Citation

Siddaway AP, Wood AM, Taylor PJ. J. Affect. Disord. 2017; 213: 180-186.

Affiliation

Division of Psychology & Mental Health, University of Manchester, Manchester, England, UK.

Copyright

(Copyright © 2017, Elsevier Publishing)

DOI

10.1016/j.jad.2017.02.015

PMID

28254608

Abstract

BACKGROUND: Two core but untested predictions of Positive Clinical Psychology (PCP) are that (1) Many psychiatric problems can be understood as one end of bipolar continua with well-being, and (2) that reducing psychiatric symptoms will provide an equal (near linear) decrease in risk for several other psychiatric variables, irrespective of position on continua. AIMS: We test these predictions in relation to a purported well-being/depression continuum, as measured by the Center for Epidemiologic Studies-Depression (CES-D), a popular measure of depressive experiences in research and clinical practice.

METHOD: A large (N=4138), diverse sample completed the CES-D, which contains a mixture of negatively worded and positively worded items (e.g., "I felt sad," "I enjoyed life"). The latter are conventionally reverse scored to compute a total score. We first examined whether purportedly separate well-being and depression CES-D factors can be reconceptualised as a bipolar well-being/depression continuum. We then characterised the (linear or nonlinear) form of the relationship between this continuum and other psychiatric variables.

RESULTS: Both predictions were supported. When controlling for shared method bias amongst positively worded items, a single factor well-being/depression continuum underlies the CES-D. Baseline levels on this continuum are found to have near linear relationships with changes in anxiety symptoms, aggression, and substance misuse over time, demonstrating that moving from depression to well-being on the CES-D provides an equal decrease in risk for several other psychological problems irrespective of position on the continuum. LIMITATIONS: The CES-D does not measure well-being as comprehensively as established scales of well-being.

CONCLUSIONS: Results support calls for mental health services to jointly focus on increasing well-being and reducing distress, and point to the value of early intervention and instilling resilience in order to prevent people moving away from high levels of well-being.

Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

Language: en

Keywords

Intervention; Prevention; Recovery; Stigma; Therapy; Well-being