Search Results (33)

Background/Objectives: Heart failure (HF) is a highly unpredictable disease that significantly impacts patients’ well-being. One of the fundamental problems faced by cardiac patients is trying to answer the question of how to lead a meaningful life. Meaning in life is a crucial predictor of well-being, ill-being and quality of life for everyone, not just cardiac patients. Therefore, identifying its predictors is crucial. Based on Leventhal et al.’s common-sense model of self-regulation of health and illness, and Lipowski’s disease perception concept, this study verified the role of illness perception and perceived stress in existential meaning in Polish HF patients. Methods: This manuscript presents the results of a cross-sectional study. Overall, 336 HF patients from Poland were examined. Four questionnaires were used: the Meaning in Life Questionnaire (MLQ), the Multidimensional Existential Meaning Scale (MEMS), the Perceived Stress Scale (PSS-10) and the Disease-Related Appraisals Scale (DRAS). Results: Negative illness perception and positive cognitive assessment of the illness were shown to be significant predictors of meaning in life in patients with HF. Furthermore, this relationship was mediated by perceived stress. Additionally, the positive correlation between negative illness assessment and positive illness perception was found. Conclusions: This study demonstrates that cognitive assessment of the disease can be associated with the existential resources of heart failure patients. It also highlights the importance of working on the existential sphere of cardiac patients and accurately verified theoretical assumptions regarding the relationship between illness perception and meaning in life, providing a basis for future longitudinal studies and meaning-oriented psychological help focused on individuals with HF. Full article

Introduction. Chronic non-cancer pain is highly prevalent and profoundly diminishes quality of life. While pharmacological and interventional treatments are central, its psychosocial and spiritual dimensions remain under-addressed. This pilot study assessed the feasibility of a therapist-led support group intervention for patients with chronic non-cancer pain and explored preliminary psychospiritual outcomes. Methods. A two-arm, non-randomized pilot feasibility study was conducted among 58 outpatients of a university pain management clinic in Poland. Feasibility was assessed through recruitment, retention, attendance, and safety, while preliminary psychological and spiritual outcomes were evaluated using validated self-report instruments. The intervention group (n = 29) participated in eight group sessions combining psychoeducation, mindfulness-based techniques, and supportive dialogue inspired by the Simonton Method. The control group (n = 29) received standard care. Participants completed the Numeric Rating Scale to measure pain intensity, the Satisfaction with Life Scale, the Positive and Negative Affect Schedule, the WHOQOL-BREF, the Spiritual Well-Being Scale, the Generalized Anxiety Disorder Scale, and the Patient Health Questionnaire-9. Results. The intervention was feasible in terms of physician workload; however, patients adherence varied significantly. At baseline, the control group showed a significantly higher positive affect and existential well-being than did the intervention group. In exploratory within-group analyses, participants in the intervention group showed improved positive affect and reduced anxiety (p < 0.05), whereas existential well-being showed a trend toward improvement (p < 0.06). However, the self-selection design limits causal inferences. Nevertheless, participants reported social connectedness, meaning-making, and enhanced vitality. Discussion. This pilot feasibility study provides preliminary evidence that a therapist-led support group intervention integrating psychoeducation, mindfulness, and supportive components is practicable within multidisciplinary pain management. Further research in a larger, randomized trial is needed to evaluate adherence and safety, as well as clinical effects, more rigorously. Full article

This study offers a critical re-examination of contemporary euthanasia debates through an Islamic legal lens, with particular focus on requests for euthanasia arising from psychological suffering within the context of mental disorders. Within bioethical discourse, advocates of euthanasia predominantly justify their position on the grounds of individual autonomy and the alleviation of unbearable suffering, framing it as consistent with modern medicine’s aspiration to optimize quality of life. Yet, by elevating autonomy and self-determination as supreme moral values, it risks reducing the human condition to its cognitive and volitional dimensions, thereby overlooking the existential, spiritual, and affective aspects of suffering. In contrast, Islamic law regards life as a divine trust bestowed by God. Human beings are understood as stewards—rather than absolute proprietors—of their lives and are thus accountable before God for their preservation. From this perspective, psychological pain—akin to physical pain—may serve as a means of moral refinement, spiritual purification, and divine testing. Methodologically, the study conducts a textual and analytical examination of Islamic legal sources, complemented by practical examples that illustrate how psychological suffering transforms into requests for euthanasia, thereby examining how these sources ought to be understood through concrete cases. Furthermore, the study aims to examine whether appeals to a “right to die,” grounded in experiences of psychological suffering, can find any juridical legitimacy within the framework of Islamic law. Full article

