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Abstract

The coherence of autobiographical narratives is thought to be reflective of individuals’ psychological adjustment. However, results are not always replicable, the longitudinal nature of the relation has remained largely unaddressed, and there is limited research on mechanisms that may explain the relation between coherence and mental health. Therefore, in a large longitudinal study, we investigated the concurrent and prospective associations of narrative coherence with mental health, as well as mediational effects of perceived social support. Concurrently, correlations showed that total narrative coherence was associated with higher psychological well-being, fewer symptoms of depression and anxiety, and fewer negative social interactions. Cross-sectional regressions showed that total narrative coherence was predictive for better psychological well-being and fewer symptoms of depression and anxiety, and that chronological coherence predicted depressive symptomatology. These relations were all mediated by perceived negative social interactions. Prospectively, over a 5-month time interval, higher coherence of positive narratives predicted relative decreases in depressive and anxious symptoms. These relations were also mediated by the amount of perceived negative social interactions. Individuals who were more coherent about their past positive life events experienced a relative decrease in depressive and anxious symptoms over a 5-month time interval because they experienced fewer negative interactions with their social network over time.

Keywords

Autobiographical memory narrative coherence psychopathology psychological well-being social support

Introduction

We go through life day by day, collecting experiences, becoming walking libraries full of stories to tell (Bruner, 1990). As our autobiographical memories are encoded, reflected on, and shared in social interactions, they take on a narrative form that provides organization and evaluation to our lived experience (Fivush, 2011). Several characteristics of autobiographical narratives have been investigated over the years (Palombo et al., 2018; Sutin & Robins, 2007). One of these characteristics is narrative coherence, which is the extent to which a narrative makes sense to a naïve listener and is thus able to convey the content and meaning of the described events in a structurally and thematically cohesive manner (Baerger & McAdams, 1999; Habermas & Bluck, 2000; Lysaker et al., 2002; Reese et al., 2011). Narrative coherence is suggested to be a multidimensional construct, consisting of a contextual (i.e. the time and place of the events), a chronological (i.e. the logical and chronological order of the events) and a thematic dimension (i.e. affective and evaluative elaboration around the central theme of the event, inclusion of a high point and a resolution), according to Reese and colleagues (2011).

It has been suggested that the ability to narrate in a coherent manner about past personal experiences is reflective of individuals’ mental health. Generally, higher autobiographical narrative coherence has shown to be related to fewer symptoms of psychopathology (e.g. Adler, 2012; Adler et al., 2013; Booker et al., 2020; Lysaker et al., 2002; Müller et al., 2014; Stadelmann et al., 2015; Vanden Poel & Hermans, 2019; Vanderveren et al., 2019) and higher levels of psychological well-being (e.g. Adler et al., 2016; Baerger & McAdams, 1999; Mitchell et al., 2020; Waters & Fivush, 2015). However, there are some inconsistencies in empirical evidence (e.g. Chen et al., 2012. Sometimes, relations between coherence and psychopathology are found in the opposite direction of what is expected. For instance, it has been observed that higher levels of coherence can be associated with more depressive symptoms, higher levels of rumination or more symptoms of PTSD (Sales et al., 2013; Vanderveren, et al., 2020; Waters et al., 2013).

One of the possible reasons for observed inconsistencies in the relation between coherence and mental health may be the specific operationalization of coherence as well as mental health. First, most studies look at either the composite measure of coherence or only the thematic dimension of coherence. This is because thematic coherence, or related concepts like meaning-making, are generally thought to be the most relevant with regards to mental health (Adler et al., 2016; Boals et al., 2011; Cox & McAdams, 2014; Graci & Fivush, 2017; Habermas, 2011; McLean et al., 2010; Mitchell et al., 2020; Reese et al., 2017).This idea has some merit, since the ability to integrate life events and make meaning of emotional experiences is critical to identity development (McAdams & McLean, 2013). However, this narrow approach has the disadvantage of overlooking possibly important structural elements of narrative coherence. Indeed, other structural aspects such as chronological coherence have also been found to be important (Vanaken & Hermans, 2020). Second, in multiple studies, a distinction has been made between the coherence of narratives of important positive life events (high points) and the coherence of narratives of important negative life events (high points) (Baker-Ward et al., 2005; Bohanek et al., 2009; Fivush et al., 2002, 2003, 2008; Rasmussen & Berntsen, 2009; Vanaken & Hermans, 2020; Vanderveren et al., 2019). Previous work has shown mean-level differences in coherence between positive and negative narratives, with negative narratives being more coherent than positive narratives, and negative narratives being more relevant for mental health (Baker-Ward et al., 2005; Fivush et al., 2002, 2003, 2008; Vanderveren et al., 2019). However, there is also mixed evidence on the moderating role of event valence in the relation between coherence and mental health (Bohanek et al., 2009; Rasmussen & Berntsen, 2009; Vanaken & Hermans, 2020; Waters et al., 2013). Examining coherence at the global level may obscure important differences by event valence. Third, many different mental health related outcomes, including forms of eudaimonic (high levels psychological well-being) and hedonic well-being (low levels of psychopathology), have been investigated with regards to narrative coherence, and studies have found conflicting results (Keyes & Magyar-Moe, 2003; Ryff & Keyes, 1995). For instance, both Vanderveren et al. (2019) and Mitchell et al. (2020) found coherence to be associated with depressive symptoms, but not with anxiety, whereas Vanden Poel and Hermans (2019) found the opposite pattern. Given these inconsistencies, the first aim of this study is to investigate the associations between coherence and mental health in a more detailed manner. We will focus on both total coherence as well as the separate three dimensions of coherence and analyse the coherence of positive and negative narratives separately. Also, we will examine multiple mental health outcomes.

