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An Exploratory Study of Adaptive Scuba Diving’s Effects on Psychological Well-Being among Military Veterans
... The evidence on the health benefits of scuba diving among people with physical impairments is scarce [21]. While limited, the available literature suggests that being a scuba diver might promote higher levels of health among scuba divers with physical impairments [22][23][24][25][26][27][28][29][30][31][32][33][34]. Socially, scuba diving has been reported to increase the ability of individuals to engage in social interactions [22], as it provides opportunities for social comfort [35]. ...
... Within the components of scuba diving there are similarities with meditation and mindfulness techniques, as scuba favors a state of full consciousness and openness associated with slow and ample breathing [29]. Some psychological outcomes reported by scuba divers with physical impairments include increased state-level mindfulness and contentment [27], improvements in the symptomology of anxiety and depression [28], enhanced self-esteem and self-confidence [22], experiencing a sense of freedom [33,34], and improved self-concept [23,24,32]. The results of studies on physical health outcomes in people with physical impairment suggest that scuba may reduce the spasticity and ...
... The influence of scuba diving on physical health was reported by participants mostly in terms of more physical activity, better mobility, relief from physical pain, and better sleep. The physical health outcomes previously reported from scuba diving among people with physical impairments included chronic pain relief [22][23][24][25][26][27][28], reduced spasticity and frequency of muscle spasms [25,26], increased pulmonary vital capacity and efficiency of the respiratory system [22,26], improved circulation and body strength [34], increased motor skills [22], and increased general physical ability [31]. ...
The impacts of scuba diving on people with physical impairments are unknown. Grounded on the social identity approach to health, the aim of this study was to test and describe the relationships between scuba diving social identity, self-efficacy, social health, psychological health, physical health, health-related quality of life (HRQOL), and disability level among recreational scuba divers with physical impairments. A mixed methods explanatory sequential design was employed. The quantitative strand used an 80-item cross-sectional survey, with the data analyzed via a path analysis. The qualitative strand used 1:1 interviews across 3 case study groups; the data were analyzed using deductive and inductive analyses. Mixing occurred via a joint display with meta-inferences. The quantitative results (n = 78) indicated that self-efficacy was a significant predictor of social health, psychological health, physical health, HRQOL, and disability level. The qualitative findings (n = 15) consisted of six themes, whereby participants described scuba as a positive social identity that provides them with meaning, purpose, and belonging. Furthermore, they described scuba diving as a positive contributor to their self-efficacy, social health, psychological health, physical health, and quality of life. During the mixing of data, the quantitative and qualitative results did not match on the influence of scuba diving social identity on self-efficacy, social health, psychological health, physical health, HRQOL, and disability level. A further analysis revealed that the range restriction impaired the conclusive quantitative evidence on the scuba diving social identity variable. The meta-inferences derived from the data integration suggest that scuba diving plays a role in the self-efficacy, health, HRQOL, and disability level among scuba divers with physical impairments. The findings point to the potential of scuba diving as a health promotion recreational activity and rehabilitation modality for people with physical impairments.
... People with physical impairments who participate in scuba diving need to negotiate activity limitations and participation restrictions, which may provide them an opportunity for personal growth. Amidst the few studies that have been conducted on scuba diving among people with physical impairments, there is some evidence that scuba diving might be an activity that produces an optimal and impactful experience with positive outcomes and personal change [16][17][18][19][20]. The authors of this manuscript conducted a concurrent study with the same participants to test and describe the relationships between scuba diving social identity, self-efficacy, social health, psychological health, physical health, health-related quality of life (HRQOL), and disability level among recreational scuba divers with physical impairments; results suggested that scuba diving might play a role in the self-efficacy, health, HRQOL, and disability level of scuba divers with physical impairments [21]. ...
... First, participants reported experiencing positive emotions such as happiness, joy, fun and excitement; previous evidence had showed a relationship between scuba diving and happiness among scuba divers with paraplegia [43], maybe due to the contact with nature, and the sense of adventure, challenge and exploration experienced during dives. Second, participants reported experiencing peace and relaxation, which relates to prior evidence on scuba reducing perceived stress [44] and improving mindfulness abilities [20,44]; this might be a result of scuba diving offering visual and psychological comfort [45], as well as requiring a state of full consciousness and slow and ample breathing [44]. Third, participants expressed that scuba is an experience that allows them to develop new skills and achieve accomplishments similar to those reported by Aganovic [19] among veterans with amputations, who were successful at adopting 20 technical scuba diving elements. ...
Purpose: This study aimed to: (1) test and explain the type of experience scuba diving is among people with physical impairments based on the experience-type framework; (2) assess and describe their personality based on the Big Five domains; and (3) identify if personality, years diving, and diving level predict experience-type. Methods: An explanatory sequential mixed methods design was employed. The quantitative phase used a cross-sectional survey (n = 103). The qualitative phase used follow-up interviews with 15 participants divided into 3 case study groups. Joint displays with meta-inferences integrated the data. Results: Quantitative and qualitative findings concurred on scuba being a transformative experience. 82.52% of survey participants reported scuba as a transformative experience, with no significant differences on experience impact based on impairment category (p = 0.56), impairment onset (p = 0.66), gender (p = 0.08), race/ethnicity (p = 0.51), or age (p = 0.07). Big Five personality domains, years diving, or diving level did not predict experience impact (R 2 = 0.14, F(12,90) = 1.304, p = 0.2305). Data strand results differed on salient personality domains. Seven qualitative themes emerged, five on experience-type and two on personality. Conclusions: We recommend the exploration of scuba diving as a prospective rehabilitation intervention. h IMPLICATIONS FOR REHABILITATION • Innovative rehabilitation interventions that provide positive experiences and long-term health benefits to people with physical impairments are needed. • Participants reported that scuba diving had a positive transformative impact in their lives through positive emotions, peace/relaxation, personal growth, development of skills, social connections, physical and mental healing, and lasting behavioral changes. • Reporting scuba diving as a transformative experience was not influenced by the scuba divers' personality domains, diving level, demographic characteristics, or the number of years they had been diving. • Authors recommend the consideration and further exploration of scuba diving as a prospective physical and psychosocial rehabilitation intervention.
