Lighten UP! A Community-Based Group Intervention to Promote Eudaimonic Well-Being in Older Adults: A Multi-Site Replication with 6 Month Follow-Up

ABSTRACT Objectives: Eudaimonic well-being (EWB), increasingly recognized as a critical component of health, typically declines in later life, and there are no existing programs to sustain or increase EWB in older adults. Lighten UP! is an 8-week program to promote EWB through facilitated group sessions in community settings and at-home practice. Building on earlier pilot research, the current study assessed the effect of the Lighten UP! Program using a longitudinal, multi-site design. Methods: Men and women (N = 169) aged 60 and over were recruited from three Wisconsin communities. EWB, life satisfaction, depression, and diverse aspects of health were assessed before and after the program and at 6-month follow up. Results: Participants reported significantly increased EWB; these changes were maintained 6 months later. The specific EWB domains of self-acceptance, positive relations, and personal growth showed the most robust gains. Participants also showed significant and sustained declines in depressive symptoms, anxiety, and hostility. Conclusions: Lighten UP! Program confirmed its positive effects for enhancing EWB in older adults living in multiple community settings. Clinical Implications: Programs that sustain or enhance EWB in older adults can be expected to yield improvements in diverse aspects of mental and physical health.

[1]  G. Leeson,et al.  Aging Well , 2019, Encyclopedia of Gerontology and Population Aging.

[2]  S. Christ,et al.  Well-being and Long-term Physical Activity Participation in Midlife Adults: A Latent Class Analysis. , 2018, Annals of behavioral medicine : a publication of the Society of Behavioral Medicine.

[3]  U. Hirisave,et al.  Well-being therapy: Treatment manual and clinical applications , 2018, The Indian Journal of Medical Research.

[4]  E. Borella,et al.  Benefits of Well-Being Training in Healthy Older Adults. , 2017, Applied psychology. Health and well-being.

[5]  C. Ruini,et al.  Beyond Ryff's scale: Comprehensive measures of eudaimonic well-being in clinical populations. A systematic review. , 2017, Clinical psychology & psychotherapy.

[6]  Eric S. Kim,et al.  Association Between Purpose in Life and Objective Measures of Physical Function in Older Adults , 2017, JAMA psychiatry.

[7]  J. Mogle,et al.  Subjective cognitive impairment and quality of life: a systematic review , 2017, International Psychogeriatrics.

[8]  A. Collier,et al.  Aging With Purpose: Systematic Search and Review of Literature Pertaining to Older Adults and Purpose , 2017, The International Journal of Aging & Human Development.

[9]  C. Ruini,et al.  The Promotion of Well-Being in Aging Individuals Living in Nursing Homes: A Controlled Pilot Intervention with Narrative Strategies , 2017, Clinical gerontologist.

[10]  Chiara Ruini,et al.  Lighten UP! A community-based group intervention to promote psychological well-being in older adults , 2017, Aging & mental health.

[11]  A. Macaskill,et al.  The Impact of Positive Psychological Interventions on Well-Being in Healthy Elderly People , 2017 .

[12]  G. Westerhof,et al.  Can We Increase Psychological Well-Being? The Effects of Interventions on Psychological Well-Being: A Meta-Analysis of Randomized Controlled Trials , 2016, PloS one.

[13]  G. Fava.  Well-Being Therapy: Treatment Manual and Clinical Applications , 2016 .

[14]  R. Helson,et al.  The Place of Purpose in Life in Women’s Positive Aging , 2016, Women on the River of Life.

[15]  R. Slatcher,et al.  Purpose in life predicts allostatic load ten years later. , 2015, Journal of psychosomatic research.

[16]  B. Wampold,et al.  How important are the common factors in psychotherapy? An update , 2015, World psychiatry : official journal of the World Psychiatric Association.

[17]  A. Spiro,et al.  Understanding inter-individual variability in purpose: Longitudinal findings from the VA Normative Aging Study. , 2015, Psychology and aging.

[18]  A. Rozanski,et al.  Abstract 52: Purpose in Life and its Relationship to All-Cause Mortality and Cardiovascular Events: A Meta-Analysis , 2015 .

[19]  Eric S. Kim,et al.  Purpose in life and use of preventive health care services , 2014, Proceedings of the National Academy of Sciences.

[20]  P. Hill,et al.  Purpose in Life as a Predictor of Mortality Across Adulthood , 2014, Psychological science.

[21]  C. Ryff.  Psychological Well-Being Revisited: Advances in the Science and Practice of Eudaimonia , 2013, Psychotherapy and Psychosomatics.

[22]  K. Laidlaw.  A Deficit in Psychotherapeutic Care for Older People with Depression and Anxiety , 2013, Gerontology.

[23]  K. Gana,et al.  Does life satisfaction change in old age: results from an 8-year longitudinal study. , 2013, The journals of gerontology. Series B, Psychological sciences and social sciences.

[24]  Su Yeon Lee,et al.  Non-pharmacological prevention of major depression among community-dwelling older adults: a systematic review of the efficacy of psychotherapy interventions. , 2012, Archives of gerontology and geriatrics.

[25]  David A Bennett,et al.  Effect of purpose in life on the relation between Alzheimer disease pathologic changes on cognitive function in advanced age. , 2012, Archives of general psychiatry.

[26]  Muirne C. S. Paap,et al.  Rumination and Age: Some Things Get Better , 2012, Journal of aging research.

