The effectiveness of subjective well-being training in a non-patient sample: A follow-up study’.

Introduction

The concept of Quality of Life (QoL) begins to emerge

in industrialized societies since the mid-1960s and it is

opposed to an economic and quantitative vision of our

social development. In the face of a vision of social

well-being as an ever-increasing possession of material

goods, a new perception of well-being and a further

need for individual happiness are seen as a qualitative

improvement of life (Goldwurm et al. 2004). As

pointed out even more recently by Bauman (2011),

often the crucial elements for happiness – love and 

friendship, the satisfaction of taking care of our loved

ones, self-esteem, freedom from offenses and humiliation,

etc. – they do not have a market price and can not

be bought in stores. Objective indicators considered

up to the 1960s in QoL studies (eg income, housing,

health) are insufficient and must be accompanied by

subjective indicators that reflect the perception of one's

well-being and the satisfaction of one's own 

aspirations

(Goldwurm 1995). Aspects that have become

central to the development of positive psychology.

Different reviews indicate the effectiveness of positive

psychology interventions to promote well-being

among a variety of populations, and in a growing

number of real-world contexts (Bolier et al. 2013;

Hone et al. 2015). Michael W. Fordyce is recognized as

a pioneer in the scientific study of happiness (Friedman

2013). His studies (Fordyce 1972, 2000) focused on the

aspects that happy people share and that can be learned

by most individuals thanks to the program based on

the so-called "The Fourteen Fundamentals":

1. Be more active and keep busy.

2. Spend more time socializing.

3. Be productive at meaningful work.

4. Get better-organized and plan things out.

5. Stop worrying.

6. Lower your expectations and aspirations. 

7. Develop positive optimistic thinking.

8. Get present-oriented.

9. WOAHP - work on a healthy personality.

10. Develop an outgoing, social personality.

11. Be yourself.

12. Eliminate the negative feelings and problems.

13. Close relationships are #1 source of happiness.

14. VALHAP – the "secret fundamental".

In the Fordyce model (1977) happiness is considered

a condition characterized by both an active, sociable

and meaningful lifestyle for the person and a style

of thought oriented to the present and to optimism.

Fordyce (1977, 1983, 1988) demonstrated the effectiveness

of the programme of the 14 fundamental of happiness

in a series of empirical studies that verified how

participants can develop the characteristics of happy

people and thus increase their happiness. The intervention

includes a wide range of strategies – ranging from

cognitive restructuring to assertive techniques –based

on a) the observation of oneself, b) the comparison with

others’ behaviour, c) the development of awareness and

environmental contingencies self-control skills.

In Italy, starting from Fordyce's research, a group

training was developed to improve personal well-being,

called Subjective Well-Being Training (SWBT), a path

of change through cognitive-behavioral strategies

(Goldwurm et al. 2003). In previous research, SWBT

has proven effective in promoting subjective well-being

(Colombo et al. 2012; Goldwurm et al. 2007). Aim

of the present study is to verify whether intervention

changes remain effective in the long term.

Material and methods

Participants

The effectiveness of the SWBT intervention was verified

with a quasi-experimental methodology. Participants

(N = 63) voluntarily chose the course to follow.

The experimental group (N = 35; 3 males; 32 females)

consists of 4 SWBT courses which followed the same

program. Participants in the control group (N = 28;

8 males; 20 females) practiced yoga or sports at an

amateur level. The experimental group is made up

of a greater number of women than the control group

(χ2 = 4.317 p<0.05). The two groups showed similar

features as concerns age (mean age of 39.8 std.dev. 6.9),

marital status (25 married), schooling (23 graduated)

and work (32 employee).

Procedures

The inclusion criterion is the will of the subject

to follow the chosen activity (SWBT or Yoga / Sport)

while frankly pathological subjects have been excluded.

Participants (N = 63) were assessed at the same time

before (t1) and after (t2) the SWBT, and then again after

a year follow up (t3). SWBT (8 two-hour meetings, one

every three weeks) explores each “fundamental” in

depth though: giving information, group discussion,

exploration of personal experiences and homework

(Goldwurm et al. 2004).

