The relationship of psychological well-being to distress and personality

Care manager role for older multimorbid heart failure patients' needs in relation to psychological distress and quality of life: a cross-sectional study

Background

There are few studies investigating patients' needs in healthcare focusing on disease severity and psychological characteristics of elderly heart failure (HF) patients with multimorbidity, specifically addressed by a care manager (CM).

Aims

To explore the role of a CM dealing with elderly multimorbid HF patients' needs/preferences according to NYHA class, ejection fraction, psychological/psychosomatic distress and quality of life (QoL), utilizing a Blended Collaborative Care (BCC) approach (ESCAPE; Grant agreement No 945377).

Methods

Cue cards, self-reported questionnaires, and a semi-structured interview were used to collect data.

Results

Twenty-five Italian patients (mean age ± SD = 77.5 ± 6.68) were enrolled between June 2021 and March 2022. The most relevant patients' needs to be addressed by a CM were: education (e.g., on medical comorbidities), individual treatment tailoring (e.g., higher number of appointments with cardiologists) and symptom monitoring.

Conclusion

The study highlights the importance of targeting HF patients' needs according to psychological characteristics, whose healthcare requires person-centered care with CM assistance. In view of ESCAPE BCC intervention, a CM should consider specific patients' needs of elderly multimorbid HF patients with psychological, psychosomatic distress, particularly somatization, and lower QoL to achieve a more personalized health care pathway.

Study registration

The «Evaluation of a patient-centred biopsychosocial blended collaborative care pathway for the treatment of multi-morbid elderly patients» (ESCAPE) study has been registered at the University of Göttingen Medical Centre (UMG Reg. No 02853) and the German Clinical Trials Register (DRKS00025120).

Direct and indirect effects of psychological well-being and therapeutic alliance on therapy outcome in eating disorders

Introduction

Outcome research in eating disorders (EDs) is commonly focused on psychopathological dysfunction. However, Ryff's model of psychological well-being (PWB) has shown promising-yet preliminary-results with ED patients. Additionally, despite substantial evidence highlighting the association between the therapeutic alliance and treatment outcome, findings in ED samples remain unclear. The present study aimed at exploring the direct effect of PWB dimensions and the early therapeutic alliance on ED patients' individual treatment responses, as well as the mediating role played by the early therapeutic alliance in the relationship between PWB dimensions and overall pre-post symptom change.

Methods

A sample of N = 165 ED patients assigned female at birth, who were receiving treatment in a residential program, completed the Psychological Well-Being Scale at treatment intake and the Working Alliance Inventory after the first four psychotherapy sessions. Patients also completed the Outcome Questionnaire-45.2 at the same time point and during the week prior to discharge.

Results

The PWB dimensions of autonomy, positive relations, and self-acceptance were associated with clinically significant change, while the dimensions of personal growth and self-acceptance were associated with reliable change. The early therapeutic alliance showed both direct and indirect effects on therapy outcome, predicting clinically significant and reliable symptom reduction. It also emerged as a significant mediator in the relationship between all PWB dimensions and overall symptomatic change.

Conclusion

The identification of individual, adaptive characteristics in ED patients that might influence their development of an early therapeutic alliance may help therapists to predict relationship ruptures and tailor their interventions to enhance treatment effectiveness.

Temporomandibular disorder pain in older adolescents-young adults: Interrelationship with somatic burden, mental ill-being, and well-being

OBJECTIVES

The associations of Temporomandibular disorder (TMD) pain with somatic symptoms, mental ill-being/distress, and well-being were explored, along with the mental correlates of TMD (TS) and somatic symptom (SS) burden in older adolescents-young adults.

METHODS

TMD/somatic symptoms were appraised with the five quintessential symptoms (5Ts) of the DC/TMD/Somatic Symptom Scale-8, whereas mental distress/well-being was assessed with the Depression, Anxiety, Stress Scales-21/Scales of Psychological Well-being-18. Data were examined using Chi-square/non-parametric tests and multivariate analyses (α = .05).

RESULTS

Among the 366 participants, 51.4%, 28.1%, 6.8%, and 13.7% had no TMD (NT), TMD pain (TP), TMD dysfunction (TD), and combined TMD (CT) respectively. Though mental distress varied substantially (CT, TP>NT, TD), no significant differences in well-being were discerned. SS burden, but not TS burden, was moderately correlated to distress.

CONCLUSIONS

The prospect of TMD pain was increased by being female, depressed, and anxious but reduced by "positive relations with others" and "self-acceptance".

The relationship between purpose in life and depression and anxiety: A meta-analysis

Purpose in life consists of having a sense of meaning and purpose regarding one's activities as well as an overall sense that life is meaningful. This study reports a comprehensive assessment of the relationship of purpose in life with depression and anxiety. A meta-analysis (total n = 66,468, total k = 99) investigated the association of purpose in life with depression and anxiety. Across samples, greater purpose in life was significantly associated with lower levels of depression and anxiety. The mean weighted effect size between purpose in life and depression was r = -0.49, [95% confidence intervals, CIs: -0.52, -0.45], p < 0.001. For the purpose in life and anxiety the mean weighted effect size was r = -0.36, [95% CIs: -0.40, -0.32], p < 0.001. The association of purpose in life with mental health was stronger for clinical populations, especially with regard to the relationship with anxiety. Both approach deficits and avoidance motivation are argued to play a role in the relationship between purpose and psychopathology, with greater purpose potentially limiting avoidance tendencies and reducing the effects of depression and anxiety. Understanding the role that purpose in life may play in depression and anxiety could help to inform current conceptualizations of these disorders and improve treatment outcomes.

Childhood maltreatment and major depressive disorder in well-being: a network analysis of a longitudinal community-based cohort

BACKGROUND

Little has been done to comprehensively study the relationships between multiple well-being constructs at a time. Even less is known about whether child maltreatment and major depressive disorder (MDD) impact different well-being constructs. This study aims to examine whether maltreated or depressed individuals have specific impacts on well-being structures.

METHODS

Data analyzed were from the Montreal South-West Longitudinal Catchment Area Study (N = 1380). The potential confounding of age and sex was controlled by propensity score matching. We used network analysis to assess the impact of maltreatment and MDD on well-being. The centrality of nodes was estimated with the 'strength' index and a case-dropping bootstrap procedure was used to test network stability. Differences in the structure and connectivity of networks between different studied groups were also examined.

RESULTS

Autonomy and daily life and social relations were the most central nodes for the MDD and maltreated groups [MDD group: strength coefficient (SC) autonomy = 1.50; SCdaily life and social relations = 1.34; maltreated group: SCautonomy = 1.69; SCdaily life and social relations = 1.55]. Both maltreatment and MDD groups had statistical differences in terms of the global strength of interconnectivity in their networks. Network invariance differed between with and without MDD groups indicating different structures of their networks. The non-maltreatment and MDD group had the highest level of overall connectivity.

