Lifestyle choices and mental health: a longitudinal survey with German and Chinese students.

BACKGROUND: A healthy lifestyle can be beneficial for one's mental health. Thus, identifying healthy lifestyle choices that promote psychological well-being and reduce mental problems is useful to prevent mental disorders. The aim of this longitudinal study was to evaluate the predictive values of a broad range of lifestyle choices for positive mental health (PMH) and mental health problems (MHP) in German and Chinese students. METHOD: Data were assessed at baseline and at 1-year follow-up. Samples included 2991 German (Mage = 21.69, SD = 4.07) and 12,405 Chinese (Mage = 20.59, SD = 1.58) university students. Lifestyle choices were body mass index, frequency of physical and mental activities, frequency of alcohol consumption, smoking, vegetarian diet, and social rhythm irregularity. PMH and MHP were measured with the Positive Mental Health Scale and a 21-item version of the Depression Anxiety and Stress Scale. The predictive values of lifestyle choices for PMH and MHP at baseline and follow-up were assessed with single-group and multi-group path analyses. RESULTS: Better mental health (higher PMH and fewer MHP) at baseline was predicted by a lower body mass index, a higher frequency of physical and mental activities, non-smoking, a non-vegetarian diet, and a more regular social rhythm. When controlling for baseline mental health, age, and gender, physical activity was a positive predictor of PMH, smoking was a positive predictor of MHP, and a more irregular social rhythm was a positive predictor of PMH and a negative predictor of MHP at follow-up. The good fit of a multi-group model indicated that most lifestyle choices predict mental health comparably across samples. Some country-specific effects emerged: frequency of alcohol consumption, for example, predicted better mental health in German and poorer mental health in Chinese students. CONCLUSIONS: Our findings underline the importance of healthy lifestyle choices for improved psychological well-being and fewer mental health difficulties. Effects of lifestyle on mental health are comparable in German and Chinese students. Some healthy lifestyle choices (i.e., more frequent physical activity, non-smoking, regular social rhythm) are related to improvements in mental health over a 1-year period.

[Unwanted Side Effects in Children and Youth Psychotherapy - Introduction and Recommendations]. / Unerwünschte Nebenwirkungen in der Kinder- und Jugendlichenpsychotherapie ­ Eine Einführung und Empfehlungen.

Psychotherapy in children and adolescents is effective, but unwanted effects can occur. Until now, psychotherapy research has neglected this important topic, although children and youths are in need of special protection. Unwanted effects caused by therapy are not systematically investigated and a corresponding conceptualization is missing. The aim of this article is to investigate whether the current classifications of unwanted effects of psychotherapy in adults are applicable to children and adolescents and to identify distinctive features. Furthermore, the adaptation of the Inventory for the Assessment of Negative Effects of Psychotherapy for children and adolescents (Children-INEP) is presented. Finally, steps for the information and prevention of unwanted, and negative effects of psychotherapy in children and adolescents are pointed out.

Measuring attitudes towards suicide: Preliminary evaluation of an attitude towards suicide scale.

OBJECTIVES: Our study aimed to validate a previously published scale assessing attitudes towards suicide. Factor structure, convergent and discriminant validity, and predictive validity were investigated. METHOD: Adult German participants (N=503; mean age=24.74years; age range=18-67years) anonymously completed a set of questionnaires. An exploratory factor analysis was conducted, and incongruous items were deleted. Subsequently, scale properties of the reduced scale and its construct validity were analyzed. A confirmatory factor analysis was then conducted in an independent sample (N=266; mean age=28.77years; age range=18-88years) to further confirm the factor structure of the questionnaire. RESULTS: Parallel analysis indicated a three-factor solution, which was also supported by confirmatory factor analysis: right to commit suicide, interpersonal gesture and resilience. The subscales demonstrated acceptable construct and discriminant validity. Cronbach's α for the subscales ranged from 0.67 to 0.83, explaining 49.70% of the total variance. CONCLUSIONS: Positive attitudes towards suicide proved to be predictive of suicide risk status, providing preliminary evidence for the utility of the scale. Future studies aiming to reproduce the factor structure in a more heterogeneous sample are warranted.

