Novel methods in psychiatric epidemiology

Positive changes in daily life? A meta-analysis of positive psychological ecological momentary interventions

Positive psychological interventions (PPI) hold promise for boosting well-being and quality of life in diverse populations, but not much is known about their efficacy as ecological momentary interventions (EMIs, e.g. via mobile applications) in daily life. This meta-analysis uses random-effects models to examine the efficacy of PPI-EMIs compared to control groups (active or passive) and exploring study region, age, gender, and risk of bias as moderators. Overall, 16 studies were included (N = 3397, 69.1% female, Mage = 21.87, SD = 13.02). We observed clinically significant effects in favor of the intervention for positive affect at posttest (k = 6; g = 0.29; p = 0.05) and well-being at follow-up (k = 5; g = 0.21; p = 0.13). No significant moderator effects were found. The number of studies was small for each outcome, risk of bias was mixed, and heterogeneity of effects was moderate to high for most outcomes.

Mental Ill-Health and the Epidemiology of Representations

One of major challenges facing contemporary psychiatry is the insufficient grasp of relationship between individual and collective mental pathologies. A long tradition of diagnosing "mental illness" of society-exemplified by Erich Fromm-stands apart from approach of contemporary social psychiatry and is not perceived as relevant for psychiatric discourse. In this Perspective article, I argue that it is possible to uphold the idea of a supra-individual dimension to mental health, while avoiding the obvious pitfalls involved in categorical diagnosing of society as suffering from mental illness. I argue for an extended notion of public mental ill-health, which goes beyond the quantitative understanding of mental health as an aggregate of individual diseased minds captured in statistics, and which can be conceived as a dynamic, emergent property resulting from interactions of individual brains/minds in social space. Such a notion, in turn, presents a challenge of how to account for the interfacing between individual minds/brains and the collective mental phenomena. A suitable theoretical framework is provided by the notion of epidemiology of representations, originally formulated by cognitive anthropologist Dan Sperber. Within this framework, it is possible to highlight the role of public (material) representations in inter-individual transfer of mental representations and mental states. It is a suitable conceptual platform to explain how the troubling experiences with causal or mediating role on mental health, to a significant degree arise through a person's direct interaction with material representations and participation in collective mental states, again generated by material representations.