The pursuit of euthymia

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

Psychological flexibility has been viewed as the ability to: recognize and adapt to various situational demands; change one's paradigms when these strategies compromise personal or social functioning; maintain balance among important life domains; display consistency in one's behavior and deeply held values.

“Psychological flexibility has been viewed 30 as the ability to: recognize and adapt to var ious situational demands; change one's paradigms when these strategies compromise personal or social functioning; maintain balance among important life domains; display consistency in one's behavior and deeply held values.”

• cites [30] 30. Kashdan TB, Rottenberg J. Psychological flex- ibility as a fundamental aspect of health. Clin Psychol Rev 2010;30:865-78. sourceSupported

May combine two claims.

There is extensive evidence that positive affects and well-being represent protective factors for health and increase resistance to stressful life situations.

“There is, in fact, extensive evidence that positive affects and well-being represent protective factors for health and increase resistance to stressful life situations 6,32,[36][37][38] .”

• cites [6] 6. Ryff CD. Psychological well-being revisited. Psychother Psychosom 2014;83:10-28. sourcePartly supported

  The Health and Biological Research section (page unavailable) describes growing evidence that eudaimonic well-being has protective health associations, including better biological regulation in contexts of risk. It does not establish that positive affect independently protects health or that well-being increases resistance to stressful life situations; it notes that hedonic well-being showed minimal linkage to biomarkers in one study. (LLM, conf=0.84)

  Experimental — accuracy not yet measured
• cites [32] 32. Hasler G. Well-being: an important concept for psychotherapy and psychiatric neuroscience. Psychother Psychosom 2016;85:255-61. sourceSupported
• cites [36] 36. Fava GA, Cosci F, Sonino N. Current psycho- somatic practice. Psychother Psychosom 2017; 86:13-30. sourceNot checked — no full text of the source
• cites [37] 37. Fava GA, Sonino N. From the lesson of George Engel to current knowledge: the biopsychoso- cial model 40 years later. Psychother Psycho- som 2017;86:257-9. sourceNot checked — no full text of the source
• cites [38] 38. McEwen BS. Epigenetic interactions and the brain-body communication. Psychother Psy- chosom 2017;86:1-4. sourcePartly supported

  In “Interventions That Change the Brain and Improve Health” (page unavailable), the paper says coping resources can promote resilience and improved mental health when people face stressful experiences. It does not establish the more specific claim that positive affect and well-being themselves protect health or increase resistance to stress, nor does it characterize the evidence for that claim as extensive. (LLM, conf=0.78)

  Experimental — accuracy not yet measured

May combine two claims.

Issues such as leading a meaningful and purposeful life as well as having quality ties to others affect the physiological substrates of health.

“Issues such as leading a meaningful and purposeful life as well as having quality ties to others affect the physiological substrates of health 32 .”

• cites [32] 32. Hasler G. Well-being: an important concept for psychotherapy and psychiatric neuroscience. Psychother Psychosom 2016;85:255-61. sourceSupported

May combine two claims.

The Euthymia Scale has been found to entail clinimetric validity and reliability.

“Such items have been incorporated in the Euthymia Scale 15 , that has been found to entail clinimetric validity and reliability 48 .”

• cites [15] 15. Fava GA, Bech P. The concept of euthymia. Psy- chother Psychosom 2016;85:1-5. sourceCould not verify

  The Definition and Measurement section says the scale was designed using clinimetric principles, and Table 1 presents its items. Neither passage reports a finding of validity or reliability. Searches for those properties found no such assessment in our copy. (LLM, conf=0.76)

  Experimental — accuracy not yet measured
• cites [48] 48. Carrozzino D, Svicher A, Patierno C et al. The Euthymia Scale: a clinimetric analysis. Psy- chother Psychosom 2019;88:119-21. sourcePartly supported

  The results and discussion (page not available in our copy) report satisfactory incremental and moderate concurrent validity for the Euthymia Scale. They do not establish its reliability, and the results say the full 10-item scale fell below the acceptable threshold for scalability. (LLM, conf=0.88)

  Experimental — accuracy not yet measured

Probably not a substantial claim: may not pass S3 (load-bearing).

Well-being therapy (WBT) is a manualized, short-term psychotherapeutic strategy that emphasizes self-observation, with the use of a structured diary, homework and interaction between patient and therapist.

“Well-being therapy (WBT) is a manualized, short-term psychotherapeutic strategy that emphasizes self-observation, with the use of a structured diary, homework and interaction between patient and therapist 14,20,64 .”

• cites [14] 14. Fava GA, Tomba E. Increasing psychological well-being and resilience by psychotherapeutic methods. J Pers 2009;77:1902-34. sourceNot checked — no full text of the source
• cites [20] 20. Fava GA. Well-being therapy. Treatment man- ual and clinical applications. Basel: Karger, 2016. sourceNot checked — no full text of the source
• cites [64] 64. Fava GA, Cosci F, Guidi J et al. Well-being ther- apy in depression: new insights into the role of psychological well-being in the clinical process. Depress Anxiety 2017;34:801-8. sourceSupported

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

Many psychotherapeutic techniques aimed to increase psychological well-being have been developed, although only a few have been tested in clinical settings.

“Many psychotherapeutic techniques aimed to increase psychological well-being have been developed, although only a few have been tested in clinical settings [61][62][63] .”

