Time-varying associations between daily skills practice and affect in a mindfulness and positive psychology-based intervention for early psychosis.
Bryan J Stiles, Aslıhan İmamoğlu, Tate F Halverson, Julia Browne, Piper S Meyer-kalos, Diana Perkins, David L Penn
The British journal of clinical psychology May 1, 2025 DOI: 10.1111/bjc.12548
Summary
Daily practice of positive coping skills significantly enhances emotional well-being among young adults with schizophrenia. In a trial involving 38 participants, those practicing these skills reported improved daily happiness and relaxation over nine months. While Integrated Coping Awareness Therapy (I-CAT) did not outperform traditional treatment in overall affect, specific phases revealed that increased positive skill practice correlated with better daily emotions. Interestingly, mindfulness practices sometimes led to negative feelings during certain periods, highlighting the nuanced effects of different therapeutic approaches on mental health.
Abstract
Using daily life methods, the present study investigated the impact of Integrated Coping Awareness Therapy (I-CAT), which includes mindfulness and positive psychological interventions, versus treatment-as-usual (TAU) on improving daily affective well-being. Among I-CAT participants only, we also examined the time-varying effect of daily I-CAT skill practice on daily affective well-being. Data are drawn from a randomized controlled treatment trial involving 38 young adults with a schizophrenia spectrum disorder. Participants completed daily reports of positive (happiness, relaxation) and negative (stress, sadness) affect across 9 months of treatment. I-CAT recipients completed daily practice of mindfulness and positive coping skills. I-CAT and TAU did not differentially impact daily affect across treatment. However, daily skill practice was associated with better daily affective outcomes in certain phases of I-CAT. We also found that increased daily practice of positive coping skills was associated with better daily affective outcomes, whereas mindfulness practice was associated with poorer affective outcomes during certain periods of the I-CAT intervention. In general, I-CAT did not improve daily affective outcomes compared with TAU. However, components of I-CAT, specifically the daily practice of positive coping skills, were associated with improved daily emotional well-being in young adults with psychosis. Implications of these findings are discussed.