Supervised by: Ellen Froustis MA, MSc. Ellen Froustis is a DPhil. Education candidate at the University of Oxford. She has a Master’s of Education-Special Emphasis School Counselling and a Master’s in Clinical Psychology. As the founder and director of EIMAI, and regional director of Peace Jam Greece, Ellen provides youth leadership development programs, bringing together youth with Nobel Peace Laureates and university students to create positive change in themselves and their communities. Ellen has served as General Secretary of the Greek Adlerian Psychological Association (2012-2016) and Vice President of Habitat for Humanity, Greater Athens (2006-2010). Ellen’s work with youth and schools has been awarded by the Near East Council of Overseas Schools, The Loukoumi Make A Difference Foundation, The Nobel Peace Laureate’s Billion Acts of Peace and Character.Org for best practices in character education.

Abstract 

The high rate of mental health issues related to depression, anxiety, and trauma among young people prompted us to conduct research on how positive psychology can alleviate their effects. Positive psychology as a science does not focus on how to ‘cure’ a mental illness, but instead, aims to use positivity to build virtues and character strengths that may be less developed which could be at the core of one’s distress. Our research question was: How can inducing positive emotions through activities reduce the effects of depression, anxiety, and trauma? To answer the question, we looked at a total of 20 research studies targeted at using positive psychology interventions to shift negative emotions to positive emotions and reviewed their outcomes from a mental health standpoint. The sheer volume of search results obtained was an indicator that positive psychology is more significantly accepted than it was in the past because it has increased evidence. Our evaluation of research found that positive psychology interventions are an effective way to reduce the distress of anxiety and trauma and most prominently depression. Positive emotions generate positive memories and post traumatic growth, as well as aiding coping.

Introduction

In recent years there has been an increase in young people who suffer from mental health challenges such as depression, anxiety, and trauma. A global meta-analysis reported that in adolescents of ages 12-17, 17.2% suffer from depression, 20.5% from anxiety, and 70% experience at least one traumatic event in their lives (Racine et al., 2021; Andress, 2018).

Psychology was termed as the science of healing and within it exists the broad subfield of positive psychology (Seligman & Csikszentmihalyi, 2000). In the 1990s, Martin Seligman began the positive psychology movement, which advocated for the study of positive psychological traits and revolved around the well-being of a person along with the monitoring of development. Positive psychology aims to improve one’s life by focusing on making people stronger and building a high human potential in addition to positive virtues instead of treating, or ‘correcting’ mental illness, which had initially been psychology’s focus for centuries. Existing research shows that over the years, psychologists have focused more on treatment than on prevention, but the advent of positive psychology changed that (Bolier et al., 2013). Its goal is to shift psychology’s focus from only repairing the worst to building positive qualities that increase positive emotions and build resilience.

Anxiety, depression, and trauma are familiar terms due to their unfortunate and vast prevalence today, especially among young people. These mental disorders have become much more widespread in our society today. Different types of therapy, such as medication and psychotherapy, are used to decrease the severity of each disorder, making positive psychology a last resort as a form of treatment. Through research we discovered that positive psychology interventions (PPIs) are extremely effective in lowering the levels of anxiety, depression, and trauma symptoms by inducing positive emotions that allow for better problem-solving and looking at one’s problem in a new way (Boiler et al, 2013). In addition, the positive effects from the PPIs to improve the well-being of patients includes encouraging more of a goal-oriented life. By shifting cognitive thoughts that lead to fear, worry or emptiness into positive thoughts that can strengthen virtues and values, people can manage their challenges better and build a more meaningful life. In the studies that were reviewed, it was heavily supported that pleasant activities that induce positive emotions play a part in reducing the intensity of each disorder and increase well-being (Fredrickson, 2001).

