Models of health enhancing and illness provoking factors in mental health.
Hipwell, M. (2005) Models of health enhancing and illness provoking factors in mental health., no. 479.
The aim of this study is to increase understanding about the causes of dysphoria, depression and anxiety by identifying the psychological factors that predict the development or protect the individual from developing mental health problems. A quantitative study, it is conducted over a period of a year and utilises a 3 wave observational longitudinal cohort design to investigate the relationship between the psychological variables and processes leading to mental health or ill health in a community group of female undergraduate students (N=183). Data is collected at 6 montly intervals for a period of a year from 183 female students. The participants are first year undergraduate students at a college of higher education. Characteristics from the students are collected using a battery of paper and pencil self report questionnaires in a group administration for the first wave of data and two postal questionnaires for follow up. Conceptual models are developed and tested statistically using structural equation modelling to explore the relationship between the elements identified for each model retrospectively and prospectively over a period of 12 months. Longitudinal and cross-sectional analyses are conducted for anxiety and depression separately. The elements of the models include positive and negative life events and protective and vulnerability factors for depression and dysphoria. Results from the cross-sectional and logitudinal analysis demonstrate that psychological factors have a significant effect on the development of depression and anxiety, with illness provoking factors explaining between 33-55% of the variance of depression in longitudinal analyses and 59-42% of the variance in cross-sectional analyses. They explain 45-57% of the variance in anxiety in longitudinal analyses and 28-50% in cross-sectional analyses. Health enhancing factors explain 18-19% of the variance in deprssion in longitudinal analyses and 47-49% of the variance in cross-sectional analyses. They explain 15-20% of the variance in anxiety in longitudinal analyses and 12-=20% of the variance in cross-sectional analyses. Health enhancing and illness provoking characteristics for depression and anxiety are identified in this study. They include enduring personality characteristics, cognitive styles and coping strategies and act as predictors for mental health outcomes or mediate or moderate the relationship between predictors and mental health outcomes.