Positive Psychiatry Research Articles

Hormesis, Resilience, and Positive Psychiatry

Hormesis, Resilience, and Positive Psychiatry

Social Determinants of Mental Health for Posttraumatic Stress Disorder

Recognizing and addressing the social determinants of mental health (SDoMH) for posttraumatic stress disorder (PTSD) is essential for the effective practice of psychiatry. Experiencing traumatic events and subsequent development of PTSD profoundly affects individuals, families, and society, making it one of the most common mental health disorders with substantial psychiatric comorbidity. This article delves into the bidirectional aspects of the SDoMH in PTSD and reviews the diagnostic criteria, prevalence rates, and repercussions of PTSD on both an individual level and within society. PTSD assessment, interventions, and treatment are reviewed, including Prolonged Exposure, Cognitive Processing Therapy, Eye Movement, Desensitization and Reprocessing, trauma-focused and grief therapy. Primary prevention of PTSD, public health considerations, and positive psychiatry tenets are reviewed. [ Psychiatr Ann . 2024;54(7):e209–e215.]

Plenary Session 2: Late onset psychosis / schizophrenia

Overview: This presentation will focus on late-onset schizophrenia (LOS) as well as ageing of persons with early-onset schizophrenia (EOS). 20% of middle-aged and older patients with schizophrenia have onset of illness after age 40. LOS is characterized by female preponderance, better premorbid functioning, fewer positive symptoms, and less cognitive impairment than EOS. EOS presents a paradox of aging – i.e., there is accelerated physical aging with multimorbidity and elevated mortality, while the mental well-being tends to improve with age. Adverse social determinants of health such as childhood traumas, social isolation, discrimination, and food insecurity worsen health. On the other hand, family and social support and access to necessary healthcare enhance the likelihood of sustained remission and recovery. Antipsychotics tend to be effective at doses lower than those in young adults, though the risk of side effects is higher. Psychosocial interventions like cognitive behavior therapy and social skills training are useful. It is important to employ the principles of Positive Psychiatry including promotion of resilience, social connections, optimism, and healthy lifestyle in people with schizophrenia

The pilot study of reminder focused positive psychiatry body mind intervention on improving heart rate variability and autonomous nervous system reactivity in adults with posttraumatic stress disorder

The pilot study of reminder focused positive psychiatry body mind intervention on improving heart rate variability and autonomous nervous system reactivity in adults with posttraumatic stress disorder

3.70 The Pilot Study of Reminder-Focused Positive Psychiatry Body-Mind Intervention on Improving Heart Rate Variability and Autonomous Nervous System Reactivity in Individuals With PTSD

3.70 The Pilot Study of Reminder-Focused Positive Psychiatry Body-Mind Intervention on Improving Heart Rate Variability and Autonomous Nervous System Reactivity in Individuals With PTSD

