Original Article

The Role of Perceived Burdensomeness, Thwarted Belongingness, and Giving Meaning to Life in Psychosocial Adjustment: The Mediating Role of Self-Care in the Elderly


Objective: In old age, people suffer from many mental and physical illnesses, which make it important for the elderly to pay attention to adapting to these diseases. So, the aim of this research was to study the role of perceived burdensomeness, thwarted belongingness, and giving meaning to life in psychosocial adjustment, as well as the mediating role of self-care in the elderly.

Method: This research was descriptive and correlational, conducted through available sampling of 200 elderly people who lived in the city of Ardabil. After the necessary assessments in terms of mental disorders and inclusion criteria, they were chosen to conduct this investigation in 2020. The Meaning in Life Questionnaire, Psychosocial Adjustment Scale, Self-Care Questionnaire for the Elderly, and Interpersonal Needs scale were used to gather the data. The data were analyzed using SPSS25 and Amos24 software.

Results: The findings showed that perceived burdensomeness and thwarted belongingness have a negative and direct effect on elderly self-care [β = -0.25, P < 0.01] [β = -0.20, P < 0.05] and psychosocial adjustment [β = -0.0, P < 0.05] [β = -0.12, P < 0.05]. Also, giving meaning to life has a positive and direct effect on elderly self-care [β = 0.32, P = 0.01] and psychosocial adjustment [β = 0.033, P < 0.01]. The variable of self-care can play a mediating role in the relationship between thwarted belongingness [β = -0.174, P < 0.05], perceived burdensomeness [β = -0.140, P < 0.05], and giving meaning to life [β = 0.223, P < 0.05] with psychosocial adjustment. Moreover, among the exogenous variables, thwarted belongingness and perceived burdensomeness by change in self-care have been able to reduce psychosocial adjustment. Giving meaning through self-care, however, has increased psychosocial adjustment.

Conclusion: The findings revealed that thwarted belongingness, perceived burdensomeness, and giving meaning to life are important variables in health and adaptability of the elderly, which draws attention to family-centered interventions and individual therapies.

