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Bibi A, Blackwell SE, Margraf J. Positive mental imagery and mental health amongst university students in Pakistan. INTERNATIONAL JOURNAL OF PSYCHOLOGY 2024; 59:55-63. [PMID: 37718468 DOI: 10.1002/ijop.12946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Accepted: 08/18/2023] [Indexed: 09/19/2023]
Abstract
Mental health problems amongst university students pose a major public health challenge, and this is particularly the case in Pakistan. Alongside broader societal and cultural pressures, cognitive factors likely also play a role in the development of and resilience to mental health problems and may provide a feasible target for interventions. The current study built on previous research in primarily European samples investigating the relationship between one cognitive factor, positive future-oriented mental imagery, and mental health, extending this to a sample of university students in Pakistan (N = 1838). In a cross-sectional design, higher vividness of positive future-oriented mental imagery was associated with lower levels of depressive symptoms and higher levels of positive mental health amongst participants completing questionnaire measures on paper (N = 1430) or online (N = 408). In the sample completing the measures on paper, these relationships remained statistically significant even when controlling for socio-demographic and mental health-related variables. The results provide a foundation for further investigating positive mental imagery as a potential mechanism of mental health and intervention target amongst university students in Pakistan.
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Affiliation(s)
- Akhtar Bibi
- Mental Health Research and Treatment Center, Faculty of Psychology, Ruhr-Universität Bochum, Bochum, Germany
| | - Simon E Blackwell
- Mental Health Research and Treatment Center, Faculty of Psychology, Ruhr-Universität Bochum, Bochum, Germany
| | - Jürgen Margraf
- Mental Health Research and Treatment Center, Faculty of Psychology, Ruhr-Universität Bochum, Bochum, Germany
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Ma X, Jiang X, Jiang Y. Increased spontaneous fronto-central oscillatory power during eye closing in patients with multiple somatic symptoms. Psychiatry Res Neuroimaging 2022; 324:111489. [PMID: 35537300 DOI: 10.1016/j.pscychresns.2022.111489] [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: 01/09/2022] [Revised: 03/20/2022] [Accepted: 05/03/2022] [Indexed: 11/24/2022]
Abstract
Functional somatic symptoms (FSS) are typically associated with excessive thoughts, feelings and behaviors related to the physical symptoms whether these symptoms are unequivocally associated with a diagnosed medical condition. However, less evidence is available concerning the neurocognitive deficits underlying these features of FSS. This study aimed to examine the resting-state oscillatory activities during both eye-opening and eye-closure states in individuals with FSS. Sixty-six FSS patients screened with PHQ-15 received two 10-minute sessions of EEG assessments. All completed clinical measurements on depression, anxiety, and psychological measurements on personality traits and alexithymia. Patients scoring high on PHQ-15 (the multiple somatic symptom (MSS) or SS-high group) demonstrated increased powers in central channels (C3 and C4) in low-beta band and in the left-frontal channel (F3) in high-gamma band, during eye-closure states. Patients with higher scores in depression were more likely to be classified as the SS-high group. SS-high patients demonstrated increased difficulties in describing and identifying emotions, and less reduced day-dreaming. The combined findings in increased fronto-central high-frequency activities and alexithymia measures suggest MSS patients are associated with enhanced internally-oriented thinking and cognitive simulation which may lead to intensified feelings of simulated events and misattribution of symptoms. Future treatments should focus on eliminating cognitive bias and enhancing accuracy in interoceptive awareness.
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Affiliation(s)
- Xiquan Ma
- Department of Developmental and Behavioral Pediatrics, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Xiaoming Jiang
- Institute of Linguistics, Shanghai International Studies University, Shanghai, China.
| | - Yu Jiang
- Institute for Physiology and Cell Biology, University of Veterinary Medicine Hannover, Foundation, Hannover, Germany
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Daniels A, Wellan SA, Walter H. Learning it the hard way - how enjoying life and positive appraisal buffer the negative effects of stressors on mental health in the COVID-19 pandemic. JOURNAL OF AFFECTIVE DISORDERS REPORTS 2021; 6:100200. [PMID: 34957432 PMCID: PMC8684292 DOI: 10.1016/j.jadr.2021.100200] [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: 06/08/2021] [Revised: 06/25/2021] [Accepted: 07/18/2021] [Indexed: 12/05/2022] Open
Abstract
Background Higher levels of stress and negative emotions such as anxiety and depression have been reported since the beginning of the COVID-19 pandemic, but it remains less clear how positive emotions, such as hedonic capacity, may be affected. Further, during lockdowns, the ability to learn new pleasurable activities (hedonic learning) may be particularly relevant. Here, we investigated if state hedonia and/or hedonic learning mediated the relationship between COVID-19 stress and mental health. Moreover, we explored whether positive appraisal style (PAS), a major resilience factor, influenced these relationships. Methods Using a cross-sectional design, 5000 German-speaking participants filled out online questionnaires targeting stressors, mental health, state hedonia, hedonic learning, and PAS between April 9 and May 15, 2020. After confirming the factor structure of our constructs, we applied latent structural equation modeling to test mediation as well as moderated mediation models. Results Stress showed a positive association with mental health symptoms, which was buffered by both state hedonia and hedonic learning. While higher stress was related to lower state hedonia, participants reported more hedonic learning with greater stressor load. The latter effect was greater for individuals with high PAS. Limitations The present results should be replicated in longitudinal designs with representative samples to confirm the directionality and generalizability of effects. Conclusions Both state hedonia and hedonic learning buffered the effect of stress on mental health in an early phase of the COVID-19 pandemic. Learning new rewarding activities in combination with a PAS may be especially relevant for maintaining mental health during lockdowns.
