Releasing a grievance and restoring a relationship.
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301 to 325 of 561Empathy and cultural competence in clinical nurses: A structural equation modelling approach.
Background: Forgiveness has the potential to resolve painful feelings arising from nurse-patient conflicts. It would be useful to evaluate direct and indirect important factors which are related to forgiveness in order to design interventions that try to facilitate forgiveness.
Aim/objective: The purpose of this study was to evaluate the intermediating role of empathy in the cultural competence-forgiveness association among nurses using structural equation modeling.
Research design: The research applied a cross-sectional correlational design.
Participants and research context: The study included 380 nurses eight hospitals in southern Iran.
Ethical considerations: The Ethics and Research Committee of Birjand University of Medical Sciences approved the study protocol. The voluntary nature of participation was explained consent was obtained from participants, and anonymity was guaranteed.
F…
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"Opening a Door to a New Life": The Role of Forgiveness in Healing From Moral Injury.
For military veterans struggling with moral injury, forgiveness can become both an animating concern and a potential path to healing. In this perspective piece, we draw on our clinical work and research findings to examine why forgiveness matters to veterans who feel guilt and shame about their actions in war, what type of forgiveness is attainable and meaningful, and what role clinicians can play in facilitating forgiveness. We conclude by reflecting on the potential, as well as the limits and tensions, of forgiveness work in the context of military moral injury.
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I'll Never Forgive You: High Conflict Divorce, Social Network, and Co-Parenting Conflicts.
The relation between divorce, co-parenting conflicts, and children's adjustment problems has been well established. An unresolved question for research and clinical interventions, however, is how conflicts between parents are maintained and/or escalate. This cross-sectional research tested the hypothesis that co-parenting conflicts in divorced couples are associated with perceived social network disapproval and that this relation is mediated by parents' tendency to forgive each other. In Study 1, a convenience sample of 136 divorced parents recruited via online forums, we showed that perceived social network disapproval was indeed positively related to co-parenting conflicts and that parents' tendency to forgive the other parent-albeit partly-explained this relationship. Strength of our research is that in Study 2, 110 parents referred to children's mental health care because the wellbei…
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Zhang JW, Chen S (2016)MEDLINE-indexed journal, not yet read by usPersonality & social psychology bulletin26 citations Self-Compassion Promotes Personal Improvement From Regret Experiences via Acceptance.
Why do some people report more personal improvement from their regret experiences than others? Three studies examined whether self-compassion promotes personal improvement derived from recalled regret experiences. In Study 1, we coded anonymous regret descriptions posted on a blog website. People who spontaneously described their regret with greater self-compassion were also judged as having expressed more personal improvement. In Study 2, higher trait self-compassion predicted greater self-reported and observer-rated personal improvement derived from recalled regret experiences. In Study 3, people induced to take a self-compassionate perspective toward a recalled regret experience reported greater acceptance, forgiveness, and personal improvement. A multiple mediation analysis comparing acceptance and forgiveness showed self-compassion led to greater personal improvement, in part, throu…
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Use of computer simulations to test the concept of dose forgiveness in the era of extended-release (XR) drugs.
"Forgiveness" - the difference between a drug's postdose duration of action and its prescribed dosing interval - estimates the margin of therapeutic effect following a missed dose. Because this margin presumably decreases as dosing becomes less frequent, QD dosing of an antiepileptic drug (AED) is expected to be less forgiving than more frequent (e.g., BID) dosing of that same AED. However, if the AED is reformulated as an extended-release (XR) preparation, drug input may be prolonged relative to its immediate-release (IR) counterpart. It therefore stands to reason that forgiveness could be increased by an XR AED that extends the period during which therapeutic plasma concentrations are maintained if a dose is missed. Computer simulation was used to estimate forgiveness for an IR formulation of a hypothetical AED and its XR counterparts reformulated for less frequent dosing. Simulations …
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The Role of Religious Involvement in the Relationship Between Early Trauma and Health Outcomes Among Adult Survivors.
