The impact of gratitude on depression and anxiety: the mediating role of criticizing, attacking, and reassuring the self

Abstract

Gratitude significantly predicts less depression and anxiety symptoms in general population. Three types of self-relating processes as possible mediators of this relationship were evaluated. Trait gratitude, depression, anxiety, and three forms of self-relating (criticizing, attacking, and reassuring the self) were assessed in 410 Italian participants. Gratitude predicted less depression and anxiety symptoms, and the three forms of self-relating partially mediated the impact of gratitude on both depression and anxiety. Self-reassuring had a stronger mediation power than self-attacking in the prediction of anxiety symptoms. Gratitude is a protective factor against psychopathology not only due to its association with improved relationships with others, but also because it is connected to a less critical, less punishing, and more compassionate relationship with the self.

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Self and Identity
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The impact of gratitude on depression and
anxiety: the mediating role of criticizing, attacking,
and reassuring the self
Nicola Petrocchi & Alessandro Couyoumdjian
To cite this article: Nicola Petrocchi & Alessandro Couyoumdjian (2015): The impact of
gratitude on depression and anxiety: the mediating role of criticizing, attacking, and reassuring
the self, Self and Identity, DOI: 10.1080/15298868.2015.1095794
To link to this article: http://dx.doi.org/10.1080/15298868.2015.1095794
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SELF AND IDENTITY, 2015
http://dx.doi.org/10.1080/15298868.2015.1095794
The impact of gratitude on depression and anxiety: the
mediating role of criticizing, attacking, and reassuring the self
Nicola Petrocchi and Alessandro Couyoumdjian
Department of Psychology, Sapienza – University of Rome, Rome, Italy
Introduction
In recent years, research has systematically shown that gratitude is strongly related to several
aspects of well-being and mental health (Watkins, 2014), and promising clinical interventions
have been developed to increase gratitude as a way of fostering positive functioning, improv-
ing well-being and psychological disorders (Emmons & McCullough, 2003; Emmons & Stern,
2013). Gratitude has been described as an emotion arising from noticing and appreciating
the benets that one has received (Wood, Froh, & Geraghty, 2010). It can be conceptualized
both as a state and as a general disposition or personality trait. People experience gratitude
when they perceive themselves to be beneciaries of an intentionally rendered benet
that is both valuable to the recipient and costly to the benefactor (McCullough, Tsang, &
Emmons, 2004).
Gratitude, as a disposition, has been dened as a “tendency to recognize and respond with
grateful emotion to the roles of other people’s benevolence in the positive experiences and
outcomes that one obtains” (McCullough et al., 2004, p. 112). On this basis, gratitude has often
been described as stemming from the appreciation of the helpful actions of other people
and, therefore, directed toward a particular benefactor (McCullough, Kilpatrick, Emmons,
ABSTRACT
Gratitude signicantly predicts less depression and anxiety
symptoms in general population. Three types of self-relating
processes as possible mediators of this relationship were evaluated.
Trait gratitude, depression, anxiety, and three forms of self-relating
(criticizing, attacking, and reassuring the self ) were assessed in
410 Italian participants. Gratitude predicted less depression and
anxiety symptoms, and the three forms of self-relating partially
mediated the impact of gratitude on both depression and anxiety.
Self-reassuring had a stronger mediation power than self-attacking
in the prediction of anxiety symptoms. Gratitude is a protective
factor against psychopathology not only due to its association with
improved relationships with others, but also because it is connected
to a less critical, less punishing, and more compassionate relationship
with the self.
© 2015 Taylor & Francis
KEYWORDS
Gratitude; self-compassion;
self-criticism; depression;
anxiety
ARTICLE HISTORY
Received 14 June 2015
Accepted 14 September 2015
CONTACT Nicola Petrocchi nicola.petrocchi@uniroma1.it
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2 N. PETROCCHI & A. COUYOUMDJIAN
& Larson, 2001). More recently, Wood et al. (2010) have described dispositional gratitude
as part of a wider life orientation toward noticing and appreciating the positive aspects in
one’s life and the world. Therefore, gratitude does not necessarily require an interpersonal
context, and it arises from both appreciating actions of specic others, and a more general
appreciation of the positive aspects in one’s life (Emmons & Crumpler, 2000).
