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. 2020 Jul 20;2020(7):CD013684. doi: 10.1002/14651858.CD013684

Wang 2012.

Study characteristics
Methods Study design: RCT
Study grouping: parallel group
Unit of randomisation: individuals
Power (power sample size calculation, level of power achieved): not specified
Imputation of missing data: no imputation of missing data; per‐protocol analysis (only participants who took part in intervention)
Participants Country: China
Setting: students from medical university; setting of training not specified
Age: mean = 20.45 (SD = 0.97) years
Sample size (randomised): 70
Sex: 40 women, 28 men
Comorbidity (mean (SD) of respective measures in indicated, if available) at baseline: Symptom Checklist (SCL‐90) subscales: somatisation: IG: 1.58 (0.41), CG: 1.55 (0.38); obsessive‐compulsive: IG: 2.72 (0.38), CG: 2.55 (0.48); interpersonal sensitivity: IG: 2.32 (0.51), CG: 2.17 (0.46); depression: IG: 2.06 (0.42), CG: 2.10 (0.52); anxiety: IG: 2.00 (0.38), CG: 2.02 (0.43); hostility: IG: 1.81 (0.47), CG: 1.84 (0.51); phobic anxiety: IG: 1.84 (0.63), CG: 1.71 (0.46); paranoid ideation: IG: 1.79 (0.42), CG: 1.90 (0.41); psychoticism: IG: 1.78 (0.32), CG: 1.82 (0.28); other symptoms: IG: 1.95 (0.53), CG: 1.83 (0.47); Global Severity Index: IG: 179.70 (19.70), CG: 176.70 (23.00)
Population description: students (freshman and sophomores) with mental crisis from medical university
Inclusion criteria: participants with psychoticism factor > 2.2 in SCL‐90
Exclusion criteria: not specified
Attrition (withdrawals and exclusions): 2 dropouts (did not participate); unclear which group
Reasons for missing data: not specified
Interventions Intervention: positive psychology‐oriented group counselling (n = not specified; of 68 analysed participants: n = 33)

  • delivery: face‐to‐face (structured leader‐led) group counselling sessions (4 groups in total with 8 ‐ 9 participants); theoretical presentations and practical activities; daily diary

  • providers: researchers themselves are group leaders; researchers are qualified as counsellors and have received training from relevant groups

  • duration of treatment period and timing: 6 weekly 2½‐hour sessions; participants required to have a diary during study period

  • description:

    • focus on positive cognition, emotional training and practical problem‐solving

      • In the aspect of CULTIVATING POSITIVE COGNITION, it mainly touches the students' perceptions through theoretical introduction, role‐playing, self‐confidence training and post‐event summary

      • In terms of CULTIVATING POSITIVE EMOTIONS, through warm‐up activities, relaxation meditation, etc. students create a positive and pleasant atmosphere

      • in the SOLUTION OF PRACTICAL PROBLEMS, use games or stories to clarify the truth, and guide students to apply by arranging tasks or case reproductions; students encouraged to expose their own problems and get support and help from their peers in the group

    • In order to improve the effectiveness of group coaching, participants are required to record daily positive awareness, experience or related events through a diary during the study period

    • INTERVENTION THEMES: each activity organised around a theme; specific activities include: walking close to the sunshine (acquaintance and support, basic concepts of positive psychology); letting go of the past (gratefulness, forgiveness); let the future come (belief, hope, realistic optimism); enjoy the present (inputting life, accepting self); changing (ABC theory, procrastination theory); happiness upgrading (summary, future plan‐sharing and parting)

  • compliance: not specified

  • integrity of delivery: not specified

  • economic information: not specified

  • theoretical basis: based on positive psychology; based on concept of active psychotherapy and applied research, combined with theoretical presentations and practical activities, focusing on positive cognition, emotional training and practical problem‐solving


Control: not specified (n = not specified; of 68 analysed participants: n = 35)
Outcomes Outcomes collected and reported:

