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Mental Health Literacy, Emotion Regulation and Psychological Wellbeing

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View the page of Samiul Hossain

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Low Mental Health Literacy (MHL) is identified as one of the common reasons for treatment-seeking delays. Furthermore, Emotion Regulation (ER) is found as a risk factor for the onset and maintenance of Common Mental Health Disorders. Most ER studies have been conducted in Western countries focusing on strategies used to downregulate negative emotions. Samiul Hossain discusses related studies conducted in Australia and Bangladesh.

Image courtesy of interviewee. April 9, 2024

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This video video discusses the concepts of mental health literacy and emotion regulation, focusing on their importance in understanding and addressing mental health issues.

1. **Mental Health Literacy**: This video video refers to the knowledge and awareness individuals possess regarding mental health, including the ability to recognize symptoms, seek help, and understand treatment efficacy. Low mental health literacy can lead individuals to not recognize symptoms of mental health disorders, such as depression, or not know where to seek help. It may also involve cultural beliefs that affect perceptions of mental health, such as attributing symptoms to karma or personal failings.

2. **Emotion Regulation**: This video video is the process by which individuals manage their emotions, including strategies to enhance or reduce emotional experiences. This video video outlines various emotional regulation strategies and discusses how effective emotion regulation can influence mental health and the ability to seek support.

3. **Cultural Influences**: The discussion highlights the impact of cultural factors on both mental health literacy and emotion regulation. The author notes that in some cultures, acknowledging mental health symptoms may carry stigma or lead to the belief that seeking help is unnecessary.

4. **Research Studies**: The speaker summarizes four studies examining the interplay between mental health literacy and emotion regulation across different cultures (specifically comparing Bangladeshi and Australian participants). Key findings from the studies include:
- Bangladeshi participants exhibited lower mental health literacy compared to Australians.
- Participants could recognize symptoms but struggled to name them, highlighting a difference in mental health literacy despite awareness.
- Online therapy was preferred among Bangladeshi participants, likely due to accessibility issues.
- Emotion regulation strategies like reappraisal were found to be more effective in different contexts.

5. **Future Research Directions**: This video video outlines ongoing research interests, including the exploration of positive emotion regulation strategies and their effects on well-being, especially in multicultural contexts. The speaker emphasizes the importance of incorporating cultural nuances in mental health treatment and assessment to improve understanding and reduce stigma.

Overall, the text underscores the significance of mental health literacy and emotion regulation in navigating mental health challenges, while also recognizing the critical role of cultural context.

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X-TIMESTAMP-MAP:LOCAL=00:00:00.000,MPEGTS=900000

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The first thing, the mental health literacy, it's an idea,

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it's an idea about the, it came from the idea

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of health literacy.

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So basically it is about when you know that you need to go

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to go and see a psychologist for your mental health issues,

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or in Australia, GP gen, general practitioner there,

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the gateway to the medical and mental health service.

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So people with mental health issues, they go

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to the GP first, and then GP determines whether they need

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to be sent to a psychologist, psych social worker,

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occupational therapist, and so forth.

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So the whole consider

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of mental health literacy is if you have some symptoms,

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whether you can recognize the symptoms, whether you know

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where to get support,

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and what do you think about the efficacy of those treatment,

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of those interventions.

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So when we say low mental health literacy, we refer

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to the, refer to that idea that, that some people, they

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a, may not recognize the symptoms just by looking, just

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by look checking or looking through the symptoms.

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So for example, if you've been having low mood for two weeks

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and now two weeks,

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and even more than that, that might,

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that might be a sign of depression.

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But some people may not know that

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that may be a sign of depression.

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And if you have depression,

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some people may not have the understanding where

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to seek support, where to go if you have depression.

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And also, and even though they know where to go,

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they may not have that sort

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of belief in this treatment that it may or they don't.

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They they don't think it's effective.

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And sometimes some, some of the cases, they have some

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idea about the causality of mental health issues.

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So in, you know, that nicely ties up

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with our cultural factor here.

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In some cultures, they think it's a sign of bad karma.

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So if you have some mental health symptoms, it's a sign

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that you have done something wrong.

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So there is not much help to go

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to a psychologist or a doctor.

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So in our context, study context, that's what we

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meant by low mental health literacy.

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And we also march

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the low mental health literacy with another concept

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that is called emotion regulation.

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So emotion regulation at the bare minimum

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is a way we deal with our emotion.

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You know, we human being, we evolve to have different kinds

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of emotions throughout, throughout the day.

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Sometimes we get sad, sometimes we get happy.

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Like, like, now I'm a bit nervous,

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I'm doing an interview on you.

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Uh, and we do certain things to get, to either

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reduce that emotion or to enhance that emotion.

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So it's all ties

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With the context.

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So in certain context, we might,

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we want to feel certain way.

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In other context, we don't want to feel that way.

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So as an example, if I'm in a funeral

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and then all of a sudden I remember something funny about

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that person who deceased

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and I start to giggle, that might not be very context,

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wise, context wise, it may not be very wise

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to giggle in that moment.

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So I can do something,

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I can apply certain strategy to fill another way.

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So basically emotion regulation, there are combination

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of strategies to alter, duration, frequency,

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and intensity of a certain emotion.

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So, the,

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so basically these are the two things

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that we studied in our, in our,

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in our papers, the emotion regulation and mental literacy.

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So this is one of the first studies

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that looked into emotional regulation

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and mental health literacy together.

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So that was one of the defining features of our study

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because what we hypothesized that if

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you are good at managing your emotions, so

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emotional regulation, it is also embedded in our beliefs,

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in our capacity to deal with emotions.

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So if I feel, if I believe that I'm good enough to deal

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with our, with my emotions on my own,

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which can be a double-edged sword, okay?

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You know, because in good days, in some good days, I,

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I can handle my emotions.

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I don't get carried away.

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I can, I don't get swayed by certain form of good emotions.

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In my bad days, I can pick myself up from bad days.

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We all have bad days at office, day to day.

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But on the other hand, as as I am,

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I have high confidence in my belief to deal with emotions.

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I can delay seeking service, I can delay seeking support

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to deal with, with my negative emotion.

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So the whole philosophy

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or the whole idea behind is it can,

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that could be some relationship

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between mental health literacy, self seeking

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and emotional regulation.

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Okay, so I must add that, mental health literacy,

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there are different domains of mental literacy.

