Elisa Albieri

School intervention for promoting psychological well-being in adolescence

OBJECTIVE to test the efficacy of a new school program for the promotion of psychological well-being. In this study a school program for promoting psychological well-being has been compared to an attention-placebo intervention in a high school setting. METHODS Nine classes (227 students) were randomly assigned to: a) Well-Being intervention (5 classes); b)attention-placebo (4 classes). Assessment was performed at pre and post-intervention, and after six months using: 1) Symptom Questionnaire (SQ); 2) Psychological Well-Being Scales (PWB); 3) Revised Childrens Manifest Anxiety Scale (RCMAS). RESULTS A significant effect of WB school intervention in improving Personal Growth (PWB), and in decreasing distress (Somatization (SQ), Physical Well-being (SQ), Anxiety (SQ), and RCMAS Physiological Anxiety) emerged. CONCLUSIONS A school intervention based on promoting positive emotions and well-being was effective not only in increasing psychological well-being among adolescents, but also in decreasing distress, in particular anxiety and somatization.

Differential effects of well-being promoting and anxiety-management strategies in a non-clinical school setting

The aim of the present study was to examine the differential effects of strategies for promotion of psychological well-being (Well-Being Therapy, WBT) and removal of distress (Anxiety Management, AM) in a non-clinical school setting.162 students attending middle schools in Northern Italy were randomly assigned to: (a) a protocol derived from WBT; (b) an anxiety-management protocol (AM). The students were assessed immediately before and after the interventions, and after 6 months using: Psychological Well-Being Scales (PWB), Symptom Questionnaire (SQ) and the Revised Childrens Manifest Anxiety Scale (RCMAS). In school children, well-being and symptom focused interventions produced slightly different effects on psychological dimensions. WBT, by facilitating progression toward positive and optimal functioning, may integrate symptom-centered strategies.

Post-traumatic Growth in Breast Cancer Survivors: New Insights into its Relationships with Well-Being and Distress

Research investigating possible relations between Post-traumatic growth (PTG) and clinical indexes—such as psychosocial distress, physical and psychological well-being—is lacking in medical settings. The aim of this study was to look into such relationships in breast cancer survivors (Bcs) and in healthy control subjects who experienced other stressful events. Sixty Bcs and 60 healthy women reporting other stressful events were compared according to the following scales: Post-traumatic Growth Inventory, Psychological Well-being Scales (PWB), Symptom Questionnaire and Psychosocial Index. Bcs reported significantly higher levels of PTG and distress, and lower levels of PWB compared to healthy women. Bcs with high levels of PTG showed increased levels of physical well-being and decreased distress. Healthy women under stressful circumstances reporting high levels of PTG showed increased levels of PWB. PTG levels were higher in Bcs and associated with decreased psychological distress and somatisation. These results carry important implications for clinical assessment, as well as for planning interventions to improve well-being and resilience in oncology.

Gender Differences in Psychological Well-Being and Distress During Adolescence

Several investigations report a greater prevalence of depressive and anxious symptoms and emotional distress in girls compared to boys. Furthermore, the scientific literature points out that females show lower psychological well-being levels compared to males. Since, in the most of these studies, participants were already out of adolescence or were adults and aging individuals, the aim of this investigation is to explore gender differences in the levels of psychological well-being and distress during adolescence, one of the most controversial periods of human life. Five hundred and seventy-two adolescents (313 females, 259 males; mean age 13.63 years, SD = 1.94) were recruited from various middle and high schools in Northern Italy, which volunteered to participate in the study. Subjects were administered the following self-rating scales: (1) Psychological Well-Being (PWB) Scales, (2) Symptom Questionnaire (SQ). Student t-test was used to analyze gender differences in PWB and SQ scores. Gender differences in psychological well-being levels were not found, even if on- test females tend to report lower scores in Self-Acceptance scale (PWB) than males. Girls reported higher levels of distress than boys. t-Test indicated significant gender differences in all SQ scales, except in friendliness. On retest, results were very similar. Females scored significantly higher than males in all SQ scales, except in contentment, where females reported better levels compared to previous data. This investigation points out that females reported higher levels of distress than males, but unlike the preceding studies, it also highlights that girls showed similar levels of psychological well-being compared to boys. These results suggest that adolescence is a period of the life with peculiar characteristics in boys and girls and that further investigations are needed.

Well-Being Therapy in Children with Emotional and Behavioral Disturbances: A Pilot Investigation

Anxiety, mood disorders and somatoform disorders are among the most prevalent forms of psychological suffering during childhood and adolescence. They are often associated with poor academic performance [1] and a number of negative outcomes; furthermore, if untreated, these problems can be predictors of severer anxiety and mood disorders in adulthood [2, 3] . Brent [4] has underlined how, even in the best center with the best clinicians, only 37% of the depressed adolescents involved have remitted. This highlights the need for new treatment modalities, which focus on each child’s competencies and the development of optimal functioning in youth [5, 6] . A specific psychotherapeutic strategy for enhancing well-being (well-being therapy; WBT) [7] has been developed from the multidimensional model of psychological well-being by Ryff [8] . In controlled trials on adult patients with affective disorders, WBT was found to be effective in determining remission of symptoms, improving psychological well-being and preventing episodes of relapse [9–12] . The aim of this study was to apply a modified form of WBT to a child population of patients with mood, anxiety and conduct disorders, and to test its effects in reducing symptoms and in improving new skills and competencies in children. Here, we report 4 of 14 cases who underwent this new treatment protocol, and are particularly interesting from a clinical point of view. Four male subjects, referred to a tertiary neuropsychiatric clinic, and aged from 8 to 11 years (mean = 9.50; SD = 1.72) with different diagnoses according to DSM-IV criteria (1 oppositional-defiant disorder, 1 ADHD, 1 major depressive disorder and 1 generalized anxiety disorder; GAD) were enrolled in this study. The child Psychother Psychosom 2009;78:387–390

