Delivering happiness: translating positive psychology intervention research for treating major and minor depressive disorders

Can One Donation a Day Keep Depression Away? Three Randomized Controlled Trials of an Online Micro-Charitable Giving Intervention

Prosocial interventions grounded in social interactions have shown limited effectiveness in alleviating depressive symptoms, possibly because of the discomfort and unease that depressed individuals experience during such interactions. We developed and examined an innovative prosocial intervention-an online micro-charitable giving intervention, in which individuals voluntarily donated at least one Chinese cent (¥0.01, or about $0.0014) daily. We conducted three preregistered, 2-month randomized controlled trials with depressed individuals (Sample 1: N = 125, Sample 2: N = 296, Sample 3: N = 462). Results showed that, compared with the waitlist group, the intervention group exhibited significantly greater improvements in both depressive symptoms (Cohen's ds = -0.19 to -0.46) and emotional positivity (Cohen's ds = 0.22 to 0.49), and that emotional positivity mediated the intervention's effect on the reduction of depressive symptoms. Exploratory analysis found a slightly larger intervention effect for generous donors than for minimal donors. This low-cost, easily accessible prosocial intervention holds potential for the prevention of depression.[Box: see text].

Local brain abnormalities in emotional disorders: Evidence from resting state fMRI studies

Emotional disorders inflict an enormous burden on society. Research on brain abnormalities implicated in emotional disorders has witnessed great progress over the past decades. Using cross-sectional and longitudinal designs, resting state functional magnetic resonance imaging (rs-fMRI) and its analytic approaches have been applied to characterize the local properties of patients with emotional disorders. Additionally, brain activity alterations of emotional disorders have shown frequency-specific. Despite the gains in understanding the roles of brain abnormalities in emotional disorders, the limitation of the small sample size needs to be highlighted. Lastly, we proposed that evidence from the positive psychology research stream presents it as a viable discipline, whose suggestions could be developed in future emotional disorders research. Such interdisciplinary research may produce novel treatments and intervention options. This article is categorized under: Psychology > Brain Function and Dysfunction.

The relationship between physical activity environment, mental wellbeing, flourishing and thriving: A mixed method study

Research shows that mental wellbeing contributes to a greater quality of life and longevity, superior overall health, life success, and fulfillment. High mental wellbeing, such as flourishing and thriving, is associated with a sense of meaning and purpose, mastery and accomplishment, social connectedness, optimism, and contribution to society. Nature-based physical activity participation has been linked with mental wellbeing enhancement over and above the impact of physical activity alone. The present study sought to address a gap in the research by exploring whether the environment in which physical activity takes place and one's gender moderate the relationship between activity time and various indices of mental wellbeing. Using a mixed methods design, participants (N = 235) aged 18 to 76 (M = 33.41, SD = 13.41) completed an online survey. We divided participants into three groups based on their preferred type of physical activity: indoor, outdoor non-nature-based, and outdoor nature-based physical activity. The moderation analyses highlight the importance of the environment in physical activity, with outdoor nature-based settings consistently showing positive associations with flourishing and thriving. These findings suggest that engaging in physical activities in natural environments can significantly predict an individual's mental wellbeing, for both males and females. Qualitative data supported the findings and also revealed that nature-based physical activity achieves these benefits through developing positive affect, social closeness and engagement, purpose, enhanced experiences, and interests beyond oneself. Findings from this study demonstrate the importance of nature-based physical activity for mental wellbeing promotion and protection, indicating that opportunities for nature-based physical activity should be more effectively provided, perhaps across multiple domains of life such as education, sport, public health, and urban planning.

The effectiveness of positive psychological interventions for patients with cancer: A systematic review and meta-analysis

AIMS AND OBJECTIVES

To evaluate the effectiveness of positive psychological interventions on quality of life, positive psychological outcomes and negative psychological outcomes in patients with cancer.

BACKGROUND

Patients with cancer often suffer from various psychological problems and have a poor quality of life. Positive psychological interventions have been increasingly applied to patients with cancer, but the results of these studies have not been synthesized.

DESIGN

A systematic review and meta-analysis of randomized controlled trials according to PRISMA.

METHODS

Six English databases and four Chinese databases were searched from the inception to December 2022. Two reviewers independently assessed the risk of bias using the Cochrane Risk of Bias tool. RevMan was used for meta-analysis.

RESULTS

Twenty-nine randomized controlled trials examined the effects of positive psychological interventions including meaning therapy, dignity therapy, positive psychotherapy, mindfulness- based intervention, life review, expressive writing intervention, acceptance and commitment psychotherapy, attention and interpretation therapy, compassion training and spiritual therapy on patients with cancer. Positive psychological interventions significantly improved the quality of life, enhanced positive psychological outcomes including well-being, meaning of life, self-esteem, optimism, resilience and self-efficacy and alleviated negative psychological outcomes including depression, anxiety and hopelessness. However, the heterogeneity of some outcomes was rather high, due to the wide diversity of the interventions included.

CONCLUSION

Positive psychological interventions have potentially positive effects on improving quality of life, enhancing positive psychological outcomes and alleviating negative psychological outcomes in patients with cancer. However, due to the heterogeneity and the lack of follow-up studies, more high-quality studies are needed to confirm the results of our review and to clarify the long-term effects of positive psychological interventions.

RELEVANCE TO CLINICAL PRACTICE

As feasible psychological interventions, healthcare professionals can consider applying appropriate positive psychological interventions according to the condition of cancer patients.

PATIENT OR PUBLIC CONTRIBUTION

No patient or public contribution.

