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Meaning making and psychological adjustment following cancer: The mediating roles of growth, life meaning, and restored just-world beliefs.
Abstract
Cancer survivors' efforts at meaning making may influence the extent to which they successfully make meaning from their experience (i.e., experience posttraumatic growth, find life meaningful, and restore beliefs in a just world), which may, in turn, influence their psychological adjustment. Previous research regarding both meaning making processes and meanings made as determinants of adjustment has shown inconsistent effects, partly because of the lack of clearly articulated theoretical frameworks and problematic research strategies. In a 1-year longitudinal study, the authors distinguished the meaning making process from the outcomes of that process (meanings made), employing specific measures of both. The authors tested pathways through which meaning making efforts led to 3 different meanings made (growth, life meaning, and restored just-world belief) in a sample of 172 young to middle-age adult cancer survivors, and they explored whether those meanings made mediated the effect of meaning making efforts on psychological adjustment. Cross-sectional and longitudinal path models of the meaning making process indicate that meaning making efforts are related to better adjustment through the successful creation of adaptive meanings made from the cancer experience. The authors conclude with clinical implications and suggestions for future research.
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“based on the broader ACT model, M-ACT specifies putative mechanisms of change including increasing active acceptance and reducing avoidance of internal experiences (i.e., difficult thoughts and emotions) and clarifying values and sources of meaning (e.g., [29–31])”
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“Once people have reframed a negative situation they should perceive it to be more manageable and meaningful, just as cancer survivors used positive reframing to make meaning of their experience (Park et al., 2008).”
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“Although this approach has seldom been employed as a way of examining shifts in these important aspects of meaning over time, results of studies that have employed this approach suggest that it is a very fruitful way to study meanings made over time (e.g. Park et al., 2008).”
ResultSelf-citationAntoni, M. H., Moreno, P. I., & Penedo, F. J. (2023) · Annual Review of Psychology · doi:10.1146/annurev-psych-030122-124119 · Cited by 132
“Facing cancer can lead to opportunities for positive change as individuals engage in efforts to find meaning in their experience (Algoe & Stanton 2009, Park et al. 2008, Stanton et al. 2006).”
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“Further, experiencing meaning in life was related to lower distress and greater well-being in Italian and US cancer patients (Park et al. 2008; Scrignaro et al. 2014).”
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“By contrast, the process of making meaning is assumed to lead to better adjustment, although whether this occurs via a process of effortful, positive reappraisal (and suffering) (125), or simply via positive reinterpretations of the cancer experience (126) is a topic of contention in the literature (71).”
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“, 2018) and two studies applied both a cross-sectional and a longitudinal design (Park et al., 2008; George and Park, 2013).”
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“, illnesses) which violate people’s BJW (Park et al., 2008).”
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van der Spek, N., Vos, J., van Uden‐Kraan, C. F., BREITBART, W. S., Tollenaar, R. A. �. �., Cuijpers, P. J., & Leeuw, I. M. V. (2013) · PLoS ONE · doi:10.1371/journal.pone.0076089 · Cited by 84
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“Yet, PTG tends to represent a eudemonic construct, associated with greater meaning in life and strengths of character (Park et al., 2008; Peterson et al., 2008).”
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“However, there is an important distinction between the process of meaning making and the outcome of meaning making (Park et al., 2008).”
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“It may be that the ability to achieve a sense of meaning may promote adjustment, while the protracted search for meaning may actually exacerbate distress through processes such as rumination (e.g., Lepore & Kernan, 2009; Park et al., 2008).”
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“H3: Presence of meaning will be negatively related to PTSD (Park et al., 2008) and positively related to stress-related growth (Steger et al.”
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Posttraumatic growth in breast cancer survivors: a comparison of volunteers and non‐volunteers
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Trauma and Meaning Making: Converging Conceptualizations and Emerging Evidence
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Self-citationAssessing Disruptions in Meaning: Development of the Global Meaning Violation Scale
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“However, given the centrality of meaning making processes in the context of health concerns (Kendler et al. 2001) and the focus on health-related stressors in meaning making research (e.g., Park et al. 2008), we retained this item and opted to re-evaluate it in the CFA.”
BackgroundSelf-citationNo evidence that social stress is associated with breast cancer incidence
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“These results may contribute therefore to an evidence-based approach to (psycho-) oncology practice, through potentially increasing understanding of meaning-focused coping processes, that may lead to improved adjustment to a cancer diagnosis, and could aid strategies designed to meet the psychosocial and emotional nee…”
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Taking on the stress‐depression link: Meaning as a resource in adolescence
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“Either way, benefits of this course of action are not likely to be realized until the process is complete (Park et al., 2008).”
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“…sharing views that relate to the philosophical aspects of death and dying such as fairness; 55 questioning, examining, and changing global meaning; 56 discussing topics of religious connotations; 55 expression of lessons learned, new insights gained, or changes in self or family since the death;…”
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“Researchers have found that suffering and uncertainty associated with a cancer diagnosis trigger a need for order and new meanings [44, 45].”
