essay on reading and mental health

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Mental Health Essay

Introduction

Mental health, often overshadowed by its physical counterpart, is an intricate and essential aspect of human existence. It envelops our emotions, psychological state, and social well-being, shaping our thoughts, behaviors, and interactions. With the complexities of modern life—constant connectivity, societal pressures, personal expectations, and the frenzied pace of technological advancements—mental well-being has become increasingly paramount. Historically, conversations around this topic have been hushed, shrouded in stigma and misunderstanding. However, as the curtains of misconception slowly lift, we find ourselves in an era where discussions about mental health are not only welcomed but are also seen as vital. Recognizing and addressing the nuances of our mental state is not merely about managing disorders; it's about understanding the essence of who we are, how we process the world around us, and how we navigate the myriad challenges thrown our way. This essay aims to delve deep into the realm of mental health, shedding light on its importance, the potential consequences of neglect, and the spectrum of mental disorders that many face in silence.

Importance of Mental Health

Mental health plays a pivotal role in determining how individuals think, feel, and act. It influences our decision-making processes, stress management techniques, interpersonal relationships, and even our physical health. A well-tuned mental state boosts productivity, creativity, and the intrinsic sense of self-worth, laying the groundwork for a fulfilling life.

Negative Impact of Mental Health

Neglecting mental health, on the other hand, can lead to severe consequences. Reduced productivity, strained relationships, substance abuse, physical health issues like heart diseases, and even reduced life expectancy are just some of the repercussions of poor mental health. It not only affects the individual in question but also has a ripple effect on their community, workplace, and family.

Mental Disorders: Types and Prevalence

Mental disorders are varied and can range from anxiety and mood disorders like depression and bipolar disorder to more severe conditions such as schizophrenia.

• Depression: Characterized by persistent sadness, lack of interest in activities, and fatigue.
• Anxiety Disorders: Encompass conditions like generalized anxiety disorder, panic attacks, and specific phobias.
• Schizophrenia: A complex disorder affecting a person's ability to think, feel, and behave clearly.

The prevalence of these disorders has been on the rise, underscoring the need for comprehensive mental health initiatives and awareness campaigns.

Understanding Mental Health and Its Importance

Mental health is not merely the absence of disorders but encompasses emotional, psychological, and social well-being. Recognizing the signs of deteriorating mental health, like prolonged sadness, extreme mood fluctuations, or social withdrawal, is crucial. Understanding stems from awareness and education. Societal stigmas surrounding mental health have often deterred individuals from seeking help. Breaking these barriers, fostering open conversations, and ensuring access to mental health care are imperative steps.

Conclusion: Mental Health

Mental health, undeniably, is as significant as physical health, if not more. In an era where the stressors are myriad, from societal pressures to personal challenges, mental resilience and well-being are essential. Investing time and resources into mental health initiatives, and more importantly, nurturing a society that understands, respects, and prioritizes mental health is the need of the hour.

• World Leaders: Several influential personalities, from celebrities to sports stars, have openly discussed their mental health challenges, shedding light on the universality of these issues and the importance of addressing them.
• Workplaces: Progressive organizations are now incorporating mental health programs, recognizing the tangible benefits of a mentally healthy workforce, from increased productivity to enhanced creativity.
• Educational Institutions: Schools and colleges, witnessing the effects of stress and other mental health issues on students, are increasingly integrating counseling services and mental health education in their curriculum.

In weaving through the intricate tapestry of mental health, it becomes evident that it's an area that requires collective attention, understanding, and action.

  Short Essay about Mental Health

Mental health, an integral facet of human well-being, shapes our emotions, decisions, and daily interactions. Just as one would care for a sprained ankle or a fever, our minds too require attention and nurture. In today's bustling world, mental well-being is often put on the back burner, overshadowed by the immediate demands of life. Yet, its impact is pervasive, influencing our productivity, relationships, and overall quality of life.

Sadly, mental health issues have long been stigmatized, seen as a sign of weakness or dismissed as mere mood swings. However, they are as real and significant as any physical ailment. From anxiety to depression, these disorders have touched countless lives, often in silence due to societal taboos.

But change is on the horizon. As awareness grows, conversations are shifting from hushed whispers to open discussions, fostering understanding and support. Institutions, workplaces, and communities are increasingly acknowledging the importance of mental health, implementing programs, and offering resources.

In conclusion, mental health is not a peripheral concern but a central one, crucial to our holistic well-being. It's high time we prioritize it, eliminating stigma and fostering an environment where everyone feels supported in their mental health journey.

Frequently Asked Questions

• What is the primary focus of a mental health essay?

Answer: The primary focus of a mental health essay is to delve into the intricacies of mental well-being, its significance in our daily lives, the various challenges people face, and the broader societal implications. It aims to shed light on both the psychological and emotional aspects of mental health, often emphasizing the importance of understanding, empathy, and proactive care.

• How can writing an essay on mental health help raise awareness about its importance?

Answer: Writing an essay on mental health can effectively articulate the nuances and complexities of the topic, making it more accessible to a wider audience. By presenting facts, personal anecdotes, and research, the essay can demystify misconceptions, highlight the prevalence of mental health issues, and underscore the need for destigmatizing discussions around it. An impactful essay can ignite conversations, inspire action, and contribute to a more informed and empathetic society.

• What are some common topics covered in a mental health essay?

Answer: Common topics in a mental health essay might include the definition and importance of mental health, the connection between mental and physical well-being, various mental disorders and their symptoms, societal stigmas and misconceptions, the impact of modern life on mental health, and the significance of therapy and counseling. It may also delve into personal experiences, case studies, and the broader societal implications of neglecting mental health.

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Why reading can be good for mental health

Sydney Timmins is a writer and founder of the Mental Health Book Club Podcast. She is a mental ill health survivor after being diagnosed with borderline personality disorder, anxiety, and depression, as well as fighting relapsing remitting multiple sclerosis. For National Book Lovers Day, here are her top eight mental health benefits of reading. As the founder of the Mental Health Book Club Podcast it would be no surprise to anyone that I love books. Thin books, thick books, colourful books picture books, e-books… I don’t discriminate. 

Today is National Book Lovers Day, an annual event celebrating reading and books. To celebrate, here are my top eight mental health benefits of reading:

1. Reading is pleasurable

When you start to read a really good book it is often hard to put it down, the story captivates you and time disappears as you become absorbed. When you reach the end, you feel sad because it is over, or you are so eager to get the next book in the series you are emailing the author daily! It is a magical feeling and choosing to read a book can provide a number of other benefits.

Click here to learn more about our mental health workplace training

2. Reading can reduce stress

Losing yourself in a good book has been shown to reduce your levels of stress . Research by Dr David Lewis showed that reading as little as six minutes a day can reduce stress levels by 60% by reducing your heart rate, easing muscle tension and altering your state of mind. That same study  showed that reading was better at reducing stress than music, drinking a cup of tea, going for a walk and playing video games.

When I mentioned this to my tea obsessed co-host Becky Lawrence about reading being better at reducing stress than tea her reply made me laugh – she asked if she could have books and tea at the same time? Because maybe in combination they would beat all of her stress. Well I guess that is something for her to experiment with!

3. Reading can provide an escape from the 'real world'

Closely linked to reducing stress levels when you read is the ability to escape from the real world. I did this a lot as a child as a coping mechanism to dealing with the emotional hurt I experienced from my family. I often become immersed in that world and helped me to forget my worries. Research has shown that escapism is more complex than just reading for light-hearted entertainment, but it did show that people found the process transformative changing the way people interact with the world and others.

4. Reading helps you develop empathy for others

People who read fiction have been shown to improve your level of empathy, the ability for you to understand someone else’s belief’s, feelings and thoughts. Known as the theory of mind. Research  has shown that people exposed to fiction predicted the results of an empathy task and even positively correlated with social support (but remember correlation does not mean causation!). Further research  into the impact of fiction on empathy showed that it was temporarily enhanced after reading fiction.

5. Reading works your brain and prevents memory loss

Participating in cognitive activities, such as reading over your life time (both early and later in life) was shown to slow down memory loss when compared to those who didn’t participate in mentally stimulating activities. The same study  also found that the rate of mental decline was reduced by 32% when people participated in reading, writing and other activities later on in life. While those with infrequent stimulating activity found that their decline was 48% faster than those with average activity.

6. Reading groups help to treat mental health issues

My default for when I’m feeling low is to read but there is actually scientific research that shows that reading and then talking about what you have read could be beneficial to mental health and well-being. There is something called bibliotherapy and it has a profound effect on people suffering with depression. Liverpool Health Inequalities Research Institute examined a two weekly reading group program for people diagnosed with depression over a 12-month period and reported a significant improvement to mental health. Participants reported improved concentration, better emotional understanding, increased self-awareness, and the ability to discuss meaningful issues related to self and being.

7. Reading helps teenagers develop insights into being an adult

Becoming an adult can be tricky – a lot of things change during this time and exploring self-identity is crucial. Research  has shown that reading for pleasure in teenagers has three key benefits, reading was shown to enhance academic performance, social engagement and personal development. Fiction helped teens by providing significant insights into mature relationships, personal values and cultural identity all of which are important in the transition from being a child to becoming an adult.

8. Reading can make you smarter

I often feel smarter after reading books, I learn new things, experience different cultures, understand myself better and research  has shown that reading does in fact make us smarter. Cognitive differences have been seen between those who read a lot and those who read a little. People who are exposed to more written information are associated with higher vocabulary, general knowledge, and verbal skills.

If you are looking to reduce your stress, educate yourself, become more empathetic and even smarter than you currently are then the Mental Health Book Club Podcast currently has reviews and recommendations on over 20 fiction and non-fiction books portraying mental health issues, expertly backed up by The Secret Psychiatrist and her professional knowledge.

We believe that mental health is important to everyone in society.

We believe that it is okay not to be okay.

We believe that books and media have a profound impact about how we see the world.

So, we created the MHBC podcast looking at books, media and speaking to people who think mental health is important identifying books that represent people in a positive and realistic way supporting the mental health community.

You can follow Sydney Timmins on Twitter , and listen to the Mental Health Book Club podcast on their website .

Click here for more details on our mental health workplace training and improving your self-care

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Can Reading Make You Happier?

Several years ago, I was given as a gift a remote session with a bibliotherapist at the London headquarters of the School of Life, which offers innovative courses to help people deal with the daily emotional challenges of existence. I have to admit that at first I didn’t really like the idea of being given a reading “prescription.” I’ve generally preferred to mimic Virginia Woolf’s passionate commitment to serendipity in my personal reading discoveries, delighting not only in the books themselves but in the randomly meaningful nature of how I came upon them (on the bus after a breakup, in a backpackers’ hostel in Damascus, or in the dark library stacks at graduate school, while browsing instead of studying). I’ve long been wary of the peculiar evangelism of certain readers: You must read this, they say, thrusting a book into your hands with a beatific gleam in their eyes, with no allowance for the fact that books mean different things to people—or different things to the same person—at various points in our lives. I loved John Updike’s stories about the Maples in my twenties, for example, and hate them in my thirties, and I’m not even exactly sure why.

But the session was a gift, and I found myself unexpectedly enjoying the initial questionnaire about my reading habits that the bibliotherapist, Ella Berthoud, sent me. Nobody had ever asked me these questions before, even though reading fiction is and always has been essential to my life. I love to gorge on books over long breaks—I’ll pack more books than clothes, I told Berthoud. I confided my dirty little secret, which is that I don’t like buying or owning books, and always prefer to get them from the library (which, as I am a writer, does not bring me very good book-sales karma). In response to the question “What is preoccupying you at the moment?,” I was surprised by what I wanted to confess: I am worried about having no spiritual resources to shore myself up against the inevitable future grief of losing somebody I love, I wrote. I’m not religious, and I don’t particularly want to be, but I’d like to read more about other people’s reflections on coming to some sort of early, weird form of faith in a “higher being” as an emotional survival tactic. Simply answering the questions made me feel better, lighter.

We had some satisfying back-and-forths over e-mail, with Berthoud digging deeper, asking about my family’s history and my fear of grief, and when she sent the final reading prescription it was filled with gems, none of which I’d previously read. Among the recommendations was “The Guide,” by R. K. Narayan. Berthoud wrote that it was “a lovely story about a man who starts his working life as a tourist guide at a train station in Malgudi, India, but then goes through many other occupations before finding his unexpected destiny as a spiritual guide.” She had picked it because she hoped it might leave me feeling “strangely enlightened.” Another was “The Gospel According to Jesus Christ,” by José Saramago: “Saramago doesn’t reveal his own spiritual stance here but portrays a vivid and compelling version of the story we know so well.” “Henderson the Rain King,” by Saul Bellow, and “Siddhartha,” by Hermann Hesse, were among other prescribed works of fiction, and she included some nonfiction, too, such as “The Case for God,” by Karen Armstrong, and “Sum,” by the neuroscientist David Eagleman, a “short and wonderful book about possible afterlives.”

Our staff and contributors share their cultural enthusiasms.

I worked my way through the books on the list over the next couple of years, at my own pace—interspersed with my own “discoveries”—and while I am fortunate enough to have my ability to withstand terrible grief untested, thus far, some of the insights I gleaned from these books helped me through something entirely different, when, over several months, I endured acute physical pain. The insights themselves are still nebulous, as learning gained through reading fiction often is—but therein lies its power. In a secular age, I suspect that reading fiction is one of the few remaining paths to transcendence, that elusive state in which the distance between the self and the universe shrinks. Reading fiction makes me lose all sense of self, but at the same time makes me feel most uniquely myself. As Woolf, the most fervent of readers, wrote, a book “splits us into two parts as we read,” for “the state of reading consists in the complete elimination of the ego,” while promising “perpetual union” with another mind.

Bibliotherapy is a very broad term for the ancient practice of encouraging reading for therapeutic effect. The first use of the term is usually dated to a jaunty 1916 article in The Atlantic Monthly , “A Literary Clinic.” In it, the author describes stumbling upon a “bibliopathic institute” run by an acquaintance, Bagster, in the basement of his church, from where he dispenses reading recommendations with healing value. “Bibliotherapy is…a new science,” Bagster explains. “A book may be a stimulant or a sedative or an irritant or a soporific. The point is that it must do something to you, and you ought to know what it is. A book may be of the nature of a soothing syrup or it may be of the nature of a mustard plaster.” To a middle-aged client with “opinions partially ossified,” Bagster gives the following prescription: “You must read more novels. Not pleasant stories that make you forget yourself. They must be searching, drastic, stinging, relentless novels.” (George Bernard Shaw is at the top of the list.) Bagster is finally called away to deal with a patient who has “taken an overdose of war literature,” leaving the author to think about the books that “put new life into us and then set the life pulse strong but slow.”

Today, bibliotherapy takes many different forms, from literature courses run for prison inmates to reading circles for elderly people suffering from dementia. Sometimes it can simply mean one-on-one or group sessions for “lapsed” readers who want to find their way back to an enjoyment of books. Berthoud and her longtime friend and fellow bibliotherapist Susan Elderkin mostly practice “affective” bibliotherapy, advocating the restorative power of reading fiction. The two met at Cambridge University as undergraduates, more than twenty years ago, and bonded immediately over the shared contents of their bookshelves, in particular Italo Calvino’s novel “If on a Winter’s Night a Traveller,” which is itself about the nature of reading. As their friendship developed, they began prescribing novels to cure each other’s ailments, such as a broken heart or career uncertainty. “When Suse was having a crisis about her profession—she wanted to be a writer, but was wondering if she could cope with the inevitable rejection—I gave her Don Marquis’s ‘Archy and Mehitabel’ poems,” Berthoud told me. “If Archy the cockroach could be so dedicated to his art as to jump on the typewriter keys in order to write his free-verse poems every night in the New York offices of the Evening Sun, then surely she should be prepared to suffer for her art, too.” Years later, Elderkin gave Berthoud,who wanted to figure out how to balance being a painter and a mother, Patrick Gale’s novel “Notes from an Exhibition,” about a successful but troubled female artist.

They kept recommending novels to each other, and to friends and family, for many years, and, in 2007, when the philosopher Alain de Botton, a fellow Cambridge classmate, was thinking about starting the School of Life, they pitched to him the idea of running a bibliotherapy clinic. “As far as we knew, nobody was doing it in that form at the time,” Berthoud said. “Bibliotherapy, if it existed at all, tended to be based within a more medical context, with an emphasis on self-help books. But we were dedicated to fiction as the ultimate cure because it gives readers a transformational experience.”

Berthoud and Elderkin trace the method of bibliotherapy all the way back to the Ancient Greeks, “who inscribed above the entrance to a library in Thebes that this was a ‘healing place for the soul.’ ” The practice came into its own at the end of the nineteenth century, when Sigmund Freud began using literature during psychoanalysis sessions. After the First World War, traumatized soldiers returning home from the front were often prescribed a course of reading. “Librarians in the States were given training on how to give books to WWI vets, and there’s a nice story about Jane Austen’s novels being used for bibliotherapeutic purposes at the same time in the U.K.,” Elderkin says. Later in the century, bibliotherapy was used in varying ways in hospitals and libraries, and has more recently been taken up by psychologists, social and aged-care workers, and doctors as a viable mode of therapy.

There is now a network of bibliotherapists selected and trained by Berthoud and Elderkin, and affiliated with the School of Life, working around the world, from New York to Melbourne. The most common ailments people tend to bring to them are the life-juncture transitions, Berthoud says: being stuck in a rut in your career, feeling depressed in your relationship, or suffering bereavement. The bibliotherapists see a lot of retirees, too, who know that they have twenty years of reading ahead of them but perhaps have only previously read crime thrillers, and want to find something new to sustain them. Many seek help adjusting to becoming a parent. “I had a client in New York, a man who was having his first child, and was worried about being responsible for another tiny being,” Berthoud says. “I recommended ‘Room Temperature,’ by Nicholson Baker, which is about a man feeding his baby a bottle and having these meditative thoughts about being a father. And of course 'To Kill a Mockingbird,' because Atticus Finch is the ideal father in literature.”

Berthoud and Elderkin are also the authors of “The Novel Cure: An A-Z of Literary Remedies,” which is written in the style of a medical dictionary and matches ailments (“failure, feeling like a”) with suggested reading cures (“The History of Mr. Polly,” by H. G. Wells). First released in the U.K. in 2013, it is now being published in eighteen countries, and, in an interesting twist, the contract allows for a local editor and reading specialist to adapt up to twenty-five per cent of the ailments and reading recommendations to fit each particular country’s readership and include more native writers. The new, adapted ailments are culturally revealing. In the Dutch edition, one of the adapted ailments is “having too high an opinion of your own child”; in the Indian edition, “public urination” and “cricket, obsession with” are included; the Italians introduced “impotence,” “fear of motorways,” and “desire to embalm”; and the Germans added “hating the world” and “hating parties.” Berthoud and Elderkin are now working on a children’s-literature version, “A Spoonful of Stories,” due out in 2016.

For all avid readers who have been self-medicating with great books their entire lives, it comes as no surprise that reading books can be good for your mental health and your relationships with others, but exactly why and how is now becoming clearer, thanks to new research on reading’s effects on the brain. Since the discovery, in the mid-nineties, of “mirror neurons”—neurons that fire in our brains both when we perform an action ourselves and when we see an action performed by someone else—the neuroscience of empathy has become clearer. A 2011 study published in the Annual Review of Psychology , based on analysis of fMRI brain scans of participants, showed that, when people read about an experience, they display stimulation within the same neurological regions as when they go through that experience themselves. We draw on the same brain networks when we’re reading stories and when we’re trying to guess at another person’s feelings.

Other studies published in 2006 and 2009 showed something similar—that people who read a lot of fiction tend to be better at empathizing with others (even after the researchers had accounted for the potential bias that people with greater empathetic tendencies may prefer to read novels). And, in 2013, an influential study published in Science found that reading literary fiction (rather than popular fiction or literary nonfiction) improved participants’ results on tests that measured social perception and empathy, which are crucial to “theory of mind”: the ability to guess with accuracy what another human being might be thinking or feeling, a skill humans only start to develop around the age of four.

Keith Oatley, a novelist and emeritus professor of cognitive psychology at the University of Toronto, has for many years run a research group interested in the psychology of fiction. “We have started to show how identification with fictional characters occurs, how literary art can improve social abilities, how it can move us emotionally, and can prompt changes of selfhood,” he wrote in his 2011 book, “Such Stuff as Dreams: The Psychology of Fiction.” “Fiction is a kind of simulation, one that runs not on computers but on minds: a simulation of selves in their interactions with others in the social world…based in experience, and involving being able to think of possible futures.” This idea echoes a long-held belief among both writers and readers that books are the best kinds of friends; they give us a chance to rehearse for interactions with others in the world, without doing any lasting damage. In his 1905 essay “On Reading,” Marcel Proust puts it nicely: “With books there is no forced sociability. If we pass the evening with those friends—books—it’s because we really want to. When we leave them, we do so with regret and, when we have left them, there are none of those thoughts that spoil friendship: ‘What did they think of us?’—‘Did we make a mistake and say something tactless?’—‘Did they like us?’—nor is there the anxiety of being forgotten because of displacement by someone else.”

George Eliot, who is rumored to have overcome her grief at losing her life partner through a program of guided reading with a young man who went on to become her husband, believed that “art is the nearest thing to life; it is a mode of amplifying experience and extending our contact with our fellow-men beyond the bounds of our personal lot.” But not everybody agrees with this characterization of fiction reading as having the ability to make us behave better in real life. In her 2007 book, “Empathy and the Novel,” Suzanne Keen takes issue with this “empathy-altruism hypothesis,” and is skeptical about whether empathetic connections made while reading fiction really translate into altruistic, prosocial behavior in the world. She also points out how hard it is to really prove such a hypothesis. “Books can’t make change by themselves—and not everyone feels certain that they ought to,” Keen writes. “As any bookworm knows, readers can also seem antisocial and indolent. Novel reading is not a team sport.” Instead, she urges, we should enjoy what fiction does give us, which is a release from the moral obligation to feel something for invented characters—as you would for a real, live human being in pain or suffering—which paradoxically means readers sometimes “respond with greater empathy to an unreal situation and characters because of the protective fictionality.” And she wholeheartedly supports the personal health benefits of an immersive experience like reading, which “allows a refreshing escape from ordinary, everyday pressures.”

So even if you don’t agree that reading fiction makes us treat others better, it is a way of treating ourselves better. Reading has been shown to put our brains into a pleasurable trance-like state, similar to meditation, and it brings the same health benefits of deep relaxation and inner calm. Regular readers sleep better, have lower stress levels, higher self-esteem, and lower rates of depression than non-readers. “Fiction and poetry are doses, medicines,” the author Jeanette Winterson has written. “What they heal is the rupture reality makes on the imagination.”

One of Berthoud’s clients described to me how the group and individual sessions she has had with Berthoud have helped her cope with the fallout from a series of calamities, including losing her husband, the end of a five-year engagement, and a heart attack. “I felt my life was without purpose,” she says. “I felt a failure as a woman.” Among the books Berthoud initially prescribed was John Irving’s novel “The Hotel New Hampshire.” “He was a favorite writer of my husband, [whom] I had felt unable to attempt for sentimental reasons.” She was “astounded and very moved” to see it on the list, and though she had avoided reading her husband’s books up until then, she found reading it to be “a very rewarding emotional experience, both in the literature itself and ridding myself of demons.” She also greatly appreciated Berthoud guiding her to Tom Robbins’s novel “Jitterbug Perfume,” which was “a real learning curve for me about prejudice and experimentation.”

One of the ailments listed in “The Novel Cure” is “overwhelmed by the number of books in the world,” and it’s one I suffer from frequently. Elderkin says this is one of the most common woes of modern readers, and that it remains a major motivation for her and Berthoud’s work as bibliotherapists. “We feel that though more books are being published than ever before, people are in fact selecting from a smaller and smaller pool. Look at the reading lists of most book clubs, and you’ll see all the same books, the ones that have been shouted about in the press. If you actually calculate how many books you read in a year—and how many that means you’re likely to read before you die—you’ll start to realize that you need to be highly selective in order to make the most of your reading time.” And the best way to do that? See a bibliotherapist, as soon as you can, and take them up on their invitation, to borrow some lines from Shakespeare’s “Titus Andronicus”: "Come, and take choice of all my library/And so beguile thy sorrow…"

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• Published: 07 August 2023

Preventive mental healthcare

The beauty of reading for pleasure

• Natalia Gass 1  

Nature Mental Health volume  1 ,  page 529 ( 2023 ) Cite this article

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In a new study, Yun-Jun Sun, Barbara Sahakian et al. examined the relationship between childhood RfP and brain structure, cognition and mental wellbeing in adolescence. Using a sample of more than 10,000 young adolescents from the Adolescent Brain Cognitive Development (ABCD) cohort, the researchers assessed brain scans, cognitive test scores, academic performance, anxiety, stress, depression scores, and psychopathological behavior, including aggression and rule-breaking. They divided the adolescents into two groups: one with a RfP duration of 3–10 years and the other with 0–2.5 years. “Adolescence is the transition between being a child to becoming an adult and so interventions in childhood that are beneficial for cognition, school academic attainment and mental health are extremely important. Many mental health disorders begin in childhood or adolescence, so improving mental health during these developmental periods is crucial,” explains Sahakian, a joint first author of the paper.

