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Gratitude, Psychological Well-Being, and Perceptions of Posttraumatic Growth in Adults Who Lost a Parent in Childhood


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Findings from an online survey of 350 adults who experienced early parental death showed that current dispositional gratitude was positively correlated with psychological well-being and posttraumatic growth and negatively correlated with depression. Further, 281 participants produced textual responses indicating they could remember the time following their parent's death. Increases in gratitude attributable to the experience of losing a parent were reported by 79% of these participants. They associated their increased gratitude with a newfound belief that life is precious and with greater appreciation for loved ones. Direction of change in gratitude was associated with psychological well-being, posttraumatic growth, and depression.
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Death Studies
ISSN: 0748-1187 (Print) 1091-7683 (Online) Journal homepage:
Gratitude, psychological well-being, and
perceptions of posttraumatic growth in adults who
lost a parent in childhood
Nathan Greene & Katie McGovern
To cite this article: Nathan Greene & Katie McGovern (2017): Gratitude, psychological well-being,
and perceptions of posttraumatic growth in adults who lost a parent in childhood, Death Studies,
DOI: 10.1080/07481187.2017.1296505
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Accepted author version posted online: 17
Feb 2017.
Published online: 17 Feb 2017.
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Gratitude, psychological well-being, and perceptions of posttraumatic
growth in adults who lost a parent in childhood
Nathan Greene and Katie McGovern
Clinical Psychology Program, The Wright Institute, Berkeley, California, USA
Findings from an online survey of 350 adults who experienced early parental death showed that
current dispositional gratitude was positively correlated with psychological well-being and
posttraumatic growth and negatively correlated with depression. Further, 281 participants
produced textual responses indicating they could remember the time following their parent’s
death. Increases in gratitude attributable to the experience of losing a parent were reported by
79% of these participants. They associated their increased gratitude with a newfound belief that life
is precious and with greater appreciation for loved ones. Direction of change in gratitude was
associated with psychological well-being, posttraumatic growth, and depression.
In the United States, at any given time, 3.5% of
individuals, or roughly 2.2 million people, have experi-
enced the death of one or both of their parents prior to
reaching the age of 18 (Social Security Administration,
2000). Childhood bereavement, otherwise known as
early parental death (EPD), has been identified as one
of the most significant, stressful events that a child
can experience (Melhem, Walker, Mortz, & Brent,
2008). Such a profound psychological event can threa-
ten the emotional and social development of a child
and can have enduring consequences (Osterweis,
Solomon, & Green, 1984).
Numerous studies have documented negative
outcomes in individuals who have experienced early
parental death. For example, parentally bereaved chil-
dren are more likely to suffer from lower self-esteem,
diminished academic success, and lower self-efficacy
when compared to similarly aged peers (Dowdney,
2000). Further, a child who has lost a parent or sibling
is also at risk for anxiety, anger, guilt, peer-isolation,
loneliness, and posttraumatic stress symptoms (Christ,
2010; Haine, Ayers, Sandler, & Wolchick, 2008; Koehler,
2010). The impact of such a profound loss is not
restricted to childhood. A number of studies have sug-
gested a link between EPD and long-term negative
psychological outcomes into adulthood, including self-
reports of depression, anxiety, posttraumatic stress
symptoms, suicidal ideation, and functional impair-
ments (Agid et al., 1999; Barnes & Prosen, 1985;
Harrison & Harrington, 2001; Kendler, Gardner, &
Prescott, 2002; Melhem, Walker, Moritz, & Brent,
2008; Tyrka, Wier, Price, Ross, & Carpenter, 2008).
Although many studies have documented the
negative outcomes associated with EPD, others have
produced contrary evidence questioning a direct link
between early parental bereavement and depression
(Hurd, 1999, 2004; Kendler, Neale, Kessler, Heath, &
Eaves, 1992) or the development of psychiatric illness
in adulthood (Tennant, Smith, Bebbington, & Hurry,
1981). Evidence thus suggests that some individuals
can adapt healthfully in the wake of parental loss. As
a result, research has been moving toward identifying
factors that mitigate negative outcomes and promote
positive health outcomes in individuals who
experienced EPD.
Factors that promote positive health outcomes in
individuals following the loss of a parent include both
external factors, such as a strong bond with the surviv-
ing caregiver, family economic stability, and positive
engagement in mourning behaviors, as well as internal
factors, such as the possession of a strong self-concept
and the capacity to think about one’s experience in a
positive manner (Hong & Scott, 2013; Hurd, 2004;
Perry, 2006; Worden, 1996).
One internal adaptive factor that has not hitherto
been studied in individuals who lost a parent in child-
hood is dispositional gratitude. Dispositional gratitude
is conceptualized in the present study as “part of a wider
life orientation towards noticing and appreciating the
CONTACT Nathan Greene Clinical Psychology Program, The Wright Institute, 2728 Durant Avenue, Berkeley, CA 94704.
© 2017 Taylor & Francis
positive in the world” (Wood, Froh, & Geraghty, 2010,
p. 980). In this view, dispositional gratitude is distinct
from the feeling of appreciation in the response to the
action of another (McCullough, Kilpatrick, Emmons,
& Larson, 2001) and from positive emotions such as
hope, optimism, and trust.
Although dispositional gratitude may be conceptua-
lized as a trait, it is understood to be a mutable trait,
one shaped by our experience and not a fixed individual
characteristic. This understanding is promoted by Froh
and Bono (2014) who viewed gratitude as a personality
trait and a life orientation that can be learned, practiced,
and cultivated. Empirical support for this view of
gratitude comes from self-reported increases in grati-
tude and subjective well-being following interventions
such as maintaining a gratitude journal or counting
one’s blessings in randomized control studies (e.g.,
Emmons & McCullough, 2003; Froh, Sefick, &
Emmons, 2008).