Positive Psychology Intervention (PPI) Program for Persons Who Use Drugs (PWUDS): A Pilot Study

Building on the premises of Positive Psychology, this undertaking conducted a pilot study of the designed 14-session Positive Psychology Intervention (PPI) program established based on the character strengths and virtues (CSV) of persons who use drugs (PWUDs) to assess its usefulness, delivery details, and impacts. Conducted in one of the biggest Drug Abuse Treatment and Rehabilitation Center in the Philippines, 24 PWUDs were randomly selected by the program staff to participate in its pilot run while securing all necessary ethical guidelines and requirements. Via within-subjects pretest-posttest experimental design, the especially adapted and developed tools were used to assess the PWUDs' progress as they were facilitated by the said program. Results yielded significant improvements in the PWUDs' mental wellbeing (M = 1.29, SD = 0.35; t(21) = 9.30, P < .00001), life satisfaction (M = 1.82, SD = 0.24; t(21) = 9.89, P < .00001), and psychological functioning (M = 1.65, SD = 0.19; t(21) = 8.58, P < .00001). Moreover, the PWUDs regarded the designed PPI program very highly and experienced it with positive outcomes, especially for their CSVs. Further improvement of the said program centers around proper time allotment, number of participants in the program sessions, appropriate activities per session, including specific ice breaker games, activity materials needed, and the proper sequencing of each session. These data are used to improve the PPI program structures and components. Pertinent conclusions about the gathered data were drawn, and relevant recommendations were also thereby provided.

Stress and well-being in autistic adults: Exploring the moderating role of coping

The wider stress literature points to negative associations between stress and well-being. Similarly, the use of engagement coping strategies and disengagement coping strategies in the face of stress are related to improved and reduced well-being respectively. However, in the autistic population stress and coping research is limited to date, and the extent to which coping may moderate the relationship between stress and well-being is not known. Using data from an Australian online study, we explored the potential moderating (i.e. buffering or exacerbating) role of coping in the relationship between stress and well-being in a sample of autistic adults (N = 86). Our findings indicated that increased stress was associated with lower well-being. Further, moderation analyses showed that while both engagement coping (e.g. problem solving, positive appraisal) and disengagement coping (e.g., self-distraction, being in denial) strategies had significant positive and negative direct effects on well-being respectively; engagement coping also moderated the relationship between stress and well-being, buffering the impact of stress on well-being. Our results illustrate the different underlying mechanisms by which coping strategies may be associated with stress and well-being. They also highlight the potential protective role of engagement coping strategies, which can be incorporated into the promotion and maintenance of well-being in autistic adults.

Gratitude and Life Satisfaction among Older Adults in Saudi Arabia: Social Support and Enjoyment of Life as Mediators

This cross-sectional study aimed to investigate the relationship between gratitude and life satisfaction, and the mediation role of social support and enjoyment of life among older individuals. The measures employed include the Gratitude, Resentment, and Appreciation test; the Enjoyment of Life scale; the Satisfaction with Life scale; and the Multidimensional Scale of Perceived Social Support. These were administered to a sample of 260 older individuals aged between 60 and 80. The main findings revealed a positive association between gratitude and life satisfaction, and social support was a partial mediator in this relationship. Although enjoyment of life was not a direct mediator in the relationship between gratitude and life satisfaction, the final model indicated a significant serial pathway from gratitude to social support and then through enjoyment of life to life satisfaction. In conclusion, enhancing gratitude, promoting the enjoyment of life, and social support to older individuals might increase their life satisfaction, which in turn might contribute to their successful aging.

When It Hurts, a Positive Attitude May Help. The Moderating Effect of Positive Affect on the Relationship Between Walking, Depression, and Symptoms in Women with Fibromyalgia

BACKGROUND

Increased exercise is a marker of health in fibromyalgia (FM). However, patients frequently avoid physical activity as a way of minimizing the pain they feel. This deprives them of opportunities to obtain positive reinforcement, increasing functional impact.

AIMS

This study examines the mediating role of depressive symptoms between walking (as physical exercise), functional impact, and pain, at different levels of positive affect (PA) among women with fibromyalgia.

DESIGN

Cross-sectional correlational study.

SETTINGS

Mutual aid associations for fibromyalgia in Spain.

PARTICIPANTS

231 women diagnosed with FM.

METHODS

Moderate mediation analyses were conducted using PROCESS.

RESULTS

First, a simple mediation model showed that depression mediated the effect of walking on functional impact, but not on pain. Additionally, the moderated mediated model showed that this effect was significant at medium and high levels of PA, but not when levels of PA were low.

CONCLUSIONS

Provision of resources focused on positive affect seem to increase the positive effects of walking on functional impact through the reduction of depressive symptoms. Nurses can improve adherence of patients with FM to walking behavior through increasing positive affect.

The Effectiveness of Positive Psychology Interventions for Promoting Well-being of Adults Experiencing Depression Compared to Other Active Psychological Treatments: A Systematic Review and Meta-analysis

This systematic review assesses if positive psychology interventions (PPI) are more effective than other active psychological interventions for increasing the well-being of depressed adults. A review of randomised trials that compared PPI to other active interventions was conducted. A systematic search was undertaken using PsycInfo, PubMed, EMBASE, Web of Science, Scopus, CINAHL, two trial registries, and a manual search. The outcomes were happiness and depression. Ten studies, totalling 1341 participants, were included in the review. The small effect sizes for depression (Hedge's g = 0.15) and happiness (Hedge's g = 0.20) favoured PPI but were not significant, indicating no difference between PPI and other active interventions for the outcomes. Heterogeneity was high mainly due to differences in trial implementation. Risks of bias ranged from moderate to high. The results should be interpreted with caution because of the small number of included studies, high heterogeneity, and presence of bias. Protocol Registration Number PROSPERO CRD42019152513.

