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化压力为动力：基于意义建构的低强度在线干预*
Transforming Stress into Motivation: A Low-Intensity, Meaning-making Online Intervention
压力应对成为人们越来越关注的话题，意义建构干预通过训练个体从压力中发现意义、赋予意义，促进应激相关成长。研究开发了意义建构低强度在线干预，包括心理教育、技能运用和摄影干预模块，依托趣练习平台，配套干预手册。研究在154名大学生中开展随机对照试验，干预组进行为期7天的意义建构干预，与空白对照组在基线、干预后和1个月的随访中进行对比。结果发现，干预组在干预后积极情绪、意义建构和应激相关成长有显著提升，消极情绪有显著下降，具有即时效应和保持效应。干预组别可以通过意义建构改变量，提升个体的应激相关成长。因此，意义建构干预在获得应激相关成长方面具有应用前景，为应激人群提供了移动健康干预的新范式。
Recent research on stress has gradually shifted from a disease-oriented approach to a health-oriented approach. Studies have shown that not everyone who experiences stress is likely to be dysfunctional, and in some circumstances, stress can have positive effects and stress-related growth, with meaning-making being one of the important factors. Meaning-making is a coping strategy aimed at changing the way individuals assess situations and better align their beliefs and goals with stressful situations. This strategy can help individuals cope with stress and achieve stress-related growth. Efforts to facilitate meaning-making interventions to promote stress-related growth are scarce but necessary. In the present study, a low-intensity, online meaning-making intervention was conducted to promote stress-related growth.
The results of this study verified the effectiveness of a seven-day, low-intensity online intervention for meaning-making. Regarding methodology, a randomized controlled trial was conducted. The study was developed according to a 3 (time: pre-test vs. post-test vs. follow-up) × 2 (group: meaning-making intervention group vs. waiting-list group) mixed experimental design. Accordingly, 230 college students were randomly assigned to an intervention or waiting-list group. A total of 76 participants completed the pre-and post-test, follow-up, and the seven-day online intervention, while 78 participants on the waiting list completed the pre-test, post-test, and follow-up. For ethical reasons, participants in the waiting list group also received a seven-day online meaning-making intervention after all measurements were completed. The intervention consisted of psychoeducation on meaning-making, the application of skills for meaning-making while experiencing stress, and a photographic intervention lasting seven days. In order to ensure the smooth running of the low-intensity online intervention, before the intervention started, the Meaning-making Intervention Operation Manual H5 page was created by the researcher according to the intervention content and the operation rules of the Fun Practice platform, which contained the operation process and the notes as well as the common problems that might be encountered during intervention. The study was pre-registered in the osf platform.
The results of the pre- and post-tests indicated an immediate effect of the intervention, with significant time and group interactions when the dependent variables were positive emotions, meaning-making, stress-related growth, perceived stress, anxiety, depression, and negative emotions after controlling for gender, age, and meaning in life on the pre-test. The intervention group had significantly greater increases in positive emotions, meaning-making, and stress-related growth on the post-test, with large effect sizes. The promoting effects on positive emotions, meaning-making, and stress-related growth were maintained in the intervention group at the one-month follow-up. The intervention group also showed significantly higher decreases in negative emotions on the post-test, with large effect sizes. The positive effects on negative mental health outcomes were maintained in the intervention group at the one-month follow-up. The mediation effect analysis highlights the mechanism of the improvement in stress-related growth. The intervention increases individual stress-related growth by enhancing meaning-making.
The present study is the first to demonstrate that an integrated meaning-making intervention can promote stress-related growth and enhance positive emotions when an individual is experiencing stress. Specifically, participants in the intervention group had higher elevations in meaning-making and stress-related growth compared to those on the waiting list. Furthermore, participants in the intervention group were able to maintain these higher levels at the one-month post-test. The low-intensity online intervention used in the study was accompanied by a manual that did not require professional instruction and was very user-friendly. This approach would be a convenient strategy for the public when attempting to cope with psychological stress during an epidemic or other stressful situation. The intervention conveys the message that individuals can find meaning or make meaning whether stressful life events are positive or negative. Moreover, they can thrive in the midst of suffering and ordinariness.
