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Magalhães E. Dual-factor Models of Mental Health: A Systematic Review of Empirical Evidence. PSYCHOSOCIAL INTERVENTION 2024; 33:89-102. [PMID: 38706709 PMCID: PMC11066810 DOI: 10.5093/pi2024a6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Accepted: 01/23/2024] [Indexed: 05/07/2024]
Abstract
Objective: Dual-factor models of mental health propose that mental health includes two interrelated yet distinct dimensions - psychopathology and well-being. However, there is no systematization of the evidence following these models. This review aims to address the following research question: what evidence exists using dual-factor models? Method: The current systematic review was conducted using PRISMA guidelines on the following databases: Web-of-science, Scopus, Academic Search Complete, APA PsycArticles, APA PsycInfo, Psychology and Behavioral Sciences Collection, ERIC, and MEDLINE. The screening process resulted in 85 manuscripts that tested the assumptions of dual-factor models. Results: Evidence revealed psychometric substantiation on the two-dimensionality of the dual-factor model, and 85% of the manuscripts provided evidence related to classifying participants into different mental health groups. Most studies showed that the Complete Mental Health or Positive Mental Health group is the most prevalent status group, and longitudinal evidence suggests that most participants (around 50%-64%) remain in the same group across time. Regarding the factors associated with mental health status groups, studies reviewed in this manuscript focus mainly on school-related outcomes, followed by supportive relationships, sociodemographic characteristics, psychological assets, individual attributes, physical health, and stressful events. Conclusions: This review highlights the importance of considering the two dimensions of mental health when conceptualizing, operationalizing, and measuring mental health. Fostering mental health must go beyond reducing symptoms, and practitioners would be able to include well-being-related interventions in their regular practice to improve individuals' mental health outcomes.
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Affiliation(s)
- Eunice Magalhães
- Instituto Universitário de LisboaLisboaPortugalInstituto Universitário de Lisboa (ISCTE-IUL), CIS-IUL, Lisboa, Portugal
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Scutt K, Ali K, Rieger E, Monaghan C, Ford R, Fabry E, Fassnacht D. An investigation of the dual continua model of mental health in the context of eating disorder symptomatology using latent profile analysis. BRITISH JOURNAL OF CLINICAL PSYCHOLOGY 2023; 62:782-799. [PMID: 37667829 DOI: 10.1111/bjc.12439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Accepted: 08/17/2023] [Indexed: 09/06/2023]
Abstract
OBJECTIVE The dual continua model of mental health suggests that mental well-being and mental illness are two distinct continua that are interrelated in their contributions to overall mental health. This study investigated the dual continua model in individuals with eating disorder symptoms. METHOD Female university students (N = 346) completed measures of mental well-being, eating disorder symptomatology, clinical impairment and psychological distress. Confirmatory factor and latent profile analyses were used to derive underlying mental health profiles. RESULTS Results revealed two oblique factors representing the mental well-being and eating disorder symptomatology constructs and four unique mental health profiles that were partially consistent with the dual continua model emerged: 'flourishing', 'vulnerable', 'partially symptomatic and content', and 'languishing'. The derived mental health profiles had unique characteristics described by psychological distress and clinical impairment. CONCLUSIONS The results did not provide conclusive evidence for the dual continua model as they could also be interpreted in a manner consistent with the unidimensional approach. While the dual continua model is a promising avenue to understand mental health in a way that looks beyond symptoms, these results caution against its rapid adoption and encourage future research to understand how eating disorder symptomatology and positive mental health assets contribute to overall mental health.
