Investigating the Relationship between University Students' Psychological Flexibility and College Self-Efficacy

Embedding positive psychology into curriculum to promote posttraumatic growth, psychological flexibility, and socio-emotional competencies in higher education

Background

The benefits of positive psychology interventions (PPIs) have become increasingly popular. While there is an emerging evidence base on the effectiveness of applying positive psychology in curriculum as preventive, early mental health intervention for higher education students, little is known about the content and pedagogy in these promising courses.

Objective

This article describes (a) the rationale for and development of a positive psychology course embedded into the curriculum that aims to foster posttraumatic growth, psychological flexibility, and socio-emotional competencies for higher education students; and (b) a mixed-method non-randomised pre-post study to evaluate the effectiveness of the positive psychology course in achieving positive participant outcomes.

Methods

Higher education students from different disciplines will be enrolled to a general education course, "Positive Psychology and Personal Growth", where they will learn progressive topics and complete summative assessments related to key areas in positive psychology. In addition to lectures, participants will engage in constructivist-based experiential activities that are guided by research on PPIs, life-design interventions and constructivist learning principles. The primary outcome is posttraumatic growth, and the secondary outcomes are psychological flexibility, and socio-emotional competencies.

Expected results

We hypothesised that after the curriculum-embedded PPI, participants will have significantly higher levels of posttraumatic growth, psychological flexibility, and socio-emotional competencies. Results derived from the questionnaire survey will be supported by corroborating evidence identified from qualitative analysis of participants' summative assessments and follow-up semi-structured interviews on their perceptions of the present course.

Discussion

The current study will fill in a gap in existing intervention research and practise in curriculum-embedded PPIs and promote research transparency and pedagogical advancement. The intervention provides guidance and recommendations for educators to consider embedding positive psychology into the formal curriculum as cost-effective, low-intensity, structured, and sustainable educational interventions for higher education students.

The Indirect Influence of Cannabis Use Disorder Symptoms on PTSD Symptom Severity Through Psychological Inflexibility

Background: One in five college students (21%) report using cannabis in the past month, and approximately 10% develop cannabis use disorder (CUD). Further, college students have high rates of trauma exposure, and CUD is prospectively linked to posttraumatic stress disorder (PTSD). Given the high rate of co-occurrence, research is needed to understand transdiagnostic, modifiable factors that could account for the relationship between CUD and PTSD. Psychological inflexibility (PI) is one such factor and refers to difficulty adapting thoughts or behaviors to various situations that reflect of one's personal values. Objectives: PI predicts worse PTSD symptom severity and has been established as a maintaining factor between alcohol use and PTSD, albeit no studies have examined this relationship with CUD. Results: College students (N = 336) completed self-report measures of CUD, PI, and PTSD. A cross-sectional mediation model explained 54% of the variance in PTSD symptom severity, F(5, 330) = 78.86, p < .001. After controlling for age, gender, and probable alcohol use disorder, CUD was not directly associated with PTSD symptom severity, yet was indirectly associated with PTSD through higher PI. Specifically, CUD was associated with higher PI (b = 0.31, p < .05, 95% CI [0.07, 0.54]), and higher PI was associated with greater PTSD symptom severity (b = 1.07, p < .001, 95% CI [0.95, 1.19]). Conclusion: Although CUD has been previously linked with worse PTSD symptoms, results suggest that this occurs through PI. Importantly, PI is malleable, and may be an important treatment target for co-occurring CUD and PTSD in college students.

The impact of a "clinical adaptation psychoeducation program" grounded in the psychological flexibility model on perceived stress and coping behaviors among nursing students: A randomized controlled experimental study

BACKGROUND

The clinical adaptation psychoeducation program grounded psychological flexibility model (PFMCAP) is consisting of six areas, fills a large gap in the literature regarding the effect of nursing students on perceived stress and coping behaviors in the clinical process.

OBJECTIVES

To determine the effect of PFMCAP on perceived stress and coping behaviors of nursing students.

DESIGN

This was a simple randomized controlled experimental pre-posttest design.