The purpose of this study was to determine the role of religious involvement and related indicators - religious coping, intrinsic religiosity, forgiveness and gratitude - in reducing the negative impact of early traumatic stress on the mental and physical health of adult survivors. Multiple linear regressions were used to analyze self-reported data of 10,283 Seventh-day Adventist men and women across North America. The study also included an original analysis on a subsample (n = 496) of the larger group, examining diabetes risk factors in conjunction with Adverse Childhood Events (ACE) data. Higher early trauma scores were associated with decreased mental health (B = -1.93 p < .0001) and physical health (B = -1.53, p < .0001). The negative effect of early trauma on mental health was reduced by intrinsic religiosity (B = .52, p = .011), positive religious coping (B = .61, p = .025), forgi…
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Religiousness and aggression in adolescents: The mediating roles of self-control and compassion.
Although people have used religion to justify aggression, evidence suggests that greater religiousness corresponds with less aggression. We explored two explanations for the religion-aggression link. First, most major religions teach self-control (e.g., delaying gratification, resisting temptation), which diminishes aggression. Second, most major religions emphasize compassionate beliefs and behavior (i.e., perspective taking, forgiveness, a broader love of humanity) that are incompatible with aggression. We tested whether self-control and compassion mediated the relationship between religion and aggression (direct and indirect) in a longitudinal study of 1,040 adolescents in the United States. Structural equation analyses revealed that self-control and compassion together completely mediated the religion-aggression relationship for both types of aggression.
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Lee YR, Enright RD (2014)MEDLINE-indexed journal, not yet read by usSpirituality in clinical practice (Washington, D.C.)18 citations A Forgiveness Intervention for Women With Fibromyalgia Who Were Abused in Childhood: A Pilot Study.
This pilot study compared the efficacy of a forgiveness intervention with a fibromyalgia (FM) health intervention on women with FM who have experienced emotional, physical, or sexual abuse, and emotional or physical neglect, in childhood by one of their parents. Eleven women with FM between the ages of 21 and 68 were randomized to the forgiveness intervention (n = 5) or the FM health intervention (n = 6), and completed the once-weekly individualized program for 24 weeks. The participants completed measures assessing forgiveness, overall FM health, depression, anger, anxiety, self-esteem, and coping strategies at the pretest, the posttest, and the 12-week follow-up test. They also completed the forgiveness intervention and FM health intervention final tests at the posttest, which assessed their knowledge on forgiveness and FM health. The forgiveness intervention participants had greater i…
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How the brain heals emotional wounds: the functional neuroanatomy of forgiveness.
IN LIFE, EVERYONE GOES THROUGH HURTFUL EVENTS CAUSED BY SIGNIFICANT OTHERS: a deceiving friend, a betraying partner, or an unjustly blaming parent. In response to painful emotions, individuals may react with anger, hostility, and the desire for revenge. As an alternative, they may decide to forgive the wrongdoer and relinquish resentment. In the present study, we examined the brain correlates of forgiveness using functional Magnetic Resonance Imaging (fMRI). Healthy participants were induced to imagine social scenarios that described emotionally hurtful events followed by the indication to either forgive the imagined offenders, or harbor a grudge toward them. Subjects rated their imaginative skills, levels of anger, frustration, and/or relief when imagining negative events as well as following forgiveness. Forgiveness was associated with positive emotional states as compared to unforgive…
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Beliefs about bad people are volatile.
People form moral impressions rapidly, effortlessly and from a remarkably young age1-5. Putatively 'bad' agents command more attention and are identified more quickly and accurately than benign or friendly agents5-12. Such vigilance is adaptive, but can also be costly in environments where people sometimes make mistakes, because incorrectly attributing bad character to good people damages existing relationships and discourages forming new relationships13-16. The ability to accurately infer the moral character of others is critical for healthy social functioning, but the computational processes that support this ability are not well understood. Here, we show that moral inference is explained by an asymmetric Bayesian updating mechanism in which beliefs about the morality of bad agents are more uncertain (and therefore more volatile) than beliefs about the morality of good agents. This asy…
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Understanding Chinese Single Mothers' Communicative Resilience Enactment Across Three Types of Social Interactions.
Recent social changes in China have contributed to a growing number of single mothers raising dependent children on their own. However, deep-seated cultural norms continue to stigmatize single motherhood, placing many of these women under considerable psychological and social strain. The well-documented challenges of single motherhood underscore the importance of understanding ways to mitigate these adverse effects. Drawing on the communication theory of resilience, this study examines how three forms of social interactions-parental disclosure to children, social support from family and friends, and contact with former or divorced partners and in-laws-shape resilience enactment among single mothers in China, and how communicative resilience enactment facilitates coping outcomes. Using two-wave data collected from 229 single mothers, our findings underscore the critical role of relational…
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Girish M (2026)MEDLINE-indexed journal, not yet read by usCulture, medicine and psychiatry "But Thanks to God, I Learned to Forgive Them and Work on Myself and Things That I Love": Revenge Fantasies of Indian Muslim Women through Drawings and Narratives.
