Abstract
Meaning in life is a multi-faceted construct that has been conceptualized in diverse ways. It refers broadly to the value and purpose of life, important life goals, and for some, spirituality. We developed a measure of meaning in life derived from this conceptualization and designed to be a synthesis of relevant theoretical and empirical traditions. Two samples, all cancer patients, provided data for scale development and psychometric study. From exploratory and confirmatory factor analyses the Meaning in Life Scale (MiLS) emerged, and includes four aspects: Harmony and Peace, Life Perspective, Purpose and Goals, Confusion and Lessened Meaning, and Benefits of Spirituality. Supporting data for reliability (internal consistency, test–retest) and construct validity (convergent, discriminant, individual differences) are provided. The MiLS offers a theoretically based and psychometrically sound assessment of meaning in life suitable for use with cancer patients.
Similar content being viewed by others
References
Frankl VE (1963) Man’s Search for Meaning: An Introduction to Logotherapy (Original work published 1959). Lasch I. Pocket Books, New York
Baumeister R (1991) Meanings of Life. The Guilford Press, New York
Klinger E. The Search for Meaning in Evolutionary Perspective and its Clinical Implications, In: Wong PTP, Fry PS (eds), The Human Quest for Meaning: A Handbook of Psychological Research and Clinical Applications. Mahwah, NJ: Lawrence Erlbaum Associates, Inc., 1998: 27–50.
Maddi SR (1967) The existential neuroses. J Abnorm Psychol 72:311–325
Reker GT, Wong PTP. Aging as an Individual Process: Toward a Theory of Personal Meaning, In: Birren JE, Bengtson VL (eds), Emergent Theories of Aging. New York: Springer Publishing Company, 1988: 214–246.
Yalom ID (1980) Existential Psychotherapy. Basic Books, New York
Crumbaugh JC, Maholick LT (1964) An experimental study in existentialism: The psychometric approach to Frankl’s concept of noogenic neurosis. J Clin Psychol 20:200–207
Battista J, Almond R (1973) The development of meaning in life. Psychiatry 36:409–427
Vickberg SM, Bovbjerg DH, DuHamel KN, Currie V, Redd WH (2000) Intrusive thoughts and psychological distress among breast cancer survivors: Global meaning as a possible protective factor. Behav Med 25:152–160
Bower JE, Kemeny ME, Taylor SE, Fahey JL (2003) Finding positive meaning and its association with natural killer cell cytotoxicity among participants in a bereavement-related disclosure intervention. Ann Behav Med 25:146–155
O’Connor AP, Wicker CA, Germino BB (1990) Understanding the cancer patient’s search for meaning. Cancer Nurs 13:167–175
Hill PC, Pargament KI, Hood RW, et al (2000) Conceptualizing religion and spirituality: Points of commonality, points of departure. J Theor Soc Behav 30:51–77
Reker GT (2000) Theoretical perspective, dimensions, and measurement of existential meaning. In: Reker GT, Chamberlain K (eds), Exploring Existenial Meaning: Optimizing Human Development Across the Life Span. Sage, Thousand Oaks CA, pp 39–55
Park CL, Folkman S (1997) Meaning in the context of stress and coping. Rev Gen Psychol 1:115–144
Frankl VE. The Doctor and the Soul: An Introduction to Logotherapy (Original work published 1946). translated by Winston R, Winston C. New York: Knopf, 1955.