Furthermore, the prospective association between coherence and mental health has remained largely under-researched. More recently, however, a couple of studies did use a longitudinal research design (e.g. Booker et al., 2020; Mason et al., 2019; Mitchell et al., 2020), but, again, findings are inconsistent. For instance, Adler (2012) found that themes of agency in patients’ narratives, but not coherence, related to improvements of their mental health over the course of psychotherapy. In contrast, Mason and colleagues (2019) showed that narratives of chronically stressed caregivers that reflected coherent integration predicted biological and psychological stress resilience over an 18-month time period. Similarly, Booker et al. (2020) found that the coherence of trauma narratives predicted less passive or avoidant coping strategies; however, this effect decreased over time. Recently, Mitchell et al. (2020) showed, in a mid-adolescent sample, that causal coherence, a part of thematic coherence in the Reese et al. (2011) system, predicted higher life satisfaction 1 year later; in the same study, however, no associations with depressive symptoms were found. Clearly, more longitudinal evidence is needed, given the importance of discovering the direction of the relation between coherence and mental health. Hence, the second aim of this study is to investigate the associations between coherence and mental health longitudinally, over a 5-month interval. Again, we will analyse the three dimensions of coherence, the coherence of positive and negative narratives, and examine multiple mental health outcomes.

Finally, little is known about why coherence is related to mental health, or in other words; what the mechanisms are that would explain the relation between narrative coherence and mental health. A couple of studies have noted that the expressed narrative characteristics and the functions of autobiographical memory can inform each other and that studying their interaction can help us to understand relations between memory and mental health (e.g. Barry et al., 2019; Beike et al., 2016; Waters, 2014; Waters & Fivush, 2015). A critical function of autobiographical memory is a social function,¹ which concerns developing and nurturing social bonds by engaging in narrative interactions and reminiscing about the personal past and thereby maintaining a supportive social network (Alea & Bluck, 2003; 2007; Bluck, 2003; Bluck et al., 2005). In this study, we will investigate if the relation between narrative coherence and mental health is mediated by indicators of the social function of autobiographical memory, which will be operationalized as perceived social support. More specifically, we argue that the absence of coherence in narration might lead to the narrator receiving more negative and fewer positive social reactions (Pasupathi & Billitteri, 2015; Vanaken et al., 2020; Vanaken & Hermans, 2020), thus causing the social function to remain unfulfilled, which is detrimental for our well-being (Coyne, 1976a; 1976b). Whilst there is plenty of evidence on the relation between social support and mental health (Harandi et al., 2017; Ozbay et al., 2007), empirical evidence for the idea that narrative coherence is associated with social support is limited to date. Waters and Fivush (2015) observed that narrative coherence for significant life events was positively associated with the quality of personal relationships. Also, Burnell et al. (2010) showed, in a sample of veterans, that narrative coherence was positively related to pleasant communication with their family and that the more incoherent veterans were, the more they found communication to be unsatisfactory. Accordingly, our third aim is to investigate if perceived social support can mediate the relation between coherence and mental health. We will again analyse the three dimensions of coherence as well as the coherence of both positive and negative narratives.

Present study

In the present study, the first aim is to investigate the association between narrative coherence and mental health, with attention to different aspects and valences of narrative coherence and multiple indicators of mental health. We will examine the contextual, chronological, thematic and total narrative coherence of written narratives about significant positive and negative memories, in line with the cognitive approach of Reese and colleagues (2011; see Supplemental Material 1). All aspects of coherence will be investigated in relations to multiple outcomes of mental health, operationalized as psychological well-being and internalizing symptoms of psychopathology (depression, anxiety and stress). We hypothesize that the relations between different aspects of coherence and psychological well-being will be positive, and the relations between different aspects of coherence and internalizing symptoms will be negative. The second aim of this study involves investigating the relations between different aspects of coherence and different outcomes of mental health prospectively, over a 5-month interval. We hypothesize to see positive prospective associations between coherence and well-being, and negative prospective associations with internalizing symptoms. The third and final aim of this study involves investigating to what extent receiving social support mediates the associations between coherence and mental health. Again, we will examine if perceived social support mediates the cross-sectional and prospective relations between different aspects of narrative coherence and different outcomes of mental health. We hypothesize that there will be a mediation, in which a part of the relation between coherence and mental health will be explained by perceived social support.

Methods

Participants

At the first timepoint (T1), a total of 635 individuals took part in the study, 554 (87.24%) were women and 81 (12.76%) were men. Their average age was M = 18.38, SD = .99, range = 17–26. All participants were contacted 5 months later for a follow-up measurement at T2 through the recruiting system of the university (Experiment Management System). At T2, the total sample consisted of 232 individuals, 204 (87.93%) women and 28 (12.07%) men. At T2, the sample averaged at an age of M = 18.32, SD = .88, range = 17–23. The gender and age distributions of the group that took part at T1 were not significantly different from the one at T2, p < .001. Recruitment occurred via the Experiment Management System (EMS) of the KU Leuven (Belgium) through which psychology students can participate in return for course credit. Therefore, the sample consisted of mostly white, female, Flemish psychology students. Besides the sample being rather homogeneous, the choice for this age group was consciously made because the coherence of personally significant experiences is considered a critical feature of psychological adjustment, especially when identity construction is a prominent developmental task (i.e. emerging adulthood) (Waters & Fivush, 2015). We conducted a post hoc power analysis using G*Power (Faul et al., 2007), based on the mean magnitude of our correlational results (r = .12) as an effect size estimate, with a critical alpha of .05, and showed that our sample at T1 (N = 635) was sufficiently large to detect cross-sectional associations, reaching a very good power of .92. For the longitudinal results, we used the mean observed R square (R² = .40), which gave us excellent power of .95 to detect predictive relations.

Procedure

Prior to the start of this online study, participants were collectively informed about the aims and procedure of the study via the online platform of the university. Participants were first year psychology students who could participate in research in exchange for research credits. They were told that they would be asked to do a writing task that concerned their personal memories, as well as filling out questionnaires concerning their well-being and their social interactions. After signing agreement to the informed consent, they could individually and online complete the writing task and questionnaires, which were randomized. Instructions were given to do this in a quiet space with no distractions and to respond to all questions as honestly possible. After completion, participants were given contact details of the research team and professional help instances. The second measurement (T2) was conducted 5 months later. Individuals who participated at T1 were invited again through the Experiment Management System to participate in a follow-up measurement. All procedural elements and instructions were kept identical to T1, which means the same online writing task and questionnaires were conducted, again in randomized order.

