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Mood Lifters: A Dimensional Approach to Mental Health Care

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Abstract

Dimensional, transdiagnostic models of psychopathology such as RDoC and HiTOP increasingly inform how core and covarying processes are conceptualized in psychopathology diagnoses. It follows that the field may benefit from considering transdiagnostic, dimensional intervention models to promote mental wellness across human experiences. The current study presents Mood Lifters as a programmatic case study of a biopsychosocial-informed treatment approach that targets psychopathology as conceptualized within RDoC and HiTOP frameworks. Mood Lifters is a 15-week, peer-led, group-based program that promotes transdiagnostic mental wellness. This program demonstrates how a single intervention can address psychopathology across various domains highlighted in prominent alternative models to the DSM. With public health and community implementation in mind, the authors hope that this applied conceptualization of a theoretical framework will encourage further development of transdiagnostic, dimensional treatment approaches.

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References

  • Alvarez, A. S., Pagani, M., & Meucci, P. (2012). The clinical application of the biopsychosocial model in mental health: A research critique. American Journal of Physical Medicine & Rehabilitation, 91(13), S173–S180. https://doi.org/10.1097/PHM.0b013e31823d54be

    Article  Google Scholar 

  • Anglin, R. E., Samaan, Z., Walter, S. D., & McDonald, S. D. (2013). Vitamin D deficiency and depression in adults: Systematic review and meta-analysis. The British Journal of Psychiatry, 202(2), 100–107. https://doi.org/10.1192/bjp.bp.111.106666

    Article  PubMed  Google Scholar 

  • Barlow, D. H., Ellard, K. K., Fairholme, C. P., Farchione, T. J., Boisseau, C. L., Allan, L. B., & Ehrenreich-May, J. T. (2010). Unified protocol for transdiagnostic treatment of emotional disorders: Workbook (1st ed.). Oxford, UK: Oxford University Press. https://doi.org/10.1093/med: psych/9780199772667.001.0001

  • Baskin, T. W., & Enright, R. D. (2004). Intervention studies on forgiveness: A meta-analysis. Journal of Counseling & Development, 82(1), 79–90. https://doi.org/10.1002/j.1556-6678.2004.tb00288.x

    Article  Google Scholar 

  • Battagliese, G., Caccetta, M., Luppino, O. I., Baglioni, C., Cardi, V., Mancini, F., & Buonanno, C. (2015). Cognitive-behavioral therapy for externalizing disorders: A meta-analysis of treatment effectiveness. Behaviour Research and Therapy, 75, 60–71. https://doi.org/10.1016/j.brat.2015.10.008

    Article  PubMed  Google Scholar 

  • Beauchaine, T. P., & Thayer, J. F. (2015). Heart rate variability as a transdiagnostic biomarker of psychopathology. International Journal of Psychophysiology : Official Journal of the International Organization of Psychophysiology, 98(2 Pt 2), 338–350. https://doi.org/10.1016/j.ijpsycho.2015.08.004

    Article  PubMed  Google Scholar 

  • Beck, A. T., Freeman, A., Davis, D. D., & Associates. (2004). Cognitive therapy of personality disorders (2nd ed.). New York, NY: Guilford Press.

  • Black, M., Hitchcock, C., Bevan, A. O., Leary, C., Clarke, J., Elliott, R., . . . Dalgleish, T. (2018). The HARMONIC trial: Study protocol for a randomised controlled feasibility trial of Shaping Healthy Minds-a modular transdiagnostic intervention for mood, stressor-related and anxiety disorders in adults. British Medical Journal Open, 8, e024546. https://doi.org/10.1136/bmjopen-2018-024546

  • Blanco, F. (2022). Cognitive bias. In Encyclopedia of Animal Cognition and Behavior (pp. 1487–1493). Cham: Springer International Publishing.

