Abstract
Recovery is a personal process of growth that involves hope, self-identity, meaning in life and responsibility. Determinants of meaning have not been explored among populations of patients with persistent psychiatric conditions. However, an evidence-based approach aiming at assessing such determinants should provide some insight into the psychotherapeutic aspects of recovery. We tested a model hypothesizing that some symptoms and social parameters of patients are related to values, and secondarily to meaning in life, and in turn that meaning is associated with various parameters, such as depressiveness and self-esteem. We assessed 176 patients with schizophrenia, anorexia, borderline personality disorder and bipolar disorder. Overall, our hypotheses proved correct: firstly, characteristics such as depression, hopelessness, self-esteem and the number of relationships influenced values; secondly, the presence and an enactment of values were associated with meaning, and thirdly, meaning was associated with some symptoms and social characteristics. This model was confirmed in the four psychiatric populations under study. These results support the relevance of addressing values and meaning in the recovery-oriented care of patients with persistent psychiatric disorders, in addition to other psychosocial interventions which are more systematically considered in this area.
Highlights
BD patients were assessed while being stabilized for several months and, as such, most of them did not suffer from current depressive episode (17 of them suffered from mild to moderate depressive episode according to the Beck Depressive Inventory (BDI-II) and the remaining 18 BD subjects had a score below 10 at the BDI-II suggesting that they did not suffer from a current depressive episode) and none of them from current manic/hypomanic episodes
Samples were similar in the LRI total score, they differed in one of the subscales (LRI Fulfilment (F = 2.93(3/175), p = 0.035), with borderline personality disorders (BPD) having the lowest scores and BD the highest ones
The present study focused on values as a mediator between various symptoms or social dimensions and meaning in life
Summary
One may infer that persons carrying the burden of a chronic psychiatric condition are challenged when searching for meaning. We made the assumption that it is possible to conduct experimental research on this issue, by testing a formerly-hypothesized model[13] This model is embedded in the bio- psycho- social paradigm[14] and relies on the current principles of cognitive behavioural approaches[15]. This model postulates that various biological (e.g. genetic), psychological (e.g. mood or cognitive “events”) and social (e.g. education or adversities) issues influence one’s values, first by allowing them to be present in one’s mind, and by allowing them to be acted upon in current life. A subject suffering from depression may lose the opportunity to promote his/ her values, due to negative thoughts and other symptoms related to his/her condition This would alter his/her sense of meaning. The study of four different psychiatric populations aims at providing a picture of distinct alterations of meaning and values depending on specificities of these disorders
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