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Effects of Mindfulness on Psychological Health: A Review of Empirical Studies
Shian-ling keng.
a Department of Psychology and Neuroscience, Duke University, Durham, NC 27708
Moria J. Smoski
b Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC 27710
Clive J. Robins
Within the past few decades, there has been a surge of interest in the investigation of mindfulness as a psychological construct and as a form of clinical intervention. This article reviews the empirical literature on the effects of mindfulness on psychological health. We begin with a discussion of the construct of mindfulness, differences between Buddhist and Western psychological conceptualizations of mindfulness, and how mindfulness has been integrated into Western medicine and psychology, before reviewing three areas of empirical research: cross-sectional, correlational research on the associations between mindfulness and various indicators of psychological health; intervention research on the effects of mindfulness-oriented interventions on psychological health; and laboratory-based, experimental research on the immediate effects of mindfulness inductions on emotional and behavioral functioning. We conclude that mindfulness brings about various positive psychological effects, including increased subjective well-being, reduced psychological symptoms and emotional reactivity, and improved behavioral regulation. The review ends with a discussion on mechanisms of change of mindfulness interventions and suggested directions for future research.
Mindfulness is the miracle by which we master and restore ourselves. Consider, for example: a magician who cuts his body into many parts and places each part in a different region—hands in the south, arms in the east, legs in the north, and then by some miraculous power lets forth a cry which reassembles whole every part of his body. Mindfulness is like that—it is the miracle which can call back in a flash our dispersed mind and restore it to wholeness so that we can live each minute of life. Hanh (1976 , p. 14)
Mindfulness has been theoretically and empirically associated with psychological well-being. The elements of mindfulness, namely awareness and nonjudgmental acceptance of one's moment-to-moment experience, are regarded as potentially effective antidotes against common forms of psychological distress—rumination, anxiety, worry, fear, anger, and so on—many of which involve the maladaptive tendencies to avoid, suppress, or over-engage with one's distressing thoughts and emotions ( Hayes & Feldman, 2004 ; Kabat-Zinn, 1990 ). Though promoted for centuries as a part of Buddhist and other spiritual traditions, the application of mindfulness to psychological health in Western medical and mental health contexts is a more recent phenomenon, largely beginning in the 1970s (e.g., Kabat-Zinn, 1982 ). Along with this development, there has been much theoretical and empirical work illustrating the impact of mindfulness on psychological health. The goal of this paper is to offer a comprehensive narrative review of the effects of mindfulness on psychological health. We begin with an overview of the construct of mindfulness, differences between Buddhist and Western psychological conceptualizations of mindfulness, and how mindfulness has been integrated into Western medicine and psychology. We then review evidence from three areas of research that shed light on the relationship between mindfulness and psychological health: 1. correlational, cross-sectional research that examines the relations between individual differences in trait or dispositional mindfulness and other mental-health related traits, 2. intervention research that examines the effects of mindfulness-oriented interventions on psychological functioning, and 3. laboratory-based research that examines, experimentally, the effects of brief mindfulness inductions on emotional and behavioral processes indicative of psychological health. We conclude with an examination of mechanisms of effects of mindfulness interventions and suggestions for future research directions.
The word mindfulness may be used to describe a psychological trait, a practice of cultivating mindfulness (e.g., mindfulness meditation), a mode or state of awareness, or a psychological process ( Germer, Siegel, & Fulton, 2005 ). To minimize possible confusion, we clarify which meaning is intended in each context we describe ( Chambers, Gullone, & Allen, 2009 ). One of the most commonly cited definitions of mindfulness is the awareness that arises through “paying attention in a particular way: on purpose, in the present moment, and nonjudgmentally” ( Kabat-Zinn, 1994 , p. 4). Descriptions of mindfulness provided by most other researchers are similar. Baer (2003) , for example, defines mindfulness as “the nonjudgmental observation of the ongoing stream of internal and external stimuli as they arise” (p. 125). Though some researchers focus almost exclusively on the attentional aspects of mindfulness (e.g., Brown & Ryan, 2003 ), most follow the model of Bishop et al. (2004) , which proposed that mindfulness encompasses two components: self-regulation of attention, and adoption of a particular orientation towards one's experiences. Self-regulation of attention refers to non-elaborative observation and awareness of sensations, thoughts, or feelings from moment to moment. It requires both the ability to anchor one's attention on what is occurring, and the ability to intentionally switch attention from one aspect of the experience to another. Orientation to experience concerns the kind of attitude that one holds towards one's experience, specifically an attitude of curiosity, openness, and acceptance. It is worth noting that “acceptance” in the context of mindfulness should not be equated with passivity or resignation ( Cardaciotto, Herbert, Forman, Moitra, & Farrow, 2008 ). Rather, acceptance in this context refers to the ability to experience events fully, without resorting to either extreme of excessive preoccupation with, or suppression of, the experience. To sum up, current conceptualizations of mindfulness in clinical psychology point to two primary, essential elements of mindfulness: awareness of one's moment-to-moment experience nonjudgmentally and with acceptance .
As alluded to earlier, mindfulness finds its roots in ancient spiritual traditions, and is most systematically articulated and emphasized in Buddhism, a spiritual tradition that is at least 2550 years old. As the idea and practice of mindfulness has been introduced into Western psychology and medicine, it is not surprising that differences emerge with regard to how mindfulness is conceptualized within Buddhist and Western perspectives. Several researchers (e.g., Chambers, Gullone, & Allen, 2009 ; Rosch, 2007 ) have argued that in order to more fully appreciate the potential contribution of mindfulness in psychological health it is important to gain an understanding of these differences, and specifically, from a Western perspective, how mindfulness is conceptualized in Buddhism. Given the diversity of traditions and teachings within Buddhism, an in-depth exploration of this topic is beyond the scope of this review (for a more extensive discussion of this topic, see Rosch, 2007 ). We offer a preliminary overview of differences in conceptualization of mindfulness in Western usage versus early Buddhist teachings, specifically, those of Theravada Buddhism.
Arguably, Buddhist and Western conceptualizations of mindfulness differ in at least three levels: contextual, process, and content. At the contextual level, mindfulness in the Buddhist tradition is viewed as one factor of an interconnected system of practices that are necessary for attaining liberation from suffering, the ultimate state or end goal prescribed to spiritual practitioners in the tradition. Thus, it needs to be cultivated alongside with other spiritual practices, such as following an ethical lifestyle, in order for one to move toward the goal of liberation. Western conceptualization of mindfulness, on the other hand, is generally independent of any specific circumscribed philosophy, ethical code, or system of practices. At the process level, mindfulness, in the context of Buddhism, is to be practiced against the psychological backdrop of reflecting on and contemplating key aspects of the Buddha's teachings, such as impermanence, non-self, and suffering. As an example, in the Satipatthana Sutta (The Foundation of Mindfulness Discourse), one of the key Buddhist discourses on mindfulness, the Buddha recommended that one maintains mindfulness of one's bodily functions, sensations and feelings, consciousness, and content of consciousness while observing clearly the impermanent nature of these objects. Western practice generally places less emphasis on non-self and impermanence than traditional Buddhist teachings. Finally, at the content level and in relation to the above point, in early Buddhist teachings, mindfulness refers rather specifically to an introspective awareness with regard to one's physical and psychological processes and experiences. This is contrast to certain Western conceptualizations of mindfulness, which view mindfulness as a form of awareness that encompasses all forms of objects in one's internal and external experience, including features of external sensory objects like sights and smells. This is not to say that external sensory objects do not ultimately form part of one's internal experience; rather, in Buddhist teachings, mindfulness more fundamentally has to do with observing one's perception of and reactions toward sensory objects than focusing on features of the sensory objects themselves.
The integration of mindfulness into Western medicine and psychology can be traced back to the growth of Zen Buddhism in America in the 1950s and 1960s, partly through early writings such as Zen in the Art of Archery ( Herrigel, 1953 ) , The World of Zen: An East-West Anthology ( Ross, 1960 ), and The Method of Zen ( Herrigel, Hull, & Tausend, 1960 ). Beginning the 1960s, interest in the use of meditative techniques in psychotherapy began to grow among clinicians, especially psychoanalysts (e.g., see Boss, 1965 ; Fingarette, 1963 ; Suzuki, Fromm, & De Martino, 1960 ; Watts, 1961 ). Through the 1960s and the 1970s, there was growing interest within experimental psychology in examining various means of heightening awareness and broadening the boundaries of consciousness, including meditation. Early electroencephalogram (EEG) studies on meditation found that individuals who meditated showed persistent alpha activity with restful reductions in metabolic rate ( Anand, Chhina, & Singh, 1961 ; Bagchi & Wenger, 1957 ; Wallace, 1970 ), as well as increases in theta waves, which reflect lower states of arousal associated with sleep ( Kasamatsu & Hirai, 1966 ). Beginning in the early 1970s, there was a surge of interest in and research on transcendental meditation, a form of concentrative meditation technique popularized by Maharishi Mahesh Yogi ( Wallace, 1970 ). The practice of transcendental meditation was found to be associated with reductions in indicators of physiological arousal such as oxygen consumption, carbon dioxide elimination, and respiratory rate ( Benson, Rosner, Marzetta, & Klemchuk, 1974 ; Wallace, 1970 ; Wallace, Benson, & Wilson, 1971 ).
Despite the fact that research on mindfulness meditation had already begun in the 1960s, it was not until the late 1970s that mindfulness meditation began to be studied as an intervention to enhance psychological well-being. Application of mindfulness meditation as a form of behavioral intervention for clinical problems began with the work of Jon Kabat-Zinn, which explored the use of mindfulness meditation in treating patients with chronic pain ( Kabat-Zinn, 1982 ), now known popularly as Mindfulness-Based Stress Reduction. Since the establishment of MBSR, several other interventions have also been developed using mindfulness-related principles and practices, including Mindfulness-Based Cognitive Therapy (MBCT; Segal, Williams, & Teasdale, 2002 ), Dialectical Behavior Therapy (DBT; Linehan, 1993a ) and Acceptance and Commitment Therapy (ACT; Hayes, Strosahl, & Wilson, 1999 ). In this review, both meditation-oriented interventions (i.e., MBSR and MBCT), as well as interventions that teach mindfulness using less meditation-oriented techniques (i.e., DBT and ACT), are considered as a family of “mindfulness-oriented interventions”, and thus are of empirical interest.
Correlational Research on Mindfulness and Psychological Health
Relationship between trait mindfulness and psychological health.
Many studies of mindfulness to date have reported on correlations between self-reported mindfulness and psychological health. Such correlations have been reported for samples of undergraduate students (e.g., Baer, Smith, Hopkins, Krietemeyer, & Toney, 2006 ; Brown & Ryan, 2003 ), community adults (e.g., Brown & Ryan, 2003 ; Chadwick et al., 2008 ) and clinical populations (e.g., Baer, Smith, & Allen, 2004 ; Chadwick et al., 2008 ; Walach, Buchheld, Buttenmuller, Kleinknecht, & Schmidt, 2006 ). Before going over these findings, it may be helpful to review questionnaires that have been developed to measure mindfulness. Questionnaires that assess mindfulness as a general, trait-like tendency to be mindful in daily life include: Freiburg Mindfulness Inventory ( Buchheld, Grossman, & Walach, 2001 ), Kentucky Inventory of Mindfulness Skills (KIMS; Baer et al., 2004 ), Mindful Attention Awareness Scale (MAAS; Brown & Ryan, 2003 ), Five-Facet Mindfulness Questionnaire ( Baer et al., 2006 ), Cognitive Affective Mindfulness Scale-Revised ( Feldman, Hayes, Kumar, Greeson, & Laurenceau, 2007 ), Toronto Mindfulness Scale-Trait Version ( Davis, Lau, & Cairns, 2009 ), Philadelphia Mindfulness Scale ( Cardaciotto et al., 2008 ), and Southampton Mindfulness Questionnaire ( Chadwick et al., 2008 ). Some of these questionnaires measure mindfulness as a single-factor construct. For example, the MAAS ( Brown & Ryan, 2003 ) assesses mindfulness as the general tendency to be attentive to and aware of experiences in daily life, and has a single factor structure of open/ receptive awareness and attention. Other questionnaires measure mindfulness as a multi-faceted construct. For example, the KIMS ( Baer et al., 2004 ) contains subscales that correspond to four mindfulness skills conceptualized in DBT's framework: observing one's moment-to-moment experience, describing one's experiences with words, acting or participating with awareness, and nonjudgmental acceptance of one's experiences. In addition to trait measures of mindfulness, state measures of mindfulness have been developed to measure momentary mindful states. These measures include the Toronto Mindfulness Scale ( Lau et al., 2006 ) and Brown and Ryan (2003) 's state version of the MAAS.
Trait mindfulness has been associated with higher levels of life satisfaction ( Brown & Ryan, 2003 ), agreeableness ( Thompson & Waltz, 2007 ), conscientiousness ( Giluk, 2009 ; Thompson & Waltz, 2007 ), vitality ( Brown & Ryan, 2003 ), self esteem ( Brown & Ryan, 2003 ; Rasmussen & Pidgeon, 2010 ), empathy ( Dekeyser, Raes, Leijssen, Leysen, & Dewulf, 2008 ), sense of autonomy ( Brown & Ryan, 2003 ), competence ( Brown & Ryan, 2003 ), optimism ( Brown & Ryan, 2003 ), and pleasant affect ( Brown & Ryan, 2003 ). Studies have also demonstrated significant negative correlations between mindfulness and depression ( Brown & Ryan, 2003 ; Cash & Whittingham, 2010 ), neuroticism ( Dekeyser et al., 2008 ; Giluk, 2009 ), absent-mindedness ( Herndon, 2008 ), dissociation ( Baer et al., 2006 ; Walach et al., 2006 ), rumination ( Raes & Williams, 2010 ), cognitive reactivity ( Raes, Dewulf, Van Heeringen, & Williams, 2009 ), social anxiety ( Brown & Ryan, 2003 ; Dekeyser et al., 2008 ; Rasmussen & Pidgeon, 2010 ), difficulties in emotion regulation ( Baer et al., 2006 ), experiential avoidance ( Baer et al., 2004 ), alexithymia ( Baer et al., 2004 ), intensity of delusional experience in the context of psychosis ( Chadwick et al., 2008 ), and general psychological symptoms ( Baer et al., 2006 ). Research also has begun to explore the association between mindfulness and cognitive processes that may have important implications for psychological health. For example, Frewen, Evans, Maraj, Dozois, and Partridge (2008) found that, among undergraduate students, mindfulness was related both to a lower frequency of negative automatic thoughts and to an enhanced ability to let go of those thoughts. Two other studies have also demonstrated an association between mindfulness and enhanced performance on tasks assessing sustained attention ( Schmertz, Anderson, & Robins, 2009 ) and persistence ( Evans, Baer, & Segerstrom, 2009 ).
Mindfulness has been shown to be related not only to self-report measures of psychological health, but also to differences in brain activity observed using functional neuroimaging methods. Creswell, Way, Eisenberger, and Lieberman (2007) found that trait mindfulness was associated with reduced bilateral amygdala activation and greater widespread prefrontal cortical activation during an affect labeling task. There was also a strong inverse association between prefrontal cortex and right amygdala responses among those who scored high on mindfulness, but not among those who scored low on mindfulness, which suggests that individuals who are mindful may be better able to regulate emotional responses via prefrontal cortical inhibition of the amygdala. Trait mindfulness also was negatively correlated with resting activity in the amygdala and in medial prefrontal and parietal brain areas that are associated with self-referential processing, whereas levels of depressive symptoms were positively correlated with resting activity in these areas ( Way, Creswell, Eisenberger, & Lieberman, 2010 ). These findings are consistent with the association of mindfulness with greater self-reported ability to let go of negative thoughts about the self (e.g., Frewen et al., 2008 ).
Relationship between Mindfulness Meditation and Psychological Health
Research also has examined the relationship between mindfulness meditation practices and psychological well-being. Lykins and Baer (2009) compared meditators and non-meditators on several indices of psychological well-being. Meditators reported significantly higher levels of mindfulness, self-compassion and overall sense of well-being, and significantly lower levels of psychological symptoms, rumination, thought suppression, fear of emotion, and difficulties with emotion regulation, compared to non-meditators, and changes in these variables were linearly associated with extent of meditation practice. In addition, the data were consistent with a model in which trait mindfulness mediates the relationship between extent of meditation practice and several outcome variables, including fear of emotion, rumination, and behavioral self-regulation. In two other studies, facets of trait mindfulness were found to mediate the relationship between meditation experience and psychological well-being in combined samples of meditators and non-meditators ( Baer et al., 2008 ; Josefsson, Larsman, Broberg, & Lundh, 2011 ). In addition to correlations with self-report measures, research has examined behavioral and neurobiological correlates of mindfulness meditation. Ortner, Kilner and Zelazo (2007) used an emotional interference task in which participants categorized tones presented 1 or 4 seconds following the onset of affective or neutral pictures. Levels of emotional interference were indexed by differences in reaction times to tones for affective pictures versus neutral pictures. A participant's mindfulness meditation experience was significantly associated with reduced interference both from unpleasant pictures (for 1 and 4 second delays) as well as pleasant pictures (for 4 second delay only), as well as higher levels of self-reported mindfulness and psychological well-being. These findings suggest that mindfulness meditation practice may enhance psychological well-being by increasing mindfulness and attenuating reactivity to emotional stimuli by facilitating disengagement of attention from stimuli. There is also emerging evidence from studies comparing meditators and non-meditators on a variety of performance-based measures that suggest that regular meditation practice is associated with enhanced cognitive flexibility and attentional functioning ( Hodgins & Adair, 2010 ; Moore & Malinowski, 2009 ), outcomes that may have important implications for psychological well-being. Research has also identified potential neurobiological correlates of mindfulness meditation by comparing brain structure and activity in adept mindfulness meditation practitioners to those of non-practitioners. These studies found that extensive mindfulness meditation experience is associated with increased thickness in brain regions implicated in attention, interoception, and sensory processing, including the prefrontal cortex and right anterior insula ( Lazar et al., 2005 ); increased activation in brain areas involved in processing of distracting events and emotions, which include the rostral anterior cingulate cortex and dorsomedial prefrontal cortex, respectively ( Hölzel et al., 2007 ); and greater gray matter concentration in brain areas that have been found to be active during meditation, including the right anterior insula, left inferior temporal gyrus, and right hippocampus ( Hölzel et al., 2008 ). These findings are consistent with the premise that systematic training in mindfulness meditation induces changes in attention, awareness, and emotion, which can be assessed and identified at subjective, behavioral, and neurobiological levels (cf. Treadway & Lazar, 2009 ).
Overall, evidence from correlational research suggests that mindfulness is positively associated with a variety of indicators of psychological health, such as higher levels of positive affect, life satisfaction, vitality, and adaptive emotion regulation, and lower levels of negative affect and psychopathological symptoms. There is also burgeoning evidence from neurobiological and laboratory behavioral research that indicates the potential roles of trait mindfulness and mindfulness meditation practices in reducing reactivity to emotional stimuli and enhancing psychological well-being. Given the correlational nature of these data, experimental studies are needed to clarify the directional links between mindfulness and psychological well-being. Does training in mindfulness practices result in improvements in psychological well-being? Does psychological well-being facilitate greater mindfulness and/or inclination towards engagement in mindfulness practice? The next section reviews empirical evidence from studies of the effects of mindfulness-oriented interventions on psychological health.
Controlled Studies of Mindfulness-Oriented Interventions
Several mindfulness-oriented interventions have been developed and received much research attention within the past two decades, including MBSR, MBCT, DBT and ACT. Some research on these interventions has been uncontrolled and some has focused primarily on physical health outcomes. In this section, we limit our review to published, peer-reviewed randomized controlled trials (RCTs) that assessed psychological health outcomes in adult populations. Some other promising interventions have also incorporated mindfulness techniques, including mindfulness-based relapse prevention ( Witkiewitz, Marlatt, & Walker, 2005 ) and exposure-based cognitive therapy for depression ( Hayes, Beevers, Feldman, Laurenceau, & Perlman, 2005 ), but no RCTs of those interventions have yet been published.
Mindfulness-Based Stress Reduction (MBSR): Description of Intervention and Review of Controlled Studies
MBSR is a group-based intervention program originally designed as an adjunct treatment for patients with chronic pain ( Kabat-Zinn, 1982 ; 1990 ). The program offers intensive training in mindfulness meditation to help individuals relate to their physical and psychological conditions in more accepting and nonjudgmental ways. The program consists of an eight-to-ten week course, in which a group of up to thirty participants meet for two to two and a half hours per week for mindfulness meditation instruction and training ( Kabat-Zinn, 1990 ). In addition to in-class mindfulness exercises, participants are encouraged to engage in home mindfulness practices and attend an all-day intensive mindfulness meditation retreat. The premise of MBSR is that with repeated training in mindfulness meditation, individuals will eventually learn to be less reactive and judgmental toward their experiences, and more able to recognize, and break free from, habitual and maladaptive patterns of thinking and behavior.