CONCLUSIONS

We discovered distinct connectivity patterns of well-being outcomes in maltreatment and MDD groups. The identified core constructs could serve as potential targets to maximize the effectiveness of clinical management of MDD and also advance prevention to minimize the sequelae of maltreatment.

Mapping the Path to Cognitive Balance: Applying the States of Mind Model and Network Analysis to Eating Disorder Patients

Background: In eating disorders (EDs), cognitive-behavioral therapy (CBT) represents one of the first-line treatment options albeit with sub-optimal results. The assessment of cognitive balance through an index measuring increased adaptive thinking and reduced maladaptive thinking, the desired outcomes, and the ultimate goal of CBT treatments warrants attention. The states of mind model (SOM) provides a framework through which a cognitive balance index can be defined. The current cross-sectional controlled study tested the clinical utility of the SOM model in a sample of ED outpatients. Methods: ED outpatients (n = 199) were assessed at baseline with the attitudes and beliefs scale-2 (ABS-2) for rational beliefs (RBs) and irrational beliefs (IBs), from which a SOM ratio score index (RBs/(RBs + IBs)) was calculated, the eating disorder inventory-3 (EDI-3) for ED symptoms and ED-related psychopathological features, the psychological well-being scales (PWB) for positive psychological functioning. A matched control sample (n = 95) was also assessed with the ABS-2. Results: ED patients exhibited significantly lower SOM and RB scores compared to controls. Network analysis results highlighted the centrality of the SOM-cognitive balance index, PWB-self-acceptance, and EDI-3-general psychological maladjustment, as well as the importance of the influence that cognitive balance and general psychological maladjustment exert on each other. Conclusions: The findings support the clinical utility of the SOM ratio applied to cognitions in EDs. This demonstrates its ability to differentiate such patients from controls and in capturing worse ED-related general psychopathology as well as compromised aspects of psychological well-being, in particular self-acceptance and environmental mastery. It thus might be considered in CBT treatment of EDs a potential cognitive clinimetric and clinical index of ED severity indicating key difficulties in counteracting maladaptive thinking with adaptive thinking.

Stability of Psychological Well-being Following a Neurological Event and in the Face of a Global Pandemic

This study examined the stability of psychological well-being in people who have experienced a neurological event resulting in focal brain damage. Evidence suggests that psychological well-being is largely stable in healthy adult populations. However, whether such stability exists in neurological patients with acquired brain lesions is an open question. Given the trait-like characteristics of psychological well-being, we hypothesized that psychological well-being would be stable in neurological patients who are in the chronic epoch of recovery (≥3 months after the neurological event). Eighty participants (women = 40; age: M = 56, standard deviation ( SD) = 13) completed the Ryff Scales of Psychological Well-Being (PWBS) twice between 2016 and 2020 (Time 1 [T1] and Time 2 [T2]). The Ryff Scales measure various facets of well-being, including autonomy, environmental mastery, personal growth, positive relations with others, purpose in life, and self-acceptance. Approximately half of participants completed their T2 assessment during the COVID-19 pandemic, creating an opportunity to investigate the effects of the pandemic on the stability of psychological well-being in a neurological population that may be particularly vulnerable to reduced well-being in this context. Pearson correlations and within-sample t-tests were conducted to examine the stability of self-reported well-being over time. Test–retest correlations ranged from .71 to .87, and no significant differences in well-being emerged across the two time points. Significant correlations between T1 and T2 were also evident in the subsample of participants who completed their second assessment during the COVID-19 pandemic. These findings provide evidence that long-term psychological well-being is remarkably reliable and consistent over time in patients who have experienced a major neurological event, even when an unprecedented global event occurred between measurement epochs. Treatment implications of these findings are discussed.

Incremental validity of acceptance over coping in predicting adjustment to endometriosis

Psychological acceptance has emerged as an important construct to explain low psychological distress in different clinical samples. However, the incremental validity of psychological acceptance to explain adjustment to medical conditions over other related and well-established constructs, such as coping, is relatively unclear. This study explored whether psychological acceptance significantly contributes to explain adjustment above and beyond coping in females with endometriosis. A total of 169 females (M_age = 34.95 years; SD_age = 6.07 years) with endometriosis and pain symptoms completed the Acceptance and Action Questionnaire-II, the Brief-COPE, the Hospital Anxiety and Depression Scale, the Psychological Wellbeing Scale, and the Endometriosis Health Profile-5. We conducted Hierarchical Regression Analyses to determine the contribution of psychological acceptance to explaining adjustment. The results showed that the contribution of psychological acceptance ranged from 11 to 20% when controlling for coping, while coping explained from 1 to 8% when the model was reversed. The findings suggest that psychological acceptance is a more useful construct than coping for predicting PD and other psychological outcomes in females with endometriosis.

Psychological Well-Being and Nature Relatedness

The way people perceive contact with nature may impact their environmental attitudes and psychological well-being (WB). Nature relatedness (NR) refers to the affective, cognitive, and experiential aspects of individuals’ connection to nature. The aim of the presented research concentrates on the assessment of the relationship between well-being, self-control and connectedness with the natural environment. The data was collected via online questionnaire between March and April 2022. In the study, we combined descriptive statistics with analysis of variance. We also quantitatively assessed correlations between major components of NR scale and psychological WB across men’ and women’ inquires. The results showed that there is a statistically significant relationship between the general index of NR and overall psychological WB. Furthermore, correlation between specific aspects of NR and WB subscales were also observed. These interactions are considerable among both men and women. We have also identified a major correlation between NR and self-control, which indicates the link between the way a person approaches oneself and natural environment. Finally, the analysis provides evidence that women are on average more related to nature, although the men may benefit more from this kind of relationship. Further gender differences could be observed in terms of nature-relatedness perspective component, general self-control, score and overall NR score These relationships are highly vital among men while irrelevant among women.