意义建构 / 低强度在线干预 / 应激相关成长 / 随机对照研究
meaning-making / low-intensity intervention / stress-related growth / randomized controlled trial
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Stressful events and meaning-making toward them play an important role in adolescents' life and growth. However, ignoring positive stressful events leads to negativity bias; further, the neural mechanisms of meaning-making are unclear. We aimed to verify the mediating role of meaning-making in stressful events and stress-related growth and the function of the default mode network (DMN) during meaning-making in this functional magnetic resonance imaging (fMRI) study.Participants comprised 59 university students. Stressful life events, meaning-making, and stress-related growth were assessed at baseline, followed by fMRI scanning during a meaning-making task aroused by mental simulation. General linear modeling and psychophysiological interaction (PPI) analyses were used to explore the activation and functional connectivity of DMN during meaning-making.Mental simulation triggered meaning-making, and DMN activity decreased during meaning-making. Activation of the DMN was negatively correlated with coping flexibility, an indicator of stress-related growth. PPI analysis showed that meaning-making was accompanied by diminished connectivity in the DMN. DMN activation during meaning-making can mediate the relationship between positive stressful events and coping flexibility.Decreased DMN activity and diminished functional connectivity in the DMN occurred during meaning-making. Activation of the DMN during meaning-making could mediate the relationship between positive stressful events and stress-related growth, which provides a cognitive neural basis for the mediating role of meaning-making in the relationship between stressful events and indicators of stress-related growth.This study supports the idea that prosperity makes heroes, expands the meaning-making model, and suggests the inclusion of enhancing personal resources and meaning-making in education. This study was the first to validate the activation pattern and functional connectivity of the DMN during meaning-making aroused by mental simulation using an fMRI task-state examination, which can enhance our sense of meaning and provide knowledge that can be used in clinical psychology interventions.The study protocol was pre-registered in Open Science Framework (see osf.io/ahm6e for details).© 2023. The Author(s).
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Metastatic breast cancer carries with it considerable psychosocial morbidity. Studies have shown that some patients with metastatic breast cancer experience clinically significant anxiety and depression and traumatic stress symptoms. Supportive-expressive group psychotherapy was developed to help patients with cancer face and adjust to their existential concerns, express and manage disease-related emotions, increase social support, enhance relationships with family and physicians, and improve symptom control.Of 125 women with metastatic breast cancer recruited into the study, 64 were randomized to the intervention and 61 to the control condition. Intervention women were offered 1 year of weekly supportive-expressive group therapy and educational materials. Control women received educational materials only. Participants were assessed at baseline and every 4 months during the first year. Data at baseline and from at least 1 assessment were collected from 102 participants during this 12-month period, and these participants compose the study population.Primary analyses based on all available data indicated that participants in the treatment condition showed a significantly greater decline in traumatic stress symptoms on the Impact of Event Scale (effect size, 0.25) compared with the control condition, but there was no difference in Profile of Mood States total mood disturbance. However, when the final assessment occurring within a year of death was removed, a secondary analysis showed a significantly greater decline in total mood disturbance (effect size, 0.25) and traumatic stress symptoms (effect size, 0.33) for the treatment condition compared with the control condition.Supportive-expressive therapy, with its emphasis on providing support and helping patients face and deal with their disease-related stress, can help reduce distress in patients with metastatic breast cancer.
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This study examined factors associated with positive psychosocial functioning in 94 cognitively intact nursing home residents reporting poor physical health. It was hypothesized that greater use of meaning-based coping strategies would be associated with higher levels of positive psychosocial functioning. Participants completed an interview containing measures of coping, affect, psychological well-being, depression, and activities of daily living. Findings suggest that meaning-based coping variables (positive reappraisal, perceived uplifts) accounted for significant variance in positive psychosocial variables but not distress variables. In contrast, physical health variables accounted for significant variance in distress but not positive psychosocial variables. Results support the view that the absence of distress does not necessarily imply optimal mental health. Thus, a comprehensive assessment of mental health in older adults requires inclusion of indices of both positive and negative psychological and social functioning.
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Pain is a common, distressing symptom experienced by cancer patients and their family caregivers. An important aspect of coping with cancer pain is the ability to make meaning of the experience. This paper provides an overview of the literature related to meaning-making processes utilized by people experiencing cancer. It also presents an integrated approach to assisting patients and their family caregivers with the meaning-making process associated with cancer pain. Approaches to intervening are integrated within a model developed through previous research.