... These include the feeling of weightlessness from physical constrictions on land, a sense of achievement, empowerment, the excitement of partaking in an adventurous activity, self-perception, social interaction, friendship, feeling equal to nondisabled divers, and a greater sense of independence (Carin-Levy & Jones, 2007;Cheng & Diamond, 2005). Various authors (Blumhorst et al., 2020;Naumann et al., 2021;Straughan, 2012) investigated scuba diving as a therapeutic experience, encompassing psychological, physiological, and social benefits. These authors emphasized the role that slow and steady breathing, coupled with the silence of the underwater environment, can play in lowering stress levels and stimulating relaxation and meditation. ...
... The "rewarding experience" and "relating to the disabled" codes highlighted strong commonalities (e.g., feeling weightless) and relational exchanges between nondisabled and disabled divers, resulting in increased awareness and satisfaction in both groups. The "therapeutic benefits" and "diving as an inclusive sport" codes recognized the rehabilitative, physical, and mental benefits of diving to disabled people, as well as the unique qualities of diving as a form of sport, recreation, and tourism (Blumhorst et al., 2020;Carin-Levy & Jones, 2007;Cheng & Diamond, 2005;Naumann et al., 2021;Straughan, 2012). Interestingly, the participants in this study, who were nondisabled, could properly elaborate on these benefits, again suggesting a good level of relatability to disabled divers through the diving activity itself, which could be focused on as the main driver of integration (Fig. 3). ...
Disability inclusion in diving tourism is a relevant topic of study, considering the documented benefits to disabled communities, the growing demand for inclusive diving tourism opportunities globally, and the limited information on the status quo. This qualitative study assessed the perspectives on disability inclusion in diving tourism among 28 diving industry members (who were not disabled divers) and one representative (who was a disabled diver) from the largest disabled diving organisation in South Africa, which is an important diving destination internationally. Benefits, challenges, involvement, and specific perspectives in inclusive diving tourism were captured through thematic analysis of participants’ narratives. The results confirmed the multidimensional benefits of diving to disabled people and highlighted barriers to inclusive diving tourism related to logistics, knowledge, awareness and attitude of the industry, marketing, and collaboration between stakeholders. This study drew useful recommendations to enhance disability inclusion in diving tourism and exploit its potential for the development of this industry.
... Scuba diving is a technique where recreational divers use a selfcontained underwater breathing apparatus that works by applying a system of compressed air cylinders and regulators to ensure that oxygen mobility is achieved for the breathing support of divers (Bitterman et al., 2009). Since the emergence of scuba diving as a unique form of recreation, hundreds of millions of visitors have been driven to try diving because of its alleged advantages in boosting divers' physical and mental well-being (Blumhorst et al., 2020;Henrykowska et al., 2021). Likewise, scuba diving in China has undergone four stages between its inception (before 1995) and its expansion (2002 to 2010) in response to enormous recreational tourism market demand (Fang and Li, 2016). ...
This study examined divers' recreational specialization, pro-environmental attitudes, and marine-based conservation behaviour intentions. A questionnaire-based data collection approach was used to survey 398 divers who visited popular diving sites in Hong Kong by employing structural equation modelling to determine the potential relationships among the proposed variables. The results showed a statistically positive relationship between divers' recreational specialization and their pro-environmental attitudes, along with a statistically valid relationship between divers' recreational specialization and their marine-based conservation behaviour intentions. However, divers' pro-environmental attitudes were not statistically significant with their marine-based conservation behaviour intentions; thus, the discrepancy regarding different research findings between the current and previous studies was further discussed. In particular, our findings confirmed that recreational specialization could be a reliable predictor of divers' pro-environmental attitudes and marine-based conservation behaviour intentions to fill the research gaps regarding scuba diving-based nature tourism in Hong Kong. Consequently, management implications and recommendations were presented in accordance with the development of marine environmental conservation and sustainable scuba diving tourism in Hong Kong.
... However, in more recent years, the focus on threats has been met by a growing body of multi and interdisciplinary research committed to investigating the opportunities that blue space holds for enhancing health and wellbeing [4][5][6][7]. Recreational activities in blue spaces are said to enable embodied sensual pleasures [8,9]; heightened spirituality [10]; creativity and resilience [11]; positive affective, imaginative, and emotional experiences [12,13]; respite from suffering [14,15]; mindfulness, connection, contentment, life-affirmation [16,17]; and problem-solving [18]. Moreover, recreational activities in blue space are argued to provoke pro-environmental holistic connections with the wider world (human and non-human) that link the health of marine environments and people [19][20][21]. ...
Our aim for this research was to identify and examine how recreation enthusiasts cope with and mitigate the violence of pollution as they strive for wellbeing in polluted “blue spaces” (e.g., seas, oceans). Our methodology to undertake the research was ethnography (online and offline), including autoethnography and informal interviews (40). The study proceeded from a constructivist epistemology which emphasizes that knowledge is situated and perspectival. The study site was a post-industrial area of northeast England where a long-standing but also rapidly growing surfing culture has to live with pollution (legacy and ongoing). We found evidence of what have become quotidian tactics that attach to themes of familiarity, embodiment, resignation, denial, and affect/emotion used by enthusiasts to cope with and mitigate the violence of pollution. We argue that by necessity some surfers are persisting in striving for wellbeing not simply in spite of pollution but rather with pollution. We assert surfers enact a “resigned activism” that influences their persistence. We extend critical scholarship concerning relationships between recreation, blue spaces, and wellbeing by moving beyond a restrictive binary of focusing on either threats and risks or opportunities and benefits of blue space to health and wellbeing, instead showing how striving for wellbeing through recreation in the presence of pollution provides evidence of how such efforts are more negotiated, fluid, situated, uncertain, dissonant, and even political than any such binary structure allows for.
... Multiple psychological and physical benefits along with opportunities to socialise with fellow veterans and civilians have been identified. These findings are consistent with previous research demonstrating an immediate positive impact on veterans' subjective well-being after participation in alternative activities [36,37], but also identified improvements in psychological symptoms, which were sustained over time [38]. ...
Purpose:
Physically or psychologically injured military veterans are motivated and benefited by physical activity or sport that may involve high levels of achievement. The aim of this study was to provide an in-depth insight into the impact of Competitive Motorsport (CM) on physically injured/disabled veterans' subjective well-being and in turn determine if it improves the quality of their lives.
Methods:
This is a qualitative study. Two sets of semi-structured interviews were conducted with 14 male British military veterans including a 6-month follow-up. All participants were subjected to a permanent, moderate or severe, physical injury/disability. Data were analysed in accordance with the principles of Thematic Analysis.
