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The effect of psychotherapy on functional medical disorders

You may need medication, physical therapy, surgery, and so on. Psychotherapy can be a vital part of holistic treatment for all patients with medical conditions.


Functional somatic disorders are common and costly, thereby driving the need for the development of effective brief treatment options. many studies showed that  psychotherapy is a valid treatment option for diverse functional somatic disorders conditions resulting in somatic symptom reductions that persist over time. So psychotherapy should be included in functional somatic disorders treatment guidelines.
"The need for innovations in mental health to improve access and quality of care is urgent," said lead author Dr. Paul Kurdyak, Director of Health Outcomes and Performance Evaluation in the Institute for Mental Health Policy Research at CAMH and lead of the Mental Health and Addictions Research Program at ICES. "But increasing the number of specialists who provide psychotherapy alone will not solve the existing problem of poor access to psychotherapy in a publicly-funded system."
Psychotherapy is an evidence-based treatment for conditions like depression and anxiety, two of the most common psychiatric disorders. Treatment guidelines suggest that structured, evidence-based therapies like Cognitive Behavioural Therapy (CBT) should be a front-line treatment option for patients with mild to moderate depression or anxiety.
"Evidence-based psychotherapy should be available to all patients suffering from the most prevalent mental disorders," said Dr. Kurdyak. 
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Timely treatment of depression could reduce the risk of dementia

the course of ineffectively treated depression carries significant medical risk.


Depression has long been associated with an increased risk of dementia, and now a new study provides evidence that timely treatment of depression could lower the risk of dementia in specific groups of patients.

Over 55 million people worldwide live with dementia, a disabling neurocognitive condition that mainly affects older adults. No effective treatment for dementia exists but identifying ways to help minimize or prevent dementia would help to lessen the burden of the disease.

The study, led by Jin-Tai Yu, MD, PhD, Huashan Hospital, Shanghai Medical College, Fudan University, and Wei Cheng, PhD, Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China, appears in Biological Psychiatry, published by Elsevier.

Professor Yu and Professor Cheng used data collected by the UK Biobank, a population-based cohort of over 500,000 participants. The current study included more than 350,000 participants, including 46,280 participants with depression. During the course of the study, 725 of the depressed patients developed dementia.

Previous studies examining whether depression therapies such as pharmacotherapy and psychotherapy could lower the risk for dementia produced mixed results, leaving the question unresolved. "Older individuals appear to experience different depression patterns over time," said Professor Yu. "Therefore, intra-individual variability in symptoms might confer different risk of dementia as well as heterogeneity in effectiveness of depression treatment in relation to dementia prevention."

To address that heterogeneity, the researchers then categorized participants into one of four courses of depression: increasing course, in which mild initial symptoms steadily increase; decreasing course, starting with moderate- or high-severity symptoms but subsequently decreasing; chronically high course of ongoing severe depressive symptoms; and chronically low course, where mild or moderate depressive symptoms are consistently maintained.

As expected, the study found that depression elevated the risk of dementia – by a striking 51% compared to non-depressed participants. However, the degree of risk depended on the course of depression; those with increasing, chronically high, or chronically low course depression were more vulnerable to dementia, whereas those with decreasing course faced no greater risk than participants without depression.

The researchers most wanted to know whether the increased risk for dementia could be lowered by receiving depression treatment. Overall, depressed participants who received treatment had reduced risk of dementia compared to untreated participants by about 30%. When the researchers separated the participants by depression course, they saw that those with increasing and chronically low courses of depression saw lower risk of dementia with treatment, but those with a chronically high course saw no benefit of treatment in terms of dementia risk.
He notes that, "in this case, symptomatic depression increases dementia risk by 51%, whereas treatment was associated with a significant reduction in this risk."

"This indicates that timely treatment of depression is needed among those with late-life depression," added Professor Cheng. "Providing depression treatment for those with late-life depression might not only remit affective symptoms but also postpone the onset of dementia."

