Effects of a Multi-Component Psychological Intervention to Cultivate Mental Health in Older Adults.

Introduction: Psychological interventions to cultivate mental health in older adults are scarce and tend to focus on and use a limited number of activities. Objective: The aim of this study was to test the effects of an intervention based on Keyes' concept of positive mental health. Methods: The intervention was conducted with 24 self-selected participants, while 34 were part of the control group. Positive mental health and distress outcomes were measured at baseline and at the end of the intervention. ANCOVA analysis and effect sizes were calculated. Results: Results showed that the intervention increased mental health (F= 18.22, p<0.001, η2= 0.334, d= 1.45, power 0.986) and decreased psychiatric symptomatology in the experimental group versus the control group (F= 7.07, p= 0.011, η2= 0.16, d= 0.87, power= 0.736), which showed no change. Discussion: Despite study limitations, the intervention effectively promoted older people's well-being. Future research, should evaluate the long-term effects of the intervention with varied older adult populations.

Adaptation to Spanish of the "Relational Needs Satisfaction Scale": Translation and psychometric testing.

This article aims to adapt to Spanish the Relational Needs Satisfaction Scale (RNSS) and to test the factor structure with a clinical and a non-clinical sample. A total of 459 individuals completed the RNSS, a measure of life satisfaction and of psychological wellbeing. Results showed that the translation was adequate. An exploratory and confirmatory factor analysis was conducted followed by the test of three models that confirmed the five-factor structure and the second-order global factor proposed in the original study, and in adaptations to other languages. The advantages and disadvantages of these models are discussed. Correlations of the RNSS with life satisfaction and psychological wellbeing measures were in the expected direction, providing evidence of convergent validity. The Spanish version of the RNSS is a valid and reliable measure of the construct it was intended to measure, though some improvements in item wording could be incorporated and tested (for instance, item 18 should be positively worded as the rest of the items in order to avoid the effect of negative wording).

A global health model integrating psychological variables involved in cancer through a longitudinal study.

Objective: The literature has shown the relevance of certain psychological variables in adjustment to cancer. However, there is a great variability, and these features could be modified through the disease process. The aim of this study is to provide an integrated and global perspective of the importance of variables such as coping, resilience, emotional control, social support, affect, and others in cancer patients through a longitudinal study, with the objective of exploring their associations and underlying interactions. Methods: The sample was composed of 71 people diagnosed with cancer who were attending psychological support at the Spanish Association Against Cancer (Biscay). We assessed the following variables in two periods of 6 months: perceived stress (PSS), emotional control (CECS), resilience (CD-RISC), coping strategies (CERQ), personality (NEOFFI), social support (MOSS), affect (PANAS), emotional distress (GHQ), quality of life (SF-12) and visual-analogic scales (EVA). Results: Results showed predictive effects of perceived stress on physical health perception (ß = -0.22; t = -3.26; p = 0.002). Mental health perception was influenced by almost all the psychological variables. Consciousness at baseline (ßCo = 0.15; p = 0.003), change in Extraversion (ßEx = 0.16; p = 0.001) and Resilience (ßRe = 0.15; p = 0.002) had significant effects on perceived mental health. Conclusion: This study provides a global health model that integrates and explores associations between psychological variables related to cancer disease. This information could be useful for guiding personalized psychotherapeutic interventions, with the aim of increasing adjustment to disease.

Cognitive behavioral therapy with and without biofeedback in fibromyalgia: Assessment of functional and clinical change.

The study compared the effectiveness of Cognitive Behavioral Therapy (CBT) with biofeedback or with emotional expression in individuals with fibromyalgia, and a waiting list control group. 88 women participated in a naturalistic study with random assignment. The Fibromyalgia Impact Questionnaire, SCL-90R, and a visual analog quality of life scale were used. Both intervention groups improved, but differed in physical and emotional control response. Using the reliable change index procedure, clinical improvement occurred in 18.8% of participants, and 4.8% achieved scores comparable with clinical recovery. Greater specificity on therapeutic objectives is warranted.

Role of resilience and emotional control in relation to mental health in people with cancer.

This study explored the relationship between emotional control, resilience, and mental health in cancer. Patients with cancer were recruited (n = 170). Courtauld Scale of Emotional Control, Connor-Davidson Resilience Scale, and the General Health Questionnaire were selected. Assuming the absence of interaction among the variables, they were analyzed separately. Four groups resulted, finding statistically significant differences (F(4, 165) = 18.03; p < 0.001). High resilience and low emotional control seem to be protective attributes, and high emotional control has demonstrated to be a risk factor for mental health. Considering differences in cancer-related psychological variables could derive in personalized psychotherapeutic interventions.

