ABSTRACT
Exposure to nature can enhance mental well-being, making nature-based interventions promising for the treatment and prevention of mental health problems like depression. Given the decreased self-focus and sense of self-diminishment associated with awe, the present study investigated the impact of exposure to awe-evoking nature on two key risk and maintenance factors of depression-repetitive negative thinking (RNT) and dampening of positive feelings-and on subjective happiness. In a randomized controlled trial, we tested the effects of exposure to awe-evoking nature clips through a 1-week intervention, consisting of watching a 1-min clip on a daily basis of either awe-evoking (n high awe = 108) or more mundane nature scenes (n low awe = 105). Before, immediately after (post-intervention) and 1 week after the intervention (follow-up), participants completed self-report scales probing RNT, dampening, and subjective happiness. Results indicated significant decreases in these outcomes at post-intervention and follow-up in both groups. We discuss study limitations, touch upon future research ideas, and reflect upon the role of nature for clinical applications.
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Event centrality is defined by the extent to which a memory of an event has become central to an individual's identity and life story. Previous research predominantly focused on the link between event centrality and trauma-related symptomatology. Nevertheless, it can be argued that the perception of (adverse) events as central to one's self is not exclusive to Posttraumatic Stress Disorder (PTSD). Other disorders where adverse events are linked to the onset of symptoms might also be related to event centrality. This study examined the relevance of event centrality for Social Anxiety Disorder (SAD) and for Major Depressive Disorder (MDD) separately. Moreover, we examined which cognitive and emotion regulation variables (i.e., trait anxiety, rumination, worry, intrusions and avoidance, and posttraumatic cognitions) mediated these relationships. No significant correlation was found between event centrality and social anxiety. However, a significant positive correlation was found between event centrality and depression. In a combined group, this relation was mediated by all cognitive and emotion regulation variables except for worry.
Subject(s)
Depressive Disorder, Major , Phobia, Social , Humans , Depressive Disorder, Major/psychology , Male , Female , Adult , Phobia, Social/psychology , Young Adult , Middle Aged , Emotional Regulation , CognitionABSTRACT
OBJECTIVE: Extending on previous findings that computerized Memory Specificity Training (c-MeST) improves memory specificity and depressive symptoms in Major Depressive Disorder (MDD) in adults, this study aimed to assess the effects of c-MeST in youth with MDD on memory specificity and depression in addition to other treatment. METHODS: Participants aged 15-25 (N = 359, 76 % female; M age = 19.2, SD = 3.1), receiving predominantly psychological therapy or counseling (85 %) and/or antidepressants (52 %) were randomized to usual care and c-MeST or usual care. Cognitive and clinical outcomes were assessed at baseline and at one, three, and six-month follow-ups. RESULTS: The usual care and c-MeST group reported higher memory specificity at one-month (d = 0.42, p = .022), but not at three or six months (d's < 0.15, p's > 0.05). The rate of MDE was numerically lower in the c-MeST group at each follow-up time-point, but group was not a statistically significant predictor at one month (64 % usual care and c-MeST vs. 68 % usual care, OR = 0.81, p = .606), three months (67 % usual care and c-MeST vs. 72 % usual care, OR = 0.64, p = .327) or six months (55 % usual care and c-MeST vs. 68 % usual care, OR = 0.56, p = .266). The usual care and c-MeST group did report lower depressive symptoms at one month (d = 0.42, p = .023) and six-months (d = 0.84, p = .001), but not three-months (d = 0.13, p > .05). CONCLUSIONS: c-MeST may reduce symptoms in youth with MDD when provided alongside other treatments. However, there are significant limitations to this inference, including high attrition in the study and a need for more data on the acceptability of the intervention.
Subject(s)
Depressive Disorder, Major , Humans , Depressive Disorder, Major/therapy , Female , Male , Adolescent , Young Adult , Adult , Antidepressive Agents/therapeutic use , Cognitive Behavioral Therapy/methods , Treatment Outcome , Memory , Therapy, Computer-Assisted/methods , Counseling/methodsABSTRACT
[This corrects the article DOI: 10.3389/fpubh.2023.1216988.].
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[This corrects the article DOI: 10.3389/fpubh.2023.1216988.].