  • Blumenthal, J. A., Babyak, M. A., Doraiswamy, P. M., Watkins, L., Hoffman, B. M., Barbour, K. A., ... & Sherwood, A. (2007). Exercise and pharmacotherapy in the treatment of major depressive disorder. Psychosomatic medicine, 69(7), 587. https://doi.org/10.1097/PSY.0b013e318148c19a

  • Branstetter-Rost, A., Cushing, C., & Douleh, T. (2009). Personal values and pain tolerance: Does a values intervention add to acceptance? The Journal of Pain, 10(8), 887–892. https://doi.org/10.1016/j.jpain.2009.01.001

    Article  PubMed  Google Scholar 

  • Coppen, A., & Bolander-Gouaille, C. (2005). Treatment of depression: Time to consider folic acid and vitamin B12. Journal of Psychopharmacology, 19(1), 59–65. https://doi.org/10.1177/0269881105048899

    Article  CAS  PubMed  Google Scholar 

  • Cox, R. C., & Olatunji, B. O. (2016). A systematic review of sleep disturbance in anxiety and related disorders. Journal of Anxiety Disorders, 37, 104–129. https://doi.org/10.1016/j.janxdis.2015.12.001

    Article  PubMed  Google Scholar 

  • Cuthbert, B. N., & Kozak, M. J. (2013). Constructing constructs for psychopathology: The NIMH research domain criteria. Journal of Abnormal Psychology, 122(3), 928–937. https://doi.org/10.1037/a0034028

    Article  PubMed  Google Scholar 

  • Dalgleish, T., Black, M., Johnston, D., & Bevan, A. (2020). Transdiagnostic approaches to mental health problems: Current status and future directions. Journal of Consulting and Clinical Psychology, 88(3), 179. https://doi.org/10.1037/ccp0000482

    Article  PubMed  PubMed Central  Google Scholar 

  • Davoodi, E., Wen, A., Dobson, K. S., Noorbala, A. A., Mohammadi, A., & Farahmand, Z. (2019). Emotion regulation strategies in depression and somatization disorder. Psychological Reports, 122(6), 2119–2136. https://doi.org/10.1177/003329411879973

    Article  PubMed  Google Scholar 

  • Deacon, B. J., & Abramowitz, J. S. (2004). Cognitive and behavioral treatments for anxiety disorders: A review of meta-analytic findings. Journal of Clinical Psychology, 60(4), 429–441. https://doi.org/10.1002/jclp.10255

    Article  PubMed  Google Scholar 

  • Dews, A. A., Pokowitz, E. L., Votta, C. M., Yan, H., Pituch, K., & Deldin, P. J. (2023). From “surviving to thriving”: Mood Lifters–A wellness program for parents of medically complex children. Palliative & Supportive Care, 1–6. https://doi.org/10.1017/S1478951523000718

  • Dimaggio, G., & Shahar, G. (2017). Behavioral activation as a common mechanism of change across different orientations and disorders. Psychotherapy, 54(3), 221. https://doi.org/10.1037/pst0000117

    Article  PubMed  Google Scholar 

  • Dimidjian, S., Hollon, S. D., Dobson, K. S., Schmaling, K. B., Kohlenberg, R. J., Addis, M. E., et al. (2006). Randomized trial of behavioral activation, cognitive therapy, and antidepressant medication in the acute treatment of adults with major depression. Journal of Consulting and Clinical Psychology, 74(4), 658–670. https://doi.org/10.1037/0022-006X.74.4.658

    Article  PubMed  Google Scholar 

  • Dog, T. L. (2010). The role of nutrition in mental health. Alternative Therapies in Health and Medicine, 16(2), 42–46.

    MathSciNet  Google Scholar 

  • Eaton, N. R., Rodriguez-Seijas, C., Carragher, N., & Krueger, R. F. (2015). Transdiagnostic factors of psychopathology and substance use disorders: A review. Social Psychiatry and Psychiatric Epidemiology, 50(2), 171–182. https://doi.org/10.1007/s00127-014-1001-2

    Article  PubMed  Google Scholar 

  • Engel, G. L. (1977). The need for a new medical model: A challenge for biomedicine. Science, 196(4286), 129–136.