"The new findings shed some light on previous work as well," said Professor Cheng. "The differences of effectiveness across depression courses might explain the discrepancy between previous studies."
Journal reference:
Yang, L., et al. (2022) Depression, Depression Treatments, and Risk of Incident Dementia: A Prospective Cohort Study of 354,313 Participants. Biological Psychiatry. doi.org/10.1016/j.biopsych.2022.08.026.
Link:
https://www.news-medical.net/news/20221017/Timely-treatment-of-depression-could-reduce-the-risk-of-dementia.aspx
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Digital interventions can help relieve depressive symptoms

data from smartphones and wearable devices might be used to identify people with symptoms of depression and anxiety.


With a shortage of therapists, help with mental health problems is being sought from digital interventions, where elements of psychological treatment are offered via computer programs or mobile applications. According to a study, smart devices can help identify people with symptoms of depression and anxiety.

Every year, 400 million people worldwide are affected by depression or anxiety, and the coronavirus pandemic has only increased the prevalence of mental health problems. At the same time, there is a shortage of psychotherapists. Digital interventions, where elements of psychological treatment are offered via computer programs or mobile applications, have been proposed as a solution.

In his doctoral thesis in the field of psychology, researcher Isaac Moshe investigated the effectiveness of digital interventions in treating mental health problems, with depressive symptoms in particular focus.

Tracking depression and anxiety with smart devices
One sub-study in the doctoral thesis examined whether symptoms of depression or anxiety can be identified from data collected by smartphones or wearable devices. A total of 60 adults who used an iPhone or an Oura Ring took part in the sub-study.

Based on the study, smartphone GPS data was predicted the user's depressive symptoms. Subjects who visited the same locations repeatedly had more depressive symptoms than those whose location had more variability. The data collected by smart rings indicated that the longer the person slept or spent time in bed on average, the more depressive symptoms they had. The ring data also revealed that the more frequently people woke up at night, the more symptoms of anxiety they had.
Digital interventions alleviate depressive symptoms
The most extensive sub-study of the doctoral thesis was an international collaboration that assessed the effectiveness of digital interventions in treating depression by conducting a meta-analysis of all previous studies. Digital interventions typically include videos, interactive exercises or text to deliver the core components of psychotherapy, which are then packaged into an online program or smartphone app.

The dataset was composed of 83 randomized controlled trials conducted between 1990 and 2020 involving 15,530 participants.
The findings indicate that digital interventions brought relief from depressive symptoms when they were offered in public or private healthcare settings. Digital interventions alleviated symptoms in people of all ages, regardless of depression severity or physical comorbidity.

Moshe points out that there are important caveats: in children and adolescents, digital interventions were less effective than in adults. Having human support alongside the digital interventions was also critical to people completing the programs and therefore getting the maximum benefits. Furthermore, the researchers felt that it was unclear whether digital interventions were indeed as effective as face-to-face psychotherapy, as so few comparative studies on the topic have so far been conducted.

Moshe believes that, overall, digital interventions could provide a valuable way to help meet the growing global demand for mental healthcare.

"They lower the barrier to accessing treatment, enabling anyone with a computer an internet connection to benefit from psychotherapy at a time and place that is convenient to them. Digital interventions also require much less time from therapists than traditional therapy, making it possible to shorten waiting lists and treat more people."
Source:
Helsingin yliopisto (University of Helsinki)
Link:
https://www.news-medical.net/news/20221220/Digital-interventions-can-help-relieve-depressive-symptoms.aspx
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Is Exercise as Effective as Medications or Talk Therapy?

A large meta-review suggests it is.