The researchers found that RfP with a duration of 3–10 years in childhood positively correlated with cognitive performance scores, speech development and academic achievement in adolescents. It negatively correlated with mental health problems and psychopathological scores and with the total screen time spent on electronic devices. In addition, this group of adolescents had increased brain cortical regions, including areas related to language, cognition and the visual system. A subsequent mediation analysis showed that the mean cortical area of the identified brain regions partially mediated the associations between early RfP and increased cognition, as well as decreased psychopathological scores. “We were very pleased to see that such a relatively low-cost intervention as RfP could have positive effects in such a broad range of important areas measured, including cognition, school attainment and mental health,” adds Sahakian.

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Can Reading Books Improve Your Mental Health?

New research explores the impact of reading on various aspects of mental health..

Posted May 24, 2019 | Reviewed by Lybi Ma

Many bookworms remain worried that the ubiquitous use of social media is leading to a decline in reading books. But a number of surveys indicate that book-reading trends have actually remained stable over the last two decades.

For example, a 2017 Gallup Poll found that 35 percent of Americans read 10 or more books per year, the same level as 2002. Likewise, a Pew Research Forum survey found that book-reading habits remained largely unchanged from 2012 to 2016, with the average American reading 4 books per year.

Interestingly, this survey found that 27 percent of Americans did not read any books at all in 2016.

Bibliotherapy

A relatively unknown mental health intervention is "bibliotherapy" or "reading therapy ." This mainly refers to structured book-reading programs run by clinics, libraries, or schools aimed at promoting recovery in people with mental health difficulties.

Such groups remain uncommon, despite the efforts of organizations such as the American Library Association, which houses a number of bibliotherapy resources on their website for adults and children.

The term bibliotherapy is also used to refer to self-initiated book reading pursued by an individual with mental illness. This can be supported by a clinician, family member or peer supporter, or simply pursued alone.

Several studies have examined whether bibliotherapy can facilitate recovery from mental illness. One classic study found a decrease in depressive symptoms after a program of bibliotherapy, a finding repeated in more recent meta-analyses and systematic reviews .

Interestingly, several studies indicate that reading works of fiction can be of particular benefit to people with or without mental health difficulties. These studies indicate that reading fiction can increase reader empathy, social skills, and inter-personal understandings (known as " theory of mind ").

This research indicates that readers can deeply engage with characters and scenarios, giving them a better understanding of our shared humanity and common struggles. Indeed, leading expert Dr. Keith Oatley of the University of Toronto notes that “fiction can augment and help us understand our social experience.”

Building on this research, I often recommend works of fiction to students in order to increase understandings about mental health. Two favourites are The Scarlett Letter by Nathaniel Hawthorne, and The Bell Jar by Sylvia Path, both of which give readers a deep understanding of the alienation, loneliness , shaming , stigma and social exclusion that is often experienced by people with mental health difficulties.

Autobiography and Recovery Narratives

A number of courageous people with mental illness have published poignant autobiographical memoirs detailing their life experience. These writings often portray both the suffering and distress caused by mental illness, as well as the journey of recovery and strategies of resilience .

Interestingly, a just-released review paper by Dr. Mike Slade and colleagues at the University of Nottingham examined how people with mental illness are affected by reading such "recovery narratives." Results indicate that reading these narratives can increase connectedness and understandings of recovery, while validating personal experience and reducing stigma.

Popular autobiographies include The Center Cannot Hold by Elyn Saks, outlining life with schizophrenia, and Matt Haig's Reasons to Stay Alive, describing life with depression . These books offer hope and inspiration by illuminating the realities of recovery in the face of adversity. I recommend such books to people with mental illness regularly.

Religion and Spirituality

Finally, much research indicates a strong and consistent relationship between religiosity and mental health. An integral part of religiosity includes the regular reading of sacred texts, which can provide much solace and support to believers with mental health issues.

This is evidenced by my own research on recovery from mental illness in African-Americans. In the course of this research , many participants report that Bible study, devotional texts, and other religious readings have facilitated their recovery, with one participant memorably stating "that is what has really been making me stay sane."

By the same token, evidence suggests that mindfulness -based approaches can enhance recovery from mental illness. In one of my ongoing studies, young men with mental health difficulties often report reading mindfulness books to promote their own mental health, with Eckhart Tolle’s The Power of Now frequently mentioned.

To conclude, books are an invaluable but underutilized resource that can increase empathy, enhance recovery and inspire those with mental health difficulties. As such, reading should be encouraged for everybody, but particularly those with mental illness—whether through formal bibliotherapy groups or individual prompting from family, friends or clinicians.

On the death of his beloved younger sister, the famed Victorian writer Lord Thomas Macaulay wrote "that I have not utterly sunk under this blow, I owe chiefly to literature. Literature has saved my life and my reason."

Readers, please take note.

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Rob Whitley, Ph.D., is an assistant professor in the department of psychiatry at McGill University and a research scientist at the Douglas Hospital Research Centre.

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Reading and Mental Health

• First Online: 05 September 2019

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• Ellie Gray 2 ,
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This chapter offers three distinct perspectives on the value of—and potential obstacles to—embedding Shared Reading within the treatment options of health professions and services. In this chapter, Ellie Gray surveys a wide range of reading or book-based interventions recently or currently in use in mental health contexts and considers their implications for clinical practice. Grace Farrington articulates the value of a literature-based intervention from the perspective of occupational therapists working with mental health patients in hospital. Mette Steenberg reports on (and assesses the criteria for success of) a collaborative venture of Danish health services, libraries and local government in which people living at risk of mental health issues are referred to reading groups.

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“It was Very Liberating”. Dialogic Literary Gatherings Supporting Mental Health Literacy

What pauline doesn’t know: using guided fiction writing to educate health professionals about cultural competence.

Writing: A Versatile Resource in the Treatment of the Clients’ Proposals

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Gray, E., Farrington, G., Steenberg, M. (2019). Reading and Mental Health. In: Billington, J. (eds) Reading and Mental Health. Palgrave Macmillan, Cham. https://doi.org/10.1007/978-3-030-21762-4_18

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Health Benefits of Reading Books

Levels of stress, depression, and anxiety are especially high in today’s hectic world. It can be hard to find time for self-care and especially hard to find time for leisure activities like reading. It’s worth it to try to fit reading into your life, though, as consistent reading can benefit your health.

Why Reading Books Is Good For You

Reading books can offer many benefits for your overall health. While these benefits primarily help the brain, they can also benefit your body.

Reading reduces stress and anxiety. Stress and anxiety in the U.S. are at an all-time high as we continue to feel the effects of the COVID-19 pandemic. A 2022 poll conducted by the American Psychological Association found that:

• 27% of respondents said that most days they felt so stressed they couldn’t function
• Stressors included inflation, violence and crime, politics, and racial climate
• 76% said that the future of the U.S. was a source of stress
• Women aged 18-34 reported more stress than older women and men
• 76% reported that stress affected their physical health

Reading is an excellent method of reducing stress. A 2009 study from Mindlab International at the University of Sussex found that reading was able to reduce stress levels by 68%. That made it more effective than other soothing activities like taking a walk or listening to music.

In general, meditative activities that force you to focus on a single task can reduce stress. Reading has the added benefit of engaging your mind and forcing your brain to be creative so you can imagine the story as you read. Dr. David Lewis, who conducted the 2009 study, explains that reading is “an active engaging of the imagination as the words on the printed page stimulate your creativity and cause you to enter what is essentially an altered state of consciousness.”

Reading battles mental decline and dementia. Dementia is a general term for mental decline that includes difficulty thinking, remembering, or making decisions. Dementia mainly affects older adults. In 2014, the Centers for Disease Control and Prevention estimated there were five million adults living with dementia, and they expect that number to rise to 14 million by 2060. 

Numerous studies have indicated a link between reading and brain health. Studies consistently show that participating in activities that engage your brain, including reading, can help reduce the chance of developing dementia.

• A study published in 2010 assessed 942 adults to determine if participating in hobbies reduced their risk of dementia. The study found that nearly 54% of those who did not develop dementia read books consistently, while only about 39% of those who did develop dementia read books consistently.
• A study published in 2013 assessed the cognitive activity of 1,651 participants over the age of 55. The study found that those who engaged in mentally stimulating tasks like reading and writing throughout their life had a much slower rate of mental decline, even when their brains showed signs of damage.
• A study published in 2010 involved multiple observational studies on participants over the age of 60 and the influence of cognitive leisure activities, including reading, on the brain. Five out of six studies showed that starting these activities in middle adulthood reduced the risk of dementia while six out of seven studies showed that starting these activities late in life also reduced the risk of dementia.

Reading is therapeutic for your mental health. Mental illness is one of the most significant medical crises facing Americans. Mental illness refers to mental health conditions that affect your behavior, mood, and thinking, such as addiction, anxiety, depression , mood disorders , and schizophrenia. 

According to the National Institute of Mental Health, in 2020:

• Nearly 20% of adults (52.9 million people) in the U.S. lived with a mental illness
• Only 46% of adults with mental illness received mental health services
• 5.6% of U.S. adults (14.2 million people) had a mental health condition that severely interfered with everyday life
• About 49.5% of U.S. adolescents ages 13-18 lived with mental illness
• About 21 million U.S. adults and 4.1 million adolescents ages 12-17 had at least one major depressive episode
• 19.1% of U.S. adults had an anxiety disorder and 31.9% of adolescents ages 13-18 had an anxiety disorder

The stress reduction that reading offers can help enormously when you’re already struggling with your mental health. But the benefits of reading extend beyond that, to the point that some doctors prescribe reading as a part of mental health therapy. This is called bibliotherapy.

What Is Bibliotherapy?

Bibliotherapy is a practice that uses books as part of therapy. Your mental health professional chooses a book, fiction or nonfiction, and as you read through the book you discuss it together. Because bibliotherapy is usually used with other forms of therapy, it’s hard to judge exactly how effective it is, but the benefits shown by bibliotherapy include:

• Developing empathy
• Enhancing self-awareness
• Increasing compassion
• Promoting problem-solving

How Much Reading Should You Do?

There isn’t much data about how much reading people should do every day. The 2009 study measuring reading and stress indicated that just six minutes of reading a day could lower stress levels. The 2010 study about hobbies and dementia showed that the best results came from participating in the hobby for at least an hour a day. 

You don’t want to add stress to your life by trying to fit a certain amount of reading into your busy schedule every day. Instead, find places you can fit it in and adjust where you can.

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Benefits of Positive Psychology-Based Story Reading on Adolescent Mental Health and Well-Being

Gökmen arslan.

1 Mehmet Akif Ersoy University, Burdur, Turkey

2 The University of Melbourne, Melbourne, Australia

Murat Yıldırım

3 Ağrı İbrahim Çeçen University, Ağrı, Turkey

Masood Zangeneh

4 Humber College, Toronto, Canada

İsmail Ak

5 Isparta Provincial Directorate of National Education, Isparta, Turkey

The importance of complete mental health in school context has recently begun to attract a lot of attention. Positive psychology interventions are often associated with improvement in mental health outcomes, but few studies have examined whether story reading is an intervention that is linked with indicators of complete mental health. This study investigated the effects of story reading interventions on both positive and negative indicators of mental health over time for a group of Turkish grade 10 high school students ( n  = 53). These included 33 students in a story reading group and 20 in a control group for comparison. The results showed that story reading led to improvement in students’ mindfulness, optimism, happiness, and positive emotions, and also caused reduction in depression, anxiety, pessimism, and other negative emotions over a 5-week period, with a small to large effect sizes. The obtained results are discussed in the context of their implications for potential psychological interventions in high school settings.

Conventional psychology has predominantly focused on mitigating dysfunctional states of human functioning caused by problems such as stress, anxiety and depression (Seligman & Csikszentmihalyi, 2000 ). Endeavours to build a science of illness have been very effective in terms of classifying the types of illness and their correlates and causes, developing and validating effective interventions to treat them, and clinical guidelines to improve efficiency (Slade, 2010 ). In contrast, the field of positive psychology focuses on the science of positive mental states rather than just avoiding negative states, and this has become an important area of research (Arslan, 2019a ; Arslan & Wong, 2022 ; Burke & Arslan, 2021 ; Yıldırım, 2019a ). This view aligns with that of the World Health Organization, who define health as a state of complete mental, social, and physical well-being, and not only the absence of disease (World Health Organization, 2004 ). Absence of illnesses or negative state of mind does necessarily correspond to states of happiness and well-being (Arslan, 2019b ; Yildirim & Balahmar, 2020 ). Thus, designing interventions to prioritise psychological strengths and promote psychological wellbeing can be as important as treating illness.

The Complete State Model of Mental Health

Prevention of mental disorders can be viewed as a product of promoting mental health and well-being. The complete state model of mental health (Keyes, 2005 ) is a framework to achieve this with two primary dimensions: mental illness and well-being. While mental illness can be represented on an essential spectrum from absent to present, well-being can be represented a spectrum from low to high. In this model, having a high level of well-being and low level of mental illness is classified as “flourishing” (i.e., complete mental health), whereas “floundering” (i.e., complete mental illness ) is characterised by a low level of well-being and a high level of mental illness. The two axes can combine in other ways as well: high level of well-being with high level of mental illness is classified as “struggling” (i.e., incomplete mental illness), while low level of mental illness with low level of well-being is classified as “languishing” (i.e., incomplete mental health.

Research have demonstrated that positive mental health corresponds to better general health, as well as better social and economic outcomes (Arslan & Allen, 2020 ; Arslan et al., 2020 ; Arslan & Renshaw, 2018 ; Keyes, 2007 ; Lyubomirsky et al., 2005 ). For example, positive mental health is associated with better social relationships, coping, physical health, income, productivity, marriage, and work satisfaction (Genç, 2021 ; Lyubomirsky et al., 2005 ) as well as reduced mortality, risk of suicide and mental health problems (Arslan, 2021a ; Campion et al., 2012 ). These findings of positive psychology research are imperative to mental health providers and services due to its emphasis on a good life both for people with and without mental illness (Arslan & Burke, 2021 ; Slade, 2010 ).

Strength-Based Training

The positive psychology literature has primarily emphasised positive psychological interventions and strength-based training to promote well-being and positive mental health. There is a wealth of empirical evidence supporting the association between strength-based training and positive mental health outcomes (Billington et al., 2010 ). A systematic review of 136 studies of this approach conducted by O'Connor et al. ( 2010 ) demonstrated that strength-based interventions are associated with reduced anxiety symptoms among healthy adults, reduced depression symptoms among patients with diagnosed depression, reduced pain intensity among patients with lower back pain, and reduced fatigue symptoms among older adults. It was also associated with improvements in cognition among older adults, better sleep quality among depressed older adults, and higher self-esteem. In particular, Seligman et al. ( 2009 ) have emphasized the effectiveness of positive psychology and classroom-based intervention to promote young people’s psychosocial health and wellbeing by reducing depressive symptoms and improving social skills, learning outcomes, and character strengths. There is a need for empirically tested interventions for improving well-being and mental health in school context. Cultivating positive interventions into the school context can be a successful approach to intervening mental health and well-being (Boniwell et al., 2016 ). Programs that promote positive mental health and prevention of mental illness can lead to higher academic achievement and better mental health in school (Levitt et al, 2007 ).

Story reading can be an effective approach for the promotion of mental health and well-being in a school context. In the literature, stories and storytelling are employed as systematic and independent psychotherapeutic technique (Chan, 1993 ). Storytelling/story reading/story-acting play-based interventions have been found to promote mental health in young adults (McCulliss & Chamberlain, 2013 ). Story reading as a therapeutic approach has also been shown to lead to reduction in depression symptoms and improvement in well-being (Billington et al., 2010 ), to be effective in building the levels of hopeful thinking (Lucas et al., 2019 ), and promote healthy social/emotional growth and maintain positive mental health (McCulliss & Chamberlain, 2013 ).

Evidence from studies support the positive effect of reading on health and well-being (Latchem & Greenhalgh, 2014 ). Lucas et al. ( 2019 ) highlighted that bibliotherapy (a projective indirect intervention involving storytelling or the reading of specific texts to treat psychological disturbance) can be used in building social relationships, empathy, resilience, solving problem skills, self-confidence, and assertiveness. In their review study, Latchem and Greenhalgh ( 2014 ) argued that although there are encouraging results concerning the positive effects of reading as a therapeutic approach, the available results should be considered with caution because of a lack of randomisation and small numbers of participants in the conducted studies. Therefore, more research showing the effectiveness of story reading is needed to establish it as a useful therapeutic approach in the promotion of mental health and well-being.

The Present Study

To study the effect of positive story reading on the mental health and well-being of students, this study surveyed a sample of high school students regarding their appraisals of story reading. Story reading design provides a unique opportunity to examine individual differences within each person. It is critical to promote a safe and healthy transition from childhood to adulthood. Adolescence– defined as occurring between 10 and 19 years– is a important period of life where specific psychosocial and physical needs occur (World Health Organization, 2021 ). Providing interventions to promote the mental health and wellbeing of this group of people is an essential step to understand their developmental process. We, therefore, believe that this study can help to fill the gap in the literature by providing a story reading-based intervention program to high school students and empirically evaluating its effect. Because there is a lack of research that has examined the unique effects of story reading on both mental health and well-being, hypotheses were generated based on earlier similar evidence: (1) story reading will have a positive impact on positive indicators of well-being (i.e., mindfulness, happiness, optimism, and positive emotions); and (2) story reading will have a negative impact on negative mental health outcomes (i.e., depression, anxiety, pessimism, and negative emotions).

Participants

Participants included 53 grade 10 students attending a public high school in the Mediterranean region of Tukey. After announcing the study in two classes, 60 students initially volunteered to participate. Of these, 25 were assigned to the control condition, while the other 35 were in the intervention condition that included the story reading. Students were assigned to groups according to their willingness, not randomly. All participants completed measures at baseline (i.e., pre-test). However, seven of the students (two in the intervention and five in control) did not fulfil the post-test measurements, resulting in the final sample size of n  = 53. The story reading group included 33 students (64% female), all 15 or 16 years of age ( M  = 15.61, SD  = 0.50). The final control group consisted of 20 students (60% female) between 15 and 18 years of age ( M  = 15.60, SD  = 0.75).

Mindful Attention Awareness Scale (MAAS)

The MAAS was designed to assess the core characteristics of mindfulness (Brown & Ryan, 2003 ). The MAAS includes five items (e.g., “I find myself doing things without paying attention”) and is scored using a 6-point Likert scale (1 = “always never”, 6 = “almost never”). The scale had strong internal reliability estimate with Turkish young people (Arslan & Yıldırım, 2020 ). In the current study, the scale showed weaker but adequate internal reliability (α = 0.71) and its distribution of scores was approximately normal (skewness = -0.51, kurtosis = -0.28).

Oxford Happiness Questionnaire-Short Form (OHQ-SF)

The OHQ-SF is an 8-item self-report measure (e.g., “I feel that life is very rewarding”) developed to assess happiness (Hills & Argyle, 2002 ). The items are rated using a 6-point Likert scale (1 = “strongly disagree” to 6 = “strongly agree”). The scale had strong internal reliability estimate with Turkish young people (Dogan & Cotok, 2011 ). It also had strong internal reliability with the sample of this study (α = 0.82) and its distribution of scores was approximately normal (skewness = -0.23, kurtosis = 0.41).

Youth Internalizing Behavior Screeners (YIBS)

The YIBS is a 10-item self-report measure developed to assess internalized problems of Turkish children and adolescents. The YIBS comprises two subscales, each of which includes five items: depression and anxiety (e.g., “I feel depressed and pessimistic”). Items are rated on a 4-point Likert scale (1 = “almost never” to 4 = “almost always”). It has shown adequate-to-strong internal and construct reliability estimates with Turkish youths (Arslan, 2019c ) and in other cultures (e.g., Asanjarani & Arslan, 2020 ). In this study, the scale had strong internal reliability (α = 0.90) and was characterized by a relatively normal distribution (skewness = 0.98, kurtosis = 1.22).

Optimism and Pessimism Measure (OPM-Short)

The OPM is a 6–item self-report scale (e.g., “I hope many things will be better in the future”, “I can't be happy with anything, I'm a pessimistic person”) designed to measure optimism and pessimism among Turkish youths and adults (Arslan & Yıldırım, 2021 ). The items are rated using a 5–point Likert scale (1 = “strongly disagree” to 5 = “strongly agree”). Previous research has indicated that the scales had strong internal reliability (Arslan & Yıldırım, 2020 ). In this study, it showed adequate internal reliability for optimism (α = 0.73), and strong internal reliability for pessimism (α = 0.84). The distribution of scores was approximately normal (skewness = -0.63, kurtosis = -0.27).

Scale of Positive and Negative Experience (SPANE)

The SPANE is a 12–item self-report measure used to assess youths’ positive and negative emotions (Diener et al., 2010 ). The items of the scales are scored on a 5-point Likert scale (1 = “very rarely or never” to 5 = “very often or always”). It has shown strong internal reliability estimates for Turkish samples (Telef, 2013 , and also in this study (α = 0.93 for positive emotions and 0.82 for negative emotions). The distribution of scores was approximately normal (skewness = -0.38, kurtosis = 0.27).

Procedure and Intervention

This study was conducted using an experimental research design, including intervention and control groups at two different time points. A web-based survey including the study measures and demographic items was generated using an online application and presented to students to gather the data. Before administering the survey, students were provided a 20-min online presentation about the purpose of the study and the study measures. All students were informed using a consent form that provided information about the study measures, that their participation in this study was voluntary, and that they could withdraw the study at any time. The study was conducted between January 13 and February 20 of 2021, during the COVID-19 pandemic. An electronic consent form on the first page of the online survey was signed by all participants.

The study was approved by the Institutional Review Board of Mehmet Akif Ersoy University. Pre-test measures were completed by students during the online presentation meeting. Stories were selected from the Rumi’s Masnavi, one of the well-known works of Sufism. The stories were chosen based on three criteria: (1) positive psychology theme, (2) reading ability of the students, and (3) age appropriateness. Participants were given a total of eight stories (two per week). Each story included at least one positive psychology theme, but some included more than one. These themes included gratitude, compassion, character strengths, mindfulness, empathy, forgiveness, responsibility, modesty, perseverance, and justice.

Following the assignment of the stories each week, participants were asked to write down what they had understood from the stories, and then report whether they had experienced such stories in their day-to-day lives. Afterwards, they were asked to practice these activities in their daily lives. This procedure was repeated for each week. Following the four-weeks of implementation, the students completed the post-test measures.

Data Analyses

Prior to the primary analyses, descriptive analysis was conducted for the pre-test and post-test scores of wellbeing (i.e., mindfulness, happiness, optimism, positive emotions) and mental health indicators (i.e., depression, anxiety, pessimism, negative emotions). Given that students were assigned to an experimental condition by willingness and not randomly, analyses of variance (ANOVA) were first run to look for differences in pre-test data between the intervention that could be confounding.

Primary analyses were conducted using analyses of covariance (ANCOVA) to investigate the effect of story reading on mental health and wellbeing while controlling for pre-test scores for both groups. ANCOVA is a sensitive and useful method to examine differences among groups in a randomized control design, when groups are random assignment to them is not possible (Huck & McLean, 1975 ; Tabachnick & Fidell, 2013 ). The intervention’s effect size was interpreted using partial eta squared ( η p 2 ) with the traditional decision rules: 0.01 to 0.059 = small, 0.06 to 0.139 = medium, and ≥ 0.14 = large (Cohen, 1988 ). All data analyses were employed using JASP v0.14.1 for Windows (The JASP Team, 2020 ).

