Psychotherapy and Psychosomatics

Vittengl J.R.a· Jarrett R.B.b· Ro E.c· Clark L.A.d

Author affiliations

aDepartment of Psychology, Truman State University, Kirksville, MO, USA
bDepartment of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
cDepartment of Psychology, Southern Illinois University Edwardsville, Edwardsville, IL, USA
dDepartment of Psychology, Notre Dame University, Notre Dame, IN, USA

Log in to MyKarger to check if you already have access to this content.

Buy FullText & PDF Unlimited re-access via MyKarger Unrestricted printing, no saving restrictions for personal use read more

CHF 38.00 *
EUR 35.00 *
USD 39.00 *

Select

KAB

Buy a Karger Article Bundle (KAB) and profit from a discount!

If you would like to redeem your KAB credit, please log in.

Save over 20% compared to the individual article price.

Learn more

Rent via DeepDyve Unlimited fulltext viewing of this article Organize, annotate and mark up articles Printing and downloading restrictions apply

Start free trial

Subscribe Access to all articles of the subscribed year(s) guaranteed for 5 years Unlimited re-access via Subscriber Login or MyKarger Unrestricted printing, no saving restrictions for personal use read more

Subcription rates

Select

* The final prices may differ from the prices shown due to specifics of VAT rules.

Article / Publication Details

Received: November 04, 2022
Accepted: February 15, 2023
Published online: March 14, 2023

Number of Print Pages: 6
Number of Figures: 1
Number of Tables: 2

ISSN: 0033-3190 (Print)
eISSN: 1423-0348 (Online)

For additional information: https://www.karger.com/PPS

Abstract

Introduction: In research and treatment of mood disorders, “euthymia” traditionally denotes the absence of clinically significant mood disturbance. A newer, expanded definition of euthymia also includes positive affect and psychological well-being. Objective: We aimed to test this comprehensive model of euthymia and estimate the coherence and predictive power of each factor in the model. Methods: Community-dwelling adults (N = 601), including both mental health outpatients and non-patients at high risk for personality pathology, completed a battery of interviews and questionnaires at time 1. Most (n = 497) were reassessed on average 8 months later (time 2). We modeled euthymia using standard mood, personality, and psychosocial functioning assessments rather than measures designed specifically for euthymia. Results: The hypothesized model of euthymia was supported by confirmatory factor analysis: specific measures loaded on three lower order factors (mood disturbance, positive affect, and psychological well-being) that reflected general euthymia at time 1. Each factor (general euthymia plus lower order factors) demonstrated moderately strong concurrent (time 1) and predictive (time 1–2) correlations with outcomes, including employment status, income, mental health treatment consumption, and disability. Compared to positive affect and psychological well-being, mood disturbance had stronger incremental (i.e., nonoverlapping) relations with these outcomes. Conclusions: Support for a comprehensive model of euthymia reinforces efforts to improve assessment and treatment of mood and other disorders. Beyond dampening of psychological distress, euthymia-informed treatment goals encompass full recovery, including enjoyment and meaning in life.