In the United States, when someone is experiencing a chronic health condition or persistent negative mood states, medications or talk therapy tend to be first to the rescue. Exercise is sometimes relegated to the category of “complementary and alternative medicine” for those who have tried medications and therapy and found them to be “ineffective” based on either provider opinion or a patient’s experience of subjective relief. However, this is not the case everywhere. In countries like Australia, behavioral approaches coined “lifestyle management,” which include exercise, is considered a front-line approach.
A new meta-review by a group of behavioral scientists from the University of South Australia highlighted the equivalence of physical activity to medications and psychotherapy in the treatment of depression, anxiety, various chronic diseases, and maintenance of overall health. The current findings, published in the British Journal of Sports Medicine, showed that physical activity has a medium effect size on depression, anxiety, and chronic disease, which is larger than the typical small effect sizes found in behavioral health research. This association improved with increased intensity of movement compared to treatment as usual. Critically, the effect size for physical activity on depression (median effect size = -0.43) and on anxiety (median effect size = -0.42) was comparable, though slightly greater, than medication or therapy (median effect size ranges = -0.22 to -0.37).
Though there have been dozens of randomized controlled trials or meta-analytic studies exploring the positive health impacts of exercise, they are typically limited due to examining very narrow demographics at a time, which may not generalize well to the larger population. The authors of the newest study attempted to include as many forms of physical activity as possible without focusing on specific subgroups of any one population to see what patterns emerged from data, which included over 128,000 participants across 1,039 clinical trials.
Any adult 18 years or older who participated in a research trial that aimed to increase physical activity was included in the analysis. Physical activity was defined as “any bodily movement produced by the contraction of skeletal muscles that results in a substantial increase in caloric requirements over resting energy expenditure.” The physical activity intervention had to occur across time (versus a single physical activity event, like a one-time marathon). Studies which included confounding variables in their intervention such as dietary changes, medications, or psychotherapy were excluded to be able to highlight the impact of physical activity alone on health outcomes. Participants included in the study ranged from 29 to 86 years old, with a median age of 55 years old.
Results showed depression and depressive symptoms were significantly reduced with a medium effect size as a result of physical activity in over 62,000 participants across 875 randomized controlled trials (RCTs) from 72 meta-analyses. Anxiety symptoms were significantly reduced with a medium effect size as a result of physical activity in over 10,000 participants across 171 RCTs from 28 meta-analyses. Psychological distress significantly reduced with a medium effect size in more than 500 participants across six RCTs from one systematic review. Importantly, effect sizes varied highly by the assessment instrument used, highlighting the importance of measurement-based care, utilizing validated screening tools to assess symptomology in patients and research participants.
Perhaps even more promising than the massive number of participants for whom these impacts of physical activity on mood symptoms held true is the finding that all modes of exercise were effective in reducing depression and anxiety symptoms. Regardless of strength-based movement, mind-body practices like yoga and tai chi, aerobic exercise, or mixed-mode exercises which include both aerobic and resistance training, exercise was shown to be effective in improving negative emotions and health distress. Higher intensity exercises were found to be more effective in ameliorating depression symptoms than lower or moderate-intensity exercises, while both moderate and higher intensity physical activity was found to be effective for reducing anxiety symptoms.
As the overall physical activity treatment was extended beyond 12 weeks, the amount of reduction in mood symptoms paradoxically diminished. This highlights the importance of structuring physical activity interventions for discrete periods of time, consistent with how individuals set effective behavioral goals, compared to giving patients open-ended guidance on physical activity which is not time-bound. Limiting physical activity interventions to a “sweet spot” of roughly three months is also more effective for patients, medical systems, and payers alike, reducing the burden of healthcare costs while maximizing health outcomes.
Weekly physical activity close to or under 150 minutes each week is ideal, compared to exercise beyond 150 minutes weekly which showed diminishing health impacts. Exercising a moderate amount, of 4-5 times per week, was found to be more closely tied to better mood than exercising at higher frequency like daily or at lower frequency like only 1-2 times each week. For anyone wondering what the optimal length of an exercise session may be, the authors found 30-60 minute exercise sessions are most effective. Given the potential benefits of physical activity as an intervention and the minimal negative side effects, it stands to reason that exercise should be considered a front-line approach for mood and chronic health problems when possible. Or at least, exercise should be given equal consideration as medications and psychotherapy for improving health outcomes.

reference:
psychology today

link:
https://www.psychologytoday.com/intl/blog/greater-than-the-sum-of-its-parts/202303/is-exercise-as-effective-as-medications-or-talk
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Virtual reality app trial offers new hope for people suffering from phobias

There’s great potential for the use of VR and mobile phone apps as a means of self-guided treatment for people struggling with often-crippling phobias.


Results from a University of Otago, Christchurch trial suggest fresh hope for the estimated one-in-twelve people worldwide suffering from a fear of flying, needles, heights, spiders and dogs.