Preliminary Analyses

In the preliminary ANOVAs on group differences in pre-test wellbeing and mental health measures indicated several significant differences, with medium to large effect sizes. These included happiness, F (1, 51) = 12.51, p  < 0.001, η p 2  = 0.20, optimism, F (1, 51) = 7.47, p  = 0.01, η p 2  = 0.13), positive emotions, F (1, 51) = 7.60, p  = 0.01, η p 2  = 0.13, depression, F (1, 51) = 7.0, p  = 0.011, η p 2  = 0.12, anxiety, F (1, 51) = 9.65, p  = 0.003, η p 2  = 0.16, and negative emotions, F (1, 51) = 9.00, p  = 0.004, η p 2  = 0.15. There were no -significant differences in mindfulness or pessimism. Further analyses regarding the assumptions of analyses (e.g., homogeneity of variance, normal distribution, and homogeneity of regression slopes), suggested the planned ANCOVA was deemed an appropriate approach to test the effectiveness of the story reading intervention.

Primary Analyses

Prior to conducting the ANCOVAs, the assumption of homogeneity of regression slopes was examined, indicating non-significant interaction terms for the dependent variables. Results from the ANCOVA for wellbeing outcome measures indicated a significant main effect of the intervention for mindfulness, F (1, 50) = 11.30, p  < 0.001, η p 2  = 0.18, and optimism, F (1, 50) = 4.28, p  < 0.05, η p 2  = 0.08, but no significant main effect for happiness, F (1, 50) = 2.95, p  = 0.092, η p 2  = 0.06, or positive emotions, F (1, 50) = 1.82, p  = 0.184, η p 2  = 0.04. The effect sizes indicated that the story reading had a large effect on mindfulness, and a medium effect on optimism.. Subsequently, the primary analyses for reducing negative mental health symptoms also demonstrated a significant main effect of the intervention for depression, F (1, 50) = 5.34, p  < 0.05, η p 2  = 0.10, anxiety, F (1, 50) = 5.67, p  < 0.05, η p 2  = 0.10, pessimism, F (1, 50) = 6.35, p  < 0.05, η p 2  = 0.11, and negative emotions, F (1, 50) = 8.85, p  < 0.001, η p 2  = 0.15. The effect sizes showed moderate-to-large beneficial changes in mental health measures for the story reading intervention group. Descriptive statistics and the ANCOVA results for wellbeing and mental health measures are presented in Table ​ Table1 1 .

Descriptive statistics and ANCOVA results for wellbeing and mental health measures

The prevalence of mental health problems (e.g., depression) among young people is extremely high worldwide. Approximately 20% of young people experience depressive symptoms during high school (Arslan, 2021b ; Lewinsohn et al., 1993 ). However, the review of existing evidence on the impact of benefits of story reading in complete mental health has received scarce attention. Although there are studies emphasizing the importance of positive psychology constructs for the promotion of mental health and wellbeing among Turkish children and adolescents, very few have focused on positive psychology-based interventions. This study therefore attempted to shed light on this topic by evaluating the benefits of story reading for cultivating positive indicators of mental health and decreasing negative indicators. This study may present one of the first attempts to expand the focus of story reading research to a conceptual background in this area and better understand complete mental health.

Results from the study first indicated a significant main effect of the intervention for mindfulness and optimism but no significant main effect for happiness and positive emotions. The effect sizes indicated that the story reading had a large effect on mindfulness, and a medium effect on optimism. This indicates that story reading interventions can have beneficial effects for positive mental health in a school context. The occurrence of insignificant results concerning happiness and positive emotions may be related to time interval for the data collection. Given that happiness and positive emotions are temporary feelings subjected to contextual factors (Yıldırım, 2021 , 2019b ), the selected time interval could have been long leading to disappearance of the effect. It is also important to interpret this finding in the context of pandemic which causes substantial reduction in the experiences of happiness and positive feelings (Arslan & Allen, 2021 ; Yıldırım & Arslan, 2020 ; Yıldırım et al., 2021 ).

We can therefore conclude that story reading can be an important resource to promote positive mental health. We cannot conclude that anyone who reads stories will become more mindful and optimistic, but we can conclude that those who participate in story reading activities in school may feel better psychologically. Therefore, story reading may lead to a positive perception and assessment of the state of positive mental health that may ultimately result in positive human functioning. These findings are consistent with previous research showing a positive influence of story reading on mental health and well-being (Latchem & Greenhalgh, 2014 ). Earlier research employed bibliotherapy, therapeutic reading, and self-help reading as tools for treating and promoting mental health. Previous research also demonstrated that by utilising therapeutic reading, participants displayed heightened cultural awareness, more empathy, and more effective problem-solving skills (Forgan, 2002 ; Pehrsson & McMillen, 2010 ). Recent research has also stressed that reading activities can be used by mental health services to promote well-being and mental health by cultivating psychological resilience, coping strategies, self-confidence, hope, social relationship, healing, personal growth, and reducing emotional disturbance (Lucas et al., 2019 ; McCulliss, 2012 ).

Subsequent findings revealed a significant main effect of the intervention for depression, anxiety, pessimism, and negative emotions. The effect sizes showed moderate-to-large beneficial changes in mental health measures for the story reading intervention group. These results suggest that the story reading has negative impact on symptoms of mental illnesses and even may function as a factor to prevent mental health problems in schools. Available evidence showed that those therapeutic approaches have various benefits to readers, from reduced loneliness and isolation to mitigated depressive symptoms (Bruneau & Pehrsson, 2014 ). The benefits of therapeutic reading in reducing depression and anxiety have been documented in different populations including adolescents and adults (Scogin et al., 2014 ). For example, a systematic review study conducted by Montgomery and Maunders ( 2015 ) reported that therapeutic reading activities are effective in reducing various mental problems including internalizing and externalizing problems and increasing adaptive prosocial behaviours in children. This suggests that story reading is a promising and useful therapeutic approach to address mental health problems and promote positive well-being and mental health, especially in school-aged young people.

Implications and Limitations

Building on prior research, our findings offer empirical support for the benefits of story reading for complete mental health in schools. The results are also important for practice: Mental health problems are common among students in school, where they may not have a chance to freely express their feelings and opinions in academic or social modes or feel appreciated and recognized by their peers or teachers. In school, we recommend that teachers acknowledge their students’ strengths and good qualities through approaches such as story reading. In the process of teaching, students can be paired in the classroom by encouraging involvement in story reading activities, and this could help to protect their mental health. Parents should also encourage their teenagers and inspire their interest in reading stories, which may ultimately allow them to build new skills for coping with mental health challenges.

There are several strong points of our study. First, we had an experimental and control group, allowing isolation of the differences in our dependent variables (i.e., mental health outcomes) attributable to the story reading intervention. Without such a control group, it could have been hard to examine whether the changes in the dependent variables have been arisen from the story reading or some other factor. Second, we tested the effect of story reading on mental health outcomes over time, which is particularly useful in terms of understanding the longitudinal impact of story reading on mental health. In addition, this study included multiple positive (e.g., mindfulness, optimism) and negative (e.g., depression, anxiety) indicators of mental health, and examined the impact of story reading on those mental health indicators simultaneously, which has rarely been done in the relevant academic literature on story telling.

Despite above-mentioned strengths, the study is not without limitations. First, the sample was relatively small and included only Grade 10 students in the Mediterranean region of Turkey. As such, the sample is barely representative of all Turkey. Recruiting more students from different regions of the country could enhance the generalizability study findings. Second, we did not take all positive and negative indicators of mental health (e.g., hope, optimism, resilience, stress, fear, post-traumatic stress disorder) into account. It would be worthwhile to explore the impact of story reading on other mental health indicators, and to better understand the underlying mechanism whereby story reading benefits mental health. Third, assignment into the control group and intervention group was not random but self-sorted, which could reduce the validity of the control comparison — though this was addressed in the analysis to a degree by looking for group differences in the pre-test measures and using the ANCOVA method to control for them.

In conclusion, the results of this study suggest that story reading is an effective approach for improving mindfulness and optimism, and reducing depression, anxiety, pessimism and negative emotions among high school students in Turkey. The findings also point to the need to study the experience of students in different states of mental health by using story reading. These findings can be useful to develop and implement support programs aimed at preventing negative mental health states in the long term, ultimately minimizing the occurrence of mental health problems and promoting positive mental health.

Declarations

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Consent was obtained from all participants included in the study.

The authors declared no conflicts of interest with respect to the research, authorship, and/or publication of this article.

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

• Arslan, G. (2019a). Exploring the effects of positive psychological strengths on psychological adjustment in adolescents. Child Indicators Research, 12 (4), 1449–1464. 10.1007/s12187-018-9589-5.
• Arslan, G. (2019b). Positive psychological traits, school functioning, and psychological adjustment in elementary schoolchildren. Journal of Psychologists and Counsellors in Schools, 29 (2), 139–150. 10.1017/jgc.2018.24.
• Arslan, G. (2019c). Development and validation of the youth externalizing behavior screener: A brief and effective measure of behavioral problems. International Journal of School & Educational Psychology, 7 (sup1), 64–74. 10.1080/21683603.2018.1466747
• Arslan, G. (2021a). Psychological well-being in college students: Psychometric properties of the Brief Inventory of Thriving (BIT) and the Comprehensive Inventory of Thriving (CIT). Journal of School and Educational Psychology, 1 (1), 6–16. 10.47602/josep.v1i1.6.
• Arslan, G. (2021b). Measuring emotional problems in Turkish adolescents: Development and initial validation of the Youth Internalizing Behavior Screener. International Journal of School & Educational Psychology, 9 (2), 198–207. 10.1080/21683603.2019.1700860.
• Arslan, G., & Allen, K.-A. (2020). Complete mental health in elementary school children: Understanding youth school functioning and adjustment. Current Psychology. 10.1007/s12144-020-00628-0.
• Arslan, G. & Allen, K. (2021). Exploring the association between coronavirus stress, meaning in life, psychological flexibility, and subjective well-being. Psychology, Health & Medicine. 10.1080/13548506.2021.1876892. [ PubMed ]
• Arslan, G., & Burke, J. (2021). Positive education to promote flourishing in students returning to school after COVID-19 closure. Journal of School and Educational Psychology, 1 (1), 1–5. 10.47602/josep.v1i1.3.
• Arslan G, Renshaw TL. Student subjective wellbeing as a predictor of adolescent problem behaviors: A comparison of first-order and second-order factor effects. Child Indicators Research. 2018; 11 (2):507–521. doi: 10.1007/s12187-017-9444-0. [ CrossRef ] [ Google Scholar ]
• Arslan, G., & Wong, P. T. P. (2022). Measuring Personal and Social Responsibility: An Existential Positive Psychology Approach. Journal of Happiness and Health, 2 (1), 1–11. 10.47602/johah.v2i1.5.
• Arslan, G. & Yıldırım, M. (2020). Psychometric properties of the Mindful Attention Awareness Scale (MAAS-5) with college students. Manuscript in preparation.
• Arslan, G., & Yıldırım, M. (2021). Coronavirus stress, meaningful living, optimism, and depressive symptoms: a study of moderated mediation model. Australian Journal of Psychology , 1–12. 10.1080/00049530.2021.1882273
• Arslan, G., Yıldırım, M., Karataş, Z., Kabasakal, Z., & Kılınç, M. (2020). Meaningful living to promote complete mental health among university students in the context of the COVID-19 pandemic. International Journal of Mental Health and Addiction , 1-13. 10.1007/s11469-020-00416-8 [ PMC free article ] [ PubMed ]
• Asanjarani, F., & Arslan, G. (2020). Measuring the emotional and behavioral problems among Iranian students: A psychometric study. Journal of Education for Students Placed at Risk , 1–14. 10.1080/10824669.2020.1854761
• Billington, J., Dowrick, C., Hamer, A., Robinson, J., & Williams, C. (2010). An investigation into the therapeutic benefits of reading in relation to depression and well-being. The Reader Organization, Liverpool Health Inequalities Research Centre . Liverpool.
• Boniwell I, Osin EN, Martinez C. Teaching happiness at school: Non-randomised controlled mixed-methods feasibility study on the effectiveness of personal well-being lessons. The Journal of Positive Psychology. 2016; 11 (1):85–98. doi: 10.1080/17439760.2015.1025422. [ CrossRef ] [ Google Scholar ]
• Brown KW, Ryan RM. The benefits of being present: Mindfulness and its role in psychological well-being. Journal of Personality and Social Psychology. 2003; 84 (4):822–848. doi: 10.1037/0022-3514.84.4.822. [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Bruneau L, Pehrsson DE. The process of therapeutic reading: Opening doors for counselor development. Journal of Creativity in Mental Health. 2014; 9 (3):346–365. doi: 10.1080/15401383.2014.892864. [ CrossRef ] [ Google Scholar ]
• Burke J, Arslan G. A new forum for sharing happiness and health research. Journal of Happiness and Health. 2021; 1 (1):1–3. [ Google Scholar ]
• Campion J, Bhui K, Bhugra D. European Psychiatric Association (EPA) guidance on prevention of mental disorders. European Psychiatry. 2012; 27 (2):68–80. doi: 10.1016/j.eurpsy.2011.10.004. [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Chan DW. Stories and storytelling in teaching and child psychotherapy. CUNK Primary Education. 1993; 3 :27–31. [ Google Scholar ]
• Cohen J. Statistical power analysis for the behavioral sciences. 2. Lawrence Erlbaum; 1988. [ Google Scholar ]
• Diener E, Wirtz D, Tov W, Kim-Prieto C, Choi D, Oishi S, Biswas-Diener R. New well-being measures: Short scales to assess flourishing and positive and negative feelings. Social Indicators Research. 2010; 97 (2):143–156. doi: 10.1007/s11205-009-9493-y. [ CrossRef ] [ Google Scholar ]
• Dogan T, Cotok NA. Oxford Mutluluk Ölçeği Kısa Formunun Türkçe Uyarlaması: Geçerlik ve Güvenirlik Çalışması Türk Psikolojik Danışma Ve Rehberlik Dergisi. 2011; 4 (36):165–172. [ Google Scholar ]
• Forgan JW. Using bibliotherapy to teach problem solving. Intervention in 685, School and Clinic. 2002; 38 :75–82. doi: 10.1177/10534512020380020201. [ CrossRef ] [ Google Scholar ]
• Genç E. Transforming stress to happiness: Positive couple therapy with distressed couples. Journal of Happiness and Health. 2021; 1 (1):4–15. [ Google Scholar ]
• Hills P, Argyle M. The Oxford happiness questionnaire: A compact scale for the measurement of psychological well-being. Personality and Individual Differences. 2002; 33 (7):1073–1082. doi: 10.1016/S0191-8869(01)00213-6. [ CrossRef ] [ Google Scholar ]
• Huck SW, McLean RA. Using a repeated measures ANOVA to analyze the data from a pre-test-post-test design: A potentially confusing task. Psychological Bulletin. 1975; 82 (4):511–518. doi: 10.1037/h0076767. [ CrossRef ] [ Google Scholar ]
• JASP Team (2020). JASP (Version 0.16)[Computer software].
• Keyes CL. Promoting and protecting mental health as flourishing: A complementary strategy for improving national mental health. American Psychologist. 2007; 62 (2):95–108. doi: 10.1037/0003-066X.62.2.95. [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Keyes CL. Mental illness and/or mental health? Investigating axioms of the complete state model of health. Journal of Consulting and Clinical Psychology. 2005; 73 (3):539–548. doi: 10.1037/0022-006X.73.3.539. [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Latchem JM, Greenhalgh J. The role of reading on the health and well-being of people with neurological conditions: A systematic review. Aging & Mental Health. 2014; 18 (6):731–744. doi: 10.1080/13607863.2013.875125. [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Levitt JM, Saka N, Romanelli LH, Hoagwood K. Early identification of mental health problems in schools: The status of instrumentation. Journal of School Psychology. 2007; 45 (2):163–191. doi: 10.1016/j.jsp.2006.11.005. [ CrossRef ] [ Google Scholar ]
• Lewinsohn, P. M., Hops, H., Roberts, R. E., Seeley, J. R., & Andrews, J. A. (1993). Adolescent psychopathology: I. Prevalence and incidence of depression and other DSM-III—R disorders in high school students. Journal of Abnormal Psychology, 102 (1), 133–144. 10.1037/0021-843X.102.1.133. [ PubMed ]
• Lucas CV, Teixeira D, Soares L, Oliveira F. Bibliotherapy as a hope-building tool in educational settings. Journal of Poetry Therapy. 2019; 32 (4):199–213. doi: 10.1080/08893675.2019.1639883. [ CrossRef ] [ Google Scholar ]
• Lyubomirsky S, King L, Diener E. The benefits of frequent positive affect: Does happiness lead to success? Psychological Bulletin. 2005; 131 :803–855. doi: 10.1037/0033-2909.131.6.803. [ PubMed ] [ CrossRef ] [ Google Scholar ]
• McCulliss D. Bibliotherapy: Historical and research perspectives. Journal of Poetry Therapy. 2012; 25 (1):23–38. doi: 10.1080/08893675.2012.654944. [ CrossRef ] [ Google Scholar ]
• McCulliss D, Chamberlain D. Bibliotherapy for youth and adolescents—School-based application and research. Journal of Poetry Therapy. 2013; 26 (1):13–40. doi: 10.1080/08893675.2013.764052. [ CrossRef ] [ Google Scholar ]
• Montgomery P, Maunders K. The effectiveness of creative bibliotherapy for internalizing, externalizing, and prosocial behaviors in children: A systematic review. Children and Youth Services Review. 2015; 55 :37–47. doi: 10.1016/j.childyouth.2015.05.010. [ CrossRef ] [ Google Scholar ]
• O'Connor PJ, Herring MP, Caravalho A. Mental health benefits of strength training in adults. American Journal of Lifestyle Medicine. 2010; 4 (5):377–396. doi: 10.1177/1559827610368771. [ CrossRef ] [ Google Scholar ]
• Pehrsson D-E, McMillen PS. A national survey of bibliotherapy preparation and practices of professional counselors. Journal of Creativity in Mental Health. 2010; 5 :412–425. doi: 10.1080/15401383.2010.527807. [ CrossRef ] [ Google Scholar ]
• Seligman MEP, Csikszentmihalyi M. Positive psychology: An introduction. American Psychologist. 2000; 55 :5–14. doi: 10.1037/0003-066X.55.1.5. [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Seligman ME, Ernst RM, Gillham J, Reivich K, Linkins M. Positive education: Positive psychology and classroom interventions. Oxford review of education. 2009; 35 (3):293–311. doi: 10.1080/03054980902934563. [ CrossRef ] [ Google Scholar ]
• Scogin F, Fairchild JK, Yon A, Welsh DL, Presnell A. Cognitive bibliotherapy and memory training for older adults with depressive symptoms. Aging & Mental Health. 2014; 18 (5):554–560. doi: 10.1080/13607863.2013.825898. [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Slade M. Mental illness and well-being: The central importance of positive psychology and recovery approaches. BMC Health Services Research. 2010; 10 (1):1–14. doi: 10.1186/1472-6963-10-1. [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Tabachnick BG, Fidell LS. Using multivariate statistics. 6. Pearson; 2013. [ Google Scholar ]
• Telef B. The Scale of Positive and Negative Experience: A validity and reliability study for adolescents. Anatolian Journal of Psychiatry. 2013; 14 (1):62. doi: 10.5455/apd.36692. [ CrossRef ] [ Google Scholar ]
• World Health Organization . Promoting mental health. Concepts, emerging evidence, practice. World Health Organization; 2004. [ Google Scholar ]
• World Health Organization (2021). Adolescent health. https://www.who.int/health-topics/adolescenthealth#tab=tab_1 .
• Yıldırım M. Irrational happiness beliefs and subjective well-being of undergraduate students: A longitudinal study. Journal of Positive School Psychology. 2021; 5 (1):65–72. doi: 10.47602/jpsp.v5i1.258. [ CrossRef ] [ Google Scholar ]
• Yıldırım, M. (2019a). Irrational happiness beliefs: conceptualization, measurement and its relationship with well-being, personality, coping strategies, and arousal . Unpublished doctoral dissertation. University of Leicester.
• Yildirim M. Mediating role of resilience in the relationships between fear of happiness and affect balance, satisfaction with life, and flourishing. Europe's Journal of Psychology. 2019; 15 (2):183–198. doi: 10.5964/ejop.v15i2.1640. [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Yıldırım, M., & Arslan, G. (2020). Exploring the associations between resilience, dispositional hope, preventive behaviours, subjective well-being, and psychological health among adults during early stage of COVID-19.  Current Psychology , 1–11. 10.1007/s12144-020-01177-2. [ PMC free article ] [ PubMed ]
• Yıldırım, M., Arslan, G., & Wong, P. T. (2021). Meaningful living, resilience, affective balance, and psychological health problems among Turkish young adults during coronavirus pandemic.  Current Psychology , 1–12. 10.1007/s12144-020-01244-8. [ PMC free article ] [ PubMed ]
• Yildirim, M., & Balahmar, N. B. (2020). Adaptation and validation of the Arabic version of the short depression-happiness scale. Current Psychology , 1-8. 10.1007/s12144-020-01214-0.

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A must-read: Physical and mental health benefits of reading books

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Neurology and Neurosurgery

Reading books can transport you to new worlds and also transform your body and mind

By Paul Wright, MD , Senior Vice President and System Chair of the Neuroscience Institute, Nuvance Health

Want to know the secret to living multiple lives, meeting people from around the world and even time travel? You can experience these things through books plus the very real physical and mental health benefits of reading. Find out what happens in your brain when you read, and bookmark these fun facts to inspire your next reading session.

Who’s reading books these days?

According to Pew Research Center, 75% of adults in the United States said they read a book in the last 12 months. However, Americans are reading fewer books now than they did in the past according to a U.S. Gallup Poll. While the poll didn’t identify why Americans are reading fewer books, we can all take an educated guess — from jam-packed family, work and daily life responsibilities to countless other options for entertainment, you may not have the time or desire to read a book.

I’m also guessing you’ll want to find at least 20 minutes to read each day when you find out the brain-boosting benefits of books. And if you’re already a voracious reader, you’ll appreciate all the ways books are contributing to your well-being.

What happens in your brain when you read?

Reading a book is like eating a superfood for your brain. Studies using functional magnetic resonance imaging (fMRI) have shown that reading is a complex task involving different parts of the brain. By observing changes to blood flow in the brain, researchers can see that reading stimulates the brain’s neural pathways. This stimulation enhances brain activity, memory and cognitive function — ultimately boosting your creativity and expanding your capacity to learn.

What are the physical health benefits of reading books?

Reading has physical benefits in addition to being an intellectual workout. Research shows that regular reading can lower blood pressure , reduce stress and improve sleep quality. Researchers have also found a link between reading books and longevity; reading keeps your brain active and promotes mental and emotional fitness.

Related content: Can staying hydrated by drinking water really help you live longer?

What are the mental health benefits of reading books?

Cognitive health: Reading enhances your critical thinking skills and creativity. It also broadens your vocabulary, boosts your knowledge and stimulates your imagination.

Related content: Your brain on music: how music can enhance your workout and brain health

Emotional health: Books can make you feel all the feels, from happiness and surprise to sadness, fear and anger. Experiencing a variety of emotions can help build your resilience and ability to deal with difficult situations. It can also help you develop empathy and connect with people by learning about other cultures and experiences through storytelling.

Entertainment: There are many options for entertainment especially with digital devices and streaming services making shows, movies, music and podcasts more accessible now than ever before. Some of you may not consider books a form of entertainment, but they certainly can be. Books can make us laugh and cry and create intrigue and excitement. Being entertained also has positive health benefits including releasing endorphins in your brain. These feel-good hormones help you relax, manage pain and relieve stress.

Related content: Your brain on laughter: what happens in your brain when you laugh?

Stress relief: Speaking of stress relief, escaping into the captivating world of books can help lower your heart rate and relax your muscles. Books are also a healthy way to help you compartmentalize when you focus on a story instead of a stressful event.

Related content: The ultimate guide to beating work burnout: effective tips and tricks

Social engagement: Engaging in the world of books can contribute to your social life. Staying social has big benefits including preventing isolation, which is a risk factor for depression and dementia .

Here are ways to expand your connections and book collection:

• Join a book club, either in person or online.
• Create a book swap with family and friends.
• Participate in groups on social media with fellow bookworms or specific book genre enthusiasts.
• Opt in for “suggested reading” lists such as through your e-reader or social media.
• Check out your local library — frequenting a library can also give you a sense of community.

