A Positive Psychology Intervention for Patients with an Acute Coronary Syndrome: Treatment Development and Proof-of-Concept Trial

Positive psychological constructs are associated with superior outcomes in cardiac patients, but there has been minimal study of positive psychology (PP) interventions in this population. Our objective was to describe the intervention development and pilot testing of an 8-week phone-based PP intervention for patients following an acute coronary syndrome (ACS). Initial intervention development and single-arm proof-of-concept trial, plus comparison of the PP intervention to a subsequently-recruited treatment as usual (TAU) cohort. PP development utilized existing literature, expert input, and qualitative interview data in ACS patients. In the proof-of-concept trial, the primary outcomes were feasibility and acceptability, measured by rates of exercise completion and participant ratings of exercise ease/utility. Secondary outcomes were pre-post changes in psychological outcomes and TAU comparisons, measured using effect sizes (Cohen’s d). The PP intervention and treatment manual were successfully created. In the proof-of-concept trial, 17/23 PP participants (74 %) completed at least 5 of 8 exercises. Participants rated the ease (M = 7.4/10; SD = 2.1) and utility (M = 8.1/10, SD = 1.6) of PP exercises highly. There were moderate pre-post improvements (ds = .46–.69) in positive affect, anxiety, and depression, but minimal effects on dispositional optimism (d = .08). Compared to TAU participants (n = 22), PP participants demonstrated greater improvements in positive affect, anxiety, and depression (ds = . 47–.71), but not optimism. A PP intervention was feasible, well-accepted, and associated with improvements in most psychological measures among cardiac patients. These results provide support for a larger trial focusing on behavioral outcomes.     

Soldiers’ perspectives of the Married Army Couples Program: A review of perceived problems and proposed solutions

The current study investigated soldiers’ perceptions of the Married Army Couples Program (MACP) using data from focus groups conducted with Army personnel in dual-military marriages. Despite the high success rate of the program (approximately 80–83%)—success being defined as establishment of a joint domicile within a 50-mile radius of each spouse’s duty station—a variety of difficulties were reported as well as consequent negative perceptions. Problems included dissatisfaction with the parameters defining joint domicile, obstacles to career advancement, lack of quality information regarding the program, and unequal allocation depending on one’s level of leadership support. Difficulties with MACP led to negative impressions of the program and of the Army as a whole. Specifically, when asked about challenges related to the program, many participants reported perceptions of a poorly functioning program, an uncaring environment, and of the Army as a hypocritical institution. For individuals in dual-military marriages, these difficulties affect quality of life. For the institution, these negative perceptions can potentially lead to problems with retention of one or both members of a dual-military couple. We propose several strategies to improve the effectiveness of MACP and to increase positive perceptions of the program based on suggestions from the focus groups in addition to the military and work literatures.