SETTING

This study was conducted with 66 first-year students studying in the nursing department of a university in Türkiye.

METHODS

A simple randomization method (computer-generated random number table) was used. Data were collected with "Sociodemographic Data Form", "Perceived Stress Scale for Nursing Students (PSSNS)" and "Stress-Coping Behaviors Scale for Nursing Students (SCBNS)". PFMCAP was conducted online with first-year nursing students, consisting of a total of six sessions, each lasting 90 min. Data were analyzed using percentiles and frequency distributions, and two-way mixed ANOVA one week after the completion of the PFMCAP.

RESULTS

There was no significant difference between the groups of descriptive characteristics (p > 0.05). Post-test measurements of students in the experimental group's PSSNS total and sub-dimension scores had a significant decrease compared to the control group (p < 0.001). There was no significant difference between the groups in the post-test SCBNS total scores of the students (p > 0.05). However, there was a significant increase in the post-test SCBNS-Staying Optimistic sub-dimension scores in the experimental group (p < 0.001).

CONCLUSION

The impact of PFMCAP on nursing students' perceived stress levels was not limited to only reducing stress levels; it also contributed to an increase in the students' levels of optimism. These findings demonstrate the potential of PFMCAP in supporting nursing students during the clinical adaptation process. It is observed that the integration of PFMCAP into nursing education could assist nursing students in better adapting to clinical practices and effectively managing stress.

A replication study of a psychotherapy incorporating horses resiliency intervention for healthcare workers

OBJECTIVES

The first aim of this pilot observational study was to replicate a previous study of a resiliency psychotherapy incorporating horses (PIH) intervention for healthcare workers. The second aim was to address some gaps in the literature regarding equine-assisted services more broadly.

DESIGN

Prospective open trial.

SETTING

A large healthcare system and a community equine facility INTERVENTION: A single-session four-hour intervention that focused on participants resilience.

MAIN OUTCOME MEASURES

Safety, feasibility, and utilization were assessed, and psychological instruments were administered. Instruments utilized were the Positive and Negative Affect Scale the Acceptance and Action Questionnaire II, and the Conner-Davidson Resiliency Scale.

RESULTS

Thirty-eight subjects participated in the study, the majority of which were female (71.1 %). The age group with the most representation included those ranging from age 25-34. The intervention was safe but underutilized. Participation was associated with improved psychological flexibility (PF), and positive affect, as well as reduction in negative affect pre- to post-intervention. There was no change in resiliency and there were no associations between improvements in affect and PF.

CONCLUSIONS

Resiliency PIH interventions for healthcare workers can be utilized safely and likely result in short-term psychological benefits for participants. Future randomized controlled investigations are warranted, and these studies should implement methods to maximize utilization. Additionally, this study and the literature suggest that enhanced affect and PF are likely important EAS outcomes across a variety of interventions. These constructs should be investigated with more rigorous studies including comparisons of interventions with and without a psychotherapy component.

A pilot observational study of horsemanship skills training for veterans with posttraumatic stress disorder

OBJECTIVES

Pilot assessment of an equine-assisted services intervention for Veterans with posttraumatic stress disorder.

DESIGN

Prospective cohort.

SETTING

A large Veterans Administration healthcare system.

INTERVENTION

Two sessions of instruction in horsemanship skills and two sessions of trail rides.

MAIN OUTCOME MEASURES

Safety and feasibility of recruitment, retention, providing the intervention, and measuring outcomes, as well as acceptability of the intervention to the population studied were the main outcome measures.

RESULTS

There were no injuries among the 18 participants, 6 staff, or 11 equines over the 3 months of the study. Eleven of 12 (92 %) planned intervention sessions were provided, with one being canceled due to weather. Out of approximately 1800 potential subjects, 21 were enrolled within three months and three dropped out before the first session. The mean number of sessions attended was 3 % and 52 % of participants completed all sessions. The mean PACES score for all sessions together was 109 (SD = 12), with a range of 50-126. Pre- to one-month post-intervention exploratory results indicated increased psychological flexibility (p = 0.008) and positive affect (p = 0.008) as measured by the Acceptance and Action Questionnaire II and the Positive and Negative Affect Scale, respectively as well as decreased PTSD (p = 0.001) and depressive symptoms (p = 0.017) as measured by the PTSD Checklist for DSM 5 and the Beck Depression Inventory, respectively.