The trial, led by Associate Professor Cameron Lacey, from the Department of Psychological Medicine, studied phobia patients using a headset and a smartphone app treatment program – a combination of Virtual Reality (VR) 360-degree video exposure therapy and cognitive behavioral therapy (CBT).

Participants downloaded a fully self-guided smartphone app called "oVRcome", developed by Christchurch tech entrepreneur Adam Hutchinson, aimed at treating patients with phobia and anxiety.

The app was paired with a headset to immerse participants in virtual environments to help treat their phobia.

The results from the trial, just published in the Australian and New Zealand Journal of Psychiatry, showed a 75 per cent reduction in phobia symptoms after six weeks of the treatment programme.
"Participants demonstrated a strong acceptability of the app, highlighting its potential for delivering easily accessible, cost-effective treatment at scale, of particular use for those unable to access in-person exposure therapy to treat their phobias."

A total of 129 people took part in the six-week randomised, controlled trial, between May 2021 and December 2021, with a 12-week follow-up. Participants needed to be aged between 18-64 years, have a fear of either flying, heights, needles, spiders and dogs. They were emailed weekly questionnaires to record their progress. Those experiencing adverse events could request contact from a clinical psychologist at any stage.

"Participants experiencing all five types of phobia showed comparable improvements in the Severity Measures for Specific Phobia scale over the course of the trial. The average severity score decreased from 28/40 (moderate to severe symptoms) to 7/40 (minimal symptoms) after six weeks. There were no participant withdrawals due to intervention-related adverse events.

"The oVRcome app involves what's called "exposure therapy", a form of CBT exposing participants to their specific phobias in short bursts, to build up their tolerance to the phobia in a clinically-approved and controlled way," Associate Professor Lacey says.
"Some participants reported significant progress in overcoming their phobias after the trial period, with one feeling confident enough to now book an overseas family holiday, another lining up for a Covid vaccine and another reporting they now felt confident not only knowing there was a spider in the house but that they could possibly remove it themselves."

The app program consisted of standard CBT components including psychoeducation, relaxation, mindfulness, cognitive techniques, exposure through VR, and a relapse prevention model. Participants were able to select their own exposure levels to their particular phobia from a large library of VR videos.

"This means the levels of exposure therapy could be tailored to an individual's needs which is a particular strength. The more traditional in-person exposure treatment for specific phobias have a notoriously high dropout rate due to discomfort, inconvenience and a lack of motivation in people seeking out fears to expose themselves to. With this VR app treatment, triallists had increased control in exposure to their fears, as well as control over when and where exposure occurs," says Associate Professor Lacey.

The researchers say this trial was novel, due to the cost-effective availability of the app and headsets and the fact that multiple phobias were tested at once. They say most comparative VR studies to date have investigated high-end VR devices which are only available in research and limited clinical settings. One Dutch study examined a low-cost VR Dutch-language program using animated imagery that demonstrated improvement in fear-of-height symptoms, however this study only examined a single type of specific phobia.

Associate Professor Lacey says public demand to take part in the trial was unprecedented, demonstrating the increasing need and desire for phobia treatment in the community.

"An estimated ten per cent of New Zealanders have been hesitant to take part in the government's COVID-19 vaccination program due to needle phobia. This hasn't been helped by a significant shortage of psychologists. A petition to Parliament last year claimed New Zealand is 1,000 psychologists short, causing ballooning wait times nationwide, making it difficult for people to access help if needed. We need to further research and explore the use of more cost-effective, easily-accessible, home-based solutions such as this oVRcome app, to provide people with the treatment and support they need."

This study builds on the Department of Psychological Medicine's existing research into structured psychotherapy for mental distress.
reference:
Lacey, C., et al. (2022) oVRcome - Self-guided virtual reality for specific phobias: A randomised controlled trial. Australian & New Zealand Journal of Psychiatry. doi.org/10.1177/00048674221110779.
Link:
https://www.news-medical.net/news/20220714/Virtual-reality-app-trial-offers-new-hope-people-suffering-from-phobias.aspx
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Lifestyle interventions can help pediatricians meet the growing need for youth depression management

Psychological Intervention for Adolescent’s Depression


With rising prevalence of depression in adolescents, screening requirements are increasingly falling on pediatric primary care providers, who are encountering more at-risk patients. A new literature review in Harvard Review of Psychiatry underscores the evidence that non-traditional, so-called lifestyle interventions can help providers meet the growing need for youth depression management. The journal is published in the Lippincott portfolio by Wolters Kluwer.