If you engage with reading groups, don’t shy away from a lively debate about a book’s meaning. A good debate can enhance your brain health through creative and persuasive thinking and problem-solving.

What if you don’t like to read books?

If you don’t like reading books, that’s okay. But given the positive benefits on your overall well-being, consider starting small and reading just 20 minutes a day. Here are some ways you can ease into reading books:

• Swap scrolling through your phone for reading just one time per day.
• Develop a routine such as reading before bedtime or sip your favorite beverage when you read.
• Select books on topics you’re curious about and really like.
• Research what people you admire read to connect with them through books, whether a celebrity, colleague, parent or best friend.

The bottom line: Whether you prefer fiction or non-fiction, short stories or novels, grab an e-reader or paperback to reap the many physical and mental benefits of reading books. Reading books can keep your brain active and healthy, boost your mood and mental health and let you endlessly explore.

Learn more about neurology and neurosurgery services at the Nuvance Health Neuroscience Institute.

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Open Access

Peer-reviewed

Research Article

Five studies evaluating the impact on mental health and mood of recalling, reading, and discussing fiction

Roles Conceptualization, Data curation, Formal analysis, Funding acquisition, Investigation, Methodology, Project administration, Resources, Writing – original draft, Writing – review & editing

* E-mail: [email protected]

Affiliation The London Interdisciplinary School, London, United Kingdom

Roles Conceptualization, Data curation, Formal analysis, Investigation, Methodology, Project administration, Writing – review & editing

Affiliation Center for Language Studies, Radboud University, Radboud, Netherlands

• James Carney, 
• Cole Robertson

• Published: April 8, 2022
• https://doi.org/10.1371/journal.pone.0266323
• Reader Comments

Does reading fiction improve mental health and well-being? We present the results of five studies that evaluated the impact of five forms of exposure to fiction. These included the effects of recalling reading fiction, of being prescribed fiction, of discussing fiction relative to non-fiction, and of discussing literary fiction relative to best-seller fiction. The first three studies directly recruited participants; the final two relied on scraped social media data from Reddit and Twitter. Results show that fiction can have a positive impact on measures of mood and emotion, but that a process of mnemonic or cognitive consolidation is required first: exposure to fiction does not, on its own, have an immediate impact on well-being.

Citation: Carney J, Robertson C (2022) Five studies evaluating the impact on mental health and mood of recalling, reading, and discussing fiction. PLoS ONE 17(4): e0266323. https://doi.org/10.1371/journal.pone.0266323

Editor: Barbara Dritschel, University of St Andrews, UNITED KINGDOM

Received: September 2, 2020; Accepted: March 20, 2022; Published: April 8, 2022

Copyright: © 2022 Carney, Robertson. This is an open access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Data Availability: The data associated with all five studies can be accessed at 10.6084/m9.figshare.17087135

Funding: This work was supported by fellowship no. 205493/Z/19/A awarded to JC from the Wellcome Trust ( wellcome.ac.uk ) The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Competing interests: The authors have declared that no competing interests exist.

Introduction

The claim that exposure to literature can have a positive impact on mental well-being has been visible for some time now. ‘Creative bibliotherapy’, as this view has come to be known, argues that the cognitive effects engendered by poetry, fiction, and drama may be of value in treating mental health conditions [ 1 – 6 ]. In one formulation, ‘attentive immersion in great literature can help relieve, restore, and reinvigorate the troubled mind—and can play a part in relieving stress and anxiety, as well as other troubled states of mind’ [ 7 ]. In a world where the need for affordable mental health resources outstrips the ability to supply them, this is an attractive proposition. It is unsurprising, therefore, that numerous popular authors have been enthusiastic in their endorsement of reading literature as a therapeutic intervention [ 8 – 14 ], or that services such as ReLit, The Reading Agency, and The School of Life seek to pair troubled readers with literature that will ostensibly improve their state of mind.

But enthusiasm for an intervention is not an argument in its favour. If anything, such enthusiasm mandates that one should even more circumspect than usual in the assessment of the evidence in support of the intervention. ‘The first principle’, as Richard Feynman observed, ‘is that you must not fool yourself—and you are the easiest person to fool’ [ 15 ]. A programme like creative bibliotherapy, which promises improvements to mental health by way of a high-prestige, hedonic activity like reading literature, needs a solid evidence base if we are to guard against its subjective attractiveness. As the evidence revolution in medicine has made clear, arguments from experience and expert-led judgment—however well-intentioned they may be—come a poor second to statistical rigour and data-driven conclusions [ 16 ]. If creative bibliotherapy is to be credited with genuine therapeutic efficacy, therefore, it needs to be tested using the full resources of experimental evaluation.

This is especially needful given the current state of the field. Though creative bibliotherapy has been sporadically subjected to empirical assessment, the results do not yield a consistent picture and hypotheses have, in general, not been well formulated (see Troscianko [ 17 ] for the best appraisal of the literature). To start with the issue of evidence, it is certainly true that a reasonable number of studies attribute therapeutic change to the experience of reading literature. For example, group-based studies record positive impact on measures of cognitive performance like concentration, memory, social skills, and creativity, as well as affective change in the direction of increased confidence, fewer feelings of isolation, and improvement on markers of depression [ 6 , 18 – 20 ]. Paralleling this, studies focused on individual reading argue for positive impacts on adolescent aggression [ 21 , 22 ], expressiveness in ill children [ 23 ], self-confidence and functioning [ 5 ], interpersonal empathy [ 24 , 25 ], and theory of mind [ 24 ] However, results do not seem to generalise, with a meta-analysis by Montgomery and Maunders [ 26 ] finding only minor evidence for the efficacy of creative bibliotherapy in addressing PTSD, and Glavin and Montgomery [ 27 ] finding no therapeutic effects at all. Perhaps most worryingly, Troscianko [ 17 ] presents evidence that readers with eating disorders recall having their symptoms exacerbated by fiction that thematises the experience of having an eating disorder. If so, creative bibliotherapy violates the very first injunction of therapeutic intervention—to do no harm.

But the problem is not solely evidential; difficulties also emerge at the conceptual level. Most obviously, terms like ‘literature’ and ‘mental health’ need to be clearly defined. It is not at all clear, for instance, that there is any common feature underlying the heterogenous collection of works, genres and individual styles that comprise what is generally accepted as literature. Even if this were not the case, it would remain unlikely that literature would impact in the same way upon the 297 or so disorders that the DSM 5 defines as constituting the repertoire of mental illness [ 28 ]. Finally, even conceding that literature (by whatever definition) has a positive impact on mental health, there remains an explanatory gap concerning what causal mechanisms may meditate or moderate this impact. So far as it has been theorised at all, the main approaches seem to volunteer literature as a form of cognitive behaviour therapy (CBT), such that literary texts allow readers to re-frame their orientation to the world by allowing the self to be refracted through identification with a third-party perspective [ 29 , 30 ]. Though such ideas have an intuitive appeal, the fact is that they often better resemble the hard-to-test constructions of psychoanalysis than they do the pragmatic paradigm of CBT. While this does not make them wrong, it does foreclose the possibility of other (possibly more mundane) causal mechanisms being identified.

These considerations, in combination with the intellectual importance of establishing the relation between culture and mental health, are what motivated us to assess the therapeutic value of literature by way of the five studies presented here. While no authors can claim to exhaust a topic, our goal was to conduct as systematic an evaluation as possible of how one form of literature—fiction—impacts on mental health, while allowing for the different modes of encounter that characterise exposure to fiction. We chose fiction for the simple reason that most people experience literature through fiction, so any results would have the widest applicability. This is not to deny that fiction can attracts problems of definition in the same way as literature [ 31 , 32 ], but for our purposes we take fiction to be the linguistically mediated evocation of a counterfactual reality in narrative form. The principal mental health conditions we evaluated were depression and anxiety—once more for the simple reason that these conditions, whether individually or in co-morbid form, are the most common mental health presentations [ 33 ]. Usefully, however, both conditions are also associated with psychometrically validated tests that allow for them be easily measured. With that said, two of the studies did not use such tests due to the fact that their data was scraped from social media, and relied instead on linguistic measures of mental state using the valence-arousal-dominance model of emotion [ 34 ] and an absolute words measure of mental distress [ 35 ].

Where our main innovation lay was with respect to the mode of encounter with fiction. Fiction can be experienced in many different contexts, and it is at least prima facie plausible that any cognitive or emotional impact it might have will be shaped by the form of this experience. For instance, being required to read a novel as part of one’s high school education will result in a very different experience from freely choosing to read that novel for personal pleasure. Any thorough appraisal of creative bibliotherapy should therefore take some account of this variation. We did this by identifying five different modes of encounter with fiction and implementing an experimental design that reflected each mode.

• Recalled impact of reading fiction : The fiction we are reading right now is always dwarfed by the amount fiction we have previously read. Moreover, the impact of fiction may involve periods of reflective consolidation that last months or even years [ 36 ]. This means that there are good grounds for evaluating fiction with respect to its recalled effects, as well as its immediate effects.
• Impact of prescribed fiction : Most people first encounter literary fiction in a classroom context, where texts are prescribed for mandatory reading from a canon of classics. The assumption here seems to be that forced exposure will have an improving effect, though this is by no means empirically established. Any assessment of creative bibliotherapy should therefore investigate the effects of prescribed fiction.
• Impact of chosen fiction : Habitual readers of fiction—i.e. those who gain most hedonic value from reading—will have well-developed tastes that guide what they choose to read. If fiction has a therapeutic effect, then it is to be expected that the act of choosing a text will impact on its effectiveness. This gives a third modality of encounter that needs to be contrasted with prescribed fiction.
• Impact of discussing fiction : Reading is typically seen as a solitary exercise, but it is also particularly effective at stimulating collective discussion. This happens at a professional level in the form of cultural journalism and academic criticism, but it is no less present in informal reading groups and online forums. As in-person reading groups are explored by one of us in another study [ 37 ], we here look exclusively at the effects of discussing reading in an online context.
• Impact of fiction quality : Judgments of artistic quality are notoriously subjective, but most readers are prepared to distinguish between fiction as entertainment and fiction as an aesthetic phenomenon. As exposure to different types of fiction may have an impact on therapeutic effects, any thorough evaluation needs to allow for variation in fiction quality.

As not all of these forms of encounter with fiction could be assessed using the same methods, our first three studies were performed by directly recruiting online participants using Amazon’s Mechanical Turk platform, while the last two relied on social media data from Twitter and Reddit. The Reddit data was accessed through the Reddit API; the Twitter data was obtained using data scraping methods. As all usernames were cryptographically hashed at point of acquisition and no text data published, we cannot make inferences about the mental states of individual users and are therefore compliant with the terms of use of both platforms. Inevitably, presenting methodologically distinct studies together in this way means there must be some compression of information. Our view is that this compression is a price worth paying, given that the creative bibliotherapy research is widely dispersed across the academic literature on account of not obviously belonging to either the humanities or the experimental social sciences. By the same token, we recognise that these studies may be of interest to readers who do not have training in quantitative methods; every effort will therefore be made to keep them accessible, consistent with accurately reporting the relevant results.

All studies that involved the collection and retention of unpublished data received ethics clearance from the Brunel University London College of Business, Arts, and Social Sciences Research Ethics Committee (Ref. 7863-A-Jan/2018–10690–1). Where study participants were directly recruited, they were paid the UK living wage on a pro-rata basis.

Study 1—Impact of recalling fiction

Our first study evaluated the hypothesis that recalling literary fiction has a therapeutic impact. The problem it poses is that different texts may not impact in the same way, due to variations between the texts; as already noted, ‘literature’ is not a well-defined phenomenon. As there is no way to entirely resolve this problem, we compromised by prompting responses around 12 well-known novels and measuring the emotional character of the language they use by way of word norm data. However, though this provided useful pilot data, our aim was not to establish the effect of these specific novels, so we also allowed participants to answer on other texts that we did not directly mention. Therapeutic change was measured using CORE-OM and PHQ scales, as well as a search for meaning measure. Given that both the word norm data and therapeutic measures feature in the subsequent studies, we deliver the background exposition for all of them in the present study.

Materials and methods

Participants..

Participants were recruited online using TurkPrime, an implementation of Amazon’s Mechanical Turk platform [ 38 ] on the basis of having read at least one of the twelve experimental texts. With a view to ensuring quality of response, only those participants who had at least a 97% approval rating from a minimum of 500 previous tasks were admitted. A total of 151 participants were recruited. Three participants were excluded: one who entered their sex as ‘other’ (because estimating effects of sex with only one observation in the ‘other’ category was not reliable) and two because their global distress change scores were more than 4.4 standard deviations from the mean and their inclusion in later regression analyses was exerting disproportionate influence on the estimation of effects. This left a final sample of N = 148 (76 females).

Participants were asked to answer on two texts. The first involved participants in selecting a text from a list and estimate how long it had been since they had read it; a validity check was included by asking them to name two characters from the chosen text in a free-text field. After doing this, they were invited to recall their mental state before encountering the text, and then complete the CORE-OM inventory for the first time (note that we were less interested in the actual mental state than in their reconstruction of that that mental state might have been). Upon completion, participants were requested to rehearse the events and world of the text and immerse themselves as much as they could in the experiences they had when they were reading. After this, they once more completed the CORE-OM—though this time with reference to their recalled mental state after reading. This procedure was repeated for a second text, with an open text field—’None of the above’—provided if the participant had read only one text on the list. Participants were then required to answer the PHQ-4 inventory for depression and anxiety, complete the search for/presence of meaning question inventory, and give a Likert-scale rating of how important they felt fiction to be in their personal lives. (Note that this study centred on the effects of recalling reading the text and not actually reading the text).

A control condition was not included due to the difficulty in identifying a meaningful comparator. Neutral textual prompts—such as the Wikipedia articles on factual topics used in Study 2 and Study 3—are inherently unmemorable, and unlikely to prompt any recollection. Non-textual prompts (such as thinking about a recalled event or experience), on the other hand, cannot be guaranteed to be neutral due to variation in personal experience. As these reasons preclude the inclusion of a meaningful control, our study took the null hypothesis—that recalling fiction has no effect on well-being as our comparator.

Study materials consisted of twelve novel-length fictional narratives, selected from an undergraduate reading list in English literature at Brunel University London. The texts referenced were Charlotte Brontë’s Jane Eyre (1847), George Eliot’s Adam Bede (1859), Mary Shelley’s Frankenstein (1818), Emily Brontë’s Wuthering Heights (1847), Mary Elizabeth Braddon’s Lady Audley’s Secret (1862), Elizabeth Gaskell’s North and South (1855), H.G. Wells’s The Island of Doctor Moreau (1896), Thomas Hardy’s Tess of the D’Urbervilles (1891), Charles Dickens’s Great Expectations (1860), Joseph Conrad’s Heart of Darkness (1899), and Charles Dickens’s Hard Times (1854). In the event that participants had read only one of these texts, they were allowed to answer on a different text of their choosing.

Independent variables.

Linguistic variation between texts was measured using word norms for valence, arousal, dominance (VAD) and concreteness (C). In this connection, a word norm is the average response to a particular word on a given dimension. Typically, word norms are the result of mega-studies, where large corpuses of words are assessed for the response that individual words evoke [ 39 , 40 ]. Here, we used the VAD norms established in Warriner, Kuperman, & Brysbaert [ 41 ] and the concreteness norms published in Brysbaert, Warriner, & Kuperman [ 42 ].

The value of word norms is that they provide a low dimensional proxy for emotional variation. That is, according to dimensional models of emotion, each discrete emotion can be represented in terms of an underlying set of finite components [ 34 , 43 ]. The VAD model identifies these components as valence, arousal, and dominance, where valence measures how positive (or negative) an emotion is felt to be, arousal measures how energising (or sedating) an emotion is felt to be, and dominance measures how in control (or controlled) and emotion is felt to be. Thus, anger is negatively valent, positively arousing, and negatively dominant, while happiness is positively valent, neutrally arousing and positively dominant.

Here, we used the VAD norms established in Warriner, Kuperman, & Brysbaert [ 41 ] and the concreteness norms published in Brysbaert, Warriner, & Kuperman [ 42 ]. Warriner et al. (2013) present VAD ratings for 13,914 common English words, thereby providing an empirically validated way of assessing the overall emotional impact of a word, making mean VAD easy to calculate. The concreteness norms published in Brysbaert et al. [ 42 ] provide ratings of 37,058 English words with respect to how concrete or abstract they are felt to be.

VAD+C levels were calculated by processing electronic copies of each text sourced at Project Gutenberg. In detail, this involved tokenizing each text into words, removing stop words (e.g. ‘to’, ‘from’, ‘for’, ‘the’, etc.), lemmatizing the remaining words into their root form (i.e. ‘running’, ‘ran’, ‘runs’ all reduce to ‘run’), and calculating the mean scores using values from word norm databases. This process was automated for future use by creating a custom process function built using the python spaCy natural language processing (NLP) library [ 44 ] Fig 1 shows the relative proportions of VAD+C in each text, normalized between 0 and 1, meaning that the text with the lowest value for a variable shows that variable as absent: i.e. Tess of the d’Urbervilles has the lowest value for arousal, while the Island of Doctor Moreau has the lowest values for valence and dominance.

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Dependent and moderating variables.

Therapeutic impact . Change in recalled pre- and post-reading states was measured using the Clinical Outcomes in Routine Evaluation Outcome Measure (CORE-OM)—a 34-item inventory that is typically used in the evaluation of psychotherapeutic interventions [ 45 ]. This battery of questions establishes change on four dimensions: well-being (W), problems or symptoms (P), functioning (F), and risk (R)—with the mean of these scores being used to define a compound variable called ‘global distress’. Typical questions include ‘Over the last week I have felt like crying’ (W), ‘Over the last week I have felt tense, anxious or nervous’ (P), ‘Over the last week I have felt able to cope when things go wrong’ (F), ‘Over the last week I have felt like hurting myself’ (R). Small changes were made in the wording of the CORE-OM to make it consistent with being applied to the pre- and post-reading state. The change in score between one completion of the survey and another can be taken as a measure of therapeutic impact. As a positive change score would have indicated an increase in distress, change scores were reverse coded such that positive scores always denote an improvement in symptoms.

Depression and anxiety . As a key item of inquiry concerns how literary materials might differentially impact on mental health conditions, interpersonal variation with respect to the two most common conditions—anxiety and depression—was recorded. This was done using the PHQ-4 screening scale for anxiety and depression [ 46 ]. The objective of this scale is to establish underlying propensity towards anxiety or depression (or both) for screening purposes. Participants are asked to score how much over the last two weeks they have been bothered by problems like ‘Not being able to stop or control worrying’ (anxiety) or having ‘Little pleasure or interest in doing things’ (depression).

Search for/presence of meaning . In a previous study, we showed that the tendency to search for meaning in one’s life moderated responsiveness to a literary text—with individuals scoring highly being more receptive to the text [ 47 ]. This suggests that search for meaning may play an important role in susceptibility to any therapeutic impacts that literary texts may have. Search for/presence of meaning was measured using the questionnaire developed in Steger, Frazier, Oishi, & Kaler [ 48 ]. This asks respondents to rate questions like ‘I am always looking to find my life’s purpose’ or ‘I understand my life’s meaning’, with a view to establishing whether they experience meaning as absent or present in their lives (and care about the fact). It outputs two scores: ‘search for meaning’ and ‘presence of meaning’, with there being a typically inverse relation between the two.

Main hypothesis.

Changes scores were calculated by subtracting post- from pre-recalled-reading state scores of the four dimensions of the CORE-OM (wellbeing, problems or symptoms, functioning, and risk), as well as the compound of these, global distress. Following Connell & Barkham (2007), CORE-OM scores are usually calculated such that increase in distress/negative symptoms are positively coded, so higher scores on the CORE-OM indicate poorer wellbeing. By subtracting post- from pre-recalled-reading scores, we reverse this convention such that in the subsequent analyses, positive change scores indicate increase (and negative change scores indicate decreases) in positive mental states in the post-recalled-reading state compared to the pre-recalled-reading state. To test our hypothesis, we conducted one-way, one-sample t -tests for all of these variables, where the null hypothesis is that there is no change (i.e. mean change score of zero). Results are reported in Table 1 and Fig 2 , which also breaks results down by gender. In all cases, unadjusted change scores across the whole sample were significantly above zero, indicating that reported positive impact in every factor of the CORE-OM was higher in the recalled post-recalled-reading state than in the pre-recalled-reading state. Applying a Bonferroni correction for multiple tests resulted in significance drop to trend level for problems or symptoms, and to become non-significant for wellbeing—but significance levels remained highly significant for the other variables, including global distress, which is a compound of the other factors, and which was tested first.

Horizontal line at zero indicates no change. Plots represent Mean +/- 2*S.E.

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Exploratory analysis.

In order to test whether any of the independent or moderating variables related to recalled change in wellbeing, we regressed global distress change on the following variables, as well as all two-way interactions between them: valence, arousal, dominance, concreteness, search for meaning, presence of meaning, propensity to anxiety, propensity to depression, personal importance fiction, social importance fiction, age, and sex. We also allowed intercepts to randomly vary, grouped within participant; this procedure allowed for the effects of grouping variables (like reading the same book) to be accounted for in the analysis. (Participants answered the CORE-OM measure for before and after reading two different books, so change scores on multiple books were grouped within participant.) To reduce the complexity of this model, we then performed a backwards stepwise model selection procedure, where α crit = .05. As such a procedure increases the likelihood of Type I errors (i.e. false positives), these results should be considered exploratory in nature. The model fitting procedure resulted in the model reported in Table 2 and Fig 3 . There are significant effects for valence, arousal, dominance, and concreteness ( Fig 4 ), as well as numerous significant interactions. Specifically, increasing valence, dominance, and concreteness engenders an improvement in the global distress measure, while increasing arousal decreases it. In other words, the more ’sensational’ and negative a text was, the more it was likely to have a negative impact when recalled. As omnibus tests of model fit like R 2 are not possible with multilevel models, we instead report the log likelihood ratio test for our model compared to a model with only the intercept randomly varied by participant. Results are highly significant at χ 2 (87.18) = 1629.8, p < .001.

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Results suggested that being prompted to remember the experience of being immersed in the fictional world can impact positively on psychometrically validated measures of distress, problems or symptoms, and ability to function, with the balance of probability suggesting that this is also the case for well-being. These results provided support for the investigated hypothesis. The exploratory analysis revealed several interactions that may explain this effect, but the model fitting procedure makes inferences unreliable. It did, however, point to VAD values being of interest in subsequent testing. In particular, the analysis indicates that VAD variation should be systematically incorporated into text selection so as to assess any causal role on text impact, particularly with respect to the differential impact of arousal relative to valence, dominance, and concreteness.

Limitations

The two principal weaknesses of this study were the lack of a control condition and the fact that each answered-on text involved taking the CORE-OM twice in close succession. This means results may not be specific to the recall of fiction and that the pre- and post-intervention measures may not be sufficiently independent of each other.

Study 2—Impact of prescribed fiction

Our second study evaluated the effect of prescribed fiction. However, it also took cognizance of the limitations of the first study by incorporating a control condition and staggering the first and second administrations of the CORE-OM over several days. In place of the less precise PHQ anxiety and depression battery, we used the Depression Anxiety Stress Scales (DASS) to measure propensity to each condition; we also assessed participants on the ‘Big Five’ personality scale. Another change came in the texts evaluated. Though novels are by far the most common vehicle of narrative fiction, these are too long to be used in an experimental setting. We used short stories instead, which can be read in a single session.

Consistent with the results of the first study, our hypothesis was that reading fiction would lead to improved outcomes on the CORE-OM relative to the control condition However, our expectation was that better diagnostic tools, a larger number of texts, and improved study design would give better insight into the causal mechanisms behind any detected change.

Participants were recruited online using TurkPrime with same approval ratings as in Study 1. There were 158 participants in total for the first stage of the experiment; 140 of these completed the second stage. One further participant who entered their sex as ‘other’ was excluded due the difficulty of drawing statistical inferences from a sample of one. This gave a usable N of 139 participants (55 females).

In the first step of the experiment, participants completed the CORE-OM, DASS, ‘Big 5’, and Search for Meaning questionnaires. Six days later, they were contacted and invited to participate in the second stage. On doing so, they were presented with a random story or a control text and asked to read it. Time controls were imposed so that participants could not continue to the next section until enough time had passed for several re-reads of the assigned text. Subsequent to reading, they were asked to complete the CORE-OM again. Participants were paid separately for each arm of the study, with payment for the first arm not requiring completion of the second arm—although participants were strongly exhorted to complete both.

