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Cited by 48Psychological Well-being and Life SatisfactionPsychometric Methodologies and TestingCancer survivorship and care

Patient-reported outcome measures for life engagement in mental health: a systematic review

Open access
McIntyre, Roger S., Ismail, Zahinoor, Watling, Christopher P., Weiss, Catherine, Meehan, Stine R., Musingarimi, Primrose, Thase, Michael E.·2022·Journal of Patient-Reported Outcomes
DOI 10.1186/s41687-022-00468-5PMC PMC9187792
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Abstract

Background: Life engagement in the context of mental health is a broad term that describes positive health aspects relating to cognition, vitality, motivation and reward, and the ability to feel pleasure—concepts that are meaningful to patients. The aim of this systematic literature review was to identify validated patient-reported outcomes (PROs) that can assess any aspect of life engagement in adults, in the field of general mental health. Methods: This was a systematic literature review of articles in English from the MEDLINE database (date of search: September 9, 2020). The search strategy had three components: (1) terms to capture PROs; (2) terms to capture mental health; and (3) terms to capture aspects of life engagement. Articles were eligible if they included a PRO that: (1) is named; (2) can be used across mental health disorders; (3) is used to assess any aspect of life engagement; and (4) has undergone psychometric validation and/or qualitative content validation. A list of PROs was extracted. Results: A total of 1585 records were screened and 233 articles were eligible for inclusion. Within these 233 articles, 49 distinct PROs were identified, two of which specifically captured their authors’ interpretation of life engagement: the Engaged Living Scale (ELS) and the Life Engagement Test (LET). However, while the ELS and LET covered motivation and reward, life fulfillment, and value-based living, neither scale captured the cognitive or vitality aspects of life engagement. The remaining identified PROs generally captured single aspects of life engagement, most commonly motivation/reward/energy–apathy, pleasure–anhedonia, and mental/psychological well-being. Conclusion: Numerous PROs are available that may capture aspects of life engagement. However, a need remains for a new PRO that can be used in clinical trials to provide a more comprehensive description of the improvements in life engagement that patients with mental health disorders may experience with successful treatment.

AI snapshot

Written from the paper’s full text.

TL;DR

This systematic review identified 49 validated patient-reported outcome measures (PROs) that may assess aspects of life engagement in adults with mental health symptoms. Only the Engaged Living Scale and Life Engagement Test specifically targeted life engagement, and neither captured the cognitive or vitality domains, leading the authors to conclude that a new comprehensive PRO is needed.

Key findings

  • From 1,585 screened records, 233 articles were eligible and 49 distinct PROs were identified.
  • Only two PROs specifically captured their authors’ interpretation of life engagement: the Engaged Living Scale (ELS) and Life Engagement Test (LET); both covered motivation/reward, life fulfillment, and value-based living, but neither captured cognitive or vitality aspects, each appeared in only 1 eligible article, and neither had been used in a mental health disorder sample.
  • The most frequently identified PROs were pleasure/anhedonia measures: Revised Chapman Physical and Social Anhedonia Scales (36 articles), Snaith–Hamilton Pleasure Scale (33 articles), and Temporal Experience of Pleasure Scale (29 articles).
  • Many PROs appeared in eligible articles just once (20/49; 40.8%), and the majority appeared ≤3 times (32/49; 65.3%); remaining PROs generally captured single aspects of life engagement, most commonly motivation/reward/energy–apathy, pleasure–anhedonia, and mental/psychological well-being.

Methods

  • Systematic literature review of MEDLINE/PubMed, searched September 9, 2020, with no language or date restrictions; reports had to be in English and include a named PRO usable across mental health disorders, assessing any aspect of life engagement, with psychometric and/or qualitative content validation.
  • Eligibility included adults in any mental health area, including non-clinical samples with mental health symptoms; full scales were included, not subscales or individual items.
  • Screening, full-text selection, and PRO extraction were performed by a single reviewer (CPW); no study outcomes were extracted and no bias assessment was performed because the purpose was to generate a list of PROs.

Limitations

  • The paper states that only a single database was searched; a single reviewer selected articles, increasing the risk of rejecting relevant reports; PROs tend to be secondary or exploratory outcomes and may not be mentioned in abstracts; and the life engagement framework requires additional validation and clarification on how it differs from existing concepts.
  • Evident from the text: data extraction was also performed by a single reviewer, and no formal risk-of-bias assessment was conducted.
  • Evident from the text: the search was run in September 2020, so later PROs would not be captured.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.1186/s41687-022-00468-5

Cites

Statistics

Nothing to recompute.

Claims the paper makes

0 of 54 cited sources checked · 0 supported · 0 flagged

  • Findingown data

    The remaining identified PROs generally captured single aspects of life engagement, most commonly motivation/reward/energy-apathy, pleasure-anhedonia, and mental/psychological well-being.

