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BackgroundPositive emotional well-being is associated with healthier lifestyle choices and overall health function, whereas poor mental health is associated with significant economic and psychological costs. Thus, the development of effective interventions that improve emotional well-being is crucial to address the worldwide burden of disease. ObjectiveThis study aims to develop a web-based emotional well-being intervention for use by health care staff using participatory design to consider adherence and engagement from a user perspective. MethodsA 3-staged iterative participatory design process was followed, including multiple stakeholders: researchers, computer scientists, mental health experts, and health care staff. Stage 1 used document analyses, direct observation, and welcome interviews; stage 2 used focus group discussions, rapid prototyping, and usability tasks; and stage 3 evaluated a high-fidelity prototype. ResultsDifferent health care staff (N=38) participated during a sustained period. A structured, sequential, automated, 12-week, web-based emotional well-being intervention based on acceptance and commitment therapy was developed. Freely navigated psychoeducational resources were also included. ConclusionsThe iterative and collaborative participatory design process successfully met its objectives. It generated an in-depth understanding of well-being within the workplace and identified barriers to access. The 3-staged process ensured that participants had the opportunity to explore and articulate criteria relevant to their roles over time and reflect on decisions made at each stage.

BackgroundPoor mental health and emotional well-being can negatively impact ability to engage in healthy lifestyle behavior change. Health care staff have higher rates of sickness and absence than other public sector staff, which has implications at both individual and societal levels. Individual efforts to self-manage health and well-being which add to the UK mental health prevention agenda need to be supported. ObjectiveThe objective of this study was to establish the feasibility and acceptability of the inclusion of a self-guided, automated, web-based acceptance and commitment therapy intervention in an existing health promotion program, to improve subjective well-being and encourage engagement with lifestyle behavior change. MethodsFor this 12-week, 4-armed, randomized controlled cluster feasibility study, we recruited participants offline and randomly allocated them to 1 of 3 intervention arms or control (no well-being intervention) using an automated web-based allocation procedure. Eligibility criteria were current health care staff in 1 Welsh health board, age≥18 years, ability to read English, and ability to provide consent. The primary researcher was blinded to cluster allocation. Feasibility outcomes were randomization procedure, acceptance of intervention, and adherence to and engagement with the wider program. We evaluated health and well-being data via self-assessment at 2 time points, registration and postintervention, using the 14-item Warwick-Edinburgh Mental Well-Being Scale, the 4-item Patient Health Questionnaire, and the 7-item Acceptance and Action Questionnaire—Revised. ResultsOf 124 participants who provided consent and were randomly allocated, 103 completed full registration and engaged with the program. Most participants (76/103) enrolled in at least one health behavior change module, and 43% (41/96) of those randomly allocated to an intervention arm enrolled in the well-being module. Adherence and engagement was low (7/103, 6.8%), but qualitative feedback was positive. ConclusionsThe procedure and randomization process proved feasible, and the addition of the well-being module proved acceptable to health care staff. However, participant engagement was limited, and no one completed the full 12-week program. User feedback should be used to develop the intervention to address poor engagement. Effectiveness should then be evaluated in a full-scale randomized controlled trial, which would be feasible with additional recruitment. Trial RegistrationInternational Standard Randomised Controlled Trial Number (ISRCTN) 50074817; http://www.isrctn.com/ISRCTN50074817

Moral vitalism refers to a tendency to view good and evil as actual forces that can influence people and events. The Moral Vitalism Scale had been designed to assess moral vitalism in a brief survey form. Previous studies established the reliability and validity of the scale in US-American and Australian samples. In this study, the cross-cultural comparability of the scale was tested across 28 different cultural groups worldwide through measurement invariance tests. A series of exact invariance tests marginally supported partial metric invariance, however, an approximate invariance approach provided evidence of partial scalar invariance for a 5-item measure. The established level of measurement invariance allows for comparisons of latent means across cultures. We conclude that the brief measure of moral vitalism is invariant across 28 cultures and can be used to estimate levels of moral vitalism with the same precision across very different cultural settings.