The study was conducted in accordance with ethical guidelines and approved by the Social and Societal Ethics Committee of the KU Leuven (G- 2018 01 1067).

Material and measures

Narrative coherence

Writing tasks . Participants were asked to write about a highly significant positive and negative autobiographical memory (in counterbalanced order across participants) using the following instructions: ‘I would like for you to write about your most positive/negative experience of your life. This should be an extremely emotional event that has affected you and your life. You may include the facts of the event, as well as your deepest thoughts and feelings. All of your writing will be kept confidential. Do not worry about spelling, sentence structure, or grammar. There is no time limit on your writing; you may write about this event for as long as needed’.

Coding system . The written narratives were coded manually according to the Narrative Coherence Coding Scheme (NCCS; Reese et al., 2011). Using this coding scheme, each narrative was assigned a total score from 0 to 9, consisting of the sum of the scores on the three dimensions that the scheme entails, namely, context (0–3), chronology (0–3), theme (0–3). Context is scored on how specifically the narrator can orient the event in time and place. Chronology refers to whether the narrator describes the components of the events along a (chrono)logical timeline, and if so, if he/she uses time words to indicate the order of events. Theme is assessed based on whether the narrator can emotionally elaborate on the topic, interpret and evaluate the events, on whether he/she makes causal or autobiographical links with other events and if he/she can come to a resolution or is able to reach closure. Specific scoring details can be found in Supplemental Material 1 (adopted from Reese et al., 2011, p. 436). Total narrative coherence (0–9) at each time point was calculated by taking the mean of the scores for positive (0–9) and negative (0–9) narratives. To make sure the data were coded reliably, multiple meetings with experienced colleagues to discuss specific coding judgements were held. All narratives at the first timepoint were scored independently by three researchers, who afterwards decided on the final scores by coming to a consensus. All narratives of the second timepoint were coded by the first author according to the established system.

Psychological well-being and internalizing symptoms

Psychological well-being was investigated using the Flourishing Scale (FS: Diener et al., 2009; Dutch translation: Van Egmond & Hanke, n.d.). This instrument consists of eight items to assess the respondent’s self-perceived psychosocial prosperity and has shown to be related to the full version of the psychological well-being scales that Ryff (1989) developed. It is a brief measurement that provides a single score of well-being, which has shown to be reliable, Cronbach’s α = .86, and highly temporally stable, r = .71 (Diener et al., 2009). Example items are, for instance: ‘I lead a purposeful and meaningful life’, or ‘I am optimistic about my future’.

To assess internalizing symptoms, we used the Dutch version of the Depression (D), Anxiety (A) and Stress (S) Scales (DASS-21: Lovibond & Lovibond, 1995; Dutch translation: De Beurs et al., 2001). This instrument assesses self-reported symptoms of depression, anxiety and stress, and has shown to be internally consistent, .85 ≤ Cronbach’s α ≤ .91, test–retest reliable, .74 ≤ r ≤ .85, and valid in a Dutch sample of first year university students, N = 289, which is similar to our sample (De Beurs et al., 2001). Example items include ‘I couldn’t seem to experience any positive feeling at all’ (D), I felt scared without any good reason (A), and ‘I found it difficult to relax’ (S).

Perceived social support

We assessed social interactions with the Social Support List – Interactions (SSL-I) and – Negative Interactions (SSL-N), which have also proven to have good construct validity, high internal reliability, SSL-I: .90 ≤ Cronbach’s α ≤ .93; SSL-N: .69 ≤ Cronbach’s α ≤ .81, and test–retest stability, SSL-I: r = .77; SSL-N: r = .56 (Van Sonderen, 2012). Research has demonstrated that negative interactions (e.g. giving one disapproving comments, treating one unfairly), are not at the other end of the spectrum of positive interactions. Negative social interactions are considered an independent aspect of interpersonal functioning and are related to psychological non–well-being (Van Sonderen & Ormel, 1997). Example items for the positive interactions are: ‘People confide in you’, ‘People are affectionate towards you’, and ‘People ask you to join in’. Example items for the negative interactions are: ‘People make disapproving remarks towards you’, ‘People treat you unjustly’, and ‘People react coolly’.

Results

Descriptive statistics

In Table 1, the descriptive statistics of all variables at T1 and T2 are presented. Paired-samples t-tests pointed out that positive narratives were generally less coherent than negative narratives, both at T1, t(634) = −4.23, p <.001, and at T2, t(231) = −1.96, p = .05.

Table 1.

Descriptive Statistics at T1 and T2.

	T1				T2
	Min	Max	M	SD	Min	Max	M	SD
TOT	0	9.0	5.50	2.05	0	9.0	5.24	2.12
POS	0	9	5.24	2.31	0	9	5.09	2.39
NEG	0	9	5.76	2.31	0	9	5.39	2.48
CON	0	3.0	1.52	0.86	0	3.0	1.48	0.91
CHR	0	3.0	1.97	0.85	0	3.0	1.89	0.85
THE	0	3.0	2.01	0.78	0	3.0	1.87	0.79
PWB	16	56	44.06	7.26	15	56	43.37	7.67
DEP	0	42	10.14	9.98	0	40	9.02	8.65
ANX	0	42	9.62	8.44	0	42	8.79	8.64
STR	0	40	14.94	9.59	0	42	14.05	8.82
SSP	50	136	92.82	17.33	34	136	90.08	16.81
SSN	7	28	11.75	3.73	7	28	11.70	3.70

Note. Abbreviations are total narrative coherence (TOT), coherence for positive narratives (POS), coherence for negative narratives (NEG), contextual coherence (CON), chronological coherence (CHR), thematic coherence (THE), psychological well-being (PWB), symptoms of depression (DEP), anxiety (ANX), stress (STR), perceived social support: positive interactions (SSP), and perceived social support: negative interactions (SSN).