• cites [61] 61. Rashid T. Positive psychology in practice: posi- tive psychotherapy. In: David SA, Boniwell I, Conley Ayers A (eds). The Oxford handbook of happiness. Oxford: Oxford University Press, 2013:978-93. sourceNot checked — no full text of the source
• cites [62] 62. Quoidbach J, Mikolajczak M, Gross JJ. Positive interventions: an emotion regulation perspec- tive. Psychol Bull 2015;141:655-93. sourceNot checked — no full text of the source
• cites [63] 63. Weiss LA, Westerhof GJ, Bohlmeijer ET. Can we increase psychological well-being? The effects of interventions on psychological well-being. PLoS One 2016;11:e0158092. sourcePartly supported

  The Introduction describes several types of interventions aimed at improving psychological well-being. However, the Results (Study characteristics; page unavailable) report that 13 of the 27 included trials used clinical samples—nearly half—so the paper does not support the claim that only a few have been tested in clinical settings. (LLM, conf=0.87)

  Experimental — accuracy not yet measured

May combine two claims.

A shorter version, the 6-item part of the PsychoSocial Index, was found to be a sensitive measure of well-being, yet it does not allow differentiation of the various dimensions.

“A shorter version, the 6-item part of the PsychoSocial Index 50,51 , has been developed and submitted to clinimetric validation: it was found to be a sensitive measure of well-being, yet it does not allow differentiation of the various dimensions.”

• cites [50] 50. Sonino N, Fava GA. A simple instrument for as- sessing stress in clinical practice. Postgrad Med J 1998;74:408-10. sourcePartly supported

  The INSTRUMENT section (page unavailable) identifies questions 31–36 as six well-being items within the 55-item Psychosocial Index. It does not report validation of those items as a shorter standalone measure, find them sensitive to well-being, or assess whether they distinguish its dimensions. The Results concern inter-rater agreement for the full index’s observer-rated dimensions. (LLM, conf=0.86)

  Experimental — accuracy not yet measured
• cites [51] 51. Piolanti A, Offidani O, Guidi J et al. Use of the PsychoSocial Index (PSI), a sensitive tool in research and practice. Psychother Psychosom 2016;85:337-45. sourceNot checked — no full text of the source

May combine two claims.

The sequential design was subsequently used in a number of randomized controlled trials and was found to entail significant benefits in a meta-analysis.

“This design was subsequently used in a number of randomized controlled trials and was found to entail significant benefits in a meta-analysis 72 .”

• cites [72] 72. Guidi J, Tomba E, Fava GA. The sequential inte- gration of pharmacotherapy and psychotherapy in the treatment of major depressive disorder: a meta-analysis of the sequential model and a critical review of the literature. Am J Psychiatry 2016;173:128-37. sourceSupported

Probably not a substantial claim: may not pass S3 (load-bearing).

A 10-item self-rating scale, the Acceptance and Action Questionnaire (AAQ-II), is available to measure psychological flexibility.

“A 10-item self-rating scale, the Acceptance and Action Questionnaire (AAQ-II), is available to measure psychological flexibility 52,53 .”

• cites [52] 52. Bond FW, Hayes SC, Baer R et al. Preliminary psychometric properties of the Acceptance and Action Questionnaire II: a revised measure of psychological inflexibility and experiential avoidance. Behav Ther 2011;42:676-88. sourcePartly supported

  The Overview of the present studies identifies the AAQ-II as a measure of psychological flexibility and inflexibility. However, the General Discussion says the authors compared seven- and 10-item versions and did not retain three items, leaving a seven-item scale—not the claimed 10-item scale. Page numbers are unavailable in our copy. (LLM, conf=0.90)

  Experimental — accuracy not yet measured
• cites [53] 53. Fledderus M, Bohlmeijer ET, Fox JP et al. The role of psychological flexibility in a self-help ac- ceptance and commitment therapy interven- tion for psychological distress in a randomized controlled trial. Behav Res Ther 2013;51:142- 51. sourceNot checked — no full text of the source

May combine two claims.

ACT was found to significantly reduce suicidal ideation as well as mental pain compared to relaxation in adult suicidal patients.

“ACT was found to significantly reduce suicidal ideation as well as mental pain compared to relaxation in adult suicidal patients 96 .”

• cites [96] 96. Ducasse D, Jaussent I, Arpon-Brand V et al. Ac- ceptance and commitment therapy for the man- agement of suicidal patients: a randomized controlled trial. Psychother Psychosom 2018;87: 211-22. sourceCould not verify

  The supplied passage is a repository page, not a results section. Searches for suicidal ideation, psychological pain, and the relaxation comparison returned only abstract text, which cannot serve as evidence under the specified rubric; no full-text passage establishes the claimed reductions. (LLM, conf=0.68)

  Experimental — accuracy not yet measured

May combine two claims.

In a subsequent study, MBCT + TAU had significant beneficial effects on remission rates, quality of life, mindfulness skills, and self-compassion in chronic, treatment-resistant depressed patients, even though the intent-to-treat analysis did not reveal a significant reduction in depressive symptoms.

“At post-treatment, MBCT + TAU had significant beneficial effects in terms of remission rates, quality of life, mindfulness skills, and self-compassion, even though the intent to treat (ITT) analysis did not reveal a significant reduction in depressive symptoms.”