This study explores how women make sense of injustice and express revenge fantasies through both visual and narrative forms of expression. Using an interpretative phenomenological approach, the study examines drawings and accompanying narratives from fourteen Muslim women in Kerala, India, an under-researched population within the literature on revenge and coping. The analysis identified four superordinate themes: emotional validation through relational reversal, restoration of moral order through indirect or inevitable justice, reclaiming power through aggression and achievement, and withdrawal, moral reflection, and transformation of response. Findings suggest that revenge fantasies are not uniform or solely driven by aggression. Rather, they reflect a range of psychological processes aimed at restoring balance, agency, and meaning following unjust experiences. Across themes, participa…
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A Theology of Health: Exploring the Ethiopian Orthodox Church's Influence on Human Well-Being in Ethiopia.
This study examines the role of Ethiopian Orthodox Tewahedo Church (EOTC) religious practices, particularly fasting, prayer, forgiveness, and community engagement, in promoting holistic health and reducing risks of noncommunicable diseases (NCDs). A mixed-method approach was employed, combining documentary analysis with qualitative interviews. Documentary review included canonical and non-canonical texts, church canons, and relevant scholarly literature. In addition, 11 purposively selected key informant interviews were conducted with religious leaders, scholars, health professionals, and community members. Data were analyzed thematically to identify patterns linking EOTC practices to health outcomes. Three interrelated domains of influence emerged. Physical health is supported through dietary restrictions, fasting practices, abstinence from alcohol and tobacco, and physically engaging r…
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The effect of self-forgiveness on academic procrastination in first-year junior high school students: the roles of state anxiety and state hope.
Background: Academic procrastination is a common self-regulatory challenge among adolescents. Identifying effective intervention strategies has become a pressing societal concern. This study aimed to investigate the dynamic relationship between self-forgiveness and academic procrastination among first-year junior high school students, and test the parallel mediating roles of state anxiety and state hope.
Method: Using a cross-sectional (N = 395) and a three-wave longitudinal design (N = 306), participants completed the State Self-Forgiveness Scale, the Aitken Procrastination Inventory (Middle School Version), the State Anxiety Subscale of the STAI, and the State Hope Scale. Data analysis was conducted using the PROCESS macro for cross-sectional mediation analysis and Structural Equation Modeling (SEM) for longitudinal mediation analysis.
Results: Cross-sectional findings revealed that st…
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The Hidden Costs of ICU Caregiving: Economic, Mental Health and Spiritual Consequences.
Background: Family caregivers of intensive care unit (ICU) patients face a double burden: the psychological toll of critical illness and the economic and occupational disruptions that often accompany prolonged caregiving. While prior research has examined caregiver distress, few studies have systematically integrated economic, psychological and spiritual domains over long-term follow-up. Methods: This study presents a cross-sectional analysis conducted at long-term follow-up examining economic, occupational, psychological, and spiritual correlates among family caregivers of former ICU patients. From an initial cohort of 189 caregivers, 92 participated in a five-year follow-up, completing validated psychometric instruments (SCL-90-R, SpREUK, CD-RISC-10, Heartland Forgiveness, F-COPES). Multivariate regression models were used to identify predictors of psychological and spiritual outcomes,…
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Tsai AC (2026)MEDLINE-indexed journal, not yet read by usSSM. Mental health Defining a shift estimand on forgivingness without domesticating forgiveness: Comment on Cowden et al.
This commentary responds to Cowden et al.'s (2026) careful epidemiologic study of the population-wide changes in well-being that might follow from two explicitly defined "shift" scenarios applied to a three-item forgivingness measure. I value the paper's candor about its counterfactual aim: it is not asking whether forgiveness is good in the abstract, but what could plausibly happen if the distribution of measured forgivingness were moved in specified ways. I argue that Cowden et al.'s (2026) methodological clarity surfaces what remains ethically and theologically decisive. In Christian thought, forgiveness is not simply an emotion-regulation technique or a general prosocial disposition; it is a demanding practice formed by grace and ordered toward truth, justice, mercy, and (where possible) repair. When we compress that "thick" practice into a several-item scale for administration in po…
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Moral Injury as a Wound of Meaning and Conscience: An Introductory Synthesis of Conceptual Foundations, Spiritual Dimensions, and Clinical Implications.