Response to TMS treatment for depression associated with higher levels of psychological well-being

Treatment resistant depression (TRD) is a complex condition associated with a great deal of disability and suffering. The relationship between TRD and psychological well-being (PWB) appears to be more complex than a simple antithesis. Transcranial magnetic stimulation (TMS) is a well-tolerated treatment for TRD. However successful, a drawback for TMS is that it has a lack of predictive biomarkers for treatment response. Our study focuses on the relationship between PWB and treatment resistant depression, and how PWB relates to TMS treatment response. We hypothesized that TMS treatment responders would have higher levels of PWB at baseline. In this study of 21 patients with TRD, we used the Ryff Scales of Psychological Well-Being and Patient Health Questionnaire-9 (PHQ-9). We found a significant relationship between environmental mastery, purpose in life, self-acceptance, and total PWB with baseline depression but no significant correlation between autonomy, personal growth, and positive relations with others and baseline PHQ-9 scores. No Ryff domain of PWB significantly predicted change in PHQ-9 score. Interestingly, however, we found that TMS responders had higher levels of autonomy (M(SD) = 62.10(10.46), p = 0.022) and personal growth (M(SD) = 65.00(11.04), p = 0.007) than non-responders at baseline. These specific aspects of well-being appear to be distinct from depression and particularly important in treatment response. This discovery suggests that assessing PWB might prove clinically useful when assessing future candidates for TMS treatment of TRD. Further research is necessary to evaluate the effects of TMS on PWB since these may be distinct from its effect on depression symptomology.

Spirituality for Coping with the Trauma of a Loved One's Death During the COVID-19 Pandemic: An Italian Qualitative Study

Spirituality may be a key factor in reducing the negative psychological effects of traumatic events and a means by which the experience of grief can be processed. The objective of the present research is to assess whether and how spirituality provided concrete support in those who lost a loved one during the COVID-19 pandemic. The participants are 8 people from the most affected cities in northern Italy. They were interviewed in depth, the interviews were transcribed and the texts were analyzed through Interpretive Phenomenological Analysis. The results show that spirituality has been found to be a protective factor with regard to the processing of grief in crisis situations such as the COVID-19 pandemic, in particular with regard to the belief that the deceased loved one is now in an otherworldly dimension. In addition, the celebration of a funeral rite offers support to the grieving person in the early stages of mourning thus laying the foundation for a healthy grieving process. It is therefore important to support individual spirituality, which can be a useful tool for processing the traumatic experience, especially in difficult times such as the COVID-19 pandemic.

Eating Behavior after Bariatric Surgery (EBBS) Questionnaire: a New Validated Tool to Quantify the Patients' Compliance to Post-Bariatric Dietary and Lifestyle Suggestions

PURPOSE

In the management of bariatric surgery follow-up, a multidisciplinary approach allows to evaluate the weight loss maintenance and the dietary and lifestyle changes adherence. The main aim of this study is to create and to validate a questionnaire (eating behavior after bariatric surgery (EBBS)) to objectivize the compliance to dietary/lifestyle suggestions after bariatric surgery.

MATERIALS AND METHODS

An observational retrospective monocentric clinical trial was carried out at the Bariatric Surgery Unit of Modena, Italy. All weight-related data of bariatric surgery patients collected during the multidisciplinary post-surgical path were recorded. EBBS questionnaire and three validated psychological tests were administered. EBBS includes 11 questions concerning food (domain A), drinks (B), behaviors (C), and lifestyle (S). All data analyzed in the study were collected during the same visit.

RESULTS

In 41 enrolled patients (52.2 + 11.9 years), the total weight loss after surgery was 44.87 + 18.37 kg (- 35.40 + 11.60%), with a weight loss maintenance of 86.92 + 14.30%. The EBBS questionnaire showed a good internal validity (Cronbach's alpha 0.743, Hotelling's T-square test p < 0.001). The S domain was directly related with the percentage of weight loss maintained (p = 0.048), suggesting that the frequent physical activity and the periodic weight self-check are the most predictive behaviors to obtain weight control. None of the psychological questionnaires appeared related to the weight trend.

CONCLUSIONS

We validated for the first time a 11-item self-filling questionnaire allowing to quantify the adaption to dietary/lifestyle suggestions provided after bariatric surgery. EBBS questionnaire could be a useful tool both in clinical and research setting to monitor the patient's adherence to post-surgical indications and to identify predictive factors for bariatric surgery efficacy.

Well-being Therapy in Depressive Disorders

A specific brief psychotherapeutic intervention aimed at empowering psychological well-being, the so-called Well-Being Therapy (WBT), has been manualized in 2016 by Giovanni Fava and has shown to be effective in randomized controlled trials. WBT is based on the multidimensional model of psychological well-being developed by Marie Jahoda which encompasses environmental mastery, personal growth, purpose in life, autonomy, self-acceptance, positive relations with others, and balance of psychic forces. WBT aims at promoting the achievement of an optimal-balanced functioning between the dimensions of psychological well-being, and such a balance is subsumed under the rubric of euthymia. There are evidences that WBT may be a suited clinical approach for second- or third-line treatment of depressive disorders with particular reference to decreasing vulnerability to relapse and modulating psychological well-being and mood. It has been also proposed a role of WBT in depressive disorders in clinical conditions such as treatment resistance, loss of antidepressant clinical efficacy, persistent post-withdrawal disorders, trauma exposure, and medical disease comorbidity. The present chapter provides an overview of the possible applications of WBT as treatment of depressive disorders.

How Does Self-Concept Differentiation Work in Chinese Retirees: A Moderated Mediation Analysis

Self-concept differentiation (SCD) is a sign of fragmentation of the self rather than specialization of role identities for its robust relationship with psychological adjustment. However, little is known about the mechanisms underlying the relationship between SCD and psychological adjustment. The aim of this study was to examine the mediating role of self-consistency and congruence (SCC) in the association between SCD and psychological adjustment (psychological well-being, depression, and anxiety), and the moderating role of age in the relationship between SCD and SCC. This moderated mediation model was examined among 158 Chinese retirees (mean age = 71.12, SD = 9.13), who completed measurements regarding SCD, SCC, psychological well-being, anxiety, and depression. The results showed that SCC partially mediated the links between SCD and the indices of psychological adjustment. Furthermore, age moderated this mediation effect, which was found in mean and high-age participants, but not in low-age ones. Our findings indicate that, at different age stages, the internal mechanisms of SCD affecting psychological adaptation are not the same, and a low differentiated or highly integrated self can serve as an adaptive resource to maintain high subjective well-being of the elderly and protect them from anxiety and depression.

Kellner's Symptom Questionnaire, a Highly Sensitive Patient-Reported Outcome Measure: Systematic Review of Clinimetric Properties

INTRODUCTION

Patient-reported outcomes (PROs) are of increasing importance in clinical medicine. However, their evaluation by classic psychometric methods carries considerable limitations. The clinimetric approach provides a viable framework for their assessment.

OBJECTIVE

The aim of this paper was to provide a systematic review of clinimetric properties of the Symptom Questionnaire (SQ), a simple, self-rated instrument for the assessment of psychological symptoms (depression, anxiety, hostility, and somatization) and well-being (contentment, relaxation, friendliness, and physical well-being).

METHODS

The PRISMA guidelines were used. Electronic databases were searched from inception up to March 2019. Only original research articles, published in English, reporting data about the clinimetric properties of the SQ, were included.

