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Continuing bonds and reconstructing meaning: mitigating complications in bereavement.

Drawing on attachment theory and constructivist conceptualizations of bereavement, the authors assessed the relation between continuing bonds coping and meaning reconstruction following the death of a loved one and complicated grief symptomatology. Five hundred six young adults in the first two years of bereavement from a variety of losses completed the Inventory of Complicated Grief along with measures of the strength of their ongoing attachment to the deceased and their capacity to make sense of the loss, find benefit in the experience, and reconstruct a progressive sense of identity following the death. Several variables concerning the survivor, his or her relationship to the deceased, and the nature of the death functioned as risk factors for heightened distress, but their role was generally moderated by meaning-making, often to the point of non-significance. In contrast, higher levels of benefit-finding and positive identity change were associated with lower levels of bereavement complication. Finally, an interaction emerged between sense-making and ongoing attachment to the deceased, suggesting that strong continuing bonds predicted greater levels of traumatic and especially separation distress, but only when the survivor was unable to make sense of the loss in personal, practical, existential, or spiritual terms.

Adaptation, Psychological↗

A path model of the effects of spirituality on depressive symptoms and 24-h urinary-free cortisol in HIV-positive persons.

OBJECTIVE: The present investigation examined the associations among spirituality, positive reappraisal coping, and benefit finding as they relate to depressive symptoms and 24-h urinary-free-cortisol output. METHODS: Following an initial screening appointment, 264 human-immunodeficiency-virus-positive men and women on highly active antiretroviral therapy provided 24-h urine samples and completed a battery of psychosocial measures. RESULTS: Spirituality was associated with higher positive reappraisal coping and greater benefit finding. Benefit finding and positive reappraisal coping scores were, in turn, both related to lower depressive symptoms. Finally, we determined that benefit finding was uniquely predictive of decreased 24-h urinary-free cortisol output. CONCLUSION: Positive reappraisal coping and benefit finding may co-mediate the effect of spirituality on depressive symptoms, and benefit finding may uniquely explain the effect of spirituality on 24-h cortisol output.

Adaptation, Psychological↗

Mothers' perceptions of benefit following pediatric stem cell transplantation: a longitudinal investigation of the roles of optimism, medical risk, and sociodemographic resources.

BACKGROUND: This longitudinal study investigated the course and predictors of benefit finding among 144 mothers of children undergoing hematopoietic stem cell transplantation (HSCT), a severely stressful and life-threatening medical procedure. PURPOSE: Children's medical risk and mothers' dispositional optimism and sociodemographic resources were examined as predictors of benefit finding. The association between benefit finding and mothers' psychosocial adaptation was also investigated. METHODS: Assessments occurred during hospitalization for HSCT (Time 1 [T1]) and 6 months later (Time 2 [T2]). RESULTS: Hierarchial multiple regression analyses revealed that predictors of benefit finding differed systematically across assessments, with optimism and medical risk predicting benefit finding at both time points but sociodemographic resources predicting only T2 benefit findings. Benefit finding did not predict psychosocial adaptation until optimism was considered as a moderator of their relation: T1 benefit finding was positively associated with T2 adaptation only for mothers high in optimism. CONCLUSION: The need for longitudinal research on posttrauma adaptation and the utility of considering the natural history of the trauma are discussed.

Adaptation, Psychological↗

The psychosocial impact of multiple sclerosis: exploring the patient's perspective.

This study examined subjective patient experiences of the psychosocial consequences of multiple sclerosis (MS). Fifty patients were interviewed regarding the effects MS had on their lives and interpersonal relationships. These statements were collated and administered with a 5-point Likert scale to 94 MS patients. The responses were subjected to factor analysis. Three areas of subjective patient experience of the psychosocial consequences of MS emerged: demoralization, benefit-finding, and deteriorated relationships. Of particular interest was benefit-finding, which included a deepening of relationships, enhanced appreciation of life, and an increase in spiritual interests. Although benefit-finding was related to adaptive coping strategies such as positive reappraisal and seeking social support, it was unrelated to depression and was related to higher levels of anxiety and anger. These findings indicate that benefit-finding is a substantial and poorly understood part of the illness experience for MS patients.