Background/Objectives: Mindfulness has been identified as a protective factor in promoting adaptive psychological outcomes among cancer patients, yet the mechanisms linking mindfulness to fundamental existential beliefs, such as basic hope, remain underexplored. In addition, mediational processes underlying these relationships remain understudied. Building on the theoretical framework of Acceptance and Commitment Therapy, we tested a serial multiple mediation model in which illness acceptance and fear of recurrence sequentially mediated the association between mindfulness and basic hope. Methods: Adult patients diagnosed with pelvic cancer (N = 273) who were undergoing oncological treatment completed questionnaires measuring mindfulness, illness acceptance, fear of recurrence, and basic hope. Mediation analysis was used to examine multiple mediation effects. Results: Illness acceptance also functioned as a single mediator between mindfulness and basic hope. In contrast, fear of recurrence was not a mediator between mindfulness and basic hope. The main finding was the serial mediation pathway through illness acceptance and fear of recurrence. The indirect effects showed that mindfulness was positively associated with illness acceptance dimensions—life satisfaction during illness, reconciliation with the disease, and self-distancing from the disease—which, in turn, were negatively associated with fear of recurrence, ultimately relating to higher levels of basic hope. Conclusions: The findings highlight the critical role of acceptance- and fear-related processes in sustaining basic hope among cancer patients and suggest that mindfulness-based interventions may foster adaptive adjustment to illness. Implications for clinical practice include integrating mindfulness and acceptance-focused strategies to enhance hope and support emotional well-being in patients coping with cancer. Full article

Background: Positive and existential psychiatry are approaches to mental health that emphasize the promotion of well-being, resilience, and optimal functioning alongside the conventional management of mental illness. Research suggests that the development of self-regulatory metacompetencies is associated with positive mental health and well-being outcomes. Artificial intelligence (AI) technologies are increasingly being used as assistive tools in psychiatry. However, the integration of AI in therapeutic interventions remains underexplored. Objectives: Thus, this systematic review aimed to synthesize evidence from randomized controlled trials evaluating whether AI-based positive and existential psychiatry interventions contribute to improvements in mental and emotional health. A second objective was to examine whether the therapeutic components and psychological processes implemented in these interventions conceptually relate to self-regulatory metacompetencies that underpin sustainable mental health and human flourishing. Methods: The review was conducted according to PRISMA 2020 guidelines. Only experimental studies including randomized controlled trials (RCTs) published from 2015 to 2025 were included. Twenty-four studies met the inclusion criteria. Results: Across interventions using conversational AI chatbots, generative AI and AI-augmented reflective systems, embodied conversational agents, social and humanoid AI robots, consistent improvements were observed in depression, anxiety, negative affect, and loneliness. The interventions enhanced various metacompetencies such as emotional regulation, emotional awareness, self-reflection, and cognitive reappraisal. Conclusions: The findings suggest that AI-based positive and existential psychiatry interventions can support mental and emotional health, especially when fostering key metacompetencies. Although promising, further high-quality trials are needed to clarify long-term effects. The findings of this study can contribute to the discussion about the ways AI-supported interventions may promote sustainable mental health. Full article

This article documents and analyzes a three-month intercultural performance collaboration with Metamorphosis Theatre in St. Petersburg, Russia, during the summer of 1992—a pivotal moment following the dissolution of the Soviet Union. Drawing on the author’s fieldwork methodology developed through decades of collaboration with Indigenous communities in Alaska, Southern Africa, and Siberia, the project employed trance techniques, rhythm-based training, and ritual archaeology to reconstruct pre-Christian Slavic performance practices. The resulting production, Shadows from the Planet Fire, emerged through a process that positioned ritual not as nostalgic revival but as a living technology for addressing cultural trauma and existential displacement. This account contributes to performance studies, applied theatre, and cultural heritage discourse by demonstrating how cosmocentric Indigenous methodologies can be adapted to address the spiritual and psychological wounds of post-industrial, post-colonial societies. The work establishes foundational principles for what the author terms “Techdigenous” practice—the synthesis of Indigenous wisdom traditions with contemporary performance contexts—and argues for ritual as a necessary consciousness technology in an era of ecological crisis and cultural fragmentation. Full article

