Positive mental health moderates the association between depression and suicide ideation: A longitudinal study

Positive Mental Health, Stressful Life Events, and Suicide Ideation

Background: Stressful life events and suicide ideation regularly occur together. Yet, little is known about factors that buffer individuals against the development of suicide ideation. Aim: In a long-term follow-up study design, it was investigated whether positive mental health, that is, high levels of subjective and psychological well-being, buffers the association between stressful life events and suicide ideation. Method: A total of 126 German students (80.2% female; age: M = 24.29, SD = 5.21) were assessed at a baseline evaluation and again 24 months later. Data were collected using self-report questionnaires. Results: Linear hierarchical regression analysis was used to analyze the data. Positive mental health was considered to moderate the impact of stressful life events on suicide ideation - controlling for age and gender. Limitations: Current results are limited to university students. Conclusions: Positive mental health interacts with stressful life events, such that those with high levels of positive mental health show an attenuated increase in suicide ideation at elevated levels of stress. Positive mental health seems to confer resilience and should be focused on in counseling centers for students.

Salutogenic constructs across Pakistan and Germany: A cross sectional study

Background/Objective

Protective factors are relevant for mental health in general, however, universality of the instruments has been rarely tested. Therefore, the current study aimed to examine psychometric properties and cross-cultural measurement invariance of salutogenic constructs.

Method

Data was collected from university students of Pakistan (n = 1,841) and Germany (n = 7,890). Single-group confirmatory analysis (CFA) and multiple-group CFA was tested to examine the proposed factor structure and measurement invariance of Positive Mental Health Scale, Resilience Scale, Perceived Social Support Questionnaire, and Life Satisfaction Scale across student samples from Pakistan and Germany respectively.

Results

We found strong measurement invariance for the Positive Mental Health Scale, Life Satisfaction Scale, and partial strong measurement for the Resilience Scale, and Perceived Social Support Questionnaire.

Conclusions

The results indicate that these scales could be recommended for the meaningful comparison of latent means across cultures. Understanding these differences would further advance our knowledge about the mechanism underlying positive mental health.

Humor as a protective factor against anxiety and depression

Background/Objectives

Even though humor its part of everyday life, only in the last 40 years has Psychology begun to discern its impact on mental health. The aim of this paper is to explore the role that humor styles may have as protectors against anxiety and depression and their relationship with optimism.

Method

A sample of 804 participants (M = 39.28; SD = 14.71) was used to analyze the uses of humor, optimism and clinical symptoms of anxiety and depression. In addition, the influence of sociodemographic variables such as sex, geographic location, age and educational level on different uses of humor was studied. Through an analysis of structural equations, the variables that had a protective or facilitating role in depression and anxiety were analyzed.

Results

Men and women differ in the use of a more aggressive humor style, and the use of affiliative humor styles decreases with age. The structural equation model indicated a good fit to the proposed theoretical model.

Conclusions

Humor is a tool of everyday life and it can act for or against an individual’s mental health.

Predicting high and low levels of positive mental health among people living alone in the Lapland region of Finland

Purpose

The purpose of this paper is to investigate positive mental health (PMH) and factors related to it among those living alone in the sparsely populated area of the Lapland region.

Design/methodology/approach

The study utilises data from the Mental Health Survey of the Lapland region in Finland, covering 12 municipalities. The scores of short Warwick–Edinburgh Mental Well-Being Scale (sWEMWBS) were categorised into three levels of PMH. Logistic regression models were used to separately estimate the odds ratios for the high level of PMH compared with the moderate level of PMH and the low level of PMH compared with the moderate level.

Findings

Social support seemed to be very strongly associated with both low and high levels of PMH among people living alone. Participating in activities provided by organisations or societies decreased the odds of having low PMH. Among men, young age predicted low PMH.

Originality/value

The number of people living alone in Finland and other parts of Europe is increasing, yet there are few studies focusing on their positive mental health (PMH). Using scales such as sWEMWBS adds to the authors’ knowledge about the positive mental well-being of those living alone, especially in rural areas, thus making it possible to utilise mental health promotion interventions effectively and accordingly.

