Baseline trait mindfulness moderates the efficacy of mindfulness interventions and active controls: A meta-analysis of 177 randomised controlled trials.

Previous evidence suggests that benefits of mindfulness-based interventions (MBIs) may depend on individuals' baseline trait mindfulness (BTM) levels. This meta-analysis investigated moderating effects of BTM on changes in mental health outcomes and trait mindfulness in randomised controlled trials (RCTs) of MBIs. A total of 177 primary studies (total N = 13,486), comparing the treatment effects of MBIs against active, treatment-as-usual (TAU) and waitlist control groups, were synthesised via three-level meta-analysis. Lower BTM was associated with larger changes in mental health outcomes (B = -0.14, 95% CI [-0.21, -0.06], p < .001) and trait mindfulness (B = -0.09 [-0.16, -0.02], p = .009) in MBIs and active controls combined. These associations were significantly larger than from those in TAU and waitlist controls. Moderating effects were less tangible for changes in trait mindfulness in MBIs and active controls individually and less tangible in various sensitivity analyses which, however, were confounded by client type across the RCTs. Individuals low in BTM may, by a small effect size, benefit more from MBIs and active control interventions. BTM may thus affect the evaluation of treatment efficacy. MBIs and active interventions could be offered specifically to persons low in BTM.

Day-to-day associations between mindfulness and perceived stress: insights from random intercept cross-lagged panel modeling.

Objective: Mindfulness is frequently seen as a protective factor of stress, but self-report measures of mindfulness may overlap with other related constructs, such as mental health, and could thus not only be a predictor, but also an outcome of stress. This study thus aimed to examine the longitudinal bidirectional associations between the use and perceived helpfulness of the four mindfulness facets Observe, Describe, Nonjudge, and Nonreact with daily perceived stress. Methods: Participants from a large (N = 1,276) mixed student and community group sample filled out a brief daily diary over the time span of 7 days. Bidirectional cross-lagged effects were investigated using the random-intercept cross-lagged panel model, an extension of the traditional cross-lagged panel model that allows to differentiate between stable between-unit differences and time-varying within-unit dynamics. In addition, we controlled for several baseline and sociodemographic confounders. Results: At the within-subject level, the use of Actaware was associated with higher perceived stress on the next day (ß = 0.03, p = 0.029). The use (ß = -0.04, p = 0.025) and perceived helpfulness (ß = -0.05, p = 0.014) of Nonreact were associated with lower perceived stress on the next day. In turn, perceived stress was associated with lower perceived helpfulness of Describe (ß = -0.04, p = 0.037) and Nonreact (ß = -0.03, p = 0.038) on the next day. In addition, there were several residual correlations between mindfulness facets and perceived stress within days. At the between-subject level, there was a positive association between the random intercept of Describe and daily stress (r = 0.15, p = 0.003). In addition, while baseline perceived stress was negatively associated with the random intercepts of the mindfulness facets, two baseline components of mindfulness were not associated with the random intercept of perceived stress. Conclusion: On the currently investigated time scale, our results challenge prior results and assumptions regarding mindfulness as a buffering and protective factor against daily stress. With the exception of Nonreact, mindfulness was either positively associated with perceived stress, or in turn perceived stress appeared to interfere with the ability to stay mindful in daily life.

Positive self-beliefs mediate the association between body appreciation and positive mental health.

Previous work has supported direct, positive associations between body appreciation and positive mental health, but has largely neglected to examine possible indirect mechanistic pathways. Here, we propose one relevant mediational pathway, wherein body appreciation is associated with positive mental health via positive self-beliefs (i.e., cognitions that lead individuals to view themselves, their lives, and/or their futures under a positive outlook). To test this hypothesis, we asked an online sample of 496 adults (249 women, 247 men) from the United Kingdom to complete measures of body appreciation, positive self-beliefs, and positive mental health. Participants also completed measures of self-efficacy and resilience, and provided their demographic information. Correlational analysis revealed significant, positive, and strong associations between body appreciation and facets of positive self-beliefs and positive mental health, respectively. Structural equation modelling showed that positive self-beliefs mediated the association between body appreciation and positive mental health after controlling for self-efficacy and resilience. This model was robust across women and men separately, and the mediational effects remained intact in sensitivity and robustness analyses. We discuss ways in which greater body appreciation may help individuals develop and maintain positive self-beliefs, which in turn shape mental health outcomes.

