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Background: Theory and research have shown that gratitude interventions have positive outcomes on measures of well-being. Gratitude listing, behavioral expressions, and grateful contemplation are methods of inducing gratitude. While research has examined gratitude listing and behavioral expressions, no study has tested the long-term effects of a gratitude contemplation intervention on well-being. Methods: The present experiment examined the efficacy of a 4-week gratitude contemplation intervention program in improving well-being relative to a memorable events control condition. Pre-test measures of cardiac coherence, trait gratitude, and positive and negative affect were collected. Preand post-test measures assessing satisfaction with life and self-esteem were also collected. Daily positive and negative affect were completed twice a week throughout the intervention period. Results: Compared to those in the memorable events condition, participants in the gratitude condition reported higher satisfaction with life and self-esteem. Trait gratitude was found to moderate the effects of the gratitude intervention on satisfaction with life. Conclusion: Grateful contemplation can be used to enhance long-term well-being.
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Gratitude and Well-Being: Who Benefits the Most
from a Gratitude Intervention?aphw_1058 350..369
Joshua A. Rash*
University of Calgary, Canada
M. Kyle Matsuba
Kwantlen Polytechnic University, Canada
Kenneth M. Prkachin
University of Northern British Columbia, Canada
Background: Theory and research have shown that gratitude interventions have
positive outcomes on measures of well-being. Gratitude listing, behavioral
expressions, and grateful contemplation are methods of inducing gratitude.
While research has examined gratitude listing and behavioral expressions, no
study has tested the long-term effects of a gratitude contemplation intervention
on well-being. Methods: The present experiment examined the efficacy of a
4-week gratitude contemplation intervention program in improving well-being
relative to a memorable events control condition. Pre-test measures of cardiac
coherence, trait gratitude, and positive and negative affect were collected. Pre-
and post-test measures assessing satisfaction with life and self-esteem were also
collected. Daily positive and negative affect were completed twice a week
throughout the intervention period. Results: Compared to those in the memo-
rable events condition, participants in the gratitude condition reported higher
satisfaction with life and self-esteem. Trait gratitude was found to moderate the
effects of the gratitude intervention on satisfaction with life. Conclusion: Grate-
ful contemplation can be used to enhance long-term well-being.
Keywords: cardiac physiology, gratitude intervention, positive psychology,
well-being
INTRODUCTION
Recent studies have shown that trait and state levels of gratitude are posi-
tively associated with positive affect, optimism, happiness, and life satisfac-
* Address for correspondence: Joshua A. Rash, Department of Clinical Psychology,
University of Calgary, 2500 University Drive, Calgary, AB, Canada, T2N 1N4. Email: jarash@
ucalgary.ca
APPLIED PSYCHOLOGY: HEALTH AND WELL-BEING, 2011, 3(3), 350–369
doi:10.1111/j.1758-0854.2011.01058.x
© 2011 The Authors. Applied Psychology: Health and Well-Being © 2011 The International
Association of Applied Psychology. Published by Blackwell Publishing Ltd., 9600 Garsington
Road, Oxford OX4 2DQ, UK and 350 Main Street, Malden, MA 02148, USA.
tion, and negatively associated with negative affect, anxiety, and depressive
symptoms (Emmons & McCullough, 2003; McCullough, Emmons, & Tsang,
2002). Furthermore, attempts to instill gratitude have produced increases in
well-being among those in a gratitude intervention group compared to those
in the control group (see Wood, Froh, & Geraghty, 2010, for a review).
However, findings from these gratitude intervention studies have not been
consistent. This may be due, in part, to differences in how gratitude has been
induced and the types of comparison groups employed (Froh, Kashdan,
Ozimkowski, & Miller, 2009a; Wood et al., 2010). Consequently, researchers
have begun to distinguish between different types of gratitude interventions
and possible mediating and moderating effects associated with health out-
comes. The purpose of our study was to implement a long-term gratitude
contemplation intervention to determine its effects on participants’ well-
being. Specific variables were then tested to determine whether they moder-
ated or mediated the effect of the intervention on participants’ well-being.
Gratitude
Gratitude is considered as both a state and a trait. State gratitude is under-
stood as a positive, social emotion experienced when an undeserved act of
kindness or generosity is freely given by another person (Emmons, 2004).
Roberts (2004) refers to such experiences as episodic gratitude, and describes
it as an acute, intense, and brief physiological change that co-occurs with
feelings of gladness. It has also been considered as a complex, higher-level
emotion since it requires cognitive sophistication. For instance, experiences
of gratitude require the abilities to distinguish self from others, and to con-
strue the act of giving as intentional (by the giver) and undeserved (Weiner,
1985). Hence, the emotion of gratitude involves a physiological change and a
subjective cognitive appraisal of the situation.
As a trait, gratitude is understood as a “virtue” or characteristic of people,
and can vary in intensity, frequency, and span (McCullough et al., 2002):
People high in gratitude feel more grateful following a positive emotion, and
experience gratitude more times per day and across a wider array of life
circumstances compared to those lower in gratitude. Further, some argue
that people high in gratitude have a lower threshold for experiencing grate-
fulness (Rosenberg, 1998), and have a propensity to dwell on the favorable
and to experience gladness in situations where they receive undeserved gifts
(Roberts, 2004; Watkins, 2004). To explain this, Wood et al. (2010) proposed
the schematic hypothesis, arguing that grateful people have a cognitive “lens”
that biases them in how they see the world. Compared to “less grateful”
people, grateful people are prone to interpret helpful actions of others as
being more costly to the other, see others as being more altruistic, and to
place greater value on their action.
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Benefits of Being Grateful
Recent studies have identified benefits associated with being grateful.
McCullough et al. (2002) found trait gratitude to be positively correlated
with life satisfaction, happiness, optimism, hope, and positive affect,
while being negatively related to anxiety, depression, and negative affect.
Watkins, Woodward, Stone, and Kolts (2003) found that dispositional
gratitude was positively correlated with life satisfaction, positive affect, and
happiness, and negatively correlated with depression, negative affect, and
physical aggression.
