Adaptation and validation of the Claremont Purpose Scale to measure Chinese adolescents' purpose in life.

Despite purpose measures being developed for adolescents, quantitative research investigating purposes prior to late adolescence and in non-Western societies remains nascent. This study evaluated the psychometric soundness of the Claremont Purpose Scale among Chinese adolescents. An initial prestudy (n = 34) was conducted to ensure linguistic equivalence. Subsequently, Study 1 (n = 1691) assessed the scale's reliability and factor structure, also investigating its functional equivalence across gender, adolescence stages, and language versions at the item level. Study 2 (n = 7842) investigated the scale's construct, convergent, predictive, and incremental validity, as well as tested for the scale's measurement invariance across different groups at the scale level. The results support the scale's use as a tool for researchers and practitioners to understand and cultivate purpose in adolescents.

Purpose in life as a resilience factor for brain health: diffusion MRI findings from the Midlife in the U.S. study.

Introduction: A greater sense of purpose in life is associated with several health benefits relevant for active aging, but the mechanisms remain unclear. We evaluated if purpose in life was associated with indices of brain health. Methods: We examined data from the Midlife in the United States (MIDUS) Neuroscience Project. Diffusion weighted magnetic resonance imaging data (n=138; mean age 65.2 years, age range 48-95; 80 females; 37 black, indigenous, and people of color) were used to estimate microstructural indices of brain health such as axonal density, and axonal orientation. The seven-item purpose in life scale was used. Permutation analysis of linear models was used to examine associations between purpose in life scores and the diffusion metrics in white matter and in the bilateral hippocampus, adjusting for age, sex, education, and race. Results and discussion: Greater sense of purpose in life was associated with brain microstructural features consistent with better brain health. Positive associations were found in both white matter and the right hippocampus, where multiple convergent associations were detected. The hippocampus is a brain structure involved in learning and memory that is vulnerable to stress but retains the capacity to grow and adapt through old age. Our findings suggest pathways through which an enhanced sense of purpose in life may contribute to better brain health and promote healthy aging. Since purpose in life is known to decline with age, interventions and policy changes that facilitate a greater sense of purpose may extend and improve the brain health of individuals and thus improve public health.

A systematic review of psychosocial protective factors against suicide and suicidality among older adults.

BACKGROUND: Research on suicide rarely focuses on protective factors. The goal of this systematic review was to assess the evidence of the associations between protective factors and reduced suicidality among older adults. METHOD: First, a scoping review was conducted to identify pertinent terms that refer to various protective factors against suicidality. A systematic review, following the PRISMA guidelines, was then conducted on a selection of 15 protective factors (e.g., perceived control, well-being and quality of life, life satisfaction, purpose-in-life, resilience, coping, religiosity, hope, self-regulation, sense of belonging, mattering, positive relationship, social support, social connectedness, and social participation), with separate searches performed on each factor in five databases. Empirical studies were eligible if participants were adults aged 60 years and over, and if the studies reported predictive statistical analysis. RESULTS: A total of 70 studies were retained for the review. Suicidal ideation was the main outcome measure (91%). Significant associations were consistently observed between all protective factors and reduced suicidal ideations or behaviors, particularly for purpose-in-life, resilience, and positive relationships, indicating that these are solid components for suicide prevention. Using scales, instead of a single item, to measure protective factors (e.g. life satisfaction) was more efficient to capture the associations. On the other hand, results were similar whether studies used subjective (e.g., sense of belonging) or objective (e.g., social connectedness) measures. CONCLUSION: Protective factors were inversely associated with suicidal ideation. Improving protective factors is essential for the development of late-life suicide prevention and interventions, instead of merely focusing on risk factors.

Meaning in life and Parkinson's disease in the UK Biobank.

Introduction: Meaning in life is an aspect of eudaimonic well-being associated with lower dementia risk. This research examines whether this protective association extends to Parkinson's disease (PD). Methods: Participants (N = 153,569) from the UK Biobank reported on their meaning in life. Cases of PD were identified through health records. Results: Meaning in life was associated with a 50 % lower likelihood of prevalent PD (OR = 0.68, 95 % CI = 0.59-0.78). Over the 5-year follow-up, meaning was associated with a 35 % lower risk of incident PD (HR = 0.74, 95 % CI = 0.65-0.83), an association robust to sociodemographic characteristics, depression, history of seeking mental health care, smoking, physical activity, and genetic risk and not moderated by age, sex, education, deprivation, or genetic risk. Conclusions: Meaning in life is associated with lower risk of incident PD, an association independent of other major risk factors and generalizable across sociodemographic groups. Meaning is a promising target of intervention for common neurodegenerative diseases.