In Table 2, cross-sectional correlations at T1 between narrative coherence, mental health and social support are presented. At T1, all measures of coherence were significantly positively associated with psychological well-being and negatively with symptoms of depression. Total coherence, coherence of positive narratives and chronological coherence were negatively associated with symptoms of anxiety and negative social interactions. No significant associations were observed with regards to stress or positive social interactions, no further analyses were run for these concepts.

Table 2.

Table of Pearson Correlations between Narrative Coherence, Mental Health and Perceived Social Support at T1.

T1	PWB	DEP	ANX	STR	SSP	SSN
TOT	.13**	−.13**	−.09*	−.00	.05	−.09*
POS	.12**	−.11**	−.08*	.02	.02	−.10**
NEG	.11**	−.12**	−.08	.02	.06	−.05
CON	.10*	−.08*	−.08	.01	.05	−.07
CHR	11**	−.15**	−.09*	−.03	.04	−.08*
THE	.13**	−.10**	−.06	.02	.03	−.07
SSP	.49**	−.26**	−.07	−.07
SSN	−.31**	.38**	.40**	.36**

Note. Abbreviations are total narrative coherence (TOT), coherence for positive narratives (POS), coherence for negative narratives (NEG), contextual coherence (CON), chronological coherence (CHR), thematic coherence (THE), psychological well-being (PWB), symptoms of depression (DEP), anxiety (ANX), stress (STR), perceived social support: positive social interactions (SSP), perceived social support: negative social interactions (SSN). * p < .05** p < .01.

In Table 3, stability correlations between T1 and T2 can be found. Cross-sectional correlations at T2 are presented in Supplemental Material 2.

Table 3.

Table of Stability Scores over Time (Pearson Correlations).

PWB	DEP	ANX	STR	SSP	SSN	TOT	POS	NEG	CON	CHR	THE
.67^**	63^*	.61^**	.58^**	.74^**	.61^**	.48^**	.43^**	.35^**	.38^**	.35^**	.40^**

Cross-sectional analyses

In Table 4, the results of cross-sectional regressions are presented. Three different series of regression analyses were conducted (series 1a, 2a, 3a). In the first series, total coherence was inserted as predictor, whereas in the second and third series, respectively, positive and negative narrative coherence were predictors, and the three dimensions (context, chronology, theme) were predictors. If the coherence measure was a significant predictor of a mental health outcome in series 1a, 2a or 3a, extra regressions (1b, 2b, 3b) were run in which social interactions were added to the model. This was done in order to test the hypothesized cross-sectional mediations. In the regression with psychological well-being as an outcome and total coherence as predictor (series 1a), higher total coherence was predictive for higher well-being. The addition of negative social interactions in series 1b caused an improvement in the total explained variance (R²); negative social interactions were observed to be a significant predictor of psychological well-being, but also total coherence remained a significant predictor (to a lesser degree). This indicates that negative social interactions partially mediated the association between total coherence and psychological well-being. The regression with psychological well-being as outcome and either positive and negative coherence or the three dimensions of coherence as predictors were both not significant.

Table 4.

Table of Cross-Sectional Regressions and Mediations at T1.

T1	PWB			DEP			ANX
T1	$β$	t	R ²	$β$	t	R ²	$β$	t	R ²
Series 1a
Ct		51.59**	.02		12.49**	.02		12.59**	.008
TOT	.13	3.32**	.02	−.13	−3.26**	.02	−.09	−2.25*	.008
Series 1b
Ct		40.05**	.11		.56	.16		.22	.16
TOT	.11	2.78**		−.10	−2.62**		−.06	−1.50
SSNEG	−.30	−7.95**		.37	10.08**		.39	10.69**
Series 2a
Ct		51.54**	.02		12.47**	.02		12.56**	.008
POS	.08	1.73		−.07	−1.48		−.06	−1.26
NEG	.06	1.33		−.07	−1.53		−.04	−.82
Series 3a
Ct		49.30**	.02		11.98**	.02		11.97**	.01
CON	.04	.94		.00	.00		−.04	−.84
CHR	.03	.49		−.14	−2.39*		−.08	−1.32
THE	.09	1.66		−.01	−.12		.01	.18
Series 3b
Ct					.51	.16
CON				.01	.34
CHR				−.13	−2.32**
THE				.01	.12
SSNEG				.37	10.08**

Note. Abbreviations are total narrative coherence (TOT), coherence for positive narratives (POS), coherence for negative narratives (NEG), contextual coherence (CON), chronological coherence (CHR), thematic coherence (THE), psychological well-being (PWB), symptoms of depression (DEP), anxiety (ANX), perceived social support: negative social interactions (SSN), constant (Ct). * p < .05**p < .01.

In the regression with symptoms of depression as an outcome and total coherence as predictor (series 1a), total coherence was again a significant predictor, with higher levels of coherence being predictive for fewer depressive symptoms. The addition of negative social interactions in series 1b caused an improvement in the total explained variance (R²); negative social interactions were observed to be a significant predictor of depressive symptoms, but also total coherence remained a significant predictor (to a lesser degree). This shows that negative social interactions partially mediated the association between total coherence and depressive symptoms. The regression with symptoms of depression as outcome and positive and negative coherence as predictors was not significant. In the regression with symptoms of depression as an outcome and the three dimensions as predictors (series 3a), chronological coherence was a significant predictor, with higher chronological coherence being predictive for fewer depressive symptoms. The addition of negative social interactions in series 3b caused an improvement in the total explained variance (R²); negative social interactions were observed to be a significant predictor of depressive symptoms, but also chronological coherence remained a significant predictor (to a lesser degree). This shows that negative social interactions partially mediated the association between chronological coherence and depressive symptoms.

In the regression with symptoms of anxiety as an outcome and total coherence as predictor (series 1a), total coherence was again a significant predictor, with higher levels of coherence being predictive for fewer anxious symptoms. The inclusion of negative social interactions in series 1b caused an improvement in the total explained variance (R²); negative social interactions were observed to be a significant predictor of anxious symptoms, whereas total coherence became no significant predictor anymore. This shows that negative social interactions fully mediated the association between total coherence and anxiety symptoms. The regressions with anxiety symptoms as outcome and either positive and negative coherence or the three dimensions of coherence as predictors were both not significant.