In addition, researchers have theorised about the potential societal benefits
of gratitude. Like other positive emotions, gratitude is believed to reflect,
motivate, and reinforce social actions in both the giver and gift recipient
(Fredrickson, 2004). For the recipient, experiences of gratitude may lead
to a readiness to respond to acts of kindness by acknowledging the benefit
(Roberts, 2004), and expressing appreciation and thankfulness for it
(Emmons, 2004). Expressions of thankfulness, which naturally flow from this
sense of appreciation (Fitzgerald, 1998), can take various prosocial behav-
ioral forms, and can be directed back to the giver, other individuals, and/or
the larger community. Thus, gratitude can act as a motivator of social action
that draws people into community (Roberts, 2004). In fact, some researchers
consider it an “essential lubricant to social interaction” (Buck, 2004, p. 110).
Inducing Gratefulness
In light of the benefits associated with being grateful, researchers have tried to
induce gratitude to produce positive outcomes. Three general methods of
gratitude induction have been identified: gratitude lists, behavioral expres-
sions of gratitude, and grateful contemplation (see Wood et al., 2010). Grati-
tude lists is the most frequently used intervention, in part because of its
simplicity in having people construct lists of things for which they are grate-
ful. For example, Emmons and McCullough (2003) randomly assigned
participants to one of three experimental conditions (i.e. hassles, gratitude
listing, and neutral life events) and asked them to keep weekly records of
various well-being measures (e.g. moods, coping behaviors, health behaviors,
physical symptoms, overall life appraisals, etc.) over 9 weeks. Gratitude
listing participants rated their lives more favorably, reported fewer illness
symptoms, and had higher levels of gratitude and positive affect compared to
other participants. However, only in experiment one of three did gratitude
listing participants report fewer physical symptoms and more hours of exer-
cise. Froh, Sefick, and Emmons (2008a) reported that middle school students
in their gratitude listing condition showed an increase in gratitude and a
decrease in negative affect compared to those in the hassles and control
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conditions, and showed improvements in satisfaction with school experience
when compared to those in the no treatment control condition. No condition
effects were found on physical illness and prosocial behaviors. Finally, grati-
tude listings have been used in clinical settings. These clinical studies suggest
that gratitude interventions are as effective as commonly used clinical thera-
pies in treating body dissatisfaction and excessive worry (Geraghty, Wood, &
Hyland, 2010a, 2010b).
A second type of gratitude induction involves behavioral expressions of
gratitude. For instance, Seligman, Steen, Park, and Peterson (2005) had
adults write and deliver a gratitude letter within 1 week. Compared to people
who had been asked to write about their early memories, gratitude partici-
pants reported more happiness and less depression at post-test and 1 month
later. Further, while large effect sizes were produced, the effects were short-
lived. Similarly, Froh et al. (2009a) randomly assigned children and adoles-
cents to a gratitude condition where they were asked to write and deliver a
letter to a person they had not yet properly thanked, or a control condition
where they were asked to write about some of the things they did, and how
they felt while they did them. While no condition effects emerged on changes
in positive affect or negative affect, Froh et al. (2009a) found that pretest
positive affect had a moderating effect: Those who were low in initial positive
affect and participated in the gratitude exercise showed the greatest increases
in their gratitude and positive affect scores, although these effects declined
over time (i.e. 1 and 2 months later).
A third type of intervention involves gratitude contemplation. Watkins
et al. (2003) randomly assigned participants to one of four conditions. In the
neutral condition, participants were asked to write about the layout of their
living room. In the remaining three conditions, participants were asked to
think about, write about, or write a letter to someone for whom they were
grateful. Significant increases in positive affect were found among partici-
pants in all three grateful conditions, but not for those in the control condi-
tion. Moreover, the “thinking” gratitude condition produced the highest
positive affect scores. No significant negative affect by condition effect was
found. While the short-term impact of grateful contemplation is encouraging,
no studies to date have investigated the long-term impact of a gratitude
contemplation intervention.
In this study, we adopted a gratitude contemplation intervention. Our
preference for gratitude contemplation was influenced by research suggesting
that there is a physiological connection between one’s emotional and physical
states, and that by manipulating one’s emotional state, one can produce a
physiological change. For instance, Tiller, McCraty, and Atkinson (1996)
demonstrated that by having people focus their thoughts on things that they
appreciate produced an entrainment between their positive emotional and
physiological states. This psychophysiological entrainment was observed
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through respiratory, cardiac, and electroencephalographic patterns becom-
ing momentarily frequency-locked (i.e. oscillating at a common frequency).
Hence, we expected that inducing gratitude should produce similar entrain-
ment between our participants’ emotional and physiological states, and that
one of the consequences would be improvement in their well-being.
Specifically, we were interested in how inducing gratitude would affect
participants’ satisfaction with life and self-esteem. As noted above, previous
work found that inducing gratitude led to increases in students’ satisfaction
with school (Froh et al., 2008a) and people’s favorability ratings of their life
(Emmons & McCullough, 2003). We were also interested in the link between
gratitude and self-esteem. Past studies with youth have found gratitude to
positively predict self-esteem (Froh, Wajsblat, & Ubertini, 2008b) and self-
satisfaction assessed concurrently (Froh, Yurkewicz, & Kashdan, 2009b), at
3 weeks (Froh et al., 2008a) and at 6 months (Froh et al., 2008b). Further-
more, Kashdan, Uswatte, and Julian (2006) assessed a sample of Vietnam
War veterans and reported that gratitude predicted greater daily self-esteem
after controlling for post-traumatic-stress severity, and dispositional positive
and negative affect.
Control Condition
Overall, gratitude intervention studies, independent of the type, report posi-
tive outcomes on measures of well-being compared to a variety of control
conditions. However, Wood et al. (2010) have cautioned that the promotion
of gratitude interventions may be premature. They note that few gratitude
intervention studies have used a “true” control group. For instance, most
studies have participants list daily hassles, or write about psychologically
neutral topics such as the layout of a room or what happened during the day
as their control condition(s). In these cases, it is unclear that these conditions
produce the same psychological expectancy of change as a gratitude inter-
vention in clinical settings. Further, interventions such as listing daily hassles
are thought to produce a negative psychological state (Froh et al., 2009a) and
consequently may exaggerate outcome differences more than if more psycho-
logically neutral control conditions were used. In our study, we used grati-
tude contemplation as our experimental condition due to previous findings
showing its psychological and physiological benefits. Asking participants to
remember a memorable event in the recent past was used in an effort to
produce a more psychologically neutral control condition.
