Measure Of Positive Mental Health Research Articles

What’s the difference between measures of wellbeing, quality of life, resilience, and coping? An umbrella review and concept map of 155 measures of positive mental health

The multitude of definitions, models, and measures of positive mental health has hindered academic precision and therefore the ongoing scientific evolution of this important area. This umbrella review aimed to synthesize the theoretical landscape of positive mental health, by reviewing measures that were designed to capture overarching, multi-dimensional concepts of positive and adaptive states of mental health (i.e., wellbeing, quality of life, and resilience/coping), and interrogating their underlying dimensions (e.g., vitality, autonomy) and design features (e.g., response scales, item valence). Our search identified 155 measures of positive mental health with a total of 410 constituent dimensions. Using thematic analysis, we consolidated these 410 original dimensions into a set of 21 themes. These themes were transformed into a concept map to illustrate their inter-relationship with the overarching concepts of positive mental health as identified in this review. Our results point to a lack of consensus on the underlying dimensions and measurement approaches for investigating positive mental health, with singular measures failing to capture its breadth, resulting in an unwieldy situation for ongoing scientific inquiry.

Developing and validating a positive mental health scale for the global south construction industry: the construction industry positive mental health inventory (CI-PMHI)

Purpose Promoting positive mental health is increasingly being encouraged as the focus of research and policies on the mental health of construction personnel. Most measures of mental health, however, typically use negative indicators such as depression and anxiety and are not specifically developed for the construction workforce, especially those with a Global South background. These limitations have made it challenging to measure construction personnel’s positive mental health. The purpose of this study was, therefore, to develop a scale for measuring the positive mental health of construction personnel with a Global South background. Design/methodology/approach Guided by Keyes’ two-continua model of mental health, the study objectives were addressed through a mixed-methods study using the case of Ghana. Qualitative data collected from eight key stakeholder groups using 16 interviews and two rounds of focus group discussions were analysed thematically. Quantitative data were obtained through a survey of 425 construction personnel and analysed using confirmatory factor analysis and correlation analysis. Findings Thematic analysis revealed a four-dimensional structure of positive mental health, namely, emotional, psychological, social and spiritual. Confirmatory factor analysis and correlation analysis of the results indicated good instrument validity and reliability. Originality/value Existing measures of positive mental health are based on a three-dimensional model, i.e. emotional, social and psychological well-being. By including spiritual well-being, this study proposes a four-dimensional measurement model as a more comprehensive and promising measure to use in surveys of positive mental health among the construction workforce, especially those with a Global South background, and to develop suitable interventions for them.

Conceptualising and measuring positive mental health literacy: a systematic literature review

PurposeThe purpose of this study is to systematically review how positive mental health literacy has been conceptualised and measured over the last 20 years. Positive mental health recognises the benefits of feeling good and functioning effectively. Developing clarity around conceptualisation and knowledge (or literacy) of what constitutes positive mental health is an area of continued development, and an important step in measuring the impact of mental health promotion.Design/methodology/approachA systematic review of literature was performed to investigate how positive mental health literacy has been conceptualised and measured over the last 20 years. Databases searched included EDS, Scopus, ERIC, PsycINFO, CINAHL and SocIndex with fulltext. Search terms relating to positive mental health were combined with proximity operators within four words denoting knowledge, competence or literacy.FindingsA total of 464 records were assessed on title level, with six articles included for final review. The final studies included three measures assessing participants’ knowledge of positive mental health, some of which included more distal themes such as awareness of coping strategies and emotional awareness. One measure, the Mental Health Promoting Knowledge – 10, stood out as the most fitting measure of positive mental health literacy.Research limitations/implicationsOur review approaches an under reported area of study, highlighting an area in need for further development with a few limitations. When building the search strategy, care was taken to line it up with literacy around positive mental health and its synonyms. The word “mental health” without positive specification was omitted in the final search strategy, increasing the risk of it also omitting potential articles of interest.Practical implicationsOur findings therefore highlight a knowledge gap in relation to conceptualisations and measures of positive mental health literacy, unfolding an area for further development. A more harmonised understanding of what is meant by positive mental health is an important step towards clarifying the concept and facilitating future study of the topic. Measures of positive mental health literacy could be an important indicator for mental health promotion.Social implicationsNew ways of measuring positive mental health literacy can be a useful way to establish benefits of mental health promotion, taking a salutogenic approach to mental health.Originality/valueThese findings expose an apparent knowledge gap in relation to conceptualisations and measures of positive mental health literacy, highlighting an area in need for further development. Measures of positive mental health literacy could be an important indicator for mental health promotion.

