University of Southern California Dissertations and Theses

Relationships and meaning: examining the roles of personal meaning and meaning-making processes in couples dealing with important life events

(USC Thesis Other)

Relationships and meaning: examining the roles of personal meaning and meaning-making processes in couples dealing with important life events

PDF

Download a page range

Download transcript

Copy asset link

Request this asset

Transcript (if available)

Content Relationships and Meaning:
Examining the Roles of Personal Meaning and Meaning-Making
Processes in Couples Dealing with Important Life Events
by
Geoffrey Winston Corner
A Dissertation Presented to the
FACULTY OF THE USC GRADUATE SCHOOL
UNIVERSITY OF SOUTHERN CALIFORNIA
In Partial Fulfillment of the
Requirements for the Dual Degrees
DOCTOR OF PHILOSOPHY IN PSYCHOLOGY
(CLINICAL)
and
MASTER OF PUBLIC HEALTH
(HEALTH PROMOTION)
August 2021
Copyright 2021 Geoffrey Winston Corner

ii
Acknowledgements
Financial support for the studies detailed in this project was provided by NIH-NICHD
Grant R21HD072170 (PI: Margolin), NSF Award BCS-1627272 (PI: Margolin), NSF CAREER
Award 1552452 (PI: Saxbe), and NSF GRFP Awards DGE-1418060 (PIs: Corner, Rasmussen)
and DGE-1842487 (PIs: Kim, Morris).
I would like to begin by thanking my committee members, Drs. Gayla Margolin, Darby
Saxbe, Richard John, Dorian Traube, and Wendy Lichtenthal, for their valuable feedback and
generosity in offering their time and attention to reviewing this project. I would also like to
express my gratitude to my fellow lab members for their invaluable input in drafting these
papers, their guidance and support throughout my time at USC, and their dedication in collecting
the data that would ultimately be used in this dissertation. From the Family Studies Project, these
include Dr. Michelle Ramos, Dr. Lauren Shapiro, Dr. Reout Arbel, Dr. Marie-Ève Daspe, Dr.
Larissa Borofsky Del Piero, Dr. Adela Timmons, Dr. Sohyan Han, Dr. Kelly Miller, Dr. Ilana
Kellerman Moss, Laura Perrone, Hannah Rasmussen, Yehsong Kim, Corey Pettit, Stassja
Sichko, Merai Estafanous, Sarah Goldstein, and Theodora Chaspari. From the
Neuroendocrinology of Social Ties Lab, these include Dr. Diane Goldenberg, Dr. Hannah
Khoddam, Sarah Stoycos, Mona Khaled, Alyssa Morris, Narcis Marshall, Sofia Cárdenas, Ann
Bryna Tsai, Katelyn Horton, and Nia Barbee. I would also like to thank the couples who
generously dedicated their time to participate in the Family Studies Project and the Hormones
Across the Transition to Childrearing project. In addition, I am grateful for the many
undergraduate and post-baccalaureate students who volunteered to assist with the FSP and in the
NEST Lab, particularly those who coded the discussions and tasks used in this dissertation.
I would like to extend special thanks to my two advisors, Drs. Gayla Margolin and Darby

iii
Saxbe. Both personally and professionally, I have been so fortunate to have the two of them as
my teachers and mentors throughout my time in graduate school, and it is through their guidance
that I have been able to grow as a clinical scientist. In addition, I want to express my sincere
gratitude to Dr. Wendy Lichtenthal. I never would have embarked on this path without having
her as a shining example of what it means to be a clinical psychologist, and her tireless support
both before and during my time in graduate school has meant so much to me. At the same time, I
am thankful for all of the other people I worked with and learned from in my time at Memorial
Sloan Kettering Cancer Center, including Dr. William Breitbart, Dr. Jack Burkhalter, Dr.
Catherine Mosher, Dr. Kailey Roberts, Dr. Malwina Tuman, Maria Farberov, Alexa Berk,
Marion Schwartz, and more. Lastly, I want to thank my parents and all of my friends at and
outside of USC. Most importantly, I am forever grateful for my wonderful and supportive
partner, Nora Nasir. I could not have done this without her.

iv

TABLE OF CONTENTS
Acknowledgements ......................................................................................................................... ii
List of Tables ................................................................................................................................... v
List of Figures ................................................................................................................................. vi
Abstract .......................................................................................................................................... vii
General Introduction ........................................................................................................................ 1
Current Studies .................................................................................................................... 2
References ........................................................................................................................... 5
Paper 1: Meaning-Making and Electrodermal Activity .................................................................. 8
Abstract ................................................................................................................................ 9
Introduction ....................................................................................................................... 10
Method ............................................................................................................................... 18
Results ............................................................................................................................... 26
Discussion .......................................................................................................................... 28
References ......................................................................................................................... 33
Tables & Figures ............................................................................................................... 40
Paper 2: Meaning-Making and Birth Experiences ........................................................................ 46
Abstract .............................................................................................................................. 47
Introduction ....................................................................................................................... 48
Method ............................................................................................................................... 55
Results ............................................................................................................................... 61
Discussion .......................................................................................................................... 64
References ......................................................................................................................... 70
Tables & Figures ............................................................................................................... 77
Paper 3: Meaning and Mental Health ............................................................................................ 84
Abstract .............................................................................................................................. 85
Introduction ....................................................................................................................... 86
Method ............................................................................................................................... 92
Results ............................................................................................................................... 97
Discussion ........................................................................................................................ 100
References ....................................................................................................................... 107
Tables & Figures ............................................................................................................. 117
General Discussion ...................................................................................................................... 124
Contributions to the Literature ........................................................................................ 125
Clinical Implications ........................................................................................................ 126
Strengths, Limitations, & Future Directions ................................................................... 127
Conclusion ....................................................................................................................... 128

v
List of Tables
Paper 1: Meaning-Making and Electrodermal Activity
Table 1. Participant characteristics .................................................................................... 40
Table 2. Loss discussion topics ......................................................................................... 41
Table 3. Correlations between key study variables ........................................................... 42
Table 4. Models testing associations between meaning-making and feelings
toward one’s partner during the discussion (H1) ................................................... 43
Table 5. Models testing associations between meaning-making and electrodermal
activity (H2) ........................................................................................................... 44
Paper 2: Meaning-Making and Birth Experiences
Table 1. Participant characteristics .................................................................................... 77
Table 2. Definitions of meaning-making processes and examples from the birth
narratives ............................................................................................................... 78
Table 3. Correlations between key study variables ........................................................... 79
Table 4. APIM results from models predicting changes in relationship functioning ........ 80
Table 5. APIM results from models predicting parenting stress ....................................... 81
Paper 3: Meaning and Mental Health
Table 1. Participant characteristics .................................................................................. 117
Table 2. Correlations between key study variables ......................................................... 118
Table 3. Changes in meaning and mental health (H1) .................................................... 119
Table 4. Associations between meaning and mental health (H2) .................................... 120

vi
List of Figures
Paper 1: Meaning-Making and Electrodermal Activity
Figure 1. Results from simple slopes analyses for the effect of the listener’s
meaning-making on the narrator’s positive feelings toward them ........................ 45
Paper 2: Meaning-Making and Birth Experiences
Figure 1. APIM results from models predicting changes in relationship
functioning (H1) .................................................................................................... 82
Figure 2. APIM results from models predicting parenting stress (H2) ............................. 83
Paper 3: Meaning and Mental Health
Figure 1. Histograms depicting participants’ changes in meaning and mental
health (H1) ........................................................................................................... 121
Figure 2. Simple slopes analyses for interactions with time predicting
depression (H2) .................................................................................................... 122
Figure 3. Simple slopes analyses for interactions with time predicting
anxiety (H2) ......................................................................................................... 123

vii
Abstract
Having meaning in one’s life – that is, having a strong, coherent sense of purpose with regard to
one’s goals and priorities – has been shown to promote well-being and adjustment in the face of adversity.
Despite the empirical attention that meaning has received, it remains understudied in the context of
romantic relationships. Although limited, there is evidence to suggest that the process of meaning-making
can unfold dyadically. For example, individuals can feel either supported or hindered by their partner in
their efforts to make meaning of challenging circumstances, and this may have important implications for
their adjustment and the adjustment of their partner. This three-paper dissertation investigated the roles of
meaning and meaning-making in couples dealing with two types of transitions: loss and parenthood.
Although these transitions are in some ways diametrically opposed – one mourning an absence and the
other welcoming a new life – they are both characterized by new, often dyadic challenges and potential
changes to identity.
This dissertation revealed novel associations between meaning, meaning-making, and
adjustment to both loss and parenthood. In Paper 1, we identified meaning-making during dyadic
discussions about loss as a predictor of both physiology and feelings toward a partner. In Paper
2, we found associations between birth-related meaning-making and postpartum individual and
relationship outcomes across the transition to parenthood. In Paper 3, we discovered links
between meaning and changes in mental health symptoms across this same transition. Together,
these studies suggest the importance of meaning and meaning-making for couples and extend the
literature on meaning to demonstrate its relevance in new contexts, including when dealing with
more ubiquitous forms of loss, challenging life transitions, and even experiences that can bring
about a mix of joy and stress.
Meaning-making may function as a supportive process in couples’ discussions about loss,
and meaning-making related to a birth experience may predict better couple and individual

viii
adjustment in the postpartum period. Similarly, an overall sense of meaning may buffer risk for
the development of mental health challenges in new parents. These findings underscore the
relevance of these processes and concepts for couples, which further supports the idea that
meaning-making may unfold dyadically, between partners, and in valuable or consequential
ways. This dissertation’s results can be a first step in informing a variety of different meaning-
focused interventions for couples, and they emphasize the need for future efforts to research the
intersection between meaning and romantic relationships.
1
General Introduction
Having a meaning in one’s life – that is, having a strong, coherent sense of purpose with regard to
one’s goals and priorities – is known to promote well-being and adjustment in the face of adversity or
challenging circumstances. In Man’s Search for Meaning, a foundational work on existential well-being,
Viktor Frankl (1959/2006) described the role that meaning played in helping him endure the atrocities of
the Holocaust and survive as a prisoner at the Auschwitz concentration camp. Since Frankl’s landmark
memoir, a number of other psychologists and philosophers have expounded on the importance of living a
meaningful life. For example, Irvin Yalom (1980) discussed the essential task of actively making meaning
in life, an often-challenging undertaking that we all need to navigate. Frankl and Yalom both developed
psychotherapeutic approaches for helping people find meaning and enhance their sense of purpose, and
after them, other clinicians have manualized these approaches for a variety of populations, including
patients with advanced cancer (Breitbart & Poppito, 2014a; Breitbart & Poppito, 2014b).
A sense of personal meaning and the act of making meaning have been researched in a
variety of contexts, including both ones that reflect normative developmental processes (e.g.,
adolescence, acculturation; Brassai et al., 2011; Pan et al., 2008) and others that can be traumatic
or devastating (e.g., illness, bereavement, other forms of trauma; Johnson Vickberg et al., 2000;
Lichtenthal et al., 2013; Neimeyer, 2001; Park & Ai, 2006). Existential well-being has even been
studied in relation to potentially positive life events, such as pregnancy and becoming a new
parent (Prinds et al., 2014). Despite the empirical attention that meaning has received, it remains
understudied in the context of romantic relationships. Although limited, there is some evidence
to suggest that meaning-making can be a dyadic process in bereavement, particularly in the case
of a shared loss (Albuquerque, Buyukcan-Tetik, et al., 2017; Albuquerque, Ferreira, et al., 2017),
and in coping with illness (Manne et al., 2004; McGovern, 2011). Individuals can feel either
supported or hindered by their partner in their efforts to make meaning in the face of adversity,
2
and how these processes unfold may have important implications for their adjustment and the
adjustment of their partner. Furthermore, feeling an overall sense of meaning and purpose likely
has implications for the lives and experiences of couples, especially in difficult circumstances
(Abbey & Halman, 1995). At the same time, consistent with Yalom’s conceptualization of
meaning-making, grappling with meaning may be an essential task of human existence, which
would suggest that it is important and influential in both times of adversity and a variety of other
life situations.
Current Studies
This three-paper dissertation investigated the roles of personal meaning and meaning-
making processes in couples dealing with two types of transitions: loss and parenthood.
Although these transitions are in some ways diametrically opposed – one mourning an absence
and the other welcoming a new life – they are both characterized by new dyadic challenges and
potential changes to identity.
Papers 1 and 2 both investigated the role of behaviorally coded meaning-making
processes in tasks completed by couples. In Paper 1, young couples engaged in conversations
about emotionally salient losses they experienced, and a moment-to-moment engagement in
meaning-making was examined as a predictor of physiology and overall feelings toward one’s
partner after the discussion. By specifically studying young adult couples and focusing on a life
stage in which partners are first learning to explore difficult topics like loss together, we hoped to
provide a window into early presentations of dyadic meaning-making processes. In Paper 2,
couples shared childbirth experiences shortly after the delivery of their first child. Their use of
three meaning-making processes (i.e., sense making, benefit finding, and changes in identity;
described by Gillies & Neimeyer, 2006) was examined as a predictor of postpartum outcomes,
3
specifically changes in relationship functioning and parenting stress. Both of these studies
represent novel applications and investigations of meaning-making. The former studied
meaning-making in relation to a variety of different forms of loss, not just bereavement, and to
our knowledge, it is the first study to examine the physiology of engagement in meaning-making.
The latter studied meaning-making outside of the context of loss and in relation to the often
positive, yet still challenging experiences of giving and becoming a new parent.
Both studies also explored dyadic meaning making processes and used statistical
techniques that accounted for the dyadic nature of the data we collected. In Paper 1, multilevel
models was used to test the effects of meaning-making exhibited by both the narrator (i.e., the
partner sharing their loss) and the listener (i.e., the partner responding to a shared loss) on the
narrator’s physiology and feelings toward their partner. In Paper 2, actor-partner interdependence
models tested the effects of parents’ meaning-making on both their own and their partner’s
outcomes. As such, these studies add to the literature on meaning-making by both studying it in
two new contexts and examining in a dyadic framework. This is particularly relevant given the
relative lack of research on positive or supportive processes in couples’ interactions (Friedlander
et al., 2019) and the important impact of the transition to parenthood on the couple’s relationship
(Doss et al., 2010; Mitnick et al., 2009). At the same time, these studies also expand the literature
on the transition to parenthood and couples’ supportive interactions to include another potentially
protective process.
Similarly, Paper 3 investigated the role of meaning as a potential protective factor with
regard to new partners’ mental health across the transition to parenthood. This delineation
between a global sense of meaning and meaning-making processes seen in Papers 1, 2, and 3 is
consistent with the meaning-making model proposed by Park (2010). Despite the potential
4
relevance of meaning and purpose in becoming a new parent, these ideas are so far unexplored in
the context of the transition to parenthood. This study sought to address this gap in the literature
by examining associations between overall levels of and changes in meaning and overall levels
of and changes in symptoms of both depression and anxiety. The transition to parenthood marks
a critical window for adult development (Saxbe et al., 2018), and new parents can potentially
experience mental health challenges. This longitudinal assessment of meaning, depression, and
anxiety enabled a novel examination how each of these three constructs change across the
transition to parenthood and how these changes are associated.

5
References
Abbey, A., & Halman, L. J. (1995). The role of perceived control, attributions, and meaning in
members’ of infertile couples well-being. Journal of Social and Clinical Psychology,
14(3), 271-296.
Albuquerque, S., Buyukcan-Tetik, A., Stroebe, M. S., Schut, H. A. W., Narciso, I., Pereira, M.,
& Finkenauer, C. (2017). Meaning and coping orientation of bereaved parents: Individual
and dyadic processes. PLoS ONE, 12(6), 1-14.
Albuquerque, S., Ferreira, L. C., Narciso, I., & Pereira, M. (2017). Parents’ positive interpersonal
coping after a child’s death. Journal of Child and Family Studies, 26(7), 1817–1830.
Brassai, L., Pika, B. F., & Steger, M. F. (2011). Meaning in life: Is it a protective factor for
adolescents’ psychological health? International Journal of Behavioral Medicine, 18(1),
44-51.
Breitbart, W., & Poppito, S. R. (2014a). Individual meaning-centered psychotherapy for patients
with advanced cancer: A treatment manual. Oxford University Press.
Breitbart, W. S., & Poppito, S. R. (2014b). Meaning-centered group psychotherapy for patients
with advanced cancer: A treatment manual. Oxford University Press.
Doss, B. D., Rhoades, G. K., Stanley, S. M., & Markman, H. J. (2010). The effect of the
transition to parenthood on relationship quality: An eight-year prospective study. Journal
of Personality and Social Psychology, 96(3), 601-619.
Frankl, V. (2006). Man’s search for meaning. Beacon Press. (Original work published 1959)
Friedlander, M. L., Lee, M., & Escudero, V. (2019). What we do and do not know about the
nature and analysis of couple interaction. Couple and Family Psychology: Research and
Practice, 8(1), 24-44.
6
Gillies, J., & Neimeyer, R. A. (2006). Loss, grief, and the search for significance: Toward a
model of meaning reconstruction in bereavement. Journal of Constructivist Psychology,
19(1), 31-65.
Johnson Vickberg, S. M., Bovbjerg, D. H., DuHamel, K. N., Currie, V., & Redd, W. H. (2000).
Intrusive thoughts and psychological distress among breast cancer survivors: Global
meaning as a possible protective factor. Behavioral Medicine, 25(4), 152-160.
Lichtenthal, W. G., Neimeyer, R. A., Currier, J. M., Roberts, K., & Jordan, N. (2013). Cause of
death and the quest for meaning after the loss of a child. Death Studies, 37(4), 311-342.
Manne, S., Ostroff, J., Winkel, G., Goldstein, L., Fox, K., & Grana, G. (2004). Posttraumatic
growth after breast cancer: Patient, partner, and couple perspectives. Psychosomatic
Medicine, 66(3), 442-454.
McGovern, J. (2011). Couple meaning-making and dementia: Challenges to the deficit model.
Journal of Gerontological Social Work, 54(7), 678-690.
Mitnick, D. M., Heyman, R. E., & Smith Slep, A. M. (2009). Changes in relationship satisfaction
across the transition to parenthood: A meta-analysis. Journal of Family Psychology,
23(6), 848-852.
Neimeyer, R. A. (2001). Meaning reconstruction and the experience of loss. American
Psychological Association.
Pan, J., Wong, D. F. K., Chan, C. L. W., & Joubert, L. (2008). Meaning of life as a protective
factor of positive affect in acculturation: A resilience framework and a cross-cultural
comparison. International Journal of Intercultural Relations, 32(6), 505-514.
Park, C. L. (2010). Making sense of the meaning literature: An integrative review of meaning
making and its effects on adjustment to stressful life events. Psychological Bulletin,
7
136(2), 257-301.
Park, C. L., & Ai, A. L. (2006). Meaning making and growth: New directions for research on
survivors on trauma. Journal of Loss and Trauma, 11(5), 389-407.
Prinds, C., Hvidt, N. C., Mogensen, O., & Buus, N. (2014). Making existential meaning in
transition to motherhood – A scoping review. Midwifery, 30(6), 733-741.
Saxbe, D., Rossin-Slater, M., & Goldenberg, D. (2018). The transition to parenthood as a critical
window for adult health. American Psychologist, 73(9), 1190-1200.
Yalom, I. (1980). Existential psychotherapy. Basic Books.

8

Making Sense of Support: Relational & Physiological Benefits of
Meaning-Making in Couples’ Discussions about Loss
Geoffrey W. Corner
Hannah F. Rasmussen
Yehsong Kim
Reout Arbel
Marie Eve-Daspe
Corey Pettit
Stassja Sichko
Darby E. Saxbe
Gayla Margolin
University of Southern California

9
Abstract
The current study investigates meaning-making as a potential supportive process in couples. A
romantic partner can be a crucial source of support during times of hardship, and meaning
reconstruction, a process by which bereaved individuals adjust to the loss of a loved one, unfolds
both intra- and interpersonally. As such, meaning-making is likely a dyadic process for many
couples, and it may affect not only coping with the loss, but also stress physiology and feelings
toward one’s partner. In the current study, 111 young adult dating couples engaged in
discussions about personally significant losses. Each individual (the “narrator”) shared an
emotionally significant loss with their partner (the “listener”). Narrators’ electrodermal activity
was measured throughout, and they reported on their feelings toward their partner after the
discussion. Conversations were coded for meaning-making processes in both partners. Greater
meaning-making in narrators was linked with more positive and less negative feelings toward
listeners, and greater meaning-making in listeners was associated with more positive feelings in
female, but not male, narrators toward their partner. Minute-to-minute changes in levels of the
listener’s meaning-making were linked with fewer skin conductance responses in the narrator.
Together, these findings suggest the potential utility of meaning-making in couples’ discussions
about loss. Clinically, building skills in meaning-making may be an effective way to help
couples navigate the challenges of loss.
Keywords: couples, support, loss, meaning, meaning-making, psychophysiology,
electrodermal activity