The article reviews studies of lifestyle medicine interventions related to physical activity, sleep, nutrition, substance use, social connectedness, and stress management and provides clinical practice recommendations. "Having additional and more comprehensive details about such lifestyle recommendations could help clinicians integrate specific advice into anticipatory guidance, management, and treatment plans," suggest Talia S. Benheim, BA, and her colleagues at Massachusetts General Hospital, along with Michelle Dalal, MD, of the University of Massachusetts Chan Medical School and Daniel Hosker, MD, in the September/October issue of the Harvard Review of Psychiatry.

Lifestyle medicine interventions can mitigate lack of access to traditional mental health treatments
Adolescent depression is strongly associated with negative academic, employment, and health outcomes well into adulthood, and studies point to the importance of early and timely access to mental health interventions. Yet, inaccessibility of mental health services persists, especially among marginalized populations.

The utility, versatility, and cost-effectiveness of lifestyle interventions are well known. They can be used by both licensed and non-licensed providers; implemented in a standalone manner or as part of a larger treatment plan; administered in-person or virtually, with a single patient or in groups; and are often more cost-effective and accommodating to patients' unique cultural situations.

The article reviews evidence of lifestyle interventions in physical activity, sleep, nutrition, substance use, social connectedness, and stress, demonstrating efficacy or feasibility in reducing depressive symptoms in adolescents. Studies included clinical trials, quantitative studies, and qualitative studies, as well as the authors' own clinical experience.

Regardless of whether physical activity is considered light or rigorous, many studies demonstrate the efficacy of physical activity in reducing depression symptoms. For example, one revealed that a two-hour decrease in sedentary activity in patients between ages 12 and 16 reduced depression scores by 16%–22% by age 18.
Sleep problems in adolescents persist into adulthood and have been associated with lack of response to depressive treatment and are even a risk factor for suicide. Yet, one study demonstrated that simple and specific guidelines for healthy sleep habits improved depressive symptoms. Bedtime routines such as keeping a diary or maintaining wind-down activities, as well as cognitive-behavioral therapy for insomnia, are also important.

Nutritional studies demonstrate that healthy plant- and whole food–based diets can alleviate or reduce depressive symptoms. The authors suggest a number of simple interventional approaches, such as tip sheets or recipes, engaging professional nutritionists, and guidance on so-called mindful or intuitive eating.

Cannabis, alcohol, and nicotine are also associated with depression in adolescents and can hinder effective treatment of both. Studies show prompt intervention is paramount. An online program in Australia has shown that increased knowledge of substances, depression, and anxiety reduced likelihood of drinking.

In adolescents, loneliness is correlated with depression, and lack of social connectedness is a predictor of suicidal ideation. One study revealed that increases in connectedness over time had corresponding reductions in adolescents' suicidal ideation. Numerous forms of connectedness-;for example, via extracurricular activities such as clubs and sports-;have proven to reduce depressive symptoms and can overlap with other lifestyle interventions.

Finally, interventions to support patients in coping with and managing stress can favorably influence the onset, maintenance, and severity of depression. Successful interventions include deep breathing, meditation, muscle relaxation techniques, and mindfulness-based cognitive therapy.

The authors caution that interventions involving significant behavioral changes can be difficult, especially without social, financial, or cultural support. Despite the scarcity of randomized controlled trials of psychological and health behavior (e.g., physical activity) promoting interventions, Benheim, Dalal, and colleagues believe these interventions can help meet the increasing need for mental health services and give teens and families opportunities to empower themselves with the knowledge, skills, and habits to combat depression.

reference:
Benheim, T.S., et al. (2022) Back to Basics: Lifestyle Interventions for Adolescent Depression. Harvard Review of Psychiatry. doi.org/10.1097/HRP.0000000000000343.