A number of RCTs of MBSR have been conducted among clinical and non-clinical populations, mostly using a waiting-list control design. Early studies were reviewed by Baer (2003) and Grossman, Niemann, Schmidt, and Walach (2004) , but several important studies have since been published. Table 1 summarizes RCTs that have examined the impact of MBSR on psychological functioning. Overall, these studies found that MBSR reduces self-reported levels of anxiety ( Shapiro, Schwartz, & Bonner, 1998 ; Anderson, Lau, Segal, & Bishop, 2007 ), depression ( Anderson et al., 2007 ; Grossman et al., 2010 ; Koszycki, Benger, Shlik, & Bradwejn, 2007 ; Sephton et al., 2007 ; Shapiro et al., 1998 ; Speca, Carlson, Goodey, & Angen, 2000 ), anger ( Anderson et al., 2007 ), rumination ( Anderson et al. 2007 ; Jain et al., 2007 ), general psychological distress, including perceived stress ( Astin, 1997 ; Bränström, Kvillemo, Brandberg, & Moskowitz, 2010 ; Nyklíček, & Kuipers, 2008; Oman, Shapiro, Thoresen, Plante, & Flinders, 2008 ; Shapiro, Astin, Bishop, & Cordova, 2005 ; Speca et al., 2000 ; Williams, Kolar, Reger, & Pearson, 2001 ), cognitive disorganization ( Speca et al., 2000 ), post-traumatic avoidance symptoms ( Bränström et al., 2010 ), and medical symptoms ( Williams et al., 2001 ). It has been found to improve positive affect ( Anderson et al., 2007 ; Bränström et al., 2010 ), Nyklíček, & Kuijpers, 2008), sense of spirituality ( Astin, 1997 ; Shapiro et al., 1998 ), empathy ( Shapiro et al., 1998 ), sense of cohesion ( Weissbecker et al., 2002 ), mindfulness ( Anderson et al., 2007 ; Shapiro, Oman, Thoresen, Plante, & Flinders, 2008 ; Nyklíček, & Kuijpers, 2008), forgiveness ( Oman et al., 2008 ), self compassion ( Shapiro et al., 2005 ), satisfaction with life, and quality of life ( Grossman et al., 2010 ; Koszycki et al., 2007 ; Nyklíček, & Kuijpers,2008; Shapiro et al., 2005 ) among both clinical and non-clinical populations.
Study | N | Type Participant | Mean Age | % Male | No. of Treatment Sessions | Control Group(s) | Main Outcome |
---|---|---|---|---|---|---|---|
28 | College undergrads | NR | 5 | 8 2-hr sessions | NI (14) | MBSR > NI: reductions in psychological symptoms, increases in domain-specific sense of control & spiritual experiences | |
78 | Medical & premedical students | NR | 44 | 7 2.5-hr sessions | WL (41) | MBSR > WL: reductions in state and trait anxiety, overall distress, & depression, increases in empathy & spiritual experiences | |
90 | Cancer patients | 51 | 19 | 7 1.5-hr sessions | WL (37) | MBSR > WL: reductions in mood disturbance & symptoms of stress | |
103 | Community adults | 43 | 28 | 8 2.5-hr sessions, 1 8-hr session | Received educational materials and referral to community resources (44) | MBSR > Control Group: reductions in daily hassles, distress, & medical symptoms | |
91 | Fibromyalgia patients | 48 | 0 | 8 2.5-hr sessions | WL (40) | MBSR > WL: increase in disposition to experience life as manageable and meaningful | |
41 | Corporate employees | 36 | 29 | 8 2.5-hr sessions, 1 7-hr session | WL (16) | MBSR > WL: increased left-sided anterior activation & antibody titer responses to influenza vaccine, reduction in anxiety | |
38 | Health care professionals | NR | NR | 8 2-hr sessions | WL (20) | MBSR > WL: reductions in perceived stress & burnout, increases in self compassion & satisfaction with life | |
53 | Generalized social anxiety disorder patients | NR | NR | 8 2.5-hr sessions, 1 7.5-hr session | CBGT (27) | MBSR = CBGT: improvements in mood, functionality, & quality of life; MBSR < CGBT: reductions in social anxiety & response and remission rates | |
91 | Fibromyalgia patients | 48 | 0 | 8 2.5-hr sessions, 1 day-long session | WL (40) | MBSR > WL: reductions in depressive symptoms | |
36 | Community adults | 44 | 25 | 8 2-hr sessions | WL (16) | MBSR > WL: reduced activation of mPFC; increased activation of lPFC & several viscerosomatic areas when engaging in mindfulness exercises | |
81 | Students | 25 | 19 | 4 1.5 hr-sessions | SR (24), NI (30) | MBSR (a shortened program) = SR > NI: reductions in distress & increase in positive mood states; MBSR > NI: reductions in rumination & distraction | |
72 | Community adults | NR | NR | 8 2-hr sessions | WL (33) | MBSR = WL: performance on attentional tasks; Tx > WL: increases in mindfulness & positive affect; reductions in depression, anxiety symptoms, & general and anger-related rumination | |
44 | College undergrads | 18 | 20 | 8 1.5-hr sessions | EPP (14), WL (15) | MBSR = EPP > WL: reductions in perceived stress & rumination, increase in forgiveness | |
Nyklíček, & Kuijpers, 2008 | 60 | Community adults with symptoms of stress | 44 | 33 | 8 2.5-hr sessions, 1 6-hr session | WL (30) | MBSR > WL: reductions in perceived stress & vital exhaustion, increases in positive affect & mindfulness |
44 | College undergrads | 18 | 20 | 8 1.5-hr sessions | EPP (14), WL (15) | MBSR = EPP > WL: increase in mindfulness | |
71 | Cancer patients | 52 | 1 | 8 2-hr sessions | WL (39) | MBSR > WL: reductions in perceived stress & posttraumatic avoidance symptoms, increase in positive states of mind | |
36 | Community adults | 44 | 25 | 8 2-hr sessions | WL (16) | MBSR > WL: reduced activation in medial and lateral brain regions, reduced deactivation in insula and other visceral and somasensory areas | |
150 | Patients with multiple sclerosis | 47 | 21 | 8 2.5-hr sessions, 1 7-hr session | UC (74) | MBSR > UC: increases in health-related quality of life, reductions in fatigue & depression |
NR = Not Reported; NI = No Intervention; WL = Wait-list; SR = Somatic Relaxation; CBGT = Cognitive-Behavioral Group Therapy; mPFC = medial prefrontal cortex; lPFC = lateral prefrontal cortex; UC = Usual Care.
Participation in MBSR has also been associated with brain changes reflective of positive emotional states and adaptive self representation and emotion regulatory processes, such as increases in left frontal activation, which is indicative of dispositional and state positive affect ( Davidson et al., 2003 ), increased activation in brain regions implicated in experiential, present-focused mode of self reference ( Farb et al., 2007 ), and reduced activation in brain regions implicated in conceptual processing, cognitive elaboration, and reappraisal ( Farb et al., 2010 ; Ochsner & Gross, 2008 ).
Mindfulness-Based Cognitive Therapy (MBCT): Description of Intervention and Review of Controlled Studies
MBCT is an eight-week, manualized group intervention program adapted from the MBSR model ( Segal et al., 2002 ). Developed as an approach to prevent relapse in remitted depression, MBCT combines mindfulness training and elements of cognitive therapy (CT) with the goal of targeting vulnerability processes that have been implicated in the maintenance of depressive episodes. Like CT, MBCT aims to help participants view thoughts as mental events rather than as facts, recognize the role of negative automatic thoughts in maintaining depressive symptoms, and disengage the occurrence of negative thoughts from their negative psychological effects ( Barnhofer, Crane, & Didonna, 2009 ). However, unlike the traditional CT approach that places considerable emphasis on evaluating and changing the validity of the content of thoughts and developing alternative thoughts, MBCT aims primarily to change one's awareness of and relationship to thoughts and emotions ( Teasdale et al., 2000 ). The theoretical rationale on which MBCT is based ( Teasdale, Segal, & Williams, 1995 ) is that the negative thoughts that accompany depression become associated with the depressed state, and that, as the number of depressive episodes increases, negative automatic thoughts become more easily reactivated by feelings of dysphoria, even when these do not occur in the context of a full-blown depressive episode. The negative thoughts, in turn, increase depressed mood and other symptoms of depression, leading to an increased risk for relapse to a major depressive episode. MBCT specifically targets loosening the association between negative automatic thinking and dysphoria. Because these associations are theorized to be stronger among those with a greater number of previous episodes, they may be expected to show the greatest benefit of the intervention.
Several RCTs, summarized in Table 2 , have evaluated the effects of MBCT on relapse prevention and other depression-related outcomes (for recent reviews, see Chiesa & Serreti, 2010 ; Coelho, Canter, & Ernst, 2007 ). Consistent with the theoretical model, initial studies found that MBCT reduced relapse rates among patients with three or more episodes of depression, but not among those with two or fewer past episodes ( Ma & Teasdale, 2004 ; Teasdale et al., 2000 ). Subsequent studies of MBCT and depression relapse selected only patients with three or more episodes and have replicated the effect of MBCT on reduced relapse rates ( Goldfrin & Heeringen, 2010 ; Kuyken et al., 2008 ) or prolonged time to relapse ( Bondolfi et al., 2010 ). Furthermore, MBCT also has been found to improve a range of symptomatic and psychosocial outcomes among remitted depressed patients, such as residual depressive symptoms and quality of life ( Goldfrin & Heeringen, 2010 ; Kuyken et al., 2008 ). There is also preliminary evidence that MBCT is more effective than treatment as usual (TAU) in reducing depressive symptoms among currently depressed patients ( Barnhofer et al., 2009 ; Hepburn et al., 2009 ). Lastly, MBCT has been adapted for treatment of bipolar disorder ( Williams et al., 2008 ), social phobia ( Piet, Hougaard, Hecksher, & Rosenberg, 2010 ), and depressive symptoms among individuals with epilepsy ( Thompson et al., 2010 ). The results of these studies are promising and in need of further replication.
Study | N | Type Participant | Mean Age | % Male | No. of Treatment Sessions | Control Group(s) | Main Outcome |
---|---|---|---|---|---|---|---|
145 | Patients in remission from depression | 43 | 24 | 8 2-hr sessions | TAU (69) | MBCT > TAU: reduction in rate of depressive relapse/recurrence for patients with 3 or more previous relapses, but not patients with 2 or fewer episodes | |
* | 45 | Patients in remission from depression | 44 | 51 | 8 2-hr sessions | TAU (20) | MBCT > TAU: reduction in generality of autobiographical memory |
100 | Patients in remission from depression | 44 | 22 | 8 2-hr sessions | TAU (48) | MBCT > TAU: increase in metacognitive awareness | |
75 | Patients in remission from depression | 45 | 24 | 8 2-hr sessions | TAU (38) | MBCT > TAU: reduction in rate of depressive relapse/recurrence for patients with 3 or more previous relapses, but not patients with 2 or fewer episodes | |
68 | Patients in remission from depression and with a history of suicidal ideation or behavior | NR | NR | 8 2-hr sessions, 1 all-day session | WL (35) | MBCT + TAU > TAU: less increase in actual-ideal self discrepancy | |
123 | Patients in remission from depression and with a history of 3 or more depressive episodes | 49 | 24 | 8 2-hr sessions | m-ADM (62) | MBCT = m-ADM: rate of depressive relapse/recurrence; MBCT > m-ADM: reductions in residual depressive symptoms & psychiatric comorbidity, increase in quality of life | |
31 | Patients with recurrent depression and a history of suicidal ideation | 42 | 25 | 8 2-hr sessions | TAU (15) | MBCT > TAU: reductions in depressive symptoms & number of patients meeting full criteria for depression at post-treatment | |
68 | Patients in remission from depression and with a history of suicidal ideation | 44 | NR | 8 2-hr sessions, 1 6-hr session | TAU (35) | MBCT > TAU: reductions in depressive symptoms & thought suppression | |
27 | Depressed patients with a history of suicidal ideation or behavior | 42 | 33 | 8 2-hr sessions | TAU (13) | MBCT + TAU > TAU: reduced depression severity, increased meta-awareness of & specificity of memory related to previous suicidal crisis | |
68 | Patients with unipolar and bipolar disorders | NR | NR | 8 2-hr sessions, 1 all-day session | WL (35) | MBCT > WL: reduced depressive symptoms in both subsamples & less increase in anxiety among bipolar patients | |
60 | Patients in remission from depression and with a history of 3 or more depressive episodes | 47 | 28 | 8 2-hr sessions | TAU (29) | MBCT + TAU > TAU: prolonged time to relapse; Tx = TAU: rate of depressive relapse/recurrence | |
106 | Recovered depressed patients with a history of 3 or more depressive episodes | 46 | 19 | 8 2.75-hr sessions | TAU (54) | MBCT + TAU > TAU: reduced rate of depressive relapse/recurrence, depressive mood & quality of life | |
26 | Patients with social phobia | 22 | 30 | 8 2-hr sessions | GCBT (12) | MBCT = GCBT: reductions in symptoms of social phobia | |
53 | Patients with epilepsy and depressive symptoms | 36 | 19 | 8 1-hr sessions | TAU (27) | MBCT > WL: reduction in depressive symptoms |
NR = Not Reported; NI = No Intervention; WL = Wait-list; TAU = Treatment As Usual; m-ADM = Maintenance Anti-depressant Medication; GCBT = Group Cognitive-Behavioral Therapy.
Dialectical Behavior Therapy (DBT): Description of Intervention and Review of Controlled Studies
DBT ( Linehan, 1993a ) was first developed as a treatment for chronic suicidal and other self-injurious behaviors, which are often present in patients with severe borderline personality disorder (BPD). It conceptualizes the dysfunctional behaviors of individuals with BPD as a consequence of an underlying dysfunction of the emotion regulation system, which involves intense emotional reactivity and an inability to modulate emotions. DBT integrates elements of traditional CBT with Zen philosophy and practice, and has a simultaneous focus on acceptance and behavior change strategies to help patients improve their emotion regulation abilities ( Linehan, 1993a ; Robins, 2002 ). There are four modes of treatment in DBT: individual therapy, group skills training, telephone consultation between therapist and patient, and consultation team meetings for therapists. Mindfulness skills are taught in the context of the skills-training group as a way of helping patients increase self acceptance, and as an exposure strategy aiming to reduce avoidance of difficult emotion and fear responses ( Linehan, 1993b ). These skills consist of a set of mindfulness “what” skills (observe, describe, and participate) and a set of mindfulness “how” skills (nonjudgmentally, one-mindfully, and effectively). Specific exercises that are used to foster mindfulness include visualizing thoughts, feelings, and sensations as if they are clouds passing by in the sky, observing breath by counting or coordinating with footsteps, and bringing mindful awareness into daily activities. Mindfulness skills are also integrated within the other three skills modules, which focus on distress tolerance, emotion regulation, and interpersonal effectiveness.
To date, 11 randomized trials of DBT, or adaptations of it, have been conducted ( Lynch, Trost, Salsman, & Linehan, 2007 ; Robins & Chapman, 2004 ). These studies are summarized in Table 3 . Standard outpatient DBT has been found to be more effective than TAU or another active treatment in reducing frequency and severity of parasuicidal and self harm behavior among individuals with BPD, especially those with a history of parasuicidal behavior; reducing number of inpatient psychiatric days, emergency visits, and hospitalizations ( Koons et al., 2001 ; Linehan, Amstrong, Suarez, Allmon, & Heard, 1991 ; Linehan et al., 2006 ; Verheul et al., 2003 ); and in reducing substance use among individuals with co-morbid BDP and substance use disorders ( Linehan et al., 1999 ; Linehan et al., 2002 ). Among studies that included follow-up assessments, the effects of DBT were found to last for up to one year on the following outcome measures: number of parasuicidal behaviors, global functioning, social adjustment, and use of crisis services ( Linehan et al., 1991 ; Linehan et al., 2006 ; Linehan et al., 1999 ; Linehan, Heard, & Armstrong, 1993 ; Linehan, Tutek, Heard, & Armstrong, 1994 ). Finally, modifications of DBT have been found to be effective in binge eating disorder ( Telch, Agras, and Linehan, 2001 ), bulimia ( Safer, Telch, & Agras, 2001 ), and chronic depression in the elderly ( Lynch, Morse, Mendelson & Robins, 2003 ).
Study | N | Type Participant | Mean Age | % Male | No. of Treatment Sessions | Control Group(s) | Main Outcome |
---|---|---|---|---|---|---|---|
46 | Chronically parasuicidal patients with BPD | NR | 0 | 1 year | TAU (22) | DBT > TAU: reductions in number of & medical severity of parasuicide behavior & number of psychiatric inpatient days, treatment retention; DBT = TAU: depression, hopelessness, suicidal ideation, & reasons for living | |
39 | Chronically parasuicidal patients with BPD | NR | 0 | 1 year | TAU (20) | DBT > TAU: increases in global functioning & social adjustment, reductions in parasuicide behavior & number of psychiatric inpatient days | |
26 | Chronically parasuicidal patients with BPD | 27 | 0 | 1 year | TAU (13) | DBT > TAU: reductions in anger, increases in global social adjustment & global functioning | |
28 | Patients with comorbid BPD and substance dependence | 30 | 0 | 1 year | TAU (16) | DBT > TAU: reductions in drug use, increased global & social adjustment, & treatment retention | |
24 | Patients with BPD | 22 | 21 | 1 year | CCT (12) | DBT > CCT: reductions in parasuicide behavior, suicidal ideation, depression, impulsivity, anger, & number of psychiatric inpatient days, & increase in global functioning | |
28 | Patients with BPD | 35 | 0 | 6 months | TAU (14) | DBT > TAU: reductions in suicidal ideation, depression, hopelessness, dissociation, & anger expression | |
44 | Patients with BED | 50 | 0 | 20 weeks | WL (22) | DBT > WL: reductions in number of binge episodes & days; DBT = WL: improvements in mood & affect regulation | |
31 | Individuals with at least one binge/purge episode per week | 34 | 0 | 20 weeks | WL (16) | DBT > WL: reductions in number of binge episodes & days; DBT = WL: improvements in mood & affect regulation | |
23 | Patients with comorbid BPD and substance dependence | NR | 0 | 1 year | CVT+12S (12) | DBT = CVT+12S: drug use; DBT > CVT+12S: maintenance of reduction of drug use throughout treatment; DBT < CVT+12S: treatment retention | |
58 | Patients with BPD | 35 | 0 | 1 year | TAU (31) | DBT > TAU: reductions in self-mutilating & self harm behaviors, treatment retention | |
34 | Depressed patients | 66 | 15 | 28 weeks | MED (17) (Note: In this study, MED was compared against MED+DBT) | DBT > MED: reduction in depression, improvements in dependency & adaptive coping, number of patients in remission at post-treatment | |
101 | Patients with BPD | 30 | 0 | 1 year | CTBE (49) | DBT > CTBE: reductions in suicide risk, medical risk of suicide attempts & self injurious behavior, psychiatric hospitalizations & emergency visits, treatment retention | |
35 | Patients with co-morbid depression and personality disorder | 61 | 34 | 24 weeks | MED (14) (Note: In this study, MED was compared against MED+DBT) | DBT > MED: reductions in interpersonal sensitivity & interpersonal aggression |
NR = Not Reported; BPD = Borderline Personality Disorder; TAU = Treatment As Usual; BED = Binge Eating Disorder; WL = Waiting List; CVT+12S = Comprehensive Validation Therapy with 12-Step; MED = Antidepressant Medication; CTBE = Community Treatment by Experts.
Acceptance and Commitment Therapy (ACT): Description of Intervention and Review of Controlled Studies
ACT ( Hayes et al., 1999 ) was developed based on the premise that psychological distress is often associated with attempts to control or avoid negative thoughts and emotions, which often paradoxically increase the frequency, intensity, or salience of these internal events, and result in further distress and inability to engage in behaviors that would lead to valued long-term goals. Thus, the central aim of ACT is to create greater psychological flexibility by teaching skills that increase an individual's willingness to come into fuller contact with their experiences, recognize their values, and commit to behaviors that are consistent with those values. There are six core treatment processes that are highlighted in ACT: acceptance, defusion, contact with the present moment, self as context, values, and committed action ( Hayes, Luoma, Bond, Masuda, & Lillis, 2006 ). Mindfulness is taught in the context of the first four processes, where a variety of exercises are used to enhance awareness of an observing self and foster the deliteralization of thoughts and beliefs. Although ACT does not incorporate mindfulness meditation exercises, its focus on helping patients cultivate present-centered awareness and acceptance is consistent with that of other mindfulness-based approaches ( Baer, 2003 ). ACT has been delivered in both individual and group settings, with durations varying from one day (e.g., Gregg, Callaghan, Hayes, & Glenn-Lawson, 2007 ) to 16 weeks (e.g., Hayes et al., 2004 ).
A number of studies, summarized in Table 4 , have been conducted to evaluate the efficacy of ACT in treating a range of mental health outcomes, including those associated with depression, anxiety, impulse control disorders, schizophrenia, substance abuse and addiction, and workplace stress ( Hayes et al., 2006 ; Powers, Zum Vorde Sive Vording, & Emmelkamp, 2009 ). Specifically, ACT has been found to be more effective than TAU in improving affective symptoms, social functioning, and symptom reporting, and lowering rehospitalization rates and symptom believability among psychiatric inpatients with psychotic symptoms ( Bach & Hayes, 2002 ; Gaudiano & Herbert, 2006 ). Among populations with depressive and anxiety symptoms, ACT was generally found to be superior to no intervention, and as effective as another established treatment in reducing levels of depression, anxiety, and poor mental health outcomes ( Bond & Bunce, 2000 ; Forman, Herbert, Moitra, Yeomans, & Geller, 2007 ; Lappalainen et al., 2007 ; Zettle, 2003 ; Zettle & Hayes, 1986 ; Zettle & Rains, 1989 ). In addition, ACT has been shown to be effective at reducing substance use and dependence among nicotine-dependent ( Gifford et al., 2004 ) and polysubstance-abusing individuals ( Hayes et al., 2004 ). Finally, there is preliminary evidence indicating the effectiveness of ACT in treating trichotillomania ( Woods, Wetterneck, & Flessner, 2006 ).