10
Partner-provided support is proven to be beneficial in a variety of challenging contexts
(Cutrona, 1996), such as while coping with serious illnesses and during important life transitions
(Cheng et al., 2016; Kamen et al., 2015; Karakurt et al., 2013). Support from one’s partner can
lead to greater psychological well-being, particularly while facing difficult or stressful
circumstances (Borstelmann et al., 2015; Lal & Bartle-Haring, 2011; Misri et al., 2000; Porter &
Chambless, 2017). In the moment, it can even have a physiologically calming effect (Ditzen et
al., 2007; Kirschbaum et al., 1995). Broadly speaking, having a partner is associated with better
health, as is having a better relationship with one’s partner (Burman & Margolin, 1989; Kiecolt-
Glaser & Newton, 2001; Koball et al., 2010; Robles & Kiecolt-Glaser, 2003). At the same time,
having a more supportive partner is linked with higher relationship satisfaction (Lal & Bartle-
Haring, 2011), potentially through its impact on individual well-being (Cramer, 2004). This
means that supportive relationship processes may even improve the health of the relationship.
Thus, the influence of a romantic partner in difficult or turbulent times is clear. What requires
further elucidation, however, is what constitutes successful or well-received partner-provided
support. Which supportive processes are most effective, and in what ways? For example,
partners may help each other create meaning during difficulty times. The current study seeks to
contribute to the body of literature answering these questions by investigating couples’
interactions about emotionally significant loss experiences. It focuses on two potential outcomes
of partner-provided support: feelings of closeness to or distance from one’s partner and in-the-
moment physiological responses.
In addition to the contexts outlined above, social support can be especially valuable when
coping with the death of a loved one (Hibberd et al., 2010), and the romantic relationship context
in particular is important in shaping the impact of bereavement (Stroebe et al., 2015; Thomas &
11
Striegel, 1995). One process proven to facilitate adjustment in bereaved individuals is meaning
reconstruction, or the act of connecting with a new or changed sense of meaning in life following
a loss (Gillies & Neimeyer, 2006; Neimeyer, 2000, 2001). Meaning and purpose have even been
targets of intervention in bereavement (Lichtenthal et al., 2019). However, meaning-making
likely occurs not only intrapersonally, but also interpersonally. Researchers who have described
meaning-making and meaning reconstruction in bereavement have discussed them as
interpersonal processes and ones that unfold in family systems (Nadeau, 1998; Neimeyer, 2000,
2001). Thus, partners may play an important role in meaning-making. The current study seeks to
examine dyadic meaning-making processes as they unfold in young adult dating couples’
conversations about loss. We hope to provide a window into early presentations of dyadic
meaning-making processes by focusing on a life stage in which partners are first learning to
explore difficult topics like loss together. The current study also broadens the focus of prior
research on meaning-making to include a variety of different forms of loss, including disability,
parental divorce, and more.
The Meaning of Meaning-Making
In the current study, “meaning” is understood as having a strong and coherent sense of
purpose with regard to one’s goals and priorities in life. A number of studies have demonstrated
associations between different facets of meaning and both general well-being and life satisfaction
(Ho et al., 2010; Reker, Peacock, & Wong, 1987; Zika & Chamberlain, 1992). With regard to
“meaning-making,” Victor Frankl (1959/2006) discussed the “will to meaning,” or an inner pull
to find meaning in life, humankind’s ultimate motivator in life. In this framework, meaning is
actively sought and achieved, not passively acquired. This understanding of meaning carries over
into modern conceptualizations of the role that meaning can play in overcoming adversity,
12
especially bereavement. Neimeyer (2000, 2001) discussed meaning reconstruction in
bereavement, or the act of re-establishing a coherent sense of meaning, purpose, and identity in
life after the loss of a loved one. Additionally, in the literature on trauma, making meaning
through expressive writing, and specifically through cognitive processing of a traumatic event,
has shown promise in improving health outcomes in trauma survivors (Park & Blumberg, 2002).
In line with this emphasis on meaning-making process, Park’s (2010) integrated model of
meaning distinguishes between meaning-making, meaning made, and a global sense of meaning.
Specifically, when encountering a potentially stressful situation, people engage in meaning-
making processes, which result in meaning made, which contributes to a global sense of
meaning. The current study focuses on meaning-making processes, a presumed precursor to a
global sense of meaning and better adjustment when encountering a difficult loss.
Meaning and Relationships. Relevant to couples, Neimeyer (2000, 2001) also described
meaning reconstruction as a process that occurs in both intra- and interpersonal contexts. Thus,
when faced with a loss, families or couples can work together to co-construct a sense of meaning
and purpose. Research on couples who lose a child finds that, despite the many psychosocial
challenges posed by the death of child, many couples actually experience greater intimacy and a
stronger relationship (Albuquerque et al., 2016; Oliver, 1999; Schwab, 1998). Hagemeister and
Rosenblatt (1997) found that bereaved parents report that the resilience of their relationship in
the wake of their loss enables them to derive meaning from an otherwise devastating experience.
Similarly, Nadeau (1998; 2001) applied a family systems perspective to the process of meaning-
making and described a variety of tasks through which family members can work together in
making sense of their shared loss experience. These include storytelling and developing a
common understanding and interpretation of evocative experiences. Together, this research
13
suggests meaning-making can unfold interpersonally, which supports the current study’s use of a
dyadic approach in examining how couples navigate and cope with important loss experiences.
Processes of Meaning-Making in Loss. Elaborating on and decomposing the broader
process of meaning-making in the context of bereavement, Gillies and Neimeyer (2006)
described three distinct tasks through which it can be achieved: sense making, benefit finding,
and changes in identity. Sense making refers to the task of understanding “why” and “how” a
loss occurred and can encompass biological explanations, religious attributions, and more.
Broadly, the task of sense making refers to developing and internalizing a coherent story and
causal understanding of a loss, including the various events leading up to the loss and the
circumstances of the loss itself. Benefit finding, on the other hand, is concerned with what
happens after a loss. Specifically, it refers to identifying or discovering positive consequences of
an otherwise devastating experience, such as a new investment in charity and outreach. Finally,
in discovering a post-loss identity, bereaved individuals experience a reorganization of their
sense of self and priorities in life. For example, people may see themselves as more affectionate
or grateful after losing a loved one. The current study will assess each of these three meaning-
making processes in couples’ discussions about loss.
Positive Interactions, Psychophysiology, and Couples
The majority of the work investigating couples’ interactions focuses primarily on
negative conversational processes and disagreements rather than on positive or supportive
processes (Friedlander et al., 2019). This is particularly true among studies that incorporate
physiological measures, which typically investigate conflict or stressful situations. Findings from
these studies include attenuated physiological responses to stress after social support from a
partner (Ditzen et al., 2007; Kirschbaum et al., 1995), physiological downregulation while
14
experiencing positive emotions (Yuan et al., 2010), and quicker cortisol recovery from conflict
with higher levels of mindfulness (Laurent et al., 2016). One study using the same loss
discussion paradigm and a sample that overlapped with the current study found that individuals
responding more compassionately to their partner’s loss demonstrated lower in-the-moment heart
rate (Corner et al., 2019).
These reductions in physiological arousal may be adaptive for long-term health. For
example, although results are mixed, hypothalamic-pituitary-adrenal axis dysregulation, higher
resting heart rate, and cardiovascular reactivity have been linked to increased risk for coronary
heart disease, myocardial infarction, left-ventricular dysfunction, hypertension, and more
(Brotman et al., 2007; Manuck, 1994; Smith & Ruiz, 2002). In a model described by Brotman et
al. (2007), psychological stress can impact neural and hormonal activity, which result in changes
in immune function and other biological processes. Thus, chronic psychological states and
accompanying physiological reactions may actually have immediate and long-term effects on
health, morbidity, and even mortality. This underlies the importance of studying the physiology
of couples’ emotionally charged interactions and suggests the relevance of expanding the kinds
of interactions studied to include potentially positive processes such as those that occur when
partners engage in meaning-making in relation to emotionally significant losses. In the current
study, physiological responses to meaning-making processes were assessed through changes in
electrodermal activity (EDA), which are indicative of arousal of the autonomic nervous system
(ANS; Lazarus, Speisman, & Mordkoff, 1963).
The Autonomic Nervous System. There are two components of the ANS: the
sympathetic and parasympathetic nervous systems. The sympathetic nervous system (SNS) is
responsible for what is commonly referred to as the “fight or flight” response, which promotes
15
action in response to threatening stimuli (Jansen et al., 1995). When threat is real and present,
this is an adaptive and beneficial response. However, chronic activation of this system can have a
negative impact on cardiovascular functioning (Curtis & O’Keefe, 2002). Unlike other
commonly used measures of ANS activity, such as heart rate, which include components of both
SNS and PNS activation (Schmidt-Nielsen, 1997), EDA can be used as a pure measure of SNS
activity.
In psychophysiological studies, EDA is referred to by many different names that can
represent somewhat different concepts; in the current study, we will specifically assess phasic
increases in skin conductance levels, or a skin conductance response. EDA is measured by
monitoring voltage on the volar surface, usually the surface of the skin on one’s hand, which
naturally varies in a wave-like rhythm and changes as a result of the activation of sweat glands
innervated by the sympathetic nervous system (Jacobs et al., 1994). The average skin
conductance level at a particular resting or baseline state, without a stimulus of interest, is
referred to as tonic skin conductance. Tonic skin conductance levels can be disrupted in response
to external stimuli, which is what produces a skin conductance or galvanic skin response
(Lykken & Venables, 1973).
Meaning, Loss, and EDA. Heightened EDA has been demonstrated experimentally in
bereaved individuals experiencing a sense of grief, with greater evoked grief being associated
with greater arousal (Gündel et al., 2003). Relatedly, Proulx and Inzlicht (2012) argued that
meaninglessness, defined as a “the feeling that follows from a meaning violation… [or]
something that just feels wrong” (p. 322), elicits physiological arousal, including a heightened
skin conductance response. O’Connor (2003) proposed that decreased skin conductance
responses in trauma survivors writing about their traumatic experiences over several sessions
16
may be related to meaning-making, i.e., cognitive reappraisal processes elicited through
expressive writing. Thus, the physiology of meaning-making in bereavement may change over
time. Engaging in meaning-making and grappling with meaninglessness may elicit physiological
arousal, whereas having found meaning and subsequently discussing a loss experience may
result in comparatively less arousal. The current study seeks to link conversational meaning-
making processes to moment-to-moment physiological arousal.
Couples’ Interactions and the ANS. A number of studies have focused on ANS
reactivity in individuals’ interactions with their romantic partners. For example, Murray-Close et
al. (2012) found that both male and female partners demonstrated increases in skin conductance
reactivity during a conflict discussion. Furthermore, partners who described their romantic
relationship as functioning more poorly demonstrated stronger positive associations between
relational aggression and ANS reactivity. Other studies have shown links between skin
conductance response to a conflict discussion with a romantic partner and early attachment
experiences (Raby et al., 2015), and heart rate hyporeactivity in men from battering couples and
verbal aggression toward their partner during conflict (Gottman et al., 1995). Research regarding
links between ANS activity and partner-provided support is more limited. Women show
diminished heart rate reactivity to the Trier Social Stress Test when provided with verbal social
support by a partner beforehand (Ditzen et al., 2007). Additionally, when discussing a loss with a
romantic partner, individuals show a gradual decline in their heart rate, as opposed to a gradual
increase observed in partners responding to a loss (Corner et al., 2019). Thus, ANS activity is
closely linked to couples’ conversational processes, especially conflict, and it may also be
relevant in positive, supportive interactions between partners.
Current Study
17
The current study sought to contribute to the literature investigating positive processes in
couples’ interactions. Specifically, it examined the consequences of meaning-making processes
in young adult couples’ discussions about significant losses they have experienced. Given the
relevance of meaning-making processes in bereavement, they are also likely to be important in
the broader context of loss. To our knowledge, this study was the first to examine meaning-
making processes as they occur in dyadic conversations and to synchronize them with
physiological responses, specifically EDA. First, we aimed to investigate associations between
meaning-making processes and both positive and negative feelings toward one’s partner while
sharing a significant loss. Next, we sought to explore the physiology of individuals sharing a loss
while both they and their partners engage in meaning-making processes.
Consistent with the literature demonstrating the benefits of meaning-making in
bereavement (Gillies & Neimeyer, 2006; Neimeyer, 2000, 2001), we hypothesized that greater
engagement in meaning-making would be associated with more positive (Hypothesis 1a) and less
negative (Hypothesis 1b) feelings about one’s partner. Furthermore, consistent with the idea of
grief eliciting physiological arousal (Gündel et al., 2003) and meaning-making a potential
effortful process, we hypothesized that individuals sharing their loss will demonstrate more skin
conductance responses (SCRs) as they actively construct a sense of meaning in their experience
(Hypothesis 2a). At the same time, understanding their partners’ meaning-making as a
potentially supportive process that may ease this burden and recognizing the value of partner-
provided support in a number of other challenging contexts (Cutrona, 1996), we hypothesized
that individuals sharing their loss will demonstrate fewer SCRs when their partners engage in
more meaning-making (Hypothesis 2b). Given that prior work on supportive processes in
couples has focused only on women or found differences between men and women (Ditzen et al.,
18
2007; Kirschbaum et al., 1995), we explored sex differences in the current study’s effects of
interest. However, no specific hypotheses about these differences were formed.
Method
Participants
The current study included 111 opposite-sex couples. The couples were part of a larger
sample of 121 couples recruited as part of the USC Family Studies project studying relationship
processes in young romantic couples. Couples were not included here if they were missing all
physiological data due to technological malfunctions (n = 3), were recruited to pilot test study
procedures (n = 3), or were same-sex couples (n = 4) due to our investigation of sex differences.
Eligibility criteria included being able to complete study activities in English and having been
dating for at least two months. About one-quarter of these couples (n = 29) were identified
through individuals participating in a larger, longitudinal research project on family and dating
relationships. This project includes a large, ethnically diverse sample of young adults who were
originally recruited in late childhood or adolescence (for details, see Margolin, Vickerman,
Oliver, & Gordis, 2010). Having participated in earlier waves of data collection, these
individuals were invited to return as young adults with a current, opposite-sex dating partner.
Additional couples (n = 82) were recruited through advertisements posted in the Los Angeles
community. To resemble the age range of returning participants, those recruited in the
community were between the ages of 18 and 25 years old. The full sample was diverse with
regard to relationship length (M = 30.0 months, SD = 24.1), cohabitation status (n = 49 couples
living together, 44.1%), and racial/ethnic background (n = 61 White non-Hispanic, 27.5%; n =
56 Hispanic, 25.2%; n = 36 Multi-racial, 16.2%; n = 35 Black non-Hispanic 15.8%; n = 26
Asian, 11.7%; and n = 8 other races/ethnicities, 3.6%). More than half of participants were either
19
part- or full-time students (n = 118, 53.2%), and nearly three-quarters were employed part- or
full-time (n = 165, 74.3%). For full characteristics of the sample, see Table 1.
Procedure
Overview. After informed consent procedures and approximately two hours into a
longer, lab-based study visit consisting of several dyadic interactions, couples engaged in two
10-minute loss discussions (Margolin et al., 2020). To prepare for these discussions, partners
separately filled out questionnaires to identify emotionally salient losses they had experienced,
and experimenters used their responses to inform five-minute, one-on-one priming interviews
conducted with each partner to identify their most meaningful loss. Experimenters then asked
participants to discuss the loss they identified. Priority was given to losses that evoked sadness or
other emotions and that occurred outside of the relationship. All participants were able to
identify at least one significant loss. During these loss discussions, each partner had an
opportunity to share his or her loss as the “narrator” of the discussion. The narrator’s partner, as
the “listener,” had an opportunity to respond to the shared loss. The order in which partners
shared their losses was randomly determined, and experimenters left the room during the
discussions. All discussions were video recorded. Participants filled out a questionnaire with
background characteristics before the visit and post-loss discussion questionnaires about their
reactions to each discussion. Topics selected for loss discussions are presented in Table 2. The
most common type of loss discussed was the death of a family member, friend, or someone close
(n = 102, 45.9% of discussions). At the beginning of their visit, each couple engaged in a 15-
minuite relaxation procedure during which they quietly watched a video with relaxing images
and music.
Capturing Physiological Data. Soon after the couple arrived in the lab and provided
20
consent, BioNomadix wireless bio-signal monitoring equipment was applied to each partner.
This equipment was used to collect psychophysiological data throughout the relaxation
procedure and loss discussions, as well as throughout other parts of the visit. The BioNomadix
system included a chest strap, a wrist strap, and sensors attached to the chest, lower rib cage, and
hand. EDA was captured through the sensors attached to participants’ hands. These devices have
been used for a number of other research studies monitoring physiological activity (Bekele et al.,
2013; Winslow et al., 2013).
Measures
Meaning-Making Processes and Other Behaviors. Recordings of all loss discussions
were segmented into one-minute clips. Each clip was coded for a variety of affective experiences
(e.g., sadness, guilt) and behaviors/conversational processes (e.g., expressing concern, showing
discomfort). Coders rated the extent to which emotions and behaviors were exhibited by each
partner during each one-minute clip. They coded one full discussion at a time (i.e., all 10 one-
minute clips coded consecutively) and provided ratings on a scale from 0, “Not at all,” to 3,
“Very much.” Coding was conducted by a team of research assistants and project coordinators.
All coders received extensive training in the codebook and the nature of the loss discussions. All
discussions were viewed and rated by at least two coders, and no coder viewed more than one
discussion from each couple.
The current study focused on the following codes: sense making, benefit finding, changes
in identity, grief, compassion, and dismissiveness. Definitions of sense making, benefit finding,
and changes in identity were guided by the literature on these topics (Gillies & Neimeyer, 2006),
and coders were trained in effectively assessing and rating these processes. Grief, compassion,
and dismissiveness were coded as important covariates. Specifically, grief was coded to capture
21
the intensity of the loss topic each partner selected (i.e., the extent to which it elicits grief), and
compassion and dismissiveness were coded as other potentially relevant conversational
processes, one positive and the other negative. For the purpose of these codes, grief was defined
as yearning or preoccupation in relation to the loss topic; compassion was defined as attempts to
validate, comfort, or reassure one’s partner and showing concern for him or her; and
dismissiveness was defined as minimizing or invalidating one’s partner and undermining his or
her view or experience. Grief codes were used only for narrators, and compassion and
dismissiveness codes were used only for listeners. We selected Gwet’s AC2 to examine coding
reliability because of the skewed distributions of our codes (i.e., the relative infrequency of each
behavior or affect) and the ordinal nature of the ratings that coders assigned (Heyman et al.,
2014; AC2 values calculated using methods outlined by Zaiontz, 2020). AC2 values were .78 for
sense making, .97 for benefit finding, .91 for changes in identify, .86 for narrators’ grief, .75 for
listeners’ compassion, and .94 for listeners’ dismissiveness. These suggest that all codes
demonstrated moderate to strong reliability.
Minute-to-minute meaning-making codes (i.e., sense making, benefit finding, and
changes in identity) were standardized separately across all partners (i.e., narrators and listeners)
and then added together within each minute from each partner to form a composite meaning-
making rating. This rating represents the presence of any kind of meaning-making behavior in
either partner. Although some studies suggest that different meaning-making processes may be
associated with different outcomes (Davis et al., 1998; Holland et al., 2006), the decision to
combine these codes was made for parsimony in the models we tested and due to the low base
rate of these behaviors in relatively short 10-minute discussions without specific instructions to
engage in them.
22
Narrators’ Reaction to the Discussion. Participants filled out questionnaires after each
loss discussion. These questionnaires assessed their emotional reactions to the discussions. The
current study uses data from questionnaires filled out by narrators after their own loss discussion.
Twenty-seven face valid items assessed “what [narrators] were feeling during the discussion”
(e.g., calm, anxious). All participants responded to each item on a scale from 0, “None” or “Not
at all,” to 4, “A lot.” The current study focused on items assessing positive feelings toward one’s
partner (i.e., taken seriously, understood, close, supported, and safe and secure) and negative
feelings toward one’s partner (i.e., ignored, criticized, distant, and judged). These items were
averaged to create separate scores for each of these categories. To investigate and justify the
selection of these specific items, we conducted exploratory factor analysis with a promax
rotation to allow for correlations between factors. All five items representing positive feelings
toward one’s partner loaded on to a single factor and were correlated with this factor at a strength
of .75 or higher. No other items were more strongly correlated with the factor. Similarly, the four
items representing negative feelings toward one’s partner were all correlated with one factor at a
strength of .5 or higher, and no other items were more strongly correlated with the factor.
Narrators’ Electrodermal Activity. EDA data for narrators was captured with
BioNomadix equipment at a sampling rate of 62.5 Hz were processed using AcKnowledge and
Matlab software. Procedures for cleaning and processing these data were developed by Chaspari
et al. (2015). Steps for data processing included: 1) applying a low-pass filter to the EDA data
files; 2) detecting phasic skin conductance responses (SCRs) with an amplitude at or greater than
.02 µS, which is based on minimum amplitude used in prior studies (Dawson et al., 2017); 3)
computationally and visually inspecting files to identify and eliminate any movement artifacts; 4)
calculating the number of SCRs in each one-minute interval. SCRs were chosen as the EDA
23
index for this study because they represent more immediate changes in SNS activity in response
to external stimuli relative to the slower changes observed in overall levels of skin conductance
(Dawson et al., 2000). This was particularly important given that we planned to synchronize
these one-minute intervals with one-minute intervals of affective and conversational processes.
The first five minutes of our relaxation EDA data were trimmed to allow participants to
acclimate to the task. Overall levels of EDA for both loss discussions and relaxation were
calculated as the number of SCRs per minute.
Due to equipment malfunctions, data storage malfunctions, and movement artifacts,
several individuals were missing EDA data completely, and others lacked one or more one-
minute intervals. Seven narrators (3.2% of participants) were missing all loss discussion SCR
data, and 13 other narrators were missing between one and eight one-minute intervals (5.9% of
participants missing, on average, 3.5 minutes of data). In total, narrators’ SCR data were missing
for 116 one-minute intervals (5.2% of 2220 total intervals). With regard to EDA captured during
relaxation, participants were counted as missing if SCR data were not available or useable for
more than 50% of the task. This resulted in missing relaxation data for 19 participants (8.6%). A
total of 22 narrators (9.9%) were missing either relaxation SCR data or all ten one-minute
intervals of loss discussion SCR data, and a total of 262 intervals (11.8%) were missing loss
discussion SCR data or belonged to individuals missing relaxation SCR data. Given that these
data were missing for reasons unrelated to the constructs being studied (i.e., technological
challenges), data were assumed to be missing completely at random. Therefore, analyses
including EDA were run with just available data.
Data Analysis
Analyses for the current study were conducted using SAS version 9.4 (SAS Institute Inc.,
24
2015). Independent samples t-tests were used to compare male and female participants with
regard to mean levels of continuous variables. A Welch-Satterthwaite adjustment was used when
variances significantly differed by sex. Pearson’s χ
2
tests were used to compare male and female
participants in their distribution of categorical variables, and Fisher’s exact test was used when
any cell counts were below 5. Pearson’s correlation coefficients were calculated to examine
associations between continuous variables representing features of the loss discussions.
Multilevel models with random intercepts only were used to test our first hypothesis. This
approach was chosen to account for within-couple dependence in our variables of interest.
Behavioral codes and narrators’ positive and negative feelings toward their partner (level 1) were
nested by couple (level 2). For the purpose of these analyses, minute-by-minute behavioral
coding ratings were averaged across the entire discussion to match post-discussion reports of
feelings toward one’s partner.
To test our second hypothesis, we used multilevel models for intensive longitudinal data
from distinguishable dyads (Bolger & Laurenceau, 2013). This approach was chosen for several
reasons. First, it uses only level 1 (i.e., minute-by-minute observations) and level 2 (i.e., the
couple) equations to model data with a 3-level structure, which is more appropriate than a 3-level
approach given that there is no random variability at the person level when second level groups
include only two individuals. Second, it enables the calculation of separate equations for each
partner (i.e., one for the male partner and one for the female partner). Third, it simultaneously
models within-couple dependence for a given observation and within-person dependence
between multiple observations. For the purpose of these analyses, SCRs from each one-minute
interval were synchronized with minute-by-minute data from behavioral coding. Group-centered
minute-by-minute behavioral coding ratings were included in models to test the effects of within-
25
person differences in meaning-making (i.e., minute-to-minute changes in meaning-making), and
average levels of behavioral codes were included to test between-person differences.
All models controlled for the listener’s levels of dismissiveness and compassion and the
narrator’s level of grief to isolate the impact of meaning-making alone, rather than other relevant
conversational processes, and account for the intensity of the grief elicited by the loss topics
partners selected. Sensitivity analyses were conducted to determine the impact of controlling for
other conversational processes, and implications of the inclusion of these covariates are
discussed. Own (i.e., the narrator’s) and partner (i.e., the listener’s) levels of meaning-making
were tested simultaneously. Additional covariates included student status, employment status,
age, years together as a couple, and the order in which the discussions took place. Models testing
our second hypothesis also controlled for SCRs during relaxation to isolate reactivity to the loss
discussion. All continuous variables were grand mean centered. All binary categorical variables
were contrast coded with the exception of sex, which was entered as 0 = Female and 1 = Male in
the models testing the second hypothesis. These decisions were made to aid in the interpretation
of model intercepts and interactions.
Sex differences in our effects of interest were tested using two-way interactions with sex
for both hypotheses and by comparing the fit (i.e., AIC) of models including and not including
separate effects for male and female partners for hypothesis 2. When significant differences were
detected in models testing our first hypothesis, results from models including two-way
interactions are reported. Simple slopes analyses were used to test the significance level of the
effect for male partners, which was represented by combination of the overall effect and the
interaction with sex. When significant differences were detected in models testing our second
hypothesis, effects from separate equations for male and female partners are reported. Model fit
26
was also examined (i.e., testing differences in fit when including and not including certain
parameters) to determine the appropriate variance and covariance structure for models testing
hypothesis 2.
Results
Correlations between features of the loss discussion are presented in Table 3. Of note,
male and female participants differed with regard to their number of skin conductance responses
per minute as the narrator, their average level of coded compassion, and their age. Specifically,
male participants showed more skin conductance responses and higher levels of compassion and
were, on average, older.
The male partner’s meaning-making as the narrator was positively associated with his
own grief and his partner’s compassion as the listener, and his grief was also associated with his
partner’s compassion. The female partner’s meaning-making as the narrator was positively
associated with her own grief and her partner’s meaning-making as the listener. The male
partner’s meaning-making as the listener was positively associated with his own dismissiveness
and the female partner’s grief as the narrator.
For both male and female narrators, positive and negative feelings toward their partner
after the discussion were negatively associated. The female narrator’s negative feelings toward
her partner were negatively associated with her own meaning-making, and her positive feelings
were positively associated with her partner’s compassion. Male and female narrators’ positive
and negative feelings toward each other (e.g., the male narrator’s positive feelings toward his
partner and the female narrator’s positive feelings toward her partner) were linked between the
two discussions.
Hypothesis 1: Meaning-Making and Narrators’ Feelings Toward Their Partner
27
Results from the two models testing hypothesis 1 are presented in Table 4. For both male
and female partners, the narrator’s meaning-making was positively associated with their positive
feelings toward their partner after the discussion and negatively associated with their negative
feelings toward their partner. Sex moderated the association between the listener’s meaning-
making and the narrator’s positive feelings toward their partner. Specifically, female narrators
demonstrated a positive association between their partner’s meaning-making and their positive
feelings toward him. Simple slopes analyses, presented in Figure 1, revealed that this association
was not significant for male narrators (p > .10).
Hypothesis 2: Meaning-Making and Narrators’ Electrodermal Activity
Results from the model testing hypothesis 2 are presented in Table 5. Comparisons of
model fit suggested that random intercepts and random effects of time (i.e., minute in the
discussion) improved fit (for random intercepts, entered together: χ
2
(3) = 262.8, p < .001; for
random effects of time, entered subsequently and together: χ
2
(7) = 25.9, p < .001). Therefore,
these parameters were included in the final model. No other random effects improved fit.
For both male and female partners, minute-to-minute increases in meaning-making by the
listener were associated with fewer skin conductance responses in the narrator. Independent of
meaning-making processes, female narrators demonstrated a decrease in their number of skin
conductance responses over the course of the discussion, while male narrators did not show
increases or decreases. With the exception of the association for the narrator’s overall meaning-
making (i.e., the between-person effect), none of the effects of meaning-making differed by sex.
Separate effects for the male and female narrators’ overall meaning-making were included in the
model, and although they significantly differed (effect for its interaction with gender: β = -3.87,
95% CI = -7.04 to -0.69, p = .02), neither was significant on its own (ps > .05).
28
Discussion
As hypothesized, we found that when individuals (“narrators”) shared a loss with their
partner, more meaning-making was linked with more positive and less negative feelings toward
their partners (“listeners”). In partial support of our expectations, female narrators felt more
positively about their partners when those partners exhibited higher levels of meaning-making.
However, this association was not observed for male narrators. Minute-to-minute changes in
levels of listeners’ meaning-making were linked with narrators’ physiological arousal, such that
narrators demonstrated lower levels of EDA when their partners were engaging in more
meaning-making. However, contrary to our expectations, narrators’ own meaning-making was
not linked to their physiology, and neither partner’s overall meaning-making across the course of
discussion was associated with overall levels of arousal. Of note, overall levels of coded
meaning-making correlated with several other coded affective and conversational processes.
Meaning-making in narrators was associated higher levels of behaviorally-exhibited grief for
both male and female narrators and greater compassion in female listeners paired with male
narrators. Meaning-making in male listeners was associated with greater dismissiveness.
These results lend partial support to the idea that couples’ dyadic meaning-making can be
a unique and valuable supportive process in the context of loss. Overall, individuals appear to
feel better about their partners when they themselves engage in more meaning-making while
sharing an emotionally significant loss. Delving into the significance of a loss and making sense
of it may foster connection and understanding between partners. Alternatively, individuals may
feel more equipped to discuss and explore these difficult loss-related topics when they are feeling
close to their partners. At the same time, assisting a partner with meaning-making while listening
to them share a loss may, in certain contexts, similarly promote positive feelings in the
29
relationship. However, there are likely sex differences in the execution of this supportive process
or how it is received. Nonetheless, despite the difference in observed associations between
listeners’ meaning-making and narrators’ feelings toward the listener for male and female
partners, there was an observed association between listeners’ meaning-making and the
narrators’ physiology for both sexes. Assisting a partner with meaning-making may lead to
momentary downregulation of their physiological activity, operationalized in the current study as
sympathetic nervous system activity as measured by skin conductance responses. We found this
for moment-to-moment, but not overall, levels of meaning-making, suggesting that this process
occurs dynamically and over time throughout complex discussions between partners.
These results are from models controlling for other affective and conversational
processes, specifically the narrators’ grief and the listeners’ compassion and dismissiveness.
Several significant bivariate correlations of moderate strength emerged between overall levels of
meaning-making and these codes, suggesting that these processes sometimes occur in tandem
with each other. When we dropped these codes as covariates, associations for meaning-making
in models testing our first hypothesis were similar in direction and magnitude, but became non-
significant. In contrast, the association for moment-to-moment meaning-making by the listener
in the model testing our second hypothesis remained significant. This suggests that the affective
impact of meaning-making may be clouded by other supportive or deleterious conversational
processes, or perhaps even by the intensity of the grief elicited by the discussion. Disentangling
these processes and features of couples’ discussions about loss is a vital task for researchers, but
it is also important for couples. Individuals may be able to best utilize meaning-making in a
supportive way when they find ways to do it without being dismissive and while being
compassionate and attuned to their partner’s affective experience. At the same time, the fact that
30
links between meaning-making and EDA persist with or without controlling for these other
processes indicates the possibility that the physiological correlates of meaning-making could be
deeply ingrained and cut across different conversational contexts.
We did not find a link between narrators’ levels of meaning-making and their own
physiology, either overall or from moment-to-moment. This is surprising given prior studies
suggesting that skin conductance responses are elicited by reckoning with meaninglessness
(Proulx & Inzlicht, 2012). It is possible that, given the variability in how long ago these losses
occurred for most individuals in the study, narrators had already engaged in several of these
meaning-making processes on their own, and their partners’ responses to their losses were
actually more relevant to their physiology. Even so, it is notable that female partners exhibit an
overall decrease in their minute-to-minute number of skin conductance responses over the course
of the discussion. Part of this may be attributable to acclimating to the conversation context, but
at this point in their in-lab study visit, couples had already engaged in at least two, if not three,
dyadic discussions. This may suggest the overall physiological benefit of discussing a loss with a
partner (Margolin et al., 2020). Taken together with the rest of the current study’s findings,
engaging in these challenging, emotionally evocative conversations in a relationship context is
potentially valuable, and the ways in which each partner helps make sense of a difficult loss may
even deepen these affective and physiological benefits.
To our knowledge, the current study was the first to examine the physiological and
affective implications of meaning-making processes as they unfold in couples’ discussions. The
use of a novel loss discussion paradigm enabled an examination of these processes in relation to
partners’ experiences of loss, a context in which sense making, benefit finding, and changes in
identity are relevant and meaningful. Another unique strength of this study was its ability to
31
synchronize EDA data with minute-to-minute behaviorally coded meaning-making processes,
the latter of which was assessed dyadically. Collecting data from both partners participating in
these discussions enabled the examination of cross-partner associations, such as how the
listener’s behavior impacted the narrator’s physiology and emotional response to the
conversation.
With regard to limitations, the current study focused exclusively on young adult dating
couples, and most participants were between the ages of 18 and 25 years old. On the one hand,
this limits the generalizability of this study’s findings. However, it also enabled the investigation
of meaning-making processes in early, yet serious relationships with diverse levels of intimacy
and experience with discussions about loss. This could be a critical period for many participants,
representing the first time they are sharing these emotionally significant losses with an intimate
partner. It is therefore vital to better understand these difficult and critical interactions in this
population. Additionally, the current study is limited to opposite-sex couples in order to facilitate
statistical exploration of gender differences and reduce any unexpected variability introduced by
differences in meaning-making processes between same- and opposite-sex couples. It will be
important to replicate this study’s findings in a sample of same-sex couples to ensure that
meaning-making processes unfold in a similar way and have similar physiological and emotional
implications, particularly given the sex differences we observed.
The current study has a variety of implications for couples’ interactions about loss. Our
findings suggest the value of partner support in meaning-making around a loss experience. They
would also suggest that conversations with an intimate partner can be helpful in coping with
losses, even distal losses experienced outside of the romantic relationship. Dyadically engaging
in meaning-making processes such as sense making, benefit finding, and uncovering changes in
32
identity appears to covary with closeness between partners. It also appears to be tied to
immediate physiological responses in the individual sharing a loss, and a partner may be able to
ease the burden of appraising and constructing meaning around a loss experience. Encouraging
these kinds of discussions between partners may be valuable for mental health clinicians working
with clients affected by loss, and fostering skills in responsive, compassionate, and non-
dismissive meaning-making may be particularly important.