Psychosocial factors associated with 7-year change in cognition among middle-aged and older Hispanics/Latinos: The Hispanic Community Health Study/Study of Latinos-Investigation of Neurocognitive Aging (SOL-INCA) and Sociocultural ancillary studies.

INTRODUCTION: Few studies have examined the associations of psychosocial factors with cognitive change in Hispanics/Latinos. METHODS: Data from the Hispanic Community Health Study/Study of Latinos-Investigation of Neurocognitive Aging (HCHS/SOL INCA) and Sociocultural studies were used (n = 2,155; ages ≥45 years). Psychosocial exposures included intrapersonal (ethnic identity, optimism, purpose in life), interpersonal (family cohesion, familism, social networks, social support), and social factors (ethnic discrimination, loneliness, subjective social status). Survey-linear regression models examined associations between psychosocial exposures and 7-year cognitive change (global cognition [GC], verbal learning, memory, word fluency [WF], and digit symbol substitution [DSS]). RESULTS: Familism predicted decline in GC, verbal learning, and memory; family cohesion predicted DSS decline; and loneliness predicted memory decline. Ethnic identity was protective against decline in GC and memory, optimism and social support were protective against decline in memory, and purpose in life was protective against WF decline. DISCUSSION: Psychosocial factors are differentially related to cognitive changes. Culturally relevant factors should be explored in Hispanic/Latino cognitive aging research. HIGHLIGHTS: Psychosocial factors are differentially related to cognitive changes in Latinos. Role of culturally relevant factors on cognition should be further explored. Familism predicted decline in global cognition, verbal learning, and memory. Ethnic identity predicted increase in global cognition and memory.

Purpose in life and cognitive performance and informant ratings of cognitive decline, affect, and activities.

OBJECTIVE: To examine (1) the association between purpose in life and multiple domains of cognitive function and informant-rated cognitive decline, affect, and activities; (2) whether these associations are moderated by sociodemographic factors, cognitive impairment, or depression; (3) whether the associations are independent of other aspects of well-being and depressive symptoms. METHOD: As part of the 2016 Harmonized Cognitive Assessment Protocol from the Health and Retirement Study, participants completed a battery of cognitive tests and nominated a knowledgeable informant to rate their cognitive decline, affect, and activities. Participants with information available on their purpose in life from the 2014/2016 Leave Behind Questionnaire were included in the analytic sample (N = 2,812). RESULTS: Purpose in life was associated with better performance in every cognitive domain examined (episodic memory, speed-attention, visuospatial skills, language, numeric reasoning; median ß =.10, p <.001; median d =.53). Purpose was likewise associated with informant-rated cognitive decline and informant-rated affective and activity profiles beneficial for cognitive health (median ß =.18, p < .001; median d =.55). There was little evidence of moderation by sociodemographic or other factors (e.g., depression). Life satisfaction, optimism, positive affect, and mastery were generally associated with cognition. When tested simultaneously with each other and depressive symptoms, most dimensions were reduced to non-significance; purpose remained a significant predictor. CONCLUSIONS: Purpose in life is associated with better performance across numerous domains of cognition and with emotional and behavioral patterns beneficial for cognitive health that are observable by knowledgeable others. These associations largely generalize across demographic and clinical groups and are independent of other aspects of well-being.

Changes in Purpose in Life and Low-Grade Chronic Inflammation Across Older Adulthood.

Background: Older adults often experience an increase in low-grade chronic inflammation. Purpose in life could act as a protective factor as it is associated with beneficial health outcomes. Purpose in life may exert part of its adaptive function by promoting persistence in goal pursuit. During older adulthood, however, when many individuals experience an increase in intractable stressors and declining resources, the adaptive function of purpose could become reduced. Purpose: We examined whether the association between inter- and intra-individual differences in purpose in life and chronic inflammation differed across older adulthood. Method: We assessed four waves of data among 129 older adults (63-91 years old) across 6 years. Results: Hierarchical linear modeling demonstrated that within-person increases in purpose in life predicted reduced levels of chronic inflammation in early old age (25th percentile or 73 years, coefficient = -.016, p < .01), but not in advanced old age (75th percentile or 81 years, coefficient = .002, p = .67). Between-person differences in purpose were not related to chronic inflammation. Conclusions: These results suggest that greater within-person increases in purpose may protect health processes particularly in early old age but become less effective in advanced old age.

