Conceptualising and Measuring Mental Fitness: A Multifactorial Approach by Paula Lesley Robinson

University of Wollongong Research Online University of Wollongong Thesis Collection University of Wollongong Thesis Collections 1954-2016 2014 Conceptualising and measuring mental fitness Paula Lesley Robinson University of Wollongong Follow this and additional works at: https://ro.au/theses University of Wollongong Copyright Warning You may print or download ONE copy of this document for the purpose of your own research or study. The University does not authorise you to copy, communicate or otherwise make available electronically to any other person any copyright material contained on this site. You are reminded of the following: This work is copyright. Apart from any use permitted under the Copyright Act 1968, no part of this work may be reproduced by any process, nor may any other exclusive right be exercised, without the permission of the author.

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Unless otherwise indicated, the views expressed in this thesis are those of the author and do not necessarily represent the views of the University of Wollongong. Recommended Citation Robinson, Paula Lesley, Conceptualising and measuring mental fitness, Doctor of Philosophy thesis, Department of Psychology, University of Wollongong, 2014.au/theses/4269 Research Online is the open access institutional repository for the University of Wollongong. For further information contact the UOW Library: research-pubs@uow.au Running Head: CONCEPTUALISING AND MEASURING MENTAL FITNESS 1 CONCEPTUALISING AND MEASURING MENTAL FITNESS A thesis submitted in fulfilment of the requirements for the award of the degree DOCTOR OF PHILOSOPHY from UNIVERSITY OF WOLLONGONG by Paula Lesley Robinson B Sc (Hons) Department of Psychology 2014 CONCEPTUALISING AND MEASURING MENTAL FITNESS 2 DECLARATION I, Paula Lesley Robinson, declare that this thesis, submitted in fulfilment of the requirements of the award of Doctor of Philosophy, in the Department of Psychology, University of Wollongong, is wholly my work unless otherwise referenced or acknowledged. The document has not been submitted for qualifications in any other academic institution.

CONCEPTUALISING AND MEASURING MENTAL FITNESS 3 TABLE OF CONTENTS DECLARATION. 2 TABLE OF CONTENTS. 3 LIST OF TABLES. 5 LIST OF FIGURES.

7 CITATIONS FOR PAPERS SUBMITTED FOR PUBLICATION. 12 Specific aims of the dissertation. 12 Mental fitness analogous to physical fitness. 16 Mental illness prevention – a proactive approach.

24 Structure of the Dissertation. 25 CHAPTER 2 – CONCEPTUAL REVIEW: CONCEPTUALISING MENTAL FITNESS. 29 Historical roots of the term fitness. 32 Contemporary meaning and use of the term fitness.

34 Literature review summary. Error! Bookmark not defined. Error! Bookmark not defined. Intentional activities aligned to mental fitness.

44 Mental fitness resources and skills. 45 What is (and is not) mental fitness?. 57 Guiding principles for mental fitness. 58 Defining mental fitness.

61 Where to from here?. 61 CHAPTER 3 – CONCEPTUALISING & MEASURING MENTAL FITNESS: A DELPHI STUDY. 63 CONCEPTUALISING AND MEASURING MENTAL FITNESS 4 Method. 89 CHAPTER 4 - A MULTIFACTORIAL MODEL OF MENTAL FITNESS.

117 CHAPTER 5 – DISCUSSION & CONCLUSIONS. Error! Bookmark not defined. Conceptual Review – Conceptualising mental fitness. Error! Bookmark not defined.

Study 1 – Conceptualising and measuring mental fitness: a Delphi study Error! Bookmark not defined. Study 2 – A multifactorial model of mental fitness. Error! Bookmark not defined. Error! Bookmark not defined.

Error! Bookmark not defined. 166 Appendix 1: Examples of Google searches: fitness, physical fitness, mental fitness, mental + physical fitness. 167 Appendix 2: PsycInfo Literature Search. 177 Appendix 3: Summary of Delphi Study Expert Panel Criteria.

191 Appendix 4: Delphi Study Round 1. 194 Appendix 5: Delphi Study Round 2. 205 Appendix 6: Mental Fitness Participant Questionnaire. 227 Appendix 7: Item Content for each Factor…………………………………………….

286 CONCEPTUALISING AND MEASURING MENTAL FITNESS 5 LIST OF TABLES Table 1: Examples of historical roots of the word ‘fit’ and its derivatives. 33 Table 2: Google’s Primary Categories for Mental Fitness (Sept, 2013). 36 Table 3: Examples of the meaning and use of mental fitness from PsycInfo 1879 – 2013. 38 Table 4: Conceptual example of a mental fitness resource index.

48 Table 5: Descriptive Statistics. 79 Table 6: Qualitative Respons es for Definition. 81 Table 7: Qualitative Responses for Principle 1. 83 Table 8: Qualitative Responses for Principle 2.

84 Table 9: Qualitative Responses for Principle 3. 85 Table 10: Qualitative Responses for Principle 4. 87 Table 11: Summary of measures. 102 Table 12: Factor Loadings based on a principal component analysis Promax with Kaiser normalization.

109 Table 13: Observed Correlations of Estimates Between Factors. 115 CONCEPTUALISING AND MEASURING MENTAL FITNESS 6 LIST OF FIGURES Figure 1: Approximate percentage breakdown for chronic happiness level. 45 Figure 2: Delphi Study Method Summary Flow Chart. Error! Bookmark not defined.

