Uniwersyteckie Czasopisma NaukoweWhich dimensions of forgiveness mediate and moderate childhood trauma and depression? Insights to prevent suicide risk among university students
Słowa kluczowe:
depression, forgiveness, adverse childhood experiences, Indonesian undergraduate student, Beck Depression Inventory-IIAbstrakt
Background:
College students who are depressed as a direct or indirect effect of childhood trauma are at risk of suicide. Although for-giveness buffers mental health problems, there are inconsistencies in the results according to the object of forgiveness. This study aimed to examine the role of forgiveness, both as a mediator and as a moderator, for the association between childhood trauma and depression among university students.
Participants and procedure:
The sample comprised 398 students from a university in Semarang, Indonesia (M = 18.60, SD = 0.60, male = 26.1%) ob-tained through cluster random sampling. Measurements used were the Adverse Childhood Experiences (ACEs) question-naire, Beck Depression Inventory-II (BDI-II) and the Forgiveness Scale which contained the dimensions of self, others, and situations.
Results:
The path analysis and the investigation of CI result showed that forgiveness mediated the relationship between ACEs and depression. Forgiveness of self and situations were also mediating, but not forgiveness of others. On the other hand, the moderating effect only applied to the forgiveness of others, the effect of which increased positively when the level was high.
Conclusions:
The result of this study indicates how the addition of ACEs affects lower level of forgiveness, thus explaining the higher level of depression among college students. Only forgiveness of others among the dimensions of forgiveness is not deter-mined by the number of ACEs, but its increase determines the addition of depression level when there are more ACEs. The discussions highlight the mechanism of each dimension, contribution of collectivistic culture, different types of ACEs and limited incidence of ACEs among the general college student population.
Downloads
Bibliografia
Akhtar, S. (2013). Good stuff: Courage, resilience, gratitude, generosity, forgiveness, and sacrifice. Jason Aronson.
Akram, U., Ypsilanti, A., Gardani, M., Irvine, K., Allen, S., Akram, A., Drabble, J., Bickle, E., Kaye, L., Lipinski, D., Matuszyk, E., Sarlak, H., Steedman, E., & Lazuras, L. (2020). Prevalence and psychiatric correlates of suicidal ideation in UK university students. Journal of Affective Disorders, 272, 191–197. https://doi.org/10.1016/J.JAD.2020.03.185.
Arslan, G. (2017). Psychological maltreatment, forgiveness, mindfulness, and internet addiction among young adults: a study of mediation effect. Computers in Human Behavior, 72, 57–66. https:// doi.org/10.1016/j.chb.2017.02.037.
Astutik, E., Sebayang, S. K., Puspikawati, S. I., Tama, T. D., & Dewi, D. M. S. K. (2020). Depression, anxiety, and stress among students in newly established remote university campus in Indonesia. Malaysian Journal of Medicine and Health Sciences, 16, 270–277.
Banyard, V., Hamby, S., & Grych, J. (2017). Health effects of adverse childhood events: Identifying promising protective factors at the intersection of mental and physical well-being. Child Abuse and Neglect, 65, 88–98. https://doi.org/10.1016/j. chiabu.2017.01.011.
Beck, A. T., Steer, R. A., & Brown, G. K. (1996). Manual for the Beck Depression Inventory II. Psychological Corporation.
Beiter, R., Nash, R., McCrady, M., Rhoades, D., Linscomb, M., Clarahan, M., & Sammut, S. (2015). The prevalence and correlates of depression, anxiety, and stress in a sample of college students. Journal of Affective Disorders, 173, 90–96. https://doi. org/10.1016/j.jad.2014.10.054.
Cerci, D., & Colucci, E. (2018). Forgiveness in PTSD after man-made traumatic events: a systematic review. Traumatology, 24, 47–54. https://doi.org/ 10.1037/trm0000130.
Chang, E. C., Kahle, E. R., Yu, E. A., & Hirsch, J. K. (2014). Understanding the relationship between domestic abuse and suicide behavior in adults receiving primary care: Does forgiveness matter? Social Work, 59, 315–320. https://doi.org/10.1093/sw/swu028.