Relationships between addictive Facebook use, depressiveness, insomnia, and positive mental health in an inpatient sample: A German longitudinal study

BACKGROUND AND AIMS

Individuals with high level of negative mental health often tend to use the social platform Facebook to escape from daily stress. They are at risk to develop an emotional bond to Facebook linked to a need to stay permanently online. The current work investigated addictive use of Facebook and its conceptual framework in clinical context.

METHODS

In a longitudinal study design, duration of daily use of Facebook, addictive Facebook use, depressiveness, insomnia, and positive mental health (PMH) were assessed in a sample of 349 inpatients [M_age (SD_age) = 50.13 (9.41)] of a psychosomatic rehabilitation clinic in Germany over a period of on average 6 weeks.

RESULTS

Regression analyses revealed that duration of daily Facebook use at the first measurement time point (T1) served as significant positive predictor of addictive Facebook use at the second measurement time point (T2). Addictive Facebook use (T1) significantly positively predicted depressiveness and insomnia (T2). Its prediction of PMH (T2) was significantly negative. Mediation analyses showed that PMH (T1) partially mediated the association between addictive Facebook use (T1) and depressiveness (T2), and fully mediated the relationship between addictive Facebook use (T1) and insomnia (T2).

DISCUSSION AND CONCLUSIONS

Current longitudinal results indicate that addictive Facebook use might negatively impact the recovery process of inpatients. Thus, it might be relevant to assess and consider addictive Facebook use in the clinical context. Therapeutic interventions are suggested to focus on the enhancement of inpatients' PMH level, which may buffer the negative effect of problematic Facebook use.

Parenting Practices, Life Satisfaction, and the Role of Self-Esteem in Adolescents

Introduction: Studies have shown significant associations between parenting practices, life satisfaction, and self-esteem, and the role of parenting practices in adolescent adjustment, emphasizing its influence on wellbeing. Objectives: To analyze the relationships between parenting practices, self-esteem, and life satisfaction, and test the mediating effect of self-esteem on the relationship between the different parenting practices and life satisfaction of adolescents. Method: The sample came to a total of 742 adolescents, with an average age of 15.63 (SD = 1.24; range 13–19). The Parenting Style Scale, the Rosenberg Self-Esteem Scale, and the Satisfaction with Life Scale were used. Results: Perception by adolescents of high levels of affect and communication, self-disclosure, and a sense of humor related to their parents, as well as low levels of psychological control, explained the life satisfaction of the adolescents. Self-esteem exerted a partial mediating effect on the relationship between parenting practices and satisfaction with the life of the adolescent. Finally, self-esteem also appeared to be a moderator variable, specifically in the effect of self-disclosure on the life satisfaction of the adolescent. Conclusions: The results reinforce the role of personal variables, especially self-esteem, in parent-child interaction and in the improved subjective wellbeing of the adolescent.

Sleep among presentations of Attention-Deficit/Hyperactivity Disorder: Analysis of objective and subjective measures

To examine subjective and objective sleep patterns in children with different Attention-Deficit/Hyperactivity Disorder (ADHD) presentations.

METHOD

We assessed 92 children diagnosed with ADHD (29 ADHD-Inattentive [ADHD-I], 31 ADHD-Hyperactive/Impulsive [ADHD-H/I], and 32 ADHD-Combined [ADHD-C)]) aged 7-11 years. The Pediatric Sleep Questionnaire (PSQ), Pediatric Daytime Sleepiness Scale (PDSS), and a sleep diary were used as subjective sleep measures, and polysomnography was used to objectively assess sleep quantity, quality, and fragmentation.

RESULTS

Subjective data showed impaired sleep in 12.7% of the sample. No significant differences were found between ADHD presentations in any objective and subjective sleep variable. Nevertheless, data on sleep fragmentation suggested a worse sleep continuity for the ADHD-H/I group, and correlation analyses confirmed that sleep is affected by age.

CONCLUSIONS

Children with ADHD may suffer from sleep breathing problems and daytime sleepiness, as reported by their parents, even when their total sleep time and sleep efficiency are not affected. It seems that sleep in this population does not largely vary as a function of the ADHD presentation. Sleep in children with ADHD evolves with age.

