Positive Psychology Theory, Research, and Practice: A Primer for Rehabilitation Counseling Professionals

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.

Promoting Well-Being in Individuals With Autism: Applying Positive Psychology in Rehabilitation Counseling

Positive psychology is a subdomain that addresses the importance of human strengths and personal assets in individuals’ well-being. The principles of positive psychology align with the philosophy of rehabilitation counseling by emphasizing individuals’ strengths to promote psychosocial adjustment to disability. Considering the intersection between positive psychology and rehabilitation counseling, applying the positive psychology framework to rehabilitation counseling will be a promising foundation for improvement in services and outcomes. As the number of individuals on the autism spectrum increases, more innovative services are needed to keep abreast of their needs. This article discusses how positive psychology can be applied to the population of individuals with autism spectrum disorder (ASD) and explores possible practices that can be replicated by practitioners to provide quality services for this emerging disability population. Implications for education and research are also discussed.

Internet-delivered psychological interventions for reducing depressive, anxiety symptoms and fear of childbirth in pregnant women: A meta-analysis and meta-regression

OBJECTIVE

The current review aims to (1) investigate the effectiveness of Internet-based psychological intervention in reducing depressive, anxiety, and stress symptoms and fear of childbirth among pregnant women at post-intervention and follow-up; (2) compare the effects of the intervention using different psychological principles; and (3) explore potential covariates on the intervention effect.

METHODS

A literature search of seven databases was carried out to identify published and unpublished randomized controlled trials (RCTs) in English without any time limitation up to February 2021. Meta-analysis and meta-regression were conducted using Comprehensive Meta-analysis software. This review protocol was registered on PROSPERO (CRD42021235565).

RESULTS

Sixteen RCTs involving 3894 pregnant women were included from more than 23 countries. Internet-delivered psychological interventions were found to significantly (p < 0.05) reduce depressive (g = -0.16 to -0.32) and anxiety (g = -0.22 to -0.33) symptoms with small effect sizes at post-intervention and follow-up during 6 to 8 weeks postpartum compared with those in the comparator group. However, there was insufficient evidence for fear of childbirth and stress symptoms. Our subgroup analyses found that psychological interventions adopting component of cognitive behavioral therapy (g = -0.29) or mindfulness therapy (g = -0.62) showed beneficial effects to improve depressive symptoms among pregnant women. Univariate random-effect regression analyses showed that the attrition rate was a significant covariate (Z = -2.33, p = 0.02) on depressive symptoms. The certainty of main outcomes was graded from low to very low in accordance with the GRADE criteria.

CONCLUSIONS

Our reviews suggested that Internet-delivered psychological intervention may complement usual antenatal care in the improvement of depressive and anxiety symptoms. Future trials involving a large-scale sample are needed to improve the methodological quality.

An Evaluation of the PERMA Model as a Framework for Reducing Psychiatric Comorbidity in Individuals With Alopecia Areata

Abstract. Background: Alopecia areata (AA) is among the most common immunological conditions. Although AA is considered to be a medically benign condition, those living with AA often report comorbid psychiatric conditions, high levels of functional impairment, and diminished quality of life. These consequences are largely due to the unique psychological turmoil associated with the condition. Unfortunately, little research has considered how to improve quality of life outcomes for this group. Aims: The purpose of this study was to evaluate how the PERMA framework of well-being is associated with the individual subjective experience of AA. A greater understanding of how PERMA applies to this group holds promise for assisting clinicians with devising psychosocial coping strategies for this population. Method: 274 individuals were recruited for participation. Hierarchical regression analyses were used to evaluate associations between the PERMA variables and AA-related (a) subjective symptoms (e.g., self-consciousness, sadness) and (b) relationship impact (e.g., perceived attractiveness). Each analysis controlled for demographic and condition-specific variables. Results: Demographic and PERMA variables were found to be significantly associated with positive experiences of each quality of life outcome. Limitations: The male to female ratio of participants was biased toward females. Furthermore, the nature of cross-sectional survey research has inherent limitations. Conclusion: The findings provide support for a relationship between PERMA variables and quality of life outcomes among people with AA. Clinical implications and future research directions are discussed.