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Affiliation(s)
- Katharine Scutt
- Australian National University, Canberra, Australian Capital Territory, Australia
| | - Kathina Ali
- University of the Sunshine Coast, Sunshine Coast, Queensland, Australia
| | - Elizabeth Rieger
- Australian National University, Canberra, Australian Capital Territory, Australia
| | - Conal Monaghan
- Australian National University, Canberra, Australian Capital Territory, Australia
| | - Rachael Ford
- Flinders University, Adelaide, South Australia, Australia
| | - Esme Fabry
- Flinders University, Adelaide, South Australia, Australia
| | - Daniel Fassnacht
- University of the Sunshine Coast, Sunshine Coast, Queensland, Australia
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Schürmann-Vengels J, Troche S, Victor PP, Teismann T, Willutzki U. Multidimensional Assessment of Strengths and Their Association With Mental Health in Psychotherapy Patients at the Beginning of Treatment. CLINICAL PSYCHOLOGY IN EUROPE 2023; 5:e8041. [PMID: 37732153 PMCID: PMC10508254 DOI: 10.32872/cpe.8041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Accepted: 05/07/2023] [Indexed: 09/22/2023] Open
Abstract
Background Modern concepts assume that mental health is not just the absence of mental illness but is also characterized by positive well-being. Recent findings indicated a less pronounced distinction of positive and negative mental health dimensions in clinical samples. Self-perceived strengths were associated with markers of mental health in healthy individuals. However, analyses of strengths and their association with different mental health variables in clinical populations are scarce. Method A cross-sectional design was conducted at a German outpatient training and research center. 274 patients before treatment (female: 66.4%, mean age = 42.53, SD = 13.34, range = 18-79) filled out the Witten Strengths and Resource Form (WIRF), a multidimensional self-report of strengths, as well as other instruments assessing positive and negative mental health variables. Data was analyzed with structural equation modeling and latent regression analyses. Results Confirmatory factor analysis of the WIRF showed good model fit for the assumed three-subscale solution. Regarding mental health, a one-factor model with positive and negative variables as opposite poles showed acceptable fit. A correlated dual-factor model was not appropriate for the data. All WIRF subscales significantly predicted unique parts of variance of the latent mental illness factor (p = .035 - p < .001). Conclusion The context-specific assessment of patients' strengths was confirmed and led to an information gain in the prediction of mental health. Results suggest that positive and negative facets of mental health are highly entwined in people with pronounced symptoms. The scientific and practical implications of these findings are discussed.
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Affiliation(s)
- Jan Schürmann-Vengels
- Department of Psychology and Psychotherapy, Witten/Herdecke University, Witten, Germany
| | - Stefan Troche
- Department of Psychology, University of Bern, Bern, Switzerland
| | - Philipp Pascal Victor
- Department of Psychology and Psychotherapy, Witten/Herdecke University, Witten, Germany
| | - Tobias Teismann
- Mental Health Research and Treatment Center, Ruhr-Universität Bochum, Bochum, Germany
| | - Ulrike Willutzki
- Department of Psychology and Psychotherapy, Witten/Herdecke University, Witten, Germany
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Mason Stephens J, Iasiello M, Ali K, van Agteren J, Fassnacht DB. The Importance of Measuring Mental Wellbeing in the Context of Psychological Distress: Using a Theoretical Framework to Test the Dual-Continua Model of Mental Health. Behav Sci (Basel) 2023; 13:bs13050436. [PMID: 37232673 DOI: 10.3390/bs13050436] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2023] [Revised: 03/20/2023] [Accepted: 05/16/2023] [Indexed: 05/27/2023] Open
Abstract
The dual-continua model of mental health suggests that psychological distress and mental wellbeing operate on two distinct yet related continua, both uniquely contributing to overall mental health. Previous literature provides support for the dual-continua model; however, inconsistent methodologies lacking a common theoretical underpinning have led to findings that are difficult to compare across studies. Using archival data, this study aimed to test the following three theoretically derived criteria proposed to accurately examine the dual-continua model: (1) confirming independent existence, (2) disconfirming bipolarity, and (3) quantifying functional independence. METHOD In total, 2065 participants (female n = 1193; 57.8%) completed two online assessments (minimum 30 days apart) measuring psychological distress, mental wellbeing, and demographic information. RESULTS In total, 1.1% of participants experienced high distress as well as mental wellbeing confirming that psychological distress and mental wellbeing exist independently (Criterion 1). Bipolarity (Criterion 2) was partly disconfirmed: mental wellbeing consistently decreased as symptom severity increased for depression; however, anxiety and stress did not meet bipolarity requirements. Functional independence (Criterion 3) was established: longitudinal analysis found that participants reliably and simultaneously increased (2.7%) or decreased (4.2%) in distress and mental wellbeing, while cross-sectional analysis showed that psychological distress only explained 38% of the variance in mental wellbeing. DISCUSSION Findings provide further support for the dual-continua model through analysis of the proposed assessment criteria, suggesting a further need to measure the dual-continua model at the subdomain level, e.g., depression, anxiety, and stress, as opposed to global psychological distress. Validation for the proposed assessment criteria provides important methodological foundations for future studies.
