Osteoarthritis is a leading cause of disability for which there is no cure. Psychosocial-oriented... more Osteoarthritis is a leading cause of disability for which there is no cure. Psychosocial-oriented treatments are underexplored. We developed and tested an intervention to build positive psychological skills (e.g., gratitude) to reduce osteoarthritis symptom severity, including pain and functioning, and to improve psychosocial well-being in patients with knee or hip osteoarthritis. Two-arm randomized design with six-month follow-up. An academic Veterans Affairs Medical Center. Patients aged 50 years or older with knee or hip osteoarthritis and pain ratings of 4 or higher. Patients (N = 42) were randomized to a six-week program containing positive skill-building activities or neutral control activities tailored to the patient population. Adherence was assessed by telephone each week. We assessed osteoarthritis symptom severity (WOMAC Osteoarthritis Index) and measures of well-being (positive affect, negative affect, and life satisfaction) at baseline and by telephone one, three, and six months after the program ended. We used linear mixed models to examine changes over time. The majority (64%) of patients completed more than 80% of their weekly activities. Patients in the positive (vs neutral) program reported significantly more improvement over time in osteoarthritis symptom severity (P = 0.02, Cohen's d = 0.86), negative affect (P = 0.03, Cohen's d = 0.50), and life satisfaction (P = 0.02, Cohen's d = 0.36). The study successfully engaged patients with knee or hip osteoarthritis in a six-week intervention to build positive psychological skills. Improving osteoarthritis symptom severity and measures of psychosocial well-being, the intervention shows promise as a tool for chronic pain management.
Body: Knee osteoarthritis is a painful, disabling condition that disproportionately affects Afric... more Body: Knee osteoarthritis is a painful, disabling condition that disproportionately affects African Americans. Existing arthritis treatments yield small to moderate improvements in pain and have not been effective at reducing racial disparities in the management of pain. The biopsychosocial model of pain and evidence from the positive psychology literature, suggest that increasing positive psychological skills (e.g., gratitude, kindness) could improve pain and functioning and reduce disparities in osteoarthritis pain management. Activities to cultivate positive psychological skills have been developed and validated; however, they have not been tested in patients with osteoarthritis, their effects on racial differences in health outcomes have not been examined, and evidence of their effects on health outcomes in patients with other chronic illnesses is of limited quality. In this article we describe the rationale and design of Staying Positive with Arthritis (SPA) study, a randomized controlled trial in which 180 African American and 180 White primary care patients with chronic pain from knee osteoarthritis will be randomized to a 6-week program of either positive skill-building activities or neutral control activities. The primary outcomes will be self-reported pain and functioning as measured by the WOMAC Osteoarthritis Index. We will assess these primary outcomes and potential, exploratory psychosocial mediating variables at an in-person baseline visit and by telephone at 1, 3, and 6 months following completion of the assigned program. If effective, the SPA program would be a novel, theoretically-informed psychosocial intervention to improve quality and equity of care in the management of chronic pain from osteoarthritis.
This article may be used for research, teaching, and private study purposes. Any substantial or s... more This article may be used for research, teaching, and private study purposes. Any substantial or systematic reproduction, redistribution, reselling, loan, sub-licensing, systematic supply, or distribution in any form to anyone is expressly forbidden. The publisher does not give any warranty express or implied or make any representation that the contents will be complete or accurate or up to date. The accuracy of any instructions, formulae, and drug doses should be independently verified with primary sources. The publisher shall not be liable for any loss, actions, claims, proceedings, demand, or costs or damages whatsoever or howsoever caused arising directly or indirectly in connection with or arising out of the use of this material.
The accuracy of the Content should not be relied upon and should be independently verified with p... more The accuracy of the Content should not be relied upon and should be independently verified with primary sources of information. Taylor and Francis shall not be liable for any losses, actions, claims, proceedings, demands, costs, expenses, damages, and other liabilities whatsoever or howsoever caused arising directly or indirectly in connection with, in relation to or arising out of the use of the Content. This article may be used for research, teaching, and private study purposes. Any substantial or systematic reproduction, redistribution, reselling, loan, sub-licensing, systematic supply, or distribution in any form to anyone is expressly forbidden.
Happiness-increasing interventions demonstrate significant variation in outcomes, suggesting that... more Happiness-increasing interventions demonstrate significant variation in outcomes, suggesting that the people who use them might be as important as the interventions themselves to determine efficacy. In light of this, instructive interventions might not be necessary to increase happiness given a population with knowledge of happiness-increasing strategies. We recruited 270 participants with knowledge of positive psychology to receive six weeks of online psychoeducation. We explored participants' use of the website, reported use of happiness strategies, and changes in well-being. Those who spent more time on the website reported smaller changes in well-being than those who spent less time on the website. Conversely, those who reported employing more happiness strategies reported greater increases in well-being than those who used fewer strategies. This shows that for those already familiar with positive psychology, information, rather than instruction, might increase well-being. This has implications for studies evaluating the efficacy of happiness-increasing interventions more broadly.
