Cited by 247Digital Mental Health InterventionsPsychological Well-being and Life SatisfactionMindfulness and Compassion Interventions

The DOI matches its Crossref record; 35 of the 37 references it cites were found in a registry or an index; none of the 31 sources its claims cite is checked for support yet.

Disseminating Self-Help: Positive Psychology Exercises in an Online Trial

Open access
Schueller, Stephen M, Parks, Acacia C·2012·Journal of Medical Internet Research

Abstract

BACKGROUND: The recent growth of positive psychology has led to a proliferation in exercises to increase positive thoughts, behaviors, and emotions. Preliminary evidence suggests that these exercises hold promise as an approach for reducing depressive symptoms. These exercises are typically researched in isolation as single exercises. The current study examined the acceptability of several multi-exercise packages using online dissemination. OBJECTIVE: The purpose of this study was to investigate methods of dissemination that could increase the acceptability and effectiveness of positive psychology exercises. To achieve this goal, we compared the use of positive psychology exercises when delivered in packages of 2, 4, or 6 exercises. METHODS: Self-help-seeking participants enrolled in this study by visiting an online research portal. Consenting participants were randomly assigned to receive 2, 4, or 6 positive psychology exercises (or assessments only) over a 6-week period. These exercises drew from the content of group positive psychotherapy. Participants visited an automated website that distributed exercise instructions, provided email reminders, and contained the baseline and follow-up assessments. Following each exercise, participants rated their enjoyment of the exercise, answered how often they had used each technique, and completed outcome measures. RESULTS: In total, 1364 individuals consented to participate. Attrition rates across the 2-, 4-, and 6-exercise conditions were similar at 55.5% (181/326), 55.8% (203/364), and 52.7% (168/319) respectively but were significantly greater than the attrition rate of 42.5% (151/355) for the control condition (χ(2)(3) = 16.40, P < .001). Participants in the 6-exercise condition were significant more likely than participants in the 4-exercise condition to use both the third (F(1,312) = 5.61, P = .02) and fourth (F(1,313 )= 6.03, P = .02) exercises. For 5 of the 6 exercises, enjoyment was related to continued use of the exercise at 6-week follow-up (r's = .12 to .39). All conditions produced significant reductions in depressive symptoms (F(1,656) = 94.71, P < .001); however, a significant condition by time interaction (F(3,656) = 4.77, P = .003) indicated that this reduction was larger in the groups that received 2 or 4 exercises compared with the 6-exercise or control condition. CONCLUSION: Increasing the number of exercises presented to participants increased the use of the techniques and did not increase dropout. Participants may be more likely to use these skills when presented with a variety of options. Increasing the number of exercises delivered to participants produced a curvilinear relationship with those in the 2- and 4-exercise conditions reporting larger decreases in depressive symptoms than participants in the 6-exercise or control conditions. Although research generally offers a single exercise to test isolate effects, this study supports that studying variability in dissemination can produce important findings.

Overview

AI snapshot

Written from the paper’s full text.

TL;DR

This online randomized trial compared dissemination of 2, 4, or 6 positive psychology exercises versus assessment-only control over 6 weeks. More exercises increased use without increasing dropout, but depressive symptom reductions were larger in the 2- and 4-exercise conditions than in the 6-exercise or control conditions.

Key findings

  • Of 1364 consenting participants, attrition was similar across active conditions—55.5% (181/326) for 2 exercises, 55.8% (203/364) for 4 exercises, and 52.7% (168/319) for 6 exercises—but significantly greater than the 42.5% (151/355) control attrition (χ²₃=16.40, P<.001).
  • Participants in the 6-exercise condition were significantly more likely than those in the 4-exercise condition to use the third (F₁,₃₁₂=5.61, P=.02) and fourth (F₁,₃₁₃=6.03, P=.02) exercises; mean usage days were 6.1 (SD 3.56), 7.94 (SD 4.77), and 12.1 (SD 7.36) for the 2-, 4-, and 6-exercise conditions.
  • For 5 of the 6 exercises, enjoyment was related to continued use at 6-week follow-up (r’s=.12 to .39, P’s<.05).
  • All conditions produced significant reductions in depressive symptoms (F₁,₆₅₆=94.71, P<.001), but a significant condition-by-time interaction (F₃,₆₅₆=4.77, P=.003) indicated larger reductions in the 2- and 4-exercise conditions than in the 6-exercise or control conditions; estimated marginal CES-D means were 12.31, 11.95, 15.89, and 14.53 for the 2-, 4-, 6-exercise, and control groups.

Methods

  • Self-help–seeking participants enrolled through an online research portal associated with the University of Pennsylvania’s Positive Psychology Center and Seligman’s *Authentic Happiness*; 1364 consented and were randomly assigned to receive 2, 4, or 6 positive psychology exercises or assessments only over 6 weeks.
  • Exercises were drawn from group positive psychotherapy and delivered in a fixed order: three good things, strengths, gratitude visit, savoring, active-constructive responding, and life summary; participants completed baseline and weekly assessments, including the 20-item CES-D.
  • Analyses included chi-square tests comparing attrition across conditions, repeated measures ANCOVA on completers controlling for baseline depressive symptoms, and regressions testing whether days of exercise use mediated changes in depressive symptoms.

