Background
Present study
Method
Search strategy
Selection of studies
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Examination of the effects of a positive psychology intervention. A positive psychology intervention (PPI) was defined in accordance with Sin and Lyubomirsky’s (2009) article as a psychological intervention (training, exercise, therapy) primarily aimed at raising positive feelings, positive cognitions or positive behavior as opposed to interventions aiming to reduce symptoms, problems or disorders. The intervention should have been explicitly developed in line with the theoretical tradition of positive psychology (usually reported in the introduction section of an article).
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Randomization of the study subjects (randomizing individuals, not groups) and the presence of a comparator condition (no intervention, placebo, care as usual).
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Publication in a peer-reviewed journal.
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At least one of the following are measured as outcomes: well-being (subjective well-being and/or psychological well-being) or depression (diagnosis or symptoms).
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Sufficient statistics are reported to enable the calculation of standardized effect sizes.
Data extraction
Study | 1 | 2 | 3 | 4 | 5 | 6 | Total |
---|---|---|---|---|---|---|---|
Abbott 2009 [78] | 0 | 0 | 1 | 1 | 0 | 1 | 3 |
Boehm 2011 [73] | 0 | 1 | 1 | 1 | 0 | 1 | 4 |
Buchanan 2010 [56] | 0 | 0 | 0 | 1 | 0 | 0 | 1 |
Burton 2004 [64] | 0 | 1 | 1 | 1 | 1 | 0 | 4 |
Cheavens 2006 [76] | 0 | 0 | 1 | 0 | 1 | 0 | 2 |
Emmons 2006 study 1 | 0 | 1 | 0 | 1 | 0 | 0 | 2 |
Emmons 2006 study 3 | 0 | 1 | 0 | 1 | 0 | 0 | 2 |
Fava 1998 [82] | 0 | 1 | 0 | 0 | 1 | 0 | 2 |
Fava 2005 [83] | 0 | 1 | 0 | 0 | 0 | 0 | 1 |
Feldman 2012 [60] | 0 | 0 | 0 | 1 | 0 | 0 | 1 |
Frieswijk 2005 | 0 | 0 | 0 | 1 | 0 | 0 | 1 |
Gander 2012 [74] | 0 | 1 | 1 | 1 | 0 | 0 | 3 |
Goldstein 2007 [84] | 0 | 0 | 0 | 1 | 0 | 0 | 1 |
Grant 2009 [79] | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
Grant 2012 [82] | 1 | 1 | 1 | 1 | 0 | 0 | 4 |
Green 2006 [33] | 0 | 0 | 0 | 1 | 1 | 0 | 2 |
Hurley 2012 [61] | 0 | 0 | 1 | 1 | 0 | 0 | 2 |
King 2001 [66] | 0 | 1 | 0 | 0 | 1 | 0 | 2 |
Kremers 2006 [57] | 0 | 0 | 1 | 1 | 1 | 0 | 3 |
Layous 2012 [75] | 0 | 1 | 1 | 1 | 0 | 0 | 3 |
Lichter 1980 study 2 [80] | 0 | 0 | 0 | 0 | 1 | 0 | 1 |
Luthans 2008 [65] | 1 | 1 | 1 | 1 | 0 | 0 | 4 |
Luthans 2010 study 1 [72] | 0 | 1 | 1 | 1 | 1 | 0 | 4 |
Lyubomirsky 2006 study 2 [58] | 0 | 1 | 1 | 1 | 1 | 0 | 4 |
Lyubomirsky 2011 [67] | 0 | 1 | 1 | 1 | 0 | 0 | 3 |
Martinez 2010 [68] | 0 | 1 | 1 | 1 | 1 | 0 | 4 |