The effects of an intervention to improve mental health during the COVID-19 quarantine: comparison with a COVID control group, and a pre-COVID intervention group.

ObjectiveThe COVID-19 pandemic has constituted an unprecedented challenge to society and science and it has provided an unexpected opportunity to explore the effects of a positive intervention in times of adversity and confinement. The goal was to evaluate the effects of a theory driven group intervention to cultivate mental health and flourishing. Design: A pre post design with three groups (151 individuals) was conducted, including an experimental group that received the intervention during the pandemic, a pre-COVID intervention group, and a COVID control group. Main Outcome Measures: Based on Keyes' concept of positive mental health, measures of subjective, psychological and social well-being were obtained, as well as an indicator of psychological distress (GHQ12). Results: Intervention groups showed an increase in well-being and the COVID control group a decrease. Change scores revealed significant differences. Overall percentage of individuals at risk of ill health in baseline was 25.2%, but after the intervention, the COVID control group reached 64.1%. Conclusions: Despite the limitations, the present findings suggest that interventions to sustain and improve mental health in times of crisis and adversity can be an effective approach.

A taxonomy of groups at risk based on reported and desired body mass index and its relationships with health.

This study aimed to identify groups at risk based on reported and desired Body Mass Index (BMI) and their relationships with weight satisfaction, food intake and perceived health, and to analyze gender differences. A pre-experimental observational study was conducted. 3380 individuals (mean age 20.16; 64.4% females) participated in a survey in the context of a healthy university project. Participants anonymously completed the SF-12, reported height, weight, desired weight, satisfaction and quality of intake. Reported BMI (BMI-r) and Desired BMI (BMI-d) were calculated following WHO standards. Combining BMI-r and BMI-d four groups emerged: Favorable Concordance, FC (67.40% normal weight wanting to maintain it), Unfavorable Concordance, UC (9.19% non-normal weight wanting such unhealthy condition), Favorable Discrepancy, FD (13.92% unhealthy weight wanting to move in a healthy direction), and Unfavorable Discrepancy, UD (9.49% normal or non-normal weight desiring an unhealthy condition). FD individuals showed lower levels of self-perceived physical health, poorer perception of the quality of their intake, and less satisfaction with weight. Both UD and UC groups are at risk, showing the UD group the lowest scores in mental health and healthy food intake. Higher proportions of females were found in the UD group, and wanting to lose weight. These findings suggest that health treatment, prevention and promotion programs can benefit from a taxonomy that identifies not only people at risk but the direction and adjustment (i.e. healthy vs non healthy) of their intention to change. Programs could be targeted at different groups, with specific goals and interventions, and avoid the 'one-fits-all' to foster a healthy weight in the young adult university population.

Discrepancy between experience and importance of recovery components in the symptomatic and recovery perceptions of people with severe mental disorders.

BACKGROUND: Personal recovery has become an increasingly important approach in the care of people with severe mental disorders and consequently in the orientation of mental health services. The objective of this study was to assess the personal recovery process in people using mental health services, and to clarify the role of variables such as symptomatology, self-stigma, sociodemographic and treatment. METHODS: Standardised measures of personal recovery process, clinical recovery, and internalized stigma were completed by a sample of 312 participants in a Severe Mental Disorder program. RESULTS: Users valued most the recovery elements of: improving general health and wellness; having professionals who care; hope; and sense of meaning in life. Significant discrepancies between perceived experience and relative importance assigned to each of the components of the REE were observed. Regression modeling (χ2 = 6.72, p = .394; GFI = .99, SRMR = .03) identified how positive discrepancies were associated with a higher presence of recovery markers (ß = .12, p = .05), which in turn were negatively related to the derived symptomatology index (ß = -.33, p < .001). Furthermore, the relationship between clinical and personal recovery was mediated by internalized stigma. CONCLUSIONS: An improvement in psychiatric services should be focused on recovery aspects that have the greatest discrepancy between importance and experience, in particular social roles, basic needs and hope. Personal and clinical recovery are correlated, but the relationship between them is mediated by internalized stigma, indicating the need for clinical interventions to target self-stigma.

Resilience and coping strategies in relation to mental health outcomes in people with cancer.

