The effectiveness of reminiscence therapy on the symptom management, the life satisfaction, and the self-transcendence in palliative care patients: a randomized controlled trial.

PURPOSE: To examine the effect of individualized reminiscence therapy on the management of global distress and physical and psychological symptoms, life satisfaction and self-transcendence levels of palliative care patients. METHODS: In a single-center palliative care service in western Turkey, 48 patients without cognitive impairment and able to communicate were included in the study. However, 44 patients completed the study. Patients who met the inclusion criteria were randomly assigned to the reminiscence therapy (intervention), unstructured social interviewing (placebo), and control groups (16 people for each group) before the start of the study. The sessions for the interview and placebo groups were conducted face-to-face in the patient's room (while the patient was sitting or lying down) for 15 days (2 weeks), every other day, for a total of eight sessions (each session was approximately 30 min). Data collection instruments-the Memorial Symptom Assessment Scale, the Contentment with Life Assessment Scale, and the Self-Transcendence Scale-were collected at baseline (first day) and after the intervention (day 15th). Statistical significance level was accepted as p < 0.05. RESULTS: There was no decrease in physical and total symptom burden (p > 0.05). There were significant reductions in general distress and psychological symptoms in the intervention and placebo groups within the group (p < 0.05), but there were no significant differences between the control group and all groups when compared (p > 0.05). Group × time interactions were statistically significant for life satisfaction and self-transcendence (p < 0.001), and there was a substantial increase in the intervention group compared to the other groups. CONCLUSION: It may be recommended that reminiscence therapy intervention be included in routine nursing care as it may contribute positively to the psychological recovery of palliative care patients approaching the end of life. TRIAL REGISTRATION: ClinicalTrails.gov (Registration number: NCT05242016). Prospectively registered on 1 February 2022.

Clarifying and measuring the characteristics of experiences that involve a loss of self or a dissolution of its boundaries.

Mystical experience, non-dual awareness, selflessness, self-transcendent experience, and ego-dissolution have become increasingly prominent constructs in meditation and psychedelic research. However, these constructs and their measures tend to be highly overlapping, imprecise, and poorly integrated with similar pathological experiences. The present study seeks to clarify the common factors involved in the characteristics of these experiences using precise distinctions across an array of experience contexts (including meditation, psychedelics, and psychopathology). Participants (N = 386) completed an online survey about an experience that involved either a dissolution of self-boundaries or a loss of selfhood. Confirmatory factor analyses resulted in 16 experience characteristics, including multiple types of changes in sense of self, co-occurring phenomenology, and cognitive and affective responses. Qualitative thematic analysis provided rich descriptions of experience characteristics. Taken together, results lead to a more specific measurement model and descriptive account of experiences involving a loss of self or self-boundary.

Individual values predict desiring more economic inequality: The moderator role of social mobility.

Attitudes towards economic inequality are crucial to uphold structural economic inequality in democratic societies. Previous research has shown that socioeconomic status, political ideology, and the objective level of economic inequality associated with individuals' attitudes towards economic inequality. However, some have suggested that people are aware of the individual and social features that are more functional according to the level of economic inequality. Therefore, individual predispositions such as cultural values could also predict these attitudes. In the current research, we expand previous results testing whether cultural variables at the individual level predict attitudes towards economic inequality. After analysing survey data including samples from 52 countries (N = 89,565), we found that self-enhancement values predict positively, and self-transcendence negatively, attitudes towards economic inequality as the ideal economic inequality measures. This result remained significant even after controlling by socioeconomic status, political ideology, and objective economic inequality. However, this effect is only true in high and middle social mobility countries, but not in countries with low social mobility. The present research highlights how cultural values and country social mobility are crucial factors to addressing attitudes towards economic inequality.

Reappraising personal values in cancer: Meaning-in-life adaptation, meaningfulness, and quality of life.