There are many psychological health benefits to
fostering gratitude. The burgeoning field of gratitude
research has provided strong evidence that gratitude is
a causal predictor of subjective well-being and psycho-
logical well-being in the general population (Emmons
& McCullough, 2004; Wood et al., 2009). Further, grati-
tude has been shown to buffer the effects of external
stressors on overall health (Krause, 2006) and protect
against the impacts of stress and depression over time
(Wood, Maltby, Gillett, Linley, & Joseph, 2008a).
Gratitude also plays an important role in helping indivi-
duals form and maintain relationships (McCullough
et al., 2001). In short, grateful people tend to be happier
(Watkins, 2004).
For those who have endured traumatic experiences,
dispositional gratitude can protect against negative
psychological outcomes. A study with female breast
cancer patients, for instance, found that gratitude
correlated strongly with reported posttraumatic growth,
positive emotions, and lower levels of distress (Ruini &
Vescovelli, 2012). Vernon, Dillon, and Steiner (2009)
similarly found positive relationships between gratitude
and posttraumatic growth in women with trauma
histories, including transportation accidents, sexual
assault, and other events identified on the Clinician-
Administered PTSD Scale (Blake et al., 1990).
Particularly relevant to the present study are findings
from a study of college-aged adults with chronically ill
parents indicating that dispositional gratitude moder-
ated the relationship between parental health status
and the students’ depression and anxiety (Stoeckel,
Weissbrod, & Ahrens, 2014). Froh and Bono (2014)
suggested that gratitude promotes healthy adjustment
following a trying experience through two primary
mechanisms: by the garnering of social support and
by making meaning from the experience. Similarly, it
has also been suggested that benefit-finding plays an
important role in recovery from a potentially traumatic
experience (Davis, Nolen-Hoeksema, & Larson, 1998;
Wood et al., 2010), a process that is likely more
accessible in individuals with a grateful disposition.
Although it has been documented that gratitude is
correlated with aspects of healthy adjustment following
distinct traumas, it has also been suggested that
experiencing a trauma may actually encourage gratitude
formation, despite the host of negative emotions
commonly associated with traumatic experience. For
instance, Peterson, Park, Pole, D’Andrea, and Seligman
(2008) demonstrated that when individuals experience
traumatic events, such as a life-threatening illness or
accident, the character strength gratitude as measured
by the Values in Action Inventory of Strengths
(Peterson, Park, & Seligman, 2005) could increase.
Similarly, Fredrickson, Tugade, Waugh, and Larkin
(2003) studied the psychological impact of the
September 11th terrorist attacks and found that
gratitude was one of the three most reported positive
emotions from traumatized persons. Peterson and
Seligman (2003) found that adults who experienced
the attacks demonstrated increases in self-reported
gratitude when compared with self-reports prior to
the attack. One potential mechanism that could account
for this unexpected finding is the concept that facing
mortality increases one’s orientation toward gratitude.
This was supported in a study by Frias, Watkins,
Webber, and Froh (2011), who showed that when
individuals were encouraged to imagine their own death
in a realistic fashion, they were likely to report higher
levels of gratitude. Frias and colleagues’ findings seem
to provide empirical support for Bonanno’s (2009)
theory that loss forces individuals to face the bigger
existential questions such as the meaning of life and find
greater value in life, which in turn could encourage one
to have a more grateful disposition.
Given the documented benefits of having a grateful
disposition for general health and well-being and the
existing literature demonstrating gratitude’s relation to
healthy adjustment following traumas, the present
researchers were curious about gratitude’s relationship
to healthy adult functioning in individuals who lost a
parent in childhood. We hypothesized that positive
relationships would be found between reports of dispo-
sitional gratitude and reports of current psychological
well-being and perceived posttraumatic growth related
to the death of the parent. Furthermore, we predicted
that dispositional gratitude would be negatively corre-
lated with reports of depression.
We also wanted to know how the loss experience
itself may have shaped individual orientations toward
gratitude. The ideal study design to approach this ques-
tion would involve a longitudinal study measuring levels
of dispositional gratitude in each individual prior to and
following the loss. Given the logistical issues of such a
study, we instead focused on individuals’ retrospective
accounts of how their sense of gratitude was influenced
by the loss of the parent with a question that asked if
they believe they experienced an increase, decrease, or
no change in their sense of gratitude following loss of
their parent. To further investigate how individuals
understood this change or lack thereof, we asked a
simple open-ended question asking that they explain
their previous response. The aim of the qualitative ques-
tion was to help us gain more context for how some
individuals were able to access gratitude following the
loss while others found benefit-finding and gratitude
formation more difficult.
Participants and procedure
A sample of 350 adults was recruited primarily via social
media sites including online bereavement organizations
such as Motherless Daughters, Parentless Parents, the
Loss of a Mother or Father Facebook Group, and others.
Inclusion criteria were loss of one or both parents prior
to age 18 and current age of at least 18 years; there were
no additional exclusion criteria. Participants composed
a primarily white female sample, varying widely in
age, education, social class identification, and religious
Participants represented 21 different countries with
the large majority of participants (n ¼297, 83.9%)
residing in the United States. The study was conducted
online via SurveyMonkey.