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Impaired episodic future thinking (EFT), as reflected in reduced specificity, low levels of detail and less use of mental imagery, has been associated with depressive symptomatology. The beneficial impact of Future Event Specificity Training (FEST) on impaired EFT has recently been demonstrated, as well as on anhedonia, the core symptom of depression reflecting low positive affect. The current study aimed to replicate these previous findings. In addition, this study is the first to examine the potential of FEST to reduce engagement in dampening, a maladaptive response style characterised by reducing the intensity and/or frequency of positive emotional states, which is linked to depressive symptoms and anhedonia. An RCT (FEST vs. waitlist control) was conducted in a large sample of Dutch-speaking undergraduate students (N = 155). In line with prior research, FEST resulted in significant improvements in EFT features. However, likely related to limited room for change detection, no significant changes were found in anhedonia and dampening. In the light of the positive impact of FEST on several EFT features, future studies should address methodological issues to create optimal conditions for potential change detection. Finally, further examination of the proposed theoretical change mechanisms aimed to reduce anhedonia and dampening is warranted.
Subject(s)
Anhedonia , Humans , Anhedonia/physiology , Male , Female , Young Adult , Adult , Emotions/physiology , Depression/psychology , Thinking/physiology , AdolescentABSTRACT
Background: Many stress-related mental health problems, like depression and anxiety, emerge during adolescence, with some recent studies suggesting numbers are increasing. One possible way to reduce adolescents' vulnerability to stress-related mental health problems is to increase their resilience by training them in recalling specific positive memories and anticipating specific positive future events. Therefore, an innovative combi-training (called Positive Events Training; PET) was developed, focusing on the enhancement of the specificity of both past and future positive autobiographical events in adolescents. Its effects on adolescents' resilience and mental wellbeing will be examined. Methods: A cluster randomized controlled trial with a 2 (condition) × 3 (time-point) factorial design was conducted. Classes of adolescents were randomized to either a PET program (intervention) or a CREAtive writing Training (CREAT) program (active control). Both trainings consisted of four sessions of 50 min (one session, weekly, for four consecutive weeks) and were delivered in schools. Before (pre-training, T1), immediately after (post-training, T2), and 2 months after the training (follow-up, T3), participants completed a series of self-report questionnaires. Primary outcomes are resilience and mental wellbeing. Secondary outcomes are positive affect, positive affect regulation and anhedonia. CONSORT criteria for conducting and reporting RCTs will be used. Ethics and dissemination: Ethical approval was obtained from the Social and Societal Ethics Committee (SMEC) and the study has been preregistered on Open Science Framework (OSF) and ClinicalTrials.gov (Trial registration number: NCT05757180). We plan to develop a free, online, web-based self-directed PET protocol for teachers if the study provides evidence for the effectiveness of the PET program in increasing adolescents' resilience and mental wellbeing, so teachers can deliver the program to future students without the need of professional external trainers.
Subject(s)
Resilience, Psychological , Humans , Adolescent , Mental Health , Anxiety , Students/psychology , Schools , Randomized Controlled Trials as TopicABSTRACT
This cluster randomised controlled trial examined the effectiveness of universal school-based mindfulness training (MT; vs. passive control) to lower anhedonia and emotional distress among mid-adolescents (15-18 years). It further examined three potential mechanisms: dampening of positive emotions, non-acceptance/suppression of negative emotions, and perceived social pressure not to experience/express negative emotions. Adolescents (ncontrol = 136, nintervention = 95) participated in three assessment points (before, after and two/three months after the in-class MT), consisting of Experience Sampling (ES) assessments and self-report questionnaires (SRQs) to corroborate the ES assessments. Analyses were based on general linear modelling and multilevel modelling. Overall, no evidence was found for a significant beneficial and long-lasting impact of the MT on adolescents' mental health. Importantly, some barriers inherently linked to universal MT approaches (low engagement in and mixed attitudes towards the MT) may have tempered the effectiveness of the MT in the current trial. Further research should prioritise overcoming these barriers to optimise programme implementation. Additionally, given the potential complex interplay of moderators at micro- (home practice), meso- (school climate), and macro-level (broader context), research should simultaneously focus on alternative ways of delivering MT at schools to strengthen adolescents' mental health.