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Affiliation(s)
- Jackson Mason Stephens
- College of Education, Psychology and Social Work, Flinders University, Bedford Park, SA 5042, Australia
- School of Psychological Science, University of Western Australia, Crawley, WA 6009, Australia
| | - Matthew Iasiello
- Mental Health and Wellbeing Theme, South Australian Health and Medical Research, Adelaide, SA 5000, Australia
| | - Kathina Ali
- College of Education, Psychology and Social Work, Flinders University, Bedford Park, SA 5042, Australia
- Mental Health and Wellbeing Theme, South Australian Health and Medical Research, Adelaide, SA 5000, Australia
- School of Health, University of the Sunshine Coast, Sippy Downs, QLD 4556, Australia
| | - Joep van Agteren
- Mental Health and Wellbeing Theme, South Australian Health and Medical Research, Adelaide, SA 5000, Australia
| | - Daniel B Fassnacht
- College of Education, Psychology and Social Work, Flinders University, Bedford Park, SA 5042, Australia
- Mental Health and Wellbeing Theme, South Australian Health and Medical Research, Adelaide, SA 5000, Australia
- School of Health, University of the Sunshine Coast, Sippy Downs, QLD 4556, Australia
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Iasiello M, van Agteren J, Ali K, Fassnacht DB. Positive psychology is better served by a bivariate rather than bipolar conceptualization of mental health and mental illness: a commentary on Zhao & Tay (2022). THE JOURNAL OF POSITIVE PSYCHOLOGY 2023. [DOI: 10.1080/17439760.2023.2179935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/28/2023]
Affiliation(s)
- M. Iasiello
- Lifelong Health Theme, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
| | - J. van Agteren
- Lifelong Health Theme, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
| | - K. Ali
- College of Education, Psychology, and Social Work, Flinders University, Bedford Park, South Australia, Australia
| | - D. B Fassnacht
- College of Education, Psychology, and Social Work, Flinders University, Bedford Park, South Australia, Australia
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Lim YJ. Psychometric Properties of the Mental Health Continuum-Short Form (MHC-SF): A Study With Individuals With Schizophrenia Living in the Community. Psychiatry Investig 2022; 19:1021-1026. [PMID: 36588436 PMCID: PMC9806510 DOI: 10.30773/pi.2022.0155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Accepted: 10/03/2022] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVE The Mental Health Continuum-Short Form (MHC-SF) is widely used to measure positive mental health. This study is the first to examine the psychometric properties of the MHC-SF in persons with schizophrenia living in the community. METHODS Two hundred thirty-one individuals with schizophrenia living in the community in South Korea filled out the MHC-SF. Confirmatory factor analysis (CFA), bifactor CFA, exploratory structural equation modeling (ESEM), and bifactor ESEM were undertaken to examine the factor structure of the MHC-SF. RESULTS Results showed that a three-factor bifactor ESEM model yielded better fit than the other alternative models. Indices of internal consistency reliability were acceptable. CONCLUSION The results suggest that bifactor ESEM is an appropriate analysis for examining the factor structure of the MHC-SF in individuals with schizophrenia. The findings support the use of the overall MHC-SF scale rather than the use of the subscales in people with schizophrenia.