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And Anthony F Charm,

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he first studied the six domain domains

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of mental health literacy and help seeking

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intention is one of them.

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So we are good that if we, if we have a certain level

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of emotional recognition strategy,

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it can impact our help seeking intention.

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Okay. Uh, so in this regard, there's different authors

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that we often cited in in our paper.

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Anthony f John is one of them.

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He was one of the pioneer figures

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of mental health literacy study.

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Um, he came up with this idea,

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of mental health literacy, 1995

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with some of his colleagues.

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And based on that idea,

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they build a model called Mental Health First Aid, MHFA.

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So Mental Health first aid is, is more of a

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same as physical first aid.

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It just like, it helps others to know what are the symptoms

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of what, which disorder and what to do in those cases.

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Um, and then in emotional regulation field, our work was,

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built up on Naia Ksky from London,

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university Netherlands

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and also Gems Cross from Stanford University,

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in, in USF.

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So Nadia GSKi

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and I, we, we used to be part of our

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same research team, Nadia GSKi, Vivian Cry,

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and me, we did a small study back in

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20 15, 16, it was published in 2017.

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So we tried to replicate one

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of the common findings in western country to Bangladesh.

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So in, in Western countries, we often see the,

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the way people manage their emotion,

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it has an impact on their wellbeing.

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In particular, if there is a specific strategy

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called rumination.

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So if I keep on thinking about negative stuff over

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and over again, it has a negative impact on my wellbeing.

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So there is a positive correlation between rumination

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and anxiety and nutrition.

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So we recruited around 300 adolescents,

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both boys and girls from schools in daca, Bangladesh.

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And then we found that we replicate the same findings

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with cogniti seen so

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and so, our study born out of this replication study, we,

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we just did it in a larger, in larger scope.

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And our study also index to

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cross gems cross process model of emotion regulation.

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So our study based, our study followed the process model

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of emotion regulation that cross developed in nineties.

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And then there was an expanded model of process,

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expanded model of process, model of reg,

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emotional regulation in 2015.

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So in this model, what gens cross are good,

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that emotion regulation happens in stages.

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It, it's not a, it's not a one off

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things, it happens in stages.

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There are five distinct stages, situation selection,

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suggestion modification, addiction modification,

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and behavior modulation.

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Okay? Um, and in those five stages,

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people apply different strategies to deal with the emotion.

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So we, we used one of the questionnaires developed

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by Cross and John in our study.

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So these are the primary studies that we,

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we rely on to do our study.

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So in the first three studies,

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we did a cross-cultural comparison.

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We, it was a cross-cultural studies.

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In the first study, we included mental health literacy,

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so medical literacy.

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We followed a vate methodology,

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to do the mental literacy study.

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So basically it's, we give both of both set of participants,

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a Australian and Bangladesh participant.

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We gave them a vate.

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And in the Vnet there was a protagonist

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and they've been experts in some symptoms.

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And we include symptoms of five disorder, depression,

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depression without suicide.

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Um, trigger warning, sorry,

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I should have given the trigger warning.

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We talked about suicide.

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So depression, depression without suicide.

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Um, and then, schizophrenia,

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SD post-traumatic stress disorder

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and social social anxiety disorder.

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It's alternatively known as social phobia as well.

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So we give these fin to our participants

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and then ask them whether they can, a,

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recognize the symptoms, whether they can,

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whether they think it's a, it's a sign

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of mental health disorder,

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and if they think it's a sign

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of mental health disorder, what could be the name.

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And then we also ask them what sort of, what sort

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of treatment would be beneficial for this participant?

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So we give them, it's a mix. It was a mixed method study.

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So you give them open-ended response.

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So we just give them a text box on a server software,

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and they could have, they could write their responses.

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And then we also ask them about the causal factors

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and what could cause these symptoms.

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And, we also ask them

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what sort of interventions that could be helpful for them.

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And finally we ask them if they have these

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symptoms, would they seek help?

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That's the help seeking intention.

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And if they seek help, what is their preference?

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What sort of treatment they want to, they would go.

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So we give them a list of treatment

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and then asked them whether you've preferred them or not.

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It's basically yes or no. Okay.

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There was a study one in the second study.

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Again, it was, it was a mixed mixture study,

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but mostly qu quantitative study.

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Um, I beg your pardon.

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It's a qu it was a quantitative study.

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So in this quantitative study, we apply some questionnaires

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to measure the emotional regulation strategies,

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like the way they measure the emotion regulation strategies.

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And there was one of the care v we we are trying

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to address is in so far are back in

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up until 2020.

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Most of the studies followed the intrapersonal emotional

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regulation, like what you do within yourself,

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that can help you to do,

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regulating your emotion.

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We add another emotion called interpersonal emotional

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regulation strategies like what others can do to help you.

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And, I can only remember,

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I can only recall the son and ni ni NIV.

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And they developed a skill in England called ERO

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emission regulation itself.

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And others, ero, sorry.

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And we get the idea from their skill.

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And then we applied and we applied other skill here too.

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So here we measure both intrapersonal emotion regulation

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strategies and interpersonal emotion regulation strategies

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in both Bangladeshi and Australian cohort.

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And for psychopathology in our field, we use psychopathology

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as an term for mental health disorder.

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Then we measure medical disorder by applying,

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some questionnaires.

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And we also applied a structured clinical interview.

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Um, so I'm a trained psychologist.

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So, I, I had the necessary training

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to apply this interview.

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So the participant would come to the lab

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or any other confidential location,

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and then we'd interview them

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with the DSM five based interview schedule.

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It's called skit structuring Clinical

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interview for DSM five.

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And based on that, they would receive a, a coding,

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either yes or no, whether they can be diagnosed with any

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of the mental health disorders in the past 12 months

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or in lifetime.

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And, and also we applied a questionnaire called IDAs

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interview, inventory of depression anxiety symptoms.

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It was developed by Watson in 2011. Yep, 2011.

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And we applied them to,

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and then as an analytical strategy, we tried

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to find the association

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between emotional remission strategies and psychopathology.

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Okay. In study three,

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we changed our method a little bit here.

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And in this, in this study, we apply a, a method called

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experiencing sampling method.

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It's called ESM. I'm being mindful when I said ESM,

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because in the field sometimes it is called EMA as well,

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ecologically momentary assessment.