• cites [93] 93. Cladder-Micus MB, Speckens AEM, Vrijsen JN et al. Mindfulness-based cognitive therapy for patients with chronic, treatment-resistant de- pression: a pragmatic randomized controlled trial. Depress Anxiety 2018;35:914-24. sourceSupported

May combine two claims.

The results indicated that WBT may address both polarities of mood swings and is geared to a state of euthymia.

“The results thus indicated that WBT may address both polarities of mood swings and is geared to a state of euthymia 15 .”

• cites [15] 15. Fava GA, Bech P. The concept of euthymia. Psy- chother Psychosom 2016;85:1-5. sourcePartly supported

  The Clinical Implications section describes WBT as a treatment for increasing psychological well-being and discusses therapies geared to euthymia. It does not say that WBT addresses both polarities of mood swings; its discussion of mania and depression elsewhere is not a finding about WBT. (LLM, conf=0.86)

  Experimental — accuracy not yet measured

May combine two claims.

A protocol based on the sequential combination of CBT and WBT in post-withdrawal disorders has been devised and tested in case reports.

“A protocol based on the sequential combination of CBT and WBT in post-withdrawal disorders has been devised 101 and tested in case reports 102 .”

• cites [101] sourceSupported
• cites [102] sourceNot checked — no full text of the source

May combine two claims.

Withdrawal symptoms do not necessarily wane after drug discontinuation and may build into persistent post-withdrawal disorders.

“Withdrawal symptoms do not necessarily wane after drug discontinuation and may build into persistent post-withdrawal disorders 98 .”

• cites [98] 98. Chouinard G, Chouinard VA. New classification of selective serotonin reuptake inhibitor (SSRI) withdrawal. Psychother Psychosom 2015;84:63- 71. sourceSupported

May combine two claims.

In a randomized controlled trial, MBCT was significantly more efficacious than treatment-as-usual in reducing depression severity in treatment-resistant depression, but not in the number of cases who remitted.

“MBCT was significantly more efficacious than TAU in reducing depression severity, but not the number of cases who remitted.”

• cites [92] 92. Eisendrath SJ, Gillung E, Delucchi KL et al. A randomized controlled trial of mindfulness- based cognitive therapy for treatment-resistant depression. Psychother Psychosom 2016;85:99- 110. sourcePartly supported

  The Results report a significantly greater reduction in depression severity with MBCT and no statistically significant difference in remission rates. But the Abstract Methods and Introduction identify the comparator as the Health-Enhancement Program (HEP), with treatment-as-usual pharmacotherapy given in both arms—not TAU alone. Page numbers are unavailable in our copy. (LLM, conf=0.91)

  Experimental — accuracy not yet measured

Probably not a substantial claim: may not pass S2 (checkable), S4 (based). May combine two claims.

The pursuit of euthymia cannot be conceived as a therapeutic intervention for specific mental disorders, but as a transdiagnostic strategy to be incorporated in an individualized therapeutic plan.

“The pursuit of euthymia cannot be conceived as a therapeutic intervention for specific mental disorders, but as a transdiagnostic strategy to be incorporated in an individualized therapeutic plan.”

May combine two claims.

Some individuals might have high levels of both ill-being and well-being, while others might have major mental disorders and poor psychological well-being, and further individuals might have no major mental disorders and high levels of psychological well-being.

“This means that some individuals might have high levels of both ill-being and well-being, while others might have major mental disorders and poor psychological well-being, and further individuals might have no major mental disorders and high levels of psychological well-being.”

Classified as probably not a substantial claim.

A full recovery can be reached only through interventions which facilitate progress toward restoration or enhancement of psychological well-being.

“Jahoda 1 had postulated that a full recovery can be reached only through interventions which facilitate progress toward restoration or enhancement of psychological well-being.”

• Also stated in: § Increasing the level of recovery · plain

  “A full recovery can be reached only through interventions which facilitate progress toward restoration or enhancement of psychological well-being 1 .”

• cites [1] 1. Jahoda M. Current concepts of positive mental health. New York: Basic Books, 1958. sourceNot checked — no full text of the source

Probably not a substantial claim: may not pass S2 (checkable).

Psychological well-being needs to be incorporated in the definition of recovery.

“Psychological well-being thus needs to be incorporated in the definition of recovery 9 .”

• cites [9] 9. Fava GA, Ruini C, Belaise C. The concept of recovery in major depression. Psychol Med 2007;37:307-17. sourceNot checked — no full text of the source

Probably not a substantial claim: may not pass S4 (based).

There is increasing evidence that the evaluation of euthymia and its components has major clinical implications.

“There is increasing evidence that the evaluation of euthymia and its components has major clinical implications.”

Probably not a substantial claim: may not pass S4 (based).

A number of psychotherapeutic techniques aiming to enhance positive affects and psychological wellbeing (such as wellbeing therapy, mindfulness-based cognitive therapy, and acceptance and commitment therapy) have been developed and validated in randomized controlled clinical trials.

“A number of psychotherapeutic techniques aiming to enhance positive affects and psychological wellbeing (such as wellbeing therapy, mindfulnessbased cognitive therapy, and acceptance and commitment therapy) have been developed and validated in randomized controlled clinical trials.”

Classified as probably not a substantial claim.

Interventions that bring the person out of negative functioning may not involve a full recovery, but the achievement of a neutral position.

