Gratitude and patience moderate meaning struggles and suicidal risk in a cross-sectional study of inpatients at a Christian psychiatric hospital.

OBJECTIVE: Suicidal behavior is a leading cause of injury and death, so research identifying protective factors is essential. Research suggests gratitude and life hardships patience are character strengths that might protect against the deleterious association of struggles with ultimate meaning and suicide risk. However, no studies have evaluated their utility among people experiencing acute/severe mental health concerns. METHOD: We tested the protective function of gratitude and life hardships patience with cross-sectional data from adults (Mage  = 31.83 years; SD = 14.84; range = 18-82) hospitalized in a Christian psychiatric inpatient facility (Mstay  = 6.37 days, SD = 4.64). RESULTS: Gratitude and life hardships patience moderated the positive relation between meaning struggles and suicide risk. Specifically, gratitude and life hardships patience protected against meaning struggles as a risk factor for suicide through mechanisms separate from ameliorating depressive symptoms. CONCLUSIONS: Findings provide initial support for gratitude and patience interventions as an adjunct to standard psychiatric treatment for minimizing suicide risk.

Religiousness, meaning, and quality of life: Test of a mediational model among adults seeking a spiritually integrated inpatient program.

OBJECTIVE: Religious beliefs and practices may augment a sense of meaning in life that could support quality of life (QOL) in physical, social, and emotional domains amid mental health crises. However, these associations have not been thoroughly tested among persons with serious mental illness (SMI). METHODS: Focusing on 248 adults who had recently enrolled in a spiritually integrated acute psychiatric hospitalization program, we incorporated structural equation modeling to examine whether (1) religiousness would be associated with better overall QOL; and (2) inpatients' sense of meaning in life would at least partially account for the religiousness-QOL link. RESULTS: Religiousness was linked indirectly with QOL at the time of admission: religiousness was associated with greater meaning in life, and a higher degree of meaning in life was associated with QOL. CONCLUSIONS: Findings underscore the crucial role of religiousness for meaning and wellness among many individuals with SMI who seek stabilization and healing.

Spiritual struggles and mental health outcomes in a spiritually integrated inpatient program.

BACKGROUND: Persons contending with serious mental health difficulties often experience struggles with religious faith and/or spirituality that may also demand clinical attention. However, research has not examined the relative importance of specific forms of spiritual struggles in mental health status or treatment outcomes of psychiatric patients. METHODS: Focusing on 217 adults who completed a spiritually integrated inpatient program, this study examined (1) which struggles in Exline et al.'s (2014) framework (Divine, Morality, Ultimate Meaning, Interpersonal, Demonic, and Doubting) represented the most salient indicators of major depressive disorder (MDD) symptomatology and positive mental health (PMH) and (2) whether alleviation of these struggles predicted improvements in patients' mental health status over the treatment period. RESULTS: Greater severity of spiritual struggles was generally associated with worse MDD symptomatology and less PMH at intake and discharge. However, when weighing the role of varying forms of struggles, issues with ultimate meaning emerged as a salient indicator of mental health status at the two assessments as well as longitudinal changes in both MDD symptomatology and PMH. LIMITATIONS: This sample was recruited from acute stabilization units in a single spiritually integrated behavioral health center with a general affiliation with Christianity. Hence, treatment periods were relatively brief in some cases and findings might not generalize to other psychiatric programs or settings. CONCLUSIONS: Findings highlight the utility of assessing prominent forms of spiritual distress for planning and delivering psychosocial interventions, particularly with respect to issues related to a perceived absence of ultimate meaning in life.

God imagery and affective outcomes in a spiritually integrative inpatient program.

Religion and/or spirituality (R/S) can play a vital, multifaceted role in mental health. While beliefs about God represent the core of many psychiatric patients' meaning systems, research has not examined how internalized images of the divine might contribute to outcomes in treatment programs/settings that emphasize multicultural sensitivity with R/S. Drawing on a combination of qualitative and quantitative information with a religiously heterogeneous sample of 241 adults who completed a spiritually integrative inpatient program over a two-year period, this study tested direct/indirect associations between imagery of how God views oneself, religious comforts and strains, and affective outcomes (positive and negative). When accounting for patients' demographic and religious backgrounds, structural equation modeling results revealed: (1) overall effects for God imagery at pre-treatment on post-treatment levels of both positive and negative affect; and (2) religious comforts and strains fully mediated these links. Secondary analyses also revealed that patients' generally experienced reductions in negative emotion in God imagery over the course of their admission. These findings support attachment models of the R/S-mental health link and suggest that religious comforts and strains represent distinct pathways to positive and negative domains of affect for psychiatric patients with varying experiences of God.

Registered Replication Report: Study 1 From Finkel, Rusbult, Kumashiro, & Hannon (2002).

Finkel, Rusbult, Kumashiro, and Hannon (2002, Study 1) demonstrated a causal link between subjective commitment to a relationship and how people responded to hypothetical betrayals of that relationship. Participants primed to think about their commitment to their partner (high commitment) reacted to the betrayals with reduced exit and neglect responses relative to those primed to think about their independence from their partner (low commitment). The priming manipulation did not affect constructive voice and loyalty responses. Although other studies have demonstrated a correlation between subjective commitment and responses to betrayal, this study provides the only experimental evidence that inducing changes to subjective commitment can causally affect forgiveness responses. This Registered Replication Report (RRR) meta-analytically combines the results of 16 new direct replications of the original study, all of which followed a standardized, vetted, and preregistered protocol. The results showed little effect of the priming manipulation on the forgiveness outcome measures, but it also did not observe an effect of priming on subjective commitment, so the manipulation did not work as it had in the original study. We discuss possible explanations for the discrepancy between the findings from this RRR and the original study.

Insufficient Justification for Exclusion Prompts Compensatory Behavior.

This experiment examined participants' compensatory behavior toward an excluded stranger. Participants engaged in a four-person social introductions task and rank-ordered each other member of the group; the lowest ranked person was excluded from a subsequent game. Using a 2 × 2 design, participants were randomly assigned to a justification condition (insufficient vs. sufficient) and to an exclusion responsibility condition (responsible for exclusion vs. exclusion by random selection). Results revealed that after limited introductions (i.e., insufficient justification for one's ranking decision), being responsible for the exclusion prompted compensatory behavior toward the excluded stranger. However, after extended introductions (i.e., sufficient justification of one's ranking decision), participants did not compensate the excluded person. These results suggest that insufficient justification for exclusion may lead to compensatory behavior, when one is responsible for the exclusion.