Using survey data to explore promising intervention areas for improving well-being
This research was conducted by Dr. Nadescha Trudel and Dr. Spencer Greenberg, and this short summary was written by Holly Muir.
Which psychological strategies might be promising ways of improving people’s overall well-being? We wanted to see if we could shed some light on this question by using survey data to explore which psychological challenges are prevalent in the general U.S. population and, correspondingly, which psychological strategies are associated with three well-being outcomes: subjective life quality, anxiety, and depression. While a survey design can never definitely prove what causes what, we uncovered a number of interesting findings!
If you're interested, you can read a detailed write-up of this investigation which includes all of our results along with a lot more information about the limitations of the study design. This article provides a quick summary of the studies we conducted and what we found.
A quick summary of our most interesting results
Figure 1: Main results. The smaller black boxes show which of the eight psychological challenges were most predictive of life quality or depression. For each of these psychological challenges, the white boxes below show the statements that participants’ agreement or disagreement with was most predictive of life quality or depression.
In terms of which psychological challenges that may be especially prevalent, our results (which we replicated in a confirmatory follow-up study) suggest that:
Reducing negative self-image and feelings of emotional isolation may be a promising way of improving subjective life quality.
Reducing negative self-talk and feelings of emotional overwhelm may be a promising way of improving depression.
Additionally, we found two psychological strategies that seemed particularly promising for improving both life quality and depression: reminders of personal strength and gratitude for positive things in life. In addition, making time for healthy activities (like exercise) and relying on other people were both correlated with an increase in life quality.
What did we do?
Our ultimate goal was to find the most promising psychological strategies for improving people’s life outcomes in three key areas: life quality, depression, and anxiety. To help us identify these strategies, we investigated the psychological challenges most predictive of change in these three outcomes. This then allowed us to identify possible psychological strategies for overcoming these challenges.
To begin, we conducted a rapid literature review to identify psychological challenges that could be predictors for these three outcomes. We identified eight broad challenges, which we then grouped into three categories: "self," "emotion,", and "social,":
Next, we ran three online studies (involving a combined total of 780 study participants) using our online study recruitment platform Positly. These studies measured the eight psychological challenges listed above in relation to our three main wellbeing outcomes. To do so, we first assessed:
the degree to which participants agreed to statements about each of the eight tested psychological challenges and whether they believed improving any of these would lead to significant changes in their lives.
participants’ subjective life quality, measured using questions about life satisfaction, levels of happiness, and sense of positivity and optimism about personal goals.
participants’ experience with symptoms of depression using a ‘phq9’ questionnaire, which asks participants to rate how frequently they experience negative, hopeless, or suicidal thoughts.
We found no promising intervention targets for anxiety in our data when controlling for its correlation with depression and so excluded anxiety from our analysis. This finding is interesting on its own: anxiety does not seem to be substantially correlated with any of the eight psychological challenges above, except through its comorbidity with depression! However, it is important to keep in mind that we did not test an exhaustive list of psychological challenges, and that other factors might be uniquely contributing to the severity of anxiety even after controlling for depression.
Here’s what we did in the three studies, along with links to view each of the studies just as participants saw them:
Figure 2: Study Overviews
Study 1 (n=474): an exploratory study testing the relationship between depression and life quality and the eight psychological challenges.
Study 2 (n=58): a qualitative study investigating which specific questions could best measure the psychological challenges that were predictive of changes in depression and/or life quality in Study 1.
Study 3 (n=250): a confirmatory replication study (using the improvements to our questions based on study 2) verifying that the factors we initially found to be most predictive of changes in depression and life quality were replicated.
In Study 1, we also presented participants with a number of strategies that could be used to handle difficult or negative life circumstances. We asked participants about the frequency that they used these strategies and how effective they found them to be (or how effective they imagined them to be, if they were to use them) when handling difficult life situations. For example, we asked participants how much they agreed with the following statement: “I remind myself of all the things that are still good in my life (despite the negative situation) so that I feel grateful for the things that I do still have.” This provided us with some information about which behavioral strategies could be most useful in improving depression and life quality.
Important note: being (a) correlational in nature and (b) based on self-reports, the results of the studies we describe in this article can only suggest hypotheses for which interventions might improve people's well-being from the set of psychological challenges and strategies tested here. In other words, our findings do not reveal whether these psychological challenges are caused by outcomes like depression and low life quality, or whether depression and low life quality lead to these psychological challenges, or if one or more "confounder" variables leads to both. Nevertheless, these results offer a starting point for identifying some potentially important areas that could be the target of future randomized controlled trials (confirming that there is a causal role between these challenges and life quality and/or depression). More caveats about this research can be found in the full report.
What did we find?
First, we evaluated which of the eight psychological factors participants were currently dealing with by asking them the extent to which they agreed (or disagreed) with statements like “I often tell myself that I am going to fail” (negative self-talk) and “It is difficult for me to find the right words for my emotions” (emotional expression). We discovered that, across the eight factors, participants agreed most with statements about experiencing challenges in coping with interpersonal conflict (experiencing distress from and seeking to avoid conflict) and feelings of emotional isolation (feeling alone or distant from other people’s emotional experiences), as seen in the left panel of the image below. Participants were less likely to agree with the statements related to the other six psychological challenges.
When it came to which of the eight psychological factors could be addressed to most improve participants’ lives, subjective self-reports showed that participants thought that interventions on every one of the eight challenge areas would improve their lives (as seen in the right panel of the image below). Given the previous finding, it seems that interventions targeting interpersonal conflict and emotional isolation might have the greatest effect on improving life quality and depression.
Figure 3: Agreement and Improvement Scores. Scores are averaged across Study 1 and Study 3 for psychological factors that were tested across both studies. Bar graphs represent the average pooled over both studies. The green and blue dots show the average score separately for Study 1 and Study 3, respectively.
Next, we investigated whether changes in these eight psychological factors might be predictive of changes in life quality or depression (regardless of whether or not people report experiencing these psychological challenges). For example, is an increase in negative self-talk related to an increase in depression? We conducted two analyses to investigate this matter: a correlational analysis and a multiple linear regression analysis. The regression analysis revealed that two different factors are predictive of life quality and depression respectively (you can read more about the findings from both analyses in our detailed write-up):
For life quality: participants who had a more negative self-image (e.g. ‘I wish I were a better person’) and felt more emotionally isolated (i.e. feeling that others don’t have similar emotional experiences) reported lower life quality.
For depression: participants who engaged more often in negative self-talk (e.g. ‘I often tell myself that I am going to fail’) and reported being more emotionally overwhelmed in difficult situations (i.e., difficulties controlling intense emotions) reported more severe depression.
Which strategies might be effective at improving life quality and reducing depression?
We asked study participants which behavioral strategies they used and which (from a given set) they think they would find most effective in dealing with negative life circumstances or situations. We also looked at the correlation between reported usage of these strategies and participants’ life quality and depression levels. We discovered that four strategies were positively correlated with life quality, including (1) gratitude, (2) relying on others, (3) investing time in healthy activities, and (4) reminders of personal strength. Two of these strategies – gratitude and reminders of personal strength – also had the strongest negative correlation with depression out of all strategies.
Here are the statements that represented each of these strategies in our studies:
Gratitude: “I remind myself of all the things that are still good in my life (despite the negative situation) so that I feel grateful for the things that I do still have.”
Reminders of personal strength: “I remind myself that I am strong and that I am capable of getting through difficult situations like this one.”