Results/conclusions:
Five key elements (familiar environment, team spirit, adrenaline rush, competition and equality) made CM a unique experience for physically injured/disabled veterans. Various psychological and physical benefits were found, including an increased sense of accomplishment, opportunity to socialise in a non-clinical environment, embracement of body image and adoption of a healthier lifestyle. Since physical activity and sport are among growing research on alternative interventions for military veterans, they deserve serious consideration as part of the treatment regimens and rehabilitation programmes to improve physically inured/disabled veterans' physical and mental health.Implications for RehabilitationCompetitive Motorsport is an effective means of improving physical health and subjective well-being of physically injured/disabled military veterans.Multiple perceived psychological and physical benefits were identified over time, including motivation for living, embracement of body image and adoption of a healthier lifestyle.Competitive Motorsport deserves consideration as part of the treatment regimens and rehabilitation programmes to improve physically injured/disabled veterans' physical and mental health while facilitating transition to civilian life.
The emergence of ocean and human health (OHH) science as a distinct scholarly discipline has led to increased research outputs from experts in both the natural and social sciences. Formal research on communication strategies, messaging, and campaigns related to OHH science remains limited despite its importance as part of the social processes that can make knowledge actionable. When utilized to communicate visible, local issues for targeting audiences, OHH themes hold the potential to motivate action in pursuit of solutions to environmental challenges, supplementing efforts to address large-scale, abstract, or politicized issues such as ocean acidification or climate change. Probing peer-reviewed literature from relevant areas of study, this review article outlines and reveals associations between society and the quality of coastal and marine ecosystems, as well as key themes, concepts, and findings in OHH science and environmental communication. Recommendations for future work concerning effective ocean and human health science communication are provided, creating a platform for innovative scholarship, evidence-based practice, and novel collaboration across disciplines.
The current university system needs a pedagogical revitalization to develop professional competences and prepare effective professionals while developing civic and democratic values. Service-learning (SL) is an innovative educative methodology that connects theoretical foundations and practice. Particularly, it is defined as a pedagogical proposal that combines learning and community service, based in the implementation of skills related to curriculum contents carried out in real contexts. As a pedagogical methodology, its main objective is to improve students' academic learning and critical capacity while offering a social benefit. The analysis of SL literature shows how its evolution is unquestionable in different fields and that it is a recurring topic in recent years. The present research suggests, from a theoretical approach, that SL is an appropriate methodology to develop programs focused on physical education and sport. It shows different possibilities to structure SL programs, potential groups receiving university SL programs related to Physical Education and Sport Sciences and possible effects on university students performing SL.
This article reports the development and psychometric properties of the 27-item Barriers to Seeking Mental Health Counseling (BMHC) scale, which assesses perceived help-seeking barriers among college-aged students. Across 2 studies involving ethnically diverse samples (e.g., Latinx majority students), the authors provided evidence for this new measure's validity and reliability. Exploratory and confirmatory factor analyses (including a bifactor analysis) provided support for the BMHC scale's multidimensionality reflecting 6 barriers: Negative Perceived Value, Discomfort with Emotions, Ingroup Stigma, Lack of Knowledge, Lack of Access, and Cultural Barriers. Evidence for criterion-related validity was shown through significant but differential correlations with self-stigma, emotional control, and the 4 components of Ajzen's (1991) Theory of Planned Behavior model-attitude, subjective norm of social stigma, perceived behavioral control, and mental health help-seeking intention. Discriminant evidence of validity was established through nonsignificant or small correlations between BMHC subscales and 2 measures of socially desirable responding. The authors also found evidence for incremental validity and measurement invariance across race, and evidence for internal reliability and temporal stability of the BMHC subscales. Findings are discussed in light of the conceptual, methodological, and clinical contributions of the BMHC scale. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
Although deficits in cognitive empathy are well established in individuals with autism spectrum disorder (ASD), the literature on emotional empathy, or emotional contagion, in individuals with ASD is sparse and contradictory. The authors tested susceptibility to contagious yawning and laughter in children with ASD ( n = 60) and typically developing (TD) children ( n = 60), ages 5–17 years, under various conditions, to elucidate factors that may affect emotional contagion in these populations. Although TD children showed equal amounts of emotional contagion across conditions, children with ASD were highly influenced by the familiarity of the target stimulus, as well as task instructions that encourage eye gaze to target. More specifically, children with ASD exhibited less contagious yawning and laughter than their TD peers except when their attention was explicitly directed to the eyes or (and even more so) when their parents served as the stimulus targets. The authors explore the implications of these findings for theories about the mechanisms underlying empathic deficits in ASD as well as the clinical implications of having parents involved in treatment.
Mindfulness-based treatments for posttraumatic stress disorder (PTSD) have emerged as promising adjunctive or alternative intervention approaches. A scoping review of the literature on PTSD treatment studies, including approaches such as mindfulness-based stress reduction, mindfulness-based cognitive therapy and metta mindfulness, reveals low attrition with medium to large effect sizes. We review the convergence between neurobiological models of PTSD and neuroimaging findings in the mindfulness literature, where mindfulness interventions may target emotional under- and overmodulation, both of which are critical features of PTSD symptomatology. Recent emerging work indicates that mindfulness-based treatments may also be effective in restoring connectivity between large-scale brain networks among individuals with PTSD, including connectivity between the default mode network and the central executive and salience networks. Future directions, including further identification of the neurobiological mechanisms of mindfulness interventions in patients with PTSD and direct comparison of these interventions to first-line treatments for PTSD are discussed.
Background: Within the components of Scuba diving there are similarities with meditation and mindfulness techniques by training divers to be in a state of open monitoring associated with slow and ample breathing. Perceived stress is known to be diminished during meditation practice. This study evaluates the benefits of scuba diving on perceived stress and mindful functioning.
Method: A recreational diving group (RDG; n = 37) was compared with a multisport control group (MCG; n = 30) on perceived stress, mood, well-being and mindfulness by answering auto-questionnaires before and after a 1-week long UCPA course. For the diving group, stability of the effects was evaluated 1 month later using similar auto-questionnaires.
Results: Perceived stress did not decrease after the course for the MCG [ The divers showed a significant reduction on the perceived stress score (p < 0.05) with a sustainable effect (p = 0.01)]. An improvement in mood scale was observed in both groups. This was associated to an increase in mindfulness abilities.