Gratitude Questionnaire-6
The Gratitude Questionnaire-6 (GQ-6; McCullough,
Emmons, & Tsang, 2002) is composed of six items rated
on a 7-point Likert scale ranging from 1 (strongly
disagree) to (strongly agree) and measures one’s prone-
ness to experience gratitude in daily life. The GQ-6
assesses gratitude as a single factor on the basis of the
frequency and intensity of grateful affect (Wood et al.,
2010). Items include statements such as “I have so much
in my life to be thankful for” and “I am grateful to a
wide variety of people.” The GQ-6 is the most widely
used measure of gratitude and has been used with a
number of distinct populations including adults, adoles-
cents, cancer patients, and United States veterans
(Wood, Maltby, Stewart, & Joseph, 2008b; Stoeckel,
Weissbrod, & Ahrens, 2014; Ruini & Vescovelli, 2012;
Kashdan, Uswatte, & Julian, 2006). The GQ-6 has
demonstrated excellent psychometric properties and
been shown to be associated with life satisfaction,
vitality, optimism, and pro-social traits— all constructs
relevant to gratitude (McCullough et al., 2002). The
Cronbach’s alpha estimates for the six item totals have
ranged from .76 to .84 (McCullough et al. 2002), reflect-
ing good internal consistency.
Posttraumatic Growth Inventory-Short Form
The Posttraumatic Growth Inventory-Short Form
(PTGI-SF; Cann et al., 2010) is an adapted version of
the Posttraumatic Growth Inventory (PTGI; Tedeschi
& Calhoun, 1996), which retrospectively assesses the
extent to which individuals are successful in
reconstructing or strengthening their perceptions of
themselves, others, and the meaning of events following
a significant traumatic event. The PTGI-SF has 10 items
rated on a 6-point Likert scale ranging from 0 (“I did
not experience this change as a result of my crisis”) to
5 (“I experienced this change to a very great degree as
a result of my crisis”). Five domains of posttraumatic
growth are assessed, which include Relating to Others
(greater intimacy and compassion for others), New
Possibilities (developing new roles and meeting new
people), Personal Strength (feeling personally stronger),
Spiritual Change (feeling more connected spiritually),
and a deeper Appreciation of Life (Tedeschi & Calhoun,
2004). Three studies tested the psychometric properties
of the original PTGI and found that the PTGI has good
internal consistency ¼.90) and acceptable test-retest
reliability (r ¼.71; Tedeschi & Calhoun, 1996). The
psychometric properties of the PTGI-SF were assessed
with a sample of 186 adults and it was shown to have
good internal consistency (α ¼.89) (Cann et al., 2010).
Confirmatory factor analysis demonstrated that the
PTGI-SF has a five-factor structure that is equivalent
to that of the PTGI.
Flourishing Scale
The Flourishing Scale (FS; Diener et al., 2009), formerly
known as The Psychological Well-Being Scale, is a shor-
tened measure of psychological well-being that is based
upon theories of universal psychological needs from Ryff
(1989) and Ryan and Deci (2000). The FS features eight
Likert scale items that assess several domains of social
and psychological functioning, including the maintenance
of positive social relationships, engagement in personally
rewarding activities, possession of a sense of purpose, and
feelings of competence (Diener et al., 2009). The FS has
been shown to have strong psychometric properties and
is related to various measures of well-being. Diener et al.
(2009) found that the measure has good internal consist-
ency, with a Cronbach’s alpha of 0.86, and adequate tem-
poral stability at 0.71. The FS also showed strong
convergent validity with Ryff’s (1989) and Ryan and
Deci’s (2000) long-form measures of psychological well-
being at .78 and .73, respectively.
Patient Health Questionnaire-9
The Patient Health Questionnaire (PHQ-9; Kroenke,
Spitzer, & Williams, 2001) is a nine-item self-report mea-
sure that assesses the frequency of occurrence in the past 2
weeks of the nine symptoms of major depressive disorder
as identified by the DSM 5. Respondents report the symp-
toms as 0 (occurring not at all), 2 (more than half the days),
and 3 (nearly every day). Finally, respondents rate the
degree of difficulty they experience in doing work, taking
care of things at home, or getting along with people as a
result of the nine symptoms on a 4-point Likert scale ran-
ging from 0 (not applicable) to 4 (extremely difficult).
Internal consistency of the PHQ evidenced Cronbach’s
alphas of 0.89 and 0.86 in a study with 3,000 primary care
patients and 3,000 patients from obstetrics-gynecology
sites, respectively (Kroenke et al., 2001). Adequate con-
struct validity and criterion validity for the PHQ-9 were
also established in the study mentioned above.
Other childhood trauma item
To estimate level of other childhood trauma, parti-
cipants were asked “Prior to your 18th birthday, did
you experience any significant stressful or traumatic
even other than your parent’s death?” Response options
were “yes” or “no.”
Adult trauma item
Level of adult trauma was assessed by a single question:
“As an adult, to what extent have you experienced
highly stressful and traumatic events?” Response
options were “very little,” “somewhat,” “moderate,”
“quite a bit,” and “extreme.”
Perceived change in gratitude items
A fixed-choice item at the end of the survey assessed part-
icipants’ perceptions of how the loss of their parent had
influenced their current sense of gratitude. The question
asked “How do you believe your sense of gratitude has
changed as a result of losing a parent?” Participants
responded to a fixed-choice scale with three response
options, denoting whether their gratitude increased, stayed
the same, or decreased. Participants then responded to an
open-ended question, which asked them to explain their
response to the perceived change in gratitude item.