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So it could be S-M-E-M-A. So ESM and EMA.

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Basically what it does it back in those days in nineties,

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but the researchers used to ask participant to come

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to the lab and they would give them beeper

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and a notebook with some questionnaires.

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So every time there is a beep one, the beeper,

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they would write about their mood on

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their notebook, and after,

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After seven days or eight days,

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they'll bring back the notebooks and just search

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and co codify them, code them, and put them into a dataset.

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Um, in our case, what we did, we asked participants to come

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to diaries via their smartphone.

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So there is a survey link on Qualtrics, Alteryx.

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Um, we send them a reminder to do the surveying,

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in four times a day.

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And they have the repeated measurement,

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repeated measurement of their mood.

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And then again, from,

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this repeated measurement, we get four

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or five signs of affective dynamics.

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So basically affected dynamics is a, is a model

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to capture their up and low up and down.

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So our mood is not designed to stay the same.

15:42.025 --> 15:44.205
If it stays the same, that's a sign.

15:44.205 --> 15:47.645
That could be a sign of mental health issues, as well.

15:48.145 --> 15:50.965
So we try to capture their up and up

15:50.965 --> 15:53.205
and down by applying some statistical methods.

15:53.665 --> 15:57.325
Um, and, and then we try to link them

15:57.325 --> 15:59.045
with the regulation strategy.

15:59.265 --> 16:00.805
So we try to understand whether,

16:01.465 --> 16:03.965
if you apply certain emission regulation strategy,

16:03.995 --> 16:07.005
whether it has an impact on your mood.

16:08.385 --> 16:11.685
And, in many of the cases, participants

16:11.985 --> 16:13.205
and the researchers argue

16:13.315 --> 16:15.245
that we have this emotional inertia.

16:16.105 --> 16:19.845
So for example, if something bad happens five minutes ago,

16:21.705 --> 16:24.235
many of us would, would bounce back from the,

16:24.425 --> 16:27.915
from this emotions and then start going, moving on

16:27.915 --> 16:28.915
and do our things.

16:30.215 --> 16:33.315
And in the case of inertia, people will stuck in that mood.

16:33.735 --> 16:36.075
So we couldn't capture this inertia.

16:36.135 --> 16:38.355
And we also could capture the high and low.

16:38.895 --> 16:42.235
And in effective dynamics model, it was our good

16:42.235 --> 16:45.755
that the sometimes the participants, they can have high,

16:45.755 --> 16:48.035
that is too high, a low, that is too low,

16:48.035 --> 16:49.435
there'll be a lot of fluctuation.

16:50.415 --> 16:53.195
So that's what we did in the study three,

16:53.415 --> 16:56.755
in both cohort Bangladeshi and Australian cohort.

16:57.735 --> 17:02.275
And in the study four, we, in study four,

17:02.315 --> 17:04.515
we mostly focused on,

17:04.965 --> 17:07.515
Australian participants due to practical reasons.

17:07.975 --> 17:10.275
And it was done during, just

17:10.275 --> 17:12.435
before the covid, during the covid.

17:13.495 --> 17:16.315
So, we couldn't travel, I couldn't travel back

17:16.335 --> 17:17.675
to Bangladesh to do the study.

17:17.895 --> 17:21.995
So in this study, what we did,

17:22.055 --> 17:25.035
we created a new paradigm to test a,

17:25.175 --> 17:28.515
to test an emotional regulation strategy called safeing

17:28.515 --> 17:29.635
and positive elimination.

17:30.305 --> 17:34.795
Okay? So again, in to gross model.

17:35.655 --> 17:39.595
So based on the gross model, emotional regulation can be,

17:39.775 --> 17:43.515
you can use emotion regulation to up regulatory your emotion

17:43.655 --> 17:44.995
or down regulatory emotion.

17:45.215 --> 17:47.275
So you can use certain strategy to,

17:47.825 --> 17:48.955
that can make you feel better

17:50.105 --> 17:51.605
or that can make you feel worse.

17:52.155 --> 17:53.485
Okay? You don't want to,

17:53.745 --> 17:57.725
but sometimes we do, we do apply some strategy

17:57.725 --> 17:58.885
that makes us feel worse.

18:00.185 --> 18:01.685
So in this study

18:01.865 --> 18:04.645
for we apply the emotional upregulation strategy.

18:05.385 --> 18:07.965
So we are interested to understand

18:08.115 --> 18:10.605
that the way we manage our positive emotion,

18:11.715 --> 18:14.205
what impact it has on our wellbeing in a day-to-day

18:14.205 --> 18:15.925
basis, a momentary basis.

18:17.065 --> 18:19.245
So this, this was an experimental study,

18:19.535 --> 18:20.725
again, quantitative study.

18:20.825 --> 18:23.805
So what we did, we asked participants to come to our lab.

18:25.105 --> 18:26.205
We did a screening.

18:26.205 --> 18:29.285
First we applied P hq, patient health questionnaire

18:29.385 --> 18:33.765
and then A SRM to rule out, anyone

18:33.765 --> 18:37.445
with bipolar disorder, or depressive disorder.

18:38.225 --> 18:40.525
And then we asked participants to come to the lab,

18:40.825 --> 18:43.605
and then we randomly assign them into three conditions.

18:44.555 --> 18:46.725
Okay? Why three conditions?

18:46.725 --> 18:50.245
Because many of the model,

18:50.505 --> 18:55.245
and we are in touch to brand work here, brand in 2022,

18:55.385 --> 18:58.565
in 1986 to 20 22, 1 has been active in this field.

18:59.305 --> 19:00.685
So based on brand

19:00.685 --> 19:04.365
and year of model, the same can happen in three timeframe.

19:05.065 --> 19:08.045
One is you can recall something

19:09.465 --> 19:11.445
and then feel good about it,

19:11.445 --> 19:12.845
and then you can save with that moment

19:12.945 --> 19:14.525
and upregulate your good feeling,

19:15.705 --> 19:17.805
or you can project something.

19:19.025 --> 19:20.845
So for example, I might,

19:21.855 --> 19:24.005
after when this interview is published

19:24.005 --> 19:26.405
and people are saying good stuff about me, I can recall

19:27.185 --> 19:28.765
and say, that was a good feeling.

19:28.905 --> 19:30.445
And then I can see what that moment,

19:30.685 --> 19:33.325
I can use up regulation strategy to make me feel better

19:34.545 --> 19:36.205
or what I can do.