“There has been growing recognition that interventions that bring the person out of negative functioning may not involve a full recovery, but the achievement of a neutral position 9 .”

• cites [9] 9. Fava GA, Ruini C, Belaise C. The concept of recovery in major depression. Psychol Med 2007;37:307-17. sourceNot checked — no full text of the source

Probably not a substantial claim: may not pass S3 (load-bearing).

The concept of subjective incompetence stands as opposite to that of resilience.

“The concept of subjective incompetence (a feeling of being trapped or blocked because of a sense of inability to plan or start actions toward goals) stands as opposite to that of resilience 33 .”

• cites [33] 33. de Figueiredo JM, Frank JD. Subjective incom- petence, the clinical hallmark of demoraliza- tion. Compr Psychiatry 1982;23:353-63. sourceNot checked — no full text of the source

Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing).

Resilience has been defined as the capacity to maintain or recover high well-being in the face of life adversity.

“Resilience has been defined as the capacity to maintain or recover high well-being in the face of life adversity 31 .”

• cites [31] 31. Ryff CD, Singer B, Dienbery Love G et al. Resil- ience in adulthood and later life. In: Lomranz J (ed). Handbook of aging and mental health. New York: Plenum, 1998:69-96. sourceNot checked — no full text of the source

May combine two claims.

Excessively elevated levels of positive emotions can also become detrimental, and are more connected with mental disorders and impaired functioning than with psychological well-being.

“Excessively elevated levels of positive emotions can also become detrimental 13 , and are more connected with mental disorders and impaired functioning than with psychological well-being.”

• cites [13] 13. Wood AM, Tarrier N. Positive clinical psychol- ogy. Clin Psychol Rev 2010;30:819-29.Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

Probably not a substantial claim: may not pass S3 (load-bearing).

The positive psychology movement attracted considerable criticism.

“Yet, this movement attracted considerable criticism 13,14 .”

• cites [13] 13. Wood AM, Tarrier N. Positive clinical psychol- ogy. Clin Psychol Rev 2010;30:819-29.Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

• cites [14] 14. Fava GA, Tomba E. Increasing psychological well-being and resilience by psychotherapeutic methods. J Pers 2009;77:1902-34. sourceNot checked — no full text of the source

Probably not a substantial claim: may not pass S3 (load-bearing).

The positive psychology movement can be credited with delivering the message that psychology needs to consider the positive as well as the negative, an issue that was much later extended to psychiatry.

“The movement can be credited with delivering the message that psychology needs to consider the positive as well as the negative, an issue that was much later extended to psychiatry 12 .”

• cites [12] 12. Jeste DV, Palmer BW. Positive psychiatry. A clinical handbook. Washington: American Psy- chiatric Publishing, 2015. sourceNot checked — no full text of the source

May combine two claims.

The two viewpoints are inextricably linked in clinical situations, where they also interact with mood fluctuations.

“However, the two viewpoints are inextricably linked in clinical situations, where they also interact with mood fluctuations 14 .”

• cites [14] 14. Fava GA, Tomba E. Increasing psychological well-being and resilience by psychotherapeutic methods. J Pers 2009;77:1902-34. sourceNot checked — no full text of the source

Probably not a substantial claim: may not pass S2 (checkable).

Appraisal of positive cognitions and affects needs to occur in the setting of an integrative framework, which may be provided by the concept of euthymia.

“Appraisal of positive cognitions and affects thus needs to occur in the setting of an integrative framework, which may be provided by the concept of euthymia.”

Probably not a substantial claim: may not pass S3 (load-bearing).

The WHO-5 scale consists of five items that cover a basic life perception of a dynamic state of well-being.

“The WHO-5 scale consists of five items that cover a basic life perception of a dynamic state of well-being.”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

The Symptom Questionnaire is a self-rating scale with 24 items referring to relaxation, contentment, physical well-being and friendliness, and 68 items referring to anxiety, depression, somatization and hostility-irritability.

“The Symptom Questionnaire is a self-rating scale with 24 items referring to relaxation, contentment, physical well-being and friendliness, and 68 items referring to anxiety, depression, somatization and hostility-irritability 17 .”

• cites [17] 17. Kellner R. A symptom questionnaire. J Clin Psy- chiatry 1987;48:269-74.Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

Probably not a substantial claim: may not pass S4 (based).

Optimal balanced well-being can be different from person to person, according to factors such as personality traits, social roles, cultural and social context.

“Optimal balanced well-being can be different from person to person, according to factors such as personality traits, social roles, cultural and social context.”

Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing).

This definition of euthymia, because of its intertwining with mood stability, is substantially different from the concept of eudaimonic well-being.

“This definition of euthymia, because of its intertwining with mood stability, is substantially different from the concept of eudaimonic well-being, that has become increasingly popular in positive psychology 34 .”

• cites [34] 34. Huta V. Eudaimonia. In: David SA, Boniwell I, Conley Ayers A (eds). The Oxford handbook of happiness. Oxford: Oxford University Press, 2013:200-13. sourceNot checked — no full text of the source

Classified as probably not a substantial claim.

It is questionable whether subthreshold symptomatic periods truly represent euthymia.

“It is thus questionable whether subthreshold symptomatic periods truly represent euthymia 28 .”