Chen, L., Wang, L., Qiu, X. H., Yang, X. X., Qiao, Z. X., Yang, Y. J., & Liang, Y. (2013). Depression among Chinese university students: Prevalence and sociodemographic correlates. PLoS One, 8, e0058379. https://doi.org/10.1371/journal.pone.0058379.
Cleare, S., Gumley, A., & O’Connor, R. C. (2019). Selfcompassion, self- forgiveness, suicidal ideation and self-harm: a systematic review. Clinical Psychology and Psychotherapy, 26, 511–530. https:// doi.org/10.1002/cpp.2372.
Coates, A. A., & Messman-Moore, T. L. (2014). A structural model of mechanisms predicting depressive symptoms in women following childhood psychological maltreatment. Child Abuse and Neglect, 38, 103–113. https://doi.org/10.1016/j.chiabu.2013.10.005.
Cook, A., Spinazzola, J., Ford, J., Lanktree, C., Blaustein, M., Cloitre, M., DeRosa, R., Hubbard, R., Kagan, R., Liautaud, J., Mallah, K., Olafson, E., & van der Kolk, B. (2005). Complex trauma in children and adolescents. Psychiatric Annals, 35, 390–398. https://doi.org/10.3928/00485713-20050501-05.
Crandall, A., Miller, J. R., Cheung, A., Novilla, L. K., Glade, R., Novilla, M., Magnusson, B. M., Leavitt, B. L., Barnes, M. D., & Hanson, C. L. (2019). ACEs and counter-ACEs: How positive and negative childhood experiences influence adult health. Child Abuse & Neglect, 96, 104089. https://doi.org/10.1016/j.chiabu.2019.104089.
Davis, D. E., Ho, M. Y., Griffin, B. J., Bell, C., Hook, J. N., Van Tongeren, D. R., DeBlaere, C., Worthington, E. L., & Westbrook, C. J. (2015). Forgiving the self and physical and mental health correlates: a meta-analytic review. Journal of Counseling Psychology, 62, 329–335. https://doi.org/10.1037/cou0000063.
Enright, R. D., Freedman, S., & Rique, J. (1998). The psychology of interpersonal forgiveness. University of Wisconsin Press.
Felitti, V. J., Anda, R. F., Nordenberg, D., Williamson, D. F., Spitz, A. M., Edwards, V., Koss, M. P., & Marks, J. S. (1998). Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults. The Adverse Childhood Experiences (ACE) Study. American Journal of Preventive Medicine, 14, 245–258. https:// doi.org/10.1016/s0749-3797(98)00017-8.
Finkelhor, D. (2020). Trends in adverse childhood experiences (ACEs) in the United States. Child Abuse & Neglect, 108, 104641. https://doi.org/10.1016/j.chiabu.2020.104641.
Gabriels, J. B., & Strelan, P. (2017). For whom we forgive matters: Relationship focus magnifies, but self-focus buffers against the negative effects of forgiving an exploitative partner. British Journal of Social Psychology, 57, 154–173. https://doi. org/10.1111/bjso.12230 GBD 2019.
Diseases and Injuries Collaborators (2020). Global burden of 369 diseases and injuries in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019.
The Lancet, 396, 1204–1222. https://doi. org/10.1016/S0140-6736(20)30925-9.
Gençoğlu, C., Şahin, E., & Topkaya, N. (2018). General self-efficacy and forgiveness of self, others, and situations as predictors of depression, anxiety, and stress in university students. Educational Sciences: Theory & Practice, 18, 605–626. https://doi.org/10.12738/estp.2018.3.0128.
Ginting, H., Näring, G., van der Veld, W. M., Srisayekti, W., & Becker, E. S. (2013). Validating the Beck Depression Inventory-II in Indonesia’s general population and coronary heart disease patients. International Journal of Clinical and Health Psychology, 13, 235–242. https://doi.org/10.1016/ s1697-2600(13)70028-0.
Gselamu, L., & Ha, K. (2020). Attitudes towards suicide and risk factors for suicide attempts among university students in South Korea. Journal of Affective Disorders, 272, 166–169. https://doi.org/10.1016/j. jad.2020.03.135.
Hayes, A. F. (2018). Introduction to mediation, moderation, and conditional process analysis: a regression-based approach (2nd ed.). Guilford Press.