Background: Companion participation in medical consultations can influence the well-being of older adults with chronic illness, yet the mechanisms underlying this effect remain unclear. This study aimed (1) to examine how companion-reported value co-creation (coproduction and value-in-use) relates to patient-reported multidimensional well-being (psychological, existential, social, and physical), and (2) to test whether these associations vary according to patient and companion characteristics. Methods: A cross-sectional dyadic study of 907 patient-companion pairs (N = 1814) was conducted in Spain prior to the COVID-19 pandemic. Companions completed the adapted Spanish Value Co-creation Scale, while patients completed the McGill Quality of Life Questionnaire-Revised (MQOL-R). Construct validity was confirmed via confirmatory factor analysis, and structural equation modeling tested hypothesized relationships using robust maximum-likelihood estimation. Results: The model showed good fit (χ²/df = 2.41, CFI = 0.96, RMSEA = 0.041). Companion coproduction was positively associated with patient psychological (β = 0.32), social (β = 0.27), and existential well-being (β = 0.29), but not physical well-being. Value-in-use showed small negative associations (β ≈ −0.10 to −0.15), which may reflect relational strain arising when companions’ involvement is excessive or mismatched with patient needs. Coproduction effects were stronger among patients aged ≤75 years. Conclusions: Companion coproduction enhances key dimensions of patient well-being, highlighting its role as a relational resource in clinical practice. Conversely, higher companion value-in-use may signal potential relational strain. These pre-pandemic findings provide a baseline for post-COVID chronic care models that aim to actively involve companions and tailor support according to patient age. Full article

Positive Body Image (PBI) has been conceptualized as a multidimensional construct encompassing acceptance, functionality appreciation, and self-care, yet little is known about the lived processes through which women move from self-criticism to reconciliation with their bodies. This study aimed to explore how women experience, construct, and sustain PBI in their everyday lives, and to identify the psychological and contextual factors that facilitate its development. Semi-structured interviews were conducted with ten women in Greece (ages 18–62) of diverse body sizes, educational backgrounds, and life circumstances, which were then analyzed using interpretative phenomenological analysis. Participants were recruited through convenience sampling and interviewed online between July and August 2025. Findings revealed three superordinate themes—(1) Catalysts of Realism and Self-Care, (2) From Rejection to Reconciliation, and (3) My Own Positive Body Image—comprising nine subthemes that together illustrated a developmental process of body acceptance and meaning-making. Findings revealed a trajectory from self-rejection to reconciliation, marked by shifts from external appearance to holistic embodiment, and from self-criticism to compassion, functionality appreciation, and intrinsic motivation. Participants described mindful self-care practices—particularly exercise and healthy eating—as acts of self-nurturing, supported by psychotherapy, positive social relationships, and turning points such as illness, aging, or personal maturation. These catalysts facilitated a reorientation of body image away from societal ideals and toward health, resilience, and existential meaning. The study contributes to understanding how women develop sustainable forms of PBI, highlighting the importance of self-compassion, supportive contexts, and body functionality. These insights have implications for interventions aiming to promote wellbeing, resilience, and healthier relationships with the body across the lifespan. Full article

Background: Perfectionism is a multidimensional personality trait encompassing both adaptive and maladaptive aspects that strongly influence students’ psychological health. Spiritual well-being, defined by existential and religious components, has been suggested as a protective factor, yet its relationship with perfectionism remains underexplored in university populations. This study aimed to investigate these associations in a large nationwide sample of Italian undergraduates. Methods: A total of 2103 students from public and private universities across Northern, Central, and Southern Italy participated in an online cross-sectional survey. Validated instruments were used to assess multidimensional perfectionism and spiritual well-being. Results: Self-oriented perfectionism emerged as the most prevalent dimension, followed by other-oriented and socially prescribed perfectionism. Scores for existential well-being were higher than those for religious well-being. Existential well-being was negatively associated with socially prescribed perfectionism, suggesting a buffering role against maladaptive forms of striving. Religious well-being showed only a small positive association with perfectionism. Gender and age differences were also observed, with women and younger students reporting higher levels of perfectionism. Conclusions: Findings highlight existential well-being as a potential protective factor in academic contexts, supporting meaning-centered strategies to mitigate maladaptive perfectionism. Longitudinal and cross-cultural studies are warranted to clarify causal mechanisms and inform culturally sensitive educational and clinical practices. Full article