The relationship between gratitude and psychopathology
Several empirical studies have established links between gratitude and lower levels of psy-
chopathological symptoms, in particular depression and anxiety (Emmons & Stern, 2013;
for a review see Wood et al., 2010). Research has systematically yielded signicant negative
correlations in the moderate range between trait gratitude and depression (Kendler et al.,
2003; McCullough et al., 2004; Stoeckel, Weissbrod, & Ahrens, 2014), even after controlling for
positive aectivity, negative aectivity, and social desirability (McCullough, Emmons, & Tsang,
2002). In two longitudinal studies, Wood et al. (2008) found that trait gratitude predicted
lower levels of depression independently of the Big Five factors of personality. As noticed
by Wood et al. (2010), these ndings are not surprising, considering that a life orientation
toward the positive seems incompatible with the “negative triad” of beliefs about self, world,
and future, which is typical of the depressive mind-set (Beck, Rush, Shaw, & Emery, 1979).
Less explored is the relationship between gratitude and anxiety symptoms, but recent
investigations have conrmed that such relationship exists. A large (N=2621) epidemio-
logical study examined the role of thankfulness in predicting the lifetime history of nine
psychiatric disorders (Kendler et al., 2003). Thankfulness predicted signicantly lower risk
of generalized anxiety disorder. Additionally, Stoeckel et al. (2014) found that dispositional
gratitude moderated the relationship between parental health status and college-age chil-
dren’s anxiety. Also McCullough et al. (2002) found gratitude to be negatively associated
with depression, anxiety, and envy in non-clinical samples.
Mediating factors
Despite these evidences, underlying mechanisms linking gratitude to well-being and
decreased psychopathology have yet to be completely understood, and several mediating
factors have been proposed and tested.
In fact, gratitude interventions might not operate through the mechanism of increased
gratitude. For example, Emmons and McCullough (2003, Study 3) showed that keeping
gratitude lists improved both positive aect and negative aect and that this eect was
mediated by increases in daily average levels of gratitude. However, changes in gratitude
did not mediate the decrease in negative aect.
Other mechanisms that have been found to partially mediate the link between gratitude,
increased well-being and less psychopathological symptoms are positive aect (Lambert,
Fincham, & Stillman, 2012), and positive coping strategies (Wood, Joseph, & Linley, 2007).
Another likely, but unexplored, candidate to mediate the association between gratitude
and the occurrence of psychopathological conditions may be the way we “relate to our-
selves,” if criticizing and attacking ourselves or trying to be warm, encouraging, and kind
with ourselves.
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SELF AND IDENTITY 3
Self-criticizing, self-attacking, and self-reassuring
Self-criticism has been dened as an integrated system of believes, emotions, and attitudes
that people might have toward themselves in response to failures or setbacks (Gilbert, 2005).
Research has shown that we respond to our own attacks with the same response systems
that we use to face external attacks and threats (Longe et al., 2010). The self-to-self relation-
ship that characterizes self-criticism constitutes a serious risk for depression and related
disorders (Whelton & Greenberg, 2005; Zuro, Mongrain, & Santor, 2004), and it is also a
major component of anxiety and personality-focused research (see, for example, Dunkley,
Sanislow, Grilo, & McGlashan, 2006).
Given that self-criticism is a trans-diagnostic mechanism pervading many disorders
(Kannan & Levitt, 2013) and that its mediating role has already been demonstrated by
previous studies (James, Verplanken, & Rimes, 2015; Martins, Canavarro, & Moreira, 2015;
Pinto‐Gouveia, Castilho, Matos, & Xavier, 2013), we hypothesized that the way we relate to
ourselves might also be a mediator in the relationship between dispositional gratitude and
psychopathological conditions, such as depression and anxiety. McCullough et al. (2002)
suggested that seeing oneself as the recipient of other people’s generosity may lead one to
feel valued, esteemed, and with a sense of “deservingness,” which may boost self-esteem,
reduces self-criticism and the sense of worthlessness, a key feature of depression phenom-
enology. Moreover, grateful people possess a worldview that is more focused on the appre-
ciation of the good things that are present in one’s life, including personal qualities, skills,
and resources. As a result, they may be less prone to see themselves as “not enough,” more
willing to consider themselves as resourceful, and to encourage themselves, which may
lead to less anxiety in facing life circumstances. Moreover, if self-criticism and self-blame are
activated in response to frustrations or failures as suggested by Gilbert (2010) and Hassija
and Gray (2013), a grateful mind-set, with its focus on what is positive and fullling in life,
could prevent people from recurring to this maladaptive coping strategy.