He, Y., Zhang, Y., Cui, X., Zhong, Y., He, W., Liu, J., Luo, X., & Gong, J. (2021). Epidemiology of major childhood adversities and its effect on depression and suicide attempts in Chinese college students. Journal of Affective Disorders, 281, 331–337. https://doi.org/10.1016/j.jad.2020.12.031.
Hirsch, J. K., Webb, J. R., & Jeglic, E. L. (2012). Forgiveness as a moderator of the association between anger expression and suicidal behaviour. Mental Health, Religion, & Culture, 15, 279–300. https:// doi.org/10.1080/13674676.2011.571666.
Hook, J. N., Worthington, E. L., Utsey, S. O., Davis, D. E., & Burnette, J. L. (2012). Collectivistic self-construal and forgiveness. Counseling and Values, 57, 109–124. https://doi.org/10.1002/j.2161- 007x.2012.00012.x.
Hovens, J. G., Giltay, E. J., Spinhoven, P., van Hemert, A. M., & Penninx, B. W. (2015). Impact of childhood life events and childhood trauma on the onset and recurrence of depressive and anxiety disorders. The Journal of Clinical Psychiatry, 76, 931–938. https://doi.org/10.4088/JCP.14m09135.
Huh, H. J., Kim, S., Yu, J. J., & Chae, J. (2014). Childhood trauma and adult interpersonal relationship problems in patients with depression and anxiety disorders. Annals of General Psychiatry, 13, 26 https://doi.org/10.1186/s12991-014-0026-y.
Ibrahim, A. K., Kelly, S. J., Adams, C. E., & Glazebrook, C. (2013). A systematic review of studies of depression prevalence in university students. Journal of Psychiatric Research, 47, 391–400. https://doi. org/10.1016/j.jpsychires.2012.11.015.
Jones Ross, R. W., Boon, S. D., & Stackhouse, M. R. D. (2017). Redefining unforgiveness: Exploring victims’ experiences in the wake of unforgiven interpersonal transgressions. Deviant Behavior, 39, 1069–1081. https://doi.org/10.1080/01639625.2017.1399747.
Ju, Y., Wang, M., Lu, X., Sun, J., Dong, Q., Zhang, L., Liu, B., Liu, J., Yan, D., Guo, H., Zhao, F., Liao, M., Zhang, X., Zhang, Y., & Li, L. (2020). The effects of childhood trauma on the onset, severity and improvement of depression: The role of dysfunctional attitudes and cortisol levels. Journal of Affective Disorders, 276, 402–410. https://doi.org/10.1016/j.jad.2020.07.023.
Kaleta, K., & Mróz, J. (2020). The relationship between basic hope and depression: Forgiveness as a mediator. Psychiatric Quarterly, 91, 877–886. https://doi.org/10.1007/s11126-020-09759-w.
Kaloeti, D. V. S., Rahmandani, A., Sakti, H., Salma, S., Suparno, S., & Hanafi, S. (2019). Effect of childhood adversity experiences, psychological distress, and resilience on depressive symptoms among Indonesian university students. International Journal of Adolescence and Youth, 24, 177–184. https://doi.org/ 10.1080/02673843.2018.1485584 .
Karremans, J. C., Regalia, C., Paleari, F. G., Fincham, F. D., Cui, M., Takada, N., Ohbuchi, K. I., Terzino, K., Cross, S. E., & Uskul, A. K. (2011). Maintaining harmony across the globe. Social Psychological and Personality Science, 2, 443–451. https:// doi.org/10.1177/1948550610396957.
Kelifa, M. O., Yang, Y., Herbert, C., He, Q., & Wang, P. (2020). Psychological resilience and current stressful events as potential mediators between adverse childhood experiences and depression among college students in Eritrea. Child Abuse & Neglect, 106, 104480. https://doi.org/10.1016/J.CHIABU.2020.104480.
Kliethermes, M., Schacht, M., & Drewry, K. (2014). Complex trauma. Child and adolescent. Psychiatric Clinics of North America, 23, 339–361. https:// doi.org/10.1016/j.chc.2013.12.009.
Krejcie, R. V., & Morgan, D. W. (1970). Determining sample size for research activities. Educational and Psychological Measurement, 30, 607–610. https://doi.org/10.1177/001316447003000308.
