Significant Improvement In Psychological Well-being Research Articles

The Effectiveness of Positive Group Psychotherapy for Improving Psychological Well-Being in Peer Support for People with HIV/AIDS on Medan Plus In Medan City

Peer supporters who are living with HIV/AIDS play a crucial role in assisting and exchanging information with other individuals living with HIV/AIDS (PLWHA). The desire to contribute more effectively motivates PLHIV to become peer supporters. However, they often encounter challenges that affect their psychological well-being while fulfilling their responsibilities. This research aims to evaluate the effectiveness of group positive psychotherapy in enhancing the psychological well-being of peer supporters among PLWHA. The study employed a quasi-experimental pretest-posttest control group design, utilizing a non-probability sampling method for data collection. The participants included an experimental group (n = 10) and a control group (n = 10). The positive psychotherapy group module comprised five sessions, covering topics such as positive introduction and gratitude journaling, character strengths and signature strengths, hope and optimism, altruism, and meaning and purpose. The Psychological Well-Being Scale-27 (PWBS-27) was used for measurements. Data analysis involved the application of the Mann-Whitney nonparametric statistical test. The results indicated a significant improvement in psychological well-being among the experimental group compared to the control group after undergoing the positive psychotherapy intervention (U = 6, Z = -3.327, p < .001, r = .74). Therefore, the group positive psychotherapy demonstrated effectiveness in enhancing the psychological well-being of individuals supporting people with HIV, yielding a relatively high effect size.

Effects of Mindfulness-based Stress Reduction Program on Perceived Stress, Internalized Stigma, and Psychological Well-being in Psychiatric Inpatients

Purpose: The aim of the study was to investigate the effects of a mindfulness-based stress reduction program on the perceived stress, internalized stigma, and psychological well-being of psychiatric inpatients. Methods: A non-equivalent control group study with a pretest-posttest design was used. Participants were obtained from the closed wards of a psychiatric hospital in K-city. A total of 45 people were included in this study, 22 in the experimental group and 23 in the control group. The pre, post, and follow-up scores of both the experimental and control groups were obtained using the Korea Perceived Stress Scale, the Korea Internalized Stigma of Mental Illness Scale, and the Korea Psychological Well-Being Scale to validate the effectiveness of the program. A 45 minute program was performed twice weekly for three weeks. Results: There was a statistically significant reduction in perceived stress (F=6.92, p=.002) and internalized stigma (F=22.76, p<.001), and a significant improvement in psychological well-being (F=38.34, p<.001) in the experimental group. Conclusion: A mindfulness-based stress reduction program could be implemented as an intervention to reduce perceived stress and internalized stigma and enhance psychological well-being in psychiatric inpatients.

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

BackgroundLife 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.ObjectiveThis systematic review and meta-analysis aimed to assess digital interventions targeting psychological well-being among university students.MethodsDatabase searches were conducted on December 2, 2021, via Embase, MEDLINE, PsycINFO, and Web of Science.ResultsA 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).ConclusionsDigital psychological interventions hold considerable promise for university students, although features that optimize service delivery and outcomes require further assessment.Trial RegistrationPROSPERO CRD42020196654; https:/www.crd.york.ac.uk/prospero/display_record.php?RecordID=196654

Mental Health Benefits of a Traditional Vegetative Biofeedback Therapy Online Program during the COVID-19 Lockdown: A Controlled Trial.

Mandatory lockdown resulting from a pandemic may be effective against the physical impact of the virus; however, the resulting mental strains can lead to the development of several mental disturbances. Taijiquan and Qigong are considered traditional vegetative biofeedback therapies that allow the practitioner to control the functions and processes of the body through specific movements or stances, breathing techniques, and meditative exercises. This study aims to understand if these techniques can be applied as an online distance therapeutic option to reduce the psychological impact of home confinement and social distancing. Sixty-four participants were recruited and allocated to three groups. The experienced and novice Taijiquan and Qigong participants’ groups received the intervention for 8 weeks while the control group did not receive any intervention. The outcomes were psychological well-being and psychological distress levels and were assessed by the Mental Health Inventory and a written interview. The experienced Taijiquan and Qigong participants achieved significant improvements in psychological well-being and psychological distress. Novice Taijiquan and Qigong participants achieved a significant improvement in anxiety levels. Additionally, the control group showed a significant decrease in psychological well-being. This study suggests that this distance online program of Taijiquan and Qigong is feasible and may benefit the mental health of participants during a lockdown.