Conclusions: The practice of a recreational sport improves the mood of subjects reporting the thymic benefits of a physical activity performed during a vacation period. The health benefits of recreational diving appear to be greater than the practice of other sports in reducing stress and improving well-being.
A perennial bestseller since 1997, this updated tenth edition of Understanding Research Methods provides a detailed overview of all the important concepts traditionally covered in a research methods class. It covers the principles of both qualitative and quantitative research, and how to interpret statistics without computations, so is suitable for all students regardless of their math background. The book is organized so that each concept is treated independently and can be used in any order without resulting in gaps in knowledge- allowing it to be easily and precisely adapted to any course. It uses lively examples on contemporary topics to stimulate students’ interest, and engages them by showing the relevance of research methods to their everyday lives. Numerous case studies and end-of-section exercises help students master the material and encourage classroom discussion. The text is divided into short, independent topic sections, making it easy for you to adapt the material to your own teaching needs and customize assignments to the aspect of qualitative or quantitative methods under study-helping to improve students’ comprehension and retention of difficult concepts. Additional online PowerPoint slides and test bank questions make this a complete resource for introducing students to research methods. New to this edition: • New topic section on design decisions in research • Additional material on production of knowledge and research methods • Significant development of material on ethical considerations in research • Fresh and contemporary examples from a wide variety of real, published research • Topic-specific exercises at the end of each section now include suggestions for further steps researchers can take as they build their research project.
During social interactions, people tend to automatically align with or mimic their interactor's facial expressions, vocalizations, postures, and other bodily states. Automatic mimicry might be implicated in empathy, affiliation, and empathy, and is impaired in several pathologies. Despite a growing body of literature on its phenomenology, the function and underlying mechanisms of mimicry remain poorly understood. The current review puts forward a new Neurocognitive Model of Emotional Contagion (NMEC) demonstrating how basic automatic mimicry can give rise to emotional contagion. We combine neurological, developmental, and evolutionary insights to argue that automatic mimicry is a precursor to healthy social development. We show that i) strong synchronization exists between people, ii) that this resonates on different levels of processing and iii) demonstrate how mimicry translates into the emotional contagion. We conclude that our synthesized model, build on integrating knowledge from various fields provides a promising avenue for future research on the role of mimicry in human mental health and social development.
In the academic literature, including the field of positive psychology, there have been articles advocating how leisure activities can be used within a behavioral activation framework. To this end, differing academic writers advocate the use of scheduling leisure activities to increase enjoyable behavioral activity (e.g., Mazzucchelli et al. 2010), but do not elaborate on how leisure can be used within a behavioral activation framework. This paper fills this void by explaining (1) how the serious leisure perspective (SLP) can help mental health counselors and other applied human service professionals structure potential activation targets based on differentiating between pleasure-based casual leisure and mastery-based serious leisure, and (2) how the SLP can be used as a potential structure for grading activation assignments. The last part of this paper provides a mental health counseling case report of a middle-aged man who had stage four renal disease, severe depression, and mild anxiety who became healthier by intervention that linked the SLP, behavioral activation, and positive psychology.
The author describes the advantages of diving and its types. He specifies conditions affecting the extremity of diving. Moreover, he indicates additional problems, barriers, obstacles and limitations of diving for the disabled that result from a particular type of disability and the methods used to overcome them. Finally, he describes diving training systems that include persons with disabilities. The conclusion of the study is to determine the possibility and practice of diving by the disabled with various disabilities, even the most serious ones, and at various age.
The purpose of this study was to examine the outcomes of a therapeutic fly-fishing program for veterans with combat-related disabilities. A total of 40 veterans participated in the 4-day therapeutic fly-fishing program and this study. The outcomes examined included reducing symptoms of posttraumatic stress (PTS), depression, perceived stress, functional impairment (i.e., work, relationships, physical, and everyday life), increasing self-determination, and leisure satisfaction. Each research participant completed pretest, posttest, and 3-month follow-up questionnaires. Repeated measures MANOVA and ANOVA were conducted to examine the differences between the three time points on each outcomes. The results indicated significant decreases from the pretest to posttest for symptoms of PTS, depression, perceived stress, and functional impairment, and an increase in leisure satisfaction from pretest to 3-month follow-up. These results highlight the use of therapeutic recreation programming for veterans with disabilities as a holistic approach to treatment and recovery.
This qualitative study explored and compared the subjective experiences of 102 veterans with posttraumatic stress disorder (PTSD) who were randomly assigned to 1 of 4 arms: (a) body scan, (b) mindful breathing, (c) slow breathing, or (d) sitting quietly. Qualitative data were obtained via semistructured interviews following the intervention and analyzed using conventional content analysis. The percentage of participants within each intervention who endorsed a specific theme was calculated. Two-proportion z tests were then calculated to determine if the differences among themes endorsed in specific groups were statistically significant.
Six core themes emerged from analysis of participant responses across the 4 groups: (a) enhanced present moment awareness, (b) increased nonreactivity, (c) increased nonjudgmental acceptance, (d) decreased physiological arousal and stress reactivity, (e) increased active coping skills, and (f) greater relaxation. More participants in the mindfulness intervention groups reported improvement in PTSD symptoms when compared to participants in non-mindfulness groups. Different types of intervention targeted different symptoms and aspects of well-being. Furthermore, type of intervention may have also differentially targeted
potential mechanisms of action. This article highlights the importance of employing both quantitative and qualitative research methods when investigating the dynamic process of mindfulness and may inform how practices can be tailored to the needs of the veteran with PTSD.
The purpose of this paper is to articulate a rationale for increased collaboration between the mental health system and recreation system by embracing recovery-oriented practice. We provide practical examples of the potential for this collaboration from our current ‘Recreation for Mental Health’ project. For example, recreation programs intended for individuals with mental health problems should be informed by individuals in the recreation sector, mental health sector and individuals with mental illnesses. As such, programming should reflect current understandings of recovery-oriented care, the benefits of recreation for mental health and consider the perspectives of those living with mental health problems. Additionally, opportunities for recreation engagement can be supported in ‘community arenas’: recreation spaces where individuals with mental health problems are not thought of or identified as mental health consumers and where they can fully participate in safe and supportive recreation environments. Finally, we outline suggestions for next steps including a number of intersectoral activities such as information sharing, asset mapping, knowledge translation, research and program evaluation.