Mitchell 2009 [69] | 1 | 1 | 1 | 1 | 0 | 1 | 5 |
Page 2012 [62] | 1 | 0 | 1 | 0 | 0 | 0 | 2 |
Peters 2010 [70] | 0 | 1 | 1 | 1 | 1 | 0 | 4 |
Quoidbach 2009 [59] | 1 | 0 | 1 | 0 | 0 | 0 | 2 |
Schueller 2012 [63] | 1 | 0 | 1 | 1 | 0 | 0 | 3 |
Seligman 2005 [30] | 0 | 1 | 1 | 1 | 1 | 0 | 4 |
Seligman 2006 study 1 [51] | 0 | 0 | 1 | 0 | 0 | 0 | 1 |
Seligman 2006 study 2 [51] | 0 | 1 | 1 | 0 | 1 | 0 | 3 |
1 | 1 | 1 | 1 | 0 | 0 | 4 | |
Sheldon 2002 [32] | 0 | 1 | 1 | 1 | 1 | 0 | 4 |
Sheldon 2006 [34] | 0 | 1 | 1 | 0 | 0 | 0 | 2 |
Spence 2007 [81] | 0 | 0 | 1 | 0 | 0 | 0 | 1 |
Wing 2006 [71] | 0 | 1 | 0 | 1 | 0 | 0 | 2 |
Total | 7 | 23 | 26 | 27 | 14 | 3 | 100 |
Meta-analysis
Results
Description of studies
Author | Intervention | Session (number), duration | Mean age (range or SD) | Delivery | Recruitment | Self-selection | Psychosocial problems / inclusion criteria | Control Group | N analyzed (post test) | Attrition rate, % (post test) | Outcome measures | Follow-up (min. 3 months) |
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Abbott 2009 [78] | ResilienceOnline | 7, 10w | 43 | Self-help | Organization | Self-selected | None | Waiting list | Ne=26 Nc=27 | 41.5% | PWB: AHI DEP: DASS-21 | - |
Boehm 2011 [73] | Optimism and gratitude exercise | 6, 6w | 35.6 (11.4) | Self-help | Community | Self-selected | None | Placebo | Ne=146 Nc=74 | ? | SWB: SWLS | - |
Buchanan 2010 [56] | Doing acts of kindness | 10, 10d | 26 (18–60) | Self-help | University | Self-selected | None | No intervention | Ne=28 Nc=28 | 0% (? nr) | SWB: SWLS | - |
Burton 2004 [64] | Writing about positive experiences | 3, 3d | College-based sample 18.6 (0.95) | Self-help | University | Not self-selected | None | Placebo | Ne=48 Nc=42 | 0% | SWB: PA | - |
Cheavens 2006 [76] | Hope therapy | 8, 8w | 49 (32–64) | Group | Community | Self-selected | Inclusion criteria unclear | Waiting list | Ne=17 Nc=15 | 12% 22% T: 18% | PWB: SHS DEP: CES-D | - |
Emmons 2006 study 1 [29] | Practising gratitude by counting one’s blessings | 10, 10w | U (students) | Self-help | University | Not self-selected | None | Placebo | Ne=65 Nc=67 | T: 4% | SWB: Life as a whole, upcoming week, PA | - |
Emmons 2006 study 3 [29] | Practising gratitude by counting one’s blessings | 21, 3w | 49 (22–77) | Self-help | Referral/hospital | Not self-selected | None | No intervention | Ne=33 Nc=32 | 0% (? nr) | SWB: Life as a whole, upcoming week, PA (self-report and observed) | - |
Fava 1998 [82] | Well-being therapy | 8, 16w | 28.4 (6.5) | Individual | Referral/hospital | Self-selected | Diagnosis of MDD or AD, succesful response to treatment | TAU | Ne=10 Nc=10 | 0% | PWB: RPWB DEP: CID, SQ subscale | - |
