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Vol. 5 No. 1 (2025)

April 2025

Psychological distress and indicators of wellbeing using the dual continua model in a rural sample

  • Hannah Cornwell
  • Nicholas Sims-Rhodes
  • Emily Barena
  • Joseph Brewer
  • Anastasia Miller
  • Kimberly Elliott
  • Yordanos M. Tiruneh
  • Karan Singh
  • Sarah Sass

Journal of Happiness and Health, Vol. 5 No. 1 (2025), 6 April 2025 , Page 17-23
https://doi.org/10.47602/johah.v5i1.94 Published: 17.03.2025

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Abstract

A growing body of research provides support for a dual continua model of mental health where psychological distress and wellbeing are separable and related dimensions. This model contrasts with the unipolar model of mental health, which suggests that psychological distress and wellbeing are on opposite ends of the same continuum. The present study expands on the dual continua model of mental health literature within a rural clinical sample. Participants (n = 127) were categorized into 4 groups (higher and lower levels of anxiety and/or depression crossed with high and low levels of life satisfaction) and assessed on wellbeing indicators (gratitude and quality of life). Present results partially supported both the unipolar and dual continua model of mental health models. Specifically, consistent with the dual continua model of mental health, higher levels of psychological distress were not uniformly associated with lower levels of gratitude or quality of life, and conversely, lower levels of distress were not uniformly associated with higher levels of gratitude or quality of life. Consistent with the dual continua model of mental health and unipolar models of mental health, the low distress and high life satisfaction group reported higher levels of both gratitude and quality of life. Results extend the dual continua model of mental health literature in a rural, treatment-seeking sample. The results suggest wellbeing measures should be included when assessing and treating psychological distress in order to holistically treat the individual.

Keywords:
  • Dual Continua Model of Mental Health
  • Psychological Distress
  • Satisfaction with Life
  • Quality of Life
  • Gratitude
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How to Cite

Cornwell, H., Sims-Rhodes, N., Barena, E., Brewer, J., Miller, A., Elliott, K., Tiruneh, Y., Singh, K., & Sass, S. (2025). Psychological distress and indicators of wellbeing using the dual continua model in a rural sample. Journal of Happiness and Health, 5(1), 17–23. https://doi.org/10.47602/johah.v5i1.94
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References

Adler, M. G., & Fagley, N. S. (2005). Appreciation: Individual Differences in Finding Value and Meaning as a Unique Predictor of Subjective Well-Being. Journal of Personality, 73(1), 79–114. https://doi.org/10.1111/j.1467-6494.2004.00305.x

Armenta, C. N., Fritz M. M., Walsh, L. C., & Lyubomirsky, S. (2022). Satisfied yet striving: Gratitude fosters life satisfaction and improvement. Motivation in Youth. Emotion, 22(5). DOI: 10.1037/emo0000896

Arslan, G., & Allen, K.-A. (2020). Complete mental health in elementary school children: Understanding youth school functioning and adjustment. Current Psychology. https://doi.org/10.1007/s12144-020-00628-0

Beck, A. T., Epstein, N., Brown, G., & Steer, R. A. (1988). An inventory for measuring clinical anxiety: Psychometric properties. Journal of Consulting and Clinical Psychology,56(6), 893–897. https://doi.org/10.1037//0022006x.56.6.893Beck,

A. T., Brown, G. K., & Steer, R. A. (1996). Beck Depression Inventory-II (BDI-II): Technical manual. Pearson.

Boggiss, A. L., Consedine, N. S., Brenton-Peters, J. M., Hofman, P. L., & Serlachius, A. S. (2020). A systematic review of gratitude interventions: Effects on physical health and health behaviors. Journal of Psychosomatic Research, 135, 110165. https://doi.org/10.1016/j.jpsychores.2020.110165

Burckhardt C. S., & Anderson K. L. (2003). The Quality of Life Scale (QOLS): reliability, validity, and utilization. Health Qual Life Outcomes. 1(60). doi: 10.1186/1477-7525-1-60.