Data handling
Initially, 464 participants responded to the survey. Of
these, 116 responded to demographics questions but
did not complete all instruments and were removed
from consideration. Of the remaining 350 complete
surveys, a small number had missing individual
responses within a given measure. Mean substitution
of missing single responses was used as the method to
obtain complete data for all participants. SPSS21 was
used for all data analysis. The demographics of the final
350 participants are shown in Table 1.
Measure descriptive statistics and relation to
demographic variables
Descriptive and reliability statistics for the four mea-
surement scales used in the study are shown in Table 2.
Gender was found to be related to PTGI scores, with
women significantly more likely to report post-
traumatic growth than men (M ¼25.85, SD ¼12.83 vs.
M ¼18.49, SD ¼13.99; p <.005). There were differ-
ences among ethnic groups on levels of post-traumatic
growth. White participants and those who did not
identify ethnicity had significantly higher PTGI scores
than both American Indian/Alaska Natives (p <.03)
and Hispanic/Latino participants (p <.03). No other
associations between demographic variables and
measurement scales were found.
To examine whether the GQ-6 and PTGI were mea-
suring the same or different constructs, tests of multicol-
linearity were conducted. A multicollinearity diagnostic
was obtained from a multiple regression analysis where
GQ-6 and PTGI-SF were considered as predictors of
FS. The variance inflation factor (VIF) was 1.087; the rule
of thumb for interpreting the VIF suggests that GQ-6 and
PTGI-SF are not correlated in this context. They appear
to be measuring different constructs.
Relationship of dispositional gratitude to
psychological well-being, posttraumatic growth,
depression, age at time of death, and years since
As expected, dispositional gratitude (GQ-6) was
positively correlated with psychological well-being (FS)
as well as posttraumatic growth (PTGI-SF), and nega-
tively correlated with depression (PHQ-9; see Table 3).
GQ-6 scores were also weakly associated with time since
death in years.
FS scores were moderately associated with PTGI,
strongly, negatively correlated with PHQ-9, and weakly
correlated with time since death. PTGI scores were
moderately correlated with age at death and negatively
correlated with time since death. PHQ-9 was negatively
correlated with time since death.
Impact of other early trauma and adult trauma
An effort was made to rule out other childhood trauma
and adult trauma as contributors to adult psychological
To estimate level of other childhood trauma, parti-
cipants were asked “Prior to your 18th birthday did
you experience any significant stressful or traumatic
even other than your parent’s death?” Thirty-two per-
cent of the sample reported no other childhood trauma;
68% did report other childhood trauma. Chi-square
analysis showed that presence of childhood trauma
(yes vs. no) was not significantly associated with reports
of change on the change in gratitude item (decrease, no
change, increase). Finally, in independent means t-tests
Table 2. Descriptive and reliability statistics for GQ-6
(Gratitude Questionnaire-6), Flourishing Scale (FS), PTGI (Post-
traumatic Growth Inventory), and PHQ-9 (Patient Health
Measure M SD Min Max Cronbach’s alpha
GQ-6 35.06 5.97 12 42 .829
FS 44.85 8.42 15 56 .912
PHQ-9 5.45 4.55 0 18 .883
PTGI 25.07 13.14 0 50 .901
Table 1. Demographics.
Variable M Minimum Maximum SD Frequency Percent
Current age 40.05 18 78 12.23
Age at death 11.13 0 18 4.77
Years since death 28.94 3 65 13.46
Female 314 89
Male 34 10
No report 2 1
African American 5 1.5
American Indian/Alaska Native 4 1.1
Asian/Pacific Islander 10 2.9
White/Caucasian 305 87.1
Hispanic/Latino 17 4.9
No report 9 2.5
Working class 53 15.1
Lower middle 116 33.1
Upper middle 164 46.9
Upper class 16 4.6
No report 1 .3
High school or less 17 4.9
Some college 83 23.7
Bachelor’s degree 126 36.0
Master’s degree 87 24.9
Doctoral degree 21 6.0
Other certification 14 4.0
No report 2 .6
Agnostic 48 13.7
Buddhist 14 4.0
Christian 165 47.1
Hindu 4 1.1
Jewish 37 10.6
Muslim 3 .9
None of these 79 22.6
Parent who died
Father 93 26.6
Mother 236 67.4
Both 21 6.0
Table 3. Correlations among GQ-6 (Gratitude Questionnaire-6),
Flourishing Scale (FS), PTGI (Posttraumatic Growth Inventory),
and PHQ-9 (Patient Health Questionnaire), age at time of
death, and time since death.
Variable 1 2 3 4-9 5
1. GQ6
2. FS .654**
3. PTGI .325** .366**
4. PHQ-9 .374** .616** .063
5. Age at death .024 .008 .225** .058
6. Time since death .130* .163** .175** .204** .424**
*p <.05. **p <.001.
presence of childhood trauma was not associated with
levels of adult GQ-6, Flourishing, PTGI, or PHQ-9.
Level of adult trauma experienced by the participants
was also assessed by a single question: “As an adult, to
what extent have you experienced highly stressful and
traumatic events?” Frequencies and percentages of
participants reporting each level of adult trauma are
shown in Table 4. Chi-square analysis showed that, as
with childhood trauma, level of adult trauma was not
associated with perceived change in gratitude.