Evaluating the effectiveness and acceptability of information and therapy guides for improving the psychosocial well-being of people with facial palsy

Facial palsy (FP) can have a negative impact on an individual's psychological and social well-being, irrespective of esthetic severity. There is a lack of psychological interventions tailored specifically for this population and individuals with FP report difficulties accessing specialist psychological treatment. This paper describes a pilot study evaluating the effectiveness, acceptability, and feasibility of information and therapy guides for this population. Quasi-experimental, repeated measures design. Six separate information and therapy guides were designed, drawing on cognitive behavioral therapy, acceptance and commitment therapy, and social skills training approaches. These were tested by 132 participants with FP, over a 4-to-6-week period. Participants completed self-report measures assessing psychological well-being, social function, and appearance-related distress before and after the testing period, as well as provided feedback on the perceived effectiveness, acceptability, and feasibility of the intervention. After completing an information and therapy guide, participants reported significant improvements in psychological well-being and social function, as well as improvements in appearance-related distress. Ninety percent of participants reported having found it helpful to complete a guide, while 79.7% reported feeling more able to cope with FP and 95.3% agreed that the guide had been easy to understand and use. Self-guided information and therapy guides are an acceptable and effective intervention for improving the psychosocial well-being of people with FP. They provide a low-intensity, universal, and cost-effective option for supporting the psychological needs of this population. NCT03943953.

Optimizing Outcomes of Treatment-Resistant Depression (TRD) in Older Adults (OPTIMUM): Measures of Psychological Well-Being

<h3>Introduction</h3> The "Optimizing Antidepressants for Treatment-Resistant Depression in Older Adults" (OPTIMUM) study, funded by the Patient-Centered Outcomes Research Institute, is a 5-center collaboration that randomized 621 depressed individuals aged 60+ with treatment-resistant depression (TRD), the largest pharmacotherapy trial of TRD in late life. A key goal of this pragmatic trial was to measure outcomes of interest to patients, which in this trial included psychological wellbeing. This construct is closely tied to psychological and physical functioning and can be measured by self-report. <h3>Methods</h3> Participants were recruited and randomized if they were 60 years and older, met the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria for Major Depressive Disorder, and had a score of 10 or higher on the Patient Health Questionnaire (PHQ-9), despite having been treated with at least two antidepressants with an adequate dosage and for at least four weeks (with previous psychotropic medications being different from the medications being testing in OPTIMUM). Upon study entry, participants were randomized to one of three strategies: augmentation with aripiprazole, augmentation with bupropion, or switch to bupropion. Treatment effectiveness was assessed using the Montgomery Asberg Rating Scale (MADRS) after ten weeks of treatment. Participants were also tested at the beginning and end of this 10-week step with the NIH Toolbox Psychological Well-being battery. Two wellbeing scales were used: positive affect (34 items) and general life satisfaction (16 items). Positive affect is characterized as happiness, contentment, and interest in pleasurable or achievement–relevant activities. Each item is scored on a 5-point scale ranging from "not at all" to "very much". General life satisfaction is the cognitive evaluation of life experiences; items assessing this concept are usually phrased in a general or global way rather than having a momentary or recent recall period. These items administered are scored on either a 5-point or 7-point scale ranging from "strongly disagree" to "strongly agree." <h3>Results</h3> Of the 621 study participants, 212 were randomized to augmentation with aripiprazole, 206 to augmentation with bupropion, and 203 to a switch to bupropion. Participants randomized to augmentation with either aripiprazole or bupropion showed a statistically significant improvement in their general life satisfaction subscale score (aripipirazole: 2.99, p< 0.0001; bupropion: 2.61, p=0.0001), while those switched to bupropion did not. Participants in either of the two augmentation arms also showed a statistically significant improvement in positive affect (aripiprazole: 5.35, p< 0.0001; bupropion: 5.02, p< 0.0001) while those switching to bupropion did not. <h3>Conclusions</h3> Among older adults with TRD, augmentation with aripiprazole or bupropion was associated with a statistically significant improvement in psychological well-being and positive affect, while a switch to bupropion monotherapy did not. Further research is needed to replicate findings. <h3>This research was funded by</h3> Patient-Centered Outcomes Research Institute (PCORI)

A controlled clinical efficacy trial of multimodal cognitive rehabilitation on episodic memory functioning in older adults with traumatic brain injury.