Bhullar, N., Surman, G., & Schutte, N. S. (2015). Dispositional gratitude mediates the relationship between a past-positive temporal frame and well-being. Personality and Individual Differences, 76, 52–55. https://doi.org/10.1016/j.paid.2014.11.025

Carver, K., Ismail, H., Reed, C., Hayes, J., Alsaif, H., Villanueva, M., & Sass, S. M. (2021). High levels of anxiety and psychological well-being in college students: A dual factor model of mental health approach. Journal of Positive School Psychology, 5(1), 32-41. https://doi.org/10.47602/jpsp.v5i1.242

Crouch, T. A., Verdi, E. K., & Erickson, T. M. (2020) Gratitude is Positively Associated With Quality of Life in Multiple Sclerosis. Rehabilitation Psychology, 65(3), 231-238. http://dx.doi.org/10.1037/rep0000319

Cuijpers, P., Smits, N., Donker, T., ten Have, M., & de Graaf, R. (2009). Screening for mood and anxiety disorders with the five-item, the three-item, and the two-item mental health inventory. Psychiatry Research 168(3) 250–255. https://doi.org/10.1016/j.psychres.2008.05.012

Diener, E., Emmons, R. A., Larsen, R. J., & Griffin, S. (1985). The Satisfaction with Life Scale.Journal of Personality Assessment, 49(1), 71–75. https://doi.org/10.1207/s15327752jpa4901_13

Diniz, G., Korkes, L., Tristão, L. S., Pelegrini, R., Bellodi, P. L., & Bernardo, W. M. (2023). The effects of gratitude interventions: a systematic review and meta-analysis. Einstein (Sao Paulo, Brazil), 21, eRW0371. https://doi.org/10.31744/einstein_journal/2023RW0371

Douthit, N., Kiv, S., Dwolatzky, T., & Biswas, S., (2015). Exposing some important barriers to healthcare access in the rural USA. Public Health, 129(6), 611-620. https://doi.org/10.1016/j.puhe.2015.04.001

Eaton, R. J., Bradley, G., & Morrissey, S. (2014). Positive predispositions, quality of life and chronic illness. Psychology, Health & Medicine, 19(4), 473-489. http://dx.doi.org/10.1080/13548506.2013.824593

Eklund, K., Dowdy, E., Jones, C, & Furlong, M. (2011). Applicability of the dual-factor model of mental health for college students. Journal of College Student Psychotherapy, 25(1), 79-92. https://doi.org/10.1080/87568225.2011.532677

Franken, K. Lamers, S. M. A., Ten Klooster, P. M., Bohlmeijer, E. T., & Westerhof, G. J. (2018). Validation of the Mental Health Continuum-Short Form and the dual continua model of well-being and psychopathology in an adult mental health setting. Journal of Clinical Psychology 78, 2187-2202. https://doi.org/10.1002/jclp.22659

Galanakis, M., Lakioti, A., Pezirkianidis, C., Karakasidou, E., & Stalikas, A. (2017). Reliability and validity of the Satisfaction with Life Scale (SWLS) in a Greek sample. The Intenational Journal of Humanities & Social Studies 5(2), 120-127.

Gamm, L., Stone, S., & Pittman, S. (2010). Mental health and mental disorders—a rural challenge: A literature review. Rural Healthy People, 2010, 97–114.

Hill, P. L., Allemand, M., & Roberts, B. W. (2013). Examining the pathways between gratitude and self-rated physical health across adulthood. Personality and Individual Differences 54, 92-96. http://dx.doi.org/10.1016/j.paid.2012.08.011

Kardas F., Cam, Z., Eskisu, M., & Gelibolu, S. (2019). Gratitude, Hope, Optimism and Life Satisfaction as Predictors of Psychological Well-Being. Eurasian Journal of Educational Research, 82, 81-100. DOI: 10.14689/ejer.2019.82.5

Kennedy, B., Sims-Rhodes, N., Avendano, J., Mathew, J., O’Brien, K., Chek, C., & Sass, S. M. (2023). Resilience, mindfulness, anxiety, and depression within a dual-continua model of mental health approach. Journal of Happiness and Health, 4(1), 11–18. https://doi.org/10.47602/johah.v4i1.54

Kerry, N., Chhabra, R., & Clifton, J. D., (2023) Being Thankful for What You Have: A Systematic Review of Evidence for the Effect of Gratitude on Life Satisfaction. Psychology Research and behavior Management 16, 44799-4816. https://doi.org/10.2147/PRBM.S372432

Keyes, C. L. M. (2005). Mental illness and/or mental health? Investigating axioms of the complete state model of mental health. Journal of Consulting and Clinical Psychology, 73(3), 539-548. https://doi.org/10.1037/0022-006X.73.3.539

Keyes, C. L. M. (2007). Promoting and protecting mental health as flourishing: A complementary strategy for improving national mental health. American Psychologist, 62(2), 95-108. https://doi.org/10.1037/0003-066X.62.2.95

Kirby, L., Zolkoski, S., O’Brien, K., Mathew, J., Kennedy, B., & Sass, S. (2022). Examining staff and faculty work–life balance and well-being using the dual continua model of mental health during COVID-19. Journal of Happiness and Health, 3(1), 34–48. https://doi.org/10.47602/johah.v3i1.31