RESULTS

A total of 284 studies was selected. The SQ has been used in populations of adults, adolescents, and older individuals. The scale significantly discriminated between subgroups of subjects in both clinical and nonclinical settings, and differentiated medical and psychiatric patients from healthy controls. In longitudinal studies and in controlled pharmacological and psychotherapy trials, it was highly sensitive to symptoms and well-being changes and discriminated between the effects of psychotropic drugs and placebo.

CONCLUSIONS

The SQ is a highly sensitive clinimetric index. It may yield clinical information that similar scales would fail to provide and has a unique position among the PROs that are available. Its use in clinical trials is strongly recommended.

My Future: Psychodrama and Meditation to Improve Well-Being Through the Elaboration of Traumatic Loss Among Italian High School Students

This study was designed as an action research aimed to help students to elaborate their feelings of traumatic grief, due to a car accident and a suicide of two of their classmates, in an Italian high school. A death education project was realized in order to prevent the Werther effect. The intervention was based on psychodramatic techniques and meditation with Tibetan bells to encourage reflection on the suffering of traumatic loss, the sense of life, and their future. A total of 89 students from four classes (46 in the experimental group: two classes, 43 in the control groups: two classes) participated in the study, among which 82 (45 in the experimental group, 37 in the control group) completed the pre- and post-test survey. The intervention consisted of eight 2-h meetings, during which the themes of death and loss were dealt with through theoretical discussions, dramatization, and meditation. Two other classes which participated in the assessment as a control group did not attend the activities. The following instruments were used: Death Attitude Profile-Revised, which measures individual attitudes toward death; Psychological Well-being Scale, which measures a person’s psychological well-being; Resilience Scale for Adolescents, which measures the construct of resilience in adolescents; Self-Transcendence Scale, which measures self-transcendence; and Testoni Death Representation Scale, which measures the ontological representations of death. The results demonstrated that in the experimental group, there was a reduction in the fear of death and its avoidance, and that the students normalized the representation of death as something natural, thus improving their well-being. It is consequently possible to say that well-being is not simply the absence of suffering and worries, but rather, is rooted in the possibility of thinking of creative solutions to the trauma.

Determinants of quality of life from the perspective of the patients: A qualitative analysis of patients with oral cavity cancer

PURPOSE

The aim of this study was to identify factors from the patient's perspective that influence quality of life and psychological stress after oral cancer, and to find out if these patients would opt for psycho-oncological assistance during further treatment.

MATERIALS AND METHODS

Standardized interviews were conducted. All interviews were transcribed and reduced according to previously established rules. Next, the patients' statements were coded, put into one format, and summarized in categories. Each category was described individually so that a rule-based quantitative and qualitative evaluation of the patients' statements was then possible.

RESULTS

50 patients were interviewed. 40 of these patients indicated that their own personality and the social support received through friends and family were the most important predictors for quality of life and coping. Therefore, they suggested a focus on these aspects during psycho-oncological treatment. Nearly every patient stated that psycho-oncological assistance should be available for each of them.

CONCLUSION

The results of this study show that patients have clear ideas about the factors that influence their quality of life, and that play a role in coping with disease. Doctors and nursing staff should also understand these factors in order to support patients in the best possible way in the context of psychological first aid.

GERMAN CLINICAL TRIALS REGISTER

DRKS00006263.

Spotlight on eudaimonia and depression. A systematic review of the literature over the past 5 years

BACKGROUND AND AIM

Recent investigations pointed out to the important role of well-being in influencing physical and mental health, with robust findings for the dimension of depression. The aim of this systematic review is to provide an updated summary of articles focused on eudaimonia and depression, including psychosocial interventions that addressed both issues.

METHOD

The literature search was performed by entering the keywords: "eudaimonia" OR "eudaimonic well-being (EWB)" and "depression" and by limiting to "journal article" and to the English language. To be included in this, review articles had to present at least one EWB measure and one depression measure, and had to investigate young and adult populations, including populations with mental health disorders. Articles were excluded if they were published before 2014.

RESULTS

Thirty-four articles were included, with a total of 81,987 participants. About the majority of participants were recruited in two twin studies, followed by college students, and by adults belonging to the general and clinical populations. Sixteen different instruments assessed eudaimonia, being Ryff's psychological well-being scale the most frequently used. The most used instrument for assessing depression was the Depression Anxiety Stress Scale, followed by Center for Epidemiological Studies Depression Scale. The studies confirmed the robust, inverse correlation between eudaimonia and depression, which was only partially explained by genetic common factors and which was mediated by other factors, as self-compassion, personality traits, and defense mechanisms. Various interventions were found to be effective both in promoting eudaimonia and in addressing depression, ranging from cognitive-behavioral therapy, acceptance and commitment therapy, mindfulness, to positive psychotherapy.

CONCLUSION

Clinicians, counselors, and practitioners can select different strategies to promote EWB and to address depression. The findings also suggest the need for a larger consensus on the definition of eudaimonia and on the specific measure(s) to evaluate it in different populations and in different life stages.

Relationship of Physicians' Rapport with Patients' Satisfaction and Psychological Well-being During Hospitalization

Objective The purpose of this study was to assess the association between the psychological well-being and satisfaction of patients with physicians during their hospitalization. Methods This cross-sectional study was conducted at a local hospital using the following surveys: Brief Inventory of Thriving (BIT), tool to assess inpatient satisfaction with care from hospitalists (TAISCH) survey, and Erlanger Internal Patient satisfaction survey addressing demographic questions and questions on physicians' quality of care and etiquette. Mixed linear regression models were created to examine the effect of psychological well-being on patient satisfaction. Models were adjusted for age, race, and gender, and all analyses were performed in R 3.1.1 using the 'lme4' package with statistical significance set at p<0.05. Results A total of 360 patients were enrolled in this analysis and the mean age of the cohort was 54.5 years. In the unadjusted analysis, each unit increase in BIT score was associated with a 0.3% (95% CI:0.19-0.4, p<0.001) increase in mean satisfaction score using the five-domain questionnaire and a 0.25% (95%CI:0.16-0.34, p<0.01) increase in mean satisfaction score using the TAISCH questionnaire. Multivariable models, after adjusting confounding variables, also showed the direct and statistically significant relationship between patients' level of psychological well-being and patient satisfaction. Each unit increase in BIT score was associated with a 0.31% (95% CI:0.20-0.43, p<0.001) and 0.26% (95% CI:0.17-0.36, p<0.001) increase in mean satisfaction scores across the five-domain questionnaire and TAISCH questionnaire. Conclusions There is a positive correlation between the level of patients' psychological well-being and satisfaction with his/her physician with a statistical significance. With patient-specific strategies, we can further improve patient rapport with their physicians, resulting in positive patient outcomes.