In addition, direct mediation analyses were run for the variables that were significantly related in Table 4, using the PROCESS macro 3.5 in SPSS, to investigate whether the association between aspects of narrative coherence (predictor) and measures of mental health (outcome) were mediated by negative social interactions (mediator). Cross-sectionally, in accordance with regression series 1b, total narrative coherence was investigated as predictor, and psychological well-being, depressive symptoms and anxiety symptoms were consecutively investigated as outcome, with negative social interactions as a mediator each time. There was a positive significant relation between total narrative coherence and psychological well-being, when controlling for negative social interactions, b = .37, t(628) = 2.78, p < .001. The effect of narrative coherence on negative social interactions was also significant but negative, b = −.15, t(628) = −2.18, p = .03. The effect of negative social interactions on psychological well-being was also significant and negative, b = −.60, t(628) = −7.95, p < .001. In other words, there was a total effect of total narrative coherence on psychological well-being, of which 19.89% was mediated through negative social interactions (IE = .09). Using non-parametric bootstrapping procedures, the indirect effect showed to be statistically significant between the 2.5th and 97.5th percentile, 95% CI [.0079–.1818]. Summarized, the relation between total narrative coherence and psychological well-being was partially mediated by the amount of perceived negative social interactions.

A significant negative relation between total narrative coherence and depressive symptoms was observed, when controlling for negative social interactions, b = −.44, t(628) = −2.62, p = .009. The effect of total narrative coherence on negative social interactions was also significant and negative, b = −.15, t(628) = −2.20, p = .03. The effect of negative social interactions on depressive symptoms was also significant but positive, b = .97, t(628) = 10.08, p < .001. In sum, there was a total effect of total narrative coherence on depressive symptoms, of which 25.18% was mediated through negative social interactions (IE = −.15). Using non-parametric bootstrapping procedures, the indirect effect showed to be statistically significant between the 2.5th and 97.5th percentile, 95% CI [−.3012 to −.0185]. In accordance with regression series 3b, chronological coherence was investigated as predictor, negative social interactions as a mediator and depressive symptoms as an outcome. A significant negative effect of chronological coherence on depressive symptoms was observed, when controlling for negative social interactions, b = −1.24, t(628) = −3.11, p = .002. The effect of chronological coherence on negative social interactions was also significant and negative, b = −.33, t(628) = −2.04, p = .04. The effect of negative social interactions on depressive symptoms was also significant but positive, b = .97, t(628) = 10.09, p < .001. In sum, there was a total effect of chronological coherence on depressive symptoms, of which 20.85% was mediated through negative social interactions (IE = −.33). Using non-parametric bootstrapping procedures, the indirect effect showed to be statistically significant between the 2.5th and 97.5th percentile, 95% CI [−.6874 to −.0155].

There was no direct effect between total narrative coherence and anxiety symptoms, after controlling for negative social interactions, b = −.22, t(628) = −1.51, p = .14. The effect of total narrative coherence on negative social interactions was significant and negative, b = −.15, t(628) = −2.20, p = .03. The effect of negative social interactions on anxiety symptoms was also significant but positive, b = .88, t(628) = 10.69, p < .001. In sum, there was a total effect of total narrative coherence on anxiety symptoms, via a full mediation (38.39%) of negative social interactions (IE = −.21). Using non-parametric bootstrapping procedures, the indirect effect showed to be statistically significant between the 2.5th and 97.5th percentile, 95% CI [−.2664 to −.0104].

Prospective analyses

In Table 5, the prospective regressions are presented with different measures of coherence at T1 as predictors and the mental health variables at T2 as criteria. The predictive value for mental health was assessed over a 5-month time interval, after control for the respective mental health variable at T1. Here again, three different series of regression were conducted (1a, 2a, 3a). In the first series, total coherence was inserted as predictor, whereas in the second and third series, respectively, positive and negative narrative coherence were predictors, and the three dimensions (context, chronology, theme) were predictors. Similar to the analyses above, we conducted follow-up prospective regression analyses if the coherence measure was a significant predictor of a mental health outcome over time in series 1a, 2a or 3a. The extra regressions (1b, 2b, 3b) in which social interactions were added to the model, were run in order to test the hypothesized prospective mediations.

Table 5.

Table of Prospective Regressions and Mediations with Predictors (Coherence) at T1 and Criterium (Mental Health Variable) at T2, after Control for Criterium at T1.

	PWB			DEP			ANX
	$β$	t	R ²	$β$	t	R ²	$β$	t	R ²
Series 1a
Ct		4.87**	.45		3.61**	.40		3.51**	.38
Crit T1	.66	13.23		.62	11.89		.60	11.28
TOT	.03	.69		−.07	−1.34		−.10	−1.83
Series 2a
Ct		4.88**	.45		3.44**	.41		3.33**	.40
Crit T1	.66	13.25		.62	11.97		.60	11.41
POS	.07	1.22		−.13	−2.00*		−.19	−3.00**
NEG	−.04	−.58		.05	.75		.08	1.28
Series 2b
Ct					−1.09	.47		−1.74
Crit T1				.53	9.91**		.48	9.23**
POS				−.08	−1.37		−.14	−2.37*
NEG				.04	.63		.08	1.32
SSN T2				.27	5.03**		.31	5.83**
Series 3a
Ct		4.81**	.45		3.92**	.41		3.32**	.38
Crit T1	.66	13.17		.62	11.95		.59	11.13
CON	−.02	−.32		.05	.83		−.06	−1.01
CHR	.04	.58		.00	−.06		−.05	−.65
THE	.01	.16		−.13	−1.79		.00	−.04

Note. Abbreviations are total narrative coherence (TOT), coherence for positive narratives (POS), coherence for negative narratives (NEG), contextual coherence (CON), chronological coherence (CHR), thematic coherence (THE), psychological well-being (PWB), symptoms of depression (DEP), anxiety (ANX), stress (STR), constant (ct), criterium (Crit). * p < .05**p < .01.

