Spiritual Well-Being and Psychological Adjustment: Mediated by Interpersonal Needs?

Spiritual well-being has been shown to reduce suicidal behavior, depressive symptoms, and hopelessness. Thwarted interpersonal needs have been shown to increase risk of suicidal behavior. This paper aims to explore the interrelationships among spiritual well-being, thwarted interpersonal needs, and negative outcomes including suicidal ideation, hopelessness, and depressive symptoms among African American women. Sixty-six African American women (M = 36.18; SD = 11.70), from a larger study of women who had experienced interpersonal violence within the past year, completed self-report questionnaires. Mediation analyses revealed that thwarted belongingness, but not perceived burdensomeness, significantly mediated the relations between spiritual well-being and the three outcomes. This study provides the first examination of the role of thwarted interpersonal needs on the link between spiritual well-being and negative psychological outcomes. Spiritual well-being serves a protective role against feelings of social isolation, which may reduce one's risk of negative psychological outcomes. Treatments that bolster a sense of spirituality and social connectedness may reduce suicidal ideation, hopelessness, and depressive symptoms.

Perceived problem-solving deficits and suicidal ideation: Evidence for the explanatory roles of thwarted belongingness and perceived burdensomeness in five samples.

Perceived social problem-solving deficits are associated with suicide risk; however, little research has examined the mechanisms underlying this relationship. The interpersonal theory of suicide proposes 2 mechanisms in the pathogenesis of suicidal desire: intractable feelings of thwarted belongingness (TB) and perceived burdensomeness (PB). This study tested whether TB and PB serve as explanatory links in the relationship between perceived social problem-solving (SPS) deficits and suicidal thoughts and behaviors cross-sectionally and longitudinally. The specificity of TB and PB was evaluated by testing depression as a rival mediator. Self-report measures of perceived SPS deficits, TB, PB, suicidal ideation, and depression were administered in 5 adult samples: 336 and 105 undergraduates from 2 universities, 53 homeless individuals, 222 primary care patients, and 329 military members. Bias-corrected bootstrap mediation and meta-analyses were conducted to examine the magnitude of the direct and indirect effects, and the proposed mediation paths were tested using zero-inflated negative binomial regressions. Cross-sectionally, TB and PB were significant parallel mediators of the relationship between perceived SPS deficits and ideation, beyond depression. Longitudinally and beyond depression, in 1 study, both TB and PB emerged as significant explanatory factors, and in the other, only PB was a significant mediator. Findings supported the specificity of TB and PB: Depression and SPS deficits were not significant mediators. The relationship between perceived SPS deficits and ideation was explained by interpersonal theory variables, particularly PB. Findings support a novel application of the interpersonal theory, and bolster a growing compendium of literature implicating perceived SPS deficits in suicide risk. (PsycINFO Database Record

Family criticism and depressive symptoms in older adult primary care patients: optimism and pessimism as moderators.

OBJECTIVE: Depression is a significant global public health burden, and older adults may be particularly vulnerable to its effects. Among other risk factors, interpersonal conflicts, such as perceived criticism from family members, can increase risk for depressive symptoms in this population. We examined family criticism as a predictor of depressive symptoms and the potential moderating effect of optimism and pessimism. METHODS: One hundred five older adult, primary care patients completed self-report measures of family criticism, optimism and pessimism, and symptoms of depression. We hypothesized that optimism and pessimism would moderate the relationship between family criticism and depressive symptoms. RESULTS: In support of our hypothesis, those with greater optimism and less pessimism reported fewer depressive symptoms associated with family criticism. CONCLUSION: Therapeutic enhancement of optimism and amelioration of pessimism may buffer against depression in patients experiencing familial criticism.

The relationship between negative life events and suicidal behavior: moderating role of basic psychological needs.