Measurement-Invariant Fluid Anti-Flynn Effects in Population-Representative German Student Samples (2012-2022).

Generational IQ test scores in the general population were observed to increase over time (i.e., the Flynn effect) across most of the 1900s. However, according to more recent reports, Flynn effect patterns have seemingly become less consistent. So far, most available evidence on this phenomenon has been categorized by drawing on the classic fluid vs. crystallized intelligence taxonomy. However, recent evidence suggests that subdomain-specific trajectories of IQ change may well be more complex. Here, we present evidence for cross-temporal changes in measurement-invariant figural reasoning tasks in three large-scale, population-representative samples of German secondary school students (total N = 19,474). Analyses revealed a consistent pattern of significant and meaningful declines in performance from 2012 to 2022. Results indicate a decrease in figural reasoning of 4.68 to 5.17 IQ points per decade (corresponding to small-to-medium effects, Cohen ds from 0.34 to 0.38). These findings may be interpreted as tentative evidence for a decreasing strength of the positive manifold of intelligence as a potential cause of the increasing number of recent reports about inconsistent IQ change trajectories.

The fraternal birth-order effect as a statistical artefact: convergent evidence from probability calculus, simulated data, and multiverse meta-analysis.

The fraternal-birth order effect (FBOE) is a research claim which states that each older brother increases the odds of homosexual orientation in men via an immunoreactivity process known as the maternal immune hypothesis. Importantly, older sisters supposedly either do not affect these odds, or affect them to a lesser extent. Consequently, the fraternal birth-order effect predicts that the association between the number of older brothers and homosexual orientation in men is greater in magnitude than any association between the number of older sisters and homosexual orientation. This difference in magnitude represents the main theoretical estimand of the FBOE. In addition, no comparable effects should be observable among homosexual vs heterosexual women. Here, we triangulate the empirical foundations of the FBOE from three distinct, informative perspectives, complementing each other: first, drawing on basic probability calculus, we deduce mathematically that the body of statistical evidence used to make inferences about the main theoretical estimand of the FBOE rests on incorrect statistical reasoning. In particular, we show that throughout the literature researchers ascribe to the false assumptions that effects of family size should be adjusted for and that this could be achieved through the use of ratio variables. Second, using a data-simulation approach, we demonstrate that by using currently recommended statistical practices, researchers are bound to frequently draw incorrect conclusions. And third, we re-examine the empirical evidence of the fraternal birth-order effect in men and women by using a novel specification-curve and multiverse approach to meta-analysis (64 male and 17 female samples, N = 2,778,998). When analyzed correctly, the specific association between the number of older brothers and homosexual orientation is small, heterogenous in magnitude, and apparently not specific to men. In addition, existing research evidence seems to be exaggerated by small-study effects.

The Influence of Age, Gender and Education on Neuropsychological Test Scores: Updated Clinical Norms for Five Widely Used Cognitive Assessments.

BACKGROUND: Sociodemographic effects (i.e., age, gender, education) have been shown to influence neuropsychological test scores. The current retrospective, quasi-epidemiological work provides age-, gender- and education-corrected clinical norms for five common cognitive assessments. METHODS: In total, test scores of 4968 patients from the University Hospital of Cologne (Department of Neurology), recruited between 2009 and 2020, were analyzed retrospectively. Conducted tests were the Mini-Mental State Examination (MMSE), F-A-S Test (FAS), Rey-Osterrieth Complex Figure Test (ROCFT) and Trail Making Test, Part A and B (TMT-A/-B). Using multiple linear regression analyses, test scores were analyzed for sociodemographic influences (age, gender, education). Based on these analyses, norms were generated by first separating patients into different age groups stratified by educational level and (if necessary) gender. Subsequently, percentile ranks and z-scores for a subsample including only individuals without dementia were calculated. RESULTS: Lower age and higher educational level predicted better test scores (MMSE, FAS, ROCFT) and completion times (TMT-A/-B). Additionally, produced words on the FAS and remembered drawings from the ROCFT were influenced by gender, with females having better FAS but lower ROCFT (delayed recall) scores than males. Considering these effects, clinical norms were provided for the five cognitive assessments. CONCLUSIONS: We found influences of age, gender and education on test scores, although they are frequently not or only partially considered for test score interpretation. With the provided norms, neuropsychologists can make more profound evaluations of cognitive performance. A user-friendly Microsoft Excel file is offered to assist this process.

