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The Effects of Two Novel Gratitude and Mindfulness Interventions on Well-Being

DOI:10.1089/acm.2014.0119
Authors:
Karen Matvienko-Sikar at University College Cork
Karen Matvienko-Sikar
Samantha Dockray at University College Cork
Samantha Dockray
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To examine the efficacy of two dual-component interventions, one based on mindfulness and one based on gratitude, to reduce depression and stress and increase happiness levels. Randomized, controlled study with data collected at baseline, 3 weeks, and 5 weeks. Participants completed an online gratitude or mindfulness intervention at home. Self-report questionnaires were completed at home or at work. Sixty-five women aged 18-46 years (mean age±standard deviation, 28.35±6.65 years). Participants were randomly assigned to a wait-list control condition or to either a gratitude or a mindfulness intervention condition. The interventions were used four times a week for 3 weeks. The gratitude intervention involved a gratitude diary and grateful reflection. The mindfulness intervention involved a mindfulness diary and mindfulness meditation, the Body Scan. The outcome variables were depression, stress, and happiness measured by using the Edinburgh Depression Scale, the Perceived Stress Scale, and the Subjective Happiness Scale, respectively. All outcome variables improved over time in both interventions group but not in the wait-list control group. Efficacy of the interventions differed between the interventions. These short novel interventions seem to provide a useful way to enhance well-being. Further research in the area is warranted.
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Short Report
The Effects of Two Novel Gratitude and Mindfulness
Interventions on Well-Being
Karen O’ Leary, MA, and Samantha Dockray, PhD
Abstract
Objective: To examine the efficacy of two dual-component interventions, one based on mindfulness and one
based on gratitude, to reduce depression and stress and increase happiness levels.
Design: Randomized, controlled study with data collected at baseline, 3 weeks, and 5 weeks.
Settings: Participants completed an online gratitude or mindfulness intervention at home. Self-report ques-
tionnaires were completed at home or at work.
Participants: Sixty-five women aged 18–46 years (mean age –standard deviation, 28.35 –6.65 years).
Interventions: Participants were randomly assigned to a wait-list control condition or to either a gratitude or a
mindfulness intervention condition. The interventions were used four times a week for 3 weeks. The gratitude
intervention involved a gratitude diary and grateful reflection. The mindfulness intervention involved a
mindfulness diary and mindfulness meditation, the Body Scan.
Outcome measures: The outcome variables were depression, stress, and happiness measured by using the
Edinburgh Depression Scale, the Perceived Stress Scale, and the Subjective Happiness Scale, respectively.
Results: All outcome variables improved over time in both interventions group but not in the wait-list control
group. Efficacy of the interventions differed between the interventions.
Conclusions: These short novel interventions seem to provide a useful way to enhance well-being. Further
research in the area is warranted.
Introduction
Mindfulness and gratitude are consistently and
positively associated with well-being in diverse pop-
ulations. Mindfulness is the intentional and nonjudgmental
awareness of all thoughts, feelings, and sensations that occur
in the present moment. It is associated with higher levels of
quality of life,
1
sleep quality and duration,
2
and life satis-
faction and happiness.
3
It is also associated with lower levels
of stress
4
and depression and anxiety.
3
Mindfulness practice
typically involves group sessions and at-home practice for
approximately 8 weeks, during which individuals learn to
regulate their awareness and approach all stimuli openly, in
the present moment.
Gratitude is a tendency toward appreciating the positive
in life. Although gratitude is not as widely used in practice
as mindfulness, a growing body of gratitude research has
found robust and consistent associations with well-being. It
is associated with reduced anxiety;
5
stress and depression;
6
and increased life satisfaction,
6
positive affect, and health
behaviors.
6
Gratitude interventions tend to involve think-
ing or writing about things one feels grateful for over a
period of time. Such single-component gratitude inter-
ventions are usually quick to complete, easy to use. and
cost-effective.
A main limitation in evaluating the usefulness of grati-
tude interventions to date is that intervention components
differ between studies and often lack suitable control con-
ditions. Mindfulness interventions, on the other hand, tend
to involve a considerable time commitment, which may
limit its usability for individuals with little available free
time. In addition, the social nature of many mindfulness
interventions may contribute to any improvements in well-
being. As such, no reported studies have fully examined the
effects of mindfulness components or assessed brief, at-
home mindfulness exercises. Rigorously examining the ef-
fects of two new brief interventions based on gratitude and
mindfulness is essential to determine their potential to im-
prove health and well-being in a cost-effective and acces-
sible manner.
School of Applied Psychology, University College Cork, Cork, Ireland.