    “The remaining identified PROs generally captured single aspects of life engagement, most commonly motivation/reward/energy–apathy, pleasure–anhedonia, and mental/psychological well-being.”
    • Also stated in: § General themes · plain
      “The remaining PROs generally captured single aspects of life engagement, rather than multiple aspects; most commonly motivation/reward/energy–apathy, pleasure–anhedonia, and mental/psychological well-being (Table 1).”
    Quote in the paperSubstantial claim
  • Findingown data

    Two of the identified PROs specifically captured their authors' interpretation of life engagement: the Engaged Living Scale (ELS) and the Life Engagement Test (LET).

    “two of which specifically captured their authors’ interpretation of life engagement: the Engaged Living Scale (ELS) and the Life Engagement Test (LET).”
    • Also stated in: § General themes · plain
      “Of the 49 identified PROs, two specifically captured their respective authors’ interpretation of life engagement (Engaged Living Scale and Life Engagement Test).”
    Quote in the paperSubstantial claim
  • Findingown data

    Within the 233 eligible articles, 49 distinct patient-reported outcomes were identified.

    “Within these 233 articles, 49 distinct PROs were identified”
    • Also stated in: § Results · plain
      “Within these 233 articles, a total of 49 distinct PROs were identified (Table 1).”
    Quote in the paperSubstantial claim
  • Findingnone given

    The ELS has not been used in a sample with mental health disorders.

    “The ELS has not been used in a sample with mental health disorders.”
    Quote in the paperNot a substantial claim
  • Findingown data

    Only two PROs specifically captured their respective authors' interpretation of life engagement.

    “only two PROs specifically captured their respective authors’ interpretation of life engagement”
    Quote in the paperSubstantial claim
  • Classified as probably not a substantial claim. 27
  • May combine two claims. 34

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

    Findingown data

    The systematic review screened 1585 records and identified 233 eligible articles.

    “A total of 1585 records were screened and 233 articles were eligible for inclusion.”
    • Also stated in: § Results · plain
      “A total of 1585 records were screened, and 233 articles were eligible for inclusion (Fig. 1).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    The ELS and LET covered motivation and reward, life fulfillment, and value-based living, but neither scale captured the cognitive or vitality aspects of life engagement.

    “However, while the ELS and LET covered motivation and reward, life fulfillment, and value-based living, neither scale captured the cognitive or vitality aspects of life engagement.”
    Quote in the paperSubstantial claim

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

    Findingcitation

    The SLR identified two prior reviews of well-being scales (using a very broad definition of well-being that included quality of life, physical well-being, and health), which found 99 and 60 PROs respectively.

    “In addition, the SLR identified two prior reviews of ‘well-being’ scales (using a very broad definition of well-being that included quality of life, physical well-being, and health), which found 99 and 60 PROs respectively [6, 7].”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [6] Linton MJ, Dieppe P, Medina-Lara A (2016) Review of 99 self-report measures for assessing well-being in adults: exploring dimensions of well-being and developments over time. BMJ Open 6(7):e010641 source

      Not checked in the free run.

    • cites [7] Lindert J, Bain PA, Kubzansky LD, Stein C (2015) Well-being measurement and the WHO health policy Health 2010: systematic review of measurement scales. Eur J Public Health 25(4):731–740 source

      Not checked in the free run.

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

    Findingnone given

    The SMVM has not been used in a sample with mental health disorders.

    “The SMVM has not been used in a sample with mental health disorders.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingreasoning

    Neither the ELS nor the LET captures the cognitive or vitality aspects of life engagement.

    “However, neither PRO captures the cognitive or vitality aspects of life engagement”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    Other aspects of engagement for which commonly used PROs were identified included motivation/reward/energy-apathy, attention/alertness, mental/psychological well-being, life satisfaction/meaning, and rumination.

    “Other aspects of engagement for which commonly used PROs were identified included motivation/reward/energy–apathy, attention/alertness, mental/psychological well-being, life satisfaction/meaning, and rumination.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingnone given

    Both the ELS and LET negatively correlate with mental health symptoms.

    “both negatively correlate with mental health symptoms”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Both the ELS and LET appeared just once in eligible systematic literature review articles.

    “both PROs appeared just once in eligible SLR articles”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    Neither the ELS nor the LET has been used in a sample with mental health disorders.

    “neither PRO has been used in a sample with mental health disorders”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Premisecitation

    Life engagement incorporates improvement of anhedonia and apathy, but anhedonia and apathy alone do not describe the aspects of life engagement relating to attention, alertness, and clarity of thought.

    “For example, life engagement incorporates improvement of anhedonia (which comprises motivational and consummatory aspects [13]) and apathy (which comprises behavior/cognition, emotion, and social interaction dimensions [14])—important treatment targets in mental health [15, 16]. However, anhedonia and apathy alone do not describe the aspects of life engagement relating to attention, alertness, and”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [9] Weiss C, Meehan SR, Brown TM et al (2021) Effects of adjunctive brexpiprazole on calmness and engagement in major depressive disorder: post hoc analysis of patient-reported outcomes from clinical trial exit interviews. J Patient Rep Outcomes 5(1):128 source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    The life engagement framework was validated in a separate study in which 20 patients with major depressive disorder were interviewed and their definitions and experiences were consistent with the four domains.