For psychological well-being, no significant results were observed.

In the regression with total coherence as a predictor or the three dimensions as predictors and depression as outcome (series 2a), no significant results were observed. However, in the regressions with positive and negative narratives as predictors and depression as outcome, positive coherence was a significant predictor of fewer depressive symptoms over time. The addition of negative social interactions in series 2b caused a significant improvement in the total explained variance (R²); negative social interactions were observed to be a significant predictor of depressive symptoms, whereas positive narrative coherence became no significant predictor anymore. This shows that negative social interactions fully mediated the prospective association between positive narrative coherence and depressive symptoms.

In the regression with total coherence as a predictor or the three dimensions as predictors and anxiety as outcome (series 2a), no significant results were observed. However, in the regressions with positive and negative narratives as predictors and anxiety as outcome, positive coherence was a significant predictor of fewer anxious symptoms. The addition of negative social interactions in series 2b caused a significant improvement in the total explained variance (R²); negative social interactions were observed to be a significant predictor of anxious symptoms, but also positive narrative coherence remained a significant predictor (to a lesser degree). This shows that negative social interactions partially mediated the prospective association between positive coherence and anxious symptoms.

Prospectively, direct mediation analyses were run for the variables that were significantly related in Table 5, using the PROCESS macro 3.5 in SPSS, to investigate whether the association between aspects of narrative coherence at T1 (predictor) and measures of mental health at T2 (outcome) were mediated by negative social interactions at T2 (mediator). In accordance with regression series 2b (Table 4), positive coherence at T1 was investigated as a predictor, negative social interactions at T2 as a mediator and depressive or anxious symptoms at T2 as an outcome. There was no direct effect between positive narrative coherence and depressive symptoms, after controlling for negative social interactions, b = −.29, t(229) = −1.56, p = .12. The effect of positive coherence on negative social interactions was significant and negative, b = −.30, t(229) = −2.86, p = .005. The effect of negative social interactions on depressive symptoms was also significant but positive, b = 1.07, t(229) = 7.77, p < .001. In sum, there was a total effect of total narrative coherence on depressive symptoms, via a full mediation (48.23%) of negative social interactions (IE = −.32). Using non-parametric bootstrapping procedures, the indirect effect showed to be statistically significant between the 2.5th and 97.5th percentile, 95% CI [−.6027 to −.0749].

A negative relation between positive narrative coherence and anxious symptoms was observed but this was not significant, when controlling for negative social interactions, b = −.41, t(229) = −1.91, p = .06. The effect of positive narrative coherence on negative social interactions was significant and negative, b = −.29, t(229) = −2.86, p = .005. The effect of negative social interactions on anxious symptoms was also significant but positive, b = 1.13, t(229) = 8.45, p < .001. In sum, there was a total effect of positive narrative coherence on anxious symptoms, via a full mediation (45.21%) through negative social interactions (IE = −.33). Using non-parametric bootstrapping procedures, the indirect effect showed to be statistically significant between the 2.5th and 97.5th percentile, 95% CI [−.6389 to −.0824].

Discussion

In this longitudinal study, three research aims were examined. Our first aim was to assess the cross-sectional associations between narrative coherence and mental health in a comprehensive way, in which multiple different mental health outcomes and multiple aspects of coherence were taken into account. In line with our hypotheses, the cross-sectional zero-order correlations indicated that at T1, all measures of coherence were significantly positively associated with psychological well-being and negatively with symptoms of depression. Total coherence, coherence of positive narratives and chronological coherence were negatively associated with symptoms of anxiety and negative social interactions. No significant associations of any of the coherence measures with stress or positive social interactions were observed. In sum, this means that individuals who are better able to narrate coherently about their past personal experiences, show better psychological and social adjustment, in terms of higher well-being, fewer internalizing symptoms and fewer negative interactions with their social circle. This is consistent with much of the previous research that has also observed these relationships (e.g. Adler et al., 2016; Baerger & McAdams, 1999; Burnell et al., 2010; Chen et al., 2012; Mitchell et al., 2020; Vanderveren et al., 2019; Waters & Fivush, 2015). In addition, our data also extend previous research by showing that not only the composite measure, the thematic dimension or negatively valenced narratives are of importance in relation to mental health; rather, other measures, specifically chronological coherence and coherence of positive narratives, also significantly correlate to well-being and internalizing symptoms. Furthermore, the cross-sectional regression analyses showed that for psychological well-being and for symptoms of anxiety, only total coherence was a significant predictor, but neither valence of the narrative, nor any of the specific dimensions of coherence were significant predictors. For symptoms of depression, total coherence was again a significant predictor, as well as chronological coherence, but, again, not the specific valence of the event. Data in this study suggest thus that, on a cross-sectional level, overall narrative coherence is the best predictor of mental health. The differentiation between positive and negative narratives did not seem to offer any additional predictive value in this study; moreover, the predictive value disappeared when only taking into account either positive or negative narratives. Possibly, it could be important to take into account the retention interval and the emotional intensity of memories in order to uncover differences in negative and positive memories (Waters et al., 2013). When assessing the three dimensions of coherence, we did not observe thematic coherence, but rather chronological coherence to be the most significant predictor of mental health, here measured as depressive symptoms. This challenges the interpretation suggested by previous research that the importance of coherence lies in its relation to thematic coherence or meaning-making in relation to mental health (Adler et al., 2016; Boals et al., 2011; Cox & McAdams, 2014; Graci & Fivush, 2017; Habermas, 2011; McLean et al., 2010; Reese et al., 2017), and suggests that being able to construct a coherent chronological account that orders actions in time may be a critical component in how narratives relate to mental health.