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Affiliation(s)
- Young-Jin Lim
- Department of Psychology, Daegu University, Gyeongsan, Republic of Korea
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Choe EJY, Jankowski PJ, Sandage SJ, Crabtree SA, Captari LE. A practice‐based study of cultural humility and well‐being among psychotherapy clients. COUNSELLING & PSYCHOTHERAPY RESEARCH 2022. [DOI: 10.1002/capr.12599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Elise J. Y. Choe
- The Albert and Jessie Danielsen Institute Boston University Boston Massachusetts USA
| | | | - Steven J. Sandage
- The Albert and Jessie Danielsen Institute Boston University Boston Massachusetts USA
- MF Norwegian School of Theology, Religion, and Society Oslo Norway
| | - Sarah A. Crabtree
- The Albert and Jessie Danielsen Institute Boston University Boston Massachusetts USA
| | - Laura E. Captari
- The Albert and Jessie Danielsen Institute Boston University Boston Massachusetts USA
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Weijers A, Rasing S, Creemers D, Vermulst A, Schellekens AFA, Westerhof GJ. Deconstructing recovery: A prospective study on well-being, symptom severity and acceptance in patients with major depressive disorders. J Affect Disord 2022; 296:653-659. [PMID: 34579968 DOI: 10.1016/j.jad.2021.09.048] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 09/12/2021] [Accepted: 09/14/2021] [Indexed: 11/19/2022]
Abstract
BACKGROUND Perceived well-being is key in the recovery from major depressive disorder (MDD). It is however unclear how well-being relates to other aspects of recovery, like depressive symptom severity, acceptance, disease identification and social participation. In patients with MDD we investigated 1) changes in these five concepts over time, 2) which concepts associate with well-being, and 3) whether a relationship between depressive symptoms and well-being is moderated by acceptance, disease identification and social participation. METHODS Adult outpatients with MDD (n=77) were administered the Mental Health Continuum-Short Form, the Inventory of Depressive Symptomatology, the Acceptance and Action Questionnaire-II, the Pictorial Representation of Illness and Self Measure, and the Scale Functional Remission before treatment and six months later. Changes over time were tested using paired samples t-tests, associations between concepts were tested with correlations. Regression analyses were used to test moderation effects. RESULTS Participants improved on all outcome measures. Well-being correlated moderately with depressive symptom severity (negative correlation) and acceptance at baseline, and strongly at follow-up. At follow-up well-being also correlated moderately with disease identification and social participation. No evidence for moderation was found. LIMITATIONS Recruitment in one regional mental health center might limit generalizability. Furthermore, confounding effects of psychiatric comorbidity on recovery and well-being cannot be ruled out. CONCLUSION Recovery in patients with MDD is associated with improvement on multiple outcome domains. Symptom severity and acceptance showed the strongest association with perceived well-being. Future studies should explore whether treatments targeting symptom severity and acceptance have the strongest impact on recovery.
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Affiliation(s)
| | - Sanne Rasing
- GGZ Oost Brabant, Netherlands; Radboud University, Nijmegen, Netherlands
| | - Daan Creemers
- GGZ Oost Brabant, Netherlands; Radboud University, Nijmegen, Netherlands
| | | | - Arnt F A Schellekens
- Radboud University Medical Center, Donders Institute for Brain, Cognition and Behavior, Department of Psychiatry, Nijmegen, The Netherlands; Nijmegen Institute for Science Practitioners in Addiction (NISPA), Netherlands
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Hernández-Torrano D, Ibrayeva L, Muratkyzy A, Lim N, Nurtayev Y, Almukhambetova A, Clementi A, Sparks J. Validation of a Kazakhstani Version of the Mental Health Continuum-Short Form. Front Psychol 2021; 12:754236. [PMID: 34721234 PMCID: PMC8548629 DOI: 10.3389/fpsyg.2021.754236] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Accepted: 09/15/2021] [Indexed: 12/03/2022] Open
Abstract
Positive mental health and well-being are significant dimensions of health, employment, and educational outcomes. Research on positive mental health and well-being requires measurement instruments in native languages for use in local contexts and target populations. This study examines the psychometric properties of the Kazakhstani version of the Mental Health Continuum—Short Form (MHC-SF), a brief self-report instrument measuring emotional, social, and psychological well-being. The sample included 664 University students (425 females) purposefully selected in three higher education institutions in South, East, and Central Kazakhstan. Their average age was 20.25 and ranged from 18 to 43. Participants completed a Kazakhstani version of the MHC-SF online. Statistical analyses to evaluate the structural validity, reliability, and measurement invariance of the Kazakhstani version of the MHC-SF were performed. The results confirmed the superiority of the bifactor model (i.e., three separated factors of well-being plus a general factor of well-being) over the alternatives. However, most of the reliable variance was attributable to the general well-being factor. Subscale scores were unreliable, explaining very low variance beyond that explained by the general factor. The findings demonstrated the measurement invariance of the MHC-SF across gender and age. Overall, these findings support the use of the Kazakhstani version of the MHC-SF to examine a general factor of well-being and the measurement invariance of the instrument across gender and age groups. However, the results advise against the interpretation of the subscale scores as unequivocal indicators of emotional, social, and psychological well-being.
