher levels of distress). The purpose of this study was to extend this literature by assessing growth specific to the pandemic in people reporting high levels of COVID-related stress and estimating the extent of real and illusory COVID-19-related growth. Methods Participants were 893 adults from Canada and the United States with high levels of COVID-related stress who provided complete responses on measures of posttraumatic growth, disability, and measures of general and COVID-related distress as part of a larger longitudinal survey. Results Approximately 77% of participants reported moderate to high growth in at least one respect, the most common being developing greater appreciation for healthcare workers, for the value of one’s own life, for friends and family, for each day, as well as changing priorities about what is important in life and greater feelings of self-reliance. Consistent with predictions, cluster analysis identified two clusters characterized by high growth, one comprising 32% of the sample and reflective of real growth (i.e., reporting little disability and stable symptoms across time) and the other comprising 17% of the sample and reflective of illusory growth (i.e., reporting high disability and worsening symptoms). These clusters did not differ in terms of socially desirable response tendencies; but, the illusory growth cluster reported greater increases in alcohol use since onset of the pandemic. Conclusion Consistent with research regarding personal growth in response to prior pandemics and COVID-19, we found evidence to suggest moderate to high levels of COVID-related growth with respect to appreciation for healthcare workers, life, friends and family, and self-reliance. Findings from our cluster analysis support the thesis that many reports of COVID-related personal growth reflect ineffectual pandemic-related coping as opposed to true growth. These findings have important implications for developing strategies to optimize stress resilience and posttraumatic growth during chronically stressful events such as pandemics.
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Diagnosis of a chronic disease like type 2 diabetes mellitus (T2DM) is frequently shocking for patients, which influences their lives. Getting aware of bad news such as obtaining a chronic illness diagnosis is a sensitive issue in patients' lives. Conversely, reactions to the reception of a diagnosis of diabetes are often varied for a few reasons. To manage the diseases through care planning, the identification and modification of the causes of various reactions are necessary. The aim of the present survey was to investigate the reaction of diabetics to the reception of diabetes diagnosis and its possible reasons. In this qualitative study, in-depth interviews were used. Furthermore, traditional content analysis of semi-structured interviews was conducted using a qualitative strategy with 20 individuals with type 2 diabetes. The purposeful sampling approach was employed for recruiting the participants. Eleven male and nine female participants having type 2 diabetes had been transferred to the diabetes association of Iran for receiving consulting assistance in the areas of nutrition, psychology, and health care. Four categories of reactions have arisen from the investigation including behavioral, emotional, contextual, and cognitive reactions. Reactions to the prognosis of diabetes may be different for some reasons. The findings of the present investigation may be employed by health care providers to obtain a more comprehensive understanding of unusual and usual reactions, their causes, and the context in the early years after the diagnosis and planning care programs for disease management.
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The implementation of lockdowns and the Covid-19 pandemic situation have negatively impacted mental health (anxiety, depression). However, little is known about individual differences in the longitudinal reactions to lockdown. We designed a longitudinal study (a) to identify the various trajectories of symptoms of depression and anxiety in the general population during and after lockdown; (b) to determine which positive psychological resources prevent individuals from falling into groups with the most severe trajectories; (c) to test the mediating role of psychological flexibility. We collected and analysed longitudinal data on a sample of French participants (N = 1399, Mage = 43.4; SDage = 12; 87.8% women) during the end of the first lockdown. Participants were asked to report their psychological resources and (in)flexibility at baseline and symptoms of anxiety and depression at each measurment occasion (five weekly observations from 17 March to 11 May 2020, including baseline). Using growth mixture modelling, seven dynamic profiles of symptoms were identified: four for depression and three for anxiety. Resilience emerged as the most frequent trajectory. Wisdom, optimism, hope, self-efficacy and peaceful disengagement significantly prevented individuals from belonging to the symptomatic groups. Moreover, psychological flexibility emerged as a significant mediator of these effects. This study highlights the importance of cultivating protective factors and psychological flexibility to prevent mental health damage during potentially traumatic events (PTE) and to favour resilience trajectories.
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How does the self-relevance of a social movement shape individuals' engagement with it? We examined the decision-making processes that underlie support for Black Lives Matter (BLM) among Black, Hispanic, Asian, and White Americans. We find significant between-group differences in levels of support for BLM, both in terms of past behavior (Study 1) and in terms of future intentions to support the movement (Study 2). These differences notwithstanding, thinking about how one's decisions impact others - which we label impact mindset - explains support for BLM across racial groups, cross-sectionally as well as longitudinally (over 8 months later). Our findings underscore the equivalence of the impact mindset construct across racial groups and its predictive power in the context of BLM. We conclude that, although the struggle for racial justice has different meanings for different racial groups, the same mindset underlies both in-group advocacy and allyship in the context of BLM.