Supplementary Information

The online version contains supplementary material available at 10.1007/s10902-022-00598-z.

A positive psychology group intervention in Greek university students by the counseling center: Effectiveness of implementation

Most institutions in higher education have emphasized success in knowledge while overlooking Students' wellbeing. The present study aimed to examine the effectiveness of the implementation of a 5-week positive psychology group intervention to a sample of 69 students that were assigned to the intervention (N = 34) and the control group (N = 35). Pre and post measures were taken assessing positive and negative emotions, resilience, happiness, optimism, and self-esteem. In particular, Modified Differential Emotions Scale (mDES), Connor-Davidson Resilience Scale (CD-RISC), Subjective Happiness Scale (SHS), Life Orientation Test-Revised (LOT-R), and Rosenberg Self-Esteem Scale (RSES) were administered to the participants. A mixed measures design was employed with the condition experimental vs. control group as the between-participants factor and time, namely, baseline vs. post-intervention as the within-participants factor. Except for optimism, compared with students in the control group, students in the experimental group showed no significant differences at baseline and experienced a significant increase in positive emotions and resilience in the post-test. On the contrary, the control group demonstrated no significant difference at post-test. Additionally, the students of the intervention group reported significantly higher levels in all measures in comparison with the students of the control group, except resilience, at post-test. However, when the interaction of design and time was considered, the increase in positive emotions solely emerged as a significant result of the intervention. The implementation of a positive psychology group intervention program can be effective in helping students experiencing positive emotions. More research is needed in order to refine and improve the application of such a program in a university setting, in regard to long term intervention.

The pursuit of happiness: A reinforcement learning perspective on habituation and comparisons

In evaluating our choices, we often suffer from two tragic relativities. First, when our lives change for the better, we rapidly habituate to the higher standard of living. Second, we cannot escape comparing ourselves to various relative standards. Habituation and comparisons can be very disruptive to decision-making and happiness, and till date, it remains a puzzle why they have come to be a part of cognition in the first place. Here, we present computational evidence that suggests that these features might play an important role in promoting adaptive behavior. Using the framework of reinforcement learning, we explore the benefit of employing a reward function that, in addition to the reward provided by the underlying task, also depends on prior expectations and relative comparisons. We find that while agents equipped with this reward function are less happy, they learn faster and significantly outperform standard reward-based agents in a wide range of environments. Specifically, we find that relative comparisons speed up learning by providing an exploration incentive to the agents, and prior expectations serve as a useful aid to comparisons, especially in sparsely-rewarded and non-stationary environments. Our simulations also reveal potential drawbacks of this reward function and show that agents perform sub-optimally when comparisons are left unchecked and when there are too many similar options. Together, our results help explain why we are prone to becoming trapped in a cycle of never-ending wants and desires, and may shed light on psychopathologies such as depression, materialism, and overconsumption.

Even in favorable circumstances, we often find it hard to remain happy with what we have. One might enjoy a newly bought car for a season, but over time it brings fewer positive feelings and one eventually begins dreaming of the next rewarding thing to pursue. Here, we present a series of computational simulations that suggest these presumable “flaws” might play an important role in promoting adaptive behavior. We explore the value of prior expectations and relative comparisons as a useful reward signal and find that across a wide range of environments, these features help an agent learn faster and adapt better to changes in the environment. Our simulations also highlight scenarios when these relative features can be harmful to decision-making and happiness. Together, our results help explain why we have the propensity to keep wanting more, even if it contributes to depression, materialism, and overconsumption.

Mindfulness-based positive psychology interventions: a systematic review

Background

There are hundreds of mindfulness-based interventions in the form of structured and unstructured therapies, trainings, and meditation programs, mostly utilized in a clinical rather than a well-being perspective. The number of empirical studies on positive potentials of mindfulness is comparatively less, and their known status in academia is ambiguous. Hence, the current paper aimed to review the studies where mindfulness-based interventions had integrated positive psychology variables, in order to produce positive functioning.

Methods

Data were obtained from the databases of PubMed, Scopus, and PsycNet and manual search in Google Scholar. From the 3831 articles, irrelevant or inaccessible studies were eliminated, reducing the number of final articles chosen for review to 21. Interventions that contribute to enhancement of eudaimonia, hedonia, and other positive variables are discussed.

Results

Findings include the potential positive qualities of MBIs in producing specific positive outcomes within limited circumstances, and ascendancy of hedonia and other positive variables over eudaimonic enhancement.

Conclusion

In conclusion, exigency of modifications in the existing MBIs to bring about exclusively positive outcomes was identified, and observed the necessity of novel interventions for eudaimonic enhancement and elevation of hedonia in a comprehensive manner.

Changes in neural reward processing following Amplification of Positivity treatment for depression and anxiety: Preliminary findings from a randomized waitlist controlled trial

Positive valence system (PVS) deficits are increasingly recognized as important treatment targets for depression and anxiety. Emerging behavioral treatments designed to upregulate the PVS show initial promise; however, neural mechanisms underlying these approaches remain unknown. This study investigated neural reward-processing-related changes following Amplification of Positivity (AMP)-a treatment designed to enhance positive thinking, emotions and behaviors through positive activity interventions (Clinicaltrials.gov: NCT02330627). Individuals with depression and/or anxiety (N = 29) were randomized to 10 sessions of AMP (n = 16) or waitlist (WL; n = 13). Participants completed a monetary incentive delay task during fMRI at baseline and post-assessment. Hypothesis-driven region of interest (ventral striatum, insula, anterior cingulate) and exploratory whole-brain activation and connectivity analyses evaluated pre-to-post changes for AMP vs. WL when anticipating potential monetary gain or loss. No between-group brain activation changes emerged in regions of interest or whole-brain analyses. Increased neural connectivity from pre-to-post-treatment was observed in AMP vs. WL, including ventral striatum, anterior insula, and anterior cingulate connectivity with prefrontal, limbic, occipital and parietal regions-predominantly during loss anticipation. This preliminary study is the first to examine neural mechanisms of positive activity interventions in depression and anxiety and suggests that AMP may strengthen brain connectivity in reward processing, attention, and emotion regulation networks.