One way analyses of variance (ANOVAs) allowed
groups with different levels of adult trauma to be
compared on the measures of adult psychological out-
comes. Mean GQ-6 scores did not differ between adult
trauma groups; however, group differences were found
for Flourishing, F(4, 341) ¼2.516, p <.05]; PTGI,
F(4, 341) ¼2.530, p <.05; and PHQ-9, F(4, 341) ¼
9.074, p <.0001. Pairwise comparisons showed that on
Flourishing, those who reported very little adult trauma
had significantly higher scores than those who reported
extreme levels of adult trauma (M ¼47.265 vs. 41.394,
p <.05); other group comparisons were not statistically
significant. On PTGI, those who reported very little
adult trauma had significantly lower scores than those
who reported quite a bit of adult trauma (M ¼19.373
vs. 27.029, p <.05); other group comparisons were not
statistically significant. On PHQ-9, there were many
differences among adult trauma groups, with a linear
increase in average PHQ-9 score from those reporting
very little adult trauma to those reporting extreme adult
trauma (see Table 5).
Perceived change in gratitude in the
remembering group
To ensure that participants’ reports of changes in
gratitude could be attributed to parental death, those
participants (n ¼69) who indicated that they could
not remember their feelings at the time of their parents’
death or could not make the judgement about changes
in gratitude were removed from further analyses. This
left a sample of 281 participants, the remembering
group. The remembering group was not statistically
different from the larger sample in terms of age, age
at time of death, or time since death or PHQ-9.
However, it has a higher GQ-6 level (M ¼35.87 vs.
35.06, p <.02), a higher FS level (M ¼45.80 vs. 44.85,
p <.05), and a higher PTGI level (M ¼27.55 vs. 25.07,
p <.001). The correlation matrix examining relation-
ships between GQ-6, FS, PTGI-SF, PHQ-9, age at
death, and time since death showed that the pattern of
significant correlations and the directions of correla-
tions were not different between the overall sample
and the remembering group.
Based on the Likert scale change in gratitude item, a
large majority of the 281 participants (222 people or
79%) reported that they experienced an increase in their
sense of gratitude related to experiencing the loss of their
parent in childhood. In contrast, 36 participants (12.2%)
reported that they experienced no change in gratitude,
and 23 participants (8.2%) reported that they experi-
enced a decrease in gratitude as a result of the loss.
A multivariate analysis of variance (MANOVA)
investigated differences across levels of change in grati-
tude (increase, no change, and decrease) on all four
study measures (PHQ-9, GQ6, FS, and PTGI). The
overall MANOVA showed significant differences
among individuals grouped by level of change, Pillia’s
trace ¼. 399, F(8., 552) ¼17.19, p <.001. Univariate
ANOVAs revealed differences between change in
gratitude groups on GQ6, F(2, 278) ¼25.395, p <.001;
flourishing, F(2, 278) ¼31.831, p <.001; PHQ9.
F(2, 278) ¼6.825, p <.001; and PTGI, F(2, 278) ¼
53.540, p <.001.
Pairwise comparisons among the gratitude groups on
each study variable showed a significant (p <.001) over-
all pattern of linear change from decrease in gratitude to
no-change to increase in gratitude in the predicted direc-
tion, with the exception that on PHQ-9 the no-change
and increase were not different and on PTGI the decrease
and no-change group were not different. In other words,
when reported change in gratitude increased between
groups, GQ6, FS, and PTGI also increased and PHQ-9
decreased among the remembering group.
Qualitative themes
Coding of textual responses to the open-ended question
asking for explanation of each participant’s perceived
change in gratitude response offers rich descriptions
Table 4. Reported levels of other adult trauma.
Level of reported trauma n %
Extreme 33 9.4
Quite a bit 104 29.7
Moderate 108 30.9
Somewhat 67 19.1
Very little 34 9.7
No response 4 1.1
Table 5. Differences among adult trauma groups on Patient
Health Questionnaire.
Level of adult trauma M SD
Extreme 8.519
Quite a bit 6.296
Moderate 5.378
Somewhat 3.910
Very little 3.375
p <.0001.
p <.0001.
p <.01.
p <.01.
p <.004.
of participants’ experience of their loss and its impact
(see Table 6).
Texts were obtained from 237 participants (84%) of
the remembering group. The principal investigators
and two additional coders read the responses and
developed thematic codes that capture meanings of
individual texts. Themes extracted from the texts were
sorted according to whether the participants reported
an increase in gratitude, no change, or a decrease in
gratitude attributable to their parent’s death.
Participants who report increases in gratitude due to
their parent’s death offered uniformly positive
explanations for their attribution. The most common
explanation (n ¼49, 27.4%) was the idea that life is pre-
cious and that one should get the most out of it while
they can. The second most frequent theme was gratitude
for family and friends (n ¼36, 20.1%).
Reports of no change in gratitude were accompanied
by both positive and negative themes including stories
of variation in gratitude, other kinds of changes, other
sources of gratitude, and other difficult experiences.
The most common theme was that the participant does
not associate any outcomes with their parent’s death
(n ¼12, 33.3%). The second most common theme was
that other difficult circumstances inhibited gratitude
(n ¼5, 13.9%).
Participants’ reports of decreases in gratitude were
accompanied by themes of pain, conflict, anxiety, and
fragility—92% of the texts contained negative state-
ments. The most common theme was participants’
experience of being afraid and anxious (n ¼4, 82%).
The next most common themes were the participants’
beliefs that they cannot depend on others (n ¼3,
13.6%) and that other difficult circumstances inhibited
gratitude (n ¼3, 13.6%).
The present study found that for this mostly White,
female sample of individuals who experienced EPD,
gratitude was positively associated with psychological
well-being and with posttraumatic growth. In other
words, individuals who reported that they were more
grateful also tended to report higher levels of psycho-
logical well-being and posttraumatic growth. As
predicted, gratitude also demonstrated an inverse
relationship with depression. In addition, those indivi-
duals who reported positive changes in gratitude
attributable EPD tended to report higher dispositional
gratitude, psychological well-being, and posttraumatic
growth, and lower depression than those who either
reported no change in gratitude or a decrease in
gratitude following the loss.