Personality Traits as Moderators
Previous research suggests that there may be certain types of people who are
better able to benefit from gratitude induction interventions than others
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(Froh et al., 2009a; Froh et al., 2008a; McCullough, Tsang, & Emmons,
2004). As previously mentioned, Wood et al. (2010) offered the schematic
hypothesis proposing that grateful people have a cognitive lens enabling
them to view the world in a more positive, altruistic manner. Similarly,
McCullough and colleagues (2004) proposed a conductance hypothesis sug-
gesting that people who have a proclivity towards gratefulness are particu-
larly responsive to the effects of gratitude relevant daily-events. According to
both hypotheses, grateful people are “primed” to experience and benefit from
positive experiences. In contrast, McCullough et al. (2004) proposed a resis-
tance hypothesis theorising that those who are predisposed to being grateful
may already experience the world in a positive light such that no additional
positive experiences (e.g. experiencing a gratitude intervention) could lead to
further benefits above and beyond what they normally experience. Prelimi-
nary support has been found for the resistance hypothesis. In a behavioral
expressions experiment on gratitude, Froh et al. (2009a) instructed youths to
write and deliver a gratitude letter and found that youth low in positive affect
at baseline reported greater gratitude and positive affect at post-test. To
explore these issues, we considered the moderating effects of gratitude dispo-
sition along with positive and negative affect.
Finally, in understanding gratitude intervention effects, few studies have
explored the kinds of items participants generate when asked to think about
or write down those things for which they are grateful. It could be that some
activities or people may produce different outcomes from others. Most grati-
tude studies are indifferent to the kinds of experiences used to generate
gratitude assuming they all will have the same effect. We wished to explore
this assumption in more detail in order to determine whether it is warranted.
Predictions
In summary, research shows that gratitude interventions have a positive
outcome on well-being; however, less is known about the mechanisms under-
lying these relationships. Based on the theoretical and empirical work
reviewed, we made the following predictions:
1. Gratitude contemplation would result in a higher degree of physiologi-
cal entrainment relative to baseline or memorable events recall.
2. Participants in the gratitude condition would score higher on satisfac-
tion of life and self-esteem compared to participants in the control
condition at post-test.
We also explored whether trait gratitude moderated the effects of gratitude
intervention on well-being. The schematic/conductance hypothesis would
predict that participants who score higher in gratitude and positive affect
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would benefit more from the intervention than participants lower in gratitude
on measures of well-being at post-test. In contrast, the resistance hypothesis
would predict that those who score lower in gratitude and positive affect
would benefit more from a gratitude intervention compared to those who
scored higher.
We also content analysed the grateful moments and memorable events
participants listed to identify common themes. Given that this was explor-
atory, no specific hypotheses were made regarding thematic differences
between the two groups. Rather, we hoped that exploring thematic differ-
ences between groups might help us to better interpret our quantitative
results.
METHOD
Participants
Fifty-six adults (30 males) were recruited from a small urban area in British
Columbia, Canada. The average age of the predominantly white (81%)
sample was 22.5 years (SD =3 years), with over 75 per cent having some years
at university. Participants were recruited through advertisements on the radio
broadcasting to a small city, and through posters distributed to people
walking through a university concourse area, and at the entrance to a sports
complex servicing the city. This experiment was advertised as “The HEW
Study: Health, Emotions, and Well-Being” with the purpose of examining the
impact that emotions associated with past events have on physical and psy-
chological health and well-being. Potential recruits were given contact infor-
mation, and told that they would receive $25 for their participation.
Apparatus
Physiological data were collected using a Dell Optiplex GX620 computer
system with Biopac physiological recording hardware running AcqKnowl-
edge 3.7.3 software. For electrocardiogram recordings, an electrical record-
ing of heart rate, Vermed disposable ECG electrodes were attached to each
wrist and the right shin, and connected to leads. An electrical recording of
blood flow through the heart (cardiac impedance) was made using four paired
dual snap disposable impedance electrodes, two attached to each side of the
rib cage and two attached to each side of the neck in a standard cardiac
impedance montage. Measures of blood pressure and arterial pulse were
obtained through a Finapres device attached to participants’ left middle
finger. Blood pressure measures were processed with MindWare BP 2.14
blood pressure analysis software.
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Pre-Test Measures
Gratitude Questionnaire-Six Item Form (GQ-6) (McCullough, Emmons, &
Tsang, 2001). The GQ-6 measures trait gratitude, and includes items such as
“I have so much in life to be thankful for” and “I am grateful to a wide variety
of people”. Participants rate their level of agreement on each item ranging
from 1 (strongly disagree) to 7 (strongly agree). McCullough et al. (2001)
reported that the GQ-6 has good inter-item reliability and construct validity.
We found the GQ-6 to have high internal consistency. Cronbach’s alphas
were .77.
Positive and Negative Affect Scale (PANAS) (Watson, Clark, & Tellegen,
1988). The PANAS comprises 10 positive affect words (e.g. excited, proud)
and 10 negative affect words (e.g. distressed, upset). Participants are asked
whether they generally feel this way using a 5-point Likert scale ranging from
1 (very slightly or not at all) to 5 (extremely). Watson et al. found the PANAS
to be reliable and possess both convergent and discriminant validity. In this
study, the PANAS was found to also have high internal consistency. Cron-
bach’s alphas ranged from .84 to .88.
During Intervention Measures
Daily Positive and Negative Affect Scale (Daily-PANAS) (Watson et al.,
1988). The Daily-PANAS includes the same 20 affective words as the
general PANAS (described above). The only difference is that with the Daily-
PANAS, people are asked how they feel “today” as opposed to “in general”.