Moral injury (MI) refers to moral, relational, and existential suffering that may follow exposure to potentially morally injurious events (PMIEs), including violence, betrayal, systemic injustice, or interpersonal abuse. Although initially conceptualized within military contexts, moral injury has increasingly been documented across civilian, occupational, and clinical populations such as healthcare professionals, first responders, and humanitarian workers. Despite rapid growth in the literature, the construct remains theoretically fragmented and diagnostically undefined, complicating assessment and intervention. This narrative review synthesizes conceptual, empirical, and methodological literature on moral injury with particular attention to its psychological, moral, and existential dimensions. The literature suggests that moral injury is best understood as a multidimensional form of tra…
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Psychotherapy for Impact of Killing During War: A Randomized Clinical Trial.
Importance: Killing in war is associated with multiple adverse outcomes, including posttraumatic stress disorder (PTSD), moral injury (MI), and suicide. Impact of killing (IOK) is an individual psychotherapy developed to treat the mental health impact of killing in war.
Objective: To determine whether IOK improves veterans' mental health symptoms and functioning at posttreatment and 6-month follow-up.
Design, setting, and participants: This multisite, superiority, randomized clinical trial was conducted from August 2018 to November 2023. Participants were veterans randomized to IOK or present-centered therapy (PCT). Diagnostic assessments were administered at screening and posttreatment by blinded evaluators. Self-report measures were collected at baseline, midtreatment, posttreatment, and 6-month follow-up at 3 Veterans Affairs health care systems in California, New York, and North Caro…
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Relationships Among Cognitive Distortions, Forgiveness of Others, and Self-Forgiveness in Psychiatric Outpatients with Depressive Disorders: A Cross-Sectional Study.
Background: Depression is associated with cognitive, emotional, and interpersonal difficulties that may influence forgiveness-related processes. This study aimed to examine the relationships among cognitive distortions, forgiveness of others, and self-forgiveness in patients with depression. Methods: This cross-sectional and correlational study was conducted with 252 voluntary psychiatric outpatients diagnosed with selected ICD-10 depressive disorders in a single outpatient clinic, excluding individuals with severe depressive episodes and psychotic features. Data were collected using the Descriptive Data Form, the Rye Forgiveness Scale (RFS), the State Self-Forgiveness Scale (SSFS), and the Cognitive Distortions Scale (CDS). Descriptive statistics, independent-samples t-tests, one-way analysis of variance (ANOVA), Pearson correlation analyses, and linear regression analyses were used for…
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Meaning of Life Therapy: A Pilot Study of a Novel Psycho-Existential Intervention for Palliative Care in Cancer.
Intervention in Palliative Care aims to provide physical, psychosocial, and spiritual relief for patients and family members. Brief interventions with a psycho-existential approach have shown positive responses; however, cultural adaptations are needed. This pilot study aimed to develop the Meaning of Life Therapy (MLT), a novel psycho-existential intervention, rooted in the Dignity Therapy, Life Review, and Meaning-Centered Psychotherapy. MLT was culturally adapted to the Portuguese context to include questions about forgiveness, apology, reconciliation, farewell, and a legacy document, i.e., the Life Letter. Nine PC cancer patients answered a 14-question MLT protocol, intended to help patients find purpose and meaning in life. Eight themes emerged: Family, Preservation of Identity, Life Retrospective, Clinical Situation, Achievements, Socio-Professional Valorization, Forgiveness/Apolog…
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Ter Heide JJ, Bicanic I, Holtrop B, Maassen L, van Nistelrooij I, Hoogeveen M, Overbeek M, Voorendonk E, Zebel S, Gevers T, van Minnen A (2026)MEDLINE-indexed journal, not yet read by usEuropean journal of psychotraumatology Deepfake perpetrator conversation for adults with sexual abuse-related posttraumatic stress disorder: intervention development and multiple baseline study protocol.