The findings are in alignment with previous studies
of the general population suggesting that grateful people
are generally happier and that there are positive
relationships among gratitude, optimism, positive affect,
pride, and hope (Emmons & Shelton, 2002; Gallup,
1999; Watkins, 2004). The present study provides
additional support for Wood et al.’s (2008a) assertion
that gratitude can serve as a protective factor against
stress and depression over time. Given gratitude’s role
in promoting positive feelings and in protecting against
stress and depression, it follows that gratitude would be
associated with adaptive functioning in adults who
experienced EPD, a major finding of the present study.
Among those who remembered the time following
the death of their parent, a large majority (79%)
reported that they believed their sense of gratitude or
appreciation for life increased as a result of losing their
Table 6. Qualitative themes from open ended question about
change in gratitude attributed to parental death (n ¼237
responses across all groups).
Theme n Percentage
Increase in gratitude responses 179 100
Life is precious/Get the most from it 49 27.4
Grateful for family and friends 36 20.1
Things can change in an instant/ No guarantees 23 12.8
Grateful for the relationship with my children/ 18 10.1
Wanting to give them the best
Shift in perspective that helps you not sweat the
small stuff
10 5.6
Grateful for lost parent 8 4.5
Grateful for my health 9 5.0
Focus on God/Higher Power/Spirituality 11 6.1
The loss taught me self-reliance 7 3.9
Grateful for surviving parent 5 2.8
Other: I just do, maturity, grateful for other helpers 3 1.7
No change in gratitude responses 36 100
Don’t associate any outcomes with parent’s death 12 33.3
Other difficult circumstances inhibit gratitude 5 13.9
Grateful for surviving parent 3 8.3
Grateful waxes 3 8.3
Not as grateful as I should be/Stuck on negatives 2 5.6
Poor relationship with surviving caregiver. 2 5.6
Grateful for family and friends 1 2.8
Grateful for lost parent 1 2.8
I can’t say 1 2.8
I confronted death 1 2.8
I felt lost 1 2.8
Life is meaningless 1 2.8
Parental death was a relief 1 2.8
Shift in perspective that helps you not sweat the
small stuff
1 2.8
The loss taught me self-reliance 1 2.8
Decrease in gratitude responses 22 100
I am afraid and anxious 4 18.2
I can’t depend on others 3 13.6
Other difficult circumstances inhibit gratitude 3 13.6
Gratitude waxes and wanes 2 9.0
I became reckless 2 9.0
Life is meaningless 2 9.0
Not as grateful as I should be/Stuck on negatives 2 9.0
Grateful for family and friends 1 4.5
I felt lost 1 4.5
I still feel sad 1 4.5
Resentment toward those who have parents 1 4.5
parent in childhood. This contrasted with the 12.8% of
participants who reported that they had experienced no
resultant change in gratitude and a mere 8.2% who
reported that they believe they are less grateful as a
result of the parental loss. These results lend support
to the counterintuitive idea that a negative experience
such as losing a parent in childhood could lead one to
feel more gratitude or appreciation for life.
The most common explanations provided by
individuals who reported increases in gratitude were
associated with newfound belief that life is precious
and with greater appreciation for loved ones. Both of
these concepts are in agreement with the scarcity
heuristic explanation put forth by King, Hicks, and
Abdelkhalik (2009). The scarcity heuristic suggests that
when individuals are reminded of death in a highly
personal manner, they place a higher value on their
own life. Subjective accounts from individuals who have
faced death and report a newfound appreciation for life
support this theory (Zamora, 2006), as do findings from
study in which individuals who were prompted to
think about their own death in a vivid way via a “death
contemplation exercise” reported higher levels of
gratitude (Frias, Watkins, Webber, & Froh, 2011).
The link between familial loss and gratitude forma-
tion is understudied in the literature. The results of this
study seem to suggest that witnessing first-hand the
death of a parent at a young age could lead one to view
life as a finite commodity, and in turn value one’s own
life more as well as the lives of loved ones. As one
participant reported:
I know and understand very much how short life can be
and how the important people in our lives might only
be here for a short amount of time. I take each day as
an opportunity to do things that are meaningful to
me and try to find ways to connect with the people I
care about.
Although a large majority of participants attributed
an increase in gratitude to the loss, a substantial number
of respondents also reported experiencing either no
change or even a decrease in gratitude. This raises the
important question of why some individuals experience
an increase in their sense of gratitude or appreciation
for life whereas other individuals experience no change
or even a decrease.
The qualitative findings speak to the factors that
inhibited gratitude formation among these participants.
The most common reason given for experiencing no
change or a decrease in gratitude was that the emotional
pain related to the loss inhibited the formation of
gratitude. Many others reported that anxiety, fearful-
ness, difficulty trusting others, resentment, multiple
traumas, and family conflict inhibited gratitude
formation. It seems that for these individuals, the loss
too greatly taxed their personal psychological resources
to allow for benefit-finding.
This study is limited by the nature of the sampling, as
the sample is composed of self-selected volunteers. Self-
selection is apparent in the large number of participants
recruited from the online bereavement organization
Motherless Daughters and the Facebook groups Parent-
less Parents and The Loss of a Mother or Father. The
sample disproportionately represents adults who report
a high degree of adult and childhood traumas and are
actively seeking support through a community of others
who share their experience. Further, generalizability of
the findings is limited due to the lack of heterogeneity
in a sample that was predominantly White, North
American, female, and highly educated.
