An early intervention to promote well-being and flourishing and reduce anxiety and depression: A randomized controlled trial

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Abstract

Background 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. Methods A total of 275 participants with low or moderate well-being (mean age = 48 years, 86% female) were randomly assigned to a TL-E (n = 137) or wait-list control group (WL; n = 138). Participants completed online self-reporting questionnaires at baseline and at 3, 6 and 12 months. Results Repeated measure analyses revealed significant more improvement on mental well-being (F = 42.00, p ≤ 0.001, d = 0.66, 95% CI = 0.42–0.90), anxiety (F = 21.65, p ≤ 0.001, d = 0.63, 95% CI = 0.39–0.87) and depression (F = 13.62, p ≤ 0.001, d = 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. Limitations 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. Conclusion 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.

Original languageEnglish
Pages (from-to)15-24
Number of pages10
JournalInternet interventions
Volume9
DOIs
Publication statusPublished - 1 Sep 2017

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Anxiety
Randomized Controlled Trials
Depression
Mental Health
Foster Home Care
Health Promotion
Mental Disorders
Control Groups
Surveys and Questionnaires

Keywords

  • Anxiety
  • Depression
  • Flourishing
  • Mental health promotion
  • Mental well-being
  • Self-help with Email support

Cite this

@article{e950cf1db7894bdbb3ea6324b4016e1a,
title = "An early intervention to promote well-being and flourishing and reduce anxiety and depression: A randomized controlled trial",
abstract = "Background 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. Methods A total of 275 participants with low or moderate well-being (mean age = 48 years, 86{\%} female) were randomly assigned to a TL-E (n = 137) or wait-list control group (WL; n = 138). Participants completed online self-reporting questionnaires at baseline and at 3, 6 and 12 months. Results Repeated measure analyses revealed significant more improvement on mental well-being (F = 42.00, p ≤ 0.001, d = 0.66, 95{\%} CI = 0.42–0.90), anxiety (F = 21.65, p ≤ 0.001, d = 0.63, 95{\%} CI = 0.39–0.87) and depression (F = 13.62, p ≤ 0.001, d = 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. Limitations 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. Conclusion 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.",
keywords = "Anxiety, Depression, Flourishing, Mental health promotion, Mental well-being, Self-help with Email support",
author = "Marijke Schotanus-Dijkstra and Drossaert, {Constance H.C.} and Pieterse, {Marcel E.} and Brigitte Boon and Walburg, {Jan A.} and Bohlmeijer, {Ernst T.}",
year = "2017",
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journal = "Internet interventions",
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T1 - An early intervention to promote well-being and flourishing and reduce anxiety and depression

T2 - A randomized controlled trial

AU - Schotanus-Dijkstra, Marijke

AU - Drossaert, Constance H.C.

AU - Pieterse, Marcel E.

AU - Boon, Brigitte

AU - Walburg, Jan A.

AU - Bohlmeijer, Ernst T.

PY - 2017/9/1

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N2 - Background 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. Methods A total of 275 participants with low or moderate well-being (mean age = 48 years, 86% female) were randomly assigned to a TL-E (n = 137) or wait-list control group (WL; n = 138). Participants completed online self-reporting questionnaires at baseline and at 3, 6 and 12 months. Results Repeated measure analyses revealed significant more improvement on mental well-being (F = 42.00, p ≤ 0.001, d = 0.66, 95% CI = 0.42–0.90), anxiety (F = 21.65, p ≤ 0.001, d = 0.63, 95% CI = 0.39–0.87) and depression (F = 13.62, p ≤ 0.001, d = 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. Limitations 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. Conclusion 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.

AB - Background 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. Methods A total of 275 participants with low or moderate well-being (mean age = 48 years, 86% female) were randomly assigned to a TL-E (n = 137) or wait-list control group (WL; n = 138). Participants completed online self-reporting questionnaires at baseline and at 3, 6 and 12 months. Results Repeated measure analyses revealed significant more improvement on mental well-being (F = 42.00, p ≤ 0.001, d = 0.66, 95% CI = 0.42–0.90), anxiety (F = 21.65, p ≤ 0.001, d = 0.63, 95% CI = 0.39–0.87) and depression (F = 13.62, p ≤ 0.001, d = 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. Limitations 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. Conclusion 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.

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KW - Depression

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