The Dual Factor Model of Mental Health in Inpatients

The Dual Factor Model of Mental Health: A Longitudinal Study in Inpatients

The Dual Factor Model of mental health (DFM; Greensporn & Saklofske, 2001) postulates that mental health consists of two at least partially unrelated factors, the experience or absence of psycho-pathological symptoms (i.e. depressive symptoms) and the experience or absence of positive mental health (i.e. life satisfaction, meaningfulness). Both factors contribute to an individual's well-being and mental health.The DFM has been used as a framework to describe and evaluate participants' mental health in different settings in cross-sectional and longitudinal designs mostly outside of clinical settings. Psychological Interventions, such as cognitive-behavioral therapy are widely studied concerning their reduction of psycho-pathological symptoms. However, little is known about the effect of psychological interventions on the second factor (positive mental health) of the DFM. This is especially important, because the latter has been shown to contribute significantly to subjective well-being and to reduce the risk of suicidal intentions and behavior.

Primary, the authors aim to investigate the DFM in an inpatient sample over the course of time (pre-treatment, post-treatment, 6 and 12 months after discharge). Secondly, they aim to investigate the relationship between positive mental health and suicidal ideation over the course of time.

Study Overview

• Status: Completed
• Conditions: Depression; Psychological Disease
• Intervention / Treatment: Behavioral: Routine care inpatient treatment

Detailed Description

Participants will be divided into four groups according to the DFM over the course of time:

1. unhappy: high psychopathology and low positive mental health; depression and/or anxiety scores above published cut -offs and positive mental health scores under published cut offs.
2. symptomatic but content: high psychopathology and high positive mental health; depression and/or anxiety scores above published cut -offs and normal to high positive mental health scores
3. vulnerable: low psychopathology and low positive mental health; depression and/or anxiety scores under published cut -offs and positive mental health scores under published cut offs
4. Complete mental health: low psychopathology and high positive mental health; depression and/or anxiety scores under published cut -offs normal to high positive mental health scores.

The authors will then depict the movements of patients through these groups graphically and use regression analyses to check for differences according to age, diagnosis and gender.

Towards the second aim they will use regression analyses to investigate the protective effect of positive mental health on suicidal ideation or behavior.

• Study Type: Observational
• Enrollment (Actual): 1552

Contacts and Locations

Study Locations

• Germany
  • Bavaria
    • Oberstdorf, Bavaria, Germany, 87561
      • Stillachhaus Privatklinik

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: No

• Sampling Method: Probability Sample

Study Population

Inpatients at Stillachhaus Privatklinik fill out the questionnaires prior and post treatment as part of their routine assessment. They are invited to fill out the same measures 6 and 12 months after discharge voluntarily to support the long-term evaluation of their treatment. They have all given written informed consent to use their data for publication.

Description

Inclusion Criteria:

-inpatients at the Stiilachaus Privatklinik

Exclusion Criteria:

-None

Study Plan

How is the study designed?

Design Details

• Observational Models: Cohort
• Time Perspectives: Prospective

Number of groups / cohorts

1

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
Study Group; All participants are inpatients at the clinic "Stillachhaus" in Germany. They are receiving treatment for a variety of psychological disoders, mostly depressive disoders.	Behavioral: Routine care inpatient treatment; All participants are receiving inpatient treatment consisting of a variety of psychological interventions such as cognitive-behavioral therapy, third-wave interventions, psycho-education and in some cases medication.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Depression Anxiety Stress Scale-21 (DASS-21; Nilges et al., 2016)	Measures depression, anxiety and stress with 21 items. Scores range from 0-63 with higher scores indicating more severe anxiety, depression and stress.	In the first 3 days of treatment
Depression Anxiety Stress Scale-21 (DASS-21; Nilges et al., 2016)	Measures depression, anxiety and stress with 21 items. Scores range from 0-63 with higher scores indicating more severe anxiety, depression and stress.	In the last three days of treatment
Depression Anxiety Stress Scale-21 (DASS-21; Nilges et al., 2016)	Measures depression, anxiety and stress with 21 items. Scores range from 0-63 with higher scores indicating more severe anxiety, depression and stress.	6 months after discharge
Depression Anxiety Stress Scale-21 (DASS-21; Nilges et al., 2016)	Measures depression, anxiety and stress with 21 items. Scores range from 0-63 with higher scores indicating more severe anxiety, depression and stress.	12 months after discharge
Positive mental health scale (PMH; Lukat et al., 2016)	Measures positive psychological functioning with 9 items. Scores range from 0-27 with higher scores indicating more positive mental health.	In the first 3 days of treatment
Positive mental health scale (PMH; Lukat et al., 2016)	Measures positive psychological functioning with 9 items. Scores range from 0-27 with higher scores indicating more positive mental health	In the last three days of treatment
Positive mental health scale (PMH; Lukat et al., 2016)	Measures positive psychological functioning with 9 items. Scores range from 0-27 with higher scores indicating more positive mental health	6 months discharge
Positive mental health scale (PMH; Lukat et al., 2016)	Measures positive psychological functioning with 9 items. Scores range from 0-27 with higher scores indicating more positive mental health.	12 months discharge

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Suicidal Behavior Questionnaire (SBQ; Osman et al., 2001) ).	Assesses past and current suicidal ideation and behavior. Scores range from 3-18 with higher scores indicating a higher risk for suicidal behavior.	In the first 3 days of treatment
Suicidal Behavior Questionnaire (SBQ; Osman et al., 2001) ).	Assesses past and current suicidal ideation and behavior. Scores range from 3-18 with higher scores indicating a higher risk for suicidal behavior.	In the last three days of treatment
Suicidal Behavior Questionnaire (SBQ; Osman et al., 2001) ).	Assesses past and current suicidal ideation and behavior. Scores range from 3-18 with higher scores indicating a higher risk for suicidal behavior.	6 months after discharge
Suicidal Behavior Questionnaire (SBQ; Osman et al., 2001) ).	Assesses past and current suicidal ideation and behavior. Scores range from 3-18 with higher scores indicating a higher risk for suicidal behavior.	12 months after discharge

Collaborators and Investigators

• Sponsor: Ruhr University of Bochum
• Collaborators: Stillachhaus Privatklinik
• Investigators: Study Director: Juergen Margraf, Prof., Ruhr-University Bochum

Study record dates

Study Major Dates

• Study Start (Actual): July 18, 2017
• Primary Completion (Actual): November 14, 2022
• Study Completion (Actual): November 14, 2022

Study Registration Dates

• First Submitted: June 10, 2020
• First Submitted That Met QC Criteria: June 26, 2020
• First Posted (Actual): June 29, 2020

Study Record Updates

• Last Update Posted (Estimated): June 19, 2023
• Last Update Submitted That Met QC Criteria: June 16, 2023
• Last Verified: June 1, 2023

More Information

Terms related to this study

• Keywords: Suicidal ideation; Dual Factor Model; Positive mental health
• Additional Relevant MeSH Terms: Behavioral Symptoms; Depression
• Other Study ID Numbers: 2017-387

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO
• IPD Plan Description: Since we do not have written consent to publish the data we will refrain from making it publicly available.

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No