Positive psychotherapy aims to increase objective and subjective welfare, positive emotion, behaviours, and cognitions (Carta, 2013). Positive emotions serve as indicators of flourishing or optimal well-being and can undo the effects of negative emotions (Fredrickson, 2001). A common theme throughout this research review on each individual disorder was that the aim of treatment was not to cure, ‘fix’ or treat the mental health issue, but rather to express positive emotions, as these disorders lack the production of happy and optimistic emotions. The positive psychology interventions have been conducted in a plethora of forms, including in an online mode during the Covid-19 pandemic (Walsh et al, 2018).

Understanding the neurobiology of emotions is important to understanding how PPI’s work. The root of emotions is in the brain. Electron impulses that travel across the axon need to convert into chemical signals for them to diffuse across the synapse. Neurotransmitters enable this conversion which means that emotions depend on the fluctuating levels of neurotransmitters, which trigger the activation of different parts of the brain responsible for different moods. A plethora of hormones such as adrenaline, dopamine, endorphins, serotonin, oxytocin, and more are released in the form of an emotional response, which are the result of coordination between major organs, neurotransmitters, and the limbic system (which is a primitive part of the brain filled with neural pathways that activate our emotions in response to stimuli and controls our fight-or-flight urges via the autonomic nervous system). The deep complexity of emotions means that multiple responses are generated including physiological responses,  behavioural responses and the release of chemicals. While we interpret different emotions by labeling them with careful consideration of context and classifying them as either positive or negative, historically, the human brain developed them based on the principle that we must survive. Thus, our mechanisms evolved in such a way that their primary focus was to keep us alive regardless of the situation. This research paper aims to explore how inducing positive emotions through activities can reduce the effects of depression, anxiety, and trauma.

 

Methods

The research question was answered after reviewing articles from the following databases: Frontiers in Psychology, Research Gate, Google Scholar, and Social Science Research Network. The following search terms were used: Positive Psychology, Depression, Anxiety, Trauma, PPI (Positive Psychology Interventions), Positive Emotions, Positive Psychotherapy, Neurochemistry of Emotions, Hormones, Emotional Response, Cognitive  Behavioural Therapy, Prediction, Treatment Response. Seventeen articles and three articles pertaining to definitions were reviewed and are cited in the references.

In accordance with our eligibility criteria (how we selected articles), we solely focused on articles that employed the use of positive psychology interventions, specifically by inducing positive emotions via activities, to treat anxiety, depression and trauma (as mentioned above in the search terms). Our research also included the neurochemical aspects of emotional responses. This massively reduced the extent of our search and narrowed it down to a smaller selection of articles than the 3,450,000 that originally appeared in our search.

The search terms were used to concentrate our research on articles and papers that studied the treatment of depression, anxiety, and trauma only through positive psychology. We entered the key terms of a specific disorder plus positive interventions as that is the main target of using positive psychology to treat patients with depression, anxiety, and trauma. We took articles out of consideration that didn’t meet our criteria of looking at how inducing positive emotions through positive activities could reduce the severity of the three disorders, which led to the ruling out of many articles: those that involved simply a treatment that is supposed to “cure” you or decrease the level of sadness, stress, or anxiety, rather than making the person actually feel better about themselves by introducing positive benefits. Additionally, we also included articles that centered around studies that contained specific samples of children or adults, such as healthcare workers, that help to answer our question. Our rationale was that the neurobiology of emotions occurs the same way across populations.

 

Depression

We researched the effect of positive psychology on the severity of depression and how positive emotions could result from the positive interventions. Positive emotions have been shown to induce resilience in people with depression as well as increase cognitive abilities such as learning, memory, problem solving, and an overall improvement to one’s health. Positive effective states show that positive effects induce resilience in people with depression. The beneficial effects of positive affective states appear through the strengthening of diverse neuronal processes. Burgdorf (2017) defines resilience as “a continued global functioning despite the presence of stressors.” Short term positive or negative life events have temporary beneficial effects, with low levels of positive affect being associated with the development and intensity of depression. Increasing positive effect through therapeutic interventions reduces levels of depression and promotes optimism, goal orientation, and purpose in life in children (Burgdorf, 2017). One of the most apparent symptoms of depression is anhedonia, which is the inability to feel pleasure, and holds a negative cognitive bias especially in social interactions (Brody, 2020).