Fava 2005 [83] | Well-being therapy | 8, 16w | 41.9 (12) | Individual | Referral/hospital | Self-selected | Diagnosis of GAD | TAU | Ne=8 Nc=8 | 20% | PWB: RPWB DEP: CID, SQ subscale | 1 yr (not in study) |
Feldman 2012 [60] | Hopeful goal-directed thinking | 1, 1d | 18.7 (18–22) | Group | University | Not self-selected | None | No intervention | Ne=37 Nc=29 | 24.7% | PWB: GSHS, PIL | |
Frieswijk 2005 [77] | Self-management positive bibliotherapy | 5, 10w | 72.9 (6.2) | Self-help | Community | Self-selected | Slightly or moderately frail (>=65 GFI) | Waiting list | Ne=79 Nc=86 | 18.4% 10.4% T: 14.5% | SWB: SPF-IL PWB: MS | 6 m |
Gander 2012 [74] | 9 exercises: gratitude visit three good things (1 and 2 weeks), strengths, three funny things, social exercises | 7, 1w 14, 2w | 44.9 (10.07) | Self-help | Internet, magazine | Self-selected | None | Placebo | Ne=559 Nc=63 | 74% | PWB: AHI DEP: CES-D | 6 m |
Goldstein 2007 [84] | Cultivating sacred moments | 15, 3w | (22–44) | Self-help | Internet | Self-selected | None | TAU | Ne=35 Nc=38 | 14.6% 9.5% T: 12.0% | SWB: SWLS PWB: RPWB | - |
Grant 2009 [79] | Executive coaching | 6, 8-10w | 49.8 | Group and individual | Organization | Self-selected | None | Waiting list | Ne=21 Nc=20 | 18% | DEP: DASS-21 | - |
Grant 2012 [85] | Solution-focused coaching | 1, 1d | 20.5 (5.4) | Self-help | University | Self-selected | None | TAU | Ne=117 Nc=108 | 0% (? nr) | SWB: PA | - |
Green 2006 [33] | Life coaching and attainment of goals | 10, 10w | 42.7 (18–60) | Group | Community | Self-selected | None | Waiting list | Ne=25 Nc=25 | 10.7% 10.7% T: 10.7% | SWB: SWLS, PA PWB: RPWB, SHS | - |
Hurley 2012 [61] | Savoring the moment | 14, 2w | 19.5 (2.06) | Group / Self-help | University | Not self-selected | None | No intervention | Ne=94 Nc=99 | 37.7% 39.6% T: 38.7% | SWB: PA DEP: BDI | - |
King 2001 [66] | Writing about best possible selves | 4, 4d | 21 (18–42) | Self-help | University | Not self-selected | None | Placebo | Ne=19 Nc=16 | 0% | SWB: PA | - |
Kremers 2006 [57] | Self-management positive group course | 6, 6w | 64.3 (7) | Group | Community | Self-selected | Single and lonely | No intervention | Ne=46 Nc=73 | 17.0% 7.6% T: 16.2% | SWB: SPF-IL | 6 m |
Layous 2012 [75] | Best possible selves exercise | 4, 4w | 19.1 (1.8) | Self-help Group | University | Not self-selected | None | Placebo | Ne=80 Nc=37 | ? | SWB: PA PWB: NS | - |
Lichter 1980 study 2 [80] | Rehearsal of positive statements | 14, 2w | U (students) | Individual | University | Not self-selected | None | Waiting list | Ne=25 Nc=23 | 0% (? nr) | SWB: AF1 DEP: BDI | - |
Luthans 2008 [65] | Online well-being program (PsyCap) | 2, 2w | 32.2 | Self-help | University | Self-selected | None | Placebo | Ne=187 Nc=177 | 6.0% 4.8% T: 5.5% | PWB: PCQ | - |