    Article  ADS  CAS  PubMed  Google Scholar 

  • Farchione, T. J., Boswell, J. F., & Wilner, J. G. (2017). Behavioral activation strategies for major depression in transdiagnostic cognitive-behavioral therapy: An evidence-based case study. Psychotherapy, 54(3), 225–230. https://doi.org/10.1037/pst0000121

    Article  PubMed  Google Scholar 

  • Fernandez, K. C., Jazaieri, H., & Gross, J. J. (2016). Emotion regulation: A transdiagnostic perspective on a new RDoC domain. Cognitive therapy and research, 40(3), 426–440. 0.1007/s10608–016–9772–2

  • Franzen, P. L., & Buysse, D. J. (2022). Sleep disturbances and depression: Risk relationships for subsequent depression and therapeutic implications. Dialogues in clinical neuroscience, 10(4). https://doi.org/10.31887/DCNS.2008.10.4/plfranzen

  • Frechette-Simard, C., Plante, I., & Bluteau, J. (2018). Strategies included in cognitive behavioral therapy programs to treat internalized disorders: A systematic review. Cognitive Behaviour Therapy, 47(4), 263–285. https://doi.org/10.1080/16506073.2017.1388275

    Article  PubMed  Google Scholar 

  • Gloster, A. T., Klotsche, J., Ciarrochi, J., Eifert, G., Sonntag, R., Wittchen, H. U., & Hoyer, J. (2017). Increasing valued behaviors precedes reduction in suffering: Findings from a randomized controlled trial using ACT. Behaviour Research and Therapy, 91, 64–71. https://doi.org/10.1016/j.brat.2017.01.013

    Article  PubMed  Google Scholar 

  • Hazell, C. M., Hayward, M., Cavanagh, K., & Strauss, C. (2016). A systematic review and meta-analysis of low intensity CBT for psychosis. Clinical Psychology Review, 45, 183–192. https://doi.org/10.1016/j.cpr.2016.03.004

    Article  PubMed  Google Scholar 

  • Hollon, S. D., & Kendall, P. C. (1980). Cognitive self-statements in depression: Development of an automatic thoughts questionnaire. Cognitive Therapy and Research, 4(4), 383–395. https://doi.org/10.1007/BF01178214

    Article  Google Scholar 

  • Insel, T., Cuthbert, B., Garvey, M., Heinssen, R., Pine, D. S., Quinn, K., & Wang, P. (2010). Research Domain Criteria (RDoC): Toward a new classification framework for research on mental disorders. American Journal of Psychiatry, 167(7). https://doi.org/10.1176/appi.ajp.2010.09091379

  • Kotov, R., Krueger, R. F., Watson, D., Achenbach, T. M., Althoff, R. R., Bagby, R. M., … Zimmerman, M. (2017). The Hierarchical Taxonomy of Psychopathology (HiTOP): A dimensional alternative to traditional nosologies. Journal of Abnormal Psychology, 126(4), 454–477. https://doi.org/10.1037/abn0000258

  • Lejuez, C. W., Hopko, D. R., & Hopko, S. D. (2001). A brief behavioral activation treatment for depression: Treatment manual. Behavior Modification, 25(2), 255–286. https://doi.org/10.1177/0145445501252005

    Article  CAS  PubMed  Google Scholar 

  • Lin, P. Y., & Su, K. P. (2007). A meta-analytic review of double-blind, placebo-controlled trials of antidepressant efficacy of omega-3 fatty acids. Journal of Clinical Psychiatry, 68(7), 1056–1061.

    Article  CAS  PubMed  Google Scholar 

  • Lipsitz, J. D., & Markowitz, J. C. (2013). Mechanisms of change in interpersonal therapy (IPT). Clinical Psychology Review, 33(8), 1134–1147. https://doi.org/10.1016/j.cpr.2013.09.002

    Article  PubMed  PubMed Central  Google Scholar 

  • Malik, K., Ibrahim, M., Bernstein, A., Venkatesh, R. K., Rai, T., Chorpita, B., & Patel, V. (2021). Behavioral activation as an ‘active ingredient’ of interventions addressing depression and anxiety among young people: A systematic review and evidence synthesis. BMC Psychology, 9(1), 1–23. https://doi.org/10.1186/s40359-021-00655-x