The International Classification of Functioning, Disability, and Health (ICF) as a community participation model for people with multiple sclerosis: A hierarchical regression analysis

Multiple sclerosis (MS) is a central nervous system disorder that impacts more than 400,000 people in the U.S. The disease results in multiple functional impairments that are diverse and varied across individuals. Additonally, MS has a profound impact on community participation which, like other rehabilitation outcomes, cannot be explained on the basis of functional limitations alone. The purpose of this study was to develop and evaluate a model of community participation for people living with MS using the World Health Organization (WHO) International Classification of Functioning, Disability, and Health (ICF) framework. The model focused on the roles that personal factors have as predictors of community participation, while also serving as mediators and moderators for the relationship between activity limitation and participation. Results from the hierarchical regression analysis indicated that demographic characteristics (i.e. MS type), personal factors (i.e. core self-evaluations (CSE), MS self-management, resilience, and social skills), and activity limitations accounted for 64% of the variance in participation. Further, mediation analysis indicated that CSE mediated the relationship between activity limitation and community participation. Finally, moderation analysis indicated an interaction effect between educational attainment and MS self-management. Implications for future research in rehabilitation and clinical application are discussed.

Positive Predictors of Life Satisfaction for Autistic College Students and Their Neurotypical Peers

Background

Positive psychological traits are associated with higher life satisfaction, academic success, and fewer mental health problems in neurotypical (NT) college students. However, it is unclear whether this is similar for autistic students. This study explores college-specific positive traits, including academic satisfaction, self-efficacy, gratitude, and school connectedness, and their relationship with life satisfaction in autistic college students and their NT peers.

Method

Autistic (n = 42) and NT (n = 50) college students completed an online survey containing measures of autistic traits, college well-being, and life satisfaction. We explored differences in life satisfaction and college well-being between groups using analysis of variances and explored these relationships based on self-reported autistic traits across groups using correlations. We assessed whether a relationship between college-specific well-being and life satisfaction was moderated by autistic traits using linear regression.

Results

Results showed emerging differences in school connectedness such that autistic students were less likely to report feeling connected despite similar scores on other domains of college well-being and life satisfaction; correcting for multiple comparisons this difference was no longer significant. However, autistic traits were significantly related to life satisfaction and school connectedness across the full sample. Differences in school connectedness also explained a significant amount of variance in life satisfaction over and above the influence of autistic traits. The interaction between connectedness and autistic traits was not significant.

Conclusions

Results suggests that students who experience higher levels of connection with their university and peers, regardless of the number of autistic traits they endorse, report higher satisfaction with life. Given the importance of social connectedness in college-specific and overall well-being, significant attention should be paid to the protective role of social support systems in addition to academic services when understanding how to support autistic individuals as well as individuals who do not meet diagnostic criteria, but share some similar clinical traits.