Using Social Network Sites to Boost Savoring: Positive Effects on Positive Emotions

Research has demonstrated that positive interventions (PIs) can be effective in enhancing well-being. Our study used Facebook to conduct a PI based on savoring. Sixty-one university students in Taiwan were randomly assigned to undergo a three-week savoring PI, and 61 participants were assigned to a no-treatment control group. The results showed significantly enhanced positive affect in the treatment group compared to the control group, in both a post-test and a final follow-up, but no significant differences between the two groups in negative affect. The treatment group also displayed significantly lower depression in the post-test, which was not maintained at the follow-up. These results indicate that, for university students, a savoring intervention via Facebook can be an effective way of enhancing positive emotions.

Does Using Social Network Sites Reduce Depression and Promote Happiness?

Positive interventions based on theories in positive psychology have proven effective in contributing to well-being. Although college students frequently use social networking sites, few studies have investigated the use of these sites to facilitate positive interventions. For this research, two positive interventions, photo diaries and the expression of gratitude, were developed and implemented in Facebook using a randomized controlled trial. 136 college students were recruited and randomly assigned them to one of two experimental groups or a control group. Results indicated that photo diary reduced depression during the posttest stage, and these effects continued during the follow up stage. Concerning happiness, the photo diary presented no significant effects in the posttest but did present significant effects in the follow up. Expression of gratitude showed no significant effects on happiness in the posttest but did show significant effects in the follow up. The results of the study demonstrate that social networking sites can be used to implement positive interventions.

Resilience, Emotions, and Character Strengths as Predictors of Job Stress in Military Personnel

Background: Job stress, which undermines productivity and physical and mental health, has been reported to be high among military personnel. Objectives: The present study aimed to explore the role of character strengths, emotions, and resilience in predicting job stress in a sample of Iranian military personnel. Methods: This cross-sectional study recruited a total number of 146 military personnel via convenience sampling and administered the Health and Safety Executive Stress Questionnaire, Conner-Davidson Resilience Scale, Values in Action Inventory of Strengths, and Positive and Negative Affect Schedule. The correlation analysis and stepwise linear regression were performed using SPSS22. Results: Job stress was negatively associated with resilience, positive emotions, and character strengths and positively associated with negative emotions (P < 0.001). Regression analysis revealed that three variables, including resilience, courage, and negative emotions could predict 57% of the variance in job stress (Adj. R2 = 0.57, P < 0.001). Conclusions: Higher resilience and courage are associated with lower job stress. Also, negative emotions such as anger, guilt, and anxiety would contribute to higher job stress. Providing training courses to develop and boost resilience and courage and manage negative emotions can offset the negative effects of job stress on military personnel. Also, considering these factors as recruitment criteria would lead to the enlistment of cadets who may be more resilient to stress.

Does Negative Emotional Reactivity Moderate the Relation between Contextual Cohesion and Adolescent Well-Being?

Although well-being is a chief indicator of positive mental health, much research has neglected to consider individual-specific and contextual factors that may promote this important outcome among youth. To address this gap, we examined whether neighborhood and family social cohesion are associated with well-being among youth varying in negative emotional reactivity, and whether findings were consistent with the diathesis-stress or differential susceptibility hypothesis. Participants were assessed at 3 time points: Time 1 (N = 775, M age = 10.95 ± 0.88 years; 71% male); Time 2 (n = 660, M age = 12.99 ± 0.95 years); and Time 3 (n = 633, M age = 15.50 ± 0.56 years). At Time 1, caregivers reported on family and neighborhood cohesion. Youth reported on their negative emotional reactivity at Time 2 and well-being at Time 3. Negative emotional reactivity moderated the relation between family cohesion and well-being. Among youth higher in negative emotional reactivity, lower family cohesion was associated with lower levels of well-being compared to higher family cohesion. Youth higher and lower in emotional reactivity evidenced similar levels of well-being when exposed to higher family cohesion. The findings thus support the diathesis-stress model, suggesting that less cohesive families may contribute to reduced happiness and well-being, particularly among youth with higher negative emotional reactivity.

A positive psychology-motivational interviewing intervention for patients with type 2 diabetes: Proof-of-concept trial

OBJECTIVE

Eighteen million Americans with type 2 diabetes (T2D) do not follow recommended guidelines for physical activity. Motivational interviewing (MI) has had modest effects on activity and related behaviors in T2D. Positive psychological attributes (e.g., optimism) are associated with superior medical outcomes in T2D, and positive psychology (PP) interventions promote such attributes. There had been no study in T2D of a combined PP-MI intervention to promote well-being and health behavior adherence. We developed a novel, telephone-delivered, 16-week PP-MI intervention and explored its feasibility and impact in T2D patients in a single-arm, proof-of-concept trial.

METHOD

Participants completed PP-based exercises and MI-based physical activity goal-setting activities and reviewed these activities weekly with a study trainer for 16 weeks. Feasibility and acceptability were assessed via exercise completion rates and post-exercise ratings of ease/utility (0-10 scales). Impact was explored by examining changes in physical activity (via accelerometers and self-report), other health behaviors, psychological measures, and medical outcomes (e.g., hemoglobin A1c (A1C)) from baseline to 16 weeks, using paired t tests.