• cites [28] 28. Fava GA. Subclinical symptoms in mood disor- ders: pathophysiological and therapeutic im- plications. Psychol Med 1999;29:47-61. sourceNot checked — no full text of the source

Classified as probably not a substantial claim.

Euthymia is often defined essentially in negative terms, as a lack of a certain intensity of mood symptoms, and not as the presence of specific positive features that characterize recovery.

“Again, euthymia is often defined essentially in negative terms 29 , as a lack of a certain intensity of mood symptoms, and not as the presence of specific positive features that characterize recovery 9 .”

• cites [29] 29. Dunner DL. Duration of periods of euthymia in patients with dysthymic disorder. Am J Psychia- try 1999;156:1992-3. sourceNot checked — no full text of the source
• cites [9] 9. Fava GA, Ruini C, Belaise C. The concept of recovery in major depression. Psychol Med 2007;37:307-17. sourceNot checked — no full text of the source

Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing). May combine two claims.

Resilience is conceptualized as a longitudinal and dynamic process, which is related to the concept of flourishing.

“Resilience is thus conceptualized as a longitudinal and dynamic process, which is related to the concept of flourishing.”

May combine two claims.

Treatment of psychiatric symptoms may induce improvement of well-being, and scales describing well-being were found to be more sensitive to medication effects than those describing symptoms.

“Treatment of psychiatric symptoms may induce improvement of well-being, and, indeed, scales de scribing well-being were found to be more sensitive to medication effects than those describing symptoms 17 .”

• cites [17] 17. Kellner R. A symptom questionnaire. J Clin Psy- chiatry 1987;48:269-74.Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

Probably not a substantial claim: may not pass S3 (load-bearing).

Jahoda defined integration as the individual's balance of psychic forces (flexibility), a unifying outlook on life which guides actions and feelings for shaping future accordingly (consistency), and resistance to stress (resilience and tolerance to anxiety or frustration).

“She defined it as integration: the individual's balance of psychic forces (flexibility), a unifying outlook on life which guides actions and feelings for shaping future accordingly (consistency), and resistance to stress (resilience and tolerance to anxiety or frustration).”

• cites [1] 1. Jahoda M. Current concepts of positive mental health. New York: Basic Books, 1958. sourceNot checked — no full text of the source

Probably not a substantial claim: may not pass S4 (based).

Consideration of psychological well-being has had a limited impact so far on general practice.

“Despite these developments, consideration of psychological well-being has had a limited impact so far on general practice.”

May combine two claims.

Considerable fluctuations in psychological distress were recorded in studies with longitudinal designs, suggesting that the illness is still active in those latter periods, even though its intensity may vary.

“However, considerable fluctuations in psychological distress were recorded in studies with longitudinal designs, suggesting that the illness is still active in those latter periods, even though its intensity may vary 28 .”

• cites [28] 28. Fava GA. Subclinical symptoms in mood disor- ders: pathophysiological and therapeutic im- plications. Psychol Med 1999;29:47-61. sourceNot checked — no full text of the source

May combine two claims.

Positive psychology developed outside the clinical field and its oversimplified approach (happiness and optimism, the more the better) was likely to clash with the complexities of clinical reality.

“Positive psychology developed outside the clinical field and, not surprisingly, its oversimplified approach (happiness and optimism, the more the better) was likely to clash with the complexities of clinical reality 13,14 .”

• cites [13] 13. Wood AM, Tarrier N. Positive clinical psychol- ogy. Clin Psychol Rev 2010;30:819-29.Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

• cites [14] 14. Fava GA, Tomba E. Increasing psychological well-being and resilience by psychotherapeutic methods. J Pers 2009;77:1902-34. sourceNot checked — no full text of the source

Probably not a substantial claim: may not pass S3 (load-bearing).

The positive psychology movement initiated by the American Psychological Association in the year 2000 had a huge impact on psychology and society in a very short time.

“Yet, probably the strongest input to the consideration of psychological well-being came from the positive psychology movement initiated by the American Psychological Association in the year 2000 11 , which had a huge impact on psychology and the society in general in a very short time.”

• cites [11] 11. Seligman MEP, Csikszentmihalyi M. Posi- tive psychology: an introduction. Am Psychol 2000;55:5-14. sourceNot checked — no full text of the source

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

Research on psychological well-being can be summarized as falling in two general groups: the hedonic viewpoint focuses on subjective well-being, happiness, pain avoidance and life satisfaction, whereas the eudaimonic viewpoint focuses on meaning and self-realization and defines well-being in terms of degree to which a person is fully functioning or as a set of wellness variables such as self-actu

“Indeed, research on psychological well-being can be summarized 35 as falling in two general groups: the hedonic viewpoint focuses on subjective well-being, happiness, pain avoidance and life satisfaction, whereas the eudaimonic viewpoint, as portrayed by Aristotle, focuses on meaning and self-realization and defines well-being in terms of degree to which a person is fully functioning or as a set”

• cites [35] 35. Ryan RM, Deci EL. On happiness and human potential: a review of research on hedonic and eudaimonic well-being. Annu Rev Psychol 2001; 52:141-66. sourceNot checked — no full text of the source

May combine two claims.

Extensive clinical research has documented the Symptom Questionnaire's sensitivity to change and ability to discriminate between different populations.

“Extensive clinical research has documented its sensitivity to change and ability to discriminate between different populations 45 .”