CONCLUSIONS

Results suggest the intervention can be conducted with minimal risk. Further, it was feasible to recruit participants as well as provide the intervention and measure exploratory outcomes. Session attendance and PACES scores indicate acceptability to the Veteran population. The exploratory results will provide sample size estimates for future randomized controlled studies of this intervention Future studies should plan for missed sessions due to weather and consider compensating subjects to enhance retention. Finally, this work provides preliminary evidence that this intervention, without a mental health treatment component, might benefit the mental health of Veterans with PTSD.

A pilot observational study of a psychotherapy incorporating equines resiliency intervention for staff at a large medical center

BACKGROUND

and purpose: Stress and burnout among healthcare workers are significant public health concerns. The primary aim of this pilot study was to conduct preliminary assessments of safety, feasibility, and participant satisfaction with a psychotherapy incorporating equines (PIE)-based resiliency intervention for healthcare workers. The overarching goal was to lay the groundwork for future, more rigorous investigations. Lastly, a very preliminary assessment of using the Acceptance and Action Questionnaire II (AAQII) to assess for changes in psychological flexibility (PF) associated with PIE was conducted.

MATERIALS AND METHODS

Thirty-seven staff members from a medical center participated in a 4-h PIE-based resiliency retreat. Pre- and post-intervention instruments were utilized to assess participants' self-perception of physical and psychological health (PROMIS Global Short Form) and enjoyment of (Physical Activity Enjoyment Scale) and satisfaction with (Client Satisfaction Questionnaire) the intervention, as well as changes in PF (AAQII).

RESULTS

There were no adverse effects on participants, staff, or equines. Preliminary results suggested that the intervention was perceived as enjoyable by participants. However, the intervention was not fully utilized. Finally, there was a significant (p = 0.02) pre-to post-intervention change in AAQII scores.

CONCLUSION

This study provides a foundation for future rigorous studies of PIE-based resiliency interventions for medical staff. Given the limitations of this pilot work, firm conclusions cannot be drawn regarding safety and feasibility. However, the preliminary results suggest that future studies of this intervention are warranted and that the AAQII may be a useful instrument to assess for possible changes in PF.

Influence of Parental Psychological Flexibility on Pediatric COVID-19 Vaccine Hesitancy: Mediating Role of Self-Efficacy and Coping Style

Background: Pediatric COVID-19 vaccine hesitancy hinders the establishment of immune barrier in children. Psychological flexibility may be a key contributing factor to pediatric COVID-19 vaccine hesitancy, and self-efficacy and coping style play an important role in the relationship, but the underlying mechanisms remain unknown.

Methods: A cross-sectional study was conducted on parents from June 2021 to July 2021. A total of 382 parents were recruited for an online-investigation. Serial mediation models were used to examine whether self-efficacy and coping style mediated in the psychological flexibility-pediatric COVID-19 vaccine hesitancy linkage.

Result: Psychological flexibility was negatively related to pediatric COVID-19 vaccine hesitancy (r = −0.198, P < 0.001). Coping styles rather than self-efficacy played a mediating role independently (95% CI: −0.263 to −0.058). Serial mediation analyses indicated that self-efficacy and coping style co-play a serial mediating role in the association of psychological flexibility and pediatric COVID-19 vaccine hesitancy (95% CI: −0.037 to −0.001).

Conclusion: The present study showed that high psychological flexibility, high self-efficacy, and positive coping style were conducive to the lower pediatric COVID-19 vaccine hesitancy.

