Positive and Negative Future Thinking Fluency: A Transdiagnostic Meta-Analysis of Associations with Psychopathology and Hopelessness

Background: Disrupted future-directed thinking such as hopelessness is recognised as a transdiagnostic process in psychopathology. Hopelessness is marked by negative future expectations and a strong link to suicidality. The Future Fluency Task (FFT) has been widely used as an idiographic, performance-based index of generative capacity for positive and negative future thinking. However, evidence for transdiagnostic and disorder-specific patterns of future thinking and their association with hopelessness remains fragmented. This preregistered meta-analysis aimed to synthesize the evidence of positive and negative future thinking patterns across mental health conditions and their associations with hopelessness. Methods: Systematic searches were done using PubMed, PsycINFO, and MEDLINE, to identify studies comparing clinical groups with controls on positive/negative FFT fluency and/or reporting associations with hopelessness. Random-effects three-level models tested group differences in future thinking fluency and associations with hopelessness. Results: Clinical groups (N = 1,726) showed significantly reduced positive FFT fluency compared with controls (k = 23; g = −0.88), whereas negative FFT fluency did not differ (k = 22; g = 0.25). Subgroup analyses indicated reduced positive FFT fluency across major depression, eating disorders, PTSD, schizophrenia, and suicidal samples, with no difference in anxiety disorders, and heterogeneous patterns for negative FFT fluency. Hopelessness was associated with lower positive FFT fluency (k = 18; r = −.19) and higher negative FFT fluency (k = 12; r = .15). Conclusions: This meta-analysis provides the first transdiagnostic synthesis of FFT performance, showing a robust transdiagnostic reduction in positive future thinking fluency alongside disorder-specific patterns in negative fluency.