OBJECTIVE: This study explores the reappraisal of personal values among people with cancer post-diagnosis and its connections to meaningfulness, encompassing personal meaning and sense of meaning, and various dimensions of quality of life. METHODS: A total of 144 patients with diverse cancer types and a control group comprising 158 healthy adults with similar demographic characteristics completed the Valued Living Questionnaire-Perceived Change, the Personal Meaning Profile-Brief, the Portrait Values Questionnaire, and the Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being. RESULTS: Cancer patients displayed a substantial values reappraisal compared to healthy adults. They reported an increased significance of social areas and self-transcendental values, including close relationships (family, partner, and friends), spirituality, citizenship, and universalism, as well as an increased importance of self-care and self in general. Conversely, cancer patients assigned less importance to work and self-enhancement values such as stimulation, power, and achievement. Cluster analysis revealed that patients who reappraised their values exhibited higher meaningfulness and better indicators of quality of life, including spiritual and physical well-being, compared to patients who did not modify their value system. CONCLUSIONS: These findings underscore the importance of assessing and promoting meaning-in-life adaptability among people with cancer, with potential applications in meaning-centered therapies and interventions aimed at enhancing psychological flexibility.

Characteristics and influencing factors of social isolation in patients with breast cancer: a latent profile analysis.

PURPOSE: The goal of this study is to investigate the social isolation (SI) subtypes of patients with breast cancer (BC) and to explore its influencing factors. METHODS: A sample of 303 BC patients participated in the study from September to December, 2021. Latent profile analysis (LPA) was performed to identify SI clusters based on the three sub-scales of the Chinese version of the Social Anxiety Scale, the Chinese version of the Social Avoidance and Distress Scale, and the Chinese version of the Loneliness Scale. RESULTS: We found that SI can be divided into three categories: high-level (Class 1), middle-level (Class 2), and low-level (Class 3), accounting for 20.46%, 33.00%, and 46.54%, respectively. Compared to Class 3, Class 1, which had the lower average monthly income per family member (RMB) (< 3000: OR = 5.298, P = .021; 3000 ~ 5000: OR = 5.320, P = .018), was more likely to suffer from SI due to occupation (Laborer: OR = 12.023, P = .009). Surgery (OR = 14.138, P < .001; OR = 2.777, P = .020), chemotherapy (OR = 10.224, P = .001; OR = 3.545, P = .001); poorer family functioning (OR = .671, P < .001; OR = .801, P = .002), and lower levels of self-transcendence (OR = .806, P < .001; OR = .911, P < .001) were important influencing factors for SI in Class 1 and Class 2 compared to Class 3. CONCLUSION: SI is classifiably heterogeneous among patients with BC. Strategies that identify characteristics of SI and give targeted intervention focusing on family functioning and improving self-transcendence levels contribute to the prevention of SI among patients with BC.

Going beyond ourselves: the role of self-transcendent experiences in wisdom.

Having good moral character often involves shifting one's focus of attention from the self to others and the world. Across three studies (N = 605 adults), we found converging evidence that self-transcendent experiences, specifically awe and flow, enabled the expression of wisdom, as captured by wise reasoning and epistemic humility measures. Study 1 found that dispositionally awe- and flow-prone people have stronger wise reasoning and epistemic humility abilities, over and above dispositional happiness. Consistent with Study 1, Study 2 found that, across diverse recalled experiences, individuals who experienced more awe showed greater wise reasoning, and those who experienced more flow showed greater epistemic humility. In Study 3, using situated interventions, we induced awe (watching a video involving vast nature scenes) and flow (composing a song using an online music maker) and compared them with neutral and amusement experiences. Compared to these control conditions, eliciting awe and flow facilitated one's (1) ability to address interpersonal conflicts with wise reasoning, (2) ability to acknowledge one's epistemic gaps, and (3) willingness to improve those aspects and one's general moral character. Altogether, these findings reveal the promising role of self-transcendent experiences in motivating people to appreciate others' perspectives beyond one's own.

Self-Transcendence as a Mediator of the Relationship Between Reminiscence Functions and Death Anxiety: Implications for Psychiatric Nurses.