Study | N | Type Participant | Mean Age | % Male | No. of Treatment Sessions | Control Group(s) | Main Outcome |
---|---|---|---|---|---|---|---|
18 | Depressed patients | NR | 0 | 12 weeks | CT (12) | ACT > CT: reductions in depression & believability of thoughts; Tx = CT; frequency of automatic thoughts | |
31 | Depressed patients | 41 | 0 | 12 weeks | CCT (10) PCT (10) | ACT = CCT = PCT: reduction in depression; ACT < CCT & PCT: reduction in dysfunctional attitudes | |
90 | Volunteers of a media organization | 36 | 50 | 3 9-hr sessions | IPP (30) WL (30) | ACT = IPP > WL: reduction in depression & increase in propensity to innovate | |
80 | Psychiatric inpatients with psychotic symptoms | 39 | 64 | 4 45-50-min sessions | TAU (40) | ACT > TAU: improvement in symptom reporting, reductions in symptom believability & rates of hospitalization | |
24 | College students | 31 | 17 | 6 weeks | SD (12) | ACT = SD: reductions in math & test anxiety; ACT < SD: reduction in trait anxiety | |
76 | Nicotine-dependent smokers | 43 | 41 | 7 weeks | NRT (43) | ACT = NRT: average number of cigarettes smoked & quit rates | |
124 | Polysubstance-abusing Opiate Addicts | 42 | 49 | 16 weeks | MM (38) ITSF (44) | ACT = ITSF > MM: reductions in opiate & drug use (at follow up); ACT = ITSF = MM: reduction in distress & improvement in adjustment | |
25 | Patients with trichotillomania | 35 | 8 | 12 weeks | WL (13) | ACT > WL: reductions in hair pulling severity, impairment, & amount of hair pulled | |
40 | Psychiatric inpatients with psychotic symptoms | 40 | 64 | 3 sessions (average) | ETAU (21) | ACT > ETAU: reductions in affective symptoms, social impairment, & hallucination-associated distress | |
28 | Outpatients (mixed symptoms/ diagnoses) | 42 | 11 | 10 sessions | CBT (14) | ACT > CBT: reduced depression, improved social functioning | |
99 | Outpatients (mixed symptoms/ diagnoses) | 28 | 20 | 15-16 sessions (average) | CT (44) | ACT = CT: reductions in depression & anxiety, improvements in quality of life, life satisfaction, & general functioning |
Notes . NR = Not Reported; CT = Cognitive Therapy; CCT = Complete Cognitive Therapy; PCT = Partial Cognitive Therapy; WL = Waitlist; TAU = Treatment As Usual; SD = Systematic Desensitization; NRT = Nicotine Replacement Therapy; MM = Methodone Alone; ITSF = Intensive Twelve Step Facilitation Therapy Plus Methodone Maintenance; ETAU = Enhanced Treatment As Usual.
A growing research body supports the efficacy of all four major forms of mindfulness-oriented interventions, but several important research questions need to be addressed in future studies. Because these interventions all involve multiple components, future research should examine how individual treatment components, especially the mindfulness training component, contribute to overall treatment effects. Also, these interventions differ in how they teach mindful awareness, and future research could compare the efficacy of different mindfulness teaching approaches in fostering greater mindful awareness in daily life. For example, both MBSR and MBCT place considerable emphasis on engaging participants in formal meditative practices. DBT and ACT, on the other hand, incorporate a range of informal mindfulness exercises in their treatment approach. Research attention should also be devoted to possible moderators of treatment effects, such as pre-existing differences in coping style and types of cognitive processes maintaining a particular psychological problem. Finally, research needs to examine whether there is a dose-response relationship between amount of intervention exposure and amount of psychological benefits. Although MBSR in its standard form involves eight weekly 2-2.5 hour classes and an all-day retreat, it has been delivered in abbreviated forms to fit the needs of specific populations. Carmody and Baer (2009) examined class contact hours and effect sizes of psychological outcomes reported in published trials of MBSR, and did not find a systematic relationship between the two variables. Another review ( Vettese, Toneatto, Stea, Nguyen, & Wang, 2009 ) found no consistent relationship between amount of home mindfulness meditation practice and treatment outcomes. Taken together, these reviews do not support a dose-response relationship between level of treatment exposure and reported psychological benefits. Other factors, such as level of expertise of an instructor, may account for the psychological improvements observed following MBSR or other mindfulness-based interventions, and should be systematically measured in future studies.
Laboratory Research on Immediate Effects of Mindfulness Interventions
In addition to correlational and clinical intervention research on mindfulness, a third line of empirical research has examined the immediate effects of brief mindfulness interventions in controlled laboratory settings on a variety of emotion-related processes, including recovery from dysphoric mood, emotional reactivity to aversive or emotionally provocative stimuli, and willingness to return to or persist on an unpleasant task. Such laboratory studies have the advantage of more easily isolating mindfulness practice from other elements typically present in clinical intervention packages, thus allowing greater control over independent variables and stronger conclusions about causal effects.
Several studies have examined the immediate effects of mindfulness interventions on coping with dysphoric mood. Instructions to practice mindfulness of thoughts and feelings following negative mood induction were found to be more effective than rumination or no instruction in alleviating negative mood states in healthy university students ( Broderick, 2005 ), previously depressed individuals ( Singer & Dobson, 2007 ), and currently depressed individuals ( Huffziger & Kuehner, 2009 ), but not in one study of university students ( Kuehner, Huffziger, & Liebsch, 2009 ). As the latter authors noted, these differential findings may result in part from differences in methods used to induce mindfulness across studies (use of mindful self-focus statements on cards in Kuehner et al., 2009 versus audiotaped guided meditation instructions in Broderick, 2005 ), and/or differences in clinical status of study samples (e.g., beneficial effects of mindfulness may be more noticeable among clinical populations than among healthy subjects). It is unsurprising that mindfulness instructions would be more helpful in recovery from sad mood than rumination, which has been shown to be maladaptive ( Nolen-Hoeksema & Morrow, 1991 ). Mindfulness also has been compared with other potentially adaptive mood-regulation strategies. Evidence is mixed with regard to the relative effects of mindfulness and distraction. Whereas two studies ( Huffziger & Kuehner, 2009 ; Singer & Dobson, 2007 ) found that mindfulness and distraction had equivalent effects on recovery from dysphoric mood, one study ( Broderick, 2005 ) found that mindfulness was more effective than distraction and another study ( Kuehner et al., 2009 ) found that distraction was more effective than mindfulness. Further studies are needed to clarify the relative effects of mindfulness and distraction on mood regulation, and whether those effects may be moderated by situational or personality factors. No published studies to date have compared the effects on recovery from dysphoric mood of mindfulness and cognitive reappraisal of distressing stimuli or situations.
Studies have also examined effects of mindfulness instructions on emotional responses to aversive or emotionally provocative stimuli. In a study by Arch and Craske (2006) , university students viewed a series of affectively-valenced pictures and rated their emotional responses to them, both before and after one of three sets of recorded instructions to which they were randomly assigned: focused breathing, unfocused attention, or worry. Whereas the other two groups showed a decrease in positive emotional response to neutral slides from pre-induction to post-induction, those assigned to the focused breathing condition maintained consistently positive responses to neutral slides. They also reported lower negative affect than the worry group in response to post-induction negative-valence slides and greater willingness to view negative slides than those in the unfocused attention condition, as indicated by viewing a greater number of additional optional negative slides. Findings of this study were extended by a recent study by Erisman and Roemer (2010) , which found that a brief mindfulness intervention, relative to a control condition, resulted in reduced emotion regulation difficulties and negative affect in response to an affectively-mixed film clip. Campbell-Sills, Barlow, Brown, and Hofmann (2006) randomly assigned patients with mood and anxiety disorders to instructions to either accept or suppress their emotions while viewing an emotionally provocative film. The two groups reported similar levels of subjective distress while watching the film but, relative to those in the suppression condition, the acceptance group displayed lower heart rate while viewing the film and reported less negative emotion during the post-film recovery period. The findings of these studies suggest that training in two key elements of mindfulness practice (focused awareness and acceptance) may reduce emotional reactivity to negative stimuli and increase willingness to remain in contact with them. There is preliminary work investigating the effects of brief mindfulness instructions on substance-related urges and substance use behavior. Bowen and Marlatt (2009) presented college smokers either brief mindfulness instructions or no instructions before and after exposure to a cue designed to elicit urges to smoke. Although there was no immediate effect on urge to smoke, mindfulness instructions resulted in significant decreases in smoking behavior during the next 7 days. As the authors noted, mindfulness training may alter responses to urges, rather than reducing urges. These findings were extended in another study that compared the effectiveness of using suppression versus a mindfulness-based strategy in coping with cigarette craving among a community sample of smokers ( Rogojanski, Vettese, & Antony, 2011 ). The study found that whereas both strategies reduced self-reported amount of smoking and increased self-efficacy associated with coping with cigarette craving, only those in the mindfulness condition reported significant decreases in negative affect and depressive symptoms and marginal decreases in nicotine dependence.
Research has also examined the efficacy of mindfulness as an emotion regulation strategy in response to a biological challenge, specifically to inhalations of carbon dioxide-enriched air (CO 2 challenge), a procedure that has frequently been used to create a laboratory analog of panic attacks ( Sanderson, Rapee, & Barlow, 1988 ). In a study by Feldner, Zvolensky, Eifert, and Spira (2003) , individuals who scored either high or low on a measure of emotional avoidance were instructed either to mindfully observe and accept or to try to suppress feelings during CO 2 challenge. High emotional avoidance participants reported higher anxiety than low emotional avoidance participants in the suppression condition, but not in the observation condition. Levitt, Brown, Orsillo, and Barlow (2004) randomized patients with panic disorder to one of three experimental conditions: a 10-minute audiotape describing a rationale for either suppressing or accepting one's emotions, or a neutral narrative, and then exposed them to CO 2 challenge. The acceptance group reported significantly lower levels of anxiety during the biological challenge than the other two groups and greater willingness to participate in a second challenge. One coping strategy commonly taught to patients with anxiety disorders, particularly panic disorder, is breathing retraining, in which patients are taught to take deeper, slower breaths. Eifert and Heffner (2003) compared the effects of brief acceptance training, breathing retraining, and no training on responses to CO 2 challenge in undergraduates who scored high on a measure of anxiety sensitivity. Acceptance instructions led to less intense fear, fewer catastrophic thoughts, and lower behavioral avoidance (indicated both by latency between trials and reported willingness to return for another experimental session) than breathing retraining instructions or no instructions. Collectively, these studies suggest that mindful observation and acceptance of emotional responses may be an effective strategy for reducing subjective anxiety and behavioral avoidance in the face of physiological arousal, among highly anxiety sensitive or emotionally avoidant individuals and patients with panic disorder.
Laboratory studies of mindfulness have helped provide further insight into the functions of mindfulness and the potential processes through which mindfulness lead to positive psychological effects. The majority of the findings suggest that brief mindfulness training, whether in the form of a short, guided meditation practice or in the form of instructions to adopt an accepting attitude toward internal experiences, can have an immediate positive effect on recovery from dysphoric mood and level of emotional reactivity to aversive stimuli, consistent with the positive psychological effects reported in research on mindfulness-oriented intervention programs. The laboratory studies also suggest that it does not take extensive prior training in mindfulness to experience some immediate benefits of mindfulness training.
From a methodological standpoint, it is important that future studies more closely examine the extent to which a state of mindfulness is actually manipulated by the study instructions. Whereas most studies did include post-experimental manipulation checks on adherence to the training instructions, they did not explicitly assess the extent to which participants were able to be mindfully aware of their emotions or thoughts during or after exposure to a mood induction or a laboratory stressor. Research also could examine which training approaches or instructions (e.g. mindful breathing or mindfulness of emotions) are most effective at helping individuals regulate emotions in response to a stressor; whether there are key moderator variables such as pre-existing differences in dispositional mindfulness or coping styles; and whether effects differ by type of stressors or across different emotions. Research is also needed to compare the effects and mechanisms of mindfulness instructions with those of other documented emotion regulation strategies, such as cognitive reappraisal and distraction.
Mechanisms of Effects of Mindfulness Interventions
The studies reviewed so far indicate that measures of mindful awareness are related to various indices of psychological health and that mindfulness interventions have a positive impact on psychological health. The next natural question, then, is how this impact comes about. Several psychological processes, some of which may overlap, have been proposed as potential mediators of the beneficial effects of mindfulness interventions, including increases in mindful awareness, reperceiving (also known as decentering, metacognitive awareness, or defusion), exposure, acceptance, attentional control, memory, values clarification, and behavioral self-regulation.
Mindfulness training would be expected to increase scores on measures of mindfulness, and changes in mindfulness would be expected, in turn, to predict clinical outcomes. Research has found that mindfulness training leads to increases in self-reported trait mindfulness, assessed by the MAAS ( Anderson et al., 2007 ; Brown & Ryan, 2003 ; Carmody, Reed, Kristeller and Merriam, 2008 ; Michalak, Heidenreich, Meibert, & Schulte, 2008 ; Shapiro, Brown & Biegel, 2007 ), the CAMS-R ( Greeson et al., in press ) and the FFMQ ( Carmody & Baer, 2008 ; Robins, Keng, Ekblad, & Brantley, 2010 ; Shapiro et al., 2008 ), as well as TMS-assessed state mindfulness ( Carmody et al., 2008 ; Lau et al., 2006 ). Intervention-associated increases in trait mindfulness, assessed by the MAAS, the KIMS, the CAMS-R, and/or the FFMQ, have been shown to predict increases in sense of spirituality ( Carmody et al., 2008 ; Greeson et al., in press ), self-compassion ( Shapiro et al., 2007 ), and positive states of mind ( Bränström et al., 2010 ), and decreases in rumination ( Shapiro et al., 2007 ), trait anxiety ( Shapiro et al., 2007 ), risk of depressive relapse ( Michalak et al., 2008 ), posttraumatic avoidance symptoms ( Bränström et al., 2010 ), perceived stress ( Bränström et al., 2010 ; Shapiro et al., 2007 ), and overall psychological distress ( Carmody et al., 2008 ). A number of studies have also demonstrated that increases in trait mindfulness (again, assessed by the MAAS, the KIMS, and/or the FFMQ) statistically mediated the effects of mindfulness interventions on perceived stress (Nyklíček, & Kuipers, 2008; Shapiro et al., 2008 ), rumination ( Shapiro et al., 2008 ), cognitive reactivity ( Raes et al., 2009 ), quality of life (Nyklíček, & Kuipers, 2008), depressive symptoms ( Kuyken et al., 2010 ; Shahar, Britton, Sbarra, Figueredo, & Bootzin, 2010 ), and behavioral regulation ( Keng, Smoski, Robins, Ekblad, & Brantley, 2010 ). Lastly, one study ( Carmody & Baer, 2008 ) demonstrated that changes in FFMQ-assessed mindfulness at least partially mediated the relationships between amount of formal mindfulness practice and changes in psychological well being, perceived stress, and psychological symptoms.
Mindfulness training also is thought to increase metacognitive awareness, which is the ability to reperceive or decenter from one's thoughts and emotions, and view them as passing mental events rather than to identify with them or believe thoughts to be accurate representations of reality ( Hayes et al., 1999 ; Segal et al., 2002 ; Shapiro, Carlson, Astin, & Freeman, 2006 ). Increased metacognitive awareness has been hypothesized to lead to reductions in rumination ( Teasdale, 1999 ), a process of repetitive negative thinking that has been considered a risk factor for a number of psychological disorders ( Ehring & Watkins, 2008 ). Preliminary evidence suggests that mindfulness training leads to increases in metacognitive awareness ( Hargus et al., 2010 ; Teasdale et al., 2002 ) and reductions in rumination ( Jain et al., 2007 ; Ramel, Goldin, Carmona, & McQuaid, 2004 ), and that increased metacognitive awareness, or decentering, may in turn predict better clinical outcomes such as lower rates of depressive relapses ( Fresco, Segal, Buis, & Kennedy, 2007 ).
Exposure is another process that several authors have suggested may occur during mindfulness practice ( Baer, 2003 ; Kabat-Zinn, 1982 ; Linehan, 1993a ). By intentionally attending to experiences in a nonjudgmental and open manner, an individual may undergo a process of desensitization through which distressing sensations, thoughts and emotions that otherwise would be avoided become less distressing. One study has shown that participation in MBSR is associated with significant pre- to post-intervention increases in exposure ( Carmody, Baer, Lykins, & Olendzki, 2009 ). A closely-related process of change that has been highlighted in the literature is acceptance ( Hayes, 1994 ). Several studies reported that increases in experiential acceptance mediated the effects of ACT on a range of psychological outcomes, including workplace stress ( Bond & Bunce, 2000 ), smoking cessation ( Gifford et al., 2004 ), and functioning difficulties ( Forman et al., 2007 ).
Because mindfulness practices involve sustaining attention on the present-moment experience, as well as switching attention back to the present-moment experience whenever it wanders ( Bishop et al., 2004 ), mindfulness training may improve the ability to control attention, which may, in turn, influence other beneficial psychological outcomes. Several aspects of attention, each related to different neurobiological substrates, may be distinguished ( Posner & Petersen, 1990 ): orienting (the ability to direct attention towards a set of stimuli and sustain attention on it), alerting (the ability to remain vigilant or receptive towards a wide range of potential stimuli), and conflict monitoring (the ability to prioritize attention among competing cognitive demands/tasks). Using a variety of neuropsychological tasks, experimental studies have shown that mindfulness training is associated with improvements in orienting ( Jha, Krompinger, & Baime, 2007 ) and conflict monitoring ( Tang et al., 2007 ). Among experienced meditators, participation in an intensive mindfulness retreat has also been associated with improved alerting ( Jha et al., 2007 ). In addition, mindfulness training has been associated with improvements in sustained attention among both novice meditators ( Chambers, Lo, & Allen, 2008 ) and experienced meditators ( Valentine & Sweet, 1999 ), with one study demonstrating an association between intervention-related improvements in sustained attention and reductions in depressive symptoms ( Chambers et al., 2008 ). Overall, evidence suggests that mindfulness training may affect various subcomponents of attention, and that the specific subsystems affected may depend on the extent of previous meditation experience.
Another mechanism through which mindfulness training may influence psychological well-being is change in memory functioning. Two studies ( Hargus et al., 2010 ; Williams et al., 2000 ) have shown that mindfulness training reduces overgeneral autobiographical memory, a construct that has been associated with increased severity of depression and suicidality ( Kuyken & Brewin, 1995 ). Participation in mindfulness training has also been shown to buffer against decreases in working memory capacity (WMC) during high stress periods, with changes in WMC mediating the relationship between amount of mindfulness practice and reductions in negative affect ( Jha, Stanley, Kiyonaga, Wong, & Gelfand, 2010 ). In addition, brief mindfulness training has been shown to reduce memory for negative stimuli ( Alberts & Thewissen, in press ), a mechanism that may partly underlie the beneficial effects of mindfulness-based interventions on emotion functioning.
Finally, values clarification and improved behavioral self-regulation may be two additional avenues through which mindfulness training improves psychological well-being ( Gratz & Roemer, 2004 ; Shapiro et al., 2006 ). Staying present with thoughts and emotions in an objective, open and nonjudgmental manner may facilitate a greater sense of clarity with regard to one's values, and behaviors that are more consistent with those values. Higher levels of self-reported mindfulness are associated with self-reports of greater engagement in valued behaviors and interests ( Brown & Ryan, 2003 ) and of ability to engage in goal-directed behavior when emotionally upset ( Baer et al., 2006 ). In addition, mindfulness training has been found to lead to self-reported improved behavioral regulation in a nonclinical sample ( Robins et al., 2010 ) and reduced self-discrepancy, which is associated with adaptive self-regulation, among recovered depressed patients with a history of depression and suicidality ( Crane et al., 2008 ). In another study, values clarification was found to mediate partially the relationship between increased mindfulness/ reperceiving and decreased psychological distress in a sample of participants who underwent MBSR ( Carmody et al., 2009 ).
Areas in Need of Further Research
Understanding and quantification of mindfulness.
Because mindfulness is a construct that originates in Buddhism, and has only a brief history in Western psychological science, it is unsurprising that there is considerable challenge in defining, operationalizing, and quantifying it ( Grossman, 2008 ). Although a number of self-report inventories have been developed to assess mindfulness, they vary greatly in content and factor structure, reflecting a lack of agreement on the meaning and nature of mindfulness ( Brown, Ryan, & Creswell, 2007 ). Whereas some researchers consider mindfulness to be a one-dimensional construct referring specifically to paying attention to the present-moment experience (e.g., Brown & Ryan, 2003 ; Carmody, 2009 ), others argue that qualities such as curiosity, acceptance, and compassion are inherent to mindfulness ( Baer & Sauer, 2009 ; Feldman et al., 2007 ; Lau et al., 2006 ). Further collaborative inquiry is needed so that researchers can reach a general agreement on the nature and meaning of mindfulness, or at least clarify and specify which aspects of mindfulness are being addressed in a particular study.