Measures

Subjective well-being scales and general self-report

inventory assessing pathological symptoms were

administered to all participants.

The Satisfaction with Life Scale (SWLS) is a 5-Items

self-report instrument on a 7-point Likert scale. It

assesses personal satisfaction, the cognitive aspect

of happiness (Diener et al. 1985).

The 80 items Psychap Inventory (PHI) which

consists of forced choice statements, each sampling a

characteristic useful to distinguish happy from unhappy

people. It has four subscales investigating: Achieved

Happiness (Ach), Happy Personality (Per), Happy Attitudes

and Values (Att), Happiness Life-style (Life). The

subscales are combined to create the Total Score for the

test (Fordyce 1988).

The Happiness Measure (HM) evaluates emotional

well-being (Fordyce 1985) consists of two items: a) an

11-point happiness/unhappiness scale; b) a question

investigating the amount of the time spent in happy,

unhappy and neutral moods. These two items are

combined to create the Combination Score (HM-Co).

The Symptom Checklist-90-R (SCL-90-R) consists

of 90 items to assess nine primary symptom dimensions

(somatization, obsessive-compulsive, interpersonal

sensitivity, depression, anxiety, hostility, phobic anxiety,

paranoid ideation, psychoticism) and it offers a general

index (Derogatis 1994).

Statistical analysis

The use of non-parametric statistics appears more suitable

in the case of limited number of samples. Nonparametric

tests must respect fewer constraints than

parametric ones (such as checking the shape of population

distribution) but they can be just as powerful (Siegel

& Castellan 1988). Statistical analysis (Wilcoxon Signed

Ranks Test, Friedman Test, Kolmogorov-Smirnov) was

conducted using SPSS 13.0 software for Windows.

Results

Table 1 shows the means and standard deviations for

well-being and pathological measures for the experimental

and the control group pre, post and follow up

treatment, and Friedman Test. It also shows Wilcoxon

Signed Ranks Test for pre and follow up treatment

comparison. Participants who attended the SWBT

reported a significant global improvement in happiness,

satisfaction with life and emotional well-being (the

only subscale did not maintain the improvement at the

follow-up is Att). The control group report a significant

worsening.

Table 2 shows Kolmogorov-Smirnov for betweengroup

analysis at pre, post and follow-up treatment. The performance of the experimental group was lower than 

that of the control group at the pre test, but better at the

follow-up.

Discussion

Happiness could be considered a fleeting emotion,

out of the individual’s control. Otherwise, it could be

considered as a lasting condition based on personality,

attitudes, values, and life-style. This second point

of view, which is certainly more useful to scientific 

research, can be used to promote health and psychological

well-being, a desirable goal according to the

World Health Organization (WHO): “Mental wellbeing

is a fundamental component of WHO’s definition

of health. Good mental health enables people to realize

their potential, cope with the normal stresses of life,

work productively, and contribute to their communities"

(WHO 2013). 

The outcomes of this study confirm that the SWBT

proves effective in improving subjective well-being both

in its emotional and cognitive aspects in a non-patient

sample. This improvement is achieved with 8 two-hour

meetings (16 total hours) and it is confirmed afterwards

a one year follow up. Our study has substantial limitations

that should be considered. We must remember

that the decision to attend SWBT could be related

to a higher motivation to change, and this could have

influenced the results of these participants who asked

to attend the training. A further limitation of our study

is the relatively small sample size.

The Fordyce model has been used also in clinical

settings, for example to help multiple sclerosis patients

manage symptoms of depression, stress and fatigue

(Khayeri et al. 2016), to increase the quality of life in

hospitalized patients diagnosed with diabetes and

cancer (Karimaali & Saba 2013) or on postpartum

depression (Rabiei et al. 2014). Future research should

implement the SWBT in clinical and therapeutic

contexts.

Conclusion

The need for an integrated perspective, which overcomes

the positive / negative contrast, is increasingly

evident: positive psychology can also contribute to clinical

psychology and psychotherapy (Maddux et al. 2004; Rashid 2015).