BACKGROUND: Jordan's population of older adults is growing due to improved health care and lifestyle, but the country has limited mental health care resources, causing challenges for the health care system. Reminiscence is a point of nursing intervention and a way for psychiatric nurses to help people improve their mental health by expanding their personal boundaries (self-transcendence). AIMS: The study aimed to examine the mediating effects of self-transcendence on the relationship between reminiscence functions and death anxiety in a sample of Jordanian older adults. Psychiatric nurses can refine reminiscence therapy by targeting aspects of self-transcendence to reduce death anxiety. METHODS: An online cross-sectional survey was employed to collect the data. A total of 319 older adults participated in the study. The sample was recruited using convenience and snowball sampling strategies through social media and personal contacts. RESULTS: The reminiscence function of "Bitterness Revival," gender, the presence of a life-threatening disease, a history of psychiatric disorder, and the work sector were statistically significant predictors of death anxiety. This model accounts for 24% of the death anxiety score (F = 7.789, p < .001). Reminiscence functions 1, 2, and 5 predicted self-transcendence. This model explained 25% of the variance in the self-transcendence score (F = 6.548, p < .001). Self-transcendence exerts a positive, partial mediating effect between "Bitterness Revival" and death anxiety, controlling for other covariates in the death anxiety model (p = .016). CONCLUSIONS: The study is informative for understanding the role of self-transcendence in buffering death anxiety, notwithstanding "Bitterness Revival" reminiscences. This knowledge reveals practical implications for psychiatric nurses about the importance of developing reminiscence interventions to promote self-transcendence and ease death anxiety.

Intentional binding and self-transcendence: Searching for pro-survival behavior in sense-of-agency.

Sense-of-agency (SoA) is implicated in a wide range of pro-survival behavioral capacities from a classical psychological perspective. However, in recent years, SoA has primarily been considered a sensorimotor process indexed by intentional binding, and pro-survival behavioral capacity has been considered multifactorial. To revisit their association, considering such conceptual updates, we examined the relationship between intentional binding and eight factors of pro-survival behavioral capacity (as defined by the power-to-live questionnaire). The level of intentional binding measured using the Libet clock method was significantly correlated with, and contributed to, the self-transcendence factor of the power-to-live questionnaire. The results demonstrated the contribution of the sensorimotor processes of SoA to pro-survival behavioral quality in the domain of self-transcendence, which may be explained by a recent social-cognitive hypothesis for the development from contingency detection to social embeddedness and moral compliance.

Potential processes of change in MDMA-Assisted therapy for social anxiety disorder: Enhanced memory reconsolidation, self-transcendence, and therapeutic relationships.

OBJECTIVE: Researchers have suggested that psychotherapy may be enhanced by the addition of 3,4-methylenedioxymethamphetamine (MDMA), particularly in the treatment of disorders wherein interpersonal dysfunction is central, such as social anxiety disorder. We review literature pertaining to three potential processes of change that may be instigated during sessions involving MDMA administration in the treatment of social anxiety disorder. DESIGN: This is a narrative review that integrates research on the etiology and maintenance of social anxiety disorder and mechanisms of action of MDMA to examine how MDMA may enhance psychotherapy outcomes. RESULTS: We first outline how MDMA may enhance memory reconsolidation in social anxiety disorder. We then discuss how MDMA may induce experiences of self-transcendence and self-transcendent emotions such as compassion, love, and awe; and how these experiences may be therapeutic in the context of social anxiety disorder. We subsequently discuss the possibility that MDMA may enhance the strength and effectiveness of the therapeutic relationship which is a robust predictor of outcomes across many disorders as well as a potential key ingredient in treating disorders where shame and social disconnection are central factors. CONCLUSION: We discuss how processes of change may extend beyond the MDMA dosing sessions themselves.

Effects of a WeChat-Based Life Review Program for Patients With Digestive System Cancer: 3-Arm Parallel Randomized Controlled Trial.