Background: The rising prevalence of neurodegenerative conditions such as dementia underscores the impact of population aging. Consequently, long-term care needs have increased and are often met by family members through informal caregiving, thereby supporting formal care systems by reducing associated costs. These caregivers face physical and mental health challenges, raising concerns about their psychological well-being and prompting interest in both clinical and psychosocial research. Ryff’s eudaimonic model offers a robust framework for the assessment of psychological well-being; yet, in Romania, data on this population segment remain limited. Objective: This study aimed to compare the psychological well-being of Romanian dementia family caregivers with a reference population from the Romanian adaptation of the 54-item Ryff Psychological Well-Being Scale, and to explore how sociodemographic characteristics relate to relevant differences across well-being dimensions. Methods: A cross-sectional study was conducted among 70 Romanian family caregivers recruited from a single clinical hospital in Bucharest, Romania. Caregivers completed the 54-item Ryff Scale (Romanian adaptation), and scores were compared to reference values using one-sample t-tests with bootstrap confidence intervals. The most relevant dimension (purpose in life) was dichotomized and further examined in relation to sociodemographic and caregiving variables using Chi-squared and Fisher’s exact tests. Results: Caregivers reported significantly lower scores compared to the reference population in purpose in life (p < 0.001, d = −1.01), personal growth (p < 0.001, d = −0.91), and positive relations (p = 0.01, d = −0.30). The most pronounced deficit was observed in purpose in life, with 85.7% of caregivers scoring below the reference mean. This dimension was further examined in relation to caregiver characteristics. Retirement status showed a statistically significant association with Purpose in Life, with retired caregivers more likely to report lower scores (χ² (1) = 4.04, p = 0.04), supported by the likelihood ratio test (p = 0.01) and a linear trend (p = 0.05). Additional marginal associations were found for household income (p = 0.14) and whether the patient slept in a separate room (p = 0.15), suggesting possible links between caregiver well-being and economic or environmental conditions. Conclusions: The study findings highlight notable psychological vulnerabilities among Romanian dementia caregivers, particularly in purpose in life and personal growth. Associations with structural and contextual factors such as retirement status, income, and caregiving environment suggest that caregiver well-being is shaped by broader socioeconomic conditions. While the magnitude of these deficits may be underestimated due to elevated stress levels in the reference group, the findings underscore the need for targeted clinical, social, and policy-level interventions aimed at strengthening existential meaning and personal development in culturally specific settings. Full article

Heart transplantation represents a pivotal intervention for end-stage heart failure, extending survival. However, it imposes profound physical, psychological, and social challenges that often undermine recipients’ quality of life (QoL). These challenges are especially pronounced in collectivist cultural contexts like China, where familial obligations and stigma surrounding chronic illness intensify existential burdens. Grounded in theoretical frameworks including Coping Theory, Self-Determination Theory, Socioemotional Selectivity Theory, and Terror Management Theory, this cross-sectional study explored the interplay between social support and QoL among Chinese heart transplant recipients, elucidating the mediating roles of self-esteem and death anxiety, as well as their sequential chain-mediating pathway. Employing validated psychometric instruments, including the Social Support Rating Scale (SSRS), Rosenberg Self-Esteem Scale (RSES), Templer Death Anxiety Scale (T-DAS) and SF-36 Health Survey, along with chain-mediation modeling, the analysis revealed that social support exerts a direct positive influence on QoL, supplemented by indirect effects through enhanced self-esteem, reduced death anxiety, and a chained cognitive-existential mechanism linking these factors. These insights highlight the complex psychosocial dynamics of post-transplant adaptation, advocating for targeted and culturally attuned interventions. These interventions include family-based support programs, self-esteem enhancement strategies, and death anxiety counseling. The aim is to promote holistic rehabilitation and sustained well-being among heart transplant recipients in China’s context. Full article

This essay explores whether romantic exclusivity is more than a cultural choice, suggesting it might be built into the very structure of love. Turning away from typical sociological or psychological explanations, I place classical philosophy in direct conversation with contemporary thinkers like Natasha McKeever, Christopher Bennett, and Carrie Jenkins to investigate this question. I argue that a synthesis of three distinct philosophical frameworks reveals exclusivity as a structural requirement for romantic love in its deepest sense. First, drawing on Kant, I suggest that love’s demand for a totalizing cognitive synthesis of two lives runs into a transcendental barrier when attempted with more than one person. Second, I use Scheler’s phenomenology to argue that the deep, sustained attention required for love’s unique power of value revelation is inherently diluted across multiple partners. Third, I introduce Schopenhauer’s metaphysics to posit that divided romantic striving contradicts the indivisible nature of the Will. I also briefly touch on how thinkers like Kierkegaard and Levinas reinforce this theme of existential singularity. Taken together, this synthesis does not condemn non-monogamous relationships but reframes the debate. It suggests that what we call “romantic love” may be structurally distinct from other valuable forms of intimacy. The powerful pull toward exclusivity, then, might not be a mere social script but may reflect the fundamental architecture of consciousness, valuation, and being itself. Full article

