Positive and meaningful lives: Systematic review and meta‐analysis of eudaimonic well‐being in first‐episode psychosis

Gleeson, John; Eleftheriadis, Dina; Santesteban-Echarri, Olga; Koval, Peter; Bastian, Brock; Penn, David L.; Lim, Michelle H.; Ryan, Richard M.; Álvarez‐Jiménez, Mario

doi:10.1111/eip.13049

Cited by 9 publications

(8 citation statements)

References 68 publications

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“…ACT as a therapeutic modality also coherently aligns with PWB as a key outcome, in addition to symptom alleviation [69][70][71]. Given that past reviews have identified PWB and flourishing as important mental health outcomes [17,18], especially for university students [19], the findings of this review provide further support for the development of digital psychological interventions grounded in ACT.…”

Section: Principal Findingsmentioning

confidence: 76%

“…PWB also offers the advantage of being strongly correlated with psychopathology in youth but is also a distinct construct that may provide a basis for the prevention of mental health problems [ 16 ]. In addition, PWB has been identified as having strong transdiagnostic utility in predicting broad psychological outcomes across diverse populations [ 17 , 18 ]. Therefore, it is not surprising that PWB has emerged as a high priority for investigation and intervention in university students [ 19 ].…”

Section: Introductionmentioning

confidence: 99%

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Digital Interventions for Psychological Well-being in University Students: Systematic Review and Meta-analysis

Ferrari¹,

Allan²,

Arnold³

et al. 2022

J Med Internet Res

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Background Life at university provides important opportunities for personal growth; however, this developmental phase also coincides with the peak period of risk for the onset of mental health disorders. In addition, specific university lifestyle factors, including impaired sleep and academic and financial stress, are known to exacerbate psychological distress in students. As a result, university students have been identified as a vulnerable population who often experience significant barriers to accessing psychological treatment. Digital psychological interventions are emerging as a promising solution for this population, but their effectiveness remains unclear. Objective This systematic review and meta-analysis aimed to assess digital interventions targeting psychological well-being among university students. Methods Database searches were conducted on December 2, 2021, via Embase, MEDLINE, PsycINFO, and Web of Science. Results A total of 13 eligible studies were identified, 10 (77%) of which were included in the meta-analysis. Mean pre-post effect sizes indicated that such interventions led to small and significant improvement in psychological well-being (Hedges g=0.32, 95% CI 0.23-0.4; P<.001). These effects remained, albeit smaller, when studies that included a wait-list control group were excluded (Hedges g=0.22, 95% CI 0.08-0.35; P=.002). An analysis of acceptance and commitment therapy approaches revealed small and significant effects (k=6; Hedges g=0.35, 95% CI 0.25-0.45; P<.001). Conclusions Digital psychological interventions hold considerable promise for university students, although features that optimize service delivery and outcomes require further assessment. Trial Registration PROSPERO CRD42020196654; https:/www.crd.york.ac.uk/prospero/display_record.php?RecordID=196654

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Section: Principal Findingsmentioning

confidence: 76%

Section: Introductionmentioning

confidence: 99%

Digital Interventions for Psychological Well-being in University Students: Systematic Review and Meta-analysis

Ferrari¹,

Allan²,

Arnold³

et al. 2022

J Med Internet Res

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“…However, our results also raise ethical concerns over whether interventions aimed at increasing insight into cognitive impairment may harm self-efficacy ( Cella et al, 2014 ; Rose et al, 2008 ). This could be counterproductive, considering the importance of self-efficacy to wellbeing in severe mental illness ( Gleeson et al, 2020 ; Hansson, 2006 ). Sensitive participants may also have difficulty engaging during cognitive remediation due to low self-efficacy ( Beck et al, 2018 ; Chang et al, 2017 ).…”

Section: Discussionmentioning

confidence: 99%

Executive dysfunction in schizophrenia: Predictors of the discrepancy between subjective and objective measures