A Sage and a Guru Walk into a Bar: Wisdom and Humor Styles

Two studies investigated the relationship between wisdom, humor styles, comic styles, and wellbeing. In Study 1, 325 English-speaking college students completed the Self-Assessed Wisdom Scale (SAWS) and the Humor Styles Questionnaire. As predicted, overall wisdom, as well as all five wisdom subscales, was positively correlated with adaptive humor styles. Furthermore, the SAWS humor subscale correlated positively with all humor styles, most strongly with the adaptive styles. In Study 2, 189 German-speaking university students and adults from the general population completed the SAWS, the Comic Style Markers, and measures of positive mental health (meaning in life, optimism, and resilience). The SAWS subscales and especially the humor subscale correlated positively with all comic styles, except for sarcasm. SAWS humor and the comic styles incrementally predicted three of the four mental health outcomes, and a significant interaction between SAWS humor and benevolent humor suggests that humor and wisdom are both relevant for mental health. Overall, the study extends our understanding of the complex interplay between different aspects of wisdom and different humor-related styles as well as their relevance for mental health.

TESTING A PORTION OF THE OKLAHOMA AGING INMATE FORGIVENESS MODEL

Abstract The study assessed the viability of the published Oklahoma Aging Forgiveness Model on women in custody using cross-sectional data collected from females, violent and non-violent, in custody in Oklahoma. The theoretical model led to a hierarchical regression of a measure of positive mental health (Positive Evaluation of Life) on a block of control variables (age, education, and crime type), a block consisting of items from the Duke Religiosity measure, and a final block utilizing forgiveness of self, others, and situation (Heartland Forgiveness Scale). Results from the complete sample, N=447, explained 36% of the variance in the outcome. Significant individual predictors included in the final model were crime type, religiosity, and forgiveness of self and situations. We split the sample on crime type and found that for the violent offenders (N=228), 39% of the variance in the outcome was explained; in addition to religiosity, all three assessments of forgiveness were significant predictors. For the non-violent offenders (N=209), 35% of the outcome’s variability was explained. Religiosity, forgiveness of self and situation were significant predictors for this sub-sample. Discussion will focus on the Oklahoma Aging Forgiveness Model and how it works similarly for men in custody (published) and for women in custody. Further, the discussion will focus on the significant role played both by religiosity and forgiveness for those in custody. Findings from this study and that of studies with men clearly demonstrate that religiosity and forgiveness are important aspects of a prisoner’s life.

The long-term outcome of accelerated experiential dynamic psychotherapy: 6- and 12-month follow-up results.