Care farming is the practice of using working farms and agricultural landscapes to promote
mental and physical health. Military veterans are increasingly using care farms to heal their
psychological wounds and reconnect socially. We examined the effectiveness of care farming
using a smartphone data collection app and single-case design to determine its effect on veterans’
life satisfaction, optimism, and perceived loneliness. Care farming improved life satisfaction in
60% of participants and optimism about future life satisfaction in 40% of participants. Perceived
loneliness decreased in 40% of participants. Findings support care farming as a treatment for
languishing veterans.
Over the past 2 decades, a major focus in psychological research has been on pursuing happiness, positivity, and optimal human flourishing. Interestingly, little attention has been paid to contentment, which, according to over 4,000 years of spiritual, philosophical, and theoretical discourse, is an emotion that sits at the deepest core of human wellbeing and is foundational to the experience of fulfillment in life. This article synthesizes etymological, religious, philosophical, and psychological treatments of contentment from multiple languages and traditions. Derived from these perspectives, it also presents a prototype approach to contentment, its core affect features and cross-cultural variations. Finally, it presents theory-grounded hypotheses intended to initiate future research on the topic. We propose a primary appraisal theme that is at the root of all experiences of contentment: perceived completeness, which refers to the perception that the present situation is enough and entire.
Schema therapy (ST) and dialectical behavior therapy (DBT) have both shown to be effective treatment methods especially for borderline personality disorder. Both, ST and DBT, have their roots in cognitive behavioral therapy and aim at helping patient to deal with emotional dysregulation. However, there are major differences in the terminology, explanatory models and techniques used in the both methods. This article gives an overview of the major therapeutic techniques used in ST and DBT with respect to emotion regulation and systematically puts them in the context of James Gross' process model of emotion regulation. Similarities and differences of the two methods are highlighted and illustrated with a case example. A core difference of the two approaches is that DBT directly focusses on the acquisition of emotion regulation skills, whereas ST does seldom address emotion regulation directly. All DBT-modules (mindfulness, distress tolerance, emotion regulation, interpersonal effectiveness) are intended to improve emotion regulation skills and patients are encouraged to train these skills on a regular basis. DBT assumes that improved skills and skills use will result in better emotion regulation. In ST problems in emotion regulation are seen as a consequence of adverse early experiences (e.g., lack of safe attachment, childhood abuse or emotional neglect). These negative experiences have led to unprocessed psychological traumas and fear of emotions and result in attempts to avoid emotions and dysfunctional meta-cognitive schemas about the meaning of emotions. ST assumes that when these underlying problems are addressed, emotion regulation improves. Major ST techniques for trauma processing, emotional avoidance and dysregulation are limited reparenting, empathic confrontation and experiential techniques like chair dialogs and imagery rescripting.
Stress is prevalent in modern society and coping strategies largely determine wellbeing. A qualitative investigation of leisure as a positive coping response to stress was undertaken using a resilience-based perspective. This approach enabled a focus on competencies and strengths in the stress-leisure-coping process, contributing to the sparse literature in this area. In-depth interviews were conducted with a sample of eight participants. From a thematic analysis three overall themes emerged: leisure as a buffer of stress, the relationship between negative and positive emotions and leisure, and benefits of leisure for coping with stress. The findings demonstrate how leisure facilitates a sense of resilience and its preventative functions. The results are discussed in relation to relevant theoretical propositions concerning the role of positive emotion in coping. In particular, the broaden-and-build theory provided a meaningful framework for suggesting how leisure and positive emotions acted in tandem to develop psychosocial resources over time.
Objectives:
The current study assessed associations between changes in 5 facets of mindfulness (Acting With Awareness, Observing, Describing, Non-Reactivity, and Nonjudgment) and changes in 4 posttraumatic stress disorder (PTSD) symptom clusters (Re-Experiencing, Avoidance, Emotional Numbing, and Hyperarousal symptoms) among veterans participating in mindfulness-based stress reduction (MBSR).
Method:
Secondary analyses were performed with a combined data set consisting of 2 published and 2 unpublished trials of MBSR conducted at a large Veterans Affairs hospital. The combined sample included 113 veterans enrolled in MBSR who screened positive for PTSD and completed measures of mindfulness and PTSD symptoms before and after the 8-week intervention.
Results:
Increases in mindfulness were significantly associated with reduced PTSD symptoms. Increases in Acting With Awareness and Non-Reactivity were the facets of mindfulness most strongly and consistently associated with reduced PTSD symptoms. Increases in mindfulness were most strongly related to decreases in Hyperarousal and Emotional Numbing.
Conclusions:
These results extend previous research, provide preliminary support for changes in mindfulness as a viable mechanism of treatment, and have a number of potential practical and theoretical implications.
This paper investigates potential mental health benefits of outdoor and adventure education programs. It is argued that experiences made in successful programs can increase self-efficacy, mindfulness and subjective well-being. Furthermore, programs may reduce feelings of time pressure and mental stress amongst participants. Evidence comes from two pilot studies: In the school project “Crossing the Alps” (Study 1), 14-year-old participants reported an increase in life satisfaction, mindfulness and a decrease in the PSQ Subscale ‘demand’ after a successful nine-day hike through the German, Austrian, and Italian Alps. In the university project “Friluftsliv” (Study 2) participants scored higher in life satisfaction, happiness, mindfulness, and self-efficacy and lower in perceived stress after having spent eight days in the wilderness of the Norwegian Hardangervidda region, miles away from the next locality. The findings suggest that outdoor education and wilderness programs can foster mental health in youths and young adults.
Growing numbers of mental health organizations are developing community music-making interventions for service users; however, to date there has been little research into their efficacy or mechanisms of effect. This study was an exploratory examination of whether 10 weeks of group drumming could improve depression, anxiety and social resilience among service users compared with a non-music control group (with participants allocated to group by geographical location.) Significant improvements were found in the drumming group but not the control group: by week 6 there were decreases in depression (-2.14 SE 0.50 CI -3.16 to -1.11) and increases in social resilience (7.69 SE 2.00 CI 3.60 to 11.78), and by week 10 these had further improved (depression: -3.41 SE 0.62 CI -4.68 to -2.15; social resilience: 10.59 SE 1.78 CI 6.94 to 14.24) alongside significant improvements in anxiety (-2.21 SE 0.50 CI -3.24 to -1.19) and mental wellbeing (6.14 SE 0.92 CI 4.25 to 8.04). All significant changes were maintained at 3 months follow-up. Furthermore, it is now recognised that many mental health conditions are characterised by underlying inflammatory immune responses. Consequently, participants in the drumming group also provided saliva samples to test for cortisol and the cytokines interleukin (IL) 4, IL6, IL17, tumour necrosis factor alpha (TNFα), and monocyte chemoattractant protein (MCP) 1. Across the 10 weeks there was a shift away from a pro-inflammatory towards an anti-inflammatory immune profile. Consequently, this study demonstrates the psychological benefits of group drumming and also suggests underlying biological effects, supporting its therapeutic potential for mental health.