Luthans 2010 study 1 [72] | PsyCap training | 1, 2 h | 21.1 (2.66) | Group | University | Not self-selected | None | Placebo | Ne=153 Nc=89) | 0% | PCQ | - |
Lyubomirsky 2006 study 2 [58] | Thinking about positive life experiences | 3, 3d | 19.5 (2.6) | Self-help | University | Not self-selected | None | No intervention | Ne=26 Nc=36 | 0% | SWB: SWLS, PA | - |
Lyubomirsky 2011 [67] | Expressing optimism or gratitude | 8, 8w | 19.7 (18–46) | Self-help | University | Self-selected | None | Placebo | Ne=218 Nc=101 | T: 10.1% | SWB: PLA, SWLS, SHS(2) | 6 m |
Martinez 2010 [68] | Practising gratitude by counting one’s blessings | 14, 2w | 20.7 (1.5) | Self-help | University | Not self-selected | None | Placebo | Ne=41 Nc=34 | 34.0% | SWB: PA, GA (self-report and observed) | - |
Mitchell 2009 [69] | Online intervention Use your strenghts in a new way | 3, 3w | 37 (18–62) | Self-help | Internet | Self-selected | None | Placebo | Ne=48 Nc=54 | 64.6% 57.4% T: 60.8% | SWB: PWI-A, SWLS, PA PWB: OTH DEP: DASS-21 | 3 m |
Page 2012 [62] | Working for Wellness Program | 6, 6w | 39.7 (10.0) | Group | Organization | Self-selected | None | No intervention | Ne=13 Nc=10 | 58.1% 66.7% T: 62.3% | SWB: SWLS, PA PWB: SPWB | 6 month |
Peters 2010 [70] | Positive future thinking | 1, 1d | 29.7 (21–50) | Self-help | University | Not self-selected | None | Placebo | Ne=44 Nc=38 | 0% | SWB: PA | - |
Quoidbach 2009 [59] | Projecting a positive self in the future | 14, 2w | 32.5 | Self-help | University | Not self-selected | None | No intervention | Ne=15 Nc=57 | T: 49.5% | SWB: SHS(2) | - |
Schueller 2012 [63] | Package of 2, 4 or 6 positive psychology exercises (active-constructive responding, gratitude visit, life summary, three good things, savoring, strengths) | 14, 2w 28, 4w 42, 6w | 42.4 (12.1) | Self-help | Internet | Self-selected | None | No intervention | Ne=457 Nc=204 | 54.7% 42.5% T: 55.4% | DEP: CES-D | - |
Seligman 2005 [30] | Strenghts excercises (2), gratitude (1), positive thinking (2) | 7, 1w | 64% between5-54 | Self-help | Internet | Self-selected | None | Placebo | Ne=341 Nc=70 | T: 28.8% | PWB: SHI DEP: CES-D | 6 m |
Seligman 2006 study 1 [51] | Group positive psychotherapy | 6, 6w | U (students) | Group | University | Self-selected | Mild to moderate depressive symptoms (BDI 10–24) | No intervention | Ne=14 Nc=20 | 26.3% 4.8% T: 15.0% | SWB: SWLS DEP: BDI | 3, 6 (in study), 12 m |
Seligman 2006 study 2 [51] | Individual positive psychotherapy | 14, 12w | U (adults) | Individual | Referral/hospital | Self-selected | Clinical diagnosis of MDD | TAU | Ne=11 Nc=9 | 15.4% 40.0% T: 28.6% | SWB: SWLS PWB: PPTI DEP: HRSD, ZSRS | - |
