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Objective: There are considerable differences in how eating disorder (ED) patients respond to treatment. This study aimed to identify change trajectories of mental health during treatment. Method: Longitudinal data of 442 patients was used with five time points during a year of outpatient treatment. ED psychopathology and well-being were used as primary measures. A series of latent growth mixture models were applied to model trajectories of change. Results: Three latent classes were found for ED psychopathology and well-being. For ED psychopathology, a high baseline severity and slow recovery class (55.9% of the patients), a high baseline severity followed by a substantial recovery class (19.9%) and a moderate baseline severity and no significant recovery class (24.2%) were found. For well-being, a low baseline followed by a slow growth class (44.6%), a low baseline and substantial growth class (9.5%) and a moderate and stable well-being class (45.9%) was found. General psychopathology, early symptom change, hope for recovery, intrinsic motivation and the ED type were predictive of class membership in either ED psychopathology or well-being. Conclusions: This study shows variability in ED psychopathology and well-being change trajectories, modelled in meaningful latent recovery classes. These results may have clinical implications, such as adjusting patients’ treatment based on change trajectories.

Background and objectives: Cultivating compassion seems a promising strategy for ameliorating emotion dysregulation in patients with personality disorders (PDs). Thus far, empirical evidence is lacking. This study aimed to examine whether a brief compassion exercise compared to a neutral exercise would positively impact on (implicit) positive affect (PA) and (implicit) negative affect (NA) and foster the use of more adaptive emotion regulation strategies in an adult clinical sample with PDs. Methods: A total of 24 patients admitted to a Dutch day-hospital treatment center for PDs participated in a two-group cross-over study. Participants were randomly allocated over two groups that were both given the compassion and neutral exercise, yet in a different order. Assessments took place prior to and following each exercise. Participants completed questionnaires assessing (implicit) PA and NA and emotion regulation strategies. Results: Multilevel analyses did not yield significant differences between the neutral and compassion exercise in terms of adaptive and maladaptive emotion regulation and implicit PA. The compassion exercise was able to significantly decrease implicit NA among participants, relative to the neutral exercise. A significant interaction effect was observed between exercise and sequence of exercises on PA and NA. Limitations: Limitations include the brief duration of the exercises, the control exercise and the low reliability for the emotion regulation measure. Conclusions: The compassion exercise decreased implicit NA but seemed not able to impact on PA, NA and emotion regulation in patients with PDs.

The current study examines the role of social ties in performing kind acts to enhance university students’ wellbeing. Due to facing multifaceted challenges, university students form a group that is particularly vulnerable in terms of their mental health. Interventions harnessing prosocial behaviour have the potential to increase students’ wellbeing, strengthen personal competencies, and broaden social networks. The first aim of the trial (N = 222) was to explore whether a 4-week acts-of-kindness intervention targeting either (1) strong social ties, (2) weak social ties or (3) unspecified receivers (treatment-as-usual) differ in their impact on students’ mental wellbeing, positive relations, depressive symptoms, anxiety, and perceived stress. The second aim was to examine whether kindness for strong versus weak social ties have different underlying working mechanisms (i.e., positive emotions versus self-esteem) and who benefits most from these instructions (i.e., those with high or low levels of self-esteem and positive relations). Results demonstrated that the most significant improvements in mental wellbeing were found in the kindness for strong social ties condition compared to the other conditions. No mediation effects of positive emotions and self-esteem were found. Moderation analyses revealed that participants who performed kind acts for weak social ties reported significantly less positive effects on mental wellbeing, but only when their levels of self-esteem at baseline were medium or high. Independent of group allocation, participants’ mental wellbeing increased throughout the intervention, but so did the experience of depressive symptoms, anxiety, and perceived stress. More research is needed to examine the timing of kindness interventions and investigate how they can improve mental wellbeing and psychological distress in acute phases of academic stress in university students.

Objective Psychometric network analysis has led to new possibilities to assess the structure and dynamics of psychiatric disorders. The current study focuses on mental health networks in patients with anorexia nervosa, bulimia nervosa, binge eating disorder and other specified eating disorders (EDs). Method Network analyses were applied with five mental health domains (emotional, psychological and social well‐being, and general and specific psychopathology) among 905 ED patients. Also, networks of 36 underlying symptoms related to the domains were estimated. The network stability, structure and (bridge) centrality of the nodes were assessed for the total group and each ED type. Network differences between the ED types were also examined. Results ED psychopathology was only weakly connected with the well‐being domains. Psychological well‐being was the most central node in the domain network. The most central nodes in the symptom network were feeling depressed, feeling worthless, purpose in life and self‐acceptance. Bridge symptoms between well‐being and psychopathology were self‐acceptance, environmental mastery, interested in life and feeling depressed. There were no network differences between the ED types in both the domain and symptom networks. Conclusions This study shows novel associations between well‐being and psychopathology in ED patients. Central domains and their underlying symptoms may be especially important to consider in treatment for promoting mental health in ED patients., Highlights Psychometric network analysis shows novel associations between well‐being and psychopathology in eating disorder (ED) patients.The most central mental health domain and underlying symptoms were psychological well‐being, feeling depressed feeling worthless, purpose in life and self‐acceptance.A transdiagnostic approach to ED treatment, focusing on central mental health symptoms may be warranted.