RESULTS

Twelve participants enrolled, and 10 provided follow-up data. Seventy-eight percent of PP-MI activities were completed, and participants rated the PP-MI content and sessions as easy (mean = 8.2/10, standard deviation (SD) = 1.9) and useful (mean = 9.1/10, SD = 1.5). PP-MI was associated with improved adherence to health behaviors and overall self-care, variable effects on accelerometer-measured activity and psychological outcomes, and modest beneficial effects on body mass index and A1C.

CONCLUSION

Further testing of this intervention is warranted in a larger, controlled trial to assess its effects on important health outcomes.

The acceptability of an online intervention using positive psychology for depression: A qualitative study

BACKGROUND

Positive psychology interventions may usefully treat depression and can be delivered online to reduce the treatment gap. However, little is known about how acceptable patients find this approach. To address this, the present study interviewed recent users of a positive psychology self-help website.

METHODS

In-depth semi-structured interviews explored the experiences of twenty-three participants from a larger feasibility study. A stratified purposive sampling strategy selected participants with varying intervention experience according to their intervention logins, as well as varying age, gender and depressive symptoms. Framework analysis was used to explore patterns and linkages within and between participants' accounts.

RESULTS

Acceptability varied between participants. Those who found it more acceptable felt it was relevant to their depression and reported feeling empowered by a self-help approach. Conversely, participants for whom it was less acceptable perceived the positive focus irrelevant to their depression and found the emphasis on self-action unsupportive.

CONCLUSIONS

The acceptability of an online positive psychology intervention may be facilitated by a patients' preference for a psychological focus on the positive. However, patients may also have distinct preferences for online self-help. Future research should investigate the importance of the therapeutic orientation of online self-help interventions and whether patients' preferences for these can be reliably identified. This could help to target online self-help in clinical practice.

What might affect acceptability of online positive psychology interventions for depression: a qualitative study on patient expectations'

BACKGROUND

Positive psychology interventions are brief self-adminstered exercises designed to promote positive emotions, behaviours, or thoughts. They are potentially effective for reducing depression and are considered suitable for online dissemination to people with depression and related conditions, as they are assumed to be more acceptable than traditional symptom-focused approaches. However, there is little investigation into perceived acceptability and potential factors that might affect it. This might limit the development and evaluation of effective interventions.

METHODS

Semi-structured interviews with patients with depression and/or anxiety (n = 18) and professionals, including GPs and psychologists (n = 5) were conducted on their perceptions of a proposed online intervention using positive psychology. Thematic analysis, according to Braun and Clarke, was used to identify meaningful patterns in the data.

RESULTS

Four key themes were identified. The fit between the positive psychological approach and the patient's context, including their personality, symptoms and other treatments, was important in determining acceptability. Social aspects of interventions were thought to facilitate acceptability, as long as these were balanced. Support was identified as important in facilitating intervention suitability, although it was not without limitations. Finally, participants identified how design features can enhance acceptability.

CONCLUSIONS

The findings suggest that positive psychology interventions might not be acceptable to all and that specific exercises might be more or less appropriate to deliver online. Design aspects can help to facilitate acceptability, beyond the psychological content. These findings may inform the design of future online psychology interventions for people with depression and anxiety, which can then be evaluated in future research.

GET.HAPPY - Acceptance of an internet-based self-management positive psychology intervention for adult primary care patients with mild and moderate depression or dysthymia: A pilot study

INTRODUCTION

A growing number of internet interventions have been shown to help in alleviating symptoms of depression. So far, only little research has focused on other methods than CBT. The present study aimed to investigate the level of satisfaction with a positive psychology online training among patients with mild and moderate depression or dysthymia. Secondary outcome measures included changes in symptom severity, health related quality of life, and negative effects.

METHODS

A total of 81 participants were allocated to the intervention. They were asked to complete online questionnaires and were called by one of the study psychologists at baseline, at post-treatment, and at follow-up (3 months after completion of the intervention). Shorter questionnaires were administered after each module.

RESULTS

Overall satisfaction was promising. While participants seemed to be very satisfied with many aspects of the program itself, they were slightly less satisfied with its impact on the problems they sought to solve. Overall, negative effects attributed to the program were small with one exception. At post-treatment, 22.6% of the participants felt that they or their problems were not taken seriously by the program. Symptom severity decreased over time with mild to moderate effect sizes. There was a moderate increase in satisfaction with mental health at both post-treatment and follow-up.

CONCLUSIONS

The online program investigated here may be a useful resource-oriented addition to the standard treatment of depression.

A Gender-Responsive Treatment Facility in Correctional Services: The Development of Psychological Gymnasium for Women Offenders

With increasing evidence suggesting a disparity in female and male offenders in terms of rehabilitative needs, growing concern has been placed on the development of gender-specific services for female offenders. As such, a prison-based psychological gymnasium (PSY GYM), with distinctive features in integrating cognitive-behavioral and positive-psychology concepts to address female offenders' needs, was set up in 2011. The present study aims to introduce the concept as well as present findings to evaluate the overall effectiveness of PSY GYM. Nineteen Chinese female offenders participated in a 6- to 8-month intensive training program at the Lo Wu Correctional Institution (LWCI) of the Hong Kong Correctional Services Department in Hong Kong. Psychometric inventories were used to assess their psychological distress and positive growth following the program. Participants showed significant reduction in their depression, anxiety, and stress symptoms, and in their tendency to pay attention to negative information. Furthermore, their sense of hope, gratitude, and tendency to pay attention to positive information had remarkably increased. This indicated the effectiveness of PSY GYM in facilitating successful rehabilitation for female offenders.