Evolution of psychopathology, purpose in life, and moral courage in healthcare workers during the COVID-19 pandemic: a longitudinal study.

Introduction: Almost 2 years and five infection waves after the COVID-19 pandemic started, healthcare workers continued dealing with the pandemic situation and facing the health consequences and the mental health disorders it caused. This study aimed to evaluate the onset and progression of psychopathology as well as the role of predictor variables such as purpose in life and moral courage among healthcare workers during this time. Materials and methods: This was a longitudinal prospective study carried out with 45 Spanish healthcare workers who answered two questionnaires, the first questionnaire in April-May 2020 (T1) and the second questionnaire in September-October 2021 (T2). Results: Although 29.5% of the sample considered that their mental health had improved over this time, almost half of them (47.7%) said it had not changed, while 22.7% reported a decline in their mental health from the first time they were asked. Specifically, 46.8% presented anxiety, 23.4% depression, and 42.6% acute stress at T1, and 38.3% had anxiety, 17% depression, and 27.7% post-traumatic stress disorder at T2. Despite this, there were no differences between T1 and T2 anxiety scores (p = 0.53), although there was a decrease in depression (p = 0.03) and acute stress (p = 0.02) scores. Predictor variable outcomes such as purpose in life (p = 0.88) and moral courage (p = 0.86; p = 0.38) did not change over time, but when modelling the data, purpose in life predicted psychopathology at T1, which in turn affected the psychopathology results at T2. Conclusion: This study showed that, although psychopathology decreased over the months, its prevalence remained high. Even though the purpose in life predicted psychopathology at T1, it seems that once the psychopathology is established (T2), the factors that would improve it would be different from the protective factors that prevented its establishment, which become secondary.

Healthy Eating as Potential Mediator of Inverse Association between Purpose in Life and Waist Circumference: Emerging Evidence from US and Chilean Cohorts.

High sense of purpose in life, a fundamental domain of eudaimonic well-being, has been consistently associated with lower risk for various obesity-related chronic diseases. Although this psychological feature correlates with some health behaviors as potential mediators, its association with healthy eating remains less explored. In addition, studies of these psycho-behavioral and health relationships in the South American population are lacking. This research sought to assess: (1) the cross-sectional association between self-reported purpose in life and overall healthy eating patterns, and (2) healthy food intake as a potential mediator of the inverse relationship between purpose in life and waist circumference. Data collected of 2060 US adults from the MIDUS study (5 ± 12 years, 55% women, mostly white people, and 42.5% obese) and 223 Chilean adults from the CHILEMED study (46.6 ± 9 years, 58.3% women, and 71.3% obese) were used. Anthropometric and sociodemographic variables were collected. Sense of purpose was assessed using the purpose in life subscale of the Ryff's psychological well-being questionnaire. Diet quality was evaluated using healthy eating or low-fat diet indexes, according to extant food intake data in each cohort. The relationship between these variables was estimated by bivariate and multivariate linear regressions with appropriate adjustments. To establish whether a better diet quality could mediate a link of purpose in life and improved nutritional status (assessed by waist circumference), the association between these three variables was tested by bootstrapping-based mediation analysis. Our results show significant associations of sense of purpose with healthy eating and low-fat dietary patterns in both US and Chilean cohorts, respectively, even after adjusting for sociodemographic variables. According to the mediation analysis, the relationship between sense of purpose and waist circumference, as an indicator of abdominal obesity, appears to be partially mediated by healthier food intake in both samples. In conclusion, our findings suggest a plausible mechanism underlying the favorable impact of this well-being dimension on physical health. Given its protective effects, interventions aimed at increasing purpose in life may facilitate adherence to better dietary patterns, which, in turn, will reduce the risk for obesity-related chronic diseases.

Purpose in Life Links Positive Aging Views to Life Satisfaction: A Within-Person Analysis Spanning 13 Years.