    “The framework was validated in a separate study, in which 20 patients with major depressive disorder (MDD) were interviewed and asked to describe how they felt when engaged with life [11]. The patients’ definitions and experiences were consistent with the four domains of Weiss et al., suggesting that the framework successfully captures the concept of life engagement, and that the concept resonates”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [11] MacKenzie E, Therrien F, Brown TM, Weiss C, Meehan SR (2021) Exploring the concept of life engagement from the perspective of patients with major depressive disorder: a study using patient interviews. Poster presented at American Society of Clinical Psychopharmacology Annual Meeting, virtual conference, 1–4 June 2021

      Not checked in the free run.

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

    Premisecitation

    Life engagement in mental health includes positive health aspects relating to cognition (including hot cognition), vitality, motivation and reward, and the ability to feel pleasure.

    “The life engagement concept includes positive health aspects relating to cognition (including ‘hot’ cognition, i.e., cognition colored by emotion), vitality, motivation and reward, and the ability to feel pleasure, and was developed based on transcripts from patient interviews and discussion with a panel of expert psychiatrists [9].”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [9] Weiss C, Meehan SR, Brown TM et al (2021) Effects of adjunctive brexpiprazole on calmness and engagement in major depressive disorder: post hoc analysis of patient-reported outcomes from clinical trial exit interviews. J Patient Rep Outcomes 5(1):128 source

      Not checked in the free run.

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

    Interpretationreasoning

    A need remains for a new PRO that can be used in clinical trials to provide a more comprehensive description of improvements in life engagement in patients with mental health disorders with successful treatment.

    “However, a need remains for a new PRO that can be used in clinical trials to provide a more comprehensive description of the improvements in life engagement that patients with mental health disorders may experience with successful treatment.”
    Quote in the paperNot a substantial claim

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

    Study design and conductown data

    The search strategy was tested during protocol development to confirm that it captured two known PROs (the Temporal Experience of Pleasure Scale and the Snaith-Hamilton Pleasure Scale).

    “During development of the protocol, the search strategy was tested to confirm that it captured two known PROs (the Temporal Experience of Pleasure Scale and the Snaith–Hamilton Pleasure Scale).”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim.

    Premisecitation

    The life engagement framework is split into four domains: emotional (affect/mood), physical (energy), social (interest), and cognitive (alertness/thinking).

    “Specifically, in the new framework, life engagement is split into four domains: emotional (affect/mood), physical (energy), social (interest), and cognitive (alertness/thinking).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [9] Weiss C, Meehan SR, Brown TM et al (2021) Effects of adjunctive brexpiprazole on calmness and engagement in major depressive disorder: post hoc analysis of patient-reported outcomes from clinical trial exit interviews. J Patient Rep Outcomes 5(1):128 source

      Not checked in the free run.

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

    Study design and conductnone given

    PRO names were extracted from eligible articles by a single reviewer (CPW).

    “PRO names were extracted from eligible articles by a single reviewer (CPW).”
    Quote in the paperNot a substantial claim

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

    Study design and conductnone given

    Eligibility assessment was performed by a single reviewer (CPW).

    “Eligibility assessment was performed by a single reviewer (CPW).”
    Quote in the paperNot a substantial claim

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

    Study design and conductnone given

    The search strategy and inclusion criteria were specified in advance and documented in a protocol.

    “The search strategy and inclusion criteria were specified in advance and documented in a protocol.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Premisecitation

    The Engaged Living Scale (ELS) and Life Engagement Test (LET) each include items to measure motivation and reward, life fulfillment, and value-based living.

    “the Engaged Living Scale (ELS) and Life Engagement Test (LET) each include items to measure motivation and reward, life fulfillment, and value-based living [22, 23].”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [22] Trompetter HR, Ten Klooster PM, Schreurs KMG, Fledderus M, Westerhof GJ, Bohlmeijer ET (2013) Measuring values and committed action with the Engaged Living Scale (ELS): psychometric evaluation in a nonclinical sample and a chronic pain sample. Psychol Assess 25(4):1235–1246 source

      Not checked in the free run.

    • cites [23] Scheier MF, Wrosch C, Baum A et al (2006) The Life Engagement Test: assessing purpose in life. J Behav Med 29(3):291–298 source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    In a general non-clinical sample and in a sample with chronic pain, the ELS showed good internal consistency (Cronbach's α = 0.90-0.91) and construct validity, correlating with psychological well-being (r = 0.35-0.64), anxiety (r = −0.30), and depression (r = −0.46).