Entrapment, positive psychological functioning and suicide ideation: A moderation analysis

The Integrated Motivational-Volitional (IMV) Model of suicide posits that the association between perceptions of entrapment and suicide ideation is buffered by so-called motivational moderators. The present study investigated, whether positive mental health as well as different facets of psychological well-being qualify as motivational moderators. Possible moderator effects were investigated in an online sample (N = 301). Results demonstrated that positive mental health and psychological well-being moderate the association between entrapment and suicide ideation. These findings underscore the importance of entrapment and positive psychological functioning in understanding pathways to suicide ideation.

Reliability and validity of the Basic Depression Questionnaire

Depressive disorders have a high prevalence around the world. They present a great comorbidity with other disorders like anxiety, thereby making a differential diagnosis very difficult. The Basic Depression Questionnaire was designed to palliate this issue by isolating specific depression symptoms. Our aim is to study the reliability, factorial structure, and differential item functioning of this questionnaire.

METHOD

The sample consisted of 1,397 adults without psychological problems (M _age  = 29.76, SD = 11.25, 64.78% women) who completed the CBD.

RESULTS

We observed that none of the items presented differential functioning. A monofactorial structure was established. In this model a good fit was obtained by confirmatory factor analysis and a strict invariance by sex. The ordinal alpha was used to check the reliability and it fetched an index of .95.

CONCLUSIONS

The Basic Depression Questionnaire has adequate psychometric properties. The absence of differential item functioning and the invariance by sex are guarantees of an adequate use to diagnose depression for men and women. So, its clinical use can help to differentiate between the specific diagnoses for depressive disorders and anxiety disorders.

Positive mental health, positive affect and suicide ideation

BACKGROUND/OBJECTIVE

Positive mental health (PMH) has been shown to confer resilience against suicide ideation. However, the mechanisms underlying the positive effect of PMH on suicide ideation/behavior are largely unknown. The current study aimed to determine whether positive affect mediates the association between PMH and suicide ideation.

METHOD

A total of 150 adult outpatients (65.3%; female; age: M(SD)=37.79(13.50), range:18-77) completed measures on PMH, positive and negative affect, as well as suicide ideation. Data were collected using self-report questionnaires. Linear hierarchical regression analysis was used to analyze the data. Positive affect was considered to mediate the association between positive mental health and suicide ideation.

RESULTS

While positive affect fully mediated the significant negative association between PMH and suicide ideation, negative affect did not reveal to be a significant mediator of this relationship.

CONCLUSIONS

The protective influence of PMH against suicide ideation is due to heightened positive affect: If positive mental health translates into positive affect, then suicide ideation becomes less likely.

Positive mental health as a moderator of the association between risk factors and suicide ideation/behavior in psychiatric inpatients

In recent studies positive mental health has been shown as a resilience factor related to suicide ideation/behavior. It is not known if positive mental health buffers the effect of various risk factors (depression, perceived burdensomeness, hopelessness, childhood maltreatment) on suicide ideation/behavior in psychiatric inpatients-a high risk population. A total of 100 psychiatric inpatients were included in the survey. Four hierarchical regression analyses were conducted to examine, whether positive mental health moderates the association between the four risks factors and suicide ideation/behavior. Positive mental health was shown to moderate the association between perceived burdensomeness and suicide ideation/behavior. The association between the other three risk factors and suicide ideation/behavior was not moderated by positive mental health. Given the cross-sectional nature of the data, conclusions on causality cannot be drawn. The buffering effect of positive mental health suggests that positive mental health may improve the identification of individuals at risk of suicide ideation/behavior and may be an important area to target in the prevention and treatment of individuals at risk of suicide. Further research is needed.

Positive mental health moderates the association between suicide ideation and suicide attempts

BACKGROUND

Positive mental health (PMH) has been shown to confer resilience against suicide ideation. However, it is unclear, whether PMH also buffers the relationship between suicide ideation and suicide attempts. The current study aimed to determine whether PMH moderates the association between lifetime suicide ideation and lifetime suicide attempts.