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Key Words
- ACIPS, Anticipatory and Consummatory Interpersonal Pleasure Scale
- AIC, Akaike Information Criterion
- Anhedonia
- BIC, Bayesian Information Criterion
- CFA, confirmatory factor analysis
- CFI, comparative fit index
- CI, confidence interval
- COVID-19
- COVID-19, coronavirus disease 2019
- DARS, Dimensional Anhedonia Rating Scale
- EFA, exploratory factor analysis
- GHQ-12, 12-item General Health Questionnaire
- MLR, robust maximum likelihood
- Mental health
- PAS, positive appraisal style
- Positive appraisal
- RMSEA, root mean square error of approximation
- Reward learning
- SARS-CoV-2, severe acute respiratory syndrome coronavirus 2
- SEM, structural equation modeling
- SRMR, standardized root mean square residual
- Stress
- TEPS, Temporal Experience of Pleasure Scale
- TLI, Tucker Lewis index
- aBIC, sample-size adjusted BIC
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Affiliation(s)
- Anna Daniels
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Psychiatry and Neurosciences CCM, Research Division of Mind and Brain, Charitéplatz 1, 10117 Berlin, Germany.,Humboldt-Universität zu Berlin, Faculty of Philosophy, Berlin School of Mind and Brain, Berlin, Germany
| | - Sarah A Wellan
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Psychiatry and Neurosciences CCM, Research Division of Mind and Brain, Charitéplatz 1, 10117 Berlin, Germany.,Humboldt-Universität zu Berlin, Faculty of Philosophy, Berlin School of Mind and Brain, Berlin, Germany
| | - Henrik Walter
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Psychiatry and Neurosciences CCM, Research Division of Mind and Brain, Charitéplatz 1, 10117 Berlin, Germany.,Humboldt-Universität zu Berlin, Faculty of Philosophy, Berlin School of Mind and Brain, Berlin, Germany
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Westermann K, Woud ML, Cwik JC, Graz C, Nyhuis PW, Margraf J, Blackwell SE. Feasibility of computerised positive mental imagery training as a treatment adjunct in in-patient mental health settings: randomised controlled trial. BJPsych Open 2021. [PMCID: PMC8596293 DOI: 10.1192/bjo.2021.1042] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
Background
Positive affect and anhedonia are important but challenging targets for mental health treatments. Previous research indicates the potential of a computerised cognitive training paradigm involving generation of positive mental imagery, termed positive mental imagery training (PMIT), to increase positive affect and reduce anhedonia.
Aims
Our main aim was to investigate the feasibility of PMIT as a positive affect-focused, transdiagnostic adjunct to treatment as usual for patients in in-patient mental health settings.
Method
We ran an open feasibility, randomised controlled trial with three parallel arms: treatment as usual; treatment as usual plus PMIT; and treatment as usual plus an active comparator, cognitive control training. Fifty-seven patients from two different in-patient mental health treatment clinics in Germany were randomised in a 1:1:1 ratio. PMIT and cognitive control training comprised an introductory session followed by eight 15-min training sessions over 2 weeks. Clinical outcomes such as positive affect (primary outcome measure) and anhedonia were assessed at pre- and post-training, and at a further 2-week follow-up.
Results
Adherence was good and attrition was low. The patterns of results for the outcome data were not consistent with a specific effect of PMIT on positive affect, but were more consistent with a specific effect on anhedonia.
Conclusions
The results indicate feasibility and potential promise of a larger efficacy trial investigating PMIT as a treatment adjunct in in-patient mental health settings. Limitations include lack of researcher blinding, small sample size and lack of pre-specified feasibility outcomes. Anhedonia may be a more suitable primary outcome for a future larger trial.
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Wellan SA, Daniels A, Walter H. State Anhedonia in Young Healthy Adults: Psychometric Properties of the German Dimensional Anhedonia Rating Scale (DARS) and Effects of the COVID-19 Pandemic. Front Psychol 2021; 12:682824. [PMID: 34248783 PMCID: PMC8260844 DOI: 10.3389/fpsyg.2021.682824] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Accepted: 05/25/2021] [Indexed: 01/18/2023] Open
Abstract
Healthy reward processing is a complex interplay of several components. Recent self-report measures of anhedonia, the decrease or loss of hedonic capacity, take this complexity into account. The Dimensional Anhedonia Rating Scale (DARS) measures interest, motivation, effort and consummatory pleasure across four domains: hobbies, food/drink, social activities and sensory experiences. In the present cross-sectional survey study, we validated the German version of the DARS in a sample of 557 young healthy adults. Factor structure as well as convergent and divergent validity were assessed. As a secondary aim, we examined the effects of the COVID-19 pandemic on state anhedonia and depression severity. Our results suggest good convergent and divergent validity and high internal consistency of the German DARS. The original differentiation of four factors mapping onto the four domains was confirmed and measurement invariance before and during the COVID-19 pandemic was established. We conclude that the DARS is a valid instrument to comprehensively assess state anhedonia in healthy German samples. Future studies should further assess the utility of the German DARS in clinical contexts. In line with many previous studies, participants during the pandemic reported significantly higher levels of depressive symptoms compared to participants in the months before. We found no indication that the COVID-19 pandemic affected state hedonic capacity.