This study aimed to examine the relationship between positive perceptions of aging, purpose in life, and life satisfaction in older adults. It was hypothesized that purpose in life mediates the relationship between positive perceptions of one's aging and life satisfaction. This hypothesis was tested in a sample of older American adults from four waves of the Health and Retirement Study collected at 4-year intervals between 2008 and 2020 (N = 11,546, mean age in 2008 = 62.772). The random intercept cross-lagged panel model was used to separate within-person and between-person sources of variance. Mediation was tested at the longitudinal within-person level and was supported. Results suggest that an increase in positive perceptions of aging is associated with a future increase in purpose in life, which in turn is associated with higher future levels of life satisfaction. The findings inform interventions promoting positive aging, purpose, and life satisfaction in older adults.

Purpose Orientation and Its Protective Effect on Self-Esteem Among Chinese Depressive Patients: A Comparative Study.

Purpose: Although previous studies have confirmed that purpose in life may negatively predict depressive symptoms, focusing on the intensity of purpose without focusing on content may ignore significant individual differences. This study explores differences in purpose orientations between depressive patients and healthy population to examine the relationship between the purpose content and self-esteem, one of the symptoms of depression. In addition, the moderating role of purpose orientations in the relationship between depression and self-esteem was analyzed to verify the protective effect of purpose orientation on self-esteem. Patients and Methods: The study utilized the questionnaire approach. The Purpose Orientation Scale (Self and Forced Rating) and the Rosenberg Self-Esteem Scale were administered to the participants. The study recruited 73 depressive patients using convenience sampling. Moreover, using random sampling, 146 participants matched based on depressive patients' demographics were selected as a healthy population in a 1:2 ratio. Results: The results showed that: 1) depressive patients valued all four types of purpose orientations to a lesser extent compared to healthy population, both depressive patients and healthy population valued family well-being and personal growth to a greater extent than personal well-being and social promotion. 2) Depressive patients reported lower self-esteem than healthy people. 3) All four types of Purpose orientations positively correlated with self-esteem in depressive patients, while only personal well-being positively correlated with self-esteem in healthy population. Family well-being and social promotion moderated the predictive effect of depression on self-esteem. Conclusion: The above results imply that prosocial purpose orientations may attenuate the harmful effects of depression on self-esteem. Additionally, intervention focusing on enhancing depressive patients' purpose in life (especially prosocial purpose) could be helpful.

Fatores associados às atitudes dos enfermeiros quanto à importância da família nos cuidados de enfermagem / Factors associated with nurses' attitudes toward the family involvement in nursing care / Factores asociados a las actitudes de los enfermeros respecto a la importancia de la familia en los cuidados de enfermería

Resumo Enquadramento: A participação da família nos cuidados potencia ganhos em saúde, sendo a atitude dos enfermeiros, influenciada por múltiplos fatores. Objetivo: Conhecer as atitudes dos enfermeiros quanto à importância atribuida à integração das famílias nos cuidados e determinar a relação entre essas atitudes e a idade, habilitações académicas, tempo na carreira, categoria profissional, sentido de vida e sintomatologia depressiva/ansiosa dos enfermeiros. Metodologia: Estudo transversal, descritivo-correlacional, realizado com 317 enfermeiros de um Centro Hospitalar da Região Centro de Portugal. Aplicou-se um questionário sociodemográfico, a escala Importância das Famílias nos Cuidados de Enfermagem-Atitudes dos Enfermeiros, o Inventário da Saúde Mental e a Escala dos Objetivos de Vida. Resultados: A maioria dos participantes documenta atitudes integrativas, sendo as correlações da variável em estudo com os fatores associados, coerentes com o esperado. Conclusão: Apesar da maioria dos enfermeiros documentar atitudes inclusivas da família, são os mais velhos, com mais habilitações e tempo na carreira, detentores de categoria profissional mais elevada, com maior extensão de sentido de vida e menor sintomatologia depressiva/ansiosa que mais priorizam o envolvimento da família nos cuidados.

Abstract Background: Family involvement in care increases health gains, and multiple factors influence nurses' attitudes toward family involvement. Objective: To identify nurses' attitudes toward family involvement in care and determine the association between nurses' attitudes and their age, education level, years in the profession, professional category, purpose in life, and symptoms of depression/anxiety. Methodology: Cross-sectional, descriptive-correlational study, carried out 317 nurses from a hospital center in the central region of Portugal. Nurses answered a sociodemographic questionnaire and completed the Families' Importance in Nursing Care-Nurses' Attitudes scale, the Mental Health Inventory, and the Purpose in Life Test. Results: Most participants reported supportive attitudes toward family involvement in care. The correlations between the variable under study and the associated factors were consistent with the expected. Conclusion: Most participants have supportive attitudes toward family involvement in care. Older nurses, with higher education levels, more years in the profession, higher professional category, a higher sense of purpose in life, and fewer symptoms of depression/anxiety attach more importance to family involvement in nursing care.

