Abstract
Multicomponent positive psychology interventions are increasing in the general population but the study of its effectiveness in adolescents is still scarce, especially in the school context. Previous meta-analyses have reported that multicomponent positive psychology interventions increase well-being and reduce distress outcomes. However, the results on these outcomes limit their samples to adult populations. The aim of the current systematic review and meta-analysis is to evaluate and compare the immediate but also long-lasting effects of school-based multicomponent positive psychology interventions aimed at increasing well-being indicators of mental health (i.e., subjective and psychological well-being) and reducing the most common psychological distress indicators (i.e., depression, anxiety, and stress) in adolescents. A total of 9 randomized and non-randomized controlled trials from the searched literature met inclusion criteria for the meta-analysis. The results showed small effects for subjective well-being (g = 0.24), psychological well-being (g = 0.25), and depression symptoms (g = 0.28). Removing low-quality studies led to a slight decrease in the effect sizes for subjective well-being and a considerable increase for psychological well-being and depression symptoms. The relevant moderation analyses had an effect on subjective well-being and depression symptoms. The present systematic review and meta-analysis found evidence for the efficacy of school-based multicomponent positive psychology interventions in improving mental health in the short and long-term. Small effects for subjective well-being, psychological well-being, and depression symptoms were identified. Effects for psychological well-being and depression symptoms remained significant over time. In light of our results, education policy-makers and practitioners are encouraged to include positive practices within the schools’ curriculum as effective and easily implemented tools that help to enhance adolescents’ mental health. Further research is needed in order to strengthen the findings about school-based multicomponent positive psychology interventions in adolescents.
Similar content being viewed by others
References
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders. Washington, D.C.: American Psychiatric Association.
Beesdo, K., Knappe, S., & Pine, D. S. (2009). Anxiety and anxiety disorders in children and adolescents: developmental issues and implications for DSM-V. Psychiatric Clinics of North America, 32(3), 483–524. https://doi.org/10.1016/j.psc.2009.06.002.
Bernard, M. E., & Walton, K. (2011). The effect of you can do it! Education in six schools on student perceptions of well-being, teaching-learning and relationships. The Journal of Student Wellbeing, 5(1), 22. https://doi.org/10.21913/jsw.v5i1.679.
Birmaher, B., Ryan, N. D., Williamson, D. E., Brent, D. A., Kaufman, J., Dahl, R. E., & Nelson, B. (1996). Childhood and adolescent depression: a review of the past 10 years. Part I. Journal of the American Academy of Child and Adolescent Psychiatry, 35(11), 1427–1439. https://doi.org/10.1097/00004583-199611000-00011.
Bolier, L., Haverman, M., Westerhof, G. J., Riper, H., Smit, F., & Bohlmeijer, E. (2013). Positive psychology interventions: a meta-analysis of randomized controlled studies. BMC Public Health, 13(1). https://doi.org/10.1186/1471-2458-13-119.
*Boniwell, I., Osin, E. N., & Martinez, C. (2015). Teaching happiness at school: non-randomised controlled mixed-methods feasibility study on the effectiveness of Personal well-being lessons. Journal of Positive. Psychology, 11(1), 85–98. https://doi.org/10.1080/17439760.2015.1025422.
Borenstein, M., Hedges, L., Higgins, J., & Rothstein, H. (2013). Comprehensive meta-analysis version 3.0. Englewood, NJ: Biostat.
Borenstein, M., Hedges, L. V., Higgins, J. P. T., & Rothstein, H. R. (2010). A basic introduction to fixed-effect and random-effects models for meta-analysis. Research Synthesis Methods, 1(2), 97–111. https://doi.org/10.1002/jrsm.12.
*Burckhardt, R., Manicavasagar, V., Batterham, P. J., & Hadzi-Pavlovic, D. (2016). A randomized controlled trial of strong minds: a school-based mental health program combining acceptance and commitment therapy and positive psychology. Journal of School Psychology, 57, 41–52. https://doi.org/10.1016/j.jsp.2016.05.008.
Burger, K., & Samuel, R. (2017). The role of perceived stress and self-feficacy in young people’s life satisfaction: a longitudinal study. Journal of Youth and Adolescence, 46(1), 78–90. https://doi.org/10.1007/s10964-016-0608-x.