Trial Registration: ClinicalTrials.gov NCT01906892
Chronic pain is a condition defined by its intractable nature, with a host of negative impacts on the lives of sufferers, including a deficit of positive emotions. This article presents an innovative group therapy program for chronic pain patients entitled Being Hopeful in the Face of Chronic Pain. Theoretical background for the creation of the group is presented, along with empirical evidence to support the efficacy of the program. The 6-week group program is described in sufficient detail for practitioners to adapt it for use, delineating the specific activities undertaken in each session. Implications for chronic pain treatment are discussed.
This book takes a lofty vision of "recovery" and of "a life in the community" for every adult with a serious mental illness promised by the U.S. President's 2003 New Freedom Commission on Mental Health and shows the reader what is entailed in making this vision a reality. Beginning with the historical context of the recovery movement and its recent emergence on the center stage of mental health policy around the world, the authors then clarify various definitions of mental health recovery and address the most common misconceptions of recovery held by skeptical practitioners and worried families. With this framework in place, the authors suggest fundamental principles for recovery-oriented care, a set of concrete practice guidelines developed in and for the field, a recovery guide model of practice as an alternative to clinical case management, and tools to self-assess the recovery orientation of practices and practitioners. In doing so, this volume represents the first book to go beyond the rhetoric of recovery to its implementation in everyday practice. Much of this work was developed with the State of Connecticut's Department of Mental Health and Addiction Services, helping the state to win a #1 ranking in the recent NAMI report card on state mental health authorities. Since initial development of these principles, guidelines, and tools in Connecticut, the authors have become increasingly involved in refining and tailoring this approach for other systems of care around the globe as more and more governments, ministry leaders, system managers, practitioners, and people with serious mental illnesses and their families embrace the need to transform mental health services to promote recovery and community inclusion. If you've wondered what all of the recent to-do has been about with the notion of "recovery" in mental health, this book explains it. In addition, it gives you an insider's view of the challenges and strategies involved in transforming to recovery and a road map to follow on the first few steps down this exciting, promising, and perhaps long overdue path.
A research study investigated student perspectives on service learning during the TRAIL to Wellness program, a four-week leisure education program for veterans being treated for substance abuse. The research explored the students' perspectives on their own learning at the end of 15 weeks. Based upon the content analysis of open-ended questions about the service learning program, several themes emerged: 1) classroom preparation improves the service learning experience, 2) service learning activities improve students' understanding of the therapeutic recreation process, and 3) the experience prompts self-awareness.
Purpose: To explore the effectiveness of scuba diving in providing therapeutic and rehabilitative benefit to ex-service personnel who have experienced traumatic physical and/or psychological injuries resulting from combat.
Methods: This study took the form of a service evaluation of Deptherapy, a UK-based niche charity offering support to military veterans who have experienced life-changing injuries. Deptherapy provides scuba diving qualifications, consisting of theory and practical diving experience, to participants alongside a Peer Support Buddy scheme that provides continuing support to servicemen involved with the charity. A total of 15 male veterans were invited to take part in the study. The methodology comprised retrospective and current quantitative measures of mental well-being and functional ability, utilising the General Health Questionnaire-28, and subsequent semi-structured interviews with participants, their families and health professionals.
Results: Participants reported an improvement in levels of anxiety, depression and social functioning, and a reduction in insomnia, following their involvement in organised scuba diving activities. There was a mean average difference of 14.3 points improvement on the General Health Questionnaire-28 scale variants between prior interaction with Deptherapy and current perceptions following engagement with the programme. The positive perceptions, as indicated from the semi-structured interviews, were more pronounced in those whose injuries were predominantly psychological, rather than physical.
Conclusion: Scuba diving can offer significant therapeutic benefits, particularly for ex-military amputees experiencing co-morbid anxiety and/or chronic psychological adjustment disorders, notably in terms of improvements in social dysfunction and symptomology of depression.
• Implications for Rehabilitation Scuba Diving as a Therapy
• Military combat can result in devastating, chronic physical and/or psychological injury.
• Current research suggests that a combination of medical and psychological therapy may prove to be the most beneficial for military veterans.
• Scuba diving has the potential to benefit injured veterans due the requirement of complete focus and the feeling of weightlessness when underwater.
• This article evaluates whether scuba diving is an effective physical and psychological therapy through GHQ-28 analysis and veteran interviews.
• Scuba diving benefited injured veterans in terms of chronic pain relief and depression symptoms alleviation.
The power of nature to both heal and inspire awe has been noted by many great thinkers. However, no study has examined how the impact of nature on well-being and stress-related symptoms is explained by experiences of awe. In the present investigation, we examine this process in studies of extraordinary and everyday nature experiences. In Study 1, awe experienced by military veterans and youth from underserved communities while whitewater rafting, above and beyond all the other positive emotions measured, predicted changes in well-being and stress-related symptoms one week later. In Study 2, the nature experiences that undergraduate students had during their everyday lives led to more awe, which mediated the effect of nature experience on improvements in well-being. We discuss how accounting for people’s emotional experiences during outdoors activities can increase our understanding of how nature impacts people’s well-being.
This book brings together two bodies of knowledge - wellbeing and recovery. Wellbeing and 'positive' approaches are increasingly influencing many areas of society. Recovery in mental illness has a growing empirical evidence base. For the first time, overlaps and cross-fertilisation opportunities between the two bodies of knowledge are identified. International experts present innovations taking place within the mental health system, which include wellbeing-informed new therapies, e-health approaches and peer-led recovery communities. State-of-the-art applications of wellbeing to the wider community are also described, across education, employment, parenting and city planning. This book will be of interest to anyone connected with the mental health system, especially people using and working in services, and clinical and administrators leaders, and those interested in using research from the mental health system in the wider community.