Subjective incompetence as a predictor of treatment outcomes in eating disorder outpatients

Eating disorder (ED) patients are frequently characterized by feelings of inefficacy. The aims of the present study were to investigate subjective incompetence and whether its early modification in therapy is associated with treatment response in terms of both psychological distress and well-being. Sixty female ED outpatients undergoing cognitive-behaviorally-based treatment integrated with nutritional rehabilitation were evaluated using: Subjective Incompetence Scale (SIS), Eating Attitudes Test (EAT), Beck Depression Inventory (BDI-II), and Psychological Well-being Scales (PWB). Repeated measures analysis of variance to test changes in variables and hierarchical regression analyses to test the predictive role of SIS were conducted. Significant improvements in SIS, and in distress measures (EAT, BDI-II) and well-being (PWB) were observed by mid-treatment. Early SIS reductions in patients significantly predicted reductions in EAT-food and bulimic preoccupations, EAT-oral control and EAT-dietary restraint scores, independently of initial depressive symptomatology and illness severity. Gains in three PWB dimensions (environmental mastery, purpose in life, self-acceptance) were also predicted by changes in subjective incompetence. Treatment response might be enhanced by targeting more specifically persistent feelings of incompetence associated with ED symptomatology and compromised psychological well-being dimensions. Such paucities in positive functioning are central themes in EDs and if left untreated might represent obstacles to recovery.

Temperament and character effects on late adolescents' well-being and emotional-behavioural difficulties

Background

Research on adults points to personality as a crucial determinant of well-being. The present study investigates the question of personality's relation to well-being and psychosocial adjustment in adolescence.

Methods

We assessed the role of temperament and character (Temperament and Character Inventory, TCI-125), on psychological well-being (PWB; Psychological Well-Being scales), subjective well-being (SWB; Positive and Negative Affect, PA and NA, respectively), and psychosocial adjustment (emotional-behavioural problems measured by the Strengths and Difficulties Questionnaire for Adolescents, SDQ-A), in 72 Italian late adolescents (aged 17.5 ± 0.75). Multiple regressions were conducted to predict PWB, SWB, and SDQ-A scores using TCI-125 scales as predictors.

Results

Character maturity, and in particular Self-Directedness, had a widespread protective effect on well-being and psychosocial adjustment, while different strengths and emotional-behavioural difficulties were associated to specific temperamental and character traits. For example, Harm-Avoidance and Novelty-Seeking positively predicted internalized and externalized problems, respectively.

Discussion

The present results suggest the usefulness of continuing to evaluate temperament and, in particular, character dimensions in investigations focused on adolescents' well-being and psychosocial functioning, especially in the contexts of potential interventions aimed at enhancing development of adolescents' character dimensions at the intrapersonal, interpersonal, and transpersonal levels.

Does psychological well-being change following treatment? An exploratory study on outpatients with eating disorders

Psychological well-being changes following cognitive-behavioral therapy-based treatment were investigated in outpatients with eating disorders (ED). While it is known that CBT reduces symptomatology in EDs, less is known about how changes in positive functioning may ensue. One-hundred and eighty five ED outpatients were analyzed for pre-treatment and post-treatment changes in psychological well-being (PWB) by last observation carried forward - Wilcoxon signed rank tests. Significant gains in all PWB dimensions were found, with moderate effect size correlations in environmental mastery (r=-.418), personal growth (r=-.351) and self-acceptance (r=-.341). A subsample of patients in remission (n=51) was selected and compared to healthy controls in PWB post-treatment scores through Mann-Whitney U tests. Remitted patients showed significantly lower psychological well-being in two dimensions compared to controls: PWB-positive relations (r=-.360) and PWB-self-acceptance (r=-.288). However, more than 50% of ED outpatients in remission had PWB scores that fell below the 50th percentile of healthy controls in all psychological well-being dimensions, despite significant treatment response. Several mechanisms of psychological well-being change following CBT-based treatment are discussed. The assessment of treatment outcome in EDs may benefit from considering changes in positive functioning such as psychological well-being, in addition to the standard measurement of BMI, symptomatology and behavioral parameters. CBT-based treatment outcomes may be strengthened by promoting the development of optimal domains particularly in the interpersonal realm, such as building of quality and warm relationships and focusing on enhancing self-acceptance.

The Impact of Social and Cultural Engagement and Dieting on Well-Being and Resilience in a Group of Residents in the Metropolitan Area of Naples

Social isolation and exclusion are associated with poor health status and premature death. A number of related isolation factors, inadequate transportation system and restrictions in individuals' life space, have been associated with malnutrition in older adults. Since eating is a social event, isolation can have a negative effect on nutrition. Cultural involvement and participation in interactive activities are essential tools to fight social isolation, and they can counteract the detrimental effects of social isolation on health. To provide data supporting the hypothesis that encouraging participation might represent an innovative preventive and health promoting strategy for healthy living and aging, we developed an ad hoc questionnaire to investigate the relationship between cultural participation, well-being, and resilience in a sample of residents in the metropolitan area of Naples. The questionnaire includes a question on adherence to diet or to a special nutritional regimen; in addition, the participants are asked to mention their height and weight. We investigated the relationship between BMI, adherence to diet, and perceived well-being (PWB) and resilience in a sample of 571 subjects over 60 years of age. Here, we present evidence that engagement into social and cultural activities is associated with higher well-being and resilience, in particular in females over 60 years of age.

Positive Psychological Wellbeing Is Required for Online Self-Help Acceptance and Commitment Therapy for Chronic Pain to be Effective

The web-based delivery of psychosocial interventions is a promising treatment modality for people suffering from chronic pain, and other forms of physical and mental illness. Despite the promising findings of first studies, patients may vary in the benefits they draw from self-managing a full-blown web-based psychosocial treatment. We lack knowledge on moderators and predictors of change during web-based interventions that explain for whom web-based interventions are especially (in)effective. In this study, we primarily explored for which chronic pain patients web-based Acceptance and Commitment Therapy (ACT) was (in)effective during a large three-armed randomized controlled trial. Besides standard demographic, physical and psychosocial factors we focused on positive mental health. Data from 238 heterogeneously diagnosed chronic pain sufferers from the general Dutch population following either web-based ACT (n = 82), or one of two control conditions [web-based Expressive Writing (EW; n = 79) and Waiting List (WL; n = 77)] were analysed. ACT and EW both consisted of nine modules and lasted nine to 12 weeks. Exploratory linear regression analyses were performed using the PROCESS macro in SPSS. Pain interference at 3-month follow-up was predicted from baseline moderator (characteristics that influence the outcome of specific treatments in comparison to other treatments) and predictor (characteristics that influence outcome regardless of treatment) variables. The results showed that none of the demographic or physical characteristics moderated ACT treatment changes compared to both control conditions. The only significant moderator of change compared to both EW and WL was baseline psychological wellbeing, and pain intensity was a moderator of change compared to EW. Furthermore, higher pain interference, depression and anxiety, and also lower levels of emotional well-being predicted higher pain interference in daily life 6 months later. These results suggest that web-based self-help ACT may not be allocated to chronic pain sufferers experiencing low levels of mental resilience resources such as self-acceptance, goals in life, and environmental mastery. Other subgroups are identified that potentially need specific tailoring of (web-based) ACT. Emotional and psychological wellbeing should receive much more attention in subsequent studies on chronic pain and illness.