Texts for the test condition were scraped from the American Literature database of 4,000 short stories using a python script written for the purpose. Although described as an American literature website, these stories offered a generic selection from world literature with no obvious bias in favour of American authors. The advantage of this database is that it offered an accessible and independent source of classic literary narratives that were of short duration and out of copyright. One disadvantage is that many of its selections seem dated to the modern reader; another is that the decision to sample the entire space of VAD variation (see below) meant that some children’s stories were included. Though a case could be made for excluding the latter, we felt that methodological rigour was better served by including them.

For the control condition, we used eight Wikipedia articles on neutral topics. There were ‘paint’, ‘dime’, ‘snow’, ‘benzene’, ‘metal’, ‘sand’, ‘ammonia’, and ‘chair’. These were chosen so as to provide an emotionally neutral experience of reading other than fiction. Table 3 summarises the presented texts.

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All texts were processed and assigned a VAD+C score using the spaCy function created in Study 1. With a view to providing a balanced sample, each story was also assigned a category designation that showed where it sat in the three-dimensional space of VAD variation. The eight categories used corresponded to whether the V, A, and D measures associated with each story were higher or lower than the zero-centred mean of each dimension for the whole corpus. With a view to maximising variance, the Euclidean distance associated with each story was taken and used to rank it relative to other stories in the same category, with the story furthest from the origin being given a rank of 1. A second constraint was imposed by word count. Allowing that each story would need to be read several times, this meant an estimated reading time of 1 minute for 238 words gave an exposure time of 18 minutes for three readings of a 1,500 word story [ 49 ]. This giving an upper limit, we placed the lower limit at 600 words so as to avoid acutely dissimilar experiences of reading time across participants. Within the word count constraint, we selected the four stories in each of the eight categories that had the greatest Euclidean distance, giving 32 stories in total. Combined with the eight control condition articles, this gave 40 test items. (The entire dataset of 4k processed stories can be downloaded from X.)

CORE-OM and SM . Following the procedures established in Study 1, the CORE-OM and Search for Meaning scales were used to measure therapeutic impact and propensity to search for meaning respectively. See previous study above for details of these questionnaires.

Depression and anxiety . Instead of the PHQ4 measure for anxiety and depression that we used in Study 1, we chose here to use the Depression Anxiety Stress Scales (DASS) questionnaire [ 50 ]. Though the DASS and the PHQ correlate strongly with each other, the DASS offers a more probing inventory of 21 questions that subdivide into three factors of anxiety, depression, and stress. As such, our view was that the DASS would perform greater explanatory work were propensity towards depression or anxiety discovered to have an effect.

Big 5 personality scale . The Big 5 model of interpersonal variation suggests that human beings differ from each other with respect to the traits of openness to new experience, conscientiousness, extraversion, agreeableness, and neuroticism [ 51 , 52 ]. There is a mixed literature on the relationship between the Big 5 and cultural preferences. Djikic, Oatley, & Carland (2012) [ 53 ], for instance, suggest that exposure to fiction can cause changes in self-assessment with respect to the Big 5; other studies argue that personality, far from being shaped by cultural objects, determines the cultural objects that are found to be engaging and how they are engaged with [ 54 – 56 ]. Give the plausibility of claims that personality variation may moderate cultural taste (and vice versa), we included the 44-item inventory for measuring the five personality factors from John & Srivastrava [ 57 ].

As with Study 1, change scores were calculated on the CORE-OM by subtracting scores at the different time points. Change scores on the test condition were then compared with scores in the control condition using an independent samples t-test on global distress , problems or symptoms , distress , well-being , and functioning . No statistically significant differences were detected on any dependent variable ( Table 4 ). Subsequent tests that compared responses in each text category with the control condition also yielded no significant results.

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The lack of significant results here challenges the outcome of Study 1. However, the grounds of the challenge are not clear. One possibility is that the design of Study 1 created an artefact and the detected effects were not real. A second is that the constraints imposed by VAD sampling and word limits created an ecologically unrealistic sample of texts (i.e. the texts, taken collectively, are not a good representation of fiction). Thirdly, it could be reasonably argued that the CORE-OM outcome measure—designed for measuring face-to-face therapeutic interventions for distressed individuals—is inappropriate to the measurement of subtle changes in affective and cognitive state brought about by reading fiction. Finally, it may be that prescribing fiction independently of individual preferences nullifies any therapeutic impact it may have. Testing the impact of chosen fiction using more sensitive measures than the CORE-OM allows us to adjudicate between these outcomes by giving a second methodological contrast to Study 1 that avoids prescribing fiction to participants and is not subject to the same exacting sampling constraints.

Study 3—Impact of choosing fiction

If fiction has a therapeutic impact, it may be that this impact is partly delivered by the act of choosing the fictional text. That is, independently of the character of the text itself, individuals may respond to it more positively when the experience of reading is felt to be congruent with an autonomous choice. Support for this idea comes from the large literature documenting how individuals denied a choice in an activity experience less hedonic return relative to individuals allowed to exercise a choice [ 58 – 60 ]. In the specific area of cultural choices, for instance, Lewis [ 61 ] shows that the same TV programmes are enjoyed more by viewers who choose them over viewers who are involuntarily exposed to them, an effect that is (with some qualifications) also visible in advertising [ 62 , 63 ].

Our third study evaluated whether these ideas can be extended to fiction. It did this by reproducing the two-arm design of Study 2, but instead of assigning fiction, it allowed participants to choose the texts they wished to read. However, though we followed the overall design of Study 2, we changed several of the dependent variables. Most significantly, we used the Profile of Mood States (POMS) measure to capture affective change between the first and the second timepoints of the study [ 64 ]. We also swapped the CORE-OM for the GP-CORE (a subset of the CORE-OM questions that is intended for use with a general population instead of a clinical one) and used the GP-CORE score as a trait rather than a state measure. These changes are explained in more detail below.

Participants were recruited online using TurkPrime, using the same approval ratings as the previous two studies. There were 219 participants in total for the first stage of the experiment; 154 of these completed the second stage. One participant who entered their sex as ‘other’ was excluded due the difficulty of drawing statistical inferences from a sample of one. Two further participants were excluded on account of being mistakenly served the blurb text for a Gabriel García Márquez story instead of the story itself. This gave a usable N of 151 participants (69 females). As the duration of the task assigned to each participant varied widely, a three-tier payment structure was adopted, such that participants who chose longer tasks were paid more.

In the first step of the experiment, participants completed the GP-CORE, Search for Meaning and Profile of Mood States (POMS) questionnaires. Six days later, they were contacted and invited to participate in the second stage. In the test condition, they were invited to select a short story from a dropdown list and asked to read it, where the list text gave the name of the story and the name of the author. Time controls were imposed so that participants could not continue to the next section until enough time had passed for several re-reads of the selected text. In the control condition, they were randomly assigned one of the eight Wikipedia articles that made up the control texts in Study 2. Subsequent to reading, they were asked to complete the POMS questionnaire again. Participants were paid separately for each arm of the study, with payment for the first arm not requiring completion of the second arm.

Texts were taken from the American Literature database of 4,000 short stories used in Study 2. Unlike Study 2, however, there was no requirement to balance the selection across VAD+C. This meant that the primary considerations were word count and the challenge of loading the story text into the survey software, which required manual text formatting using html tags. In the interests of realistic reading times, word count was capped at 20k words and the 32 stories from Study 2 were increased to 67 so as to provide greater story choice. The control texts were once more the Wikipedia articles for ‘paint’, ‘dime’, ‘snow’, ‘benzene’, ‘metal’, ‘sand’, ‘ammonia’, and ‘chair’. Participants from Study 2 were excluded from Study 3.

The hypothesis informing this study was that choosing a fictional text would have a stronger impact on well-being than reading a randomly assigned alternative text. For this reason, the independent variable was categorical, and consisted of whether the participant chose (or did not choose) the text they were exposed to. In the test condition, this involved being exposed to a voluntarily chosen piece of fiction; in the control condition, they were randomly exposed to a Wikipedia article. As Study 2 already indicates that prescribing fiction does not seem to have a therapeutic effect, any positive result in the test condition in the present study favours the hypothesis that choosing a text has an impact on well-being. We acknowledge that this leaves undecided the question of whether a similar effect would also be achieved by choosing a non-fiction text. However, as our aim was to establish the result of choosing fiction relative to prescribing fiction compared to the same control, the best procedure was to retain the control texts from Study 2.

In contrast to Study 2, we used the POMS inventory rather than the CORE-OM as the dependant variable. On consideration, we felt that the CORE-OM, as an inventory designed to test structured therapeutic interventions, may not have the sensitivity to capture improvements to well-being that did not reach the threshold of clinical significance. By contrast, the POMS inventory is explicitly designed to capture transient changes in mood states that load onto the dimensions of tension, depression, anger, vigour, fatigue, and confusion [ 64 ]. In the interests of brevity, we used the reduced 39-item scale validated in Grove & Prapavessis [ 65 ] rather than the original 64-item questionnaire. Questions ask participants to quantify how they are feeling at the time of testing by presenting a mood word—‘Tense’, ‘Sad’, ‘Energetic’, etc.—and requiring them to circle an option on a scale that runs from ‘Not at all’ to ‘Extremely’. Several precedents exist for using POMS to capture affective and cognitive change following interventions designed to improve well-being [ 66 – 68 ].

Paralleling this movement away from measures designed to capture clinical variation, we took the GP-CORE as a moderating variable instead of the DASS. This is a subset of 14 questions from the CORE-OM that are selected for use in mental health assessment outside of clinical settings [ 69 ]. The chief difference is that extreme questions like ‘I have been physically violent to others’ or ‘I have felt panic or terror’ are omitted in favour of questions that pick out non-clinically relevant emotional variation.

The other included moderating variable, the Search for Meaning measure, was included due to it predicting receptivity to literary effects in Carney & Robertson [ 47 ]. The Big 5 personality scale was not used as analysis of Study 2 results showed no significant variation in responses across the five personality factors.

Change scores were calculated for POMS on two dimensions: total mood disturbance (TMD) and esteem-related affect (ERA). The first is the sum of the scores on the negatively valent dimensions minus the sum of the positively valent ones; the second is the specific subset of questions that pertain to positive mood states. An independent samples t-test was used to compare change scores between the test and control conditions. No statistically significant results were recorded on either dimension (TMD: t = -0.382, DF = 48.01, lower CI = -9.32, p = .703; ERA: t = -1.04, DF = 56.53, lower CI = -2.09, p = .301).

The lack of statistically significant differences between groups in this study challenges the hypothesis that choosing fiction impacts on wellbeing. Given that this matches the results achieved for prescribing fiction, the bigger question it raises concerns whether any positive results can be expected from direct exposure to fiction. It may be, for instance, that fiction needs to be cognitively or emotionally processed before positive effects can be accessed. This means that the testing programme needs to incorporate these dimensions if fiction is to be properly assessed for its impact on well-being.

Study 4—Impact of discussing fiction

One of the most common ways in which fiction is processed is through group discussion. In the first instance, most comprehensive education programmes will include a component that involves reading and discussing fiction, meaning that even individuals who do not enjoy fiction will have experience discussing it. Beyond educationally mandated discussions of fiction, books clubs provide popular forums in which like-minded individuals can discuss named titles. Typically, such groups are independent of each other, but they are occasionally coordinated in a top-down way by public libraries or TV shows. Finally, evaluations of fiction by academic researchers and professional journalists constitute a type of collective cultural discussion that individuals participate in to greater and lesser degrees, just as groups of friends who associate for social reasons may discuss fiction as part of general conversation.

Our fourth study evaluated the impact on mood and emotion of discussing book-related topics (mostly fiction) relative to the discussion of non-book-related topics. We chose to use the VAD word norms explored in the previous studies to measure mood and emotion. However, we supplemented this with an ‘absolute word’ measure, which has previously been used to assess linguistically mediated mental distress. In practice, this involved testing four claims.

• Valence : Discourse on books should be more positively valent, on average, than discourse on other topics. This follows directly from bibliotherapeutic claims that reading has positive impacts on well-being. Though this does not imply that discourse on reading will be the most positively valent of all surveyed discourse, it should score significantly higher than a random selection of other topics.
• Arousal : Discourse on books should be lower in arousal, on average, than discourse on other topics. While it is certainly true that high arousal is consistent with both positive and negative experiences, states of high physiological excitement are particularly associated with stress [ 70 , 71 ]. Thus, if discourse about books has a therapeutic effect, it is to be expected that it would exhibit lower arousal than other topics of discussion.
• Dominance : The conviction that one is the author of one’s own actions is often cited as a feature of psychological well-being [ 72 – 74 ]. Any positive impact of discourse on books on well-being should therefore be characterised by higher mean levels of dominance, which measures how in-control a stimulus makes its experiencer feel. Thus, we predict that dominance levels should be higher in book-related topics than in other topics.
• Absolute words : Al-Mosaiwi and Johnstone [ 35 ] argue that the use of what they call ‘absolute words’ is a linguistic covariate of anxiety, depression, and suicidal ideation. These are words that express magnitudes or probabilities without nuance or qualification, such as ‘always’, ‘totally,’ or ‘entire’. The supposition is that mental distress results in over- or underestimation of threats and rewards and the use of absolute words characterises this. We therefore predict that that the probability of encountering absolute words should be higher in non-book-related subreddits.

Given that one of the present authors was already involved in a long-term, in-person study that evaluated the impact of reading and discussing fiction [ 37 ], we chose here to focus on online discussions of fiction from the Reddit social media platform. While it is only fair to acknowledge from the outset that how people talk about a topic online may differ from offline interactions, it is unlikely to be wholly dissimilar. Moreover, given the role of social media in present-day social interactions, any results will be of equivalent importance to those from in-person studies.

Participants were not directly recruited. As per the procedure outlined below, they were selected when Reddit was accessed using the Reddit API in accordance with specific search criteria. This produced 286 participants. All scraped data were already in the public domain, but Reddit usernames were nevertheless hashed so as to protect the identity of users who may have been using their actual name.

Reddit is an open platform that allows users to create and participate in themed forums; its functionality allows for users (‘redditors’) to post original content, links, or other media and comment on it. Specific comments and posts can be voted up or down by individual users, with upvoted content remaining visible for longer. At the time of writing, Reddit has over 330 million users and approximately 180 thousand active subreddits, with the latter covering every major articulation of human activity. What makes Reddit useful in the present connection is that it can be accessed via an API that makes it possible to quickly and efficiently aggregate large bodies of text data. This makes it ideal for comparing the different ways in which people talk about different activities.

Using the Python Reddit API Wrapper (PRAW), the authors wrote scripts for extracting content from Reddit. For any specific subreddit, the scripts extracted the most upvoted submissions. With respect to an individual submission, the relevant script scraped all the comments associated with that submission. Two scripts dealt with individual redditors: one of these extracted the comments of a particular redditor on other redditors’ submissions in order of most upvoted comments; the other pulled their own submissions in order of upvotes. The scrape was initiated by scraping the top-rated 1,000 submissions in the books subreddit, with the ratings attaching to the number of upvotes received. The authors of these posts were identified, and all of their other submissions and comments were extracted up to a maximum value of 1,000 items. Each script generated a dataframe with the same columns—namely, ‘text’, ‘datetime’, ‘score’, ‘title’, ‘subreddit’, ‘type’, and ‘redditor’. Where a given script did not return a value for column field, a ‘NaN’ (‘not a number’) value was recorded. Using the same columns allowed for the output of one script to be easily concatenated with the results of every other. In all cases, content extraction was capped by PRAW rate limits, which return a maximum of 1,000 items for any Reddit listing and only allow a finite number of API calls in a given session.

Data were extracted on the 20 th of May 2019. This generated a dataset of 251,403 observations. Of these, 22,803 were generated by the AutoModerator Reddit bot and were removed, as were occasional duplicate entries. The result was a dataset of 228,600 items, spread across 5,942 subreddits.

Experimental variables.

Clean text and VAD values were extracted using a spaCy process function built in Study 1; an absolute words metric was also calculated for each text item. As processed texts were on average relatively short ( M = 40.14 words), this meant that a taking a mean across words for each of valence, arousal, and dominance gave an accurate measure of the emotional components of each item. (This is because longer linguistic samples tend to regress towards the mean VAD of English as a whole.). However, it should be noted that there was high variability in item length ( SD = 94.45), so internal VAD variation in longer texts may not have been captured. The absolute word metric was calculated by determining the probability of a randomly selected word being an absolute word for every text item.

With a view to distinguishing between books-themed subreddits and non-book-themed subreddits, the ‘subreddit’ column was analysed. Using string matching methods, any subreddit that contained ‘book’ or ‘fiction’ in its name was identified. Manual examination of these identified 30 subreddits that were directly concerned with the discussion of fiction or with reading generally. These were distinguished from other subreddits by adding a further ‘genre’ column to the dataframe that grouped books-related subreddits and non-book-related subreddits (here the word ‘genre’ is used in the loosest possible sense as a grouping variable). This gave 198,464 non-reading related items relative to 30,136 reading-related items.

Valence, arousal, dominance, and absolute words were regressed on multilevel mixed models with random intercepts and random slopes for redditor and subreddit (this allowed for the effects of autocorrelation within multiple posts by the same user and within multiple posts in the same subreddit). Fixed effects were included for whether or not the genre was related to books. This initial model failed to converge so the random slopes stipulation was removed in favour of a model with random intercepts only, which reached convergence. Results are summarised in Table 5 , but genre had a statistically significant impact on all variables with the exception of arousal. Effects were in the predicted directions for valence, arousal, and dominance, but in the opposite direction for absolute words ( Fig 5 ). As Study 5 also used the same variables as this study, a Bonferroni correction was made to allow for multiple comparisons on the same dependent variable; this had the effect of making absolute words statistically non-significant.

https://doi.org/10.1371/journal.pone.0266323.g005

https://doi.org/10.1371/journal.pone.0266323.t005

Of the three VAD variables, dominance is probably the one most explicitly connected with well-being. Valence and arousal, though obviously central to affective experiences, are nevertheless more directly associated with changes in physiological states. Dominance, by contrast, attaches to the sense of agency: it relates to how autonomous a stimulus makes a person feel. As attested in the literature, autonomy is a signal of both positive mental health and, where mental illness has previously supervened, recovery from such illness [ 75 , 76 ]. In one formulation, ‘recovery is a journey, characterized by a growing sense of agency and autonomy’ [ 77 ]. Thus, the significant result for dominance counts as a useful item of evidence in favour of the view that discussing books can have a positive effect on mental health. What is less clear is why discussing books should foster dominance to a greater degree than other topics. Though we did not disambiguate between fiction and books more generally in this study, the predominance of fiction in the data means that the answer may lay in the effects of narrative on identity construction. Several theorists argue that individuals frame their personal and collective identities using narrative modes of thinking [ 78 – 81 ]; if so, discussing recently consumed fictional narratives may activate a high dominance stance.

The significant result for valence also points to the value for mental health in discussing books. That a positive frame of mind should be associated with mental health is unsurprising; where the puzzle arises is why books should systematically impact on valence. Many books, whether factual or fictional, deal with unpleasant subject matter and challenging experiences, which would lead one to expect wide variation in valence in discussions of these books. Instead, the discussions have a positive valence that is significantly higher than the mean for other topics. It would seem, therefore, that reading has the effect of allowing readers to access and talk about low valence content in a way that is not itself negatively valent.

It is worth noting that this effect of valence replicates results for in-person, group discussions of fiction in Troscianko, Carney, and Holman [ 82 ], which show that low valence in a text does not mandate that the discussions of text are recalled as being unpleasant. It also aligns with a long-standing view that assigns a cathartic or functional value to being exposed to third-party experiences, for example via fiction. Aristotle first mooted the idea that drama has the effect of purging powerful emotions in the audience [ 83 ]. Twenty-first century scholarship has taken up this idea, with Glavin & Montgomery (2017) hypothesising that fictional worlds make anxiety inducing experiences salient while removing their threatening immediacy, thereby allowing them to be processed in a safe way. Similar ideas are also advanced for fiction by Troscianko [ 17 ] and Koopman [ 84 ]; Khoo & Oliver [ 85 ] make equivalent claims for cinema. Moving on to the functional advantages of representations of others’ experiences, Pinker [ 86 ] argues for the view that fiction may have evolved to allow for the offline processing of challenging scenarios. Clasen [ 87 , 88 ], takes up this idea with respect to negatively valent content in genres like horror; his claim is that the enjoyment of this disturbing content can be explained as an incentive for processing evolutionarily relevant threats like predation. Thus, there are several mechanisms that can explain why discussing books, in particular, should be associated with positive valence when their content may often have a negative valence.

The result on arousal prima facie challenges the hypothesis that discussing books improves mental well-being. It is notable, however, that the distribution of values found here for arousal is strongly bimodal—an effect that is also visible for dominance and (to a much smaller extent) for valence ( Fig 6 ). This suggests that books-related discussion does not exhibit uniform variance, but that people tend to use language that peaks either higher or lower than the mean for arousal and dominance. For dominance, the lower peak is still greater than the mean dominance for non-books discussion; for arousal, the higher peak is close to the non-books mean, while the lower peak gives a smaller value than the non-books mean. It would seem, therefore, that, in books-themed discussion there is a latent variable systematically pulling discourse into high-dominance, low-arousal and into low-dominance, high-arousal states. As much of books-related discussion is evaluative, we conjecture that this hidden variable is the quality of a book, with low quality books driving the low-dominance, high-arousal responses and high-quality books informing the high-dominance, low-arousal responses. We recognise, however, that these kernel-density estimate plots do not account for the autocorrelation of errors in the data, and thus make Type I errors of interpretation more likely.

https://doi.org/10.1371/journal.pone.0266323.g006

Our hypothesis is challenged by the result on absolute words, even if this effect becomes non-significant after correction for multiple comparisons. We note, however, that evaluative language uses many of the words in the absolute word lexicon, so it may be that absolute words and evaluative language are both forms of assessment applied to different things (i.e. cultural objects and one’s own mental state). Regardless, it does suggest caution in interpreting the overall set of results as being supportive of the idea that discussing books improves wellbeing.

One limitation of this study is that it did not systematically account for variation within books discussed. Though the majority of book-themed discussion concerns fiction, we did not control for how much. As our overall hypothesis concerns how fiction impacts on wellbeing, a more precise focus on fiction is needed. A second limitation is that the high variability in the length of reddit posts means that taking a per-item VAD average may conceal VAD variation within items. Limiting the length of items is needed to prevent this.

Study 5—Impact of discussing literary and non-literary fiction

One assumption of creative bibliotherapy is that any therapeutic efficacy fiction may have will scale with the quality of that fiction. That is, literary fiction will have a more salutary effect than non-literary fiction. This assumption is challenging to test because ‘literary’ is not an objective designation: it usually functions to identify what a historically shaped interpretive community nominates as literature rather than any feature of the text itself [ 89 ]. In Studies 1–3, this was side-stepped by using classic texts that have already been selected by critical opinion as exemplars of literature. The fact that two of these three studies showed no change means we must question the claim that the experience of reading literature has therapeutic effects. However, Study 4 did find effects, and gave evidence to think that there may be a latent variable to do with quality affecting discussions of books. This possibility justifies a study that evaluates the differential impact on wellbeing of literary fiction relative to non-literary fiction in a context that relates to community discussion.

Our fifth study did this by evaluating fiction-themed discourse on Twitter. Specifically, we compared the VAD and absolute words profile of the language surrounding best-seller fiction relative to that surrounding fiction that has won or been shortlisted for a literary award. There were three reasons for choosing to use Twitter as the source of data for this study. The first is that it gives access to the judgments of an interpretive community in an accessible way. Literary awards are explicitly offered as the outcome of informed critical opinion, so winners of these awards can with reasonable confidence be identified as ‘literary’ by the standards of present-day judgment. This contrasts with best-seller lists, which capture titles that are popular without necessarily being literary (allowing that the two can sometimes coincide). The second reason for using Twitter responses to literary awards is that it gives access to opinions on long-form contemporary fiction. Two limitations of earlier studies were that texts were required to be older than 70 years (due to copyright law) and, for Study 2 and Study 3, needed to be short enough to be presented in an experimental setting. As the effect of both limitations was to exclude much of the fiction read by present-day audiences, it challenges the relevance of these studies for contemporary readers. By contrast, Twitter responses to literary rewards and best-sellers directly connect with longer instances of contemporary fiction. Our third reason for using Twitter is that Twitter responses are limited to 280 characters. Tweets do not allow much scope for emotional equivocation, so they resolve the problem of VAD variability presented by long Reddit posts in Study 4.

