Wellness Check: Mental Health

Virtual yoga and meditation intervention may be associated with increased health-related quality of life

1. This cross-sectional study found that a 100-day virtual yoga and meditation program resulted in improved health-related quality of life (HRQOL).

2. Participants who reported over two years of meditation experience had significantly greater improvements in HRQOL than those who did not.

Evidence Rating Level: 2 (Good)

It is well-established that yoga and meditation may improve mental and physical wellbeing through relaxation. Consistent yoga and meditation programming over an extended period confers strong benefits to HRQOL. One of the major barriers to compliance with these programs is accessibility. Accordingly, virtual guidance may represent a way to deliver yoga and meditation to individuals across broad geographic regions, improving adherence and associated benefits.

The present cross-sectional study assessed the impact of a 100-day yoga and meditation program on HRQOL. Daily programming included sessions of yoga, meditation, and speakers discussing effective relaxation practice. Participants in the program were given the option to participate in the study through online survey, with no exclusion criteria. The main outcome of the study was change in HRQOL scores following program participation. Seven domains of HRQOL were measured: quality of life, healthy lifestyle, relaxation, stress, coping, productivity, and ability to maintain health habits.

In total, 3,164 participants completed the survey (mean age 33.8; 52% female) from 39 countries. Most participants were students from India who had previous experience with yoga. Approximately half of participants completed all 100 days of programming with an average participant rate of 71 days. Participants with previous experience practicing yoga reported significantly greater improvements in HRQOL as compared to those who did not. Across all study participants, the yoga and meditation program was associated with significant improvement in all seven domains of HRQOL. However, this study was limited as participants voluntarily chose to be involved in the study (which may have biased the study population to those more engaged in the program), and there was no control group. In summary, virtually delivered yoga and meditation programs may provide an accessible means of improving HRQOL.

University students perceive that Instagram improves social connection but impairs mental wellbeing

1. This qualitative study evaluated post-secondary students’ perceptions on how the social media platform, Instagram, influences their mental health.

2. Students reported that Instagram helped them develop social relationship, but negatively impacted their emotional wellness.

Evidence Rating Level: 3 (Average)

The incidence of mental illness is highest in adolescents and young adults. Additionally, many students entering university must cope with the pressures of a new social environment combined with separation from their usual support systems. Social media platforms, such as Instagram, can assist students in building social connects, but may adversely impact emotional wellbeing. Social media apps may build false expectations and aesthetic standards for young adults, creating feelings of inadequacy or anxiety.

A qualitative analysis was conducted on interview data collected from post-secondary students on their perceptions of Instagram. Undergraduate students were included who were studying at the University of Birmingham, United Kingdom, fluent in English, and used Instagram. Students who discontinued Instagram use or who were unable to give informed consent were excluded. Interview transcripts were assessed using thematic analysis focused on mental wellbeing.

A total of 16 students were included in the study, of which 56% were female, and the mean age was 19.8 years. The main themes identified during the interviews were mental wellbeing, social connectivity, idealization, social approval, and online bullying. Students demonstrated an understanding of the concept of mental wellbeing and that they felt it improved their social relationships. Students also felt that the standards for lifestyle and appearance on Instagram created pressure on them which negatively impacted their perception of themselves. Similarly, interviewees also felt that social media created a platform for increased cyberbullying and susceptibility to negative interactions or judgements. The major limitation of this study was that students were only recruited from a single institution and no control group was included. Thus, the generalizability of the results may be limited. In summary, Instagram may help students create larger social circles, but has the potential to decrease confidence and mental health.

Gratitude-focused writing may improve mental wellness during periods of chronic stress

1. This randomized control trial found that gratitude-focused writing improved levels of stress as compared to expressive writing and controls.

2. Participants in the gratitude-focused writing group also showed decreases in negative affect but no improvements in positive affect.

Evidence Rating Level: 2 (Good)

The coronavirus disease 2019 (COVID-19) pandemic has created a global state of chronic stress. Consequently, it is critical that coping methods are identified that decrease anxiety and improve mood in the general population. Creative expression techniques can be implemented independently and may be modified by users to address their personal sources of distress. Particularly, creative expression focusing on gratitude may help highlight and amplify positive emotions and perspectives of difficult situations.

This randomized control trial evaluated mental wellbeing following one month of either gratitude-focused writing, expressive writing, or no intervention. Participants were included who were >18 years old, could communicate in English, and were able to complete an online survey. Participants were excluded if they did not have access to email. Gratitude was assessed with the Gratitude Adjective Checklist (GAC), and emotional wellbeing was measured with the Depression, Anxiety, and Stress Scale (DASS-21), Positive and Negative Affect Schedule (PANAS), and Cohen-Hoberman Inventory of Physical Symptoms (CHIPS).

A total of 79 participants were included (35 control group; 25 expressive writing group; 19 gratitude-focused writing group). GAC score was sustained in the intervention group as compared to baseline but significantly decreased in both the expressive writing and control groups. Compared to the expressive writing and control groups, the gratitude-focused writing group had significant improved stress and negative affect scores. Interestingly, negative affect improved in the control and gratitude-focused writing groups at follow-up. Depression, anxiety, positive affect, and CHIPS scores did not differ between groups or within groups at one month follow-up. This study was limited due to the small sample size and substantial loss of follow-up, which may impair generalizability of the results. Nonetheless, this study was significant in suggesting gratitude-focused writing may improve mood during times of sustained stress.

Image: PD

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