Limitations

  • Stated: the sample was overwhelmingly female, highly affluent, and well educated, and was not representative of the world population; recruitment through a positive psychology book website and the University of Pennsylvania Positive Psychology Center may have contributed to this.
  • Stated: because content was delivered through an automated system, the authors could not be sure participants actually read and understood the instructions; exercises were also delivered one per week over subsequent weeks, whereas real-world users may receive several activities at once and use them at will.
  • Evident from the text: high attrition and the use of completer-only efficacy analyses may bias results, and adherence was based on self-report rather than objective tracking.

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

Integrity signals

Registry

Crossref · 10.2196/jmir.1850

Cites

35 of 35 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Verification

Claims the paper makes

0 of 31 cited sources checked · 0 supported · 0 flagged

Show all 38 claims

  • It may state two separate claims as one. 27
  • Probably not a substantial claim. 15
35 of 35
  • The paper relies on this without support.

    The positive psychology exercises used in group PPT can be effectively translated to an online self-help format.

    “The design of the investigation that we report in this paper translated the individual exercises used in group PPT for online dissemination.”
  • The paper relies on this without support.

    Self-help-seeking participants who enroll via an online research portal are an appropriate population for testing the acceptability and effectiveness of positive psychology exercises.

    “Self-help–seeking participants enrolled in this study by visiting an online research portal.”
  • The paper relies on this without support.

    The meta-analysis finding that packages with multiple positive psychology strategies have higher effect sizes applies to online self-help positive psychology exercises.

    “consistent with the findings of the meta-analysis of positive interventions, we predicted that participants receiving more exercises would experience greater benefits.”
  • The paper relies on this without support.

    The attrition rates in the exercise conditions being similar to each other, despite being higher than the control condition, can be interpreted as increasing the number of exercises did not increase dropout.

    “Attrition rates across the 2-, 4-, and 6-exercise conditions were similar at 55.5% (181/326), 55.8% (203/364), and 52.7% (168/319) respectively but were significantly greater than the attrition rate of 42.5% (151/355) for the control condition (χ2 3 = 16.40, P < .001).”
  • The paper relies on this without support.

    The package of positive psychology exercises used in the study had been previously validated.

    “The main aim of this study was to translate a previously validated package of positive psychology exercises for online dissemination.”
  • The paper relies on this without support.

    The completers (participants who completed the pretest and posttest measures) are representative of the randomized sample, so that analyses of completers yield unbiased estimates of intervention effects.

    “Given the high rates of attrition in Internet-based studies, we conducted analyses of the completers, that is, participants who completed the pretest and posttest measures.”
6 of 6

Claims other papers make about this one

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Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

  • Discussion claims significant benefits over control that the results deny

    Major

    The Discussion says the 2- and 4-exercise groups had significant reductions compared with the control group, but the Results state that their depressive-symptom scores were only numerically, not significantly, lower than control.

1 of 1

Citations

Cites

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Show all 37 references

2 of the 37 references couldn’t be matched to a known paper.

Research works printed but not linked: 3

  1. Seligman, ME, 2002, Authentic Happiness: Using the New Positive Psychology to Realize Your Potential for Lasting Fulfillment
  2. Parks, AC, 2012, Emotion, in press
  3. Tkach, CT, 2006, Dissertation Abstracts International: Section B: The Sciences and Engineering

Cited by

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Items 201–247 of 247

Metadata

Authors
Schueller, S. M., & Parks, A. C.
Affiliations
  • University of Pennsylvania (US)
  • Hiram College (US)
Corresponding author
Schueller, Stephen M
Venue
Journal of Medical Internet Research
Published
2012-06-25
Volume
14
Issue
3
Pages
e63
ISSN
1438-8871 (ISSN-L)
OpenAlex
W2084068173
Cited by
246
References
37
Citations by year
2026: 4 · 2025: 9 · 2024: 8 · 2023: 3 · 2022: 6 · 2021: 48 · 2020: 17 · 2019: 15 · 2018: 47 · 2017: 19 · 2016: 19 · 2015: 14 · 2014: 20 · 2013: 15 · 2012: 2
FWCI
23.47
Type
journal article
Language
en
Open access
Licence
cc-by
Locations
  • Journal of Medical Internet Research (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Funders
  • University of Pennsylvania
  • University of California, San Francisco
Topics
  • Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
  • Social Sciences › Psychology › Social Psychology › Psychological Well-being and Life Satisfaction
  • Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
Keywords
self-help, digital dissemination, depressive symptoms, attrition, exercise enjoyment, digital mental health interventions, dissemination of evidence-based interventions, email reminders, exercise duration, exercise frequency
MeSH terms
Online Systems, Psychology, Self Care

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