BackgroundAlthough positive psychology interventions (PPIs) show beneficial effects on mental health in non-clinical populations, the current literature is inconclusive regarding its effectiveness in clinical settings. We aimed to examine the effects of PPIs on well-being (primary outcome), depression, anxiety, and stress (secondary outcomes) in clinical samples with psychiatric or somatic disorders.MethodsA systematic review and meta-analysis was conducted following PRISMA guidelines. PsycINFO, PubMed, and Scopus were searched for controlled studies of PPIs in clinical samples between Jan 1, 1998 and May 31, 2017. Methodological quality of each study was rated. We used Hedges’ adjusted g to calculate effect sizes and pooled results using random-effect models.ResultsThirty studies were included, representing 1864 patients with clinical disorders. At post-intervention, PPIs showed significant, small effect sizes for well-being (Hedges’ g = 0.24) and depression (g = 0.23) compared to control conditions when omitting outliers. Significant moderate improvements were observed for anxiety (g = 0.36). Effect sizes for stress were not significant. Follow-up effects (8–12 weeks), when available, yielded similar effect sizes. Quality of the studies was low to moderate.ConclusionThese findings indicate that PPIs, wherein the focus is on eliciting positive feelings, cognitions or behaviors, not only have the potential to improve well-being, but can also reduce distress in populations with clinical disorders. Given the growing interest for PPIs in clinical settings, more high quality research is warranted as to determine the effectiveness of PPIs in clinical samples.Trial registrationPROSPERO CRD42016037451Electronic supplementary materialThe online version of this article (10.1186/s12888-018-1739-2) contains supplementary material, which is available to authorized users.

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There is a growing number of studies evaluating the impact of positive psychology interventions (PPI's) in people with severe mental illnesses (SMI). The results of these studies have not been quantitatively reviewed yet. In this study, we conduct a meta-analysis on the effects of PPI's on mental health in people with SMI across studies. Sixteen studies are included (nine RCTs), representing 729 patients. Meta-analyses were performed for well-being as the primary outcome at post-treatment. We found no significant effects on both well-being en psychopathology for the PPI's in comparison with the control conditions. Within-group effects revealed a moderate effect (Hedge's g = 0.40) on well-being and a large effect on psychopathology (g = 0.70). Though there is at present no evidence that PPIs are more effective in comparison with other active interventions, our findings demonstrated that people with SMI do benefit from PPIs in terms of enhancement of mental health.

Objectives To evaluate the psychometric properties of the Responses to Positive Affect (RPA) questionnaire in a sample of persons with bipolar disorder (BD). Method Cross‐sectional survey study with 107 persons with BD. The original 3‐factor model of the RPA was compared with a 2‐factor model. Construct validity was determined with measures of well‐being, personal recovery, social role participation, and psychopathology and incremental validity was evaluated. Results The fit of the 3‐factor model was acceptable for most fit indices. Subscores of the RPA revealed a significant relationship with aspects of well‐being, personal recovery, and psychopathology. Dampening and self‐focused positive rumination explained additional variance in personal recovery above and beyond well‐being. Conclusions The RPA is an internally consistent and valid tool to assess positive emotion regulation processes in persons with BD. Specifically, the processes of dampening and emotion‐focused positive rumination seem to play an important role in BD.

The aim of the current study was to evaluate the impact of a 6-week gratitude intervention for people with low to moderate well-being and moderate symptomatology of depression and anxiety up to 6 months follow-up. 217 Dutch adults were randomly assigned to one of three conditions: a 6-week gratitude intervention, a 6-week self-kindness intervention as an active control condition and a waitlist control condition. Participants completed online assessments on well-being, depression, anxiety and gratitude at baseline, post-test, 6 weeks and 6 months follow-up. Changes in outcome measures over time were examined using multilevel growth curve modeling in R to account for repeated measures nested within individuals. The gratitude intervention was more effective in improving mental well-being in comparison to the self-kindness intervention (d = .63 at post-intervention and d = .40 at 6 weeks follow-up) and waitlist control (d = .93 at post-intervention and d = .66 at 6 weeks follow-up). The data also demonstrated that the gratitude intervention was superior to waitlist control and practicing self-kindness on various measures of gratitude but not on distress. The results of this study suggest that a 6-week gratitude intervention is an effective, low-intensity intervention for enhancing mental well-being but not distress among people with low to moderate levels of well-being and moderate distress, at least in higher-educated women. The sustained effects on various measures of gratitude up to 6 months follow-up suggest that it is possible to promote a lasting appreciative perspective on life.