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In this study, we evaluated the validity of self-reported posttraumatic growth (PTG) by assessing the relation between perceived growth and actual growth from pre- to posttrauma. Undergraduate students completed measures tapping typical PTG domains at Time 1 and Time 2 (2 months later). We compared change in those measures with scores on the Posttraumatic Growth Inventory (PTGI; Tedeschi & Calhoun, 1996) for those participants who reported a traumatic event between Time 1 and Time 2 (n= 122). PTGI scores generally were unrelated to actual growth in PTG-related domains. Moreover, perceived growth was associated with increased distress from pre- to posttrauma, whereas actual growth was related to decreased distress, a pattern suggesting that perceived and actual growth reflect different processes. Finally, perceived (but not actual) growth was related to positive reinterpretation coping. Thus, the PTGI, and perhaps other retrospective measures, does not appear to measure actual pre- to posttrauma change.
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Stress psychology is an interesting and important interdisciplinary research field. In this perspective article, we briefly discuss 10 challenges related to the conceptual definition, research methodology, and translation in the field of stress that do not receive sufficient attention or are ignored entirely. Future research should attempt to integrate a comprehensive stress conceptual framework into a multidimensional comprehensive stress model, incorporating subjective and objective indicators as comprehensive measures. The popularity of machine learning, cognitive neuroscience, and gene epigenetics is a promising approach that brings innovation to the field of stress psychology. The development of wearable devices that precisely record physiological signals to assess stress responses in naturalistic situations, standardize real-life stressors, and measure baselines presents challenges to address in the future. Conducting large individualized and digital intervention studies could be crucial steps in enhancing the translation of research.© 2022 Institute of Psychology, Chinese Academy of Sciences and John Wiley & Sons Australia, Ltd.
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The authors conducted a meta-analysis to examine the relations of benefit finding to psychological and physical health as well as to a specific set of demographic, stressor, personality, and coping correlates. Results from 87 cross-sectional studies reported in 77 articles showed that benefit finding was related to less depression and more positive well-being but also more intrusive and avoidant thoughts about the stressor. Benefit finding was unrelated to anxiety, global distress, quality of life, and subjective reports of physical health. Moderator analyses showed that relations of benefit finding to outcomes were affected by the amount of time that had passed since stressor onset, the benefit finding measured used, and the racial composition of the sample.Copyright 2006 APA, all rights reserved.
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This pilot study aimed to provide supportive evidence for the acceptability and usefulness of the Meaning-Making intervention (MMi) in patients newly diagnosed with Stage III or IV ovarian cancer, and to provide estimates of parameters needed to design a full-scale study.A randomized controlled trial with 24 patients (12 experimental and 12 control) was conducted. Existential well-being (primary outcome), overall quality of life, distress, anxiety, depression and self-efficacy were measured.Compared to the control group, patients in the experimental group had a better sense of meaning in life at one and three months post-intervention.The MMi seems a promising intervention for advanced cancer patients, and a full randomized controlled trial is warranted to further investigate its efficacy.
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Cognitive control plays a key role in both adaptive emotion regulation, such as positive reappraisal, and maladaptive emotion regulation, such as rumination, with both strategies playing a major role in resilience and well-being. As a result, cognitive control training (CCT) targeting working memory functioning may have the potential to reduce maladaptive emotion regulation and increase adaptive emotion regulation. The current study explored the effects of CCT on positive reappraisal ability in a lab context, and deployment and efficacy of positive appraisal and rumination in daily life. A sample of undergraduates (n = 83) was allocated to CCT or an active control condition, performing 10 online training sessions over a period of 14 days. Effects on regulation of affective states in daily life were assessed using experience sampling over a 7-day posttraining period. Results revealed a positive association between baseline cognitive control and self-reported use of adaptive emotion regulation strategies, whereas maladaptive emotion regulation strategies showed a negative association. CCT showed transfer to working memory functioning on the dual n-back task. Overall, effects of CCT on emotion regulation were limited to reducing deployment of rumination in low positive affective states. However, we did not find beneficial effects on indicators of adaptive emotion regulation. These findings are in line with previous studies targeting maladaptive emotion regulation but suggest limited use in enhancing adaptive emotion regulation in a healthy sample. (PsycINFO Database Record(c) 2016 APA, all rights reserved).