Emmons and Crumpler (2000) have pointed out a paradoxical aspect to gratitude: genuine
gratefulness is to feel indebted for a gift that is appraised as costly to provide, valuable, and
altruistically oered, and that can never be fully repaid. Thus, gratitude involves a “willingness
to remain indebted,” and a sense of safety in acknowledging dependency on the benefactor.
Feeling gratitude entails recognizing and accepting that we need or needed the support of
external sources to reach our goals, and, implicitly, that “it is ok” to be needy and not totally
self-reliant. This might lessen the sense of inadequacy and self-criticism that often stems
from realizing our own limitations, while increasing acceptance of our shared humanity (the
“common humanity” facet of self-compassion, as described by Ne, 2003a,b).
Findings from cross-sectional studies have been supporting the link between “other-ori-
ented” processes, such as gratitude, and “self-oriented” processes, such as self-blame and
self-esteem. Wood, Joseph, and Linley (2007) found that coping styles, such as self-blame (a
strong correlate of self-criticism; Petrocchi, Ottaviani, & Couyoumdjian, 2014), signicantly
mediated the relationship between gratitude and stress, but did not substantially medi-
ate the relationship between gratitude and happiness, depression, or satisfaction with life.
However, despite the similarities, self-blame and self-criticism refer to distinct processes. Self-
blame is conceptualized as an internal attributional style that focuses on one’s behavior or
on stable aspects of a person’s disposition as the casual forces for external events, specically
stressors (Jano-Bulman, 1979). Self-criticism has been described as a “reexive psychological
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4 N. PETROCCHI & A. COUYOUMDJIAN
behavior” (Whelton & Greenberg, 2005), which entails not only a self-blaming attributional
style, but also maladaptive, negative thoughts about the self, aective states (anger, disgust,
contempt, disappointment for the self), and action tendencies (correcting, or punishing and
attacking the self; Gilbert et al., 2004). To our knowledge, the link between gratitude and
self-criticism had not been directly explored yet. Also the relationship between gratitude
and a positive form of self-evaluation (i.e., self-esteem) has been established. Dispositional
gratitude was found to predict greater daily self-esteem in persons with post-traumatic
stress disorder (Kashdan, Uswatte, & Julian, 2006), and self-esteem mediated the relations
between dispositional gratitude, and suicide ideation and attempts in a large sample of
adolescents (Li, Zhang, Li, Li, & Ye, 2012). However, the self-evaluative process that is at the
core of self-esteem and the positive emotions stemming from such evaluation relevantly
dier from the ability to reassure and be kind and compassionate toward ourselves (Ne,
2003a). Evaluating and liking the self, emphasizing our good qualities is connected to feelings
of pride and superiority (Aberson, Healy, & Romero, 2000), which may lead to narcissism,
self-absorption, and self-centeredness (Damon, 1995). Being kind and reassuring with our-
selves, which is a core component of self-compassion (Ne, 2003b), gives rise to positive
emotions that are not based on comparisons between self and others, but are linked to the
warm positive feelings of contentment, soothing, and connectedness (Gilbert, 2010). We are
not aware of any research that considered the link between dispositional gratitude and this
positive self-relating process, but the already established association between gratitude and
positive self-evaluation seems to suggest that such link may exist.
