Further Investigation of the Dimensionality of the Questionnaire for Eudaimonic Well-Being.

The dimensionality of the Questionnaire for Eudaimonic Well-Being (QEWB) has been a topic of debate and divergent findings in the literature up to date. This study investigated the factor structure and measurement invariance of the QEWB in four culturally diverse South African samples using confirmatory factor analysis (CFA), bifactor CFA, exploratory structural equation modelling (ESEM), and bifactor ESEM. Three student samples completed the English (n = 326), Afrikaans (n = 478), or Setswana (n = 260) version of the QEWB. An adult sample (n = 262) completed the English version. The one-factor structure revealed poor fit for the student samples. Although the four-factor models generally showed slightly better fit than the three-factor models, the latter was preferred for parsimony. The bifactor ESEM model displayed good fit for the student samples, with the general factor and some specific factors attaining sufficient reliability scores, pointing to the potential use of the scale in these samples. Configural invariance between the student samples was supported, but not metric nor scalar invariance. For the adult sample, none of the models displayed good fit and the use of the QEWB in this sample is not recommended. The results point towards the existence of a global eudaimonic well-being factor and, at the same time, the interrelatedness of facets of eudaimonic well-being. It suggests that eudaimonic well-being may be represented by the same items across the three student groups. The influence of developmental phase on the manifestation and measurement of eudaimonic well-being should be explored in future.

The Inspired Life Program: Development of a multicomponent positive psychology intervention for rural adults in Ghana.

Although several theories and studies have explored human strengths and mental well-being at the global level, these insights are rarely tested and translated into practice in sub-Saharan Africa. This study aims to describe the development of a 10-session multicomponent positive psychology intervention, the Inspired Life Program (ILP), designed to promote mental health and reduce symptoms of depression and negative affect in rural adults in Ghana. Guided by the Medical Research Council's framework for developing complex interventions, a seven-step iterative community-based participatory research approach was adopted to develop the ILP, based on constructs and principles of positive psychology and cognitive-behavioral model. The final intervention components included a 10-session, two-hourly, once-weekly manualized program designed to promote meaningful and purposeful living, self-acceptance, personal growth, goal-setting and problem-solving skills, and positive thinking through group discussion and activity sessions. We describe the program theory and implementation strategy of the final intervention, and reflect on the challenges and lessons learned from applying this framework in the study context. The development of strengths-based interventions and practicality of methods to promote positive mental health in rural adults are feasible, and have important policy implications for mental health and social care in sub-Saharan Africa.

Factor structure and measurement invariance of the Basic Psychological Needs Scale in three South African samples: A bifactor exploratory structural equation modelling approach.

The Basic Psychological Needs Scale (BPNS) is still being used but validation studies that applied confirmatory factor analysis (CFA) revealed that the scale has inadequate psychometric properties. CFA is based upon restrictive statistical assumptions that may result in biased parameter estimates. There are statistical developments that overcome these limitations. This study explored the factorial validity of the scale in three South African student samples who completed the English (n = 326), Afrikaans (n = 478), or Setswana (n = 260) version of the BPNS. CFA, bifactor CFA, exploratory structural equation modelling (ESEM) and bifactor ESEM were applied to the data. The three-factor bifactor ESEM model yielded the best fit, but model fit was inadequate for the English and Setswana versions, and almost adequate for the Afrikaans version. After removal of problematic items based on substantive reasons, high modification indices, and high expected parameter change values, reduced bifactor ESEM models displayed adequate fit. The general factor showed sufficient reliability scores for all language versions. Subscales exhibited insufficient reliability scores, except for the Competence and Relatedness subscales of the BPNS-Afrikaans. A reduced three-factor bifactor ESEM model was partially metric invariant for the English and Afrikaans groups. The BPNS-Afrikaans showed potential for use, but alternative measures of basic psychological needs should be considered for the English and Setswana groups in the current context. The cross-cultural application of basic psychological needs in a South African context is questioned. An emic approach to exploring and conceptualising basic psychological needs in African contexts is recommended.

Participants' experiences and impressions of a group-based positive psychology intervention programme for rural adults in Ghana.