Depressive symptoms include low levels of positive emotions, engagement, and a sense of purposelessness. Studies have shown that low levels of positive affect are strongly linked to depression far more than other emotional disorders. Different researchers state that there is a lack of inclusion of positive affect as a main target of treatment for depression, opening up positive psychology as a part of the recovery process. Using positive psychology explores the conditions and processes that contribute to the flourishing or optimal functions of people. Meta-analyses have disclosed that positive psychological interventions (PPIs) are effective in enhancing well-being and reducing depressive symptoms (Mira et al., 2018). This includes internet interventions that are significantly more affordable and accessible than in-person interventions and allows users to quickly receive feedback about their progress and self-manage their distress and well-being. Despite the convenience these interventions have, it is reported that face-to-face interventions have a greater impact on the patients. 

Positive Technology was created as a combination of in-person positive psychology and internet self-help interventions. It is a technology-based strategy to improve the quality of the personal experience, increase wellness, and generate strengths and resilience in individuals. The PP modules in the study were designed to improve well-being and encourage psychological strengths and positive emotions. The main objectives of the PP modules were to promote involvement in pleasant and significant activities, socialising and remaining in contact with people, enjoying positive experiences, and savouring positive aspects of life. Furthermore, it helps people to identify their own psychological strengths. Participating in meaningful activities is linked to setting goals and creating values, life mottos, and discovering one’s personal path. The results from this experiment of comparing the use of different internet interventions and in-person interventions on patients with depressed people showed that the participants did not improve positive affect after the Cognitive  Behavioural Therapy component (Sin and Lyubomirsky, 2009). After the Positive Psychology component was introduced to the participants, patients with mild to moderate depressive symptoms had significantly larger improvements in positive affect in contrast to those with minimal depression (Mira et al., 2018).

The results of an experiment conducted by Burgdorf (2017) showed consistency in the meta-analysis, showing that the depression severity scale controls the effectiveness of Positive Psychology Interventions (Sin and Lyubomirsky, 2009). Patients with mild to moderate depressive symptoms retain lower levels of positive affect and have more room for improvement, making the results more accurate. Patients with severe depressive symptoms might benefit less from Positive Psychology Interventions according to the data because their affective, behavioural and cognitive characteristics restrain them from taking full advantage of the necessary positive activities, proven by Sin and Lyubomirsky (2009) and as stated in their meta-analysis.

A secondary analysis conducted by the National Library of Medicine was of an existing clinical trial dataset to test the theoretical hypothesis that individual differences in trait positive emotions would predict an effective response for anxiety with Cognitive  Behavioural Therapy (CBT). The participants were 61 adults aged 18–55 recruited from the San Diego community via public flyers and online advertisements, as well as from mental health outpatient clinics and primary care centers. From the initial pool of 107 participants, 61 were eligible and met DSM-IV criteria for a primary diagnosis of either panic disorder, or generalised anxiety disorder (Taylor et al., 1993).

Participants were informed that the purpose of the study was to examine the effects of CBT on brain function in people with anxiety disorders. Eligible participants were given medical examinations, including a physical, medical history, EKG, drug and pregnancy screenings, and a clinical laboratory evaluation. Additionally, participants completed a battery of self-report measures assessing demographic characteristics, symptoms, and personality traits. Following an fMRI scan, participants received 10 one-hour individual CBT sessions over 10–12 weeks, using a CBT protocol adapted from the Coordinated Anxiety and Management Learning Program. The treatment utilised computer-based modules including generic psychoeducation, breathing retraining and relapse prevention, as well as additional modules, such as cognitive restructuring and exposure, that were tailored directly to the treatment of the primary anxiety disorder. Participants meeting diagnostic criteria for panic disorder or generalised anxiety disorder completed 10 weekly individual CBT sessions. Trait positive emotionality was assessed at pre-treatment, and severity of anxiety symptoms and associated impairment was assessed throughout treatment as well. Exclusions were made for substance dependence, substance abuse, psychotic disorders, bipolar, neurologic, and organic disorders. Additionally, participants were excluded for psychopharmacological treatment within the last 6 weeks. Presence of other anxiety disorders were permitted, as were co-occurring diagnosis of Generalised Anxiety Disorder (GAD) or Personality Disorders (PD); however, one disorder was selected as the focus of CBT treatment (Taylor et al., 1993).