This study
The aim of the study was to evaluate possible mediation models for the relationship between
gratitude and symptoms of depression and anxiety. Specically, we tested three types of “self-
to-self” relationships as possible mediators: self-criticizing, self-attacking, and self-reassuring,
as assessed by the Forms of Self-criticizing/attacking and Self-reassuring Scale (FSCRS; Gilbert
et al., 2004). We hypothesized that these three forms of self-relating processes would be
signicant mediators of the association of gratitude with depression and anxiety. However,
given that self-attacking has found to be particularly connected with depressive symptoms
(Gilbert et al., 2004), we expected self-attacking to have a stronger mediation power than
self-criticizing and self-reassuring in the prediction of depressive symptoms. Instead, self-re-
assuring and self-criticizing, which represent less extreme forms of self-relationship than the
one that usually characterizes depression, were expected to convey a stronger mediation
power than self-attacking in the prediction of anxiety symptoms.
Method
Participants
The study was conducted through an online survey (QuestionPro), and participants were
recruited via both Sapienza University students mailing list, and other professional mail-
ing lists (consisting of subjects who had previously provided consent to be contacted for
participation in future studies), and web advertising. The e-mail with the link to the online
survey invited participants “to take part of a study on the relationship between thoughts
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SELF AND IDENTITY 5
and positive emotions.” Five hundred and thirty-nine participants agreed to participate and
410 completed the study (Mage=33.35; SD=11.2; age range: 17–65; 252 women (61.46%)
and 158 men (38.53%)). Most respondents had nished junior (11%) or senior high school
(27.2%), 19.5% had a bachelor’s degree, 30.5% had a master’s degree, and 11.8% had a
doctoral degree or a second-level master’s degree. Many respondents (40%) were students,
while 29.1% were employed, 14.1% were self-employed professionals, 9.7% were retired, and
7.1% were unemployed. One hundred and ninety-four participants described themselves
as religious (97.3% of them were Catholic), and 216 as non-religious.
Measures
Each participant completed an assessment battery that included several self-report
questionnaires.
Socio-demographic and personal information
Participants were asked to complete a socio-demographic form, which included items
regarding gender, age, and religiosity (yes/no).
Gratitude
The Gratitude Questionnaire (GQ-6; McCullough et al., 2002; Italian adaptation by Ruini and
Vescovelli, 2013) is a six-item self-report questionnaire that was used to assess participants’
proneness to experience gratitude in daily life. Items reected the gratitude intensity facet
(e.g., “I feel thankful for what I have received in life.”), the gratitude frequency facet (e.g., “Long
amounts of time can go by before I feel grateful to something or someone.”), the gratitude
span facet (e.g., “I sometimes feel grateful for the smallest things.”), and the gratitude density
facet (e.g., “I am grateful to a wide variety of people.”). Six items are rated on a seven-point
Likert scale, ranging from 1 (strongly disagree) to 7 (strongly agree), which are summed to
give a single score between 6 and 42. The GQ-6 has consistently demonstrated strong con-
current and predictive validity across multiple studies (e.g., McCullough et al., 2002; Wood
et al., 2009). In this study, internal consistency was α=.82.
Self-criticizing, self-attacking, and self-reassuring
The Forms of Self-criticizing/attacking and Self-reassuring Scale (FSCRS; Gilbert et al., 2004)
was employed. The scale consists of 22 items assessing the way people “treat themselves”
when things go wrong. Participants rate a series of armations on a ve-point Likert scale,
ranging from 0 (not at all like me) to 4 (extremely like me). This measure is composed by
three dimensions: inadequate-self (self-criticizing), which assesses feelings of inadequacy
and a sense of irritation and frustration toward the self (e.g., “When things go wrong for me
I am easily disappointed with myself”); hated-self (self-attacking), which assesses a more
extreme form of self-criticism, characterized by feeling of self-repugnance and desire to hurt
the self in response to failures and setbacks (e.g., “I have a sense of disgust with myself”);
and reassured-self (self-reassuring), which indicates the ability to be self soothing/reassuring
and treat the self with kindness and compassion when facing faults and failures (e.g., “I am
gentle and supportive with myself”).