Accelerated experiential dynamic psychotherapy (AEDP; Fosha, 2000, 2021b) is an integrative, healing-oriented, mind-body, affect-focused therapy. A posttreatment outcome study demonstrated AEDP's effectiveness (Iwakabe et al., 2020) on a variety of measures of psychological functioning. This study sought to address AEDP's long-term effectiveness. As previously reported, 63 adult patients completed a 16-session AEDP treatment with qualified therapists in private practice in the United States, Canada, Israel, Japan, and Sweden. Forty patients responded to 6-month follow-up and 52 responded to 12-month follow-up. Results indicate that patients maintained their posttreatment therapeutic gains, both 6 and 12 months later. Large effect sizes (d = 0.74 to d = 1.60) both for reductions on measures of psychopathology (e.g., depression, negative automatic thoughts, experiential avoidance) and improvements on measures of positive mental health (e.g., well-being, self-compassion) were obtained. Patients with more pervasive and severe problems tended to have larger effect sizes (all ds > 1.0) and a larger proportion of them achieved clinically significant change over 6 and 12 months than patients with subclinical symptomatology. Piecewise growth modeling was used to confirm these results, with attrition over the follow-up period taken into account. Consistent with the above findings, piecewise growth modeling similarly showed that patients significantly improved from pre- to posttreatment and maintained gains from posttreatment through the 6- and 12-month follow-up. These results provide empirical support for the long-term effectiveness of AEDP for alleviating a variety of psychological problems and enhancing positive functioning. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Universal process-based CBT for positive mental health in early adolescence: A cluster randomized controlled trial

Early adolescence is a key developmental phase for promoting positive mental health and preventing psychological difficulties. Despite calls to develop the evidence base for universal interventions in early adolescence and the promise of process-based CBT, the literature is devoid of empirical investigations of the efficacy of universal process-based CBT in this cohort. This cluster randomized controlled trial aimed to extend the empirical literature by evaluating the efficacy of a six-session universal process-based CBT intervention in elementary schools. Twenty-nine schools were randomly allocated to intervention or waiting list control groups. Six hundred four participants completed measures of positive mental health, resilience, emotional literacy, and mindfulness at baseline, post-intervention, and six-week follow-up. Although participants reported that the intervention was satisfactory, it did not yield significantly superior growth rates on the outcome measures than the control condition at post-intervention or follow-up. Implications of the findings and directions for future research are discussed.

Why Studies in the Effect of Positive Psychological Interventions Should Use Life-Satisfaction as an Outcome.

The effect of positive psychological interventions (PPIs) is mostly assessed using self-report measures of positive mental health. These measures are problematic because (1) the content addressed is often not clear, (2) different scales are used to assess different notions of positive mental health, which impedes comparability, (3) the concept of positive mental health involves objective capabilities which are not well measurable using subjective self-estimates, and (4) the concept behind the measures denotes presumed chances for adaptation to life rather than adaptation as such. Therefore, we should also measure the effect of PPIs using life-satisfaction, which is (a) a clear-cut concept and as such tells us what an intervention brings about, (b) is well measurable using self-reports, since it is a subjective concept, (c) it allows better comparability across studies, and (d) it indicates actual adaptation to life instead of strengthening of presumed of chances for adaptation.

Psychiatric risk and resilience: Plasticity genes and positive mental health.

ObjectiveThe at‐risk mental state (ARMS) for psychosis has long played a key role in diathesis‐stress models of schizophrenia. More recent studies, however, have called for extending the boundaries of the ARMS construct beyond attenuated psychosis in nonhelp‐seeking samples to include not only other vulnerability indicators but also protective factors related to genotype, mental health, personality, and cognition.MethodAccordingly, we assessed in a sample of 100 college students, the ARMS construct with the Brief Prodromal Questionnaire (PQ‐B) for psychosis, in conjunction with measures of positive mental health, childhood adversity, psychiatric symptoms, personality traits, social cognition, and genetic variables derived from assays of the serotonin transporter (5‐HTTLPR) and the brain‐derived neurotrophic factor (BDNF).ResultsHigher PQ‐B scores correlated positively with vulnerability indicators of childhood adversity and heightened levels of a wide variety of psychiatric symptoms but correlated negatively with protective factors of better overall mental health, social cognition as well as with a distinct NEO profile marked by reduced neuroticism and elevated agreeableness and conscientiousness. Multivariate analyses indicated that a composite ARMS measure comprised of PQ‐B scores plus anxiety and depression symptoms revealed significant genotype differences, with lowest risk and highest resilience for allelic carriers of 5‐HTTLPR‐short and BDNF Met polymorphisms.ConclusionsResults provided support for extending the ARMS construct, pointing to important contributions of personality, social cognition, and genes that support neural plasticity in mitigating vulnerability and enhancing resilience and well‐being.