© 2023 S. Karger AG, Basel

References Fava GA, Bech P. The concept of euthymia. Psychother Psychosom. 2016;85(1):1–5. Fava GA, Guidi J. The pursuit of euthymia. World Psychiatry. 2020 Feb;19(1):40–50. Guidi J, Fava GA. The clinical science of euthymia: a conceptual map. Psychother Psychosom. 2022;91(3):156–67. Demyttenaere K, Donneau AF, Albert A, Ansseau M, Constant E, van Heeringen K. What is important in being cured from depression? Discordance between physicians and patients (1). J Affect Disord. 2015 Mar 15;174:390–6. Frank E, Prien RF, Jarrett RB, Keller MB, Kupfer DJ, Lavori PW, et al. Conceptualization and rationale for consensus definitions of terms in major depressive disorder. Remission, recovery, relapse, and recurrence. Arch Gen Psychiatry. 1991 Sep;48(9):851–5. American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 5th ed. Washington, DC: American Psychiatric Association; 2013. Watson D, Wiese D, Vaidya J, Tellegen A. The two general activation systems of affect: structural findings, evolutionary considerations, and psychobiological evidence. J Personal Soc Psychol. 1999 May;76(5):820–38. Ryff CD. Psychological well-being revisited: advances in the science and practice of eudaimonia. Psychother Psychosom. 2014;83(1):10–28. Ryff CD, Keyes CL. The structure of psychological well-being revisited. J Pers Soc Psychol. 1995 Oct;69(4):719–27. Sharp C, Wall K. DSM-5 level of personality functioning: refocusing personality disorder on what it means to be human. Annu Rev Clin Psychol. 2021 May 7;17:313–37. Clark LA, Ro E. Three-pronged assessment and diagnosis of personality disorder and its consequences: personality functioning, pathological traits, and psychosocial disability. Personal Disord. 2014 Jan;5(1):55–69. Clark LA, Nuzum H, Shapiro JL, Vanderbleek EN, Daly EJ, Simons AD, et al. Personality profiles as potential targets for intervention: identification and replication. Personal Ment Health. 2020 Feb;14(1):142–63. Langbehn DR, Pfohl BM, Reynolds S, Clark LA, Battaglia M, Bellodi L, et al. The Iowa Personality Disorder Screen: development and preliminary validation of a brief screening interview. J Pers Disord. 1999;13(1):75–89. Sheehan DV, Lecrubier Y, Harnett Sheehan K, Janavs J, Weiller E, Keskiner A, et al. The validity of the mini international neuropsychiatric interview (MINI) according to the SCID-P and its reliability. Eur Psychiatry. 1997;12(5):232–41. Watson D, O’Hara MW, Naragon-Gainey K, Koffel E, Chmielewski M, Kotov R, et al. Development and validation of new anxiety and bipolar symptom scales for an expanded version of the IDAS (the IDAS-II). Assessment. 2012 Dec;19(4):399–420. Diener E, Emmons RA, Larsen RJ, Griffin S. The satisfaction with life scale. J Pers Assess. 1985 Feb;49(1):71–5. Development of the world health organization WHOQOL-BREF quality of life assessment. The WHOQOL Group. Psychol Med. 1998 May;28(3):551–8. Parker G, Hadzi-Pavlovic D, Both L, Kumar S, Wilhelm K, Olley A. Measuring disordered personality functioning: to love and to work reprised. Acta Psychiatr Scand. 2004 Sep;110(3):230–9. Ro E, Clark LA. Psychosocial functioning in the context of diagnosis: assessment and theoretical issues. Psychol Assess. 2009 Sep;21(3):313–24. Ryff CD, Singer B. Psychological well-being: meaning, measurement, and implications for psychotherapy research. Psychother Psychosom. 1996;65(1):14–23. World Health Organization. Measuring health and disability: manual for WHO disability assessment Schedule (WHO-DAS 2.0). Geneva, Switzerland: World Health Organization; 2010. Rosseel Y. Lavaan: an R package for structural equation modeling. J Stat Softw. 2012 May;48(2):1–36. R Core Team. R. A language and environment for statistical computing. Vienna, Austria: R Foundation for Statistical Computing; 2021. Available from: https://www.R-project.org/. Vittengl JR, Jha MK, Minhajuddin A, Thase ME, Jarrett RB. Quality of life after response to acute-phase cognitive therapy for recurrent depression. J Affect Disord. 2021 Jan 1;278:218–25. World Health Organization. The WHO special initiative for mental health (2019-2023): universal health coverage for mental health. Geneva, Switzerland: World Health Organization; 2019. Dunn BD, German RE, Khazanov G, Xu C, Hollon SD, DeRubeis RJ. Changes in positive and negative affect during pharmacological treatment and cognitive therapy for major depressive disorder: a secondary analysis of two randomized controlled trials. Clin Psychol Sci. 2020 Jan;8(1):36–51. Vittengl JR, Clark LA, Thase ME, Jarrett RB. Levels of depressed mood and low interest for two years after response to cognitive therapy for recurrent depression. Behav Res Ther. 2022 Jan;148:103996. Craske MG, Meuret AE, Ritz T, Treanor M, Dour H, Rosenfield D. Positive affect treatment for depression and anxiety: a randomized clinical trial for a core feature of anhedonia. J Consult Clin Psychol. 2019 May;87(5):457–71. Dunn BD, Widnall E, Reed N, Owens C, Campbell J, Kuyken W. Bringing light into darkness: a multiple baseline mixed methods case series evaluation of Augmented Depression Therapy (ADepT). Behav Res Ther. 2019 Sep;120:103418. Geschwind N, Arntz A, Bannink F, Peeters F. Positive cognitive behavior therapy in the treatment of depression: a randomized order within-subject comparison with traditional cognitive behavior therapy. Behav Res Ther. 2019 May;116:119–30. Fava GA, Tomba E, Grandi S. The road to recovery from depression-don’t drive today with yesterday’s map. Psychother Psychosom. 2007;76(5):260–5. Fava GA. Well-being therapy: conceptual and technical issues. Psychother Psychosom. 1999;68(4):171–9. Fava GA. Well-being therapy: Treatment manual and clinical applications. Basel: Karger; 2016. Guidi J, Fava GA. The emerging role of euthymia in psychotherapy research and practice. Clin Psychol Rev. 2020;82:101941. Carrozzino D, Christensen KS, Mansueto G, Brailovskaia J, Margraf J, Cosci F. A clinimetric analysis of the euthymia, resilience, and positive mental health scales. J Affect Disord. 2021;294:71–6. Lukat J, Margraf J, Lutz R, van der Veld WM, Becker ES. Psychometric properties of the positive mental health scale (PMH-scale). BMC Psychol. 2016 Feb 10;4:8. Bartova L, Dold M, Fugger G, Kautzky A, Mitschek MMM, Weidenauer A, et al. The role of relationship status in major depressive disorder: results of the European group for the study of resistant depression. J Affect Disord. 2021;286:149–57. Article / Publication Details

Received: November 04, 2022
Accepted: February 15, 2023
Published online: March 14, 2023

Number of Print Pages: 6
Number of Figures: 1
Number of Tables: 2

ISSN: 0033-3190 (Print)
eISSN: 1423-0348 (Online)

For additional information: https://www.karger.com/PPS

Copyright / Drug Dosage / Disclaimer Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.