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The Effects of Positive Psychological Interventions on Medical Patients’ Anxiety

A Meta-analysis

Brown, Lydia M(Psyc)/PhD; Ospina, Juan Pablo MD; Celano, Christopher M. MD; Huffman, Jeff C. MD

doi: 10.1097/PSY.0000000000000722
SYSTEMATIC REVIEW/META-ANALYSIS
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Objective Positive psychology interventions, which involve systematic completion of activities designed to promote well-being, are being increasingly studied in medically ill patients. However, the extent to which these interventions ameliorate patient anxiety remains unclear. Therefore, the aim of the study was to conduct a meta-analysis to determine the efficacy of positive psychology interventions in reducing anxiety in medical patients.

Methods Electronic databases Medline, PsycINFO, SciELO, Cochrane (Central), and ClinicalTrials.gov were searched from inception to June 18, 2018, to identify studies of positive psychology interventions that included a validated measure of anxiety as an outcome measure.

Results The search generated a total of 1024 studies. Twelve randomized controlled trials (n = 1131) delivered to medical patients were included in the review, and a further 11 nonrandomized trials (n = 300) were included in a secondary analysis. Positive psychology interventions were effective at reducing patient anxiety relative to a control with a small to medium effect size (g = −0.34, 95% confidence interval = −0.50 to −0.18), and results were maintained at a mean of 8-week follow-up (g = −0.31, 95% confidence interval = −0.54 to −0.08). Clinician-led interventions seemed to be more effective than self-administered interventions, and longer interventions were more effective than shorter interventions. Secondary analysis of nonrandomized trials also found that positive psychology interventions are associated with reduced anxiety.

Conclusions Positive psychology interventions seem to be effective at reducing medical patient anxiety. Future research is needed to determine optimal intervention characteristics, including dose and intervention content, that maximize the observed treatment effects.

From the Department of Psychiatry (Brown, Ospina, Celano, Huffman), Massachusetts General Hospital; Department of Psychiatry (Brown, Ospina, Celano, Huffman), Harvard Medical School, Boston, Massachusetts; Melbourne School of Psychological Sciences (Brown), University of Melbourne; and North Eastern Rehabilitation Centre (Brown), Healthscope Hospitals, Melbourne, Victoria, Australia.

Address correspondence to Jeff C. Huffman, MD, Department of Psychiatry, Massachusetts General Hospital, 55 Fruit St, Boston, MA 02114. E-mail: JHUFFMAN@mgh.harvard.edu

Supplemental Content

J.C.H. and C.M.C. devised the research question. L.B. and J.P.O. conducted the literature search and the screening of studies for inclusion in the meta-analysis. J.C.H. and C.M.C. adjudicated discrepancies. L.B. conducted the meta-analysis and wrote the first draft of the manuscript. All authors contributed to its revisions and approved the final version of the manuscript.

Received for publication January 18, 2019; revision received May 13, 2019.

Online date: July 24, 2019

Copyright © 2019 by American Psychosomatic Society
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