BACKGROUND: Patients with digestive system cancer often experience psychospiritual distress. Life review is an evidence-based psychological intervention for patients with cancer, but the effects of digital life review programs are unclear, especially for patients with digestive system cancer. OBJECTIVE: We examined the effects of a WeChat-based life review program on the psychospiritual well-being of patients with digestive system cancer. METHODS: This study was a 3-arm parallel randomized controlled trial. Eligible patients with digestive system cancer were recruited from a university hospital in Fujian, China. They were randomized to a life review group and 2 control groups. All participants received routine care, and the life review group also received the 4-week WeChat-based life review program. Control group 1 also received a 4-week program of friendly visiting. Anxiety, depression, hope, and self-transcendence were measured at baseline and 2 days, 1 month, and 6 months after the intervention. RESULTS: A total of 150 participants were randomly allocated to the WeChat-based life review group (n=50), control group 1 (n=50), or control group 2 (n=50). The overall dropout rate was 10% (15/150), and 92% (46/50) of participants in the the life review group completed the intervention. Significant interaction effects for time and group membership were found for anxiety (P<.001), depression (P<.001), hope (P<.001), and self-transcendence (P<.001) at all follow-up time points. For anxiety and depression, the scores did not differ significantly between the life review group and control group 1 on day 2 (P=.80 for anxiety, P=.51 for depression), but the scores were significantly lower in the life review group at month 1 and month 6 (P=.02 for anxiety at both months 1 and 6; P=.003 and P<.001 for depression at months 1 and 6, respectively). Significant increases in hope and self-transcendence were revealed in the life review group compared to control group participants at all follow-up sessions. CONCLUSIONS: The WeChat-based life review program was effective in reducing anxiety and depressive symptoms and in improving the level of hope and self-transcendence among patients with digestive system cancer. Though friendly visiting can also help to relieve anxiety, its effects are short-term. TRIAL REGISTRATION: Chinese Clinical Trial Registry ChiCTR-IOR-17011998; https://tinyurl.com/5acycpd4.

Self-transcendence among adults 65 years and older: A meta-analysis.

INTRODUCTION: Self-transcendence is a human capacity for wellbeing by expanding one's personal boundaries and may act as a health-promoting resource among adults ≥65 years. Therefore, the objectives of this meta-analysis were to determine the mean score of self-transcendence based on place of residence and gender, and to evaluate the correlations of self-transcendence with meaning, sense of coherence, resilience and depression. METHODS: Based on inclusion criteria, 13 studies were included. Orwin Safe N and Egger's test assessed publication bias. The mean score of self-transcendence and the correlation coefficients of the selected variables were estimated by random effects models. RESULTS: The self-transcendence mean score (n = 1634) was low (M = 43.6) and a bit lower among those staying in care facilities (M = 42.8), but did not vary significantly across gender. The correlation coefficients were self-transcendence_depression (r = -0.40), self-transcendence_meaning-in-life (r = 0.53), self-transcendence_resilience (r = 0.50) and self-transcendence_sense of coherence (r = 0.28). The correlation coefficients, except for meaning-in-life, were homogeneous. CONCLUSION: In a health-promoting perspective, the concept of self-transcendence can help to better understand wellbeing among older individuals and provide guidance for health professionals in facilitating wellbeing and health. The concept and theory of self-transcendence can inspire health professionals in realising new health-promoting approaches to support older individuals in maintaining health, wellbeing and independency.

Nurses as the leading fighters during the COVID-19 pandemic: Self-transcendence.

BACKGROUND: The Covid 19 pandemic has led to and continues to pose challenges for healthcare systems globally, especially in intensive care units. This research was conducted to examine the self-transcendence of the leading fighters, intensive care nurses, during the Covid 19 pandemic. METHODS: The descriptive phenomenological research method was used in the study. The research was carried out between June and December 2020 with the nurses who care for Covid 19 patients in the Covid 19 intensive care service in different provinces of Turkey. The research was completed with 25 participants. A semi-structured interview form prepared based on the Theory of Self-Transcendence (vulnerability, self-transcendence, and well-being) and based on the literature was used to collect data. ETHICAL CONSIDERATIONS: Ethical requirements were respected in every phase of the research process. Results: The nurses in the study were found to experience vulnerability due to "administrative loneliness," "inability to give care," "fear of being a source of infection," and "loneliness of patients." CONCLUSIONS: It has been found that "improvement in nursing roles and skills," "being proud for oneself and the team," "understanding the value of life," and "feeling like a superhero due to the responsibilities shouldered during the pandemic" support nurses' self-transcendence, which contributes to physical and mental well-being.

Self-transcendence and life stories of humanistic growth among late-midlife adults.

