Login S. George

A meta-analytic approach to examining the correlation between religion/spirituality and mental health in cancer.

Religion and spirituality (R/S) are patient‐centered factors and often are resources for managing the emotional sequelae of the cancer experience. Studies investigating the correlation between R/S (eg, beliefs, experiences, coping) and mental health (eg, depression, anxiety, well being) in cancer have used very heterogeneous measures and have produced correspondingly inconsistent results. A meaningful synthesis of these findings has been lacking; thus, the objective of this review was to conduct a meta‐analysis of the research on R/S and mental health. Four electronic databases were systematically reviewed, and 2073 abstracts met initial selection criteria. Reviewer pairs applied standardized coding schemes to extract indices of the correlation between R/S and mental health. In total, 617 effect sizes from 148 eligible studies were synthesized using meta‐analytic generalized estimating equations, and subgroup analyses were performed to examine moderators of effects. The estimated mean correlation (Fisher z) was 0.19 (95% confidence interval [CI], 0.16‐0.23), which varied as a function of R/S dimensions: affective R/S (z = 0.38; 95% CI, 0.33‐0.43), behavioral R/S (z = 0.03; 95% CI, −0.02‐0.08), cognitive R/S (z = 0.10; 95% CI, 0.06‐0.14), and ‘other’ R/S (z = 0.08; 95% CI, 0.03‐0.13). Aggregate, study‐level demographic and clinical factors were not predictive of the relation between R/S and mental health. There was little indication of publication or reporting biases. The correlation between R/S and mental health generally was positive. The strength of that correlation was modest and varied as a function of the R/S dimensions and mental health domains assessed. The identification of optimal R/S measures and more sophisticated methodological approaches are needed to advance research. Cancer 2015;121:3769–3778.

Assessing meaning and meaning making in the context of stressful life events: Measurement tools and approaches

Theory and research on meaning has proliferated in recent years, focusing on both global meaning and processes of making meaning from difficult life events such as trauma and serious illness. However, the measurement of meaning constructs lags behind theoretical conceptualizations, hindering empirical progress. In this paper, we first delineate a meaning-making framework that integrates current theorizing about meaning and meaning making. From the vantage of this framework, we then describe and evaluate current approaches to assessing meaning-related phenomena, including global meaning and situational meaning constructs. We conclude with suggestions for an integrative approach to assessing meaning-related constructs in future research.

Meaning in life as comprehension, purpose, and mattering: Toward integration and new research questions.

To advance meaning in life (MIL) research, it is crucial to integrate it with the broader meaning literature, which includes important additional concepts (e.g., meaning frameworks) and principles (e.g., terror management). A tripartite view, which conceptualizes MIL as consisting of 3 subconstructs—comprehension, purpose, and mattering—may facilitate such integration. Here, we outline how a tripartite view may relate to key concepts from within MIL research (e.g., MIL judgments and feelings) and within the broader meaning research (e.g., meaning frameworks, meaning making). On the basis of this framework, we review the broader meaning literature to derive a theoretical context within which to understand and conduct further research on comprehension, purpose, and mattering. We highlight how future research may examine the interrelationships among the 3 MIL subconstructs, MIL judgments and feelings, and meaning frameworks.

Are meaning and purpose distinct? An examination of correlates and predictors

Existing empirical literature has typically treated meaning and purpose as identical. Based on previous theoretical propositions of these two constructs as distinct, we hypothesized that meaning (defined as a sense of comprehension and significance in life) and purpose (defined as a sense of goals, aims, and direction in life) would have different predictors and correlates. We utilized a longitudinal design and collected data from 167 cancer survivors at two time points one year apart. Although meaning and purpose were strongly correlated, they had different predictors and correlates. Regression analyses showed Time 2 meaning was predicted by Time 1 spirituality, whereas Time 2 purpose was predicted by Time 1 social support. At Time 2, meaning was positively correlated with posttraumatic growth and negatively with posttraumatic depreciation, whereas purpose was negatively correlated with intrusive thoughts pertaining to cancer. Implications of an understanding of meaning and purpose as distinct constructs are discussed.

Existential Mattering: Bringing Attention to a Neglected but Central Aspect of Meaning?

Most current literature on meaning uses the term meaning to refer to a variety of different specific aspects, such as having a sense of goals, direction, significance, fulfillment, engagement in valued activities, ability to make sense of life, and so forth. One essential aspect of meaning that has yet to receive focused and in-depth attention is existential mattering (EM). EM can be defined as the degree to which individuals feel that their lives are of value and significance in the world. Although EM is an implicit part of the current theoretical and empirical literature on meaning, it is rarely given adequate and focused attention. In this chapter, we discuss EM at length. Citing the work of prior theorists, we highlight how EM may play a crucial role in individuals’ lives, and how individuals are strongly inclined to see their lives as having significance and value. We argue that future theoretical and empirical work that specifically focuses on EM, without conflating it with other aspects of meaning, may foster more nuanced theorizing and research regarding how different aspects of meaning, such as EM, may be related to important variables such as spirituality, resilience, well-being, and death anxiety. We briefly examine EM as it exists in the current empirical literature on meaning. Further, we discuss EM as it relates to Terror Management Theory (TMT). We argue that the construct of EM is intimately tied to TMT. TMT argues that individuals are motivated to feel that their lives are of enduring value, and to feel that they are valued members of a reality that transcends death. TMT conceptualizes self-esteem as the construct that best taps this motivation. Contrary to this, we argue that EM may capture this motivation more accurately than does self-esteem. Research that examines EM in the context of TMT is warranted, as EM may provide additional explanatory power beyond that provided by self-esteem. We conclude the chapter with directions for future research on EM.