Lawson, D. M., & Quinn, J. (2013). Complex trauma in children and adolescents: Evidence-based practice in clinical settings. Journal of Clinical Psychology, 69, 497–509. https://doi.org/10.1002/jclp.21990.
Leach, M. M., & Parazak, S. (2015). Culture, forgiveness, and health. In L. L. Toussaint, E. L. Worthington, Jr., & D. R. Williams (Eds.), Forgiveness and health: Scientific evidence and theories relating forgiveness to better health (pp. 221–235). Springer Science+Business Media.
Lei, X. Y., Xiao, L. M., Liu, Y. N., & Li, Y. M. (2016). Prevalence of depression among Chinese university students: a meta-analysis. PLoS One, 11, e0153454. https://doi.org/10.1371/journal.pone.015345.4
Liang, L., Zhou, D., Yuan, C., Shao, A., & Bian, Y. (2016). Gender differences in the relationship between internet addiction and depression: a crosslagged study in Chinese adolescents. Computers in Human Behavior, 63, 463–470. https://doi.org/10.1016/j.chb.2016.04.043.
Liu, Y., Wu, A. D., & Zumbo, B. D. (2010). The impact of outliers on Cronbach’s coefficient alpha estimate of reliability: Ordinal/rating scale item responses. Educational and Psychological Measurement, 70, 5–21. https://doi.org/10.1177/0013164409344548.
Lopez, S. J., Pedrotti, J. T., & Snyder, C. R. (2015). Positive psychology: The scientific and practical explorations of human strengths (3rd ed.). SAGE Publications.
Madsen, J., & Harris, K. M. (2021). Negative self-appraisal: Personal reasons for dying as indicators of suicidality. PLoS One, 16, e0246341. https://doi.org/10.1371/journal.pone.0246341.
Marthoenis, M. I., Fathiariani, L., & Sofyan, H. (2018). Prevalence of depression and anxiety among college students living in a disaster-prone region. Alexandria Journal of Medicine, 54, 337–340. https://doi.org/10.1016/j.ajme.2018.07.002.
McCullough, M. E., & Witvliet, V. O. (2002). The psychology of forgiveness. Oxford University Press. McKeen, H., Hook, M., Podduturi, P., Beitzell, E., Jones, A., & Liss, M. (2021). Mindfulness as a mediator and moderator in the relationship between adverse childhood experiences and depression. Current Psychology. https://doi.org/10.1007/s12144-021-02003-z.
Megawati, A. H., Dannisworo, C. A., & Hanum, L. (2018). The impact of negative symptoms and selfcriticism on the urge to self-injure. Advances in Social Science, Education and Humanities Research, 229, 216–227. https://doi.org/10.2991/iciap-18.2019.18.
Mersky, J. P., Janczewski, C. E., & Topitzes, J. (2017). Rethinking the measurement of adversity: Moving toward second-generation research on adverse childhood experiences. Child Maltreatment, 22, 58–68. https://doi.org/10.1177/1077559516679513.
Ministry of Health of the Republic of Indonesia (2019). National report 2018. Retrieved from http:// labdata.litbang.kemkes.go.id/images/download/laporan/RKD/2018/Laporan_Nasional_RKD2018_ FINAL.pdf.
Mojallal, M., Simons, R. M., & Simons, J. S. (2021). Childhood maltreatment and adulthood proneness to shame and guilt: The mediating role of maladaptive schemas. Motivation and Emotion, 45, 197–210. https://doi.org/10.1007/s11031-021-09866-6.
Murphy, S., Shevlin, M., Armour, C., Elklit, A., & Christoffersen, M. N. (2014). Childhood adversity and PTSD experiences: Testing a multiple mediator model. Traumatology, 20, 225–231. https:// doi.org/10.1037/h0099838.
Nelson, J., Klumparendt, A., Doebler, P., & Ehring, T. (2017). Childhood maltreatment and characteristics of adult depression: a meta-analysis. British Journal of Psychiatry, 210, 96–104. https://doi. org/10.1192/bjp.bp.115.180752.
Othieno, C. J., Okoth, R. O., Peltzer, K., Pengpid, S., & Malla, L. O. (2014). Depression among university students in Kenya: Prevalence and sociodemographic correlates. Journal of Affective Disorders, 165, 120–125. https://doi.org/10.1016/J.JAD.2014.04.070.