Positive Mental Health in Youth with ADHD: Exploring the Role of Social Support

Positive mental health in youth has important implications for overall well-being. This study examined the extent to which different types of social support are associated with positive mental health among individuals, ages 15–24, diagnosed with attention deficit/hyperactivity disorder (ADHD). Compared to respondents without a diagnosis of ADHD, those with a diagnosis had significantly lower scores on measures of positive mental health and on four of five types of social support. Among the five types of social support, social integration and reassurance of worth were found to be significant predictors of positive mental health in respondents diagnosed with ADHD.

Measuring positive mental health and flourishing in Denmark: validation of the mental health continuum-short form (MHC-SF) and cross-cultural comparison across three countries

BackgroundThe Mental Health Continuum–Short Form (MHC-SF) is a measure of positive mental health and flourishing, which is widely used in several countries but has not yet been validated in Denmark. This study aimed to examine its qualitative and quantitative properties in a Danish population sample and compare scores with Canada and the Netherlands.MethodsThree thousand five hundred eight participants aged 16–95 filled out an electronic survey. Both the unidimensional and multidimensional aspects of the Danish MHC-SF were studied through bifactor modelling. Cognitive interviews examined face validity and usability.ResultsThe general score of the Danish MHC-SF was reliable for computing unit-weighted composite scores, as well as using a bifactor model to compute general factor scores or measurement models in an SEM context. Nonetheless, subscale scores were unreliable, explaining very low variance beyond that explained by the general factor. The participants of the qualitative interviews observed problems with wording and content of the items, especially from the social subscale. The general score correlated with other scales as expected. We found substantial variation in flourishing prevalence rates between the three cultural settings.ConclusionsThe Danish MHC-SF produced reliable general scores of well-being. Most of the issues observed regarding the subscale scores have been shown in previous research in other contexts. The further analysis of indices of the bifactor model and the inclusion of qualitative interviews allowed for a better understanding of the possible sources of problems with the questionnaire’s subscales. The use of subscales, the substantive understanding of the general score, as well as the operationalization of the state of flourishing, require further study.

Act-Belong-Commit Framework For A Mentally Healthy College Campus: Campus Recreation And Exercise Science Partnership

A growing concern for universities is the state of mental health with a clear need for positive mental health campaigns and strategies to shift the culture surrounding mental well-being. Our campus has adopted a holistic framework, Act-Belong-Commit, to improve mental health through positive intentional engagement in activities. PURPOSE: The purpose of this study was to examine the mental health climate and well-being of current students on a primarily residential collegiate campus before the implementation of Act-Belong-Commit campaign. METHODS: 176 students (21.2±2.5yrs; 162 female, 19 male, 2 gender non-binary) participated in the campus-wide survey. There was equal representation of the students across years in school with little ethnic/racial diversity: (Caucasian=93%; African American=2%; Hispanic/Latinx=3%; Asian=2%) and some diversity in sexual orientation (heterosexual=87%; homosexual=2%; bisexual=8%, or other=2%). Measures included: Satisfaction With Life (SWL), Multidimensional Scale of Perceived Social Support (MSPSS), Self-Stigma of Seeking Help Scale (SSSHS), Depression Anxiety Stress Scale (DASS), Resilience and the Meaning of Life Questionnaire (MLQ). A small subset (n=55) completed an ABC self-assessment. RESULTS: Social Support was significantly correlated (p<0.05) with many positive mental health outcomes: SWL (r=.62); Resilience (r=.39); Meaning of Life (r=.34); Depression Subscale (r=-.56); Anxiety Subscale (r=-.34); Stress (r= -0.35). High perceived social support and positive mental health were also seen in people high on ACT (Social Support r=.32; resilience r=.37, depression r=-.32, anxiety r=-.26, and stress r=-.36) and BELONG (SWL r=.35, resilience r=.39, depression r=-.29, stress r=-.28). CONCLUSION: Social support and a sense of belonging was integrally tied to measures of positive mental health and improved satisfaction with life measures. Belonging comes from being engaged in an active life with people and activities that bring meaning and purpose. Campus recreation and exercise science programs will lead the implementation of the ABC campaign, promoting physical activity, mindfulness/mediation, and play as activities to engage in a various levels as part of this positive mental health campaign.