Subject(s)
Mindfulness , Psychological Distress , Adolescent , Humans , Anhedonia , Ecological Momentary Assessment , Emotions , SchoolsABSTRACT
Background: It is increasingly recognised that the study of responses to positive emotions significantly contributes to our understanding of psychopathology. Notably, positive emotions are not necessarily experienced as pleasurable. Instead, some believe that experiencing happiness may have negative consequences, referred to as fear of happiness (FOH), or they experience a fear of losing control over positive emotions (FOLC). According to reward devaluation theory, such an association of positivity with negative outcomes will result in positive stimuli being devalued over time, contributing to or maintaining depressive symptoms. The prospective relationship between fears of positivity and depressive symptoms is yet to be examined in adolescents. The present longitudinal study investigated whether FOH and FOLC prospectively predict depressive symptoms. Method: 128 adolescents between 16-18 years of age (M = 16.87, SD = 0.80) recruited from two secondary schools in Flanders, Belgium, completed measures of depressive symptoms (Depression Anxiety Stress Scales) including consummatory anhedonia, FOH (Fear of Happiness Scale), and FOLC (Affective Control Scale) in their classroom at baseline and 2-months follow-up. Regression analyses were performed to test the association between FOH, FOLC, and depressive symptoms. Results: FOH concurrently, but not prospectively, predicted depressive symptoms. There was no significant association between FOH and consummatory anhedonia. FOLC was not a significant predictor of depressive symptoms or consummatory anhedonia. Conclusion: These findings suggest that FOH may only be concurrently related to depressive symptoms. Considering prior findings in adults, future research should investigate the association of FOH with anticipatory anhedonia in adolescents.
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BACKGROUND AND OBJECTIVES: Individuals at risk for depression exhibit a decreased ability to disengage from negative memory retrieval during times of mental distress, partly because they have difficulty retrieving positive memories to repair sad mood. In this study, we tested whether this persistent tendency for negative memory retrieval could be reduced in adolescents through repeated practice to retrieve positive autobiographical memories, namely Positive Memory Specificity Training (PMST). Further, we examined the impact of this intervention on secondary outcomes, including depressive symptoms, emotion regulation strategies, and fear of positive emotions. METHODS: Adolescents (n = 68) between 16 and 18 years old were randomly allocated to either PMST or bogus control training. Persistent negative memory retrieval was assessed following the training using a behavioral decision-making task (Emotional Reversal Learning Task). Additionally, participants completed self-report measurements (e.g., depressive symptoms) before and two weeks after the training. RESULTS: We found preliminary supportive evidence for a significant training effect such that adolescents following PMST showed less persistence in negative memory retrieval compared to those in the control group. Only for anhedonia a significant training effect was found, indicating a possible adverse effect of the intervention. LIMITATIONS: The primary outcome was assessed only at post-intervention to prevent a potential learning effect due to repeated measurements. We cannot exclude the possibility that baseline individual differences contaminated our results. To examine possible adverse effects of PMST, larger sample are needed. CONCLUSIONS: PMST may help to reduce persistent negative memory retrieval in adolescents. Recommendations for future studies are addressed.
Subject(s)
Cognitive Training , Memory, Episodic , Humans , Adolescent , Mental Recall/physiology , Emotions/physiology , Cognition/physiologyABSTRACT
Plastic pollution is both a societal and environmental problem and citizen science has shown to be a useful tool to engage both the public and professionals in addressing it. However, knowledge on the educational and behavioral impacts of citizen science projects focusing on marine litter remains limited. Our preregistered study investigates the impact of the citizen science project Citizen Observation of Local Litter in coastal ECosysTems (COLLECT) on the participants' ocean literacy, pro-environmental intentions and attitudes, well-being, and nature connectedness, using a pretest-posttest design. A total of 410 secondary school students from seven countries, in Africa (Benin, Cabo Verde, Côte d'Ivoire, Ghana, Morocco, Nigeria) and Asia (Malaysia) were trained to sample plastics on sandy beaches and to analyze their collection in the classroom. Non-parametric statistical tests (n = 239 matched participants) demonstrate that the COLLECT project positively impacted ocean literacy (i.e., awareness and knowledge of marine litter, self-reported litter-reducing behaviors, attitudes towards beach litter removal). The COLLECT project also led to higher pro-environmental behavioral intentions for students in Benin and Ghana (implying a positive spillover effect) and higher well-being and nature connectedness for students in Benin. Results are interpreted in consideration of a high baseline in awareness and attitudes towards marine litter, a low internal consistency of pro-environmental attitudes, the cultural context of the participating countries, and the unique settings of the project's implementation. Our study highlights the benefits and challenges of understanding how citizen science impacts the perceptions and behaviors towards marine litter in youth from the respective regions.