Several issues pertaining to the assessment of mindfulness are also worth highlighting here. First, individual responses to questionnaire items may vary as a function of differential understanding of the questionnaire items ( Grossman, 2008 ), which may depend on the extent of an individual's exposure to the idea or practice of mindfulness. One study demonstrated that the factor structure of the Freiburg Mindfulness Inventory changed within the same group of respondents from just before to just after attending meditation retreats of 3 to 10 days ( Buchheld, Grossman, & Wallach, 2001 ). Further research is clearly needed to improve the construct validity of self-report mindfulness questionnaires, in part via reducing potential variability in item functioning across meditators and non-meditators. A second issue concerns limitations in the use of self-report measures of mindfulness, which rely on the assumption that mindfulness is assessable by declarative knowledge ( Brown et al., 2007 ). It is not known how well self-reports of mindfulness correspond with actual experiences in daily life. To make the matter more complicated, there is an inherent paradox in using frequency of attention lapses as an index of mindfulness because the ability to detect such lapses is contingent upon one's overall level of mindfulness ( Van Dam, Earlywine, & Borders, 2010 ; Van Dam, Earleywine, & Danoff-Burg, 2009 ). One way in which the validity of self-report questionnaires can be improved is by developing performance-based measures of mindfulness against which they can be calibrated, or which can be used in multi-method assessment of the construct ( Garland & Gaylord, 2009 ).
Specificity of Effects of Mindfulness Interventions
Little is yet known regarding for whom and under what conditions mindfulness training is most effective, but there is some preliminary evidence to suggest that its effectiveness may vary as a function of individual differences. Cordon, Brown, and Gibson (2009) found that participation in MBSR resulted in greater reduction in perceived stress for individuals with an insecure attachment style than for securely attached individuals. Another recent study ( Shapiro, Brown, Thoresen, & Plante, 2011 ) showed that trait mindfulness moderated the effects of MBSR. Specifically, compared to controls, participants with higher levels of baseline trait mindfulness demonstrated greater improvements in mindfulness, subjective well-being, empathy, and hope, and larger decreases in perceived stress up to one year post-intervention. MBCT is effective for reducing depressive relapses among remitted depressed patients with a history of three or more depressive episodes, but not among patients with two previous episodes (e.g., Teasdale et al., 2000 ; Ma & Teasdale, 2004 ). In light of these considerations, several researchers have cautioned against the indiscriminate application of mindfulness as a general-purpose, “cure-all” therapeutic technique, and instead advocated for a problem formulation approach in the use of mindfulness techniques for treating psychological conditions ( Kocovski, Segal, Battista, & Didonna, 2009 ; Teasdale, Segal, & Williams, 2003 ). In order to maximize the effectiveness and clinical utility of mindfulness interventions, sufficient attention needs to go into tailoring them to fit the needs of specific populations and psychological conditions. For example, treatment of disorders that primarily involve a deficit in attentional abilities, like attention deficit hyperactivity disorder (ADHD), may require that greater focus be placed on the attentional aspect of mindfulness training. On the other hand, treatment of disorders that tend to involve excessive shame and guilt, such as eating disorders, may benefit from greater treatment emphasis on the acceptance and self compassion aspects of mindfulness. Finally, given that mindfulness training has been increasingly integrated with a variety of psychotherapeutic techniques (e.g., Linehan, 1993a ), it is important that future research examine how mindfulness works alongside these psychotherapeutic techniques.
Other Potential Applications of Mindfulness Interventions
Mindfulness-oriented interventions have been shown to improve psychological health in nonclinical populations and effectively treat a range of psychological and psychosomatic conditions. There may be additional therapeutic applications of mindfulness training. Researchers have reported promising results in pilot trials of mindfulness interventions for attention deficit hyperactivity disorder ( Zylowska et al., 2008 ), bipolar disorder ( Miklowitz et al., 2009 ; Weber et al., 2010 ; Williams et al., 2008 ), panic disorder ( Kim et al., 2010 ), generalized anxiety disorder ( Evans et al., 2008 ; Craigie, Rees, Marsh, & Nathan, 2008 ; Roemer, Orsillo, & Salters-Pedneault, 2008 ), eating disorders ( Baer, Fischer, & Huss, 2005 ; Kristeller & Hallett, 1999 ), psychosis ( Chadwick, Taylor, & Abba, 2005 ), and alcohol and substance use problems ( Bowen et al., 2006 ; Witkiewitz et al., 2005 ). While the data is overall preliminary and requires further validation, the results are promising. Researchers have also begun to investigate the application of mindfulness techniques within specific populations and settings, such as children ( Bogels, Hoogstad, van Dun, de Schutter, & Restifo, 2008 ; Lee, Semple, Rosa, & Miller, 2008 ; Napoli, Krech, & Holley, 2005 ), adolescent psychiatric outpatients ( Biegel, Brown, Shapiro, & Schubert, 2009 ), parents ( Altmaier & Maloney, 2007 ; Bögels et al., 2008 ; Singh et al., 2006 ), school teachers ( Napoli, 2004 ), elderly and their caregivers ( Epstein-Lubow, McBee, Darling, Armey, & Miller, in press ; McBee, 2008 ; Smith, 2004 ), prison inmates ( Bowen et al., 2006 ; Samuelson, Carmody, Kabat-Zinn, & Bratt, 2007 ), and socio-economically disadvantaged individuals ( Hick & Furlotte, 2010 ).
With regard to applications of mindfulness training that have received empirical support, research now needs to examine practical issues surrounding their implementation, delivery, and dissemination. Little is known about their cost effectiveness, nor about the amount and type(s) of training that is required for an individual to be a competent provider of mindfulness training ( Allen, Blashki, & Gullone, 2006 ). Future research should examine these issues as they are critical to the successful implementation and dissemination of mindfulness-oriented interventions.
Based on an examination of empirical literature across multiple methodologies, this review concludes that mindfulness and its cultivation facilitates adaptive psychological functioning. Despite existing methodological limitations within each body of literature, there is a clear convergence of findings from correlational studies, clinical intervention studies, and laboratory-based, experimental studies of mindfulness—all of which suggest that mindfulness is positively associated with psychological health, and that training in mindfulness may bring about positive psychological effects. These effects ranged from increased subjective well-being, reduced psychological symptoms and emotional reactivity, to improved regulation of behavior. There is also an increasingly substantial research body pointing to a number of psychological processes that may serve as key mechanisms of effects of mindfulness interventions. As research on mindfulness is in its early stages of development, further collaborative research is needed to develop a more solid understanding concerning the nature of mindfulness, how mindfulness can best be measured, fostered, and cultivated, and the mechanisms and specificity of effects of mindfulness-oriented interventions. Future research should also continue to explore other potential applications of mindfulness, and examine practical issues concerning the delivery, implementation, and dissemination of mindfulness-oriented interventions. Given the advances that have been made thus far, it is likely that new paradigms for the understanding and application of mindfulness will continue to appear, which would move us further toward the goals of alleviating human psychological suffering and helping others live a life that is happier and more fulfilling.
Acknowledgments
We gratefully acknowledge M. Zachary Rosenthal, Mark Leary, Jeffrey Brantley, and Kathleen Sikkema for their helpful comments on an earlier version of this manuscript.
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10 Clinical Psychology Research Topics to Explore
Whether you’re working toward a PsyD or a PhD in Clinical Psychology , landing on a research paper that will sustain your interest throughout your doctoral program can be both thrilling and challenging.
Should you go with a niche you know well or branch out to another psychology specialization ? Should you choose a research topic you’re passionate about or opt for something more topical and needed in the broader realm of behavioral and mental health?
Only you can answer these questions—however, this blog may provide you with some inspiration and direction. Let’s walk through 10 of the most fascinating clinical psychology research topics and how they might bring you closer to your educational and professional objectives.
Explore Clinical Psychology Programs
10 Emerging Research Topics in Clinical Psychology
One of the benefits of clinical psychology is that it’s far from a static field.
With each passing year, we gain more and more insight into the brain and how it affects behavior. In the last few years alone, for example, we’ve obtained a clearer picture of the negative effects of digital media on mental health and behavior. But we’ve also seen how digital media (specifically, mobile apps) can enhance mental health when used correctly. 1
Put simply, clinical psychology is a dynamic, exhilarating realm with seemingly boundless possibilities for further research.
Nonetheless, it’s easy to feel overwhelmed when settling on a clinical psychology research paper topic, especially when it’s one that you may be intimate with for years. To that end, consider these top 10 psychology topics to get you started in your research area:
#1. Mental Health Technology and Digital Interventions
The pandemic dramatically altered how healthcare practitioners interact with their patients and clients. Whereas psychotherapy and other forms of counseling were once performed almost exclusively in person, COVID-19 turned mental telehealth into our new reality.
But what might the long-term effects of this be? And will it persist as we march into the future?
Exploring the impact of digital mental health interventions (such as apps, other digital tools, and teleconferences) on well-being may open up a world of possible clinical psychology research topics and questions. 2 For instance, it may compel you to ask and research thoughts like:
- How will AI alter mental health treatments, if at all?
- Will digital mental health interventions ultimately cause or worsen isolation?
- What are the downsides and perks of turning to social media for mental health information?
- What is the relevance and value of in-person counseling sessions, post-pandemic?
- Do clients feel safer in online sessions?
- How can technology be employed to monitor patients outside of sessions?
- How does mental telehealth affect the elderly?
Technology is rapidly and constantly changing. In other words, psychology and technology may be exciting subjects to explore as you work towards starting or completing your doctorate.
#2. Cross-Cultural and Global Mental Health
Globalization has its pros and cons. Studies indicate that while it may have its advantages, it can also heighten: 4
- Discrimination
Each of these may have lasting effects, including increasing the risk of mental disorders like addiction, depression, and anxiety. In other words, it needs to be examined by experts from multiple standpoints.
As a doctoral student, you’re in an ideal spot to investigate this complex issue. It also emphasizes the need to gain cultural competency and a global mindset as a mental health practitioner, which is another possible research topic in and of itself.
#3. Neuropsychology and Cognitive Processes
The field of neuropsychology and cognitive processes continues to grow, particularly with the advent of digital tools and their ability to monitor cognition. 5 Exploring our advancing knowledge of how the brain affects behavior may allow you to look at a wide range of mental health disorders and the newest clinical interventions that are being made available, such as treating:
- Alcohol use disorder (AUD)
- Eating disorders
- Post-traumatic stress disorder (PTSD)
#4. Trauma and Resilience Studies
Psychologists and psychiatrists ranging from Bessel Van der Kolk to Peter Levine forever altered our understanding of trauma. What was once thought of as a purely psychological issue is now understood as a bodily ailment. 6
But how might this look as we move forward in time and gain an enhanced understanding of neuroplasticity? Will somatics continue to play a role in treating trauma, or will technological advances send practitioners and their clients in a completely different direction?
You may be in a position to dig deeper and find out.
#5. Behavioral Health and Chronic Conditions
The unique relationship between chronic conditions and behavioral health is also up for exploration. Growing research indicates that chronic conditions (such as diabetes) can trigger mental health complications like depression, which can then perpetuate the cycle of the chronic condition.
This topic may be especially timely and relevant as it emphasizes the need to bridge the gap between a patient’s full healthcare team and points out flaws in treating chronic conditions solely from a pharmaceutical stance.
#6. Psychotherapy Process and Outcome Research
Cognitive behavioral therapy (CBT), acceptance and commitment therapy (ACT), and other forms of traditional “talk therapy” have been mainstays in the field of clinical psychology for decades. But this, too, isn’t static, especially as clients continue to look more toward body-based therapies and technology-fueled solutions, like: 8
- Transcranial magnetic stimulation (TMS)
- Neurofeedback therapy
- Brainspotting
- Somatic Experiencing (SE)
Is it too soon to know if these and other fresh forms of mental health treatments have the same staying power as, say, cognitive behavioral therapy? This might be optimal for exploration.
#7. Social Determinants of Mental Health
Social determinants of mental health (SDOMH) refer to the external circumstances that may impact an individual’s mental well-being and make them more vulnerable to conditions ranging from depression to addiction. SDOMH includes: 9
- Unemployment
- Social isolation
- Urban crowding
How will SDOMH change as we move forward? Will it? Additionally, what is a clinical psychologist’s role in addressing these issues? What are the most effective strategies for working with those who have been disadvantaged?
This is an important topic as we, as a society, continue to address long-buried issues of race and class.
#8. Addiction and Substance Use Disorders
Addiction remains a prevalent topic: Alcohol use disorder (AUD) affects roughly 10.5% of the population, while 46.8 million Americans wrestled with a substance abuse disorder in 2022 alone. 10
Analyzing the most recent treatments and the future of treatments might not only pave the way for your own work after completion of your PsyD or PhD but also do a tremendous service for those who suffer from addiction (and their loved ones and families).
#9. Child and Adolescent Mental Health
Numerous studies indicate that kids and teens now have unusually high rates of: 11
- Substance use
What plays into this? Is social media entirely to blame, or can social sites also be a resource for youngsters? And how can clinical psychologists tweak their methods to resonate with kids and teens?
These are just three of the many questions you might ask if you decide to adopt this topic for your clinical research.
#10. Ethics and Professional Issues in Clinical Psychology
Last but not least, consider the value of examining both the main and more subtle ethics and professional issues in clinical psychology at work today, such as:
- Privacy
- Informed consent
- Cultural sensitivity
- Termination of counseling
Shape the Future of Mental Health with Alliant International University
From making a substantial difference in the lives of others to eradicating the stigmas that surround certain mental health conditions, clinical psychologists are in a prime position to fuel lasting change. Selecting a clinical research topic that ignites your spirit and works toward solving larger social issues takes this notion to the next level.
Alliant International University may get you closer to becoming the type of clinical psychologist who can make an impact. Whether you’re exploring our PsyD in Clinical Psychology or have just started college, we’re proud to offer doctoral programs for psychology that can help you excel in your future profession. And with online and in-person classes and training, you might find the flexibility your life requires.
Learn more about our clinical psychology programs today.
Sources:
- “Exploring the Latest Frontiers in Clinical Psychology Research.” The Clinic, March 25, 2024. https://theclinicca.org/exploring-the-latest-frontiers-in-clinical-psyc… .
- Park, Susanna Y, Chloe Nicksic Sigmon, and Debra Boeldt. “A Framework for the Implementation of Digital Mental Health Interventions: The Importance of Feasibility and Acceptability Research.” Cureus, September 19, 2022. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9580609/.
- Bond, Raymond R., Maurice D. Mulvenna, Courtney Potts, Siobhan O’Neill, Edel Ennis, and John Torous. “Digital Transformation of Mental Health Services.” Nature News, August 22, 2023. https://www.nature.com/articles/s44184-023-00033-y.
- “Cross-Cultural Mental Health.” CMHA British Columbia, July 14, 2016. https://bc.cmha.ca/documents/cross-cultural-mental-health-and-substance-use-2/.
- “New Research Looks at the Promise of ‘Digital Neuropsychology.’” McLean News | New Research Looks at the Promise of “Digital Neuropsychology,” January 7, 2019. https://www.mcleanhospital.org/news/new-research-looks-promise-digital-neuropsychology.
- Kuhfuß, Marie, Tobias Maldei, Andreas Hetmanek, and Nicola Baumann. “Somatic Experiencing - Effectiveness and Key Factors of a Body-Oriented Trauma Therapy: A Scoping Literature Review.” European journal of psychotraumatology, July 12, 2021. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8276649/.
- “The Intersection of Mental Health and Chronic Disease.” Johns Hopkins Bloomberg School of Public Health. Accessed April 17, 2024. https://publichealth.jhu.edu/2021/the-intersection-of-mental-health-and-chronic-disease.
- Theodora Blanchfield, AMFT. “What to Know about Brainspotting Therapy.” Verywell Mind, January 16, 2024. https://www.verywellmind.com/brainspotting-therapy-definition-techniques-and-efficacy-5213947.
- Social Determinants of Health and Mental Health. Accessed April 17, 2024. https://www.ncsc.org/__data/assets/pdf_file/0025/70864/Social-Determinants-of-Health.pdf.
- “Alcohol and Drug Abuse Statistics (Facts about Addiction).” American Addiction Centers, April 4, 2024. https://americanaddictioncenters.org/addiction-statistics#.
- “Data and Statistics on Children’s Mental Health.” Centers for Disease Control and Prevention, March 8, 2023. https://www.cdc.gov/childrensmentalhealth/data.html.
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Clinical Psychology History, Approaches, and Careers
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Clinical psychology specialty integrates the science of psychology with treating complex human problems. In addition to directing treating people for mental health concerns, the field of clinical psychology also supports communities, conducts research, and offers training to promote mental health for people of all ages and backgrounds.
This article discusses what clinical psychologists do, the history of the discipline, and the different approaches used today in treating mental health conditions.
What Is Clinical Psychology?
Clinical psychology is the branch of psychology concerned with assessing and treating mental illness, abnormal behavior, and psychiatric problems. This psychology specialty area provides comprehensive care and treatment for complex mental health problems. In addition to treating individuals, clinical psychology also focuses on couples, families, and groups.
History of Clinical Psychology
Early influences on the field of clinical psychology include the work of the Austrian psychoanalyst Sigmund Freud . He was one of the first to focus on the idea that mental illness was something that could be treated by talking with the patient, and it was the development of his talk therapy approach that is often cited as the earliest scientific use of clinical psychology.
American psychologist Lightner Witmer opened the first psychological clinic in 1896 with a specific focus on helping children who had learning disabilities. It was also Witmer who first introduced the term "clinical psychology" in a 1907 paper.
Witmer, a former student of Wilhelm Wundt , defined clinical psychology as "the study of individuals, by observation or experimentation, with the intention of promoting change."
By 1914, 26 other clinics devoted to clinical psychology had been established in the United States. Today, clinical psychology is one of the most popular subfields and the single largest employment area within psychology.
Evolution During the World Wars
Clinical psychology became more established during the period of World War I as practitioners demonstrated the usefulness of psychological assessments. In 1917, the American Association of Clinical Psychology was established, although it was replaced just two years later with the establishment of the American Psychological Association (APA).
During World War II, clinical psychologists were called upon to help treat what was then known as shell shock, now referred to as post-traumatic stress disorder (PTSD).
The demand for professionals to treat the many returning veterans in need of care contributed to the growth of clinical psychology during this period.
During the 1940s, the United States had no programs offering a formal clinical psychology degree. The U.S. Veterans Administration set up several doctoral-level training programs and by 1950 more than half of all the Doctor of Philosophy (PhD)-level degrees in psychology were awarded in the area of clinical psychology.
Changes in Focus
While the early focus in clinical psychology had mainly been on science and research, graduate programs began adding additional emphasis on psychotherapy . In clinical psychology PhD programs, this approach is today referred to as the scientist-practitioner or Boulder Model.
Later, the Doctor of Psychology (PsyD) degree option emerged, which emphasized professional practice more than research. This practice-oriented doctorate degree in clinical psychology is known as the practitioner-scholar or Vail model.
The field has continued to grow tremendously, and the demand for clinical psychologists today remains strong. One survey found that the percentage of women and minorities in clinical psychology programs has grown over the last two decades. Today, around two-thirds of clinical psychology trainees are women and one-quarter are ethnic minorities.
Treatment Approaches in Clinical Psychology
Clinical psychologists who work as psychotherapists often utilize different treatment approaches when working with clients. While some clinicians focus on a very specific treatment outlook, many use what is referred to as an eclectic approach. This involves drawing on different theoretical methods to develop the best treatment plan for each individual client.
Some of the major theoretical perspectives within clinical psychology include:
Psychodynamic Approach
This perspective grew from Sigmund Freud's work; he believed that the unconscious mind plays a vital role in our behavior. Psychologists who utilize psychoanalytic therapy may use techniques such as free association to investigate a client's underlying unconscious motivations.
Modern psychodynamic therapy utilizes talk therapy to help people gain insight, solve problems, and improve relationships. Research has found that this approach to treatment can be as effective as other therapy approaches.
Cognitive Behavioral Approaches
This approach to clinical psychology developed from the behavioral and cognitive schools of thought. Clinical psychologists using this perspective will look at how a client's feelings, behaviors, and thoughts interact.
Cognitive-behavioral therapy (CBT) often focuses on changing thoughts and behaviors contributing to psychological distress. Specific types of therapy that are rooted in CBT include:
- Acceptance and commitment therapy
- Cognitive processing therapy
- Dialectical behavior therapy
- Rational emotive behavior therapy
- Trauma-focused cognitive behavioral therapy
- Mindfulness-based cognitive therapy
Humanistic Approaches
This approach to clinical psychology grew from the work of humanist thinkers such as Abraham Maslow and Carl Rogers . This perspective looks at the client more holistically and is focused on such things as self-actualization .
Some types of humanistic therapy that a clinical psychologist might practice include client-centered therapy , existential therapy, Gestalt therapy, narrative therapy, or logotherapy.
How to Become a Clinical Psychologist
In the United States, clinical psychologists usually have a doctorate in psychology and receive training in clinical settings. The educational requirements to work in clinical psychology are quite rigorous, and most clinical psychologists spend between four to six years in graduate school after earning a bachelor's degree .
Generally speaking, PhD programs are centered on research, while PsyD programs are practice-oriented. Students may also find graduate programs that offer a terminal master's degree in clinical psychology.
Before choosing a clinical psychology program, you should always check to be sure that the program is accredited by the APA. After completing an accredited graduate training program, prospective clinical psychologists must also complete a period of supervised training and an examination.