Adaptation, Psychological↗

Getting unstuck: the roles of hope, finding meaning, and rumination in the adjustment to bereavement among college students.

The relationships between hope, bereavement-related rumination, and finding meaning (making sense and benefit finding) were examined in 158 college students who experienced the death of a loved one within the latter half of their lives. Greater rumination was related significantly to lessened psychological well-being, and it mediated the relationship between being able to make sense of the death and superior well-being. Finding benefits in bereavement was associated with positive adjustment for those who recently experienced the death of a loved one, whereas it was related to negative adjustment for those who experienced the death longer ago. Higher hope predicted greater well-being, but it was not related to rumination or finding meaning.

Adaptation, Psychological↗

Writing about the benefits of an interpersonal transgression facilitates forgiveness.

The authors examined the effects of writing about the benefits of an interpersonal transgression on forgiveness. Participants (N = 304) were randomly assigned to one of three 20-min writing tasks in which they wrote about either (a) traumatic features of the most recent interpersonal transgression they had suffered, (b) personal benefits resulting from the transgression, or (c) a control topic that was unrelated to the transgression. Participants in the benefit-finding condition became more forgiving toward their transgressors than did those in the other 2 conditions, who did not differ from each other. In part, the benefit-finding condition appeared to facilitate forgiveness by encouraging participants to engage in cognitive processing as they wrote their essays. Results suggest that benefit finding may be a unique and useful addition to efforts to help people forgive interpersonal transgressions through structured interventions. The Transgression-Related Interpersonal Motivations Inventory--18-Item Version (TRIM-18) is appended.

Adolescent↗

Construing benefits from adversity: adaptational significance and dispositional underpinnings.

The discovery of benefits from living with adversity has been implicated in psychological well-being in numerous investigations, is pivotal to several prominent theories of cognitive adaptation to threat, and can be predicted by personality differences. This article summarizes the prevalence and adaptive significance of finding benefits from major medical problems, locates the place of benefit-finding in stress and coping theories, and examines how it may be shaped by specific psychological dispositions such as optimism and hope and by broader personality traits such as Extraversion and Openness to Experience. The distinction between beliefs about benefits from adversity (benefit-finding) and the use of such knowledge as a deliberate strategy of coping with the problem (benefit-reminding) is underscored and illustrated by daily process research on coping with chronic pain.

Adaptation, Psychological↗

Opportunistic screening for broad range of medically relevant secondary findings: Laboratory benefits and burdens.

PURPOSE: Exome and genome sequencing enable opportunistic screening for secondary findings (SFs). We report on exome analysis for a broad range of medically relevant SFs in the setting of the Incidental Genomics randomized clinical trial (NCT03597165). METHODS: Participants had exome sequencing and were randomized to receive only primary cancer findings (control) or cancer findings and a choice of SFs (intervention). RESULTS: Across 279 participants, there were 4441 unique variants in SF genes: 5.0% (221) were reportable pathogenic/likely pathogenic variants, and 81.4% (3615) were nonreportable variants of uncertain significance (VUS). Intervention arm participants had on average 2.6 (SD 1.66, range 0-9) pathogenic/likely pathogenic variants and 29.5 VUS (SD 13.2, range 2-74). SFs for monogenic disease risk were reported in 35.3% (49/139) of participants (American College of Medical Genetics and Genomics non-cancer subset in 1.4%) and carrier status in 89.3% (117/131). In the intervention arm, variant filtration was 7.7 times longer per case (95% CI 5.3 to 11.3, P < .0001), variant classification was 13.3 times longer (95% CI 10.6 to 16.5, P < .0001), and report preparation was 3.3 times longer (95% CI 2.6 to 4.1, P < .0001). CONCLUSION: Although the yield of reportable SFs was high, this was accompanied by many nonreportable VUS and increased efforts for exome analysis.

Humans↗

The mediating role of protective factors in relationship between caregiving components and psychosocial adjustment among young carers: a meta-analysis.