This study aimed to evaluate the impact of a 12-week, 24-session multimodal group cognitive intervention, the Cognitive Enrichment Program (CEP), on episodic memory in older adults with traumatic brain injury (TBI) compared to an active control group that received usual care in the form of individual holistic rehabilitation. In total, 37 patients with a TBI who were 57 to 90 years old were assigned to experimental (n=23) and control (n=14) groups in a semi-randomized, controlled, before-after intervention trial with follow-up at 6 months, with blinded outcome measurement. The CEP's Memory module consisted of memory strategies to promote encoding. Efficacy was evaluated by using Face-name association, Word list recall, and Text memory measures, and generalization was assessed with the Self-Evaluation Memory Questionnaire (SEMQ), the Psychological General Well-Being Index, and a satisfaction questionnaire. ANCOVA mixed model repeated-measures analysis revealed a strong group-by-time interaction, with the experimental group showing statistically significant improvement on the Face-name association test, with a large effect size. We also found a statistically significant group-by-time interaction on 3 dimensions of the SEMQ generalization measure: the experimental group showed increased memorization of the content of Conversations, reduced Slips of attention, and increased memory of Political and social events, with medium to large effect sizes. The group also showed clinically significant improvements in psychological well-being. Scores on the satisfaction questionnaire indicated a perceived positive impact on daily life habits requiring memory abilities. The CEP is a promising cognitive rehabilitation program for older individuals with TBI, showing high satisfaction in participants, that could improve their episodic memory functioning as well as enhance their psychological well-being. ClinicalTrials.gov Identifier: NCT04590911.

Yoga as an Exercise Prescription for the Pregnancy or Postpartum Period: Recent Advances and Perspective

The aim of this study is to examine studies published from 2015 to 2020 and to determine whether yoga can be an efficacious approach during the pregnancy or postpartum period. PubMed, EBSCO, Wiley and Science Direct databases were searched for studies published from January 2015 to June 2020. A total of 14 studies met the inclusion criteria, covering 1116 participants were identified. The results demonstrated that yoga intervention could significantly reduce depression (P < 0.001), anxiety (P = 0.003), labor pain (P = 0.001), back pain and the percentage of cesarean section (P = 0.002). There was significant improvement in psychological well-being (P < 0.5), immune function and the intrauterine fetal growth (P < 0.5). Moreover, the yoga intervention group has lower salivary cortisol (P < 0.001), salivary alpha-amylase and salivary a-amylase levels (P < 0.5) and higher immunoglobulin A (P < 0.001) levels when compared with that in control groups. The findings suggested that yoga is well benefited for either pregnant women or postpartum women. More high-quality and well-controlled randomized controlled trials are required to provide more information regarding the utility of yoga interventions for different stages of pregnancy women.

Psychosocial outcomes following surgery in women with unilateral, nonhereditary breast cancer.

570 Background: Rates of bilateral mastectomy continue to rise in average-risk women with unilateral breast cancer. We aim to characterize psychosocial predictors of surgical procedure and how psychosocial outcomes change over time after surgery for breast cancer. Methods: A prospective cohort of women with unilateral, nonhereditary breast cancer were recruited at University Health Network in Toronto, Canada between 2014-2017. Women completed validated psychosocial questionnaires (BREAST-Q) pre-operatively, and 6 and 12 months after surgery. Outcomes were assessed between three surgical groups (unilateral lumpectomy, unilateral mastectomy, bilateral mastectomy). Predictors of surgical procedure were identified using a multinomial logistic regression model. Change in psychosocial scores over time according to procedure was assessed using linear mixed models. All models control for age, stage, reconstruction and treatment. P values &lt; .05 were considered statistically significant. Results: 506 women underwent surgery as follows: 216 unilateral lumpectomy (43%), 181 unilateral mastectomy (36%) and 109 bilateral mastectomy (22%). In the multinomial regression model, younger age (p &lt; .01), and lower chest physical (p = .03) and sexual well-being (p = .02) predicted having bilateral mastectomy over unilateral lumpectomy while younger age (p &lt; .01) and lower disease stage (p = .02) predicted bilateral mastectomy over unilateral mastectomy. The mixed model demonstrates that breast satisfaction follows a non-linear pattern of change over time, with 6- but not 12-month scores being significantly different from baseline (p = .015). Procedure predicts baseline satisfaction (p = .016), with bilateral mastectomy having worse satisfaction than unilateral lumpectomy. Procedure also predicts change in satisfaction, with unilateral and bilateral mastectomy having lower scores across time than lumpectomy. While a significant improvement in psychological well-being is detected by 12 months (p = .02), those with unilateral and bilateral mastectomy have worse psychological well-being over time compared to lumpectomy. Women having mastectomy start with worse physical well-being than those in the lumpectomy group, but their physical well-being does not decline as much as the lumpectomy group over time (p &lt; .01). Conclusions: Definitive surgical procedure affects the trajectory of psychosocial functioning over time. This emerging data may be used to further facilitate surgical decision-making in women considering contralateral prophylactic mastectomy.