The proximal experience of gratitude

Although a great deal of research has tested the longitudinal effects of regularly practicing gratitude, much less attention has been paid to the emotional landscape directly following engagement in gratitude exercises. In three studies, we explored the array of discrete emotions people experience after being prompted to express or recall gratitude. In Studies 1 and 2, two different gratitude exercises produced not only greater feelings of gratitude relative to two positive emotion control conditions (i.e., recalling relief), but also higher levels of other socially relevant states like elevation, connectedness, and indebtedness. In a third study, conducted in both the U.S. and S. Korea, we compared a gratitude exercise to another positive emotion elicitation (i.e., recalling a kind act) and to a neutral task, and again found that the gratitude exercise prompted greater gratitude, elevation, indebtedness, and guilt, but no more embarrassment or shame, than the two comparison conditions. Additionally, in all three studies, emodiversity and cluster analyses revealed that gratitude exercises led to the simultaneous experience of both pleasant and unpleasant socially-relevant states. In sum, although it may seem obvious that gratitude exercises would evoke grateful, positive states, a meta-analysis of our three studies revealed that gratitude exercises actually elicit a mixed emotional experience—one that simultaneously leads individuals to feel uplifted and indebted.

Positive affect predicts cerebral glucose metabolism in late middle-aged adults

Positive affect is associated with a number of health benefits; however, few studies have examined the relationship between positive affect and cerebral glucose metabolism, a key energy source for neuronal function and a possible index of brain health. We sought to determine if positive affect was associated with cerebral glucose metabolism in late middle-aged adults (n = 133). Participants completed the positive affect subscale of the Center for Epidemiological Studies Depression Scale at two time points over a two-year period and underwent 18F-fluorodeoxyglucose-positron emission tomography scanning. After controlling for age, sex, perceived health status, depressive symptoms, anti-depressant use, family history of Alzheimer’s disease, APOE ε4 status and interval between visits, positive affect was associated with greater cerebral glucose metabolism across para-/limbic, frontal, temporal and parietal regions. Our findings provide evidence that positive affect in late midlife is associated with greater brain health in regions involved in affective processing and also known to be susceptible to early neuropathological processes. The current findings may have implications for interventions aimed at increasing positive affect to attenuate early neuropathological changes in at-risk individuals.

Upregulating the positive affect system in anxiety and depression: Outcomes of a positive activity intervention

BACKGROUND

Research suggests that the positive affect system may be an important yet underexplored treatment target in anxiety and depression. Existing interventions primarily target the negative affect system, yielding modest effects on measures of positive emotions and associated outcomes (e.g., psychological well-being). The objective of the present pilot study was to evaluate the efficacy of a new transdiagnostic positive activity intervention (PAI) for anxiety and depression.

METHOD

Twenty-nine treatment-seeking individuals presenting with clinically impairing symptoms of anxiety and/or depression were randomly allocated to a 10-session protocol comprised of PAIs previously shown in nonclinical samples to improve positive thinking, emotions, and behaviors (e.g., gratitude, acts of kindness, optimism; n = 16) or a waitlist (WL) condition (n = 13). Participants were assessed at pre- and posttreatment, as well as 3- and 6-month follow-up, on measures of positive and negative affect, symptoms, and psychological well-being. ClinicalTrials.gov Identifier: NCT02330627 RESULTS: The PAI group displayed significantly larger improvements in positive affect and psychological well-being from pre- to posttreatment compared to WL. Posttreatment and follow-up scores in the PAI group were comparable to general population norms. The PAI regimen also resulted in significantly larger reductions in negative affect, as well as anxiety and depression symptoms, compared to WL. Improvements across all outcomes were large in magnitude and maintained over a 6-month follow-up period.

CONCLUSIONS

Targeting the positive affect system through a multicomponent PAI regimen may be beneficial for generating improvements in positive emotions and well-being, as well as reducing negative affect and symptoms, in individuals with clinically impairing anxiety or depression.

The Efficacy of Well-Being Therapy for Depression in Infertile Women

BACKGROUND

Infertility is a major public health problem with physical, psychological and social dimensions. High prevalence of psychological problems has been reported in infertile women. The objective of this study was to examine the effectiveness of well- being therapy (WBT) for depression in infertile women who were referred to an infertility center in Mashhad, Iran.

MATERIALS AND METHODS

This preliminary trial was conducted at the Montasariya Infertility Center, Mashhad, Iran, between July and October 2011. A group of 22 infertile women were randomly assigned into experimental (n=11) and control groups (n=11). Patients were assessed with two self-rating inventories including the Psychological Well- being (PWB) and the Depression, Anxiety and Stress Scale-21 (DASS-21) before and after the interventions and the waiting-list period. WBT was performed in 8 to 10 sessions according to the published protocol.

RESULTS

Analysis of covariance (ANCOVA) showed a significant difference regarding the depression scores of experimental group between preand post-treatment as compared to control subjects.

CONCLUSION

The results suggested the feasibility and clinical advantages of adding WBT to repertoire of the treatment techniques for depression in infertile women.

The happy elderly as a being-toward-death: a phenomenological research

INTRODUCTION

Little research has been done on elderly adults from an optimistic perspective. What is it like to be a happy elderly person who is moving toward death? How can we approach their health promotion? This study aimed at exploring ways of being happy in older adults in Chile.

METHODS

We used a phenomenological approach, using Martin Heidegger’s philosophical frame. Participants were chosen after applying the Lyubomirski scale – those who fell into the “happy” category were invited to a semi-structured interview.

RESULTS

We identified categories in happy elderly people; such as being autonomous, traveling, dancing, childcare, reading, pets, enjoy material goods. Thus, being able to understand the happy elderly person as being placed in the world without any choice other than accepting life and death as best as possible, with an optimistic regard about the past, an ability to reinvent themselves, and an awareness of being closer to death.