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“Anagnostopoulos et al, 2010 ; Park, Edmondson, et al, 2008 ; Schroevers et al, 2004 ; Vehling et al, 2010 ); the current investigation focused more narrowly on the stem cell transplant setting.”
BackgroundPosttraumatic growth among cancer patients in India
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“Overall however, there have been few theoreticallydriven studies (e.g., Park et al. 2008; Sears et al. 2003; Widows et al. 2005).”
BackgroundInfluentialEffects of an Empowerment Program on Resilience and Posttraumatic Growth Levels of Cancer Survivors
Üzar‐Özçetin, Y. S., & Hi̇çdurmaz, D. (2018) · Cancer Nursing · doi:10.1097/ncc.0000000000000644 · Cited by 53
“During the cancer process, many people experience an existential questioning and find meanings as a result of this questioning, causing lower stress levels, better adaptation, and improved psychological well-being.(47) This reinvention of meanings is called the existential process of cancer.”
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“For example, meaning-making has been found to be extremely common among cancer survivors and has been identified as an important factor in their psychological growth (e.g. Park et al., 2008).”
BackgroundMartino, M. L., & Freda, M. F. (2016) · Europe’s Journal of Psychology · doi:10.5964/ejop.v12i4.1150 · Cited by 44
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Martino, M. L., Lemmo, D., Gargiulo, A., Barberio, D., Abate, V., Avino, F., & Tortoriello, R. (2019) · Frontiers in Psychology · doi:10.3389/fpsyg.2019.00618 · Cited by 47
“…in Psychology | www.frontiersin.org 2 March 2019 | Volume 10 | Article 618 when dealing with traumatic events (Gillies and Neimeyer, 2006; Hall, 2011; Waters et al., 2013; Freda and Martino, 2015) and can explain health outcomes and symptom reduction (Tolstikova et al., 2005; Park et al., 2008).”
BackgroundCost‐utility analysis of meaning‐centered group psychotherapy for cancer survivors
van der Spek, N., Jansen, F., Holtmaat, K., Vos, J., BREITBART, W. S., van Uden‐Kraan, C. F., Tollenaar, R. A. �. �., Cuijpers, P. J., Coupé, V. M. H., & Leeuw, I. M. V. (2018) · Psycho-Oncology · doi:10.1002/pon.4726 · Cited by 43
Illness centrality, disclosure, and well‐being in younger and middle‐aged adult cancer survivors
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“These results confirm that the specific meaning ascribed to current life circumstances has relevance to the process of coping with stressful life events (Park, 2010; Park et al., 2008; Visser et al., 2010).”
BackgroundMeaning mediates the association between suffering and well-being
Edwards, M., & Tongeren, D. R. V. (2019) · The Journal of Positive Psychology · doi:10.1080/17439760.2019.1651890 · Cited by 47
Experiencing positive change after a diagnosis of breast cancer: a grounded theory analysis
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“Recent work has shown that these questions can be distinguished empirically [75].”
BackgroundFreda, M. F., & Martino, M. L. (2014) · Qualitative Health Research · doi:10.1177/1049732314551059 · Cited by 40
Nilsen, M., Stalsberg, R., Sand, K., Haugan, G., & Reidunsdatter, R. J. (2021) · Frontiers in Psychology · doi:10.3389/fpsyg.2021.734198 · Cited by 39
Owens, G. P. (2016) · Journal of Clinical Psychology · doi:10.1002/jclp.22309 · Cited by 50
Arpawong, T. E., Sussman, S. Y., Milam, J. E., Unger, J. B., Land, H. M., Sun, P., & Rohrbach, L. A. (2014) · Psychology and Health · doi:10.1080/08870446.2014.979171 · Cited by 37
Dimensions of Posttraumatic Growth in Patients With Cancer
Heidarzadeh, M., Rassouli, M., Brant, J. M., Shahboulaghi, F. M., & Majd, H. A. (2017) · Cancer Nursing · doi:10.1097/ncc.0000000000000537 · Cited by 38
Siblings in foster care: A relational path to resilience for emancipated foster youth
Richardson, S. M., & Yates, T. M. (2014) · Children and Youth Services Review · doi:10.1016/j.childyouth.2014.10.015 · Cited by 37
Family Resilience From the Perspective of Caregivers of Youth With Sickle Cell Disease
Reader, S. K., Pantaleao, A., Keeler, C. N., Ruppe, N. M., Kazak, A. E., Rash-Ellis, D. L., Wadman, J., Miller, R. E., & Deatrick, J. A. (2019) · Journal of Pediatric Hematology/Oncology · doi:10.1097/mph.0000000000001682 · Cited by 38
Arslan, G., Genç, E., Yıldırım, M., Tanhan, A., & Allen, K. (2021) · Children and Youth Services Review · doi:10.1016/j.childyouth.2021.106296 · Cited by 42
Bias Within Because of Threat From Outside
Steele, R. R., Parker, M. T., & Lickel, B. A. (2014) · Social Psychological and Personality Science · doi:10.1177/1948550614548727 · Cited by 39
Samios, C., Abel, L., & Rodzik, A. K. (2013) · Anxiety Stress & Coping · doi:10.1080/10615806.2013.784278 · Cited by 36
Ameli, R., Sinaii, N., Luna, M. J., Cheringal, J., Gril, B., & Berger, A. M. (2018) · PLoS ONE · doi:10.1371/journal.pone.0207820 · Cited by 35
Rosen, R. K., van den Berg, J. J., Vargas, S. E., Senocak, N., Shaw, J. G., Buckheit, R. W., Smith, K. A., & Guthrie, K. M. (2015) · Contraception · doi:10.1016/j.contraception.2015.08.007 · Cited by 33
“Although it has recently flourished in health-related research [17–21], meaning-making has been an existing, if underused, acceptability-related construct for decades.”