An Italian adaptation for this scale was missing. Thus, before being used in this study,
the 22 items comprising the FSCRS were translated and adapted for Italian language with
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6 N. PETROCCHI & A. COUYOUMDJIAN
a back-translation procedure. A conrmatory factor analysis with Mplus 5.1 (Mplus, Los
Angeles, CA), using the maximum likelihood estimation, was then performed to test the
factorial validity of the Italian version of the FSCRS. Fit indices conrmed the appropriateness
of the three-factor model devised by Gilbert et al. (2004) and conrmed by recent study
(Baião, Gilbert, McEwan, & Carvalho, 2014): χ2=624.60 (df=191), p<.0001, χ2/df=3.2,
RMSEA=.069, SRMR=.057, CFI=.91 and TLI=.90 (see Figure 1).
Subscale scores are computed by calculating the mean of subscale item responses. In this
study, internal consistency was α=.90 for the inadequate-self, α=.86 for the reassured-self,
and α=.84 for the hated-self.
Depression
The Center for Epidemiologic Studies Depression Scale (CES-D; Radlo, 1977; validated in
Italian by Fava, 1983) was administered. The CES-D is a widely used 20-item self-report scale
designed to measure the frequency of occurrence of symptoms of depression during the
past week in the general population. A sample item is: “I felt that I could not shake o the
blues even with help from my family or friends.” The frequency of each symptom during the
past week is rated on a scale that ranges from 0 (rarely/none of the time, less than 1day)
to 3 (most or all of the time, 5–7days). A total score, ranging from 0 to 60, is computed by
adding the 20 items together. CES-D has systematically shown adequate internal consistency
Figure 1.CFA model of factorial structure of the FSCRS.
Note: All parameters are standardized and statistically significant at p<.001.
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SELF AND IDENTITY 7
and construct validity (Eaton, Bradley, & Morrisey, 2014). In this study, internal consistency
was α=.92.
Anxiety
The Spielberger State-Trait Anxiety Inventory—Trait Form (STAI; Spielberger, Gorsuch, &
Lushene, 1970; validated in Italian by Pedrabissi and Santiello, 1996) was employed.
STAI-Trait is a commonly used 20-item self-report measure of anxiety proneness requiring
participants to rate their frequency of anxiety symptoms on a four-point Likert scale, ranging from
1 (almost never) to 4 (almost always). A sample item is: “I worry too much over something
that really doesn’t matter.” A total score, ranging from 20 to 80, is computed by adding the
20 items together. Internal consistency coecients for the scale have ranged from .86 to .95
(Spielberger, Sydeman, Owen, & Marsh, 1999). In this study, internal consistency was α=.93.
Procedure
The survey was administered in a single session, and it took about 40min to complete. After
providing instructions and informed consent, all respondents completed a series of forms,
and then, they were debriefed and thanked for their time. This study was approved by the
Institutional Review Board of the University where the study was conducted.
Results
Preliminary data analyses and descriptive statistics
The assumptions of linearity, independence of errors, and homoscedasticity were met.
Kolmogorov–Smirnov and Shapiro–Wilk tests showed that several variables were not nor-
mally distributed. However, skewness and kurtosis’ values were not severely biased, as these
were below the recommended cuto points (Kline, 1998), consistent with the assumption of
approximate normal distributions. Means and standard deviations of all the study variables
are presented in Table 1. A series of one-way ANOVAs showed that religious participants
scored signicantly lower than non-religious participants on the anxiety, F(1, 408)=4.1,
p<.05 (M (SD)=42.3 (11.1) and M (SD)=44.8 (12.4), respectively), and self-attacking scales,
F(1, 408)=6.5, p<.05 (M (SD)=1.6 (.6), and M (SD)=1.7 (.7), respectively). Women scored
signicantly higher than men on the gratitude scale, F(1, 408)=8.5, p<.01 (M (SD)=32.1
(6.4) and M (SD)=30.0 (7.6), respectively) and lower on the self-attacking scale, F(1, 408)=4.6,
Table 1.Means, standard deviations, and correlations among the study variables.