• cites [45] 45. Rafanelli C, Ruini C. Assessment of psychologi- cal well-being in psychosomatic medicine. In: Fava GA, Sonino N, Wise TN (eds). The psycho- somatic assessment. Basel: Karger, 2012:182- 202. sourceNot checked — no full text of the source

Classified as probably not a substantial claim. May combine two claims.

Healthy functioning is characterized by an optimal balance of positive and negative cognitions and affects, and psychopathology is marked by deviations from this balance.

“In 1991, Garamoni et al 16 suggested that healthy functioning is characterized by an optimal balance of positive and negative cognitions and affects, and that psychopathology is marked by deviations from this balance.”

• cites [16] 16. Garamoni GL, Reynolds CF 3rd, Thase ME. The balance of positive and negative affects in major depression: a further test of the states of the mind model. Psychiatry Res 1991;39:99- 108. sourceNot checked — no full text of the source

May combine two claims.

Every successful psychotherapy, regardless of its target, is likely to improve subjective well-being and to reduce symptomatic distress.

“Every successful psychotherapy, regardless of its target, is likely to improve subjective well-being and to reduce symptoma tic distress 60 .”

• cites [60] 60. Howard KI, Lueger RJ, Maling MS et al. A phase model of psychotherapy outcome: causal me- diation of change. J Consult Clin Psychol 1993; 61:678-85. sourceNot checked — no full text of the source

Probably not a substantial claim: may not pass S3 (load-bearing).

The PWB questionnaire, because of its length, may be problematic to use in a busy clinical setting.

“The questionnaire, because of its length, may be problematic to use in a busy clinical setting.”

Probably not a substantial claim: may not pass S3 (load-bearing).

Flexibility is only one component of euthymia.

“Yet, flexibility is only one component of euthymia.”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

Padesky and Mooney's strengths-based CBT and forgiveness therapy have been suggested to increase well-being, but await adequate clinical validation.

“There are also further psychotherapeutic approaches, such as Padesky and Mooney's strengths-based CBT 68 and forgiveness therapy 69 , that have been suggested to increase well-being, but await adequate clinical validation 66 .”

• cites [68] 68. Padesky CA, Mooney K. Strengths based cog- nitive-behavioural therapy. Clin Psychol Psy- chother 2012;19:283-90.Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

• cites [69] 69. Enright RD, Fitzgibbons RP. Forgiveness thera- py. Washington: American Psychological Asso- ciation, 2014. sourceNot checked — no full text of the source
• cites [66] 66. MacLeod AK, Luzon O. The place of psycho- logical well-being in cognitive therapy. In: Fava GA, Ruini C (eds). Increasing psychological well-being in clinical and educational settings. Dordrecht: Springer, 2014:41-55. sourceNot checked — no full text of the source

Probably not a substantial claim: may not pass S2 (checkable), S4 (based).

It is wishful thinking to believe that one course of treatment will be sufficient for yielding lasting and satisfactory remission.

“It is simply wishful thinking to believe that one course of treatment will be sufficient for yielding lasting and satisfactory remission.”

May combine two claims.

Both the PWB scales and derived indices and the AAQ-II provide assessment of the impaired and optimal levels, but do not yield information about excessive levels.

“Further, both the PWB scales and derived indices and the AAQ-II provide assessment of the impaired and optimal levels, but do not yield information about excessive levels.”

Probably not a substantial claim: may not pass S2 (checkable).

Diagnosis needs to be integrated with positive affects and psychological well-being, as well as with a broad range of further elements, including stress, lifestyle, subclinical symptoms, illness behavior and social support, in a longitudinal perspective.

“It needs to be integrated with positive affects and psychological well-being, as well as with a broad range of further elements, including stress, lifestyle, subclinical symptoms, illness behavior and social support, in a longitudinal perspective 54 .”

• cites [54] 54. Fava GA, Rafanelli C, Tomba E. The clinical process in psychiatry. J Clin Psychiatry 2012; 73:177-84. sourceNot checked — no full text of the source

Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing). May combine two claims.

The planning of treatment requires determination of the symptomatic target of the first line approach (e.g., pharmacotherapy), and tentative identification of other areas of concern to be addressed by subsequent treatment (e.g., psychotherapy).

“The planning of treatment thus requires determination of the symptomatic target of the first line approach (e.g., pharmacotherapy), and tentative identification of other areas of concern to be addressed by subsequent treatment (e.g., psychotherapy) 59 .”

• cites [59] 59. Guidi J, Tomba E, Cosci F et al. The role of stag- ing in planning psychotherapeutic interven- tions in depression. J Clin Psychiatry 2017;78: 456-63. sourceNot checked — no full text of the source

Probably not a substantial claim: may not pass S4 (based).

In most instances of diagnostic reasoning in psychiatry, the process ends with the identification of a disorder, according to a diagnostic system.

“In most instances of diagnostic reasoning in psychiatry, the process ends with the identification of a disorder, according to a diagnostic system.”

Probably not a substantial claim: may not pass S3 (load-bearing).

The choice of instruments for micro-analysis is dictated by the clinimetric concept of incremental validity: each aspect of psychological measurement should deliver a unique increase in information in order to qualify for inclusion.

“The choice of these instruments is dictated by the clinimetric concept of incremental validity 54 : each aspect of psychological measurement should deliver a unique increase in information in order to qualify for inclusion.”