METHODS

A total of 199 psychiatric inpatients with lifetime suicide attempts (female: n = 109; age: M = 37.56, SD = 14.38, range: 18-81) were interviewed on lifetime suicide ideation/behavior and completed a measure on PMH.

RESULTS

PMH moderated the impact of lifetime suicide ideation on lifetime suicide attempts: For those individuals who reported high levels of PMH, the rate of lifetime suicide attempts was reduced even when experiencing frequent episodes of lifetime suicide ideation.

LIMITATIONS

Given the cross-sectional nature of the data, conclusions on causality should be handled carefully.

CONCLUSION

PMH seems to confer resilience and should be taken into account, when assessing individuals for suicide risk.

Suicidal Ideation in People With Psychosis Not Taking Antipsychotic Medication: Do Negative Appraisals and Negative Metacognitive Beliefs Mediate the Effect of Symptoms?

Between 5% and 10% of people with psychosis will die by suicide, a rate which is 20-75 times higher than the general population. This risk is even greater in those not taking antipsychotic medication. We examined whether negative appraisals of psychotic experiences and negative metacognitive beliefs about losing mental control mediated a relationship between psychotic symptoms and suicidal ideation in this group. Participants were diagnosed with schizophrenia spectrum disorders, antipsychotic-free for 6 months at baseline, and were participating in an 18-month randomized controlled trial of cognitive therapy vs treatment as usual. We conducted a series of mediation analyses with bootstrapping on baseline (N = 68), follow-up data (9-18 mo; n = 49), and longitudinal data (n = 47). Concurrent general symptoms were directly associated with suicidal ideation at baseline, and concurrent negative symptoms were directly associated with suicidal ideation at 9-18 months. Concurrent positive, negative, general, and overall symptoms were each indirectly associated with suicidal ideation via negative appraisals and/or negative metacognitive beliefs, at baseline and 9-18 months, except for negative symptoms at baseline. Controlling for baseline suicidal ideation and treatment allocation, baseline general symptoms were indirectly associated with later suicidal ideation, via baseline negative appraisals and negative metacognitive beliefs. Baseline negative metacognitive beliefs also had a direct association with later suicidal ideation. These findings suggest the clinical assessment of suicidal ideation in psychosis may be enhanced by considering metacognitive beliefs about the probability and consequences of losing mental control.

Suicide ideation as a predictor of treatment outcomes in cognitive-behavioral therapy for unipolar mood disorders

Background/Objective: Suicide ideation is common in depressed patients. However, no studies to date have examined whether pretreatment suicide ideation is associated with poorer outcomes after cognitive-behavioral therapy for adult depression. Method: 475 depressed outpatients (age: M = 39.9 years, SD = 11.71; 60.2% female) took part in a pre-treatment and a post-treatment assessment. Pre-treatment suicide ideation measured with the BDI suicide item was considered as a predictor of treatment outcomes - controlling for age, gender, number of attended therapy sessions, as well as pre-treatment depression severity. Results: Hierarchical regression revealed that age, gender, number of completed therapy sessions and depression severity at baseline could explain 25% of the variance in post-treatment BDI-scores. Adding suicide ideation significantly improved the amount of variance explained to 27%. Treatment outcomes were worse for patients with more severe depression, suicidal patients, patients receiving more therapy-sessions and older patients. Conclusions: Suicide ideation added only little incremental variance to the prospective prediction of post-treatment depression severity. Depressed patients with suicide ideation can attain almost as good treatment outcomes as patients without suicide ideation, which is a clinically encouraging result.

Cyberbullying, positive mental health and suicide ideation/behavior

Cyberbullying has regularly been shown to be associated with suicide ideation/behavior. The present study investigated whether positive mental health, i.e., high levels of emotional, cognitive and psychological well-being, buffers the association between cyberbullying and suicide ideation/behavior. A total of 225 students completed measures of cyberbullying, suicide ideation/behavior, and positive mental health. Positive mental health fully mediated the association between cyberbullying and suicide ideation/behavior. Positive mental health seems to confer resilience and should be taken into account in clinical and preventive programs for student populations.