    “In a general non-clinical sample, and in a sample with chronic pain, the ELS showed good internal consistency (Cronbach’s α = 0.90–0.91) and construct validity, correlating with outcomes including psychological well-being (Pearson’s r = 0.35–0.64), anxiety (r = − 0.30), and depression (r = − 0.46) [22].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [22] Trompetter HR, Ten Klooster PM, Schreurs KMG, Fledderus M, Westerhof GJ, Bohlmeijer ET (2013) Measuring values and committed action with the Engaged Living Scale (ELS): psychometric evaluation in a nonclinical sample and a chronic pain sample. Psychol Assess 25(4):1235–1246 source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    In a general non-clinical sample, university students, and a variety of clinical (non-mental health) samples, the LET showed acceptable internal consistency (Cronbach's α = 0.72-0.87), moderately stable test-retest reliability (r = 0.61-0.76), and construct validity based on correlations with depression (r = −0.33 to −0.49) and mental health (r = 0.32-0.49).

    “In a general non-clinical sample, university students, and a variety of clinical (non-mental health) samples, the LET showed acceptable internal consistency (Cronbach’s α = 0.72–0.87), moderately stable test–retest reliability (r = 0.61–0.76), and construct validity based on correlations with other psychosocial measures including depression (r = − 0.33 to − 0.49) and mental health (r = 0.32–0.49)”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [23] Scheier MF, Wrosch C, Baum A et al (2006) The Life Engagement Test: assessing purpose in life. J Behav Med 29(3):291–298 source

      Not checked in the free run.

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

    Premisecitation

    The MEI was designed to be responsive to treatment effects and able to discriminate among patient populations with differing clinical characteristics.

    “It was designed to be responsive to treatment effects and able to discriminate among patient populations with differing clinical characteristics.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [35] Fehnel SE, Bann CM, Hogue SL, Kwong WJ, Mahajan SS (2004) The development and psychometric evaluation of the Motivation and Energy Inventory (MEI). Qual Life Res 13(7):1321–1336 source

      Not checked in the free run.

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

    Premisenone given

    The LET comprises just six items.

    “the LET comprises just six items”
    Quote in the paperNot a substantial claim

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

    Premisecitation

    The Shirom-Melamed Vigor Measure (SMVM) measures vigor or energetic feelings at work during the past 30 days.

    “The SMVM [27] measures vigor or energetic feelings at work during the past 30 days.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [27] Shirom A (2003) Feeling vigorous at work? The construct of vigor and the study of positive affect in organizations. In: Perrewe PL, Ganster DC (eds) Emotional and physiological processes and positive intervention strategies (Research in occupational stress and well being vol 3). Emerald Group Publishing Limited, Bingley

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Each SMVM subscale negatively correlated with emotional exhaustion (mean r = −0.17), and positively correlated with personal accomplishment (mean r = 0.47) and another measure of work engagement (r = 0.45-0.66).

    “Each subscale negatively correlated with a measure of emotional exhaustion (burnout) (mean r = − 0.17), and positively correlated with personal accomplishment (mean r = 0.47) and another measure of work engagement (r = 0.45–0.66) [27, 80].”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [27] Shirom A (2003) Feeling vigorous at work? The construct of vigor and the study of positive affect in organizations. In: Perrewe PL, Ganster DC (eds) Emotional and physiological processes and positive intervention strategies (Research in occupational stress and well being vol 3). Emerald Group Publishing Limited, Bingley

      Not checked in the free run.

    • cites [80] Wefald AJ, Mills MJ, Smith MR, Downey RG (2012) A comparison of three job engagement measures: examining their factorial and criterion-related validity. Appl Psychol Health Well Being 4(1):67–90 source

      Not checked in the free run.

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

    Premisecitation

    The Dimensional Anhedonia Rating Scale (DARS) measures desire/interest, motivation, effort, and pleasure "right now".

    “The DARS [49] measures desire/interest, motivation, effort, and pleasure “right now”.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [49] Rizvi SJ, Quilty LC, Sproule BA, Cyriac A, Michael Bagby R, Kennedy SH (2015) Development and validation of the dimensional anhedonia rating scale (DARS) in a community sample and individuals with major depression. Psychiatry Res 229(1–2):109–119 source

      Not checked in the free run.

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

    Premisenone given

    The LET also includes an item to measure valued activities.

    “The LET also includes an item to measure valued activities.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Premisecitation

    In schizophrenia, an 18-item inpatient version of the MEI distinguished between patients and controls, and correlated with depressive symptoms (Spearman's r = −0.49) and overall psychopathology (r = −0.37), but not positive symptoms (r = −0.14), indicating good divergent validity.

    “In schizophrenia, an 18-item inpatient version of the MEI distinguished between patients and controls, and correlated with symptoms including depressive symptoms (Spearman’s r = − 0.49) and overall psychopathology (r = − 0.37), but not positive symptoms (r = − 0.14), indicating good divergent validity [82].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [82] Trémeau F, Goldman J, Antonius D, Javitt DC (2013) Inpatients with schizophrenia report impaired situational motivation but intact global and social motivation. Psychiatry Res 210(1):43–49 source

      Not checked in the free run.

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    Premisecitation

    The WHO-5 is a widely administered PRO that can be used irrespective of underlying illness (or lack of illness), and has been thoroughly validated across many different mental health settings.