CONCLUSIONS

There is still not enough knowledge available about the psychological resources that promote a welfare state in old age in juxtaposition with the losses at this stage of life. Studies show that happiness levels in older adults are very good, albeit in a context of high concentration of emotional and material losses, and the imminence of death. Unlike the common standpoint that conceives older adults within a biomedical framework, we believe it is necessary to promote an ontological understanding of old age; that is to say an understanding beyond bodily conditions, which includes the meaning of life experiences, and happiness as a tool for active and healthy aging.

Occupational Stress: Preventing Suffering, Enhancing Wellbeing

Occupational stress is a known health risk for a range of psychological, behavioral, and medical disorders and diseases. Organizations and individuals can mitigate these disorders through preventive stress management and enhanced wellbeing. This article addresses, first, the known health risk evidence related to occupational stress; second, the use of preventive stress management in organizations as the framework for intervention; and third, the emerging domain of enhancing wellbeing, which strengthens the individual. Premature death and disability along with chronic suffering from occupational stress are not inevitable, despite being known outcome risks.

Effect of Group Positive Psychotherapy on Improvement of Life Satisfaction and The Quality of Life in Infertile Woman

BACKGROUND

Positive psychotherapy is one of the new approaches in psychology which is innovated for treating psychological disorders and enhancing positive emotions. The aim of this study is to investigate the effectiveness of the group positive psychotherapy on elevation of life satisfaction and quality of life in infertile women.

MATERIALS AND METHODS

In a randomized trial study, Beck Depression Inventory II (BDI-II) and clinical interview were used in a pre-test post-test control group design. After analyzing the result of the questionnaire, 36 infertile women who showed signs of mild to moderate depression were randomly placed into two following groups: control (n=18) and intervention (n=18). Before the treatment, the members of both groups answered BDI-II, Satisfaction With Life Scale (SWLS) and 12 item Short Form Health Survey (SF-12). The intervention group received six sessions of group positive psychotherapy, but the treatment of the control group began six weeks after the intervention group.

RESULTS

The results showed that the life satisfaction scores of the intervention group were significantly elevated from 22.66 in pre-test to 26.13 in post-test (P<0.001), while this improvement was not significant in the control group (P=0.405). The difference between life satisfaction scores of the intervention and the control groups was also significant (F=8.92, P=0.006). However, no significant change in the quality of life level of the intervention and control groups was observed (P=0.136).

CONCLUSION

Thus it can be deduced from the findings that this treatment method could be introduced as solution to increase the life satisfaction in infertile women, but not as a treatment for elevating their quality of life (Registration Number: IRCT2013042810063N3).

The effectiveness of group positive psychotherapy on depression and happiness in breast cancer patients: A randomized controlled trial

Background

Breast cancer is one of the most prevalent cancers in women in the world. It causes fear, despair, and takes a tremendous toll on psychological status.

Objective

To determine the effectiveness of group positive psychotherapy on the depression and happiness of breast cancer patients.

Methods

This randomized controlled trial was conducted with 42 breast cancer patients in The Oncology Center at Kermanshah, Iran in 2015. The Data were gathered before intervention and ten weeks afterwards. The data were collected using Beck’s Depression Inventory (BDI-II) and Oxford’s happiness Inventory (OHI). The data were analyzed by SPSS-16, Kolmogorov-Smirnov (K-S), chi-squared, and multivariate analysis of covariance (MANCOVA).

Results

The results showed a significant reduction in the depression of the group on positive psychotherapy compared with the control group. Also the positive psychotherapy group experienced a significant increase in the patients’ happiness, while there was no significant increase in the control group.

Conclusion

The results of this research showed the effectiveness of positive psychotherapy on the reduction of mental pressure and the improvement of the mental status of breast cancer patients. This economical therapy can be used to increase patients’ psychological health.

Clinical Trial Registration

The trial was registered at the Iranian Registry of Clinical Trials (IRST) with the identification number IRCT2013101410063N4.

Funding

The authors received financial support for the research from Kermanshah University of Medical Sciences.

A randomised control trial of an Internet-based cognitive behaviour treatment for mood disorder in adults with chronic spinal cord injury

STUDY DESIGN

Prospective parallel waitlist randomised controlled trial.

OBJECTIVES

Evaluate the feasibility and effectiveness of an Internet-based psychological intervention treating comorbid mood disorder in adults with spinal cord injury (SCI). Improved mood and satisfaction with life were primary outcomes.

SETTING

Victoria, Australia.

INTERVENTION

Electronic Personal Administration of Cognitive Therapy (ePACT).

MEASURES

Depression, Anxiety and Stress Scale-Short Form (DASS21), Personal Well-being Index, Helplessness subscale of the Spinal Cord Lesion Emotional Well-being Scale v1 Australia, at each time point.Participant qualifying criteria:Adults (18-70 years), chronic SCI, attend SCI review clinic at Austin or Caulfield Hospital and score above normative threshold of the Depression, Anxiety and Stress Scale-Short Form (DASS21).

METHODS

Forty-eight participants completed Time 2 post intervention (n=23) or time equivalent for waitlist control group (n=25) telephone interviews. The measures were repeated a third time (Time 3) for a small subgroup (n=12) at 6 months post intervention within the study implementation time frame.

RESULTS

Univariate within group analyses revealed significant improvement in mood in the intervention group at Time 2: (lower depression (effect size (ES)=0.4), anxiety (ES=0.4) and stress (ES=0.3)) and higher satisfaction with life (ES=0.2). Waitlist control group improved in depression only (ES=0.3) by Time 2. Multilevel variance components analyses, although not as positive, were still encouraging. Improvement in mood symptoms was maintained in the small group reinterviewed at Time 3.