Gender differences in psychological well-being: tests of factorial invariance

PURPOSE

This research investigated gender differences in the six factors of Li's 18-item version of Ryff's psychological well-being (PWB) scale by using factorial invariance procedures. This version improved on Ryff's shorter PWB scale in regard to the reliability of each subscale.

METHODS

The sample comprised 653 adult participants, specifically, 271 men and 382 women. Factorial invariance tests were conducted using multigroup confirmatory factor analysis.

RESULTS

The results showed that the Li's version of Ryff's PWB scale has configural invariance, factor loading invariance, intercept invariance, partial invariance of factor variances and covariances, partial invariance of latent means, and partial invariance of error variances. According to latent means, women had significantly less autonomy (AU) and more environmental mastery (EM) than men did. Moreover, based on interfactor correlations, the correlation of EM and self-acceptance was higher for men than for women, and the correlation of positive relations with others and AU was lower for men than for women.

CONCLUSIONS

Gender differences in PWB can be found at the subscale levels of Li's version, which exhibits metric and scalar invariance.

Character profiles and life satisfaction

BACKGROUND

There is a surge of interest in subjective well-being (SWB), which concerns how individuals feel about their happiness. Life satisfaction tends to be influenced by individual psychological traits and external social factors. The aim of this study was to examine the relationship between individual character and SWB.

METHODS

Data from 3522 university students were analyzed in this study. Character profiles were evaluated using the Temperament and Character Inventory-Revised Short version (TCI-RS). Life satisfaction was assessed using the Satisfaction with Life Scale (SWLS). All statistical tests regarding the correlations between each character profile and life satisfaction were conducted using ANOVAs, t-tests, multiple linear regression models and correlation analyses.

RESULTS

The creative (SCT) profile was associated with the highest levels of life satisfaction, whereas the depressive (sct) profile was associated with the lowest levels of life satisfaction. Additionally, high self-directedness, self-transcendence and cooperation were associated with high life satisfaction. The results of gender-adjusted multiple regression analysis showed that the effects of self-directedness were the strongest in the assessment of one's quality of life, followed by self-transcendence and cooperativeness, in that order. All of the three-character profiles were significantly correlated with one's quality of life, and the character profiles of TCI-RS explained 27.6% of life satisfaction in total. Among the three-character profiles, the self-directedness profile was most associated with life satisfaction.

LIMITATIONS

Our study was cross-sectional, and self-reported data from students at a single university were analyzed.

CONCLUSIONS

The results of this study showed that, among the character profiles, the effects of self-directedness were the strongest for predicting life satisfaction.

Self-rated and observer-rated measures of well-being and distress in adolescence: an exploratory study

The evaluation of eudaimonic well-being in adolescence is hampered by the lack of specific assessment tools. Moreover, with younger populations, the assessment of positive functioning may be biased by self-report data only, and may be more accurate by adding significant adults' evaluations. The objective of this research was to measure adolescents' well-being and prosocial behaviours using self-rated and observer-rated instruments, and their pattern of associations. The sample included 150 Italian high school adolescents. Observed-evaluation was performed by their school teachers using the Strengths and Difficulties Questionnaire. Adolescents completed Ryff's Psychological Well-being Scales and Symptom Questionnaire. Pearson' r correlations and Linear regression were performed. Self-rated dimensions of psychological well-being significantly correlated with all observer-rated dimensions, but Strengths and Difficulties Emotional symptom scale. Multiple linear regression showed that the self-rated dimensions Environmental Mastery and Personal Growth, and surprisingly not Positive Relations, are related to the observer-rated dimension Prosocial Behaviour. Adolescents with higher levels of well-being in specific dimensions tend to be perceived as less problematic by their teachers. However, some dimensions of positive functioning present discrepancies between self and observer-rated instruments. Thus, the conjunct use of self-reports and observer-rated tools for a more comprehensive assessment of students' eudaimonic well-being is recommended.

Psychological Well-Being and Anticipated Positive Personal Events: Their Relationship to Depression

Well-being is now defined in a number of multicomponent ways. One approach to defining well-being-psychological well-being (PWB; Ryff, )-encompasses six dimensions of positive functioning. This study's first aim was to compare PWB self-report scores from a group of depressed participants (N = 26) with a non-depressed group (N = 26). The second aim was to examine anticipated well-being, specifically, how the positive events people anticipate in the future are seen as being related to various aspects of their well-being. Participants completed the self-report scales of PWB and a task which elicited events participants were looking forward to in the future and their thoughts about what was good about those events. Responses about the value of the events were independently coded for the presence of the six PWB dimensions. The depressed group scored significantly lower on all dimensions of self-reported PWB than the control group, with particularly marked deficits on environmental mastery and self-acceptance. For anticipated events, positive relations with others was the most commonly present aspect of PWB in participants' responses about what was good about the events. The frequency of PWB dimensions present in participants' responses was similar between the two groups with the exception of the depressed group having more self-acceptance related responses and fewer positive relationship responses. The well-established lack of positive anticipation found in depressed individuals is likely to mean a diminished resource for a wide range of aspects of well-being but especially positive relationships with others.

KEY PRACTITIONER MESSAGE

The treatment of depression is thought to be more effective when it enhances psychological well-being as well as reducing dysfunction. In the present study, all dimensions of psychological well-being were lower in depressed participants with particularly marked deficits in environmental mastery and self-acceptance, suggesting that these may be particularly important treatment targets. People with depression show specific deficits in being able to anticipate future positive events. The present study suggests that anticipated well-being linked to positive relationships with other people may be particularly impacted by the lack of anticipated future events found in depression.

Psychological well-being in out-patients with eating disorders: a controlled study

OBJECTIVE

Positive functioning is widely neglected in research on eating disorders (EDs). The aim of this exploratory study was to assess psychological well-being (PWB) in out-patients with ED and in controls.