Our second aim concerned the investigation of the relation between coherence and mental health over a 5-month time interval. Longitudinal regressions indicated that the measures of coherence showed almost no predictive value for the mental health criteria at T2, after controlling for the mental health criteria at T1, probably because of high stability of mental health over this relatively short interval. Due to high correlations (see Supplemental Material 2) of the criterium measures at T1 versus T2, there was little room left for the coherence measures at T1 to predict additional variance in the criterium at T2. Nonetheless, coherence for positive narratives at T1 predicted relative decreases in depressive and anxious symptoms over a 5-month time period. Individuals who can construct more coherent narratives about their positive past experiences, will experience better mental health (i.e. fewer internalizing symptoms of depression and anxiety) over time. These results are in line with other findings showing that coherence is prospectively predictive of mental health (Booker et al., 2020; Cox & McAdams, 2014; Fivush et al., 2004; Mason et al., 2019; Mitchell et al., 2020). However, the findings in this study contradict the often-suggested idea that the coherence of negative narratives, in particular, is most relevant with regards to mental health (Baker-Ward et al., 2005; Boals et al., 2011; Fivush et al., 2003; 2008; Vanderveren et al., 2019). In contrast, in our study, only the coherence of positive narratives predicted a relative decrease of depressive and anxious symptoms over time. Overall, the cross-sectional analyses revealed that narrative coherence was associated to both forms of eudaimonic (high levels psychological well-being) and hedonic well-being (low levels of psychopathology) (Keyes & Magyar-Moe, 2003; Ryff & Keyes, 1995). Nonetheless, in the prospective analyses, coherence indices only predicted forms of hedonic well-being. It may be the case that coming to a coherent account of (positive) past personal experiences protects against psychopathology, but not necessarily promotes living a flourishing life over time. Future research would benefit from including broader and more diverse assessments of mental health, as well as longitudinal studies with longer time intervals in an effort to better understand differences in relation to narrative coherence.

Our third research aim concerned testing the mediating effect of perceived negative social interactions in the relation between narrative coherence and mental health. We tested the mediations via regression analyses as well as via the PROCESS macro. Both types of analyses produced the same results. We can conclude that negative social interactions partially mediate the cross-sectional relations between total narrative coherence and psychological well-being. The same was found for depression, as negative social interactions partially mediated the cross-sectional relations between total narrative coherence and depressive symptoms. A further analysis showed that in particular chronological coherence was associated with depressive symptoms, and that this relation was also partially mediated through perceived negative social interactions. With regards to anxiety, negative social interactions fully mediated the cross-sectional relations between total narrative coherence and anxious symptoms. Thus, individuals who were more coherent experienced fewer negative social interactions and had better mental health. Although correlational, these results might suggest that coherent narrators garner more positive social interactions (e.g. Pasupathi & Billitteri, 2015; Vanaken et al., 2020; Vanaken & Hermans, 2020), which in turn facilitates better mental health. Prospectively, positive narrative coherence predicted a relative decrease in depressive symptoms and anxious symptoms over a 5-month time window, which was fully explained by the amount of perceived negative social interactions over time. This suggests that individuals who are more coherent, will experience fewer internalizing symptomatology 5 months later, again, perhaps because they will experience fewer negative social interactions over time. Given our provocative findings, future research should investigate the causal nature of these relations in more detail. It is important to note that due to the large number of correlations tested in this study, replication studies are needed to evaluate possible type-I errors as well as to demonstrate the robustness of current results.

Still, our results suggest that individuals who were able to narrate coherently about their life stories, are less likely to experience negative social interactions with the people in their social network, both at the same moment in time, and over a 5-month time span. Furthermore, these social interactions have proven to be of significant importance for mental health outcomes of well-being and internalizing psychopathology. In sum, we observed that the relation between narrative coherence and mental health may be explained by the extent to which individuals experience negative social interactions with the people around them. This is in line with previous research suggesting that characteristics of autobiographical memory and the functions of autobiographical memory (here: the social function) are related, and that studying their relation may help us to understand why memory and mental health are related (Barry et al., 2019; Beike et al., 2016; Waters, 2014). Our findings are also consistent with recent experimental work (Vanaken et al., 2020), which shows that the absence of narrative coherence has a detrimental impact on the social reactions we receive from listeners. As we share our experiences with others through narrative interactions, the ability to create more coherent narratives is related to social support, most likely in a bidirectional way. Coherence garners more positive social responses than incoherence, and as we narrate our experiences to interested and involved listeners, those experiences become more narratively coherent for ourselves (Pasupathi & Billitteri, 2015), and this whole process is related to higher levels of well-being. This is also in accordance with a broad domain of evidence supporting the relation between social support and mental health (e.g. Ozbay et al., 2007; Harandi et al., 2017) and with Coyne’s interactional theory of depression (1976a; 1976b), in which he stated the importance of social factors in maintaining depression.

Furthermore, prospectively, coherence seemed particularly important in narratives about positive life events, in comparison to negative ones. Negative social interactions fully mediated the relation between positive coherence and both depressive and anxious symptoms over time. This is consistent with recent experimental work which also suggests that lower levels of coherence can negatively impact the social responses of listeners (i.e. in terms of willingness to interact, social support, attitude), but only when these narratives concern positive memories (Vanaken & Hermans, 2020). When speakers were incoherent, social support of listeners only diminished when the narratives were about positive topics, but not when they were about negative topics. Listeners are likely to be more tolerant towards incoherent individuals when they are narrating about a negative life event, since they assume that incoherence might be part of the cognitive-emotional processing of the event, or that the individual is still in the process of making meaning of the event. Some research is indeed in support of the idea that negative emotional content, and especially traumatic content, can disturb the coherence of autobiographical memories (Bisby et al., 2018; Brewin, 2001; Brewin et al., 1996. Furthermore, listeners could be more habituated towards incoherent negative stories, since the help of loved ones is often sought after going through a difficult event, for compassion reasons (Duprez et al., 2015) or in order to co-construct a chronologically ordered and emotionally regulated narrative (Fivush & Sales, 2006; Pasupathi et al., 1998). Hence, there might be fewer negative social reactions when coherence is lower in negative stories, compared to in positive stories. Relatedly, positive stories are more frequently used for entertaining purposes and hence possibly expected to be more coherent. Indeed, research proposes that positive autobiographical memories are, in comparison to negative ones, more frequently employed to bond with other people, as they are more adept at evoking feelings of interpersonal closeness and liking (Alea et al., 2013; McLean & Lilgendahl, 2008; Rasmussen & Berntsen, 2009).The absence of coherence in positive narratives might thus hinder the development or maintenance of a social support network. When social support is limited or absent, risks for mental and physical health problems are severely heightened (Coyne, 1976a; 1976b; Ozbay et al., 2007; Harandi et al., 2017). A great deal of memory and clinical research has focused on the importance of social support in the face of negative life events or trauma resilience Sippel et al., 2015; Ozer et al., 2003; Southwick et al., 2014), but Frederickson’s ‘broaden and build’ model of positive emotions provides additional ways to think about the mental health benefits of sharing positive experiences with others (Fredrickson, 2013). Importantly, the innovativeness of our findings lies in the idea that social support might not only be important after experiencing a negative or traumatic event, but also after experiencing a positive event, and that the level of coherence may play a crucial role here.