    “The WHO-5 is a widely administered PRO that can be used irrespective of underlying illness (or lack of illness), and has been thoroughly validated across many different mental health settings [84–87].”
    Quote in the paperNot a substantial claim0 of 4 sources checked
    • cites [84] Hall T, Krahn GL, Horner-Johnson W, Lamb G, Rehabilitation Research and Training Center Expert Panel on Health Measurement (2011) Examining functional content in widely used health-related quality of life scales. Rehabil Psychol 56(2):94–99 source

      Not checked in the free run.

    • cites [85] Topp CW, Østergaard SD, Søndergaard S, Bech P (2015) The WHO-5 Well-Being Index: a systematic review of the literature. Psychother Psychosom 84(3):167–176 source

      Not checked in the free run.

    • cites [86] Lara-Cabrera ML, Mundal IP, De Las Cuevas C (2020) Patient-reported well-being: psychometric properties of the World Health Organization Well-Being Index in specialised community mental health settings. Psychiatry Res 291:113268 source

      Not checked in the free run.

    • cites [87] Lara-Cabrera ML, Bjørkly S, De Las Cuevas C, Pedersen SA, Mundal IP (2020) Psychometric properties of the Five-item World Health Organization Well-Being Index used in mental health services: protocol for a systematic review. J Adv Nurs 76(9):2426–2433 source

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

    Premisecitation

    The Motivation and Pleasure Scale-Self-Report (MAP-SR) measures motivation and pleasure during the past week.

    “The MAP-SR [32] measures motivation and pleasure during the past week.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [32] Llerena K, Park SG, McCarthy JM, Couture SM, Bennett ME, Blanchard JJ (2013) The Motivation and Pleasure Scale—Self-Report (MAP-SR): reliability and validity of a self-report measure of negative symptoms. Compr Psychiatry 54(5):568–574 source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    In patients with MDD/bipolar depressive episodes, the DARS showed excellent internal consistency (Cronbach's α = 0.96), convergent validity with another anhedonia scale (r = −0.79), moderate correlation with a depression measure (r = −0.37), and was able to distinguish MDD from healthy controls.

    “In patients with MDD/bipolar depressive episodes, the DARS showed excellent internal consistency (Cronbach’s α = 0.96), convergent validity with another anhedonia scale (r = − 0.79), moderate correlation with a depression measure (r = − 0.37), and was able to distinguish MDD from healthy controls [49].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [49] Rizvi SJ, Quilty LC, Sproule BA, Cyriac A, Michael Bagby R, Kennedy SH (2015) Development and validation of the dimensional anhedonia rating scale (DARS) in a community sample and individuals with major depression. Psychiatry Res 229(1–2):109–119 source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Cognitive and vitality aspects are important aspects of treatment effectiveness.

    “which are important aspects of treatment effectiveness [12].”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [12] Rosenblat JD, Simon GE, Sachs GS et al (2019) Treatment effectiveness and tolerability outcomes that are most important to individuals with bipolar and unipolar depression. J Affect Disord 243:116–120 source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    In schizophrenia/schizoaffective disorder, the MAP-SR showed excellent internal consistency (Cronbach's α = 0.90), good convergent validity with another rating of motivation and pleasure (r = 0.65), and divergent validity from depressive/anxiety symptoms (r = 0.06) and positive symptoms (r = 0.11), though not from agitation/mania (r = 0.41).

    “In schizophrenia/schizoaffective disorder, the MAP-SR showed excellent internal consistency (Cronbach’s α = 0.90), good convergent validity with another rating of motivation and pleasure (r = 0.65), and divergent validity from depressive/anxiety symptoms (r = 0.06) and positive symptoms (r = 0.11), though not from agitation/mania (r = 0.41) [32].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [32] Llerena K, Park SG, McCarthy JM, Couture SM, Bennett ME, Blanchard JJ (2013) The Motivation and Pleasure Scale—Self-Report (MAP-SR): reliability and validity of a self-report measure of negative symptoms. Compr Psychiatry 54(5):568–574 source

      Not checked in the free run.

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

    Study design and conductreasoning

    Since the purpose of the review was to generate a list of PROs, no study outcomes were extracted and no bias assessment was necessary.

    “Since the purpose of the review was to generate a list of PROs, no study outcomes were extracted and no bias assessment was necessary.”
    Quote in the paperSubstantial claim

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

    Premisecitation

    The World Health Organization (Five) Well-Being Questionnaire (WHO-5) measures psychological well-being over the past 2 weeks.

    “The WHO-5 [62] measures psychological well-being over the past 2 weeks.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [62] World Health Organization Regional Office for Europe (1998) Well-being measures in primary health care: the DepCare Project. World Health Organization, Copenhagen. https://www.euro.who.int/__data/assets/pdf_file/0016/130750/E60246.pdf. Accessed 23 Sep 2021

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    In depression, the three MEI subscales each showed good internal consistency (Cronbach's α = 0.75-0.89), construct validity (moderate correlation with quality of life, r = −0.42 to −0.64, and modest correlation with depressive symptoms, r = −0.15 to −0.26), and could detect changes over time.