OBJECTIVE: Higher youth caregiving is associated with poorer psychosocial outcomes in young carers; hence a research priority is to investigate protective factors that mitigate the adverse effects of youth caregiving. This systematic review with meta-analysis examined the relationships among youth caregiving components and young carer psychosocial adjustment and protective factors, as well as the mediating role of the protective factors in the relationship between caregiving components and psychosocial adjustment. METHODS: Three electronic databases were searched until April 2024 and 10,244 unique publications were identified. Following abstract and title screening, 422 publications were subjected to full-text screening and 60 quantitative studies were included in this study. RESULTS: Meta-analytic structural equation modeling (MASEM) results revealed positive direct effects of caregiving responsibilities and caregiving experiences on benefit finding (&#x3b2;&#xa0;=&#xa0;.43, 95% CI [.074, .782], p&#xa0;<&#xa0;.05) and emotion regulation (&#x3b2;&#xa0;=&#xa0;.72, 95% CI [.44, 1.00], p&#xa0;<&#xa0;.001), respectively. However, there was neither a significant direct effect of caregiving components on psychosocial adjustment nor a significant indirect effect of caregiving components on psychosocial adjustment through benefit finding or emotion regulation. CONCLUSION: Findings revealed a need for research into how caregiving contextual factors affect relations among youth caregiving, protective factors, and adjustment.

Humans↗

Work while receiving disability insurance benefits: additional findings from the New Beneficiary Followup Survey.

From the foregoing analyses, the following picture emerges about persons who work after award of DI benefits: Almost one-quarter of the sample population attempted to reenter the labor force in the 10-year NBS-NBF period. The higher the level of education, the greater the proportion of persons who worked. Younger beneficiaries were more likely to work than older beneficiaries. About half of the beneficiaries who worked did so on a full-time (40-hour-or-more per week) basis. Most beneficiaries worked because of financial need. The profile of reasons for working did not vary across demographic groups and aspects of the first job held. Most beneficiaries began working without attributing this decision to an improvement in their health. Individuals pursued different methods of job search. No single approach emerged as the most successful. Job search modes did not vary for different groups and different jobs. Four activities were most likely to lead to job offers: persons checking where they had worked before, asking a friend, answering an ad, and following up a vocational rehabilitation lead. These findings were not conclusive because small numbers of persons engaged in these activities. Thirty percent of DI workers returned to their preentitlement employer. The beneficiaries' first postentitlement jobs had less exertion, fewer hours, and lower pay than did their job held prior to award. The likelihood of working was the same across a broad range of disabling health conditions. In terms of work return policy, formal work return programs aimed at young beneficiaries and those with higher levels of educational attainment would produce the greatest number of job placements. It appears that no targeting of programs is necessary along gender lines. The anomalous finding of an absence of the relationship between improvement in health and labor-force reentry requires further investigation. Any followup in this area of inquiry should plan to have the data collected close to the time of postentitlement job entry.

Adolescent↗

Making sense of loss and benefiting from the experience: two construals of meaning.

Theoretical models of the adjustment process following loss and trauma have emphasized the critical role that finding meaning plays. Yet evidence in support of these models is meager, and definitions of meaning have been too broad to facilitate a clear understanding of the psychological process involved. Using a prospective and longitudinal study of people coping with the loss of a family member, we differentiate 2 construals of meaning--making sense of the event and finding benefit in the experience--and demonstrate that both independently play roles in the adjustment process following the loss. Results indicate that making sense of the loss is associated with less distress, but only in the 1st year postloss, whereas reports of benefit finding are most strongly associated with adjustment at interviews 13 and 18 months postloss.

Adult↗

Findings and benefit of liver biopsies in 46 patients infected with human immunodeficiency virus.