Introduction: There is growing evidence that group-based mental health intervention programmes can encourage the development of peer support, psychosocial skills, and collaborative therapeutic relationships with longer lasting effects. This study explored participants' experiences of, perceived benefits of, and recommendations to improve a 10-session group-based multicomponent positive psychology intervention (mPPI)-the Inspired Life Programme (ILP)-designed to promote positive mental health and reduce symptoms of depression and negative affect in a sample of rural Ghanaian adults.Method: Face-to-face semi-structured individual interviews were conducted with 18 randomly selected programme participants three months after their participation in the ILP. Data were analysed thematically with an inductive approach.Results: Participants described their experience of the ILP as a forum for growth that granted them the opportunity to introspect, practicalise and situate everyday life challenges, connect with others, and to develop a sense of mutual accountability. Results indicate that the ILP  led participants to develop a stronger sense of positivity and well-being, fructify their ideas, and to cultivate stronger social networks and relationships that led to increased vocational productiveness. Participants recommended that researchers include facets of physical health promotion in the programme and invite close relations of participants to participate in the programme.Conclusion: This study provides the first insight into participants' experiences of a group-based mPPI in Ghana. These findings may provide useful information to inform the design of context-appropriate community-based mental health interventions to fit participants' specific needs, capacities, and circumstances.

Beyond the "Third Wave of Positive Psychology": Challenges and Opportunities for Future Research.

The positive psychology (PP) landscape is changing, and its initial identity is being challenged. Moving beyond the "third wave of PP," two roads for future research and practice in well-being studies are discerned: The first is the state of the art PP trajectory that will (for the near future) continue as a scientific (sub)discipline in/next to psychology (because of its popular brand name). The second trajectory (main focus of this manuscript) links to pointers described as part of the so-called third wave of PP, which will be argued as actually being the beginning of a new domain of inter- or transdisciplinary well-being studies in its own right. It has a broader scope than the state of the art in PP, but is more delineated than in planetary well-being studies. It is in particular suitable to understand the complex nature of bio-psycho-social-ecological well-being, and to promote health and wellness in times of enormous challenges and changes. A unique cohering focus for this post-disciplinary well-being research domain is proposed. In both trajectories, future research will have to increase cognizance of metatheoretical assumptions, develop more encompassing theories to bridge the conceptual fragmentation in the field, and implement methodological reforms, while keeping context and the interwovenness of the various levels of the scientific text in mind. Opportunities are indicated to contribute to the discourse on the identity and development of scientific knowledge in mainstream positive psychology and the evolving post-disciplinary domain of well-being studies.

Motivations for Relationships as Sources of Meaning: Ghanaian and South African Experiences.

Afrocentric paradigms reflect assumptions of the overarching importance of interconnectedness and social bonds in meaningful experiences. It is, however, not known if types of relatedness vary in importance as meaning sources in the subjective experiences of laypeople, or what the reasons are that they ascribe to the importance of relationships. The empirical and theoretical substantiation of philosophical assumptions is needed to provide a scientific basis for appropriate well-being interventions in African contexts. Therefore, this study aimed to empirically explore the relative importance of various types of relationships as sources of meaning and in particular why relationships are important to laypeople in relatively collectivist African contexts. Using a bottom-up qualitative approach with quantification of responses, this study explored how prominently relationships featured as meaning sources compared to other domains of life and then, in particular, the motivations for the importance of various types of relationships as found in four African samples: a Ghanaian urban group (n = 389), a South African multicultural, English-speaking urban group (n = 585), and two South African Setswana-speaking groups (n = 512 rural, n = 380 urban). Findings showed that the relational domains of life, namely, family, interpersonal relations, spirituality/religion, and community/society, made up a large proportion of responses on what provides meaning in life-in particular family and spirituality/religion with community/society occurring the least. The reasons for meaning experienced in various relationship types included domain-typical relational descriptors, such as contributions made or rewards received. However, many intrapersonal motives also emerged: inner well-being, happiness, joy, a sense of competence, and own growth. Material needs and harmony also surfaced as motivations for relational importance. Findings are aligned with African philosophical perspectives as far as the importance of relationships and the value attached to spirituality/religion are concerned, but contributed additionally by showing that different types of relationships vary in importance: close relationships are more important than community/societal relationships. Unearthing the reasons for the importance of relationships points toward a dialectic pattern of African individualism-collectivism in which independent and interdependent orientations flow together. Such knowledge is vital for the promotion of mental health and well-being in these contexts.

Factorial validity of the Twi versions of five measures of mental health and well-being in Ghana.