Systematic reviews, such as meta-analyses, are highly valued within scientific, professional, and... more Systematic reviews, such as meta-analyses, are highly valued within scientific, professional, and lay communities because they provide an easily digestible aggregate of a large body of work. A recently published meta-analysis of positive psychology interventions concluded that these interventions have small effects and argued for the use of these interventions in diverse populations (Bolier et al., 2013). We caution researchers against drawing conclusions from this study because of the unusual definition of what is (and is not) a positive psychological intervention. Bolier and colleagues (2013) define their area of inquiry as "pure positive psychology interventions" and limit their sample to studies conducted within the years following the formal founding of the positive psychology movement. This decision-while well intentioned, as it provides specificity to their criteria for inclusion-is, in our view, too narrow, excluding a host of studies that use the same intervention strategies and target the same outcomes but do not explicitly reference "positive psychology". The inclusion criteria of a systematic review directly impact its findings and conclusions. Using the criterion of papers that explicitly reference positive psychology creates an arbitrary boundary that reflects neither the research nor practice of the field; the best practitioners prioritize effectiveness and efficiency over explicit ties to "positive psychology". Arbitrary boundaries hinder science and impair the ability of researchers, clinicians, and the general public to draw accurate conclusions from the findings. It also limits the metaanalyst's ability to conduct moderation analysis that can help drive the field forward by answering research questions that are difficult to address in a single study. Positive psychology and psychology more generally would benefit from definitions of terms that are conceptually-based and thus meta-analyses that are theoretically sound.
The current article discusses the potential utility of self-help books as a means of disseminatin... more The current article discusses the potential utility of self-help books as a means of disseminating positive psychological interventions, and presents data comparing a positive psychology-based self-help book with a cognitive-behavioral self-help book and a self-monitoring control condition. We studied college freshmen (N=58), and argue that this population is a particularly appropriate target for well-being intervention. Outcome measures included both indices of efficacy (depressive symptoms and life satisfaction) and effectiveness (e.g. the extent to which participants found their assigned activities to be meaningful). The two book groups outperformed the control and were equivalently efficacious at reducing depressive symptoms; on life satisfaction, positive self-help outperformed cognitive-behavioral, but only at 6-month follow-up. Positive self-help was also superior to cognitive-behavioral self-help on indices of effectiveness. Possibilities for future directions are discussed, with an emphasis on the realities of practical dissemination to both college students, and to the general public.
... Acacia Parks is now at the University of Pennsylvania, and Keith Herman is at the University ... more ... Acacia Parks is now at the University of Pennsylvania, and Keith Herman is at the University of Oregon. Correspondence concerning this article should be addressed to Email: [email protected]. ...
Osteoarthritis is a leading cause of disability for which there is no cure. Psychosocial-oriented... more Osteoarthritis is a leading cause of disability for which there is no cure. Psychosocial-oriented treatments are underexplored. We developed and tested an intervention to build positive psychological skills (e.g., gratitude) to reduce osteoarthritis symptom severity, including pain and functioning, and to improve psychosocial well-being in patients with knee or hip osteoarthritis. Two-arm randomized design with six-month follow-up. An academic Veterans Affairs Medical Center. Patients aged 50 years or older with knee or hip osteoarthritis and pain ratings of 4 or higher. Patients (N = 42) were randomized to a six-week program containing positive skill-building activities or neutral control activities tailored to the patient population. Adherence was assessed by telephone each week. We assessed osteoarthritis symptom severity (WOMAC Osteoarthritis Index) and measures of well-being (positive affect, negative affect, and life satisfaction) at baseline and by telephone one, three, and six months after the program ended. We used linear mixed models to examine changes over time. The majority (64%) of patients completed more than 80% of their weekly activities. Patients in the positive (vs neutral) program reported significantly more improvement over time in osteoarthritis symptom severity (P = 0.02, Cohen's d = 0.86), negative affect (P = 0.03, Cohen's d = 0.50), and life satisfaction (P = 0.02, Cohen's d = 0.36). The study successfully engaged patients with knee or hip osteoarthritis in a six-week intervention to build positive psychological skills. Improving osteoarthritis symptom severity and measures of psychosocial well-being, the intervention shows promise as a tool for chronic pain management.
Body: Knee osteoarthritis is a painful, disabling condition that disproportionately affects Afric... more Body: Knee osteoarthritis is a painful, disabling condition that disproportionately affects African Americans. Existing arthritis treatments yield small to moderate improvements in pain and have not been effective at reducing racial disparities in the management of pain. The biopsychosocial model of pain and evidence from the positive psychology literature, suggest that increasing positive psychological skills (e.g., gratitude, kindness) could improve pain and functioning and reduce disparities in osteoarthritis pain management. Activities to cultivate positive psychological skills have been developed and validated; however, they have not been tested in patients with osteoarthritis, their effects on racial differences in health outcomes have not been examined, and evidence of their effects on health outcomes in patients with other chronic illnesses is of limited quality. In this article we describe the rationale and design of Staying Positive with Arthritis (SPA) study, a randomized controlled trial in which 180 African American and 180 White primary care patients with chronic pain from knee osteoarthritis will be randomized to a 6-week program of either positive skill-building activities or neutral control activities. The primary outcomes will be self-reported pain and functioning as measured by the WOMAC Osteoarthritis Index. We will assess these primary outcomes and potential, exploratory psychosocial mediating variables at an in-person baseline visit and by telephone at 1, 3, and 6 months following completion of the assigned program. If effective, the SPA program would be a novel, theoretically-informed psychosocial intervention to improve quality and equity of care in the management of chronic pain from osteoarthritis.