Button, K. S., Ioannidis, J. P. A., Mokrysz, C., Nosek, B. A., Flint, J., Robinson, E. S. J., & Munafò, M. R. (2013). Power failure: why small sample size undermines the reliability of neuroscience. Nature Reviews Neuroscience, 14(5), 365–376. https://doi.org/10.1038/nrn3475.
Chakhssi, F., Kraiss, J. T., Sommers-Spijkerman, M., & Bohlmeijer, E. T. (2018). The effect of positive psychology interventions on well-being and distress in clinical samples with psychiatric or somatic disorders: a systematic review and meta-analysis. BMC Psychiatry, 18(1), 1–17. https://doi.org/10.1186/s12888-018-1739-2.
Ciocanel, O., Power, K., Eriksen, A., & Gillings, K. (2017). Effectiveness of positive youth development interventions: a meta-analysis of randomized controlled trials. Journal of Youth and Adolescence, 46(3), 483–504. https://doi.org/10.1007/s10964-016-0555-6.
Clonan, S. M., Chafouleas, S. M., McDougal, J. L., & Riley-Tillman, T. C. (2004). Positive psychology goes to school: are we there yet? Psychology in the Schools, 41(1), 101–110. https://doi.org/10.1002/pits.10142.
Cuijpers, P. (2016). Meta-analysis in mental health: a practical guide. Amsterdam, The Netherland: Pim Cuijpers Uitgeverij.
Dalton, D. R., Aguinis, H., Dalton, C. M., Bosco, F. A., & Pierce, C. A. (2012). Revisiting the file drawer problem in meta-analysis: an assessment of published and nonpublished correlation matrices. Personnel Psychology, 65(2), 221–249. https://doi.org/10.1111/j.1744-6570.2012.01243.x.
Datu, J. A. D. (2018). Flourishing is associated with higher academic achievement and engagement in filipino undergraduate and high school students. Journal of Happiness Studies, 19(1), 27–39. https://doi.org/10.1007/s10902-016-9805-2.
Derdikman-Eiron, R., Indredavik, M. S., Bratberg, G. H., Taraldsen, G., Bakken, I. J., & Colton, M. (2011). Gender differences in subjective well-being, self-esteem and psychosocial functioning in adolescents with symptoms of anxiety and depression: findings from the Nord-Trøndelag health study. Scandinavian Journal of Psychology, 52(3), 261–267. https://doi.org/10.1111/j.1467-9450.2010.00859.x.
Diener, E. (1984). Subjective well-being. Psychological Bulletin, 95(3), 542–575. https://doi.org/10.1037/0033-2909.95.3.542.
Dunning, D. L., Griffiths, K., Kuyken, W., Crane, C., Foulkes, L., Parker, J., & Dalgleish, T. (2018). Research review: The effects of mindfulness-based interventions on cognition and mental health in children and adolescents – a meta-analysis of randomized controlled trials. Journal of Child Psychology and Psychiatry and Allied Disciplines. https://doi.org/10.1111/jcpp.12980.
Duval, S., & Tweedie, R. (2000). Trim and fill: a simple funnel-plot-based method of testing and adjusting for publication bias in meta-analysis. Biometrics, 56(2), 455–463. https://doi.org/10.1111/j.0006-341X.2000.00455.x.
Egger, M., Smith, G. D., Schneider, M., & Minder, C. (1997). Bias in meta-analysis detected by a simple, graphical test measures of funnel plot asymmetry. BMJ, 315(7109), 629–634. https://doi.org/10.1136/bmj.315.7109.629.
*Freire, T., Lima, I., Teixeira, A., Araújo, M. R., & Machado, A. (2018). Challenge to be+. A group intervention program to promote the positive development of adolescents. Children and Youth Services Review, 87, 173–185. https://doi.org/10.1016/j.childyouth.2018.02.035.
Froh, J. J., Kashdan, T. B., Ozimkowski, K. M., & Miller, N. (2009). Who benefits the most from a gratitude intervention in children and adolescents? Examining positive affect as a moderator. The Journal of Positive Psychology, 4(5), 408–422. https://doi.org/10.1080/17439760902992464.