  • somatisation ‐ SCL‐90

  • obsessive‐compulsive ‐ SCL‐90

  • interpersonal sensitivity ‐ SCL‐90

  • depression ‐ SCL‐90

  • anxiety ‐ SCL‐90

  • hostility ‐SCL‐90

  • phobic anxiety ‐ SCL‐90

  • paranoid ideation ‐ SCL‐90

  • psychoticism ‐ SCL‐90

  • other symptoms (sleep and diet) ‐ SCL‐90

  • Global Severity Index (GSI) ‐ SCL‐90

  • well‐being/happiness ‐ General Well‐Being Schedule

  • resilience ‐ Resilience Scale for Chinese Adolescents


Time points measured and reported: 1) pre‐intervention (1 week before start of intervention); 2) post‐intervention ; and 3) 3‐month follow‐up (3 months post‐intervention)
Adverse events: not specified
Notes Contact with authors: no correspondence required
Study start/end date: not specified
Funding source: not specified
Declaration of interest: not specified
Ethical approval needed/obtained for study: not specified
Comments by authors: not relevant
Miscellaneous outcomes by the review authors: article in Chinese (translated)
Correspondence: Zhe Wang; School of Nursing, Southern Medical University, Guangzhou 510515, China
Risk of bias
Bias Authors' judgement Support for judgement
Random sequence generation (selection bias) Unclear risk Quote: "在检出的本科生中,遵循自愿招募的原则,经简 短访谈后纳入团体。 鉴于团体干预的适应性,排除症 状自评量表中精神病性因子大于 2.2 的成员,最终选 取大一、大二学生 70 名,随机分配到试验组和对照组" ["In view of the adaptability of group intervention, members with a psychotic factor greater than 2.2 in the self‐rating scale of the exclusion syndrome were selected, and 70 freshmen and sophomores were selected and randomly assigned to the experimental group and the control group."]
Quote: "全程有效参与干预的学生共 68 名,其中试验组 33 名, 男 12 名,女 21 名,年 龄(20.4±1.09)岁,对 照 组 35 名,男 16 名,女 19 名,年龄 20.5±0.85)岁,两组间年 龄、性别、专业等基本情况经分析差异无统计学意义P>0.05)" ["A total of 68 students participated in the intervention, including 33 experimental groups, 12 males and 21 females, aged (20.4±1.09) years old, 35 in the control group, 16 males and 19 females, aged 20.5±0.85). At the age of the two groups, the differences in age, gender, and specialty between the two groups were not statistically significant (P>0.05)"]
Quote: "3.1 两组间测量指标的基线比较 干预前两组各 项指标平衡,均无统计学意义(P>0.05)" ["3.1 Baseline comparison of measured indicators between the two groups. There was no statistically significant difference between the two groups before the intervention (P>0.05).]
Judgement comment: insufficient information about random‐sequence generation to permit judgement of ‘Low risk’ or ‘High risk’; verified baseline comparability of groups for sociodemographic characteristics and outcomes of interest on the basis of analysis
Allocation concealment (selection bias) Unclear risk Judgement comment: insufficient information about allocation concealment to permit judgement of ‘Low risk’ or ‘High risk’
Blinding of participants and personnel (performance bias)
Subjective outcomes High risk Judgement comment: blinding of participants and personnel probably not done (face‐to‐face intervention) and outcome is likely be related to true outcome
Blinding of outcome assessment (detection bias)
Subjective outcomes High risk Judgement comment: insufficient information about blinding of outcome assessment; but due to potential performance bias (no blinding of participants), the review authors judge that the participants' responses to questionnaires may be affected by the lack of blinding (i.e. knowledge and beliefs about intervention they received)
Incomplete outcome data (attrition bias)
All outcomes Low risk Judgement comment: number of participants randomised to each group not specified, unclear in which group dropout of 2 occurred; per‐protocol analysis (only participants who participated in the study)
Selective reporting (reporting bias) Low risk Judgement comment: no study protocol available but it is clear that the published reports include all expected outcomes, including those that were prespecified