Resumen Marco contextual: La participación de la familia en los cuidados optimiza los beneficios para la salud y la actitud de los enfermeros hacia esta participación se ve influida por múltiples factores Objetivo: Identificar las actitudes de los enfermeros con respecto a la importancia que conceden a la integración de las familias en los cuidados y determinar la relación entre las actitudes de los enfermeros y su edad, titulación académica, tiempo en la profesión, categoría profesional, sentido de la vida y sintomatología depresiva/ansiedad. Metodología: Estudio transversal, descriptivo-correlacional, que se realizó con 317 enfermeros de un centro hospitalario de la Región Centro de Portugal. Los participantes respondieron a un cuestionario sociodemográfico, a la escala "La Importancia de la Familia en los Cuidados de Enfermería-Actitudes de los Enfermeros", al "Inventario de Salud Mental" y a la "Escala de los Objetivos de Vida". Resultados: La mayoría de los participantes documentan actitudes integradoras de la familia hacia el cuidado y el resultado de las correlaciones de la variable objeto de estudio con los factores asociados es coherente con lo esperado. Conclusión: La mayoría de los participantes mostraron actitudes integradoras hacia la familia en los cuidados de enfermería, y fueron los enfermeros de mayor edad, con más titulación y tiempo en la profesión, mayor categoría profesional, mayores extensiones del sentido de vida y menores índices de sintomatología depresiva/ansiedad los que atribuyeron más importancia a la familia en los cuidados de enfermería.

Thriving amidst adversity: Flourishing and grit in Ukrainian college students with strong life purpose before and after the onset of the Russian war in Ukraine.

This multi-study examined the role of life purpose in the well-being of Ukrainian university students before (Study 1) and during the Russian war in Ukraine (Study 2) during the 2021-22 academic year using a cross-sectional design. University students from a city highly affected by the war, a region which borders Russia, completed measures of sense of purpose in life (awakening to purpose, awareness to purpose, altruistic purpose), specific purpose orientations (others-growth, self-growth, career-focused), flourishing, and grit (consistency of interests, perseverance of effort). Structural equation modeling was used to test four alternative path models. In Study 1 (N = 159), flourishing was positively predicted by all measures of purpose, except for awareness of purpose, which was a negative but weak predictor. Similar to flourishing, both dimensions of grit were positively predicted by career-focused purpose orientation above and beyond the overall sense of life purpose. Additionally, perseverance of effort was predicted positively by awakening to purpose. Consistent with Study 1, in Study 2 (N = 107), flourishing and perseverance of effort were positively predicted by career-focused purpose orientation above and beyond the overall sense of life purpose. Additionally, flourishing was positively predicted by awakening to purpose and others-growth purpose orientation. Overall, students with a strong life purpose reported high sense of flourishing and grit. Findings also highlighted the salient role of career-focused purpose orientation in students' well-being. It is thereby important to support students in exploring and connecting life's purpose with their career aspirations.

Informant-rated change in personality traits, psychological distress, well-being, and social connection with dementia.

OBJECTIVES: Studies of retrospective personality change with dementia consistently find caregivers report large changes in personality (e.g., increases in neuroticism) of their care recipients compared to before dementia. This work seeks to replicate the established pattern of personality change, extend it to change in psychological distress, well-being, and social connection, and evaluate whether changes vary by stage of dementia. METHODS: Caregivers of people with dementia (N = 188) reported on the psychological and social health of their care recipient currently and how they were before they developed dementia. Personality was measured as five factor model traits. Psychological distress was measured as symptoms of depression and anxiety, perceived stress, and pessimism. Psychological well-being was measured as purpose in life, life satisfaction, happiness, self-efficacy, and optimism. Social connection was measured as loneliness, belonging, social support, and social strain. RESULTS: There were substantial increases in neuroticism (d = 1.14) and decreases in the other four personality traits (d range=-0.85 to -1.37). There were significant increases in psychological distress (e.g., d = 1.07 for depression) and substantial decreases in well-being (e.g., d=-1.18 for purpose in life) and social connection (e.g., d=-1.12 for belonging). Change was apparent across dementia stage and generally larger in more severe dementia. DISCUSSION: In addition to personality, there are large retrospective changes in psychological distress, well-being, and social connection with dementia. These quantitative findings complement clinical observations of the natural history of psychosocial changes in people with dementia, and can inform families, clinicians, and researchers on commonly observed changes and improve interventions to mitigate dementia burden.