Given the correlative nature of the design of this
study, questions still remain regarding whether the dis-
positional gratitude experienced by participants as
adults was a personality trait that was present prior to
the loss or whether it was developed through the experi-
ence of the loss. Addressing this question would require
a long-term prospective study to assess gratitude levels
of a large number of children before and after the loss
of a parent and compare these changes in gratitude with
a matched control group and is beyond the scope of this
The retrospective nature of the study design pre-
sented some inherent challenges. Tennen and Affleck
(2009) have raised concerns about assessing posttrau-
matic growth multiple years after a traumatic incident
due to the difficulty that individuals may have in accu-
rately assessing a baseline of functioning prior to the
loss. A number of participants expressed this sentiment
in the open-ended responses, reporting that they were
either too young at the time of loss to remember their
functioning prior or that at the age when they lost a
parent they lacked a clear understanding of gratitude.
We addressed this issue by removing these individuals
from the analysis of perceptions of gratitude. Frazier
et al. (2009) have argued that most individuals have dif-
ficulty assessing their baseline functioning prior to
experiencing a trauma and that PTGI more accurately
measures perceived posttraumatic growth than actual
posttraumatic growth. The researchers decided that
the PTGI-SF was nevertheless an appropriate measure
for this population because the focus of the study is
on both current functioning of adults who lost a parent
in childhood as well as their personal attributions of
posttraumatic growth and changes in gratitude in
relation to the loss.
To further investigate the impact of the passage of
time, we analyzed the relationship between age at the
time of death, years since death, and the study variables.
Age at the time of the death was found to have a small
positive association with posttraumatic growth such
that those who were older when they lost a parent
report higher levels of posttraumatic growth as adults.
It is possible that those participants who were adoles-
cents at the time of the loss had more self-reflective
capacities and were thus more able to make meaning
from the loss than those who were younger at the time
of loss. Age at time of death was not associated with
gratitude, flourishing, or depression.
Small positive associations were found between years
since the death with gratitude and flourishing; small
negative associations were noted between time since
death and posttraumatic growth and depression. In
other words, individuals for whom more time had
passed since the death reported higher gratitude and
psychological well-being, less posttraumatic growth,
and less depression. This may suggest that as time
passes following the loss, emotional recovery from the
loss occurs, individuals acquire additional life
experiences, and they incorporate the loss more
comprehensively into their personal narrative.
The impact of additional traumas in childhood and
adulthood on change in gratitude and current function-
ing was also investigated. Reports of childhood traumas
in addition to parental death were not associated with
change in gratitude, current dispositional gratitude,
flourishing, posttraumatic growth or depression.
Although the degree of trauma that participants had
experienced in adulthood was not found to be related
to dispositional gratitude, reported adult trauma was
found to be related to other aspects of current function-
ing. For instance, a linear relationship was evidenced
between degree of adult trauma and current levels of
depression. Although such a clear linear relationship
was not present between adult trauma and other mea-
sures of functioning, those in the upper extremes of
trauma reported lower posttraumatic growth and
flourishing than those who reported the lowest levels
of adult trauma.
It was somewhat surprising that although the
presence of additional traumas in adulthood was related
to current functioning, those experienced in childhood
were not, especially in light of prior studies that suggests
that cumulative childhood traumas negatively impact
adult physical and psychological health outcomes
(Chapman et al., 2004; Felitti et al., 1998). Perhaps for
the participants who experienced additional traumas
in childhood have had adequate time to adapt to effects
of those traumatic events, whereas those who have
experienced the traumas in adulthood are currently still
dealing with their effects. Further investigation is
Findings from this study contribute to research
demonstrating that gratitude plays a role in promoting
health and well-being in those who experience psycho-
logical trauma. The demonstrated link between grati-
tude and adaptive functioning in adults who have
experienced EPD provide important clinical implica-
tions. Research supports the concept that gratitude
can be fostered (Froh & Bono, 2014; Froh et al., 2008)
and a number of empirically supported strategies geared
toward fostering gratitude have been created (e.g.,
Emmons, 2013). When working with children and
adults who have lost a parent in childhood, it is
important that clinicians consider using gratitude inter-
ventions to facilitate meaning making, promote social
connectedness, and foster healthy adaptation. With
support, people who lost a parent in childhood may
come to feel as one woman in this study reported,
“Losing my mother reminds me daily how precious
life is and that I shouldn’t take a single second for
granted … From darkness I eventually came into the
This article contains data presented in the corresponding
author’s original doctoral dissertation submitted in June
2015 to the Wright Institute Graduate School of Psychology
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... In some orphans, this stressful event may reinforce family values and the desire to form their own family, thus resulting later in a greater likelihood of having a child, less delay in entering parenthood, and larger family size. A positive relationship could stem from a greater appreciation for loved ones and a stronger belief that life is precious, a feeling often shared by adults who have lost a parent in childhood (Greene and McGovern 2017). In addition, orphans who have reached adulthood may demonstrate a better ability to cope with adverse events (Finkelstein 1988), develop a positive image of the missing parent (Miller and Barbara 1971;Cournos 2001), and be more prone to having large families because of their greater appreciation for life (Greene and McGovern 2017). ...
... A positive relationship could stem from a greater appreciation for loved ones and a stronger belief that life is precious, a feeling often shared by adults who have lost a parent in childhood (Greene and McGovern 2017). In addition, orphans who have reached adulthood may demonstrate a better ability to cope with adverse events (Finkelstein 1988), develop a positive image of the missing parent (Miller and Barbara 1971;Cournos 2001), and be more prone to having large families because of their greater appreciation for life (Greene and McGovern 2017). Orphanhood can also trigger a need for creating family links that were not experienced in childhood or for recreating links that were suddenly interrupted by the parent's death (Hetherington 1972). ...