Specific licensure requirements vary by state, so you should check with your state's licensing board to learn more.
Students in the United Kingdom can pursue a doctorate-level degree in clinical psychology (DClinPsychol or ClinPsyD) through programs sponsored by the National Health Service.
These programs are generally very competitive and are focused on both research and practice. Students interested in enrolling in one of these programs must have an undergraduate degree in a psychology program approved by the British Psychological Society in addition to experience requirements.
Careers In Clinical Psychology
Clinical psychologists work in a variety of settings (hospitals, clinics, private practice, universities, schools, etc.) and in many capacities. All of them require these professionals to draw on their expertise in special ways and for different purposes.
Some of the job roles performed by those working in clinical psychology can include:
- Assessment and diagnosis of psychological disorders , such as in a medical setting
- Treatment of psychological disorders , including drug and alcohol addiction
- Offering testimony in legal settings
- Teaching, often at the university level
- Conducting research
- Creating and administering programs to treat and prevent social problems
Some clinical psychologists may focus on one of these or provide several of these services. For example, someone may work directly with clients who are admitted to a hospital for psychological disorders, while also running a private therapeutic office that offers short-term and long-term outpatient services to those who need help coping with psychological distress.
Clinical psychology is one of the most popular areas in psychology, but it's important to evaluate your interests before deciding if this area might be right for you. If you enjoy working with people and are able to handle stress and conflict well, clinical psychology may be an excellent choice.
The field of clinical psychology will continue to grow and evolve thanks to the changing needs of the population, as well as shifts in approaches to healthcare policy. If you're still unsure whether clinical psychology is right for you, taking a psychology career self-test may help.
Roccella M, Vetri L. Adventures of clinical psychology . J Clin Med . 2021;10(21):4848. doi:10.3390/jcm10214848
Benjamin LT Jr. A history of clinical psychology as a profession in America (and a glimpse at its future) . Annu Rev Clin Psychol . 2005;1:1-30. doi:10.1146/annurev.clinpsy.1.102803.143758
Witmer L. Clinical psychology . Am Psychol. 1996 ;51 (3):248-251. doi:10.1037/0003-066X.51.3.248
Gee DG, DeYoung KA, McLaughlin KA, et al. Training the next generation of clinical psychological scientists: A data-driven call to action . Annu Rev Clin Psychol . 2022;18:43-70. doi:10.1146/annurev-clinpsy-081219-092500
American Psychological Association. Doctoral degrees in psychology: How are they different, or not so different ?
Foley KP, McNeil CB. Scholar-Practitioner Model . In: Cautin RL, Lilienfeld SO, eds. The Encyclopedia of Clinical Psychology . Hoboken, NJ: John Wiley & Sons; 2015. doi:10.1002/9781118625392.wbecp532
Norcross JC, Sayette MA, Pomerantz AM. Doctoral training in clinical psychology across 23 years: Continuity and change . J Clin Psychol . 2018;74(3):385-397. doi:10.1002/jclp.22517
Shedler J. The efficacy of psychodynamic psychotherapy . Am Psychol. 2010;65(2):98-109. doi:10.1037/a0018378
Steinert C, Munder T, Rabung S, Hoyer J, Leichsenring F. Psychodynamic therapy: as efficacious as other empirically supported treatments? A meta-analysis testing equivalence of outcomes . Am J Psychiatry . 2017;174(10):943-953. doi: 10.1176/appi.ajp.2017.17010057
Fenn K, Byrne M. The key principles of cognitive behavioural therapy . InnovAiT: Educ Inspir Gen Prac . 2013;6(9):579-585. doi:10.1177/1755738012471029
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By Kendra Cherry, MSEd Kendra Cherry, MS, is a psychosocial rehabilitation specialist, psychology educator, and author of the "Everything Psychology Book."
- Utility Menu
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Psychology Graduate Program
- Psychology Department
The Clinical Psychology Program adheres to a clinical science model of training, and is a member of the Academy of Psychological Clinical Science. We are committed to training clinical psychologists whose research advances scientific knowledge of psychopathology and its treatment, and who are capable of applying evidence-based methods of assessment and clinical intervention. The main emphasis of the program is research, especially on severe psychopathology. The program includes research, course work, and clinical practica, and usually takes five years to complete. Students typically complete assessment and treatment practica during their second and third years in the program, and they must fulfill all departmental requirements prior to beginning their one-year internship. The curriculum meets the requirements for licensure in Massachusetts, accreditation requirements of the American Psychological Association (APA; Office of Program Consultation and Accreditation, American Psychological Association, 750 First Street, NE, Washington, DC 20002-4242, [email protected] , Tel. [202] 336-5979), and accreditation requirements of the Psychological Clinical Science Accreditation System (PCSAS). PCSAS re-accredited the program on December 15, 2022 for a 10-year term. APA most recently accredited the program on April 28, 2015 for a seven-year term, which was extended due to COVID-related delays.
Requirements
Required courses and training experiences fulfill requirements for clinical psychology licensure in Massachusetts as well as meet APA criteria for the accreditation of clinical psychology programs. In addition to these courses, further training experiences are required in accordance with the American Psychological Association’s guidelines for the accreditation of clinical psychology programs (e.g., clinical practica [e.g., PSY 3050 Clinical Practicum, PSY 3080 Practicum in Neuropsychological Assessment]; clinical internship).
Students in the clinical psychology program are required to take the following courses:
- PSY 3900 Professional Ethics
- PSY 2445 Psychotherapy Research
- PSY 2070 Psychometric Theory and Method Using R
- PSY 2430 Cultural, Racial, and Ethnic Bases of Behavior
- PSY 3250 Psychological Testing
- PSY 2050 History of Psychology
- PSY 1951 Intermediate Quantitative Methods
- PSY 1952 Multivariate Analysis in Psychology
- PSY 2040 Contemporary Topics in Psychopathology
- PSY 2460 Diagnostic Interviewing
- PSY 2420 Cognitive-Behavioral Treatment of Psychological Disorders
Clinical students must also take one course in each of the following substantive areas: biological bases of behavior (e.g., PSY 1202 Modern Neuroanatomy; PSY 1325 The Emotional, Social Brain; PSY 1355 The Adolescent Brain; PSY 1702 The Emotional Mind); social bases of behavior (e.g., PSY 2500 Proseminar in Social Psychology); cognitive-affective bases of behavior (e.g., PSY 2400 Cognitive Psychology and Emotional Disorders); and individual differences (Required course PSY 2040 Contemporary Topics in Psychopathology fulfills the individual differences requirement for Massachusetts licensure). In accordance with American Psychological Association guidelines for the accreditation of clinical psychology programs, clinical students also receive consultation and supervision within the context of clinical practica in psychological assessment and treatment beginning in their second semester of their first year and running through their third year. They receive further exposure to additional topics (e.g., human development) in the Developmental Psychopathology seminar and in the twice-monthly clinical psychology “brown bag” speaker series. Finally, students complete a year-long clinical internship. Students are responsible for making sure that they take courses in all the relevant and required areas listed above. Students wishing to substitute one required course for another should seek advice from their advisor and from the director of clinical training prior to registering. During the first year, students are advised to get in as many requirements as possible. Many requirements can be completed before the deadlines stated below. First-year project: Under the guidance of a faculty member who serves as a mentor, students participate in a research project and write a formal report on their research progress. Due by May of first year. Second-year project: Original research project leading to a written report in the style of an APA journal article. A ten-minute oral presentation is also required. Due by May of second year. General exam: A six-hour exam covering the literature of the field. To be taken in September before the start of the third year. Thesis prospectus: A written description of the research proposed must be approved by a prospectus committee appointed by the CHD. Due at the beginning of the fourth year. Thesis and oral defense: Ordinarily this would be completed by the end of the fourth year. Clinical internship: Ordinarily this would occur in the fifth year. Students must have completed their thesis research prior to going on internship.
Credit for Prior Graduate Work
A PhD student who has completed at least one full term of satisfactory work in the Graduate School of Arts and Sciences may file an application at the Registrar’s Office requesting that work done in a graduate program elsewhere be counted toward the academic residence requirement. Forms are available online .
No more than the equivalent of eight half-courses may be so counted for the PhD.
An application for academic credit for work done elsewhere must contain a list of the courses, with grades, for which the student is seeking credit, and must be approved by the student’s department. In order for credit to be granted, official transcripts showing the courses for which credit is sought must be submitted to the registrar, unless they are already on file with the Graduate School. No guarantee is given in advance that such an application will be granted.
Only courses taken in a Harvard AB-AM or AB-SM program, in Harvard Summer School, as a GSAS Special Student or FAS courses taken as an employee under the Tuition Assistance Program (TAP) may be counted toward the minimum academic residence requirements for a Master’s degree.
Academic and financial credit for courses taken as a GSAS Special Student or FAS courses taken as a Harvard employee prior to admission to a degree program may be granted for a maximum of four half-courses toward a one-year Master’s and eight half-courses toward a two-year Master’s or the PhD degree.
Applications for academic and financial credit must be approved by the student’s department and should then be submitted to the Registrar’s Office.
Student Admissions, Outcomes, and other data
1. Time to Completion
![research study on clinical psychology Time to Completion 2023](https://grad.psychology.fas.harvard.edu/sites/projects.iq.harvard.edu/files/styles/os_files_xlarge/public/psych-grad/files/time_to_completion_2023.png?m=1698866053&itok=WFchBoR_)
Students can petition the program faculty to receive credit for prior graduate coursework, but it does not markedly reduce their expected time to complete the program.
2. Program Costs
![research study on clinical psychology Program costs 2023](https://grad.psychology.fas.harvard.edu/sites/projects.iq.harvard.edu/files/styles/os_files_xlarge/public/psych-grad/files/program_costs_2023.png?m=1698866083&itok=QZ9BdfmC)
3. Internships
![research study on clinical psychology Internship placement Table 1 2023](https://grad.psychology.fas.harvard.edu/sites/projects.iq.harvard.edu/files/styles/os_files_xlarge/public/psych-grad/files/internships_placement_table_1_2023.png?m=1698866113&itok=vNrePNKF)
4. Attrition
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5. Licensure
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Standard Financial Aid Award, Students Entering 2023
The financial aid package for Ph.D. students entering in 2023 will include tuition and health fees support for years one through four, or five, if needed; stipend support in years one and two; a summer research grant equal to two months stipend at the end of years one through four; teaching fellowship support in years three and four guaranteed by the Psychology Department; and a dissertation completion grant consisting of tuition and stipend support in the appropriate year. Typically students will not be allowed to teach while receiving a stipend in years one and two or during the dissertation completion year.
Year 1 (2023-24) and Year 2 (2024- 25) Tuition & Health Fees: Paid in Full Academic Year Stipend: $35,700 (10 months) Summer Research Award: $7,140 (2 months)
Year 3 (2025-26) & Year 4 (2026- 27) Tuition & Health Fees: Paid in Full Living Expenses: $35,700 (Teaching Fellowship plus supplement, if eligible) Summer Research Award: $7,140 (2 months)
Year 5 (2027-28) - if needed; may not be taken after the Dissertation Completion year Tuition & Health Fees: Paid in Full
Dissertation Completion Year (normally year 5, occasionally year 6) Tuition & Health Fees: Paid in Full Stipend for Living Expenses: $35,700
The academic year stipend is for the ten-month period September through June. The first stipend payment will be made available at the start of the fall term with subsequent disbursements on the first of each month. The summer research award is intended for use in July and August following the first four academic years.
In the third and fourth years, the guaranteed income of $35,700 includes four sections of teaching and, if necessary, a small supplement from the Graduate School. Your teaching fellowship is guaranteed by the Department provided you have passed the General Examination or equivalent and met any other department criteria. Students are required to take a teacher training course in the first year of teaching.
The dissertation completion year fellowship will be available as soon as you are prepared to finish your dissertation, ordinarily in the fifth year. Applications for the completion fellowship must be submitted in February of the year prior to utilizing the award. Dissertation completion fellowships are not guaranteed after the seventh year. Please note that registration in the Graduate School is always subject to your maintaining satisfactory progress toward the degree.
GSAS students are strongly encouraged to apply for appropriate Harvard and outside fellowships throughout their enrollment. All students who receive funds from an outside source are expected to accept the award in place of the above Harvard award. In such cases, students may be eligible to receive a GSAS award of up to $4,000 for each academic year of external funding secured or defer up to one year of GSAS stipend support.
For additional information, please refer to the Financial Support section of the GSAS website ( gsas.harvard.edu/financial-support ).
Registration and Financial Aid in the Graduate School are always subject to maintaining satisfactory progress toward the degree.
Psychology students are eligible to apply for generous research and travel grants from the Department.
The figures quoted above are estimates provided by the Graduate School of Arts and Sciences and are subject to change.
Office of Program Consultation and Accreditation American Psychological Association 750 First Street, NE Washington, DC 20002 Phone: (202) 336-5979 E-mail: [email protected] www.apa.org/ed/accreditation
The Director of Clinical Training is Prof. Richard J. McNally who can be reached by telephone at (617) 495-3853 or via e-mail at: [email protected] .
- Clinical Internship Allowance
Harvard Clinical Psychology Student Handbook
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Clinical Psychology
Mission statement.
Our mission is to advance knowledge that promotes psychological well-being and reduces the burden of mental illness and problems in living and to develop leading clinical scientists whose skills and knowledge will have a substantial impact on the field of psychology and the lives of those in need. Our faculty and graduate students promote critical thinking, innovation, and discovery, and strive to be leaders in their field, engaging in and influencing research, practice, policy, and education. Our pursuit of these goals is guided by the values of collaboration, mutual respect, and fairness, our commitment to diversity, and the highest ethical standards.
Information about the Clinical Psychology Graduate Major
UCLA’s Clinical Psychology program is one of the largest, most selective, and most highly regarded in the country and aims to produce future faculty, researchers, and leaders in clinical science, who influence research, policy development, and practice. Clinical science is a field of psychology that strives to generate and disseminate the best possible knowledge, whether basic or applied, to reduce suffering and to advance public health and wellness. Rather than viewing research and intervention as separable, clinical science construes these activities as part of a single, broad domain of expertise and action. Students in the program are immersed in an empirical, research-based approach to clinical training. This, in turn, informs their research endeavors with a strong understanding of associated psychological phenomena. The UCLA Clinical Science Training Programs employs rigorous methods and theories from multiple perspectives, in the context of human diversity. Our goal is to develop the next generation of clinical scientists who will advance and share knowledge related to the origins, development, assessment, treatment, and prevention of mental health problems.
Admissions decisions are based on applicants’ research interests and experiences, formal coursework in psychology and associated fields, academic performance, letters of recommendation, dedication to and suitability for a career as a clinical scientist, program fit, and contributions to an intellectually rich, diverse class. Once admitted, students engage with faculty in research activities addressing critical issues that impact psychological well-being and the burden of mental illness, using a wide range of approaches and at varying levels of analysis. Their integrated training is facilitated by on-campus resources including the departmental Psychology Clinic, the Semel Institute for Neuroscience and Human Behavior, and the David Geffen School of Medicine.
Our program philosophy is embodied in, and our goals are achieved through, a series of training activities that prepare students for increasingly complex, demanding, and independent roles as clinical scientists. These training activities expose students to the reciprocal relationship between scientific research and provision of clinical services, and to various systems and methods of intervention, assessment, and other clinical services with demographically and clinically diverse populations. The curriculum is designed to produce scientifically-minded scholars who are well-trained in research and practice, who use data to develop and refine the knowledge base in their field, and who bring a reasoned empirical perspective to positions of leadership in research and service delivery.
The program’s individualized supervision of each student in integrated research and practice roles provides considerable flexibility. Within the parameters set by faculty interests and practicum resources, there are specializations in child psychopathology and treatment, cognitive-behavior therapy, clinical assessment, adult psychopathology and treatment, family processes, assessment and intervention with distressed couples, community psychology, stress and coping, cognitive and affective neuroscience, minority mental health, and health psychology and behavioral medicine. The faculty and other research resources of the Department make possible an intensive concentration in particular areas of clinical psychology, while at the same time ensuring breadth of training.
Clinical psychology at UCLA is a six-year program including a full-time one-year internship, at least four years of which must be completed in residence at UCLA. The curriculum in clinical psychology is based on a twelve-month academic year. The program includes a mixture of coursework, clinical practicum training, teaching, and continuous involvement in research. Many of the twenty clinical area faculty, along with numerous clinical psychologists from other campus departments, community clinics, and hospitals settings, contribute to clinical supervision. Clinical training experiences typically include four and a half years of part-time practicum placements in the Psychology Clinic and local agencies. The required one-year full-time internship is undertaken after the student has passed the clinical qualifying examinations and the dissertation preliminary orals. The student receives the Ph.D. degree when both the dissertation and an approved internship are completed.
Accreditation
PCSAS – Psychological Clinical Science Accreditation System
The Graduate Program in Clinical Psychology at UCLA was accredited in 2012 by the Psychological Clinical Science Accreditation System (PCSAS). PCSAS was created to promote science-centered education and training in clinical psychology, to increase the quality and quantity of clinical scientists contributing to the advancement of public health, and to enhance the scientific knowledge base for mental and behavioral health care. The UCLA program is deeply committed to these goals and proud to be a member of the PCSAS Founder’s Circle and one of the group of programs accredited by PCSAS. (Psychological Clinical Science Accreditation System, 1800 Massachusetts Avenue NW, Suite 402, Washington, DC 20036-1218. Telephone: 301-455-8046). Website: https://www.pcsas.org
APA CoA – American Psychological Association Commission on Accreditation
The Graduate Program in Clinical Psychology at UCLA has been accredited by the American Psychological Association Commission on Accreditation since 1949. (Office of Program Consultation and Accreditation, American Psychological Association, 750 First Street NE. Washington, DC 20002-4242. Telephone: 202-336-5979 .) Website: http://www.apa.org/ed/accreditation/
Future Accreditation Plans:
Against the backdrop of distressing evidence that mental health problems are increasingly prevalent and burdensome, the field of psychological clinical science must think innovatively to address the unmet mental health needs of vulnerable populations. UCLA’s clinical psychology program remains committed to training clinical psychological scientists who will become leaders in research, dissemination, and implementation of knowledge, policy development, and evidence-based clinical practice. This commitment is firmly rooted in our overall mission of promoting equity and inclusion, adhering to ethical standards, and developing collaborations in all aspects of clinical psychology.
Increasingly, we believe that significant aspects of the academic and clinical-service requirements of accreditation by the American Psychological Association (APA) obstruct our training mission. Too often, APA requirements limit our ability to flexibly adapt our program to evolving scientific evidence, student needs, and global trends in mental health. Like many other top clinical science doctoral programs, we see our longstanding accreditation by the Psychological Clinical Science Accreditation System (PCSAS) as better aligned with our core values, including advancement of scientifically-based training.
Accordingly, we are unlikely to seek renewal of our program’s accreditation by APA, which is set to expire in 2028. The ultimate decision about re-accreditation will be made with the best interests and well-being of current and future students in our program in mind. To that end, we will continue to monitor important criteria that will determine the career prospects of students completing a doctoral degree in clinical psychology from programs accredited only by PCSAS. For example, we are working to understand the potential implications for securing excellent predoctoral internships and eligibility for professional licensure across jurisdictions in North America. Although the UCLA clinical psychology program has no direct influence over these external organizations, we are excited to continue to work to shape this evolving training landscape with the Academy of Psychological Clinical Science (APCS) and leaders from other clinical science programs.
Our ongoing monitoring of trends in clinical psychology training is encouraging for PCSAS-accredited programs. However, evolving circumstances could result in our program changing its opinion with respect to seeking APA re-accreditation in the future. In the spirit of transparency and empowering potential applicants to make informed choices for their own professional development, we are pleased to share our thinking on these important issues.
Notice to Students re: Professional Licensure and Certification
University of California programs for professions that require licensure or certification are intended to prepare the student for California licensure and certification requirements. Admission into programs for professions that require licensure and certification does not guarantee that students will obtain a license or certificate. Licensure and certification requirements are set by agencies that are not controlled by or affiliated with the University of California and licensure and certification requirements can change at any time.
The University of California has not determined whether its programs meet other states’ educational or professional requirements for licensure and certification. Students planning to pursue licensure or certification in other states are responsible for determining whether, if they complete a University of California program, they will meet their state’s requirements for licensure or certification. This disclosure is made pursuant to 34 CFR §668.43(a)(5)(v)(C).
NOTE: Although the UCLA Clinical Psychology Program is not designed to ensure license eligibility, the majority of our graduates do go on to become professionally licensed. For more information, please see https://www.ucop.edu/institutional-research-academic-planning/content-analysis/academic-planning/licensure-and-certification-disclosures.html .
Clinical Program Policy on Diversity-Related Training
In light of our guiding values of collaboration, respect, and fairness, this statement is to inform prospective and current trainees, faculty, and supervisors, as well as the public, that our trainees are required to (a) attain an understanding of cultural and individual diversity as related to both the science and practice of psychology and (b) provide competent and ethical services to diverse individuals. Our primary consideration is always the welfare of the client. Should such a conflict arise in which the trainee’s beliefs, values, worldview, or culture limits their ability to meet this requirement, as determined by either the student or the supervisor, it should be reported to the Clinic and Placements Committee, either directly or through a supervisor or clinical area faculty member. The Committee will take a developmental view, such that if the competency to deliver services cannot be sufficiently developed in time to protect and serve a potentially impacted client, the committee will (a) consider a reassignment of the client so as to protect the client’s immediate interests, and (b) request from the student a plan to reach the above-stated competencies, to be developed and implemented in consultation with both the trainee’s supervisor and the Clinic Director. There should be no reasonable expectation of a trainee being exempted from having clients with any particular background or characteristics assigned to them for the duration of their training.