THE JOURNAL OF ALTERNATIVE AND COMPLEMENTARY MEDICINE
Volume 00, Number 0, 2015, pp. 1–3
ªMary Ann Liebert, Inc.
DOI: 10.1089/acm.2014.0119
1
Materials and Methods
Participants
Sixty-two women took part in this randomized, controlled
trial. Participants were aged 18–46 years (mean age–standard
deviation, 28.35 –6.65 years). All participants had com-
pleted secondary education; most were in a relationship or
married (67.7%). Twenty-nine participants were assigned to
the gratitude intervention; 22 were assigned to the mind-
fulness intervention; and 10 were assigned to a wait-list
control. Thirty-five participants completed the full study.
Materials
Both interventions were completed online on the research
website 4 times a week for 3 consecutive weeks. The grat-
itude intervention involved a gratitude diary for listing up to
5 things participants felt grateful for and a guided gratitude
reflection that focused on 1 thing they were grateful for. The
mindfulness intervention involved a mindfulness diary for
listing thoughts, feelings, and emotions in the present mo-
ment. It also involved a mindfulness meditation, the Body
Scan, that guided attention to the breath and body. The in-
terventions took 10–15 minutes to complete.
Self-report questionnaires were used to indicate levels of
stress, depression, and happiness: the Perceived Stress Scale,
7
which measures the extent to which people view situations in
their life as stressful; the Edinburgh Depression Scale;
8
and
the 4-item Subjective Happiness Scale,
9
respectively.
Procedure
The University Ethics Committee approved the study, and
all participants provided informed consent. At study com-
mencement, all participants completed baseline (time 1)
self-report measures. Self-report measures were completed
again at the middle of the study (week 3) and at the end of
the study (week 5). Participants began using the intervention
1 week after baseline measures and used it 4 times a week
for 3 weeks. Wait-list participants completed only self-
report measures during the study and were given access to
both interventions at study completion. Data were analyzed
using SPSS software, version 20 (SPSS, Inc., Cary, NC).
Results
Mean scores and standard deviations for stress, depres-
sion, and happiness for each experimental group at each
time point were calculated (Table 1). A mixed between- and
within-subjects analysis of variance was conducted for each
outcome measure. No significant change was found for
stress (F[8, 58] =0.65; p=0.73; gp
2
=0.08), depression (F[4,
46] =1.61; p=0.34; gp
2
=.09), or happiness (F[4, 64] =1.21;
p=0.31; gp
2
=0.07). However, all outcome measures im-
proved during the study (Fig. 1). Both intervention condi-
tions demonstrated reductions in stress and depression and
increases in happiness from baseline to week 3. The control
condition demonstrated negligible change over time.
Discussion
All observed changes in outcome variables were in the
expected directions. Reductions in stress and depression and
increases in happiness were observed for the gratitude and
mindfulness interventions. These changes did not occur for
the wait-list control participants, highlighting the potential
benefits of incorporating mindfulness or gratitude inter-
ventions into daily life. The gratitude intervention was most
efficacious for reducing stress, demonstrating a continuous
decline across the 5 weeks. The mindfulness intervention
was most effective in reducing depression and increasing
happiness.
Although the results of this study are promising, they may
have limited generalizability because of the homogenous
participant group of well-educated women. The attrition rate in
this study (43%) was also problematic and resulted in a small
sample size at completion. This could have affected the ability
to detect a significant effect of the interventions because the
study may have been underpowered to detect an effect.
In conclusion, both the novel gratitude and mindfulness
interventions in this study demonstrated improvements in
well-being over 5 weeks. The interventions resulted in dif-
fering outcomes between variables; gratitude appears more
useful for reducing stress, while mindfulness is more
Table 1. Mean Stress, Depression,
and Happiness at Each Time Point
Variable
Gratitude
(n=15)
Mindfulness
(n=13)
Control
(n=7)
Stress
Week 1 30.87 –7.90 26.92 –5.74 32.43 –7.81
Week 2 27.33 –8.93 26.92 –5.63 30.86 –8.86
Week 3 26.53 –7.23 23.61 –7.34 32.14 –9.25
Depression
Week 1 20.08 –5.21 20.44 –3.94 20.17 –5.85
Week 2 19.83 –6.41 18.11 –5.90 19.33 –6.02
Week 3 18.00 –5.10 14.89 –2.98 19.67 –8.38
Happiness
Week 1 17.07 –5.98 18.62 –4.59 15.71 –3.68
Week 2 17.40 –7.16 19.92 –3.95 15.86 –3.13
Week 3 18.87 –6.15 22.00 –4.06 16.00 –4.40
Percentage change in stress from weeks 1 to 3: gratitude, 14.06%;
mindfulness, 7.67%; control, 0.06%. Percentage change in depres-
sion from weeks 1 to 3: gratitude, 10.36%; mindfulness, 27.15%;
control, 2.48%. Percentage change in stress from weeks 1 to 3:
gratitude, 10.54%; mindfulness, 18.15%; control, 1.85%.
