Jack W. Berry

On the form and function of forgiving: modeling the time-forgiveness relationship and testing the valuable relationships hypothesis.

In two studies, the authors sought to identify the mathematical function underlying the temporal course of forgiveness. A logarithmic model outperformed linear, exponential, power, hyperbolic, and exponential-power models. The logarithmic function implies a psychological process yielding diminishing returns, corresponds to the Weber-Fechner law, and is functionally similar to the power law underlying the psychophysical function (Stevens, 1971) and the forgetting function (Wixted & Ebbesen, 1997). By 3 months after their transgressions, the typical participants forgiveness had increased by two log-odds units. Individual differences in rates of change were correlated with robust predictors of forgiveness. Consistent with evolutionary theorizing (McCullough, 2008), Study 2 revealed that forgiveness was uniquely associated with participants perceptions that their relationships with their offenders retained value.

Empathy in Mental Illness: Empathy and depression: the moral system on overdrive

Introduction This chapter describes the intimate connection between empathy and depression, the epidemic of our modern world. While depression has been described as a ‘disorder of the self’, it may be more accurately characterized as a disorder of ‘concern for others’. People who are depressed most often have normal or elevated levels of empathy; however, their affect-directed, automatic causal interpretations of pain in others are often disturbed, leading to non-conscious assertions of blame, usually placed on themselves. Empathy, a socially organizing neural system, allows us to share others feelings, to mimic without awareness, and forms the basis of our relationships and our social learning (Decety & Jackson, 2004). A sophisticated Theory of Mind (ToM), or the ability to know what others are thinking, is sometimes considered a prerequisite for true empathy. The capacity for empathy, present in infants from the first days of life, may be independent of cognitive maturity and a developed ToM. Healthy empathy, however, requires an understanding of causality, undeveloped in very young children and affectively distorted in depression. The empathic reaction in depressives often leads to great distress because they tend to unrealistically blame themselves for pain felt by others. Thus, in mood disorders, the empathy system may be functional; however, an overly active and automatic moral system, connected to the empathic experience, tends to misinterpret attribution, and the guilt felt at believing that you have caused pain in another leads to empathic distress, an exaggerated reaction.

Conciliatory Gestures Facilitate Forgiveness and Feelings of Friendship by Making Transgressors Appear More Agreeable

The authors examined how conciliatory gestures exhibited in response to interpersonal transgressions influence forgiveness and feelings of friendship with the transgressor. In Study 1, 163 undergraduates who had recently been harmed were examined longitudinally. Conciliatory gestures exhibited by transgressors predicted higher rates of forgiveness over 21 days, and this relationship was mediated by victims perceptions of their transgressors Agreeableness. Study 2 was an experiment including 145 undergraduates who experienced a breach in trust from an anonymous partner during an iterated prisoners dilemma. When transgressors apologized and offered financial compensation, participants reported higher levels of forgiveness and feelings of friendship when compared to a control condition and an aggravating condition. The effects of apology/compensation on forgiveness and perceived friendship were mediated by victims perceptions of their transgressors Agreeableness. Results suggest that conciliatory gestures promote forgiveness in part by depicting transgressors as more sympathetic, considerate, fair, and just (i.e., agreeable).

Telephone-based problem-solving intervention for family caregivers of stroke survivors: a randomized controlled trial.

OBJECTIVEnIntervention trials for stroke caregivers after the early poststroke period are lacking. To address this gap, we examined the effectiveness of a problem-solving intervention (PSI) for stroke caregivers who provided care for at least 6 months and who experienced significant strain in their role.nnnMETHODnOne hundred twenty-two family caregivers (age = 66.2 years, 77.9% female) were randomly allocated to a PSI or control group. The PSI was composed of 2 home visits and 18 telephone calls delivered over a 3-month intensive intervention and a 9-month maintenance period. PSI and control groups received monthly information letters in addition to usual care. Primary caregiver outcomes were depressive symptoms (measure: Center for Epidemiologic Studies-Depression Scale) and sense of competence (measure: Sense of Competence Questionnaire).nnnRESULTSnIn covariance analyses, caregivers of the PSI group showed significantly lower levels of depressive symptoms after 3 months (p < .01, d = -.48) and after 12 months (p < .05, d = -.37), but no better sense of competence compared with the control group. Latent growth curve analyses revealed positive significant (p < .05) linear and quadratic effects of PSI on both primary outcomes. No effects, however, were found on caregiver social-problem-solving abilities.nnnCONCLUSIONSnAlthough beneficial effects were observed among caregivers in the PSI group, the lack of effects on problem-solving abilities implies other characteristics of the intervention might account for these benefits. The relative intensity and therapeutic contact during the first 3 months of the intervention may be particularly helpful to caregivers of stroke survivors.