AIMS: The aim of this work is to evaluate the role of liver biopsy and to determine the histological findings in patients infected with the human immunodeficiency virus (HIV) who have abnormal liver function tests (LFT). METHODS: We performed a percutaneous liver biopsy in 46 HIV-seropositive patients with abnormal LFT. Parts of biopsied tissue were used for bacterial and fungal culture and the rest was processed for histological examination including special staining. RESULTS: Of these 46 patients, 41 patients were males and five were females. The median age was 31+/-6 years. Mycobacterium tuberculosis was the most common histological finding (15 cases). Of 15 tuberculosis patients, 11 (73.3%) had lymphadenopathy and positive acid-fast bacilli (AFB) in node aspiration or biopsy. The other findings included AFB-negative granuloma (eight cases), histoplasmosis (six cases), cryptococcosis (six cases), penicillosis (four cases), viral hepatitis: hepatitis C virus (HCV; one case), hepatitis B virus and HCV infection (one case), fatty liver (two cases), drug-induced hepatitis (one case) and non-specific changes (five cases). There were double infections in three patients. We were able to demonstrate opportunistic infections in 41 cases (89.3%). CONCLUSIONS: Mycobacterium tuberculosis was the most common histological finding in HIV patients with abnormal LFT in Thailand. Liver biopsy was a useful procedure in evaluating abnormal LFT in HIV patients.

AIDS-Related Opportunistic Infections↗

Income of new retired workers by age at first benefit receipt: findings from the New Beneficiary Survey.

Using data from the New Beneficiary Survey (NBS) of the Social Security Administration (SSA), this article examines how income sources and total monthly income received by newly retired social security beneficiaries vary with the age at which the first benefit check was received. The NBS respondents who received a first benefit at age 65 or older were better off economically than were those who received a first benefit at ages 62-64. At the time of the interview, 18-30 months after receiving a first benefit, these older beneficiaries had higher levels of total income and were more likely to have income from earnings and assets. Pension receipt rates did not vary by the age at which the first social security benefit was received except for married women retired workers, for whom the rate was higher at the older ages. The largest proportion of aggregate income (slightly more than one-third) was derived from social security benefits. More than 90 percent of the NBS Medicare-only respondents--a sample of nonbeneficiaries who were eligible for monthly cash benefits but had established their entitlement only for the purpose of enrolling in the Medicare program--reported earnings income. They had lower rates of pension receipt and higher rates of asset income receipt than the retired workers. The Medicare-only respondents had substantially higher incomes than did retired workers, and most of their aggregate income was from earnings. The NBS retirees were generally in better financial condition than a group of social security beneficiaries aged 65 or older from all benefit categories in the Current Population Survey Income Supplement with whom they were compared.

Age Factors↗

Pension coverage and benefits, 1972: findings from the retirement history sutdy.

This article, based on data from the Retirement History Study, examines coverage by an employee pension plan on the longest job and the extent to which covered workers received an employee pension upon retirement and the size of their benefits. It also examines the joint receipt of employee pension and OASDI benefits and the size of the combined benefits. Each of these pension variables is analyzed for differences by class of worker (private wage and salary or government), sex, and characteristics of the longest job (industry, occupation, tenure, recency of job, extent of employment, and annual earnings rate). The majority of completely retired individuals in their early to middle sixties in 1972 did not receive employee pension benefits in that year. Women employed in private industry on their longest job were the most disadvantaged in this regard. Even when they were fortunate enough to receive retirement benefits from employee pension plans, their benefits were substantially lower than those of men or of women employed in government.

Aged↗

Cognitive adaptation theory and breast cancer recurrence: Are there limits?

Relations of the components of cognitive adaptation theory (self-esteem, optimism, control) to quality of life and benefit finding were examined for 70 women (91% Caucasian) diagnosed with Stage I, II, or III breast cancer over 5 years ago. Half of these women experienced a recurrence within the 5 years; the other half remained disease free. Women were matched on age, race, stage of disease, and intervention condition. Baseline perceptions of personal control over illness, but not general self-esteem or optimism, were associated with women's reports of worse physical functioning, worse mental functioning, and less benefit finding 5 years later for recurrent women but not disease-free women. These findings highlight the notion that there may be boundary conditions on the adaptiveness of perceived control.

Adaptation, Psychological↗