Understanding procrastination: A case of a study skills course

Procrastination is consistently viewed as problematic to academic success and students’ general well-being. There are prevailing questions regarding the underlying and maintaining mechanisms of procrastination which are yet to be learnt. The aim of the present study was to combine different ways to explain procrastination and explore how students’ time and effort management skills, psychological flexibility and academic self-efficacy are connected to procrastination as they have been commonly addressed separately in previous studies. The data were collected from 135 students who participated in a voluntary time management and well-being course in autumn 2019. The results showed that students’ ability to organize their time and effort has the strongest association with procrastination out of the variables included in the study. Psychological flexibility also has a strong individual role in explaining procrastination along with time and effort management skills. Surprisingly, academic self-efficacy did not have a direct association with procrastination. Interestingly, our findings further suggest that time and effort management and psychological flexibility are closely related and appear to go hand in hand and, thus, both need to be considered when the aim is to reduce procrastination. The implications of the findings are further discussed.

Cultivating Affective Resilience: Proof-of-Principle Evidence of Translational Benefits From a Novel Cognitive-Emotional Training Intervention

Available evidence highlights the importance of emotion regulation (ER) in psychological well-being. However, translation of the beneficial effects of ER from laboratory to real-life remains scarce. Here, we present proof-of-principle evidence from a novel cognitive-emotional training intervention targeting the development of ER skills aimed at increasing resilience against emotional distress. This pilot intervention involved training military veterans over 5-8 weeks in applying two effective ER strategies [Focused Attention (FA) and Cognitive Reappraisal (CR)] to scenarios presenting emotional conflicts (constructed with both external and internal cues). Training was preceded and followed by neuropsychological, personality, and clinical assessments, and resting-state functional MRI data were also collected from a subsample of the participants. Results show enhanced executive function and psychological well-being following training, reflected in increased working memory (WM), post-traumatic growth (PTG), and general self-efficacy (GSE). Brain imaging results showed evidence of diminished bottom-up influences from emotional and perceptual brain regions, along with evidence of normalized functional connectivity in the large-scale functional networks following training. The latter was reflected in increased connectivity among cognitive and emotion control regions and across regions of self-referential and control networks. Overall, our results provide proof-of-concept evidence that resilience and well-being can be learned through ER training, and that training-related improvements manifested in both behavioral change and neuroplasticity can translate into real-life benefits.

Development of a Web-Based Intervention Course to Promote Students' Well-Being and Studying in Universities: Protocol for an Experimental Study Design

BACKGROUND

The decline in the well-being among university students well as increasing dropouts has become a serious issue in universities around the world. Thus, effective ways to support students' well-being and their ability to study are highly needed.

OBJECTIVE

The purpose of this study was to build an intervention course for university students, which promotes both students' well-being as well as their learning and study skills, and to describe the experimental study design that explores the effects of this intervention course.

METHODS

Research has shown that psychological flexibility has a great effect on the well-being as well as the study skills of students pursuing higher education. The basis of our intervention course was to promote psychological flexibility and students' study skills with the help of peer support and reflection.

RESULTS

This course was offered as a voluntary course to all the students at the University of Helsinki twice during the academic year 2020-2021. The first course was from October to December and the second course was from January to March. This course was advertised in fall 2020 through social media and by different student organizations and program leaders at different faculties of the University of Helsinki. As of October 2020, we enrolled 566 students comprising 310 students for the course in fall 2020 and 256 students for the course in spring 2021. Of the 256 students who enrolled in the second course, 170 students voluntarily participated in this study and they answered the questionnaires, including all the measures, simultaneously with the participants in the first group and thus served as the control group. The effect of this course will be measured with multiple data, including questionnaire data, reflective journals, and physiological data of well-being with a longitudinal experimental design. This research very strictly follows the ethical guidelines drawn up by the Finnish National Board on Research Integrity. We expect to publish the results of this study in fall 2021 at the latest.

CONCLUSIONS

We argue that a web-based, 8-week intervention course, which promotes both student well-being and their study skills, is a good way to support students pursuing higher education, and both aspects should be considered when supporting university students.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

DERR1-10.2196/23613.