Predicting quality of life 5 years after medical discharge for traumatic spinal cord injury

OBJECTIVESnThis study tested an a priori contextual model of the mediating effects of participation on the predictive relationships of functional impairment, family satisfaction, and pain to quality of life (QoL) following traumatic spinal cord injury (SCI).nnnDESIGNnA longitudinal design was used to study 144 persons following discharge for traumatic SCI. Predictor variables included functional impairment and family satisfaction (at 12xa0months post-discharge) and the presence of pain (at 24xa0months), and mediating variables were two indicators of participation (assessed 48xa0months post-discharge). Life satisfaction and self-rated health status at 60xa0months post-discharge were the outcome variables.nnnMETHODSnA path model tested hypothesized prospective effects of functional impairment, family satisfaction and pain on participation and the subsequent effects of participation on the QoL variables.nnnRESULTSnGreater functional impairment and pain were predictive of less participation, and participation significantly predicted both indicators of QoL. The two participation variables mediated the relationship of functional impairment and pain to life satisfaction over time. Family satisfaction had an indirect effect on QoL through its association with social integration.nnnCONCLUSIONSnParticipation appears to mediate the prospective influence of functional impairment, family satisfaction, and pain on QoL in the years following SCI. These findings provide insight into factors that can predict QoL post-SCI and support the use of contextual models to understand the temporal influence of disability and psychological variables on participation and subsequent QoL.nnnSTATEMENT OF CONTRIBUTIONnWhat is already known on this subject? Life satisfaction and self-rated health status are important aspects of quality of life following traumatic spinal cord injury. Functional impairment has been inconsistently predictive of these variables over time. Prospective research to date has not examined the mediating effects of participation in predicting quality of life. What does this study add? The results indicate that greater functional impairment and pain are prospectively predictive of lower participation. Greater participation, in turn, is prospectively predictive of greater quality of life. Participation appears to mediate the prospective influence of functional impairment, family satisfaction, and pain to quality of life.

Does problem-solving training for family caregivers benefit their care recipients with severe disabilities? A latent growth model of the Project CLUES randomized clinical trial.

OBJECTIVEnTo examine whether an individualized problem-solving intervention provided to family caregivers of persons with severe disabilities provides benefits to both caregivers and their care recipients.nnnDESIGNnFamily caregivers were randomly assigned to an education-only control group or a problem-solving training (PST) intervention group. Participants received monthly contacts for 1 year.nnnPARTICIPANTSnFamily caregivers (129 women, 18 men) and their care recipients (81 women, 66 men) consented to participate.nnnMAIN OUTCOME MEASURESnCaregivers completed the Social Problem-Solving Inventory-Revised, the Center for Epidemiological Studies-Depression scale, the Satisfaction with Life scale, and a measure of health complaints at baseline and in 3 additional assessments throughout the year. Care recipient depression was assessed with a short form of the Hamilton Depression Scale.nnnRESULTSnLatent growth modeling was used to analyze data from the dyads. Caregivers who received PST reported a significant decrease in depression over time, and they also displayed gains in constructive problem-solving abilities and decreases in dysfunctional problem-solving abilities. Care recipients displayed significant decreases in depression over time, and these decreases were significantly associated with decreases in caregiver depression in response to training.nnnCONCLUSIONSnPST significantly improved the problem-solving skills of community-residing caregivers and also lessened their depressive symptoms. Care recipients in the PST group also had reductions in depression over time, and it appears that decreases in caregiver depression may account for this effect.