Spiritual peace predicts 5-year mortality in congestive heart failure patients.

OBJECTIVE Spirituality is favorably related to depression, quality of life, hospitalizations, and other important outcomes in congestive heart failure (CHF) patients but has not been examined as a predictor of mortality risk in this population. Given the well-known difficulties in managing CHF, we hypothesized that spirituality would be associated with lower mortality risk, controlling for baseline demographics, functional status, health behaviors, and religiousness. METHOD Participants were 191 CHF patients (64% male; M age = 68.6 years, SD = 10.1) who completed a baseline survey and were then followed for 5 years. RESULTS Nearly 1/3 of the sample (32%) died during the study period. Controlling for demographics and health status, smoking more than doubled the risk of mortality, whereas alcohol consumption was associated with slightly lower risk of mortality. Importantly, adherence to healthy lifestyle recommendations was associated with halved mortality risk. Although both religion and spirituality were associated with better health behaviors at baseline in bivariate analyses, a proportional hazard model showed that only spirituality was significantly associated with reduced mortality risk (by 20%), controlling for demographics, health status, and health behaviors. CONCLUSIONS Experiencing spiritual peace, along with adherence to a healthy lifestyle, were better predictors of mortality risk in this sample of CHF patients than were physical health indicators such as functional status and comorbidity. Future research might profitably examine the efficacy of attending to spiritual issues along with standard lifestyle interventions.

The Multidimensional Existential Meaning Scale: A tripartite approach to measuring meaning in life

Abstract To address conceptual difficulties and advance research on meaning in life (MIL), it may be useful to adopt a tripartite view of meaning as consisting of comprehension, purpose, and mattering. This paper discusses the development of the Multidimensional Existential Meaning Scale (MEMS), which explicitly assesses these three subconstructs. Results from three samples of undergraduates showed the MEMS to have favorable psychometric properties (e.g. good factor structure and reliability) and demonstrated that it can effectively differentiate the three subconstructs of meaning. Regression and relative importance analyses showed that each MEMS subscale carried predictive power for relevant variables and other meaning measures. Additionally, the MEMS subscales demonstrated theoretically consistent, differential associations with other variables (e.g. dogmatism, behavioral activation, and spirituality). Overall, results suggest that the MEMS may offer more conceptual precision than existing measures, and it may open new avenues of research and facilitate a more nuanced understanding of MIL.

Managing Family Conflict Over Career Decisions The Experience of Asian Americans

Conflict over career decisions is a main source of intergenerational conflict among Asian American families. This qualitative study explored the topic using consensual qualitative research methodology in a sample of eight Asian Americans. Results indicated that participants experienced feelings of guilt and indebtedness due to conflicting values, traditions, and expectations. Most participants dealt with parental disapproval regarding their career choice by seeking advice from friends and relatives. Participants employed many strategies to earn approval such as educating parents about their chosen career, seeking honors, and compromising between personal desires and parental expectations. Implications for career counseling and research are discussed.

Does spirituality confer meaning in life among heart failure patients and cancer survivors

The provision of a sense of meaning in life, especially during adverse life circumstances, is widely considered to be a central function of spirituality. However, limited empirical evidence exists for this notion. The present study used cross-lagged panel analyses, in samples of 140 congestive heart failure patients and 161 cancer survivors, to examine whether spirituality can provide meaning in the context of serious illness. Survey data were collected at baseline and 6 (heart failure patients) or 12 months (cancer survivors) later. In both studies, cross-lagged paths showed that higher baseline spirituality predicted more positive change in meaning over time. These results support the widely held notion that spirituality can provide increased meaning in life among individuals dealing with substantial adversity.

Lab- and Field-Based Approaches to Meaning Threats and Restoration: Convergences and Divergences.

Two distinct approaches to meaning—experimental lab-based research on meaning and its maintenance in response to situational cues and observational field research on meaning-focused coping following highly stressful or traumatic situations—have both produced important insights into the mechanics underlying responses to meaning-relevant threats. It has been suggested that although these 2 approaches focus on different, specific aspects of meaning, they converge on common underlying phenomena. The present article considers how lab-based and field-based approaches align and diverge on their answers to 4 questions: (1) How is meaning defined in the context of meaning violation and restoration? (2) What are threats to meaning? (3) How do people respond to these threats? and (4) Why does meaning restoration matter? Our comparison of these lab- and field-based approaches suggests that they share considerable commonalities in conceptualization, but they diverge in important ways in terms of emphasis and empirical considerations. We conclude that lab- and field-based approaches to meaning violation and restoration may be focusing on the same phenomena studied at different levels, but with some qualitative differences, and we offer suggestions for how lab- and field-based approaches can better inform one another. Considering these two approaches conjointly provides a more holistic and comprehensive understanding of the fundamental phenomena of meaning threat and restoration.