Clinical Program Grievance Policies & Procedures
Unfortunately, conflicts between students and faculty or with other students will occur, and the following policies and procedures are provided in an effort to achieve the best solution. The first step in addressing these conflicts is for the student to consult with their academic advisor. If this option is not feasible (e.g. the conflict is with the advisor) or the conflict is not resolved to their satisfaction, then the issue should be brought to the attention of the Director of Clinical Training. If in the unlikely event that an effective solution is not achieved at this level, then the student has the option of consulting with the Department’s Vice Chair for Graduate Studies. Students also have the option of seeking assistance from the campus Office of Ombuds Services and the Office of the Dean of Students. It is expected that all such conflicts are to be addressed first within the program, then within the Department, before seeking a resolution outside of the department.
More Clinical Psychology Information
- For a list of Required Courses please see the Psychology Handbook
- Psychology Clinic
- Student Admissions Outcomes and Other Data
Clinical Psychology Research
![research study on clinical psychology clinical psychology research](https://www.allpsychologycareers.com/wp-content/uploads/2021/02/clinical-psychology-research.jpg)
Clinical psychology research is as important to the nation’s health and well being as medical research. In the same way that medical scientists work to understand the prevention, genesis, and spread of various genetic and infectious diseases, scientists conduct rigorous psychological research studies to understand, prevent, and treat the human condition as it applies psychologically to individuals, couples, families, cultures, and diverse communities.
Empirical results gathered from psychological research studies guide practitioners in developing effective interventions and techniques that clinical psychologists employ – proven, reliable results that improve lives, mend troubled relationships, manage addictions, and help manage and treat a variety of other mental health issues. Clinical psychology by definition marries science with practical knowledge, integrates the two, and produces a field that encourages a robust, ongoing process of scientific discovery and clinical application.
Trained at how to evaluate this large body of research, clinical psychology students continue to make significant professional contributions to the field even after graduation, staying current and up-to-date with psychological research taking place at universities and research labs across the world. Some decide to stay in research, investigating new ways to understand the human mind, and developing solutions to enrich the lives of all others.
Research in the area of clinical psychology is vast, containing hundreds if not thousands of topics. However, most of these research studies generally fall within one of three main areas integral to clinical psychology:
A large part of a clinical psychologist’s job, and therefore clinical psychology research, involves assessment – or developing valid and reliable tests. Assessments take the form of written tests, such as intelligence and achievement tests, vocational tests, and other tests designed to measure aptitude and skill levels for specific jobs, careers, interests, and personality types.
Clinical psychologists also interview individuals, review their medical records, and conduct clinical observations as part of the assessment process. A comprehensive assessment approach ensures that psychologists apply the most effective and appropriate psychological treatments and interventions.
In addition, assessment research in clinical psychology also involves developing valid and reliable ways to measure the outcome of specific treatments and interventions. Michael C. Roberts and Stephen S. Hardi state in their article, “Research Methodology and Clinical Psychology: An Overview,” that improvements in therapy and psychotherapeutic effects rest on targeted research informed by scientific methodologies.
“Measurement of treatment procedures, treatment integrity, behavioral changes, functional performance, objective measurements, perceptions of change, and satisfaction from a variety of sources, follow-up assessment, etc., are needed to establish the ‘scientific credentials’ of each therapeutic approach,” Roberts and Hardi state.
They also stress the importance of robust research assessments to measure the costs and benefits associated with psychotherapeutic outcomes and prevention interventions.
After gathering assessment data, psychologists consult the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-R), which lists criteria and standardized definitions for mental illnesses and conditions. Categories of symptoms differentiate one mental illness from another, and the usual course of each illness.
Beyond the DSM-IV-R, however, research in the area of diagnosing mental health problems remains one of the most exciting research areas in the field today – thanks to rapid advances in technology. Numerous brain imaging techniques that map brain structure and function now give researchers “images” of both normal and abnormal brain functioning. Scientists are using computed tomography (CT), magnetic resonance imaging (MRI), and positron emission tomography (PET) to come up with greater precision and accuracy in diagnosing various mental illnesses.
Psychotherapies
The number of psychotherapies – a set of procedures or techniques that evaluate psychological problems, and come up with alternative ways of thinking, behaving, or feeling – has exploded in popularity since the middle of the last century. Most psychotherapies fall within one of the four main psychotherapeutic frameworks:
What is Psychodynamic Therapy?
Psychodynamic therapy explores an individual’s unconscious, seeking reasons or explanations for the individual’s current behavior. This therapy, also called insight-oriented therapy, attempts to bring underlying factors grounded in early life to the individual’s attention, increasing self-awareness and self-understanding.
Psychodynamic therapy stems from Sigmund Freud’s focus on psychoanalysis, making it the oldest form of psychotherapy. As a result, a large body of research exists to either support or refute the effectiveness of this approach.
Because the results of psychoanalysis research are harder to measure than behavioral-oriented therapies, research methodologies and outcomes of treatment have been questioned – especially those of the earliest studies. Psychodynamic therapy requires long-term treatment, sometimes a year or more, also complicating the research process. However, researchers today apply the most rigorous scientific processes, including meta-analysis studies completed over a number of years, to study of efficacy of psychodynamic practice and techniques, and many studies report significant positive outcomes.
In 2008, the Journal of the American Medical Association (JAMA) used a meta-analysis process to examine studies published between January 1, 1960, and May 31, 2008, identifying the possible effects of long-term psychodynamic psychotherapy. JAMA reported positive outcomes – especially for those with complex mental disorders, such as patients with personality disorders, chronic mental disorders, multiple mental disorders, and complex depressive and anxiety disorders .
Current Sample Topics in Research Psychodynamic Therapy Include:
- Psychodynamic therapy with addicted individuals.
- Childhood neurosis and adult mental health.
- Dreams and emotions in situations of childhood abuse.
- Psychodynamic psychology and sexuality.
- Structure and function of the psyche.
- Psychoanalytic play therapy.
- Psychic suffering.
- The practice and art of psychotherapeutic dialogue.
- Treating schizophrenia with psychodynamic therapies.
- Individuation and wholeness.
- Psychodynamic psychology and human development.
- Transference and psychodynamic psychology.
What is Humanistic Therapy?
According to the Association of Humanistic Psychology (AHP) , humanistic psychology today emphasizes “the independent dignity and worth of human beings and their conscious capacity to develop personal competence and self respect. This value orientation has led to the development of therapies to facilitate personal and interpersonal skills, and to enhance the quality of life.”
Humanistic therapy, founded by psychologist Carl Rogers, grew out of a reaction to psychoanalysis and behaviorism, two schools of thought that Rogers considered too “pessimistic.” Through psychoanalysis, Freud dwelled on unconscious motivators for behavior, while behaviorism, which followed developments in psychoanalysis, attributed behaviors to learned conditioning processes.
Instead, Rogers believed in downplays the pathological dimensions to an individual’s life, and alternatively, focusing on healthy aspects or behaviors. Rogers emphasized human potential, inherent goodness, the ability to self-direct by making choices; his form of psychotherapy came to be known as client-centered therapy. Self-actualization and developing a strong “sense of self” became the groundwork for this psychological framework and area of research.
AHP also acknowledges that negative and destructive forces in society can affect the mind, causing harm and dysfunction. Therefore, many humanistic psychologists also stress the importance of social change, modifying institutions and organizations to support human development, and acknowledging and building connectedness throughout a globally interdependent world.
Research, therefore, in humanistic psychology focuses not only on finding appropriate interventions toward helping individuals find their purpose and meaning in life, but also on peace and social justice issues within communities, nations, and the world. Transpersonal and quantum psychology, metaphysics, politics, economics, neuroconsciousness, and the environment are examples of topics explored in humanistic psychology research.
Some of the Current Research Topics in Humanistic Therapy and Theory:
- Feminism and psychology.
- Issues of Identity.
- The self and authenticity.
- The connection between people, the environment and spirituality.
- The psychology of climate change.
- Diet: physiological, psychological, and spiritual growth.
- Creative, empathetic, and critical thinking with self-reflection.
- Finding meaning in one’s work and career.
- Finding meaning in suffering.
- The psychology of creativity.
- Community-building.
- Evolving consciousness.
- Spirituality and personal growth.
- Existential psychotherapy.
What is Cognitive Behavioral Therapy (CBT)?
As the name implies, this therapy addresses both cognition – thoughts, feelings, emotions – and behaviors, attempting to change dysfunctional ways of thinking or misguided thought patterns that often lead to dysfunctional and sometimes harmful behaviors.
The therapy focuses on the present, current thought patterns, identifying distortions, and applying interventions that specifically target those errant thoughts. These interventions and techniques are problem-solving solutions, first guiding individuals in how to evaluate and modify beliefs, and then, how to change correspondingly unhealthy behaviors and interactions. Metaphorically, CBT interventions resemble a step-by-step “how-to” manual, giving instructions, and then empowering the individual to follow the steps, observe how they feel, and report back to the therapist the successes or challenges encountered. Typically, this type of therapy is short-term and goal-oriented, with occasional “checkups” to gauge progress and help in correcting any missteps.
CBT is “evidence-based” therapy, meaning that psychologists seek interventions that have been proven empirically through rigorously controlled experiments. The National Association of Cognitive-Behavioral Therapists bases its definition of evidence-based therapy on the following explanation by Aldo R. Pucci, MA, DCBT:
- an approach to therapy that emphasizes the pursuit of evidence on which to base its theory and techniques, as well as encourages its patients or clients to consider evidence before taking action; or
- an approach to therapy is supported by research findings, and those findings provide evidence that it is effective.
Because cognitive behavioral therapists base their applications on evidence-based research, the amount of CBT research surpasses the amount of psychotherapeutic research in nearly all other areas.
Some of the Popular Research Topics that CBT Addresses:
- Controlling chronic pain
- Treating anxiety and panic disorders
- CBT techniques for criminal offenders
- Using CBT for substance abuse and addiction disorders
- Eating disorders
- Post traumatic stress disorder
- Trauma from abusive relationships and situations
- Seasonal Affect Disorder
- Agoraphobia
**In addition, CBT research often addresses the management and treatment of a number of medical conditions through cognitive behavioral therapies and interventions, including: side effects of cancer; sickle cell; disease pain; irritable-bowel syndrome; obesity; asthma; rheumatic disease pain; temporomandibular disorder; erectile dysfunction; infertility; chronic fatigue syndrome; pre-menstrual syndrome.
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What is Family Systems Therapy or Family Therapy?
Family systems therapy is psychotherapy that treats families, couples, and close-knit groups of people or extended families, as a system. This means that the psychologist treats the family, couple, or group as a unit, which scientists believe function as one organism or system, operating with a distinct set of communication and interaction patterns, and internal rules – all directly affecting behaviors. Rather than focus on the dysfunction or problems of one individual, the entire system receives therapy.
Over the past 20 years, this form of psychotherapy that began with a focus on the traditional family unit has expanded to include therapy for all types of familial relationships, including gay and lesbian couples and families, extended families related through divorce and re-marriage, and other groups that resemble family systems, such as church or religious groups.
For this reason, researchers of family systems theory and therapy have experienced an exponential growth in the number of topics and issues for study and investigation.
Family systems research projects fall within the following categories:
- School and learning difficulties
- Adjustments to bereavement
- Adjustments to geographical location
- Adjustment to physical or mental illness or disability
- Marital or relationship problems
- Divorce issues
- Substance abuse and behavioral disorders
- Nutritional, physiological and health issues
Within each research category, researchers study specific issues, issues that often cross into other categories as well. Below are some additional research topics studied today in family systems therapy
Eating Disorders Research:
- Is family therapy or individual therapy most effective for treating adolescent anorexia nervosa?
- Does dysfunctional family communication and relationship patterns cause eating disorders? Or does the stress associated with raising a child with an eating disorder cause dysfunctional family problems?
- What is the impact of eating disorders on families?
- How do family dynamics affect individuals with eating disorders?
- How does the mother-infant relationship affect future eating disorders?
- How does the Maudsley Method of treating eating disorders work compared to other more traditional forms of family systems therapy? (Maudsley takes a behavioral approach of giving all family members responsibility of ensuring that the suffering individual eats, finishes each meal, and receives incentives and rewards for eating.)
School and Learning Research:
- How do learning disabilities of one family member affect the entire family? Parents? Other siblings? And how the family functions?
- Should the assessment and treatment of a person with ADHD ( Attention Deficit Hyperactivity Disorder ) occur in the context of an individual’s family system?
- What are effective family therapies for childhood behavioral disorders?
- What are the psychological effects on parents and families of autistic children?
Adjustments to Bereavement Research:
- What are the needs of bereaved families?
- What are the long-term effects of a child’s death on a family?
- How do social/cultural influences affect how families cope with the loss of a family member?
- How does disenfranchised grief affect families? (Disenfranchised grief is grief not acknowledged by society, such as loss of a pet, an aborted or miscarried pregnancy, the loss of a child to adoption, the death of a celebrity, or a fictional character.)
Adjustments to Geographical Location Research:
- Re-location effects on military children and spouses.
- Re-location effects on civilian children: social, behavioral and cognitive development.
- Immigration and family emotional process.
Marital or Relationship Research:
- Does emotion-focused couples therapy work and facilitate forgiveness?
- Does a couple-based approach work to reduce the effects of post traumatic stress disorder (ptsd)?
- How can couples restore emotional intimacy and passion?
- What are the most effective interventions for aiding better communication between couples?
- The interplay between healthy relationships and reproduction.
- Genetics, physiology and relationships
Substance Abuse and Behavioral Disorders Research:
- How does family structure and functioning affect drug abusers?
- How does drug abuse by a family member affect siblings/parents/family functioning?
- What is the importance of parent-child relationships on preventing drug use and abuse?
Adjustment to Physical and Mental Illness or Disability Research:
- Family involvement in the treatment of mentally ill relatives.
- Multimedia interventions for families where one or more members suffer with a genetic disease.
- What are the effects of family network support and mental health recovery?
- Family functioning and depression in low-income Latino families and couples.
- Implications of violence and abuse on the family.
- The effect of AIDS on the family.
Nutritional, Physiological and Health Research:
- Cancer prevention for families.
- Family functioning and the effects of obesity.
Divorce Research:
- Does therapeutic divorce mediation work? (Divorce mediation is a therapeutic intervention for helping highly conflicted parents resolve disputes about their children.)
- What are the effects of divorce on young children, adolescents, and young adults?
- Reconciliation issues after divorce.
- Inter-parental conflict and its effects on children of divorce.
- How to establish healthy co-parenting roles.
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80 fascinating psychology research questions for your next project
Last updated
15 February 2024
Reviewed by
Brittany Ferri, PhD, OTR/L
Short on time? Get an AI generated summary of this article instead
Psychology research is essential for furthering our understanding of human behavior and improving the diagnosis and treatment of psychological conditions.
When psychologists know more about how different social and cultural factors influence how humans act, think, and feel, they can recommend improvements to practices in areas such as education, sport, healthcare, and law enforcement.
Below, you will find 80 research question examples across 16 branches of psychology. First, though, let’s look at some tips to help you select a suitable research topic.
- How to choose a good psychology research topic
Psychology has many branches that break down further into topics. Choosing a topic for your psychology research paper can be daunting because there are so many to choose from. It’s an important choice, as the topic you select will open up a range of questions to explore.
The tips below can help you find a psychology research topic that suits your skills and interests.
Tip #1: Select a topic that interests you
Passion and interest should fuel every research project. A topic that fascinates you will most likely interest others as well. Think about the questions you and others might have and decide on the issues that matter most. Draw on your own interests, but also keep your research topical and relevant to others.
Don’t limit yourself to a topic that you already know about. Instead, choose one that will make you want to know more and dig deeper. This will keep you motivated and excited about your research.
Tip #2: Choose a topic with a manageable scope
If your topic is too broad, you can get overwhelmed by the amount of information available and have trouble maintaining focus. On the other hand, you may find it difficult to find enough information if you choose a topic that is too narrow.
To determine if the topic is too broad or too narrow, start researching as early as possible. If you find there’s an overwhelming amount of research material, you’ll probably need to narrow the topic down. For example, instead of researching the general population, it might be easier to focus on a specific age group. Ask yourself what area of the general topic interests you most and focus on that.
If your scope is too narrow, try to generalize or focus on a larger related topic. Expand your search criteria or select additional databases for information. Consider if the topic is too new to have much information published on it as well.
Tip #3: Select a topic that will produce useful and relevant insights
Doing some preliminary research will reveal any existing research on the topic. If there is existing research, will you be able to produce new insights? You might need to focus on a different area or see if the existing research has limitations that you can overcome.
Bear in mind that finding new information from which to draw fresh insights may be impossible if your topic has been over-researched.
You’ll also need to consider whether your topic is relevant to current trends and needs. For example, researching psychology topics related to social media use may be highly relevant today.
- 80 psychology research topics and questions
Psychology is a broad subject with many branches and potential areas of study. Here are some of them:
Developmental
Personality
Experimental
Organizational
Educational
Neuropsychology
Controversial topics
Below we offer some suggestions on research topics and questions that can get you started. Keep in mind that these are not all-inclusive but should be personalized to fit the theme of your paper.
Social psychology research topics and questions
Social psychology has roots as far back as the 18th century. In simple terms, it’s the study of how behavior is influenced by the presence and behavior of others. It is the science of finding out who we are, who we think we are, and how our perceptions affect ourselves and others. It looks at personalities, relationships, and group behavior.
Here are some potential research questions and paper titles for this topic:
How does social media use impact perceptions of body image in male adolescents?
2. Is childhood bullying a risk factor for social anxiety in adults?
Is homophobia in individuals caused by genetic or environmental factors?
What is the most important psychological predictor of a person’s willingness to donate to charity?
Does a person’s height impact how other people perceive them? If so, how?
Cognitive psychology research questions
Cognitive psychology is the branch that focuses on the interactions of thinking, emotion, creativity, and problem-solving. It also explores the reasons humans think the way they do.
This topic involves exploring how people think by measuring intelligence, thoughts, and cognition.
Here are some research question ideas:
6. Is there a link between chronic stress and memory function?
7. Can certain kinds of music trigger memories in people with memory loss?
8. Do remote meetings impact the efficacy of team decision-making?
9. Do word games and puzzles slow cognitive decline in adults over the age of 80?
10. Does watching television impact a child’s reading ability?
Developmental psychology research questions
Developmental psychology is the study of how humans grow and change over their lifespan. It usually focuses on the social, emotional, and physical development of babies and children, though it can apply to people of all ages. Developmental psychology is important for understanding how we learn, mature, and adapt to changes.
Here are some questions that might inspire your research:
11. Does grief accelerate the aging process?
12. How do parent–child attachment patterns influence the development of emotion regulation in teenagers?
13. Does bilingualism affect cognitive decline in adults over the age of 70?
14. How does the transition to adulthood impact decision-making abilities
15. How does early exposure to music impact mental health and well-being in school-aged children?
Personality psychology research questions
Personality psychology studies personalities, how they develop, their structures, and the processes that define them. It looks at intelligence, disposition, moral beliefs, thoughts, and reactions.
The goal of this branch of psychology is to scientifically interpret the way personality patterns manifest into an individual’s behaviors. Here are some example research questions:
16. Nature vs. nurture: Which impacts personality development the most?
17. The role of genetics on personality: Does an adopted child take on their biological parents’ personality traits?
18. How do personality traits influence leadership styles and effectiveness in organizational settings?
19. Is there a relationship between an individual’s personality and mental health?
20. Can a chronic illness affect your personality?
Abnormal psychology research questions
As the name suggests, abnormal psychology is a branch that focuses on abnormal behavior and psychopathology (the scientific study of mental illness or disorders).
Abnormal behavior can be challenging to define. Who decides what is “normal”? As such, psychologists in this area focus on the level of distress that certain behaviors may cause, although this typically involves studying mental health conditions such as depression, obsessive-compulsive disorder (OCD), and phobias.
Here are some questions to consider:
21. How does technology impact the development of social anxiety disorder?
22. What are the factors behind the rising incidence of eating disorders in adolescents?
23. Are mindfulness-based interventions effective in the treatment of PTSD?
24. Is there a connection between depression and gambling addiction?
25. Can physical trauma cause psychopathy?
Clinical psychology research questions
Clinical psychology deals with assessing and treating mental illness or abnormal or psychiatric behaviors. It differs from abnormal psychology in that it focuses more on treatments and clinical aspects, while abnormal psychology is more behavioral focused.
This is a specialty area that provides care and treatment for complex mental health conditions. This can include treatment, not only for individuals but for couples, families, and other groups. Clinical psychology also supports communities, conducts research, and offers training to promote mental health. This category is very broad, so there are lots of topics to explore.
Below are some example research questions to consider:
26. Do criminals require more specific therapies or interventions?
27. How effective are selective serotonin reuptake inhibitors in treating mental health disorders?
28. Are there any disadvantages to humanistic therapy?
29. Can group therapy be more beneficial than one-on-one therapy sessions?
30. What are the factors to consider when selecting the right treatment plan for patients with anxiety?
Experimental psychology research questions
Experimental psychology deals with studies that can prove or disprove a hypothesis. Psychologists in this field use scientific methods to collect data on basic psychological processes such as memory, cognition, and learning. They use this data to test the whys and hows of behavior and how outside factors influence its creation.