Predictors of high and low mental well-being and common mental disorders: findings from a Danish population-based study.

BackgroundMental well-being is fundamental for a good life. Previous literature has examined the predictors of mental disorders and continuous measures of positive mental health. Very few studies have specifically focused on the predictors of different levels of mental well-being, but those that have suggest a different picture. This study aimed to compare socioeconomic and relational/recreational behaviour predictors of different levels of mental well-being as well as common mental disorders (CMDs).MethodsData from 3508 adults aged 16+ years old from the Danish Mental Health and Well-Being Survey 2016 were linked to Danish national register-based data. Mental well-being was assessed using the Warwick-Edinburgh Mental Well-being Scale, and information on CMDs was assessed using the Patient Health Questionnaire (PHQ-4). Regression analyses were conducted to estimate the predictors of low and high mental well-being compared to moderate mental well-being and also of CMDs.ResultsLower socioeconomic position (education, income and employment status) was associated with increased odds of low mental well-being and the presence of CMDs, but did not significantly predict high mental well-being. Relational/recreational behaviours (informal and formal social participation, social support and recreational activity) were associated with reduced odds of low mental well-being and CMDs, and also with increased odds of high mental well-being.ConclusionsSocioeconomic predictors of high mental well-being do not mirror those of low mental well-being and CMDs, whereas relational/recreational predictors of high mental well-being do mirror those of low mental well-being and CMDs. These findings have important implications for public mental health strategies.

Is the DSM-5 Anxious Distress Specifier Interview a valid measure of anxiety in patients with generalized anxiety disorder: A comparison to the Hamilton Anxiety Scale

DSM-5 includes criteria for an anxious distress specifier for major depressive disorder, and measures have been developed to assess these criteria. The validity of measures of the severity of anxious distress has been established in depressed patients. In the present report from the Rhode Island Methods to Improve Diagnostic Assessment and Services (MIDAS) project, we examined whether a severity measure of anxious distress was as valid as the Hamilton Anxiety Scale (HAMA) as a measure of the severity of anxiety in patients with generalized anxiety disorder (GAD). Eighty-five patients with GAD were interviewed by trained raters who administered the DSM-5 Anxious Distress Specifier Interview (DADSI), HAMA, and Hamilton Depression Rating Scale (HAMD). The patients completed self-report measures of depression, anxiety, and irritability. The DADSI and HAMA were significantly correlated (r 0.52, p < .001). Both the DADSI and HAMA were more highly correlated with measures of anxiety than with measures of the other symptom domains. The HAMD was significantly more highly correlated with the HAMA than with the DADSI. Both measures were significantly correlated with measures of positive mental health, functioning, life satisfaction, and general well-being. Both measures were sensitive to change in response to treatment. Both the DADSI and HAMA were valid measures of anxiety severity in patients with GAD, though the HAMA was more highly confounded with the HAMD than the DADSI. The DADSI is briefer than the HAMA, and thus may be more practical to use in research studies as well as clinical practice.

The Portuguese Adaptation of the Mental Health Continuum-Short Form for Adult Population.