33
References
Albuquerque, S., Pereira, M., & Narciso, I. (2016). Couple’s relationship after the death of a
child: A systematic review. Journal of Child and Family Studies, 25(1), 30-53.
Bolger, N., & Laurenceau, J-P. (2013). Intensive longitudinal methods: An introduction to diary
and experience sampling research. The Guilford Press.
Borstelmann, N. A., Rosenberg, S. M., Ruddy, K. J., Tamimi, R. M., Gelber, S., Schapira, L., …
Partridge, A. H. (2015). Partner support and anxiety in young women with breast cancer.
Psycho-Oncology, 24(12), 1679-1685.
Brotman, D. J., Golden, S. H., & Wittstein, I. S. (2007). The cardiovascular toll of stress. The
Lancet, 370, 1089-1100.
Burman, B., & Margolin, G. (1989). Marriage and health. Advances, 6(4), 51-58.
Cheng, E. R., Rifas-Shiman, S. L., Perkins, M. E., Rich-Edwards, J. W., Gilman, M. W., Wright,
R., & Taveras, E. M. (2016). The influence of antenatal partner support on pregnancy
outcomes. Journal of Women’s Health, 25(7), 672-679.
Corner, G. W., Saxbe, D. E., Chaspari, T., Rasmussen, H. F., Perrone, L., Pettit, C., … Margolin,
G. (2019). Compassion in a heartbeat: Physiology during couples’ loss discussions.
Journal of Social and Personal Relationships, 36(6), 1671-1694.
Cramer, D. (2004). Emotional support, conflict, depression, and relationship satisfaction in a
romantic partner. The Journal of Psychology, 138(6), 532-542.
Curtis, B. M., & O’Keefe, J. H. (2002). Autonomic tone as a cardiovascular risk factor: The
dangers of chronic fight or flight. Mayo Clinic Proceedings, 77(1), 45-54.
Cutrona, C. E. (1996). Social support in couples. Thousand Oaks, CA: SAGE Publications, Inc.
Davis, C. G., Nolen-Hoeksema, S., & Larson, J. (1998). Making sense of loss and benefitting
34
from the experience: Two construals of meaning. Journal of Personality and Social
Psychology, 75(2), 561-574.
Dawson, M. E., Schell, A. M., & Filion, D. L (2017). The electrodermal system. In J. T.
Cacioppo, L G. Tassinary, & G. G. Bernston (Eds.), Principles of psychophysiology:
Physical social and inferential elements (4th ed., pp. 217-243). New York, NY:
Cambridge University.
Ditzen, B., Neumann, I. D., Bodenmann, G., von Dawans, B., Turner, R. A., Ehlert, U.,
Heinrichs, M. (2007). Effects of different kinds of couple interaction on cortisol and heart
rate responses to stress in women. Psychoneuroendocrinology, 32(5), 565-574.
Frankl, V. (2006). Man’s search for meaning. Boston, MA: Beacon Press. (Original work
published 1959)
Friedlander, M. L., Lee, M., & Escudero, V. (2019). What we do and do not know about the
nature and analysis of couple interaction. Couple and Family Psychology: Research and
Practice, 8(1), 24-44.
Gillies, J., & Neimeyer, R. A. (2006). Loss, grief, and the search for significance: Toward a
model of meaning reconstruction in bereavement. Journal of Constructivist Psychology,
19(1), 31-65.
Gottman, J. M., Jacobson, N. S., Rushe, R. H., Shortt, J. W., Babcock, J., La Taillade, J. J., &
Waltz, J. (1995). The relationship between heart rate reactivity, emotionally aggressive
behavior, and general violence in batterers. Journal of Family Psychology, 9(3), 227-248.
Gündel, H., O’Connor, M., Littrell, L., Fort, C., & Lane, R. D. (2003). Functional neuroantomy
of grief: An fMRI study. The Americann Journal of Psychiatry, 160(11), 1946-1953.
Hagemeister, A. K., & Rosenblatt, P. C. (1997). Grief and the sexual relationship of couples who
35
have experienced a child’s death. Death Studies, 21(3), 231-252.
Heyman, R. E., Lorber, M. F., Eddy, J. M., & West, T. V. (2014). Behavioral observation and
coding. In H. T. Reis & C. M. Judd (Eds.), Handbook of research methods in social and
personality psychology (2nd ed., pp. 345-372). Cambridge University Press.
Hibberd, R., Elwood, L. S., & Galovski, T. E. (2010). Risk and protective factors for
posttraumatic stress disorder, prolonged grief, and depression in survivors of the violent
death of a loved one. Journal of Loss and Trauma, 15(5), 426-447.
Ho, M. Y., Cheung, F. M., & Cheung, S. F. (2010). The role of meaning in life and optimism in
promoting well-being. Personality and Individual Differences, 48(5), 658-663.
Holland, J. M., Currier, J. M., & Neimeyer, R. A. (2006). Meaning reconstruction in the first two
years of bereavement: The role of sense-making and benefit-finding. Omega: Journal of
Death and Dying, 53(3), 175-191.
Jacobs, S. C., Friedman, R., Parker, J. D., Tolfer, G. H., Jimenez, A. H., Muller, J. E., … Stone,
P. H. (1994). Use of skin conductance changes during mental stress testing as an index of
autonomic arousal in cardiovascular research. American Heart Journal, 128(6), 1170-
1177.
Jansen, A. S. P., Nguyen, X. V., Karpitskiy, V., Mettenleiter, T. C., & Loewy, A. D. (1995).
Central command neurons of the sympathetic nervous system: Basis of the fight-or-flight
response. Science, 270(5236), 644-646.
Kamen, C., Mustian, K., Heckler, C., Janelsins, M., Peppone, L., Mohile, S, … Morrow, G. R.
(2015). The association between partner support and psychological distress among
prostate cancer survivors in a nationwide study. Journal of Cancer Survivorship, 9(3),
492-499.
36
Karakurt, G., Christiansen, A. T., MacDermid Wadsworth, S. M., & Weiss, H. M. (2013).
Romantic relationships following wartime deployment. Journal of Family Issues, 34(11),
1427-1451.
Kiecolt-Glaser, J. K., & Netwon, T. L. (2001). Marriage and health: His and hers. Psychological
Bulletin, 127(4), 472-503.
Kirschbaum, C., Klauer, T., Filipp, S. & Hellhammer, D. H. (1995). Sex-specific effects of social
support on cortisol and subjective responses to acute physiological stress. Psychosomatic
Medicine, 57(1), 23-31.
Koball, H. L., Moiduddin, E., Henderson, J., Goesling, B., & Besculides, M. (2010). What do we
know about the link between marriage and health? Journal of Family Issues, 31(8), 1019-
1040.
Lal, A., & Bartle-Haring, S. (2011). Relationship among differentiation of self, relationship
satisfaction, partner support, and depression in patients with chronic lung disease and
their partners. Journal of Marital and Family Therapy, 37(2), 169-181.
Laurent, H. K., Hertz, R., Nelson, B., & Laurent, S. M. (2016). Mindfulness during romantic
conflict moderates the impact of negative partner behaviors on cortisol responses.
Hormones and Behavior, 79(1), 45-51.
Lazarus, R. S., Speisman, J. C., & Mordkoff, A. M. (1963). The relationship between autonomic
indicators of psychological stress: Heart rate and skin conductance. Psychosomatic
Medicine, 25(1), 19-30.
Lichtenthal, W. G., Catarozoli, C., Masterson, M., Slivjak, E., Schofield, E., Roberts, K. E., …
Breitbart, W. (2019). An open trial of meaning-centered grief therapy: Rationale and
preliminary evaluation. Palliative & Supportive Care, 17(1), 2-12.
37
Lykken, D. T., & Venables, P. H. (1973). Direct measurement of skin conductance: A proposal
for standardization. Psychophysiology, 8(5), 656-672.
Manuck, S. B. (1994). Cardiovascular reactivity in cardiovascular disease: “Once more unto the
breach.” International Journal of Behavioral Medicine, 1(1), 4-31.
Margolin, G., Daspe, M-E., Timmons, A., Schacter, H., Corner, G., Pettit, C., … Del Piero, L.
(2020). What happens when young couples discuss personal loss? Relational, emotional
and physiological impacts. Department of Psychology, Los Angeles, CA.
Margolin, G., Vickerman, K. A., Oliver, P. H., & Gordis, E. B. (2010). Violence exposure in
multiple interpersonal domains: cumulative and differential effects. Journal of Adolescent
Health, 47(2), 198-205.
Misri, Kostaras, Fox, & Kostaras, (2000). The impact of partner support in the treatment of
postpartum depression. The Canadian Journal of Psychiatry, 45(6), 554-558.
Murray-Close, D., Holland, A. S., & Roisman, G. I. (2012). Autonomic arousal and relational
aggression in heterosexual dating couples. Personal Relationships, 19(2), 203-218.
Nadeau, J. W. (1998). Families making sense of death. Thousand Oaks, CA: Sage Publishing.
Nadeau, J. W. (2001). Family construction of meaning. In R. A. Neimeyer (Ed.), Meaning
reconstruction and the experience of loss (pp. 95-111). American Psychological
Association.
Neimeyer, R. A. (2000). Searching for the meaning of meaning: Grief therapy and the process of
reconstruction. Death Studies, 24(6), 541-558.
Neimeyer, R. A. (2001). Meaning reconstruction and the experience of loss. American
Psychological Association.
O’Connor, M. (2003). Making meaning of life events: Theory, evidence, and research directions
38
for an alternative model. Omega: Journal of Death and Dying, 46(1), 51-75.
Oliver, L. E. (1999). Effects of a child’s death on the marital relationship: A review. Omega:
Journal of Death and Dying, 39(3), 197-227.
Park, C. L. (2010). Making sense of the meaning literature: An integrative review of meaning
making and its effects on adjustment to stressful life events. Psychological Bulletin,
136(2), 257-301.
Park, C. L., & Blumberg, C. J. (2002). Disclosing trauma through writing: Testing the meaning-
making hypothesis. Cognitive Therapy and Research, 26(5), 597-616.
Porter, E. & Chambless, D. L. (2017). Social anxiety and social support in romantic
relationships. Behavior Therapy, 48(3), 335-348.
Proulx, T., & Inzlicht, M. (2012). The five “A”s of meaning maintenance: Finding meaning in
the theories of sense-making. Psychological Inquiry, 23(4), 317-335.
Raby, K. L., Roisman, G. I., Simpson, J. A., Collins, W. A., & Steele, R. D. (2015). Greater
maternal insensitivity in childhood predicts greater Electrodermal reactivity during
conflict discussions with romantic partners in adulthood. Psychological Science, 26(3),
348-353.
Reker, G. T., Peacock, E. J., & Wong, P. T. P. (1987). Meaning and purpose in life and well-
being: A life-span perspective. Journal of Gerontology, 42(1), 44-49.
Robles, T. F., & Kiecolt-Glaser, J. K. (2003). The physiology of marriage: Pathways to health.
Physiology & Behavior, 79(3), 409-416.
SAS Institute Inc. (2015). SAS® 9.4 Intelligence Platform: System administration guide, fourth
edition. SAS Institute Inc.
Schmidt-Nielsen, K. (1997). Animal physiology: Adaptation and environment. Cambridge, UK:
39
Cambridge University Press.
Schwab, R. (1998). A child’s death and divorce: Dispelling the myth. Death Studies, 22(5), 445-
468.
Smith, T. W., & Ruiz, J. M. (2002). Psychosocial Influences on the development and course of
coronary heart disease: Current status and implications for research and practice. Journal
of Consulting and Clinical Psychology, 70(3), 548-568.
Stroebe, M., Finkenauer, C., Wijngaards-de Meij, L., Schut, H., van den Bout, J., & Stroebe, W.
(2013). Partner-oriented self-regulation among bereaved parents: The costs of holding in
grief for the partner’s sake. Psychological Science, 24(4), 395-402.
Thomas, V., & Striegel, P. (1995). Stress and grief of a perinatal loss: Integrating qualitative and
quantitative methods. Omega: Journal of Death and Dying, 30(4), 299-311.
Yuan, J. W., McCarthy, M., Holley, S. R., & Levenson, R. W. (2010). Physiological down-
regulation and positive emotion in marital interaction. Emotion, 10(4), 467-474.
Zaiontz, C. (2020). Gwet’s AC1 and AC2. Real statistics using Excel. Retrieved October 7, 2019,
from https://www.real-statistics.com/reliability/interrater-reliability/gwets-ac2/
Zika, S., & Chamberlain, K. (1992). On the relation between meaning in life and psychological
well-being. British Journal of Psychology, 83(1), 133-145.

40
Table 1. Participant characteristics (n = 111 couples, 222 individuals).

Male
Participants

Female
Participants

Test
Statistic

Participant Characteristics M (SD) / n (%) (e.g., t, χ
2
)
Age 23.11 (2.83) 22.16 (1.79) 2.98**
Race 1.61
Asian 11 (9.9%) 15 (13.5%)
Black/African American 20 (18.0%) 15 (13.5%)
Hispanic/Latinx 27 (24.3%) 29 (26.1%)
White/Caucasian 30 (27.0%) 31 (27.9%)
Other 4 (3.6%) 4 (3.6%)
Multi-Racial 19 (17.1%) 17 (15.3%)
Student Status 5.22
Not in School 60 (54.1%) 45 (40.5%)
Part-Time 17 (15.3%) 16 (14.4%)
Full-Time 34 (30.6%) 50 (45.0%)
Employment Status 2.16
Not Employed 27 (24.3%) 31 (27.9%)
Part-Time 46 (41.4%) 52 (46.8%)
Full-Time 38 (34.2%) 28 (25.2%)
Couple Characteristics
Living Together 49 (44.1%)
Married 2 (1.8%)
Years Together 2.50 (2.01)
Loss Discussion Variables
SCRs (Narrator)
a
6.49 (2.73) 5.60 (2.88) 2.30*
SCRs (Relaxation)
b
3.03 (2.13) 2.49 (2.37) 1.69
MM (Narrator) 0.34 (0.51) 0.22 (0.45) 1.89
MM (Listener) -0.25 (0.26) -0.31 (0.22) 1.78
Grief (Narrator) 0.23 (0.36) 0.26 (0.36) -0.50
Comp (Listener) 0.72 (0.47) 0.57 (0.42) 2.36*
Dismiss (Listener) 0.19 (0.33) 0.14 (0.24) 1.23
Pos Feelings (Narrator)
c
3.42 (0.81) 3.32 (0.87) 0.85
Neg Feelings (Narrator)
c
0.12 (0.34) 0.17 (0.45) -1.03

Significance: * = p < .05, ** = p < .01.

Critical values represent comparisons between male and female participants. For comparisons between means, t-
tests (with Welch-Satterthwaite adjustment when variances significantly differed) were used. For comparisons
between distributions, Pearson’s χ
2
tests (or Fisher’s exact tests for distributions with small cell counts) were
used.

Missing data: a = 4 men, 3 women; b = 8 men, 11 women; c = 3 men, 2 women.

Abbreviations: SCRs = Skin conductance responses; MM = Meaning-making; Comp = Compassion; Dismiss =
Dismissiveness; Pos = Positive post-discussion feelings toward partner; Neg = Negative post-discussion feelings
toward partner.

41
Table 2. Loss discussion topics (n = 222 discussions).

Male
Participants

n (%)

Female
Participants

n (%)

Topic Selected
Death (Parent) 4 (3.6%) 9 (8.1%)
Death (Other Family or Friend) 50 (45.0%) 36 (32.4%)
Death or Loss (Pet) 5 (4.5%) 4 (3.6%)
Health Problems (Self) 3 (2.7%) 5 (4.5%)
Health Problems (Family or Friend) 13 (11.7%) 18 (16.2%)
Career or Educational Setbacks 9 (8.1%) 10 (9.0%)
Divorce (Parents) 11 (9.9%) 7 (6.3%)
Divorce (Other Family or Friend) 5 (4.5%) 4 (3.6%)
Loss of Contact (Parent) 1 (0.9%) 4 (3.6%)
Loss of Contact (Friend) 5 (4.5%) 4 (3.6%)
Moving Away (Self, Friend, or Family) 4 (3.6%) 4 (3.6%)
Abortion (Self or Friend) 1 (0.9%) 3 (2.7%)
Other 0 (0.0%) 3 (2.7%)

Male and female participants did not differ in the frequency with which they discussed different topics (p > .10
with a Fisher’s exact test).

42

43
Table 4. Models testing associations between meaning-making and feelings toward one’s partner
during the discussion (H1).

Predicting Positive Feelings

Predicting Negative Feelings

Fixed Effects β 95% CI β 95% CI
Intercept 3.44*** 3.20 to 3.68 0.18** 0.07 to 0.29
Covariates
Male -0.31* -0.61 to -0.00 -0.07 -0.17 to 0.03
Her Loss First -0.09 -0.22 to 0.03 0.06* 0.00 to 0.12
Student -0.04 -0.15 to 0.08 0.02 -0.04 to 0.08
Employed 0.07 -0.05 to 0.19 -0.02 -0.08 to 0.04
Living Together 0.00 -0.12 to 0.13 0.03 -0.04 to 0.09
Age 0.00 -0.05 to 0.05 0.03* 0.01 to 0.06
Years Together -0.06 -0.13 to 0.02 0.04* 0.01 to 0.08
Male * Years Together 0.11** 0.02 to 0.20 -0.06** -0.11 to -0.02
Loss Discussion
Characteristics

MM (Narrator) 0.28* 0.05 to 0.51 -0.14* -0.25 to -0.02
MM (Listener) 0.74** 0.18 to 1.30 -0.15 -0.37 to 0.07
Male * MM (Listener) -1.21** -2.08 to -0.35 --- ---
Grief (Narrator) -0.24 -0.56 to 0.08 0.04 -0.02 to 0.10
Comp (Listener) 0.28* 0.05 to 0.51 -0.04 -0.11 to 0.03
Random Effects
Intercept 0.20** 0.11 to 0.44 0.03* 0.02 to 0.11

Significance: * = p < .05, ** = p < .01, *** p < .001.

All continuous variables are grand mean centered. All categorical variables are contrast coded with the exception
of “Male,” which is coded as 0 = Female Participants, 1 = Female Participants. These decisions were made to aid
in the interpretation of model intercepts and interactions.

Missing data for both models: 3 men, 2 women.

Abbreviations: SCRs = Skin conductance responses; MM = Meaning-making; Comp = Compassion; Dismiss =
Dismissiveness; Positive Feelings = Positive post-discussion feelings toward partner; Negative Feelings =
Negative post-discussion feelings toward partner.

44
Table 5. Models testing associations between meaning-making and electrodermal activity (H2).
Fixed Effects β 95% CI
Intercept Men 6.09*** 5.08 to 7.12
Intercept Women 6.48*** 5.58 to 7.37
Covariates
Her Loss First -0.09 -0.51 to 0.34
Student -0.34 -0.75 to 0.07
Employed -0.50* -0.93 to -0.08
Living Together -0.14 -0.56 to 0.29
Age -0.07 -0.25 to 0.10
Years Together 0.29** 0.09 to 0.49
SCRs (Relaxation) 0.35*** 0.19 to 0.51
Loss Discussion Covariates
Grief (Within-Person, Narrator) 0.02 -0.11 to 0.15
Grief (Between-Person, Narrator) -0.42 -1.57 to 0.73
Comp (Within-Person, Listener) -0.01 -0.13 to 0.12
Comp (Between-Person, Listener) -0.07 -0.91 to 0.77
Dismiss (Within-Person, Listener) 0.03 -0.09 to 0.16
Dismiss (Between-Person, Listener) -0.71 -2.05 to 0.63
Loss Discussion Characteristics
Minute Men -0.03 -0.10 to 0.04
Minute Women -0.14*** -0.20 to -0.08
MM (Within-Person, Narrator) 0.04 -0.14 to 0.21
MM (Between-Person, Narrator) -0.14 -0.97 to 0.68
MM (Within-Person, Listener) -0.34* -0.65 to -0.03
MM (Between-Person, Listener) Men -2.31 -4.78 to 0.16
MM (Between-Person, Listener) Women 1.56 -0.50 to 3.62
Random Effects
Within-Couple
Intercept Men 6.33*** 4.71 to 8.97
Intercept Women 6.64*** 4.94 to 9.39
Minute Men 0.06** 0.03 to 0.13
Minute Women 0.02 0.01 to 0.17
Between-Couple
Partners’ Residual Covariance 0.28 -0.10 to 0.66
Autocorrelation 0.10** 0.04 to 0.17

Significance: * = p < .05, ** = p < .01, *** = p < .001

Within-person associations are calculated for group-centered ratings (i.e., how the ratings for a given minute
compare to the mean rating for a given individual during a given discussion). Between-person associations are
calculated for the average rating for a given individual during a given discussion. All continuous variables are
grand mean centered, and all categorical covariates are contrast coded. These decisions were made to aid in the
interpretation of model intercepts and interactions.

Missing data for the model: 10 men and 12 women; 31 other observations from 9 men and 11 from 3 women.

Abbreviations: MM = Meaning-making; Comp = Compassion; Dismiss = Dismissiveness

45
Figure 1. Results from simple slopes analyses for the effect of the listener’s meaning-making on
the narrator’s positive feelings toward them.