• cites [54] 54. Fava GA, Rafanelli C, Tomba E. The clinical process in psychiatry. J Clin Psychiatry 2012; 73:177-84. sourceNot checked — no full text of the source

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

MBCT's main aim is to reduce the impact of potentially distressing thoughts and feelings, but it also introduces techniques such as mindful, non-judgmental attention and mastery, and pleasure tasks that may be geared to a good life.

“Its main aim is to reduce the impact of potentially distressing thoughts and feelings, but it also introduces techniques such as mindful, non-judgmental attention and mastery, and pleasure tasks that may be geared to a good life 66 .”

• cites [66] 66. MacLeod AK, Luzon O. The place of psycho- logical well-being in cognitive therapy. In: Fava GA, Ruini C (eds). Increasing psychological well-being in clinical and educational settings. Dordrecht: Springer, 2014:41-55. sourceNot checked — no full text of the source

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

Unlike WBT, ACT argues that attempts at changing thoughts can be counterproductive, and encourages instead awareness and acceptance through mindfulness practice.

“Unlike WBT, ACT argues that attempts at changing thoughts can be counterproductive, and encourages instead awareness and acceptance through mindfulness practice.”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

The PWB scales encompass 84 items and six dimensions (environmental mastery, personal growth, purpose in life, autonomy, self-acceptance, and positive relations with others).

“They encompass 84 items and six dimensions (environmental mastery, personal growth, purpose in life, autonomy, self-acceptance, and positive relations with others) 2 .”

• cites [2] 2. Ryff CD. Happiness is everything, or is it? Explo- rations on the meaning of psychological well- being. J Pers Soc Psychol 1989;6:1069-81. sourceNot checked — no full text of the source

Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based). May combine two claims.

The good life that is strived for in MBCT is a state involving detachment, as portrayed by Epicurus, and not necessarily euthymia, as depicted by Plutarch.

“However, the good life that is strived for is a state involving detachment, as portrayed by Epicurus, and not necessarily euthymia, as depicted by Plutarch.”

Probably not a substantial claim: may not pass S3 (load-bearing).

Acceptance and commitment therapy (ACT) is aimed to increase psychological flexibility.

“Acceptance and commitment therapy (ACT) 67 is aimed to increase psychological flexibility 53 .”

• cites [67] 67. Hayes SC, Strosahal K, Wilson KG. Acceptance and commitment therapy. New York: Guilford, 1999. sourceNot checked — no full text of the source
• cites [53] 53. Fledderus M, Bohlmeijer ET, Fox JP et al. The role of psychological flexibility in a self-help ac- ceptance and commitment therapy interven- tion for psychological distress in a randomized controlled trial. Behav Res Ther 2013;51:142- 51. sourceNot checked — no full text of the source

Probably not a substantial claim: may not pass S3 (load-bearing).

ACT consists of an integration of behavioral theories of change with mindfulness and acceptance strategies.

“It consists of an integration of behavioral theories of change with mindfulness and acceptance strategies.”

Classified as probably not a substantial claim.

The staging method characterizes a disorder according to severity, extension and longitudinal development.

“The second technical step requires reference to the staging method, whereby a disorder is characterized according to severity, extension and longitudinal development 57,58 .”

• cites [57] 57. Fava GA, Kellner R. Staging: a neglected dimen- sion in psychiatric classification. Acta Psychiatr Scand 1993;87:225-30. sourceNot checked — no full text of the source
• cites [58] 58. Cosci F, Fava GA. Staging of mental disorders: systematic review. Psychother Psychosom 2013; 82:20-34. sourceNot checked — no full text of the source

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

Mindfulness-based cognitive therapy (MBCT) is a psychotherapeutic strategy intended to increase psychological wellbeing, built on the Buddhist philosophy of a good life.

“Another psychotherapeutic strategy intended to increase psychological wellbeing is mindfulness-based cognitive therapy (MBCT) 65 , which is built on the Buddhist philosophy of a good life.”

• cites [65] 65. Segal ZV, Williams JMG, Teasdale JD. Mindful- ness-based cognitive therapy for depression. New York: Guilford, 2002.Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

Probably not a substantial claim: may not pass S3 (load-bearing).

Certain psychotherapeutic strategies can be deferred to a residual stage of psychiatric illness, when state-dependent learning has been improved by the use of medications.

“Further, certain psychotherapeutic strategies can be deferred to a residual stage of psychiatric illness, when state-dependent learning has been improved by the use of medications 59 .”

• cites [59] 59. Guidi J, Tomba E, Cosci F et al. The role of stag- ing in planning psychotherapeutic interven- tions in depression. J Clin Psychiatry 2017;78: 456-63. sourceNot checked — no full text of the source

May combine two claims.

From the available studies, it cannot be detected whether the pursuit of psychological well-being was a specific effective ingredient and what mechanism decreased the likelihood of relapse.

“From the available studies, we are unable to detect whether the pursuit of psychological well-being was a specific effective ingredient and what was the mechanism decreasing the likelihood of relapse.”

May combine two claims.

Positive changes in post-traumatic growth can be observed in self-concept, appreciation of life opportunities, social relations, hierarchy of values and priorities, and spiritual growth.

“Positive changes can be observed in self-concept (e.g., new evaluation of one's strength and resilience), appreciation of life opportunities, social relations, hierarchy of values and priorities, spiritual growth.”