Considering the importance of psychological variables on health-related processes, this study investigated the role of resilience and coping strategies in relation to health. The aim of this research was to explore the underlying association between these aspects for the better understanding of the effect of psychosocial variables on mental health in cancer. This information could lead to the design of adapted psychological interventions in cancer. Participants with different diagnosis of cancer were recruited (N = 170). They came from the Spanish Association Against Cancer of Biscay. Resilience was measured with the 10 items Connor-Davidson Resilience Scale, coping with the Cognitive Emotion Regulation Questionnaire and mental health was measured as a global indicator through the SF-12 and the GHQ-12. A structural equation model (SEM) was conducted to test the effects between the constructs. Results showed that resilience and coping were significantly associated. Results reflected an absence of significant correlation between adaptive and disadaptive coping strategies. Resilience was the factor that most correlated with health outcomes (ß = -.45, p < .001). However, disadaptive coping strategies did not correlate with resilience or mental health indicators. Findings in this study underscore the positive contribution of high levels of resilience and an adaptive coping on participants´ level of health. Disadaptive coping strategies did not reflect any positive relation with resilience or health indicators. Thus, promoting resilience and adaptive coping could be a significant goal for psychosocial and educational interventions in people with cancer.

Design and evaluation of a positive intervention to cultivate mental health: preliminary findings.

The past two decades have witnessed a proliferation of positive psychological interventions for clinical and non-clinical populations, and recent research, including meta-analyses, is providing evidence of its effectiveness. Most interventions have focused on increasing life satisfaction, positive affect, and psychological well-being. Manualized, multi-component interventions based on a comprehensive theory are scarce. Keyes' concept of mental health and flourishing (subjective, psychological, and social well-being) is an overarching theoretical framework to guide the design of a multi-component psychological intervention to cultivate well-being and personal development. Therefore, the purpose of this study was to design a theory-driven positive intervention and to pilot test the intervention. The manual presents an 8-week group program that includes homework activities. A sample of 56 young adults completed the intervention. Participants were assessed at base line, after termination, and at a 6-month follow-up session. Standardized instruments were used to assess the dimensions of mental health proposed by Keyes. Pre- and post-test measures of subjective, psychological, and social well-being showed significant differences, as did the total mental health scores. At 6-month follow-up, differences remained in subjective and psychological well-being and in positive mental health, with smaller effect sizes. Limitations of these preliminary findings as well as future lines of research and improvements in this manualized intervention are proposed in the light of current research on positive interventions.

Design and evaluation of a positive intervention to cultivate mental health: preliminary findings

Abstract The past two decades have witnessed a proliferation of positive psychological interventions for clinical and nonclinical populations, and recent research, including meta-analyses, is providing evidence of its effectiveness. Most interventions have focused on increasing life satisfaction, positive affect, and psychological well-being. Manualized, multi-component interventions based on a comprehensive theory are scarce. Keyes' concept of mental health and flourishing (subjective, psychological, and social well-being) is an overarching theoretical framework to guide the design of a multi-component psychological intervention to cultivate well-being and personal development. Therefore, the purpose of this study was to design a theory-driven positive intervention and to pilot test the intervention. The manual presents an 8-week group program that includes homework activities. A sample of 56 young adults completed the intervention. Participants were assessed at base line, after termination, and at a 6-month follow-up session. Standardized instruments were used to assess the dimensions of mental health proposed by Keyes. Pre- and post-test measures of subjective, psychological, and social well-being showed significant differences, as did the total mental health scores. At 6-month follow-up, differences remained in subjective and psychological well-being and in positive mental health, with smaller effect sizes. Limitations of these preliminary findings as well as future lines of research and improvements in this manualized intervention are proposed in the light of current research on positive interventions.

Role of neuroticism and extraversion in the emotional health of people with cancer.

The impact that cancer disease can have on individuals varies depending, among other things, on their personal characteristics, so it is important to explore aspects such as the personality traits in relation to mental health in people with cancer. The aim of this study was to analyse the relationship between neuroticism, extraversion and mental health in people with cancer. Besides, this study also explored differences in mental health when combining extraversion and neuroticism levels. One hundred and seventy people who had been diagnosed with different types of cancer (breast cancer, lung, colon, gynaecological cancer and others) composed the sample. Almost all of them (92.9%) had received oncological treatment. The GHQ-12 scale was used to assess the mental health and the 60-item NEO Five-Factor Inventory was applied in order to measure neuroticism and extraversion in participants. A hierarchic lineal regression model was conducted. Neuroticism and extraversion did not show any interaction effect, although a partial mediation was observed in relation to mental health outcomes. Given the significant correlation between neuroticism and extraversion with mental health (r = .59, p < .001; r = -.41, p < .001), both personality traits were combined, resulting in a classification of four different personality profiles (F (4;165) = 19.85; p < .001). Results in this study have shown that low levels of neuroticism and high levels of extraversion are related to positive health outcomes. They seem to be protective factors with respect to the mental health in people with cancer. The knowledge of the positive effects of these aspects contributes to the comprehension of mental health in the oncological sample, which should be considered in order to design and guide particular therapeutic interventions adapted to each person.