Background: Evidence is growing that psychedelic substances have positive effects in the setting of Palliative Care (PC), focusing on special needs in this patient population. After a scoping review of the literature, no published expert recommendations guiding best practice for psychedelic-assisted therapy (PAT) towards the end of life were identified. Objective: To draw conclusions from first-hand experienced professionals on PAT in PC (PATPC). Setting, Design, Participants: An international workshop with experts was held in Wasserfallen, Switzerland. A thematic analysis of a semi-structured, questionnaire-based qualitative study with 13 experts in PC, oncology, psychiatry/psychology, and PAT from Europe, the United States, and Oceania was made. Measurements: The questionnaire was designed to elicit the participant’s perspectives on (A) special considerations on PATPC, (B) specific characteristics of PATPC (versus mental illness), and (C) the relevance of these differences during preparation, substance dosing session, and integration in PATPC. Results: (A) Special Considerations included (non-medicalized) setting, potential need, and possibility to reduce preparation time. (B) Distinguishing characteristics included the patient’s intrinsic motivation for treatment success, the importance of anxiety, depression, and spiritual distress as indications for PATPC, and the importance of sufficient integration of the psychedelic experience into life in the face of limited time due to the life-limiting illness. (C) Flexibility in setting and timing of preparation, choosing the appropriate dosage of the psychedelic substance depending on the patient’s intended focus, low/medium (relational issues), higher for transcendental experiences, considering mental capacity and vulnerability for the individual. In addition, respondents noted that for therapists, knowledge about transcendental states, such as mystical experiences, existential aspects of life-threatening illness, and the role of therapists’ own self-experience/inner work, as well as good knowledge of the theoretical basis for treatment, was highlighted. Conclusions: This study highlights special considerations for PAT PC and could be a first step towards specific treatment recommendations (guidelines) for PATPC. Full article

Employee well-being is essential for organizational growth and success in stable times and is even more critical during crises and life-threatening events. Although the COVID-19 pandemic highlighted the importance of holistic approaches to sustaining employee well-being, limited research has been conducted to identify strategies for maintaining employee well-being and preventing burnout during life-threatening events, such as wars or terrorist attacks. Addressing this gap, the current study investigates how and why a range of organizational resources (i.e., perceived organizational support, managerial accessibility, and psychological safety) and personal resources (i.e., hope and paradox mindset) contribute to reducing employee burnout in times of existential threat. Drawing on Conservation of Resources (COR) theory, we propose that employee well-being mediates the relationship between organizational and personal resources and burnout at work. Data were collected through an online two-wave survey administered by a professional survey firm with access to a diverse pool of Israeli employees across occupations and work roles in November (time 1) and December 2023 (time 2), following the October 7 terrorist attack by Hamas. A time-lagged design, with key outcomes collected one month after the predictors, was employed to reduce the risk of common method bias. The data were analyzed using path analysis with bootstrapped indirect effects. The results demonstrate that hope, organizational support, psychological safety, and managerial accessibility positively contribute to employee well-being, which, in turn, is associated with lower levels of burnout. Theoretical and practical implications of these results are discussed. Full article

Attachment theory, originally developed to explain interpersonal relationships, may also be relevant to understanding the psychological aspects of group belonging. Accordingly, the current study examined the role of attachment to Israel as a group of belonging in shaping mental health outcomes among Israeli citizens following the October 7th attack, focusing on psychological mechanisms involving meaning in life and intolerance of uncertainty. A sample of 1179 participants completed an online survey assessing attachment to Israel, sense of meaning in life, intolerance of uncertainty, and mental health. Path analysis revealed that attachment to Israel was positively associated with better mental health, both directly and indirectly through two key mechanisms: a stronger sense of meaning in life and lower intolerance of uncertainty. Specifically, attachment to Israel was positively associated with meaning in life, which, in turn, was significantly linked to enhanced mental well-being. Moreover, attachment to Israel was associated with lower intolerance of uncertainty, which was also positively correlated with improved mental health. These findings demonstrate that a strong attachment to Israel can enhance mental health by fostering a sense of meaning in life and reducing uncertainty. The implications of these findings are discussed within the frameworks of existential psychology, social identity theory, and attachment theory. Full article