A045 An Exercise Based Cardiac Rehabilitation Programme is Associated with Significant Improvement in Psychological Health

A cardiac event is a major life event and is known to be associated with significant psychological distress in patients. Poor psychological responses to a cardiac event are associated with poorer long term both psychological and physical outcomes. This has been attributed to reduced adherence to cardiac rehabilitation recommendations [[1]Rao A. Zecchin R. Newton P.J. Phillips J.L. DiI Giacomo M. Denniss A.R. Hickman L.D. The Prevalence and Impact of Depression and Anxiety in cardiac rehabilitation: a Longitudinal cohort study.Eur J Prev Cardiol. 2020; 27: 478-489Crossref Scopus (47) Google Scholar]. Waikato DHB (WDHB) runs exercise programmes consisting of 6, weekly 2hr classes with educational and exercise Components. During classes, patients interact with each other and with cardiac rehabilitation nurses and can seek support. We seek to discover whether classes improve psychological health post cardiac event. Patients undergoing the exercise programme at WDHB in 2019 were asked to complete a 42point DASS score at the beginning and end of a course. The DASS score is a validated questionnaire of depression, anxiety and stress [[2]Lovibond P.F. Lovibond S.H. “The structure of negative emotional states: Comparison of the Depression Anxiety Stress Scales (DASS) with the Beck Depression and Anxiety Inventories”.Behaviour Research and Therapy. March 1995; 33: 335-343Crossref PubMed Scopus (6865) Google Scholar]. Higher scores indicate worse psychological distress. 56 patients completed the initial questionnaire. 24 patients (43%) had scores suggestive of >mild psychological distress. Of these 24 patients, 16 completed both initial and final DASS questionnaires. Individual DASS scores changed -30.9%. Overall the cohort total DASS score fell 34.2% (p=0.0058 t-Test), indicating a significant improvement in psychological well-being at an individual and cohort level. In our study, there is a significant burden of psychological distress post cardiac event. An exercise cardiac rehab programme was associated with significant improvement in psychological health. Further studies are required to elucidate what components of the programme are associated with this improvement and whether these improvements are associated with long term prognostic gains.

The PATHS curriculum for promoting social and emotional well-being among children aged 7–9 years: a cluster RCT