Background:
Understanding the complex interrelationships between combat injuries, physical health, and mental health symptoms is critical to addressing the healthcare needs of wounded military personnel and veterans. The relationship between injury characteristics, pain, posttraumatic stress disorder (PTSD), and depression among combat-injured military personnel is unique to modern conflicts and understudied in the nursing literature.
Aim:
This integrative review synthesizes clinical presentations and relationships of combat injury, PTSD, depression, and pain in Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF) United States military service members and veterans.
Methods:
A literature search was conducted using relative key terms across databases to identify peer-reviewed publications between 2001 and 2016 that examined health outcomes of combat-injured persons in OEF and OIF. The quality of evidence was evaluated and results synthesized to examine the association of combat injury as a risk factor for PTSD, the relationship of PTSD and depression pre- and postinjury, and pain management throughout care.
Results:
Twenty-two articles were included in this review. Greater injury and pain severity poses risks for developing PTSD following combat injury, while early symptom management lessens risks for PTSD. Depression appears to be both a contributing risk factor to postinjury PTSD, as well as a comorbidity.
Linking evidence to action:
Findings demonstrate a compelling need for improvements in standardized assessment of pain and mental health symptoms across transitions in care. This integrative review informs nurse researchers and providers of the clinical characteristics of pain, PTSD, and depression following combat injury and offers implications for future research promoting optimal surveillance of symptoms.
This study investigated the relationships among resilience, social anxiety, and procrastination in a sample of college students. Specifically, structural equation modeling analyses were applied to examine the effect of resilience on procrastination and to test the mediating effect of social anxiety. The results of this study suggested that social anxiety partially mediated the relationship between resilience and procrastination. Students with higher levels of resilience reported a lower frequency of procrastination behavior, and resilience had an indirect effect on procrastination through social anxiety. The results of this study clarify the current knowledge of the mixed results on resilience and procrastination behaviors and offer practical learning strategies and psychological interventions.
Based on differing theories of moral development proposed by Lawrence Kohlberg, Martin Hoffman, and John Gibbs, this paper posits that listening to Bruce Springsteen’s music can increase moral growth. Scores of Springsteen songs parallel psychological techniques used to increase moral development, such as being exposed to two or more beliefs that are contradictory, social perspective-taking by listening to moral dilemmas, gaining empathy with the distress that another person experiences, hypothetical contemplation, and meta-ethical reflection. Through qualitative-based autoethnographical storytelling, the author outlines how his moral development was enabled through such Springsteen songs as “Factory,” “Highway Patrolman,” “Independence Day,” “Johnny 99,” and “Used Cars,” as well as two self-disclosures from Springsteen’s Live 1975-85 album.
Carefully designed interventions consistently help K-12 teachers learn how to implement a more autonomy-supportive classroom motivating style. In the present study, we investigated what resources teachers acquired during these interventions that explained why they are so able to successfully upgrade the quality of their motivating style. We randomly assigned 91 full-time teachers to participate or not in a year-long autonomy-supportive intervention program (ASIP), and we longitudinally assessed autonomy support and three hypothesized mediating resources—gains in need satisfaction during teaching, gains in teaching efficacy, and a greater adoption of intrinsic instructional goals. The ASIP did increase teachers’ autonomy support, as expected, and the two resources that explained this professional developmental achievement were intervention-enabled gains in teaching efficacy and intrinsic instructional goals.
Previous research has recognized the need to better understand the experience of female veterans and their adjustment upon returning home, especially considering that a growing number of veterans are women. Their stories, particularly as they relate to combat and the associated wounds of war, largely remain untold. Therefore, the purpose of this project was to employ a theoretical sample from Grounded Theory methodology to determine if similar recreation opportunity structure patterns existed in the use of outdoor sports and recreation for a sample of female veterans, as had been found in previous research with individuals with physical disabilities. The investigation revealed findings that substantiated the way in which recreation opportunity structures provide novel environments where physical skills and emotional capacities could be developed through (a) establishing social networks and bonding, (b) facilitating a sense of freedom from constraints, and (c) by providing opportunities to redefine or recapture their identity.
Emotional processes influence a wide range of mental and physical systems, which makes them difficult to understand from a single perspective. In this special issue of the Review of General Psychology, contributing authors present 4 articles that draw from several areas within psychology in the service of understanding a topic relevant to emotion. In this overview, the authors argue that the long neglect of the scientific study of complex processes such as emotion might be linked, in part, to the fractionation of the field into specialized subdisciplines. Just as emotions were of central concern in the early years of psychology (which was a generalist's era), as psychology moves toward more integration in the late 20th century broad phenomena such as emotions are once again central interests. The 4 articles of this special issue are briefly reviewed as exemplars of an integrated approach to understanding emotional phenomena.
This chapter provides an overview of the most up-to-date understanding of the neuroscience of posttraumatic stress disorder (PTSD). A variety of topics are covered throughout this chapter in a systematic fashion with the goal that each section can be read and understood as a stand-alone piece of a greater whole. The first section presents an overview of the neurobiology of traumatic stress from receptors to structural brain changes. After this general overview, a discussion of the various animal models of PTSD is provided. These models include fear conditioning, fear-potentiated startle, and models of unpredictable stress. This review of animal models is then followed by a discussion of biomarkers, PTSD and somatic health, neuroimaging, and treatment. Following these in-depth topics, this chapter provides some possible avenues for future research including exploration of the neuroscience of sleep and PTSD or through new technologies such as magnetoencephalography.
This quasi-experimental study evaluated the effectiveness of a multi-modal experiential stress management course for college students. Experiential approaches included yoga, mindfulness hiking, and equine-assisted stress management activities. Univariate analysis of covariance revealed significantly lower perceived stress for the experimental group at the conclusion of the stress management course. Repeated measures univariate analysis of variance revealed that the stress management course significantly reduced present moment stress over time and that equine-assisted activities were as effective as yoga and mindfulness hiking in reducing student stress.
Universities are currently embracing community engagement strategies to increase opportunities for student learning in community settings such as community organizations. Experiential learning is often touted as the pedagogy underlying such experiences. We undertook a research project exploring the challenges and benefits for students and faculty who are offering integrated experiential curriculum in universities within North American Recreation and Leisure studies programs. We also address the ways in which interviewees defined experiential, and in particular, integrated experiential education. In the paper, we propose a model, defining the breadth of integrated experiential education approaches across continua of place, curriculum, philosophy, instructor role, and content. The model provides a tool for both understanding common aspects of integrated experiential approaches and identifying where specific experiential activities lie across these continua.