Starck PL (1983) Patients’ perceptions of the meaning of suffering. Int Forum Logotherapy 6:110–116
Janoff-Bulman R (1989) Assumptive worlds and the stress of traumatic events: Applications of the schema construct. Soc Cognition 7:113–136
Fife BL (1995) The measurement of meaning in illness. Soc Sci Med 40:1021–1028
Thompson SC, Sobolew-Shubin A, Graham MA, Janigian AS (1989) Psychosocial adjustment following a stroke. Soc Sci Med 28:239–247
Andersen BL, Farrar WB, Golden-Kreutz D, et al (1998) Stress and immune responses after surgical treatment for regional breast cancer. J Natl Cancer Inst 90:30–36
Jemal A, Murray T, Ward E, et al (2005) Cancer statistics, 2005. CA Cancer J Clin 55:10–30
Collins RL, Taylor SE, Skokan LA (1990) A better world or a shattered vision? Changes in life perspectives following victimization. Soc Cognition 8:263–285
Prager E, Solomon Z (1995) Perceptions of world benevolence, meaningfulness, and self-worth among elderly Israeli holocaust survivors and non-survivors. Anxiety Stress Copin 8:265–277
Bower JE, Meyerowitz BE, Desmond KA, Bernaards CA, Rowland JH, Ganz PA (2005) Perceptions of positive meaning and vulnerability following breast cancer: Predictors and outcomes among long-term breast cancer survivors. Ann Behav Med 29:236–245
Schnoll RA, Knowles JC, Harlow L (2002) Correlates of adjustment among cancer survivors. J Psychosoc Oncol 20:37–60
Vickberg SMJ, Duhamel KN, Smith MY, et al (2001) Global meaning and psychological adjustment among survivors of bone marrow transplant. Psychooncology 10:29–39
Peterman AH, Fitchett G, Brady MJ, Hernandez L, Cella D (2002) Measuring spiritual well-being in people with cancer: The Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being Scale (FACIT-Sp). Ann Behav Med 24:49–58
Johnson SC, Spilka B (1991) Coping with breast cancer: The roles of clergy and faith. J Relig Health 30:21–33
Carver CS, Pozo C, Harris SD, et al (1993) How coping mediates the effects of optimism on distress: A study of women with early stage breast cancer. J Pers Soc Psychol 65:375–390
Beck AT, Rush AJ, Shaw BF, Emery G (1979) Cognitive Therapy of Depression. Guildford Press, New York
Brewin CR, Power MJ (1997) Meaning and psychological therapy: Overview and introduction. In: Power MJ, Brewin CR (eds), The Transformation of Meaning in Psychological Therapies. Chichester, Wiley, pp 1–14
Biswas-Diener R, Diener E (2001) Making the best of a bad situation: Satisfaction in the slums of Calcutta. Soc Indic Res 55:329–352
Andersen BL, Anderson B, DeProsse C (1989) Controlled prospective longitudinal study of women with cancer: II. Psychological outcomes. J Consult Clin Psychol 57:692–697
Hughes J (1982) Emotional reactions to the diagnosis and treatment of early breast cancer. J Psychosom Res 26: 277–283
Northouse L (1989) A longitudinal study of the adjustment of patients and husbands to breast cancer. Oncol Nurs Forum 16:511–516
Campbell DT, Fiske DW (1959) Convergent and discriminant validation by the multitrait-multimethod matrix. Psychol Bull 56:81–105
Cronbach LJ, Meehl PE (1955) Construct validity in psychological tests. Psychol Bull 52:281–302
Helgeson VS, Cohen S (1996) Social support and adjustment to cancer: Reconciling descriptive, correlational, and intervention research. Health Psychol 15:135–148
Andersen BL, Farrar WB, Golden-Kreutz DM, et al (2004) Psychological, behavioral, and immune changes after a psychological intervention: A clinical trial. J Clin Oncol 22:3570–3580
Community health assessments and the center for public health data and statistics [Data File]. Columbus, OH. Ohio Department of Health, 2002
Surveillance, Epidemiology, and End Results Program (SEER) [Data File]. Rockville, MD. Division of Cancer Control and Population Sciences, National Cancer Institute, 2000
Ware JE, Kosinski M, Keller SD (1994) SF-36 Physical and Mental Health Summary Scales: A User’s Manual. Health Assessment Lab, Boston
Ware JE, Snow KK, Kosinski M (2000) SF-36 Health Survey: Manual and Interpretation Guide. Quality Metric Incorporated, Lincoln, RI
Comstock GW, Helsing KJ (1976) Symptoms of depression in two communities. Psychol Med 6:551–563
Radloff LS (1977) The CES-D Scale: A self-report depression scale for research in the general population. App Psych Meas 1:385–401