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The need to further our understanding of positive affect dysregulation in depression has been widely acknowledged. Two related relevant concepts in this realm, are Avoidance Of Positivity (AOP; referring to avoidance behaviour towards positivity) and Fear Of Positivity (FOP; referring to anxious or unpleasant feelings related to positivity). However, traditionally manifestations of AOP and FOP are considered in isolation, and self-report scales used to measure both concepts show considerable content overlap. Therefore, the first study aim was to examine how AOP and FOP relate to one another, depressive symptomatology and anhedonia, through new clearly delineated scales. For exploratory purposes, general and state-specific versions were developed. The second aim was to uncover beliefs that underlie the tendency towards AOP/FOP. An adult community sample (n = 197) completed online measures of AOP, FOP, depressive symptoms and anhedonia, and answered open-ended questions about reasons for AOP and FOP. Cross-sectionally, preliminary evidence was found for AOP and FOP being positively associated with one another, depressive symptomatology and anhedonia. Even after controlling for depressive symptomatology, anhedonia remained positively associated with AOP and FOP. So, AOP and FOP may be viable candidate mechanisms maintaining anhedonia that are worth further investigation and may be appropriate to target during treatment. Answers to the open-ended questions (n = 77) reflected various beliefs underlying AOP/FOP, which were broader than simply anticipating negative consequences of feeling positive and also touched on themes of unworthiness and social inappropriateness of feeling positive. Some theoretical and clinical implications of different beliefs underlying AOP/FOP are discussed.
Subject(s)
Anhedonia , Emotions , Adult , Humans , Fear/psychology , Anxiety , Self ReportABSTRACT
Learning theories of depression propose that negative thinking is acquired through subsequent rewarding experiences and is often resistant to change even when it becomes associated with punishment. We examined whether this persistency of negative thinking is related to current and future levels of depressive symptoms among adolescents. Persistency of negative self-referent thinking was assessed by means of a decision-making task, namely the emotional reversal learning task. This task offers participants the choice between thinking about negative and positive self-related aspects. Their choice for negative self-referent thinking is initially rewarded but is later punished. Therefore, participants were expected to efficiently switch between negative and positive self-referent thinking, and to internally update their reward expectancy for these thinking options. Results showed that persistency of negative self-referent thinking was related to concurrent levels of depressive symptoms, replicating earlier findings in adults. However, persistency of negative thinking was unrelated to future levels of depressive symptoms. These findings suggest that adolescents with depressive symptoms tend to hold on to the belief that negative self-referent thinking has beneficial consequences, even when it is no longer being rewarded. This tendency should be seen as a concurrent feature of depression, as the predictive value is still in question.
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Depression , Pessimism , Adult , Humans , Adolescent , Depression/diagnosis , Emotions , Cognition , LearningABSTRACT
Several decades of research have established reduced autobiographical memory specificity, or overgeneral memory, as an important cognitive factor associated with the risk for and maintenance of a range of psychiatric diagnoses. In measuring this construct, experimenters code autobiographical memories for the presence or absence of a single temporal detail that indicates that the remembered event took place on a single, specific, day (Last Thursday when I rode bikes with my son), or multiple days (When I rode bikes with my son). Studies indicate that the specificity of memories and the amount of other episodic detail that they include (e.g., who, what, and where) are related and may rely on the same neural processes to elicit their retrieval. However, specificity and detailedness are nonetheless separable constructs: imperfectly correlated and differentially associated with current and future depressive symptoms and other associated intrapersonal (e.g., rumination) and interpersonal (e.g., social support) outcomes. The ways in which the details of our memories align with narrative themes (i.e., agency, communion, identity) and the coherence with which these details are presented, are also emerging as important factors associated with psychopathology. The temporal specificity of autobiographical memories may be important, but other memory constructs warrant further attention in research and theory, especially given the associations, and dependencies, between each of these constructs. Researchers in this area must consider carefully whether their research questions necessitate a focus on autobiographical memory specificity or whether a more inclusive analysis of other autobiographical memory features is necessary and more fruitful. This article is categorized under: Psychology > Memory.
