Crystal L. Park

Meaning in the context of stress and coping.

Although theoretical and empirical work on topics related to meaning and meaning making proliferate, careful evaluation and integration of this area have not been carried out. Toward this end, this article has 3 goals: (a) to elaborate the critical dimensions of meaning as it relates to stressful life events and conditions, (b) to extend the transactional model of stress and coping to include these dimensions, and (c) to provide a framework for understanding current research and directions for future research within this extended model. First, the authors present a framework for understanding diverse conceptual and operational definitions of meaning by distinguishing 2 levels of meaning, termed global meaning and situationalmeaning. Second, the authors use this framework to review and synthesize the literature on the functions of meaning in the coping process and propose a definition of meaningmaking that highlights the critical role of reappraisal. The authors specify the roles of attributions throughout the coping process and discuss implications for future research.

Religiousness/spirituality and health: A meaning systems perspective.

The existence of links between religion and spirituality (R/S) and health appear to be firmly established, but much less is known about how these various aspects of R/S are translated into health outcomes. Within a meaning systems framework, this article reviews and integrates findings regarding the many pathways through which R/S may influence physical health and well-being. In particular, evidence for the pathways of body sanctification, meaning in life, social support, health locus of control, health behaviors, positive and negative affect and stress moderation, treatment adherence, and coping is examined. The article concludes with suggestions for future research.

Does Self-Reported Posttraumatic Growth Reflect Genuine Positive Change?

In this study, we evaluated the validity of self-reported posttraumatic growth (PTG) by assessing the relation between perceived growth and actual growth from pre- to posttrauma. Undergraduate students completed measures tapping typical PTG domains at Time 1 and Time 2 (2 months later). We compared change in those measures with scores on the Posttraumatic Growth Inventory (PTGI; Tedeschi & Calhoun, 1996) for those participants who reported a traumatic event between Time 1 and Time 2 (n = 122). PTGI scores generally were unrelated to actual growth in PTG-related domains. Moreover, perceived growth was associated with increased distress from pre- to posttrauma, whereas actual growth was related to decreased distress, a pattern suggesting that perceived and actual growth reflect different processes. Finally, perceived (but not actual) growth was related to positive reinterpretation coping. Thus, the PTGI, and perhaps other retrospective measures, does not appear to measure actual pre- to posttrauma change.

Anger toward God: social-cognitive predictors, prevalence, and links with adjustment to bereavement and cancer.

Many people see themselves as being in a relationship with God and see this bond as comforting. Yet, perceived relationships with God also carry the potential for experiencing anger toward God, as shown here in studies with the U.S. population (Study 1), undergraduates (Studies 2 and 3), bereaved individuals (Study 4), and cancer survivors (Study 5). These studies addressed 3 fundamental issues regarding anger toward God: perceptions and attributions that predict anger toward God, its prevalence, and its associations with adjustment. Social-cognitive predictors of anger toward God paralleled predictors of interpersonal anger and included holding God responsible for severe harm, attributions of cruelty, difficulty finding meaning, and seeing oneself as a victim. Anger toward God was frequently reported in response to negative events, although positive feelings predominated. Anger and positive feelings toward God showed moderate negative associations. Religiosity and age correlated negatively with anger toward God. Reports of anger toward God were slightly lower among Protestants and African Americans in comparison with other groups (Study 1). Some atheists and agnostics reported anger involving God, particularly on measures emphasizing past experiences (Study 2) and images of a hypothetical God (Study 3). Anger toward God was associated with poorer adjustment to bereavement (Study 4) and cancer (Study 5), particularly when anger remained unresolved over a 1-year period (Study 5). Taken together, these studies suggest that anger toward God is an important dimension of religious and spiritual experience, one that is measurable, widespread, and related to adjustment across various contexts and populations.

Facets of Spirituality as Predictors of Adjustment to Cancer: Relative Contributions of Having Faith and Finding Meaning

Spirituality is a multidimensional construct, and little is known about how its distinct dimensions jointly affect well-being. In longitudinal studies (Study 1, n = 418 breast cancer patients; Study 2, n = 165 cancer survivors), the authors examined 2 components of spiritual well-being (i.e., meaning/peace and faith) and their interaction, as well as change scores on those variables, as predictors of psychological adjustment. In Study 1, higher baseline meaning/peace, as well as an increase in meaning/peace over 6 months, predicted a decline in depressive symptoms and an increase in vitality across 12 months in breast cancer patients. Baseline faith predicted an increase in perceived cancer-related growth. Study 2 revealed that an increase in meaning/peace was related to improved mental health and lower cancer-related distress. An increase in faith was related to increased cancer-related growth. Both studies revealed significant interactions between meaning/peace and faith in predicting adjustment. Findings suggest that the ability to find meaning and peace in life is the more influential contributor to favorable adjustment during cancer survivorship, although faith appears to be uniquely related to perceived cancer-related growth.