1. Taghdisi MH, Doshmangir P, Dehdari T, Doshmangir L. Influencing factors on healthy lifestyle from viewpoint of ederly people: Qualitative study. Iranian Journal of Ageing. 2013;7(4):47-58.
2. Kolokotroni P, Anagnostopoulos F, Missitzis I. Psychosocial Adjustment to Illness Scale: Factor structure, reliability, and validity assessment in a sample of Greek breast cancer patients. Women Health. 2017;57(6):705-22.
3. Sadri Damirchi E, Ayadi N, Dargahi S, Ahmadboukani S, Pireinaladin S. The Mediating Role of Sexual Self-esteem in the Relationship Between Marital Quality and Psychological Adaptation in Women with Chronic Pain Illness. Jundishapur J Chronic Dis Care. 2021;10(2): 1-13.
4. Michael SR. Integrating chronic illness into one's life: a phenomenological inquiry. J Holist Nurs. 1996;14(3):251-67.
5. Sözeri-Varma G. Depression in the elderly: clinical features and risk factors. Aging Dis. 2012;3(6):465-71.
6. Yang W, Staps T, Hijmans E. Existential crisis and the awareness of dying: the role of meaning and spirituality. Omega (Westport). 2010;61(1):53-69.
7. Korte J, Cappeliez P, Bohlmeijer ET, Westerhof GJ. Meaning in life and mastery mediate the relationship of negative reminiscence with psychological distress among older adults with mild to moderate depressive symptoms. Eur J Ageing. 2012;9(4):343-51.
8. Jamshidian Y, Kiani A, Dargahi S. Relationship of cognitive emotion regulation and meaning in life with health anxiety among emergency nurses. HDQ. 2018;3(4):199-206.
9. Mascaro N, Rosen DH. Existential meaning's role in the enhancement of hope and prevention of depressive symptoms. J Pers. 2005;73(4):985-1013.
10. Bryan CJ. The clinical utility of a brief measure of perceived burdensomeness and thwarted belongingness for the detection of suicidal military personnel. J Clin Psychol. 2011;67(10):981-92.
11. Joiner TE, Van Orden KA, Witte TK, Selby EA, Ribeiro JD, Lewis R, et al. Main predictions of the interpersonal-psychological theory of suicidal behavior: empirical tests in two samples of young adults. J Abnorm Psychol. 2009;118(3):634-46.
12. Nikkhah M, Heravi-Karimooi M, Rejeh N, Nia HS, Montazeri A. Measuring quality of life in elderly populations: a review of instruments used. Payesh (Health Monitor). 2017;16(3):303-14.
13. Van Orden KA, Lynam ME, Hollar D, Joiner TE. Perceived burdensomeness as an indicator of suicidal symptoms. Cognit Ther Res. 2006;30(4):457-67.
14. Cukrowicz KC, Cheavens JS, Van Orden KA, Ragain RM, Cook RL. Perceived burdensomeness and suicide ideation in older adults. Psychol Aging. 2011;26(2):331-8.
15. Jahn DR, Cukrowicz KC, Linton K, Prabhu F. The mediating effect of perceived burdensomeness on the relation between depressive symptoms and suicide ideation in a community sample of older adults. Aging Ment Health. 2011;15(2):214-20.
16. Silva C, Ribeiro JD, Joiner TE. Mental disorders and thwarted belongingness, perceived burdensomeness, and acquired capability for suicide. Psychiatry Res. 2015;226(1):316-27.
17. Depner RM, Cook-Cottone CP, Kim S. Structural relationship between mindful self-care, meaning made, and palliative worker’s quality of life. Int J Stress Manag. 2021;28(1):74.
18. Mak WW, Law RW, Woo J, Cheung FM, Lee D. Social support and psychological adjustment to SARS: the mediating role of self-care self-efficacy. Psychol Health. 2009;24(2):161-74.
19. Mueller RO. Basic principles of structural equation modeling: An introduction to LISREL and EQS. Springer Science & Business Media; 1999.
20. American Psychiatric Association. Structured clinical interview for DSM-5 (SCID-5). Washington, DC: American Psychiatric Association. 2015.
21. Steger MF, Frazier P, Oishi S, Kaler M. The meaning in life questionnaire: Assessing the presence of and search for meaning in life. J Couns Psychol. 2006;53(1):80.
22. Steger MF, Kawabata Y, Shimai S, Otake K. The meaningful life in Japan and the United States: Levels and correlates of meaning in life. J Res Pers. 2008;42(3):660-78.
23. Ahmadi, Somayeh, Mahmood Heidari, Fatemeh Bagherian, & Abdolrasoul Kashfi. Adolescence and development of meaning: Comparing the sources and dimensions of meaning in life in adolescent boys and girls. Clin Psycho Studi. 2016: 149-177.
24. Derogatis LR. The psychosocial adjustment to illness scale (PAIS). J Psychosom Res. 1986;30(1):77-91.
25. Feghhi H, Saadatjoo SA, Dastjerdi R. Psychosocial adaptation in patients with type 2 diabetes referring to Diabetes Research Center of Birjand in 2013. Modern Care J. 2014;10(4):249–56.
26. Hemmati Maslak Pak M, Hashemlo L. Design and psychometric properties of a self-care questionnaire for the elderly. Irani J Age. 2015;10(3):120-31.
27. Hill RM, Rey Y, Marin CE, Sharp C, Green KL, Pettit JW. Evaluating the Interpersonal Needs Questionnaire: Comparison of the Reliability, Factor Structure, and Predictive Validity across Five Versions. Suicide Life Threat Behav. 2015;45(3):302-14.
28. Hawkins KA, Hames JL, Ribeiro JD, Silva C, Joiner TE, Cougle JR. An examination of the relationship between anger and suicide risk through the lens of the interpersonal theory of suicide. J Psychiatr Res. 2014; 50:59-65.
29. Kiani A, Ahmad Bukani S, Najafi N, Karaji Z. Validation of Psychometric Characteristics of the Interpersonal Needs Questionnaire in Students, Cognit & Behav Sci Res. 2020; 9 (2,17): 78-65.
30. Delavar A, Saeed-O-Zakerin M. Autonomy in the elderly: a phenomenological study. Hakim Res J. 2010;12(4):1-10.
31. Garcini LM, Short M, Norwood WD. Affective and motivational predictors of perceived meaning in life among college students. The Journal of Happiness & Well-Being. 2013;1(2):47-60.
32. Weber MC, Pavlacic JM, Gawlik EA, Schulenberg SE, Buchanan EM. Modeling resilience, meaning in life, posttraumatic growth, and disaster preparedness with two samples of tornado survivors. Traumatology. 2020;26(3):266.
33. Park SJ, Kim S. The effects of social support and recovery resilience on self-care behavior among the elderly with hypertension in the senior welfare center. KAIS. 2019;20(7):182-91.
34. Van Orden K, Conwell Y. Suicides in late life. Curr Psychiatry Rep. 2011;13(3):234-41.
35. Ho MY, Cheung FM, Cheung SF. The role of meaning in life and optimism in promoting well-being. Pers. Individ. Differ. 2010;48(5):658-63.
36. Jamshidian Y, Kiani A, Dargahi S. Relationship of cognitive emotion regulation and meaning in life with health anxiety among emergency nurses. Health in Emergencies and Disasters. 2018;3(4):199-206.
37. Lutz J, Fiske A. Functional disability and suicidal behavior in middle-aged and older adults: A systematic critical review. J Affect Disord. 2018; 227:260-71.
38. Zhang J, Peng J, Gao P, Huang H, Cao Y, Zheng L, et al. Relationship between meaning in life and death anxiety in the elderly: self-esteem as a mediator. BMC Geriatr. 2019;19(1):308.
39. Barghi Irani Z, Rajabi M, Nazami M, MJ BK. The role of lifestyle, psychological capital and self-care behaviors in predicting subjective well-being of diabetic elderly peoples. Health Psychol. 2017;6(23):17-38.
40. Dieserud G, Røysamb E, Ekeberg O, Kraft P. Toward an integrative model of suicide attempt: a cognitive psychological approach. Suicide Life Threat Behav. 2001;31(2):153-68.
IssueVol 18 No 2 (2023) QRcode
SectionOriginal Article(s)
Aged Adaptation Family Health Promotion Mental Disorders Psychotherapy

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How to Cite
Dargahi S, Pireinaladin S, Ahmadboukani S, Bashirgonbadi S, Molaei B, Fathi D. The Role of Perceived Burdensomeness, Thwarted Belongingness, and Giving Meaning to Life in Psychosocial Adjustment: The Mediating Role of Self-Care in the Elderly. Iran J Psychiatry. 2023;18(2):145-152.