    “In depression, the three MEI subscales each showed good internal consistency (Cronbach’s α = 0.75–0.89), construct validity (moderate correlation with quality of life, r = − 0.42 to − 0.64, and modest correlation with depressive symptoms, r = − 0.15 to − 0.26), and could detect changes over time [35].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [35] Fehnel SE, Bann CM, Hogue SL, Kwong WJ, Mahajan SS (2004) The development and psychometric evaluation of the Motivation and Energy Inventory (MEI). Qual Life Res 13(7):1321–1336 source

      Not checked in the free run.

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

    Premisecitation

    The Comprehensive Inventory of Thriving (CIT) is a comprehensive measure of psychological well-being designed for research and for in-depth assessment of well-being in health settings such as psychiatric and clinical practices.

    “The CIT [67] is a comprehensive measure of psychological well-being designed for use in research purposes and for in-depth assessment of well-being in health settings, such as psychiatric and clinical practices.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [67] Su R, Tay L, Diener E (2014) The development and validation of the Comprehensive Inventory of Thriving (CIT) and the Brief Inventory of Thriving (BIT). Appl Psychol Health Well Being 6(3):251–279 source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    The AES has also been validated in psychosis/schizophrenia, and is able to distinguish patients with schizophrenia from healthy controls.

    “The AES has also been validated in psychosis/schizophrenia, and is able to distinguish patients with schizophrenia from healthy controls [31, 81].”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [31] Faerden A, Nesvåg R, Barrett EA et al (2008) Assessing apathy: the use of the Apathy Evaluation Scale in first episode psychosis. Eur Psychiatry 23(1):33–39 source

      Not checked in the free run.

    • cites [81] Kiang M, Christensen BK, Remington G, Kapur S (2003) Apathy in schizophrenia: clinical correlates and association with functional outcome. Schizophr Res 63(1–2):79–88 source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    The CIT negatively correlates with measures of depression (r = −0.46) and anxiety (r = −0.34).

    “The CIT also negatively correlates with measures of depression (r = − 0.46) and anxiety (r = − 0.34) [88].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [88] Duan W, Fei Y, Zhao J, Guo X (2020) Incremental validity of the Comprehensive Inventory of Thriving in predicting self-reporting mental and physical health among community populations. J Health Psychol 25(10–11):1366–1373 source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    In a sample including healthy participants and those with MDD, the AES-S showed satisfactory internal consistency (Cronbach's α = 0.86) and test-retest reliability (r = 0.76); convergent validity with clinician-rated apathy (r = 0.72) (smaller with informant-rated apathy, r = 0.43); divergent validity with patient-rated depression and anxiety (r = 0.42 for both); and discriminated between healthy,

    “In a sample that included healthy participants and those with MDD, the AES-S showed satisfactory internal consistency (Cronbach’s α = 0.86) and test–retest reliability (Pearson’s r = 0.76); convergent validity with clinician-rated apathy (r = 0.72) (the correlation was smaller with informant-rated apathy, r = 0.43); divergent validity with patient-rated depression and anxiety (r = 0.42 for both);”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [29] Marin RS, Biedrzycki RC, Firinciogullari S (1991) Reliability and validity of the Apathy Evaluation Scale. Psychiatry Res 38(2):143–162 source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    The WHO-5 can be used as a screening tool for depression (a raw score below 13 indicates testing for depression), and can capture improvement in well-being over time in clinical trials.

    “It can be used as a screening tool for depression (a raw score below 13 is an indication that the individual should be tested for depression), and it can capture improvement in well-being over time in clinical trials [62, 85].”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [62] World Health Organization Regional Office for Europe (1998) Well-being measures in primary health care: the DepCare Project. World Health Organization, Copenhagen. https://www.euro.who.int/__data/assets/pdf_file/0016/130750/E60246.pdf. Accessed 23 Sep 2021

      Not checked in the free run.

    • cites [85] Topp CW, Østergaard SD, Søndergaard S, Bech P (2015) The WHO-5 Well-Being Index: a systematic review of the literature. Psychother Psychosom 84(3):167–176 source

      Not checked in the free run.

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

    Premisecitation

    The Apathy Evaluation Scale Self-report (AES-S) measures apathy including interests, productivity and initiative during the past 4 weeks.

    “The AES-S [29] measures apathy including interests, productivity and initiative during the past 4 weeks.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [29] Marin RS, Biedrzycki RC, Firinciogullari S (1991) Reliability and validity of the Apathy Evaluation Scale. Psychiatry Res 38(2):143–162 source

      Not checked in the free run.

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

    Premisecitation

    In a sample of employees, the SMVM subscales each showed good internal consistency (Cronbach's α = 0.95 for Physical strength, 0.72 for Cognitive liveliness, and 0.88 for Emotional energy), with moderate intercorrelation between subscales (mean r = 0.44).