19:36.485 --> 19:41.085
I can, you know, when we booked for a travel a holiday,

19:41.345 --> 19:43.165
we often daydream about it.

19:43.785 --> 19:45.125
You know, we, we look for

19:45.305 --> 19:47.445
and we think, okay, how nice it would be

19:47.545 --> 19:50.325
or be just sitting on a tropical island

19:50.545 --> 19:54.405
and having a sun, or a cocktail.

19:55.505 --> 19:58.565
So brand are good that we can also save a positive emotion

19:59.195 --> 20:00.645
that derived through prospection.

20:01.755 --> 20:04.965
Okay? And there's another eco based researcher, Andrew

20:06.565 --> 20:09.725
t he did, he did some studies in the prospection as well.

20:10.945 --> 20:15.605
So, so these are two, two fun timeframes through resing,

20:15.605 --> 20:17.565
through prospection or anticipation.

20:17.945 --> 20:20.205
And there is another form of savoring that is,

20:20.625 --> 20:22.525
you are savoring the moment right now.

20:23.315 --> 20:27.445
Okay? Um, and here, there is a

20:27.995 --> 20:29.805
ment in the field where the savoring

20:29.805 --> 20:31.645
and mindfulness, whether they're the same.

20:32.065 --> 20:36.045
So what out argue that in the mindfulness,

20:36.305 --> 20:38.645
we just pay attention to the present moment.

20:39.425 --> 20:44.285
We try, we, we don't, we don't try to actively enhance any

20:44.285 --> 20:47.405
of the emotions that we have at this stage in savoring

20:47.405 --> 20:48.445
or positive rumination.

20:48.445 --> 20:50.685
We try to enhance, we, we ask participant

20:50.685 --> 20:52.645
to enhance the positive emotion.

20:52.945 --> 20:55.445
So that is a subtle difference.

20:55.785 --> 20:59.125
And again, I, I acknowledge that there is disagreement

20:59.225 --> 21:00.885
and it does overlap with each other.

21:01.905 --> 21:05.805
So in our study, we ask participants to come to the lab,

21:06.185 --> 21:09.165
we give them a diary of he and activity.

21:09.905 --> 21:11.765
We ask them, okay, have you done any

21:11.765 --> 21:13.245
of these activities in the past week?

21:13.915 --> 21:14.965
Just say yes or no.

21:16.425 --> 21:19.885
So in the ING conditions, I, we ask them, okay,

21:20.305 --> 21:22.605
can you please recall doing this activity?

21:23.475 --> 21:25.085
Just pick one of those activities

21:25.085 --> 21:26.765
and then recall and write about it.

21:27.505 --> 21:30.845
So they write, they, they wrote about this event,

21:30.865 --> 21:33.885
and then we asked them to reflect on this emotions.

21:34.425 --> 21:38.325
How, how did it make them feel just by recalling this event

21:39.345 --> 21:42.205
and in the anticipation condition, the instruction was more

21:42.205 --> 21:44.205
or less the same that we asked them.

21:44.205 --> 21:46.685
Okay, just imagine that you're doing the same activity

21:47.705 --> 21:51.445
in the, next, next one week

21:51.825 --> 21:53.325
and see how it makes you feel.

21:54.265 --> 21:56.365
And in the in moment condition, we,

21:56.745 --> 21:59.565
we showed them a clip from a movie called The Mighty Duck,

21:59.945 --> 22:01.805
in 1991.

22:02.105 --> 22:05.325
Um, well, I haven't watched that either.

22:06.005 --> 22:07.285
I just want, I just only watched

22:07.955 --> 22:11.685
because, I wanted to find, I wanted

22:11.685 --> 22:12.965
to find out about the stimuli.

22:13.505 --> 22:16.285
So we are in debt to care in Coman work.

22:16.285 --> 22:20.685
They did a, fantastic review on this clip

22:20.745 --> 22:23.005
and then what sort of emotions it can induce.

22:23.785 --> 22:26.805
So we, we agreed that it can induce,

22:27.025 --> 22:29.165
positive emotions.

22:29.185 --> 22:31.725
So in the moment conditions, we asked participant

22:31.725 --> 22:34.365
to watch the clip and then write about the emotions

22:34.365 --> 22:35.565
and reflect on the emotions.

22:36.115 --> 22:40.165
Okay? So this study, we were really hopeful

22:40.355 --> 22:43.045
that we could do something with this study.

22:43.145 --> 22:47.365
And then Covid hit, so we have to wrap up the study

22:47.505 --> 22:49.325
and then, finalize it.

22:49.345 --> 22:50.805
So these are, these are the four studies.

22:51.435 --> 22:53.645
It's challenging to find, it's challenging to tell

22:54.355 --> 22:56.285
what is the most interesting findings.

22:56.465 --> 22:57.685
All, they didn't ask me

22:57.685 --> 22:58.885
what is the most interesting funding.

22:59.345 --> 23:02.285
So to me, the most interesting funding is in the study one,

23:02.305 --> 23:05.445
we found that the mental health literacy level was lower in

23:05.835 --> 23:09.285
Bangladeshi participants than Austrian participated, even

23:09.575 --> 23:12.845
after we controlled the effect of lived experience.

23:14.185 --> 23:18.685
So we've been getting big on lived experience now

23:19.075 --> 23:20.685
both in UK and Australia.

23:20.845 --> 23:25.245
Likewise, we are, we are focusing on, consumer's idea

23:25.245 --> 23:26.325
of the lived experience.

23:26.355 --> 23:30.205
Like, previously what we thought, okay, we use such a,

23:30.305 --> 23:32.765
we we can determine what sort of treatment

23:32.765 --> 23:35.685
that could be helpful for any participants.

23:35.965 --> 23:37.285
Nowadays we listening more and more

23:37.285 --> 23:38.485
to this lived experience.

23:39.025 --> 23:41.005
So that's why we include the lived experience there.

23:41.225 --> 23:42.605
And we found out that if we,

23:42.605 --> 23:44.365
even if we control the lived experience,

23:45.345 --> 23:46.725
Um, in Bangladesh,

23:46.865 --> 23:50.205
the participants had lower mental health literacy.