OBJECTIVE: Self-transcendence is the experience of feeling connected to something greater than oneself. Previous studies have shown high scores on self-transcendence are associated with well-being and other psychological benefits, but have rarely examined the lived experiences of highly self-transcendent people. METHOD: Black and White men and women in late-midlife completed Life Story Interviews and self-report measures of self-transcendence. In Study 1 (N = 144, Mage  = 56.4), we used grounded theory methodology to differentiate the stories told by participants scoring either extremely high or extremely low on self-transcendence. In Study 2 (N = 125; Mage  = 60.4), we created a quantitative coding scheme and scored 1,375 new life story scenes. RESULTS: In Study 1, six narrative themes were identified (closure, interconnectedness, lifelong learning, secure attachment, self-actualization, and spiritual pluralism) as part of a "humanistic growth story." In Study 2, four of the narrative themes were found to predict self-transcendence scores with significant effect sizes of ß = .26 to .47. CONCLUSIONS: In our sample, highly self-transcendent individuals tended to narrate their lived experiences as spiritual journeys of humanistic growth. This study adds to our understanding of one path of personality growth in late-midlife, that toward self-transcendence.

Effects of self-transcendence on neural responses to persuasive messages and health behavior change.

Self-transcendence refers to a shift in mindset from focusing on self-interests to the well-being of others. We offer an integrative neural model of self-transcendence in the context of persuasive messaging by examining the mechanisms of self-transcendence in promoting receptivity to health messages and behavior change. Specifically, we posited that focusing on values and activities that transcend the self can allow people to see that their self-worth is not tied to a specific behavior in question, and in turn become more receptive to subsequent, otherwise threatening health information. To test whether inducing self-transcendent mindsets before message delivery would help overcome defensiveness and increase receptivity, we used two priming tasks, affirmation and compassion, to elicit a transcendent mindset among 220 sedentary adults. As preregistered, those who completed a self-transcendence task before health message exposure, compared with controls, showed greater increases in objectively logged levels of physical activity throughout the following month. In the brain, self-transcendence tasks up-regulated activity in a region of the ventromedial prefrontal cortex, chosen for its role in positive valuation and reward processing. During subsequent health message exposure, self-transcendence priming was associated with increased activity in subregions of the ventromedial prefrontal cortex, implicated in self-related processing and positive valuation, which predicted later decreases in sedentary behavior. The present findings suggest that having a positive self-transcendent mindset can increase behavior change, in part by increasing neural receptivity to health messaging.

Spiritual well-being, self-transcendence, and spiritual practices among Filipino women with breast cancer.

OBJECTIVE: The study was conducted in order to determine the relationship between spiritual well-being and self-transcendence and to identify the spiritual practices utilized by Filipino patients who are recovering from breast cancer. METHODS: A descriptive correlational study was used, and a purposive sampling technique was utilized to select the participants in the study. Data were collected using self-administered questionnaires and were analyzed using frequency, percentage, mean, standard deviation, and Pearson's r correlation. RESULTS: The study revealed that the overall mean score of the spiritual index of well-being among the participants was 4.41 (±0.54), while the mean score of self-transcendence was 3.64 (±0.50). The results showed that there was a significant relationship between spirituality and self-transcendence among Filipino women with breast cancer. SIGNIFICANCE OF RESULTS: Filipino women with breast cancer rely on their spirituality, which enables them to find meaning in their illness. Hence, assessing spirituality among this population group will enable nurses to provide holistic nursing care, as this can help them cope with the challenges associated with their illness.

Determination of Factors Affecting Self-Transcendence and Meaning in Life Among the Elderly Receiving Institutional Care.

This study was conducted in order to determine factors that influence self-transcendence and meaning in life in the elderly receiving institutional care. This descriptive and analytic study was conducted on 72 elderly individuals living in a nursing home in Turkey. Data were collected with the Barthel Index of Activities of Daily Living (ADL), the Lawton&Brody Instrumental Activities of Daily Living (IADL), the Meaning in Life Questionnaire (MLQ) and the Self-Transcendence Scale (STS). The mean score of STS is 48.17 ± 6.67 at the intermediate level, and the mean scores of presence and search subscales of the MLQ are 28.07 ± 6.55 and 24.06 ± 7.73 above the intermediate level. The STS mean score is poorly correlated with the ADL (r = 0.277) and the IADL scale (r = 0.343). Increased perception of general health status of the elderly improved self-transcendence (ST) level (p = 0.04) and search for meaning in life (ML) level (p = 0.02). These findings show that the health perceptions of the elderly must be improved in the first place.

Effects of Death Anxiety on Perceived Stress in Individuals With Multiple Sclerosis and the Role of Self-Transcendence.