Lay summary

What was the purpose of this study?: College well-being is related to life satisfaction in neurotypical (NT) college students. However, it is unclear whether this is similar for autistic college students. The purpose of this study was to understand how different aspects of college well-being support life satisfaction in autistic college students compared with their NT peers.What did the researchers do?: We invited both autistic and NT college students to complete an online survey. The survey asked about college well-being and life satisfaction. We looked at similarities and differences in responses between autistic and NT students. We also looked at whether college well-being was related to life satisfaction and whether that depended on the number of autistic traits that individuals selected to describe themselves.What were the results of the study?: We found that there were no group differences between autistic and NT college students in their overall college well-being or life satisfaction. However, there were differences in life satisfaction and one individual aspect of college well-being, school connectedness, based on autistic traits. Students with more autistic traits were less likely to report feeling connected to their university and peers and were less satisfied with life overall. We also found that school connectedness and the number of autistic traits, rather than diagnostic status, were related to life satisfaction. Students who feel more connected to their university and peers, regardless of the number of autistic traits they endorse, report higher satisfaction with life.What do these findings add to what was already known?: While there are many studies of life satisfaction in autistic individuals, most focus on the negative aspects. Our study is the first to look at positive factors, such as college well-being, in autistic students and their NT peers. This is important because both autistic and NT students struggle with academics, social isolation, and mental health in college. However, understanding the positive traits that can help counteract those challenges is important in supporting all students in college. Our findings show that both autistic traits and school connectedness are important, but separate, components for understanding life satisfaction in college students with and without autism.What are the potential weaknesses in the study?: This study only recruited autistic participants from disability resource centers of 4-year colleges, so students who were attending community colleges, private institutions, or who did not disclose their diagnosis to the disability resource centers were not included. As autistic students may be more likely to attend community or private colleges or may not disclose their diagnostic status, our results may not apply to other people. Our sample of students was also small, which limits our ability to find differences and have confidence in the results.How will these findings help autistic adults?: These findings show the importance of social integration for the well-being of neurodivergent and NT college students and support ongoing requests from autistic students for more nonacademic supports in college. Screening for college well-being and improving social integration are potential ways to increase life satisfaction for neurodivergent college students.

An Empirically Derived Taxonomy of Biopsychosocial Factors of Adjustment to Fibromyalgia: Results of a Multivariate Analysis

Fibromyalgia (FM) is a lifelong central nervous system disorder that is precipitated by a range of biological, psycho-cognitive, and social factors. The aims of this exploratory study were to (a) identify biopsychosocial and cognitive factors that may affect an individual’s response to FM, (b) determine whether individuals with FM can be grouped into homogeneous subgroups based on biopsychosocial factors associated with response to FM, and (c) compare subgroup differences in health outcomes and life satisfaction. This study included 302 participants with FM. Principal components analysis yielded three sets of biopsychosocial factors that may affect response to FM (i.e., protective, cognitive-affective, and physical factors). Based on these three factors, a cluster analysis was performed, which produced three homogeneous subgroups: (a) the moderate amount of problems group, (b) the least amount of problems group, and (c) the many problems group. Analysis of variance (ANOVA) results indicated that these three subgroups differed significantly in terms of health outcomes and life satisfaction. The findings of this study broaden the existing literature related to understanding FM from a multidimensional symptom response perspective and contribute to the development and validation of biopsychosocial interventions for people with FM.

The relationship between social experience and subjective well-being in autistic college students: A mixed methods study

This mixed methods study examined the relationship between the college social experience and subjective well-being in autistic students in the Midwestern United States. An online survey focused on social connectedness, social participation, social support, and subjective well-being. A semi-structured interview discussed transition, supports received, and social participation. Correlations and a hierarchical regression were used to examine the relationship between social experience variables and subjective well-being from the survey. Inductive thematic analysis was used to identify interview themes. Theme counts for students who reported higher and lower subjective well-being were examined. Social connectedness, time spent with friends, and perceived social support were positively correlated with students' subjective well-being, with social connectedness explaining unique variance. Common themes included challenges navigating a new social environment and the importance of family, friends, and professors in providing social support. Students with lower subjective well-being more frequently discussed struggles to make social connections and the trade-off between socializing and succeeding academically, whereas students with higher subjective well-being more frequently described college as providing opportunities to develop meaningful social connections. This study adds new perspectives on the college experience for autistic students and highlights the important role that social connections and support play in their subjective well-being.

The Buffering Effect of Character Strengths on Depression

Abstract. The transition from high school to college can be very stressful for Turkish students because they may experience value conflicts and adjustment issues, which can trigger the development of mental health problems. Character strengths can serve as a buffer against psychopathology. The aim of the study was to examine perceived stress and negative attributional style as mediating factors between character strengths and depression among Turkish college students. Bootstrap testing approach was implemented to compute direct and indirect effects and total effect in the mediation analysis. Altogether 235 students from two Turkish universities participated in the study. The results showed that character strengths were associated with lower levels of depression and it was negatively associated with perceived stress and negative attributional style. The results also indicated that perceived stress and negative attribution style completely mediated the relationship between character strengths and depression among Turkish college students. These findings suggested the need to develop empirically supported interventions that can promote character strengths toward reducing stress, negative attributions, and depression in this population.