Limitations

Inevitably, there are a couple of limitations to discuss. The amount of drop-out at the second timepoint was rather large. However, descriptive results showed that the sample at T2 was not significantly different from the one at T1 in terms of gender, age and narrative coherence scores. In addition, attrition analyses showed that none of the well-being or psychopathology measures predicted attrition. Thus, staying in versus dropping out occurred at random. Also, in comparison to recent similar research (Mitchell et al., 2020), our sample size at the second timepoint was still larger than average and sufficiently powered. Nonetheless, this research domain would benefit from future studies working with larger samples over longer periods of time. Another limitation concerns the fact that our sample was very homogeneous in terms of gender and culture, which limits the generalizability of our results. Narrative coherence has shown to differ over genders and cultures (Altunnar & Habermas, 2018; Fivush et al., 2003; 2017; Fivush & Nelson, 2004; Grysman et al., 2016; Grysman & Hudson, 2013; Han et al., 1998; Nelson, 1993; Reese et al., 2017). However, the number of men in our study was insufficiently large to examine gender differences. Due to this, our findings are in particular applicable to women, and follow-up studies in more gender-balanced samples are strongly recommended, as well as research on the relation between coherence and social interactions in culturally and ethnically diverse contexts. Furthermore, our correlational design does not allow to draw any causal conclusions. Future experimental research would be beneficial to investigate the causal impact of narrative coherence on mental health. Also, since this is only one of the first studies taking into account both valence and different dimensions of coherence, replication studies are highly recommended to examine the robustness and generalizability of the currently obtained results. Additionally, we only investigated indicators of the social function as mediator in this study. Possibly, there are other mediators of the relation between coherence and mental health, for instance, linked to the self or the directive function of autobiographical memory. Future attempts to integrate research on characteristics and functions of autobiographical narratives are thus recommended. In addition, other possible mediators of the relation between narrative coherence and mental health could be examined. Inspiration could be put from the work on schizophrenia in which disturbances in narrative are easier to detect ad more dramatic (Lysaker et al., 2002). For instance, there is the idea that the ability to successfully narrate challenges is linked to the ability of how to manage them (Allé et al., 2015). Finally, future community based research could pay more attention to examining possible covariates of narrative coherence, including the role of problems in metacognitive capacity and social isolation (Holm et al., 2020; Lysaker et al., 2021).

Conclusion

The ability to form coherent narratives about autobiographical experiences is an important skill that differs between individuals. Concurrently, correlations showed that narrative coherence was associated with higher psychological well-being, fewer symptoms of depression and anxiety, and fewer negative social interactions. Cross-sectional regressions showed that total narrative coherence was significantly predictive for higher psychological well-being and fewer symptoms of depression and anxiety, and that chronological coherence was particularly significant in the prediction of depressive symptomatology. These relations were mediated by perceived negative social interactions, which indicate that individuals who were more narratively coherent showed better mental health, because they experienced fewer negative social interactions. Furthermore, over a 5-month time interval, higher coherence of positive narratives predicted relative decreases in depressive and anxious symptoms. These relations were fully mediated by the amount of perceived negative social interactions. Individuals who were more coherent about their past positive life events experienced a relative decrease in depressive and anxious symptoms over a 5-month time interval because they experienced fewer negative interactions with their social network over time.

Supplemental Material

sj-pdf-1-epp-10.1177_20438087211068215 – Supplemental Material for An investigation of the concurrent and longitudinal associations between narrative coherence and mental health mediated by social support

Supplemental Material, sj-pdf-1-epp-10.1177_20438087211068215 for An investigation of the concurrent and longitudinal associations between narrative coherence and mental health mediated by social support by Lauranne Vanaken, Patricia Bijttebier, Robyn Fivush and Dirk Hermans in Journal of Experimental Psychopathology

Supplemental Material

sj-pdf-2-epp-10.1177_20438087211068215 – Supplemental Material for An investigation of the concurrent and longitudinal associations between narrative coherence and mental health mediated by social support

Supplemental Material, sj-pdf-2-epp-10.1177_20438087211068215 for An investigation of the concurrent and longitudinal associations between narrative coherence and mental health mediated by social support by Lauranne Vanaken, Patricia Bijttebier, Robyn Fivush and Dirk Hermans in Journal of Experimental Psychopathology

Footnotes

Acknowledgments

The authors wish to offer their sincere thanks to Elien Vanderveren and Louise Vanden Poel for their great help with the coding of the narratives.

Declaration of conflicting interests

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Funding

The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: Preparation of this manuscript was supported by Fonds Wetenschappelijk Onderzoek (FWO) Research Project G070217N (PI: DH). The funder had no role in study design, data collection and analyses, decision to publish or preparation of the manuscript.

Data availability statement

The study was conducted in accordance with ethical guidelines and approved by the Social and Societal Ethics Committee of the KU Leuven (G- 2018 01 1067) and was pre-registered on AsPredicted https://aspredicted.org/v62ri.pdf. The data that support the findings of this study are openly available in Open Science Framework (OSF):

Supplemental material

Supplemental material for this article is available online.

ORCID iD

Lauranne Vanaken

Notes

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