**p<.01; *p<.05.
M (SD) 1 2 3 4 5 6 7
(1) Anxiety 43.5 (11.7) 1
(2) Depression 19.2 (11.8) .71** 1
(3) Gratitude 31.4 (6.9) −.36** −.45** 1
(4) Self-criticizing 2.7 (.9) .66** .51** −.22** 1
(5) Self-attacking 1.6 (.7) .59** .52** −.30** .58** 1
(6) Self-reassuring 3.5 (.7) −.64** −.51** .39** −.56** −.54** 1
(7) Age 33.35 (11.2) −.13** −.07 .08 −.15** −.11* .11* 1
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8 N. PETROCCHI & A. COUYOUMDJIAN
p<.05 (M (SD)=1.5 (.6) and M (SD)=1.7 (.7), respectively). No other signicant dierences
emerged.
Bivariate correlations among the study variables
As illustrated in Table 1, gratitude showed negative correlations with the self-criticizing and
the self-attacking scales, and a positive correlation with the self-reassuring scale, with eects
ranging from small to medium in terms of Cohen’s standards. Moreover, gratitude was mod-
erately and negatively correlated with both depression and anxiety scales. FSCRS subscales
were signicantly inter-correlated in the expected direction with large eects, as well as
correlated with depression and anxiety in the expected direction. This pattern of correlations
appeared to be consistent with the mediation model hypothesized.
Additionally, age was found to correlate negatively with anxiety, self-criticizing, and self-at
-
tacking, and positively with self-reassuring.
Direct and indirect eects of gratitude on depression
All mediation tests were performed using the Preacher and Hayes (2008) PROCESS macro
with 5000 bootstrap samples, which provides unstandardized betas for total, direct, and
indirect eect estimates, and corresponding 95% condence intervals. If the values between
the upper and lower condence limits of indirect eects do not include zero, this indicates a
statistically signicant mediation eect. If the value of the direct eect remains signicant,
this indicates partial mediation. A test of the dierence between indirect eects was also
Figure 2.Total, direct, and indirect effects of gratitude on depression, controlling for age, gender, and
religiosity.
Notes: All coefficients are unstandardized (B); ***p<.001. Completely standardized indirect effect of
Gratitude on Depression: Gratitude/Self-criticizing path, β = −.0474, (CI [−.09, −.02]); Gratitude/Self-
attacking path β=−.0563, (CI [−.09, −.01]); Gratitude/Self-reassuring β=−.0548, (CI [−.08, −.01]). Path
a=path b=path c.
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SELF AND IDENTITY 9
conducted. Again, unstandardized betas for each of the three dierences and the corre-
sponding 95% condence intervals are provided in order to determine signicance.
The model including gratitude as predictor, the three FSCRS subscales as mediators, and
depression as criterion, controlling for age, gender, and religiosity accounted for 43.8% of
depression, and all individual direct eects were signicant and in the expected direction
(see Figure 2 for unstandardized and standardized coecients). The total indirect eect of
gratitude (via all FSCRS subscales) was signicant (B=−.31; CI [−.42, −.22]), suggesting that
the three FSCRS dimensions mediated the eect of gratitude on depression. In addition,
the direct eect of gratitude on depression remained signicant (B=−.48, t(402)=−6.91,
p<.001, CI [−.62, −.34]) when the mediators were included in the model, thus suggesting a
partial mediation. Individual indirect eects of gratitude were all signicant, with B=−.09
(CI [−.16, −.05]) for the gratitude/self-criticizing path, B=−.11 (CI [−.18, −.06]) for the grati-
tude/self-attacking path, and B=−.10 (CI [−.18, −.03]), for the gratitude/self-reassuring path.
Moreover, no signicant dierences were found between indirect eects, suggesting that
the eect of gratitude on depression was mediated similarly by the three FSCRS dimensions.
Direct and indirect eects of gratitude on anxiety
The model including gratitude as predictor, the three FSCRS subscales as mediators, and
anxiety as criterion, controlling for age, gender, and religiosity accounted for 58.5% of anxiety
and all individual direct eects (see Figure 3 for unstandardized and standardized coe-
cients) were signicant and in the expected direction. The total indirect eect of gratitude
(via all FSCRS subscales) was signicant (B=−.40; CI [−.53, −.28]), suggesting that the three
Figure 3.Total, direct, and indirect effects of gratitude on anxiety, controlling for age, gender, and religiosity.