BACKGROUND: Individuals who experience negative life events may be at increased risk for suicidal behavior. Intrapersonal characteristics, such as basic psychological needs, however, may buffer this association. AIMS: To assess the potential moderating role of overall basic psychological needs, and the separate components of autonomy, competence, and relatedness, on the association between negative life events and suicidal behavior. METHOD: Our sample of 439 college students (311 females, 71%) completed the following self-report surveys: Life Events Scale, Basic Psychological Needs Scale, Beck Depression Inventory - II, and the Suicide Behaviors Questionnaire-Revised. RESULTS: In support of our hypotheses, negative life events were associated with greater levels of suicidal ideation and attempts, and satisfaction of basic psychological needs, including autonomy, relatedness, and competence, significantly moderated this relationship, over and above the effects of the covariates of age, sex, and depressive symptoms. CONCLUSIONS: Suicidal behavior associated with the experience of negative life events is not inevitable. Therapeutically bolstering competence, autonomy, and relatedness may be an important suicide prevention strategy for individuals experiencing life stressors.

Illness burden and symptoms of anxiety in older adults: optimism and pessimism as moderators.

BACKGROUND: We assessed the association between medical illness burden and anxiety symptoms, hypothesizing that greater illness burden would be associated with symptoms of anxiety, and that optimism would buffer, while pessimism would exacerbate, this relationship. METHODS: We recruited 109 older adults, aged 65 years and older, from primary care and geriatric clinics to participate in this cross-sectional, interview-based study. Participants completed the Snaith Clinical Anxiety Scale and the Life Orientation Test - Revised, a measure of optimism/pessimism. A physician-rated measure of illness burden, the Cumulative Illness Rating Scale, was also administered. RESULTS: Supporting our hypotheses, greater levels of overall optimism weakened, and pessimism strengthened, the association between illness burden and anxiety symptoms, after accounting for the effects of demographic, cognitive, functional, and psychological covariates. CONCLUSIONS: Bolstering positive and reducing negative future expectancies may aid in the prevention of psychological distress in medically ill older adults. Therapeutic strategies to enhance optimism and reduce pessimism, which may be well-suited to primary care and other medical settings, and to which older adults may be particularly amenable, may contribute to reduced health-related anxiety.

Hallucinations, psuedohallucinations, and parahallucinations.

BACKGROUND: There are several clinical phenomena that resemble hallucinations which are inadequately studied because the terminology defining them is inadequate. METHODS: A review of the relevant literature, identified by searches of Ovid and PubMed databases. RESULTS: A historical review reveals that the term pseudohallucination has been used to describe several separate and unrelated phenomena. Herein this term is redefined, and an additional term, parahallucinations, is introduced. Hallucinations are defined as sensory perceptions that have the compelling sense of reality of true perceptions but that occur without external stimulation of the relevant sensory organ and are experienced as following the sensory path, that is, can be localized in three-dimensional space outside the body. Pseudohallucinations are defined as hallucinatory phenomena that do not follow the sensory path and are experienced predominantly by psychiatrically ill subjects. Parahallucinations are defined as hallucinatory phenomena that occur due to an injury or abnormality to the peripheral nervous system. Insight into the reality of these experiences-the realization that they are not real-is not felt to be important in their phenomenology. CONCLUSION: Utilization of this classification system during clinical investigations will yield greater insight into the pathophysiology, course, treatment, and prognosis of psychiatric and neurologic disorders.

Hallucinations, pseudohallucinations, and severity of suicidal ideation among emergency psychiatry patients.

AIMS: This study investigated relative relationships between auditory hallucinations and nonpsychotic hallucinations (pseudohallucinations), and suicidal risk. METHODS: A sample of 206 consecutive patients seen in an emergency psychiatric service was evaluated for the presence and intensity of hallucinatory experiences (the hallucination item of the Positive and Negative Symptoms Scale), suicidal intensity (the suicide item of the Montgomery Asberg Depression Rating Scale), and cumulative suicide risk (the total number of risk factors). RESULTS: Individuals with nonpsychotic hallucinations experienced greater intensity of suicidal ideation versus subjects with no hallucinations or subjects with psychotic hallucinations (p = .0001). CONCLUSIONS: Pseudohallucinosis is associated with higher intensity of suicidal ideation compared with psychotic hallucinations or no hallucinations.