The Duality of Human Experience: Perspectives From Psychosocial Adaptation to Chronic Illness and Disability—Empirical Observations and Conceptual Issues

The authors examine the current views on the duality of the human experience as portrayed within the process of coping with traumatic life events. Emphasis is placed on those views associated with the onset or diagnosis of chronic illnesses and disabilities (CID). In a companion article, the authors reviewed experiential dualities focusing on (a) modes of psychosocial adaptation to CID, such as coping versus succumbing, disabled and nondisabled selves; (b) models of denial; and (c) models of personal growth following adversity and traumatic events, such as the onset or diagnosis of CID. Discussion then focused on the dualities espoused by the latter models, which typically dichotomize human functioning following traumatic experiences. In the present article, the authors discuss (a) the main factors, considered by the various theoretical models, that have been found to exert influence on the genuineness of personal growth, with a special emphasis on post-CID psychological growth; (b) pertinent empirical findings that, directly and indirectly, address the perceived dualities of personal growth in the context of psychosocial adaptation to CID; and (c) theoretical and research implications associated with the study of the dual nature of post-CID growth, including recommendations for investigating the veracity of this reported personal growth.

Psychosocial Adaptation to Disability Within the Context of Positive Psychology: Philosophical Aspects and Historical Roots

PURPOSE

The purpose of this article is to review the conceptual and clinical similarities that exist between the principles of positive psychology and those underlying rehabilitation counseling and psychology, occupational rehabilitation, and those espoused by the field of psychosocial adaptation to chronic illness and disability (CID).

METHODS

Three themes were selected for review. These included the historical contributions of early scholars in the area of psychosocial adaptation to CID that later were indirectly infused into mainstream positive psychology; state and trait constructs that constitute much of the infrastructure of positive psychology and psychosocial adaptation to CID; and, finally, the philosophical congruencies between positive psychology and psychosocial adaptation to CID.

CONCLUSION

The existing literature indicates that there is a substantial philosophical and conceptual overlap between the fields of positive psychology and psychosocial adaptation to CID. Since theoreticians and researchers, from both fields, often use differing terminology and definitions to describe similar concepts, as well as seek similar research goals, it would behoove both fields to seek a closer partnership in order to establish a meaningful dialogue that focuses on human strengths and virtues in the lives of people with CID.

Core Self-Evaluations as a Mediator Between Functional Disability and Life Satisfaction in College Students With Disabilities Majoring in Science and Technology

Purpose: To examine the mediational effect of core self-evaluations (CSE) on the relationship between functional disability and life satisfaction.

Methods: A quantitative descriptive design using multiple regression analysis. The participants were 97 college students with disabilities receiving services through Hunter College’s Minority-Disability Alliance (MIND Alliance) in science, technology, engineering, and mathematics.

Results: CSE was a partial mediator between functional disability and life satisfaction. After controlling for CSE, functional disability was no longer a significant predictor of life satisfaction.

Conclusions: CSE partially mediated the impact of functional disability on life satisfaction. Future research should explore the development of interventions to increase CSE to reduce the effect of disability and to improve life satisfaction and employment outcomes for individuals with disabilities.

Introduction to Positive Psychology in Rehabilitation

Positive psychology has received increasing attention in rehabilitation counseling research and practice. The rehabilitation counseling philosophy shares a similar emphasis of personal assets and strengths, which provides a solid foundation for the integration of positive psychology into the professional practice of rehabilitation counseling. In this article, the guest editors present their rationale for developing this special issue on positive psychology and rehabilitation research. They highlight some of the exciting findings reported in the articles included in this special issue on positive psychology and rehabilitation research. The goal of this special issue is to stimulate thinking and discussion about applying positive psychology theory, research, assessment, and interventions in rehabilitation counseling for promoting overall well-being, quality of life, and happiness for people with chronic illness and disabilities.