In our study, Chronbach’s alpha ranged from .77 to .90.
Pre- and Post-Test Measures
Satisfaction with Life Scale (SWLS) (Diener, Emmons, Larsen, & Griffin,
1985). The SWLS is a five-item scale that measures general life satisfaction.
It includes items such as “In most ways my life is close to my ideals”.
Participants respond to these items using a 7-point Likert-type scale ranging
from 1 (strongly disagree) to 7 (strongly agree). Diener et al. (1985) found the
SWLS to have good reliability and validity. We also found it to have good
reliability with the pretest alpha being .88 and the post-test alpha being .80.
Rosenberg Self-Esteem Scale (RSE) (Rosenberg, 1965). The RSE is a
10-item questionnaire that measures global self-esteem. Examples of items
include “I feel that I have a number of good qualities”. Participants are asked
to respond using a 4-point Likert scale ranging from 1 (strongly disagree) to
4 (strongly agree). The RSE has been shown to have good reliability and
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validity (e.g. Rosenberg, 1965; Silber & Tippett, 1965). We found the RSE
to have good internal consistency. Pretest alpha was .86 and post-test alpha
was .78.
Procedures
Participants were invited to a laboratory where they completed the informed
consent form, provided demographic information, and were asked to disclose
any prior or current medical conditions or diagnoses that may affect
physiological recording. No participants were excluded on these grounds.
Participants then completed questionnaires followed by the recording of
physiological measures. These recordings entailed a series of 5-minute phases:
baseline, gratitude induction, return to baseline, and memorable events
induction. The order of gratitude and memorable events induction was ran-
domised and counterbalanced. In the gratitude induction, participants were
asked to bring to mind people for whom, or items or moments for which they
were grateful this past week, and to sustain the feelings of gratitude associ-
ated with these people, items, or moments. During the memorable events
induction, participants were asked to bring to mind a memorable event from
the past week, and to sustain the emotions associated with that event.
To collect physiological data, participants were fitted with ECG electrodes
and a Finapres cuff, and then seated in a comfortable, reclining chair that
minimised postural changes. Prior to recording, participants were instructed
to refrain from talking, falling asleep, performing exaggerated bodily move-
ments, or intentionally altering their respiratory patterns.
Following the pretest physiological recording, participants were randomly
assigned to one of two intervention conditions (i.e. gratitude vs. memorable
events) by an experimenter blind to the purpose of the study. For each
condition, participants were given a journal package along with specific
condition instructions. In the gratitude condition, participants were asked to
begin by thinking “about items, people or events for which you are particu-
larly grateful,” and trying “to experience and maintain the sincere heart-felt
feelings of gratitude associated with that thought”. This reflection process
was to be completed twice a week over the next 4 weeks for a total of 8 days.
Participants were instructed that they could perform this reflection on any
day and time that was convenient for them so long as the period between each
reflection process was 2 or more days. In addition, instructions were given for
each of the 8 days, asking participants to generate people, items, or events for
which they were grateful and then they were asked to reflect on one of them
for 5 minutes. Following the 5 minutes, participants were asked to write
down their grateful experiences in the journal provided. In the memorable
events condition, a similar procedure occurred, this time asking participants
to begin by ”recalling a memorable event” and trying “to experience and
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maintain the feelings associated with [the] one event”. For each condition,
after experiencing a grateful or memorable experience, participants were
asked to report their mood during the last couple of days. Finally, the
journals were designed to be user-friendly to enhance compliance and
decrease the burden participants may feel, which are two primary concerns
with journal-keeping studies (Green, Eshkol, Bolger, Shrout, & Reis, 2006).
The experimenter contacted participants 2 weeks into the intervention to
assess progress, answer questions, and schedule post-test visits. No partici-
pants reported problems or concerns with the intervention and all partici-
pants appeared to be complying with the procedure.
After completing the 4-week intervention component of the study, partici-
pants returned to the lab to deliver their journal package, and complete the
same battery of questionnaires as in the pretest. Out of the initial 56 partici-
pants, 47 returned the journal package and completed the post-test measures.
There were no significant differences in gender, age, years of education, or
pretest measures between those who remained in and those who exited the
study. Differential mortality between conditions could not be evaluated
among the nine subjects who failed to return their questionnaire packages
due to the double-blind group randomisation procedure. Finally, there were
no significant differences in gender, age, or years of education between the
participants in the two conditions (i.e. gratitude and memorable events).
Journals submitted by the 47 participants were examined for compliance.
Three of the 47 participants were missing one or more of the 8 days of
recordings. In total 6 days (1.6%) were missed. No participants were excluded
on the basis of non-compliance. Positive and negative affect scores for par-
ticipants’ missing days were determined using mean imputation.
Content Analysis of Participants’ Experiences
We explored participants’ descriptions of their memorable events or grateful
experiences to determine if there were differences in the kinds of experiences
participants generated. Participants’ experiences were open-coded looking
for common themes. Twelve categories were generated based on these
themes, including people, activities, major concerns, surroundings, positive
and negative emotions/experiences, character, objects, work, school, self, and
events/occasions (see Table 1 for examples). There was good interrater reli-
ability, Kappa =0.81.
RESULTS
Gratitude Intervention
To determine whether our intervention was having its intended effect in
creating physiological entrainment, we compared pretest cardiac coherence
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scores between the gratitude induction condition, the memorable events con-
dition, and baseline. Cardiac coherence is a measure of entrainment and is
represented by a stable, ordered sine-wave-like pattern in the heart rate
variability (HRV) waveform. To calculate cardiac coherence, the HRV time
series is first converted into its spectral components by applying a mathemati-
cal Fast-Fourier transformation to the data. The resultant power spectrum
reduces the heart rhythm into its constituent frequency components that can
be divided into three main frequency ranges. The very low frequency range
(VLF; 0.0033–.04 Hz) is primarily an index of sympathetic activity while
power in the high frequency range (HF; 0.15–0.4 Hz) is primarily due to
parasympathetic activity and represents more rapid beat-to-beat changes in
heart rate. The low frequency region (LF; 0.04–0.15 Hz) reflects activity in
the feedback loops that regulate short-term blood pressure changes and other
regulatory processes (McCraty, Atkinson, Tomasino, & Bradley, 2006).