23:50.705 --> 23:54.895
And what is interesting here is in Bangladesh, they could,

23:56.445 --> 23:59.775
they could acknowledge this is the mental health symptoms,

23:59.795 --> 24:00.975
but they couldn't name it.

24:02.125 --> 24:04.815
Okay? So we could argue what's in the name.

24:05.235 --> 24:07.855
Um, and the literature is divided here.

24:07.965 --> 24:09.935
Some researcher are good that it,

24:09.935 --> 24:11.015
there's everything in the name.

24:11.075 --> 24:13.095
If you could name it, you could name it.

24:13.555 --> 24:15.535
And some researcher said, no, it doesn't matter.

24:15.755 --> 24:17.335
As long as you can recognize it's

24:17.335 --> 24:18.455
the symptoms, it should be fine.

24:18.475 --> 24:21.015
So that's, that is a ma one of the major findings

24:21.525 --> 24:23.055
from the mental health literacy study.

24:23.955 --> 24:27.455
And also in mental health literacy study, we found out that,

24:27.635 --> 24:31.015
the Bangladeshi participants, they,

24:31.525 --> 24:35.775
they prefer online therapy more than Austrian participant.

24:36.115 --> 24:39.335
Um, it could be due to the accessibility issue.

24:40.395 --> 24:45.255
And in the study too, what we found the reprisal,

24:45.285 --> 24:47.015
that is a common form

24:47.015 --> 24:49.135
of emission regulation strategy reprisal.

24:49.195 --> 24:52.215
So reprisal was more effective in austral context

24:52.965 --> 24:54.015
than context.

24:55.675 --> 24:57.375
Um, and in,

24:58.335 --> 25:00.875
in the study form in savoring

25:00.875 --> 25:02.595
and wellbeing, what we found the,

25:02.735 --> 25:05.595
for the premium study is we found that

25:06.735 --> 25:10.155
the resing space savoring was more effective in increasing

25:10.705 --> 25:13.635
momentary happiness than any other two forms of savoring.

25:14.615 --> 25:18.635
Uh, and we are good from theoretical perspective,

25:18.815 --> 25:21.635
it is easier because when you have a memory

25:21.815 --> 25:25.435
and you can re retract this memory, it can be more,

25:26.135 --> 25:28.635
it is more concrete in your imagination rather

25:28.635 --> 25:30.595
than prospecting.

25:31.055 --> 25:33.635
And there are different studies register that we are not

25:34.185 --> 25:36.515
that right in prospecting.

25:36.855 --> 25:40.195
So we often assume this thing will make us

25:40.195 --> 25:41.435
happier, but it doesn't.

25:41.815 --> 25:44.595
So I'm still continuing on starting

25:44.595 --> 25:45.835
with disabling and wellbeing.

25:45.995 --> 25:49.675
I have a lab with undergrad researchers.

25:49.675 --> 25:50.875
Were still continu continuing this study.

25:51.255 --> 25:53.795
So the study three, we found that, that, again,

25:53.795 --> 25:57.235
the reappraisal, if you apply the appraisal,

25:57.415 --> 26:01.075
it is helpful for you in terms of effective dynamics.

26:01.075 --> 26:03.835
That means you don't stay in one stage

26:03.935 --> 26:06.275
or you don't, it, it can help you

26:06.295 --> 26:09.115
to move on from the inertia, English, Russia.

26:10.095 --> 26:13.195
So the future research we're, we continue with the safe

26:13.615 --> 26:16.355
and wellbeing studies in Australian population.

26:17.735 --> 26:20.355
So we tweaked the experiment a little bit.

26:20.575 --> 26:24.435
So now in our current experiment, we added a control group

26:25.345 --> 26:28.555
with the three conditions, the three suffering conditions.

26:28.775 --> 26:31.875
In this control group, we asked participants

26:31.955 --> 26:34.195
to recall their morning routine.

26:34.195 --> 26:37.675
Routine. And we assume that it's a neutral condition

26:37.675 --> 26:40.595
because recalling morning routine, it can be neither

26:41.795 --> 26:44.605
positive or neither negative, or even if it is positive

26:44.605 --> 26:46.565
or negative, it'll balance out eventually

26:46.565 --> 26:49.685
because we're not asking to recall anything positive

26:49.685 --> 26:50.765
or negative per se.

26:51.625 --> 26:53.125
So that is, we are, we continue

26:53.125 --> 26:54.725
with the savoring and wellbeing studies.

26:55.065 --> 26:57.765
Um, that is the future research we're doing.

26:58.745 --> 27:00.005
And we are also interested

27:00.005 --> 27:03.645
to understand whether the savoring has any buffering effect

27:03.645 --> 27:05.765
against stress and depression.

27:05.825 --> 27:07.405
So the, me

27:07.425 --> 27:09.325
and one of my other students we're,

27:10.295 --> 27:13.685
we're contacting another study to understand if we

27:15.195 --> 27:18.225
prime participant to feel sad inside the lab,

27:18.925 --> 27:23.095
and then we induce severing and then to check.

27:23.515 --> 27:24.815
And then we we're interested

27:24.835 --> 27:27.055
to understand whether it can help them

27:27.055 --> 27:28.375
to bounce back from the sadness,

27:28.565 --> 27:30.775
whether it has some sort of buffering effect.

27:31.755 --> 27:35.615
Um, in, in current time, we do spend a lot of time

27:35.635 --> 27:40.175
to understand that the treatment of depression

27:41.355 --> 27:43.135
and whether we can

27:44.045 --> 27:47.015
only target with a 'cause.

27:47.015 --> 27:49.535
In so far in depression, we only target the negative emotion

27:49.955 --> 27:51.535
to reduce the intensity of sadness.

27:52.195 --> 27:53.815
And there has been some studies coming out.

27:53.845 --> 27:56.095
It's talked about the positive affect you,

27:56.715 --> 27:59.455
so whether we can enhance positive affect

27:59.475 --> 28:01.735
and it can have a,

28:02.485 --> 28:04.135
have any impact on the negative effect.

28:04.155 --> 28:07.255
So this is the feature of studies we're doing.

28:07.435 --> 28:11.175
And my takeaway message is,

28:14.755 --> 28:16.495
I think culture is still important.

28:17.355 --> 28:21.935
It, it can influence, in many different ways.

28:22.955 --> 28:27.135
And perhaps we all are ever in Australia, in the uk

28:27.195 --> 28:29.175
and in many of those western countries,

28:29.795 --> 28:32.295
the society has become increasingly multicultural.