Are Speeded Tests Unfair? Modeling the Impact of Time Limits on the Gender Gap in Mathematics.

When cognitive and educational tests are administered under time limits, tests may become speeded and this may affect the reliability and validity of the resulting test scores. Prior research has shown that time limits may create or enlarge gender gaps in cognitive and academic testing. On average, women complete fewer items than men when a test is administered with a strict time limit, whereas gender gaps are frequently reduced when time limits are relaxed. In this study, we propose that gender differences in test strategy might inflate gender gaps favoring men, and relate test strategy to stereotype threat effects under which women underperform due to the pressure of negative stereotypes about their performance. First, we applied a Bayesian two-dimensional item response theory (IRT) model to data obtained from two registered reports that investigated stereotype threat in mathematics, and estimated the latent correlation between underlying test strategy (here, completion factor, a proxy for working speed) and mathematics ability. Second, we tested the gender gap and assessed potential effects of stereotype threat on female test performance. We found a positive correlation between the completion factor and mathematics ability, such that more able participants dropped out later in the test. We did not observe a stereotype threat effect but found larger gender differences on the latent completion factor than on latent mathematical ability, suggesting that test strategies affect the gender gap in timed mathematics performance. We argue that if the effect of time limits on tests is not taken into account, this may lead to test unfairness and biased group comparisons, and urge researchers to consider these effects in either their analyses or study planning.

Support for weight-related anti-discrimination laws and policies: Modelling the role of attitudes toward poverty alongside weight stigma, causal attributions about weight, and prejudice.

In the present study, we sought to position support for weight-related anti-discrimination laws and policies within a broader political and socioeconomic context. Specifically, we hypothesised that individualistic (rather than structural) anti-poverty attitudes would provide the basis for negative weight-related dispositions. To test this hypothesis, we asked 392 respondents from the United Kingdom to complete measures of support for weight-related anti-discrimination laws and policies, attributions about the causes of being larger-bodied, and weight-related stigma and prejudice. Path analysis with robust maximum likelihood estimation indicated that greater individualistic anti-poverty attitudes were significantly and directly associated with lower support for weight-related anti-discrimination laws and policies. This direct association was also significantly mediated by weight-related stigma and via a serial mediation involving both weight-related stigma and prejudice. Although greater individualistic anti-poverty attitudes were significantly associated with greater personal attributions for being larger-bodied, the latter did not emerge as a significant mediation pathway. The present findings highlight the importance of considering broader political and socioeconomic contextual factors that may provide a basis for the development, maintenance, and manifestation of negative weight-related dispositions.

Bosnian Paternal War Orphans: Mental Health in Postwar Time.

ABSTRACT: More research on the medium- and long-term effects of childhood exposure to war, including orphanhood, is needed. We compared 50 orphans 1 who lost their father during the war in Bosnia and Herzegovina (1992-1995) and 50 age- and sex-matched adolescents from two-parent families during 2011-2012 in terms of sociodemographic characteristics, behavioral/emotional problems, depression, resilience, maternal mental health, and perceived social support. The two groups differed on sociodemographic factors, that is, number of children, family composition, income, school grades, and refugeehood. Paternal war orphans did not differ in terms of adolescent mental health and resilience from their nonorphaned peers, controlling for sociodemographic variables. The mothers of orphans had comparably more posttraumatic psychopathology. As for perceived resources for social support, orphans identified those comparably more often among distant relatives and in the community, that is, religious officials and mental health professionals, and less often among siblings, paternal grandparents, paternal and maternal uncles/aunts, school friends and teachers. Our findings suggest that contextual factors may play an important role in orphans' postwar mental health.