Heart rhythm coherence approximates the LF/(VLF+HF) ratio of the
HRV power spectrum and is quantified by the formula (peak power/(total
power—peak power))2. Peak power represents the power associated with
the highest peak found in the LF range of the HRV’s power spectrum
(see McCraty et al., 2006; Tiller et al., 1996). Due to the positive skew to the
TABLE 1
Thematic Categories of Participants’ Experiences
Categories Subcategories Examples
People Family/Relatives Daughter, Grandmother,
Parents
Partner/Girl or Boyfriend Wife
Peers/Friends Teammates, Girl from class
Other/Community Attractive man
Activities Sports/Hobbies Ping pong, Playing basketball
Leisure/Social Life Party last night
Daily/Domestic Cleaning the house
Major Concerns Health My alcoholism
Finances Money
Time Free time to travel
Surroundings Place Home
Travel Trip to Nova Scotia
Positive Emotions/Experiences Happy
Negative Emotions/Experiences Stress
Character Careful, Trust
Objects TV, Cell phone, Beer
Work Spent all day applying for jobs
School Cramming for midterm
Self All of my opportunities, my life
Events/Occasions Old sister got engaged
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data, the coherence scores were log transformed and reported in units of
(ln ms2/Hz).
Ideally, we would expect the gratitude induction to produce a high
coherence score relative to baseline and memorable events condition.
Using a within-subject ANOVA, we found a main effect for intervention,
F(2, 54) =4.22, p<.05, h2=.14. Post-hoc t-tests indicated that coherence
during the gratitude condition (M=.30, SD =.20) was significantly higher
than during the memorable events (M=.26, SD =.18) ( p<.05), which was
marginally higher than during the baseline conditions (M=.23, SD =.23)
(p=.08). Hence, our intervention seems to have had the predicted physi-
ological effect with respect to cardiac coherence.
We then conducted ANCOVAs on our psychological well-being measures
at post-test, controlling for the respective pretest measure. We found general
support for our predictions. There was a significant intervention effect on
Satisfaction with Life, F(1, 43) =4.53, p<.05, h2=.10, and self-esteem,
F(1, 43) =5.00, p<.05, h2=.10 (see Table 2). Participants in the gratitude
intervention scored significantly higher on life satisfaction and self-esteem
compared to participants in the memorable events condition as predicted.
Moderating Effects
To probe for trait gratitude by intervention interactions on our outcome
measures, we used the Johnson-Neyman (J-N) technique recommended
TABLE 2
Group Raw Mean (SD) Scores by Condition
Gratitude Condition Memorable Events
Pre- & Post Measures Pre Post Pre Post
Satisfaction with Life* 25.36 (6.48) 27.27 (4.47) 27.84 (4.28) 26.92 (4.79)
Self-Esteem* 3.34 (.49) 3.45 (.36) 3.31 (.40) 3.26 (.32)
Gratitude Condition Memorable Events
Daily Mood Measures
Positive Daily Mood 3.30 (.12) 3.22 (.11)
Negative Daily Mood** 1.64 (.40) 1.99 (.37)
Thematic Category Scores
People** 7.43 (4.70) 2.75 (3.21)
Negative Emotions/Experiences** 0.14 (0.36) 2.98 (2.98)
School** 1.05 (1.53) 4.17 (3.19)
Events/Occasions* 0.19 (0.68) 0.71 (0.95)
Note:**p<.01; * p<.05.
GRATITUDE AND WELL-BEING 361
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Association of Applied Psychology.
by Hayes and Matthes (2009), which is a more rigorous method than the
separate regressions approach often used to test interactions. Using the
MODPROBE macro for SPSS (see Hayes & Matthes, 2009), we found an
interaction effect, b=3.18, t(42) =2.34, p=.02, for Satisfaction with Life (see
Figure 1). Further examination of the results revealed that for gratitude
values above 38.28 the treatment effect was nonsignificant. But below 38.28
the treatment effect is significant and negative. That is, those who were lower
in trait gratitude appeared to benefit from the gratitude intervention relative
to those who were higher on trait gratitude on the Satisfaction with Life
Scale. No interaction effect was found on self-esteem.
We also tested whether there was a positive affect by intervention effect and
a negative affect by intervention effect on well-being. However, no interaction
effects were found on pretest measures of positive and negative affect. Positive
and negative daily mood was then considered over the 4-week period. Fol-
lowing Froh et al. (2008a), we aggregated the eight positive daily mood scores
and eight negative daily mood scores to create a positive daily affect compos-
ite score and a negative daily affect composite score. While no intervention
effect was found on the positive daily affect score, F(1, 43) =0.16, p=.75,
observed power =.06, an intervention effect was found on the negative daily
affect score, F(1, 43) =11.17, p<.01, h2=.21. Those in the gratitude condi-
FIGURE 1. Mean Satisfaction with Life Scale scores and associated error as a
function of gratitude trait grouping (high vs. low) and intervention condition
(memorable events comparison vs. gratitude experimental).
362 RASH ET AL.
© 2011 The Authors. Applied Psychology: Health and Well-Being © 2011 The International
Association of Applied Psychology.
tion scored significantly lower in their negative daily affect compared to those
in the memorable events condition (see Table 2).
Using SEM in AMOS, we compared groups on their latent trajectories for
positive and negative daily mood by treating group as a dummy variable (see
Singer & Willett, 2003). No group effects were found for either the intercept
or the slope for positive mood. Nor was there a group effect on the slope for
negative mood. However, a group effect was found for the intercept for
negative mood, with b=-.49, p=.015. Overall model fit for negative mood
was adequate, c2(31) =40.8, p=.11, IFI =.90, RMSEA =.075. These find-
ings demonstrate that those in the gratitude condition were in a less negative
mood than comparison individuals at the beginning of the study, and this
difference was maintained through the duration of the intervention.
