Targeted prevention of common mental health disorders in university students: randomised controlled trial of a transdiagnostic trait-focused web-based intervention

Background: A large proportion of university students show symptoms of common mental disorders, such as depression, anxiety, substance use disorders and eating disorders. Novel interventions are required that target underlying factors of multiple disorders.<p></p> Aims: To evaluate the efficacy of a transdiagnostic trait-focused web-based intervention aimed at reducing symptoms of common mental disorders in university students.<p></p> Method: Students were recruited online (n = 1047, age: M = 21.8, SD = 4.2) and categorised into being at high or low risk for mental disorders based on their personality traits. Participants were allocated to a cognitive-behavioural trait-focused (n = 519) or a control intervention (n = 528) using computerised simple randomisation. Both interventions were fully automated and delivered online (trial registration: ISRCTN14342225). Participants were blinded and outcomes were self-assessed at baseline, at 6 weeks and at 12 weeks after registration. Primary outcomes were current depression and anxiety, assessed on the Patient Health Questionnaire (PHQ9) and Generalised Anxiety Disorder Scale (GAD7). Secondary outcome measures focused on alcohol use, disordered eating, and other outcomes.<p></p> Results: Students at high risk were successfully identified using personality indicators and reported poorer mental health. A total of 520 students completed the 6-week follow-up and 401 students completed the 12-week follow-up. Attrition was high across intervention groups, but comparable to other web-based interventions. Mixed effects analyses revealed that at 12-week follow up the trait-focused intervention reduced depression scores by 3.58 (p<.001, 95%CI [5.19, 1.98]) and anxiety scores by 2.87 (p = .018, 95%CI [1.31, 4.43]) in students at high risk. In high-risk students, between group effect sizes were 0.58 (depression) and 0.42 (anxiety). In addition, self-esteem was improved. No changes were observed regarding the use of alcohol or disordered eating.<p></p> Conclusions This study suggests that a transdiagnostic web-based intervention for university students targeting underlying personality risk factors may be a promising way of preventing common mental disorders with a low-intensity intervention

Positive functioning inventory: initial validation of a 12-item self-report measure of well-being

Background: This paper describes the validation of the Positive Functioning Inventory (PFI-12). This is a 12-item self-report tool developed to assess a spectrum of functioning ranging from states of mental distress to states of well-being. Method: Two samples (Sample 1: N = 242, mean age = 20 years. Sample 2: N = 301, mean age = 20 years) completed self-report measures of personality and social, physical and psychological functioning. Results: Evidence is provided for internal-consistency reliability, test-retest reliability, incremental validity, and convergent and discriminant validity in relation to a number of other measures of personality, social, physical and psychological functioning. Conclusion: The tool promises to be useful to practitioners and researchers who wish to assess positive psychological functioning

Stress-Induced Reinstatement of Drug Seeking: 20 Years of Progress

In human addicts, drug relapse and craving are often provoked by stress. Since 1995, this clinical scenario has been studied using a rat model of stress-induced reinstatement of drug seeking. Here, we first discuss the generality of stress-induced reinstatement to different drugs of abuse, different stressors, and different behavioral procedures. We also discuss neuropharmacological mechanisms, and brain areas and circuits controlling stress-induced reinstatement of drug seeking. We conclude by discussing results from translational human laboratory studies and clinical trials that were inspired by results from rat studies on stress-induced reinstatement. Our main conclusions are (1) The phenomenon of stress-induced reinstatement, first shown with an intermittent footshock stressor in rats trained to self-administer heroin, generalizes to other abused drugs, including cocaine, methamphetamine, nicotine, and alcohol, and is also observed in the conditioned place preference model in rats and mice. This phenomenon, however, is stressor specific and not all stressors induce reinstatement of drug seeking. (2) Neuropharmacological studies indicate the involvement of corticotropin-releasing factor (CRF), noradrenaline, dopamine, glutamate, kappa/dynorphin, and several other peptide and neurotransmitter systems in stress-induced reinstatement. Neuropharmacology and circuitry studies indicate the involvement of CRF and noradrenaline transmission in bed nucleus of stria terminalis and central amygdala, and dopamine, CRF, kappa/dynorphin, and glutamate transmission in other components of the mesocorticolimbic dopamine system (ventral tegmental area, medial prefrontal cortex, orbitofrontal cortex, and nucleus accumbens). (3) Translational human laboratory studies and a recent clinical trial study show the efficacy of alpha-2 adrenoceptor agonists in decreasing stress-induced drug craving and stress-induced initial heroin lapse

A finer grained approach to psychological capital and work performance

Purpose Psychological capital is a set of personal resources comprised by hope, efficacy, optimism, and resilience, which previous research has supported as being valuable for general work performance. However, in today’s organizations, a multidimensional approach is required to understanding work performance, thus, we aimed to determine whether psychological capital improves proficiency, adaptivity, and proactivity, and also whether hope, efficiency, resilience, and optimism have a differential contribution to the same outcomes. Analyzing the temporal meaning of each psychological capital dimension, this paper theorizes the relative weights of psychological capital dimensions on proficiency, adaptivity, and proactivity, proposing also that higher relative weight dimensions are helpful to cope with job demands and perform well. Methodology Two survey studies, the first based on cross-sectional data and the second on two waves of data, were conducted with employees from diverse organizations, who provided measures of their psychological capital, work performance, and job demands. Data was modeled with regression analysis together with relative weights analysis. Findings Relative weights for dimensions of psychological capital were supported as having remarkable unique contributions for proficient, adaptive, and proactive behavior, particularly when job demands were high. Originality/Value We concluded that organizations facing high job demands should implement actions to enhance psychological capital dimensions; however, those actions should focus on the specific criterion of performance of interest

