Schotanus-Dijkstra Marijke, Drossaert Constance H C, Pieterse Marcel E, Boon Brigitte, Walburg Jan A, Bohlmeijer Ernst T
Trimbos Institute, Netherlands Institute of Mental Health and Addiction, Department of Public Mental Health, P.O. Box 725, 3500 AS Utrecht, The Netherlands.
Center for eHealth and Well-being Research, Department of Psychology, Health and Technology, University of Twente, P.O. Box 217, 7500 AE Enschede, The Netherlands.
Internet Interv. 2017 Apr 28;9:15-24. doi: 10.1016/j.invent.2017.04.002. eCollection 2017 Sep.
There is growing evidence that fostering mental well-being and flourishing might effectively prevent mental disorders. In this study, we examined whether a 9-week comprehensive positive self-help intervention with email support (TL-E) was effective in enhancing well-being and flourishing and decreasing anxiety and depressive symptoms in a non-clinical sample.
A total of 275 participants with low or moderate well-being (mean age = 48 years, 86% female) were randomly assigned to a TL-E ( = 137) or wait-list control group (WL; = 138). Participants completed online self-reporting questionnaires at baseline and at 3, 6 and 12 months.
Repeated measure analyses revealed significant more improvement on mental well-being ( = 42.00, ≤ 0.001, = 0.66, 95% CI = 0.42-0.90), anxiety ( = 21.65, ≤ 0.001, = 0.63, 95% CI = 0.39-0.87) and depression ( = 13.62, ≤ 0.001, = 0.43, 95% CI = 0.19-0.67) in the TL-E group versus the WL group. The proportion of flourishing in the TL-E group increased from 7 to 30% after 3 months (NNT = 5.46) and to 34% after 6 months (NNT = 5.25). All within group effects were maintained up to 12 months. We found no meaningful dose-response relationship for adherence, nor a clear moderator pattern.
It is unknown whether results were influenced by the email support that accompanied the self-help intervention since TL-E was only compared to a wait-list condition. The generalizability of the findings is limited by the self-selected sample of mainly higher-educated women.
A guided positive self-help intervention might be considered as a new mental health promotion strategy because it has the potential to improve well-being up to the status of flourishing mental health, and to decrease anxiety and depressive symptomatology.
越来越多的证据表明，促进心理健康和幸福可能有效地预防精神障碍。在本研究中，我们检验了一项为期9周、有电子邮件支持的综合积极自助干预措施（TL-E）是否能有效提高非临床样本的幸福感和繁荣感，并减轻焦虑和抑郁症状。
共有275名幸福感较低或中等的参与者（平均年龄 = 48岁，86%为女性）被随机分配到TL-E组（n = 137）或等待列表对照组（WL；n = 138）。参与者在基线以及3个月、6个月和12个月时完成在线自我报告问卷。
重复测量分析显示，与WL组相比，TL-E组在心理健康（F = 42.00，p ≤ 0.001，η² = 0.66，95% CI = 0.42 - 0.90）、焦虑（F = 21.65，p ≤ 0.001，η² = 0.63，95% CI = 0.39 - 0.87）和抑郁（F = 13.62，p ≤ 0.001，η² = 0.43，95% CI = 0.19 - 0.67）方面有更显著的改善。TL-E组中繁荣感的比例在3个月后从7%增加到30%（NNT = 5.46），6个月后增加到34%（NNT = 5.25）。所有组内效应在12个月内均得以维持。我们未发现依从性的有意义剂量反应关系，也未发现明确的调节模式。
由于TL-E仅与等待列表情况进行比较，尚不清楚结果是否受到自助干预所伴随的电子邮件支持的影响。研究结果的普遍性受到主要为高学历女性的自我选择样本的限制。
一种有指导的积极自助干预措施可被视为一种新的心理健康促进策略，因为它有可能将幸福感提升至繁荣心理健康的状态，并减轻焦虑和抑郁症状。
