When happiness becomes aversive: A meta-analysis of fear of happiness in depression and anxiety

Objective: Many current interventions target reward deficits in depression and anxiety. However, fear of happiness, a construct representing reward devaluation may negatively impact the efficacy of these reward-based interventions. As such, the current meta-analysis sought to examine the associations between fear of happiness and psychopathology.Method: We conducted a scoping literature review in July 2025 from various databases. We calculated the pooled Hedges’ g for each of the following meta-analyses: the association between fear of happiness and (1) concurrent depression, (2) longitudinal depression, (3) concurrent anxiety, and (4) concurrent anhedonia. We also conducted moderation analyses for culture, scale version, symptom severity, and demographics.Results: Twenty-six samples were included, representing 6,604 different individuals. We found large effect sizes for the cross-sectional associations between fear of happiness and depression (g = 1.117), anxiety (g = 0.999), and anhedonia (g = 0.837), and a small-to-medium effect size for the longitudinal association between fear of happiness and depression (g = 0.481). We also found stronger associations in Eastern cultures compared to Western cultures.Conclusion: Our findings provide evidence of strong concurrent and predictive implications of fear of happiness on depression, as well as concurrent implications on anxiety and anhedonia. Moreover, there were nuanced differences across cultures, symptom severity, and scale version, indicating that the clinical implications of fear of happiness may differ across populations. Nevertheless, these findings provide rationale for the assessment and treatment of fear of happiness among persons with depression and anxiety.