Psychometric Adequacy of Recovery Enhancing Environment (REE) Measure: CHIME Framework as a Theory Base for a Recovery Measure.

PURPOSE: The aim of this study was to assess to what extent the recovery elements of the Recovery Enhancing Environment (REE) instrument measured the dimensions proposed by the CHIME framework, (Connectedness, Hope and optimism about future, Identity, Meaning in life and Empowerment dimensions), so as to evaluate personal recovery in people with severe mental illness. METHODS: Two processes were conducted. Firstly, five experts matched the elements of recovery evaluated by the REE items with the CHIME domains and subdomains. Then, the resulting structure from those experts agreement was analyzed with different confirmatory factor analyses (CFA) using responses to the recovery elements dimension of the REE of 312 mental health service users. RESULTS: The percentage of agreements and the kappa coefficients were adequate taking into account the CHIME dimensions (κ = 0.57 to 0.69, total κ = 0.74); however, lower agreement was found at the subdimensions level. Some indexes of the CFA were acceptable for a second order factor analysis [χ 2 (242)= 346.03, p < 0.001, CFI= 0.931, RMSEA= 0.037 (0.028 to 0.046)] and the most adequate solution was obtained from the bi-factorial structure (χ 2 (223)=233.19, p=0.306, CFI= 0.993, RMSEA= 0.012 [0.000 to 0.027]). CONCLUSIONS: Despite the subjective and complex nature of the personal recovery construct, the REE measure can be a valid instrument to verify the existing CHIME conceptual framework, since two of the models tested have resulted in adequate indexes and were also congruent with the theoretical framework and the statistical solution. Thus, REE can be used to obtain a global index of Personal Recovery dimension, and the five indicators proposed by the CHIME framework.

Expression of resilience, coping and quality of life in people with cancer.

Considering the importance of coping strategies and resilience in adapting to the stress caused by cancer, the objective of this research is to explore which coping strategies are the most used, in order to know whether different groups of levels of resilience and an appropriate coping style are related to a higher quality of life and better adaptation to the disease. There were 74 participants with cancer in this study (79.7% of them were women) ranging in age from 29 to 85 years (M = 50.9). Different instruments were used to measure the resilience construct (ER-20 items Resilience Scale), coping strategies (Cognitive Emotion Regulation Questionnaire-Short) and quality of life (General Health Questionnaire). People with higher resilience showed higher scores in the use of adaptive strategies, being acceptance and positive revaluation the most frequent ones. Regarding perception of quality of life, people with lower resilience showed statistically significant differences in the dimensions of pain and general health, which were likewise the most common ones for people with lower resilience. A significant association has been demonstrated between resilience and an adaptive coping, which at the same time are positively linked to quality of life of people with cancer. This study provides information about how different groups of resilience levels are related with coping and quality of life in people with cancer. It could be useful information for psychologists in the oncological area who have to take decisions in the clinical context. A practical consequence would involve trying to modify the type of coping, as well as increasing the level of resilience in people with cancer, in order to achieve a better adjustment to the disease.

Effectiveness of a Mindfulness-based Intervention on Groups with Presence/Absence of Clinically Significant Depressive Symptoms / Eficacia de una intervención basada en mindfulness en grupos con presencia/ausencia de síntomas depresivos clínicamente significativos

Depressive symptoms have an important effect on everyday life. Its development could be associated with a lack of metacognitive skills among other variables. It seems they can be trained by an intervention based in meditation techniques called mindfulness based intervention. The aims of this study were to evaluate 1) the relationship between depressive symptoms, emotional regulation, and metacognitive skills, 2) the effectiveness of an eight-week mindfulness based intervention program on depressive symptoms, metacognition, and emotional regulation in non-clinical population, and 3) the different effect of this intervention on people with presence/absence of clinically significant depressive symptoms. Sixty-seven participants received mindfulness training on a weekly basis during two months. Data on metacognition, emotional regulation, and depressive symptoms was collected one month before the intervention, the first and last day of the intervention, and at 3-month follow up. Significant correlations were found for the total sample and the presence/absence of clinically significant depressive symptoms groups. Differences were found with larger effect sizes in the depressive group (η2 = .73-.99) than in the group with no depressive simptoms (η2 = .41-.70). These results support mindfulness intervention as an effective technique in the alleviation of depressive symptoms and in the improvement of metacognitive skills