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Although the treatment options are increased with a great acceleration and the most suitable drug / drugs are selected, the desired treatment goals cannot be achieved in the patients.Pharmacogenetics is the study of the variability of drug response on the basis of heritability and is influenced by ethnicity, age and gender. Pharmacogenetic testing may help physicians to determine differences in the effects of drugs based on inter-individual variations. By using pharmacogenetic testing, genetic variations have been identified and linked to the risk of developing medical conditions as well as treatment responses. Applying pharmacogenetic results clinically may improve the medication choose, optimize dosage regimens, and reduce the side effects and this may reduce the health costs [1]. Psychiatry has a special position because the effect of many psychotropic drugs, especially antipsychotics, mood stabilizers, antidepressants, can be observed only after minimum three or four weeks. Even though the symptoms of the patients who applied to the psychiatric clinics seem to be similar, their medical and psychiatric histories, social situations, education, beliefs, ethnic groups and socioeconomic status, cognitive view and eating behaviors are different from each other. Although the proper medication for the patients is used at the appropriate dosage with the correct timing, sometimes the response to psychotropic treatment cannot be obtained or the response to the treatment may be insufficient or undesirable effects may occur. The most important question at this point is whether the selected drug or drugs are really the most suitable drug (s) for the patient. In another words, the success of the treatment may be possible by choosing the proper drugs to be used specific for the patient and not for the disease [2]. Another difficult area in psychiatry is that most of the etiologies of psychiatric disorders (schizophrenia, major depression and bipolar disorders) are polygenic. Especially in many psychiatric disorders, it is difficult to choose a good candidate gene because of the lack of well-known pathophysiology. The dopamine receptor DRD2 was the most widely studied gene among the patients with bipolar disorder. Also polymorphisms in the PDLIM5 gene that is expressed in the brain have been associated with bipolar disorder. In addition it has been revealed that PDLIM5 may be a good marker for bipolar disorder. Induced pluripotent stem cells in bipolar disorder was found to be directly associated with mania symptoms [3]. Choosing the proper treatment options for bipolar disorder is important. Because patients with bipolar disorder have to face many difficulties about drugs that may influence the treatment adherence. But the decision to use a particular treatment in bipolar disorder can be difficult because of the complexity of genetics and variations in drug metabolism with cytochrome P450 enzymes variations they may influence treatment response. Genetic differences in the induction or inhibition of enzymes they determine the individuals as slow or fast metabolizer are extremely important in both monotherapy and polypharmacy. In patients whose CYP2D6 enzyme, which metabolizes a large part of the psychotropic medications\s, is considered to be practically ineffective, toxic effects are frequently seen, but in patients with the same enzyme working too fast, the expected response to the drugs cannot be obtained. Therefore, the polymorphisms of the CYP system allow us to not only choose the proper dose of the drug for that patient and also to know the possible interactions, the adverse reactions and side effects [4]. One of the most important issue in treatment effectiveness is increasing the effects of drugs by inhibition of P-glycoprotein (P-gp) and developing the new treatment strategies. This protein, which regulates the passage of the blood-brain barrier of drugs, is formed by overexpression of the gene located on chromosome 7 (MDR-1) and shows polymorphism. P-gp inhibitor drugs compete with P-gp to bind to the drug and bind the substrate to P-gp instead of the drug. Many drugs are dual substrates for P-gp and CYP3A4, and this has a significant effect on the concentration of some drugs in the brain. P-gp is important for both pharmacogenetics and the interaction of psychotropic drugs. P-gp may play a role in treatment-resistant psychiatric disorders. Also, in patients with more than one disease which is called as syntrophic diseases (such as autism, bipolar disorder and schizophrenia), it is mentioned that there are syntrrophic genes and in these patients, individualization of treatment becomes more important [5]. In terms of psychotropic medications, the polymorphisms of enzymes involved in the synthesis of neurotransmitters, their receptors, post-receptor events and neurotransmitter carriers are also important. Although these genetic differences related to the drug target molecule are as important as the genetic polymorphism of the metabolism in order to individualize the treatment, they are not routinely used in clinic practice. Although the results of genetic studies vary considerably, they are very important in terms of understanding the brain function, pathology and bringing new perspective to treatment [1–3]. Carriers are regulated at both cellular and molecular level. Maximum variability is observed at in single nucleotide polymorphism (single nucleotide polymorphism = SNP). Also Dopamine (D), noradrenaline (NA), adrenaline (A) and serotonin (5-hydroxytryptamine = 5-HT) and the enzymes