Only Small Effects of Mindfulness-Based Interventions on Biomarker Levels of Inflammation and Stress: A Preregistered Systematic Review and Two Three-Level Meta-Analyses.

Mindfulness-based interventions (MBIs) have a positive effect on biomarkers of inflammation and stress in patients with psychiatric disorders and physical illnesses. Regarding subclinical populations, results are less clear. The present meta-analysis addressed the effects of MBIs on biomarkers in psychiatric populations and among healthy, stressed, and at-risk populations. All available biomarker data were investigated with a comprehensive approach, using two three-level meta-analyses. Pre-post changes in biomarker levels within treatment groups (k = 40 studies, total N = 1441) and treatment effects compared to control group effects, using only RCT data (k = 32, total N = 2880), were of similar magnitude, Hedges g = -0.15 (95% CI = [-0.23, -0.06], p < 0.001) and g = -0.11 (95% CI = [-0.23, 0.001], p = 0.053). Effects increased in magnitude when including available follow-up data but did not differ between type of sample, MBI, biomarker, and control group or duration of the MBI. This suggests that MBIs may ameliorate biomarker levels in both psychiatric and subclinical populations to a small extent. However, low study quality and evidence of publication bias may have impacted on the results. More large and preregistered studies are still needed in this field of research.

Differential associations of the two higher-order factors of mindfulness with trait empathy and the mediating role of emotional awareness.

Empathy enables us to understand the emotions of others and is an important determinant of prosocial behavior. Investigating the relationship between mindfulness and empathy could therefore provide important insights into factors that promote interpersonal understanding and pathways that contribute to prosocial behavior. As prior studies have yielded only inconsistent results, this study extended previous findings and investigated for the first time the associations of two important factors of mindfulness (Self-regulated Attention [SRA] and Orientation to Experience [OTE]) with two commonly proposed components of empathy (cognitive empathy and affective empathy). Using a community sample of N = 552 German-speaking adults, the two mindfulness factors were differentially associated with cognitive and affective empathy. SRA correlated positively with cognitive empathy (r = 0.44; OTE: r = 0.09), but OTE correlated negatively with affective empathy (r = - 0.27; SRA: r = 0.11). This negative association was strongest for one specific aspect of affective empathy, emotional contagion. Revisiting previously reported mediating effects of emotion regulation, we found that emotional awareness mediated the associations with both components of empathy, but only for SRA. Together, these findings imply that mindfulness benefits the cognitive understanding of others' emotions via two distinct pathways: by promoting emotional awareness (SRA) and by limiting the undue impact of others' emotions on oneself (OTE).

Effects of caste, birth season, and family income on digit ratios.

OBJECTIVES: The contributions of latitude and ethnicity in the determination of cross-society differences in digit ratios are unclear. In India, different castes (endogamous groups) have been living in the same areas (villages or towns) for the last 1500 years and, therefore, these groups may have different gene pools without a latitude-related difference component. Thus, in the present study, we studied the effect of caste on digit ratios. We also studied the effects of sex, birth season, and family income on digit ratios. METHODS: We selected a sample of 301 college students (age: M = 19.9 years, SD = 2.63) in Muzaffarnagar city of western Uttar Pradesh, India, and asked participants for information regarding their birth month, religion, caste, and monthly family income. We measured participants' dorsal and palmar digit lengths (of all fingers, except the thumb, in both hands) using vernier calipers of 0.01 mm accuracy. RESULTS: Other backward castes (intermediate castes) had longer digit lengths than general castes (upper castes), scheduled castes (lower castes), and Muslims. However, there was no difference in digit ratios of caste groups (scheduled castes vs. other backward castes vs. general castes vs. Muslims) or specific castes (Chamar-Jatav vs. Jat vs. Pandit-Tyagi). Winter-born women had lower left dorsal 2D:4D and 3D:4D ratios than summer-born women. Family income was related to higher dorsal 2D:4D and 3D:4D ratios among women. Moreover, in dorsal digit ratios, sex difference (men < women) occurred in digit ratios constituting digit 5, whereas, in palmar digit ratios, sex difference occurred in digit ratios constituting digit 2. CONCLUSIONS: The present study suggests that endogamy-led genetic difference in ethnic/caste groups is not a determinant, whereas birth season (i.e., the exposure to sunlight) and family income might be determinants of digit ratios. In addition, compared to palmar digit ratios, dorsal digit ratios are better markers of sexual dimorphism.