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Coping flexibility was defined as the ability to discontinue an ineffective coping strategy (i.e., evaluation coping) and produce and implement an alternative coping strategy (i.e., adaptive coping). The Coping Flexibility Scale (CFS) was developed on the basis of this definition. Five studies involving approximately 4,400 Japanese college students and employees were conducted to test the hypothesis that flexible coping produces more adaptive outcomes. Studies 1, 2, and 3 provided evidence of the reliability of the CFS scores as well as of its convergent and discriminant validity for Japanese samples. Study 4 further demonstrated that flexible coping was positively associated with improved psychological health, including reduced depression, anxiety, and distress. In Study 5, coping flexibility as measured by the CFS was associated with reduced future depression, even after controlling for the effects of other coping flexibility measures and popular coping strategies. Overall, these results suggest that a valid approach for assessing coping flexibility has been developed and that flexible coping can contribute to psychological health. The implications of these findings for clinical practice are discussed.
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We conducted a randomised, controlled trial of cognitive-existential group therapy (CEGT) for women with early stage breast cancer receiving adjuvant chemotherapy with the aim of improving mood and mental attitude to cancer.Women were randomised to 20 sessions of weekly group therapy plus 3 relaxation classes or to a control arm receiving 3 relaxation classes. Assessments, independently done at baseline, 6 and 12 months, included a structured psychiatric interview and validated questionnaires covering mood, attitudes to cancer, family relationships, and satisfaction with therapy.Three hundred and three of 491 (62%) eligible patients participated over 3 years. Distress was high pre-intervention: 10% were diagnosed as suffering from major depression, 27% from minor depression and 9% from anxiety disorders. On an intention-to-treat analysis, there was a trend for those receiving group therapy (n=154) to have reduced anxiety (p=0.05, 2-sided) compared to controls (n=149). Women in group therapy also showed a trend towards improved family functioning compared to controls (p=0.07, 2-sided). The women in the groups reported greater satisfaction with their therapy (p<0.001, 2-sided), appreciating the support and citing better coping, self-growth and increased knowledge about cancer and its treatment. They valued the CEGT therapy. Overall effect size for the group intervention was small (d=0.25), with cancer recurrence having a deleterious effect in three of the 19 therapy groups. Psychologists as a discipline achieved a moderate mean effect size (d=0.52).CEGT is a useful adjuvant psychological therapy for women with early stage breast cancer. Interaction effects between group members and therapists are relevant to outcome. Group-as-a-whole effects are powerful, but the training and experience of the therapist is especially critical to an efficacious outcome.Copyright 2003 John Wiley & Sons, Ltd.
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Research indicates that informal caregiving can have intense physical and mental impact on the individual. Relative to caregivers of adults, pediatric palliative caregivers appear less in literature despite experiencing greater mental, physical, financial, and social strain. There is limited research on the creation and evaluation of interventions specifically for this population despite clear need.
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In this study, we examined the psychometric properties of the Chinese version of the Stress-Related Growth Scale-Short Form (SRGS-SF) for undergraduate nursing students. Using a cross-sectional design, a convenience sample of 253 undergraduate nursing students was included in this study. Half of the sample (n = 126) was randomly selected to explore the factorial structure of the SRGS-SF via exploratory factor analysis. The rest of the sample (n = 127) was selected to confirm the structure via confirmatory factor analysis. The results showed that the Chinese version of the SRGS-SF consisted of two factors: interpersonal and intrapersonal growth. The scale also had the power to discriminate between undergraduate nursing students with high and low levels of stress-related growth (SRG). The internal consistency and stability of the scale were also adequate. The Chinese version of the SRGS-SF is a valid and reliable measurement for assessing SRG among undergraduate nursing students. One suitable application would be the evaluation of the process underpinning SRG and the effectiveness of interventions.© 2018 John Wiley & Sons Australia, Ltd.