Komiti, A., Judd, F., & Jackson, H. (2006). The influence of stigma and attitudes on seeking help from a GP for mental health problems: a rural context. Social psychiatry and psychiatric epidemiology, 41, 738-745. DOI: 10.1007/s00127-006-0089-4

Kroenke, K., Spitzer, R. L., & Williams, J. B., (2001). The PHQ-9: validity of a brief depression severity measure. Journal of General Internal Medicine 16(9), 606-613. doi: 10.1046/j.1525-1497.2001.016009606.x

Maddux, J. E. (2018). Subjective well-being and life satisfaction: An introduction to conceptions, theories, and measures. Routledge/Taylor & Francis Group. https://doi.org/10.4324/9781351231879-1

McCullough, M. E., Emmons, R. A., & Tsang, J. (2002). The Grateful Disposition: A conceptual and Empirical Topography. Journal of Personality and Social Psychology, 82, 112-127. doi:10.1037/0022-3514.82.1.112

Mills, P. J., Redwine, L., & Chopra, D. (2015). A grateful Heart May Be a Healthier Heart. Spirituality in Clinical Practice, 2(1), 23-24. http://dx.doi.org/10.1037/scp0000063

Nehme E, Schuessler K, Alvarado C, Elerian N, Miyakado H, Mandell D, Lakey D. (2021). The Health Status of Northeast Texas, 2021. Tyler, TX: The University of Texas at Tyler/University of Texas System Population Health.

Nguyen A.T., Trout K.E., Chen L-W., Madison L., Watkins K.L., Watanabe-Galloway S. (2016). Nebraska’s rural behavioral healthcare workforce distribution and relationship between supply and county characteristics. Rural and Remote Health 16: 3645

Pavot, W., & Diener, E. (2008). The Satisfaction With Life Scale and the emerging construct of life satisfaction. The Journal of Positive Psychology, 3(2) 137-152. DOI:10.1080/17439760701756946

Pavot W., & Diener, E. (1993). Review of the Satisfaction with Life Scale. Psychological Assessment 5(2) 164-172. doi: 10.1207/s15327752jpa4901_13

Renshaw, T. L., & Cohen, A. S. (2014). Life satisfaction as a distinguishing indicator of college student functioning: Further validation of the two-continua model of mental health. Social Indicators Research, 117(1), 319–334.https://doi.org/10.1007/s11205-013-0342-7

Ryff, C. D. (2013). Psychological Well-Being Revisited: Advances in the Science and Practice of Eudaimonia. Psychiatry and Psychology 83(1) 10-28. https://doi.org/10.1159/000353263

Savitz, D. A., & Wellenius, G. A., (2023). Can Cross-Sectional Studies Contribute to Causal Inference? It Depends. American Journal of Epidemiology 192(4) 514-516. doi: 10.1093/aje/kwac037

Spitzer, R. L., Kroenke, K., Williams, J. B., & Löwe, B. (2006). A brief measure for assessing generalized anxiety disorder: the GAD-7. Archives of internal medicine, 166(10), 1092–1097. https://doi.org/10.1001/archinte.166.10.1092

Szczesniak M., & Soares, E. (2011). Are proneness to forgive, optimism and gratitude associated with life satisfaction? Polish Psychological Bulletin, 42(1), 20-23. Doi: 10.2478/v10059-011-0004-z

Teoli D, & Bhardwaj A. (2023). Quality of Life. StatPearls Publishing.

Terry, D. L., & Terry, C. P. (2019). Addressing mental health concerns in primary care: practices among medical residents in a rural setting. Journal of Clinical Psychological Medicine, 26(4), 395-401. Doi:10.1007/s10880-019-09609-3

Valikhani, A., Ahmadnia, F., Karimi, A., & Mills, P. J. (2019). The relationship between dispositional gratitude and quality of life: The mediating role of perceived stress and mental health. Personality and Individual Differences, 141, 40-46. https://doi.org/10.1016/j.paid.2018.12.014

Wong, H., Moore, K., Angstman, K. B., & Garrison, G. M. (2019). Impact of rural address and distance from clinic on depression outcomes within a primary care medical home practice. BMC Family Practice, 20, 1-8. DOI: 10.1186/s12875-019-1015-7

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Journal of Happiness and Health (JOHAH) is a peer-reviewed journal covering happiness and provides an international forum for the science of happiness and health. The JOHAH, which is published two times a year, is an open-access that publishes research outcomes with significant contributions to the understanding and improvement of happiness and health and publishes research regarding the happiness of populations across the life span

Journal of Happiness and Health is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.