The Mental Health Continuum-Short Form (MHC-SF) is a self-report questionnaire that allows the assessment of positive mental health, including three well-being components-emotional, psychological and social-as well as the categorical diagnosis of the presence or absence of mental health. The purpose of this study is to describe the adaptation and validation of the Portuguese version of MHC-SF and to examine whether this is an adequate measure of positive mental health for the Portuguese context. The participants included 1448 respondents between the ages of 18 and 94 (M = 33.15; SD = 16.3), 70.1% of which were females. Results confirm the reliability (α = .93), tripartite factor structure, and the external and internal validity of the MHC-SF. Data also supported the two-continuum model, with positive mental health and mental illness belonging to two correlated but distinct dimensions. These findings indicated that the Portuguese MHC-SF is valid instrument to measure well-being and positive mental health.

Outcomes from a One-Week Adapted Sport and Adapted Adventure Recovery Programme for Military Personnel.

Background: The Battle Back Centre offers a bespoke, Self Determination Theory-oriented adapted sport and adventurous training programme centred on experiential learning and reflection to support the recovery of military personnel. Aim: To identify the short-term impact of participation in the programme on positive mental health and psychological need satisfaction. Method: Participants were 978 wounded, injured and sick (WIS) personnel classified as: Wounded (battle casualties), Injured (non-battle casualties) and Sick (mental/physical illness). Participants completed the Basic Need Satisfaction in General Scale (Gagné, 2003) and Warwick and Edinburgh Mental Well Being Scale (Tennant et al. 2006) on arrival and course completion. Results: All measures of positive mental health and psychological need satisfaction showed statistically significant increases, with a large effect size, from baseline to course completion (mean ± SD change in positive mental health, competence, autonomy and relatedness were 7.19 ± 9.61, 0.46 ± 0.9, 0.27 ± 0.84, 0.26 ± 0.86, respectively, p < 0.05). While the average magnitude of the intervention effect for positive mental health (16%) is comparable or greater than other reported interventions, changes were achieved in a shorter time. Conclusion: Findings highlight the positive short-term effect adapted sport and adventurous activities have for WIS personnel. Declaration of interest: Work supported by The Royal British Legion.

The development and preliminary psychometric properties of the Values Wheel

BackgroundIn Acceptance and Commitment Therapy (ACT), personal values function as motivational guideposts for behavior change and adaptive functioning. The continued empirical progress of this process-based therapy necessitates the development and evaluation of measures of values-directed behavior. This study reports on the preliminary psychometric properties of the Values Wheel: a new psychometric instrument designed and manufactured to provide an idiographic and weighted index of clients’ values-directed behavior. MethodOne hundred fifty adults attended an assessment session on an individual basis to complete a values card sort task, Values Wheel and questionnaire measures of positive mental health, psychological distress and ACT processes. To investigate temporal stability, 39 participants completed two subsequent assessment sessions – each separated by a two-week interval. ResultsThe Values Wheel demonstrated evidence of temporal stability with large correlations between the scores obtained on the three occasions. Correlations with indices of valued living provided preliminary support for the measure’s construct validity, whereas criterion-related validity was partially supported by correlations with positive mental health and stress. ConclusionsThese findings provide preliminary support for the psychometric properties of the Values Wheel. Notwithstanding this study’s limitations, the Values Wheel may hold potential as a measure of values-directed behavior with a broad scope of application in diverse contexts and languages.

Using Bayesian methodology to explore the profile of mental health and well-being in 646 mothers of children with 13 rare genetic syndromes in relation to mothers of children with autism