BackgroundUniversal social and emotional learning interventions can produce significant practical improvements in children’s social skills and other outcomes. However, the UK evidence base remains limited.ObjectivesTo investigate the implementation, impact and cost-effectiveness of the Promoting Alternative THinking Strategies (PATHS) curriculum.DesignCluster randomised controlled trial. Primary schools (n = 45) were randomly assigned to implement PATHS or to continue with their usual provision for 2 years.SettingPrimary schools in seven local authorities in Greater Manchester.ParticipantsChildren (n = 5218) in Years 3–5 (aged 7–9 years) attending participating schools.InterventionPATHS aims to promote children’s social skills via a taught curriculum, which is delivered by the class teacher, generalisation activities and techniques, and supplementary materials for parents. Schools in the usual provision group delivered the Social and Emotional Aspects of Learning programme and related interventions.Main outcome measuresChildren’s social skills (primary outcome, assessed by the Social Skills Improvement System); pro-social behaviour and mental health difficulties (Strengths and Difficulties Questionnaire); psychological well-being, perceptions of peer and social support, and school environment (Kidscreen-27); exclusions, attendance and attainment (National Pupil Database records); and quality-adjusted life-years (QALYs) (Child Health Utility 9 Dimensions). A comprehensive implementation and process evaluation was undertaken, involving usual provision surveys, structured observations of PATHS lessons, interviews with school staff and parents, and focus groups with children.ResultsThere was tentative evidence (at ap-value of &lt; 0.10) that PATHS led to very small improvements in children’s social skills, perceptions of peer and social support, and reductions in exclusions immediately following implementation. A very small but statistically significant improvement in children’s psychological well-being [d = 0.12, 95% confidence interval (CI) –0.02 to 0.25;p &lt; 0.05) was also found. No lasting improvements in any outcomes were observed at 12- or 24-month post-intervention follow-up. PATHS was implemented well, but not at the recommended frequency; our qualitative analysis revealed that this was primarily due to competing priorities and pressure to focus on the core academic curriculum. Higher levels of implementation quality and participant responsiveness were associated with significant improvements in psychological well-being. Finally, the mean incremental cost of PATHS compared with usual provision was determined to be £29.93 per child. Mean incremental QALYs were positive and statistically significant (adjusted mean 0.0019, 95% CI 0.0009 to 0.0029;p &lt; 0.05), and the incremental net benefit of introducing PATHS was determined to be £7.64. The probability of cost-effectiveness in our base-case scenario was 88%.LimitationsModerate attrition through the course of the main trial, and significant attrition thereafter (although this was mitigated by the use of multiple imputation of missing data); suboptimal frequency of delivery of PATHS lessons.ConclusionsThe impact of PATHS was modest and limited, although that which was observed may still represent value for money. Future work should examine the possibility of further modifications to the intervention to improve goodness of fit with the English school context without compromising its efficacy, and identify whether or not particular subgroups benefit differentially from PATHS.Trial registrationCurrent Controlled Trials ISRCTN85087674 (the study protocol can be found at:www.journalslibrary.nihr.ac.uk/programmes/phr/10300601/#/).FundingThis project was funded by the National Institute for Health Research (NIHR) Public Health Research programme and will be published in full inPublic Health Research; Vol 6, No. 10. See the NIHR Journals Library website for further project information.

Implicit or Explicit Compassion? Effects of Compassion Cultivation Training and Comparison with Mindfulness-based Stress Reduction

Mindfulness-based interventions generally include compassion implicitly, but it remains to be seen whether implicit compassion training can be effective, or if it needs to be trained explicitly through specific meditations and relational practices. This research study had two specific goals. The first was to expand the literature on the effects of compassion-based interventions (CBIs) by assessing the impact of the Compassion Cultivation Training program (CCT) on anxiety, depression, stress, life satisfaction, happiness, mindfulness, empathy, self-compassion, compassion for others, and identification with all humanity, through a wait-list randomized controlled trial in a community sample (study 1). Secondly, this research addressed the following question: Does a CBI—an explicit compassion training—have a differential impact in terms of empathy, compassion, and identification with all humanity, compared to a mindfulness-based intervention (mindfulness-based stress reduction (MBSR)) in which compassion is taught implicitly? (study 2). Groups were assessed at baseline, post-intervention, and 2-month follow-up, and analyses involved repeated-measures of analysis of variance (ANOVA) for group contrasts. Compared to the wait-list group, CCT participants showed significant improvements in psychological well-being (decreased depression and stress, increases in life satisfaction, happiness, mindfulness, and self-compassion) and compassion skills. Both MBSR and CCT were effective in generally enhancing psychological well-being and increasing mindfulness and compassion, but CCT had a greater impact on developing compassionate skills, especially empathic concern and identification with all humanity. This research highlights the potential for a complementary (rather than competitive) relationship between mindfulness- and compassion-based interventions.

An early Phase II randomised controlled trial testing the effect on persecutory delusions of using CBT to reduce negative cognitions about the self: The potential benefits of enhancing self confidence