46

The Birth of a Story:
How Meaning-Making Around a Birth Experience Predicts
Postpartum Adjustment for Individuals and Couples
Geoffrey W. Corner
Hannah F. Rasmussen
Mona Khaled
Alyssa Morris
Hannah Khoddam
Nia Barbee
Shirin Herzig
Elizabeth Seibert
Yesenia Brasby
Gayla Margolin
Darby E. Saxbe
University of Southern California

47
Abstract
Many individuals and couples face stress and relationship strain during the transition to
parenthood. The childbirth experience may set the stage for this transition and shape resilience to
these challenges. Specifically, parents’ ability to make meaning of their birth experience could
play a critical role in postpartum adjustment. Meaning-making is recognized as beneficial when
facing bereavement and illness, but may also be valuable during the transition to parenthood. The
current study investigated how three meaning-making processes (i.e., sense making, benefit
finding, and changes in identity) predict new parents’ changes in relationship functioning and
levels of parenting stress. These processes were behaviorally coded in birth narratives provided
by a sample of new parent dyads (n = 83), typically within two days of the birth of their child.
Mothers’ levels of sense making and benefit finding predicted smaller declines in her own
relationship functioning, and mothers’ sense making similarly predicted smaller declines for
fathers. Fathers’ sense making and benefit finding were associated with lower levels of their own
parenting stress, and mothers’ sense making and benefit finding were linked with higher
parenting stress in fathers. Finally, fathers’ discussion of changes in identity was associated with
lower levels of parenting stress in mothers. These results underscore the importance of birth-
related meaning-making in adjustment during the transition to parenthood and highlight the value
of studying these meaning-making processes dyadically. Efforts by clinicians to support new
parents in making meaning of their birth experience or other critical events during the transition
to parenthood may be warranted.
Keywords: transition to parenthood, birth experiences, couples, relationship satisfaction,
meaning, meaning-making

48
Becoming a new parent can be both marked by joy and celebration and fraught with
difficulty and stress. It is also an experience that many people navigate with a partner, which
makes it a unique transition in the context of a couple’s relationship. LeMasters (1957) referred
to parenthood as a “crisis event,” one in which parents learn to navigate new roles, new
responsibilities, and changes in their relationship with their partner. They seek to accomplish this
all while forming a relationship with a new member of the family unit. This can result in strain
for the couple and stress for the individual. On average, new parents experience a decline in
relationship satisfaction following the birth of their child (Doss et al., 2010; Mitnick et al., 2009),
and many find the tasks of early parenting or of fully assimilating the newly acquired role of
“mother” or “father” to be challenging (Barnett & Baruch, 1985; Genesoni & Tallandini, 2009).
Identifying factors that attenuate relationship or individual stress over the transition to
parenthood can help protect new parents from these challenges. One critical, yet underexplored
rite of passage that may represent an inflection point for psychosocial change is the childbirth
experience itself (Saxbe, 2017). Childbirth experiences can vary widely from challenging yet
joyful to painful and traumatic (Beck et al., 2011). How new parents understand and make
meaning of what they experience may be important. The current study investigated the role of
meaning-making in the perinatal period. Specifically, it explored how birth-related meaning-
making exhibited by new mothers and fathers predicts changes in relationship functioning across
the transition to parenthood and experiences of parenting stress in the postpartum period.
The Transition to Parenthood
A large body of literature suggests a negative impact of the transition to parenthood on
the couple’s relationship. Some researchers have posited that declines in relationship satisfaction
for new parents may be no different than what non-parents experience (Mitnick et al., 2009), but
49
others have shown that, compared to non-parents, new parents experience larger, immediate
declines in the quality of their relationship with their partner, which may persist for eight years
or longer (Doss et al., 2010). Even so, there is significant variability in how couples respond to
this transition, and a variety of factors may help mitigate the effects of this potential crisis on the
relationship between new parents. The current study investigated meaning-making as one
potential process that may affect or even potentially attenuate the challenges faced by new
parents in their relationship with their partner.
In addition to requiring a reorganization of the couple’s relationship, the transition to
parenthood is stressful. Parenting-specific stress can result from difficulties fulfilling the
responsibilities of childrearing, but it can also involve challenges faced in developing a
relationship with the child (Berry & Jones, 2005), an experience that may otherwise be
rewarding and enriching. Some researchers have discussed this in relation to “role strain,” or
difficulty fulfilling the various responsibilities associated with a socially defined role (Goode,
1970). For women, the role of “mother” may be one of the most common and intense sources of
role strain (Barnett & Baruch, 1985), and for men, ideas about masculinity and work may create
challenges in adopting the role of “father” (Dolan, 2014; O’Neil & Greenberger, 1994). In line
with the idea of the importance of role strain, identity theory in suggests that parents are tasked
with verifying the beliefs they hold about being a mother or father (Cast, 2004; Stets & Burke,
2000). This can result in distress when partners differ in how they understand the meaning of
being a parent. Importantly, the current study examined meaning-making processes dyadically,
in both parents, and how they predict feelings of parenting stress.
The Birth Experience
Despite the near ubiquity of birth as a rite of passage for many parents, except in most
50
cases of adoption or surrogacy, its psychological dimensions and implications for the transition
to parenthood remain relatively underexplored. The childbirth experience may play a critical role
in how new parents adjust to both relationship and parenting challenges (Saxbe, 2017). When
considering the full range of different experiences parents can have during childbirth, it is
important to note that for many mothers, birth can be traumatic. Most studies estimate a
prevalence of approximately 2-3% of posttraumatic stress disorder (PTSD) related to childbirth
in mothers (Wijma et al., 1997), which likely declines over time (Ayers & Pickering, 2001).
However, other studies have found prevalence rates closer to 6% (Creedy et al., 2000) or even
9%, and many more mothers, perhaps even close to one-fifth, experience elevated posttraumatic
stress symptoms even if they do not meet diagnostic criteria (Beck et al., 2011). Men attending
the birth may also experience some symptoms of posttraumatic stress, but they appear unlikely to
meet full criteria for PTSD (Bradley et al., 2008). Importantly, one author indicated that many
traumatic birth experiences are likely viewed by the parents’ medical team as routine (Beck,
2004), which indicates that even childbirth experiences that many would call normative can be
worth studying.
Various factors affect how negative birth experiences are perceived and how these
perceptions affect adjustment to parenthood. For example, how mothers understand their
childbirth-related pain moderates the association between the intensity of that pain and their
overall satisfaction with the birth (Mander, 2000), and feeling a sense of personal control and
having birth-related expectations that are met by the actual experience similarly predict higher
birth satisfaction (Goodman et al., 2004). Lack of partner support can predict post-birth
posttraumatic stress (Creedy et al., 2000; Olde et al., 2006), and similarly, emotional support
provided by a partner may buffer the impact of negative birth experiences on post-birth
51
adjustment (Collins et al., 1993; Lemola et al., 2007). Even for fathers, how they feel toward
their wife is associated how they feel during a preparatory visit to a hospital prior to childbirth
(Sapountzi-Krepia et al., 2010). In turn, how fathers view their partner during childbirth (e.g., as
strong and capable) may strengthen the couple’s relationship (Fagerskiold, 2008), and fathers
may view their presence during the birth as bringing the family closer together (Vehviläinen-
Julkunen & Liukkonen, 1998). On the opposite side of that same coin, mothers’ post-birth
posttraumatic stress symptoms may be associated with lower relationship satisfaction two years
after the birth (Garthus-Niegel et al., 2018). With regard to parenthood, mothers’ birth
experiences may be associated with their experiences parenting, their efforts to bond with their
infant, their perceptions of their infant’s personality, and their overall adjustment and levels of
stress (Bailhaim & Joseph, 2003; Bell et al., 2019; Quine et al., 1993; Reynolds, 1997; Zeanah et
al., 1985). Similarly, for fathers, birth experiences or their presence during the birth may be
linked with their attachment with their infant or their involvement in parenting (Bowen & Miller,
1980; Palkovitz, 1982; Skari et al., 2002).
How parents make meaning of the birth may affect postpartum outcomes affected by the
transition to parenthood. The current study investigated associations between birth-related
meaning-making, measured shortly following the birth, and these indices of postpartum
adjustment.
Meaning-Making
Meaning-making refers to the processes through which individuals come to understand
and integrate their experiences of difficult, challenging, or important events. Park (2010)
proposed a model of meaning-making that differentiated between global meaning and situational
meaning and suggested that meaning-making occurs in the context of situational meaning.
52
According to this model, the processes through which people make meaning of a potentially
stressful situation can contribute to a global sense of meaning and purpose. Furthermore, distress
arises when people experience discrepancies between global meaning and the appraised meaning
of a given situation, and meaning-making occurs to resolve these discrepancies. Gillies and
Neimeyer (2006) proposed three processes through which meaning-making can unfold in the
context of bereavement: sense making, benefit finding, and changes in identity. Sense making
refers to developing a coherent understanding of how and why a loss occurred; benefit finding
refers to discovering unexpected positive consequences of a loss; and identity change refers to
how an individual’s sense of self is changed by and reorganized following a loss. These
processes expand on Janoff-Bulman and Frantz’s (1997) conceptualization of meaning-making
in trauma, which focus on comprehensibility (i.e., sense making) and significance (e.g., benefit
finding, identity change).
The majority of the research on meaning-making and the related process of meaning
reconstruction has focused on bereavement or trauma more generally, but other studies have
applied these concepts to illness (McGovern, 2011; Pakenham, 2007) and war (Steger et al.,
2015). Meaning-making has also been discussed in broader developmental terms by other
researchers (Kegan, 1994; Kroger, 1996; Kunna & Bosma, 2000). However, the
conceptualization of meaning-making in the current study was primarily guided by Park’s (2010)
model and Gillies and Neimeyer’s (2006) framework for different meaning-making processes.
Although the transition to parenthood is an important developmental milestone and an
experience that is typically joyful and sometimes incredibly positive, it is also a period that is
often marked by stress and challenges. The birth experience in particular can be a difficult event
for many new parents. Thus, an understanding of meaning-making as a process through which
53
one copes with stressful situations may be particularly well-suited for investigating childbirth
and the transition to parenthood. At the same time, this context is also a novel one in which to
study meaning-making because it represents an intersection between this potential for adversity
and the simultaneous capacity for remarkable elation, celebration, and growth. In addition, some
research has suggested that meaning-making may be a dyadic process in bereavement
(Albuquerque, Buyukcan-Tetik, et al., 2017; Albuquerque, Ferreira, et al., 2017), and theories of
meaning-making and meaning reconstruction have posited that these processes unfold both intra-
and interpersonally (Nadeau, 1998; Neimeyer, 2000, 2001). Therefore, meaning-making may be
especially important during the transition to parenthood, which is a relatively unique dyadic
experience that results in simultaneous and substantial changes in the identities of two people.
The current study explored the roles of sense making, benefit finding, and changes in
identity in relation to the birth experience. This represents a novel application of these meaning-
making processes. Some research in the area of bereavement suggests that different meaning-
making processes impact post-loss adjustment in different ways; specifically, sense making may
be the most important process for adjustment, and benefit finding may even reduce the
advantages offered by sense making (Holland et al., 2006). Although there is no research to
guide how these processes impact adjustment during the transition to parenthood, investigating
each of them separately was a strength of the current study.
Current Study
The current study investigates how meaning-making immediately after childbirth predicts
individual and couple outcomes in the postpartum period, specifically parenting stress and
changes in relationship functioning. To our knowledge, it is the first examination of meaning-
making in this context, and it represents a novel application of processes that have proven to be
54
useful for adjustment to other difficult situations. As such, it expands both 1) the literature on the
transition to parenthood to include a potentially supportive process that may occur for new
parents around childbirth, and 2) the literature on meaning-making to begin to understand how it
functions in what is typically perceived as a more positive life development. At the same time,
the current study focuses on the experience of couples and examines how partners affect both
themselves and each other. This is critical for the transition to parenthood literature, which has
historically neglected the experience of fathers despite the dyadic nature of most pregnancy,
birth, and new parenting experiences (Saxbe, 2017). It is also important for better understanding
meaning-making, which has been described as a both intra- and interpersonal process in the
context of bereavement (Nadeau, 1998; Neimeyer, 2000, 2001).
Consistent with prior research suggesting the role of meaning-making in adjustment
during other difficult situations and studies that have shown immediate decreases in relationship
satisfaction for new parents, we hypothesized that greater meaning-making following childbirth
would be associated with smaller declines in relationship functioning for new mothers and
fathers (hypothesis 1). Similarly, consistent with literature linking birth experiences and a
number of different parenting-related outcomes, we hypothesized that greater meaning-making
would be associated with lower parenting stress (hypothesis 2). Because there are dyadic
components to the birth experience and clear differences between partners’ roles during the birth,
we explored mothers’ and fathers’ meaning-making processes as predictors of both their own
and their partner’s postpartum outcomes. In addition, in line with a prior study that showed
different effects for different meaning-making processes, we examined the role of each process
separately (i.e., sense making, benefit finding, and changes in identity; Holland et al., 2006).
However, given the novelty of studying meaning-making in the context of birth and the
55
transition to parenthood, we did not form specific hypotheses about sex differences, differences
between meaning-making processes, or how partners affect each other.
Method
Participants
A total of 83 opposite-sex couples provided data for the current study. Eligibility criteria
included being 18 or older, being able to complete all study procedures in English, expecting a
first child from a single child pregnancy, and cohabitating with plans to continue to cohabitate
after the birth. Strategies for recruitment of couples included posting flyers in the Los Angeles
community, advertising the study over social media, and encouraging word of mouth recruitment
from participants. These couples were drawn from a larger study on the transition to parenthood
and include only dyads who participated in a perinatal study visit and for whom a birth narrative
was available. Characteristics of the remaining sample (n = 166 individuals) are presented in
Table 1. These individuals were racially and ethnically diverse, generally highly educated, and in
their early 30s on average.
Procedure
Overview. Couples were initially recruited to participate in an in-lab study visit when
expectant mothers were approximately six months pregnant (M = 28.7 weeks, 6.6 months; SD =
4.0 weeks). At this visit (i.e., the prenatal visit), mothers and fathers separately filled out a
battery of questionnaires after a series of dyadic discussions. Couples were subsequently visited
in the hospital after the birth of their baby (i.e., the perinatal visit). This visit was conducted at
couples’ homes if they elected to have their baby outside of the hospital or if a hospital visit was
not possible. If a home visit was not possible, the visit was conducted remotely. The majority of
visits were conducted in-person, at the birth location, and within 48 hours of the birth. At the
56
perinatal visit, couples filled out a brief questionnaire and provided a birth narrative, as detailed
below. Couples returned to the lab with their baby approximately six months after the birth (M =
28.6 weeks, 6.6 months; SD = 3.2 weeks). At this visit (i.e., the postpartum visit), they again
filled out a battery of questionnaires after a series of discussions and interactions with their child.
A total of 5 couples (6.0%) dropped out between the perinatal visit and the postpartum visit, and
a total of 3 couples (3.6%) needed to complete postpartum questionnaires remotely because of
restrictions related to the COVID-19 public health crisis.
Birth Narrative. As part of the perinatal visit, couples were asked to share a story of
their birth experience. The following prompt was read aloud to participants by trained research
staff: “We’d like to hear you tell the story of your birth experience. Start from the beginning and
tell us as much as you remember.” In addition, couples were provided with a printed copy of 11
questions to help prompt their narrative (e.g., “How did you decide it was time to go to the
hospital,” “What was it like to meet your baby for the first time,” “Is there anything that you wish
had gone differently, either before the birth, during or after?”). For birth narratives collected
remotely, electronic copies of these prompts were sent to parents. New mothers and fathers
engaged in this task together, and both partners participated in each birth narrative. Any other
family members in the room for the perinatal visit were asked to either step out or not participate,
and the couple’s baby was always present. All birth narratives were audio-recorded, and couples
completing the perinatal visit remotely audio-recorded and electronically submitted their
narratives on their own. In order to collect a birth narrative that was as ecologically valid as
possible, no instructions were provided about how partners should share the responsibility of
telling the story, how long they should speak, or which questions from the printed handout to
focus on or answer first or last.
57
Measures
Relationship Functioning. The Dyadic Adjustment Scale (DAS; Spanier, 1976) was
used to assess mothers’ and fathers’ self-reported relationship functioning prenatally and during
the postpartum period. The DAS is a widely used, 32-item measure of relationship functioning,
and it captures a range of different aspects of adjustment in a romantic relationship, specifically
satisfaction, consensus, cohesion, and affectional expression. Researchers have debated whether
the DAS is best used as a single score of relationship functioning or a multidimensional measure
of different aspects of adjustment (Eddy et al., 1991; Kazak et al., 1988). For the current study, a
total score of relationship functioning, the sum of these separate subscales, was used. Total
scores on the DAS range from 0 to 151, and higher scores represent better adjustment. Previous
investigations of the DAS have provided evidence for adequate internal consistency regardless of
gender or marital status (Graham et al., 2006); adequate stability regardless of age, education,
parental status, or time together (Carey et al., 1993); and content, criterion-related, and construct
validity (Spanier, 1976). The DAS has been used in prior investigations of the transition to
parenthood (Belsky et al., 1983).
Parenting Stress. The Parental Stress Scale (PSS; Berry & Jones, 2005) was used to
assess stress related to parenting in new mothers and fathers. The PSS comprises 18 items that
tap into positive and negative experiences of becoming a parent or having a child (e.g., “Having
a child has been a financial burden,” “I feel overwhelmed by the responsibility of being a
parent”). Respondents answer each item on a scale from 1, “Strong Disagree,” to 2, “Strong
Agree.” Items that assess positive aspects of the parenting experience (e.g., “I am happy in my
role as parent,” “I feel close to my child”) are reverse scores. For the current study, responses to
each item were averaged, which produced scale scores ranging from 1 to 5. The PSS has been
58
praised for its ability to capture both rewarding and challenging aspects of parenting and for its
cross-cultural relevance (Louie et al., 2017). The initial validation of the PSS provided evidence
for the scale’s internal consistency, test-retest reliability over 6 weeks, convergent validity,
discriminant validity, and concurrent validity, and comparable reliability and validity for both
mothers and fathers with children who have or do not have clinically relevant behavioral
problems (Berry & Jones, 2005).
Narrative-Related and Meaning-Making Processes. Audio-recordings of birth
narratives were rated by a coding team of three undergraduate and post-baccalaureate research
assistants. Coders listened to each recorded narrative three times: the first to orient themselves to
the narrative, the second to make initial ratings, and the third to verify or modify the ratings they
made. The current study focused on four of these codes: sense making, benefit finding, changes
in identity, and engagement in the narrative. Ratings were provided for each partner and
represented the relative absence or presence of the coded behavior or process on a scale from 0,
“Not at all / None,” to 3, “A lot.” Coders used a detailed codebook to guide their ratings, and the
coding team met regularly during the initiation of coding to ensure consensus on how to code
each of the relevant processes or behaviors. Definitions of meaning-making processes were
guided by the literature on sense making, benefit finding, and changes in identity (e.g., Gilles &
Neimeyer, 2006), and engagement in the narrative was defined as the extent to which each parent
was involved in telling the story of the birth (e.g., how much they spoke, how on topic they
were). This was coded as an important covariate because the birth narrative task did not involve
instruction about how much each partner should speak and respond to the provided prompts,
which resulted in variability in the extent to which parents took the lead or stepped back in
providing a birth narrative. Definitions of each of the three meaning-making processes and
59
example quotes from birth narratives that illustrate these processes are presented in Table 2.
Reliability of coders’ ratings was assessed by calculating intraclass correlations,
specifically ICC(2,3) given that codes were provided three coders and averaged for a score to be
used in the current study’s analyses. ICCs for sense making, benefit finding, changes in identity,
and engagement in the narrative were .75, .71, .70, and .70, respectively, which suggest adequate
reliability. There was substantial variability between individuals in the absence or presence of
sense-making (M = 1.85, SD = 0.68) and benefit finding (M = 1.03, SD = 0.74). These processes
were present (i.e., at least one coder provided a rating of 1 or greater) in the birth narratives for
98.8% and 88.0% of participants, respectively. Discussing changes in identity was less common
(M = 0.35, SD = 0.61; present for 36.7% of participants). All participants were at least somewhat
engaged in the narrative (i.e., all had an average rating above 0.0), and most were at least
moderately engaged (i.e., 88.6% had an average rating of 2.0 or higher). However, there was still
substantial variability in how engaged participants were on the high end of engagement (M =
2.40, SD = 0.52; 17.5% had an average rating of 2.0, 19.9% had an average rating of 2.3, 31.3%
had an average rating of 2.7, and only 19.9% had an average rating of 3.0).
Data Analysis
Analyses for the current study were conducted using SPSS version 25 and Mplus 8.4
program (Muthén & Muthén, 2017). Characteristics of male and female participants were
compared using t-tests, Pearson’s χ
2
tests, and Fisher’s exact tests when variables were
continuous, categorical with large cell sizes (i.e., all greater than five participants), and
categorical with small cell sizes, respectively. Welch-Satterthwaite adjustments were used for t-
tests with unequal variances. Associations between key variables of interest were calculated
using Pearson’s correlation coefficients. Since both of the current study’s aims focused on
60
postpartum measures (i.e., changes in relationship functioning and parenting stress), analyses
testing hypotheses 1 and 2 included only couples who completed a postpartum visit. One
additional mother was missing data on relevant covariates and prenatal relationship functioning
and was therefore dropped from these analyses; as a result, her partner was also dropped given
our use of an APIM framework to model both actor and partner effects. This resulted in a sample
size of 77 couples out of a possible 83 (92.8%).
Analyses for our primary aims were conducted using actor-partner interdependence
models (APIM; Kenny, 1996; Kenny & Judd, 1986) in a structural equation modeling
framework. This approach was chosen to address the dyadic nature of these data and the
interdependence of partners’ behaviors in a birth narrative that they completed together. APIMs
simultaneously model actor effects (i.e., the effect of one’s behavior or characteristics on one’s
own outcome) and partner effects (i.e., the effect of one’s behavior or characteristics on one’s
partner’s outcome). Each meaning-making process was tested in a separate model (e.g., men’s
sense making and women’s sense making predicting both partners’ parenting stress). Covariates
in these models included both parents’ ages, both parents’ education, the couple’s marital status,
the age of the baby at the postpartum visit, the number of weeks pregnant at the prenatal visit for
models testing hypothesis 1, prenatal relationship functioning in models testing hypothesis 1, and
both parents’ level of engagement during the birth narrative. Continuous predictor variables were
grand mean centered, and binary predictor variables (i.e., education and marital status) were
contrast coded (i.e., -0.5 for unmarried and college education or less, 0.5 for married and
graduate degree). These decisions were made to aid in the interpretation of model intercepts.
Procedures for testing hypotheses 1 and 2 were guided by the framework and conceptual
models outlined by Fitzpatrick et al. (2016) and Kenny and Cook (1999). First, we estimated a
61
fully saturated, unconstrained APIM. Next, in models with at least one significant effect of
meaning-making, we tested four conceptual models and compared their fit (i.e., SABIC values)
to each other and to the unconstrained model to determine which pattern of effects fit our data
best: actor only (i.e., partner paths are constrained to be zero), partner only (i.e., actor paths are
constrained to be zero), couple-oriented (i.e., actor and partner paths are constrained to be equal),
or contrast (i.e., actor and partner paths are equal in magnitude but opposite in direction). Fit was
examined separately for each partner’s outcome (e.g., a contrast model was estimated predicting
women’s changes in relationship functioning while men’s effects were left unconstrained), and
the best fitting models for each partner’s outcome were then tested together in a final model.
Once a final model was estimated, sensitivity analyses were conducted to determine how
several decisions made in running these models impacted the observed results. Specifically, final
best fitting models were tested without controlling for engagement and, separately, with all three
meaning-making processes in the same model. Models testing hypothesis 1 were also tested
without controlling for prenatal relationship functioning with raw change scores and, separately,
residualized change scores as the outcomes. First, we examined whether any paths that were not
previously significant became significant. Next, we examined previously significant paths to
determine whether they became non-significant and whether the observed effect changed in
direction or magnitude (i.e., a change of 20% or more).
Results
Table 1 displays participant characteristics and presents comparisons between male and
female participants. On average, male participants were older. Female participants engaged in
higher levels of sense making and benefit finding in the birth narrative, and they were generally
more engaged in the narrative. Table 3 presents correlations between key study variables. Older
62
mothers showed larger declines in relationship functioning, and mothers of older babies reported
greater parenting stress. For both mothers and fathers, sense making and benefit finding were
positively associated with each other and with engagement in the narrative. For fathers, changes
in identity were positively associated with sense making and engagement, but not benefit
finding. Fathers’ benefit finding and mothers’ engagement were positive associated with their
own prenatal relationship functioning. Prenatal relationship functioning and changes in
relationship functioning were both positively associated with postpartum relationship functioning
for both partners. Parenting stress was negatively associated with postpartum relationship
functioning for both partners and negatively associated with changes in relationship functioning
for mothers.
Hypothesis 1: Changes in Relationship Functioning
At least one meaning-making path (i.e., an actor or partner path for mothers or fathers)
was significant in models with sense making and benefit finding predicting changes in
relationship functioning. An examination of model fit with the four conceptual APIM models
revealed that, for sense making, an actor only model was the best fit for mothers’ changes in
relationship functioning, and a partner only model was the best fit for fathers’ changes in
relationship functioning. For benefit finding, an actor only model was best for mothers, and a
contrast model was best for fathers. All of these models improved fit (i.e., produced lower
SABIC values) relative to the saturated model, as did the final models combining the best fitting
models for mothers and fathers for each meaning-making process (sense making: χ
2
(2) = 0.86, p
= .65; benefit finding: χ
2
(2) = 1.00, p = .61). Effects of interest from saturated, unconstrained
models and the final best fitting models predicting changes in relationship functioning are
presented in Table 4. The best fitting models are also displayed in Figure 1. Lower levels of
63
sense making in mothers are associated with greater decreases in relationship functioning for
both parents, and higher levels are associated with greater increases. Similarly, lower levels of
benefit finding in mothers are associated with greater decreases in their own relationship
functioning.
Sensitivity Analyses. No new paths became significant in any of the alternative models
tested. No previously significant paths changed in significance, direction, or magnitude when
removing prenatal relationship functioning or using residualized change. Without engagement,
associations between mothers’ sense making and benefit finding and their own changes in
relationship functioning reduced in magnitude (5.64 to 3.91 and 3.80 to 2.98, respectively). With
all three meaning-making processes in the model, the association between mothers’ sense
making and their own changes in relationship functioning changed from significant to non-
significant (p = .016 to p = .093) and dropped in magnitude (5.64 to 4.08). No other paths
changed in significance, direction, or magnitude without engagement or with all three meaning-
processes in the same model.
Hypothesis 2: Parenting Stress
At least one meaning-making path was significant in all models predicting parenting
stress. An examination of model fit with the four conceptual APIM models revealed that, for
sense making, a partner only model was the best fit for mothers’ changes in relationship
functioning, and a contrast model was the best fit for fathers’ changes in relationship functioning.
For benefit finding, contrast models were best for both mothers and fathers. For changes in
identity, a partner only model was best for mothers, and a contrast model was best for fathers.
All of these models improved fit (i.e., produced lower SABIC values) relative to the saturated
model, as did the final models combining the best fitting models for mothers and fathers for each
64
meaning-making process (sense making: χ
2
(2) = 0.06, p = .97; benefit finding: χ
2
(2) = 1.27, p =
.53; changes in identity: χ
2
(2) = 0.05, p = .97). Effects of interest from saturated, unconstrained
models and the final best fitting models predicting parenting stress are presented in Table 5. The
best fitting models are also displayed in Figure 2. Higher levels of sense making in mothers are
associated with greater parenting stress in fathers. The opposite is observed for fathers’ own
sense making, which is associated with less parenting stress. The same pattern is observed for
benefit finding; fathers’ parenting stress is lower when mothers engage in less sense making and
they engage in more sense making themselves. Fathers’ discussion of changes in identity is
associated with lower parenting stress for mothers.
Sensitivity Analyses. No new paths became significant in either alternative model tested.
Associations between both partners’ sense making and fathers’ parenting stress dropped in
magnitude when engagement was removed (+/- 0.53 to +/- 0.17). Associations between both
partners’ benefit finding and fathers’ parenting stress changed from significant to non-significant
and dropped in magnitude in both alternative models (with removal of engagement: +/- 0.23 to
+/- 0.14 and p = .004 to p = .051; with all three meaning-making processes: +/- 0.23 to +/- 0.15
and p = .004 to p = .057). No other paths changed in significance, direction, or magnitude in
either of the alternative models tested.
Discussion
The current study investigated meaning-making processes in relation to the birth
experiences of new mothers and fathers. As expected, we found that several meaning-making
processes predicted better relationship functioning and lower parenting stress across the
transition to parenthood. Specifically, mothers who showed greater sense making and benefit
finding in their birth narratives also showed smaller declines in self-reported relationship
65
functioning from pregnancy to the postpartum period. Similarly, when fathers showed higher
levels of sense making and benefit finding following childbirth, they reported lower subsequent
parenting stress. Given that many birth experiences are dyadic and many couples make meaning
of the birth and the transition to parenthood together, the current study also explored partner
effects of birth-related meaning-making in an APIM framework. When mothers demonstrated
higher levels of sense making, their partners showed smaller declines in relationship functioning
across the transition to parenthood, and when fathers described changes in identity after birth,
their partners reported lower postpartum parenting stress. However, the current study also found
that mothers’ sense making and benefit finding were associated with higher levels of parenting
stress in fathers.
These results have several important implications for understanding the experiences of
new parents following childbirth. For one, making sense of and finding benefits from the birth
experience may support healthy individual and relationship functioning across the transition to
parenthood, as we found for mothers’ relationship functioning and fathers’ parenting stress.
However, while these processes appeared to be generally advantageous for the parent engaging
in them, a mixed pattern of results emerged for partners’ meaning-making. Although speculative,
it could be that meaning made as an individual, without a partner’s input, actually distances a
partner from his or her role as a new parent. The exception to this was lower observed parenting
stress in mothers when their partner discussed changes in identity following childbirth. It is
possible that when men find the transition to parenthood more transformative, they are also able
to embrace their role as father and become more involved in parenting (Pleck, 2012). Overall, the
pattern of actor and partner effects observed in the current study highlights the importance of the
dyadic context for couples engaging in meaning-making during this transition. Finding ways to
66
make meaning together, as co-parents rather than as individuals, may mitigate some of the
negative effects of partner meaning-making or amplify the positive effects of own meaning-
making. For clinicians supporting couples across the transition to parenthood, encouraging
parents to make meaning of their birth experience together may be beneficial for their
relationship and for them as new parents. For example, some new parents may enjoy recording
or writing down their birth narrative, and there are thousands of “birth stories” posted on blogs,
through social media, and elsewhere on the Internet. Journaling interventions have been used
successfully to facilitate meaning-making in the context of bereavement (Lichtenthal &
Neimeyer, 2012), and they may also be useful during the transition to parenthood.
Sensitivity analyses revealed that these findings were relatively robust with regard to
several decisions made in running the APIMs testing our hypotheses (i.e., how to predict and
model change, whether to control for engagement, and whether to include all three meaning-
making processes in the same model). However, several effects decreased in magnitude or
changed from significant to non-significant when removing engagement in the birth narrative as
a covariate and when testing all three meaning-making processes in the same model. These
charges are not surprising given the current study’s small sample size and the observed
correlations between engagement and the three meaning-making processes. However, they
suggest something important about the shared variance between different meaning-making
processes and the extent to which each parent chooses to engage in telling the story of their
child’s birth. Even though the pattern of results differs for different partners and processes, the
co-occurrence of sense making and benefit finding in particular may be relevant in predicting
partners’ postpartum outcomes.
Although we did not form specific hypotheses about different meaning-making
67
processes, results were relatively similar for sense making and benefit finding, which were
correlated with each other. This may suggest that these processes look similar in practice or both
represent a broader approach to making meaning in this context. This is not consistent with prior
work in the realm of bereavement, which has shown differences between sense making and
benefit finding with regard to adjustment to a loss (Holland et al., 2006). Benefit finding may be
more advantageous in the positive context of birth and the transition to parenthood, and sense
making and benefit finding may both be examples of weaving together a coherent narrative of a
birth experience. Discussing changes in identity was relatively infrequent in our sample. This
may be because the birth narrative protocol does not pull for this kind of meaning-making.
Alternatively, it may result from how soon after the birth we collected these narratives;
processing identity changes may unfold over a longer time span. Nonetheless, a potentially
important association emerged between fathers’ changes in identity and mothers’ parenting
stress, which was not predicted by any other meaning-making process. The different pattern of
results for identity changes may suggest that integrating the new identity of “parent” has
different implications than sense making or benefit finding during this important period.
The birth narrative protocol was designed to be open-ended, and as such, it did not
constrain the content or length of the narrative and did not specifically ask parents to engage in
any meaning-making process. This enabled a potentially ecologically valid examination of
meaning-making processes as they occur naturally, without intervention. At the same time, it
also led to variable participant engagement in the discussion, which appeared to be relevant for
some of the study’s observed results, and it may have resulted in some parents not engaging in
meaning-making in the context of the narrative, even if they would have done so if prompted.
However, all parents were at least somewhat engaged in the narrative, and most were moderately
68
to completely engaged. In addition, even without prompting, the vast majority of parents
spontaneously engaged in sense making, benefit finding, or both. This suggests the potential
value of the birth narrative protocol in investigating birth-related meaning-making. Another
important aspect of this protocol is that the narrative was collected during a perinatal visit that
was scheduled as close to the actual birth as possible. This enabled an examination of meaning-
making processes that unfold during a critical period, before which many parents may not have
had many opportunities to share their birth story together. In line with the model of meaning
proposed by Park (2010), this may have enabled us to assess meaning-making processes before
they are integrated and become “meaning made.” At the same time, meaning-making around
birth experiences and more broadly around the transition to parenthood are likely dynamic and
do not unfold in a single moment. In addition, given the chaotic and stressful nature of many
birth experiences, it may have been challenging or exhausting for parents to share their story at
this time; nonetheless, it is notable that several couples shared that they enjoyed providing their
birth narrative. Lastly, having partners share their birth story together enabled a dyadic
investigation of birth-related meaning-making, but there may be differences between what
parents are and are not willing to share in front of their partner.
Additional strengths of the current study include its investigation of meaning-making in a
novel context, the birth experience and the transition to parenthood; its multimodal data
collection, which included self-report questionnaires and behavioral coding; its longitudinal
design, including the collection of data across three time points – prenatally, perinatally, and
during the postpartum period; and the use of APIMs to account for the dyadic nature of our data
and the processes we captured. Limitations include a relatively small sample of only 77 couples
who provided complete prenatal, perinatal, and postpartum data, which may have resulted in
69
insufficient power for analyses using APIMs and a structural equation modeling framework.
Despite this, it is notable that several significant associations nonetheless emerged, which
highlights the potential importance of birth-related meaning-making processes in the transition to
parenthood. Future studies should replicate the current study’s findings with a larger sample of
parents. They could also investigate meaning-making with a task that specifically prompts
parents to engage in these processes, as well as during other critical moments during the
transition to parenthood (e.g., late pregnancy, several days after returning home with their baby)
and in relation to other important or challenging aspects of the experience of becoming a new
parent (e.g., encountering medical adversity during pregnancy, encountering behavioral
problems in a young child).
Overall, the current study’s results suggest the importance of meaning-making processes
during the transition to parenthood, particularly as they relate to how couples experience the
birth of their child. As new parents, making meaning of the birth experience may relate to
postpartum adjustment, and as a clinician, supporting parents in making meaning of the birth,
including challenges encountered throughout the process, may result in better adjustment for
both individual parents and the couple. At the same time, it may be important for new couples to
engage in birth-related meaning-making together to enable them to come to a shared
understanding of the experience. Future research can elucidate how birth-related meaning-
making can be accomplished most effectively and what specific support strategies can be useful
for couples making meaning of their transition to parenthood.