Haugen

Stubberud

Ueland

et al. 2021

Schizophrenia Research: Cognition

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This study aimed to investigate what characterizes individuals with schizophrenia who experience more or less subjective executive dysfunction in everyday life compared to objective executive performance on neuropsychological tests. Sixty-six participants with broad schizophrenia spectrum disorders completed a comprehensive assessment of executive function. Discrepancies between performance on neuropsychological tests (objective) and an extensive self-report questionnaire (subjective) of central executive functions (inhibition, shifting and working memory) were calculated. Higher level of self-efficacy was the best predictor of experiencing fewer subjective cognitive complaints compared to objective performance, followed by higher levels of disorganized symptoms. Depressive symptoms did not predict discrepancy between subjective and objective executive function. Higher estimated IQ predicted greater subjective working memory difficulties in everyday life despite better objective performance. Results may aid clinicians in the assessment and remediation of cognitive impairment. Low self-efficacy may identify individuals who are not able to utilize their potential executive functions in daily life. Interventions aimed at fostering self-efficacy ought to be included in cognitive remediation for these individuals. Disorganized symptoms could prove useful in identifying individuals who are in need of cognitive remediation for executive dysfunction, despite that they overestimate their skills. These individuals may benefit from efforts to increase insight into cognitive dysfunction.

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“…Recent studies suggest that the key factors associated with lower levels of psychological well-being in patients with schizophrenia are depressive symptoms, motivational deficits [ 2 , 11 , 13 , 14 ], and cognitive disorganization [ 14 ]. A recent review found that deficits in well-being in schizophrenia are present prior to the onset of the first episode of psychosis and hypothesized that lower well-being is a risk factor for both the onset of psychosis and poorer functional outcomes [ 19 ]. When assessed using a validated objective measure, psychological well-being was positively and significantly related to the strength of the therapeutic alliance between psychiatrists and patients with schizophrenia [ 20 ].…”

Section: Introductionmentioning

confidence: 99%

Functioning and Happiness in People with Schizophrenia: Analyzing the Role of Cognitive Impairment

Gutiérrez‐Rojas

González-Domenech

Junquera

et al. 2021

IJERPH

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Schizophrenia is associated with marked functional impairment and low levels of subjective happiness. The aim of the current study was to evaluate the relationship between subjective happiness and functioning in patients with schizophrenia, while considering the role of cognitive functioning. Methods: In total, 69 schizophrenia patients and 87 matched healthy controls participated in the study. Patients’ clinical status was assessed, and a series of self-report questionnaires were administered to both patients and healthy controls to measure subjective happiness, satisfaction with life, well-being, functioning, and cognitive impairment. A multiple linear regression model identified significant predictors of subjective happiness and related constructs. Results: Schizophrenia participants endorsed lower levels of happiness and well-being, and higher perceived stress compared to healthy controls. In schizophrenia patients, there was an inverse and significant correlation (r = −0.435; p = 0.013) between subjective happiness and functioning in a subgroup of patients without cognitive impairment. This correlation was not significant (r = −0.175; p = 0.300) in the subgroup with cognitive impairment. When controlling for other clinical variables (by multiple lineal regression), the severity of symptoms and level of insight failed to demonstrate significant relationships with happiness; meanwhile, perceived stress and some specific cognitive dominions (as verbal learning and processing speed) were associated with satisfaction of life of the patients. Conclusions: The relationship between subjective happiness and functioning in schizophrenia patients was influenced by level of cognitive impairment. Findings from this study suggest that rehabilitation programs may improve recovery outcomes with a focus on subjective happiness and functioning, especially in patients with cognitive impairment. Future research is needed to better understand the complex interplay between subjective happiness, functioning, and cognitive impairment in patients with schizophrenia.

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Positive and meaningful lives: Systematic review and meta‐analysis of eudaimonic well‐being in first‐episode psychosis

Cited by 9 publications

References 68 publications

Digital Interventions for Psychological Well-being in University Students: Systematic Review and Meta-analysis

Digital Interventions for Psychological Well-being in University Students: Systematic Review and Meta-analysis

Executive dysfunction in schizophrenia: Predictors of the discrepancy between subjective and objective measures

Functioning and Happiness in People with Schizophrenia: Analyzing the Role of Cognitive Impairment

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