Areas of interest in this branch relate to perception, memory, emotion, and sensation. The below are example questions that could inspire your own research:
31. Do male or female parents/carers have a more calming influence on children?
32. Will your preference for a genre of music increase the more you listen to it?
33. What are the psychological effects of posting on social media vs. not posting?
34. How is productivity affected by social connection?
35. Is cheating contagious?
Organizational psychology research questions
Organizational psychology studies human behavior in the workplace. It is most frequently used to evaluate an employee, group, or a company’s organizational dynamics. Researchers aim to isolate issues and identify solutions.
This area of study can be beneficial to both employees and employers since the goal is to improve the overall work environment and experience. Researchers apply psychological principles and findings to recommend improvements in performance, communication, job satisfaction, and safety.
Some potential research questions include the following:
36. How do different leadership styles affect employee morale?
37. Do longer lunch breaks boost employee productivity?
38. Is gender an antecedent to workplace stress?
39. What is the most effective way to promote work–life balance among employees?
40. How do different organizational structures impact the effectiveness of communication, decision-making, and productivity?
Forensic psychology research questions
Some questions to consider exploring in this branch of psychology are:
41. How does incarceration affect mental health?
42. Is childhood trauma a driver for criminal behavior during adulthood?
43. Are people with mental health conditions more likely to be victims of crimes?
44. What are the drivers of false memories, and how do they impact the justice system?
45. Is the media responsible for copycat crimes?
Educational psychology research questions
Educational psychology studies children in an educational setting. It covers topics like teaching methods, aptitude assessment, self-motivation, technology, and parental involvement.
Research in this field of psychology is vital for understanding and optimizing learning processes. It informs educators about cognitive development, learning styles, and effective teaching strategies.
Here are some example research questions:
46. Are different teaching styles more beneficial for children at different times of the day?
47. Can listening to classical music regularly increase a student’s test scores?
48. Is there a connection between sugar consumption and knowledge retention in students?
49. Does sleep duration and quality impact academic performance?
50. Does daily meditation at school influence students’ academic performance and mental health?
Sports psychology research question examples
Sport psychology aims to optimize physical performance and well-being in athletes by using cognitive and behavioral practices and interventions. Some methods include counseling, training, and clinical interventions.
Research in this area is important because it can improve team and individual performance, resilience, motivation, confidence, and overall well-being
Here are some research question ideas for you to consider:
51. How can a famous coach affect a team’s performance?
52. How can athletes control negative emotions in violent or high-contact sports?
53. How does using social media impact an athlete’s performance and well-being?
54. Can psychological interventions help with injury rehabilitation?
55. How can mindfulness practices boost sports performance?
Cultural psychology research question examples
The premise of this branch of psychology is that mind and culture are inseparable. In other words, people are shaped by their cultures, and their cultures are shaped by them. This can be a complex interaction.
Cultural psychology is vital as it explores how cultural context shapes individuals’ thoughts, behaviors, and perceptions. It provides insights into diverse perspectives, promoting cross-cultural understanding and reducing biases.
Here are some ideas that you might consider researching:
56. Are there cultural differences in how people perceive and deal with pain?
57. Are different cultures at increased risk of developing mental health conditions?
58. Are there cultural differences in coping strategies for stress?
59. Do our different cultures shape our personalities?
60. How does multi-generational culture influence family values and structure?
Health psychology research question examples
Health psychology is a crucial field of study. Understanding how psychological factors influence health behaviors, adherence to medical treatments, and overall wellness enables health experts to develop effective interventions and preventive measures, ultimately improving health outcomes.
Health psychology also aids in managing stress, promoting healthy behaviors, and optimizing mental health, fostering a holistic approach to well-being.
Here are five ideas to inspire research in this field:
61. How can health psychology interventions improve lifestyle behaviors to prevent cardiovascular diseases?
62. What role do social norms play in vaping among adolescents?
63. What role do personality traits play in the development and management of chronic pain conditions?
64. How do cultural beliefs and attitudes influence health-seeking behaviors in diverse populations?
65. What are the psychological factors influencing the adherence to preventive health behaviors, such as vaccination and regular screenings?
Neuropsychology research paper question examples
Neuropsychology research explores how a person’s cognition and behavior are related to their brain and nervous system. Researchers aim to advance the diagnosis and treatment of behavioral and cognitive effects of neurological disorders.
Researchers may work with children facing learning or developmental challenges, or with adults with declining cognitive abilities. They may also focus on injuries or illnesses of the brain, such as traumatic brain injuries, to determine the effect on cognitive and behavioral functions.
Neuropsychology informs diagnosis and treatment strategies for conditions such as dementia, traumatic brain injuries, and psychiatric disorders. Understanding the neural basis of behavior enhances our ability to optimize cognitive functioning, rehabilitate people with brain injuries, and improve patient care.
Here are some example research questions to consider:
66. How do neurotransmitter imbalances in specific brain regions contribute to mood disorders such as depression?
67. How can a traumatic brain injury affect memory?
68. What neural processes underlie attention deficits in people with ADHD?
69. Do medications affect the brain differently after a traumatic brain injury?
70. What are the behavioral effects of prolonged brain swelling?
Psychology of religion research question examples
The psychology of religion is a field that studies the interplay between belief systems, spirituality, and mental well-being. It explores the application of the psychological methods and interpretive frameworks of religious traditions and how they relate to both religious and non-religious people.
Psychology of religion research contributes to a holistic understanding of human experiences. It fosters cultural competence and guides therapeutic approaches that respect diverse spiritual beliefs.
Here are some example research questions in this field:
71. What impact does a religious upbringing have on a child’s self-esteem?
72. How do religious beliefs shape decision-making and perceptions of morality?
73. What is the impact of religious indoctrination?
74. Is there correlation between religious and mindfulness practices?
75. How does religious affiliation impact attitudes towards mental health treatment and help-seeking behaviors?
Controversial topics in psychology research question examples
Some psychology topics don’t fit into any of the subcategories above, but they may still be worthwhile topics to consider. These topics are the ones that spark interest, conversation, debate, and disagreement. They are often inspired by current issues and assess the validity of older research.
Consider some of these research question examples:
76. How does the rise in on-screen violence impact behavior in adolescents.
77. Should access to social media platforms be restricted in children under the age of 12 to improve mental health?
78. Are prescription mental health medications over-prescribed in older adults? If so, what are the effects of this?
79. Cognitive biases in AI: what are the implications for decision-making?
80. What are the psychological and ethical implications of using virtual reality in exposure therapy for treating trauma-related conditions?
- Inspiration for your next psychology research project
You can choose from a diverse range of research questions that intersect and overlap across various specialties.
From cognitive psychology to clinical studies, each inquiry contributes to a deeper understanding of the human mind and behavior. Importantly, the relevance of these questions transcends individual disciplines, as many findings offer insights applicable across multiple areas of study.
As health trends evolve and societal needs shift, new topics emerge, fueling continual exploration and discovery. Diving into this ever-changing and expanding area of study enables you to navigate the complexities of the human experience and pave the way for innovative solutions to the challenges of tomorrow.
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Research Article
A study of the effects of four reading styles on college students’ mental health and quality of life based on positive psychology-A first-of-its-kind study
Roles Writing – original draft, Writing – review & editing
* E-mail: [email protected]
Affiliation Shanghai University Of Political Science and Law, Shanghai, China
![research study on clinical psychology ORCID logo](https://journals.plos.org/resource/img/orcid_16x16.png)
- Published: August 28, 2024
- https://doi.org/10.1371/journal.pone.0308475
- Reader Comments
The increase in mental health problems among college students has become a global challenge, with anxiety and depression in particular becoming increasingly prevalent. Positive psychology has gained attention as an important psychological intervention that emphasizes improving mental health by promoting positive emotions and mindfulness. However, with the diversity of reading styles, however, there is a lack of systematic research on these effects. Therefore, this study aims to explore the specific effects of different reading styles on college students’ mental health and quality of life based on positive psychology, with the aim of providing more effective interventions and recommendations for improving college students’ mental health.
This study used a two-round questionnaire to select students with mental health problems and divided them into four experimental groups with a control group. The study was conducted by distributing questionnaires and experimental interventions, and a total of 2860 valid questionnaires were collected. The study used the Self-Assessment Scale for Anxiety (SAS) and the Self-Depression Scale (SDS) to assess the participants’ anxiety and depression levels. In addition, the study used the Physical Composite Score (PCS) and the Mental Composite Score (MCS) to assess the participants’ quality of life. SPSS 26.0 was used for data statistics and repeated measures ANOVA was used.
Paper text reading and audio reading methods were effective in reducing anxiety levels and improving sleep quality. However, the electronic text reading approach was less effective compared to paper text reading and audio reading, and the video reading approach was not effective in improving depression. In addition, the positive psychology literature reading intervention showed significant improvements in college students’ quality of life scores.
The results of this study suggest that paper text reading and audio reading modalities have a positive impact on the mental health and quality of life of college students, while e-text reading and video reading modalities are less effective. These findings provide suggestions for college students to choose appropriate reading styles and further demonstrate the effectiveness of positive psychology reading on mental health. These results have important academic and practical implications for promoting mental health and improving quality of life among college students.
Citation: Liu Y (2024) A study of the effects of four reading styles on college students’ mental health and quality of life based on positive psychology-A first-of-its-kind study. PLoS ONE 19(8): e0308475. https://doi.org/10.1371/journal.pone.0308475
Editor: Ehsan Namaziandost, Ahvaz Jundishapur University: Ahvaz Jondishapour University of Medical Sciences, ISLAMIC REPUBLIC OF IRAN
Received: June 5, 2024; Accepted: July 25, 2024; Published: August 28, 2024
Copyright: © 2024 Yamei Liu. This is an open access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Data Availability: All the relevant data are in the manuscript itself.
Funding: The author(s) received no specific funding for this work.
Competing interests: The authors have declared that no competing interests exist.
Introduction
Concern, and the problem of negative emotions among college students is becoming increasingly serious, with anxiety and depression becoming prevalent mental health challenges [ 1 ]. The college student population is particularly vulnerable to anxiety and depression due to factors such as academic stress, interpersonal relationships, and uncertain employment prospects [ 2 – 4 ]. A study by Stallman [ 5 ] noted that poor mental health in higher education globally has become a serious problem for public health. Li [ 6 ] found that mental health problems can lead to serious consequences such as extreme behaviors such as suicide. These studies emphasize the urgency and importance of mental health problems among college students. Mental health problems also affect the quality of daily life and sleep quality of university students, which negatively affects academic efficiency and life status [ 7 ]. A study by Ataei [ 8 ] showed that mental health problems such as anxiety and depression reduce life satisfaction and make it more difficult to enjoy life. This may manifest itself in the form of diminished interest in daily activities, reduced socialization, and even a loss of confidence and motivation in life. Mental health problems are also closely related to the quality of sleep and academic efficiency of college students. Studies by Alsubaie [ 9 ] have shown that mental health problems such as anxiety and depression can lead to decreased quality of sleep, which affects college students’ learning and memory. This reduced sleep quality may lead to daytime fatigue and poor concentration, which in turn affects academic efficiency and performance. In addition, negative mental states can seriously affect the quality of life, mainly in daily physical discomfort, as well as negative mental states in life [ 10 ]. Lovell’s [ 11 ] study showed that persistent negative emotions can lead to tension and stress responses in the body, increasing the risk of various physical illnesses, and that a long-term state of anxiety may lead to muscle tension, headache, stomach upset, and other physical discomfort, while chronic depressive states may be associated with physiological problems such as decreased immune system function and cardiovascular disease. In addition, negative psychological states can also have an impact on an individual’s habits and behaviors. Jenkins [ 12 ] showed that psychological problems such as depression and anxiety tend to lead to a decrease in an individual’s interest and motivation in daily activities, which in turn affects his or her quality of life. In addition, a study by Tavakoly [ 13 ] found that depressed individuals often lack active participation in daily life and may suffer from sleep disorders, eating disorders, and other problems, which further exacerbate their feelings of physical discomfort and negative psychological states. Therefore, timely and effective intervention and management of negative psychological states are essential to promote individuals’ physical and mental health and enhance their quality of life.
Positive psychology is a branch of psychology that emphasizes individual strengths, abilities, and resources and aims to improve the quality of life by enhancing positive emotions, individual growth, and psychological resilience [ 14 ] Scholars such as Martin Seligman proposed this theory in the early 1990s, arguing that psychology should focus not only on problems and deficits, but also on the positive aspects of individuals. They pointed out that through the cultivation of positive emotions, the development of individual strengths, and the search for meaning and purpose, individuals can better cope with the challenges and difficulties of life. Positive psychology emphasizes individual strengths and resources rather than problems or deficits, and enhances mental health and quality of life by promoting positive emotions and individual growth. In addition, positive psychology emphasizes an individual’s psychological resilience, which is how quickly an individual adapts and recovers in the face of challenges and adversity [ 15 ]. This resilience is not only the ability to cope with stress, but also the ability to learn, grow, and rebuild hope from setbacks and failures. By developing this psychological resilience, individuals can better cope with change and uncertainty in their lives, thereby maintaining mental health and a stable emotional state. In addition, positive psychology deals with how individuals find and realize meaning and purpose in life. It is believed that individuals having clear goals and perceived meaning in life can help them to be more motivated to pursue their desires and ambitions. This pursuit not only enhances an individual’s intrinsic motivation and fulfillment, but can also lead to lasting mental health benefits in the long term.
From a reading perspective, positive psychology suggests that positive psychology works can have a positive impact on mental health by stimulating positive emotions, self-identity, and a sense of social support in readers. From a reading perspective, proponents of the theory of positive psychology argue that reading works related to positive psychology can produce multiple benefits psychologically [ 16 ]. Several studies have shown that readers are able to feel a positive emotional impact through exposure to positive thoughts and emotional expressions, which can enhance psychological well-being and satisfaction. These works often help individuals to better cope with daily stresses and challenges by encouraging them to utilize their strengths, enhancing their sense of self-identity, and strengthening their social support networks. Further research has also pointed out that reading about positive psychology can also help individuals build greater psychological resilience, i.e., return to normal more quickly in the face of adversity. This positive psychological resilience not only helps individuals to perform well in their personal lives, but also to better maintain social and interpersonal relationships [ 17 ]. some literary works have been shown to have positive psychological effects in the context of positive psychology. Through plot, characterization, and emotional expression, these works stimulate readers’ inner positive emotions and psychological resources, thus promoting individuals’ mental health and lifestyle improvement [ 18 ]. For example, Yang’s [ 19 ] study found that reading positive psychology works can enhance people’s sense of self-identity, emotional regulation and sense of social support, and thus improve their mental health. Therefore, the reading of positive psychology works is not only a recreational activity, but also an effective way of mental health promotion. This is because the reading of literature can be an effective method of promoting students’ mental health and well-being in a school setting. Liu’s [ 20 ] study demonstrated that positive literature reading can be used as a therapeutic approach to mental health that can reduce depressive symptoms and improve well-being, which in turn is expected to further enhance students’ quality of life and well-being.
Positive psychology has become an important area of research by investigating ways in which individuals can realize their potential and enhance their well-being and mental health. Whereas, previous research in positive psychology has usually focused on investigating individuals’ emotional states, levels of mental health, and the factors that influence them. Researchers have assessed participants’ emotional states and mental health indicators by using various psychometric tools and instruments, such as psychological questionnaires and mood logs. In addition, some intervention studies have received extensive attention, such as verbal counseling and emotion regulation skills training [ 21 ], which are interventions designed to help individuals enhance their positive emotions and mental health. However, despite the remarkable progress in positive psychology in terms of emotion investigation and intervention research, there is a relative lack of in-depth exploration of literary reading in this area. Literature reading, as a process of deep thinking, is believed to have a significant impact on individuals’ mental health and emotional states, but its specific effects and its association with positive psychology remain under-explored [ 22 ].
Although there have been studies proving the positive effects of positive psychology works on mental health, with the diversification of social life and the development of information technology, people’s ways of reading literature have become increasingly diverse [ 23 ]. In addition to traditional paper-based reading methods, emerging reading methods such as e-reading, audio reading, and video reading are increasingly favored by people. However, different reading styles may have different effects on mental health, but there is a lack of systematic research on the specific effects of different reading styles on college students’ mental health. Therefore, this study aims to investigate the effects of different reading styles based on positive psychology (including paper reading, e-reading, audio reading, and video reading) on the mental health and quality of life of college students, and to further analyze their effects on sleep quality and quality of life, so as to provide more effective interventions and suggestions for college students’ mental health.
Purpose and significance of the study: this study aims to explore the specific effects of different reading styles on the mental health and quality of life of college students, based on positive psychology. With the increase in mental health problems among college students and the growing prevalence of issues such as anxiety and depression, positive psychology has gained attention as an important psychological intervention that emphasizes the improvement of mental health through the promotion of positive emotions and positive thoughts. However, due to the diversity of reading styles, there is a lack of systematic research on these effects. Therefore, this study aimed to explore the specific effects of different reading styles on the mental health and quality of life of college students for the purpose of providing more effective interventions and recommendations for improving their mental health.
Participants and methods
Participants, participant recruitment and selection..
Participant recruitment began on March 20, 2024 and lasted until April 30th. We chose four universities in the Shanghai area as the study sites, which included (Shanghai University of Political Science and Law, Shanghai University of Physical Education, East China Normal University, and Shanghai University). The target group was students enrolled in these universities, mainly because college students generally face academic stress and mental health challenges.
Questionnaire instruments and platform.
We used the Self-Assessment Anxiety Scale (SAS) and Self-Assessment Depression Scale (SDS) as the main psychometric instruments. These scales are widely used to assess individuals’ anxiety and depression levels. The questionnaire survey was conducted through an online platform, Questionnaire Star, which facilitated questionnaire distribution, retrieval, and data management.
Questionnaire distribution and recovery.
A total of 2915 questionnaires were distributed to the participants, which included basic personal information, and the completion of the SAS and SDS scales. The questionnaires were designed with clear language, logical questions and completeness of information in mind to ensure the quality of the data.
Data screening and processing.
The returned questionnaires were carefully screened and validated to confirm that they contained valid and complete data. Invalid questionnaires mainly consisted of errors in filling out, incomplete information or failure to fill out the scale correctly. These invalid questionnaires were excluded from the analysis to ensure the accuracy and credibility of the follow-up data.
Screening for anxiety and depression levels.
in the first round of questionnaires, we analyzed participants’ SAS and SDS scores. Participants with high levels of anxiety and depression were identified based on scores above the normal range. These participants were included in the subsequent experimental intervention group for assessment and analysis of intervention effects.
Ethical review and informed consent.
all participants received a detailed description of the experiment, including its purpose, procedures, risks, and benefits, before participating in the experiment. Each participant signed an informed consent form confirming their voluntary participation and understanding of the experiment. The ethics committee reviewed the study protocol and approved the ethical compliance of the experiment (approval number SH20240126). Through the above steps, we ensured that the data sources of the study and the participant selection process were scientifically sound and transparent. These measures not only helped to ensure the quality of the data, but also protected the rights and interests of the participants and the legitimacy of the study. The results of the survey are presented in Table 1 .
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https://doi.org/10.1371/journal.pone.0308475.t001
Experimental design
College students suffering from anxiety and depression levels were randomized in equal proportions into five groups (Paper text reading), (Electronic text reading), (Audio listening reading), (Video image reading), (Control group) ( Table 2 ) and an 8-week intervention of literary reading with stories selected from Lao She’s Camel Xiangzi, one of the famous works of modern literature [ 24 ]. The stories were selected based on three criteria; (1) positive psychology themes, and (2) participants were given a total of eight chapters (1 per week). Each story contained at least one positive psychology theme, but some stories contained more than one theme. These themes included gratitude, compassion, character strengths, positive thinking, empathy, forgiveness, responsibility, humility, perseverance, and justice. The specific experimental process and protocol are shown in Fig 1 .
PTR: paper text reading, ETR: electronic text reading, ALR: audio listening reading, VIR: video image reading, CG: control group.
https://doi.org/10.1371/journal.pone.0308475.g001
https://doi.org/10.1371/journal.pone.0308475.t002
Mental health measurement modalities
Self-assessment anxiety scale (sas)..
The Self-Assessment Anxiety Scale (SAS) was developed by William Zung in 1971 (42) and is intended to be widely used among college students for the assessment of anxiety states [ 25 ]-. The scale consists of 15 positively rated items and 5 negatively rated items. Each item is rated on a four-point scale: 1 for “none or very little of the time”; 2 for “some of the time”; 3 for “most of the time”; and 4 for “The main statistical measure of the SAS is the total score (standardized score). The total score is calculated by adding the scores of all items, multiplying by 1.25, and rounding to the nearest whole number to obtain the standardized score. Standard scores below 50 are considered normal, while higher standard scores indicate more severe anxiety symptoms. The reliability of the scale was good, with a retest reliability of 0.82. The Cronbacha’s alpha for this study’s scale was 0.976.
Self-Rated Depression Scale (SDS).
The Self-Rating Depression Scale (SDS) was originally created by William Zung in 1965 [ 26 ]. It consists of 10 positively rated items and 10 negatively rated items. Each item is rated on a four-point scale: 1 for “none or very little of the time”; 2 for “some of the time”; 3 for “most of the time”; 4 for “most or all of the time”; and 5 for “most or all of the time”. “The main statistical indicator of the SDS is the total score. The crude score was multiplied by 1.25 and rounded to the nearest whole number to generate a standardized score, where the crude score was obtained by adding up the scores of all items in the questionnaire. Standard scores below 50 were considered normal, while higher standard scores indicated more severe depressive symptoms. The reliability of the scale was good with a retest reliability of 0.83. The Cronbacha’s alpha for this study scale was 0.82.