Devins GM, Orme CM, Costello CG, et al (1988) Measuring depressive symptoms in illness populations: Psychometric properties of the Center for Epidemiologic Studies Depression (CES-D) scale. Psychol Health 2:139–156
Andresen EM, Malmgren JA, Carter WB, Patrick DL (1994) Screening for depression in well older adults: Evaluation of a short form of the CESD. Am J Prev Med 10:77–84
McNair DM, Lorr M, Droppleman LF (1971) EITS Manual for the Profile of Mood States. Educational and Industrial Testing Service, San Diego
Procidano ME, Heller K (1983) Measures of perceived social support from friends and from family: Three validation studies. Am J Community Psychol 11:1–24
Berkman LF. Social networks, host resistance, and mortality: A follow-up study of Alameda County residents. Dissertation Abstracts International 39: 671–672
Goldberg LR (1992) The development of markers for the Big-Five factor structure. Psychol Assessment 4:26–42
Reynolds WM (1982) Development of reliable and valid short forms of the Marlowe-Crowne Social Desirability Scale. J Clin Psychol 38:119–125
Crowne DP, Marlowe D (1960) A new scale of social desirability independent of psychopathology. J Consult Psychol 24:349–354
Hutzell RR (1986) Meaning and purpose in life: Assessment techniques of logotherapy. Hosp J 2:37–50
Hyland ME, Kenyon CP (1992) A measure of positive health-related quality of life: The Satisfaction with Illness Scale. Psychol Rep 71:1137–1138
Paloutzian RF, Ellison CW (1982) Loneliness, spiritual well-being, and the quality of life. In: Palau LA, Perlman D (eds), Loneliness: A Sourcebook of Current Theory, Research, and Therapy. John Wiley and Sons, New York, pp 224–237
Tabachnik BG, Fidell LS (2001) Using multivariate statistics (4th ed). Allyn and Bacon, Needham Heights, MA
Crawford CB, Ferguson GA (1970) A general rotation criterion and its use in orthogonal rotation. Psychometrika 35:321–332
Fabrigar LR, Wegener DT, MacCallum RC, Strahan EJ (1999) Evaluating the use of exploratory factor analysis in psychological research. Psychol Methods 4:272–299
Browne MW, Cudeck R, Tateneni K, Mels G (1998) CEFA: Comprehensive Exploratory Factor Analysis. Software. The Ohio State University, Columbus, OH
Browne MW, Cudeck R (1992) Alternative ways of assessing model fit. Soc Method Res 21:230–258
Nunnally JC, Bernstein LH (1994) Psychometric Theory. McGraw-Hill, New York
Marsh HW, Hocevar D. Application of confirmatory factor analysis to the study of self-concept: First- and higher order factor models and their invariance across groups. Psychol Bull 1985; 97: 562–582
Cortina JM (1993) What is coefficient alpha? An examination of theory and applications. J Appl Psychol 78:98–104
Davis CG, Nolen-Hoeksema S, Larson J (1998) Making sense of loss and benefiting from the experience: Two construals of meaning. J Pers Soc Psychol 75:561–574
Durkheim E. Suicide: A Study of Sociology. translated by Spaulding JA, Simpson G. New York: The Free Press, 1951
Thoits PA (1983) Multiple identities and psychological well-being: A reformulation and test of the social isolation hypothesis. Am Sociol Rev 48:174–187
Wethington E, Kessler RC (1986) Perceived support, received support, and adjustment to stressful life events. J Health Soc Behav 27:78–89
Watson D, Clark LA, Harkness AR (1994) Structures of personality and their relevance to psychopathology. J Abnorm Psychol 103:18–31
True G, Phipps EJ, Braitman LE, Harralson T, Harris D, Tester W (2005) Treatment preferences and advance care planning at end of life: The role of ethnicity and spiritual coping in cancer patients. Ann Behav Med 30:174–179
Csikzentmihalyi M (1990) Flow: The Psychology of Optimal Experience. HarperPerennial, New York
Fredrickson BL (1998) What good are positive emotions? Rev Gen Psychol 2:300–319
Gotay CC, Muraoka MY (1998) Quality of life in long-term survivors of adult-onset cancers. J Natl Cancer Inst 90:656–667
Folkman S (1997) Positive psychological states and coping with severe stress. Soc Sci Med 45:1207–1221
Brady MJ, Peterman AH, Fitchett G, Mo M, Cella D (1999) A case for including spirituality in quality of life measurement in oncology. Psychooncology 8:417–428
Jim HS, Richardson SA, Golden-Kreutz DM, Andersen BL. Strategies used in coping with a cancer diagnosis predict meaning in life for survivors. Health Psychol 25.