González-Carrasco, M., Casas, F., Viñas, F., Malo, S., Gras, M. E., & Bedin, L. (2017). What leads subjective well-being to change throughout adolescence? An exploration of potential factors. Child Indicators Research, 10(1), 33–53. https://doi.org/10.1007/s12187-015-9359-6.
González-Carrasco, M., Vaqué, C., Malo, S., Crous, G., Casas, F., & Figuer, C. (2019). A Qualitative longitudinal study on the well-being of children and adolescents. Child Indicators Research, 12(2), 479–499. https://doi.org/10.1007/s12187-018-9534-7.
Hendriks, T., Schotanus-Dijkstra, M., Hassankhan, A., de Jong, J., & Bohlmeijer, E. (2019). The efficacy of multi-component positive psychology interventions: a systematic review and meta-analysis of randomized controlled trials. Journal of Happiness Studies. https://doi.org/10.1007/s10902-019-00082-1.
Higgins, J. P. T., & Thompson, S. G. (2002). Quantifying heterogeneity in a meta-analysis. Statistics in Medicine, 21(11), 1539–1558. https://doi.org/10.1002/sim.1186.
Keyes, L. M. (1998). Social well-being. Social Psychology Quarterly, 61(2), 121–137. https://doi.org/10.2307/2787065.
Keyes, L. M. (2002). The mental health continuum: from languishing to flourishing in life. Journal of Health and Social Behavior, 43(2), 207–222. https://doi.org/10.2307/3090197.
Keyes, L. M. (2009). The nature and importance of positive mental health in America’s adolescents. In Handbook of Positive Psychology in Schools (pp. 9–23). https://doi.org/10.4324/9780203884089-10.
Koydemir, S., Sökmez, A. B., & Schütz, A. (2020). A meta-analysis of the effectiveness of randomized controlled positive psychological interventions on subjective and psychological well-Being. Applied Research in Quality of Life. https://doi.org/10.1007/s11482-019-09788-z.
Lipsey, M. W., & Wilson, D. B. (1993). The efficacy of psychological, educational, and behavioral Tteatment: confirmation from meta-analysis. American Psychologist, 48(12), 1181–1209. https://doi.org/10.1037/0003-066X.48.12.1181.
Malle, B. F. (2006). Supplemental material for the actor–observer asymmetry in attribution: a (surprising) meta-analysis. Psychological Bulletin, 132(6), 895–919. https://doi.org/10.1037/0033-2909.132.6.895.supp.
Marques, S. C., Lopez, S. J., & Pais-Ribeiro, J. L. (2011). Building hope for the future”: A program to foster strengths in middle-school students. Journal of Happiness Studies, 12(1), 139–152.https://doi.org/10.1007/s10902-009-9180-3.
McHugh, M. L. (2012). Interrater reliability: the kappa statistic. Biochemia Medica, 22(3), 276–282. https://doi.org/10.11613/bm.2012.031.
Moher, D., Shamseer, L., Clarke, M., Ghersi, D., Liberati, A., Petticrew, M., & Whitlock, E. (2015). Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015 statement. Systematic Reviews, 4(1), 1–9. https://doi.org/10.1186/2046-4053-4-1.
Noble, T., & McGrath, H. (2008). The positive educational practices framework: a tool for facilitating the work of educational psychologists in promoting pupil wellbeing. Educational and Child Psychology, 25(2), 119–134.
Paus, T., Keshavan, M., & Giedd, J. N. (2008). Why do many psychiatric disorders emerge during adolescence? Nature Reviews Neuroscience, 9(12), 947–957. https://doi.org/10.1038/nrn2513.
Popp, L., & Schneider, S. (2015). Attention placebo control in randomized controlled trials of psychosocial interventions: Theory and practice. Trials, 16(1), 1–3. https://doi.org/10.1186/s13063-015-0679-0.
Proctor, C., Tsukayama, E., Wood, A. M., Maltby, J., Eades, J. F., & Linley, P. A. (2011). Strengths Gym: The impact of a character strengths-based intervention on the life satisfaction and well-being of adolescents. The Journal of Positive Psychology, 6(5), 377–388. https://doi.org/10.1080/17439760.2011.594079.