Sense of purpose in life and work-life tension: Perceptions of interference and enhancement.

This research examines the relation between purpose in life and perceptions of work-life interference (work interferes with personal life and vice versa) and enhancement (work enhances personal life and vice versa) and whether these dimensions mediate purpose and cognition over 10 years. Employed participants from the Health and Retirement Study (N = 4,492) reported on their purpose in life and work-life interference and enhancement; a subset (N = 2,207) had cognition measured at baseline and again 10 years later. Purpose was associated with less work-life interference and greater work-life enhancement. Purpose was associated with maintenance of cognition, but the work-life dimensions were unrelated to cognition and thus did not account for the relation between purpose and maintenance of cognitive function. This research suggests that purpose in life is associated with greater integration of working and personal lives. Such integration can promote better aging-related outcomes, but not cognitive function.

Purpose in life as an asset for well-being and a protective factor against depression in adolescents.

Purpose in life, which is a central component of the eudaimonic paradigm of well-being, has been sparsely examined in adolescence. This is unfortunate as adolescence is characterised by identity development and is a key period for the onset of mental disorders. To inform future research on well-being and purpose in life in adolescents, we drew factors from several fields of research, including mental health and psychological factors, and explored which factors were most strongly associated with purpose in life. Data were collected in a sample of 444 Italian adolescents (Mage = 16.30 [SD = 1.50], range: 14 to 20 years; 58% girls) and associations with mental health (stress, anxiety, depression, anger), psychological traits (mindfulness, self-hate, self-inadequacy, self-reassurance, isolation), and sociodemographic variables (age, sex, place of birth) were examined. Regression, dominance, and network analyses indicated that a stronger sense of purpose in life was associated with lower depressive symptoms, higher levels of self-reassurance, and being born in Italy. Our findings suggest that purpose in life is an important asset for well-being in adolescents and may protect against depression. Future longitudinal and/or experimental research should examine the potential protective role of purpose in life in relation to adolescent depression and how self-reassurance and sociodemographic factors (e.g., immigrant background) are involved.

Improving Purpose in Life in School Settings.

Background and aim: The dimension of purpose in life (PiL) is one of the core features of eudaimonia and plays a crucial role in developmental settings. However, few studies have examined purpose in life in younger generations and verified if it is amenable to improvements following a wellbeing-promoting intervention. The aim of the present investigation is to explore correlates and predictors of purpose in life in school children and to test if it can be ameliorated after school-based wellbeing interventions. Methods: A total of 614 students were recruited in various schools in Northern Italy. Of these, 456 belonged to junior high and high schools and were randomly assigned to receive a protocol of School Well-Being Therapy (WBT) or a psychoeducational intervention (controls). A total of 158 students were enrolled in elementary schools and received a positive narrative intervention based on fairytales or were randomly assigned to controlled conditions. All students were assessed pre- and post- intervention with Ryff scales of eudaimonic wellbeing (short version) and with other self-report measures of anxiety, depression and somatization. Additionally, the Strengths and Difficulties Questionnaire (SDQ) was administered to their schoolteachers as observed-rated evaluation. Results: In both elementary and high schools, purpose in life after the intervention was predicted by initial depressive symptoms and by group assignment (positive interventions vs. controls). In older students, PiL was predicted by female gender and anxiety levels, while no specific strengths identified by teachers were associated with PiL. Conclusions: PiL plays an important and strategic role in developmental settings, where students can develop skills and capacities to set meaningful goals in life. Depressive symptoms and anxiety can be obstacles to developing PiL in students, while positive school-based interventions can promote this core dimension of eudaimonia.

Purpose in life and markers of immunity and inflammation: Testing pathways of episodic memory.