Qualitative Analysis of Participants’ Experiences
Our intervention groups were compared in the frequency of experiences listed
for each of the 12 categories. Significant group differences were found for:
People, t=3.85, p<.01; School, t=-4.27, p <. 001; and Events, t=-2.11,
p<.05; and for Negative Emotions/Experiences, t=-3.23, p<.01 (see
Table 2). Participants in the grateful condition described more people-related
experiences compared to those in the memorable events condition. Partici-
pants in the memorable events condition described more school, events, and
negative emotions-related experiences relative to grateful participants. To
determine if these differences in content categories were mediating the inter-
vention effects on well-being, we used a nonparametric bootstrapping proce-
dure recommended by Preacher and Hayes (2004). This is a more powerful
approach to testing mediations than the approach recommended by Baron
and Kenny (1986), especially with small samples. No significant effects were
found.
DISCUSSION
First, our results led us to conclude that asking participants to undergo
grateful contemplation in the laboratory produces a positive physiological
response as demonstrated in a more ordered heart rate ECG waveform and
greater physiological coherence. Physiological coherence occurs during posi-
tive experiences and is thought to be the result of increased parasympathetic
activation and reduced sympathetic activation where the net result is equiva-
lent levels of activation among the two branches of the autonomic nervous
system (see McCraty et al., 2006). When the parasympathetic and sympa-
thetic nervous system reach this harmonious balance there is an increase in
total power of the ECG power spectral density plot. Among other things,
physiological coherence has been hypothesised to reduce stress, naturally
GRATITUDE AND WELL-BEING 363
© 2011 The Authors. Applied Psychology: Health and Well-Being © 2011 The International
Association of Applied Psychology.
increase the body’s regenerative processes, correlate with a general sense of
well-being, and improve cognition and social performance (McCraty &
Childre, 2010). In the present experiment, contemplating grateful thoughts
appears to have resulted in increased physiological coherence presumably
reducing stress and boosting well-being. This is an encouraging result given
that participants were not trained in emotion induction before experimenta-
tion; however, it should be noted that these are preliminary findings and
additional research is needed to replicate these findings and ensure there are
not other confounding influences such as history or maturation. Further,
future work can explore possible accompanying health benefits of coherence
during a gratitude contemplation intervention.
Second, our results led us to conclude that a gratitude intervention has an
effect on well-being. First, the gratitude contemplation intervention had an
effect of increasing self-esteem. This suggests that gratitude may be a self-
acceptance-related emotion, with gratitude interventions having the effect of
improving one’s self-concept, a finding which is best conceptualised using the
sociometer theory of self-esteem (Leary & Baumeister, 2000). Sociometer
theory offers an interpersonal explanation of self-esteem, suggesting that the
self-esteem system evolved to monitor degree of acceptance versus rejection
in the social environment (Leary & Baumeister, 2000). According to sociom-
eter theory, the self-esteem system monitors the social environment for cues
indicating change in acceptance. Such changes are then registered by corre-
sponding changes in self-esteem, with lowered self-esteem indicating a declin-
ing relational evaluation and vice versa. According to this theory then,
grateful contemplation may lead to increases in participants’ perceived rela-
tional value and social acceptance, suggesting that it may function as an
acceptance-related emotion. Hence, simply contemplating items, moments,
or events for which one is grateful may lead to greater perceived social
acceptance; an interesting possibility considering that gratitude and social
integration have been found to serially enhance one another (Froh, Bono, &
Emmons, 2010). However, this is one possible interpretation of our findings.
Exactly how gratitude and self-esteem are linked awaits further investigation.
Our results also indicate that a gratitude contemplation intervention
increases life satisfaction. Gratitude has a unique and direct relationship with
satisfaction with life (Wood, Joseph, & Maltby, 2008). Life satisfaction refers
to the cognitive portion of well-being in which quality of life is assessed on the
basis of an individual’s own unique set of criteria (Pavot & Diener, 1993).
When an individual assesses life satisfaction, they are assessing the positive
side of an experience rather than focusing on unpleasant emotions (Pavot &
Diener, 1993). Research demonstrates that people who attend to and recall
the pleasant aspects of life more easily are happier and more satisfied with
their lives (Tamir & Robinson, 2007). The mechanism whereby our gratitude
intervention promoted increased life satisfaction may be through the acces-
364 RASH ET AL.
© 2011 The Authors. Applied Psychology: Health and Well-Being © 2011 The International
Association of Applied Psychology.
sibility and recollection of pleasant life events in memory (Watkins, 2004).
A grateful predisposition and the practice of gratitude may increase the
access to and the enhancement of positive information regarding one’s life.
Lyubomirsky, Sheldon, and Schkade (2005) argue that gratitude increases life
satisfaction by offering an alternative to the “hedonic treadmill” where the
focus is on increasing one’s possessions in order to maintain one’s short-term
gains in happiness. In support of such an interpretation, Lambert, Fincham,
Stillman, and Dean (2009) found that satisfaction with life mediated the
relationship between high gratitude and low materialism.
Third, we found that trait gratitude moderated the intervention condition
effect on satisfaction with life. Consistent with McCullough et al.’s (2004)
resistance hypothesis, the intervention was most effective in raising people’s
satisfaction with life when they were low on dispositional gratitude. In con-
trast, people who rated themselves high on gratitude were already high on life
satisfaction, and the gratitude intervention did not lead to greater satisfac-
tion. Thus, gratitude-type interventions employing grateful contemplation as
their methods of emotion induction may be most beneficial to those who are
low in trait gratitude. This finding implies that there may be a ceiling effect to
the increase in accessibility and recollection of positive life events that arises
due to the practice of gratitude. Future work is needed to better understand
the breadth of the resistance hypothesis as it relates to other psychological
outcomes, and the underlying mechanisms. If evidence in support of the
resistance hypothesis becomes robust in the literature, one implication of
such a finding would be that interventions employing grateful contemplation
should focus on people who are lower in dispositional gratitude.
However, positive and negative affect did not moderate the effects of the
intervention on well-being. This was surprising considering past research
demonstrating the moderating effect of positive affect (Froh et al., 2009a).