BACKGROUND: Mental health is considered an integral part of human health. Reliable and valid measurement instruments are needed to assess various facets of mental health in the native language of the people involved. This paper reports on five studies examining evidence for the factorial validity of the Twi versions of five mental health and well-being measurement instruments: Affectometer-2 (AFM-2); Automatic Thought Questionnaire-Positive (ATQ-P); Generalized Self-Efficacy Scale (GSEs); Patient Health Questionnaire-9 (PHQ-9); and Satisfaction with Life Scale (SWLS) in a rural Ghanaian adult sample. METHOD: Measures were translated and evaluated using a research-committee approach, pilot-tested, and administered to adults (N = 444) randomly selected from four rural poor communities in Ghana. We applied confirmatory factor analysis (CFA), bifactor CFA, exploratory structural equation modeling (ESEM), and bifactor ESEM to the AFM-2, ATQ-P, and the PHQ-9, and CFA to the GSEs and the SWLS. The omega coefficient of composite reliability was computed for each measure. RESULTS: A two-factor bifactor ESEM model displayed superior model fit for the AFM-2. The total scale and the Negative Affect subscale, but not the Positive Affect subscale, attained sufficient reliability. Two models (a four-factor 22-item bifactor ESEM model and a 5-factor 22-item ESEM model) fitted the data best for the ATQ-P. The bifactor ESEM model displayed a high reliability value for the total scale and satisfactory reliability values for three of its four subscales. For the GSEs, a one-factor CFA model (residuals of items 4 and 5 correlated) demonstrated superior model fit with a high reliability score for the total scale. A two-factor ESEM model outperformed all other models fitted for the PHQ-9, with moderate and satisfactory reliability scores for the subscales. A one-factor CFA model (residuals of item 4 and 5 correlated) demonstrated superior model fit for the SWLS, with a satisfactory reliability value for the total scale. CONCLUSIONS: Findings established evidence for the factorial validity of the Twi versions of all five measures, with the global scores, but not all subscale scores, demonstrating satisfactory reliability. These validated measurement instruments can be used to assess mental health and well-being in the research and practice contexts of the current sample.

Effects of a Community-Based Multicomponent Positive Psychology Intervention on Mental Health of Rural Adults in Ghana.

BACKGROUND: There is growing evidence that positive psychology interventions (PPIs) enhance positive mental health and lead to a decrease in symptoms of psychopathology. This study examines the effectiveness of a 10-week multicomponent PPI (the Inspired Life Program; ILP) in promoting positive mental health and reducing symptoms of depression and negative affect in a sample of rural poor adults in Ghana. METHODS: Using a quasi-randomized controlled trial design, participants from four rural poor communities were randomly allocated to intervention (n = 40) or control (n = 42) conditions. The intervention group participated in the 10-week ILP. Both groups completed a battery of mental health measures, including the Mental Health Continuum-Short Form, at pre-intervention, immediately after the intervention, and at 3 months follow-up. Hierarchical linear modeling was applied to evaluate whether the intervention was effective. RESULTS: There was a greater improvement in positive mental health, with a marked reduction in symptoms of depression in the intervention group compared to the control group, immediately and 3 months after the intervention. There were also larger increases in the proportion of flourishers in the intervention group compared to the control group, immediately and three months after the intervention. CONCLUSIONS: The observed effects of the ILP intervention program suggest that group-based PPIs can promote positive mental health and buffer against psychopathology among people living in rural poor communities in sub-Saharan Africa.

Lay Definitions of Happiness across Nations: The Primacy of Inner Harmony and Relational Connectedness.

In well-being research the term happiness is often used as synonymous with life satisfaction. However, little is known about lay people's understanding of happiness. Building on the available literature, this study explored lay definitions of happiness across nations and cultural dimensions, analyzing their components and relationship with participants' demographic features. Participants were 2799 adults (age range = 30-60, 50% women) living in urban areas of Argentina, Brazil, Croatia, Hungary, India, Italy, Mexico, New Zealand, Norway, Portugal, South Africa, and United States. They completed the Eudaimonic and Hedonic Happiness Investigation (EHHI), reporting, among other information, their own definition of happiness. Answers comprised definitions referring to a broad range of life domains, covering both the contextual-social sphere and the psychological sphere. Across countries and with little variation by age and gender, inner harmony predominated among psychological definitions, and family and social relationships among contextual definitions. Whereas relationships are widely acknowledged as basic happiness components, inner harmony is substantially neglected. Nevertheless, its cross-national primacy, together with relations, is consistent with the view of an ontological interconnectedness characterizing living systems, shared by several conceptual frameworks across disciplines and cultures. At the methodological level, these findings suggest the potential of a bottom-up, mixed method approach to contextualize psychological dimensions within culture and lay understanding.