70
References
Albuquerque, S., Buyukcan-Tetik, A., Stroebe, M. S., Schut, H. A. W., Narciso, I., Pereira, M.,
& Finkenauer, C. (2017). Meaning and coping orientation of bereaved parents: Individual
and dyadic processes. PLoS ONE, 12(6), 1-14.
Albuquerque, S., Ferreira, L. C., Narciso, I., & Pereira, M. (2017). Parents’ positive interpersonal
coping after a child’s death. Journal of Child and Family Studies, 26(7), 1817–1830.
Ayers, S., & Pickering, A. D. (2001). Do women get posttraumatic stress disorder as a result of
childbirth? A prospective study of incidence. Birth, 28(2), 111-118.
Bailham, D., & Joseph, S. (2003). Post-traumatic stress following childbirth: A review of the
emerging literature and directions for research and practice. Psychology, Health &
Medicine, 8(2), 159-168.
Barnett, R. C., & Baruch, G. K. (1985). Women's involvement in multiple roles and
psychological distress. Journal of Personality and Social Psychology, 49(1), 135-145.
Beck, C. T. (2004). Birth trauma: In the eye of the beholder. Nursing Research, 53(1), 28-35.
Beck, C. T., Gable, R. K., Sakala, C., Declercq, E. R. (2011). Posttraumatic stress disorder in
new mothers: Results form a two-stage U.S. national survey. Birth, 38(3), 216-227.
Bell, A. F., Rubin, L. H., Davis, J. M. , Golding, J., Adejumo, O. A., & Carter, C. S. (2019). The
birth experience and subsequent maternal caregiving attitudes and behavior: a birth
cohort study. Archives of Women’s Mental Health, 22(5), 613-620.
Belsky, J., Spanier, G. B., & Rovine, M. (1983). Stability and change in marriage across the
transition to parenthood. Journal of Marriage and Family, 45(3), 567-577.
Berry, J. O., & Jones, W. H. (1995). The parental stress scale: Initial psychometric evidence.
Journal of Social and Personal Relationships, 12(3), 463-472.
71
Bowen, S. M., & Miller, B. C. (1980). Paternal attachment behavior as related to presence at
delivery and preparenthood classes: A pilot study. Nursing Research, 29(5), 307-311.
Bradley, R., Slade, P., & Leviston, A. (2008). Low rates of PTSD in men attending childbirth: A
preliminary study. British Journal of Clinical Psychology, 47(3), 295-302.
Carey, M. P., Spector, I. P., Lantinga, L. J., & Krauss, D. J. (1993). Reliability of the Dyadic
Adjustment Scale. Psychological Assessment, 5(2), 238-240.
Cast, A. D. (2004). Well-being and the transition to parenthood: An identity theory approach.
Sociological Perspectives, 47(1), 55-78.
Collins, N. L., Dunkel-Schetter, C., Lobel, M., & Scrimshaw, S. C. (1993). Social support in
pregnancy: psychosocial correlates of birth outcomesand postpartum depression. Journal
of Personality and Social Psychology, 65(6), 1243-1258.
Creedy, D. K., Shochet, I. M., & Horsfall, J. (2001). Childbirth and the development of acute
trauma symptoms: Incidence and contributing factors. Birth, 27(2), 104-111.
Dolan, A. (2014). ‘I’ve learnt what a dad should do’: The interaction of maculine and fathering
identities among men who attended a ‘dads only’ parenting programme. Sociology, 48(4),
812-828.
Doss, B. D., Rhoades, G. K., Stanley, S. M., & Markman, H. J. (2010). The effect of the
transition to parenthood on relationship quality: An eight-year prospective study. Journal
of Personality and Social Psychology, 96(3), 601-619.
Eddy, J. M., Heyman, R. E., & Weiss, R. L. (1991). An empirical evaluation of the Dyadic
Adjustment Scale: Exploring the differences between marital “satisfaction” and
“adjustment.” Behavioral Assessment, 13(3), 199-220.
Fägerskiöld, A. (2008). A change in life as experienced by first-time fathers. Scandanavian
72
Journal of Caring Sciences, 22(1), 64-71.
Fitzpatrick, J., Gareau, A., Lafontaine, M-F., & Gaudreau, P. (2016). How to use the actor-
partner interdependence model (APIM) to estimate different dyadic patterns in MPLUS:
A step-by-step tutorial. The Quantiative Methods for Psychology, 12(1), 74-86.
Garthus-Niegel, S., Horsch, A., Handtke, E., von Soest, T., Ayers, S., Weidner, K., & Eberhard-
Gran, M. (2018). The impact of postpartum posttraumatic stress and depression
symptoms on couples’ relationship satisfaction: A population-based prospective study.
Frontiers in Psychology, 9, 1728.
Genesoni, L., & Tallandini, M. A. (2009). Men’s psychological transition to fatherhood: An
analysis of the literature, 1989-2008. Birth: Issues in Perinatal Care, 36(4), 305-318.
Gillies, J., & Neimeyer, R. A. (2006). Loss, grief, and the search for significance: Toward a
model of meaning reconstruction in bereavement. Journal of Constructivist Psychology,
19(1), 31-65.
Goode, W. J. (1960). A theory of role strain. American Sociological Review, 25(4), 483-496.
Goodman, P., Mackey, M. C., & Tavakoli, A. S. (2004). Factors related to childbirth satisfaction.
Journal of Advanced Nursing, 46(2), 212-219.
Graham, J. M., Liu, Y. J., & Jeziorski, J. L. (2006). The Dyadic Adjustment Scale: A reliability
generalization meta-analysis. Journal of Marriage and Family, 68(3), 701-717.
Holland, J. M., Currier, J. M., & Neimeyer, R. A. (2006). Meaning reconstruction in the first two
years of bereavement: The role of sense-making and benefit-finding. Omega: Journal of
Death and Dying, 53(3), 175-191.
Janoff-Bulman, R., & Frantz, C. M. (1996). The impact of trauma on meaning: From
meaningless world to meaningful life. In M. J. Power & C. R. Brewin (Eds.), The
73
transformation of meaning in psychological therapies: Integrating theory and practice
(pp. 91-106). John Wiley & Sons Inc.
Kazak, A. E., Audre, J., & Snitzer, L. (1988). The assessment of marital satisfaction: An
evaluation of the Dyadic Adjustment Scale. Journal of Family Psychology, 2(1), 82-91.
Kegan, R. (1994). In over our heads. Harvard University Press.
Kenny, D. A. (1996). Models of non-independence in dyadic research. Journal of Social and
Personal Relationships, 13(2), 279–294.
Kenny, D. A., & Cook, W. (1999). Partner effects in relationship research: Conceptual issues,
analytic difficulties, and illustrations. Personal Relationships, 6(4), 433-448.
Kenny, D. A., & Judd, C. M. (1986). Consequences of violating the independence assumption in
analysis of variance. Psychological Bulletin, 99(3), 422-431.
Kroger, J. (1996). Identity in adolescence: The balance between self and other. Routledge.
Kunnen, E. S., & Bosma, H. A. (2000). Development of meaning making: A dynamic systems
approach. New Ideas in Psychology, 18(1), 57-82.
LeMasters, E. E. (1957). Parenthood as crisis. Marriage and Family Living, 19(4), 352-355.
Lemola, S., Stadlmayr, W., & Grob, A. (2007). Maternal adjustment five months after birth: The
impact of the subjective experience of childbirth and emotional support from the partner.
Journal of Reproductive and Infant Psychology, 25(3), 190–202.
Lichtenthal, W. G., & Neimeyer, R. A. (2012). Directed journaling to facilitate meaning-making.
In R. Neimeyer (Ed.), Techniques of grief therapy: Creative practices for counseling the
bereaved (pp. 165-168). Routledge.
Louie, A. D., Cromer, L. D., & Berry, J. O. (2017). Assessing parenting stress: Review of the use
and interpretation of the parental stress scale. The Family Journal: Counseling and
74
Therapy for Couples and Families, 25(4), 359-367.
Mander, R. (2000). The meanings of labour pain or the layers of an onion? A woman-oriented
view. Journal of Reproductive and Infant Psychology, 18(2), 133-141.
McGovern, J. (2011). Couple meaning-making and dementia: Challenges to the deficit model.
Journal of Gerontological Social Work, 54(7), 678-690.
Mitnick, D. M., Heyman, R. E., & Smith Slep, A. M. (2009). Changes in relationship satisfaction
across the transition to parenthood: A meta-analysis. Journal of Family Psychology,
23(6), 848-852.
Muthén, L. K. & Muthén, B. O. (2017). Mplus user’s guide. Muthén and Muthén.
Nadeau, J. W. (1998). Families making sense of death. Thousand Oaks, CA: Sage Publishing.
Nadeau, J. W. (2001). Family construction of meaning. In R. A. Neimeyer (Ed.), Meaning
reconstruction and the experience of loss (pp. 95-111). American Psychological
Association.
Neimeyer, R. A. (2000). Searching for the meaning of meaning: Grief therapy and the process of
reconstruction. Death Studies, 24(6), 541-558.
Neimeyer, R. A. (2001). Meaning reconstruction and the experience of loss. American
Psychological Association.
O’Neil, R., & Greenberger, E. (1994). Patterns of commitment to work and parenting:
Implications for role strain. Journal of Marriage and the Family, 56(1), 101-118.
Olde, E., van der Hart, O., Kleber, R., & van Son, M. (2006). Posttraumatic stress following
childbirth: A review. Clinical Psychology Review, 26(1), 1-16.
Palkovitz, R. (1982). Fathers’ birth attendance, early extended and father-infant interaction at
five months postpartum. Birth, 9(3), 173-177.
75
Pleck, J. H. (2012). Integrating father involvement in parenting research. Parenting, 12(2-3),
243-253.
Pakenham, K. I. (2007). Making sense of multiple sclerosis. Rehabilitation Psychology, 52(4),
380-389.
Park, C. L. (2010). Making sense of the meaning literature: An integrative review of meaning
making and its effects on adjustment to stressful life events. Psychological Bulletin,
136(2), 257-301.
Quine, L., Rutter, D. R., & Gowen, S. (1993). Women’s satisfaction with the quality of the birth
experience: A prospective study of social and psychological predictors. Journal of
Reproductive and Infant Psychology, 11(2), 107-113.
Reynolds, J. L. (1997). Posttraumatic stress disorder after childbirth: The phenomenon of
traumatic birth. Canadian Medical Association Journal, 156(6), 831-835.
Saxbe, D. E. (2017). Birth of a new perspective? A call for biopsychosocial research on
childbirth. Current Directions in Psychologist Science, 26(1), 81-86.
Sapountzi-Krepia, D., Lavdaniti, M., Dimitriadou, A., Psychogiou, M., Sgantzos, M., He, H-G.,
… Vehviläinen-Julkunen, K. (2010). Fathers’ feelings and experience related to their
wife/partner’s delivery in northern Greece. The Open Nursing Journal, 4, 48-54.
Skari, H., Skreden, M., Malt, U. F., Dalholt, M., Ostensen, A. B., Egeland, T., & Emblem, R.
(2002). Comparative levels of psychological distress, stress symptoms, depression and
anxiety after childbirth – A prospective population-based study of mothers and fathers.
Obstetrics & Gynaecology, 109(1), 1154-1163.
Spanier, G. B. (1976). Measuring dyadic adjustment: New scales for assessing the quality of
marriage and similar dyads. Journal of Marriage and Family, 38(1), 15-28.
76
Steger, M. F., Owens, G. P., & Park, C. L. (2015). Violations of war: Testing the meaning-
making model among Vietnam veterans. Journal of Clinical Psychology, 71(1), 105-116.
Stets, J. E., & Burke, P. J. (2000). Identity theory and social identity theory. Social Psychology
Quarterly, 63(3), 224-237.
Vehviläinen-Julkunen, K., & Liukkonen, A. (1998). Fathers’ experiences of childbirth.
Midwifery, 14(1), 10-17.
Wijma, K., S, Söderquist, J., & Wijma, B. (1997). Posttraumatic stress disorder after childbirth:
A cross sectional study. Journal of Anxiety Disorders, 11(6), 587-597.
Zeanah, C. H., Keener, M. A., Stewart, L., & Anders, T. F. (1985). Prenatal perception of infant
personality: A preliminary investigation. Journal of the American Academy of Child
Psychiatry, 24(2), 204-210.

77
Table 1. Participant characteristics (n = 83 couples).

Male
Participants

Female
Participants

Test
Statistic

Participant Characteristics M (SD) / n (%) (e.g., t, χ
2
)
Age
a
33.5 (5.5) 31.4 (4.1) -2.74**
Race
a
0.46
Asian / Pacific Islander 16 (19.3%) 15 (18.3%)
Black / African American 6 (7.2%) 5 (6.1%)
Hispanic / Latinx 14 (16.9%) 17 (20.7%)
White / Caucasian 41 (49.4%) 39 (47.6%)
Other / Decline to State 6 (7.2%) 6 (7.3%)
Educational Attainment
a
3.74
High School / GED 2 (2.4%) 1 (1.2%)
Some College 8 (9.6%) 8 (9.8%)
College Degree 44 (53.0%) 33 (40.2%)
Graduate Degree 29 (34.9%) 40 (48.8%)
Couple Characteristics
Married 72 (86.7%)
Weeks Pregnant (PN) 28.7 (4.0)
Baby’s Age (Weeks, PP) 28.6 (3.2)
Meaning & Mental Health
MM: Sense Making 1.7 (0.7) 2.0 (0.6) 2.78**
MM: Benefit Finding 0.8 (0.6) 1.3 (0.8) 4.45***
MM: Changes in Identity 0.4 (0.7) 0.3 (0.5) -1.19
Engagement 2.3 (0.6) 2.5 (0.4) 3.12**
Relationship Functioning (PN) 134.2 (12.7) 137.4 (12.4) 1.62
Relationship Functioning (PP) 131.6 (14.9) 134.5 (14.2) 1.24
Relationship Functioning (Ch) -2.9 (8.9) -2.8 (10.3) 0.51
Parenting Stress 1.9 (0.5) 1.9 (0.5) -0.36

Significance: * = p < .05, ** = p < .01, *** = p < .001.

Critical values are from t-tests and Pearson’s χ2 tests comparing continuous and categorical characteristics of
male and female participants. A Welch-Satterthwaite adjustment was used for t-tests with unequal variances, and
Fisher’s exact tests were used for categorical comparisons with small cell sizes.

Missing data: With the exception of weeks pregnant, all prenatal data are missing for 1 female participant; as a
result, this same participant is also missing changes in relationship functioning. All postpartum statistics are
missing 5 couples who dropped out prior to the postpartum visit.

Abbreviations: PN = Prenatal; PP = Postpartum; Ch = Changes; MM = Meaning-making; Engagement =
Engagement in the birth narrative.

78
z
79
z
80
Table 4. APIM results from models predicting changes in relationship functioning.