    “In a sample of employees, the SMVM subscales each showed good internal consistency (Cronbach’s α = 0.95 for Physical strength, 0.72 for Cognitive liveliness, and 0.88 for Emotional energy), with moderate intercorrelation between subscales (mean r = 0.44) [27].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [27] Shirom A (2003) Feeling vigorous at work? The construct of vigor and the study of positive affect in organizations. In: Perrewe PL, Ganster DC (eds) Emotional and physiological processes and positive intervention strategies (Research in occupational stress and well being vol 3). Emerald Group Publishing Limited, Bingley

      Not checked in the free run.

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

    Premisecitation

    The Motivation and Energy Inventory (MEI) measures vitality in the past 4 weeks.

    “The MEI [35] measures vitality in the past 4 weeks.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [35] Fehnel SE, Bann CM, Hogue SL, Kwong WJ, Mahajan SS (2004) The development and psychometric evaluation of the Motivation and Energy Inventory (MEI). Qual Life Res 13(7):1321–1336 source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    In a general non-clinical sample, the CIT subscales showed good internal consistency (Cronbach's α = 0.71-0.96), good test-retest reliability (r = 0.57-0.83), convergent validity with other measures of psychological well-being, divergent validity with measures of ill-being, and good predictive validity for health and quality of life.

    “In a general non-clinical sample, the CIT subscales showed good internal consistency (Cronbach’s α = 0.71–0.96), good test–retest reliability (r = 0.57–0.83), convergent validity with other measures of psychological well-being, divergent validity with measures of ill-being, and good predictive validity for health and quality of life [67].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [67] Su R, Tay L, Diener E (2014) The development and validation of the Comprehensive Inventory of Thriving (CIT) and the Brief Inventory of Thriving (BIT). Appl Psychol Health Well Being 6(3):251–279 source

      Not checked in the free run.

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

    Premisecitation

    The 18-item inpatient version of the MEI has also been used in MDD.

    “The 18-item inpatient version has also been used in MDD [83].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [83] Hewett K, Chrzanowski W, Schmitz M et al (2009) Eight-week, placebo-controlled, double-blind comparison of the antidepressant efficacy and tolerability of bupropion XR and venlafaxine XR. J Psychopharmacol 23(5):531–538 source

      Not checked in the free run.

  • May combine two claims.

    Premisenone given

    The ELS comprises six 'life fulfillment' items that measure a person's current status.

    “the ELS comprises six ‘life fulfillment’ items that measure a person’s current status”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Interpretationreasoning

    Neither the ELS nor the LET has become established in mental health clinical research or practice.

    “suggesting that neither PRO has become established in mental health clinical research or practice.”
    Quote in the paperSubstantial claim

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

    Study design and conductnone given

    A single database was searched.

    “a single database was searched”
    Quote in the paperNot a substantial claim

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

    Study design and conductnone given

    A single reviewer selected articles, increasing the risk of rejecting relevant reports.

    “a single reviewer selected articles, increasing the risk of rejecting relevant reports”
    Quote in the paperNot a substantial claim

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

    Interpretationreasoning

    The ELS remaining ten 'valued living' items are more conceptual and potentially less useful to track changes over time.

    “with the remaining ten ‘valued living’ items being more conceptual and potentially less useful to track changes over time”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Premisecitation

    Anticipatory pleasure and consummatory pleasure may be suppressed in mental health disorders.

    “Anticipatory pleasure (related to motivation to engage in rewarding and goal-directed behavior) and consummatory pleasure (momentary pleasure that is experienced while engaged in an enjoyable activity) may be suppressed in mental health disorders [93, 94]”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [93] Hallford DJ, Sharma MK (2019) Anticipatory pleasure for future experiences in schizophrenia spectrum disorders and major depression: a systematic review and meta-analysis. Br J Clin Psychol 58(4):357–383 source

      Not checked in the free run.

    • cites [94] Strauss GP, Wilbur RC, Warren KR, August SM, Gold JM (2011) Anticipatory vs. consummatory pleasure: what is the nature of hedonic deficits in schizophrenia? Psychiatry Res 187(1–2):36–41 source

      Not checked in the free run.

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

    Premisecitation

    The panel selected relevant items from the Inventory of Depressive Symptomatology Self-Report (IDS-SR) to create the 'IDS-SR10 Life Engagement' exploratory subscale.

    “The panel selected relevant items from the Inventory of Depressive Symptomatology Self-Report (IDS-SR) to create the ‘IDS-SR10 Life Engagement’ exploratory subscale.”
    Quote in the paperNot a substantial claim
53 of 53

  • The paper relies on this without support.

    The MEDLINE search and screening process identified all validated PROs relevant to life engagement in adults with mental health disorders.

    “The search was performed on September 9, 2020, by CPW.”

  • The paper relies on this without support.

    The search terms developed for life engagement capture all relevant aspects of the concept.

    “The terms to capture life engagement were developed in pairs such that each aspect of life engagement had both a positively and negatively valenced descriptor (e.g., engaged–disengaged; pleasure–anhedonia; motivated–aimless).”

  • The paper relies on this without support.

    Life engagement is a meaningful clinical outcome beyond improvement of core symptoms.

    “a meaningful clinical outcome beyond improvement of core symptoms”

  • The paper relies on this without support.