Viswanathan Chosen APA’s Next President-Elect

Back to table of contents Previous article Next article APA & MeetingsFull AccessViswanathan Chosen APA’s Next President-ElectCatherine BrownCatherine BrownSearch for more papers by this authorPublished Online:24 Feb 2023https://doi.org/10.1176/appi.pn.2023.03.3.65AbstractAPA’s next president-elect is a nationally known researcher and clinician and has worked tirelessly on such issues as access to care, social justice, empowerment of minorities and women, physician wellness, positive psychiatry, and environmental psychiatry. He has held numerous leadership positions at APA and other organizations.APA’s voting members have elected Ramaswamy Viswanathan, M.D., Dr.Med.Sc., of Brooklyn, N.Y., as APA’s next president-elect. He ran against Robert L. Trestman, Ph.D., M.D., of Roanoke, Va.Ramaswamy Viswanathan, M.D., Dr.Med.Sc. (left), will become president-elect of APA at the end of APA’s Annual Meeting in May, when Petros Levounis, M.D., M.A., becomes president.Viswanathan is professor, interim chair of psychiatry, director of the consultation-liaison psychiatry and fellowship, and co-chair of the Faculty Wellness Committee at SUNY Downstate Health Sciences University. His research has been in physician communication, ethics, innovations in psychotherapy and pharmacotherapy, treatment adherence in gynecologic cancers, children’s sickle cell disease, HIV, and substance use.Viswanathan has held numerous leadership positions within APA and other national organizations. He currently serves as the Brooklyn Psychiatric Society representative in the APA Assembly and is chair of the Committee on Consultation-Liaison Psychiatry for the Group for the Advancement of Psychiatry.“I am honored that my colleagues in psychiatry have elected me to the APA presidency,” said Viswanathan. “I look forward to working together to further develop and expand our workforce and to keeping up our momentum on research and development of cutting-edge psychopharmacologic, neuro-interventional, and psychotherapeutic treatment and preventive approaches. We will also work together to advance physician wellness, reduce practice burdens, advocate for our patients and our profession, address inequities in health care, and promote appreciation of diversity and inclusion.”“Congratulations to Dr. Viswanathan and the other candidates on their election,” said APA President Rebecca Brendel, M.D., J.D. “I look forward to working with him and all the newly elected APA leaders to advance psychiatric practice and APA’s leadership role in increasing access to care and improving the quality of mental health care.”APA CEO and Medical Director Saul Levin, M.D., M.P.A., echoed those sentiments. “APA members and the profession of psychiatry will be well served by Dr. Viswanathan’s leadership and commitment. I want to congratulate Dr. Viswanathan and all the newly elected APA leaders.”The race for secretary, which has a two-year term, was up for election this cycle. Gabrielle L. Shapiro, M.D., of New York City defeated Jenny L. Boyer, M.D., Ph.D., J.D., of Norman, Okla., and C. Freeman, M.D., M.B.A., of Marina Del Rey, Calif.In the race for minority/underrepresented representative trustee, Kamalika Roy, M.D., M.C.R., of Seattle emerged the winner. Her opponent was Dora-Linda Wang, M.D., of New York City. The term for minority/underrepresented representative trustee is two years.Two of APA’s seven geographic Areas voted for their trustee in this cycle. Area trustees hold three-year terms. In the race for Area 2 trustee, Kenneth B. Ashley, M.D., of New York City defeated Glenn A. Martin, M.D., of Forest Hills, N.Y. The winner of the Area 5 trustee race was Heather Hauck, M.D. She defeated Sudhakar Madakasira, M.D., of Flowood, Miss.The winner of the race for resident-fellow member (RFM) trustee-elect was Sarah El Halabi, M.D., M.S., a psychiatry resident at Westchester Medical Center in New York. She defeated Sarah A. Friedrich, D.O., M.B.A., M.S., chief resident at Jefferson Health’s Albert Einstein Medical Center in Philadelphia, and Sarin Pakhdikian, D.O., a psychiatry resident at the Kirk Kerkorian School of Medicine at the University of Nevada. El Halabi will serve for a year in the RFM trustee-elect position and then rotate into the RFM trustee position.Election results were approved by the Tellers Committee in February, but the results are not official until the Board of Trustees reviews them at its meeting this month. All of the winning candidates will assume their positions on the Board at the close of APA’s Annual Meeting in May. ■ResourcesComplete results, including vote counts for each race ISSUES NewArchived

AAGP Session to Highlight Research on Resilience, Emotional Well-Being in Aging

AAGP Session to Highlight Research on Resilience, Emotional Well-Being in Aging

Incorporating positive psychiatry with children and adolescents

Incorporating positive psychiatry with children and adolescents

Building toward population reserve and a critical positive psychiatry.

Building toward population reserve and a critical positive psychiatry.

Using the tools of positive psychiatry to improve clinical practice

Using the tools of positive psychiatry to improve clinical practice

PRACTICING WHAT YOU PREACH: POSITIVE CHILD AND ADOLESCENT PSYCHIATRY INSIDE AND OUTSIDE THE CLINICAL ENCOUNTER

The session overviews the concepts and approach that set positive child and adolescent psychiatry apart from child and adolescent psychiatry-as-usual. These include emphasis on family resilience, character strengths, building psychosocial resources, and addressing motivation via connection to values and culture. The Workshop outlines and practices implementation of positive psychiatry practices in selected domains of positive assessment, goal setting, compassion, and mindfulness. Although child and adolescent psychiatry is concerned with promoting well-being, our systems of care and training are typically problem focused and illness oriented.