Unconstrained Model

Best Fitting Model

Models with Sense-Making (SM) β (SE) β (SE)
Intercept Mothers -5.37** (1.92) -4.99** (1.88)
Intercept Fathers -3.00 (1.66) -2.99 (1.62)
Effects of Meaning-Making
Mothers’ SM à Mothers’ DAS Changes (Actor) 7.03* (2.80) 5.64* (2.35)
Fathers’ SM à Mothers’ DAS Changes (Partner) -2.80 (3.12) –
Fathers’ SM à Fathers’ DAS Changes (Actor) -0.03 (2.69) –
Mothers’ SM à Fathers’ DAS Changes (Partner) 5.45* (2.42) 5.43** (2.02)
Predictor & Residual Covariance
Mothers’ SM à Fathers’ SM 0.20*** (0.05) 0.20*** (0.05)
Mothers’ DAS Changes à Fathers’ DAS Changes 17.26* (7.71) 17.27* (7.75)
Models with Benefit Finding (BF) β (SE) β (SE)
Intercept Mothers -5.74** (1.92) -5.60** (1.91)
Intercept Fathers -3.20 (1.71) -3.19 (1.71)
Effects of Meaning-Making
Mothers’ BF à Mothers’ DAS Changes (Actor) 4.15* (1.70) 3.80* (1.57)
Fathers’ BF à Mothers’ DAS Changes (Partner) -1.96 (2.17) –
Fathers’ BF à Fathers’ DAS Changes (Actor) -2.43 (1.93) -1.34 (1.34)
Mothers’ BF à Fathers’ DAS Changes (Partner) 1.17 (1.52) 1.34 (1.34)
Predictor & Residual Covariance
Mothers’ BF à Fathers’ BF 0.17** (0.06) 0.17** (0.06)
Mothers’ DAS Changes à Fathers’ DAS Changes 21.02** (8.11) 21.50** (8.20)
Models with Changes in Identity (Ch) β (SE) β (SE)
Intercept Mothers -5.18** (1.94)
Intercept Fathers -2.88 (1.71)
Effects of Meaning-Making
Mothers’ Ch à Mothers’ DAS Changes (Actor) -2.30 (2.19)
Fathers’ Ch à Mothers’ DAS Changes (Partner) -1.47 (1.73)
Fathers’ Ch à Fathers’ DAS Changes (Actor) 0.30 (1.53)
Mothers’ Ch à Fathers’ DAS Changes (Partner) -0.14 (1.93)
Predictor & Residual Covariance
Mothers’ Ch à Fathers’ Ch 0.05 (0.04)
Mothers’ DAS Changes à Fathers’ DAS Changes 22.89** (8.43)

Significance: * = p < .05, ** = p < .01, *** = p < .001

All models include n = 77 couples and control for both partners’ ages, both partners’ education, the couple’s marital status, both partners’
reports of prenatal relationship functioning, weeks pregnant at the prenatal visit, baby’s age at the postpartum visit, and both partners’ coded
engagement in the birth narrative. All continuous variables are grand mean centered, and all categorical covariates are contrast coded (i.e., -0.5
vs. 0.5). These decisions were made to aid in the interpretation of model intercepts.

Abbreviations / Notes: DAS Changes = Changes in relationship functioning.

81
Table 5. APIM results from models predicting parenting stress.

Unconstrained Model

Best Fitting Model

Models with Sense-Making (SM) β (SE) β (SE)
Intercept Mothers 1.92*** (0.08) 1.87*** (0.08)
Intercept Fathers 1.99*** (0.10) 1.97*** (0.09)
Effects of Meaning-Making
Mothers’ SM à Mothers’ Parenting Stress (Actor) -0.02 (0.13) –
Fathers’ SM à Mothers’ Parenting Stress (Partner) -0.07 (0.14) -0.09 (0.11)
Fathers’ SM à Fathers’ Parenting Stress (Actor) -0.51*** (0.15) -0.53*** (0.12)
Mothers’ SM à Fathers’ Parenting Stress (Partner) 0.53*** (0.14) 0.53*** (0.12)
Predictor & Residual Covariance
Mothers’ SM à Fathers’ SM 0.20*** (0.05) 0.20*** (0.05)
Mothers’ Parenting Stress à Fathers’ Parenting Stress 0.05* (0.02) 0.05* (0.02)
Models with Benefit Finding (BF) β (SE) β (SE)
Intercept Mothers 1.88*** (0.09) 1.92*** (0.08)
Intercept Fathers 1.97*** (0.09) 1.99*** (0.10)
Effects of Meaning-Making
Mothers’ BF à Mothers’ Parenting Stress (Actor) -0.08 (0.08) -0.11 (0.07)
Fathers’ BF à Mothers’ Parenting Stress (Partner) 0.18 (0.09) 0.11 (0.07)
Fathers’ BF à Fathers’ Parenting Stress (Actor) -0.24* (0.11) -0.23** (0.08)
Mothers’ BF à Fathers’ Parenting Stress (Partner) 0.22* (0.09) 0.23** (0.08)
Predictor & Residual Covariance
Mothers’ BF à Fathers’ BF 0.17** (0.06) 0.17** (0.06)
Mothers’ Parenting Stress à Fathers’ Parenting Stress 0.07** (0.02) 0.07** (0.02)
Models with Changes in Identity (Ch) β (SE) β (SE)
Intercept Mothers 1.89*** (0.08) 1.89*** (0.08)
Intercept Fathers 2.06*** (0.10) 2.06*** (0.10)
Effects of Meaning-Making
Mothers’ Ch à Mothers’ Parenting Stress (Actor) -0.02 (0.10) –
Fathers’ Ch à Mothers’ Parenting Stress (Partner) -0.14* (0.07) -0.15* (0.07)
Fathers’ Ch à Fathers’ Parenting Stress (Actor) 0.01 (0.09) 0.01 (0.08)
Mothers’ Ch à Fathers’ Parenting Stress (Partner) -0.02 (0.12) -0.01 (0.08)
Predictor & Residual Covariance
Mothers’ Ch à Fathers’ Ch 0.05 (0.04) 0.05 (0.04)
Mothers’ Parenting Stress à Fathers’ Parenting Stress 0.06* (0.02) 0.06* (0.02)

Significance: * = p < .05, ** = p < .01, *** = p < .001

All models include n = 77 couples and control for both partners’ ages, both partners’ education, the couple’s marital status, baby’s age at the
postpartum visit, and both partners’ coded engagement in the birth narrative. All continuous variables are grand mean centered, and all
categorical covariates are contrast coded (i.e., -0.5 vs. 0.5). These decisions were made to aid in the interpretation of model intercepts.

82
Figure 1. APIM results from models predicting changes in relationship functioning (H1).

Panel (a) depicts results for sense making, panel (b) depicts results for benefit finding, and panel (c)
depicts results for changes in identity. All models include n = 77 couples and control for both partners’
ages, both partners’ education, the couple’s marital status, both partners’ reports of prenatal relationship
functioning, weeks pregnant at the prenatal visit, baby’s age at the postpartum visit, and both partners’
coded engagement in the birth narrative.

83
Figure 2. APIM results from models predicting parenting stress (H2).

Panel (a) depicts results for sense making, panel (b) depicts results for benefit finding, and panel (c)
depicts results for changes in identity. All models include n = 77 couples and control for both partners’
ages, both partners’ education, the couple’s marital status, baby’s age at the postpartum visit, and both
partners’ coded engagement in the birth narrative.

84

The Meaning of Becoming a Parent:
Links Between a Meaning and Mental Health
Across the Transition to Parenthood
Geoffrey W. Corner
Mona Khaled
Shirin Herzig
Hannah Khoddam
Alyssa R. Morris
Katelyn Horton
Nia Barbee
Gayla Margolin
Darby E. Saxbe
University of Southern California

85
Abstract
The current study investigates whether having a sense of meaning and purpose plays a role in the
development of depression and anxiety during the transition to parenthood. The transition to
parenthood is a critical window for both positive and negative changes in adult development.
Many new mothers and fathers report heightened psychological symptoms in the postpartum
period, and yet, becoming a parent can be a joyful occasion, marked by a shift in priorities and
the integration of an important new identity. In acknowledgment of the potential importance of
existential well-being during this transition, the current study examined 1) trajectories of
meaning, depression, and anxiety across the transition to parenthood; and 2) overall and
longitudinal associations between meaning and mental health symptoms. A total of 77 opposite-
sex couples expecting their first child filled out questionnaires at approximately six months of
pregnancy and again approximately six months after the birth of their child. Overall, many new
parents reported reliable changes in meaning (16.1%), depression (34.4%), and anxiety (13.9%).
Levels of meaning predicted changes in depression, and changes in meaning predicted changes
in both depression and anxiety. Specifically, parents reporting low meaning or large decreases in
meaning showed increases in depressive symptoms, and parents with large increases in meaning
showed decreases in symptoms of anxiety. New mothers with decreases in meaning also showed
increased anxiety. These findings demonstrate the importance of meaning and purpose during the
transition to parenthood and suggest that parenting interventions may benefit from incorporating
elements focused on meaning. Additional clinical implications are discussed.
Keywords: transition to parenthood, mental health, depression, anxiety, meaning

86
The transition to parenthood is a critical period for many individuals and couples.
Becoming a parent can be meaningful and transformative, but it is also often fraught with
challenges and requires a reorganization of priorities, relationships, time, and responsibilities
(LeMasters, 1957; Saxbe et al., 2018). For that reason, many couples experience declines in
relationship functioning (Mitnick et al., 2010), and many individuals develop symptoms of
mental health disorders. Postpartum depression is often assumed to primarily affect mothers, but
some new fathers also show increases in depressive symptoms (Goodman, 2003). At the same
time, some researchers have argued for the importance of assessing symptoms of anxiety during
the postpartum period, which may also be elevated (Matthey et al., 2003). Various risk factors
for the emergence of mental health symptoms in new parents have been explored, including
parenting challenges, sleep problems, and difficulties in the couple’s relationship (Möller et al.,
2015; Parfitt & Ayers, 2014). Protective factors have received comparatively less attention,
although a sense of control and social support may mitigate some of the risk for the development
of mental health problems across this transition (Collins et al., 1993; Kamalifard et al., 2014;
Keeton et al., 2008).
The role of meaning and purpose is one critical but underexplored factor in the transition
to new parenthood. For many people, becoming a parent means taking on a new identity, one
that prioritizes caretaking and shifts a focus from the self to a focus on an infant or the family.
By and large, having meaning in one’s life benefits well-being and adjustment in challenging and
important contexts, and has been associated with various aspects of psychological well-being
(Debats et al., 1993; Zika & Chamberlain, 1992). Parents may report higher levels of meaning
than non-parents (Nelson et al., 2012), which suggests the importance of this construct across the
transition to parenthood. Despite this, little is known about how meaning and purpose change
87
from pregnancy to early parenthood and the relevance of these changes with regard to
psychological well-being. The current study explores the trajectories of meaning, depressive
symptoms, and symptoms of anxiety across the transition to parenthood, along with associations
between a sense of meaning and purpose and mental health challenges across this critical period.
Importantly, it investigates meaning as a potential protective factor for new parents and,
conversely, the risk when new parents experience meaning-related deficits or challenges.
Mental Health and Parenthood
Although becoming a new parent is often characterized by celebration and joy, many
individuals experience this transition as challenging or even as a crisis, and difficulties with
depression and anxiety can emerge in the postpartum period. Indeed, both mothers and fathers
appear to report higher rates of emotional distress than non-parents (Evenson & Simon, 2005),
and many parents develop clinically significant symptoms of postpartum depression. Estimates
of the prevalence of postpartum depression in new mothers are around 13% on average (O’Hara
& Swain, 1996), and estimates of prenatal and postpartum depression in fathers are similar, at
approximately 10% (Paulson & Bazemore, 2010). Many new mothers and fathers also
experience difficulties with postpartum anxiety (Matthey et al., 2003), and mothers may
experience fluctuations in their levels of anxiety at various points from pregnancy through early
parenthood (Figueiredo & Conde, 2011). Although a history of psychopathology is a risk factor
for postpartum depression in mothers (O’Hara & Swain, 1996), many women actually
experience their first depressive episode in the postpartum period (Stowe & Nemeroff, 1995),
which suggests that something unique occurs in the transition to parenthood that may bring about
mental health difficulties.
A variety of risk factors have been explored with regard to depression and anxiety in new
88
parents. These include parental age at birth, the birth of multiple children, unplanned versus
planned pregnancy, prenatal mental health challenges, other postpartum mental health
symptoms, low social support, financial stress, relationship difficulties, partner’s mental health
difficulties, and expected parenting efficacy (Choi et al., 2009; Don et al., 2014; Grant et al.,
2008; Mirowsky & Ross, 2002; Moreno-Rosset et al., 2016; Quinlivan & Condon, 2005; Seimyr
et al., 2004; Vismara et al., 2016). Although protective factors have received comparatively less
attention, one study of new parents across the transition to parenthood showed that a sense of
control and increasing control over time predicted lower levels of and decreasing depression and
anxiety (Keeton et al., 2010). The current study similarly explores the potential roles of levels of
meaning and changes in meaning as protective factors in the emergence and level of depressive
symptoms and symptoms of anxiety across the transition to parenthood. This topic is particularly
important given the implications of depression and anxiety in the postpartum period for both
mothers and fathers; these mental health challenges can impact the parent-child relationship and
parenting practices, which may also affect child outcomes (Glasheen et al., 2010; Letourneau et
al., 2012; Murray & Cooper, 1996; Paulson et al., 2006).
The Role of Meaning
In conversation and empirical investigation, the construct of “meaning” has been referred
to and studied both on its own and as a variety of related terms and ideas: existential well-being,
spiritual well-being, purpose in life, and more. In the current study, “meaning” refers to having a
strong, coherent sense of purpose with regard to one’s goals and priorities. This is consistent
with more recent conceptualizations of the different components of meaning, particularly the
ideas of purpose and coherence (Martela & Steger, 2016). Meaning can be achieved through how
one understands and makes sense of life, through spirituality or connection to a higher power, or
89
through participation in organized religion. Regardless of its origins, which likely vary from
person-to-person, it is clear that meaning plays an important role in adjustment and
psychological well-being. Studies have demonstrated associations between different facets of
meaning and both mental health symptoms and life satisfaction (Debats et al., 1993; Ho et al.,
2010). In Man’s Search for Meaning, a foundational work on existential well-being, Viktor
Frankl (1959/2006) described the role that meaning played in helping him endure the atrocities
of the Holocaust and survive as a prisoner at the Auschwitz concentration camp. Since Frankl’s
landmark memoir, a number of other psychologists and philosophers have expounded on the
importance of living a meaningful life. For example, Irvin Yalom (1980) discussed active
meaning-making as an essential task with which we all must wrestle. Frankl and Yalom both
developed psychotherapeutic approaches to help people find meaning and enhance their sense of
purpose, and after them, other clinicians have adapted and manualized these approaches for a
variety of populations, including patients with advanced cancer (Breitbart & Poppito, 2014a,
2014b).
Consistent with the role that it apparently played in Frankl’s life, meaning has also been
conceptualized as a protective factor in a variety of normative and non-normative contexts,
including adolescence, cancer, and acculturation (Brassai et al., 2011; Johnson Vickberg et al.,
2000; Pan et al., 2008). Furthermore, both having a sense of personal meaning and the act of
meaning-making have been researched in the contexts of bereavement (Lichtenthal et al., 2013;
Neimeyer, 2001) and various forms of trauma (Park & Ai, 2006). Although limited, there is even
some evidence to suggest that meaning-making can be a dyadic process that unfolds in a
relationship between partners who are coping with bereavement (Albuquerque, Buyukcan-Tetik,
et al., 2017; Albuquerque, Ferreira, et al., 2017) or illness (Manne et al., 2004; McGovern, 2011).
90
Feeling a sense of meaning and purpose likely has many implications for the lives and
experiences of couples, especially in difficult or challenging circumstances, such as infertility
(Abbey & Halman, 1995). At the same time, consistent with Yalom’s conceptualization of
meaning-making, grappling with meaning may be an essential task of human existence, which
would suggest that it is important and influential in a variety of life situations, not just when
confronting adversity. The current study investigates meaning as a potential protective factor in
the context of becoming a new parent, an important life event often experienced jointly by
partners in a relationship.
Meaning and Parenthood
Meaning remains underexplored in the context of the transition to parenthood, and the
link between meaning and perinatal mental health has not yet been investigated. This is true
despite the clear relevance of meaning, purpose, identity, growth, and other related constructs
during this critical window of adult development (Morse & Steger, 2019). Both new mothers and
new fathers suggest that their confidence adopting this new role of “parent” is important in their
adjustment (Nyström & Öhrling, 2004), and some research suggests that having a greater sense
of meaning in life is partly responsible for the extent to which parenthood is linked with feelings
of happiness and overall well-being (Nelson et al., 2014). Relative to non-parents, mothers and
fathers report higher levels of meaning (Nelson et al., 2012), and this link between parenthood
and purpose may be particularly strong for fathers (Mahalik et al., 2020). For fathers,
experiencing this sense of meaning may lead to higher social support and greater engagement in
healthy behaviors, which suggests a potential protective role for meaning (Mahalik et al., 2020).
For mothers, a greater sense of meaning and purpose in life may be one of the most commonly
identified gains during pregnancy and after the birth of their child (Wells et al., 1999), and
91
existential changes and experiences during the transition to motherhood appear to be of
paramount importance despite their relative lack of attention in the medical context encountered
by pregnant women and new mothers (Prinds et al., 2014).
Overall, becoming a new parent is often associated with experiences of personal growth,
although the mechanisms through which parents grow and the antecedents of growth need to be
investigated further (Taubman-Ben-Ari, 2019). The current study investigates the mental health
implications of the related construct of meaning for new parents. Consistent with research that
suggests the existence of gender differences in the adoption of and identification with new roles
during the transition to parenthood (Morris et al., 2014; Simon, 1995), we explore differences
between fathers and mothers in the role of meaning in relation to depression and anxiety.
Current Study
The current study aims to expand the literature on mental health in new parents across the
transition to parenthood by investigating the role of a sense of meaning and purpose in life. In
doing so, it focuses first on characterizing how levels of meaning, depressive symptoms, and
symptoms of anxiety change in a sample of new parents assessed longitudinally, from the
prenatal to the postpartum period. Next, it investigates associations between meaning and mental
health, building on prior work that demonstrated links between meaning and psychological well-
being by exploring these associations longitudinally and during the transition to parenthood,
which has been referred to as a critical window for adult development (Saxbe et al., 2018).
Consistent with prior work demonstrating heightened risk for depression and anxiety in
new mothers and fathers (Figueiredo & Conde, 2011; Goodman, 2003; Matthey et al., 2003;
Stowe & Nemeroff, 1995) and research suggesting the importance of parenthood in relation to a
sense of meaning (Nelson et al., 2012; Wells et al., 1999), we hypothesized that many parents
92
would show significant increases or decreases in each of these three areas (Hypothesis 1). Next,
consistent with studies that show associations between meaning and psychological well-being
(Debats et al., 1993; Zika & Chamberlain, 1992) and research that suggests the potential
protective role of meaning in various other contexts (Brassai et al., 2011; Johnson Vickberg et
al., 2000; Pan et al., 2008), we hypothesized that higher levels of and greater increases in
meaning would be associated with lower levels of and smaller increases in depression and
anxiety (Hypothesis 2). We explore sex differences in these associations, but given the paucity of
research on this topic, we did not form any specific hypotheses about those differences.
Method
Participants
The current study included approximately 83 opposite-sex couples. To participate in the
study, expectant couples needed to be having their first child from a single, not twin, pregnancy.
They also needed to be cohabitating and planning to cohabitate after the birth of their child. Both
partners needed to be 18 years old or older. Recruitment for the study was primarily carried out
through social media and advertisements posted in the Los Angeles community. As displayed in
Table 1, the sample was diverse with regard to racial/ethnic background and high in educational
attainment. At the start of participation and on average, expectant fathers were 33.2 years old
(SD = 5.7), expectant mothers were 31.3 years old (SD = 4.3), and couples were 29.0 weeks
pregnant (i.e., 6.7 months; SD = 3.9 weeks). Most couples were married.
Procedure
Overview. The current study is part of the Hormones Across the Transition to
Childrearing (HATCH) study, an ongoing longitudinal project examining biopsychosocial
changes in new mothers and fathers across the transition to parenthood. In order to complete
93
procedures for the current study, participants visited the lab twice, once at approximately six
months gestational age (i.e., the prenatal visit) and again approximately six months after the birth
of the baby (i.e., the postpartum visit). Of the 83 couples in the current study, 77 (92.8%)
returned for the postpartum visit. At the postpartum visit, participants’ babies were, on average,
29.0 weeks old (i.e., 6.7 months; SD = 2.8 weeks). Participants completed informed consent
procedures at the beginning of the prenatal visit, and at each visit, after engaging in a series of
dyadic interactions, they completed a battery of questionnaires before leaving the lab.
Measures
Personal Meaning. Personal meaning was assessed using the Personal Meaning Index
(PMI) from the Life Attitude Profile-Revised (LAP-R; Reker, 1992; Reker, 2005). The LAP-R is
a 48-item measure with items using a 7-point Likert scale with responses ranging from 1,
“strongly disagree,” to 7, “strongly agree.” It draws substantially from Viktor Frankl’s work in
its conceptualization of meaning (Frankl, 1959/2006). It was created to assess meaning across
multiple dimensions. The PMI comprises two of these dimensions: purpose (i.e., having life
goals and a sense of direction, which is assessed with items that include, “I know where my life
is going in the future”) and coherence (i.e., having a clear and logically integrated identity or
sense of self, which is assessed with items that include, “In thinking of my life, I see a reason for
my being here”). Each of these subscales consists of 8 items, and all responses to all 16 items are
added together for a total PMI score. Scores on the PMI range from 16 to 112, and higher scores
represent a great sense of meaning and purpose in life. The PMI has demonstrated adequate
internal consistency with a Cronbach’s alpha of .91 and adequate test-retest reliability at a four-
to six-week interval with a correlation of .90 (Reker, 1992). The PMI has also demonstrated
adequate concurrent validity in its associations with optimism, well-being, life satisfaction, social
94
desirability, and more, and the PMI appears to have impressive discriminant validity as
evidenced by results from a factor analysis including items from the purpose and coherence
scales and a variety of psychosocial measures (e.g., depression, physical health, religious
practice; Reker, 1992). It has been used both in conjunction with other LAP-R subscales (Dennis
et al., 2004) and by itself, without the rest of the LAP-R (Halama, 2005).
Depression. Depression was assessed using the Beck Depression Inventory-II (BDI-II;
Beck et al., 1996). The BDI-II is a widely used measure of symptoms of depression in a variety
of clinical and research contexts. It comprises 16 items that map on to the symptoms of Major
Depressive Disorder defined by the Diagnostic and Statistical Manual of Mental Disorders, 4
th

education (DSM-IV; American Psychiatric Association, 1994). Each item has a set of responses
coded from 0 (e.g., “I do not feel sad”) to 3 (e.g., “I am so sad or unhappy that I can’t stand it”).
Symptoms are assessed over the last week. Responses to each item are added together for a total
BDI-II score, which can range from 0 to 63 with higher scores representing more several
depressive symptoms. Examinations of the BDI-II have provided strong support for its reliability
and validity (Beck et al., 1996; Dozois et al., 1998).
Anxiety. Anxiety was assessed using the State subscale of the Spielberger State-Trait
Anxiety Inventory Form Y (STAI-S; Spielberger et al., 1983). The STAI-S is a widely used
measure of state anxiety, which can be thought of as feelings of anxiety experienced at a
particular time. It is often used in conjunction with and in contrast to the Trait subscale of the
STAI, which measures longstanding features of anxiety that are experienced across situations
and over time. The STAI-S consists of 20 items that assess how individuals feel in a particular
moment (e.g., calm, upset, worried). Respondents indicate the extent to which they feel each of
these emotions on a scale from 1 (“Not at all”) to 4 (“Very much so”). Responses are added
95
together for a total score, which can range from 20 to 80 with higher scores representing higher
levels of state anxiety. Examinations of the STAI-S have provided strong support for its
reliability and validity (Novy et al., 1993; Spielberger et al., 1983).
Data Analysis
SAS version 9.4 was used to carry out analyses for the current study (SAS Institute Inc.,
2015). To compare the characteristics of male and female participants, t-tests and Pearson’s χ
2