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Affiliation(s)
- Sarah A. Wellan
- Research Division of Mind and Brain, Department of Psychiatry and Psychotherapy Campus Charité Mitte, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- Berlin School of Mind and Brain, Faculty of Philosophy, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Anna Daniels
- Research Division of Mind and Brain, Department of Psychiatry and Psychotherapy Campus Charité Mitte, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- Berlin School of Mind and Brain, Faculty of Philosophy, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Henrik Walter
- Research Division of Mind and Brain, Department of Psychiatry and Psychotherapy Campus Charité Mitte, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- Berlin School of Mind and Brain, Faculty of Philosophy, Humboldt-Universität zu Berlin, Berlin, Germany
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Miragall M, Borrego A, Cebolla A, Etchemendy E, Navarro-Siurana J, Llorens R, Blackwell SE, Baños RM. Effect of an upright (vs. stooped) posture on interpretation bias, imagery, and emotions. J Behav Ther Exp Psychiatry 2020; 68:101560. [PMID: 32078947 DOI: 10.1016/j.jbtep.2020.101560] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2019] [Revised: 01/10/2020] [Accepted: 02/09/2020] [Indexed: 12/01/2022]
Abstract
BACKGROUND AND OBJECTIVES Adopting an upright (vs. stooped) posture has been related to positive effects on emotional and cognitive processes. However, there is no evidence concerning the effect of posture on two key processes associated with the maintenance of depression: interpretation bias and vividness of mental imagery. The objectives were to investigate the effect of adopting an upright (vs. stooped) posture on interpretation bias and vividness of positive and negative mental imagery, and to explore the interplay between these processes and depression-related emotions. METHODS The sample consisted of 54 participants (Mage = 22.00, 64.8% women), who were randomly assigned to the upright or stooped condition. Participants answered self-report measures while they were adopting a specific posture. Posture was monitored through inertial technology. RESULTS Main results were that: upright (vs. stooped) posture led to more positive interpretations of ambiguous information and increased positive emotions related to depression (happiness, optimism and vigor); time in an upright position was associated with change in interpretation bias and vividness of positive mental imagery; and level of depressive symptomatology moderated the effect of posture on the change in interpretation bias. LIMITATIONS Limitations are related to the use of non-clinical sample, the use of short-term measurements, and the lack of an experimental condition adopting the usual posture. CONCLUSIONS Posture interacts with mechanisms involved in the maintenance of depression, as well as with depression-related emotions. This study has clinical implications that should be continued explored in order to clarify the role of manipulating the posture in individuals with depressive symptomatology.
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Affiliation(s)
- Marta Miragall
- Department of Personality, Evaluation and Psychological Treatment, University of Valencia, Valencia, Spain; CIBER Fisiopatología Obesidad y Nutrición (CIBEROBN). Instituto Carlos III, Spain.
| | - Adrián Borrego
- Neurorehabilitation and Brain Research Group, Instituto de Investigación e Innovación en Bioingeniería. Universitat Politècnica de València, Valencia, Spain.
| | - Ausiàs Cebolla
- Department of Personality, Evaluation and Psychological Treatment, University of Valencia, Valencia, Spain; CIBER Fisiopatología Obesidad y Nutrición (CIBEROBN). Instituto Carlos III, Spain.
| | - Ernestina Etchemendy
- Department of Personality, Evaluation and Psychological Treatment, University of Valencia, Valencia, Spain.
| | - Jéssica Navarro-Siurana
- Department of Personality, Evaluation and Psychological Treatment, University of Valencia, Valencia, Spain.
| | - Roberto Llorens
- Neurorehabilitation and Brain Research Group, Instituto de Investigación e Innovación en Bioingeniería. Universitat Politècnica de València, Valencia, Spain; Servicio de Neurorrehabilitación y Daño Cerebral de los Hospitales Vithas-NISA. Fundación Hospitales NISA, Valencia, Spain.
| | - Simon E Blackwell
- Department of Psychology, Ruhr-Universität Bochum, Germany; Mental Health Research and Treatment Center, Faculty of Psychology, Ruhr-Universität Bochum, Germany.
| | - Rosa M Baños
- Department of Personality, Evaluation and Psychological Treatment, University of Valencia, Valencia, Spain; CIBER Fisiopatología Obesidad y Nutrición (CIBEROBN). Instituto Carlos III, Spain.
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