3.14 Comorbid PTSD and ADHD: Trauma-Informed Interventions Across Diverse Youth Ethnicities

ADHD and PTSD are prevalent chronic comorbid neuropsychiatric disorders. ADHD is associated with higher levels of morbidity and dysfunction associated with PTSD. We study the relation of ADHD with the severity of PTSD symptoms, also evaluating the impact of reminder-focused positive psychiatry (RFPP) in youth with ADHD and comorbid PTSD symptoms in youth in emergency department (ED) and outpatient settings.

Mental health care for older adults: recent advances and new directions in clinical practice and research.

The world's population is aging, bringing about an ever-greater burden of mental disorders in older adults. Given multimorbidities, the mental health care of these people and their family caregivers is labor-intensive. At the same time, ageism is a big problem for older people, with and without mental disorders. Positive elements of aging, such as resilience, wisdom and prosocial behaviors, need to be highlighted and promoted, both to combat stigma and to help protect and improve mental health in older adults. The positive psychiatry of aging is not an oxymoron, but a scientific construct strongly informed by research evidence. We champion a broader concept of geriatric psychiatry - one that encompasses health as well as illness. In the present paper, we address these issues in the context of four disorders that are the greatest source of years lived with disability: neurocognitive disorders, major depression, schizophrenia, and substance use disorders. We emphasize the need for implementation of multidisciplinary team care, with comprehensive assessment, clinical management, intensive outreach, and coordination of mental, physical and social health services. We also underscore the need for further research into moderators and mediators of treatment response variability. Because optimal care of older adults with mental disorders is both patient-focused and family-centered, we call for further research into enhancing the well-being of family caregivers. To optimize both the safety and efficacy of pharmacotherapy, further attention to metabolic, cardiovascular and neurological tolerability is much needed, together with further development and testing of medications that reduce the risk for suicide. At the same time, we also address positive aging and normal cognitive aging, both as an antidote to ageism and as a catalyst for change in the way we think about aging per se and late-life mental disorders more specifically. It is in this context that we provide directions for future clinical care and research.

Reminder-Focused Positive Psychiatry: Suicide Prevention Among Youths With Comorbid Posttraumatic Stress Disorder and Suicidality.

This study aimed to investigate the effect of brief reminder-focused positive psychiatry and suicide prevention (RFPP-S) on suicidal ideation, posttraumatic stress disorder (PTSD) symptoms, and clinical outcomes among youths with PTSD treated in psychiatric emergency rooms. This study included youths with PTSD and suicidality who received either RFPP-S (N=50) or treatment as usual (N=150). The Columbia Suicide Severity Rating Scale (C-SSRS), Clinician-Administered PTSD Scale for children and adolescents, University of California, Los Angeles Trauma Reminder Inventory, Patient Health Questionnaire-9, Positive Emotion, Engagement, Relationships, Meaning, and Accomplishment Scale, and positive psychiatry test batteries were administered at baseline, on day 2, and 1 week and 1 month after discharge. On day 2, the RFPP-S group showed a greater reduction in PTSD symptoms (55%) and reactivity to trauma and loss reminders (80%) compared with the control group (10% for both) (p=0.001). A significantly greater reduction in C-SSRS score for RFPP-S (80%), compared with treatment as usual (15%), was noted (p=0.001), and RFPP-S showed more rapid stabilization (mean±SD=2.0±0.5 days) and enhanced postdischarge follow-up (100%) compared with treatment as usual (5.0±2.0 days and 50%, respectively) (p<0.05). RFPP-S, but not treatment as usual, was associated with significant increases in well-being, flexible thinking, and coping skills (p<0.05). Hospital readmission due to suicidality 1 month after discharge was 0% for the RFPP-S group and 20% for the control group. RFPP-S was associated with reduced PTSD symptoms, enhanced coping skills while experiencing trauma reminders, adoption of safety skills, rapid stabilization of acute crises of PTSD with suicidality, adherence to post-emergency room visits and treatment, and favorable clinical outcomes.