METHOD

The authors assessed PWB in 245 out-patients with EDs [105 with bulimia nervosa (BN), 57 with anorexia nervosa (AN), and 83 with binge eating disorder (BED) who met DSM-IV-TR] and 60 controls. They tested whether PWB was associated with eating attitude test (EAT) scores and if such associations differed among ED groups while taking into account confounding variables.

RESULTS

Significant differences between groups in all PWB scales were found. While individuals with BN reported significantly lower scores in all PWB dimensions than healthy controls, patients with BED scored significantly lower than controls in PWB autonomy, environmental mastery, and self-acceptance scales. Patients with AN showed similar scores to controls in all PWB dimensions, except for positive relationships and self-acceptance. In all ED groups, most PWB dimensions resulted significantly and negatively associated with EAT scales, except for AN where oral control was found to positively correlate with a high sense of purpose in life. All results were maintained even after adjusting for possible confounding variables.

DISCUSSION

Patients with EDs reported an impairment in PWB. The paucity of PWB was not necessarily dependent on the presence of high levels of psychological distress and on the severity of the disorder. Such assessments may therefore yield a more comprehensive evaluation in this clinical population.

The psychometrics and validity of the Junior Temperament and Character Inventory in Portuguese adolescents

Personality traits related to persistence and self-regulation of long-term goals can predict academic performance as well or better than measures of intelligence. The 5-factor model has been suggested to outperform some other personality tests in predicting academic performance, but it has not been compared to Cloninger's psychobiological model for this purpose. The aims of this study were, first, to evaluate the psychometric properties of the Junior Temperament and Character Inventory (JTCI) in adolescents in Portugal, and second, to evaluate the comparative validity of age-appropriate versions of Cloninger's 7-factor psychobiological model, Costa and McCrae's five-factor NEO-Personality Inventory-Revised, and Cattell's 16-personality-factor inventory in predicting academic achievement. All dimensions of the Portuguese JTCI had moderate to strong internal consistency. The Cattell's sixteen-personality-factor and NEO inventories provided strong construct validity for the JTCI in students younger than 17 years and for the revised adult version (TCI-Revised) in those 17 years and older. High TCI Persistence predicted school grades regardless of age as much or more than intelligence. High TCI Harm Avoidance, high Self-Transcendence, and low TCI Novelty Seeking were additional predictors in students older than 17. The psychobiological model, as measured by the JTCI and TCI-Revised, performed as well or better than other measures of personality or intelligence in predicting academic achievement.

Characterizing the psychological distress response before and after a cancer diagnosis

Psychological distress among cancer survivors is common. It is unknown if symptoms predate diagnosis or differ from patients without cancer because studies are limited to patient follow-up. Linked cohort (Wisconsin Longitudinal Study) and tumor registry records were used to assess the psychological distress response pre- to post-cancer diagnosis. Adjusted predicted probabilities of being in one of five categories of change for three psychological distress measures (depression, anxiety, well-being) were compared for participants diagnosed with cancer between 1993-1994 and 2004-2005 and participants without cancer (N = 5,162). Cancer survivors were more likely to experience clinically significant increases (≥0.8 standard deviation) in depression (15, 95 % CI = 12-18 %) and anxiety (19 %, CI = 16-22 %) compared to their no-cancer counterparts (10 %, CI = 10-11 %; 11 %, CI = 11-12 %). Cancer survivors <5 years from diagnosis were more likely to experience worsening depression. Survivors ≥5 years were more likely to experience worsening anxiety. No significant results were found for well-being. Characterizing the psychological distress response is a prerequisite for identifying at-risk patients and communicating expected symptoms, allowing for proactive resource provision.

Psychobiological correlates of allostatic overload in a healthy population

The concept of allostatic load (AL) represents the cost of the continual adjustment of the internal milieu required by an organism to adapt to different challenges. The majority of studies concerning AL have focused mainly on identifying its biological components. Recently, new criteria for a clinimetric evaluation of AL have been introduced, adding a new definition of allostatic overload (AO). This study aims to identify psychological and biological correlates of AO in a population of blood donors, according to this new definition of AO. Participants included 240 blood donors recruited from May 2007 to December 2009 in 4 different blood Centers. Blood samples from each participant were collected for laboratory analysis and self-rating instruments were administered on the same day. Biological parameters included those usually assessed during blood donation. Individuals were selected based on the criteria for the clinimetric evaluation of AO. Differences in biomarkers between subjects with and without allostatic overload were performed using the GLM with biological measures as dependent variables, AO groups as the fixed factor and specific confounders as covariates. Based on the selection criteria for allostatic overload, 98 subjects have been identified as presenting with AO. Results showed that individuals with allostatic overload presented lower levels of serum proteins, erythrocytes and immune differential count than donors without allostatic overload. Further, greater mean corpuscular volume has been found in persons included in the AO group. The evaluation of the AO correlates, along with a biomarker profile, may help to identify those conditions that, by exceeding individual resources, may constitute a danger to health.

Psychological well-being (PWB): a natural life outlook? An Italian twin study on heritability of PWB in young adults

BACKGROUND

To date, the genetic and environmental architecture of the dimensions of psychological well-being (PWB) remains unexplored.

METHOD

PWB of 742 twins aged 23-24 years and enrolled in the Italian Twin Registry was assessed with the three-item version of Ryff's Scales of Psychological Well-Being (SPWB). These scales include items for evaluating the PWB dimensions of self-acceptance, positive relations with others, autonomy, environmental mastery, purpose in life, and personal growth. A twin design was used to obtain correlations in the PWB dimensions for monozygotic (MZ) and dizygotic (DZ) twins and to estimate the contribution of genetic and environmental factors to variation and covariation in the dimensions.

RESULTS

Genetic factors explained moderate to substantial proportions of variance in the six SPWB dimensions, with heritability estimates between 37% and 64%. The estimates of genetic correlations were very high (range 0.77-0.99), indicating that genetic factors that influence the expression of the different dimensions of PWB may be shared to a large extent. Non-shared environmental correlations ranged from substantial to high, with the exception of the correlation between autonomy and the dimensions of purpose in life, self-acceptance and personal growth.

CONCLUSIONS

This study presents a twin analysis of PWB measured by the SPWB dimensions; it was found that both genes and non-shared environment play a role in individual differences. The genetic and non-shared environmental correlations between SPWB dimensions suggest that common underlying genetic and non-shared environmental factors influence the expression of the different facets of PWB.