Although the importance of well-being in mental health is widely acknowledged, well-being as a predictor of and outcome in the treatment for posttraumatic stress disorder (PTSD) has received little attention. This naturalistic study aimed to investigate well-being in the context of care-as-usual treatment for PTSD. Patients with PTSD attending a community mental health center (N = 318) completed measures of well-being and PTSD symptoms before and after symptom-focused treatment. Following treatment, well-being increased among patients with PTSD, with emotional, d = -0.25, and psychological well-being, d = -0.24, showing the largest improvements relative to social well-being, d = -0.15. Although levels of well-being improved overall within the sample, participant scores on measures of well-being remained low compared with the general population. Well-being predicted treatment efficiency such that participants with more severe PTSD symptoms benefitted more from care-as-usual treatment when they reported relatively high levels of well-being at the start of treatment. The findings suggest a benefit to including well-being as a pretreatment and outcome variable when evaluating PTSD treatments.

Many individuals with posttraumatic stress disorder (PTSD) continue to have substantial residual symptoms after completing psychological treatment. Well-being therapy (WBT) has been developed to treat the residual phase of mental disorders, prevent relapse, and promote a full recovery. The present study aimed to compare treatment as usual (TAU) with the long-term effects of WBT as a rehabilitation therapy in adults who successfully completed psychological treatment for PTSD. Participants who did not meet PTSD diagnostic criteria after completing treatment were randomized to WBT (n = 29) or TAU (n = 35) groups. Assessments of well-being, residual PTSD symptoms, and posttraumatic growth were conducted at baseline (T0) and again after 3 months (T1), 6 months (T2), and 1 year (T3). The results of the multilevel analysis revealed that WBT was not more effective than TAU in increasing levels of well-being, γ = 0.02 (SE = 0.11) or posttraumatic growth, γ = 0.10 (SE = 0.13) nor in decreasing PTSD symptoms, γ = -0.04 (SE = 0.05). However, for participants with low levels of well-being at baseline (Mental Health Continuum-Short Form score < 2.6), WBT was more effective than TAU in increasing ratings of well-being, γ = -0.41 (SE = 0.19) and posttraumatic growth, γ = -0.55 (SE = 0.24); this effect was most evident at T3 for posttraumatic growth, d = 1.23. Future research should assess clinically relevant individual characteristics that to optimize the effectiveness and utility of WBT.

Purpose Personality functioning is strongly linked to well-being in the general population. Yet, there is a lack of scientific knowledge about the pathways between personality trait facets and emotional, psychological and social well-being in ED patients. The general aim was to examine potential associations between maladaptive personality trait facets and the three main dimensions of well-being. Methods Participants were 1187 female eating disorder patients who were referred for specialized treatment. Patients were diagnosed with anorexia nervosa (31.7%), bulimia nervosa (21.7%), binge eating disorder (11%) and other specified eating disorders (35.5%). The Personality Inventory for the DSM 5 (PID-5) was used to measure 25 trait facets, and well-being was measured with the Mental Health Continuum Short Form (MHC-SF). Multiple hierarchical regression analyses were applied to examine potential associations between personality and well-being while controlling for background and illness characteristics. Results Personality trait facets led to a statistically significant increase of the explained variance in emotional (38%), psychological (39%), and social well-being (26%) in addition to the background and illness characteristics. The personality trait facets anhedonia and depression were strongly associated with all three well-being dimensions. Conclusion Personality traits may play an essential role in the experience of well-being among patients with EDs. To promote overall mental health, it may be critical for clinicians to address relevant personality trait facets, such as anhedonia and depression, associated with well-being in treatment. Level of evidence Level V, cross-sectional descriptive study.

The results of our study on the effects of well‐being therapy (WBT) compared with a treatment‐as‐usual (TAU) control condition among individuals with residual symptoms of posttraumatic stress disorder (PTSD) were recently published in the Journal of Traumatic Stress (Radstaak et al., 2020). In a subsequent commentary, Fava and Guidi (2020) raised several conceptual and methodological issues that they asserted potentially limited the interpretation of the results. In this response, we aim to clarify these issues, thus contributing to the optimal interpretation of the findings.