Notes: All coefficients are unstandardized (B); ***p<.001. Completely standardized indirect effect of
Gratitude on Anxiety: Gratitude/Self-criticizing path, β=−.0716, (CI [−.12, −.04]); Gratitude/Self-attacking
path β=−.0474, (CI [−.08, −.02]); Gratitude/Self-reassuring β=−.1105, (CI [−.15, −.07]). Path a<path c.
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10 N. PETROCCHI & A. COUYOUMDJIAN
FSCRS dimensions mediated the eect of gratitude on anxiety. In addition, the direct eect
of gratitude on anxiety remained signicant (B=−.18, t(402)= −3.08, p<.005, CI [−.30,
−.07]) when the mediators were included in the model, thus suggesting a partial mediation.
Individual indirect eects of gratitude were all signicant, with B=−.13 (CI [−.20, −.07]), for
the gratitude/self-criticizing path, B=.08 (CI [−.15, −.03]) for the gratitude/self-attacking path,
and B=−.19 (CI [−.27, −.13]), for the gratitude/self-reassuring path.
Moreover, the indirect eect of gratitude/self-attacking path was signicantly lower than
the gratitude/self-reassuring path (contrast dierence: B=.11; (CI [.02, .21]), suggesting that
the latter had a more relevant role in the mediation model.
Discussion
A growing body of recent research ndings shows that the disposition to be grateful has
robust associations with multiple aspects of mental health. Grateful people not only tend to
show more fullling, meaningful relationships (Algoe, Gabel, & Meisel, 2010), but also lower
rates of many psychological disorders such as depression and anxiety (Kendler et al., 2003).
However, research on possible mediating factors of the relationship between trait gratitude
and mental health is still scarce. The aim of the study was to expand the knowledge on pos-
sible underlying mechanisms linking gratitude to lesser depression and anxiety, evaluating
three types of “self-to-self” relationships as possible mediators.
Results conrmed that three types of self-relating processes (criticizing, attacking, and
reassuring the self) partially mediated the impact of trait gratitude on depression and anx-
iety. These mediation models were conrmed even when controlling for age, gender, and
religiosity, which have been found to be signicant moderators of trait gratitude (Allemand
& Hill, 2014; Kashdan, Mishra, Breen, & Froh, 2009).
The grateful disposition represents a protective factor against depression and anxiety
partly because it is signicantly connected to a lower level of feelings of inadequacy and
self-denigration, but also lower self-hate and self-repugnance, which represent more severe
forms of self-criticism. Additionally, being grateful renders individuals more prone to show
kindness, comprehension, support, and compassion toward themselves when setbacks
and frustrations occur. As regards depressive symptoms, contrary to our expectations,
self-attacking did not convey a stronger mediation power than self-criticizing and self-reas-
suring. Thus, a grateful disposition positively impacts depressive symptoms not prevalently
through the lessening of the typical depressive self-relating style (self-attacking), but also
because it is linked to increased ability to reassure and encourage the self, and to attenuate a
sense of self-inadequacy in front of failures. However, as regards anxiety, self-reassuring was
a signicantly stronger mediator than self-attacking. Thus, grateful people experience less
anxiety mostly because they are able to encourage and be compassionate and reassuring
toward themselves when things go wrong in life.
Several observations could be advanced to explain the relationship between dispositional
gratitude and positive self-relating. McCullough et al. (2002) suggested that seeing oneself
as the recipient of other people’s generosity may lead one to feel valued, esteemed, and
with a sense of “deservingness,” which may boost self-esteem, reduce self-criticism and the
sense of worthlessness.
