Positive psychology, social support predict subjective mental health

In people with severe psychiatric disorders, psychosocial factors and positive psychology were important in predicting subjective well-being, according to a Spanish study published in Comprehensive Psychiatry.

“Research focusing on [subjective well-being (SWB)] in severe psychiatric conditions (SPC) has been neglected for a long time, partly because psychiatry and clinical psychology have had a clear bias towards negative emotional states and impaired functioning,” Rocío Caballero, a PhD student at Complutense University of Madrid, and colleagues wrote. “Nevertheless, recent studies have shown that it is possible to experience well-being despite suffering serious mental disorders and that SWB has a positive influence on health and can enhance functioning.”

Through therapists, researchers recruited 237 patients (men, 64.1%) with SPC aged 18 to 65 years who were treated at 18 psychosocial and vocational/employment rehabilitation centers between September 2018 and July 2019. Most patients were single and had schizophrenia diagnoses.

Participants completed questionnaires used to analyze their self-perceived distress, positive psychology factors, social support and well-being; referral staff members reported participants’ functioning and well-being.

Independent predictors were added to the regression in steps: first, age and psychosocial functioning; second, perceived stress, depression and negative affect; third, character strengths, openness to the future and self-compassion; finally, social support and degree of patient-therapist agreement. A total of eight models were created.

The final model revealed low levels of perceived stress and depression, strengths, social support, patient-therapist agreement and openness to the future were significant in SWB, explaining 74% of variance (F (8, 228) = 5.38, P = 0.021); openness to the future was most significant. Negative affect, psychosocial functioning and self-compassion had no significant association with SWB.

While the study was strengthened by large sample size, validated standardized assessments and clinician perspective, it was limited by exclusion of negative outcomes such as stigma or negative symptoms and its voluntary and cross-sectional nature.

“These results have some important clinical implications,” Caballero and colleagues wrote. “Without losing track of the therapeutic tools that aim to reduce distress and other negative outcomes, our results highlight the importance of incorporating factors associated with positive psychology (ie, openness to the future and strengths) with those traditional factors (ie, social support, low levels of stress and depression) to enhance the effect on well-being of the users of psychiatric rehabilitation services.”