Disclosing Trauma Through Writing: Testing the Meaning-Making Hypothesis

Salutary effects of writing about trauma on health are well documented, but little research has directly examined the underlying mechanisms by which these effects occur. The principal study in this article assessed the potential underlying mechanism of meaning-making, defined as changing situational meaning (appraisals of the traumatic experience) and global meaning (world views, personality, and coping styles) in order to reduce the discrepancy between global and situational meaning. Forty-one trauma-writing participants and 21 nontrauma-writing control participants completed 4 days of writing and a 4 month follow-up. Decrements in health were noted for the control group but not for the trauma-writing group. Over time, the trauma-writing groups appraisals changed to reflect less aversive situational meaning (e.g., less stressful, less threatening), and their cognitive processing, reflected by intrusions and avoidance, decreased. Less stressful appraisals and reduced cognitive processing were related to improved health outcomes. Results indicate that writing about trauma facilitates the making of meaning. A second study examined whether scores on several measures used in the first study changed across 4 months without a writing intervention. It was found that these measures did not change across time.

Meaning Making and Growth: New Directions for Research on Survivors of Trauma

The meaning-making framework of trauma and recovery is presented. The following specific topics are discussed: (a) the meaning-making coping framework and the processes of meaning that typically occur following traumatic encounters; (b) empirical support for the meaning-making model; (c) the possibility that growth may result from this making of meaning; (d) methodologies for examining meaning making, including both quantitative and qualitative research; and (e) clinical implications of the meaning-making framework.

Religion and Spirituality in Adjustment Following Bereavement: An Integrative Review

Surprisingly little research has examined the widely held assumption that religion and spirituality are generally helpful in adjusting to bereavement. A systematic literature search located 73 empirical articles that examined religion/spirituality in the context of bereavement. The authors describe the multidimensional nature of religion/spirituality and use this framework to organize and integrate the findings of these empirical articles. Overall, results suggest that relations between religion and adjustment to bereavement are generally positive but inconsistent and vary depending in part on how religion/spirituality is measured. The authors conclude with a critique of the current research and directions for future research.

Trauma and Stress Response Among Hurricane Katrina Evacuees

OBJECTIVES Hurricane Katrinas impact on public health has been significant and multifaceted, with trauma-related psychological sequelae likely to result in a sizable burden of disease. Data were collected that assessed acute stress disorder (ASD) prevalence and factors related to ASD symptomatology among sheltered evacuees. METHODS On days 12 to 19 after Katrina, evacuees at a major emergency shelter completed surveys that assessed demographics, Katrina-specific experiences, and ASD symptomatology. RESULTS Sixty-two percent of the sample met ASD threshold criterion. Projections based on the predictive power of ASD to posttraumatic stress disorder (PTSD) suggest that 38% to 49% of the sample will meet PTSD criteria 2 years post-disaster. Female gender (odds ratio [OR] = 4.08), positive psychiatric history (OR=5.84), injury (OR=2.75), increased life-threat perception (OR=1.37), and decreased sense of personal control (OR=1.56) were significantly related to ASD. Black race was associated with greater symptom severity (B=7.85, SE[B]=3.50). CONCLUSIONS Katrina-related trauma and its psychological sequelae will remain a significant public health issue for years to come. The identification of several vulnerability factors related to ASD and PTSD provides a brief sketch of those at greatest risk.

Psychosocial Mediation of Religious Coping Styles: A Study of Short-Term Psychological Distress Following Cardiac Surgery

Although religiousness and religious coping styles are well-documented predictors of well-being, research on the mechanisms through which religious coping styles operate is sparse. This prospective study examined religious coping styles, hope, and social support as pathways of the influence of general religiousness (religious importance and involvement) on the reduced postoperative psychological distress of 309 cardiac patients. Results of structural equation modeling indicated that controlling for preoperative distress, gender, and education, religiousness contributed to positive religious coping, which in turn was associated with less distress via a path fully mediated by the secular factors of social support and hope. Furthermore, negative religious coping styles, although correlated at the bivariate level with preoperative distress but not with religiousness, were associated both directly and indirectly with greater post-operative distress via the same mediators.