Rosenberg, M. S. (2005). The file-drawer problem revisited: a general weighted method for calculating fail-safe numbers in meta-analysis. Evolution, 59(2), 464–468. https://doi.org/10.1111/j.0014-3820.2005.tb01004.x.
*Roth, R. A., Suldo, S. M., & Ferron, J. M. (2017). Improving middle school students’ subjective well-being: efficacy of a multicomponent positive psychology intervention targeting small groups of youth. School Psychology Review, 46(1), 21–41. https://doi.org/10.17105/10.17105/spr46-1.21-41.
*Ruini, C., Ottolini, F., Tomba, E., Belaise, C., Albieri, E., Visani, D., & Fava, G. A. (2009). School intervention for promoting psychological well-being in adolescence. Journal of Behavior Therapy and Experimental Psychiatry, 40(4), 522–532. https://doi.org/10.1016/j.jbtep.2009.07.002.
Rusk, R. D., Vella-Brodrick, D. A., & Waters, L. (2017). A complex dynamic systems approach to lasting positive change: The Synergistic Change Model. The Journal of Positive Psychology, 13(4), 406–418. https://doi.org/10.1080/17439760.2017.1291853.
Ryan, R. M., & Deci, E. L. (2001). On happiness and human potentials: a review of research on hedonic and eudaimonic well-being. Annual Review of Psychology, 52(1), 141–166. https://doi.org/10.1146/annurev.psych.52.1.141.
Ryff, C. D. (1989). Happiness is everything, or is it? Explorations on the meaning of psychological well-being. Journal of Personality and Social Psychology, 57(6), 1069–1081. https://doi.org/10.1037/0022-3514.57.6.1069.
Ryff, C. D. (1995). Psychological well-being in adult life. Current Directions in Psychological Science, 4(4), 99–104.
Schotanus-Dijkstra, M., Drossaert, C. H., Pieterse, M. E., Walburg, J. A., & Bohlmeijer, E. T. (2015). Efficacy of a multicomponent positive psychology self-help intervention: study protocol of a randomized controlled trial. JMIR Research Protocols, 4(3), 1–16. https://doi.org/10.2196/resprot.4162.
Seligman, M. (2011). Flourish: a visionary new understanding of happiness and well-being. New York, NY: Simon & Schuster.
Seligman, M. (2018). PERMA and the building blocks of well-being. Journal of Positive. Psychology, 13(4), 333–335. https://doi.org/10.1080/17439760.2018.1437466.
Seligman, M., Ernst, R. M., Gillham, J., Reivich, K., & Linkins, M. (2009). Positive education: positive psychology and classroom interventions. Oxford Review of Education, 35(3), 293–311. https://doi.org/10.1080/03054980902934563.
Shapero, B. G., Hankin, B. L., & Barrocas, A. L. (2013). Stress generation and exposure in a multi-wave study of adolescents: transactional processes and sex differences. Journal of Social and Clinical Psychology, 32(9), 989–1012. https://doi.org/10.1521/jscp.2013.32.9.989.
*Shoshani, A., & Steinmetz, S. (2014). Positive psychology at school: a School-based intervention to promote adolescents’ mental health and well-being. Journal of Happiness Studies, 15(6), 1289–1311. https://doi.org/10.1007/s10902-013-9476-1.
*Shoshani, A., Steinmetz, S., & Kanat-Maymon, Y. (2016). Effects of the Maytiv positive psychology school program on early adolescents’ well-being, engagement, and achievement. Journal of School Psychology, 57, 73–92. https://doi.org/10.1016/j.jsp.2016.05.003.
Sterne, J. A. C., Savović, J., Page, M. J., Elbers, R. G., Blencowe, N. S., Boutron, I., … Higgins, J. P. T. (2019). RoB 2: a revised tool for assessing risk of bias in randomised trials. The BMJ, 366. https://doi.org/10.1136/bmj.l4898.
