Mental health literacy, emotion regulation and psychological wellbeing: an exploration in Australian and Bangladeshi adults
Common Mental Health Disorders (CMHD) consist of anxiety and depression (including active suicidal ideation), which are primary causes for disability worldwide. However, the uptake of mental health services for CMHDs has been lower than the prevalence rates. Low Mental Health Literacy (MHL) is identified as one of the common reasons for treatment-seeking delays. There is a notable paucity of cross-cultural studies which have evaluated MHL between samples living in different countries. Furthermore, Emotion Regulation (ER) is found as a risk factor for the onset and maintenance of CMHD. Most ER studies have been conducted in Western countries focusing on strategies used to downregulate negative emotions. Four related studies were conducted in two phases by recruiting adult residents residing in Australia and Bangladesh. The findings from the first study showed that overall, culture influenced the accuracy in labelling as Bangladeshi residents reported lower levels of MHL accuracy of depressive and specific anxiety-related symptoms than Australian residents. Nevertheless, the effect of culture was not that pronounced in other MHL domain. Such as, there were no significant cross-cultural differences related to help-seeking intentions. In the second study, associations between interpersonal and intrapersonal emotion regulation strategies and psychopathology were assessed. As predicted, suppression frequency was higher in the Bangladeshi participants, but rumination frequency did not differ between Australian and Bangladeshi participants. Moreover, reappraisal was negatively associated with anxiety and depression severity, only in Australian participants. For the most part, reappraisal showed an opposite effect in Bangladeshi participants. The results from the third study showed that anxiety was characterised by unstable negative affect, while average negative mood was the strongest predictor of depression in an Australian sample. Suppression also had a stronger association with average negative affect than affective instability. Hence, suppression was strongly associated with depression severity. Phase 1 of this program of research focused primarily on the downregulation of negative emotion and its association with psychopathology caseness and symptoms. The second phase of this study aimed to investigate the effect of savouring on enhancing positive affect and reducing negative affect. Savouring was induced through anticipating a future event, focusing on a current event, and reminiscing a past event. As hypothesised, no significant group differences were found regarding positive or negative changes from baseline assessments. Nonetheless, the reminiscent condition reported significant reductions in negative affect. The findings from this program of research suggest that there are some distinct cultural variations in MHL, including ER strategy use between Australian and Bangladeshi adults. The findings from the latter two studies showed that anxiety and depression were deferentially associated with affective dynamics metrics and emotion regulation strategies. Finally, savouring practice through anticipating and reminiscing hedonic and eudaimonic experiences and focusing on a non-personal event in the present may be equally beneficial to strengthen positive affectivity in non-clinical samples. The outcomes of this research program showed MHL could be an important tool to address treatment access barriers in both in Bangladesh and Australia. Savouring based wellbeing interventions may also be useful in increasing subjective wellbeing.