Subject(s)
Memory, Episodic , Mental Disorders , Humans , Mental Disorders/diagnosis , Mental Recall , Attention , NarrationABSTRACT
Coastal environments are increasingly shown to have a positive effect on our health and well-being. Various mechanisms have been suggested to explain this effect. However, so far little focus has been devoted to emotions that might be relevant in this context, especially for people who are directly or indirectly exposed to the coast on a daily basis. Our preregistered qualitative study explored how coastal residents experience the emotions they feel at the coast and how they interpret the effect these emotions have on them. We conducted semi-structured interviews with a purposive sample of eight Belgian coastal residents aged 21-25 years old. The interviews were analyzed with the approach of interpretative phenomenological analysis. Five superordinate themes were identified and indicate that, for our participants, the coast represents a safe haven (1) in which they can experience emotional restoration (2), awe (3), and nostalgia (4). These emotional states are accompanied with adaptive emotion regulating strategies (5), such as reflection and positive reappraisal, that may facilitate coping with difficult thoughts and feelings. Our study demonstrates the importance of investigating specific emotions and related processes triggered at the coast and how these could contribute to the therapeutic value of the coast.
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INTRODUCTION: Infertility and its treatment bring a considerable emotional burden. Increasing evidence demonstrates the effectiveness of smartphone-delivered mindfulness apps for reducing symptoms of emotional distress in both clinical and non-clinical populations. Evidence on this topic in women, men and couples experiencing infertility is currently under-represented. The aim of the MoMiFer study is, therefore, to investigate the efficacy of a stand-alone mobile mindfulness app on symptoms of emotional distress and fertility-related quality of life in people experiencing infertility. METHODS AND ANALYSIS: This study is an exploratory randomised controlled trial (RCT) with open enrollment. The primary outcomes are symptoms of emotional distress and fertility-related quality of life. Secondary outcomes are mindfulness skills, repetitive negative thinking, self-compassion, user-rated quality of the stand-alone mobile mindfulness app and use of the app. Experience sampling method and standardised self-report questionnaires are combined within a repeated measures design to measure the effects of the stand-alone mobile mindfulness app on the primary and secondary outcomes, apart from the use of the app. The latter will be evaluated through app tracking. People, including women, men and couples, experiencing infertility (n=60) will be randomised to an intervention group receiving the stand-alone mobile mindfulness app for 3 months or a wait-list control group. The app follows the format and content of Mindfulness-Based Stress Reduction. Data will be collected at baseline, at 1.5 months and 3 months after randomisation. Analysis will be according to intention to treat and based on general linear modelling and multilevel mixed-effects modelling. ETHICS AND DISSEMINATION: This study received approval from the Medical Ethical Committee of the Leuven University Hospital (Belgium). The findings of this exploratory RCT will be disseminated through presentations at public lectures, scientific institutions and meetings, and through peer-reviewed scientific articles. TRIAL REGISTRATION NUMBER: NCT04143828.