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Affiliation(s)
| | - Laura Ibrayeva
- Graduate School of Education, Nazarbayev University, Nur-Sultan, Kazakhstan
| | - Ainur Muratkyzy
- Graduate School of Education, Nazarbayev University, Nur-Sultan, Kazakhstan
| | - Natalya Lim
- Department of Medicine, Nazarbayev University School of Medicine, Nur-Sultan, Kazakhstan
| | - Yerden Nurtayev
- Health and Wellness Center, Nazarbayev University, Nur-Sultan, Kazakhstan
| | | | - Alessandra Clementi
- Department of Medicine, Nazarbayev University School of Medicine, Nur-Sultan, Kazakhstan
| | - Jason Sparks
- Graduate School of Education, Nazarbayev University, Nur-Sultan, Kazakhstan
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van Agteren J, Ali K, Fassnacht DB, Iasiello M, Furber G, Howard A, Woodyatt L, Musker M, Kyrios M. Testing the Differential Impact of an Internet-Based Mental Health Intervention on Outcomes of Well-being and Psychological Distress During COVID-19: Uncontrolled Intervention Study. JMIR Ment Health 2021; 8:e28044. [PMID: 34357876 PMCID: PMC8448081 DOI: 10.2196/28044] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Revised: 07/16/2021] [Accepted: 07/21/2021] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND During COVID-19, the psychological distress and well-being of the general population has been precarious, increasing the need to determine the impact of complementary internet-based psychological interventions on both positive mental health as well as distress states. Psychological distress and mental well-being represent distinct dimensions of our mental health, and congruent changes in outcomes of distress and well-being do not necessarily co-occur within individuals. When testing intervention impact, it is therefore important to assess change in both outcomes at the individual level, rather than solely testing group differences in average scores at the group level. OBJECTIVE This study set out to investigate the differential impact of an internet-based group mental health intervention on outcomes of positive mental health (ie, well-being, life satisfaction, resilience) and indicators of psychological distress (ie, depression, anxiety, stress). METHODS A 5-week mental health intervention was delivered to 89 participants using the Zoom platform during 2020. Impact on outcomes of distress, well-being, and resilience was assessed at the start and end of the program with multiple analysis of variance (MANOVA) and reliable change indices (RCIs) being used to determine program impact at the group and individual levels, respectively. RESULTS The intervention significantly improved all mental health outcomes measured, (F6,83=5.60, P<.001; Wilks Λ=.71; partial η2=.29) showing small to moderate effect sizes on individual outcomes. The largest effect sizes were observed for life satisfaction and overall well-being (η2=.22 and η2=.2, respectively). Larger effect sizes were noted for those with problematic mental health scores at baseline. A total of 92% (82/89) of participants demonstrated reliable change in at least one mental health outcome. Differential response patterns using RCI revealed that more than one-half of the participants showed improvement in both mental well-being and psychological distress, over one-quarter in outcomes of well-being only, and almost one-fifth in distress only. CONCLUSIONS The results provide evidence for the significant impact of an internet-based mental health intervention during COVID-19 and indicate the importance of assessing dimensions of both well-being and distress when determining mental health intervention effectiveness.
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Affiliation(s)
- Joep van Agteren
- Wellbeing and Resilience Centre, South Australian Health and Medical Research Institute, Adelaide, Australia
- Órama Institute for Mental Health and Wellbeing, Flinders University, Adelaide, Australia
| | - Kathina Ali
- Wellbeing and Resilience Centre, South Australian Health and Medical Research Institute, Adelaide, Australia
- Órama Institute for Mental Health and Wellbeing, Flinders University, Adelaide, Australia
- College of Education, Psychology and Social Work, Flinders University, Adelaide, Australia
| | - Daniel B Fassnacht
- Wellbeing and Resilience Centre, South Australian Health and Medical Research Institute, Adelaide, Australia
- Órama Institute for Mental Health and Wellbeing, Flinders University, Adelaide, Australia
- College of Education, Psychology and Social Work, Flinders University, Adelaide, Australia
| | - Matthew Iasiello
- Wellbeing and Resilience Centre, South Australian Health and Medical Research Institute, Adelaide, Australia
- Órama Institute for Mental Health and Wellbeing, Flinders University, Adelaide, Australia
- College of Nursing and Health Sciences, Flinders University, Adelaide, Australia
| | - Gareth Furber
- Health Counselling & Disability Services, Flinders University, Adelaide, Australia
| | - Alexis Howard
- College of Education, Psychology and Social Work, Flinders University, Adelaide, Australia
| | - Lydia Woodyatt
- Órama Institute for Mental Health and Wellbeing, Flinders University, Adelaide, Australia
- College of Education, Psychology and Social Work, Flinders University, Adelaide, Australia
| | - Michael Musker
- Wellbeing and Resilience Centre, South Australian Health and Medical Research Institute, Adelaide, Australia