BackgroundIt is well documented that mothers of children with intellectual disabilities or autism experience elevated stress, with mental health compromised. However, comparatively little is known about mothers of children with rare genetic syndromes. This study describes mental health and well-being in mothers of children with 13 rare genetic syndromes and contrasts the results with mothers of children with autism.MethodsMothers of children with 13 genetic syndromes (n = 646; Angelman, Cornelia de Lange, Down, Fragile-X, Phelan McDermid, Prader-Willi, Rett, Rubenstein Taybi, Smith Magenis, Soto, Tuberous Sclerosis Complex, 1p36 deletion and 8p23 deletion syndromes) and mothers of children with autism (n = 66) completed measures of positive mental health, stress and depression. Using Bayesian methodology, the influence of syndrome, child ability, and mother and child age were explored in relation to each outcome. Bayesian Model Averaging was used to explore maternal depression, positive gain and positive affect, and maternal stress was tested using an ordinal probit regression model.ResultsDifferent child and mother factors influenced different aspects of mental well-being, and critically, the importance of these factors differed between syndromes. Maternal depression was influenced by child ability in only four syndromes, with the other syndromes reporting elevated or lower levels of maternal depression regardless of child factors. Maternal stress showed a more complex pattern of interaction with child ability, and for some groups, child age. Within positive mental health, mother and child age were more influential than child ability. Some syndromes reported comparable levels of depression (SMS, 1p36, CdLS) and stress (SMS, AS) to mothers of children with autism.ConclusionsBayesian methodology was used in a novel manner to explore factors that explain variability in mental health amongst mothers of children with rare genetic disorders. Significant proportions of mothers of children with specific genetic syndromes experienced levels of depression and stress similar to those reported by mothers of children with autism. Identifying such high-risk mothers allows for potential early intervention and the implementation of support structures.

Psychometric properties and population norms of the positive mental health instrument in a representative multi-ethnic Asian population

BackgroundMeasures of mental well-being and positive mental health (PMH) have been largely developed and used in Western populations, however, data on representative Asian communities are lacking. Using data from a population sample, this study sought to establish psychometric properties and norms of the PMH Instrument (PMH-I), a measure of positive mental health developed in Singapore.MethodsWe conducted a nationally representative survey among 1925 adults aged 18–79 years of Chinese, Malay, Indian or other ethnicity. Participants reported socio-demographic characteristics and completed the PMH-I along with measures of health-related quality of life (HRQoL) and psychological distress. Construct validity of the PMH-I was assessed using confirmatory factor analysis and concurrent validity was tested through correlation with other psychological measures. Normative PMH values and differences in population subgroups were estimated.ResultsThe six-factor-higher-order structure of the PMH-I comprising six subscales of general coping, emotional support, spirituality, interpersonal skills, personal growth and autonomy and global affect was confirmed. Concurrent validity was shown through significant positive correlation of the total PMH score and its subscales with HRQoL and an inverse correlation with psychological distress. Weighted age, gender and ethnicity-specific norms were derived for the Singapore population. Total PMH was significantly higher in participants aged over 40 years as compared with 18–29 year olds and in non-Chinese ethnic groups as compared with Chinese. These differences were observed for all PMH-I subscales, with the exception of emotional support and interpersonal skills score differences by age. In contrast, gender, marital status, and education level were significantly associated with some of the subscales, but not with total PMH.ConclusionsThese results support the psychometric properties of the PMH-I in a multi-ethnic Asian population sample. The generalizable population-based norms support the application of the PMH-I for measuring mental health and assessing its determinants within the Singapore general population.

Dual factor model of mental health: Co-occurrence of positive mental health and suicide ideation in inpatients and outpatients

Positive and negative mental health are independent but correlated concepts. Yet, it is unknown whether positive mental health does co-occur with suicide ideation. The present study aimed to determine the proportion of patients who have positive mental health as well as suicide ideation. Inpatients (N=100) and outpatients (N=182) completed self-report measures of positive mental health, suicide ideation and lifetime suicide attempts. Eleven outpatients (6%) and ten inpatients (10%) with suicide ideation reported moderate to high levels of positive mental health. Lifetime suicide attempts were less likely in inpatients who suffered from suicide ideation in the presence of positive mental health. Positive mental health does co-occur with suicide ideation and should be considered as a protective factor in suicide risk assessments.