CONCLUSION

Although Internet-based interventions for mental health issues in SCI not a solution for all, our results indicate that they are a potentially valuable addition to the currently available options.

Changes in HIV Outcomes Following Depression Care in a Resource-Limited Setting: Results from a Pilot Study in Bamenda, Cameroon

BACKGROUND

Little is known about how improved depression care affects HIV-related outcomes in Africa. In a sample of depressed HIV patients in a low income, sub-Saharan country, we explored how implementing measurement-based antidepressant care (MBC) affected HIV outcomes over 4 months of antidepressant treatment.

METHODS

As part of a project adapting MBC for use in Cameroon, we enrolled 41 depressed HIV patients on antiretroviral therapy in a pilot study in which a depression care manager (DCM) provided an outpatient HIV clinician with evidence-based decision support for antidepressant treatment. Acute depression management was provided for the first 12 weeks, with DCM contact every 2 weeks and HIV clinician appointments every 4 weeks. We measured HIV clinical and psychiatric outcomes at 4 months.

RESULTS

Participants were moderately depressed at baseline (mean Patient Health Questionnaire [PHQ] score = 14.4, range 13.1, 15.6). All HIV clinical outcomes improved by four month follow-up: mean (range) CD4 count improved from 436 (2, 860) to 452 (132, 876), mean (range) log-viral load decreased from 4.02 (3.86, 4.17) to 3.15 (2.81, 3.49), the proportion with virologic suppression improved from 0% to 18%, mean (range) HIV symptoms decreased from 6.4 (5.5, 7.3) to 3.1 (2.5, 3.7), the proportion reporting good or excellent health improved from 18% to 70%, and the proportion reporting any missed ARV doses in the past month decreased from 73% to 55%. Concurrently, psychiatric measures improved. The mean (range) PHQ score decreased from 14.4 (13.1, 15.6) to 1.6 (0.8, 2.4) and 90% achieved depression remission, while mean maladaptive coping style scores decreased and mean adaptive coping scores and self-efficacy scores improved.

CONCLUSION

In this pilot study of an evidence-based depression treatment intervention for HIV-infected patients in Cameroon, a number of HIV behavioral and non-behavioral health outcomes improved over 4 months of effective depression treatment. These data are consistent with the hypothesis that better depression care can lead to improved HIV outcomes.

Feasibility, Acceptability, and Impact of a Web-based Gratitude Exercise among Individuals in Outpatient Treatment for Alcohol Use Disorder

This mixed-methods pilot study examined the feasibility, acceptability, and impact of a web-based gratitude exercise (the 'Three Good Things' exercise (TGT)) among 23 adults in outpatient treatment for alcohol use disorder (AUD). Participants were randomized to TGT or a placebo condition. The intervention was feasible with high rates of completion. Participants found TGT acceptable and welcomed the structure of daily emails; however, they found it difficult at times and discontinued TGT when the study ended. Participants associated TGT with gratitude, although there were no observed changes in grateful disposition over time. TGT had a significant effect on decreasing negative affect and increasing unactivated (e.g., feeling calm, at ease) positive affect, although there were no differences between groups at the 8 week follow up. Qualitative results converged on quantitative findings that TGT was convenient, feasible, and acceptable, and additionally suggested that TGT was beneficial for engendering positive cognitions and reinforcing recovery.

Charting the internal landscape: Affect associated with thoughts about major life domains explains life satisfaction

Studies of happiness have examined the impact of demographics, personality and emotions accompanying daily activities on life satisfaction. We suggest that how people feel while contemplating aspects of their lives, including their weight, children and future prospects, is a promising yet uncharted territory within the internal landscape of life satisfaction. In a sample of 811 American women, we assessed women’s feelings when thinking about major life domains and frequency of thoughts about each domain. Regression and dominance analyses showed that emotional valence of thoughts about major life domains was an important predictor of current and prior life satisfaction, surpassing, in descending order, demographics, participants’ feelings during recent activities, and their neuroticism and extraversion scores. Domains thought about more frequently were often associated with greater emotional valence. These results suggest that life satisfaction may be improved by modifying emotional valence and frequency of thoughts about life domains. Moreover, these thoughts appear to be an important and relatively stable component of well-being worthy of further study.

Review of the application of positive psychology to substance use, addiction, and recovery research

Advances in positive psychology have grown exponentially over the past decade. The addictions field has experienced its own growth in a positive direction, embodied by the recovery movement. Despite parallel developments, and great momentum on both sides, there has been little crosspollination. This article introduces positive psychology and the recovery movement, describes the research on positive psychology in the addictions, and discusses future avenues of theory, research, and intervention based on a positive-psychology framework. A systematic review of positive psychology applied to substance use, addiction, and recovery found nine studies which are discussed according to the following themes: theoretical propositions, character strengths and drinking, positive psychology and recovery, positive interventions, and addiction: feeling good and feeling bad. The current scholarship is scant, but diverse, covering a wide range of populations (adults, adolescents, those in and out of treatment), topics (character strengths, recovery, positive affect), and addictive behaviors (work addiction, cigarette smoking, and alcohol use disorders). There is diversity, too, in country of origin, with work originating in the U.S., U.K., Poland, and Spain. The rigorous application of the lens, tools, and approaches of positive psychology to addiction research generally, and to the aims of the recovery movement specifically, has potential for the development of theory and innovation in prevention and intervention. Further, because the work in positive psychology has primarily focused on microsystems, it may be primed to make contributions to the predominantly macrosystems focus of the recovery movement. (PsycINFO Database Record (c) 2013 APA, all rights reserved).