Positive Psychology Interventions for Adults with Spinal Cord Injury: A Systematic Review and Meta-analysis.

Objectives

To systematically synthesize the evidence on the effect of positive psychology interventions (PPIs) on health and wellbeing outcomes in adults with spinal cord injury (SCI). DATA SOURCES We performed a comprehensive search across six electronic databases: Medline, Embase, CINAHL, PsycInfo, SPORTDiscus, and CENTRAL (Cochrane Library). STUDY SELECTION We included interventional studies published between 2000 and 2025. Studies were eligible for inclusion if they involved individuals with SCI and implemented PPIs aligned with Seligman's PERMA (Positive Emotion, Engagement, Relationships, Meaning, and Accomplishment) model. Studies with all health and wellbeing outcomes were included. The initial search retrieved 8288 studies, of which eight met the eligibility criteria for inclusion in the systematic review. DATA EXTRACTIONS Two independent reviewers extracted data on study designs, intervention characteristics, outcome measures, and key findings using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline. Meta-analyses were performed for outcomes reported in at least three studies. DATA SYNTHESIS The systematic review included eight studies, and the meta-analyses included seven of them. Of the eight studies, seven integrated one or more PPI components within their interventions, whereas only one study was fully grounded in a positive psychology framework. Results from the systematic review suggest the significant positive effects of PPIs on selected physical, emotional, and psychosocial outcomes. In meta-analyses conducted for self-efficacy, life satisfaction, anxiety, and depression outcomes, the standardized mean differences were statistically significant for self-efficacy, life satisfaction, and anxiety. However, evidence on the follow-up or long-term effects of PPIs remains limited or inconsistent.

Conclusions

The PPIs or PPI-derived components exert beneficial effects on various health and wellbeing outcomes, particularly in emotional or psychological health. Nevertheless, further research using standardized, full-scale PPI and a larger sample is essential to establish these interventions as potential mainstream interventions within SCI rehabilitation.