28:32.955 --> 28:36.855
So when we, when, when you talk about, the importance of

28:37.415 --> 28:39.015
mental health treatment and assessment,

28:39.635 --> 28:41.975
I'm not only talking about,

28:42.125 --> 28:46.295
some cultures there in far land, it's happening right now,

28:46.295 --> 28:50.335
right here in in, in any of the societies that we live in.

28:50.795 --> 28:54.215
So if we can capture this culture

28:54.275 --> 28:55.775
and nuances in our treatment

28:55.775 --> 28:57.815
and assessment of mental health disorders, we,

28:57.955 --> 28:59.055
we can reduce the burden.

00:00 - The first thing, the mental health literacy, it's an idea, it's an idea about the, it came from the idea of health literacy. So basically it is about when you know that you need to go to go and see a psychologist for your mental health issues, or in Australia, GP gen, general practitioner there,

00:19 - the gateway to the medical and mental health service. So people with mental health issues, they go to the GP first, and then GP determines whether they need to be sent to a psychologist, psych social worker, occupational therapist, and so forth. So the whole consider of mental health literacy is if you have some symptoms, whether you can recognize the symptoms, whether you know where to get support, and what do you think about the efficacy of those treatment,

00:47 - of those interventions. So when we say low mental health literacy, we refer to the, refer to that idea that, that some people, they a, may not recognize the symptoms just by looking, just by look checking or looking through the symptoms. So for example, if you've been having low mood for two weeks and now two weeks, and even more than that, that might, that might be a sign of depression. But some people may not know that

01:18 - that may be a sign of depression. And if you have depression, some people may not have the understanding where to seek support, where to go if you have depression. And also, and even though they know where to go, they may not have that sort of belief in this treatment that it may or they don't. They they don't think it's effective. And sometimes some, some of the cases, they have some idea about the causality of mental health issues.

01:49 - So in, you know, that nicely ties up with our cultural factor here. In some cultures, they think it's a sign of bad karma. So if you have some mental health symptoms, it's a sign that you have done something wrong. So there is not much help to go to a psychologist or a doctor. So in our context, study context, that's what we meant by low mental health literacy. And we also march

02:20 - the low mental health literacy with another concept that is called emotion regulation. So emotion regulation at the bare minimum is a way we deal with our emotion. You know, we human being, we evolve to have different kinds of emotions throughout, throughout the day. Sometimes we get sad, sometimes we get happy. Like, like, now I'm a bit nervous, I'm doing an interview on you. and we do certain things to get, to either

02:53 - reduce that emotion or to enhance that emotion. So it's all ties With the context. So in certain context, we might, we want to feel certain way. In other context, we don't want to feel that way. So as an example, if I'm in a funeral and then all of a sudden I remember something funny about that person who deceased and I start to giggle, that might not be very context,

03:19 - wise, context wise, it may not be very wise to giggle in that moment. So I can do something, I can apply certain strategy to fill another way. So basically emotion regulation, there are combination of strategies to alter, duration, frequency, and intensity of a certain emotion. So, the, so basically these are the two things that we studied in our, in our,

03:48 - in our papers, the emotion regulation and mental literacy. So this is one of the first studies that looked into emotional regulation and mental health literacy together. So that was one of the defining features of our study because what we hypothesized that if you are good at managing your emotions, so emotional regulation, it is also embedded in our beliefs, in our capacity to deal with emotions. So if I feel, if I believe that I'm good enough to deal

04:20 - with our, with my emotions on my own, which can be a double-edged sword, okay? You know, because in good days, in some good days, I, I can handle my emotions. I don't get carried away. I can, I don't get swayed by certain form of good emotions. In my bad days, I can pick myself up from bad days. We all have bad days at office, day to day. But on the other hand, as as I am, I have high confidence in my belief to deal with emotions.

04:56 - I can delay seeking service, I can delay seeking support to deal with, with my negative emotion. So the whole philosophy or the whole idea behind is it can, that could be some relationship between mental health literacy, self seeking and emotional regulation. Okay, so I must add that, mental health literacy, there are different domains of mental literacy. And Anthony F Charm,

05:23 - he first studied the six domain domains of mental health literacy and help seeking intention is one of them. So we are good that if we, if we have a certain level of emotional recognition strategy, it can impact our help seeking intention. Okay. so in this regard, there's different authors that we often cited in in our paper. Anthony f John is one of them. He was one of the pioneer figures

05:51 - of mental health literacy study. he came up with this idea, of mental health literacy, 1995 with some of his colleagues. And based on that idea, they build a model called Mental Health First Aid, MHFA. So Mental Health first aid is, is more of a same as physical first aid. It just like, it helps others to know what are the symptoms of what, which disorder and what to do in those cases.

06:26 - and then in emotional regulation field, our work was, built up on Naia Ksky from London, university Netherlands and also Gems Cross from Stanford University, in, in USF. So Nadia GSKi and I, we, we used to be part of our same research team, Nadia GSKi, Vivian Cry, and me, we did a small study back in 20 15, 16, it was published in 2017.

07:02 - So we tried to replicate one of the common findings in western country to Bangladesh. So in, in Western countries, we often see the, the way people manage their emotion, it has an impact on their wellbeing. In particular, if there is a specific strategy called rumination. So if I keep on thinking about negative stuff over and over again, it has a negative impact on my wellbeing. So there is a positive correlation between rumination

07:31 - and anxiety and nutrition. So we recruited around 300 adolescents, both boys and girls from schools in daca, Bangladesh. And then we found that we replicate the same findings with cogniti seen so and so, our study born out of this replication study, we, we just did it in a larger, in larger scope. And our study also index to cross gems cross process model of emotion regulation. So our study based, our study followed the process model

08:05 - of emotion regulation that cross developed in nineties. And then there was an expanded model of process, expanded model of process, model of reg, emotional regulation in 2015. So in this model, what gens cross are good, that emotion regulation happens in stages. It, it's not a, it's not a one off things, it happens in stages. There are five distinct stages, situation selection, suggestion modification, addiction modification,

08:38 - and behavior modulation. Okay? and in those five stages, people apply different strategies to deal with the emotion. So we, we used one of the questionnaires developed by Cross and John in our study. So these are the primary studies that we, we rely on to do our study. So in the first three studies, we did a cross-cultural comparison. We, it was a cross-cultural studies.

