The Impact of Stress Reappraisal and Mindset Interventions on Physiological, Endocrine, and Psychological Stress Outcomes: A Meta-Analysis

How individuals think about stress—their appraisals and beliefs—directly shape stress responses. This meta-analysis assessed the efficacy of psychological interventions aimed at helping people value stress as growth supportive and use it to thrive, referred to as stress optimization interventions, on physiological (cardiovascular and neuroendocrine) and subjective stress-related outcomes. Data from 35 studies (total N = 6,834) that used randomized designs and reported biological or self-reported outcomes before and after stress reappraisal, stress mindsets or a combination of these interventions were analyzed. Random-effect models indicated that stress optimization interventions functioned to increase cardiac output (CO; d = 0.41), decrease total peripheral resistance (TPR; d = 0.47), and reduce salivary cortisol levels (d = 0.20) in acute stress contexts, with small-to-medium effect sizes. These effects were accompanied by small-to-high heterogeneity as a function of outcome (I² from 0% to 67%). No effects of interventions on pre-ejection period (PEP; d = 0.11) or heart rate (HR; d = -0.03) emerged. For subjective outcomes, interventions showed small but reliable benefits. Stress optimization interventions reduced recent distress (d = 0.30) and improved affective responses (d = 0.15), with meaningful heterogeneity across both. In contrast, interventions exhibit no significant effect on reported stress arousal (d = 0.07) with little heterogeneity. Collectively, findings demonstrate that stress optimization interventions can help improve physiological and subjective stress-related responses in acute stress settings, offering a promising approach to promoting resilience, thriving, and performance when navigating everyday social stressors.