    PROs tend to be secondary or exploratory study outcomes in clinical trials, and thus may not be mentioned in the publication abstract.

    “PROs tend to be secondary or exploratory study outcomes in clinical trials, and thus may not be mentioned in the publication abstract.”
4 of 4

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • Limitations of the MoodHacker study included the use of a convenience sample of interested individuals, the use of self-report surveys, and the use of compensation for completing assessments, which may reduce generalizability of results.

    “Limitations of this study included the use of a convenience sample of interested individuals, the use of self-report surveys, and the use of compensation for completing assessments, which may reduce generalizability of results.76”

    From Digital health technologies and major depressive disorder (2023) · cites this paper as [76]

  • A general attenuation of effects was observed at the 10-week follow-up for MoodHacker.

    “However, a general attenuation of effects was observed at the 10-week follow-up.76”

    From Digital health technologies and major depressive disorder (2023) · cites this paper as [76]

  • The MoodHacker app was assessed vs access to relevant depression websites in a randomized controlled trial of 300 employed adults with mild to moderate depression.

    “The MoodHacker app was assessed vs access to relevant depression websites in a randomized controlled trial of 300 employed adults with mild to moderate depression.76”

    From Digital health technologies and major depressive disorder (2023) · cites this paper as [76]

  • Digital health technologies for depression gained broad public attention after the release of the SuperBetter app, MoodHacker app, and SPARX, which are self-management tools to reduce depressive symptoms supported by randomized controlled trial data.

    “Digital health technologies for depression gained broad public attention after the release of the SuperBetter app, 75 MoodHacker app, 76 and SPARX, 77 which are self-management tools to reduce depressive symptoms supported by randomized controlled trial data.”

    From Digital health technologies and major depressive disorder (2023) · cites this paper as [76]

  • Participants using MoodHacker self-reported significant effects on symptoms of depression at the 6-week follow-up when compared with participants in the nontreatment arm.

    “Participants using MoodHacker self-reported significant effects on symptoms of depression at the 6-week follow-up when compared with participants in the nontreatment arm.76”

    From Digital health technologies and major depressive disorder (2023) · cites this paper as [76]

The citation lists haven’t been fetched yet

References 90 · Cited by 48

Research works printed but not linked: 4

  1. MacKenzie E, Therrien F, Brown TM, Weiss C, Meehan SR (2021) Exploring the concept of life engagement from the perspective of patients with major depressive disorder: a study using patient interviews. Poster presented at American Society of Clinical Psychopharmacology Annual Meeting, virtual conference, 1–4 June 2021
  2. Shirom A (2003) Feeling vigorous at work? The construct of vigor and the study of positive affect in organizations. In: Perrewe PL, Ganster DC (eds) Emotional and physiological processes and positive intervention strategies (Research in occupational stress and well being vol 3). Emerald Group Publishing Limited, Bingley
  3. Chapman LJ, Chapman JP (1978) The Revised Physical Anhedonia Scale. University of Wisconsin–Madison, Wisconsin
  4. Keyes CLM (2005) The subjective well-being of America’s youth: toward a comprehensive assessment. Adolesc Fam Health 4(1):3–11

Authors
McIntyre, R. S., Ismail, Z., Watling, C. P., Weiss, C., Meehan, S. R., Musingarimi, P., & Thase, M. E.
Affiliations
  • University Health Network (CA)
  • University of Calgary (CA)
  • Otsuka Pharmaceutical Development & Commercialization, Inc. (United States) (US)
  • Lundbeck (Denmark) (DK)
  • Philadelphia VA Medical Center (US)
Corresponding author
McIntyre, Roger S.
ORCID
Venue
Journal of Patient-Reported Outcomes
Publisher
Springer Science and Business Media LLC
Published
2022-06-10
Volume
6
Issue
1
Pages
62-62
ISSN
2509-8020 (ISSN-L)
DOI
10.1186/s41687-022-00468-5
PMC
PMC9187792
OpenAlex
W4281642281
Semantic Scholar
eaf707a0f754fe795c5e5f07f62103fac87e23fd
Cited by
48
References
90
Citations by year
2026: 7 · 2025: 15 · 2024: 15 · 2023: 6 · 2022: 5
FWCI
1.53
Type
journal article
Language
en
Open access
Licence
Locations
  • Journal of Patient-Reported Outcomes (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
  • Libraries and Cultural Resources (University of Calgary) (submittedVersion)
  • Libraries and Cultural Resources (University of Calgary)
Funders
  • Otsuka Pharmaceutical Development & Commercialization Inc.
  • H. Lundbeck A/S
Topics
  • Social Sciences › Psychology › Social Psychology › Psychological Well-being and Life Satisfaction
  • Social Sciences › Decision Sciences › Management Science and Operations Research › Psychometric Methodologies and Testing
  • Health Sciences › Medicine › Oncology › Cancer survivorship and care
Keywords
life engagement, patient-reported outcomes, mental health, psychometric validation, motivation, reward, anhedonia, vitality, psychological well-being, life fulfillment

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