With respect to hypotheses, we make the same predictions as made in Study 4, but with ‘book-related’ and ‘non-book-related’ replaced by ‘best-seller’ and ‘literary award’. That is, we predict that posts about books on the literary award category will (1) be higher in valence, (2) be lower in arousal, (3) be higher in dominance, and (4) have a lower probability of featuring absolute words.

Participants were not directly recruited. As per the procedure outlined below, they were selected when Twitter was scraped in accordance with specific search criteria. This produced 129,134 participants. All scraped data were already in the public domain, but Twitter usernames were nevertheless hashed so as to protect the identity of users who may have been using their actual name.

We identified six well-known literary awards for contemporary fiction: the Booker International, the Walter Scott Prize, the National Book Critics’ Award, the Man Booker, the Pulitzer, and the American Book Award. We then recorded the titles that these awards had either shortlisted or selected for these awards in the year from December 2017 to December 2018, which produced 40 titles in total. We then took a sample of the books that occupied the number one position in the New York Times best-seller list over the same time period; this gave 35 titles.

Using these 75 titles as search terms, we scraped Twitter from December 2017 to December 2018. This was performed using the Twint library, which is a python package that accesses with Twitter via the html public web interface. The advantage of Twint is that it does not impose rate limits, though as an open source project it is less reliable than the official Twitter API. This produced a total of 233,360 tweets that were authored by 128,134 users. Of the scraped tweets, 46,895 belonged to the ‘literary awards’ category and 186,465 belonged to the ‘best-seller’ category. Using the spaCy text cleaning function developed for the previous studies, tweet text was extracted and regularised. This text was then scored for VAD and absolute words. As anticipated, there was low variation in processed tweet length in words relative to the mean ( M = 11.87; SD = 6.59).

Valence, arousal, dominance, and absolute words were regressed on multilevel mixed models with random intercepts and random slopes for book title and user. This allowed for the effects of autocorrelation in tweets about the same title and in tweets by the same user. Fixed effects were included for whether or not the category was best-seller or literary award. This initial model failed to converge so the random slopes stipulation was removed in favour of a model with random intercepts only, which reached convergence (see Table 6 ). Effects were in the predicted directions for valence, arousal, and dominance, but in the opposite direction for absolute words ( Fig 7 ). Since Study 4 also used the same variables as this study, however, a Bonferroni correction was made to allow for multiple comparisons on the same dependent variable; this had the effect of also making arousal statistically non-significant.

https://doi.org/10.1371/journal.pone.0266323.g007

https://doi.org/10.1371/journal.pone.0266323.t006

As always, evidence against the null hypothesis is not necessarily evidence in favour of a competing hypothesis. Nevertheless, the fact that tweets about books featured in literary awards should evince a healthier mood profile with respect to valence and dominance than tweets about best-sellers is a provocative result. In particular, it supports the results for valence and dominance presented in Study 4, as well as validating the supposition that the Study 4 result for arousal is caused by a bimodal latent variable concerned with quality. The result on absolute words was not significant in this case, though the fact that it was in the same direction as in Study 4 indicates that it may be a factor in need of explanation.

In terms of the statistically significant results, we acknowledge that ‘literary award’ and ‘best-seller’ do not map onto ‘book-related’ and ‘non-book-related’, and thus the congruence of results between Study 4 and Study 5 is not a replication. With that said, the categories do cohere with respect to their status as test and control conditions relating to exposure to fiction; in this sense, ‘book-related’ and ‘literary award’ seem to be exercising a similar effect. Across the two studies, the Twitter and Reddit test conditions all have statistically significant differences between each other for valence and dominance, though it is not clear what conclusions should be drawn from this, except perhaps that Reddit and Twitter discourse simply have different emotional profiles.

More generally, the results for the most part support the claim that tweets about literary fiction have a more salutary character than tweets about best-sellers. The reasons why this might be so for valence and dominance have already been explored in the discussion for Study 4 so we will not repeat them here. Though arousal loses significance after the application of a Bonferroni correction, it remains in the predicted direction and no longer exhibits the bimodal distribution found in Study 4. Once again, the absolute words measure is not statistically significant, but this time in the opposite direction to Study 4. On reviewing the absolute words measure in both studies, we note that most comments or tweets had no absolute words in both studies, meaning that a great deal of variation is mapped onto a value of zero for absolute words. This does not invalidate absolute words as a measure of mental distress, but it does contrast unfavourably with the resolution provided by the VAD values, which assign a measure to all observations. It may be, for instance, that high levels of distress are needed to trigger the use of many absolute words, and lower levels are therefore undetected. However, the general point remains that tweets about literary fiction evince a profile more consistent with mental wellbeing than tweets about bestsellers.

Tweeting is not a neutral process; it introduces several confounds that may challenge the results presented here. It is likely, for instance, that social media users who tweet about literary awards are in a relatively secure economic position and well educated—two factors that would impact on well-being. Similarly, as explored in Murray [ 90 ], the digital environment selects for certain types of readers and reading experiences that may systematically impact on the kinds of tweets that are produced. The nature of twitter data means it is not possible to control for these issues, but they should still be borne in mind as important considerations.

General discussion

Across all five studies, a mixed pattern of results emerges. For the two studies in which there was a direct exposure to fiction, no results were recorded; in the three studies that dealt with the recall and discussion of fiction, results were on the whole supportive of the view that engaging with fiction has positive impacts on well-being. For Study 1, this relates to the outcome measures associated with the CORE instrument; in Study 4 and Study 5, the measure was mean change on valence, arousal, and dominance affect measures. How are we to make sense of these results?

At the broadest level, the implication of the five studies is to disconfirm what we might term the ‘pharmaceutical’ model of creative bibliotherapy. This is the view that fiction, in virtue of some intrinsic property, has salutary effects on well-being, and can thus be dose-prescribed in much the same way as, say, an antidepressant or a vitamin supplement. Though no authoritative proponent of creative bibliotherapy holds to so simplistic a view as this, it is nevertheless the intuition behind journalistic claims that ‘reading strengthens your brain’ [ 91 ], or that ‘books may have as many health benefits as running or eating broccoli’ [ 92 ]. But whether one subscribes to the pharmaceutical view or not, our results suggest that direct exposure to fiction does not seem to confer any measurable benefit in the time adjacent to exposure, at least with respect to common standardised test instruments. (Note that Troscianko [2018b] indicates that individuals with eating disorders recall being harmed by reading eating-disorder-themed fiction, but her study does not capture whether this was immediate or required reflective consolidation.) We suggest, therefore, that prescribing fiction to bring about a quick amelioration of symptoms is unlikely to work.

What does seem to have an effect, however, are modes of presentation that require indirect engagement with fiction. Study 1 showed this with respect to the effect of recalling reading fiction, Study 4 indicates that discussing books has more salutary effects than discussing non-book-related topics, and Study 5 gives evidence that discussing literary fiction has more positive effects than best-seller fiction. What is common in all cases is an opportunity to reflect on the material that has been read, whether by way of ordinary mnemonic integration or as a necessary preliminary to engaging with the opinions of others. And even in the case of mnemonic integration, this result was demonstrated only for classic literary texts that are the subject of sustained cultural discussion—potentially allowing that there is a social component at work here, too. The question that emerges is why these modes of encounter with fiction should engender positive effects when more direct encounters do not. We propose three explanations, all of which are consistent with each other.

The first explanation is that reading, when conducted on different time horizons, has different effects. Brysbaert (2019) challenges the view that readers have different mental ’gears’ that cause them to read faster or slower, depending on the reading aims. Nevertheless, his results do show that scanning a text and reading a text occurs in give very different results in words-per-minute metrics. As the experimental presentation of texts in Studies 2 and 3 may well have resulted in readers scanning or skimming them instead of attentively reading them, this may have affected the cognitive impact of the relevant texts. In a similar vein, Fabry and Kokkonen [ 93 ] make the case for mind wandering as a form on engagement with the text. That is, the reader’s successful engagement with a text is achieved by bringing to bear predictions generated from enculturated knowledge in a dynamical way in response to textual prompts. The failure of Studies 2 and 3 to produce results may therefore be because the experimental design inhibited this process. If so, new designs that respect the potential effects of long-term reading processes are mandated.

One such design would involve a long-term, three condition study, where participants are assigned to a fiction condition and a non-fiction condition, with the fiction condition being subdivided into literary and non-literary categories. All groups would be provided with the same set of interpretive prompts, which would be congruent with all three texts. Control groups would be generated by creating a second arm of the study with the same design but a substantially shorted duration (e.g. 1 year vs 2 weeks). At fixed points over each arm’s duration, participants would be prompted to interpretively engage with their text and a measure of well-being taken. The first prediction is that, in the long term arm, well-being would improve in the fiction condition relative to the non-fiction condition, and that within the fiction condition, participants in the literary category would improve most. The second prediction is that improvements would only occur in the long-term arm of the study and not the short term one.

Our second explanation of our results centres on social processing; it claims that fiction is an intrinsically social phenomenon, and thus that the positive impacts of fiction on well-being will most visibly manifest in social contexts. That fiction may be intrinsically social arises from evolutionary arguments concerning its utility. One of the more puzzling aspects of fiction from an evolutionary perspective has always been that it should exist at all. Fiction not alone communicates explicitly false information—it does so in a way that uses up temporal, cognitive, and material resources, such as by causing us to care about characters that do not, and often could not, exist. Known as the paradox of fiction [ 94 ], this problem has directly or indirectly exercised a number of evolutionary and cognitive theorists [ 86 , 87 , 95 – 100 ]. One proposed solution is that stories exist as a cultural tool for facilitating large-group living [ 101 – 103 ]. In this view, the performance and discussion of fictional narratives can create prosocial dispositions by activating shared frames of reference and a collective orientation towards the future [ 81 , 104 ]. In Terence Cave’s words, ‘literature promotes its own downstream conversation, where it becomes mingled with the everyday, the social, the ethical, the political’ [ 105 ]. Where this potentially impacts on mood state is through the opioid system. The brain opioid theory maintains that social bonding is experienced as positively valent because it stimulates the endogenous production of μ -opioids during affiliative behaviour [ 106 – 108 ]. If so, the positive impact of fiction on well-being and mood derives from the activation of endogenous opioid production through the mechanism of social bonding. Evidence that narratives in general can activate the opioid system is already provided in Dunbar et al. (2016), which shows that group exposure to an emotionally arresting short film can increase pain thresholds relative to less febrile narratives (increased pain threshold is a proxy for opioid system activation). The specific efficacy of literary fiction can, on this basis, be explained as the result of literary fiction providing a better focus for social bonding, possibly by way of its status as a culturally prestigious aesthetic form.

A useful paradigm for testing the social processing explanation is offered in Tarr, Launay, Benson, & Dunbar [ 109 ], where administration of naltrexone is used to blockade the endogenous opioid system. That is, Tarr and colleagues conducted a naltrexone-placebo double blind trial to determine whether increases in positive mood, pain threshold and self-reported social closeness between strangers following synchronised dance is suppressed in the test condition. A methodologically straightforward extension of this method would involve exposing matching cohorts to the same fictional materials and subsequently inviting both to participate in separate group discussions of this fiction, with the test group being administered naltrexone before each session. The social processing explanation predicts that discussions in the naltrexone condition should score lower on valence and dominance, as well as on other measures of affect like POMS.

Our second explanation centres on the distinction between lived experience and recalled experience. Specifically, Kahneman & Riis [ 110 ] make the useful theoretical distinction between the experiencing self and the evaluating self, with the experiencing self comprehending the moment-to-moment flux of phenomenal experience and the evaluating self taking in the retrospective summation of these experiences. Though the evaluating and experiencing selves often align, there are also many circumstances when they do not—and in these circumstances is typically the judgments of the evaluative self that persist. For instance, the predicted, experienced, and recalled enjoyment of a vacation often differ [ 111 ]—but it is the recalled enjoyment that makes choosing to repeat the experience most likely [ 112 ]. These systematic differences suggest that the findings generated here may be explicable as the result of the evaluating self extracting therapeutic value from an experience in a way that was not possible for the experiencing self. Literature, it has often been suggested, combines sensorimotor effects with intellectual patterns in a way that secures cognitive engagement that is greater than would result from either factor alone [ 105 , 113 – 115 ]. If so, then time-dependent cognitive processes will have had no opportunity to take effect upon immediate exposure; instead, there will be a minimum period of reflective processing that allows for these processes to supervene. (Or it may be that these processes are accelerated by discussion, which makes the reflective processing of others available.) Whatever the precise mechanism, the general point is that literature seems especially engaging of the evaluative rather than the experiencing self, and that this may account for the results presented here.

With respect to testing the experience-evaluation hypothesis, we propose a multiple cohort, staggered timeline experiment. This would involve n experimental groups, where each group is divided into test and control conditions. Individuals in the test condition would be exposed to one of a set of fictional literary texts; individuals in the control condition to a neutral textual stimulus. At timepoint t 0 , all groups will be exposed to their relevant text and a measure of impact on wellbeing taken. At t 1 , all groups will be prompted to interpretively elaborate on same text, except for one group which will be dropped; at t 2 , another prompt will be issued, and a second group dropped; this procedure will continue until timepoint t n is reached, when only one group remains. At timepoint t n+1 all participants will be asked to evaluate the impact on wellbeing of the text they have been exposed to using the same instrument as at t 0 . The experience-evaluation hypothesis predicts (1) that impact on wellbeing will be greater in the test over the control conditions, and (2) that wellbeing will scale positively with the number of interpretive engagements.

In proposing these studies, our first intention is to gain clarity on the results outlined here. However, we are also conscious of the fact that there is paucity of designs in experimental literary studies. As noted by van Peer and Pander Maat [ 116 ], “The problem with literary studies is that the given assumptions are usually vague and general—though often strong and unqualified—and have not been tested with real readers”.

To conclude, we maintain that our studies offer evidence in support of the view that fiction can have a positive impact in well-being. However, these effects do not seem to be realised in peculiarly modern models of reading, where the primary response of the reader is assumed to occur during the privacy of the reading process. Instead, fiction’s positive impact on well-being seems to require processes of mnemonic or social evaluation before it can occur. This result is less important for its positive content—that discussion and reflection amplify the impact of fiction was always known to educators and readers—than it is for what it rules out. If fiction is to be leveraged for therapeutic value, then it cannot be operationalised as a type of cultural pharmacy or—worse—as a cultic object that cures through mere exposure. Instead, it needs to be supported by an infrastructure that systematically and patiently encourages readers to evaluate their experiences by way of reflection and discussion. Inevitably, more research is needed, both with respect to fiction and other modes of literature not discussed here, before more concrete recommendations can be offered. However, we hope to have pointed towards some of the directions this research might take.

• View Article
• Google Scholar
• 2. Billington J. Is Literature Healthy? Oxford: Oxford University Press; 2016.
• PubMed/NCBI
• 8. Davis J. Reading books can positively impact your mental health. In: Harper’s Bazaar. 2020.
• 9. Quaine C. Get reading: this is how books can impact your mental health. In: The Stylist [Internet]. 2020 [cited 27 Apr 2020]. Available: https://www.stylist.co.uk/books/new-books-to-read-bibliotherapy-nhs-mental-health-anxiety-depression-stress-bereavement-heartbreak-kate-atkinson-fiction-non-fiction-poetry/255550
• 10. Allner H. How reading fiction can help improve our mental health. In: Metro [Internet]. 2018 [cited 24 Jun 2020]. Available: https://metro.co.uk/2018/01/05/how-reading-fiction-can-help-improve-our-mental-health-7164567/
• 11. Kelly R. Black Rainbow. London: Hodder & Stoughton; 2014.
• 13. Ferguson D. Can picture books meet the crisis in children’s mental health? | Books | The Guardian. 18 Oct 2018. Available: https://www.theguardian.com/books/2018/oct/18/can-picture-books-meet-the-crisis-in-childrens-mental-health . Accessed 19 Nov 2018.
• 14. Freeman L. The reading cure: How books restored my appetite. London: Hachette UK; 2018.
• 15. Feynman R. Cargo cult science. In: Hutchings E, editor. Surely You’re Joking Mr Feynman! London: Vintage Books; 1992. pp. 338–346.
• 18. Billington J, Dowrick C, Hamer A, Robinson J, Williams C. An investigation into the therapeutic benefits of reading in relation to depression and well-being. Liverpool; 2010.
• 20. Robinson J. Reading and talking: Exploring the experience of taking part in reading groups at the Vauxhall Health Care Centre. Liverpool; 2008. Report No.: 8.
• 22. Shechtman Z. Treating Child and Adolescent Aggression Through Bibliotherapy. Berlin: Springer; 2009.
• 28. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Arlington VA: American Psychiatric Association; 2013.
• 34. Mehrabian A. Basic dimensions for a general psychological theory: Implications for personality, social, environmental, and developmental studies. Cambridge MA: Oelgeschlager, Gunn & Hain; 1980.
• 44. Honnibal M, Johnson M. An Improved Non-monotonic Transition System for Dependency Parsing. Proceedings of the 2015 Conference on Empirical Methods in Natural Language Processing. Lisbon, Portugal: Association for Computational Linguistics; 2015. pp. 1373–1378. Available: https://aclweb.org/anthology/D/D15/D15-1162
• 45. Connell J, Barkham M. CORE-10 User Manual, Version 1.1. CORE System Trust & CORE Information Management Systems Ltd; 2007.
• 50. Lovibond P, Lovibond S. Manual for the depression anxiety stress scales. Sydney: Psychology Foundation of Australia; 1995.
• 51. McCrae R et al. The Five-Factor Model of Personality Across Cultures. Berlin: Springer; 2002.
• 57. John OP, Srivastrava S. The Big-Five Trait Taxonomy: History, Measurement, and Theoretical Perspectives. 2nd ed. In: Pervin LA, John OP, editors. Handbook of Personality: Theory and Research. 2nd ed. New York: Guilford Press; 1999.
• 64. McNair D, Lorr M, Doppelman L. POMS Manual for the Profile of Mood States. San Diego: Educational and Industrial Testing Service; 1971.
• 83. Aristotle . Aristotle’s Poetics. Baxter J, Atherton P, editors. MontrealAesthetic engagement during moments of suffering_Kuiken and Oliver 2013.PDF: McGill-Queen’s University Press; 1997.
• 88. Clasen M. Why Horror Seduces. Oxford: Oxford University Press; 2017.
• 89. Fish SE. Is There a Text in this Class? The Authority of Interpretive Communities. Cambridge MA: Harvard University Press; 1980.
• 91. Stainborough RJ. Benefits of Reading Books: How It Can Positively Affect Your Life. In: healthline [Internet]. 2019 [cited 24 Jun 2020]. Available: https://www.healthline.com/health/benefits-of-reading-books
• 95. Dutton D. The Art Instinct: Beauty, Pleasure, and Human Evolution. Oxford: Oxford University Press; 2009.
• 98. Salmon C. Crossing the Abyss: Erotica and the Intersection of Evoltionary Psychology and Literary Studies. In: Wilson DS, Gottschall J, editors. The Literary Animal: Evolution and the Nature of Narrative. Evanston IL: Northwestern University Press; 2005. pp. 244–257.
• 99. Sugiyama MS. Reverse-Engineering Narrative: Evidence of Special Design. In: Gottchall J, Sloan Wilson D, editors. The Literary Animal: Evolution and the Nature of Narrative. Evanston IL: Northwestern University Press; 2005. pp. 177–196.
• 104. Bhabha HK. Nation and Narration. Bhabha HK, editor. Oxford: Routledge; 1990. Available: http://books.google.com/books?hl=en&lr=&id=2jhLLd4F6BgC&pgis=1
• 105. Cave T. Thinking with Literature: Towards a Cognitive Literary Criticism. Oxford: Oxford University Press; 2016.
• 107. Kyte D, Jerram M, DiBiase R. Brain opioid theory of social attachment: A review of evidence for approach motivation to harm. Motivation Science. Kyte, Denise: Department of Psychology, Suffolk University, 73 Tremont Street, 8th Floor, Boston, MA, US, 02108, [email protected] : Educational Publishing Foundation; 2020. pp. 12–20. https://doi.org/10.1037/mot0000135
• 110. Kahneman D, Riis J. Living, and thinking about it: Two perspectives on life. In: Huppert F, Baylis N, Keverne B, editors. The Science of Well-Being. Oxford: Oxford University Press; 2012. pp. 285–304. https://doi.org/10.1093/acprof:oso/9780198567523.003.0011
• 113. Carney J. Necessary Fictions: Supernormal Cues, Complex Cognition and the Nature of Fictional Narrative. In: Poulaki M, Grishakova M, editors. Narrative Complexity. Lincoln: University of Nebraska Press; 2019. pp. 391–413.
• 114. Boyd B. Why Lyrics Last: Evolution, Cognition, and Shakespeare’s Sonnets. Harvard: Harvard University Press; 2012.

Step Up For Mental Health

To Educate. Fight Causes. Change minds on Mental Health.

Reading Books Can Benefit Your Mental Health

Posted on 11.02.20 by Katie Martinez

Photo by Fabiola Peñalba on Unsplash

Around this time of year, I often begin to feel lonelier and struggle to feel connected with others. Lately, I’ve turned to a beloved pastime: reading. Reading always reminds me of how much healing power stories hold.

Reading an engrossing book with dynamic characters, a charming setting, and beautiful prose that pulls me into the plot, brings me indescribable comfort—especially when seasonal depression begins to creep in. 

Autumn is here, and with colder weather often comes excitement about the holiday season. But many people also experience seasonal depression, making this time of year difficult. Because of Covid-19 and the falling temperatures, many of us will be cooped up inside with less sunlight and fresh air. This may have a negative impact on our mental health.

The little boost I get from reading each day made me think about the different ways reading benefits mental health. Reading is a fairly inexpensive, accessible hobby that can bring tremendous benefits.  

Mental Health Benefits of Reading

Studies have shown that reading as little as 6 minutes per day can improve your quality of sleep, reduce stress, and sharpen mental acuity. Reading strengthens the neural circuits and pathways of our brain while lowering heart rate and blood pressure.

The ability to empathize and engage with diverse stories outside of our own lived experiences can bring us a greater sense of human connection and empathy. This often leads to stronger relationships and shared understanding.

Last year I began reading more consistently. It has undoubtedly played a major role in helping me deal with feelings of loneliness and anxiety. Reading gives me the opportunity to slow down and be present within the story,  a welcome escape from moments of anxious overthinking. My favorite times to sit down with a good cup of tea and dedicate time to reading are right before bed and on Sunday mornings.

Many people shy away from reading or fail to see it as a form of self-care. They’ll think back to the boring novels they were assigned to read in school. And they may not have much energy after spending a full day at work, caring for your homes and families, and dealing with the daily stressors of life.

I hope to help people view reading as a way to support their mental wellness. Reading allows you ton engage with fun entertainment while calming and strengthening the mind.

What Should I Read?  

If you’d like to try reading more often, choose books that are of interest to you. No matter what type of book you choose, simply reading a few pages when you can is what counts.

Start with visiting your local used bookstore or library. Many librarians and bookstore employees will be happy to give you recommendations. Skim the first few pages of the book before purchasing. Does the story include characters or a setting you want to know more about? The key is finding books that capture your attention.

You’ll probably start to notice a difference in your sleep quality and mood after you get in the reading habit—whether you’re listening intently to an audiobook during your commute or devouring a few pages while doing laundry. 

Even though colder weather means spending more time inside, your mind can go wherever you want with the help of a good story. 

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By Katie Martinez

Katie Martinez is a new writer based in Austin TX. She graduated from the University of Texas at Austin with a degree in English and currently works in publishing. She’s interested in the mental health issues young people face and hopes her writing can educate readers and spark more discussions about mental health. In her free time, she likes to read, go salsa dancing, and shop for home décor

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What are the benefits of reading books? A lot, actually

Love to curl up on the couch with a good book ? You aren’t alone.

According to a Gallup poll published in 2022, in 2021 Americans read roughly 12 books a year, amounting to around one a month. That number is the lowest it's been since Gallup began tracking Americans' reading habits back in 1990.

Whether the decline in reading books is the result of busy lifestyles or the lure of binge-watching the latest series on TV, the time has come to get back on the book bandwagon.