Figure 3: Example Question. 75 Figure 4: 4-factor Structure. 112 Figure 5: Results from CFA displaying Structural Model. 116 CONCEPTUALISING AND MEASURING MENTAL FITNESS 7 ACKNOWLEDGEMENTS I thank my supervisors, Associate Professor Lindsay Oades and Associate Professor Peter Caputi for allowing me to explore my passion of changing minds and hearts about how to view and engage with mental health.

I thank my family and close friends who have supported me during times of doubt and illness. They have been my rock and without their support, I wouldn’t have been able to complete. I thank my colleagues, staff and interns at Positive Psychology Institute who gave me time, space and practical support. I thank my clients who already believe in the idea of becoming mentally fit.

I thank the students who participated in the data gathering. CONCEPTUALISING AND MEASURING MENTAL FITNESS 8 CITATIONS FOR PAPERS SUBMITTED FOR PUBLICATION Robinson, P. Conceptualising mental fitness. Manuscript submitted for publication.

Conceptualising and measuring mental fitness: a Delphi Study. (2014c) A multifactorial model of mental fitness. Manuscript submitted for publication. CONCEPTUALISING AND MEASURING MENTAL FITNESS 9 Abstract Despite the increasing use of the term mental fitness, there are no consistent theoretical foundations, models or reliable and valid measures to use in research and practice.

By using the adjective ‘mental’ prior to fitness, mental fitness can be seen as analogous to physical fitness. Physical fitness is a better known domain and it can be used to enable people to grasp potential meanings of mental fitness. To commence the process of defining and measuring mental fitness, a conceptual review and two studies were conducted. The purpose of the conceptual review was to explore the historical, popular and scientific meaning and use of the term mental fitness and how it could be utilised within psychology.

The review provided evidence to formulate an initial definition of mental fitness and a set of four guiding principles. Further, this review suggested an example of a resource index containing existing, published psychological theories and variables that are associated to positive mental health outcomes. This example resource index was proposed within a framework based on the physical fitness analogy of strength, endurance and flexibility. Following on from the conceptual review, a Delphi study was conducted to engage an international expert panel (n = 25) to evaluate the proposed definition and four guiding principles of mental fitness, expert consensus was achieved.

Results provided an updated definition of mental fitness as being “the modifiable capacity to utilise resources and skills to flexibly adapt to challenges or advantages, enabling thriving”. Results for the four guiding principles were (1) fitness is a positive term without connotations of illness implied by mental health or mental illness; (2) mental fitness could be understood by the wider community in a similar way to physical fitness; (3) mental fitness is measurable; and (4) mental fitness can be improved, in a similar way to physical fitness. The panel also offered valuable, qualitative input and recommendations for future research and practice. The final study was conducted to provide preliminary empirical support for the concept and CONCEPTUALISING AND MEASURING MENTAL FITNESS 10 measurement of mental fitness.

Exploratory (EFA) and confirmatory (CFA) factor analysis (n = 223) was used to analyse items from a selection of variables drawn from established measures. Results from the EFA identified four factors labelled strength, endurance, flexibility, and team supporting the item content and the physical fitness analogy. Results from the CFA provided preliminary evidence for a multifactorial model of mental fitness and validation for the four factors. Moreover, results provided initial validation for a mental fitness model containing the four factors subsumed by a second order factor of mental fitness.

Limitations and future directions are discussed, as are the broader theoretical and empirical implications of the research. The preliminary findings suggest that the concept and model of mental fitness can provide a new and positive approach to the language and measurement of positive mental health aligned to the physical fitness analogy. This can create a broader understanding that, as in physical fitness, mental fitness requires the practice of intentional activities to create positive habits of mind that lead to higher levels of well-being, optimal functioning and quality of life outcomes. CONCEPTUALISING AND MEASURING MENTAL FITNESS 11 CHAPTER 1 – INTRODUCTION A vision for the future: Listen in on this conversation… “How’s your fitness regime going?” “Right now I’m working on building my biceps and improving my mood”.

“Is it working?” “Yes, my muscles are bigger and my brain is giving me more automatic positive thoughts now, so I have much more energy”. Rationale The overarching objective of this dissertation is to develop the concept of mental fitness to provide a contribution to theory, the development of research propositions and practical interventions. To date the concept of mental fitness has no consistent theoretical foundations, construct validity or standardised measurement to research, replicate or for practitioners’ to apply. The essential premise is that the concept of mental fitness will assist psychologists, mental health professionals, medical practitioners, organisations, the wider community, policy makers and governments meet the challenge of reducing mental illness and improving mental health.

It is proposed that the language of fitness is effective in the mental health context because (a) it utilises language already known and understood and is easy to relate to; (b) it reduces stigma that exists around the concept of mental health; (c) it helps to address the need for more proactive, preventative and holistic approaches to improved mental health that has consumer acceptability; (d) it progresses the idea that a fit mind and body are equally important and need regular, intentional activities and practices to build sustainable habits of mind. It is argued that the concept of mental fitness, offered in a similar framework to physical fitness, can provide a way of explaining positive mental health theory, research and activities in a non-threatening and proactive way so as to increase mental health outcomes. CONCEPTUALISING AND MEASURING MENTAL FITNESS 12 Research Questions To commence this process, the primary research questions for this dissertation are: (1) what is mental fitness and how should it be defined? (2) what are the components of mental fitness? and (3) what are the factors underlying current published measures, that can be used to operationalise mental fitness?