such as tyrosine hydroxylase (TH), tryptophan hydroxylase (TPH),aromatic amino acid decarboxylase (AAD), dopamine beta hydroxylase (DBH), monoamine oxidase (MAO) and catechol-o-methyl transferase (KOMT) that are involved in the metabolism of these neurotransmitters are also important and thought to be good biomarkers [2]. In the treatment with antipsychotics, any proper effect is not observed among 30-40% of patients and serious side effects are seen in about 70%. This is due to either the ineffectiveness of the drug treatment due to the genetic mutation of metabolic enzymes, or the presence of toxic effects or the change in the effectiveness of the treatment due to the alter in the binding of receptors to the target receptors and the change in their functional capacity. Also while the differences in Synaptic Vesicle Protein 2C (SVC2) were found to associated with the response to olanzapine and quetiapine treatment, DRD2 SNP, rs2514218, was found to be associated with better antipsychotic response specifically with risperidone. The 16Gly allele of ARDB2 was significantly found to correlated with a higher risk of sexual adverse events in patients taking risperidone. A study comparing the Malaysian patients with Chinese and Indian patients in terms of treatment response to valproic acid therapy, it was revealed that Malaysian patients showed better treatment response to valproic acid therapy when they express the functional SCN1A IVS5Nþ5 polymorphism [2–4]. The use of SSRIs and MAOIs in long-term antidepressant therapy causes the sensitization of inhibitor somatodentritic 5-HT1A receptors and presynaptic inhibitor 5-HT1D autoreceptors. Tricyclic antidepressants, electroconvulsive therapy and non-SSRI antidepressants may increase the sensitivity of the inhibitor post-synaptic 5-HT1A receptors and reduce the expression of the stimulator 5-HT2A receptors [1]. It has been suggested that there is a significant decrease in Gs protein in depressive patients and it can be used as a biochemical parameter in these patients. It has been shown that long-term treatment with fluoxetine causes desensitization of postsynaptic 5-HT1A receptors in the paraventricular nucleus of the hypothalamus, and this effect is due to a decrease in Gαi, Gα, Gα2 protein levels. Subchronic therapy with tricyclic antidepressants did not alter G protein levels [2]. It was revealed that Gαs proteins were increased in bipolar disorders, especially in frontal cortex and Gαs proteins were reduced in the occipital cortex with lithium treatment. Again, lithium treatment showed decreased Gαi expression in the cerebral cortex and similarly Gαi1 / 2 decreased in cortex and hippocampus. Also, the decrease in Gαi expression in the cerebral cortex and the decrease in Gαi1 / 2 decreased in cortex and hippocampus. In addition, subchronic treatment of buspirone, a partial agonist of 5-HT1A receptors reduced Gαi1 and Gαi2 protein levels in cerebellum, and benzodiazepines such as alprazolam did not alter G protein levels in various brain regions [1]. Choosing the proper treatment options for bipolar disorder is important. But the use of pharmacogenetics testing is still lacking. By providing the most appropriate pharmacotherapy with pharmacogenetics, early diagnosis, severity of side effects and interactions can be determined, and possible adverse drug reactions can be predicted. References [1] Routhieaux M, Jessica J, Tillery EE. The use of pharmacogenetic testing in patients with schizophrenia or bipolar disorder: A systematic review. Ment Health Clin. 2018;8:294–302. [2] Arıcıoğlu F, Çetin M. Psikiyatride Bireye Özgü Tedavi: Belki Biraz Eski Veya Biraz Yeni, Ama Geleceğin Tedavisi. Bulletin of Clinical Psychopharmacology. 2010;20:269–273. [3] Goh LL, Lim CW, Sim WC, Toh LX, Leong KP. Analysis of genetic variation in CYP450 genes for clinical implementation. PLoS One 2017;12:e0169233. [4] Azuma J, Hasunuma T, Kubo M, Miyatake M, Koue T, Higashi K et al. The relationship between clinical pharmacokinetics of aripiprazole and CYP2D6 genetic polymorphism: effects of CYP enzyme inhibition by coadministration of paroxetine or fluvoxamine. Eur J Clin Pharmacol. 2012;68:29–37. [5] Zain MA, Jahan SN, Reynolds GP, Zainal NZ, Kanagasundram S, Mohamed Z. Peripheral PDLIM5 expression in bipolar disorder and the effect of olanzapine administration. BMC Med Genet. 2012;13:91.
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The present study examined the degree to which event related rumination, a quest orientation to religion, and religious involvement is related to posttraumatic growth. Fifty-four young adults, selected based on prescreening for experience of a traumatic event, completed a measure of event related ruminations, the Quest Scale, an index of religious participation, and the Posttraumatic Growth Inventory. The three subscales of the Quest Scale, the two groups of rumination items (soon after event/within past two weeks), and the index of religious participation were entered in a standard multiple regression with the total score of the Posttraumatic Growth Inventory as the dependent variable. The degree of rumination soon after the event and the degree of openness to religious change were significantly related to Posttraumatic Growth. Congruent with theoretical predictions, more rumination soon after the event, and greater openness to religious change were related to more posttraumatic growth. Present findings offer some confirmation of theoretical predictions, and also offer clear direction for further research on the relationships of religion, rumination, and posttraumatic growth.