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Although the efficacy of smartphone-delivered interventions for mental health problems is emerging, randomized controlled trials (RCTs) of smartphone interventions are characterized by high rates of attrition and low adherence. High attrition and low adherence may threaten the validity of RCT findings, so a better understanding of these phenomena is needed. We examined attrition and adherence in 70 RCTs of smartphone interventions.Four online databases were searched for RCTs of mental health interventions delivered via smartphones.The mean meta-analytic study attrition rate was 24.1% (95% CI [19.3, 29.6]) at short-term follow up and 35.5% (95% CI [26.7, 45.3]) at longer-term follow up. These rates varied according to target mental health condition. Attrition rates were significantly lower in trials that delivered an acceptance-based intervention, offered participants monetary compensation, and reminded participants to engage in the intervention, and were significantly higher in trials that used an online enrollment method (relative to telephone or in-person enrollment). No participant-level baseline characteristic reliably predicted attrition. Evidence of attrition bias came from many RCTs not conducting intention-to-treat analyses. However, the mean difference in the between-groups effect size on primary outcomes in trials that reported both per protocol an intention-to-treat analyses was only Δ = 0.18. Adherence rates were also suboptimal based on our qualitative synthesis; several participants failed to download the intervention, and intervention usage consistently declined over the course of the trial.Study attrition and low adherence are common, problematic, and may undermine the validity of findings in RCTs of smartphone-delivered interventions for mental health problems. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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Recent conceptualisations of resilience have advanced the notion that it is a dynamic and multifaceted construct. However, its adaptive components, especially those forged by adversity, have not been fully realised, and its neurobiological and psychosocial underpinnings are yet to be meaningfully integrated. In part, this is because a developmental perspective is often neglected in the formulation of resilience. In this review, we consider the findings of resilience research, with a specific emphasis on the developmental period of adolescence. To bridge the gaps in our current understanding, we propose a model of resilience that is predicated on experiencing adversity. Specifically, our model provides a sophisticated insight into the components of resilience, which, together with intrinsic features, involves facilitation of, and skill acquisition via strengthening processes we term tempering and fortification. The model also points to the potential trajectories of adversity-driven resilience and forms the basis of a framework that allows for individual variance in resilience, and the identification of both neurobiological and psychosocial targets for prevention and therapeutic interventions.
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Previous literature on growth after major life events has primarily focused on negative experiences and operationalized growth with measures which rely on the post hoc self-perception of change. Because this method is prone to many biases, two questions have become increasingly controversial: Is there genuine growth after major life events and does growth require suffering? The present meta-analysis is the first synthesis of longitudinal research on the effects of life events on at least one subdomain of psychological well-being, posttraumatic, or postecstatic growth. Studies needed to have a longitudinal design, assess changes through independent measures over time, and provide sufficient data to estimate change scores. The present meta-analysis comprises 364 effect sizes from 154 independent samples (total = 98,436) in 122 longitudinal studies. A positive trend has been found for self-esteem, positive relationships, and mastery in prospective studies after both positive and negative events. We found no general evidence for the widespread conviction that negative life events have a stronger effect than positive ones. No genuine growth was found for meaning and spirituality. In the majority of studies with control groups, results did not significantly differ between event and control group, indicating that changes in the outcome variables cannot simply be attributed to the occurrence of the investigated life events. More controlled prospective studies are necessary to validate the genuine nature of postevent growth. Overall, the meta-analysis provides a systematic overview of the state of life event research and delineates important guidelines for future research on genuine growth. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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This study examined the effectiveness of a photographic intervention method on meaning in life (MIL) and further investigated the self-regulatory mechanism responsible for the effect of MIL in the promotion of proactive coping.Participants were 145 Chinese adults (M = 27.82; 71.3% female), who were randomly assigned into one of three conditions: An intervention (taking photos and writing expressively), a taking-photos-only control, or an assessment-only control. MIL, positive affect, future temporal focus, and proactive coping were measured before and after the intervention, with follow-up assessments conducted 1 week and 1 month later. Additionally, daily assessments were conducted during the intervention week.MIL improved daily in the intervention condition, an effect that was also found post-intervention and at follow-up. Significant increases in positive affect, future temporal focus, and proactive coping were also observed after the intervention. Hierarchical linear modeling demonstrated that daily MIL positively predicted daily future temporal focus and positive affect. Furthermore, longitudinal mediation analysis confirmed that future temporal focus and positive affect mediated the relationship between MIL and proactive coping.MIL's self-regulatory mechanism is reflected in both cognitive (future temporal focus) and emotional (positive affect) dimensions, which promotes proactive coping with future stressors.© 2018 Wiley Periodicals, Inc.