OBJECTIVE: This prospective cohort study examines whether purpose in life is associated with markers of immunity and inflammation and tests these markers as mediators between purpose and episodic memory. METHODS: Participants from the Venous Blood Study of the Health and Retirement Study reported on their purpose in life, had their blood assayed for markers of immunity and inflammation, and were administered an episodic memory task (N = 8999). Regression analyses tested the association between purpose and each marker. Prospective mediation analyses (N = 6092) tested whether these markers measured in 2016 were mediators between purpose measured in 2012/2014 and episodic memory measured in 2018. RESULTS: Higher purpose in life was associated with lower neutrophil counts (ß = -0.08, p < .001), lower ratio of neutrophils/lymphocytes (ß = -0.05, p < .001), and lower systemic immune inflammation index (ß = -0.04, p < .001); purpose was unrelated to monocyte, platelet, and lymphocyte counts or the ratio of platelets/lymphocytes (all ns). Purpose was associated negatively with c-reactive protein (ß = -0.07, p < .001), Interleukin-6 (ß = -0.08, p < .001), Interleukin-10 (ß = -0.07, p < .001), Interleukin-1ra (ß = -0.08, p < .001), and soluble Tumor Necrosis Factor Receptor 1 (sTNFR1; ß = -0.10, p < .001); purpose was unrelated to Transforming Growth Factor beta 1. These associations were largely not moderated by age, sex, race, ethnicity, and education. Lower neutrophils, Interleukin-6, and sTNFR1 were associated prospectively with better episodic memory and mediated the association between purpose and episodic memory. CONCLUSION: Purpose in life is associated with markers of immunity and inflammation, some of which are one mechanism in the pathway between purpose and healthier episodic memory.

Informant-rated change in personality traits, psychological distress, well-being, and social connection with dementia.

Objectives: Studies of retrospective personality change with dementia consistently find caregivers report large changes in personality (e.g., increases in neuroticism) of their care recipients compared to before dementia. This work seeks to replicate the established pattern of personality change, extend it to change in psychological distress, well-being, and social connection, and evaluate whether changes vary by stage of dementia. Methods: Caregivers of people with dementia (N=194) reported on the psychological and social health of their care recipient currently and how they were before they developed dementia. Personality was measured as five factor model traits. Psychological distress was measured as symptoms of depression and anxiety, perceived stress, and pessimism. Psychological well-being was measured as purpose in life, life satisfaction, happiness, self-efficacy, and optimism. Social connection was measured as loneliness, belonging, social support, and social strain. Results: There were substantial increases in neuroticism (d=1.10) and decreases in the other four personality traits (d range=-.82 to -1.31). There were significant increases in psychological distress (e.g., d=1.05 for depression) and substantial decreases in well-being (e.g., d=-1.07 for purpose in life) and social connection (e.g., d=-1.09 for belonging). Change was apparent across dementia stage and generally larger in more severe dementia. Discussion: In addition to personality, there are large retrospective changes in psychological distress, well-being, and social connection with dementia. These quantitative findings complement clinical observations of the natural history of psychosocial changes in people with dementia, and can inform families, clinicians, and researchers on commonly observed changes and improve interventions to mitigate dementia burden.

Psychological and spiritual interventions to enhance meaning in adults diagnosed with cancer: a systematic review with meta-analysis and meta-regression.

OBJECTIVE: To summarize the evidence on the effectiveness that psychological and/or spiritual interventions may have to change the levels of meaning, measured with the Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being Scale (FACIT-Sp), in adults diagnosed with cancer. METHODS: Systematic review with meta-analysis and meta-regression. CINAHL (via EBSCOhost), Embase, PubMed, PsycINFO (via ProQuest), and the Cochrane Library were searched from inception to 21st October 2022. Manual searches were conducted. Only randomized clinical trials (RCTs) were included. The risk of bias was assessed with the Cochrane Risk of Bias tool 2. The Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) approach was used to judge the certainty of the evidence. RESULTS: Eight RCTs were included (N = 1682). Although some individual studies showed positive effects to enhance meaning using mindfulness or dignity therapy, the overall and individual meta-analyses showed a lack of effect of psychological and spiritual interventions in comparison to comparator interventions (MD (95%CI) = -0.19 (-0.45 to 0.06), p = 0.11, Tau2 = 0.0015, I2 = 2%). Publication bias was undetected (Egger's test = 0.35). Furthermore, no RCTs were judged to have a low risk of bias and the overall certainty of the evidence was judged as low. Meta-regression and subgroups meta-analyses also found possible sources of heterogeneity such as some cancer characteristics, the educational stage, or the religious affiliation. CONCLUSIONS: Despite some RCTs may show promising results following mindfulness or dignity therapy, no effects were observed in the meta-analysis. Moreover, important methodological and clinical concerns precluded us to make sound clinical recommendations with the available evidence. OPEN SCIENCE FRAMEWORK DOI REGISTRATION: https://doi.org/10.17605/OSF.IO/4YMTK .