A large-scale cross-sectional study of older individuals in the UK supports contextual, process-based models of mental health that emphasise values-guided behaviour, psychosocial resources and biopsychosocial integration, according to a study published September 3, 2025, in the open-access journal PLOS Mental Health by Darren Edwards from Swansea University, UK, and colleagues. This has important implications for clinical and rehabilitation contexts, such that efforts to enhance well-being are complementary and have additional benefits over and above reducing distress.
Understanding the interplay between well-being and ill-being is essential for refining psychological theory and informing clinical practice. Recently emerging therapeutic approaches emphasize that well-being is determined by meaning-oriented behavior (MOB), psychological flexibility, and the body's capacity for stress regulation (which can be monitored using heart rate variability (HRV). Ill-being encompasses psychological and physical symptoms such as anxiety, depression, and poor general health, which contribute substantially to global disease burdens and mortality. These two constructs are often assumed to lie on a single continuum, with well-being representing the absence of ill-being. However, evidence indicates that individuals can experience both simultaneously.
To better understand the complex dynamics between well-being and ill-being, Edwards and colleagues analyzed UK Biobank data from 8,047 individuals with a mean age of 65 years, guided by a focus on meaning, flexibility, and stress regulation. MOB appeared to have the strongest total effects on both the well-being and ill-being of individuals. It exerted both direct effects on mental health and indirect effects via social connectedness and resilience. HRV also played a key upstream role, showing positive associations with well-being, and indirect links with lower ill-being through its positive influence on MOB. Lifetime adversity, however, had the largest total effect on ill-being but no direct effect on well-being.
Together, these findings highlight HRV and MOB as key correlates of mental health outcomes, operating through social connectedness and resilience. HRV may serve as a physiological foundation, while MOB facilitates behavioral alignment with meaning and values. However, longer-term and more demographically diverse studies are needed to test causal directions and broader generalizability.
While not an intervention study, the findings suggest that strategies tailored to individuals' values, psychosocial resources, and life contexts may be more effective than uniform approaches. In particular, these results support interventions that target both vagal regulation and Fvalue-driven behavior to optimize well-being. Associations with well-being and ill-being outcomes were non-linear, cubic for MOB, social connection and resilience, exponential for HRV with well-being, and logarithmic for adversity with ill-being, with gains greatest when meaning, connection, and challenge were optimally balanced within the individual's unique context. Public health efforts should therefore aim to support balanced engagement, rather than assuming that more is always better. According to the authors, this research agenda lays a strong foundation for enhancing well-being and reducing ill-being, providing a robust framework for future personalized mental health interventions and policies.
Darren Edwards, principal investigator, adds: "Effective support is less about diagnostic categories and more about processes tailored to each person's context, aligning daily actions with personal values, sustaining supportive relationships, and bolstering autonomic regulation. This blended, context sensitive approach is likely to deliver greater gains than targeting symptoms in isolation."
Tom Gordon, co-author and computational statistician, summarizes: "Our study shows that the pathways linking resilience, meaning, adversity, and social connection are often exponential, cubic, or logarithmic in form. Assuming only linear patterns risks oversimplifying reality, missing thresholds where small changes make a huge difference, or where benefits plateau. Non-linear analysis helps us uncover these hidden dynamics, showing that well-being is not just the absence of ill-being. For psychologists, embracing this complexity is essential, it pushes us beyond one-size-fits-all models and opens the door to personalised, context-sensitive approaches that can transform both theory and practice."