Trait positive emotions were assessed using the Revised NEO Personality Inventory. The NEO-PI-R is a 240-item self-rated measure designed to assess five personality domains: neuroticism, extraversion, agreeableness, conscientiousness, and openness to experience. Facets within each domain describe lower-level groups of personality characteristics. Within the domain of extraversion is an 8-item Positive Emotions scale, which measures levels of happiness, joy, excitement and optimism characteristic to one’s personality. The positive emotion index used in the current study was based on participant T-scores obtained using gender- and age-matched norms. Thus, any predictive relationship between positive emotions and treatment outcomes should be interpreted in relation to a given participant’s own gender- and age-referenced normative group. The Overall Anxiety Severity and Impairment Scale (OASIS) was administered at the baseline session and subsequently every other session throughout treatment. The OASIS was used as the primary measurement of treatment response in this study because it is transdiagnostic and thus relevant for both GAD and PD (Taylor et al., 1993).

Evaluation of the effect of positive emotions on symptom change used a multilevel modeling approach, which accounts for the repeated measures of symptom outcomes nested within individual participants. Symptom outcomes were OASIS scores collected for each individual over the course of treatment. An intent-to-treat approach was taken such that any individual with at least one post-baseline assessment was included. All models used restricted maximum likelihood estimation procedures and an unstructured covariance matrix for the errors of repeated measures, with random effects of intercept modeled. Time was treated as a continuous variable representing weeks in treatment, centered such that the intercept represented the post-treatment outcome score. They also tested whether the predictive relationship of positive emotions on treatment outcome was non-linear by including quadratic terms for the NEO-PE and its interaction with time. Supplemental sensitivity analyses were also conducted to establish the predictive power of positive emotions above and beyond baseline symptoms of depression, a clinical condition characterised by low positive emotions that frequently co-occurs with anxiety. All analyses were conducted using the linear mixed effects procedure in SPSS version 19 (Taylor et al., 1993).

Overall, this study used an existing dataset composed of study participants drawn from a trial with specific inclusion and exclusion criteria intended to address a different research question, and using a positive emotion measure of convenience that was subsumed within a larger personality assessment inventory. Thus, it remains to be established whether the current findings generalise to other anxious populations, or to other well-established measures of positive emotions (Taylor et al., 1993).

 

Trauma

According to the American Psychology Association, trauma is defined as “an emotional response to a terrible event like an accident, rape, or a natural disaster” or most common sources of trauma, or PTSD (post traumatic stress disorder) from times of war (Leonard, 2020). Trauma is an umbrella term for different sources of trauma or the way in which people react to traumatic events. Each victim reacts to trauma differently, but the general consensus of trauma is that it provokes a reaction to any event they find physically threatening, emotionally threatening, or harmful (Leonard, 2020).

PTSD comes with unpredictable long-term responses such as flashbacks, spiraling emotions, constant headaches, nausea and other adverse effects that trigger the body’s stress response. In this research paper we centered our research on how positive psychology can treat trauma, specifically how inducing positive emotions through activities reduces the effects of trauma on a person with PTSD. Epidemiologic studies show a general low report of PTSD in people who are older compared to younger adults (Friedman, 2019). Lifetime prevalence of PTSD was estimated cross-sectionally to find 6% in ages between 18-29, 8% in ages 30-44, in ages 45-59, and 3% in ages 60 and older by the U.S. nationally representative National Comorbidity Survey Replication (Kessler et al., 2005). Mihaly Csikszentmihalyi, a Hungarian American psychologist known for his contribution to positive psychology, experienced trauma as a child. In his TedTalk in 2004 he said, “As a child in the war I’d seen something drastically wrong with how adults—the grown-ups I trusted—organized their thinking. I was trying to find a better system to order my life” (Cherry, 2020). According to Csikszentmihalyi, people are reported as happy when they are in a state of flow, a form of intrinsic motivation, that involves being completely focused on a specific situation or task (Cherry, 2020). He defines flow as being completely involved in an activity for its own sake (Cherry, 2020).