Link:
https://www.news-medical.net/news/20220915/Lifestyle-interventions-can-help-pediatricians-meet-the-growing-need-for-youth-depression-management.aspx
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Digital interventions can help relieve depressive symptoms

Psychotherapy with Electronic , Online Intervention


With a shortage of therapists, help with mental health problems is being sought from digital interventions, where elements of psychological treatment are offered via computer programs or mobile applications. According to a study, smart devices can help identify people with symptoms of depression and anxiety.

Every year, 400 million people worldwide are affected by depression or anxiety, and the coronavirus pandemic has only increased the prevalence of mental health problems. At the same time, there is a shortage of psychotherapists. Digital interventions, where elements of psychological treatment are offered via computer programs or mobile applications, have been proposed as a solution.

In his doctoral thesis in the field of psychology, researcher Isaac Moshe investigated the effectiveness of digital interventions in treating mental health problems, with depressive symptoms in particular focus.
Tracking depression and anxiety with smart devices

One sub-study in the doctoral thesis examined whether symptoms of depression or anxiety can be identified from data collected by smartphones or wearable devices. A total of 60 adults who used an iPhone or an Oura Ring took part in the sub-study.

Based on the study, smartphone GPS data was predicted the user's depressive symptoms. Subjects who visited the same locations repeatedly had more depressive symptoms than those whose location had more variability. The data collected by smart rings indicated that the longer the person slept or spent time in bed on average, the more depressive symptoms they had. The ring data also revealed that the more frequently people woke up at night, the more symptoms of anxiety they had.
Digital interventions alleviate depressive symptoms
The most extensive sub-study of the doctoral thesis was an international collaboration that assessed the effectiveness of digital interventions in treating depression by conducting a meta-analysis of all previous studies. Digital interventions typically include videos, interactive exercises or text to deliver the core components of psychotherapy, which are then packaged into an online program or smartphone app.

The dataset was composed of 83 randomized controlled trials conducted between 1990 and 2020 involving 15,530 participants.

The findings indicate that digital interventions brought relief from depressive symptoms when they were offered in public or private healthcare settings. Digital interventions alleviated symptoms in people of all ages, regardless of depression severity or physical comorbidity.

Moshe points out that there are important caveats: in children and adolescents, digital interventions were less effective than in adults. Having human support alongside the digital interventions was also critical to people completing the programs and therefore getting the maximum benefits. Furthermore, the researchers felt that it was unclear whether digital interventions were indeed as effective as face-to-face psychotherapy, as so few comparative studies on the topic have so far been conducted.

Moshe believes that, overall, digital interventions could provide a valuable way to help meet the growing global demand for mental healthcare.

"They lower the barrier to accessing treatment, enabling anyone with a computer an internet connection to benefit from psychotherapy at a time and place that is convenient to them. Digital interventions also require much less time from therapists than traditional therapy, making it possible to shorten waiting lists and treat more people."

Reference:
Helsingin yliopisto (University of Helsinki)
Link: 
https://www.news-medical.net/news/20221220/Digital-interventions-can-help-relieve-depressive-symptoms.aspx
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Do Introverts Really Have Less Fun?

New research traces whether introverts can squeeze joy out of their daily lives.