Contains fulltext : 200880.pdf (Publisher’s version ) (Open Access) Contingent self-worth has been studied as an individual differences variable affecting how self-relevant information is processed. We examined the effects of self-relevant information on contingent self-worth as a dependent variable. In Experiment 1 (N = 79, college students), participants’ performance contingency was higher after negative than positive performance feedback. In Experiment 2 (N = 3764, community sample), social approval and appearance contingencies were lower in a social approval condition than in control conditions. Mediation analyses suggested this effect was mediated by enhanced self-esteem. Thus, self-esteem increased due to the very source that participants came to regard as less important: Social approval. Results are explained in terms of sociometer theory and limited introspection abilities: All self-esteem is sensitive to external contingencies, people just become more aware of this when it is threatened. 18 p.

Contains fulltext : 135097.pdf (Publisher’s version ) (Open Access) Objectives: This longitudinal study examined the associations between work stressors, perseverative cognition and subjective and objective sleep quality. We hypothesized work stressors to be associated with (i) poor nocturnal sleep quality and (ii) higher levels of perseverative cognition during a free evening. We further hypothesized (iii) perseverative cognition to be associated with poor nocturnal sleep quality and (iv) the association between work stressors and sleep quality to be mediated by perseverative cognition. Methods: The participants were 24 pilots working for the Dutch Helicopter Emergency Medical Service (HEMS). They completed six questionnaires: at the end of three consecutive day shifts and each morning following the shifts. The questionnaires addressed work stressors (workload, distressing shifts and work-related conflicts), subjective sleep quality and perseverative cognition. Participants wore actigraphs to assess sleep onset latency, total sleep time and number of awakenings. Results: Correlation analysis revealed that (i) distressing shifts were related to delayed sleep onset (r=0.50, p=0.026) and that workload was related to impaired sleep quality (e.g., subjective sleep quality: r=-0.42, p=0.044). Moreover, (ii) distressing shifts were positively related to perseverative cognition (r=0.62, p=0.002), (iii) perseverative cognition delayed sleep onset (r=0.74, p

Orientation: The right balance between job demands and job resources are essential for employees to bring energy and enthusiasm to work. Employees who experience high-quality relationships with their supervisors may actively craft their job demands and job resources and feel more engaged. Research purpose: The current study examined the associations between leader–member exchange (LMX), job crafting and work engagement. Motivation: This study attempts to gain more insight in the associations between LMX, job crafting and work engagement. It was hypothesised that high-quality relationships with supervisors fosters work engagement because it stimulates employees to craft their jobs by increasing social and structural job resources and challenging job demands and by decreasing hindering job demands. Research approach, design and methodology: Participants ( N = 402) working for a leading mail and parcels company in the Netherlands completed questionnaires measuring LMX, work engagement and job crafting. Structural equation modelling was used to examine the hypotheses. Main findings: Increasing social job resources ( β = 0.01, SE = 0.00, p < 0.001) and increasing challenging job demands ( β = 0.08, SE = 0.04, p < 0.05) were significant mediators in the association between LMX and work engagement. Increasing structural job resources ( β = 0.00, SE = 0.00, p = 0.92) and decreasing hindering job demands ( β = -0.00, SE 0.00, p = 0.09) were not significant mediators. Practical and managerial implications: Supervisors who are capable of building high-quality relationships with their employees based on trust, respect and loyalty will foster a positive, fulfilling work-related state of mind among employees because they are more willing to proactively craft a challenging and resourceful work environment. Contribution or value-add: The findings of this study showed the importance of high-quality relationships with supervisors and were unique in examining the association between LMX and job crafting.

Contains fulltext : 132723.pdf (Publisher’s version ) (Closed access) Objective: This experimental study examined whether listening to self-chosen music after stress exposure improves mood, decreases subjective arousal and rumination, and facilitates cardiovascular recovery. Method: Participants (N = 123) were exposed to a mental arithmetic task with harassment to induce stress. Afterward, participants were randomly assigned to one of four "recovery'' conditions where they (1) listened to self-chosen relaxing music, (2) listened to self-chosen happy music, (3) listened to an audio book, or (4) sat in silence. After this 5-minute "recovery manipulation period,'' participants sat in silence for another 5 minutes. Systolic blood pressure, diastolic blood pressure, and heart rate were continuously measured. Results: The recovery conditions caused differences in positive affect (F(3,119) = 13.13, p < .001) and negative affect (F(3,119) = 2.69, p = .049). As expected, mood improved while listening to either relaxing music or happy music. The conditions showed no differences in subjective arousal (F(3,117) = 2.03, p = .11) and rumination (F(3,119) = 1.10, p = .35). Systolic blood pressure recovery, however, differed between the conditions (linear time trend: F(3,116) = 4.50, p = .005; quadratic time trend: F(3,115) = 5.24, p = .002). Listening to both relaxing and happy music delayed systolic blood pressure recovery when compared with both control conditions. Conclusions: Listening to self-selected music is an effective mood enhancer, but it delays blood pressure recovery. 9 p.