Three good things, signature strengths, self-compassion, optimism, compassionate action, gratitude intervention | 7, 1w | 34 (11.8) | Self-help | Internet | Self-selected | None | Placebo | Ne=804 Nc=138 | 75% | PWB: SHI DEP: CES-D | 3 (in study), 6 m | |
Sheldon 2002 [32] | Goal-training program | 2, 2w | U (students) | Group | University | Not self-selected | None | Placebo | Ne=36 Nc=42 | T: 13.3% | SWB: PA PWB: RPWB | - |
Sheldon 2006 [34] | Gratitude or visualizing positive self | 14, 2w | U (students) | Self-help | University | Not self-selected | None | Placebo | Ne=44 Nc=24 | T: 6.0% | SWB: PA | - |
Spence 2007 [81] | Life coaching and attainment of goals | 10, 10w | 38.6 | Individual | Community | Self-selected | None | Waiting list | Ne=20 Nc=17 | 4.8%15.0% T: 9.8% | SWB: SWLS, PA PWB: RPWB | - |
Wing 2006 [71] | Positive writing | 3, 3d | 40.3 (18–79) | Self-help | Community | Self-selected | None | Placebo | Ne=58 Nc=55 | 6.3% | SWB: SWLS | - |
Post-test effects
Outcome measures | n | N | Studies | Cohen’s d(95% CI) | Heterogeneity | Test for overall effect |
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Post-test | ||||||
Subjective well-being | 28 | Ne=1449 Nc=1265 | 0.34 (0.22 – 0.45) | Q=53.5, df=27, T2=0.04 (p<.01); I2=49.5% | Z=5.82 (p<.01) | |
Psychological well-being | 20 | Ne=2511 Nc=977 | 0.20 (0.09 – 0.30) | Q=26.8, df=19, T2=0.01 (p=0.11); I2=29.0% | Z=3.65 (p<.01) | |
Depression | 14 | Ne=2435 Nc=760 | 0.23 (0.09 – 0.38) | Q=24.5, df=13, T2=0.03 (p=0.03); I2=47.0% | Z=3.21 (p<.01) | |
Follow-up | ||||||
Subjective well-being | 6 | Ne=329 Nc=298 | 0.22 (0.05 – 0.38) | Q=5.05, df=5, T2=0.00 (p=0.41); I2=1.1% | Z=2.61 (p<.01) | |
Psychological well-being | 6 | Ne=1830 Nc=417 | 0.16 (0.02 – 0.30) | Q=6.8, df=5, T2=0.01 (p=0.24); I2=26.0% | Z=2.20 (p=.03) | |
Depression | 5 | Ne=1765 Nc=343 | 0.17 (−0.06 – 0.39) | Q=11.1, df=4, T2=0.04 (p=0.03); I2=63.9% | Z=1.44 (p=.15) |
Follow-up effects
Subgroup analyses
Outcome measure | Criteria | Subgroup (study) | n | Cohen’s d (95% CI) | Test for subgroup differences |
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Subjective well-being | Self-selection | Self-selected | 15 | 0.29 (0.18 – 0.39)*** | Q=0.64, df=1 (p=.43) |
Not self-selected | 13 | 0.38 (0.17 – 0.60)** | |||
Duration | <=4 weeks | 17 | 0.35 (0.18 – 0.52)*** | Q=1.84, df=2 (p=.91) | |
<=8 weeks | 6 | 0.24 (0.10 - 0.39)** | Slope=0.01, Z=0.14 (p=.89) | ||
>8 weeks | 5 | 0.43 (0.17 – 0.68)** | |||
Type | Self help | 20 | 0.33 (0.20 – 0.46)*** | Q=0.20, df=2 (p=.91) | |
Group | 5 | 0.38 (0.03 – 0.73)* | |||
Individual | 3 | 0.41 (0.01 – 0.81)* | |||
Recruitment | Community | 6 | 0.29 (0.11 – 0.48)** | Q=5.36, df=4 (p=.25) | |
Internet | 2 | 0.06 (−0.24 – 0.35)ns | |||