Avoidance of both traumatic and positive memories as well as retrieval difficulties are all associated with PTSD symptoms. Targeting positive memories in PTSD interventions has been proved effective and could increase positive effects and reduce the negative effects of PTSD, correct negative cognitions, and increase methods of retrieving autobiographical memories (Contractor, 2018). In addition, focusing on positive memories could effectively integrate and enhance the effects of trauma-focused interventions. Encoding is the process of obtaining information in our memory system through automatic or effortful processing. Disrupted encoding is directly related to memory and the way in which one stores and accesses memory. Consolidation has to do with the neurobiological processes by which a permanent memory is created, in this case, it is formed by a traumatic experience. The retrieval of emotional memories is an act of signaling the memory of experiences that provoked an emotional reaction (Kensinger, 2012). It is used to refer to the ability to consciously remember aspects of the effects of an emotion on an episodic memory. Specifically with trauma patients, it is important to decipher the emotions evoked from their traumatic experiences and analyse them to treat the patients during inventions.

All of these concepts have to do with the trilogy, symptomatology, and treatment of posttraumatic stress disorder patients (Contractor, 2018). Difficulties in retrieving specific positive memories relates to the severity of PTSD, which is why it is important to integrate the recovery of positive memory into the treatment of PTSD patients. The hypothesised effects of targeting positive memories with PTSD interventions reduce the intensity of the disorder. It enhances positive effects and generates more accurate cognitions, reduced negative effects, higher autobiographical memory specificity, and augmentation of trauma-focused interventions’ outcomes. The goal of the retrieval of positive memories is to increase the ease of processing specific positive memories, decrease anxiety behind trauma-focused interventions, reduce fear in discussing traumatic memories, and increase ease and effectiveness of processing traumatic memories (Contractor, 2018).

After obtaining the basic foundation of how implementing positive interventions could have optimistic benefits for people suffering with PTSD, we went into more depth by researching a study on healthcare workers in China. The study was named Effect of Positive Psychological Intervention on Posttraumatic Growth among Primary Healthcare Workers in China: A Preliminary Prospective Study. The focus of the study measures posttraumatic growth and sees how it varies when performing different tests on different genders and ages. Posttraumatic growth (PTG) is defined as when “someone has been affected by PTSD and finds a way to take new meaning from their experiences in order to live their lives in a different way than prior to the trauma” (Trent, 2021). Due to the creation of positive psychology and its impact on trauma cases, there are more studies that have examined the potential positive aftermath post-trauma. The most common response to trauma is posttraumatic growth. In comparison to resilience, which stresses an adaptive response to a challenging situation results in constant physical functioning, PTG emphasises a higher level of function surpassing pre-trauma functioning (Xu et al., 2016). Rumination is a fundamental cognitive process of changing one’s worldview after suffering from a traumatic experience and is considered a key factor in the development of posttraumatic growth. Resilience is also a key factor in the development of PTG, as it decreases the pathogenic reactions after trauma (Xu et al., 2016). Furthermore, positive emotions are closely associated with PTG because under a positive emotion state, people are able to expand their attention and cognitive abilities, prompting PTG. Positive activities that induce positive emotions and coping strategies for patients with PTSD consist of problem-focused coping strategies and emotion focused coping strategies facilitate the management of emotions and adversity that affect PTG. PTG is known as a protective factor of reducing stress and grief so developing more intervention programs focused on increasing PTG will assure a higher quality of life. PTG has been studied extensively in individuals who survived earthquakes and tsunamis, with occasional studies of healthcare workers.