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In clinical settings, nurses look for ways to encourage and to understand their patients' thoughts about the meaning of an illness in their lives. The meaning of illness is appreciated when thoughtful communication that respects the individual's needs and responses. By encouraging patients to describe their thoughts, hopes, and fears about their illness, clinicians will understand what is meaningful in life. Because creating meaning is an individual process, nurses must listen to the patient's personal story and look for the meaning of illness imbedded in it.
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Childhood abuse has an enduring impact on the brain's stress system. Whether the effects of childhood abuse and adulthood stress are additive (cumulative stress hypothesis) or interactive (mismatch hypothesis) is widely disputed, however. The primary aim of this study was to test the utility of the cumulative stress and mismatch hypotheses in understanding brain and behaviour. We recruited 64 individuals (aged 14-26) from a specialised clinic for assessment and early intervention of mental health problems in young people. A T1-weighted MRI, a resting state fMRI and clinical assessment were acquired from each participant. Grey matter estimates and resting state functional connectivity (rsFC) of the hippocampus, amygdala and anterior cingulate cortex (ACC) were determined using segmentation and seed-to-voxel rsFC analyses. We explored the effects of childhood abuse and recent stress on the structure and function of the regions of interest within general linear models. Worse psychiatric symptoms were significantly related to higher levels of life time stress. Individuals with mismatched childhood and recent stress levels had reduced left hippocampal volume, reduced ACC-ventrolateral prefrontal cortex rsFC and greater ACC-hippocampus rsFC, compared to individuals with matched childhood and recent stress levels. These results show specific utility of the cumulative stress hypothesis in understanding psychiatric symptomatology and of the mismatch hypothesis in modelling hippocampal grey matter, prefrontal rsFC, and prefrontal-hippocampal rsFC. We provide novel evidence for the enduring impact of childhood abuse on stress reactivity in a clinical population, and demonstrate the distinct effects of stress in different systems. Hum Brain Mapp 38:2709-2721, 2017. © 2017 Wiley Periodicals, Inc.© 2017 Wiley Periodicals, Inc.
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Interest in meaning and meaning making in the context of stressful life events continues to grow, but research is hampered by conceptual and methodological limitations. Drawing on current theories, the author first presents an integrated model of meaning making. This model distinguishes between the constructs of global and situational meaning and between "meaning-making efforts" and "meaning made," and it elaborates subconstructs within these constructs. Using this model, the author reviews the empirical research regarding meaning in the context of adjustment to stressful events, outlining what has been established to date and evaluating the strengths and weaknesses of current empirical work. Results suggest that theory on meaning and meaning making has developed apace, but empirical research has failed to keep up with these developments, creating a significant gap between the rich but abstract theories and empirical tests of them. Given current empirical findings, some aspects of the meaning-making model appear to be well supported but others are not, and the quality of meaning-making efforts and meanings made may be at least as important as their quantity. This article concludes with specific suggestions for future research.
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This article reports the development of the Stress-Related Growth Scale (SRGS) and its use in a study examining determinants of stress-related positive outcomes for college students. Study 1 analyses showed that the SRGS has acceptable internal and test-retest reliability and that scores are not influenced by social desirability. Study 2 analyses showed that college students' SRGS responses were significantly related to those provided by friends and relatives on their behalf. Study 3 analyses tested the determinants of stress-related growth longitudinally. Significant predictors of the SRGS were (a) intrinsic religiousness; (b) social support satisfaction; (c) stressfulness of the negative event; (d) positive reinterpretation and acceptance coping; and (e) number of recent positive life events. The SRGS was also positively related to residual change in optimism, positive affectivity, number of socially supportive others, and social support satisfaction, lending further support to the validity of this new scale. Results have implications for current theory on stress-related positive outcomes.
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The Coronavirus Disease 2019 (COVID-19) epidemic emerged in Wuhan, China, spread nationwide and then onto half a dozen other countries between December 2019 and early 2020. The implementation of unprecedented strict quarantine measures in China has kept a large number of people in isolation and affected many aspects of people’s lives. It has also triggered a wide variety of psychological problems, such as panic disorder, anxiety and depression. This study is the first nationwide large-scale survey of psychological distress in the general population of China during the COVID-19 epidemic.