Association of 7 million+ tweets featuring suicide-related content with daily calls to the Suicide Prevention Lifeline and with suicides, United States, 2016-2018.

OBJECTIVE: The aim of this study was to assess associations of various content areas of Twitter posts with help-seeking from the US National Suicide Prevention Lifeline (Lifeline) and with suicides. METHODS: We retrieved 7,150,610 suicide-related tweets geolocated to the United States and posted between 1 January 2016 and 31 December 2018. Using a specially devised machine-learning approach, we categorized posts into content about prevention, suicide awareness, personal suicidal ideation without coping, personal coping and recovery, suicide cases and other. We then applied seasonal autoregressive integrated moving average analyses to assess associations of tweet categories with daily calls to the US National Suicide Prevention Lifeline (Lifeline) and suicides on the same day. We hypothesized that coping-related and prevention-related tweets are associated with greater help-seeking and potentially fewer suicides. RESULTS: The percentage of posts per category was 15.4% (standard deviation: 7.6%) for awareness, 13.8% (standard deviation: 9.4%) for prevention, 12.3% (standard deviation: 9.1%) for suicide cases, 2.4% (standard deviation: 2.1%) for suicidal ideation without coping and 0.8% (standard deviation: 1.7%) for coping posts. Tweets about prevention were positively associated with Lifeline calls (B = 1.94, SE = 0.73, p = 0.008) and negatively associated with suicides (B = -0.11, standard error = 0.05, p = 0.038). Total number of tweets were negatively associated with calls (B = -0.01, standard error = 0.0003, p = 0.007) and positively associated with suicide, (B = 6.4 × 10-5, standard error = 2.6 × 10-5, p = 0.015). CONCLUSION: This is the first large-scale study to suggest that daily volume of specific suicide-prevention-related social media content on Twitter corresponds to higher daily levels of help-seeking behaviour and lower daily number of suicide deaths. PREREGISTRATION: As Predicted, #66922, 26 May 2021.

Contextual factors predicting compliance behavior during the COVID-19 pandemic: A machine learning analysis on survey data from 16 countries.

Voluntary isolation is one of the most effective methods for individuals to help prevent the transmission of diseases such as COVID-19. Understanding why people leave their homes when advised not to do so and identifying what contextual factors predict this non-compliant behavior is essential for policymakers and public health officials. To provide insight on these factors, we collected data from 42,169 individuals across 16 countries. Participants responded to items inquiring about their socio-cultural environment, such as the adherence of fellow citizens, as well as their mental states, such as their level of loneliness and boredom. We trained random forest models to predict whether someone had left their home during a one week period during which they were asked to voluntarily isolate themselves. The analyses indicated that overall, an increase in the feeling of being caged leads to an increased probability of leaving home. In addition, an increased feeling of responsibility and an increased fear of getting infected decreased the probability of leaving home. The models predicted compliance behavior with between 54% and 91% accuracy within each country's sample. In addition, we modeled factors leading to risky behavior in the pandemic context. We observed an increased probability of visiting risky places as both the anticipated number of people and the importance of the activity increased. Conversely, the probability of visiting risky places increased as the perceived putative effectiveness of social distancing decreased. The variance explained in our models predicting risk ranged from < .01 to .54 by country. Together, our findings can inform behavioral interventions to increase adherence to lockdown recommendations in pandemic conditions.

The relationships of family income and caste-status with religiousness: Mediation role of intolerance of uncertainty.

