Confirmatory Factor Analysis of the French Version of the Savoring Beliefs Inventory

Effectiveness of a positive psychology and mindfulness-based app on mental health for parents of children with a neurodevelopmental disorder: study protocol of a pragmatic international randomized controlled trial

INTRODUCTION

Parents of children with a neurodevelopmental disorder (NDD) experience more stress than parents of typically developing children. In a cocreation process with experts and parents, a low-threshold application that uses exercises based on the principles of positive psychology and mindfulness was developed. This application, called "Adappt," aims at enhancing the ability to adapt of the parents and caregivers of children with NDDs and at supporting their mental health. This protocol describes the evaluation study of the effectiveness of Adappt, its core working mechanisms and user experiences.

METHOD

A pragmatic international multicenter randomized controlled trial will compare the effectiveness of Adappt with a (delayed) waitlist control condition. At least 212 parents or primary caregivers of children younger than 18 years diagnosed with or suspected of a NDD will be randomly assigned to the intervention or waitlist control condition. Participants are excluded if they have severe anxiety or depression levels or are in treatment for mental health issues. Measures will be collected online at baseline, post-intervention (1 month after baseline), and 4 and 7 months after baseline. The primary outcome is the improvement in generic sense of ability to adapt as measured with the Generic Sense of Ability to Adapt Scale (GSAAS; (Front Psychol 14:985408, 2023)) at 4-month follow-up. Secondary outcomes are mental well-being, (parental) distress, and client satisfaction with "Adappt."

DISCUSSION

Results of this study will contribute to knowledge on the effectiveness of a low-threshold application for parents of children with a NDD in multiple countries. If the application is found to be effective in improving mental health, recommendations will be made for implementation in health care.

TRIAL REGISTRATION

This study is registered on clinicaltrials.gov (NCT06248762) on February 8, 2024, and the Open Science Framework ( https://osf.io/5znqv ).

Self‐compassion and savouring buffer the impact of the first year of the COVID‐19 on PhD students' mental health

Doctoral students face many challenges that were reinforced by COVID-19-related lockdowns. We assessed this impact over 1 year on doctoral students' depression, anxiety, stress, well-being, and doctoral engagement. We also investigated the potential protective role of self-compassion and savouring on mental health, well-being, and doctoral engagement. A total of 134 PhD students from several French universities responded to the three-time points of this longitudinal study. The results showed a significant increase in depression, anxiety and stress and a significant decrease in well-being and doctoral engagement during the first year of the pandemic. Self-compassion and savouring predicted lower levels of depression, anxiety, and stress, and higher levels of well-being over time. Savouring alone predicted higher doctoral engagement over time. This study reveals the significant impact of the pandemic year on the mental health of doctoral students, and the relevance of self-compassion and savouring as psychological resources to cope with adversity.

Correlates of Dampening and Savoring in Generalized Anxiety Disorder

Chronic worry and generalized anxiety disorder (GAD) symptoms are associated with infrequent savoring, and high dampening, of positive emotions. The goal of the present study was to investigate the indirect role of GAD-relevant processes, including intolerance of uncertainty (IU), fear of negative emotional contrasts, and negative beliefs about positive emotion and its regulation, in the relationship between GAD symptom severity and the tendency to engage in dampening and not savor positive emotions. Community participants (N = 233) completed questionnaires online.

In separate models, IU, fear of negative emotional contrasts, and negative beliefs about positive emotion and its regulation fully mediated the relationships between GAD symptom severity and greater dampening and lower savoring. However, controlling for depression, only IU remained a significant mediator. A post hoc latent analysis of the mediators provided support for an underlying construct that may reflect intolerance of uncomfortable states. Intolerance of uncomfortable states was found to significantly mediate the relationship between GAD symptoms and greater dampening and lower savoring. Difficulty withstanding uncertainty may be particularly relevant in understanding why people with elevated GAD symptoms engage in efforts to avoid experiencing positive emotions. Further, the findings suggest that there may be a common factor underlying a variety of GAD-associated constructs reflecting a broad intolerance of uncomfortable inner states. Theoretical and clinical implications are discussed.

Can Cognitive Control and Attentional Biases Explain More of the Variance in Depressive Symptoms Than Behavioral Processes? A Path Analysis Approach

Background

This study explored the proportion of variance in depressive symptoms explained by processes targeted by BA (activation, behavioral avoidance, anticipatory pleasure, and brooding), and processes targeted by cognitive control training (cognitive control, attentional biases, and brooding).

Methods

Five hundred and twenty adults were recruited. They completed a spatial cueing task as a measure of attentional biases and a cognitive task as a measure of cognitive control and completed self-report measures of activation, behavioral avoidance, anticipatory pleasure, brooding, and depressive symptoms. With path analysis models, we explored the relationships between these predictors and depressive symptoms.

Results

BA processes were significant predictors of depressive symptoms, and activation partially predicted anticipatory pleasure, which in turn predicted depressive symptoms. However, cognitive control and attentional biases predicted neither brooding nor depressive symptoms. A comprehensive model including all processes fit the data but did not explain more of the variance in brooding or depressive symptoms than a model including only BA processes.

Limitations

The spatial cueing task was associated with low reliability and the use of a non-clinical sample limited the generalizability of the conclusions.

Conclusion

Activation, behavioral avoidance, brooding, and anticipatory pleasure are relevant processes to target in order to reduce depressive symptoms, while cognitive control and attentional biases are not.