FIG. 1. Mean levels of stress, depression, and happiness
for 5 weeks of study.
2 O’LEARY AND DOCKRAY
beneficial for happiness and depression. These findings in-
dicate that mindfulness and gratitude interventions are po-
tentially beneficial and could also be usefully combined to
further improve well-being. Further research on brief in-
terventions such as these is warranted.
Acknowledgments
The authors thank the participants who volunteered their
time to take part in this study.
Author Disclosure Statement
No competing financial interests exist.
References
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Address correspondence to:
Karen O’Leary, MA
School of Applied Psychology
University College Cork
Cork
Ireland
E-mail: k.oleary@ucc.ie
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Article
  • Jul 1987
The development of a 10-item self-report scale (EPDS) to screen for Postnatal Depression in the community is described. After extensive pilot interviews a validation study was carried out on 84 mothers using the Research Diagnostic Criteria for depressive illness obtained from Goldberg's Standardised Psychiatric Interview. The EPDS was found to have satisfactory sensitivity and specificity, and was also sensitive to change in the severity of depression over time. The scale can be completed in about 5 minutes and has a simple method of scoring. The use of the EPDS in the secondary prevention of Postnatal Depression is discussed.
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A Global Measure of Perceived Stress
Article
  • Jan 1984
This paper presents evidence from three samples, two of college students and one of participants in a community smoking-cessation program, for the reliability and validity of a 14-item instrument, the Perceived Stress Scale (PSS), designed to measure the degree to which situations in one's life are appraised as stressful. The PSS showed adequate reliability and, as predicted, was correlated with life-event scores, depressive and physical symptomatology, utilization of health services, social anxiety, and smoking-reduction maintenance. In all comparisons, the PSS was a better predictor of the outcome in question than were life-event scores. When compared to a depressive symptomatology scale, the PSS was found to measure a different and independently predictive construct. Additional data indicate adequate reliability and validity of a four-item version of the PSS for telephone interviews. The PSS is suggested for examining the role of nonspecific appraised stress in the etiology of disease and behavioral disorders and as an outcome measure of experienced levels of stress.
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The Benefits of Being Present: Mindfulness and Its Role in Psychological Well-Being
Article
  • May 2003
Mindfulness is an attribute of consciousness long believed to promote well-being. This research provides a theoretical and empirical examination of the role of mindfulness in psychological well-being. The development and psychometric properties of the dispositional Mindful Attention Awareness Scale (MAAS) are described. Correlational, quasi-experimental, and laboratory studies then show that the MAAS measures a unique quality of consciousness that is related to a variety of well-being constructs, that differentiates mindfulness practitioners from others, and that is associated with enhanced self-awareness. An experience-sampling study shows that both dispositional and state mindfulness predict self-regulated behavior and positive emotional states. Finally, a clinical intervention study with cancer patients demonstrates that increases in mindfulness over time relate to declines in mood disturbance and stress.
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Mindfulness-Based Stress Reduction in Relation to Quality of Life, Mood, Symptoms of Stress, and Immune Parameters in Breast and Prostate Cancer Outpatients
Article
This study investigated the relationships between a mindfulness-based stress reduction meditation program for early stage breast and prostate cancer patients and quality of life, mood states, stress symptoms, lymphocyte counts, and cytokine production. Forty-nine patients with breast cancer and 10 with prostate cancer participated in an 8-week MBSR program that incorporated relaxation, meditation, gentle yoga, and daily home practice. Demographic and health behavior variables, quality of life (EORTC QLQ C-30), mood (POMS), stress (SOSI), and counts of NK, NKT, B, T total, T helper, and T cytotoxic cells, as well as NK and T cell production of TNF, IFN-gamma, IL-4, and IL-10 were assessed pre- and postintervention. Fifty-nine and 42 patients were assessed pre- and postintervention, respectively. Significant improvements were seen in overall quality of life, symptoms of stress, and sleep quality. Although there were no significant changes in the overall number of lymphocytes or cell subsets, T cell production of IL-4 increased and IFN-gamma decreased, whereas NK cell production of IL-10 decreased. These results are consistent with a shift in immune profile from one associated with depressive symptoms to a more normal profile. MBSR participation was associated with enhanced quality of life and decreased stress symptoms in breast and prostate cancer patients. This study is also the first to show changes in cancer-related cytokine production associated with program participation.
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