Subjective age and positive psychiatry: Identifying the positive characteristics associated with successful aging

IntroductionFor older adults, feeling subjectively younger is associated with improvements in cognition, subjective well-being and depressive symptoms. Positive psychiatry is the field that focuses on patient strengths and the promotion of positive outcomes, rather than just mitigation of illness. Younger subjective age may be a useful measure of successful aging, but little is known about how subjective age is associated with positive psychosocial characteristics.ObjectivesOur objective is to characterize how subjective age is related validated positive psychosocial measures, with the goal of better understanding the determinants of successful aging.MethodsThe Successful Aging Evaluation (SAGE) longitudinal study recruited over 1,300 community-dwelling residents of San Diego County, CA, from age 21 to over 100. A single-item question asked “How old/young do you feel?” We used spearman correlations to assess the relationship between subjective age and validated positive psychosocial scales such as the Self-Rated Successful Aging, Life Orientation Test, Personal Mastery Scale, Connor-Davidson Resilience Scale, Satisfaction with Life Scale, Adult Hope Scale, and Social Support Index.ResultsMean chronological age was 65.5, and mean subjective age was 53.6. Mean age discrepancy was 11.5 years. Younger subjective age was positively associated with most of the positive psychosocial characteristics measured, including self-rated successful aging, optimism, personal mastery, resilience, curiosity, hope, and social support.ConclusionsThere is a growing movement within psychiatry to understand the positive characteristics that lead to successful aging. This is one of the first studies demonstrating younger age identities are associated with positive psychosocial characteristics and successful aging.DisclosureNo significant relationships.

Taking a positive psychiatry approach to depression and cognitive decline among older adults.

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Character Strengths Across Disabilities: An International Exploratory Study and Implications for Positive Psychiatry and Psychology.

The purpose of this study was to examine the differences in character strengths for people with disabilities by using an international dataset by the VIA Institiute on Character. Specifically, we aimed to explore (a) the top and bottom five character strengths reported by different disability groups and all people with disabilities more broadly, and (b) group differences in each character strength and total character strengths. The investigator contacted the VIA Institute on Character (http://www.viacharacter.org/) for obtaining the dataset for the current study. After data cleaning, our sample size resulted in 11,699 people with disabilities. Among most people with disabilities, the top five character strengths scores were love of learning, honesty, appreciation of beauty and excellence, kindness, and fairness. The bottom five character strengths scores were self-regulation, perseverance, zest, spirituality, and prudence. Knowing that there is heterogeneity in character strengths across groups gives us a better understanding of the areas that people with different disabilities and conditions might thrive and provides clinicians and practitioners with a more nuanced understanding for how to possibly intervene with their clients. Positive psychiatry and psychology implications are discussed.

Neurodiversity and Opportunities in Psychiatry

Neurodiversity and Opportunities in Psychiatry

The effect of reminder focused positive psychiatry suicide safety (RFPP-S) on COVID-19 related PTSD with PGD

The effect of reminder focused positive psychiatry suicide safety (RFPP-S) on COVID-19 related PTSD with PGD

The Model for Sustainable Mental Health: Future Directions for Integrating Positive Psychology Into Mental Health Care.

This position paper proposes a model for systematic integration of positive psychology interventions (PPIs) in mental healthcare. On the one hand, PPIs can contribute to the decrease of dysfunctional processes underlying mental illness. This evidence is at the core of the new domains of positive clinical psychology and positive psychiatry. On the other hand, a growing number of studies demonstrate that mental health is not merely the absence of mental illness. Mental wellbeing represents a related but separate dimension of mental health. Mental wellbeing reduces the risk of future incidence of mental illness and is highly valued by people receiving psychological treatment as an important aspect of personal and complete recovery and personal growth. This makes mental wellbeing a vital outcome of mental healthcare. PPIs can directly increase mental wellbeing. The model of sustainable mental health is presented integrating the science of positive psychology and mental wellbeing into mental healthcare. This heuristic model can guide both practitioners and researchers in developing, implementing, and evaluating a more balanced, both complaint- and strength-oriented, treatment approach. The role of gratitude interventions is discussed as an example of applying the model. Also, three potential modalities for implementing PPIs as positive psychotherapy in treatment are as: positive psychotherapy as primary treatment, as combinatorial treatment, and as intervention for personal recovery of people with severe or persistent mental disorder. Finally, we argue that longitudinal studies are needed to substantiate the model and the processes involved.