Rasch analysis of the Meaning in Life Questionnaire among adults from South Africa, Australia, and New Zealand.

BACKGROUND: Meaning in life is a key indicator of subjective well-being and quality of life. Further developments in understanding and enhancing the construct will depend inter alia on the sound measurement thereof. This study is at the forefront of applying modern psychometric techniques to the Meaning in Life Questionnaire, a scale widely used to assess meaning in life. METHOD: The Rasch rating scale model was applied to the Presence and Search subscales of the Meaning in Life Questionnaire using a sample of 601 adults from South Africa, Australia, and New Zealand. RESULTS: The Presence subscale was insensitive at high levels of presence of meaning while the majority of the respondents fell in that range. Removal of item 9 ("My life has no clear purpose") and collapsing the response categories indicative of low and medium levels of the latent construct significantly improved the subscale's targeting and fit to the Rasch model, resulting in a subscale that exhibited differential item functioning on items 1 ("I understand my life's meaning"), 4 ("My life has a clear sense of purpose"), and 5 ("I have a good sense of what makes my life meaningful") for country, but none for gender, age group, or education level. The Search subscale yielded disordered category threshold calibrations, but after collapsing some of the response categories representing low and medium levels of the target construct, a subscale that demonstrated good fit to the Rasch model, good targeting, and no differential item functioning resulted. CONCLUSIONS: In terms of this particular scale, adaptation of the rating scale and removal of item 9 is recommended. Country-level parameter estimates may be needed for items that exhibited differential item functioning. The study also has significant implications for the theory, measurement, and practice of meaning in and quality of life in general. Reasons for and the far-reaching implications of the insensitivity of the Presence subscale for high levels of presence of meaning on, for example, the correlation between meaning in life and indicators of health are contemplated. Further investigation of the construct's nature and measurement, especially at high levels, is indicated.

Psychological distress and the development of hypertension over 5 years in black South Africans.

Alarming increases in the incidence of hypertension in many low- and middle-income countries are related to alcohol overuse. It is unclear whether alcohol overuse is a symptom of psychological distress. The authors assessed psychological distress in Africans and its relationship with a 5-year change in blood pressure (BP), independent of alcohol intake. The authors followed 107 Africans with optimal BP (≤120/80 mm Hg) (aged 35-75 years) over 5 years. Alcohol intake (self-report and serum γ-glutamyl transferase) and nonspecific psychological distress (Kessler Screening Scale for Psychological Distress [K6]) were assessed. The K6 predicted hypertension development (P=.019), and its individual component "nervous" increased a participant's risk two-fold to become hypertensive (hazard ratio, 2.00 [1.23-3.26]). By entering K6 and γ-glutamyl transferase into multivariable-adjusted regression models for change in systolic BP, both were independently associated with change in systolic BP. Psychological distress and scoring high on being nervous predicted the development of hypertension over 5 years, independent of alcohol intake.

Towards a theory-based positive youth development programme.

The aim of this study was to develop and describe an intervention programme for young adolescents, guided by the Positive Youth Development Intervention (PYDI) model, which provides a perspective on the facilitation of development in a more positive trajectory. The key concepts and processes suggested by the PYDI model were further analysed and broadened using existing literature for operationalisation and application purposes. Self-regulation is the central process effectuating developmental change, within the contexts of: a) the navigation of stressors; and b) the formulation and effective pursuit of relevant personal goals. Self-regulation, together with a developmental perspective, provided guidelines regarding the relevant skills and knowledge. These are facilitating: a) identity development; b) formulation of goals congruent with the latter; c) decision-making skills; d) coping skills; e) regulation of affect and cognition; and f) socialisation skills. The relevant content areas and the manner of the facilitation of these are indicated. The theory-based programme can be implemented and its effect empirically evaluated. Levels of hope, problem-solving efficacy and social efficacy may serve as, inter alia, indicators of developmental change.

A model for a positive youth development intervention.