    Article  Google Scholar 

  • Manber, R., Bernert, R. A., Suh, S., Nowakowski, S., Siebern, A. T., & Ong, J. C. (2011). CBT for insomnia in patients with high and low depressive symptom severity: Adherence and clinical outcomes. Journal of Clinical Sleep Medicine, 7(6), 645–652. https://doi.org/10.5664/jcsm.1472

    Article  PubMed  PubMed Central  Google Scholar 

  • Marrero-Cristobal, G., Gelpi-Dominguez, U., Morales-Silva, R., Alvarado-Torres, J., Perez-Torres, J., Perez-Perez, Y., & Sepulveda-Orengo, M. (2022). Aerobic exercise as a promising nonpharmacological therapy for the treatment of substance use disorders. Journal of Neuroscience Research, 100(8), 1602–1642. https://doi.org/10.1002/jnr.24990

    Article  CAS  PubMed  Google Scholar 

  • Matusiewicz, A. K., Hopwood, C. J., Banducci, A. N., & Lejuez, C. W. (2010). The effectiveness of cognitive behavioral therapy for personality disorders. Psychiatric Clinics, 33(3), 657–685. https://doi.org/10.1016/j.psc.2010.04.007

    Article  PubMed  Google Scholar 

  • Mathews, A., Mogg, K., Kentish, J., & Eysenck, M. (1995). Effect of psychological treatment on cognitive bias in generalized anxiety disorder. Behaviour Research and Therapy, 33(3), 293–303.

    Article  CAS  PubMed  Google Scholar 

  • McKay, M., Wood, J. C., & Brantley, J. (2019). The dialectical behavior therapy skills workbook: Practical DBT exercises for learning mindfulness, interpersonal effectiveness, emotion regulation, and distress tolerance. New Harbinger Publications.

  • Miller, M. A., Wright, H., Hough, J., & Cappuccio, F. P. (2014). Sleep and cognition. In Sleep and its disorders affect society. IntechOpen.

  • Mirchandaney, R., Barete, R., & Asarnow, L. D. (2022). Moderators of cognitive behavioral treatment for insomnia on depression and anxiety outcomes. Current Psychiatry Reports, 24(2), 1–8. https://doi.org/10.1007/s11920-022-01326-3

  • Moghadam, M., Makvandi, B., Bakhtiyar Pour, S., Ehteshamzadeh, P., & Naderi, F. (2020). A comparison of the effectiveness of Dialectical Behavior Therapy (DBT) and mindfulness training in improving sleep quality and reducing distress tolerance in drug-addicted treatment seekers. Journal of Health Management & Information Science, 7(1), 33–41.

    Google Scholar 

  • National Institute of Mental Health (2022). About RDoC. Retrieved from https://www.nimh.nih.gov/research/research-funded-by-nimh/rdoc/about-rdoc

  • Nelson-Gray, R. O., Keane, S. P., Hurst, R. M., Mitchell, J. T., Warburton, J. B., Chok, J. T., & Cobb, A. R. (2006). A modified DBT skills training program for oppositional defiant adolescents: Promising preliminary findings. Behaviour Research and Therapy, 44(12), 1811–1820. https://doi.org/10.1016/j.brat.2006.01.004

    Article  PubMed  Google Scholar 

  • Nordin, G., Sundqvist, R., Nordin, S., & Gruber, M. (2021). Somatic symptoms in sleep disturbance. Psychology, Health & Medicine, 28(4) 1–11. https://doi.org/10.1080/13548506.2021.1985149

  • North, T. C., McCullagh, P., Tran, Z. V., Lavallee, D., Williams, J. M., Jones, M. V. & Papathomas, A. (2008). Effect of exercise on depression. In D. Lavallee, J. M. Williams, M. V. Jones (Eds.) & M. Allen, C. Spray, H. Peters, M. Eys, G. Morgan, V. Krane, C. Douglas, M. I. Jones, A. Papathomas, C. Scherzer, K. Goodger (Collaborators), Key studies in sport and exercise psychology (pp. 258–284). Open University Press.