If the latest bestseller is collecting dust on your nightstand, knowing the benefits of reading might be just the motivation you need to pick it back up.

Of course, you can also join TODAY's own book club band leader, Jenna Bush Hager, in the new initiative " Streaking With Jenna " to get back on track because as readers already know, there's nothing quite like settling in a with a great book. Designed to build or bolster a reading habit, Streaking With Jenna encourages people to keep track of their reading streak in 2023.

Download a printable Streaking With Jenna calendar here .

"It's like a sanctuary," Maryanne Wolf, professor-in-residence at UCLA and director, Center for Dyslexia, Diverse Learners, and Social Justice, tells TODAY.com.

"I have 20 minutes in the morning, 20 minutes in the evening after Netflix or whatever I've done in between a thousand emails," Wolf explains of her reading habit.

"And that helps center me, it helps remind me of the priorities of the day before, of the next day, and of that very moment."

From increasing your vocabulary and conversation skills to sleeping better and living longer, here are 10 scientific and psychological benefits of reading to inspire you to get back into the habit.

1) Reading might lengthen your lifespan

Good news, bookworms: Reading books might be part of the key to a long life.

A 2016 study published in the journal Social Science & Medicine found reading books can reduce mortality by up to 20%.

According to the researchers, "any level of book reading gave a significantly stronger survival advantage," particularly for adults 65 and older who "redirect leisure time" from watching TV into reading books.

The study also found that reading alone isn't enough — it's reading books that makes the difference. Books contributed to a "survival advantage that was significantly greater than that observed for reading newspapers or magazines," the authors noted.

2) Encourages empathy

Reading books can help us become more compassionate, empathetic people.

"We have more opportunity to deepen our insights, our epiphanies, our sense of our own best thoughts," explains Wolf. "It gives us more empathy, perspective — taking into other people's viewpoints, thoughts and feelings."

And there's science to back it up.

In a 2013 study published in "Science," researchers found that literary fiction, in particular, led to readers being better at understanding what other people were thinking and feeling, along with increasing their capacity for empathy.

Keep calm and read on!

• Books we can't wait to read in 2023
• A complete guide to Read With Jenna's book list
• Cozy up with one of these winter books

3) Helps lessen cognitive decline

Like the rest of your body, your brain needs exercise to help keep it working at its best. Reading books is one way to help keep your mind sharp.

"Various activities, including reading, that are seen as cognitively engaging are definitely associated with better brain health," Jonathan King, Ph.D., senior scientific advisor in the division of behavioral and social research at National Institute on Aging, tells TODAY.com.

While the jury is still out on if reading can prevent dementia, research suggests that older people who read more than those who don't appear to have a reduced risk of cognitive decline.

At the very least, King says that older adults who read more often generally have "larger vocabularies than younger adults because of all the reading experiences that they've done," which helps in obtaining "crystalized knowledge,"or things people have read about that they can put to use in their day-to-day lives.

4) Reduces stress

The American Psychological Association found in its 2022 annual survey on stress in America that a quarter of American adults feel that they're "too stressed to function."

High levels of stress are associated with a variety of physical and mental problems, making stress management essential to personal wellness.

Engaging in stress-relieving activities, like reading books, is an easy way to help keep cortisol levels down.

"Reading has been connected to meditation in terms of the way our brain processes our environment and our physiological state," Zoe Shaw , Psy.D., licensed psychotherapist and author of “A Year of Self-Care: Daily Practices and Inspiration for Caring for Yourself," tells TODAY.com.

"If you're sitting in a chair or laying in your bed and you're focusing on reading, your body can actually go into a type of meditative state," Shaw says. "So, you can get some of the benefits of meditating by reading."

Research backs this up, including a study that found 30 minutes of reading had the same ability to decrease stress as 30 minutes of yoga.

5) Improves critical thinking

Can reading make you smarter? In short, yes. Of course, it’s complicated and any number of things contribute to a person's overall knowledge and intelligence.

That said, a 1998 study concluded that reading "yields significant dividends for everyone."

In the study, those who were more "avid" readers, regardless of their overall abilities, were better able to answer various practical knowledge questions, like who their U.S. senators were and how many teaspoons equal one tablespoon, even if they weren't necessarily versed in those topics.

Reading can also improve critical thinking skills, Wolf tells TODAY.com.

"One of the great benefits is not just to the individual's insights; it's to the individual's ability to participate in democracy with a critical, empathic mind," she says.

6) Promotes self-care

If you've ever gotten lost in a book, then you can attest to this: Reading a book simply makes you feel good. Entertainment is as much of a perk of reading as all those positive psychological and scientific benefits.

Shaw says that, while they're engrossing in their own ways, TV, movies and scrolling through social media don't offer the same degree of escape and calm that reading a book provides.

"It's not as relaxing to our body to read on computers or devices," Shaw says, explaining that when you read a book, your brain comes up with images to accompany what you're reading about, engaging your creative mind while helping you relax at the same time.

"We're gaining knowledge and, to a certain extent, caring for ourselves because we are expanding our understanding of the world, of ourselves – and that is self-care," she continues.

7) Enhances conversation skills

According to a 2015 study , above-average readers had a much higher rate of vocabulary growth than average readers did.

"We know that the best way to help children learn to write, to help children with their vocabulary and increase their general academic performance is to read to them," Shaw says.

"It also works for us as adults. Our vocabulary is increased, our conversation skills are increased," she says. "More than that, we write better when we read more."

8) Improves sleep

Does your bedtime routine include a few minutes (or hours) of screen time?

If it does, chances are good that scrolling through Instagram or checking your email is negatively impacting your ability to sleep.

A 2020 study published in Nature and Science of Sleep found that using a mobile device for at least 30 minutes after turning off the lights resulted in poor sleep quality, daytime sleepiness and other sleep disturbances.

Reading a book before bed, however, has exactly the opposite effect.

"Reading can improve sleep," Shaw says. "It activates the frontal lobe, the limbic system, and it creates a relaxing cascade in our body."

In 2021, researchers studied reading and sleep patterns and found that, overall, reading a book in bed before sleeping led participants to feel their quality of sleep improved.

"It can help calm you and get you into that place much better than other types of activities," says Shaw.

9) Fosters connection

Divisiveness has been on the rise in recent years, leading to what many consider to be a disconnect between people and decline of community.

While every issue can't obviously be solved by reading a book, picking one up can be beneficial in helping close the gap.

"In this minute of our society in this tiny, strained, moment in human history, we need to have people have communication with each other," Wolf tells TODAY.com.

"Not just connects with friends and social media, but deeper forms of communication, so that we understand each other, even when we are by ourselves," she says.

"There is this amazing miracle that we can understand another if we give it time, without ever leaving our chair."

10) Provides time to recharge your batteries

Time with a book is also time for you .

"Reading forces you to spend time with yourself. It forces you to kind of isolate in a healthy way," she tells TODAY.com.

"There’s also this sense of self-comforting in the process of reading, which is different than on our devices," Shaw says and explains that when you use your phone or device as an escape, it's easy to be interrupted by notifications and other distractions.

"But usually when we choose to read a book, we’re taking specific space and time where we’re going to get more comfortable and just kind of hunker down with the book."

Sarah Lemire is a lifestyle and entertainment reporter for TODAY based in New York City. She covers holidays, celebrities and everything in between.

16 Personal Essays About Mental Health Worth Reading

Here are some of the most moving and illuminating essays published on BuzzFeed about mental illness, wellness, and the way our minds work.

BuzzFeed Staff

1. My Best Friend Saved Me When I Attempted Suicide, But I Didn’t Save Her — Drusilla Moorhouse

"I was serious about killing myself. My best friend wasn’t — but she’s the one who’s dead."

2. Life Is What Happens While You’re Googling Symptoms Of Cancer — Ramona Emerson

"After a lifetime of hypochondria, I was finally diagnosed with my very own medical condition. And maybe, in a weird way, it’s made me less afraid to die."

3. How I Learned To Be OK With Feeling Sad — Mac McClelland

"It wasn’t easy, or cheap."

4. Who Gets To Be The “Good Schizophrenic”? — Esmé Weijun Wang

"When you’re labeled as crazy, the “right” kind of diagnosis could mean the difference between a productive life and a life sentence."

5. Why Do I Miss Being Bipolar? — Sasha Chapin

"The medication I take to treat my bipolar disorder works perfectly. Sometimes I wish it didn’t."

6. What My Best Friend And I Didn’t Learn About Loss — Zan Romanoff

"When my closest friend’s first baby was stillborn, we navigated through depression and grief together."

7. I Can’t Live Without Fear, But I Can Learn To Be OK With It — Arianna Rebolini

"I’ve become obsessively afraid that the people I love will die. Now I have to teach myself how to be OK with that."

8. What It’s Like Having PPD As A Black Woman — Tyrese Coleman

"It took me two years to even acknowledge I’d been depressed after the birth of my twin sons. I wonder how much it had to do with the way I had been taught to be strong."

9. Notes On An Eating Disorder — Larissa Pham

"I still tell my friends I am in recovery so they will hold me accountable."

10. What Comedy Taught Me About My Mental Illness — Kate Lindstedt

"I didn’t expect it, but stand-up comedy has given me the freedom to talk about depression and anxiety on my own terms."

11. The Night I Spoke Up About My #BlackSuicide — Terrell J. Starr

"My entire life was shaped by violence, so I wanted to end it violently. But I didn’t — thanks to overcoming the stigma surrounding African-Americans and depression, and to building a community on Twitter."

12. Knitting Myself Back Together — Alanna Okun

"The best way I’ve found to fight my anxiety is with a pair of knitting needles."

13. I Started Therapy So I Could Take Better Care Of Myself — Matt Ortile

"I’d known for a while that I needed to see a therapist. It wasn’t until I felt like I could do without help that I finally sought it."

14. I’m Mending My Broken Relationship With Food — Anita Badejo

"After a lifetime struggling with disordered eating, I’m still figuring out how to have a healthy relationship with my body and what I feed it."

15. I Found Love In A Hopeless Mess — Kate Conger

"Dehoarding my partner’s childhood home gave me a way to understand his mother, but I’m still not sure how to live with the habit he’s inherited."

16. When Taking Anxiety Medication Is A Revolutionary Act — Tracy Clayton

"I had to learn how to love myself enough to take care of myself. It wasn’t easy."

Topics in this article

• Mental Health

September 4, 2023

Reading for Pleasure Helps Kids’ Brain Development

The simple and fun act of reading for pleasure in early childhood produces better cognition, mental health and educational attainment in adolescence

By Barbara Jacquelyn Sahakian , Christelle Langley , Jianfeng Feng , Yun-Jun Sun & The Conversation US

Cavan Images/Getty Images

The following essay is reprinted with permission from The Conversation , an online publication covering the latest research.

Early childhood is a  critical period for brain development , which is important for boosting cognition and mental wellbeing. Good brain health at this age is directly linked to better mental heath, cognition and educational attainment in adolescence and adulthood. It can also  provide resilience  in times of stress.

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But, sadly, brain development can be hampered by poverty. Studies have shown that early childhood poverty  is a risk factor  for lower educational attainment. It is also associated with differences in brain structure, poorer cognition, behavioural problems and mental health symptoms.

This shows just how important it is to give all children an equal chance in life. But until sufficient measures are taken to reduce inequality and improve outcomes, our new study,  published in Psychological Medicine , shows one low-cost activity that may at least counteract some of the negative effects of poverty on the brain: reading for pleasure.

Wealth and brain health

Higher family income in childhood  tends to be associated  with higher scores on assessments of language, working memory and the processing of social and emotional cues. Research  has shown  that the brain’s outer layer, called the cortex, has a larger surface are and is thicker in people with higher socioeconomic status than in poorer people.

Being wealthy has also been linked with having more grey matter (tissue in the outer layers of the brain) in the frontal and temporal regions (situated just behind the ears) of the brain. And we know that these areas support the development of cognitive skills.

The association between wealth and cognition is greatest in the most  economically disadvantaged families . Among children from lower income families, small differences in income are associated with relatively large differences in surface area. Among children from higher income families, similar income increments are associated with smaller differences in surface area.

Importantly, the results from one study found that when mothers with low socioeconomic status were given monthly cash gifts,  their children’s brain health improved . On average, they developed more changeable brains (plasticity) and better adaptation to their environment. They also found it easier to subsequently develop cognitive skills.

Our socioeconomic status will even  influence our decision-making . A report from the London School of Economics found that poverty seems to shift people’s focus towards meeting immediate needs and threats. They become more focused on the present with little space for future plans - and also tended to be more averse to taking risks.

It also showed that children from low socioeconomic background families seem to have poorer stress coping mechanisms and feel less self-confident.

But what are the reasons for these effects of poverty on the brain and academic achievement? Ultimately, more research is needed to fully understand why poverty affects the brain in this way. There are many contributing factors which will interact. These include poor nutrition and stress on the family caused by financial problems. A lack of safe spaces and good facilities to play and exercise in, as well as limited access to computers and other educational support systems, could also play a role.

Reading for pleasure

There has been much interest of late in levelling up. So what measures can we put in place  to counteract the negative effects  of poverty which could be applicable globally?

Our observational study shows a dramatic and positive link between a fun and simple activity – reading for pleasure in early childhood – and better cognition, mental health and educational attainment in adolescence.

We analysed the data from the Adolescent Brain and Cognitive Development (ABCD) project, a US national cohort study with more than 10,000 participants across different ethnicities and and varying socioeconomic status. The dataset contained measures of young adolescents ages nine to 13 and how many years they had spent reading for pleasure during their early childhood. It also included data on their cognitive, mental health and brain health.

About half of the group of adolescents starting reading early in childhood, whereas the other, approximately half, had never read in early childhood, or had begun reading late on.

We discovered that reading for pleasure in early childhood was linked with better scores on comprehensive cognition assessments and better educational attainment in young adolescence. It was also associated with fewer mental health problems and less time spent on electronic devices.

Our results showed that reading for pleasure in early childhood can be beneficial regardless of socioeconomic status. It may also be helpful regardless of the children’s initial intelligence level. That’s because the effect didn’t depend on how many years of education the children’s parents had had – which is our best measure for very young children’s intelligence (IQ is partially heritable).

We also discovered that children who read for pleasure had larger cortical surface areas in several brain regions that are significantly related to cognition and mental health (including the frontal areas). Importantly, this was the case regardless of socioeconomic status. The result therefore suggests that reading for pleasure in early childhood may be an effective intervention to counteract the negative effects of poverty on the brain.

While our current data was obtained from families across the United States, future analyses will include investigations with data from other countries – including developing countries, when comparable data become available.

So how could reading boost cognition exactly? It is already known that language learning, including through reading and discussing books, is a key factor in healthy brain development. It is also a  critical building block  for other forms of cognition,  including executive functions  (such as memory, planning and self-control) and social intelligence.

Because there are many different reasons why poverty may negatively affect brain development, we need a comprehensive and holistic approach to improving outcomes. While reading for pleasure is unlikely, on its own, to fully address the challenging effects of poverty on the brain, it provides a simple method for improving children’s development and attainment.

Our findings also have important implications for parents, educators and policy makers in facilitating reading for pleasure in young children. It could, for example, help counteract some of the negative effects  on young children’s cognitive development  of the COVID-19 pandemic lockdowns.

This article was originally published on The Conversation . Read the original article .

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Reading for pleasure early in childhood linked to better cognitive performance and mental wellbeing in adolescence

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Children who begin reading for pleasure early in life tend to perform better at cognitive tests and have better mental health when they enter adolescence, a study of more than 10,000 young adolescents in the US has found.

We found significant evidence that reading is linked to important developmental factors in children, improving their cognition, mental health, and brain structure, which are cornerstones for future learning and well-being Barbara Sahakian

In a study published today in Psychological Medicine , researchers in the UK and China found that 12 hours a week was the optimal amount of reading, and that this was linked to improved brain structure, which may help explain the findings.

Reading for pleasure can be an important and enjoyable childhood activity. Unlike listening and spoken language, which develop rapidly and easily in young children, reading is a taught skill and is acquired and developed through explicit learning over time.

During childhood and adolescence, our brains develop, making this an important time in which to establish behaviours that support our cognitive development and promote good brain health.  However, until now it has been unclear what impact – if any – encouraging children to read from an early age will have on their brain development, cognition and mental health later in life.

To investigate this, researchers from the universities of Cambridge and Warwick in the UK and Fudan University in China looked at data from the Adolescent Brain and Cognitive Development (ABCD) cohort in the US, which recruited more than 10,000 young adolescents.

The team analysed a wide range of data including from clinical interviews, cognitive tests, mental and behavioural assessments and brain scans, comparing young people who began reading for pleasure at a relatively early age (between two and nine years old) against those who began doing so later or not at all. The analyses controlled for many important factors, including socio-economic status.

Of the 10,243 participants studied, just under a half (48%) had little experience of reading for pleasure or did not begin doing so until later in their childhood. The remaining half had spent between three and ten years reading for pleasure.

The team found a strong link between reading for pleasure at an early age and a positive performance in adolescence on cognitive tests that measured such factors as verbal learning, memory and speech development, and at school academic achievement.

These children also had better mental wellbeing, as assessed using a number of clinical scores and reports from parents and teachers, showing fewer signs of stress and depression, as well as improved attention and fewer behavioural problems such as aggression and rule-breaking.

Children who began reading for pleasure earlier also tended to spend less screen time – for example watching TV or using their smartphone or tablet – during the week and at weekends in their adolescence, and also tended to sleep longer.

When the researchers looked at brain scans from the adolescent cohort, they found that those participants who had taken to reading for pleasure at an early age showed moderately larger total brain areas and volumes, including in particular brain regions that play critical roles in cognitive functions. Other brain regions that were different among this group were those that have been previously shown to relate to improved mental health, behaviour and attention.

Professor Barbara Sahakian from the Department of Psychiatry at the University of Cambridge said: “Reading isn’t just a pleasurable experience – it’s widely accepted that it inspires thinking and creativity, increases empathy and reduces stress. But on top of this, we found significant evidence that it’s linked to important developmental factors in children, improving their cognition, mental health, and brain structure, which are cornerstones for future learning and well-being.”

The optimal amount of reading for pleasure as a young child was around 12 hours per week. Beyond this, there appeared to be no additional benefits. In fact, there was a gradual decrease in cognition, which the researchers say may be because it suggests they are spending more time sedentary and less time at other activities that could be cognitively enriching, including sports and social activities.

Professor Jianfeng Feng from Fudan University in Shanghai, China, and the University of Warwick, UK, said: “We encourage parents to do their best to awaken the joy of reading in their children at an early age. Done right, this will not only give them pleasure and enjoyment, but will also help their development and encourage long-term reading habits, which may also prove beneficial into adult life.”

Funders included: Wellcome and the National Institute for Health & Care Research (UK) and the National Natural Science Foundation of China.*

Reference Yun-Jun Sun & Barbara J. Sahakian et al. Early-Initiated Childhood Reading for Pleasure: Associations with Better Cognitive Performance, Mental Well-being and Brain Structure in Young Adolescence. Psychological Medicine; 28 June 2023; DOI: 10.1017/S0033291723001381.

*A full list of funders can be found in the paper.

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• Mental Health Essay

Essay on Mental Health

According to WHO, there is no single 'official' definition of mental health. Mental health refers to a person's psychological, emotional, and social well-being; it influences what they feel and how they think, and behave. The state of cognitive and behavioural well-being is referred to as mental health. The term 'mental health' is also used to refer to the absence of mental disease. 

Mental health means keeping our minds healthy. Mankind generally is more focused on keeping their physical body healthy. People tend to ignore the state of their minds. Human superiority over other animals lies in his superior mind. Man has been able to control life due to his highly developed brain. So, it becomes very important for a man to keep both his body and mind fit and healthy. Both physical and mental health are equally important for better performance and results.

Importance of Mental Health 

An emotionally fit and stable person always feels vibrant and truly alive and can easily manage emotionally difficult situations. To be emotionally strong, one has to be physically fit too. Although mental health is a personal issue, what affects one person may or may not affect another; yet, several key elements lead to mental health issues.

Many emotional factors have a significant effect on our fitness level like depression, aggression, negative thinking, frustration, and fear, etc. A physically fit person is always in a good mood and can easily cope up with situations of distress and depression resulting in regular training contributing to a good physical fitness standard. 

Mental fitness implies a state of psychological well-being. It denotes having a positive sense of how we feel, think, and act, which improves one’s ability to enjoy life. It contributes to one’s inner ability to be self-determined. It is a proactive, positive term and forsakes negative thoughts that may come to mind. The term mental fitness is increasingly being used by psychologists, mental health practitioners, schools, organisations, and the general population to denote logical thinking, clear comprehension, and reasoning ability.

 Negative Impact of Mental Health

The way we physically fall sick, we can also fall sick mentally. Mental illness is the instability of one’s health, which includes changes in emotion, thinking, and behaviour. Mental illness can be caused due to stress or reaction to a certain incident. It could also arise due to genetic factors, biochemical imbalances, child abuse or trauma, social disadvantage, poor physical health condition, etc. Mental illness is curable. One can seek help from the experts in this particular area or can overcome this illness by positive thinking and changing their lifestyle.

Regular fitness exercises like morning walks, yoga, and meditation have proved to be great medicine for curing mental health. Besides this, it is imperative to have a good diet and enough sleep. A person needs 7 to 9 hours of sleep every night on average. When someone is tired yet still can't sleep, it's a symptom that their mental health is unstable. Overworking oneself can sometimes result in not just physical tiredness but also significant mental exhaustion. As a result, people get insomnia (the inability to fall asleep). Anxiety is another indicator. 

There are many symptoms of mental health issues that differ from person to person and among the different kinds of issues as well. For instance, panic attacks and racing thoughts are common side effects. As a result of this mental strain, a person may experience chest aches and breathing difficulties. Another sign of poor mental health is a lack of focus. It occurs when you have too much going on in your life at once, and you begin to make thoughtless mistakes, resulting in a loss of capacity to focus effectively. Another element is being on edge all of the time.

It's noticeable when you're quickly irritated by minor events or statements, become offended, and argue with your family, friends, or co-workers. It occurs as a result of a build-up of internal irritation. A sense of alienation from your loved ones might have a negative influence on your mental health. It makes you feel lonely and might even put you in a state of despair. You can prevent mental illness by taking care of yourself like calming your mind by listening to soft music, being more social, setting realistic goals for yourself, and taking care of your body. 

Surround yourself with individuals who understand your circumstances and respect you as the unique individual that you are. This practice will assist you in dealing with the sickness successfully.  Improve your mental health knowledge to receive the help you need to deal with the problem. To gain emotional support, connect with other people, family, and friends.  Always remember to be grateful in life.  Pursue a hobby or any other creative activity that you enjoy.

What does Experts say

Many health experts have stated that mental, social, and emotional health is an important part of overall fitness. Physical fitness is a combination of physical, emotional, and mental fitness. Emotional fitness has been recognized as the state in which the mind is capable of staying away from negative thoughts and can focus on creative and constructive tasks. 

He should not overreact to situations. He should not get upset or disturbed by setbacks, which are parts of life. Those who do so are not emotionally fit though they may be physically strong and healthy. There are no gyms to set this right but yoga, meditation, and reading books, which tell us how to be emotionally strong, help to acquire emotional fitness. 

Stress and depression can lead to a variety of serious health problems, including suicide in extreme situations. Being mentally healthy extends your life by allowing you to experience more joy and happiness. Mental health also improves our ability to think clearly and boosts our self-esteem. We may also connect spiritually with ourselves and serve as role models for others. We'd also be able to serve people without being a mental drain on them. 

Mental sickness is becoming a growing issue in the 21st century. Not everyone receives the help that they need. Even though mental illness is common these days and can affect anyone, there is still a stigma attached to it. People are still reluctant to accept the illness of mind because of this stigma. They feel shame to acknowledge it and seek help from the doctors. It's important to remember that "mental health" and "mental sickness" are not interchangeable.

Mental health and mental illness are inextricably linked. Individuals with good mental health can develop mental illness, while those with no mental disease can have poor mental health. Mental illness does not imply that someone is insane, and it is not anything to be embarrassed by. Our society's perception of mental disease or disorder must shift. Mental health cannot be separated from physical health. They both are equally important for a person. 

Our society needs to change its perception of mental illness or disorder. People have to remove the stigma attached to this illness and educate themselves about it. Only about 20% of adolescents and children with diagnosable mental health issues receive the therapy they need. 