Education and mental health: Do psychosocial resources matter?

Prevalence rates for mental health problems are higher when an individual's socioeconomic status (SES) is low, but the underlying mechanisms are not clearly understood. We investigated associations between education as indicator for SES and depressive symptoms as well as positive mental health (PMH). Moreover, we hypothesized that low education is associated with a lack of psychosocial resources and more daily hassles, which in turn mediate the relationships between education and mental health. In a German representative sample (N = 7937), we cross-sectionally first examined whether a person's educational level was associated with depressive symptoms and PMH. Educational level was defined as the highest academic qualification achieved. Second, we investigated whether also sense of control, resilience, delay of gratification, cultural activity and daily hassles followed gradients along the educational level. Third, we investigated whether they mediated the relationship between education and mental health. Results showed that depressive symptoms measured by items from the DASS-42 depression subscale were more prevalent for persons with a low educational level, PMH operationalized by the Positive Mental Health Scale was equally distributed, and all psychosocial characteristics followed the gradient of educational level. In addition, the group with a high school diploma was particularly burdened. Structural equation modeling indicated that the associations between education and mental health were mediated by all psychosocial characteristics and daily hassles, apart from the delay of gratification. In the group with the lowest educational level the model fit indices for depressive symptoms and PMH were acceptable (χ2 = 10007.243 (627), CFI = 0.869, RMSEA = 0.04 (90% CI [0.04, 0.04], SRMR = 0.05; and χ2 = 12779.968 (741), CFI = 0.86, RMSEA = 0.05 (90% CI [0.05, 0.05], SRMR = 0.05), respectively). The effect size Pm refers to the proportion of the total effect that is mediated by one or more variables ("M"), and the effect size of all indirect effects in the model for depressive symptoms was Pm = .80 and for PMH it was Pm = .68. The results support our hypotheses that low education is associated with less psychosocial resources, which in turn serve together with daily hassles as pathways between education and depressive symptoms as well as PMH. Building on these findings, longitudinal studies are necessary to investigate causality.

A Cross-Cultural Study in Germany, Russia, and China: Are Resilient and Social Supported Students Protected Against Depression, Anxiety, and Stress?

This study cross-culturally investigated resilience and social support as possible protective factors for mental health. The values of depression, anxiety, and stress symptoms, resilience and social support were collected from German (N = 4433), Russian (N = 3774), and Chinese students (N = 4982). The samples were split (two-thirds vs. one-third) to cross-validate the results. In all samples, resilience and social support were significantly negatively associated with depression, anxiety, and stress symptoms. While in Germany those associations were stronger for social support, in Russia and in China stronger associations were found for resilience. Furthermore, in all samples, resilience was found to mediate the association between social support and the negative mental health variables significantly. In conclusion, resilience and social support are universal interrelated protective factors for mental health independently of historical, cultural, social, and geographical conditions of a country.

Testing measurement invariance of the Depression, Anxiety, and Stress Scales (DASS-21) across four countries.

The rising burden of mental and behavioral disorders has become a global challenge (Murray et al., 2012). Measurement invariant clinical instruments are necessary for the assessment of relevant symptoms across countries. The present study tested the measurement invariance of the 21-item version of the Depression, Anxiety, and Stress Scales (DASS; Lovibond & Lovibond, 1995b) in Poland, Russia, the United Kingdom (U.K.), and the United States of America (U.S.). Telephone interviews were conducted with population-based samples (nPL = 1003, nRU = 3020, nU.K. = 1002, nU.S. = 1002). The DASS-21 shows threshold measurement invariance. Comparisons of latent means did not indicate differences between U.K. and U.S. SAMPLES: However, Polish and Russian samples reported more depressive symptoms compared with U.K. and U.S. samples; the Russian sample had the highest levels of anxiety symptoms and the Polish sample demonstrated the highest stress levels. The DASS-21 can be recommended to meaningfully compare the relationships between variables across groups and to compare latent means in Polish-, Russian-, and English-speaking populations. (PsycINFO Database Record

Universal happiness? Cross-cultural measurement invariance of scales assessing positive mental health.