• cites [103] sourceNot checked — no full text of the source

Probably not a substantial claim: may not pass S3 (load-bearing).

The process of rehabilitation requires the promotion of well-being and changes in lifestyle as primary targets of intervention.

“The process of rehabilitation, in fact, requires the promotion of well-being and changes in lifestyle as primary targets of intervention 106 .”

• cites [106] sourceNot checked — no full text of the source

May combine two claims.

In a randomized controlled trial, both WBT and CBT were associated with a significant reduction of residual symptoms in patients with mood or anxiety disorders, but WBT had a significant advantage over CBT as detected by observer-rated methods.

“Both WBT and CBT were associated with a significant reduction of those symptoms, but a significant advantage of WBT over CBT was detected by observer-rated methods.”

• cites [18] 18. Fava GA, Rafanelli C, Cazzaro M et al. Well-being therapy: a novel psychotherapeutic ap proach for residual symptoms of affective disorders. Psy- chol Med 1998;28:475-80. sourceNot checked — no full text of the source

May combine two claims.

The clinical results obtained with the sequential model are impressive, and the sequential model seems to be a strategy that has enduring effects in the prevention of relapse in depression.

“Nonetheless, the clinical results that have been obtained are impressive, and the sequential model seems to be a strategy that has enduring effects in the prevention of the vexing problem of relapse in depression.”

Probably not a substantial claim: may not pass S2 (checkable).

It is possible to postulate a role for psychotherapeutic interventions modulating psychological well-being in the setting of medical diseases, to counteract the limitations and challenges induced by illness experience.

“It is thus possible to postulate a role for psychotherapeutic interventions modulating psychological well-being in the setting of medical diseases, to counteract the limitations and challenges induced by illness experience.”

May combine two claims.

CTRA patterns have been implicated in the pathophysiology of cancer and cardiovascular diseases.

“Such patterns have been implicated in the pathophysiology of cancer 108 and cardiovascular diseases 109 .”

• cites [108] sourceNot checked — no full text of the source
• cites [109] sourceNot checked — no full text of the source

Probably not a substantial claim: may not pass S4 (based).

The evidence supporting the clinical value of the pursuit of euthymia is still limited.

“The evidence supporting the clinical value of the pursuit of euthymia is still limited.”

Probably not a substantial claim: may not pass S4 (based). May combine two claims.

Customary clinical taxonomy and evaluation do not include psychological well-being, which may demarcate major prognostic and therapeutic differences among patients who otherwise seem deceptively similar since they share the same diagnosis.

“Customary clinical taxonomy and evaluation do not include psychological wellbeing, which may demarcate major prognostic and therapeutic differences among patients who otherwise seem to be deceptively similar since they share the same diagnosis.”

Probably not a substantial claim: may not pass S2 (checkable), S4 (based).

This perspective is different from interventions that are labelled as positive but are actually distress oriented.

“This perspective is different from interventions that are labelled as positive but are actually distress oriented.”

Probably not a substantial claim: may not pass S2 (checkable), S4 (based). May combine two claims.

The insights gained may unravel innovative approaches to the assessment and treatment of mental disorders, with particular reference to decreasing vulnerability to relapse, increasing the level of recovery, and modulating mood.

“However, the insights gained may unravel innovative approaches to the assessment and treatment of mental disorders, with particular reference to decreasing vulnerability to relapse, increasing the level of recovery, and modulating mood.”

Probably not a substantial claim: may not pass S4 (based). May combine two claims.

WBT, MBCT, and ACT have been found effective in randomized controlled clinical trials.

“WBT, MBCT and ACT have been found effective in ran domized controlled clinical trials.”

May combine two claims.

Psychological distress and low levels of well-being are commonly observed among patients with chronic conditions and represent important obstacles to behavioral change.

“yet psychological distress and low levels of well-being are commonly observed among patients with chronic conditions and represent important obstacles to behavioral change 36 .”

• cites [36] 36. Fava GA, Cosci F, Sonino N. Current psycho- somatic practice. Psychother Psychosom 2017; 86:13-30. sourceNot checked — no full text of the source

Probably not a substantial claim: may not pass S2 (checkable), S4 (based).

The current long-term outcomes of mental disorders may be unsatisfactory not because technical interventions are missing, but because our conceptual models, shifted on the side of psychological dysfunction, are inadequate.

“These outcomes may be unsatisfactory not because technical interventions are missing, but because our conceptual models, shifted on the side of psychological dysfunction, are inadequate.”

Probably not a substantial claim: may not pass S3 (load-bearing).

Lifestyle modification focused on weight reduction, increased physical activity, and dietary change is recommended as first line therapy in a number of disorders.

“Lifestyle modification focused on weight reduction, increased physical activity, and dietary change is recommended as first line therapy in a number of disorders, yet psychological distress and low levels of well-being are commonly observed among patients with chronic conditions and represent important obstacles to behavioral change 36 .”

• cites [36] 36. Fava GA, Cosci F, Sonino N. Current psycho- somatic practice. Psychother Psychosom 2017; 86:13-30. sourceNot checked — no full text of the source

Probably not a substantial claim: may not pass S4 (based).

An important characteristic of WBT is having euthymia as a specific target.

“An important characteristic of WBT is having euthymia as a specific target.”