The relationship between lower socioeconomic status (SES) and religiousness is well known; however, its (psychological mediation) mechanism is not clear. In the present study, we studied the mediation role of intolerance of uncertainty (IU; a personality measure of self-uncertainty) in the effect of SES on religiousness and its dimensions (i.e., believing, bonding, behaving, and belonging), in two different samples (students sample, N = 868, and community sample, N = 250), after controlling the effects of factors like age, sex, handedness, and self-reported risk-taking. The results showed that IU mediated the effects of lower family income and lower caste status (in students' sample only) on religiousness and its dimensions; higher caste status had a direct effect on religiousness (and its dimensions), and; among the sub-factors of IU, only prospective IU affected religiousness. Thus, along with showing that IU is a mediator of the effects of lower family income and lower caste status on religiousness, the present study supports the contention that religiousness is a latent variable that varied factors can independently initiate. Moreover, the present study suggests a nuanced model of the relationship between the hierarchical caste system and religiousness.

No Effects of a Brief Mindfulness Intervention on Controlled Motivation and Amotivation, but Effect Moderation Through Trait Mindfulness: a Randomized Controlled Trial.

Objectives: Mindfulness is associated with the different forms of motivation according to self-determination theory (intrinsic, identified, and external motivation, and amotivation). However, causal evidence for reported negative associations of mindfulness with external motivation and amotivation is currently lacking. Therefore, this study investigated causal effects of a brief mindfulness intervention on motivation towards a personal goal. We differentiated distinct forms of motivation and also controlled for baseline motivation and trait mindfulness, which could act as a moderator of the interventional effects. Methods: Data of N = 91 participants were used, who were randomly assigned to either audio-guided meditation or a control condition. Situational motivation for a personal goal was assessed before and after the intervention. Trait mindfulness was measured with the Five Facet Mindfulness Questionnaire. Results: The intervention had a positive effect on the more autonomous forms of motivation (d = 0.48), which was, however, qualified by trait mindfulness; i.e., the effect was larger among participants low in trait mindfulness (d = 1.13 at 1 SD below the overall mean). There were no practically relevant effects on external motivation and amotivation. Conclusions: Mindfulness has a positive causal effect on more autonomous forms of motivation, but probably no relevant effects on external motivation and amotivation. Moderating effects of trait mindfulness need to be considered more systematically in this field of research, but also in research of mindfulness intervention more generally. Mindfulness interventions could be beneficially offered to persons low in trait mindfulness. Supplementary Information: The online version contains supplementary material available at 10.1007/s12671-022-01968-7.

Dimensionality analysis of the German version of the Screen for Cognitive Impairment in Psychiatry (SCIP-G).

Background: Psychiatric disorders, especially schizophrenia, are characterised by cognitive impairment. The rapid detection of cognitive dysfunction - also in the course of the disease - is of great importance. The Screen for Cognitive Impairment in Psychiatry (SCIP) was developed to provide screening of psychiatric patients in clinical practice and is available in several languages. Prior psychometric investigations into the dimensionality of the SCIP have produced two different models: a one-factor model assumes that the five subscales of the SCIP load together, whereas an alternative model suggests that the subscales load on two factors, namely verbal memory and processing speed. We carried out a confirmatory factor analysis of the German version of the SCIP (SCIP-G). Methods: 323 patients with psychotic, bipolar affective, and depressive disorders were studied. Results: The one-factor approach did not yield an acceptable model fit (chi-squared test: χ2 = 109.5, df = 5, p < 0.001, χ2/df = 21.9). A two-factor solution, with the subtests Verbal Learning Test-Immediate Recall, Delayed Recall Test of the VLT, and Working Memory Test loading on the first factor, whereas the subtests Verbal Fluency Test and Psychomotor Speed Test loading on the second factor, obtained a good model fit (χ2 = 6.7, df = 3, p = 0.08, χ2/df = 2.2). Conclusions: These data show that a good model fit can be achieved with a two-factor solution for the SCIP. This study is the first to conduct a confirmatory factor analysis using the German SCIP version and to test its dimensional structure using a hypothesis-testing approach.