tests were used for continuous and categorical variables, respectively. A Welch-Satterthwaite
adjustment was used for t-tests with unequal variances, and Fisher’s exact tests were used for
categorical comparisons with small cell sizes (i.e., five individuals or fewer). Associations
between key continuous variables were examined using Pearson’s correlation coefficients. In
order to examine changes in meaning, depression, and anxiety, only individuals with both
prenatal and postpartum observations were included in the analyses testing our hypotheses. This
resulted in the exclusion of the five couples who did not return for the prenatal visit, two
individuals who received an older version of the questionnaire without the PMI, and one
individual for whom prenatal data were lost due to storage issues. Overall, 151 (n = 76 men and
77 women) out of a possible 166 participants (90.9%) were included in these analyses.
For our first hypothesis, we calculated a Reliable Change Index (RCI; Jacobson et al.,
1984) for changes in meaning, depression, and anxiety for each participant. Estimates of test-
retest reliability, which are used to calculate the standard error of the difference, were taken from
the literature. Specifically, we calculated RCIs with a test-retest reliability of .90 for the PMI
(Reker, 1992), .93 for the BDI-II (Beck et al., 1996), and .70 for the STAI-S (Barnes et al.,
2002). Estimates of variability were taken from the current sample (i.e., prenatal standard
deviations of 16.4 for the PMI, 6.2 for the BDI, and 9.2 for the STAI-S). An RCI of 1.96, which
96
represents reliable or significant change (Jacobson et al., 1984), corresponded to increases or
decreases of 14.38 in PMI scores, 4.52 in BDI-II scores, and 13.94 in STAI-S scores. We
calculated frequencies for participants who demonstrated reliable change and participants who
demonstrated any increase or decrease.
Analyses for our second hypothesis were conducted using a series of multilevel models,
which were selected to account for interdependence in the two observations from each individual
and observations from partners. Model specification, particularly the specification of variance
and covariance parameters, was guided by the approach detailed by West (2013). This enabled us
to model residual variance and covariance 1) for each partner at each time point, 2) between
prenatal and postpartum observations for male and female partners, 3) between partners’
observations at each time point, and 4) between partners’ observations across time points.
Models included the effects of both overall meaning (i.e., average meaning across both time
points) and changes in meaning (i.e., the difference between time points). All models included
the effect of time, which tested changes in mental health symptoms across the transition to
parenthood. Two-way interactions between time and meaning were used to test the extent to
which expected changes in mental health symptoms across the transition to parenthood were
modified by overall levels of and changes in meaning. Simple slopes analyses were used to
investigate significant interactions between meaning and time.
Model fit (e.g., AIC values) and parameter estimates were examined to select the final
reported models. Specifically, gender differences were examined in the effects of our covariates
and our effects of interest by including their interactions with gender. Similarly, when
interactions between levels of meaning and time were significant, they were included; otherwise,
they were left out to report more parsimonious and interpretable models. All models controlled
97
for age, weeks pregnant at the prenatal visit, baby’s age at the postpartum visit, marital status,
and educational attainment. Models testing associations between meaning and depression
controlled for anxiety, and models testing associations between meaning and anxiety controlled
for depression. This decision was made to uniquely predict variance in depressive symptoms and
symptoms of anxiety rather than their shared variance. Sensitivity analyses were conducted using
the final models to determine the impact of controlling for anxiety or depression. Further
sensitivity analyses were conducted to examine the impacts of outliers in change and the
inclusion of overall and changes in levels of meaning in the same model, which could potentially
result in the detection of spurious effects stemming from measurement error (Sorjonen et al.,
2019). All continuous variables (e.g., anxiety, age) were mean-centered, sex and time were
dummy-coded (i.e., 0 = Female / Prenatal and 1 = Male / Postpartum), and educational
attainment and marital status were contrast coded (i.e., -0.5 = College degree or less / Unmarried
and 0.5 = Graduate degree / Married). These decisions were made to ensure the interpretability
of model intercepts and parameter estimates, particularly those for interactions.
Results
Participant characteristics and comparisons between male and female participants are
presented in Table 1. Male participants were older, reported lower levels of meaning both
prenatally and postpartum, and reported lower symptoms of depression prenatally. Men and
women did not differ with regard to race, educational attainment, postpartum depressive
symptoms, anxiety at either time point, or changes in any of our variables of interest.
Correlations between key study variables are presented in Table 2. A number of
significant associations emerged. For both men and women, changes in meaning were negatively
associated with changes in depression and changes in anxiety, changes in depression were
98
positively associated with changes in anxiety, and postpartum levels of meaning were positively
associated with changes in meaning and negatively associated with changes in depression and
anxiety. Between partners, there were links between age, prenatal and postpartum meaning,
prenatal depression, and changes in depression, prenatal and postpartum anxiety. However,
partners’ changes in meaning, postpartum depressive symptoms, and changes in anxiety were not
associated. Consistent with expectations, prenatal and postpartum levels of meaning, depression,
and anxiety were positively associated for both partners, and prenatal levels of each of these
variables were negatively associated with changes.
Hypothesis 1: Changes in Meaning, Depression, and Anxiety
Changes in meaning, depression, and anxiety for male and female participants are
reported in Table 3 and depicted in Figure 1. Overall, 16.1% of participants (n = 24)
demonstrated reliable change in meaning, 34.4% (n = 52) demonstrated reliable change in
depression, and 13.9% (n = 21) demonstrated reliable change in depression. More men appeared
to change reliably in meaning, and more women appeared to change reliably in depression and
anxiety. However, this difference was only significant for depression (χ
2
(1, N = 153) = 4.37, p =
.04). Irrespective of the magnitude of their change, approximately equal numbers of participants
showed increases and decreases in meaning, anxiety, and depression. The exceptions to this were
women being more likely to increase in meaning than to decrease (n = 42, 56.0%, vs. n = 26,
34.7%) and men being more likely to decrease in symptoms of anxiety than to increase (n = 46,
59.7%, vs. n = 26, 33.8%). However, this difference was only significant for men’s anxiety (p =
.02 with a binomial test).
Hypothesis 2: Associations Between Meaning and Mental Health Symptoms
Results from models testing associations between meaning and both depression and
99
anxiety are presented in Table 4. Across both models predicting depression and anxiety, the
following parameter estimates differed between men and women: model intercepts, the effect of
changes in meaning on depression, and changes in symptoms of anxiety. To aid in the
interpretation of these results, separate intercepts for men and women were estimated in both
models, separate effects of changes in meaning were estimated in models predicting depression,
separate effects of time were estimated in models predicting anxiety. Interactions between
overall levels of meaning and time in predicting anxiety were not significant, and their inclusion
did not improve model fit. Therefore, this interaction was not included in the final model.
Both overall levels of meaning and changes in meaning moderated the effect of time in
predicting depression, and changes in meaning moderated the effect of time in predicting
anxiety. Results from simple slopes analyses probing these significant interactions are presented
in Figure 2. There were significant estimated increases in depressive symptoms for individuals
with low levels of meaning (i.e., overall meaning 1 SD below the mean) and large decreases in
meaning (i.e., a decrease of 1 SD their prenatal level of meaning). There were significant
decreases in symptoms of anxiety for individuals with large increases in meaning, and there were
significant increases in symptoms of anxiety for women with large decreases in meaning.
Changes in anxiety were not significant for men with large decreases in meaning.
Sensitivity analyses were conducted to investigate the impact of outliers in change (i.e.,
change scores in any of our variables or interest greater than or equal to 3 SDs in change), the
decision to test levels of and changes in meaning in the same model, and the decision to control
for depressive symptoms in models predicting anxiety and vice versa. Removal of outliers did
not affect the direction or significance level or drastically alter the magnitude (i.e., a change of
less than 6%) of the interaction between meaning and time in predicting depression. Removal of
100
outliers did not affect the direction or significance level of the interaction between changes in
meaning and time in predicting anxiety; however, the effect did drop in magnitude from -0.29 to
-0.20. Testing levels of and changes in meaning in separate models predicting anxiety and
depression did not affect the direction or significance level of any effects of interest, and it did
not drastically alter the magnitude of any previously significant effects (i.e., changes in their
magnitude were all less than 5%). Leaving out other mental health symptoms as a covariate
resulted in similar patterns of changes across both models. First, significant main effects of
changes in meaning emerged for men in predicting depression and for both partners in predicting
anxiety. The magnitude of both of these effects increased (i.e., from 0.09 to 0.12 for depression
in men and from 0.08 to 0.15 for anxiety in both partners). Second, there was an increase in the
magnitude of the interaction between time and changes in meaning (i.e., from -0.10 to -0.20 for
depression and from -0.29 to -0.45 for anxiety).
Discussion
The current study expands our understanding of the role of meaning in predicting mental
health across the transition to parenthood. Many parents in our sample experienced reliable
changes from the prenatal to the postpartum period in their levels of meaning (15.9% of the
sample demonstrated reliable change in meaning) and their symptoms of depression (34%
demonstrated reliable change) and anxiety (13.7% demonstrated reliable changes). More mothers
than fathers changed reliably in their depressive symptoms, and men were more likely to
decrease than increase in their symptoms of anxiety. For both mothers and fathers, overall levels
of meaning predicted changes in depression from the prenatal to the postpartum period, and
changes in levels of meaning predicted changes in both depression and anxiety. Specifically, for
both men and women with low levels of meaning or large decreases in meaning, depressive
101
symptoms increased. For new mothers who decreased in meaning, anxiety increased, whereas
anxiety decreased for both mothers and fathers when they increased in meaning. Together, these
results suggest that meaning is an important protective factor for the mental health of new
mothers and fathers. Not only are overall levels of meaning predictive of changes in depression,
but also, the extent to which new parents make meaning of their new identity may play a critical
role in the development of depression or anxiety. Although sex differences in the observed
associations were minimal, mothers were higher than fathers in overall meaning both prenatally
and postpartum, which is consistent with differences between men and women observed in prior
studies using the PMI (Reker, 1992; Reker, 2005). This suggests that sex differences should
continue to be explored in future work on meaning and the transition to parenthood.
The observed results were relatively robust when examining the effect of outliers in
changes in meaning, depression or anxiety and the impact of several decisions made about how
to run the models testing our second hypothesis. This reinforces our confidence that meaning and
mental health are truly linked across the transition to parenthood. Of note, low overall levels of
meaning and decreases in meaning appear to be risk factors for increasing depressive symptoms,
whereas increases in meaning are associated with decreases in anxious symptoms from
pregnancy to parenthood. Therefore, while the associations between meaning and depression are
relatively similar to the ones observed for meaning and anxiety, meaning may play more of a
protective role in anxiety, whereas a lack of meaning may be a risk factor in depression.
Importantly, we measured meaning, depression, and anxiety at the same two timepoints.
Therefore, it is possible that changes mental health influence changes in meaning, rather than the
other way around, or that changes in meaning and mental health are bidirectionally associated.
Although this is a limitation, our findings still support the contention that meaning and mental
102
health are both dynamic across the transition to parenthood and appear to be linked with each
other. Meaning may therefore be an important target of intervention across the transition to
parenthood. Helping expectant parents connect to an overall sense of meaning and purpose may
protect against the development of depression in the postpartum period. Similarly, facilitating
meaning-making in late pregnancy, around the birth experience, and while parenting an infant
may be helpful in both reducing anxiety and preventing the development of depression. If
depression and anxiety diminish a sense of meaning in new parents, then interventions for
expectant and new parents who are struggling with mental health should also attend to their
existential needs. Finally, if mental health and meaning are bidirectionally associated, meaning
may be another target for intervention, above and beyond just depression and anxiety. Meaning
may be more amenable to brief intervention, and new parents may be more open to discussions
about meaning and existential well-being than ones about mental health.
A variety of approaches may be useful in supporting individuals and couples existentially
through the transition to parenthood. Broadly speaking, several case studies suggest the value of
existential psychotherapeutic approaches for new parents experiencing difficulties with meaning
and identity (Levin-Keini & Schlomo, 2019). In addition to psychotherapy for existentially
distressed parents, prenatal or early postpartum parenting skills interventions – which have been
shown to increase parental responsiveness, reduce infant sleep difficulties, and potentially even
reduce risk for postpartum depression in mothers (Matthey et al., 2004; Mihelic et al., 2017) –
could potentially incorporate elements that help new parents integrate fatherhood or motherhood
into their sense of identity. Consistent with this, prior work has advocated for the inclusion of
existential components in early parenting interventions for Hong Kong-Chinese parents (To &
Chan, 2011). Parental bonding-oriented interventions, with their focus on the parent-child
103
relationship and the centrality of the identity of “parent” in that context, may also be a useful
forum to discuss issues related to meaning and purpose. Additionally, given the potential
importance of birth experiences in mitigating or exacerbating the effects of prenatal difficulties
on postpartum adjustment (Saxbe, 2017) and the fact that the current study’s results highlight the
importance of changes in meaning from the prenatal to postpartum period, interventions that
facilitate meaning-making immediately after the birth of a child could be particularly useful in
bolstering a sense of meaning and purpose in new parents. For example, encouraging new
parents to talk or journal about difficult birth experiences may help them make sense of these
experiences. Our findings suggest that either of these approaches may be helpful in reducing the
risk of the development of depressive symptoms or symptoms of anxiety across the transition to
parenthood.
Aside from intervention implications, asking about meaning and purpose may be useful
in identifying individuals at risk for the emergence of mental health challenges in the postpartum
period. Of note, mental health in new parents may be linked to emotional and behavioral
outcomes in their children years later (Ramchandani et al., 2005), and although speculative, the
same may be true for meaning. Either way, it is clear that the psychological well-being of new
parents is of paramount importance in both the short- and the long-term, and being able to
identify parents at risk for problems with meaning, depression, or anxiety and support them
directly through existential well-being and indirectly through targeting their risk for mental
health may have immediate and downstream benefits for parents and the overall family.
Several other factors that were not investigated in the current study are worth attending to
in future research on this topic. For example, meaning-making around parenthood may be tied to
bonding with the infant, as well as parenting efficacy and infant disposition. Prior studies have
104
shown links between parenting efficacy and postpartum depression (Gross & Marcussen, 2017),
and levels of meaning may both affect and be affected by the emotional and logistical challenges
of learning how to parent. Additionally, our sample was highly educated (86.7% of parents had a
college or graduate degree), and the role of meaning may differ depending on levels of
educational attainment (Ryff et al., 1994). Although we controlled for education in our analyses,
the composition of our sample may have prevented being able to effectively examine its role.
Similarly, our sample comprised only opposite-sex couples, and the transition to parenthood
experience of same-sex couples warrants further attention. This is particularly true given some
evidence that identification with the role of “parent” may differentially affect meaning of life in
gay fathers (Shenkman & Shmotkin, 2016). Finally, we were not able to explore the influence of
several other factors potentially relevant to meaning and purpose in new parents. For example, it
is likely that the extent to which couples choose to become parents will influence their levels of
meaning prenatally and postpartum and how they make sense of their new identity and
responsibilities. Prior research has shown that new fathers may be more stressed by an unplanned
pregnancy (Clinton & Kelber, 1993) and that pregnant women may be at greater risk for
depression when their pregnancy was not planned (Yanikkerem et al., 2013). In addition, leave
from and return to work may play a role in how parents’ sense of meaning changes in late
pregnancy and early parenthood. Consistent with prior research showing that life-related stress
mediates the development and maintenance of depressive symptoms (Dunkel Schetter et al.,
2016), meaning-focused intervention may be particularly important for individuals and couples
experiencing an unplanned pregnancy or difficulties related to work-family conflict, such as lack
of access to paid family leave. Future studies should investigate the role played by these factors.
This study would have been stronger if we had more data collection timepoints in order
105
to better establish directionality and clarify exactly when meaning and mental health change
during pregnancy and parenthood. For example, in our sample, fathers were more likely than
mothers to demonstrate reliable change in levels of meaning (19.7% vs. 12.0%). This may be
because mothers are more likely to identify as such soon after becoming pregnant, while fathers
take on their role as a parent only after the birth of their child (Longworth & Kingdon, 2011;
Widarsson et al., 2015). Assessing levels of meaning early in pregnancy may provide a better
baseline of meaning for mothers, and assessing levels of meaning later in parenthood may be
important in determining how fathers adapt to their new sense of identity over time. Despite
these and other potential limitations, the current study has many notable strengths. Most
importantly, to our knowledge, it is the first to explore links between meaning and mental health
across the critical window of the transition to parenthood. It does so with a longitudinal design
and repeated measurements of meaning, depression, and anxiety, which enabled us to test overall
associations between meaning and mental health as well as links between changes in both.
Additionally, the current study included both mothers and fathers, which is a strength because
men have often been omitted from studies of the transition to parenthood. We tested differences
between men and women in the effects of interest and found that associations between meaning
and mental health for mothers and fathers were remarkably consistent.
Overall, the current study contributes to our understanding of the trajectories of meaning,
depression, and anxiety across the transition to parenthood. Identifying meaning as a potentially
important protective factor in the development of depression and anxiety has notable
implications for clinical assessment and intervention in expectant and new parents. Existing
interventions can incorporate elements that enable expectant parents to reflect on and make sense
of their changing identity and priorities in life, and additional meaning-focused interventions
106
around the birth experience may be warranted. Future research should investigate the timing of
changes in meaning and the directionality of associations between meaning and mental health.
Nonetheless, it is clear that meaning is an underexplored and potentially valuable target for
research and intervention focusing on the transition to parenthood.

107
References
Abbey, A., & Halman, L. J. (1995). The role of perceived control, attributions, and meaning in
members’ of infertile couples well-being. Journal of Social and Clinical Psychology,
14(3), 271-296.
Albuquerque, S., Buyukcan-Tetik, A., Stroebe, M. S., Schut, H. A. W., Narciso, I., Pereira, M.,
& Finkenauer, C. (2017). Meaning and coping orientation of bereaved parents: Individual
and dyadic processes. PLoS ONE, 12(6), 1-14.
Albuquerque, S., Ferreira, L. C., Narciso, I., & Pereira, M. (2017). Parents’ positive interpersonal
coping after a child’s death. Journal of Child and Family Studies, 26(7), 1817–1830.
American Psychiatric Association. (1994). Diagnostic and statistical manual of mental
disorders: DSM-IV. American Psychiatric Association.
Barnes, L. L., Harp, D., & Jung, W. S. (2002). Reliability generalization of scores on the
Spielberger State-Trait Anxiety Inventory. Educational and Psychological Measurement,
62(4), 603-618.
Beck, A. T., Steer, R. A., & Brown, G. K. (1996). Manual for the Beck Depression Inventory-II.
Psychological Corporation.
Breitbart, W., & Poppito, S. R. (2014a). Individual meaning-centered psychotherapy for patients
with advanced cancer: A treatment manual. Oxford University Press.
Breitbart, W. S., & Poppito, S. R. (2014b). Meaning-centered group psychotherapy for patients
with advanced cancer: A treatment manual. Oxford University Press.
Brassai, L., Pika, B. F., & Steger, M. F. (2011). Meaning in life: Is it a protective factor for
adolescents’ psychological health? International Journal of Behavioral Medicine, 18(1),
44-51.
108
Choi, Y., Bishai, D., & Minkovitz, C. S. (2009). Multiple births are a risk factor for postpartum
maternal depressive symptoms. Pediatrics, 123(4), 1147-1154.
Clinton, J. F., & Kelber, S. T. (1993). Stress and coping in fathers of newborns: Comparisons of
planned versus unplanned pregnancy. International Journal of Nursing Studies, 30(5),
437-443.
Collins, N. L., Dunkel-Schetter, C., Lobel, M., & Scrimshaw, S. C. M. (1993). Social support in
pregnancy: Psychosocial correlates of birth outcomes and postpartum depression. Journal
of Personality and Social Psychology, 65(6), 1243-1258.
Debats, D., van Der Lubbe, P., & Wezeman, F. (1993). On the psychometric properties of the
life regard index (LRI): A measure of meaningful life: An evaluation in three
independent samples based on the Dutch version. Personality and Individual Differences,
14(2), 337-345.
Dennis, D., Muller, S.M., Miller, K., & Banerjee, P. (2004). Spirituality among a college student
cohort: A quantitative assessment. American Journal of Health Education, 35(4), 220-
227.
Don, B. P., Chong, A., Biehle, S. N., Gordon, A., & Mickelson, K. D. (2014). Anxiety across the
transition to parenthood: Change trajectories among low-risk parents. Anxiety, Stress &
Coping, 27(6), 633-649.
Dozois, D. J. A., Dobson, K. S., & Ahnberg, J. L. (1998). A psychometric evaluation of the Beck
Depression Inventory-II. Psychological Assessment, 10(2), 83-89.
Dunkel Schetter, C., Saxbe, D. E., Cheadle, A. C. D., & Guardino, C. M. (2016). Postpartum
depressive symptoms following consecutive pregnancies: Stability, change, and
mechanisms. Clinical Psychological Science, 4(5), 909-918.
109
Evenson, R. J., & Simon, R. W. (2005). Clarifying the relationship between parenthood and
depression. Journal of Health and Social Behavior, 46(4), 341-358.
Figueiredo, B., & Conde, A. (2011). Anxiety and depression in women and men from early
pregnancy to 3-months postpartum. Archives of Women's Mental Health, 14(3), 247-255.
Frankl, V. (2006). Man’s search for meaning. Beacon Press. (Original work published 1959)
Glasheen, C., Richardson, G. A., & Fabio, A. (2010). A systematic review of the effects of
postnatal maternal anxiety on children. Archives of Women’s Mental Health, 13(1), 61-
74.
Goodman, J. H. (2003). Paternal postpartum depression, its relationship to maternal postpartum
depression, and implications for family health. Journal of Advanced Nursing, 45(1), 26-
35.
Grant, K., McMahon, C., & Austin, M. (2008). Maternal anxiety during the transition to
parenthood: A prospective study. Journal of Affective Disorders, 108(1-2), 101-111.
Halama, P. (2005). Relationship between meaning in life and the big five personality traits in
young adults and the elderly. Studia Psychologica, 47(3), 167-178.
Ho, M. Y., Cheung, F. M., & Cheung, S. F. (2010). The role of meaning in life and optimism in
promoting well-being. Personality and Individual Differences, 48(5), 658-663.
Jacobson, N. S., Follette, W. C., & Revenstorf, D. (1984). Psychotherapy outcome research:
Methods for reporting variability and evaluating clinical significance. Behavior Therapy,
15(4), 336-352.
Johnson Vickberg, S. M., Bovbjerg, D. H., DuHamel, K. N., Currie, V., & Redd, W. H. (2000).
Intrusive thoughts and psychological distress among breast cancer survivors: Global
meaning as a possible protective factor. Behavioral Medicine, 25(4), 152-160.
110
Julian, L. J. (2011). Measures of anxiety: State-Trait Anxiety Inventory, Beck Anxiety Inventory
(BAI), and Hospital Anxiety and Depression Scale – Anxiety. Arthritis Care & Research,
63(S11), S467-S472.
Kamalifard, M., Hasanpoor, S., Kheiroddin, J. B., Panahi, S., & Payan, S. B. (2014).
Relationship between fathers’ depression and perceived social support and stress in
postpartum period. Journal of Caring Sciences, 3(1), 57-66.
Keeton, C. P., Perry-Jenkins, M., & Sayer, A. G. (2008). Sense of control predicts depressive and
anxious symptoms across the transition to parenthood. Journal of Family
Psychology, 22(2), 212-221.
LeMasters, E. E. (1957). Parenthood as crisis. Marriage and Family Living, 19(4), 352-355.
Letourneau, N. L., Dennis, C., Benzies, K., Duffett-Leger, L., Stewart, M., Tryphonopoulos, P.
D., … Watson, W. (2012). Postpartum depression is a family affair: Addressing the
impact on mothers, fathers, and children. Issues in Mental Health Nursing, 33(7), 445-
457.
Levin-Keini, N., & Schlomo, S. B. (2019) Confronting existential concerns in the transition to
parenthood: A theoretical and therapeutic model. In O. Taubman-Ben-Ari (Ed.),
Pathways and barriers to parenthood: Existential concerns regarding fertility,
pregnancy, and early parenthood (pp. 235-249). Springer.
Lichtenthal, W. G., Neimeyer, R. A., Currier, J. M., Roberts, K., & Jordan, N. (2013). Cause of
death and the quest for meaning after the loss of a child. Death Studies, 37(4), 311-342.
Longworth, H. L., & Kingdon, C. K. (2011). Fathers in the birth room: What are they expecting
and experiencing? A phenomenological study. Midwifery, 27(5), 588-594.
Mahalik, J. R., Di Bianca, M., & Sepulveda, J. A. (2020). Examining father status and purpose to
111
understand new dads’ healthier lives. Psychology of Men & Masculinities. Advanced
online publication.
Manne, S., Ostroff, J., Winkel, G., Goldstein, L., Fox, K., & Grana, G. (2004). Posttraumatic
growth after breast cancer: Patient, partner, and couple perspectives. Psychosomatic
Medicine, 66(3), 442-454.
Martela, F., & Steger, M. F. (2016). The three meanings of meaning in life: Distinguishing
coherence, purpose, and significance. The Journal of Positive Psychology, 11(5), 531-
545.
Matthey, S., Barnett, B., Howie, P., & Kavanagh, D. J. (2003). Diagnosing postpartum
depression in mothers and fathers: Whatever happened to anxiety? Journal of Affective
Disorders, 74(2), 139-147.
Matthey, S., Kavanagh, D. J., Howie, P., Barnett, B., & Charles, M. (2004). Prevention of
postnatal distress or depression: An evaluation of an intervention at preparation for
parenthood classes. Journal of Affective Disorders, 79(1-3), 113-126.
McGovern, J. (2011). Couple meaning-making and dementia: Challenges to the deficit model.
Journal of Gerontological Social Work, 54(7), 678-690.
Mihelic, M., Morawska, A., & Filus, A. (2017). Effects of early parenting interventions on
parents and infants: A meta-analytic review. Journal of Child and Family Studies, 26,
1507-1526.
Mirowsky, J., & Ross, C. E. (2002). Depression, parenthood, and age at first birth. Social
Science & Medicine. 54(8), 1281-1298.
Mitnick, D. M., Heyman, R. E., & Smith Slep, A. M. (2010). Changes in relationship satisfaction
across the transition to parenthood: A meta-analysis. Journal of Family Psychology,
112
23(6), 848-852.
Möller, E.,L., Majdandzic, M., & Bögels, S.,M. (2015). Parental anxiety, parenting behavior, and
infant anxiety: Differential associations for fathers and mothers. Journal of Child and
Family Studies, 24(9), 2626-2637.
Moreno-Rosset, C., Arnal-Remón, B., & Antequera-Jurado, R. (2016). Anxiety and
psychological wellbeing in couples in transition to parenthood. Clíica y Salud, 27(1), 29-
35.
Morris, K. L., Goldenberg, J. L., & Heflick, N. A. (2014). The trio of terror (pregnancy,
menstruation, and breastfeeding): An existential function of literal self-objectification
among women. Journal of Personality and Social Psychology, 107(1), 181-198.
Morse, J. L., & Steger, M. F. (2019) Giving birth to meaning: Understanding parenthood through
the psychology of meaning in life. In O. Taubman-Ben-Ari (Ed.), Pathways and barriers
to parenthood: Existential concerns regarding fertility, pregnancy, and early parenthood
(pp. 1-17). Springer.
Murray, L., & Cooper, P. J. (1996). The impact of postpartum depression on child development.
International Review of Psychiatry, 8(1), 55-63.
Neimeyer, R. A. (Ed.). (2001). Meaning reconstruction and the experience of loss. Washington,
DC: American Psychological Association.
Nelson, S. K., Kushlev, K., English, T., Dunn, E. W., & Lyubomirsky, S. (2012). In defense of
parenthood: Children are associated with more joy than misery. Psychological
Science, 24(1), 3-10.
Nelson, S. K., Kushlev, K., & Lyubomirsky, S. (2014). The pains and pleasures of parenting:
When, why, and how is parenthood associated with more or less well-being?
113
Psychological Bulletin, 140(3), 846-895.
Novy, D. M., Nelson, D. V., Goodwin, J., & Rowzee, R. D. (1993). Psychometric comparability
of the State-Trait Anxiety Inventory for difference ethnic subpopulations. Psychological
Assessment, 5(3), 343-349.
Nyström, K., & Öhrling, K. (2004). Parenthood experiences during the child’s first year:
Literature review. Journal of Advanced Nursing, 46(3), 319-330.
O’Hara, M. W., & Swain, A. M. (1996). Rates and risk of postpartum depression – A meta-
analysis. International Review of Psychiatry, 8(1), 37-54.
Pan, J., Wong, D. F. K., Chan, C. L. W., & Joubert, L. (2008). Meaning of life as a protective
factor of positive affect in acculturation: A resilience framework and a cross-cultural
comparison. International Journal of Intercultural Relations, 32(6), 505-514.
Parfitt, Y., & Ayers, S. (2014). Transition to parenthood and mental health in first!time
parents. Infant Mental Health Journal, 35(3), 263-273.
Park, C. L., & Ai, A. L. (2006). Meaning making and growth: New directions for research on
survivors on trauma. Journal of Loss and Trauma, 11(5), 389-407.
Paulson, J. F., & Bazemore, S. D. (2010). Prenatal and postpartum depression in fathers and its
association with maternal depression. Journal of the American Medical Association,
303(19), 1961-1969.
Paulson, J. F., Dauber, S., & Leiferman, J. A. (2006). Individual and combined effects of
postpartum depression in mothers and fathers on parenting behavior. Pediatrics, 118(2),
659-668.
Prinds, C., Hvidt, N. C., Mogensen, O., & Buus, N. (2014). Making existential meaning in
transition to motherhood – A scoping review. Midwifery, 30(6), 733-741.
114
Quinlivan, J. A., & Condon, J. (2005). Anxiety and depression in fathers in teenage pregnancy.
Australian and New Zealand Journal of Psychiatry, 39(10), 915-920.
Ramchandani, P., Stein, A., Evans, J., O’Connor, T. G., & The ALSPAC Study Team.
(2005). Paternal depression in the postnatal period and child development: A prospective
population study. Lancet, 365(9478), 2201-2205.
Reker, G. T. (1992). Manual: Life Attitude Profile – Revised. Student Psychologists Press.
Reker, G. T. (2005). Meaning in life of young, middle-aged, and older adults: Factorial validity,
age, and gender invariance of the Personal Meaning Index (PMI). Personality and
Individual Differences, 38(1), 71-85.
Ryff, C. D., Lee, Y. H., Essex, M. J., & Schmutte, P. S. (1994). My children and me: Midlife
evaluations of grown children and of self. Psychology and Aging, 9(2), 195-205.
SAS Institute Inc. (2015). SAS® 9.4 Intelligence Platform: System administration guide, fourth
edition. SAS Institute Inc.
Saxbe, D. E. (2017). Birth of a new perspective? A call for biopsychosocial research on
childbirth. Current Directions in Psychologist Science, 26(1), 81-86.
Saxbe, D., Rossin-Slater, M., & Goldenberg, D. (2018). The transition to parenthood as a critical
window for adult health. American Psychologist, 73(9), 1190-1200.
Seimyr, L., Edhborg, M., Lundh, W., & Sjögren, B. In the shadow of maternal depressed mood:
Experiences of parenthood during the first year after childbirth. Journal of Psychosomatic
Obstetrics & Gynecology, 25(1), 23-34.
Shenkman, G., & Shmotkin, D. (2016). The association between self-perceived parental role and
meaning in life among gay and heterosexual fathers. Journal of Family Psychology,
30(5), 552-561.
115
Simon, R. W. (1995). Gender, multiple roles, role meaning, and mental health. Journal of Health
and Social Behavior, 36(2), 182-194.
Sorjonen, K., Falkstedt, D., Melin, B., & Ingre, M. (2019, September 10). The peril of adjusting
for baseline when using change as a predictor. https://doi.org/10.31234/osf.io/6p5hj
Spielberger, C. D., Gorsuch, R. L., Lushene, R., Vagg, P. R., & Jacobs, G. A. (1983). Manual for
the State-Trait Anxiety Inventory. Consulting Psychologists Press.
Stowe, Z. N., & Nemeroff, C. B. (1995). Women at risk for postpartum-onset major
depression. American Journal of Obstetrics and Gynecology, 173(2), 639-645.
Stuart, S., Couser, G., Schilder, K., O’Hara, M. W., & Gorman, L. (1998). Postpartum anxiety
and depression: Onset and comorbidity in a community sample. The Journal of Nervous
& Mental Disease, 186(7), 420-424.
Taubman-Ben-Ari, O. (2019) Blossoming and growing in the transition to parenthood. In O.
Taubman-Ben-Ari (Ed.), Pathways and barriers to parenthood: Existential concerns
regarding fertility, pregnancy, and early parenthood (pp. 271-290). Springer.
Vismara, L., Rollè, L., Agostini, F., Sechi, C., Fenaroli, V., Molgora, S., … Tambelli, R. (2016).
Perinatal parenting stress, anxiety, and depression outcomes in first-time mothers and
fathers: A 3- to 6-months postpartum follow-up study. Frontiers in Psychology, 7, 938.
Wells, D. J., Hobfoll, E. S., & Lavin, J. (1999). When it rains, it pours: The greater impact of
resource loss compared to gain on psychological distress. Personality and Social
Psychology Bulletin, 25(9), 1172–1182.
West, T. V. (2013). Repeated measures with dyads. In J. A. Simpson & L. Campbell (Eds.), The
Oxford handbook of close relationships (pp. 731–749). Oxford University Press.
Widarsson, M., Engström, G., Tydén, T., Lundberg, P., & Hammar, L. M. (2015). ‘Paddling
116
upstream’: Fathers’ involvement during pregnancy as described by expectant fathers and
mothers. Journal of Clinical Nursing, 24(7-8), 1059-1068.
Yalom, I. (1980). Existential psychotherapy. Basic Books.
Yanikkerem, E., Ay, S., & Piro, N. (2013). Planned and unplanned pregnancy: Effects on health
practice and depression during pregnancy. The Journal of Obstetrics and Gynaecology
Research, 39(1), 180-187.
Zika, S., & Chamberlain, K. (1992). On the relation between meaning in life and psychological
well-being. British Journal of Psychology, 83(1), 133-145.