Sterne, J. A., Egger, M., & Moher, D. (2008). Addressing reporting biases. Cochrane Handbook for Systematic Reviews of Interventions. (pp. 297–333). Chichester, UK: John Wiley & Sons, Ltd. https://doi.org/10.1002/9780470712184.ch10.
*Suldo, S. M., Savage, J. A., & Mercer, S. H. (2014). Increasing middle school students’ life satisfaction: efficacy of a positive psychology group intervention. Journal of Happiness Studies, 15(1), 19–42. https://doi.org/10.1007/s10902-013-9414-2.
Taylor, R. D., Oberle, E., Durlak, J. A., & Weissberg, R. P. (2017). Promoting positive youth development through school‐based social and emotional learning interventions: a meta‐analysis of follow‐up effects. Child Development, 88(4), 1156–1171. https://doi.org/10.1111/cdev.12864.
*Tomba, E., Belaise, C., Ottolini, F., Ruini, C., Bravi, A., Albieri, E., & Fava, G. A. (2010). Differential effects of well-being promoting and anxiety-management strategies in a non-clinical school setting. Journal of Anxiety Disorders, 24(3), 326–333. https://doi.org/10.1016/j.janxdis.2010.01.005.
Turner, Herbert, M. I., & Bernard, R. M. (2006). Calculating and synthesizing effect sizes. Contemporary Issues in Communication Science and Disorders, 33, 42–55. https://doi.org/10.1044/cicsd_33_s_42.
UN General Assembly. (2015). Transforming our world: The 2030 agenda for sustainable development (A/RES/70/1). United Nations.
Vittersø, J. (2016). The most important idea in the world: an introduction. In Handbook of Eudaimonic Well-Being (pp. 1–24). Cham: Springer International Publishing. https://doi.org/10.1007/978-3-319-42445-3_1.
Waterman, A. S. (1993). Two conceptions of happiness: contrasts of personal expressiveness (eudaimonia) and hedonic enjoyment. Journal of Personality and Social Psychology, 64(4), 678–691. https://doi.org/10.1037/0022-3514.64.4.678.
Waters, L. (2011). A review of school-based positive psychology interventions. The Australian Educational and Developmental Psychologist, 28(2), 75–90. https://doi.org/10.1375/aedp.28.2.75.
Weiss, L. A., Westerhof, G. J., & Bohlmeijer, E. T. (2016). Can we increase psychological well-being? The effects of interventions on psychological well-being: a meta-analysis of randomized controlled trials. PLoS ONE, 11(6). https://doi.org/10.1371/journal.pone.0158092.
World Health Organization (2004). Promoting Mental Health: Concepts, emerging evidence and practice. Summary report Geneva. Geneva.
World Health Organization (2017). Depression and other common mental disorders global health etimates. Geneva.
Acknowledgements
We would like to thank Jorge Moya and Jaume March for their contributions to earlier versions of this manuscript.
Authors' Contributions
C.T.G. conceived of the study, participated in the initial literature search, the evaluation of quality of studies, conducted the preliminary statistical analysis and wrote the first draft of the manuscript; A.B.B. advised the design, participating in the identification of relevant studies, the evaluation of quality of studies, interpretation of the study findings and helped to draft the manuscript; C.T.N. participated in the literature search, data extraction and statistical analysis; C.A. contributed to the conceptualization of the study, interpretation of the findings and oversaw study execution. All authors read and approved the final manuscript.
Data Sharing and Declaration
The datasets generated and/or analyzed during the current study are not publicly available but are available from the corresponding author on reasonable request.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of Interest
The authors declare that they have no conflict of interest.
Ethical Approval
The current manuscript used published studies as the sole data source and did not involve any other data collection or direct interactions with human participants. As such, seeking approval from a human subjects’ review committee is irrelevant.
Informed Consent
This research did not involve any data collection or direct interaction with participants and therefore informed consent was not obtained.
Additional information
Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
Tejada-Gallardo, C., Blasco-Belled, A., Torrelles-Nadal, C. et al. Effects of School-based Multicomponent Positive Psychology Interventions on Well-being and Distress in Adolescents: A Systematic Review and Meta-analysis. J Youth Adolescence 49, 1943–1960 (2020). https://doi.org/10.1007/s10964-020-01289-9
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10964-020-01289-9