BackgroundResearch has shown that paranoia may directly build on negative ideas about the self. Feeling inferior can lead to ideas of vulnerability. The clinical prediction is that decreasing negative self cognitions will reduce paranoia. MethodThirty patients with persistent persecutory delusions were randomised to receive brief CBT in addition to standard care or to standard care (ISRCTN06118265). The six session intervention was designed to decrease negative, and increase positive, self cognitions. Assessments at baseline, 8weeks (posttreatment) and 12weeks were carried out by a rater blind to allocation. The primary outcomes were posttreatment scores for negative self beliefs and paranoia. Secondary outcomes were psychological well-being, positive beliefs about the self, persecutory delusions, social comparison, self-esteem, anxiety, and depression. ResultsTrial recruitment and retention were feasible and the intervention highly acceptable to the patients. All patients provided follow-up data. Posttreatment there was a small reduction in negative self beliefs (Cohen's d=0.24) and a moderate reduction in paranoia (d=0.59), but these were not statistically significant. There were statistically significant improvements in psychological well-being (d=1.16), positive beliefs about the self (d=1.00), negative social comparison (d=0.88), self-esteem (d=0.62), and depression (d=0.68). No improvements were maintained. No adverse events were associated with the intervention. ConclusionsThe intervention produced short-term gains consistent with the prediction that improving cognitions about the self will reduce persecutory delusions. The improvement in psychological well-being is important in its own right. We recommend that the different elements of the intervention are tested separately and that the treatment is lengthened.

Effect of integrative reminiscence therapy on depression, well-being, integrity, self-esteem, and life satisfaction in older adults

Reminiscence therapy is a psychological intervention for older adults to remembering and interpreting life events that were experienced at some time in the past. The purpose of the present study was to investigate the extent of integrative reminiscence intervention effects, with the aim to produce statistically significant reduction in depression symptoms, and significant improvement in psychological well-being, life satisfaction, self esteem, and integrity were examined. Thirty-four healthy elderly participated in the intervention that was implemented in eight sessions. To evaluate the effects of the program, a quasi-experimental design was applied with pretest and posttest evaluations comparing the intervention group with a control group on a waiting list. In comparison to control group, individuals in treatment sample of older adults in an integrative reminiscence group demonstrated statistically significant reduction in depression symptoms and a significant improvement in self-esteem, integrity, life satisfaction, and psychological well-being.

Meditation Awareness Training (MAT) for Psychological Well-Being in a Sub-Clinical Sample of University Students: A Controlled Pilot Study

Mindfulness has been practiced in the Eastern world for over twenty-five centuries but has only recently become popular in the West. Today, interventions such as “Mindfulness-Based Cognitive Therapy” are used within the Western health setting and have proven to be successful techniques for reducing psychological distress. However, a limitation of such interventions is that they tend to apply the practices of mindfulness in an “out of context” manner. To overcome this, a newly formed Meditation Awareness Training (MAT) program focusses on the establishment of solid meditative foundations and integrates various support practices that are traditionally assumed to effectuate a more sustainable quality of well-being. The aim of this pilot study was to assess the feasibility and effectiveness of MAT for improving psychological well-being in a sub-clinical sample of higher education students with issues of stress, anxiety, and low mood. Utilizing a controlled design, participants of the study (n = 14) undertook an 8-week MAT program and comparisons were made with a control group (n = 11) on measures of self-assessed psychological well-being (emotional distress, positive affect, and negative affect) and dispositional mindfulness. Participants who received MAT showed significant improvements in psychological well-being and dispositional mindfulness over controls. MAT may increase emotion regulation ability in higher education students with issues of stress, anxiety, and low mood. Individuals receiving training in mindfulness meditation may benefit by engendering a broader, more ethically informed, and compassionate intention for their mindfulness practice.

Does a Coeliac School increase psychological well‐being in women suffering from coeliac disease, living on a gluten‐free diet?

To assess the effects of an active method of patient education on the psychological well-being of women with coeliac disease in remission. Despite remission with a gluten-free diet, adults with coeliac disease and especially women experience a subjective poor health. Self-management education seems to be promising tool to help patients suffering from coeliac disease to cope with their disorder. A randomised controlled trial. A total of 106 women, ≥ 20 years, with confirmed coeliac disease, who had been on a gluten-free diet for a minimum of five years. The intervention group (n = 54) underwent a 10-session educational programme, 'Coeliac School', based on problem-based learning. The controls (n = 52) received information regarding coeliac disease sent home on a regular basis. The primary outcomes were psychological general well-being measured with a validated questionnaire. Participants in the Coeliac School reported a significant improvement in psychological well-being at 10 weeks, whereas the controls given usual care reported a worsening in psychological well-being. After six months, a significant improvement remained for the index of vitality. Patient education increased psychological well-being in women with coeliac disease. There is a need to refine the methods of patient education to make the effects of well-being more pronounced over time. Patient education using problem-based learning promotes self-management in coeliac disease by improving the well-being of patients who have been struggling with the gluten-free diet for years.