117
Table 1. Participant characteristics (n = 83 couples).

Male
Participants

Female
Participants

Test
Statistic

Participant Characteristics M (SD) / n (%) (e.g., t, χ
2
)
Age
a
33.2 (5.7) 31.3 (4.3) -2.48*
Race
a
0.44
Asian / Pacific Islander 15 (18.1%) 14 (17.1%)
Black / African American 6 (7.2%) 5 (6.1%)
Hispanic / Latinx 15 (18.1%) 18 (22.0%)
White / Caucasian 41 (49.4%) 39 (47.6%)
Other / Decline to State 6 (7.2%) 6 (7.3%)
Educational Attainment
a
4.03
High School / GED 2 (2.4%) 1 (1.2%)
Some College 10 (12.0%) 8 (9.8%)
College Degree 42 (50.6%) 32 (39.0%)
Graduate Degree 29 (34.9%) 41 (50.0%)
Couple Characteristics
Married 70 (84.3%)
Weeks Pregnant (PN) 29.0 (3.9)
Baby’s Age (Weeks, PP) 29.0 (2.8)
Meaning & Mental Health
Meaning (PN)
b
83.6 (16.4) 88.9 (16.1) 2.06*
Meaning (PP)
c
83.9 (16.6) 90.7 (15.0) 2.65**
Meaning (Change)
b
0.3 (11.9) 0.9 (9.2) 0.35
Depression (PN)
a
8.0 (6.1) 10.2 (6.0) 2.40*
Depression (PP) 8.8 (6.6) 10.4 (6.7) 1.54
Depression (Change)
a
0.7 (4.7) 0.3 (6.7) -0.42
Anxiety (PN)
a
31.7 (8.7) 29.8 (9.6) -1.30
Anxiety (PP) 30.4 (8.4) 31.1 (10.7) 0.46
Anxiety (Change)
a
-1.0 (8.7) 1.2 (10.0) 1.45

Significance: * = p < .05, ** = p < .01, *** = p < .001.

Critical values are from t-tests and Pearson’s χ2 tests comparing continuous and categorical characteristics of
male and female participants. A Welch-Satterthwaite adjustment was used for t-tests with unequal variances, and
Fisher’s exact tests were used for categorical comparisons with small cell sizes.

Missing data: a = 0 men, 1 woman; b = 2 men, 1 woman; c = 1 man, 0 women.
All postpartum descriptive statistics are missing 6 couples who dropped out prior to the postpartum visit. Missing
data beyond these couples are reported with the above notations.

Abbreviations: PN = Prenatal; PP = Postpartum; Meaning = Personal Meaning (PMI Scores); Depression =
Depressive Symptoms (BDI-II Scores); Anxiety = Symptoms of Anxiety (STAI-S Scores).

118

119
Table 3. Changes in meaning and mental health (n = 77 men, 76 women; H1).

Male
Participants

Female
Participants

Participant Characteristics n (%)
Personal Meaning (PMI)
a

Any Reliable Change (+/- 14.38) 15 (19.7%) 9 (12.0%)
Reliable Increase 7 (9.2%) 6 (8.0%)
Any Increase 37 (48.7%) 42 (56.0%)
No Change 4 (4.8%) 7 (9.3%)
Any Decrease 35 (46.1%) 26 (34.7%)
Reliable Decrease 8 (10.5%) 3 (4.0%)
Depressive Symptoms (BDI-II)
Any Reliable Change (+/- 4.52) 19 (24.7%) 33 (43.4%)
Reliable Increase 13 (15.7%) 17 (22.4%)
Any Increase 38 (49.4%) 33 (43.4%)
No Change 8 (10.4%) 3 (3.9%)
Any Decrease 31 (40.5%) 40 (52.6%)
Reliable Decrease 8 (9.6%) 16 (21.1%)
Symptoms of Anxiety (STAI-S)
Any Reliable Change (+/- 13.94) 7 (9.1%) 14 (18.4%)
Reliable Increase 3 (3.9%) 9 (11.8%)
Any Increase 26 (33.8%) 35 (46.1%)
No Change 5 (6.5%) 8 (10.5%)
Any Decrease 46 (59.7%) 33 (43.4%)
Reliable Decrease 4 (5.2%) 5 (6.6%)

Significance: * = p < .05, ** = p < .01, *** = p < .001.

Missing data: a = 1 man, 1 woman.

Reliable Change = Increases or decreases less than or equal to 1.96 units on the reliable change index.

120
Table 4. Associations between meaning and mental health (n = 76 men, 75 women; H2).

Models Predicting Depression

Models Predicting Anxiety

Fixed Effects β (95% CI) β (95% CI)
Intercept Men 8.09*** (6.66 to 9.53) 32.58*** (30.55 to 34.61)
Intercept Women 10.44*** (9.24 to 11.63) 29.50*** (27.41 to 31.58)
Covariates
Age -0.00 (-0.15 to 0.14) -0.03 (-0.23 to 0.16)
Weeks Pregnant -0.15 (-0.34 to 0.05) 0.04 (-0.25 to 0.33)
Baby’s Age (Weeks) 0.09 (-0.18 to 0.36) 0.32 (-0.08 to 0.72)
Marital Status -0.82 (-2.92 to 1.28) -0.51 (-3.63 to 2.61)
Education -0.44 (-1.92 to 1.04) -0.51 (-2.58 to 1.56)
Other Mental Health Sx 0.28*** (0.22 to 0.34) 0.71*** (0.57 to 0.85)
Meaning & Time
Time Men 0.57 (-0.30 to 1.44) -1.64 (-3.47 to 0.19)
Time Women 0.57 (-0.30 to 1.44) 1.03 (-0.69 to 2.75)
Overall Meaning -0.02 (-0.07 to 0.03) -0.02 (-0.09 to 0.05)
Overall Meaning * Time -0.06* (-0.11 to -0.01) N/A
Changes in Meaning Men 0.09 (-0.00 to 0.18) 0.08 (-0.03 to 0.19)
Changes in Meaning Women -0.06 (-0.16 to 0.04) 0.08 (-0.03 to 0.19)
Changes in Meaning * Time -0.10** (-0.18 to -0.03) -0.29*** (-0.41 to -0.17)
Variance & Covariance Parameters
Variance Parameters
Men Prenatal 25.45*** (18.76 to 36.51) 50.22*** (36.80 to 72.63)
Women Prenatal 20.82*** (15.22 to 30.23) 59.70*** (44.06 to 85.47)
Men Postpartum 29.62*** (21.83 to 42.51) 43.52*** (31.99 to 62.68)
Women Postpartum 23.48*** (17.23 to 33.88) 57.98*** (42.66 to 83.38)
Covariance Parameters
Men Prenatal to Postpartum 17.59*** (9.76 to 25.41) 14.91* (3.39 to 26.44)
Women Prenatal to Postpartum 8.18** (2.63 to 13.73) 30.92*** (15.22 to 46.62)
Couple Prenatal 7.19* (1.43 to 12.95) 14.84* (1.22 to 28.46)
Couple Postpartum 3.72 (-2.63 to 10.06) 9.74 (-3.03 to 22.51)
Couple Men’s PN to Women’s PP -1.66 (-7.50 to 4.18) 16.02* (1.87 to 30.16)
Couple Women’s PN to Men’s PP 6.68* (0.56 to 12.79) 5.92 (-6.51 to 18.34)

Significance: * = p < .05, ** = p < .01, *** = p < .001

Changes in meanings are tested as a predictor of mental health symptoms using a change score. Overall meaning
is tested as a predictor of mental health symptoms using average levels of meaning across both time points.
Interactions between indices of meaning and time test the effect of meaning on changes in mental health. All
continuous variables are grand mean centered, and all categorical covariates are contrast coded (i.e., -0.5 vs. 0.5).
These decisions were made to aid in the interpretation of model intercepts and interactions.

Separate estimated for the effect of changes in meaning were calculated for depression, but not anxiety. Separate
estimates for the effect of time were calculated for anxiety, but not depression.

Abbreviations / Notes: Time = Change Across the Transition to Parenthood (Prenatal vs. Postpartum),
Fluctuations in Meaning = Within-Person Associations, Overall Meaning = Between-Person Associations;
Education = Graduate Degree vs. College Degree or Less.

121
Figure 1. Histograms depicting participants’ changes in meaning and mental health (H1).

122
Figure 2. Simple slopes analyses for interactions with time predicting depression (H2).

123
Figure 3. Simple slopes analyses for interactions with time predicting anxiety (H2).

124
General Discussion
This dissertation revealed novel associations between meaning, meaning-making, and
adjustment to both loss and parenthood. In Paper 1, we identified meaning-making during dyadic
discussions about loss as an important predictor of both physiology and feelings toward a
partner. Specifically, when women shared their own personal loss, they felt more positively
about partners who exhibited higher levels of meaning-making. Additionally, both men and
women who shared their loss showed lower physiological arousal when their partners engaged in
more meaning-making.
In Paper 2, we found associations between birth-related meaning-making processes and
postpartum outcomes for couples across the transition to parenthood. Specifically, if mothers
engaged in more sense making and benefit finding when sharing their birth story, they showed
less of a decline in their self-reported relationship functioning across the transition to parenthood.
Similarly, when fathers who demonstrated higher levels of sense making and benefit finding,
they subsequently reported lower parenting stress at six months postpartum. Fathers whose
partners engaged in more sense making reported less of a decline in relationship functioning
across the transition to parenthood, and mothers whose partners discussed changes in identity
more reported less parenting stress. However, mothers’ sense making and benefit finding were
actually associated with higher subsequent parenting stress in fathers.
In Paper 3, we found that, across the transition to parenthood, many new mothers and
fathers experience significant changes in their levels of meaning and purpose, as well as their
depressive symptoms and symptoms of anxiety. Moreover, we found links between meaning and
changes in mental health symptoms. For both mothers and fathers, overall levels of meaning
predicted changes in depression from the prenatal to the postpartum period, and changes in levels
125
of meaning predicted changes in both depression and anxiety. Specifically, for both men and
women with low levels of meaning or large decreases in meaning, depressive symptoms
increased. For new mothers who decreased in meaning, anxiety increased, whereas anxiety
decreased for both mothers and fathers when they increased in meaning.
Contributions to the Literature
Together, these studies suggest the importance of meaning and meaning-making for
couples, particularly in relation to challenging life events such as experiences of loss and the
transition to parenthood. Meaning-making may function as a supportive process in couples’
discussions about loss, and meaning-making related to a birth experience may predict better
couple and individual adjustment in the postpartum period. Similarly, an overall sense of
meaning and purpose may buffer mental health risk in new parents. Despite these overall
positive associations between meaning-making and well-being, we also found evidence that
meaning-making can sometimes have negative effects. Paper 1 demonstrated a link between
male listeners’ meaning-making and their behaviorally coded dismissiveness, and Paper 2
showed that higher levels birth-related sense making and benefit finding in mothers were
associated with higher parenting stress for fathers. This highlights the importance of studying
meaning-making dyadically and determining not just when meaning-making occurs, but also
when and how it is most effective or helpful.
At the same time, these studies expand the literature on meaning and meaning-making to
demonstrate their relevance in other contexts, not just in coping with acute grief, illness, or
trauma. Meaning and meaning-making may be beneficial or important not only in times of
intense adversity, but also when dealing with more ubiquitous forms of loss, potentially
challenging life transitions, or even experiences that can bring about a mix of joy and stress. The
126
findings from all three of these studies underscore the relevance of these processes and ideas for
couples, which suggests that meaning-making may unfold dyadically, between partners, and in
valuable or consequential ways. In addition, Papers 2 and 3 highlight the dynamic nature of
meaning and meaning-making, demonstrating both the importance of changes in meaning and
the roles of meaning and meaning-making in predicting future adjustment. The results of Paper 3
indicate that the transition to parenthood, as a key developmental period, may be a valuable
window in which to study the precipitants and impact of a global sense of meaning and purpose.
Clinical Implications
These three studies take an initial step forward in understanding the roles of meaning and
meaning-making for couples in the contexts of loss and the transition to parenthood. Our
findings may inform how clinicians can support couples during difficult times and through
important transitions. Paper 1 suggests that it may be beneficial for clinicians working with
clients who have experienced loss, or whose partners have experienced losses, to encourage
these clients to engage in meaning-related discussions with their partners and to help build the
necessary skills to navigate these discussions effectively (e.g., assisting in meaning-making
without being dismissive or while being compassionate). Papers 2 and 3 suggest that meaning-
related interventions may promote both couple and individual well-being transition to
parenthood. For example, parenting skills interventions or programs to facilitate parent-child
bonding may benefit from incorporating elements that help parents reflect on how their sense of
purpose has changed since having a child or that encourage parents to connect with aspects of the
parenting experience that bolster their sense of meaning. In addition, the birth experience may
represent a critical window during which meaning-making can occur. Clinicians, including both
mental health clinicians and medical providers involved in the birth, can help parents form a
127
coherent understanding of their experiences during childbirth. This may be particularly relevant
when aspects of the birth are unexpected, troubling, or even traumatic. Narrative-based
interventions, such as journaling or story-telling, could be useful in this regard. At the same time,
these studies highlight the value of including both partners in these efforts to make meaning and
reflect on questions of meaning, rather than having individual parents accomplish these tasks on
their own. As such, meaning-focused interventions specifically for couples to support them
through loss and the transition to parenthood may be warranted.
Strengths, Limitations, & Future Directions
As discussed above, these studies all involved the investigation of meaning and meaning-
making in novel contexts. In addition, each of the three studies had several notable strengths. In
Paper 1, we were able to capture moment-to-moment physiology and synchronize it with
behaviorally-coded meaning-making. In Papers 2 and 3, we employed longitudinal data
collection to assess changes in meaning, depression, anxiety, and relationship functioning across
the transition o parenthood, and for Paper 2, we also conducted a perinatal visit and collected
birth narratives from parents in the days immediately following the birth of their child. All three
studies also used statistical approaches that enabled us to ask and answer complicated, yet
important questions about change, between- and within-person associations, and how partners
affect each other.
Despite the strengths of and contributions made by these three studies, they also had a
number of limitations. Reflecting on of the more notable limitations may be useful in guiding
future research. First, all three studies, particularly those detailed in Papers 2 and 3, had
relatively small sample sizes. For Papers 2 and 3, this reflects the intensive nature of longitudinal
data collection across the transition to parenthood. The larger project from which these data were
128
drawn also involved the collection of biological indices (e.g., saliva, blood, meconium) and a
neuroimaging protocol, which contribute to challenges in recruiting a sufficiently large sample.
These sample sizes are particularly notable with regard to using statistical techniques that
appropriately account for the dyadic nature of the data we collected. As much as is possible,
future studies should recruit larger samples, which may be more plausible if their focus is on
meaning or meaning-making, rather than including biological or neurological aims. In addition,
neither of the tasks used in Papers 1 and 2 (i.e., the loss discussions and the birth narrative)
specifically instructed participants to engage in meaning-making. On the one hand, this may
have enabled us to collect ecologically valid data on how meaning-making occurs naturally,
without intervention. On the other hand, it created challenges for behavioral coding and may not
have enabled us to capture meaning-making that was occurring in other contexts (e.g., outside of
the lab or in other conversations about the birth). Future studies may benefit from designing tasks
that specifically encourage meaning-making in couples, which would be an important step in
ultimately translating these findings to meaning-focused interventions.
Conclusion
Overall, this dissertation represents a novel and valuable investigation of the role played
by meaning in couples’ relationships. These studies examined both meaning-making process and
a global sense of meaning and purpose in life, they investigated both young adult couples and
more established couples having their first child, and they explored meaning in relation to a
variety of different kinds of outcomes, including ones that are physiological, interpersonal, and
psychological. The findings from these studies can be a first step in informing a variety of
different meaning-focused interventions for couples, and they emphasize the need for future
research efforts on the intersection between meaning and romantic relationships.

Abstract (if available)

Linked assets

University of Southern California Dissertations and Theses

Conceptually similar

PDF

The physiology of compassion in couples’ discussions about loss

PDF

The old ball and linkage: couples’ prenatal conflict behavior, cortisol linkage, and postpartum depression risk

PDF

Couple conflict during pregnancy: Do early family adversity and oxytocin play a role?

PDF

Young adult dating couple interactions in daily life: links to family aggression and physiological processes

PDF

Pregnancy in the time of COVID-19: effects on perinatal mental health, birth, and infant development

PDF

Predictors and outcomes across the transition to fatherhood

PDF

You always say that: physical aggression perpetration, linguistic behavior, and conflict intensity in young adult dating couples

PDF

Inhibitory control in first-time fathers: Neural correlates and associations with paternal mental health

PDF

Theory of mind processing in expectant fathers: associations with prenatal oxytocin

PDF

Investigating discrimination and depression within a couple context

PDF

Prenatal predictors of parental sensitivity in first-time mothers and fathers

PDF

Prior exposure to aggression and young adults' negative expectancies about romantic partner discussions

PDF

Neural and behavioral correlates of fear processing in first-time fathers

PDF

Minority stress and intersectionality: how are identity, discrimination, and biological stress related to depression and suicidality among multiple minority subgroups?

PDF

Biological and behavioral correlates of emotional flexibility and associations with exposure to family aggression

PDF

Spouse aggression, depression, and physical health: a multivariate longitudinal study of midlife couples

PDF

Not just talk: observed communication in adolescent friendship and its implications for health risk behavior

PDF

Examining the associations of respiratory problems with psychological functioning and the moderating role of engagement in pleasurable activities during late adolescence

PDF

Partners of breast cancer survivors: Research participation and understanding of survivors' concerns

PDF

Effectiveness and implementation of a maternal depression treatment in a Head Start setting: a mixed method study

Asset Metadata

Creator Corner, Geoffrey Winston (author)

Core Title Relationships and meaning: examining the roles of personal meaning and meaning-making processes in couples dealing with important life events

School College of Letters, Arts and Sciences

Degree Doctor of Philosophy / Master of Public Health

Degree Program Psychology / Public Health

Degree Conferral Date 2021-08

Publication Date 07/16/2021

Defense Date 07/17/2020

Publisher University of Southern California (original), University of Southern California. Libraries (digital)

Tag childbirth,Couples,dyadic research,meaning,meaning-making,Mental Health,OAI-PMH Harvest,psychophysiology,transition to parenthood

Format application/pdf (imt)

Language English

Contributor Electronically uploaded by the author (provenance)

Advisor Margolin, Gayla (committee chair), Saxbe, Darby (committee chair), John, Richard (committee member), Lichtenthal, Wendy (committee member), Traube, Dorian (committee member)

Creator Email gcorner@usc.edu

Permanent Link (DOI) https://doi.org/10.25549/usctheses-oUC15582112

Unique identifier UC15582112

Legacy Identifier etd-CornerGeof-9747

Document Type Dissertation

Format application/pdf (imt)

Rights Corner, Geoffrey Winston

Type texts

Source University of Southern California (contributing entity), University of Southern California Dissertations and Theses (collection)

Access Conditions The author retains rights to his/her dissertation, thesis or other graduate work according to U.S. copyright law. Electronic access is being provided by the USC Libraries in agreement with the author, as the original true and official version of the work, but does not grant the reader permission to use the work if the desired use is covered by copyright. It is the author, as rights holder, who must provide use permission if such use is covered by copyright. The original signature page accompanying the original submission of the work to the USC Libraries is retained by the USC Libraries and a copy of it may be obtained by authorized requesters contacting the repository e-mail address given.

Repository Name University of Southern California Digital Library

Repository Location USC Digital Library, University of Southern California, University Park Campus MC 2810, 3434 South Grand Avenue, 2nd Floor, Los Angeles, California 90089-2810, USA

Repository Email cisadmin@lib.usc.edu