Subject(s)
Infertility , Mindfulness , Mobile Applications , Female , Humans , Infertility/therapy , Male , Mindfulness/methods , Pessimism , Psychological Distress , Quality of Life , Randomized Controlled Trials as TopicABSTRACT
The COVID-19 pandemic strongly impacts adolescents' mental health, a population particularly vulnerable to mental disorders, highlighting the need to identify protective factors against COVID-19 related psychological distress to inform policies and intervention strategies. Previous research suggests that mindfulness may be a promising factor that can lower the risk of detrimental psychological consequences related to the COVID-19 pandemic. However, it is currently unknown which aspects of mindfulness contribute most to its protective effects. Moreover, previous studies mainly focused on adult samples. The present study aimed to address this gap by investigating the impact of specific mindfulness facets on adolescents' COVID-19 related psychological functioning. 246 Dutch-speaking adolescents were recruited via social media to complete a cross-sectional online survey between June 29 and October 11, 2020. Participants were 16-18 years of age, most of them women (71%), and the majority followed the highest level of Belgian secondary education. Logistic regression analyses were performed to test the differential effects of each mindfulness facet on psychological functioning. Our results identified decentering as the facet of mindfulness that was uniquely associated with decreased worry and stress, improved mental health and quality of life, as well as with an increase in social connectedness with others following the outbreak of the COVID-19 pandemic. Unexpectedly, decentering was negatively associated with adolescents' helping behaviour during compared to before the pandemic. Implications for research on and application of mindfulness are discussed. Taken together, these findings suggest that the facet of decentering, among all facets of mindfulness, may represent the main protective factor against psychological distress during the COVID-19 pandemic.
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There is increasing evidence that blue spaces, particularly coastal environments, are beneficial for well-being. During the first-wave lockdown of the COVID-19 pandemic in Belgium, access to the coast was restricted due to restraint in circulation. Making use of this unique opportunity, this study investigated whether access and visits to the coast were positively associated with well-being by using a quasi-experimental design. The emotions of awe and nostalgia were studied as potential mediators between coastal visits and well-being. A total of 687 Flemish adults took part in an online survey that was launched end of April until beginning of June 2020. After controlling for covariates, results showed that access to the coast, but not visit frequency, was positively associated with well-being. More specifically, coastal residents reported less boredom and worry, and more happiness than inland residents. Awe and nostalgia were not significantly associated with coastal visits, but awe was negatively correlated with boredom. The study suggests a potential buffer effect of residential proximity to the coast against negative psychological consequences of the COVID-19 pandemic, supporting the notion that the coast has a positive impact on well-being.
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Co-rumination has consistently been shown to be maladaptive in the context of emotional well-being. However, not much is known about factors that predict one's tendency to co-ruminate. The current study investigated temperament, attachment, and gender as predictors of co-rumination trajectories in a sample of 1549 early and middle adolescents from fifth to ninth grade (53.4% girls; Mage = 12.93). Analyses were performed on four waves of data with one-year intervals using multi-level modeling. First, girls were found to be more likely to co-ruminate. Second, high positive affectivity in boys and girls and high effortful control in boys was related to higher co-rumination. Third, high attachment anxiety and high general trust in the availability and support of a mother were predictive of higher co-rumination levels. High attachment avoidance was negatively related to co-rumination in boys. High positive affectivity in boys and girls and high trust in boys predicted decreases in reported co-rumination levels over time. Results highlight differences between boys and girls in factors that predict the tendency to co-ruminate. The current study adds to the literature by helping to identify factors associated with the development of co-rumination, which is a well-established risk factor of internalizing symptoms. Monitoring youth affected with these vulnerabilities may be recommended for prevention efforts.
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INTRODUCTION: Adolescents with chronic conditions often experience high levels of stress, anxiety and depression, and reduced quality of life. Mindfulness-based interventions (MBIs) have been found to improve emotional distress in clinical and non-clinical populations and are a promising technique to support adolescents with chronic conditions in managing their symptoms and ultimately enhance their quality of life. METHODS AND ANALYSIS: To test the effects of an MBI on emotional distress and quality of life and delineate the underlying mechanisms, the You.Mind! study uses a randomised staggered within-subjects design. Thirty adolescents with a chronic condition will be randomised to a baseline phase of 14-28 days followed by an MBI, consisting of four online group sessions and online support spread over 8 weeks. Outcomes will be assessed by short, repeated measurements throughout the baseline, intervention and follow-up phases and by standardised questionnaires and experience sampling measures before randomisation, at postintervention and at 3-months follow-up. Analysis will be based on general linear modelling and multilevel mixed-effects modelling. ETHICS AND DISSEMINATION: Ethical approval was obtained from the Ethics Committee Research UZ/KU Leuven and the Ethics Committee of Ghent University Hospital and Ghent University (S63485). Results will be disseminated through presentations at public lectures, scientific institutions and meetings, and through publication in peer-reviewed journals. TRIAL REGISTRATION NUMBER: NCT04359563.