Well-Being Therapy: State of the Art and Clinical Exemplifications

A specific psychotherapeutic strategy for increasing psychological well-being, well-being therapy (WBT), has been developed almost two decades ago, and tested in a number of randomized controlled trials over these years. WBT is described in its current clinical features, with two clinical case presentations (one involving a depressed woman and one involving a child with ADHD) that illustrate its additive value in combination with cognitive behavioral treatment or pharmacotherapy. Recent developments with children and adolescents, both in school and clinical settings, are also reported. These contributions underline the peculiarities of this approach: it is aimed at promoting well-being, but differentiates form other positive interventions since it adopts a wider eudaimonic perspective. Thus, WBT takes into consideration both psychological well-being and distress in determining patient’s clinical outcomes. Limitations of current research on WBT and future developments as a preventive strategy for vulnerable individuals are discussed.

Self-rated and observer-rated measures of well-being and distress in adolescence: an exploratory study

The evaluation of eudaimonic well-being in adolescence is hampered by the lack of specific assessment tools. Moreover, with younger populations, the assessment of positive functioning may be biased by self-report data only, and may be more accurate by adding significant adults’ evaluations. The objective of this research was to measure adolescents’ well-being and prosocial behaviours using self-rated and observer-rated instruments, and their pattern of associations. The sample included 150 Italian high school adolescents. Observed-evaluation was performed by their school teachers using the Strengths and Difficulties Questionnaire. Adolescents completed Ryff’s Psychological Well-being Scales and Symptom Questionnaire. Pearson’ r correlations and Linear regression were performed. Self-rated dimensions of psychological well-being significantly correlated with all observer-rated dimensions, but Strengths and Difficulties Emotional symptom scale. Multiple linear regression showed that the self-rated dimensions Environmental Mastery and Personal Growth, and surprisingly not Positive Relations, are related to the observer-rated dimension Prosocial Behaviour. Adolescents with higher levels of well-being in specific dimensions tend to be perceived as less problematic by their teachers. However, some dimensions of positive functioning present discrepancies between self and observer-rated instruments. Thus, the conjunct use of self-reports and observer-rated tools for a more comprehensive assessment of students’ eudaimonic well-being is recommended.

[The use of Well-Being Therapy in childhood: clinical cases].

Anxiety, mood and somatoform disorders are among the most prevalent forms of psychological suffering during childhood and adolescence. If untreated, these problems can be predictors of more severe disorders in adulthood. New trends in clinical psychology suggest the relevance of focusing on childs competencies and developing optimal functioning in youth. A specific psychotherapeutic strategy for enhancing well-being (Well-Being Therapy; WBT) has been developed for adult patients and it was found to be effective in determining remission from affective symptoms, in improving psychological well-being and in preventing relapses. In this article we describe a modified form of WBT which has been applied for the first time to children suffering from emotional and behavioral disorders in order to test its feasibility and potential effects in reducing symptoms and in improving new skills. Four cases particularly interesting by a clinical point of view are reported. This new therapeutic approach, based on the promotion of psychological well-being seems to be a very promising intervention: children improved at post treatment and during 1 year follow-up, both in symptomatology and in social skills. The promotion of psychological well-being and optimal functioning is an innovative and relevant ingredient and could play an important role in the treatment of somatic and psychosocial symptoms in paediatric settings.

The Role of Psychological Well-being in Childhood Interventions

The high worldwide prevalence of mental disorders in childhood and adolescence is well documented, even though the majority of available data pertain to youth living in developed countries. If untreated, these conditions could herald more severe disorders in adulthood. Indeed, they often remain under-recognized and do not receive appropriate treatment. This chapter gives a brief overview of the main evidence-based psychotherapies for affective disorders in youth, considering both the ingredients of traditional protocols and new therapeutic approaches, which aim to cultivate positive emotions, cognitions, and behaviors. This is in line with a more comprehensive conceptualization of remission and recovery in childhood, which should not be limited to symptoms reduction, but also encompasses the improvement of well-being and resilience.

School Programs for the Prevention of Mental Health Problems and the Promotion of Psychological Well-being in Children

Childhood and adolescence provide key opportunities to promote optimal functioning and prevent mental health disorders. Schools represent an ideal setting for this goal. The main effective, evidence-based school interventions are listed in the chapter, but a paucity of interventions specifically focused on well-being according to the eudaimonic perspective emerged. Recently, a new school program for the promotion of psychological well-being and optimal human functioning has been developed: The Well-Being Therapy (WBT) school intervention. Its applicability and effectiveness were tested in controlled studies, documenting that enhancing specific well-being dimensions among students may result in reducing distress and anxiety and improving developmental processes.