Pathogens represent a significant threat to human health leading to the emergence of strategies designed to help manage their negative impact. We examined how spiritual beliefs developed to explain and predict the devastating effects of pathogens and spread of infectious disease. Analysis of existing data in studies 1 and 2 suggests that moral vitalism (beliefs about spiritual forces of evil) is higher in geographical regions characterized by historical higher levels of pathogens. Furthermore, drawing on a sample of 3140 participants from 28 countries in study 3, we found that historical higher levels of pathogens were associated with stronger endorsement of moral vitalistic beliefs. Furthermore, endorsement of moral vitalistic beliefs statistically mediated the previously reported relationship between pathogen prevalence and conservative ideologies, suggesting these beliefs reinforce behavioural strategies which function to prevent infection. We conclude that moral vitalism may be adaptive: by emphasizing concerns over contagion, it provided an explanatory model that enabled human groups to reduce rates of contagious disease.

The present study examined the preliminary efficacy of an ultra-brief cognitive defusion intervention, compared to a positive self-affirmation intervention, on moderate subclinical Public Speaking Anxiety (PSA). Sixty-three participants (M = 25.70 years, SD = 9.48) first completed a questionnaire assessing PSA symptomology and were then randomly assigned to receive one of two interventions (cognitive defusion, positive self-affirmation) or nothing at all (no-treatment control). All participants then performed an impromptu speech task before recompleting the questionnaire. A significant decrease in PSA was reported within the cognitive defusion condition, relative to the positive self-affirmation and no-treatment control conditions. An ultra- brief cognitive defusion intervention has the potential to reduce short-term anxiety among those with moderate PSA. Keywords Public speaking anxiety * Defusion * Self-affirmation, The fear of public speaking, or public speaking anxiety (PSA), is a context-dependent social anxiety occurring during real or imagined enactment of oral speeches, such as presentations and interviews (Bodie, [...]

The current study aimed to provide an implicit measure of experiential avoidance (EA). Fifty undergraduate participants were exposed to an implicit (Implicit Relational Assessment Procedure: IRAP) and an explicit (Acceptance and Action Questionnaire II: AAQ II) measure of EA. Subsequently participant's response latencies on viewing a negatively affective IAP image were recorded. Participants were randomly assigned to either a thought suppression, or mindfulness group. The induction for both groups involved a 10 minute audio file that operationalized either suppression or mindfulness as a useful coping strategy for unwanted thoughts about the negatively affective IAP image. In the last stage of the experiment participants were re-exposed to both the AAQ II and the IRAP in order to determine whether the respective inductions had impacted on participant's level of EA (either explicitly or implicitly). The results indicated that the mindfulness group experienced a reduction of EA from pre to postinduction in comparison to those in the thought suppression group on the implicit measure (IRAP) but not the explicit measure (AAQ II). Results are discussed in terms of the utility of an implicit measure of experiential avoidance. (Contains 1 table and 2 figures.)

Guidance for schools regarding the promotion and enhancement of psychological wellbeing represents an invitation to intervene to promote effective, evidence-informed, whole-school approaches for school staff, students and parents. With its transdiagnostic approach and evidence from empirical literature, Acceptance and Commitment Therapy (ACT) is asserted as a coherent psychological model that has potential to support schools in developing effective and sustainable practices to promote psychological wellbeing. Three ways of applying ACT within educational contexts are discussed, demonstrating potential utility of the model: supporting school staff wellbeing; targeted interventions for children and young people; and a potential universal application, through the development of an ACT-based emotional health and wellbeing curriculum.

Recent research suggests that attempting to avoid unwanted psychological events is maladaptive. Contrastingly, cognitive defusion, which is an acceptance-based method for managing unwanted thoughts, may provide a plausible alternative. The current study was designed to compare defusion and experiential avoidance as strategies for coping with unwanted thoughts during a learned helplessness preparation. Before entering the learned helplessness preparation, participants were provided with 1 of 3 instructions: defusion, experiential avoidance (via a thought distraction instruction), or control (i.e., no instruction). Directly after the learned helplessness preparation, participants were instructed to attempt a pen-and-paper maze task, where their completion time was recorded. Results indicated that participants who received the defusion instruction produced maze times that were significantly shorter than the thought distraction and control groups. Results are discussed in terms of the efficacy of defusion instructions in the management of unwanted thoughts and the maladaptive nature of engaging in experiential avoidance. (Contains 2 figures.)