Los síntomas depresivos tienen un efecto importante en la vida cotidiana. Su desarrollo podría asociarse entre otras variables con una falta de habilidades metacognitivas. Parece que estas pueden ser entrenados por una intervención mediante técnicas de meditación basada en mindfulness. Los objetivos de este estudio fueron evaluar: 1) la relación entre los síntomas depresivos, la regulación emocional y las habilidades metacognitivas, 2) la eficacia de un programa de intervención basado en mindfulness de ocho semanas en los síntomas depresivos, metacognición y regulación emocional en población no clínica y 3) el efecto diferente de esta intervención en personas con presencia/ausencia de síntomas depresivos clínicamente significativos. Sesenta y siete participantes recibieron un entrenamiento semanal en mindfulness durante dos meses. Los datos sobre la metacognición, la regulación emocional y los síntomas depresivos se recogieron un mes antes de la intervención, el primer y último día de la intervención y a los 3 meses de seguimiento. Se encontraron correlaciones significativas para la muestra total y la presencia/ausencia de grupos de síntomas depresivos clínicamente significativos. Las diferencias se encontraron con tamaños de efecto más grandes en el grupo depresivo (η2 = .73-.99) que en el grupo sin síntomas depresivos (η2 = .41-.70). Estos resultados avalan la intervención mindfulness como una técnica eficaz en el alivio de los síntomas depresivos y la mejora de las habilidades metacognitivas

Evaluación de resultados clínicos individuales: a propósito de un caso tratado con terapia electroconvulsiva / Assessment of individual clinical outcomes: regarding an electroconvulsive therapy case

La valoración de resultados terapéuticos y la evaluación de la eficacia y efectividad de los tratamientos es un área de interés para clínicos e investigadores. Habitualmente se utiliza la metodología basada en diseños controlados aleatorizados y la comparación intergrupos con un mínimo de participantes en cada brazo de tratamiento. No obstante, estos procedimientos raramente pueden ser aplicados en la práctica clínica habitual, si bien es importante para el clínico evaluar si los resultados del tratamiento propuesto para una persona específica cumplen con los objetivos terapéuticos, tanto por su significación estadística como por su relevancia clínica. La metodología basada en el índice de cambio fiable (Jacobson y Truax) permite estimar esta doble consideración. El objetivo del artículo es proponer un procedimiento de aplicación a través del estudio de un caso con diagnóstico de depresión mayor y tratado con terapia electroconvulsiva (AU)

Evaluation of therapeutic results and of the efficacy and effectiveness of treatments is an area of interest both for clinicians and researchers. In general, randomized controlled trial designs have been used as the methodology of choice in which intergroup comparisons are made having a minimum of participants in each arm of treatment. However, these procedures are seldom used in daily clinical practice. Despite this fact, the evaluation of treatment results for a specific patient is important for the clinician in order to address if therapeutic goals have been accomplished both in terms of statistical significance and clinical meaningfulness. The methodology based on the reliable change index (Jacobson y Truax) provides an estimate of these two criteria. The goal of this article is to propose a procedure to apply the methodology with a single case study of a woman diagnosed with major depression and treated with electroconvulsive therapy (AU)

[Assessment of individual clinical outcomes: regarding an electroconvulsive therapy case]. / Evaluación de resultados clínicos individuales: a propósito de un caso tratado con terapia electroconvulsiva.

Evaluation of therapeutic results and of the efficacy and effectiveness of treatments is an area of interest both for clinicians and researchers. In general, randomized controlled trial designs have been used as the methodology of choice in which intergroup comparisons are made having a minimum of participants in each arm of treatment. However, these procedures are seldom used in daily clinical practice. Despite this fact, the evaluation of treatment results for a specific patient is important for the clinician in order to address if therapeutic goals have been accomplished both in terms of statistical significance and clinical meaningfulness. The methodology based on the reliable change index (Jacobson y Truax)1 provides an estimate of these two criteria. The goal of this article is to propose a procedure to apply the methodology with a single case study of a woman diagnosed with major depression and treated with electroconvulsive therapy.