Part of the reason for our anomalous findings could be related to the more
negative daily mood our control participants were in at the start of the
intervention, compared to our gratitude participants, and which was main-
tained throughout the intervention. Hence, there may have been an uniden-
tified confound affecting our control participants’ daily mood. Nevertheless,
no differences emerged on the daily positive affect trajectory between our two
groups. This could be the result of a small sample and lack of power and/or
insufficient time duration for the intervention to have an effect on our mea-
sures of well-being.
Finally, participants in the gratitude contemplation condition recalled dif-
ferent thematic information than did participants in the memorable events
control. In the present experiment, gratitude contemplation was accompa-
nied by the recall of fewer negative emotions compared to memorable events.
Grateful thoughts also carried a more social tone involving more people
themes than did memorable events, which centered around events, occasions,
GRATITUDE AND WELL-BEING 365
© 2011 The Authors. Applied Psychology: Health and Well-Being © 2011 The International
Association of Applied Psychology.
and negative emotions. The strong social intonation of gratitude contempla-
tion was not surprising given that gratitude has been conceptualised as an
inherently social emotion that promotes the formation and maintenance of
relationships. Previous research examining the role of naturally occurring
gratitude in college sororities during a week of gift giving found that gratitude
predicted the formation and maintenance of relationships 1 month later
(Algoe, Haidt, & Gable, 2008).
Arguably one of the most significant findings in our exploration of the-
matic differences between the two conditions is that none of these differences
mediated the effects of our intervention on well-being. This suggests that it
may not be important what people specifically think about in the gratitude
intervention, but that whatever they choose seems to have the same general
effect. Methodologically speaking, simply asking people to think about
things for which they are grateful is sufficient versus asking them to think
about specific people or events. Given the small sample of our study, further
examination of this issue is warranted in future research.
In summary, our intervention produced significant main effects focused on
well-being. Like other intervention studies that have attempted to induce
gratitude, the results were mixed. One explanation for this could be that the
intervention period was not sufficiently long or intense, a common problem
with intervention studies. Having people reflect on experiences once a day,
twice a week for 4 weeks may not be sufficient to produce immediate post-test
effects on all facets of well-being. Second, our sample size was small, and
hence, our effects were modest. Future work should employ larger samples
over longer periods.
CONCLUSION
The purpose of this study was to explore the effects of a gratitude interven-
tion on well-being. We found that participants in the gratitude condition
displayed higher levels of self-esteem and satisfaction with life compared to
those in the memorable events condition. Furthermore, some of the psycho-
logical benefits of a gratitude contemplation intervention may be more
marked for those low in trait gratitude. Given the small sample size, our
results ought to be replicated with a larger sample, additional comparison
conditions, and long-term post-intervention assessments. If our results are
found to be robust, they can have significant clinical implications in terms of
providing an alternative means by which to improve one’s well-being.
ACKNOWLEDGEMENT
This research was supported by funding from the Michael Smith Foundation
for Health Research.
366 RASH ET AL.
© 2011 The Authors. Applied Psychology: Health and Well-Being © 2011 The International
Association of Applied Psychology.
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Self-esteem is recognized as an essential psychological resource. Low self-esteem is a trans-diagnostic symptom of many psychological disorders. Considering its association with coping skills and psychological adjustment strategies, the preservation of self-esteem appears to be an important clinical issue in oncology care as it would allow patients to better cope with the diagnosis and treatment of cancer. This thesis, through a meta-analysis of the interventions proposed to increase self-esteem in adults, has highlighted some of their characteristics that limit their efficacy and clinical applicability. Then, seven randomized controlled studies were conducted and allowed the development of a new short and self-administered technique for self-esteem increase, easily applicable to cancer patients. The lexical association technique aims at improving self-esteem by reinforcing the associative links between the Self and positive concepts stored in memory, through the activation of semantic and episodic forms of self-knowledge. This reinforcement is based on a reading and mental visualization exercise. In this thesis, the efficacy of the lexical association technique on global self-esteem was highlighted in students and breast cancer patients. Various studies aiming to simplifying and increasing the clinical applicability of the technique have demonstrated the need for retrieval of detailed memory traces, as well as the importance of contact with the experimenter in the efficacy of our technique. These results enabled us to develop and test a second format of the lexical association technique on global self-esteem, optimizing the activation of episodic self-perceptions, and proposing personalized and engaging exercises. Self-perceptions, on which self-esteem is based, are rooted in the individual's memory system. This thesis has contributed to highlighting that their reinforcement requires a combined activation of the different forms of self-knowledge that constitute them. However, the clinical applications of the lexical association technique as a transdiagnostic intervention have yet to be defined.
... Rights reserved. tude interventions (e.g., Harbaugh & Vasey 2014;Rash et al., 2011). Consistent with the resistance hypothesis (McCullough et al., 2004), these results suggest that a ceiling effect may emerge for individuals that already experience gratitude in various contexts (Harbaugh & Vasey, 2014). ...
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Outcomes of gratitude interventions are encouraging, but inconsistent across studies. In addition, both mechanisms of change and effect modifiers for these interventions are largely unknown. Recent data point toward potential candidates and suggest reward processing may be a promising mechanism underlying these interventions, while childhood adversity (CA) and trait gratitude may impact on them. However, existing research aimed at investigating these hypotheses is scarce. Building on these, we examined the effectiveness of a gratitude intervention for decreasing depressive symptoms and negative affect and increasing positive affect. We also investigated changes in reward processing following intervention and explored differences in adherence and drop-out between groups. Finally, we investigated the moderating role of CA and trait gratitude. Participants (N=237, ages between 18–56) were randomly allocated to a gratitude or active control condition (14 days). Following intervention, findings indicated a significant decrease in depressive symptoms and negative affect in both conditions. While positive affect remained stable, a significant time effect emerged for reward processing. CA severity, but not multiplicity, moderated the effectiveness of the intervention, adherence and drop-out. Trait gratitude moderated the effectiveness of the gratitude intervention only on depressive symptoms. Gratitude interventions may not be the best fit for everyone. Thus, we recommend tailoring interventions, especially in individuals reporting a history of severe CA.