Family satisfaction predicts life satisfaction trajectories over the first 5 years after traumatic brain injury

OBJECTIVESnExamined the influence of functional impairment, stable marital status, and family satisfaction on life satisfaction trajectories for 609 individuals (435 men, 174 women) over the first 5 years after traumatic brain injury (TBI).nnnMEASURESnParticipants completed the Family Satisfaction Scale (FSS), Functional Independence Measure (FIM), and the Life Satisfaction Index (LSI) at years 1, 2, 4, and 5 after sustaining a TBI.nnnRESULTSnTrajectory modeling revealed that higher family satisfaction was associated with increases in life satisfaction for individuals with less functional impairment. Stable marital status was not significantly associated with life satisfaction trajectories.nnnIMPLICATIONSnFamily satisfaction appears to have pronounced beneficial effects on life satisfaction for persons with less functional impairment after TBI regardless of marital status. In contrast, a stable marriage appears to have no apparent benefits to self-reported life satisfaction over the first 5 years post-TBI. Theoretical and clinical implications of these results are discussed.

Predictors of health-related quality-of-life following traumatic brain injury

Abstract Primary objective: To examine the predictive associations of family satisfaction, functional impairment, pain, and depression on health-related quality-of-life (HRQoL) among persons with traumatic brain injury (TBI) through structural equation modelling (SEM). Research design: Participants were part of a larger longitudinal study of adjustment following TBI. Direct and indirect effects of predictor variables on HRQoL were analyzed through SEM. Methods and procedures: The sample included 131 participants with TBI (89 men, 42 women) who had been discharged from an acute care hospital. The Sickness Impact Profile was administered to measure HRQoL at or beyond 24 months post-discharge. Predictor variable measures included the Functional Independence Measure, Family Satisfaction Scale and single items assessing the presence of pain and depression. Main outcomes and results: SEM revealed direct effects of functional impairment (pu2009<u20090.001), family satisfaction (pu2009<u20090.01), depression (pu2009<u20090.05) and pain (pu2009<u20090.01) on HRQoL. Indirect effects from functional impairment (pu2009<u20090.05) and pain (pu2009<u20090.05) to HRQoL through depression were also present. Conclusions: The presence of pain and depression, greater functional impairment and lower family satisfaction were predictively associated with lower HRQoL. Depression further mediated the effects of pain and functional impairment on HRQoL. The present study advances understanding of the ways in which pain, depression and functional impairment predict HRQoL.

Forgiveness Working Forgiveness, Health, and Productivity in the Workplace

Purpose: Associations between forgiveness and health promotion in the workplace were examined as mediating effects of workplace interpersonal stress. Design: Cross-sectional. Setting: Multiple Washington, DC, office-based and Midwestern manufacturing workplaces. Participants: Study 1: 108 employees (40 males and 68 females); mean age was 32.4 years. Study 2: 154 employees (14 males and 140 females); mean age was 43.9 years. Measures: Questionnaires measured forgiveness, unproductivity, absenteeism, stress, and health problems. Analysis: Bivariate and multiple correlation/regression and structural equation models were used. Indirect effects were estimated with bootstrapping methods. Results: In study 1, forgiveness of a specific workplace offense was inversely associated with unproductivity (r = −.35, P < .001) and mental (r = −.32, P = .001) and physical (r = −.19, P = .044) health problems. In study 2, trait forgiveness was inversely associated with unproductivity (β = −.20, P = .016) and mental (β = −.31, P < .001) and physical health problems (β = −.28, P = .001), and workplace interpersonal stress partially mediated these associations (indirect effects = −.03, −.04, −.05, respectively). Conclusion: The association of forgiveness and occupational outcomes is robust. Forgiveness may be associated with outcomes by (at least partially) reducing stress related to workplace offenses. Forgiveness may be an effective means of coping following being emotionally hurt on the job that may promote good health, well-being, and productivity.

Does participation mediate the prospective relationships of impairment, injury severity, and pain to quality of life following burn injury?

We examined the prospective impact of injury severity, functional impairment, and pain on participation in the community and subsequently on life satisfaction and self-rated health of 260 burn survivors 5u2009years post-discharge. Predictor variables include injury severity and total body surface area burned (assessed during acute care), functional independence (assessed at 12u2009months post-discharge), pain (assessed at the 24th month), and participation (assessed at the 48th month). Participation predicted life satisfaction and self-rated health. Functional independence and injury severity had significant indirect influences on adjustment via their influence on participation. Pain predicted both outcome variables. Clinical and research implications are discussed.