An Evaluation of an Online Training Platform for Teaching Positive Emotions for People With Schizophrenia

BACKGROUND

The dissemination of new interventions in clinical practice remains challenging. E-learning may provide wide access in various settings and allow tailored learning trajectories and an adapted training pace. This study evaluates an online platform to train professionals to lead the Positive Emotion Program for Schizophrenia (PEPS) for patients with anhedonia. This study aims to test the reception provided by clinicians to the platform and its perceived usefulness and investigate whether e-PEPS training improves knowledge about the facilitation of PEPS.

MATERIALS AND METHODS

Participants were recruited through advertisements. All participants provided their informed consent on a registration form and completed two pre-test questionnaires, a knowledge test on negative symptoms in schizophrenia, learning strategies and the partnership relationship, and a test on the ability to savor pleasant moments. After the training, they completed the same questionnaire and an evaluation form of the training and its application in personal and professional life.

RESULTS

Two-hundred and ten participants were registered to participate into the study, 185 received the access to the platform, and 101 participants completed the training and the post-test assessments. Satisfaction with training was high. The results showed that the participants significantly improved their knowledge about PEPS and increased the skills taught in their personal repertoire after the training. The training allows most clinicians to plan to lead a PEPS group in the year following training.

DISCUSSION

As a result of this study, training has been improved and is now freely available to all interested clinicians.

Current Progress and Future Directions for Theory and Research on Savoring

As research on savoring has increased dramatically since publication of the book Savoring: A New Model of Positive Experience (Bryant and Veroff, 2007), savoring has gradually become a core concept in positive psychology. I begin by reviewing the evolution of this concept, the development of instruments for assessing savoring ability and savoring strategies, and the wide range of applications of savoring in the psychosocial and health sciences. I then consider important directions for future theory and research. To advance our understanding of how naturalistic savoring unfolds over time, future work should integrate the perceptual judgments involved in not only the later stages of attending to and regulating positive experience (where past research has concentrated), but also the initial stages of searching for and noticing positive stimuli. Whereas most research has investigated reactive savoring, which occurs spontaneously in response to positive events or feelings, future work is also needed on proactive savoring, which begins with the deliberate act of seeking out or creating positive stimuli. To advance the measurement of savoring-related constructs, I recommend future work move beyond retrospective self-report methods toward the assessment of savoring as it occurs in real-time. The development of new methods of measuring meta-awareness and the regulation of attentional focus are crucial to advancing our understanding of savoring processes. I review recent research on the neurobiological correlates of savoring and suggest future directions in which to expand such work. I highlight the need for research aimed at unraveling the developmental processes through which savoring skills and deficits evolve and the role that savoring impairments play in the etiology and maintenance of psychopathology. Research is also needed to learn more about what enhances savoring, and to disentangle how people regulate the intensity versus duration of positive emotions. Finally, I encourage future researchers to integrate the study of anticipation, savoring the moment, and reminiscence within individuals across time.

Improving Pleasure and Motivation in Schizophrenia: A Randomized Controlled Clinical Trial

BACKGROUND

Negative symptoms are frequent in patients with schizophrenia and are associated with marked impairments in social functioning. The efficacy of drug-based treatments and psychological interventions on primary negative symptoms remains limited. The Positive Emotions Programme for Schizophrenia (PEPS) is designed to improve pleasure and motivation in schizophrenia patients by targeting emotion regulation and cognitive skills relevant to apathy and anhedonia. The main hypothesis of this study is that patients who attend 8 one-hour sessions of PEPS and treatment as usual (TAU) will have lower total apathy-avolition and anhedonia-asociality composite scores on the Scale for the Assessment of Negative Symptoms (SANS) than patients who attend only TAU.

METHODS

Eighty participants diagnosed with schizophrenia or schizoaffective disorder were randomized to receive either TAU or PEPS + TAU. The participants were assessed by independent evaluators before randomization (T0), in a post-test after 8 weeks of treatment (T1) and at a 6-month follow-up (T2).

RESULTS

The post-test results and 6-month follow-up assessments according to an intention-to-treat analysis showed that the apathy and anhedonia composite scores on the SANS indicated statistically greater clinical improvements in PEPS participants than in non-PEPS participants. In the post-test, anhedonia but not apathy was significantly improved, thus favouring the PEPS condition. These results were sustained at the 6-month follow-up.

CONCLUSIONS

PEPS is an effective intervention to reduce anhedonia in schizophrenia. PEPS is a short, easy-to-use, group-based, freely available intervention that is easy to implement in a variety of environments (ClinicalTrials.gov ID: NCT02593058).

Impact of Positive Emotion Regulation Training on Negative Symptoms and Social Functioning in Schizophrenia: A Field Test

Background: The poor efficacy of drug or psychological treatments on the primary negative symptoms of schizophrenia has led to the development of new interventions. The Positive Emotions Program for Schizophrenia (PEPS) is an emotion regulation strategy training that aims to intensify positive emotions and develop positive performance beliefs. A randomized controlled trial showed that PEPS is effective in reducing the composite score of the reduction of experience syndrome (anhedonia and apathy). The present study is designed to evaluate its feasibility in natural conditions to measure external validity of PEPS. Materials and Methods: Twenty-one participants recruited through the French national network of expert centers followed eight sessions of PEPS and were assessed pre- and posttest with the Scale for Assessment of Negative Symptoms (SANS) and the Personal and Social Performance (PSP). The scales of the SANS were divided into a composite score of the reduction of the ability to experience and a composite score of the reduction of expression. Results: All participants followed the 8 sessions of PEPS, and both composite scores were significantly and clinically improved at posttest. Social functioning assessed with the PSP was also improved. Conclusions: This field test shows that participation in PEPS is accompanied by a reduction of negative symptoms and an improvement of social functioning. Both negative syndromes, reduction of expression and reduction of experience, are improved. Participants are younger than those in previous studies, which may explain this unexpected result. However, this calls for a controlled study with younger participants.