Modern-day life necessitates the application of interventions to facilitate the development of the youth in a more positive trajectory. Lacunae in the Positive Youth Development (PYD) paradigm include, inter alia, the lack of integration between theory and application and a lack of exposition of the processes underlying developmental change in the youth. The aim of this study was to develop a theoretical model to facilitate the development of youth in early adolescence. The proposed model builds on existing models, namely the Phenomenological Variant of Ecological Systems Theory and the Selection Optimization and Compensation (SOC) model. A review of the literature on the PYD paradigm and other areas of psychology with a similar strength-based focus, yielded theory which could be used to expand on the basic framework. The resulting Positive Youth Development Intervention model (PYDI) is described with reference to meta-theoretical assumptions, theoretical hypotheses, and constructs referring to phenomena and processes to be facilitated on an empirical level. This model can be operationalised to develop an intervention which can then be evaluated, thereby contributing to bridging theory and application in PYD.

The nutrition and health transition in the North West Province of South Africa: a review of the THUSA (Transition and Health during Urbanisation of South Africans) study.

OBJECTIVE: To describe how urbanisation influences the nutrition and health transition in South Africa by using data from the THUSA (Transition and Health during Urbanisation of South Africans) study. DESIGN: The THUSA study was a cross-sectional, comparative, population-based survey. SETTING: The North West Province of South Africa. SUBJECTS: In total, 1854 apparently healthy volunteers, men and women aged 15 years and older, from 37 randomly selected sites. Pregnant and lactating women, those with diagnosed chronic diseases and taking medication, with acute infections or inebriated were excluded but screened for hypertension and diabetes mellitus. Subjects were stratified into five groups representing different levels of urbanisation in rural and urban areas: namely, deep rural, farms, squatter camps, townships and towns/cities. OUTCOME MEASURES AND METHODS: Socio-economic and education profiles, dietary patterns, nutrient intakes, anthropometric and biochemical nutrition status, physical and mental health indicators, and risk factors for non-communicable diseases (NCDs) were measured using questionnaires developed or adapted and validated for this population, as well as appropriate, standardised methods for the biochemical analyses of biological samples. RESULTS: Subjects from the rural groups had lower household incomes, less formal education, were shorter and had lower body mass indices than those in the urban groups. Urban subjects consumed less maize porridge but more fruits, vegetables, animal-derived foods and fats and oils than rural subjects. Comparing women from rural group 1 with the urban group 5, the following shifts in nutrient intakes were observed: % energy from carbohydrates, 67.4 to 57.3; from fats, 23.6 to 31.8; from protein, 11.4 to 13.4 (with an increase in animal protein from 22.2 to 42.6 g day(-1)); dietary fibre, 15.8 to 17.7 g day(-1); calcium, 348 to 512 mg day(-1); iron from 8.4 to 10.4 mg day(-1); vitamin A from 573 to 1246 mug retinol equivalents day(-1); and ascorbic acid from 30 to 83 mg day(-1). Serum total cholesterol, low-density lipoprotein cholesterol and plasma fibrinogen increased significantly across groups; systolic blood pressure >140 mmHg was observed in 10.4-34.8% of subjects in different groups and diabetes mellitus in 0.8-6.0% of subjects. Women in groups 1 to 5 had overweight plus obesity rates of 48, 53, 47, 61 and 61%, showing an increase with urbanisation. Subjects from group 2 (farm dwellers) showed the highest scores of psychopathology and the lowest scores of psychological well-being. The same subjects consistently showed the lowest nutrition status. CONCLUSIONS: Urbanisation of Africans in the North West Province is accompanied by an improvement in micronutrient intakes and status, but also by increases in overweight, obesity and several risk factors for NCDs. It is recommended that intervention programmes to promote nutritional health should aim to improve micronutrient status further without leading to obesity. The role of psychological strengths in preventing the adverse effects of urbanisation on health needs to be examined in more detail.

Biopsychosocial determinants of self-management in culturally diverse South african patients with essential hypertension.

Associations between self-management and biopsychosocial variables in a group of Afrikaans- (n= 102) and Sotho-speaking (n= 94) patients with essential hypertension (EH) were investigated. Self-management in terms of predetermined criteria for medical and lifestyle prescriptions was achieved by only 30.6 per cent of the participants. Significant differences were found between self-managing and non self-managing participants regarding language and culture, doctor-patient fit, complexity of prescriptions, medication side-effects, aspects of health beliefs, illness behaviour and health locus of control. In addition, a first empirical indication was found that self-management is also linked with psychological wellbeing, as manifested in a sense of coherence. The significantly accurate prediction of self-management by various biopsychosocial variables endorses the relevance of a biopsychosocial perspective in the treatment of patients with EH.