  • O’Connell, B. H., O’Shea, D., & Gallagher, S. (2016). Enhancing social relationships through positive psychology activities: A randomised controlled trial. The Journal of Positive Psychology, 11(2), 149–162. https://doi.org/10.1080/17439760.2015.1037860

    Article  Google Scholar 

  • Páez-Blarrina, M., Luciano, C., Gutiérrez-Martínez, O., Valdivia, S., Ortega, J., & Rodríguez-Valverde, M. (2008). The role of values with personal examples in altering the functions of pain: Comparison between acceptance-based and cognitive-control-based protocols. Behaviour Research and Therapy, 46(1), 84–97. https://doi.org/10.1016/j.brat.2007.10.008

    Article  PubMed  Google Scholar 

  • Park, N., & Peterson, C. (2006). Moral competence and character strengths among adolescents: The development and validation of the Values in Action Inventory of Strengths for Youth. Journal of Adolescence, 29(6), 891–909. https://doi.org/10.1016/j.adolescence.2006.04.011

    Article  PubMed  Google Scholar 

  • Pokowitz, E. L., Menzies, C., Votta, C.M., Ye, H., & Deldin, P.J. (2023). Pilot effectiveness trial of Mood Lifters for individuals who self-report bipolar disorder. Mental Health Review Journal, 28. https://doi.org/10.1108/MHRJ-12-2022-0077

  • Prakash, N., Votta, C. M., & Deldin, P. J. (2023). Treatment for graduate students: Blunting the emotional toll of postgraduate education. Journal of Consulting and Clinical Psychology, 91. https://doi.org/10.1037/ccp0000844

  • Prakash, N., Pokowitz, E. L., Votta, C. M., & Deldin, P. J. (under review). Mood Lifters in the real world: Studying the effectiveness of a novel intervention. Global Journal of Community Psychology Practice.

  • Ringwald, W. R., Forbes, M. K., & Wright, A. G. (2023). Meta-analysis of structural evidence for the Hierarchical Taxonomy of Psychopathology (HiTOP) model. Psychological Medicine, 53(2), 533–546. https://doi.org/10.1017/S0033291721001902

    Article  PubMed  Google Scholar 

  • Roberts, J. S., Ferber, R. A., Funk, C. N., Harrington, A. W., Maixner, S. M., Porte, J. L., ... & Connell, C. M. (2022). Mood Lifters for seniors: Development and evaluation of an online, peer-led mental health program for older adults. Gerontology and Geriatric Medicine, 8. https://doi.org/10.1177/23337214221117431

  • Robertson, C. L., Ishibashi, K., Chudzynski, J., Mooney, L. J., Rawson, R. A., Dolezal, B. A., ... & London, E. D. (2016). Effect of exercise training on striatal dopamine D2/D3 receptors in methamphetamine users during behavioral treatment. Neuropsychopharmacology, 41(6), 1629–1636. https://doi.org/10.1038/npp.2015.331

  • Ross, R. E., VanDerwerker, C. J., Saladin, M. E., & Gregory, C. M. (2022). The role of exercise in the treatment of depression: Biological underpinnings and clinical outcomes. Molecular Psychiatry, 28(1), 1–31. https://doi.org/10.1038/s41380-022-01819-w

  • Schlarb, A. A., Claßen, M., Hellmann, S. M., Vögele, C., & Gulewitsch, M. D. (2017). Sleep and somatic complaints in university students. Journal of Pain Research, 10, 1189. https://doi.org/10.2147/JPR.S125421

    Article  PubMed  PubMed Central  Google Scholar 

  • Shams, S., Ghelichkhan, N., & Elaheh Tahmasebiashtiani, E. (2022). The role of mentalization, insecure attachment, and emotional dysregulation in predicting somatization symptoms and coronavirus anxiety in nurses during the corona epidemic. Quarterly Journal of Nursing Management, 10(4), 13–24.

  • Shibata, S., & Tahara, Y. (2014). Circadian rhythm and exercise. The Journal of Physical Fitness and Sports Medicine, 3(1), 65–72.

