Positive event training combined with homework assignments more sustainably improves mental health in college students: a randomized controlled trial

Autobiographical memory and episodic future thinking are pivotal to psychological well-being. To explore the application of integrated training of these 2 components in school mental health education, this study aims to evaluate the effects of a group psychological training program involving recalling and anticipating positive events on mental health in college students.

A total of 79 college students were voluntarily enrolled through verbal announcements posted by the mental health center of a university. After pre-enrollment interviews, 75 students who met the inclusion criteria provided informed consent and participated in this study. Using a stratified randomization method based on gender, the participants were assigned into a training group (n=25), a training-plus-homework group (n=25), and a waitlist group (n=25). Both the training group and the training-plus-homework group received group psychological training for positive events for 6 consecutive days, with one session (120 min) per day, and the training-plushomework group was additionally required to complete homework assignment once per week, for 4 weeks after training. The waitlist group received no psychological training during the intervention period. All 3 groups were assessed before training, after training, and 30 d after training using Psychological Richness Questionnaire, Satisfaction with Life Scale, and Chinese Simplified Version of the Depression-Anxiety-Stress Scale to evaluate psychological richness, life satisfaction, and psychological distress, respectively.

Since 6 participants dropped out during the study, there were finally 69 participants (training group: n=22; training-plus-homework group: n=23; waitlist group: n=24). Statistical analysis indicated no serious common method bias in this study. Further analyses revealed that: ① There were no significant differences among the 3 groups in demographic variables or baseline scores of psychological richness, life satisfaction, and depression-anxiety-stress; ② Psychological richness scores showed significant effects for time (F=32.036, P<0.001, partial η²=0.327), group (F=4.425, P=0.016, partial η²=0.118), and time×group interaction (F=15.324, P<0.001, partial η²=0.317). Simple effect analyses revealed significant within-group differences (training group: F=20.339, P<0.001, partial η²=0.385; training-plus-homework group: F=34.912, P<0.001, partial η²=0.518) and between-group differences (post-intervention: F=6.710, P=0.002, partial η²=0.169; 30 d after intervention: F=10.394, P<0.001, partial η²=0.240). After intervention, both the training group and the training-plus-homework group had higher psychological richness scores than the waitlist group (P=0.007, P=0.008). At 30 d after intervention, the training-plus-homework group had higher psychological richness scores than both the training group and the waitlist group (P=0.042, P<0.001). The training group scored significantly higher after intervention than at baseline and at 30 d after intervention (P<0.001, P=0.002). The training-plus-homework group showed significantly higher scores after training than at baseline (P<0.001), and higher scores at 30 d after training than both after training and at baseline (P=0.011, P<0.001); ③ for life satisfaction, the main effect of time (F=3.379, P=0.039, partial η²=0.049) and the time×group interaction effect (F=3.799, P=0.006, partial η² =0.103) were significant. Simple effect analysis showed significant within-group differences in the training-plus-homework group (F=8.454, P<0.001, partial η²=0.206) and significant between-group differences at 30 d after training (F=6.076, P=0.004, partial η²=0.156). The training-plus-homework group had higher scores at 30 d after training than both the training group and the waitlist group (P=0.036, P=0.004), and higher scores than those of the same group after training and at baseline (P=0.045, P<0.001); ④ there were no significant within-group or between-group differences in depression-anxiety-stress scores among the 3 groups at the 3 time points (P>0.05).

Group psychological training involving recall and anticipation of positive events combined with homework demonstrates more pronounced effects in enhancing positive mental health levels in college students.