Moreover, grateful people may possess a worldview that is more focused on the appreci-
ation of the good things in life, including personal qualities, skills, and resources, which may
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SELF AND IDENTITY 11
lead to less self-criticism when facing life circumstances. In fact, the association of gratitude
and self-esteem, which is a positive evaluation of the self, has already been reported (see, for
example, Chen & Wu, 2014). This study adds to this literature by showing that dispositional
gratitude is also associated with specic ways of relating with the self, in particular with
higher compassionate self-reassuring, and less self-criticizing and self-attacking. Gratitude,
as an “other-oriented” process, has been found to promote prosocial behavior (Tsang, 2006)
and improve relationships with others (Algoe, Fredrickson, & Gable, 2013; Williams & Bartlett,
2014). The present ndings show that gratitude is also associated with an improved “rela-
tionship with the self,” in the form of a more positive and compassionate way of treating
ourselves when things go wrong in life, which partially explains why grateful people are also
less depressed and anxious. Recent ndings suggest that a grateful disposition is signi-
cantly connected to a higher secretion of oxytocin, a neuropeptide that has been shown to
lead to social approach-related motivation and behavior (Algoe & Way, 2014). Additionally,
Colonnello and Heinrichs (2014) have shown that oxytocin administration inuences eortful
stage of self-related information processing, enhancing self-attribution of positive adjectives,
thus improving the representation of self. Cardoso, Ellenbogen, and Linnen (2012) have also
reported the eect of acute intranasal oxytocin in improving positive self-perceptions of
personality, with participants in the oxytocin condition showing higher ratings of extraver-
sion and openness to experiences (traits characterized by positive emotions, warmth, trust,
altruism, and openness to values and ideas) than participants in the placebo condition.
Similarly, the calm and peaceful types of positive feelings associated with feeling cared
for, reassured, and warmly supported, instead of harshly criticized, are also linked to a neu-
rohormonal prole of increased oxytocin (Depue & Morrone-Strupinsky, 2005; Gilbert, 2010).
Thus, it is possible that a grateful mind-set may facilitate the activation of cognitive and
emotional processes that exhibit a similar psychophysiological prole, such as warmth and
self-reassurance (Gilbert, 2014), concomitantly reducing incompatible processes, such as
self-criticism and self-attacking.
Limitations and future directions
Our results should be considered within the context of several limitations. First, the use of
a largely Caucasian convenience sample may limit the generalizability of our results. The
correlational and cross-sectional nature of the study prevents conclusions being drawn
regarding causal links between gratitude, self-relating styles, and psychopathological symp-
toms. However, several longitudinal explorations have conrmed the impact of a grateful
disposition on both depression and anxiety symptoms (Kleiman, Adams, Kashdan, & Riskind,
2013; Wood et al., 2008) allowing us condence in the direction of inuence tested in this
study. Similarly, longitudinal studies have shown the link between a grateful disposition and
self-relating processes such as self-esteem (Chen & Wu, 2014), and between self-criticism
and symptoms of both depression and anxiety (Cox, Clara, & Enns, 2009; Gautreau, Sherry,
Mushquash, & Stewart, 2015), supporting the directionality hypothesized by our model.
However, causal directionality could be more clearly established by future experimental or
longitudinal research.
Future explorations might also compare the mediators analyzed in this study with some
of the previously studied mediators, and see also how they might interact.
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12 N. PETROCCHI & A. COUYOUMDJIAN
The self-report nature of the study increases the possibility that social desirability may
have inated both reports of gratitude and self-criticism. However, McCullough et al. (2002)
showed that the self-report of gratitude is substantially related to peer report, not highly
correlated with social desirability, and controlling for social desirability does not signicantly
alter the relationship between gratitude and other psychological variables. Despite these
limitations, this study provided novel ndings, which might potentially lead to improve-
ments in the clinical practices aimed at the reduction of self-criticism and shame-based
diculties.
If the disposition to be grateful predicts less self-criticism and self-hate, and more warm
and self-reassuring attitude, then it is possible that also gratitude interventions might
be eective in reducing self-criticism and enhancing self-kindness and self-compassion.
Sergeant and Mongrain (2011) investigated the benets of gratitude exercises in self-critical
individuals and found that self-critics, as opposed to needy individuals, were particularly
responsive to this kind of intervention. According to the authors, gratitude exercises are
especially well suited to highly self-critical individuals, encouraging them to compensate
for the negative self-focus and replace it with appreciation for the outside world.
Thus, future research could experimentally test whether incorporating gratitude exer-
cises into existing compassion-focused approaches, such as Compassion-Focused Therapy
(Gilbert, 2010, 2014), could enhance their ecacy in reducing self-aversion (Brach, 2012)
and increasing compassionate self-acceptance.
Disclosure statement
No potential conict of interest was reported by the authors.
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