According to research conducted on adults, mental illness affects 19% of the adult population. Nearly one in every five children and adolescents on the globe has a mental illness. Depression, which affects 246 million people worldwide, is one of the leading causes of disability. If  mental illness is not treated at the correct time then the consequences can be grave.

One of the essential roles of school and education is to protect boys’ and girls' mental health as teenagers are at a high risk of mental health issues. It can also impair the proper growth and development of various emotional and social skills in teenagers. Many factors can cause such problems in children. Feelings of inferiority and insecurity are the two key factors that have the greatest impact. As a result, they lose their independence and confidence, which can be avoided by encouraging the children to believe in themselves at all times. 

To make people more aware of mental health, 10th October is observed as World Mental Health. The object of this day is to spread awareness about mental health issues around the world and make all efforts in the support of mental health.

The mind is one of the most powerful organs in the body, regulating the functioning of all other organs. When our minds are unstable, they affect the whole functioning of our bodies. Being both physically and emotionally fit is the key to success in all aspects of life. People should be aware of the consequences of mental illness and must give utmost importance to keeping the mind healthy like the way the physical body is kept healthy. Mental and physical health cannot be separated from each other. And only when both are balanced can we call a person perfectly healthy and well. So, it is crucial for everyone to work towards achieving a balance between mental and physical wellbeing and get the necessary help when either of them falters.

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My Unsung Hero

When wil was struggling with depression, a therapist said just the right thing.

Laura Kwerel

Wil Davenport in 2015. Wil Davenport hide caption

The following story includes references to suicide.

This story is part of the My Unsung Hero series, from the Hidden Brain team. It features stories of people whose kindness left a lasting impression on someone else.

In the fall of 2014, Wil Davenport was in a dark place. He had just lost a job he loved, and his mental health began to unravel.

“I just remember feeling such self-destructive thoughts about how I must have done something terrible to lose that job. I must be terrible to have lost that job,” Davenport said.

'I got you, girl': A toll collector's unexpected reply to a driver's tears

By the end of December, he had attempted to take his life, and he admitted himself to an inpatient mental health program.

“I remember for days, even weeks, not feeling like any progress was happening,” Davenport said. “So in between our therapy sessions and whatever else we were doing, I would walk laps inside this locked unit.”

One day, as he was doing his usual circuit around the facility, he noticed one of his therapists walking toward the community room. He thinks her name was Yvette.

“With a wry smile on her face, she looked over at me and she said, ‘I bet I'll beat you to the community room,’” Davenport remembered. “And somehow, that small act triggered something inside of me. And I didn't want to be beaten.”

For the first time in months, Davenport felt he had a purpose. Walking as fast as he could, he raced her to the room — and won. He was surprised and, for the first time in a long time, full of hope.

“I remember sitting down in this therapy session that she was leading shortly thereafter and feeling like a spark of life had been ignited in me by her simple act,” Davenport said.

When an earthquake struck in 1989, Julia locked eyes with a stranger and embraced

His therapist helped him want to live again, Davenport said. And not just to live, but to thrive.

“For that small act and so many other things that she did, I'm just so grateful.”

Today, Davenport is the founder of a leadership consulting business that helps people remove psychological barriers to become more effective at work. Davenport says he has done years of work to improve his mental health, and now, he likes the person he has become.

If you or someone you know is in crisis, call or text the 988 Suicide & Crisis Lifeline at 988 for help.

My Unsung Hero is also a podcast — new episodes are released every Tuesday. To share the story of your unsung hero with the Hidden Brain team, record a voice memo on your phone and send it to [email protected].

• mental health
• mental health care

We must tackle the model-minority myth with self-advocacy and personal storytelling

3-minute read.

When we were both 14-year-old high school students in Scarsdale, my friend Emma (a pseudonym) confided in me that she had thought about suicide. Normally, an admission like this would have been shocking. But I understood where Emma was coming from.

My conversations with Emma inspired my advocacy work. I share her story with her blessing.

Emma and I grew up in Chinese-American families with deeply held cultural beliefs emphasizing the value of hard work and perseverance while minimizing discussion of mental health. Emma felt her parents saw her as a high-achieving high school standout and feared they would not take her mental health challenges seriously. In our families, "saving face" often took priority over well-being.

Our emotion-suppressing culture was born from intergenerational and immigration-related traumas and shaped, in part, by the “model minority myth.” This is the societal perception, rooted in racism, that Asian-Americans and Pacific Islanders (AAPIs) are a “problem-free” group – setting the expectations of perfection and preventing help seeking.

Research released by  The Jed Foundation (JED) , a leading nonprofit that protects emotional health and prevents suicide, found that AAPI teenagers are more likely than others to believe their problems are not serious enough to discuss with someone else. Another  study  found that only 36% of AAPI people with a mental health condition received treatment in the previous year — 15 percentage points lower than the national average.

These factors contribute to suicide being the  leading  cause of death among AAPI teens and young adults. It is essential we bridge the chasm between cultural assumptions and the urgent need for mental health support. We must equip people to know the signs of distress and how to act. Identifying those at risk quickly is critical in linking people to necessary support, and these efforts are most effective when employed as part of a comprehensive suicide prevention program.

We must also work to change perceptions and expectations of AAPI youth. While this burden cannot rest just on young people’s shoulders, self-advocacy and storytelling play crucial roles in confronting these challenges.

Self-advocacy can take many forms, including confiding in a trusted friend or adult, starting a mental health club at school, or visiting a counselor. And for those comfortable doing so, it may include speaking about our experiences.

Sharing our stories is vital in dismantling the model minority myth, which reduces a diverse population to a simplistic stereotype and imposes unrealistic expectations on AAPI youth.  We cannot, should not, be forced into a singular narrative.

Emma was not yet ready to seek professional help, but her admission sparked something in me. I resolved to do something to help my friend, along with my AAPI peers struggling with cultural pressures. 

That’s when I founded SchoolSight: A Comprehensive Mental Health Vision, which is dedicated to raising awareness about mental health issues and reducing the cultural stigma within my Westchester County community. Through fundraisers, speakers, and wellness spaces for students to share their experiences, we work to shatter the silence Emma and so many others face. Instead of waiting for adults to prepare psychoeducation for us students, we students developed presentations for parents in the community, outlining mental health challenges AAPI youth face.

Two years ago, I gave a talk at a national mental health convention to discuss Emma’s journey. Since then, I’ve shared our story at numerous events, allowing me to advocate for the mental health needs of AAPI youth.

Today, I am pleased to share that Emma is thriving. With access to  culturally competent mental health care , she found the support she needed. She also began her own journey of  self-advocacy  to help communities invest in their most valuable, yet traditionally overlooked stakeholders: those with firsthand experience.

While self-advocacy and storytelling are vital, they alone won’t bring meaningful change. Nor is it our responsibility as youth to create the conditions in which our mental health is taken seriously and treated effectively. Everyone who cares about our well-being, including schools and the mental-health establishment, must work to ensure AAPI youth — and all young people — have access to culturally competent mental health care, safe spaces online and offline to connect with and support each other, better training in coping mechanisms and managing stress, and more. Publicizing our stories is an important step in moving in that direction.

By speaking out, we forge pathways to a more inclusive and empathetic understanding of mental health. It is equally important to seek help when needed. Whether it is reaching out to a trusted friend, family member, or mental health professional, taking that first step can make a difference. By advocating for ourselves and seeking support, we pave the way for future generations to inherit a society that recognizes and respects the full spectrum of mental health needs across racial and cultural lines.

Rick Yang, a native of Scarsdale, is a first-year student at Harvard University.

Watch CBS News

Will 988 call the police? Data suggests 1% of mental health crisis calls get "involuntary" rescues

By Alexander Tin

Edited By Allison Elyse Gualtieri

September 16, 2024 / 7:00 AM EDT / CBS News

Many people in mental health crisis fear that if they dial 988 , law enforcement might show up or they might be forced to go to the hospital.

But getting sent that kind of "involuntary emergency rescue" happens to around 1% of callers, suggests new data from Vibrant Emotional Health, the administrator of the 988 Lifeline for suicide and mental health crises .

"Involuntary intervention is the last resort. We want to make sure we're collaborating and engaging with people in crisis and empowering them, so we don't need to go in that direction," said Christopher Drapeau, Vibrant's director of research and evaluation.

A Pew Charitable Trusts survey last year cited by Vibrant's white paper found that around 1 in 5 adults worry that law enforcement would be sent after them for using 988 or that they might be forced to go to the hospital.

According to 988's policies , counselors are urged to use "the least invasive intervention" possible to respond to suicide attempts. But if other attempts to deescalate fail, then counselors can summon other emergency response services like an involuntary rescue.

Counselors for 988 do not have the ability to track the exact location of callers. But the Substance Abuse and Mental Health Services Administration or SAMHSA, which oversees Vibrant and the hotline, says in "rare situations" that counselors are able to ask a 911 dispatcher to use "geolocation services" to try and find where a call is coming from.

It is not clear from the data what percentage of the "involuntary" rescues relied on police responding to calls, as opposed to paramedics or another kind of emergency response.

"We haven't been this transparent in the past. So we want to acknowledge that, and show people that this is what we have," Drapeau told CBS News of the white paper he authored.

Drapeau said the white paper is his team's first evaluating the performance of 988 and is the most comprehensive look at the topic to date. The idea for the report came from talks with SAMHSA officials.

Law enforcement have often been the go-to for 911 dispatchers responding to suicide attempts. Advocacy groups have called for more jurisdictions to fund "mobile crisis teams" that can respond to suicide attempts with medics and behavioral health professionals, instead of police.

"If somebody attempted suicide during the call and had a medical injury as a result, you need to respond to that. So I don't know if we could completely abolish all involuntary interventions," Drapeau said.

"These numbers may not be perfect"

Vibrant's white paper focuses on two snapshots of data that come largely from when the line was a 1-800 number, before the nationwide launch of the easier-to-remember 988 shortcut to reach a counselor during a mental health crisis.

The largest snapshot in the paper still only spans around 2 million calls made from 2019 through 2023, tallied from a fraction of the now more than 200 locally run crisis centers that underpin the network. 

For context, more than 400,000 calls were routed by the 988 network in July alone .

"We acknowledge the limitations of these data. These numbers may not be perfect. They may differ if we had every single center reporting data, if we had a more precise definition, maybe it changes. But it appears today that the vast majority of 988 calls do not involve emergency services intervention," said Drapeau. 

Of those nearly 2 million calls, the white paper tallies around 2% resulting in emergency services – both "voluntary" and "involuntary" – being sent in response to calls.

Callers categorized by counselors as being at "imminent risk" of suicide, a much narrower group, had emergency services sent to them at a higher rate.

Among those, a quarter got "voluntary dispatches" — with the consent of the callers — while another quarter got "involuntary" rescues.

Better data is in the works. While current figures rely on a mix of requirements and voluntary reporting, a Vibrant spokesperson said it is working with SAMHSA to develop a national standard for what metrics all centers will be required to report in the future.

A plan drawn up by SAMHSA in April calls for states to submit data to the agency on the number of contacts that result in law enforcement being sent.

Another evaluation planned by Vibrant will try to refine the definition of when to deem a caller at "imminent risk" and how to handle those cases. Completing that evaluation will likely take a couple of years, Drapeau said, and will help them figure out how to move from involuntary to more collaborative interventions.

• Mental Health

Alexander Tin is a digital reporter for CBS News based in the Washington, D.C. bureau. He covers the Biden administration's public health agencies, including the federal response to infectious disease outbreaks like COVID-19.

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perspective

Photographer's fight to improve mental health services in Victoria

Topic: Mental Health

A woman stands in the bush, her back turned to the golden sunlight surrounding her. 

She is shrouded in darkness, her head turned away from both the beauty and the help that approaches.  

It's one of Christine Sayer's images — forged in her imagination and brought to life with her camera.

The 63-year-old worked as a photographer, using her craft to depict human experiences that all too often seem invisible.

Neurodiversity.

Mental illness.

Christine had no idea how closely her own life would imitate art. 

The photographer has been admitted to public health facilities more than 30 times in the past six years for mental health treatment.

She says at times the system has helped her.

But Christine also believes some of the care she's received has been degrading and worsened her mental health, despite the best efforts of staff.

"A lot of people who have mental health conditions, we're marginalised in society," Christine says.

"If you go to a psychiatric hospital, you're even more so. If you have more than one visit there, who's going to believe anything you say?

"I want people who have mental illnesses to be treated with dignity and respect and to be given compassion when they go into hospital."

Christine says depression changed her outlook and her sense of self.

Supplied: Beth Sayer

The first thing Christine noticed during her stay in Bendigo Health's acute adult unit was the state of the room around her. 

Brown smears on the carpet next to a "visible brown lump", a red stain on the carpet, a partially detached toilet seat, brown marks on the couch and a dirty window. 

"Forty-eight hours later, three cleaners and as many staff members, it appeared the room had just as little hope of being cleaned as I had of surviving this," Christine wrote in a 14-page complaint to the former Victorian Mental Health Complaints Commissioner. 

"I wanted to sign myself out." 

Christine documented the conditions in the room, including "brown poo marks".

Supplied: Christine Sayer

Bendigo Health's acute adult unit provides short-term inpatient mental health treatment for people aged 16 to 65.

Like most other rural Victorian mental health services, Bendigo Health's adult inpatient beds ran above 90 per cent occupancy last financial year. 

Christine says being admitted to the adult acute unit used to help, but the care she's received has dropped in the past two years.

She says she was admitted to dirty and damaged rooms, was not given hourly checks while suicidal, and had to stay in dirty clothes for more than 24 hours.

"I felt humiliated having to ask, and then beg, for my things." 

Christine says cleanliness remained an issue during her most recent admission.

Christine says she was often too unwell to leave her room, which limited her access to food and beverages.  

"When I couldn't go out of my room, I'd see a nurse for a total of 20 minutes in a 12-hour period ... which covers day shift and evening.   

"They used to talk to you, the nurses. They don't have time for that anymore." 

In her complaint to the former Mental Health Complaints Commissioner, Christine wrote that seven days in Bendigo Health's adult acute unit had reinforced her belief that the world would be a better place without her.  

"My voice was ignored, dismissed or not taken seriously," she wrote. 

Victoria's new Mental Health and Wellbeing Commission investigated and recommended that Bendigo Health make improvements.  

In a statement, Bendigo Health said it had acted on all the commission's recommendations, including reviewing its complaints resolution process, improving its response to cleanliness and maintenance issues, and reviewing processes to care for the physical health needs of mental health service consumers.  

The health service said it had also improved training for new staff about risk identification and management.

"Bendigo Health acknowledges the cleanliness of the consumer's room and elements of her care were below our usual standard during her admission," a spokesperson said. 

The Mental Health and Wellbeing Commission closed Christine's complaint after Bendigo Health committed to improve on the issues. 

Christine says her experiences during a subsequent admission to the adult acute unit were similar. 

She says she was left for 24 hours without help to change a catheter earlier this year. 

Christine's psychotherapist, Mark Colletti, says his client's negative experiences in hospital have made it more challenging to keep her safe when she is most unwell. 

"When ... I'm worried about things like death by misadventure, or suicidal ideation, the only alternative is to go to hospital," he says. 

"Yet [Christine's] thought process is, 'If I go to hospital, I'm going to feel more unsafe than I am here'. 

"Do I put my client in a place where they feel unsafe already, or do we maintain a level of risk here?" 

Christine has since had positive experiences in another of Bendigo Health's psychiatric units, with support from Mr Colletti and the rest of her treating team.

Word games, jigsaw puzzles and colouring in help Jenette with her mental health, but it's not always enough. 

Despite her best efforts to manage, the 64-year-old often struggles with self-harm and suicidal ideation. 

"Right up until this year, I would get help if I attended the emergency department," she says. 

"But this year, they're being really rude to me."  

For much of this year, Jenette felt she was being viewed as a pest because of how often she went to the hospital seeking help.

She complained to Bendigo Health about the way she was spoken to at the emergency department, while suicidal, earlier this year.

A few weeks after Jenette said she had that experience, Bendigo Health asked her to sign a care plan, which would restrict her voluntary admissions to a mental health unit.

Jenette wouldn't agree to it, fearing the plan would give staff greater licence to turn her away when she was most vulnerable. 

"It makes me feel angry because I only go up to ED or in triage if I'm really bad," she says. 

"Because I don't yell and scream, like some do, they think I'm not needy." 

Jenette's NDIS funding for therapy and other forms of support ran out, months ahead of schedule, leaving her feeling more alone than ever.

Her mental health and wellbeing at home further deteriorated after the reduction in services.

Jenette has been admitted to hospital several times since the plan was drafted, and Bendigo Health has stepped up mental health support.

"Treatment plans do not prevent a person being admitted to hospital if needed," a Bendigo Health spokesperson said.  

"Treatment plans are standard clinical practice for consumers.  

"They are designed to support individual recovery in the community and in the individual's own home." 

Jenette says she just wants to be treated with respect and to receive the support she needs. 

"I just hope it doesn't happen to other people.  

"If someone says they're suicidal, it should be taken seriously." 

Bendigo Health says Jenette and Christine's experiences do not reflect the usual standard of care provided by its mental health and wellbeing services.  

"We are committed to continually enhancing the quality of care we offer to our community," a spokesperson said. 

Victoria is grappling with reforming its mental health system after a royal commission found it had "catastrophically failed to meet expectations and was woefully underprepared for current and future challenges".  

However, people relying on, and working in, the system say not enough has changed in the three years since the royal commission tabled its 10-year plan for reform. 

George Skoufis is a worker in public mental health in Victoria who also has lived experience.  

"It's just simply not good enough what people have to experience within the public mental health system currently," he says.

That is especially true for people who access inpatient units, he says.

"They're not pleasant environments ... not the type of place you'd ever want to have to go to, and typically leave a lot of consumers with more trauma than they actually solve." 

Eminent psychiatrist and former Australian of the Year Patrick McGorry says mental health care in hospitals should be of the same standard people would expect for cancer or heart disease.  

"Very high-quality, with tremendous respect and compassionate care." 

A 2023 survey of Victorian Health and Community Services Union members working in public mental health showed fewer than half felt positive about their work, and many were struggling to pay their rent or service their mortgage.  

"Mental health workers are at breaking point," the union's state secretary, Paul Healey, says.

Occupational violence, high workloads, short staffing, and increasingly complex cases are among the key challenges the sector's workers face, with negotiations for the public mental health services enterprise agreement underway. 

Mr Skoufis says workers are under "quite extreme" stress.

"While there are good people trying to make a real impact in the industry, we simply don't have the ability to provide the care that the public deserves." 

The Victorian government committed to implement all the royal commission's recommendations and to make people with lived experience "central to the design and delivery of the new mental health and wellbeing system". 

However, key stakeholders say they are uncertain about the government's plan for reforms after work on several royal commission recommendations was either delayed or not funded in this year's state budget.

There was no funding for a Lived and Living Experience Agency, and the rollout of Mental Health and Wellbeing Locals — aimed at helping people over 26 get support — has slowed, with 15 established. 

"We simply can't deliver these reforms, or the first-rate care Victorians deserve, without the workforce behind us," the budget papers said, highlighting the need for an additional 2,500 mental health workers.  

"An evaluation of the existing rollout and a plan for the next phase of the work will be done prior to the next budget." 

The government says it has made "significant progress" since the royal commission's final report in 2021 and is leading the way for health reform nationally, with work underway to implement more than 90 per cent of the recommendations and more than $6 billion invested.

"We remain absolutely determined to deliver on the royal commission recommendations," Premier Jacinta Allan says. 

"The need for this is even more so than when we first called for the commission to do its work." 

The government did not respond to the ABC's questions about how it was considering changing its approach to reforms and the timeframe for delivery.

However, the government on Friday released its new suicide prevention strategy and reiterated its commitment to implementing the royal commission's reforms.

The Mental Health and Wellbeing Commission has requested information from the government about the future of mental health reforms, including plans to address workforce pressures.  

"We are strongly encouraging government to be transparent with its future plans for the royal commission implementation and are working hard to ensure stakeholders get the answers and direction they need," a commission spokesperson said. 

Emily Wolter, the acting chief executive of peak body Mental Health Victoria, says it wants to ensure momentum is not lost. 

"We need to see this change," she says. 

Victorian Mental Illness Awareness Council chief executive Vrinda Edan says people with lived experience are disappointed there has not been more substantial improvement.  

"What we're seeing at the moment doesn't look like it's sustainable or achieving anywhere near the level of change that people wanted and expected, and in some ways were set up by the royal commission and the speeches that were done at the time the report was released to expect," she says. 

The royal commission recommended interim regional bodies be replaced by legislated Regional Mental Health and Wellbeing boards "by no later than the end of 2023", so they could plan for the future of services and engage with their communities.  

The Victorian government's website states that eight interim regional bodies were established in 2022 but it does not mention a timeframe for the boards. 

"It's really important that we see those reforms back on track sooner rather than later," shadow mental health minister Emma Kealy said. 

Professor McGorry chaired the royal commission's expert advisory committee and says reforms to Victoria's mental health system must be led by experts.

"We need to identify what are the most strategic and transformational things we could do to not just end up with a much better system, but address the incredible stresses and strains that are on the current system which people are really suffering from at the moment."

More Victorians are considered active mental health consumers now than in the past four years, even though the number of new consumers is comparable to last year, state health data shows. 

Mental health-related presentations to Victorian emergency departments have been at a four-year high for most of this year, particularly in people over 65.

Many people are re-presenting to emergency departments within 48 hours, and there was a spike mid-year in people with mental health concerns spending more than 24 hours in emergency.

Just over 45 per cent of adults are transferred from emergency departments to mental health beds within eight hours.

Meanwhile, Suicide Prevention Australia data shows three-quarters of Australians are feeling elevated levels of distress, pushing support services to the brink , as the federal government seeks to improve the nation's approach to suicide prevention .

Paul Healey, from the Health and Community Services Union, says the challenges the mental health system face don't justify negative experiences for consumers.   

"There's no excuse for people who have been sitting in unsanitary conditions or not being able to access food and medication." 

He says mental health workers are concerned about the increased rate of suicide in the state, with more than 450 lives lost so far this year. 

"The system is not keeping up and keeping people safe." 

The Coroners Court of Victoria recorded 801 deaths by suicide in 2023, up from 761 the previous year.  

The government's new strategy acknowledges more needs to be done to prevent suicidal distress.

"We are working to deliver robust suicide prevention and support measures that are safe, accessible and respectful to all Victorians, no matter who they are or where they live," Ingrid Stitt, the Minister for Mental Health, says.

Professor McGorry and other mental health experts are calling for programs that offer intensive mental health support at home to be expanded.  

Both Barwon Health and Orygen offer Mental Health Hospital In The Home initiatives, with Barwon Health's program providing the equivalent of 245 bed days of care a month. 

"It takes enormous pressure off the hospital-based system and emergency departments," says Professor McGorry, who is Orygen's executive director. 

This is the moment Christine picked up her camera for the first time in six years.

Her depression has at times robbed her of her ability to take photographs so until recently she was writing to express herself.

A piece she wrote is now being used to give nursing students an insight into what patients are battling.

Christine's depression continues, but after years of trying different forms of treatment, it's improving.

She credits her treating team with helping her rediscover her voice and her self-worth. 

Among those she thanks are staff at Bendigo Health.

• Reporting: Emma D'Agostino
• Photography: Emma D'Agostino , Sean Warren, Christine Sayer and Beth Sayer
• Video: Emma D'Agostino
• Illustrations: Sharon Gordon
• Digital production: Daniel Franklin
• X (formerly Twitter)

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English KS3 / KS4 World Mental Health Day 10 October 2024 Reading Comprehension Analysis Writing

Subject: English

Age range: 11-14

Resource type: Lesson (complete)

Last updated

16 September 2024

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This extract and associated activities gives weaker students a simplified and broken down way of accessing a non-fiction text, on the theme of ‘Mental Health Day’, In 2024 this day falls on Thursday 10 December. This extract is suitable for KS3 students but can be adapted for less able KS4 pupils. The first part poses keywords for the subject. The second part has comprehension and language activities to ensure the text is carefully read. There are tasks which allow the student opportunities to analyse the use of persuasive language. There is a writing activity which encourages the use of a wide vocabulary, whilst giving students the opportunity to use information from the text they have just read. This lesson can easily be adapted to suit any GCSE curriculum. As the content is linked to personal health, it can be used to support PSHE as well as English

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