Compulsive workers often face psychological and physical health disturbances because of working long hours and an obsessive preoccupation with work during off-job time. Prolonged respite episodes may either relief these employees from their daily stressors to recover or trigger withdrawal symptoms. Our research question was as follows: How do (1) work hours, (2) rumination and (3) affective well-being unfold for compulsive workers compared with non-compulsive workers across long vacations? In a longitudinal field study, work hours, rumination and affective well-being were assessed in 54 employees 2weeks before, during and in the first, second and fourth week after a long summer vacation. Working compulsively was assessed 3weeks before vacation. Work hours decreased during and increased after vacation. Levels of rumination dropped during vacation and remained below baseline until 2weeks after vacation. Initial differences in rumination between obsessive and non-obsessive workers disappeared during and directly after vacation. Affective well-being rose during vacation and returned to baseline directly after vacation. Increases in affective well-being during vacation as well as decreases after vacation were greater in obsessive workers than in non-obsessive workers. Vacations seem to temporarily offset characteristic differences between obsessive and non-obsessive workers, decrease rumination and improve affective well-being.

According to recent insights, humans might not be aware of a substantial part of their cognitive stress representations while these still have prolonged physiological effects. Unconscious stress' can be measured by implicit affect (IA) tests. It was shown that IA predicts physiological stress responses, in fact better than explicit (conscious') affect. It is not known yet whether IA is associated with concurrent prolonged stress responses. In two studies (n=62 and 123), anger harassment was used to induce stress. Blood pressure (BP) and heart rate (HR) were measured continuously. During BP and HR recovery, IA was measured by an anger' version of the implicit association test (IAT) or the implicit positive and negative affect test (IPANAT). Blood pressure and HR increased during anger harassment and recovery afterwards. When using the IPANAT BP recovery levels were lower when positive IA was high and higher when negative IA was high, independent of explicit affect and rumination. These results were not found using the IAT. These results provide preliminary evidence that physiological stress recovery is associated with IA. This is in line with the theory that unconscious stress is responsible for a possibly considerable part of unhealthy prolonged stress-related physiological activity.

Contains fulltext : 99823.pdf (Publisher’s version ) (Closed access) This study examined the psychological processes that may impede or facilitate cardiovascular recovery. It was hypothesized that cardiovascular recovery would be hampered by negative affect and rumination, and facilitated by positive affect. In an experimental study, stress was elicited by exposing participants (N = 110) to a mental arithmetic task with harassment. After the stress task, affective levels were manipulated via a movie scene with negative, neutral, or positive emotional valence, or without an affect manipulation (control condition). During the entire experiment, heart rate and systolic and diastolic blood pressure levels were measured continuously. Results indicated that blood pressure recovery was hampered by the negative affect manipulation and by rumination. However, the positive affect manipulation did not facilitate blood pressure recovery. No effects were found on heart rate recovery. In sum, the findings emphasize the importance of negative affect and rumination in stress recovery. 8 p.

Compulsive workers often face psychological and physical health disturbances because of working long hours and an obsessive preoccupation with work during off-job time. Prolonged respite episodes may either relief these employees from their daily stressors to recover or trigger withdrawal symptoms. Our research question was as follows: How do (1) work hours, (2) rumination and (3) affective well-being unfold for compulsive workers compared with non-compulsive workers across long vacations? In a longitudinal field study, work hours, rumination and affective well-being were assessed in 54 employees 2 weeks before, during and in the first, second and fourth week after a long summer vacation. Working compulsively was assessed 3 weeks before vacation. Work hours decreased during and increased after vacation. Levels of rumination dropped during vacation and remained below baseline until 2 weeks after vacation. Initial differences in rumination between obsessive and non-obsessive workers disappeared during and directly after vacation. Affective well-being rose during vacation and returned to baseline directly after vacation. Increases in affective well-being during vacation as well as decreases after vacation were greater in obsessive workers than in non-obsessive workers. Vacations seem to temporarily offset characteristic differences between obsessive and non-obsessive workers, decrease rumination and improve affective well-being.

Contains fulltext : 128044.pdf (Publisher’s version ) (Closed access) This study investigated the effects of a compressed working week with high cognitive and emotional work demands within the population of Dutch Helicopter Emergency Medical Service (HEMS) pilots. Work stressors were measured and levels of well-being were examined before, during and after a series of day and night shifts. Results revealed that (i) the start of a series of day shifts was more taxing for wellbeing than the start of a series of night shifts, (ii) there were no differences in the decrease in well-being during day and night shifts, (iii) distress during shifts was more strongly related to a decrease in wellbeing during night than during day shifts and (iv) it took HEMS pilots more time to recover from a series of night shifts than from a series of day shifts. It is concluded that HEMS pilots should not start earlier during day shifts, nor have longer series of night shifts. 8 p.