Stress is a commonly reported concern of individuals with chronical diseases, including multiple sclerosis (MS). This study sought to investigate the relationships between self-transcendence, death anxiety, and perceived stress among individuals with MS from Iran. A second aim of the study was to assess the buffering effect of self-transcendence in the relationship between death anxiety and perceived stress. Two hundred and fifteen participants with MS from four hospitals completed measures assessing self-transcendence, death anxiety, and perceived stress. Using structural equation modeling, death anxiety was found to be positively related to perceived stress. In addition, there was a negative relationship between self-transcendence and perceived stress. Results of the study suggest that self-transcendence is a buffer in the link between death anxiety and perceived stress for individuals with MS. The findings demonstrate the importance of self-transcendence in decreasing the effects of death anxiety on perceived stress and have clinical implications for health professionals.

Nurse-patient interaction and self-transcendence: assets for a meaningful life in nursing home residents?

BACKGROUND: Due to the shift to an older population worldwide and an increased need for 24-h care, finding new and alternative approaches to increase wellbeing among nursing home (NH) residents is highly warranted. To guide clinical practice in boosting wellbeing among NH residents, knowledge about nurse-patient interaction (NPI), inter- (ST1) and intra-personal (ST2) self-transcendence and meaning-in-life (PIL) seems vital. This study tests six hypotheses of the relationships between NPI, ST1, ST2 and PIL among cognitively intact NH residents. METHODS: In a cross-sectional design, 188 (92% response rate) out of 204 long-term NH residents representing 27 NHs responded to NPI, ST, and the PIL scales. Inclusion criteria were: (1) municipality authority's decision of long-term NH care; (2) residential time 3 months or longer; (3) informed consent competency recognized by responsible doctor and nurse; and (4) capable of being interviewed. The hypothesized relations between the latent constructs were tested through structural equation modeling (SEM) using Stata 15.1. RESULTS: The SEM-model yielded a good fit (χ2 = 146.824, p = 0.021, df = 114, χ2/df = 1.29 RMSEA = 0.040, p-close 0.811, CFI = 0.97, TLI = 0.96, and SRMR = 0.063), supporting five of the six hypothesized relationships between the constructs of NPI, ST1, ST2 and PIL. CONCLUSION: NPI significantly relates to both ST1, ST2 and PIL in NH residents. ST revealed a fundamental influence on perceived PIL, while NPI demonstrated a significant indirect influence on PIL, mediated by ST.

Effects of a mind map-based life review programme on psychospiritual well-being in cancer patients undergoing chemotherapy: A randomised controlled trial.

OBJECTIVES: To evaluate the effects of a mind map-based life review programme (MBLRP) on psychological distress, hope, meaning in life and self-transcendence in cancer patients undergoing chemotherapy. METHODS: Eighty-four cancer patients undergoing chemotherapy from a university-affiliated hospital in Fujian, China. The participants were randomly allocated to a MBLRP group (n = 40) or usual care group (n = 44). Data were collected at baseline (T0), on the second day (T1) and four weeks after the programme (T2) using the Distress Thermometer, Meaning in Life Questionnaire, Herth Hope Scale and Self-transcendence Scale. RESULTS: No significant interaction effects for time and group membership were found for psychological distress either at T1 (t = -1.707, p = .090) or at T2 (t = -1.123, p = .263). The interaction effects for T1 and group membership were statistically significant for meaning in life (t = 3.487, p = .001) and hope (t = 5.313, p < .001), but not statistically significant for self-transcendence (t = 0.148, p = .882). The interaction effects for T2 and group membership were statistically significant for meaning in life (t = 2.592, p = .01), hope (t = 5.215, p < .001) and self-transcendence (t = 2.843, p = .005). CONCLUSIONS: The MBLRP could improve hope, meaning in life and self-transcendence in cancer patients undergoing chemotherapy.

Selfless self-transcendence in the clinical setting as a source of self-enhancement.

This paper examines the paradox of Selfless-Self-Transcendence, that is, how the self is enriched through self-renunciation. The article discusses what enables being carried away without forethought into selfless-self-transcendence and how, eventually, these inadvertent surrenders create therapeutic shifts. Using clinical vignettes, we suggest that the selfless move towards patients is part of a latent mutual process, with them, and it enables the restoration of the self to an enriched form. These depictions imply that like the patients, the analysts also encounter themselves in a truer way which allows them to become who they really are, through selflessly transcending themselves.