... Indeed, NoiBene includes a series of interventions to increase some fundamental life skills, such as emotional awareness, assertiveness, and goal setting, elements that have an important role in determining mental health (Savoji and Ganji, 2013). Moreover, it provides a series of interventions focusing on selfacceptance-related emotions, an important factor that positively affects mental health (Rash et al., 2011;Weiss et al., 2016). Lastly, the NoiBene conditions include a psychoeducation about healthy lifestyles; students are then encouraged to link them with their own values and to set goals according to them. ...
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University students’ mental health has become a public health issue since increasingly students report high levels of psychological distress. Mental health difficulties influence students’ lives, such as academic performance, relationships satisfaction, and quality of life. Moreover, different kinds of obstacles often hinder help-seeking behavior. Such evidence strongly suggests the need to implement prevention and promotion strategies to increase health and well-being in educational contexts. This article presents a study protocol for implementing and evaluating NoiBene, an evidence-based group intervention that aims to promote mental health and well-being, improve a series of transversal competencies (e.g., emotional awareness, commitment to values, assertiveness, goal setting), and decrease dysfunctional transdiagnostic mechanisms (i.e., perfectionism, repetitive thinking, experiential avoidance). A randomized controlled trial will be conducted to evaluate the protocol’s efficacy. Participants will be assigned to one of the three conditions: the NoiBene Group condition (NB-G), the NoiBene guided web-based condition (NB-WB), or the waiting list condition (WLC). The NB-G intervention consists of six face-to-face group meetings, each dedicated to specific issues related to well-being or vulnerabilities. Every meeting includes an explanation of the theoretical contents, individual and group exercises, and role-plays. The NB-WB intervention covers the same topic addressed in the NB-G intervention. In this case, participants carry out a series of online modules, including theoretical explanations, practical exercises, useful activities, and self-monitoring tools. Students will individually meet the Tutor once every 2 weeks. The primary outcome will include an increase in mental health and well-being. Secondary outcomes will include changes in emotional awareness, assertiveness, perfectionism, rumination, worry, self-criticism, experiential avoidance, and academic performance and satisfaction. We expect that participants in both NoiBene conditions will show these outcomes. However, we hypothesized that the NB-G conditions will be more effective than the NB-WB in improving assertiveness. Besides treatment efficacy, we expect that students can benefit from the NB-G or NB-WB differently based on their specific behavioral and motivational patterns. Outcomes will be assessed at pre-, post-intervention and 6-months follow-up. In conclusion, we believe that NoiBene is a promising tool that can improve students’ well-being, and it could have positive implications for preventing mental health disorders among students.
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Most people want to be happy and many look out for opportunities to achieve a more satisfying life. Following a happiness training is an option, but the effectiveness of such training is being questioned. In this research synthesis we assessed: 1) whether happiness training techniques add to the happiness of their users, 2) how much happiness training techniques add to happiness, 3) how long the effect of happiness training lasts, 4) what kinds of training techniques work best, and 5) what types of groups of people profit from taking happiness training. We took stock of the available research and found 106 reports of effect studies on training techniques, which together yielded 314 findings. These findings are available in an online ‘findings archive’, the World Database of Happiness. Using links to this source allows us to condense information in tabular overviews, while providing the reader with access to much detail. Happiness training techniques seem to do what they are designed to do: 96% of the studies showed a gain in happiness post intervention and at follow-up, about half of the positive results were statistically significant. Studies with cross-sectional designs and studies that used control groups showed more mixed results. The average effect of happiness training was approximately 5% of the scale range. We conclude that taking a form of happiness training is advisable for individuals looking for a more satisfying life. Since happier workers tend to be more productive, organizations would be wise to provide such training techniques for their workforce.
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This chapter examines the difference between gratitude of exchange and gratitude of caring from a developmental-interactionist perspective of moral emotion. It suggests that complete treatments of gratitude must recognize its dual nature because important implications of failing to do so follow. It attempts to relate each form of gratitude to its biological origins in curiosity and attachment, and highlights the importance of this distinction for understanding important social issues such as the nature of evil.
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The effect of a grateful outlook on psychological and physical well-being was examined. In Studies 1 and 2, participants were randomly assigned to 1 of 3 experimental conditions (hassles, gratitude listing, and either neutral life events or social comparison); they then kept weekly (Study 1) or daily (Study 2) records of their moods, coping behaviors, health behaviors, physical symptoms, and overall life appraisals. In a 3rd study, persons with neuromuscular disease were randomly assigned to either the gratitude condition or to a control condition. The gratitude-outlook groups exhibited heightened well-being across several, though not all, of the outcome measures across the 3 studies, relative to the comparison groups. The effect on positive affect appeared to be the most robust finding. Results suggest that a conscious focus on blessings may have emotional and interpersonal benefits.
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In four studies, the authors examined the correlates of the disposition toward gratitude. Study 1 revealed that self-ratings and observer ratings of the grateful disposition are associated with positive affect and well-being prosocial behaviors and traits, and religiousness/spirituality. Study 2 replicated these findings in a large nonstudent sample. Study 3 yielded similar results to Studies 1 and 2 and provided evidence that gratitude is negatively associated with envy and materialistic attitudes. Study 4 yielded evidence that these associations persist after controlling for Extraversion/positive affectivity, Neuroticism/negative affectivity, and Agreeableness. The development of the Gratitude Questionnaire, a unidimensional measure with good psychometric properties, is also described.
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Gratitude, like other positive emotions, has inspired many theological and philosophical writings, but it has inspired very little vigorous, empirical research. In an effort to remedy this oversight, this book brings together prominent scientists from various disciplines to examine what has become known as the most-neglected emotion. The volume begins with the historical, philosophical, and theoretical foundations of gratitude, and then presents the current research perspectives from social, personality, and developmental psychology, as well as from primatology, anthropology, and biology. The volume also includes a comprehensive, annotated bibliography of research on gratitude. This work contributes a great deal to the growing positive psychology initiative and to the scientific investigation of positive human emotions. It will be an invaluable resource for researchers and students in social, personality, developmental, clinical, and health psychology, as well as to sociologists and cultural anthropologists.