- College of Nursing and Health Sciences, Flinders University, Adelaide, Australia
- Adelaide Nursing School, Adelaide University, Adelaide, Australia
| | - Mike Kyrios
- Wellbeing and Resilience Centre, South Australian Health and Medical Research Institute, Adelaide, Australia
- Órama Institute for Mental Health and Wellbeing, Flinders University, Adelaide, Australia
- College of Education, Psychology and Social Work, Flinders University, Adelaide, Australia
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Weijers A, Rasing S, Creemers D, Vermulst A, Schellekens AFA, Westerhof GJ. The relationship between depressive symptoms, general psychopathology, and well-being in patients with major depressive disorder. J Clin Psychol 2021; 77:1472-1486. [PMID: 33188711 PMCID: PMC8246916 DOI: 10.1002/jclp.23083] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Revised: 10/08/2020] [Accepted: 10/18/2020] [Indexed: 12/28/2022]
Abstract
OBJECTIVE In mental health care, treatment effects are commonly monitored by symptom severity measures. This study aimed to investigate the relationship between symptom severity and well-being in the treatment of patients with major depressive disorder (MDD). METHODS Adult MDD outpatients (n = 77) were administered the Quick Inventory of Depressive Symptomatology-Self-Report (QIDS-SR), the Outcome Questionnaire (OQ-45), and the Mental Health Continuum-Short Form (MHC-SF) before treatment and 6 months later. RESULTS Symptom severity correlated moderately with well-being at baseline and strongly at follow-up. Reliable change index scores showed improvement on the QIDS-SR, OQ-45, and MHC-SF in 65%, 59%, and 40%, respectively. A quarter of patients improved in symptom severity but not well-being (Inventory of Depressive Symptomatology-Self-Report [IDS-SR]: 25%; OQ-45: 24%). CONCLUSION Findings suggest that symptom severity and subjective well-being are related, but distinct concepts. Several reasons for the stronger improvements in symptoms than in well-being are discussed.
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Affiliation(s)
| | - Sanne Rasing
- GGZ Oost BrabantBoekelThe Netherlands
- Behavioral Science InstituteRadboud UniversityNijmegenThe Netherlands
| | - Daan Creemers
- GGZ Oost BrabantBoekelThe Netherlands
- Behavioral Science InstituteRadboud UniversityNijmegenThe Netherlands
| | | | - Arnt F. A. Schellekens
- Department of Psychiatry, Donders Institute for Brain, Cognition and BehaviorRadboud University Medical CenterNijmegenThe Netherlands
- Nijmegen Institute for Science Practitioners in Addiction (NISPA)Radboud UniversityNijmegenThe Netherlands
| | - Gerben J. Westerhof
- Department Psychology, Health, and TechnologyUniversity of TwenteEnschedeThe Netherlands
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12
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Agteren J, Iasiello M. Advancing our understanding of mental wellbeing and mental health: The call to embrace complexity over simplification. AUSTRALIAN PSYCHOLOGIST 2021. [DOI: 10.1111/ap.12440] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Affiliation(s)
- Joep Agteren
- Wellbeing and Resilience Centre, Lifelong Health Theme, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia,
- College of Education, Psychology and Social Work, Flinders University, Adelaide, South Australia, Australia,
| | - Matthew Iasiello
- Wellbeing and Resilience Centre, Lifelong Health Theme, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia,
- College of Nursing and Health Science, Flinders University, Adelaide, South Australia, Australia,
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13
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Ferentinos P, Yotsidi V, Porichi E, Douzenis A, Papageorgiou C, Stalikas A. Well-being in Patients with Affective Disorders Compared to Nonclinical Participants: A Multi-Model Evaluation of the Mental Health Continuum-Short Form. J Clin Psychol 2019; 75:1585-1612. [PMID: 30995352 DOI: 10.1002/jclp.22780] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2018] [Revised: 03/12/2019] [Accepted: 03/28/2019] [Indexed: 12/31/2022]
Abstract
OBJECTIVES The Mental Health Continuum-Short Form (MHC-SF), measuring emotional, social, and psychological well-being, has scarcely been validated in clinical populations. We evaluated MHC-SF in 203 patients with affective disorders and 163 nonclinical participants. METHOD Traditional confirmatory factor analysis (CFA), bifactor CFA, three-factor exploratory structural equation modeling (ESEM), and bifactor ESEM models were compared. Convergent/discriminant validity was tested against classic well-being validators and current mood state. RESULTS All three subscales were significantly lower in patients. Test-retest reliability in patients was moderate. Bifactor ESEM fitted data best and displayed full scalar gender and partial scalar invariance across groups. Factor strength indices suggested that MHC-SF is primarily unidimensional, especially in patients. However, subscales differed considerably on size, internal consistency, distinctness, discriminant validity, and temporal stability. CONCLUSIONS MHC-SF was valid and reliable for monitoring well-being in both clinical and nonclinical samples, but further research is needed before safely concluding on its dimensionality.