Xin Xu, along with other researchers, designed an intervention focusing on growth in places of traditional risk management. They derived inspiration from previous intervention such as Stress Management and Resiliency Training, and were able to explore the impact of the novel intervention on PTG in medical staff, taking in Chinese traditional culture values. In this study, hospital administration asked staff to attend a voluntary positive psychological intervention. 579 medical workers from different hospitals in China participated. In this intervention there were 249 males and 367 females who were all around 36 years old. Among these participants, 14 reported that they were suffering from a severe disease, 73 reported a family member or close friend suffered from a severe disease or death, 89 reported financial difficulty, 72 reported difficulty in relationships, 2 participants were experiencing domestic violence, 83 suffered from abuse or an injury in medical disputes and 93 people reporting other stressful events. During this intervention, the posttraumatic growth inventory (PTGI), the Minnesota Satisfaction Questionnaire, and a shortened version of the Depression Anxiety and Stress Scales, were all used to test the efficacy of positive interventions on people who suffer from PTSD. The PTGI was used to measure the benefits obtained from the traumatic events and participating in activities that promote PTGI. The PTGI includes 21 items that contain five categories: relating to others, experiencing new possibilities, personal strengths, spiritual change and more gratitude towards life. Higher scores on PTGI reflect greater perceived benefit. The MSQ is known for its effective tools in measuring job satisfaction in China. The expectation was that there would be an inverse relationship between PTG and emotional exhaustion, depersonalisation, depression, anxiety, and stress while there was a positive relationship between PTG and personal accomplishment, intrinsic satisfaction, and extrinsic satisfaction. The results showed that their hypothesis was not only supported, but the strength of the relationship had surpassed the researchers’ predictions. These findings indicate that results on the PTG are a valid indicator of healthcare workers’ quality of life and work. It was found that the positive psychological intervention used significantly improved the participants’ PTG, with the “new possibilities” aspect showing the greatest improvement. The traumatic events lead to emotional responses, with negative strategies such as smoking and drinking temporarily increasing the mood. Positive strategies were known to provide better health benefits and beneficial long-term effects. The positive strategies of consistently exercising and eating healthy diets were productive ways in managing or preventing stress, therefore promoting the development of PTG (Xu et al., 2016).

The study was the first to use a positive psychological intervention based on Chinese culture to better the lifestyle and emotional development of medical workers’ PTG. The results show that the promising and highly suggested psychological intervention can be used as a tool within the medical community to instigate positive change in trauma patients.

Discussion

Following the table is our discussion on our findings from research pertaining to anxiety, depression, and trauma, showing how positive psychology interventions can shift negative emotions to positive ones in order to improve mental health. Positive psychology provides a new perspective of treatment as the goal, in essence, is to increase resilience by strengthening character traits. Specifically for people who suffer from trauma, we found that positive activities that promote positive emotions and coping strategies enhance the posttraumatic growth a person experiences. Using problem and emotional-focused coping strategies to enhance PTG can improve quality of life.

Overall, as stated before, this study involving anxiety demonstrates how researchers used positive emotion measures of convenience that were subsumed within a larger personality assessment inventory. In addition, it still remains to be established whether the current findings generalise to other anxious populations, or to other well-established measures of positive emotions.

Continuing to reflect on our results for PTSD, a study by Xin Xu and other researchers proved through their positive psychological intervention that it improved the Chinese health workers’ PTG greatly. In their intervention, they avoided negative strategies that affected the participants’ health, such as drinking and smoking, and took another approach: consistently exercising and changing the participants’ eating habits as a positive strategy that had better long-term results. Xin Xu’s results showed that the underrated but highly recommended psychological intervention could be a possible new form of treatment and recovery for the medical community who have experienced trauma. However, in this experiment there were limitations that could have given a full in depth consensus on the success of positive interventions.