Obesity and eating disorders

The presence of fat in the small intestine slows gastric emptying, stimulates the release of many gastrointestinal hormones, and suppresses appetite and energy intake as a result of the digestion of fats into free fatty acids; the effects of free fatty acids are, in turn, dependent on their chain length. Given these effects of fat, it is paradoxical that high dietary fat intakes have been linked to increased energy intake and body weight and are considered to play a significant role in the pathogenesis of obesity. However, increasing evidence indicates that a chronic increase in dietary fat is associated with an attenuation of the feedback signals arising from the small intestine induced by fat, with a consequent relative acceleration of gastric emptying, modulation of gastrointestinal hormone secretion, and attenuation of the suppression of energy intake. This review addresses the gastrointestinal factors involved in the regulation of appetite and energy intake, with a particular focus on 1) the gastrointestinal mechanisms triggered by small intestinal fat that modulate energy intake, 2) the potential role of a high dietary fat intake in the development of obesity, and 3) implications for the prevention and management of obesity. Am J Clin Nutr 2007;86:531–41.

Counselling in primary care: A study of the psychological impact and cost benefits for four chronic conditions

Primary care counselling services have expanded rapidly over the last twenty years. Their principal focus has been to manage the demands placed on general practitioners by high service users, such as frequent attenders and patients with mental health problems. To date, very little research has been conducted to ascertain the impact of counselling for other patient groups in terms either of psychological outcomes or of cost-benefits. This study looked at the effect of short-term counselling on both the uptake of health services and the psychological states of four patient groups – frequent attenders and patients with diabetes, hypertension and asthma. All patients on the chronic disease register for these conditions and all patients who had made at least eight GP appointments over the previous twelve months were invited to take part in the study. The participants received eight 90-minute small-group counselling sessions, conducted by trained counsellors. The counselling followed a cognitive behavioural therapy (CBT) approach, with an emphasis on developing personal responsibility. Psychological outcomes were assessed using three proprietary measures (SF 36, HADS and CORE) immediately following counselling and at six months post-intervention. Health service uptake was assessed for each group over the twelve months post-intervention, using number of GP consultations, home visits, hospital referrals and test/investigations requested as outcome indicators. These data were compared with those for comparable control groups for each condition. The results suggested that, overall, all patient groups showed a significant improvement in psychological well-being, and that these gains were maintained for the six-month study period. The intervention groups also significantly reduced their uptake of primary and secondary care services, by comparison with their comparable control groups. The results suggest that the psychological and fiscal benefits of counselling provision within a primary care setting can extend to other patient categories.

Attributional Style, Efficacy, and the Enhancement of Well-Being Among Housebound Older People

This study examines the effects of an intervention that involves the compilation of a book of wartime experiences on a group of housebound older people who live in the community with the support of social services. Using the theoretical framework of the Hopelessness Theory of Depression (Abramson, Metalsky, & Alloy, 1989), we examine the impact of attributional style (Abramson et al., 1989) and efficacy (Bandura, 1977; Houston, 1995) on changes in psychological well-being following the intervention. Prior to the intervention, participants completed a newly constructed Extended Attributional Style Scale for the Elderly and the General Health Questionnaire (Goldberg & Hillier, 1979). Following the intervention there was a significant improvement in psychological well-being across the sample-those with depressogenic styles and low efficacy and those with high efficacy and nondepressogenic styles reported most improvement. The findings indicate that a relatively small-scale intervention can have a significant impact on the well-being of older people living alone in the community.

Attributional Style, Efficacy, and the Enhancement of Well-Being Among Housebound Older People

This study examines the effects of an intervention that involves the compilation of a book of wartime experiences on a group of housebound older people who live in the community with the support of social services. Using the theoretical framework of the Hopelessness Theory of Depression (Abramson, Metalsky, & Alloy, 1989), we examine the impact of attributional style (Abramson et al., 1989) and efficacy (Bandura, 1977; Houston, 1995) on changes in psychological well-being following the intervention. Prior to the intervention, participants completed a newly constructed Extended Attributional Style Scale for the Elderly and the General Health Questionnaire (Goldberg & Hillier, 1979). Following the intervention there was a significant improvement in psychological well-being across the sample-those with depressogenic styles and low efficacy and those with high efficacy and nondepressogenic styles reported most improvement. The findings indicate that a relatively small-scale intervention can have a significant impact on the well-being of older people living alone in the community.