Stress and subjective well-being among first year UK undergraduate students

Transition to university is stressful and successful adjustment is imperative for well-being. Historically research on transitional stress focussed on negative outcomes and ill health. This is the first UK study applying a positive psychology approach to investigate the characteristics that facilitate adjustment among new university students. A range of psychological strengths conceptualised as covitality factors, shown individually to influence the stress and subjective well-being (SWB) relationship were assessed among 192 first year UK undergraduates in week three of their first semester and again six months later. Path analyses revealed that optimism mediated the relationship between stress and negative affect (a component of SWB) over time, and academic self-efficacy demonstrated significant relationships with life satisfaction and positive affect. Contrary to predictions, stress levels remained stable over time although academic alienation increased and self-efficacy decreased. Optimism emerged as a key factor for new students to adjust to university, helping to buffer the impact of stress on well-being throughout the academic year. Incorporating stress management and psycho-educational interventions to develop strengths is discussed as a way of promoting confidence and agency in new students to help them cope better with the stress at university

Who Looks Forward to Better Health? Personality Factors and Future Self-Rated Health in the Context of Chronic Illness

Background: Self-rated health (SRH) is an important predictor of objective health-related outcomes that, according to the Cognitive Process Model of SRH, is influenced by contextual factors (symptoms and personality). Although research indicates that personality contours SRH, less attention has been given to understanding the contributions of personality to future self-rated health (FSRH) or the contextual factors that play a role in shaping these effects. Purpose: The aim of the present study was to extend the theory and research on FSRH by exploring the contributions of personality, current SRH, and fatigue to FSRH in the context of chronic illness, and to test the potential mediating role of optimism for explaining these effects. Method: Two chronic illness samples (arthritis, N = 365, and inflammatory bowel disease, IBD; N = 290) completed identical surveys. A hierarchical regression model with age, education, and current health, and fatigue entered in the first two steps and traits entered in the last step, tested the effects of personality on FSRH. Mediation analyses controlling for contextual variables tested the explanatory role of optimism. Results: Fatigue was a significant contributor to FSRH accounting for 11 % of the variance in the arthritis sample and 17 % in the IBD sample over the demographic variables. Both Agreeableness and Neuroticism accounted for additional significant but modest variance in FSRH (4 %); Agreeableness was associated with higher FSRH, whereas Neuroticism was associated with lower FSRH. For both traits, optimism fully explained the associations with FSRH. Conclusion: After accounting for the influence of fatigue and other variables, the contributions of high Agreeableness and low Neuroticism to FSRH are modest in the context of chronic illness, and these associations may be explained by optimism

Joy leads to overconfidence, and a simple countermeasure

Overconfidence has been identified as a source of suboptimal decision making in many real-life domains, with often far-reaching consequences. This study identifies a mechanism that can cause overconfidence and demonstrates a simple, effective countermeasure in an incentive-compatible experimental study. We observed that joy induced overconfidence if the reason for joy (an unexpected gift) was u

The Mental Vitality @ Work study: design of a randomized controlled trial on the effect of a workers' health surveillance mental module for nurses and allied health professionals

Employees in health care service are at high risk for developing mental health complaints. The effects of mental health complaints on work can have serious consequences for the quality of care provided by these workers. To help health service workers remain healthy and productive, preventive actions are necessary. A Workers' Health Surveillance (WHS) mental module may be an effective strategy to monitor and promote good (mental) health and work performance. The objective of this paper is to describe the design of a three arm cluster randomized controlled trial on the effectiveness of a WHS mental module for nurses and allied health professionals. Two strategies for this WHS mental module will be compared along with data from a control group. Additionally, the cost effectiveness of the approaches will be evaluated from a societal perspective. The study is designed as a cluster randomized controlled trial consisting of three arms (two intervention groups, 1 control group) with randomization at ward level. The study population consists of 86 departments in one Dutch academic medical center with a total of 1731 nurses and allied health professionals. At baseline, after three months and after six months of follow-up, outcomes will be assessed by online questionnaires. In both intervention arms, participants will complete a screening to detect problems in mental health and work functioning and receive feedback on their screening results. In cases of impairments in mental health or work functioning in the first intervention arm, a consultation with an occupational physician will be offered. The second intervention arm offers a choice of self-help e-mental health interventions, which will be tailored based on each individual's mental health state and work functioning. The primary outcomes will be help-seeking behavior and work functioning. Secondary outcomes will be mental health and wellbeing. Furthermore, cost-effectiveness in both intervention arms will be assessed, and a process evaluation will be performed. When it is proven effective compared to a control group, a WHS mental module for nurses and allied health professionals could be implemented and used on a regular basis by occupational health services in hospitals to improve employees' mental health and work functioning. NTR278