Finding joy in everyday experiences is an important way to keep yourself stressless and carefree. It may be something as simple as a young relative taking your hand as you walk down a hallway. That immediate boost helps shine a little light on your day. Known as an “uplift” in the psychological literature, such events are known to help reduce stress. Uplifts can counteract the effects of “hassles,” which are equally small events that, through wear and tear, can impact your mental and physical health.
As described in a new study by Pennsylvania State University’s Natasha DeMeo and colleagues (2023), “uplifts and hassles not only make up the topography of daily life…but these experiences… have implications for health and well-being” (p. 355). Importantly, though, people differ in their propensity to and resistance to such impacts.
Why Introverts Might Have Fewer Uplifts
Previous research has established that extraverts seek out and relish joyful experiences, even those tiny ones that qualify as uplifts. Introverts, with their greater inner focus, may be less likely to take advantage of these stress-buffering effects. However, they may also be more affected by hassles. Laboratory studies provide compelling evidence that introverts show greater emotional and physiological reactivity to external stressors. They may also be less likely to see themselves as successful copers and even take a bleaker view of a stressful situation than people high in extraversion. These self-perceptions, seen as critical in the so-called “cognitive” model of stress, can further exacerbate the deleterious effects of stress on health.
The Penn State authors note that, despite the strength of these prior studies, they may fail to capture the nuances of the personality–stress relationship. A lab study is useful for experimentation purposes, it but lacks the so-called “external validity” of seeing how people react in the context of their daily lives. Furthermore, prior studies rely on people’s memories for their hassles and uplifts, making the data subject to a retrospective bias. You can appreciate this problem if you think about the way you recall an event from several days or even hours ago. The details fade and, worse, become colored by the emotions the event arises after the fact.
Testing the Personality–Stress Link
Taking the approach that hassles and uplifts are best studied as they occur in real time, DeMeo and her collaborators used the method known as “ecological momentary assessment” (EMA). Their 242 participants ranging in age from 25 to 65 years lived in housing development in the Bronx and were part of a larger study on aging through which the EMA data were collected. Racially and ethnically diverse, nearly two-thirds were non-Hispanic Black, and a quarter were Hispanic; three-quarters either had a college degree or had at least some college courses.
Each participant was beeped through a smartphone app five times a day for 14 days. At each assessment, they reported on “any event, even a minor one, which affected [the participant] in a positive way.” If they did report an uplift, follow-up questions asked them to rate its intensity on a 1-to-100 scale. To measure introversion, the Penn State researchers administered a standard 10-item questionnaire, and the research team also measured hassles at the same time as they assessed uplifts.
The sample appeared relatively fortunate in the sense of experiencing relatively few hassles (less than 1 per day on average) and on the 0-to-100 scale, the average hassle amounted to about 67 points in intensity. Also fortunately for the sample, they reported about 19 uplifts over the 14-day period, and these qualified for a rating of nearly 80 in intensity.
Although prior research indicated a tendency for introverts to derive less joy out of their days, DeMeo et al.’s analyses hinged on the findings with respect to uplifts, based on the idea that introverts would be less sensitive to rewards. Consistent with prediction, those scoring higher on introversion reported fewer uplifts on a daily basis and they rated those uplifts as less enjoyable than did their less introverted counterparts. In round numbers, this amounted to only 15 uplifts over the two weeks that were rated as 76 rather than 79 out of 100.
Introversion alone, however, wasn’t the only factor affecting uplift ratings. When neuroticism, depression, and anxiety were taken into account, the effect of introversion remained only for frequency of uplifts, not intensity.
In terms of predictions regarding the ways that introverts would perceive their own coping abilities, the finding did emerge of a tendency for them to regard “miscellaneous” hassles (i.e., not specific to situations such as finances or traffic) as higher in intensity. As the authors concluded, “we found some preliminary evidence of person-environment interactions—where the occurrence or experience of an event depends on the characteristics of both the situation and the person” (p. 361). In other words, whether people high in introversion believe an event to be a hassle may be specific to the given situation and the match between the way they see themselves and the nature of the hassle itself.
How Introverts Can Extract More Joy From Life
As the Penn State study suggests, people who tend to focus on their inner life appear to be more resistant to the possibility that an ordinary experience, however small, could produce a rush of positive feelings. Although the authors didn’t explore this particular line of reasoning, it may very well be that this focus on an inner state may not only inoculate them from hassles but also stand in the way of the simple pleasures that are so much a part of everyday life.
Given the high stakes in terms of mental and physical health associated with achieving a favorable pleasure–pain balance, the DeMeo results suggest that it would be worth the effort for people high in introversion to find ways to let the sun shine in on a more frequent basis.
To sum up, successful coping is more than a matter of fending off the bad. Finding joy in the seemingly insignificant experiences in life can help build not only resilience but also fulfillment.

reference:
psychology today

link:
https://www.psychologytoday.com/intl/blog/fulfillment-at-any-age/202303/do-introverts-really-have-less-fun