Quality of life measurement modalities
Pittsburgh sleep quality index (psqi)..
The Pittsburgh Sleep Quality Index (PSQI) was developed and revised by several scholars [ 27 ]. It is designed to assess the quality of sleep of college students during the past month. The scale contains 18 self-assessment items covering seven areas: subjective sleep quality, sleep duration, sleep efficiency, sleep disorders, use of hypnotic medication, and daytime dysfunction. Each item is scored on a scale ranging from 0 to 3, and all item scores are summarized to form a total PSQI score. The higher the total score, the worse the quality of sleep. Some studies have used a PSQI total score greater than or equal to 8 as a criterion for poor sleep quality [ 28 ]. The scale has good reliability and validity, with a retest reliability of 0.86. The Cronbacha’s alpha for this study scale was 0.861.
Short Form 36 Health Survey Questionnaire (SF-36).
The SF-36 (Short Form 36 Health Survey) is a universal scale for evaluating health-related quality of life, developed by the U.S. Bureau of Medicine Research Group [ 29 ]. The scale consists of eight dimensions that assess quality of life in terms of physical health and mental health. These dimensions include Physical Functioning (PF), Role Physical (RP), Bodily Pain (BP), General Health (GH), Vitality (VT), Social Functioning, SF), Emotional Functioning (Role Emotional, RE), and Mental Health (MH). Based on these eight dimensions, two summary scales were constructed in this study:Physical Composite Score (PCS) and Mental Composite Score (MCS).Generally assessing quality of life below 60 indicates a poor standard of living, and the higher the score the better the quality of life. The reliability of this scale was good, with a re-test reliability of 0.87. The Cronbacha’s alpha for this study scale was 0.92.
Quality control of the scale.
The researchers received special training to ensure the quality of the survey during the first round of the scale’s distribution phase, and during the second round of the pre- and post-intervention distribution phase. The purposes of the surveys were clearly labeled in the guidelines for the use of the questionnaires. The SAS, SDS, PSQI, and SF-36 have a high degree of reliability and validity and are widely used internationally. To ensure that participants were able to truthfully report their psychological state, responses were anonymous and no private information such as name and address was collected. Participants were asked to complete the questionnaire within 2 days after it was sent out to avoid selection bias that would prolong the study period. In addition, to ensure the validity of the reading intervention, the researchers were asked to take ownership of the experimental process and to understand what needed to be done during the intervention, when to start and end the intervention, etc. When analyzing and processing the statistical data after the reading intervention, the researchers strictly followed the principles of truthfulness and objectivity.
Statistical analysis.
SPSS 26.0 software was used for data processing and analysis. All indicators were analyzed by descriptive statistics and expressed using the mean plus or minus standard deviation. Paired-samples t-test was used for within-group comparisons before and after the intervention, while comparisons between groups were analyzed by ANOVA using the difference [ 30 ]. The difference value is also the value of the change after the intervention minus the change before the intervention in different reading styles, so that the statistics better reflect the changes brought about by the effect of the intervention between groups, and the significance level was set at 0.05 in the statistical analysis, with a P-value of less than 0.05 being regarded as significant.
Mental health outcomes before and after 4 literary reading interventions based on positive psychology
Table 3 shows that, the within-group changes in the mental health of college students before and after the intervention of the 4 reading styles. Anxiety results showed that the anxiety scores of reading styles of PTR and ALR were very significantly lower after the intervention than before the intervention (P < 0.01), the anxiety scores of reading styles of VIR were significant after the intervention than before the intervention (P < 0.05), and the anxiety scores of reading styles of ETR and CG were not significantly different before and after the intervention (P > 0.05). Depression results showed that the anxiety scores of reading styles of PTR and ALR were very significantly lower after the intervention than before the intervention (P < 0.01), the anxiety scores of reading styles of ETR were significantly pre-intervention after the intervention (P < 0.05), and the anxiety scores of reading styles of VIR and CG were not significantly different before and after the intervention (P > 0.05).
https://doi.org/10.1371/journal.pone.0308475.t003
The Table 4 shows that the differences between the groups before and after the intervention of the four reading styles on the mental health of college students, and the results show that At the level of anxiety, all four reading styles, PTR, ETR, ALR, and VIR, had significant changes for CG (P < 0.05), and the effect of PTR reading style was more significant, followed by ALR reading style, and there was no difference in the effect of ETR and VIR on anxiety improvement (P > 0.05). At the depression level, all four reading modalities, PTR, ETR, ALR, and VIR, had significant changes for CG (P < 0.05), and the effect of ALR reading modality was more significant, followed by PTR reading modality, and there was no difference in the effect of ETR and VIR on the improvement of depression (P > 0.05).
https://doi.org/10.1371/journal.pone.0308475.t004
Results of sleep quality before and after intervention of 4 types of literature reading based on positive psychology
Changes in sleep quality before and after intervention, the Table 5 shows, within-group changes before and after the intervention of the 4 reading styles on college students’ sleep, the results show that the four reading styles of PTR, ETR, ALR, and VIR had very significantly lower sleep quality scores after the intervention than before the intervention (P < 0.01), and there was no significant difference in the sleep quality scores of the CG’s reading styles before and after the intervention (P > 0.05).
https://doi.org/10.1371/journal.pone.0308475.t005
The Table 6 shows that the differences between groups before and after the intervention of the four reading styles on the mental health of college students, the results show that PTR, ETR, ALR, VIR four kinds of reading before and after the intervention of sleep quality have significant changes for CG (P < 0.05), and PTR reading mode effect is higher significant, ETR reading mode is significantly the lowest, ALR and VIR for the improvement of sleep quality effect does not have a difference in the change (P > 0.05).
https://doi.org/10.1371/journal.pone.0308475.t006
Positive psychology-based quality of life results before and after the intervention of 4 types of literature reading
The Table 7 shows, the within-group changes in quality of life of college students before and after the intervention of the 4 reading styles, the results show that the quality of life- (PCS) scores after the intervention of the four reading styles of PTR, ETR, ALR, and VIR were very significantly higher than the pre-intervention (P < 0.01), and there was no significant difference in the quality of sleep scores before and after the intervention of the CG’s reading styles (P > 0.05), the Quality of life- (MCS) scores were very significantly higher after the four reading styles intervention for PTR, ETR, ALR, and VIR than before the intervention (P < 0.01), and there was no significant difference in CG’s reading style sleep quality scores before and after the intervention (P > 0.05).
https://doi.org/10.1371/journal.pone.0308475.t007
The Table 8 shows, the differences between groups before and after the intervention of the four reading styles on the quality of life of college students, the results show that PTR, ETR, ALR, VIR four reading styles before and after the intervention of quality of life ‐ (PCS) scores have a significant change for CG (P < 0.05), and the effect of PTR and ETR reading styles is more significant. And there was no differential change between. The quality of life- (MCS) scores before and after the intervention of the four reading styles PTR, ETR, ALR, and VIR all had significant changes for CG (P < 0.05), and there was no difference in the effect of the intervention between PTR and ETR, and there was no difference in the effect of the intervention between ALR and VIR.
https://doi.org/10.1371/journal.pone.0308475.t008
A positive psychology-based analysis of 4 reading styles affecting college students’ mental health
Our study found that college students’ anxiety and depression levels improved significantly with four different reading modality interventions. Specifically, the PTR and ALR reading modalities showed significant reductions in anxiety and depression scores, and the VIR modality showed significant improvements in anxiety scores. the ETR and CG (traditional reading) modalities showed smaller or non-significant effects on anxiety and depression improvements. When comparing the effects of the different reading modalities together, the PTR reading modality showed the most significant improvement in anxiety, while the ALR reading modality had the most significant effect on depression improvement. This finding is consistent with Zhang’s [ 31 ] study, who found that paper books often make people feel the tactile sensation of the texture of the paper, while audio content can create an emotional atmosphere through the conveyance of sound, and these factors work together to motivate people to engage more deeply with the work, which in turn triggers more profound emotional resonance and reflection. Further analysis reveals that the reason why paper text and audio reading methods can be so effective may stem from the fact that they stimulate people’s imagination and emotional expression. Through Macdonald’s [ 32 ] study, it was shown that imaginative activities during the reading process could deepen the understanding and experience of the textual content, resulting in a more profound emotional experience. This further emphasizes the importance of choosing a reading style that suits one’s needs. Therefore, through paper text and audio reading methods, people can not only enhance their reading experience, but also improve anxiety symptoms, thus promoting mental health [ 33 ]. This is because positive psychology is read in a way that focuses on personal strengths, positive emotions, and experiences aimed at fostering a sense of well-being and psychological resilience [ 34 ]. By emphasizing personal strengths and positive emotions, positive psychology helps people to better adapt to challenges, overcome difficulties, and better cope with various stresses and negative emotions in their lives [ 35 ].
Our study also found that VIR approach can also significantly improve anxiety levels, albeit slightly less effectively than paper-based text and audio reading. However, video reading also has a higher degree of variability and interactivity, and readers can obtain more information through visual elements, which contribute to the attractiveness and comprehension of the reading [ 36 ]. Therefore, our study shows that video reading can reduce anxiety symptoms to a certain extent, especially for those who are not interested enough or not very good at text and audio reading. Therefore, video reading, as an emerging reading method, also has an important role in mental health promotion, especially in the digital reading environment, which provides people with a new reading choice and meets the reading needs of different groups of people. However, this study found that reading by audio reading method did not improve college students’ anxiety. This may be due to the fact that the audio reading method does not provide a similar sense of immersion and imagination as paper-based text reading. It is not a good choice of method for improving anxiety, and in summary, choosing the right reading method for you is crucial for improving anxiety. Paper-based text reading and audio reading are better able to trigger imagination and emotional resonance, thus having a significant improvement effect on college students’ anxiety. Therefore, encouraging college students to choose text reading and audio reading methods will help improve their mental health and reduce anxiety symptoms.
In addition, this paper found that the e-text reading approach was slightly less effective than PTR and ALR in intervening on depressive symptoms, which may be due to the lack of tactile and audio emotional experience in e-text reading compared to traditional paper text reading. This is consistent with the study of Floyd [ 37 ], who found that depressed patients often face a state of physical and mental exhaustion, and they may feel tired, helpless, and frustrated, and may even experience physical discomfort, in which their perception of external stimuli and emotional experiences may be reduced, which means that they are more in need of sensory-rich experiences to alleviate their emotional distress. However, electronic text reading often fails to provide the sense of touch and the texture of paper that traditional paper books have, and it also fails to bring about the sound experience that audio reading brings. This prevents depressed patients from enjoying the pleasurable feelings that accompany physical books during reading, thus reducing the likelihood that they will obtain psychological relief through reading. Therefore, the electronic text reading method is not as effective as paper text reading and audio reading. In addition, our study found that the video reading method had no effect on depression improvement, which is different from the previous study by Pan [ 38 ], in which a number of previous studies had shown that viewing video content can enhance an individual’s mood state, thereby helping to alleviate mild depressive mood. Our study found that video reading had less of an effect compared to text reading, which may be related to a possible lack of the depth of thought and introspection that text reading has. Depressed patients often need to resolve their inner distress through deep reflection and emotional empathy, while video reading may not provide enough space and time for them to engage in self-reflection and emotional adjustment [ 39 ]. Positive psychology emphasizes the use of positive emotions, personal strengths, and positive experiences to enhance individual mental health and well-being Positive psychology-based literature reading has a positive effect on improving the mental health of college students, but when dealing with anxiety and depression, it is necessary to choose the appropriate reading method to avoid the influence of negative emotions, so as to better enhance mental health.
A positive psychology-based analysis of four reading styles affecting college students’ quality of life
Our study found that college students’ sleep quality significantly improved with four different reading style interventions. Specifically, all four reading styles, PTR, ETR, ALR, and VIR, significantly reduced students’ sleep quality scores after the intervention. Further comparison of the effects between the reading styles revealed that the PTR reading style was the most effective in improving sleep quality. These results further confirm the effectiveness of positive psychology literature reading in improving sleep. Of particular note is the higher significance of the effect of the PTR reading style. This may be due to the fact that the paper text reading approach is closer to the traditional reading experience and can provide a more comfortable and immersive reading environment, which helps to relax the brain and body and mind, thus promoting the improvement of sleep quality [ 40 ]. This is in line with a previous related study by Zhang [ 41 ]. His study found a correlation between literature reading and sleep quality. By immersing themselves in literature, readers can get rid of the stress and anxiety of real life and enter a relaxed and quiet mental state, which helps to fall asleep and improve the depth of sleep. Promoting the improvement of college students’ sleep quality will bring multiple benefits. In addition, good sleep quality can improve the attention and concentration of college students, which can help improve learning efficiency and academic performance [ 42 ]. Therefore, this study further confirms the important role of positive psychology literature reading on college students’ sleep quality and provides an easy and effective intervention to promote college students’ physical and mental health.
In addition, our results found that the quality of life of college students significantly improved under four different reading style interventions. Specifically, the four reading styles, PTR, ETR, ALR, and VIR, significantly improved students’ physical health and mental health composite scores (PCS) after the intervention. Conventional reading style (CG) had no significant effect on quality of life improvement. Further comparison of the effects between the reading styles revealed that the PTR and ETR reading styles were more effective in improving the physical health scores, while there was no significant difference in the effects of ALR and VIR on the mental health scores. Therefore, In our study, we found that the quality of life-PCS (physical health subscale) and quality of life-MCS (mental health subscale) scores of college students were significantly improved through the literature reading intervention of positive psychology. This implies that literature reading not only helps to improve the physical health of college students, but also enhances their mental health, which comprehensively improves the overall quality of life. This is consistent with Egert’s [ 43 ] study that by immersing themselves in literature with positive psychology, readers can experience the lives of different characters and feel emotional resonance and empathy, thus promoting their own emotional regulation and psychological growth. This emotional experience and thinking process can improve an individual’s mental health, reduce negative emotions such as anxiety and depression, and enhance psychological resilience and coping ability, thereby improving the quality of life [ 44 ]. This study further confirms the positive impact of positive psychology literature reading on quality of life. This finding not only provides an easy and effective way for college students to enhance their quality of life, but also provides new ideas and approaches for mental health interventions. By promoting and applying this positive psychology literature reading approach, it can further promote the physical and mental health of college students and improve their overall quality of life. And it provides a reasonable choice for college students to choose the appropriate way of reading.
Therefore, this paper examines different reading styles through positive psychology and finds that it can significantly improve the mood and quality of life of college students. Paper text reading and audio reading helped to reduce anxiety levels and enhance mental health and well-being. Visual reading, although slightly less effective, provides interactivity and variability that is suitable for college students in a digital reading environment. Choosing the right type of reading is critical to improving anxiety, and these studies provide effective mental health strategies and reading options for college students.
This is a first-of-its-kind study that examines the effects of different reading styles on the mental health and quality of life of college students, based on a positive psychology perspective, and fills a research gap in a related field. The study involved four different reading styles, including paper text reading, electronic text reading, audio listening and video image reading, and explored the impact of reading styles on mental health and quality of life from multiple perspectives. The study adopted positive psychology as an important psychological intervention, emphasizing the improvement of mental health through the promotion of positive emotions and positive thoughts, and providing more effective interventions and suggestions for the mental health of college students.
Limitations.
sample limitations, lack of detail in the experimental design, and possible subjectivity in the interpretation of results. Future research could further improve sample selection, expand the scope of the study population, and increase the diversity of the sample in order to increase the generalization of the findings. In addition, future studies could enhance the rigor of the experimental design by describing the experimental steps and control variables in more detail to ensure the reliability of the findings.
This study examined how various reading styles rooted in positive psychology affect college students’ mental health and quality of life. Paper-based text and audio reading significantly reduced anxiety levels, likely due to their tactile and emotional engagement benefits, fostering deeper emotional resonance and reflection. Paper text reading notably enhanced sleep quality by creating a relaxing, immersive environment. In contrast, electronic text reading proved less effective than paper and audio formats, possibly due to its lack of tactile and immersive qualities. Video reading did not improve depression symptoms compared to text reading, possibly due to its limited capacity for introspection. These findings underscore the benefits of paper and audio reading for mental health enhancement, offering guidance for college students seeking effective reading strategies aligned with positive psychology principles. These findings have important academic and practical implications for promoting mental health and improving quality of life among college students.
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Stop Worrying About Being Happy: New Berkeley Psychology Research Suggests Doing So Makes People Unhappy
![research study on clinical psychology headshot of woman smiling](https://vcresearch.berkeley.edu/sites/default/files/inline-images/unnamed_1.jpg)
A new Berkeley Psychology research study suggests that worrying too much about happiness can actually make you feel less happy and even more depressed.
The research, which was published in August in the American Psychological Association’s journal Emotion and titled “Unpacking the Pursuit of Happiness,” is a collaboration between UC Berkeley Psychology professors Iris Mauss and Oliver P. John, along with Berkeley Psychology alumni Felicia K. Zerwas (New York University postdoctoral researcher) and Brett Q. Ford (University of Toronto associate psychology professor).
The study examined two different aspects of pursuing happiness: aspiring to be happy and being concerned about one’s level of happiness. Results showed that aspiring to be happy did not predict a person’s overall well-being. But being concerned about happiness was heavily associated with lower well-being, including less satisfaction with life and greater depression symptoms.
“This means that changing how one thinks about happiness — specifically, decreasing one’s concern about happiness — should benefit mental health,” Professor Mauss said. “We need to be alert when we obsess over our happiness and paradoxically thwart our efforts to attain it.”
Mauss added: “While these findings raise a possible conundrum — wanting to feel happy ultimately involves feeling less happy — people should not take away that they are stuck. There are productive ways of thinking about happiness.”
![research study on clinical psychology headshot of woman smiling](https://vcresearch.berkeley.edu/sites/default/files/inline-images/img_8712.jpg)
The researchers propose that one way people can change their thinking and avoid being too concerned with happiness is to accept that they may never feel perfectly happy, even during positive experiences.
“Very few moments, if any, will bring only happiness, and latching on to the less-than-perfect aspects of positive moments will ultimately spoil them,” Zerwas said. “Instead, accepting the emotions we are feeling in the moment allows us to move forward without adding any extra negativity to the experience.”
Other ways people can prevent potentially harming their mental health include accepting that negative emotions are natural responses to life, not viewing positive activities as a means to an end (i.e., only doing something because you think it will make you happier), and partaking in activities that involve social connection, Mauss said.
Researchers carried out this study by having participants complete a series of surveys and diaries that measured valuing happiness as well as three facets of well-being: satisfaction with life, psychological well-being and depressive symptoms.
Future research related to this study may examine if results are consistent cross-culturally by including participants from other countries, and also if certain interventions (i.e., mindfulness practices) may increase psychological well-being in those overly concerned with happiness, Zerwas, the NYU researcher said.
Read the paper in the American Psychological Association’s journal Emotion : https://psycnet.apa.org/doiLanding?doi=10.1037%2Femo0001381
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McLaren Health Care is a fully integrated health network committed to quality, evidence-based patient care with locations in Michigan and Indiana. The McLaren system includes 13 hospitals in Michigan, ambulatory surgery centers, imaging centers, a primary and specialty care physician network, commercial and Medicaid HMOs, home health, infusion and hospice providers, pharmacy services, a clinical laboratory network and a wholly owned medical malpractice insurance company. McLaren operates Michigan’s largest network of cancer centers and providers, anchored by the Karmanos Cancer Institute, one of only 53 National Cancer Institute-designated comprehensive cancer centers in the U.S.
Clinical Research Coordinator II
🔍 michigan, detroit.
Provide study coordinator/data management/regulatory specialist support to the Clinical Trials Office (CTO). Manage independent assignment, providing excellent customer support and guidance in the clinical trials arena.
Responsibilities:
- Assure all study requirements are met and documented and meet both internal and external regulations in accordance with protocol guidelines.
- Maintain logs, including tracker submissions and update the CTO Oncore database in a timely manner according to CTO SOPs.
- Design systems for coordinating, compiling and submission of data; design workflow processes and participate in quality assurance measures; coordinate site visits.
- Manage all patient and/or protocol data as assigned and respond to queries in a timely fashion.
- Schedule and participate in monitoring visits and participate in multidisciplinary team program meetings as required.
· Bachelor’s degree required or equivalent combination of education and experience.
· Medical and/or science experience/education preferred.
· Clinical research certification preferred.
Equal Opportunity Employer of Minorities/Females/Disabled/Veterans
- Schedule: Full-time
- Requisition ID: 24005185
- Daily Work Times: TBD
- Hours Per Pay Period: 80
- On Call: No
- Weekends: No
Equal Opportunity Employer
McLaren Health Care is an Equal Opportunity Employer. Qualified applicants will receive consideration for employment without regard to race, color, religion, sexual orientation, gender identification, age, sex, marital status, national origin, disability, genetic information, height or weight, protected veteran or other classification protected by law.
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COMMENTS
from Practice Innovations. August 3, 2023. It is time for a measurement-based care professional practice guideline in psychology. from Psychotherapy. July 31, 2023. Methodological and quantitative issues in the study of personality pathology. from Personality Disorders: Theory, Research, and Treatment. April 26, 2023.
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