Development of Instruments and Evaluative Procedures on Contributors to Illness and Health

Instruments available for a person-centered assessment of the causes of well-being and ill-being are described. Monitoring at the level of symptoms of illness and past lifestyle behavior has failed to promote change in well-being in a strong and consistent way. Therefore, we illustrate a way of assessing the interactions among multiple aspects of the causes of well-being. For example, at least three distinct aspects of human well-being are known to interact synergistically to promote health - neurobiological plasticity, self-regulatory functioning and virtue. The neglect of any one of the ternary aspects of well-being impedes understanding and treatment of the whole person. Each aspect can be reliably measured using quantitative and qualitative techniques to facilitate treatment planning and analysis of their interactions as a complex adaptive system, although further work is needed to clarify the content and structure of each aspect.

Psychological predictors of mortality in heart transplanted patients: a prospective, 6-year follow-up study

BACKGROUND

Some reports suggest a link between poor psychological adjustment to heart transplantation and an increased risk of subsequent adverse clinical outcome. Despite its prognostic and therapeutic implications, this issue is still lacking adequate empirical studies. We prospectively tested the predictive value of a complete set of psychiatric and psychological variables, collected with both self-rating and observer-based instruments at midterm after heart transplantation, on the subsequent 6-year survival status.

METHODS

Ninety-five heart transplanted patients underwent the structured clinical interview for Diagnostic and Statistical Manual of Mental Disorders-4th Edition and the structured interview for Diagnostic Criteria for Psychosomatic Research and filled three questionnaires assessing the dimensions of psychological distress, quality of life, and psychological well-being. Demographic characteristics and several clinical parameters were also collected. A 6-year follow-up survival was performed.

RESULTS

Analyses of survival showed that hostility, depression, purpose in life, the occurrence of at least one cardiac event, chronic renal insufficiency, diabetes, number of drug prescriptions, a New York Heart Association (NYHA) class more than or equal to II, and ischemic origin of the cardiopathy significantly predicted subsequent survival duration. When multivariate analyses were performed, high levels of hostility and the presence of diabetes resulted the independent predictors of survival status.

CONCLUSIONS

These findings point out the predictive role of specific components of psychological adjustment to heart transplantation and pose the basis for the evaluation of whether the provision of pharmacologic and psychotherapeutic interventions, aimed at reducing the empirically identified psychological risk factors, may result in a better long-term outcome.

Differential effects of well-being promoting and anxiety-management strategies in a non-clinical school setting

The aim of the present study was to examine the differential effects of strategies for promotion of psychological well-being (Well-Being Therapy, WBT) and removal of distress (Anxiety Management, AM) in a non-clinical school setting.162 students attending middle schools in Northern Italy were randomly assigned to: (a) a protocol derived from WBT; (b) an anxiety-management protocol (AM). The students were assessed immediately before and after the interventions, and after 6 months using: Psychological Well-Being Scales (PWB), Symptom Questionnaire (SQ) and the Revised Children's Manifest Anxiety Scale (RCMAS). In school children, well-being and symptom focused interventions produced slightly different effects on psychological dimensions. WBT, by facilitating progression toward positive and optimal functioning, may integrate symptom-centered strategies.

Chronic disease and sexuality: a generic conceptual framework

Although sexual dysfunctions are frequently comorbid with many chronic diseases and their treatments, until recently, these dysfunctions have been neglected in both research and clinical practice. Fortunately, sexual functioning in the context of chronic disease has now begun to receive more scientific attention. Studies in the field are, however, quite diverse in terms of topics and methodology, not only making comparisons across studies on a single disease difficult, but also making comparisons across different diseases impossible. In an attempt to inspire researchers, this article presents a "generic" conceptual framework regarding the impact of chronic diseases (and their treatments) on sexual function. The major goals of this conceptual framework are to provide an in-depth analysis of, and insight into, the process by which disease-related psychological and relational factors impact the sexual functioning and well-being of patients, their partners, and their relationships. Some of the associations within the conceptual framework have already been supported by the results of empirical studies on various diseases. This review ends with an overview of the limitations of previous research, proposes a research agenda for the field, and presents a research tool that may be helpful in developing new studies investigating the association between chronic diseases and sexuality.

Promotion of Well-Being in Person-Centered Mental Health Care

An understanding of the mechanisms of personality development provides a systematic way to promote health as an integrated state of physical, mental, social, and spiritual well-being. Individual differences in personality are causal antecedents of the full range of psychopathology. The maturation with integration of personality appears to be an important mechanism by which diverse modalities of treatment promote wellness and reduce illness. First, the authors review the relationship between personality and a wide range of psychiatric disorders. Second, the authors evaluate the impact of character structure on a wide range of measures of well-being, including positive emotions, negative emotions, life satisfaction, perceived social support, and perceived health. Third, the authors describe a practical and inexpensive clinical method for facilitating the maturation and integration of personality based on an understanding of the processes of human thought, which underlie changes in personality and well-being.

School intervention for promoting psychological well-being in adolescence

OBJECTIVE

to test the efficacy of a new school program for the promotion of psychological well-being. In this study a school program for promoting psychological well-being has been compared to an attention-placebo intervention in a high school setting.

METHODS

Nine classes (227 students) were randomly assigned to: a) Well-Being intervention (5 classes); b)attention-placebo (4 classes). Assessment was performed at pre and post-intervention, and after six months using: 1) Symptom Questionnaire (SQ); 2) Psychological Well-Being Scales (PWB); 3) Revised Children's Manifest Anxiety Scale (RCMAS).

RESULTS

A significant effect of WB school intervention in improving Personal Growth (PWB), and in decreasing distress (Somatization (SQ), Physical Well-being (SQ), Anxiety (SQ), and RCMAS Physiological Anxiety) emerged.

CONCLUSIONS

A school intervention based on promoting positive emotions and well-being was effective not only in increasing psychological well-being among adolescents, but also in decreasing distress, in particular anxiety and somatization.

Psychological well-being, depression, and anxiety in Japanese university students

BACKGROUND

In order to further investigate the relationship of psychological well-being with depression and anxiety.

METHOD

Students from five universities were solicited to participate in this study and 545 students with a mean age of 20.1 (SD = 2.2) years were finally accessed to analysis.

RESULT

All six dimensions-autonomy (AU), environment mastery (EM), personal growth (PG), positive relationships with others (PR), purpose in life (PL), and self-acceptance (SA)-of the Scales of Psychological Well-being Inventory (SPWB) were moderately negatively correlated with depression and anxiety as measured by the Hospital Anxiety and Depression Scale (HADS). Furthermore, due to a good fit with the present data, the model of SPWB on depression and anxiety was consistent with the theory of psychological well-being and indicated that HADS depression was predicted by EM, PR, and SA, while HADS anxiety was predicted by AU, EM, PG, PR, and SA.

CONCLUSION

SPWB is a reliable measure of well-being for Japanese young adults, and the negative affectivity such as depression and anxiety is to some extent determined by the lack of psychological well-being.