Of differing methods, disputed estimates and discordant interpretations: the meta-analytical multiverse of brain volume and IQ associations.

Brain size and IQ are positively correlated. However, multiple meta-analyses have led to considerable differences in summary effect estimations, thus failing to provide a plausible effect estimate. Here we aim at resolving this issue by providing the largest meta-analysis and systematic review so far of the brain volume and IQ association (86 studies; 454 effect sizes from k = 194 independent samples; N = 26 000+) in three cognitive ability domains (full-scale, verbal, performance IQ). By means of competing meta-analytical approaches as well as combinatorial and specification curve analyses, we show that most reasonable estimates for the brain size and IQ link yield r-values in the mid-0.20s, with the most extreme specifications yielding rs of 0.10 and 0.37. Summary effects appeared to be somewhat inflated due to selective reporting, and cross-temporally decreasing effect sizes indicated a confounding decline effect, with three quarters of the summary effect estimations according to any reasonable specification not exceeding r = 0.26, thus contrasting effect sizes were observed in some prior related, but individual, meta-analytical specifications. Brain size and IQ associations yielded r = 0.24, with the strongest effects observed for more g-loaded tests and in healthy samples that generalize across participant sex and age bands.

Effects of media stories of hope and recovery on suicidal ideation and help-seeking attitudes and intentions: systematic review and meta-analysis.

BACKGROUND: There is strong evidence that suicides increase after media stories about suicides by celebrities, particularly those that highlight the suicide method (the Werther effect). Much less is known about the Papageno effect-the protective effects of media stories of hope and recovery from suicidal crises. A synthesis of the retrievable evidence is lacking. We aim to summarise findings from randomised controlled trials about the effects of stories of hope and recovery on individuals with some degree of vulnerability to suicide. METHODS: For this systematic review and individual participant data meta-analysis, we searched PubMed (including MEDLINE), Scopus, Embase, PsycInfo, Web of Science, and Google Scholar published from inception to Sept 6, 2021, without language restrictions. We included trials that reported suicidal ideation (the primary outcome) or help-seeking attitudes or intentions (the secondary outcome) and tested a media narrative of hope and recovery. Studies were excluded if they did not feature a clearly positive story of hope and recovery, or had a control group exposed to suicide-related stimulus material. We contacted the lead or senior authors of all original studies to obtain participant-level data for this study. The primary analysis was restricted to individuals with some vulnerability to suicide. Risk of bias was assessed using the Cochrane risk-of-bias tool for randomised trials. The study is registered with PROSPERO, number CRD42020221341. FINDINGS: Our search yielded 7347 records. 3920 records were screened by title and abstract, and 25 full-text records assessed for eligibility. There were eight eligible studies with 2350 participants for which individual participant data were sought. For suicidal ideation, six studies met the inclusion criteria for the primary analysis. Follow-up responses were available for 569 (90%) of 633 participants who were randomised with high vulnerability (345 [55%] allocated to the intervention group and 288 [45%] to the control group). The pooled standardised mean difference (SMD) indicated a small reduction in suicidal ideation of -0·22 (95% CI -0·39 to -0·04, p=0·017; six studies) in the intervention group. For help-seeking attitudes and intentions, four studies met the inclusion criteria and follow-up data were available for 362 (86%) of 420 participants (247 [59%] allocated to the intervention group and 173 [41%] to the control group). The pooled SMD showed no evidence of a difference between the groups (SMD=0·14, 95% CI -0·15 to 0·43, p=0·35; four studies). Low levels of cross-study heterogeneity effects were observed for both analyses (I2=5% [suicidal ideation] and I2=36% [help-seeking attitudes and intentions]). We found no evidence of publication bias. INTERPRETATION: Media narratives of hope and recovery from suicidal crises appear to have a beneficial effect on suicidal ideation in individuals with some vulnerability, but there is insufficient evidence regarding help-seeking attitudes and intentions. These findings provide new evidence about narratives for suicide prevention. FUNDING: None.