The limitations we faced with some research articles was that the samples we used weren’t random samples and thus they weren’t representative of the entire population globally. For example, our use of a study involving PPI for PTG had a small sample size and in future research including a larger sample size from a variety of medical healthcare workers in more areas in China could give us more information about the effectiveness of positive interventions. Since the study was conducted in specific areas in China, they represented a niche sub-population of one country in the world. This study can be difficult to replicate due to the absence of a random sample. Another limitation in this specific study was that the researchers didn’t separate the participants into different types of trauma, rather they used different questionnaires and different forms of measuring PTGI on the patients. If the experiment were to be done again they should use the Secondary Trauma Questionnaire to measure trauma severity and the type of trauma as well as create a scale of how the event impacted the participant. (Xu et al., 2016) The same occurred in another study that dealt with adolescents, so it was representative of only that part of the population, thus it indicates a very specific trend. 

The cumulation of the results from our plethora of findings led us to delineate that there was a varying success rate across different types of interventions and different mental health issues. Generally, the success rate for those undergoing anxiety was higher (31%) than those who experienced post-traumatic growth (PTG) (9.7% and 7.7%). The treatment of depression had the highest success rate (north of 50%).

The answer we have come to regarding our research question is that inducing positive emotions through positive activities is an effective method of treatment because the strategies used have been shown to broaden patients’ outlook on life. Specifically, using the positive activities that are centered to produce positive emotions and better recovery habits have been proven, through the data we researched, to have a high percentage of improvement for each method and a general success rate. Through narrowed down ways of executing positive intervention, the severity levels of anxiety, depression, and trauma have reduced and people have reported finding a new purpose in life, new possibilities that awakened, spiritual change, resilience achieved, a healthy lifestyle, and an overall change in mindset. While we were researching, we knew that anxiety, depression, and trauma have no exact medicine or treatment that could completely cure the disorder but we found how using positive psychology has a significant positive effect on people’s lives. We dived deeper into how age comes into play as well as race, using all specific considerations to come to a conclusion about whether positive psychology is effective in treating patients with the three main disorders.

 

Conclusions

Our findings indicate that PPIs, aimed at enhancing the experience of positive thoughts and emotions, may help treat suffering adolescents because they seem to be effective at ameliorating symptoms of anxiety in patients with medical illnesses. PPIs were effective in reducing symptoms of anxiety among patients with a physical medical condition, with a small to medium effect.

During our research we noticed that certain empathy-based interventions helped bridge the gap between an individual and other people by leading to broadened perceptions and building relationships through effective communication (Davis et al., 2004). This is based on the core principle of understanding the perspectives of others and building a strong connection to them (Hodges et al., 2011). 

Our resilience is increased by feeling well (the emotional resources needed for coping). They increase our awareness and help us notice more choices for resolving issues. Research shows that when people experience positive emotions rather than negative ones, they feel and perform at their best. Positive emotions have been demonstrated to boost resilience in depressed individuals as well as cognitive skills including learning, memory, and problem-solving, as well as one’s general health. Children who receive therapeutic interventions have a greater beneficial impact, which lowers their depression levels and increases their optimism, goal-orientation, and sense of purpose in life. The PP modules in the trial improved well-being and encouraged psychological strengths and positive emotions in people with mild to moderate depressive symptoms. The subjective assessment of one’s capacity to feel good when under stress was found to potentially lessen depression but not so much anxiety issues. Whether the current findings generalise to other anxious populations or to other accepted measures of positive emotions is still up for debate. It has been demonstrated that focusing on good memories in PTSD interventions can boost positive effects, decrease negative effects, correct negative cognitions, and improve methods of recalling autobiographical memories. Retrieving good memories aims to make it easier to process certain positive memories, lessen anxiety surrounding trauma-focused interventions, lessen fear while talking about terrible experiences, and make it easier and more effective to process traumatic memories. Problem-focused coping techniques and emotion-focused coping techniques help PTSD patients manage their emotions and the challenges that affect their post-traumatic growth. Positive activities that elicit positive feelings and coping techniques are available for people with PTSD. Previous studies indicate that the healing process from depression and anxiety, and traumatic issues depends greatly on good feelings.

Line chart showing Singapore's Total Fertility Rate 1957-2001

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