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Traumatic experiences can have a powerful impact on individuals and communities but the relationship between perceptions of beneficial and pathological outcomes are not known. Therefore, this meta-analysis examined both the strength and the linearity of the relationship between symptoms of posttraumatic stress disorder (PTSD) and perceptions of posttraumatic growth (PTG) as well as identifying the potential moderating roles of trauma type and age. Literature searches of all languages were conducted using the ProQuest, Wiley Interscience, ScienceDirect, Informaworld and Web of Science databases. Linear and quadratic (curvilinear) rs as well as βs were analysed. Forty-two studies (N = 11,469) that examined both PTG and symptoms of PTSD were included in meta-analytic calculations. The combined studies yielded a significant linear relationship between PTG and PTSD symptoms (r = 0.315, CI = 0.299, 0.331), but also a significantly stronger (as tested by Fisher's transformation) curvilinear relationship (r =0.372, CI = 0.353, 0.391). The strength and linearity of these relationships differed according to trauma type and age. The results remind those working with traumatised people that positive and negative post-trauma outcomes can co-occur. A focus only on PTSD symptoms may limit or slow recovery and mask the potential for growth.Copyright © 2013. Published by Elsevier Ltd.
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| [48] |
This randomized controlled trial evaluated the effect of a mindfulness-based mobile health (mHealth) intervention, tailored to the pandemic context, among young adult students (N = 114) with elevated anxiety and/or depressive symptoms during quarantine in China, compared to a time- and attention-matched social support-based mHealth control. At baseline, postintervention (1 month), and 2-month follow-up, participants completed self-reports of primary outcomes (anxiety and depression), secondary outcomes (mindfulness and social support), and emotional suppression as a culturally relevant mechanism of change. Feasibility and acceptability were also evaluated. Using intent-to-treat (ITT) analysis, linear mixed effects models showed that compared to social support mHealth, mindfulness mHealth had a superior effect on anxiety (p =.024, between-group d = 0.72). Both conditions improved on depression (baseline-to-FU ds > 1.10, between-group difference not significant, d = 0.36 favoring mindfulness). There was an interaction of Emotional suppression reduction × Condition in the improvement of anxiety and depression. Further, mindfulness mHealth was demonstrated to be more feasible and acceptable in program engagement, evaluation, skills improvement, and perceived benefit. Retention was high in both conditions (>80%). The difference in self-reported adverse effect was nonsignificant (3.9% in mindfulness and 8.7% in social support). Results of this pilot trial suggest that both mindfulness and social support, delivered via mHealth, show promise in reducing distress among young adults in quarantine, with mindfulness being particularly effective in addressing anxiety. Successful implementation and dissemination of this mHealth intervention approach have the potential for addressing the psychological consequences of the pandemic. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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| [49] |
To test the efficacy of a therapist-guided high-intensity internet intervention compared with an unguided low-intensity internet intervention among individuals with alcohol use disorder.A three-group randomized controlled trial with follow-up assessments post-treatment (12 weeks) and 6 months post-randomization (primary end-point).General population sample in Sweden.A total of 166 on-line self-referred adults (49% males) with a score of 14 (females)/16 (males) or more on the Alcohol Use Disorders Identification Test, a preceding week alcohol consumption of 11 (females)/14 (males) or more standard drinks and an alcohol use disorder according to a diagnostic interview.Both the high- (n = 72) and low-intensity internet interventions (n = 71) consisted of modules based on relapse prevention. Controls were on a waiting-list (n = 23), and were only followed until the post-treatment follow-up. Participants were randomized at a 7 : 7 : 2 ratio.Primary outcome was self-reported alcohol consumption in the preceding week measured as (1) number of standard drinks and (2) number of heavy drinking days at the 6-month follow-up.Alcohol use disorders were largely in the severe category (74.7%), with the majority of participants having had alcohol problems for more than 5 years. Attrition was 13 and 22% at the post-treatment and 6-month follow-up, respectively. At the 6-month follow-up, an intent-to-treat analysis showed no significant differences in alcohol consumption between the high- and low-intensity interventions [standard drinks d = -0.17, 95% confidence interval (CI) = -0.50 to 0.16; heavy drinking days: d = -0.07, 95% CI = -0.40 to 0.26]. Prevalence of negative effects was somewhat low (8-14%) in both intervention groups, as was deterioration (3-5%).At 6-month follow-up, there were no significant differences between a therapist-guided high-intensity internet intervention and an unguided low-intensity internet intervention in reducing alcohol consumption among individuals with an alcohol use disorder.© 2019 The Authors. Addiction published by John Wiley & Sons Ltd on behalf of Society for the Study of Addiction.
