Skip to main content
. 2020 Jul 20;2020(7):CD013684. doi: 10.1002/14651858.CD013684

Gerson 2013 (study 2).

Methods Study design:RCT
Study grouping: parallel group
Unit of randomisation: individuals
Power (power & sample size calculation, level of power achieved): Although power with a sample of 63 approached a moderate level for a multiple linear regression analysis with 3 predictors (f2 = .70), it was still low for an analysis of covariance (f = .50), so caution should be used in interpreting findings
Imputation of missing data: not specified; form of per‐protocol analysis (only participants who took part in treatment in general; participants who only attended 1st session were also considered)
Participants Country: USA
Setting: university, psychology lab
Age: mean = 21.58 (SD = 3.88); range = 17 ‐ 50 years
Sample size (randomised): not exactly specified; 63 finally analysed; probably 73 randomised
Sex: 52 women, 12 men
Comorbidity (mean (SD) of respective measures in indicated, if available) at baseline: depressive symptoms at baseline not specified
Population description: undergraduates
Inclusion criteria: not specified
Exclusion criteria: not specified
Attrition (withdrawals and exclusions): 9 dropouts (IG: 5, CG: 4); 1 exclusion (IG)
Reasons for missing data: not specified
Interventions Intervention: Program for Accelerated Thriving and Health (PATH) (n = 36)
  • delivery: face‐to‐face; group sessions (3 ‐ 7 participants); PowerPoint slides, handouts, discussion sessions

  • providers: group leaders selected for their interest in participating in a psychology research team; 6 student research assistants led the groups (4 seniors, 1 junior, 1 beginning student in psychology master’s programme); importance of maintaining consistency across groups and conditions emphasised

  • duration of treatment period and timing: 3 x 30‐ to 50‐minute sessions spaced over 5‐ to 6‐day period

  • description:

    • focus on teaching undergraduates an adaptive explanatory style in order to promote thriving and resilience; sessions similar in form and content to Gerson 2013 (study 1)

    • several slides modified or condensed to emphasise application of explanatory style to coping with stressful experiences by using a combination of personal control style and positive mindset

    • 3 dimensions of explanatory style translated into 3‐step process, beginning with focus on decreasing perceived globality (step 1: getting perspective by seeing event as specific and limited), followed by increasing unstable (temporary), internal attributions (step 2: considering what changeable aspects of one’s self or behaviours may have been to blame or could be changed for the future) and ending with decreasing perceived stability (permanence) in general (step 3: realising that bad things do not last forever, so it is important to know when to “Let go”); participants encouraged in Step 2 to consider anything they could do differently for the future, but to realise when there was nothing more they could do; Step 3 described as important because some experiences are not within one’s control and could not have been prevented

    • SESSION 1:

      • introduction of globality, internality, stability and summary of the 3‐step process

      • participants can jot down any questions for the leader to address at the next session

      • participants encouraged to think about applications of 3 steps to their own experiences before next session

    • SESSION 2:

      • review of 3‐step process

      • discussion of HANDOUT 1: asks participants to describe a stressful experience, rate how upsetting it had been, and note how they have responded to it, to analyse their response in terms of globality, internality, and perceptions of permanence/changeability, to indicate how they have felt about the experience, to describe a pessimistic way of explaining the experience; and finally, to re‐analyse the experience by applying the 3 steps, volunteers share their response and group leaders guide discussions using response key

      • after handout: illustration of self‐perpetuating cycle of hopelessness and review of the 3‐step process

      • HANDOUT 2: presents 7 brief scenarios of various explanatory styles for negative events; participants instructed to analyse each scenario in terms of uses of globality, internality, and perceived permanence and then to offer an optimally‐constructive response; group leaders again guide discussion with assistance of response key

      • end of Session 2 with questions of participant to leader for next session

    • SESSION 3: only discussion of participants’ questions and review of 3‐step process

  • compliance: 5 dropouts between pretest and first group meeting, 4 only attended 1st meeting

  • integrity of delivery: not specified

  • economic information: not specified

  • theoretical basis: literature on optimism and optimistic style; concept of thriving; expectations of the adaptiveness of optimistic and personal control explanatory styles formed the basis for the programme’s content


Control: attention control (equivalent in every way to IG except for content; n = 37)
  • delivery: face‐to‐face; group sessions (2 ‐ 7 participants with exception of 2 single‐member groups); PowerPoint slides, handouts, discussion sessions

  • providers: group leaders selected for their interest in participating in a psychology research team; 6 student research assistants led the groups (4 seniors, 1 junior, 1 beginning student in psychology master’s programme); importance of maintaining consistency across groups and conditions emphasised

  • duration of treatment period and timing: 3 x 30‐ to 50‐minute sessions spaced over 5‐ to 6‐day period

  • description:

    • differs from IG only in content

    • following topics addressed: nature of stress, nature of stressors, variations in the impact of stressors, stress‐related disorders, diathesis‐stress hypothesis, mind–body connection, stressor–stress connection, 3 phases of the stress response, response, the anxiety and performance curve, the benefits of moderate arousal, and the positive consequences of the resistance phase

    • HANDOUT 1: 7 scenarios for analysis in terms of stages of the stress response

    • HANDOUT 2: asks participants to describe some stressors in their lives, to rate the intensity of the stressors, and to analyse them in terms of the 3 stages of the stress response and/or the anxiety and performance curve

  • compliance: 4 dropouts between pretest and first group meeting, 3 only attended 1st meeting

  • integrity of delivery: not specified

  • economic information: not specified

  • theoretical basis: not specified

Outcomes Outcomes collected and reported:
  • thriving/resilience ‐ CD‐RISC‐10

  • optimism/optimistic explanatory style ‐ ASQ (only at post‐intervention)

  • personal control explanatory style ‐ ASQ

  • depression ‐ BDI‐II


Time points measured and reported: 1) pre‐intervention; 2) post‐intervention
Adverse events: not specified
Notes Contact with authors: We contacted the authors for the number of participants randomised (N = 73?) in total and to each group as well as for the means and SDs for the outcomes in both groups at each time point (Gerson 2018a [pers comm]). In a second inquiry, we also asked if healthcare students were included in the sample and whether subgroup data could be provided, but received no response
Study start/end date: not specified (held at start of new school year)
Funding source: supported in part by a Summer Undergraduate Research Fellowship provided by the Office for Undergraduate Research of California Lutheran University
Declaration of interest: not specified
Ethical approval needed/obtained for study: approved by the university’s IRB
Comments by study authors: not relevant
Report ID (e.g. duplicate publications, follow‐up studies): not relevant
Miscellaneous outcomes by the review authors: means, SDs and sample sizes for both groups at pre‐ and posttest for resilience and depression provided by authors; unclear if psychology students were included in the study
Correspondence: Marylie W. Gerson; Department of Psychology, California Lutheran University, 60 W. Olsen Road, mail code 3800, Thousand Oaks, CA 91360, USA; mgerson@callutheran.edu