Panagioti, M., Gooding, P. A., & Tarrier, N. (2012). Hopelessness, defeat, and entrapment in posttraumatic stress disorder. The Journal of Nervous and Mental Disease, 200, 676–683. https://doi.org/10.1097/NMD.0b013e3182613f91.
Peltzer, K., Yi, S., & Pengpid, S. (2017). Suicidal behaviors and associated factors among university students in six countries in the Association of Southeast Asian Nations (ASEAN). Asian Journal of Psychiatry, 26, 32–38. https://doi.org/10.1016/j.ajp.2017.01.019.
Rahmandani, A., Kaloeti, D. V. S., Salma, S., Sakti, H., & Suparno, S. (2020). Relationship between forgiveness, triadic forgiveness dimensions, and resilience in Javanese emerging adults. Advances in Social Science, Education and Humanities Research, 494, 11–34. https://doi.org/10.2991/assehr.k.201125.002.
Rahmandani, A., La Kahija, Y. F., & Salma, S. (2016). Forgiveness meditation to increase self-forgiveness, forgiveness of others, and forgiveness of situations for students (unpublished research report). Universitas Diponegoro, Semarang, Indonesia.
Ramsey, J. C. (2019). Gratitude and forgiveness as moderators of depression, cognitive distortions, and perceived peer relationships in late adolescence. Retrieved from https://www.proquest.com/ dissertations-theses/gratitude-forgiveness-asmoderators-depression/docview/2228384364/se2?accountid=49069.
Sandage, S. J., & Williamson, I. (2005). Forgiveness in cultural context. Routledge.
Santrock, J. W. (2014). Child development (14th ed.). McGraw-Hill Education.
Sheldon, E., Simmonds-Buckley, M., Bone, C., Mascarenhas, T., Chan, N., Wincott, M., Gleeson, H., Sow, K., Hind, D., & Barkham, M. (2021). Prevalence and risk factors for mental health problems in university undergraduate students: a systematic review with meta-analysis. Journal of Affective Disorders, 287, 282–292. https://doi.org/10.1016/j.jad.2021.03.054.
Sinclair, E., Hart, R., & Lomas, T. (2020). Can positivity be counterproductive when suffering domestic abuse? A narrative review. International Journal of Wellbeing, 10, 26–53. https://doi.org/10.5502/ijw.v10i1.754.
Thompson, L. Y., Snyder, C. R., Hoffman, L., Michael, S. T., Rasmussen, H. N., Billings, L. S., Heinze, L., Neufeld, J. E., Shorey, H. S., Roberts, J. C., & Roberts, D. E. (2005). Dispositional forgiveness of self, others, and situations. Journal of Personality, 73, 313– 359. https://doi.org/10.1111/j.1467-6494.2005.00311.x.
Vieira, I. S., Pedrotti Moreira, F., Mondin, T. C., Cardoso, T. A., Branco, J. C., Kapczinski, F., Jansen, K., Souza, L., & da Silva, R. A. (2020). Resilience as a mediator factor in the relationship between childhood trauma and mood disorder: a community sample of young adults. Journal of Affective Disorders, 274, 48–53. https://doi.org/10.1016/j.jad.2020.04.011.
Weissman, D. G., Lambert, H. K., Rodman, A. M., Peverill, M., Sheridan, M. A., & McLaughlin, K. A. (2020). Reduced hippocampal and amygdala volume as a mechanism underlying stress sensitization to depression following childhood trauma. Depression and Anxiety, 37, 41–48. https://doi.org/ doi:10.1002/da.23062.
Wong, A. E., Dirghangi, S. R., & Hart, S. R. (2019). Self-concept clarity mediates the effects of adverse childhood experiences on adult suicide behavior, depression, loneliness, perceived stress, and life distress. Self and Identity, 18, 247–266. https://doi.org/10.1080/15298868.2018.1439096.
Wu, Q., Chi, P., Zeng, X., Lin, X., & Du, H. (2019). Roles of anger and rumination in the relationship between self-compassion and forgiveness. Mindfulness, 10, 272–278. https://doi.org/10.1007/s12671- 018-0971-7.