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| [50] |
Although research has identified dozens of behavioral and psychosocial strategies for boosting resilience in adults, little is known about the common underlying pathways. A comprehensive review of these strategies using an affective neuroscience approach indicates three distinct general routes to resilience: 1) down-regulating the negative (e.g., exposure, cognitive reappraisal) by reducing distress-related responses of the amygdala, hypothalamic-pituitary-adrenal axis, and autonomic nervous system; 2) up-regulating the positive (e.g., optimism, social connectedness) by activating mesostriatal reward pathways, which in turn can buffer the effects of stress; and 3) transcending the self (e.g., mindfulness, religious engagement) by reducing activation in the default mode network, a network associated with self-reflection, mind-wandering, and rumination. Some strategies (e.g., social support) can boost resilience via more than one pathway. Under- or over-stimulation of a pathway can result in vulnerability, such as over-stimulation of the reward pathway through substance abuse. This tripartite model of resilience-building is testable, accounts for a large body of data on adult resilience, and makes new predictions with implications for practice.Copyright © 2020 Elsevier Ltd. All rights reserved.
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| [51] |
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| [52] |
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| [53] |
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| [54] |
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| [55] |
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| [56] |
Meaning-focused coping is an important coping strategy in the face of stressful life events. The "construal level theory" and recent research suggest that reflecting on a stressful situation from a self-distanced stance (temporal or spatial) allows individuals to find meaning in negative life events; however, its long-term effects have not yet been explored. The present research had two main goals: (1) to determine whether distanced meaning making enhances meaning in life and (2) to explore the underlying emotional mechanism of this effect. We hypothesized that positive affect (relative to negative affect) may play a more important role in the relationship between self-distanced meaning making and meaning in life. A total of 136 university students were recruited as participants in two studies. The participants were prospectively instructed to make meaning of a highly stressful event. They were randomly assigned to one of three conditions: (a) self-immersed, (b) temporally distanced, or (c) spatially distanced. The findings indicate that both the temporally and spatially distanced perspectives in the meaning-making process can enhance meaning in life and that they do so by promoting positive affect. Implications for future research on meaning-focused coping and self-distancing are discussed.© 2019 The Institute of Psychology, Chinese Academy of Sciences and John Wiley & Sons Australia, Ltd.
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| [57] |
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| [58] |
Mental simulation, the process of self-projection into alternate temporal, spatial, social, or hypothetical realities is a distinctively human capacity. Numerous lines of research also suggest that the tendency for mental simulation is associated with enhanced meaning. The present research tests this association specifically examining the relationship between two forms of simulation (temporal and spatial) and meaning in life. Study 1 uses neuroimaging to demonstrate that enhanced connectivity in the medial temporal lobe network, a subnetwork of the brain's default network implicated in prospection and retrospection, correlates with self-reported meaning in life. Study 2 demonstrates that experimentally inducing people to think about the past or future versus the present enhances self-reported meaning in life, through the generation of more meaningful events. Study 3 demonstrates that experimentally inducing people to think specifically versus generally about the past or future enhances self-reported meaning in life. Study 4 turns to spatial simulation to demonstrate that experimentally inducing people to think specifically about an alternate spatial location (from the present location) increases meaning derived from this simulation compared to thinking generally about another location or specifically about one's present location. Study 5 demonstrates that experimentally inducing people to think about an alternate spatial location versus one's present location enhances meaning in life, through meaning derived from this simulation. Study 6 demonstrates that simply asking people to imagine completing a measure of meaning in life in an alternate location compared with asking them to do so in their present location enhances reports of meaning. This research sheds light on an important determinant of meaning in life and suggests that undirected mental simulation benefits psychological well-being.PsycINFO Database Record (c) 2015 APA, all rights reserved.
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