Research into positive aspects of the psyche is growing as psychologists learn more about the protective role of positive processes in the development and course of mental disorders, and about their substantial role in promoting mental health. With increasing globalization, there is strong interest in studies examining positive constructs across cultures. To obtain valid cross-cultural comparisons, measurement invariance for the scales assessing positive constructs has to be established. The current study aims to assess the cross-cultural measurement invariance of questionnaires for 6 positive constructs: Social Support (Fydrich, Sommer, Tydecks, & Brähler, 2009), Happiness (Subjective Happiness Scale; Lyubomirsky & Lepper, 1999), Life Satisfaction (Diener, Emmons, Larsen, & Griffin, 1985), Positive Mental Health Scale (Lukat, Margraf, Lutz, van der Veld, & Becker, 2016), Optimism (revised Life Orientation Test [LOT-R]; Scheier, Carver, & Bridges, 1994) and Resilience (Schumacher, Leppert, Gunzelmann, Strauss, & Brähler, 2004). Participants included German (n = 4,453), Russian (n = 3,806), and Chinese (n = 12,524) university students. Confirmatory factor analyses and measurement invariance testing demonstrated at least partial strong measurement invariance for all scales except the LOT-R and Subjective Happiness Scale. The latent mean comparisons of the constructs indicated differences between national groups. Potential methodological and cultural explanations for the intergroup differences are discussed. (PsycINFO Database Record

The effects of daily stress on positive and negative mental health: Mediation through self-efficacy.

Daily stressors, compared to traumatic events, are increasingly recognized as important risk factors for mental health. The role of general self-efficacy on the relationship between daily stress and aspects of mental health has not yet been examined. Taking into account the dual factor model of mental health, which postulates that mental health is more than the absence of psychopathological symptoms, we tested mediation effects of self-efficacy separately for positive and negative mental health. Total, direct and indirect effects were estimated using data from a large nationally representative German population sample (N = 1,031) by bootstrapped mediation analyses providing 95% bias corrected bootstrap confidence intervals. Results indicated self-efficacy as a mediator of the effects of daily stressors on mental health, with superior effect sizes for positive compared to negative mental health. Mediation effects were replicated in student samples from Germany (N = 394), Russia (N = 604) and China (N = 8,669). Findings suggest that self-efficacy operates as a buffer of daily stress. However, a full mediation model was not supported as multiple psychological resources can have protective effects. This study provides the first transnational evidence for different stress-buffer effects for the two dimensions of mental health.

El estrés cotidiano, en comparación con acontecimientos traumáticos, es reconocido cada vez más como un importante factor de riesgo para la salud mental. El papel de la autoeficacia general en la relación entre estrés diario y aspectos de la salud mental todavía no se ha examinado. Teniendo en cuenta el modelo de dos factores, que postula que la salud mental es más que la ausencia de síntomas psicopatológicos, examinamos la mediación de la autoeficacia separadamente para la salud mental positiva y negativa. Efectos totales, directos e indirectos fueron evaluados, utilizando datos de una muestra de la población alemana representativa (N = 1.031). La autoeficacia es un mediador de los efectos del estrés cotidiano, con efectos superiores para la salud mental positiva. Los resultados fueron replicados en muestras de estudiantes de Alemania (N = 394), Rusia (N = 604) y China (N = 8.669). La autoeficacia actúa como un búfer para el estrés cotidiano. Un modelo de mediación completo no fue apoyado con múltiples recursos psicológicos que pueden tener efectos protectores. Es la primera evidencia transnacional para diferentes efectos del búfer-estrés para las dos dimensiones de salud mental.