    Article  Google Scholar 

  • Sloan, E., Hall, K., Moulding, R., Bryce, S., Mildred, H., & Staiger, P. K. (2017). Emotion regulation as a transdiagnostic treatment construct across anxiety, depression, substance, eating and borderline personality disorders: A systematic review. Clinical Psychology Review, 57, 141–163. https://doi.org/10.1016/j.cpr.2017.09.002

    Article  PubMed  Google Scholar 

  • Taylor, C. T., Pearlstein, S. L., & Stein, M. B. (2020). A tale of two systems: Testing a positive and negative valence systems framework to understand social disconnection across anxiety and depressive disorders. Journal of Affective Disorders, 266, 207–214. https://doi.org/10.1016/j.jad.2020.01.041

    Article  PubMed  PubMed Central  Google Scholar 

  • Taylor, D. J., & Pruiksma, K. E. (2014). Cognitive and behavioural therapy for insomnia (CBT-I) in psychiatric populations: A systematic review. International Review of Psychiatry, 26(2), 205–213. https://doi.org/10.3109/09540261.2014.902808

    Article  PubMed  Google Scholar 

  • Verplanken, B., & Melkevik, O. (2008). Predicting habit: The case of physical exercise. Psychology of Sport and Exercise, 9(1), 15–26. https://doi.org/10.1016/j.psychsport.2007.01.002

    Article  Google Scholar 

  • Votta, C. (2020). Mood Lifters: Increasing accessibility to mental health care through a novel peer-led approach (Doctoral dissertation).

  • Votta, C. M., & Deldin, P. J. (2022). Mood Lifters: Evaluation of a novel peer-led mental wellness program. Mental Health Review Journal, 27(4), 398–411. https://doi.org/10.1108/MHRJ-11-2021-0084

    Article  Google Scholar 

  • Walker, M. P. (2009). The role of sleep in cognition and emotion. Annals of the New York Academy of Sciences, 1156(1), 168–197. https://doi.org/10.1111/j.1749-6632.2009.04416.x

    Article  ADS  PubMed  Google Scholar 

  • Wigman, J. T. W., de Vos, S., Wichers, M., van Os, J., & Bartels-Velthuis, A. A. (2017). A transdiagnostic network approach to psychosis. Schizophrenia Bulletin, 43(1), 122–132. https://doi.org/10.1093/schbul/sbw095

    Article  PubMed  Google Scholar 

  • Wright, A. G. C., Krueger, R. F., Hobbs, M. J., Markon, K. E., Eaton, N. R., & Slade, T. (2013). The structure of psychopathology: Toward an expanded quantitative empirical model. Journal of Abnormal Psychology, 122(1), 281–294. https://doi.org/10.1037/a0030133

    Article  PubMed  Google Scholar 

  • Wu, T. J., Yuan, K. S., Yen, D. C., & Xu, T. (2019). Building up resources in the relationship between work–family conflict and burnout among firefighters: Moderators of guanxi and emotion regulation strategies. European Journal of Work and Organizational Psychology, 28(3), 430–441. https://doi.org/10.1080/1359432X.2019.1596081

    Article  Google Scholar 

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Acknowledgements

The authors thank the Eisenberg Depression Center and the LSA Department of Psychology at the University of Michigan for funding research on Mood Lifters. The authors would also like to thank Dr. Ashley Gearhardt for her advice on an early draft of this manuscript. We thank the World Congress of Cognitive and Behavioral Therapies for hosting Dr. Deldin as a speaker and for inviting our team to contribute to this special issue. Finally, we thank the Mood Lifters participants who continue to strive for mental wellness.

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Correspondence to E. L. Pokowitz.

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Mood Lifters is a mental health program created by Dr. Patricia Deldin. As such, author PJD has the potential to profit from the use of Mood Lifters in commercial settings. No other authors have a conflict of interest to declare.

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Pokowitz, E.L., Prakash, N., Foster, K.T. et al. Mood Lifters: A Dimensional Approach to Mental Health Care. J Cogn Ther (2024). https://doi.org/10.1007/s41811-024-00204-5

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