09:07 - In the first study, we included mental health literacy, so medical literacy. We followed a vate methodology, to do the mental literacy study. So basically it's, we give both of both set of participants, a Australian and Bangladesh participant. We gave them a vate. And in the Vnet there was a protagonist and they've been experts in some symptoms. And we include symptoms of five disorder, depression,

09:35 - depression without suicide. trigger warning, sorry, I should have given the trigger warning. We talked about suicide. So depression, depression without suicide. and then, schizophrenia, SD post-traumatic stress disorder and social social anxiety disorder. It's alternatively known as social phobia as well. So we give these fin to our participants

10:01 - and then ask them whether they can, a, recognize the symptoms, whether they can, whether they think it's a, it's a sign of mental health disorder, and if they think it's a sign of mental health disorder, what could be the name. And then we also ask them what sort of, what sort of treatment would be beneficial for this participant? So we give them, it's a mix. It was a mixed method study. So you give them open-ended response.

10:28 - So we just give them a text box on a server software, and they could have, they could write their responses. And then we also ask them about the causal factors and what could cause these symptoms. And, we also ask them what sort of interventions that could be helpful for them. And finally we ask them if they have these symptoms, would they seek help? That's the help seeking intention. And if they seek help, what is their preference?

11:00 - What sort of treatment they want to, they would go. So we give them a list of treatment and then asked them whether you've preferred them or not. It's basically yes or no. Okay. There was a study one in the second study. Again, it was, it was a mixed mixture study, but mostly qu quantitative study. I beg your pardon. It's a qu it was a quantitative study. So in this quantitative study, we apply some questionnaires

11:29 - to measure the emotional regulation strategies, like the way they measure the emotion regulation strategies. And there was one of the care v we we are trying to address is in so far are back in up until 2020. Most of the studies followed the intrapersonal emotional regulation, like what you do within yourself, that can help you to do, regulating your emotion. We add another emotion called interpersonal emotional

12:03 - regulation strategies like what others can do to help you. And, I can only remember, I can only recall the son and ni ni NIV. And they developed a skill in England called ERO emission regulation itself. And others, ero, sorry. And we get the idea from their skill. And then we applied and we applied other skill here too. So here we measure both intrapersonal emotion regulation strategies and interpersonal emotion regulation strategies

12:39 - in both Bangladeshi and Australian cohort. And for psychopathology in our field, we use psychopathology as an term for mental health disorder. Then we measure medical disorder by applying, some questionnaires. And we also applied a structured clinical interview. so I'm a trained psychologist. So, I, I had the necessary training to apply this interview. So the participant would come to the lab

13:14 - or any other confidential location, and then we'd interview them with the DSM five based interview schedule. It's called skit structuring Clinical interview for DSM five. And based on that, they would receive a, a coding, either yes or no, whether they can be diagnosed with any of the mental health disorders in the past 12 months or in lifetime. And, and also we applied a questionnaire called IDAs

13:40 - interview, inventory of depression anxiety symptoms. It was developed by Watson in 2011. Yep, 2011. And we applied them to, and then as an analytical strategy, we tried to find the association between emotional remission strategies and psychopathology. Okay. In study three, we changed our method a little bit here. And in this, in this study, we apply a, a method called experiencing sampling method.

14:18 - It's called ESM. I'm being mindful when I said ESM, because in the field sometimes it is called EMA as well, ecologically momentary assessment. So it could be S-M-E-M-A. So ESM and EMA. Basically what it does it back in those days in nineties, but the researchers used to ask participant to come to the lab and they would give them beeper and a notebook with some questionnaires. So every time there is a beep one, the beeper, they would write about their mood on

14:49 - their notebook, and after, After seven days or eight days, they'll bring back the notebooks and just search and co codify them, code them, and put them into a dataset. in our case, what we did, we asked participants to come to diaries via their smartphone. So there is a survey link on Qualtrics, Alteryx. we send them a reminder to do the surveying, in four times a day. And they have the repeated measurement,

15:20 - repeated measurement of their mood. And then again, from, this repeated measurement, we get four or five signs of affective dynamics. So basically affected dynamics is a, is a model to capture their up and low up and down. So our mood is not designed to stay the same. If it stays the same, that's a sign. That could be a sign of mental health issues, as well. So we try to capture their up and up

15:50 - and down by applying some statistical methods. and, and then we try to link them with the regulation strategy. So we try to understand whether, if you apply certain emission regulation strategy, whether it has an impact on your mood. And, in many of the cases, participants and the researchers argue that we have this emotional inertia. So for example, if something bad happens five minutes ago,

16:21 - many of us would, would bounce back from the, from this emotions and then start going, moving on and do our things. And in the case of inertia, people will stuck in that mood. So we couldn't capture this inertia. And we also could capture the high and low. And in effective dynamics model, it was our good that the sometimes the participants, they can have high, that is too high, a low, that is too low, there'll be a lot of fluctuation.

16:50 - So that's what we did in the study three, in both cohort Bangladeshi and Australian cohort. And in the study four, we, in study four, we mostly focused on, Australian participants due to practical reasons. And it was done during, just before the covid, during the covid. So, we couldn't travel, I couldn't travel back to Bangladesh to do the study. So in this study, what we did,

17:22 - we created a new paradigm to test a, to test an emotional regulation strategy called safeing and positive elimination. Okay? So again, in to gross model. So based on the gross model, emotional regulation can be, you can use emotion regulation to up regulatory your emotion or down regulatory emotion. So you can use certain strategy to, that can make you feel better or that can make you feel worse.