Referral/hospital | 2 | 0.51 (0.08 – 0.95)* | |||
University | 16 | 0.36 (0.19 – 0.53)*** | |||
Organization | 2 | 0.62 (0.11-1.12)* | |||
Psychosocial problems | Specific psychosocial problems | 4 | 0.31 (0.09 – 0.52)** | Q=0.10, df=1 (p=.76) | |
None | 24 | 0.35 (0.22 – 0.48)*** | |||
Quality rating | Low (1–2) | 16 | 0.29 (0.17 – 0.40)*** | Q=2.41, df=2 (p=.30) | |
Medium (3–4) | 11 | 0.40 (0.19 – 0.61)*** | Slope=−0.00, Z=0.08 (p=.94) | ||
High (5–6) | 1 | 0.05 (−0.34 – 0.44)ns | |||
Psychological well-being | Self-selection | Self-selected | 15 | 0.18 (0.05 – 0.30)** | Q=0.32, df=1 (P=.57) |
Not self-selected | 5 | 0.25 (0.04- 0.46) * | |||
Duration | <=4 weeks | 11 | 0.16 (0.07 – 0.25)*** | Q=1.91, df=2 (p=.39) | |
<=8 weeks | 2 | 0.35 (−0.20 – 0.89)ns | Slope=0.05, Z=0.95 (p=.34) | ||
>8 weeks | 7 | 0.41 (0.03 – 0.79)* | |||
Type | Self help | 10 | 0.14 (0.05 – 0.23)** | Q=3.76, df=2 (p=.15) | |
Group | 6 | 0.26 (0.08 – 0.44)** | |||
Individual | 4 | 0.81 (−0.01 – 1.63)ns | |||
Recruitment | Community | 4 | 0.20 (−0.03 – 0.44)ns | Q=7.04, df=4 (p=.13) | |
Internet | 5 | 0.09 (−0.03 – 0.21)ns | |||
Referral/hospital | 4 | 0.91 (0.24 – 1.57)** | |||
University | 5 | 0.22 (0.08 – 0.35)** | |||
Organization | 2 | 0.18 (−0.43 – 0.78)ns | |||
Psychosocial problems | Specific psychosocial problems | 5 | 0.59 (0.00 – 1.18)* | Q=1.93, df=1 (p=.17) | |
None | 15 | 0.17 (0.08 – 0.25)*** | |||
Quality rating | Low (1–2) | 10 | 0.32 (0.07 – 0.58)* | Q=1.86, df=2 (p=.40) | |
Medium (3–4) | 9 | 0.15 (0.06 – 0.24)** | Slope=−0.01, Z=−0.45 (p=.66) | ||
High (5–6) | 1 | 0.29 (−0.11 – 0.68)ns | |||
Depression | Self-selection | Self-selected | 12 | 0.20 (0.05– 0.36)* | Q=1.73, df=1 (p=.19) |
Not self-selected | 2 | 0.41 (0.15 – 0.66)** | |||
Duration | <=4 weeks | 7 | 0.15 (0.02 - 0.28)* | Q=4.86, df=2 (p=.09) | |
<=8 weeks | 2 | 0.47 (−0.02 - 0.97)ns | Slope=0.20, Z=2.32 (p=.02) | ||
>8 weeks | 5 | 0.68 (0.15 – 1.21)* | |||
Type | Self help | 8 | 0.15 (0.03 – 0.27)* | Q=6.99, df=2 (p=.03) | |
Group | 2 | 0.47 (−0.02 – 0.97)ns | |||
Individual | 4 | 0.88 (0.29 – 1.47)** | |||
Recruitment | Community | 1 | 0.48 (−0.23 – 1.18)ns | Q=15.76, df=4 (p<.01) | |
Internet | 5 | 0.11 (−0.02 – 0.23)ns | |||
Referral/hospital | 3 | 1.14 (0.55 – 1.73)*** | |||
University | 3 | 0.41 (0.17 – 0.65)** | |||
Organization | 2 | 0.22 (−0.18 – 0.63)ns | |||
Psychosocial problems | Specific psychosocial problems | 5 | 0.78 (0.35 – 1.21)*** | Q=7.65, df=1 (p=.01) | |
None | 9 | 0.16 (0.05 – 0.27)** | |||
Quality rating | Low (1–2) | 7 | 0.47 (0.26 – 0.67)*** | Q=10.14, df=2 (p=.01) | |
Medium (3–4) | 6 | 0.15 (0.00 – 0.30)* | Slope=−0.10, Z=−2.26 (p=.02) | ||
High (5–6) | 1 | −0.17 (−0.56 – 0.22)ns |