Background: A conversation between a victim and a perpetrator of sexual abuse has the potential to reduce posttraumatic stress disorder (PTSD) symptoms in the victim. However, an actual conversation may not always be possible or feasible. Deepfake technology may offer a way to simulate a conversation in a clinical context. Therefore, a feasible, acceptable and potentially effective intervention protocol is required. Objective: We aimed to develop an intervention protocol for a deepfake victim-perpetrator conversation to be used in the treatment of patients with sexual abuse-related PTSD, that would be technologically, legally, ethically, and clinically feasible as well as acceptable. In addition, we aimed to design a single-case experimental design (SCED) multiple baseline study to evaluate its efficacy. Method: The intervention protocol was developed through an iterative multidisciplina…
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Religion, Faith, and Spirituality as Barriers and Facilitators to Antiretroviral Therapy Initiation Among People with HIV in Indonesia.
Indonesia is a country deeply rooted in religion, faith, and spirituality. These aspects significantly determine individuals' decision-making and behavior, including health care decisions. Given the suboptimal attainment of the HIV-cascade targets in the country, we conducted a study to explore the role of religion, faith, and spirituality on antiretroviral therapy (ART) initiation. Our study involved individual interviews with 67 participants recruited from community health centers, public hospitals, and private clinics, predominantly Muslim, including 17 untreated people with HIV (ART-naïve), 30 people with HIV on treatment (ART-experienced), and 20 HIV service providers. Findings revealed that many individuals perceived HIV as a godly punishment related to individual failure (prior risk-prone behaviors), generating shame, guilt, and stigma. Perceiving religion as punitive and unforgiv…
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Family-Level Impact of Germline Genetic Testing in Childhood Cancer: A Multi Family Member Interview Analysis.
Objectives: Germline genetic testing is increasingly being integrated into pediatric oncology and a large number of families are interested. Current research on the psychological impact of germline genetic testing is limited by a main focus on individual outcomes in parents or children and little is known about its impact at the family level. Our study addresses that limitation by exploring parents' lived experiences of how their family-as a whole-is affected by germline genetic testing for cancer predisposition. Methods: In six families who opted for germline genetic testing in the context of cancer predisposition, both parents of six ill children (five boys) with an average age of 9.67 years (SD = 3.77 years) were interviewed individually (N = 12). Germline genetic testing was performed by exome sequencing followed by analysis of a panel of childhood cancer predisposition genes in pedi…
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Ip MWS, Wong DSW (2025)MEDLINE-indexed journal, not yet read by usInternational journal of offender therapy and comparative criminology Intimate Partner Violence among Adolescents in Hong Kong.
Intimate Partner Violence (IPV) among adolescents is a prime public health concern worldwide. Research found that IPV victimization and peers' IPV perpetration could increase the likelihood of IPV perpetration. In contrast, healthy partner attachment, forgiveness, shame management, and family harmony could serve as protective factors for IPV. Therefore, this study aims to investigate the risk and protective factors of IPV perpetration among adolescents in Hong Kong. The present study recruited 1,815 full-time secondary school students in Hong Kong aged 11 to 19 years. Healthy partner attachment, forgiveness, shame management, and family harmony were negatively correlated with IPV perpetration. IPV victimization and peers' IPV perpetration were positively correlated with IPV perpetration. Specifically, peers' IPV perpetration partially mediated the effect of IPV victimization on IPV perpe…
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Tirrell JM, Sampa M, Wootten K, Harris SK, McGrath RE, Mulavu M, Sindano N, Kasanga L, Mweemba O, Seale DM, Seale JP, Mutale W (2025)MEDLINE-indexed journal, not yet read by usChild & youth care forum Measuring Character Strengths and Promoting Positive Youth Development in Zambia: Initial Findings from the GROW Hopes for Life Study.
Background: The Global Resilience Oral Workshops (GROW) Free and Strong programs take a strengths-based, positive youth development (PYD) approach to promoting thriving. Through both prevention (GROW Strong) and intervention (GROW Free) exercises, these programs aim to build character and emotional resilience while also lowering unhealthy alcohol use.
Objective: To meaningfully assess the impact of the GROW programs on health and PYD, ecologically and psychometrically valid measures of character strengths were needed, with a focus on the strengths of hope, forgiveness, spirituality, prudence, and self-control (self-regulation) promoted by GROW.
Method: We tested a series of exploratory and confirmatory factor analyses of these five key constructs using two samples: a school-based youth sample enrolled in GROW Strong (n = 460; M age = 15.04 years, SD age = 1.21; 53.0% female); and a com…
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