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Affiliation(s)
- Panagiotis Ferentinos
- National and Kapodistrian University of Athens, 2nd Department of Psychiatry, Athens, Greece
| | - Vasiliki Yotsidi
- National and Kapodistrian University of Athens, 2nd Department of Psychiatry, Athens, Greece.,Panteion University of Social and Political Sciences, Department of Psychology, Athens, Greece
| | - Evgenia Porichi
- National and Kapodistrian University of Athens, 2nd Department of Psychiatry, Athens, Greece
| | - Athanassios Douzenis
- National and Kapodistrian University of Athens, 2nd Department of Psychiatry, Athens, Greece
| | | | - Anastassios Stalikas
- Panteion University of Social and Political Sciences, Department of Psychology, Athens, Greece
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Pénzes I, van Hooren S, Dokter D, Hutschemaekers G. How Art Therapists Observe Mental Health Using Formal Elements in Art Products: Structure and Variation as Indicators for Balance and Adaptability. Front Psychol 2018; 9:1611. [PMID: 30258374 PMCID: PMC6143814 DOI: 10.3389/fpsyg.2018.01611] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2018] [Accepted: 08/13/2018] [Indexed: 11/13/2022] Open
Abstract
In clinical practice, formal elements of art products are regularly used in art therapy observation to obtain insight into clients' mental health and provide directions for further treatment. Due to the diversity of formal elements used in existing studies and the inconsistency in the interpretation, it is unclear which formal elements contribute to insight into clients' mental health. In this qualitative study using Constructivist Grounded Theory, eight art therapists were interviewed in-depth to identify which formal elements they observe, how they describe mental health and how they associate formal elements with mental health. Findings of this study show that art therapists in this study observe the combination of movement, dynamic, contour and repetition (i.e., primary formal elements) with mixture of color, figuration and color saturation (i.e., secondary formal elements). Primary and secondary elements interacting together construct the structure and variation of the art product. Art therapists rarely interpret these formal elements in terms of symptoms or diagnosis. Instead, they use concepts such as balance and adaptability (i.e., self-management, openness, flexibility, and creativity). They associate balance, specifically being out of balance, with the severity of the clients' problem and adaptability with clients' strengths and resources. In the conclusion of the article we discuss the findings' implications for practice and further research.
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Affiliation(s)
- Ingrid Pénzes
- Faculty of Health Care, Department of Arts Therapies, Zuyd University of Applied Sciences, Heerlen, Netherlands
- KenVaK Research Centre for the Arts Therapies and Psychomotricity, Heerlen, Netherlands
| | - Susan van Hooren
- Faculty of Health Care, Department of Arts Therapies, Zuyd University of Applied Sciences, Heerlen, Netherlands
- KenVaK Research Centre for the Arts Therapies and Psychomotricity, Heerlen, Netherlands
- Faculty of Psychology and Educational Sciences, Open University of the Netherlands, Heerlen, Netherlands
| | - Ditty Dokter
- KenVaK Research Centre for the Arts Therapies and Psychomotricity, Heerlen, Netherlands
- Music and Performing Arts Department, MA Music Therapy and Drama Therapy, Anglia Ruskin University, Cambridge, United Kingdom
- MA Dance and Music Therapy, Codarts University for the Arts, Rotterdam, Netherlands
| | - Giel Hutschemaekers
- School of Psychology, Radboud University, Nijmegen, Netherlands
- Pro Persona, Centre for Mental Health Care, Nijmegen, Netherlands
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