Centre for eHealth and Well-Being Research, Department of Psychology, Health and Technology, University of Twente, Enschede, The Netherlands.
Radboud Alzheimer Center, Department of Primary and Community Care, Radboudumc, Nijmegen, The Netherlands.
J Clin Psychol. 2023 Nov;79(11):2650-2667. doi: 10.1002/jclp.23574. Epub 2023 Aug 5.
There is a growing interest in mental well-being as a vital outcome in clinical practice in addition to mental illness. The model of sustainable mental health (SMH) was recently introduced to delineate how interventions can improve mental health by targeting barriers and resources of adaptation to life stressors, improving the ability to adapt and thereby reducing mental illness and improving mental well-being. The aim of the current study is to empirically validate the conceptual model of SMH as well as the assumed indirect role of ability to adapt.
This study used an existing dataset of the general population with self-reported reduced well-being due to the corona crisis (n = 849, mean age 53 years, SD = 15). Measurements of mental illness (depression and anxiety), mental well-being, ability to adapt, a specific barrier for adaptation (i.e., repetitive negative thinking), and a specific resource for adaptation (i.e., positive reframing) were included. Structural equation modeling was used to assess both the structural validity of the model and the indirect effect of ability to adapt.
An acceptable to good fit was found for the model of SMH and all paths between the proposed elements of the model were significant and in the hypothesized direction. Ability to adapt served as an indirect pathway trough which repetitive negative thinking (B = 0.149, 95% confidence interval [CI] = 0.016-0.028) and positive reframing (B = 0.163, 95% CI = 0.065-0.123) were linked with mental illness and mental well-being.
The current study provides the first empirical support of the internal validity of the model of SMH in a sample of the general population with reduced well-being, suggesting that barriers and resources to adaptation have an effect on mental illness and mental well-being through the ability to adapt. The model of SMH may therefore be a good model to use in research and clinical practice for developing, implementing, and evaluating a balanced treatment approach targeting both barriers and resources for adaptation.
除了精神疾病外，人们对心理健康作为临床实践中的重要结果越来越感兴趣。可持续心理健康模型（SMH）最近被引入，以描述干预措施如何通过针对适应生活压力源的障碍和资源来改善心理健康，提高适应能力，从而减少精神疾病和改善心理健康。本研究的目的是实证验证 SMH 概念模型以及适应能力的假设间接作用。
本研究使用了一个因新冠危机而自我报告幸福感降低的普通人群的现有数据集（n=849，平均年龄 53 岁，标准差 15）。测量了精神疾病（抑郁和焦虑）、心理健康、适应能力、适应的特定障碍（即重复消极思维）和适应的特定资源（即积极重新框架）。结构方程模型用于评估模型的结构有效性和适应能力的间接效应。
发现 SMH 模型的拟合度为可接受至良好，模型中提出的要素之间的所有路径均具有统计学意义且方向与假设一致。适应能力是通过重复消极思维（B=0.149，95%置信区间 [CI] = 0.016-0.028）和积极重新框架（B=0.163，95% CI = 0.065-0.123）与精神疾病和心理健康相关的间接途径。
本研究在幸福感降低的普通人群样本中首次提供了 SMH 模型内部有效性的实证支持，表明适应的障碍和资源通过适应能力对精神疾病和心理健康产生影响。因此，SMH 模型可能是研究和临床实践中开发、实施和评估针对适应障碍和资源的平衡治疗方法的良好模型。