BackgroundLagerdahl, A. S. K., Moynihan, M., & Stollery, B. (2014) · Journal of Psychosocial Oncology · doi:10.1080/07347332.2014.936647 · Cited by 33
“, 2002), adjustment process (Park et al., 2008), and coping (Mullen, Smith, & Hill, 1993).”
BackgroundHoltmaat, K., van der Spek, N., Lissenberg-Witte, B. I., BREITBART, W. S., Cuijpers, P. J., & Leeuw, I. M. V. (2019) · Psycho-Oncology · doi:10.1002/pon.5323 · Cited by 33
“There is growing evidence that meaning-focused coping is a viable way to successfully adjust to the aftermath of cancer,(2) especially if meaning can be made from the cancer experience.(3,4) Breitbart and colleagues developed meaningcentered group psychotherapy (MCGP) to improve psychological wellbeing in patients wit…”
Baník, G., & Gajdošová, B. (2014) · Supportive Care in Cancer · doi:10.1007/s00520-014-2217-0 · Cited by 32
“Several authors [1, 2, 9, 10, 13, 16, 21, 27, 30, 37] have noted the presence of PTG in patients with cancer.”
BackgroundDo We Know How Adversity Impacts Human Development?
Jayawickreme, E., Rivers, J., & Rauthmann, J. M. (2018) · Research in Human Development · doi:10.1080/15427609.2018.1495515 · Cited by 26
Arslan, G., Yıldırım, M., & Leung, M. M. (2021) · Frontiers in Psychology · doi:10.3389/fpsyg.2021.638379 · Cited by 30
“Meaning in life was also related with better psychological adjustment (Park et al., 2008), growth and healing (Wong, 2011; Leung, 2019), lower post-traumatic stress disorders (Updegraff et al.”
BackgroundPosttraumatic growth and demoralization after cancer: The effects of patients' meaning-making
Li, Y.-C., Yeh, P.-C., Chen, H.-W., Chang, Y.-F., Pi, S.-H., & Fang, C.-K. (2015) · Palliative & Supportive Care · doi:10.1017/s1478951515000048 · Cited by 30
“In addition, cancer survivors’ efforts at meaning-making may influence the extent to which they successfully achieve posttraumatic growth (Park et al., 2008).”
Background
Metadata
- Authors
- Park, C. L., Edmondson, D., Fenster, J. R., & Blank, T. O.
- Affiliations
- University of Connecticut (US)
- Venue
- Journal of Consulting and Clinical Psychology
- Published
- 2008-10
- Volume
- 76
- Issue
- 5
- Pages
- 863-875
- ISSN
- 0022-006X (ISSN-L)
- 1939-2117
- OpenAlex
- W2075953856
- Cited by
- 376
- References
- 108
- Citations by year
- 2026: 14 · 2025: 17 · 2024: 21 · 2023: 28 · 2022: 32 · 2021: 23 · 2020: 23 · 2019: 26 · 2018: 21 · 2017: 17 · 2016: 22 · 2015: 22 · 2014: 31 · 2013: 21 · 2012: 19
- FWCI
- 6.79
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Consulting and Clinical Psychology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Lance Armstrong Foundation
- Topics
- Health Sciences › Medicine › Oncology › Cancer survivorship and care
- Social Sciences › Health › Religion, Spirituality, and Psychology
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Childhood Cancer Survivors' Quality of Life
- Keywords
- meaning-making, cancer survivors, psychological adjustment, posttraumatic growth, meaning of life, belief in a just world, mediation, cancer experience
- MeSH terms
- Adaptation, Psychological, Adult, Age Factors, Cross-Sectional Studies, Culture, Female, Humans, Internal-External Control, Longitudinal Studies, Male, Middle Aged, Neoplasms, Surveys and Questionnaires, Sick Role, Survival, Self Efficacy
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