Jim HS, Andersen BL. Meaning in life mediates the relationship between social and physical functioning and distress in cancer survivors. Brit J Health Psych, in press.
Waterman AS (1984) The Psychology of Individualism. Praeger, New York
Waterman AS (1993) Two conceptions of happiness: Contrasts of personal expressiveness (eudaimonia) and hedonic enjoyment. J Pers Soc Psychol 64:678–691
Maddi SR. The search for meaning. In A. Williams, M. Page (Eds.) (pp 134–183). Lincoln, NE: University of Nebraska Press. Nebr Symp Motiv 1970.
Clark DA, Beck AT, Alford BA. Scientific Foundations of Cognitive Theory and Therapy of Depression In: Williams A, Page M (eds.), Lincoln, NE: University of Nebraska Press, Hoboken, NJ: John Wiley & Sons, Inc., 1999.
Dykman BM (1998) Integrating cognitive and motivational factors in depression: Initial tests of a goal-orientation approach. J Pers Soc Psychol 74:139–158
Tedeschi RG, Calhoun LG (1996) The Posttraumatic Growth Inventory: Measuring the positive legacy of trauma. J Trauma Stress 9:455–472
Tomich PL, Helgeson VS (2004) Is finding something good in the bad always good? Benefit finding among women with breast cancer. Health Psychol 23:16–23
Thompson SC (1985) Finding positive meaning in a stressful event and coping. Basic Appl Soc Psych 6:279–295
Bower JE, Kemeny ME, Taylor SE, Fahey JL (1998) Cognitive processing, discovery of meaning, CD4 decline, and AIDS-related mortality among bereaved HIV-seropositive men. J Consult Clin Psychol 66:979–986
Anastasi A, Urbina S. Psychological testing 7th ed. New Jersey: Prentice Hall, 1997.
Acknowledgements
Preparation of this manuscript was supported in part by the American Cancer Society (PBR-89), Longaberger Company-American Cancer Society Grant for Breast Cancer Research (PBR-89A), U.S. Army Medical Research Acquisition Activity Grants (DAMD17–94-J-4165; DAMD17– 96-1–6294; DAMD17–97-1–7062), National Institutes of Mental Health (RO1 MH51487), the National Cancer Institute (RO1 CA92704; KO5 CA098133) awarded to B.L. Andersen, the Ohio State University Alumni Grant for Graduate Research and Scholarship to H. Jim, and The Ohio State University Comprehensive Cancer Center (NCI, P30 CA16058). We wish to thank participants for their continuing and new involvement in the research. We thank Lynn Neely for her early contributions in measure development, Anna Han for early technical assistance with the web study, the professional and research staff of the Stress and Immunity Breast Cancer Project, and Drs. Timothy Crespin and Hae-Chung Yang for statistical efforts.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Jim, H.S., Purnell, J.Q., Richardson, S.A. et al. Measuring meaning in life following cancer. Qual Life Res 15, 1355–1371 (2006). https://doi.org/10.1007/s11136-006-0028-6
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11136-006-0028-6