17:52 - Okay? You don't want to, but sometimes we do, we do apply some strategy that makes us feel worse. So in this study for we apply the emotional upregulation strategy. So we are interested to understand that the way we manage our positive emotion, what impact it has on our wellbeing in a day-to-day basis, a momentary basis. So this, this was an experimental study,

18:19 - again, quantitative study. So what we did, we asked participants to come to our lab. We did a screening. First we applied P hq, patient health questionnaire and then A SRM to rule out, anyone with bipolar disorder, or depressive disorder. And then we asked participants to come to the lab, and then we randomly assign them into three conditions. Okay? Why three conditions? Because many of the model,

18:50 - and we are in touch to brand work here, brand in 2022, in 1986 to 20 22, 1 has been active in this field. So based on brand and year of model, the same can happen in three timeframe. One is you can recall something and then feel good about it, and then you can save with that moment and upregulate your good feeling, or you can project something. So for example, I might,

19:21 - after when this interview is published and people are saying good stuff about me, I can recall and say, that was a good feeling. And then I can see what that moment, I can use up regulation strategy to make me feel better or what I can do. I can, you know, when we booked for a travel a holiday, we often daydream about it. You know, we, we look for and we think, okay, how nice it would be

19:47 - or be just sitting on a tropical island and having a sun, or a cocktail. So brand are good that we can also save a positive emotion that derived through prospection. Okay? And there's another eco based researcher, Andrew t he did, he did some studies in the prospection as well. So, so these are two, two fun timeframes through resing, through prospection or anticipation. And there is another form of savoring that is, you are savoring the moment right now.

20:23 - Okay? and here, there is a ment in the field where the savoring and mindfulness, whether they're the same. So what out argue that in the mindfulness, we just pay attention to the present moment. We try, we, we don't, we don't try to actively enhance any of the emotions that we have at this stage in savoring or positive rumination. We try to enhance, we, we ask participant to enhance the positive emotion.

20:52 - So that is a subtle difference. And again, I, I acknowledge that there is disagreement and it does overlap with each other. So in our study, we ask participants to come to the lab, we give them a diary of he and activity. We ask them, okay, have you done any of these activities in the past week? Just say yes or no. So in the ING conditions, I, we ask them, okay, can you please recall doing this activity?

21:23 - Just pick one of those activities and then recall and write about it. So they write, they, they wrote about this event, and then we asked them to reflect on this emotions. How, how did it make them feel just by recalling this event and in the anticipation condition, the instruction was more or less the same that we asked them. Okay, just imagine that you're doing the same activity in the, next, next one week and see how it makes you feel.

21:54 - And in the in moment condition, we, we showed them a clip from a movie called The Mighty Duck, in 1991. well, I haven't watched that either. I just want, I just only watched because, I wanted to find, I wanted to find out about the stimuli. So we are in debt to care in Coman work. They did a, fantastic review on this clip and then what sort of emotions it can induce.

22:23 - So we, we agreed that it can induce, positive emotions. So in the moment conditions, we asked participant to watch the clip and then write about the emotions and reflect on the emotions. Okay? So this study, we were really hopeful that we could do something with this study. And then Covid hit, so we have to wrap up the study and then, finalize it. So these are, these are the four studies.

22:51 - It's challenging to find, it's challenging to tell what is the most interesting findings. All, they didn't ask me what is the most interesting funding. So to me, the most interesting funding is in the study one, we found that the mental health literacy level was lower in Bangladeshi participants than Austrian participated, even after we controlled the effect of lived experience. So we've been getting big on lived experience now both in UK and Australia.

23:20 - Likewise, we are, we are focusing on, consumer's idea of the lived experience. Like, previously what we thought, okay, we use such a, we we can determine what sort of treatment that could be helpful for any participants. Nowadays we listening more and more to this lived experience. So that's why we include the lived experience there. And we found out that if we, even if we control the lived experience,

23:45 - in Bangladesh, the participants had lower mental health literacy. And what is interesting here is in Bangladesh, they could, they could acknowledge this is the mental health symptoms, but they couldn't name it. Okay? So we could argue what's in the name. and the literature is divided here. Some researcher are good that it, there's everything in the name. If you could name it, you could name it.

24:13 - And some researcher said, no, it doesn't matter. As long as you can recognize it's the symptoms, it should be fine. So that's, that is a ma one of the major findings from the mental health literacy study. And also in mental health literacy study, we found out that, the Bangladeshi participants, they, they prefer online therapy more than Austrian participant. it could be due to the accessibility issue. And in the study too, what we found the reprisal,

24:45 - that is a common form of emission regulation strategy reprisal. So reprisal was more effective in austral context than context. and in, in the study form in savoring and wellbeing, what we found the, for the premium study is we found that the resing space savoring was more effective in increasing momentary happiness than any other two forms of savoring.

25:14 - and we are good from theoretical perspective, it is easier because when you have a memory and you can re retract this memory, it can be more, it is more concrete in your imagination rather than prospecting. And there are different studies register that we are not that right in prospecting. So we often assume this thing will make us happier, but it doesn't. So I'm still continuing on starting

25:44 - with disabling and wellbeing. I have a lab with undergrad researchers. Were still continu continuing this study. So the study three, we found that, that, again, the reappraisal, if you apply the appraisal, it is helpful for you in terms of effective dynamics. That means you don't stay in one stage or you don't, it, it can help you to move on from the inertia, English, Russia. So the future research we're, we continue with the safe

26:13 - and wellbeing studies in Australian population. So we tweaked the experiment a little bit. So now in our current experiment, we added a control group with the three conditions, the three suffering conditions. In this control group, we asked participants to recall their morning routine. Routine. And we assume that it's a neutral condition because recalling morning routine, it can be neither positive or neither negative, or even if it is positive or negative, it'll balance out eventually

26:46 - because we're not asking to recall anything positive or negative per se. So that is, we are, we continue with the savoring and wellbeing studies. that is the future research we're doing. And we are also interested to understand whether the savoring has any buffering effect against stress and depression. So the, me and one of my other students we're,

27:10 - we're contacting another study to understand if we prime participant to feel sad inside the lab, and then we induce severing and then to check. And then we we're interested to understand whether it can help them to bounce back from the sadness, whether it has some sort of buffering effect. in, in current time, we do spend a lot of time to understand that the treatment of depression and whether we can

27:44 - only target with a 'cause. In so far in depression, we only target the negative emotion to reduce the intensity of sadness. And there has been some studies coming out. It's talked about the positive affect you, so whether we can enhance positive affect and it can have a, have any impact on the negative effect. So this is the feature of studies we're doing. And my takeaway message is,

28:14 - I think culture is still important. It, it can influence, in many different ways. And perhaps we all are ever in Australia, in the uk and in many of those western countries, the society has become increasingly multicultural. So when we, when, when you talk about, the importance of mental health treatment and assessment, I'm not only talking about, some cultures there in far land, it's happening right now, right here in in, in any of the societies that we live in.

28:50 - So if we can capture this culture and nuances in our treatment and assessment of mental health disorders, we, we can reduce the burden.

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