This article may be used for research, teaching, and private study purposes. Any substantial or s... more This article may be used for research, teaching, and private study purposes. Any substantial or systematic reproduction, redistribution, reselling, loan, sub-licensing, systematic supply, or distribution in any form to anyone is expressly forbidden. The publisher does not give any warranty express or implied or make any representation that the contents will be complete or accurate or up to date. The accuracy of any instructions, formulae, and drug doses should be independently verified with primary sources. The publisher shall not be liable for any loss, actions, claims, proceedings, demand, or costs or damages whatsoever or howsoever caused arising directly or indirectly in connection with or arising out of the use of this material.
The accuracy of the Content should not be relied upon and should be independently verified with p... more The accuracy of the Content should not be relied upon and should be independently verified with primary sources of information. Taylor and Francis shall not be liable for any losses, actions, claims, proceedings, demands, costs, expenses, damages, and other liabilities whatsoever or howsoever caused arising directly or indirectly in connection with, in relation to or arising out of the use of the Content. This article may be used for research, teaching, and private study purposes. Any substantial or systematic reproduction, redistribution, reselling, loan, sub-licensing, systematic supply, or distribution in any form to anyone is expressly forbidden.
Happiness-increasing interventions demonstrate significant variation in outcomes, suggesting that... more Happiness-increasing interventions demonstrate significant variation in outcomes, suggesting that the people who use them might be as important as the interventions themselves to determine efficacy. In light of this, instructive interventions might not be necessary to increase happiness given a population with knowledge of happiness-increasing strategies. We recruited 270 participants with knowledge of positive psychology to receive six weeks of online psychoeducation. We explored participants' use of the website, reported use of happiness strategies, and changes in well-being. Those who spent more time on the website reported smaller changes in well-being than those who spent less time on the website. Conversely, those who reported employing more happiness strategies reported greater increases in well-being than those who used fewer strategies. This shows that for those already familiar with positive psychology, information, rather than instruction, might increase well-being. This has implications for studies evaluating the efficacy of happiness-increasing interventions more broadly.
Systematic reviews, such as meta-analyses, are highly valued within scientific, professional, and... more Systematic reviews, such as meta-analyses, are highly valued within scientific, professional, and lay communities because they provide an easily digestible aggregate of a large body of work. A recently published meta-analysis of positive psychology interventions concluded that these interventions have small effects and argued for the use of these interventions in diverse populations (Bolier et al., 2013). We caution researchers against drawing conclusions from this study because of the unusual definition of what is (and is not) a positive psychological intervention. Bolier and colleagues (2013) define their area of inquiry as "pure positive psychology interventions" and limit their sample to studies conducted within the years following the formal founding of the positive psychology movement. This decision-while well intentioned, as it provides specificity to their criteria for inclusion-is, in our view, too narrow, excluding a host of studies that use the same intervention strategies and target the same outcomes but do not explicitly reference "positive psychology". The inclusion criteria of a systematic review directly impact its findings and conclusions. Using the criterion of papers that explicitly reference positive psychology creates an arbitrary boundary that reflects neither the research nor practice of the field; the best practitioners prioritize effectiveness and efficiency over explicit ties to "positive psychology". Arbitrary boundaries hinder science and impair the ability of researchers, clinicians, and the general public to draw accurate conclusions from the findings. It also limits the metaanalyst's ability to conduct moderation analysis that can help drive the field forward by answering research questions that are difficult to address in a single study. Positive psychology and psychology more generally would benefit from definitions of terms that are conceptually-based and thus meta-analyses that are theoretically sound.
The current article discusses the potential utility of self-help books as a means of disseminatin... more The current article discusses the potential utility of self-help books as a means of disseminating positive psychological interventions, and presents data comparing a positive psychology-based self-help book with a cognitive-behavioral self-help book and a self-monitoring control condition. We studied college freshmen (N=58), and argue that this population is a particularly appropriate target for well-being intervention. Outcome measures included both indices of efficacy (depressive symptoms and life satisfaction) and effectiveness (e.g. the extent to which participants found their assigned activities to be meaningful). The two book groups outperformed the control and were equivalently efficacious at reducing depressive symptoms; on life satisfaction, positive self-help outperformed cognitive-behavioral, but only at 6-month follow-up. Positive self-help was also superior to cognitive-behavioral self-help on indices of effectiveness. Possibilities for future directions are discussed, with an emphasis on the realities of practical dissemination to both college students, and to the general public.
... Acacia Parks is now at the University of Pennsylvania, and Keith Herman is at the University ... more ... Acacia Parks is now at the University of Pennsylvania, and Keith Herman is at the University of Oregon. Correspondence concerning this article should be addressed to Email: [email protected]. ...
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