De nos jours, les universités ont recours aux stratégies d’engagement communautaire afin de donner aux étudiants de plus grandes possibilités d’apprentissage dans les milieux communautaires tels que les organismes communautaires. L’apprentissage par l’expérience est souvent présenté comme étant la pédagogie sous-jacente à de telles expériences. Nous avons entrepris un projet de recherche visant à explorer les défis et les avantages pour les étudiants et les professeurs qui offrent des programmes d’études intégrés basés sur l’expérience dans les universités nord-américaines au sein de programmes d’Études en loisirs et en récréologie. Nous nous sommes également intéressés aux manières dont les personnes interviewées définissent les termes « basé sur l’expérience », en particulier l’enseignement intégré basé sur l’expérience. Dans cet article, nous proposons un modèle qui définit l’étendue des approches de l’enseignement intégré basé sur l’expérience indépendamment des lieux, des programmes d’études, des philosophies, des rôles des instructeurs et des contenus. Le modèle présente un outil pour comprendre les aspects communs des approches de l’enseignement intégré basé sur l’expérience et par ailleurs, il identifie où se situent les activités spécifiquement basées sur l’expérience d’un bout à l’autre du continuum.
Posttraumatic stress disorder (PTSD) is one of the signature injuries of the U.S. conflicts in Afghanistan and Iraq, but it affects veterans of all eras. It is estimated that 7-20% of service members and veterans who served in Operation Enduring Freedom and Operation Iraqi Freedom may have the disorder. PTSD is characterized by a combination of mental health symptoms - re-experiencing of a traumatic event, avoidance of trauma-associated stimuli, adverse alterations in thoughts and mood, and hyperarousal - that last at least 1 month and impair functioning. PTSD can be lifelong and pervade all aspects of a service member's or veteran's life, including mental and physical health, family and social relationships, and employment. It is often concurrent with other health problems, such as depression, traumatic brain injury, chronic pain, substance abuse disorder, and intimate partner violence. The Department of Defense (DoD) and the Department of Veterans Affairs (VA) provide a spectrum of programs and services to screen for, diagnose, treat for, and rehabilitate service members and veterans who have or are at risk for PTSD. The 2010 National Defense Authorization Act asked the Institute of Medicine to assess those PTSD programs and services in two phases. The Phase 1 study, Treatment for Posttraumatic Stress Disorder in Military and Veteran Populations: Initial Assessment, focused on data gathering. Treatment for Posttraumatic Stress Disorder in Military and Veteran Populations Final Assessment is the report of the second phase of the study. This report analyzes the data received in Phase 1 specifically to determine the rates of success for each program or method. Treatment for Posttraumatic Stress Disorder in Military and Veteran Populations Final Assessment considers what a successful PTSD management system is and whether and how such a system is being implemented by DoD and VA. This includes an assessment of what care is given and to whom, how effectiveness is measured, what types of mental health care providers are available, what influences whether a service member or veteran seeks care, and what are the costs associated with that care. This report focuses on the opportunities and challenges that DoD and VA face in developing, implementing, and evaluating services and programs in the context of achieving a high-performing system to care for service members and veterans who have PTSD. The report also identifies where gaps or new emphases might be addressed to improve prevention of, screening for, diagnosis of, and treatment and rehabilitation for the disorder. The findings and recommendations of Treatment for Posttraumatic Stress Disorder in Military and Veteran Populations: Final Assessment will encourage DoD and VA to increase their efforts in moving toward a high-performing, comprehensive, integrated PTSD management strategy that addresses the needs of current and future service members, veterans, and their families. © 2014 by the National Academy of Sciences. All rights reserved.
This article explores the strengths approach in therapeutic recreation practice, as articulated through the Flourishing through Leisure Model: An Ecological Extension of the Leisure and Well-Being Model (Anderson & Heyne, 2012a, 2012b), and examines the Upward Spiral Theory of Lifestyle Change (Fredrickson, 2015) as an explanatory framework for why and how leisure can drive sustained positive lifestyle change. Overviews are provided of the strengths approach and the Flourishing through Leisure Model, emphasizing the central role leisure plays in strengths-based therapeutic recreation practice. The broaden-and-build theory (Fredrickson, 2013b) is explained as it is the basis for the Upward Spiral Theory of Lifestyle Change. The Upward Spiral theory is described in detail in the contexts of the neuroscience of enjoyment, passion (obsessive and harmonious), and prioritizing positivity. Practical applications of the Upward Spiral Theory of Lifestyle Change to strengths-based therapeutic recreation practice are drawn, as well as recommendations for future research.
The purpose of this exploratory qualitative study was to gain insight into the motives, perceptions and behaviours of adventure tourists engaged in scuba diving, with the intent of revealing the nature of the experience sought by these tourists. Specifically, we examined whether there is a balance between the thrill of risk vs. the search for total relaxation and tranquility. In-depth interviews with scuba divers indicated that scuba diving represented a search for relaxation rather than the pursuit of risk. Even the divers who were well aware of the risks and of their fears, almost never explicitly expressed the possible fear-associated sensations of thrill and of adrenaline rush. New issues and motivations associated with scuba diving were identified, including the crucial role of the diving partner. A four-quadrant model for classifying scuba divers along the dimensions of tranquility and risk perception is presented as a means to integrate the various behaviours of the divers.
The learned helplessness hypothesis is criticized and reformulated. The old hypothesis, when applied to learned helplessness in humans, has two major problems: (a) It does not distinguish between cases in which outcomes are uncontrollable for all people and cases in which they are uncontrollable only for some people (univervsal vs. personal helplessness), and (b) it does not explain when helplessness is general and when specific, or when chronic and when acute. A reformulation based on a revision of attribution theory is proposed to resolve these inadequacies. According to the reformulation, once people perceive noncontingency, they attribute their helplessness to a cause. This cause can be stable or unstable, global or specific, and internal or external. The attribution chosen influences whether expectation of future helplessness will be chronic or acute, broad or narrow, and whether helplessness will lower self-esteem or not. The implications of this reformulation of human helplessness for the learned helplessness model of depression are outlined.