[27]  G. Nisticó,et al.  Subthreshold depression in older subjects: An unmet therapeutic need , 2012, The journal of nutrition, health & aging.

[28]  C. Annweiler,et al.  Development of a short form of Mini-Mental State Examination for the screening of dementia in older adults with a memory complaint: a case control study , 2011, BMC geriatrics.

[29]  Yngvil Søholt,et al.  Life satisfaction goes with pleasure and personal growth goes with interest: Further arguments for separating hedonic and eudaimonic well-being , 2011 .

[30]  A. Leon,et al.  Psychosocial interventions for late-life major depression: evidence-based treatments, predictors of treatment outcomes, and moderators of treatment effects. , 2011, The Psychiatric clinics of North America.

[31]  R. Hill.  A positive aging framework for guiding geropsychology interventions. , 2011, Behavior therapy.

[32]  R. Ryan,et al.  Pursuing Pleasure or Virtue: The Differential and Overlapping Well-Being Benefits of Hedonic and Eudaimonic Motives , 2010 .

[33]  D. Bennett,et al.  Purpose in life is associated with a reduced risk of incident disability among community-dwelling older persons. , 2010, The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry.

[34]  Sabine Springer,et al.  Living conditions and life satisfaction of older Europeans living alone: a gender and cross-country analysis , 2010, Ageing and Society.

[35]  L. George.  Still happy after all these years: research frontiers on subjective well-being in later life. , 2010, The journals of gerontology. Series B, Psychological sciences and social sciences.

[36]  A. Wood,et al.  The absence of positive psychological (eudemonic) well-being as a risk factor for depression: a ten year cohort study. , 2010, Journal of affective disorders.

[37]  David A Bennett,et al.  Effect of a purpose in life on risk of incident Alzheimer disease and mild cognitive impairment in community-dwelling older persons. , 2010, Archives of general psychiatry.

[38]  G. Fava,et al.  School intervention for promoting psychological well-being in adolescence. , 2009, Journal of behavior therapy and experimental psychiatry.

[39]  David A Bennett,et al.  Purpose in Life Is Associated With Mortality Among Community-Dwelling Older Persons , 2009, Psychosomatic medicine.

[40]  G. Fava,et al.  Well-being therapy for generalized anxiety disorder. , 2009, Journal of clinical psychology.

[41]  George S Alexopoulos,et al.  Depression in the elderly , 2005, The Lancet.

[42]  L. Salmaso,et al.  Well-Being Therapy of Generalized Anxiety Disorder , 2004, Psychotherapy and Psychosomatics.

[43]  L. Finos,et al.  Six-year outcome of cognitive behavior therapy for prevention of recurrent depression. , 2004, The American journal of psychiatry.

[44]  Joar Vittersø.  Subjective Well-Being versus Self-Actualization: Using the Flow-Simplex to Promote a Conceptual Clarification of Subjective Quality of Life , 2004 .

[45]  C. Keyes,et al.  Optimizing well-being: the empirical encounter of two traditions. , 2002, Journal of personality and social psychology.

[46]  C. Keyes,et al.  The mental health continuum: from languishing to flourishing in life. , 2002, Journal of health and social behavior.

[47]  B. Fredrickson.  The role of positive emotions in positive psychology. The broaden-and-build theory of positive emotions. , 2001, The American psychologist.

[48]  E. Deci,et al.  On happiness and human potentials: a review of research on hedonic and eudaimonic well-being. , 2001, Annual review of psychology.

[49]  B. Wheaton,et al.  Measuring Psychological Well-Being in the Canadian Study of Health and Aging , 2001, International Psychogeriatrics.

[50]  Richard E. Lucas,et al.  Subjective Weil-Being: Three Decades of Progress , 2004 .

[51]  C. Keyes,et al.  The structure of psychological well-being revisited. , 1995, Journal of personality and social psychology.

[52]  A. Waterman.  Two conceptions of happiness: Contrasts of personal expressiveness (eudaimonia) and hedonic enjoyment. , 1993 .

[53]  Daniel J Buysse,et al.  Quantification of subjective sleep quality in healthy elderly men and women using the Pittsburgh Sleep Quality Index (PSQI) , 1991, Sleep.

[54]  Daniel J Buysse,et al.  The Pittsburgh sleep quality index: A new instrument for psychiatric practice and research , 1989, Psychiatry Research.

[55]  R. Kellner.  A symptom questionnaire. , 1987, The Journal of clinical psychiatry.

[56]  R. Larsen,et al.  The Satisfaction with Life Scale , 1985, Journal of personality assessment.

[57]  Butler Rn,et al.  Successful Aging and the Role of the Life Review , 1974 .

[58]  L. Lunsky.  Childhood and Society. , 1965 .

[59]  C. Ruini.  Positive Psychology in the Clinical Domains , 2017 .

[60]  John T. E. Richardson,et al.  Eta Squared and Partial Eta Squared as Measures of Effect Size in Educational Research. , 2011 .

[61]  D. Hopko,et al.  Psychosocial and pharmacological interventions for depressed adults in primary care: a critical review. , 2008, Clinical psychology review.

[62]  B. Singer,et al.  Know Thyself and Become What You Are: A Eudaimonic Approach to Psychological Well-Being , 2008 .

[63]  C. Ryff.  Happiness is everything, or is it? Explorations on the meaning of psychological well-being. , 1989 .

[64]  J. Yesavage.  The use of self-rating depression scales in the elderly. , 1986 .