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Death of a parent during childhood has become rare in developed countries but remains an important life course event that may have consequences for family formation. This paper describes the link between parental death before age 18 and fertility outcomes in adulthood. Using the large national 2011 French Family Survey (INSEE-INED), we focus on the 1946-66 birth cohorts, for whom we observe entire fertility histories. The sample includes 11,854 respondents who have lost at least one parent before age 18. We find a strong polarization of fertility behaviours among orphaned males, more pronounced for those coming from a disadvantaged background. More often childless, particularly when parental death occurred in adolescence, some seem to retreat from parenthood. But orphaned men and women who do become parents seem to embrace family life, by beginning childbearing earlier and having more children, especially when the deceased parent is of the same sex.
... Secondly, experiences of loss, whether real or imagined (e.g. losing a relative, reflecting on one's own death), were found to enhance gratitude, increasing people's appreciation of what they still have [23,24]. Such experiences are all too familiar to people with lifethreatening illnesses, who are likely to undergo multiple losses throughout the course of their illness, e.g. of physical functions, independence, sense of identity, and future, and to reflect on their own mortality [25]. ...
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Background Psychological research examining the nature and workings of gratitude has burgeoned over the past two decades. However, few studies have considered gratitude in the palliative care context. Based on an exploratory study which found that gratitude was correlated with better quality of life and less psychological distress in palliative patients, we designed and piloted a gratitude intervention where palliative patients and a carer of their choice wrote and shared a gratitude letter with each other. The aims of this study are to establish the feasibility and acceptability of our gratitude intervention and provide a preliminary assessment of its effects. Methods This pilot intervention study adopted a mixed-methods, concurrent nested, pre-post evaluation design. To assess the intervention’s effects, we employed quantitative questionnaires on quality of life, quality of relationship, psychological distress, and subjective burden, as well as semi-structured interviews. To assess feasibility, we considered patients and carers’ eligibility, participation and attrition rates, reasons for refusal to participate, appropriateness of intervention timeframe, modalities of participation, and barriers and facilitators. Acceptability was assessed through post-intervention satisfaction questionnaires. Results Thirty-nine participants completed the intervention and twenty-nine participated in interviews. We did not find any statistically significant pre/post intervention changes for patients, but found significant decrease in psychological distress for carers in terms of depression (median = 3 at T0, 1.5 at T1, p = .034) and total score (median = 13 at T0, 7.5 at T1, p = .041). Thematic analysis of interviews indicates that overall, the intervention had: (1) multiple positive outcomes for over a third of interviewees, in the form of positive emotional, cognitive, and relational effects; (2) single positive outcomes for nearly half of interviewees, who experienced emotional or cognitive effects; (3) no effect on two patients; and (4) negative emotional effects on two patients. Feasibility and acceptability indicators suggest that the intervention was well received by participants, and that it should adopt flexible modalities (e.g. writing or dictating a gratitude message) to ensure that it is feasible and adapted to individual needs and preferences. Conclusions Larger scale deployment and evaluation of the gratitude intervention, including a control group, is warranted in order to have a more reliable evaluation of its effectiveness in palliative care.
... (P2, female, 25 years old) Factors that promote positive outcomes lie primarily within the individual. These factors include a strong self-concept, bonding with a caregiver and the capacity to think about the experience in a positive manner [39]. ...
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Background: Passing of a close family member is one of the foremost traumatic occasions in a person's life. The way in which this misfortune unfolds, shifts from individual to individual, and depend on how close you were with the deceased. It was unclear on what were the support measures provided to youth after the loss a family member to HIV/AIDS. Aim: The aim of this article is to understand the support measures for the youth following the unexpected loss of a family member to HIV/AIDS. Setting: Khayelitsha, Western Cape province, South Africa. Method: A descriptive phenomenological design was followed, with an accessible population of youth who lost a family member to HIV/AIDS. Individual semi-structured interviews were conducted with 11 purposively selected participants after obtaining written informed consent. The sessions held with an interview schedule, did not take longer than 45 minutes to conduct until data saturation was reached. A digital recorder was used and field notes held. Open coding followed after transcribing interviews. Results: Youths did not know how to manage themselves as a result of a lack of therapeutic sessions, which could provide emotional support and help them with their healing process. Conclusion: Support measures for the next of kin were needed. Grieving influenced the emotions of an individual who experienced the burden of not having someone to speak to about their feelings. Contribution: The context-based information in this study addresses the important of support measures to be provided or implemented for the next of kin after they had lost a family member.
... In fact, using the between-person design, empirical studies have consistently found that trait gratitude can exhibit a positive predictive effect on well-being. First, correlational research has demonstrated that gratitude is substantively associated with HWB (Chopik et al., 2019;Kong et al., 2017;Mccullough et al., 2002;Wood et al., 2007) and EWB (Greene & McGovern, 2017;Mason, 2019;Wood et al., 2009). Second, the longitudinal method has been used to investigate the temporal association between trait gratitude and well-being. ...
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Preceding research has demonstrated the positive relation between gratitude and well-being at the trait level, but less is known about the day-to-day association between them. This study investigated the within-person associations of gratitude with hedonic and eudaimonic well-being using a daily diary design. A sample of 363 young adults (M = 19.77, SD = 1.84) finished an online questionnaire once a day for 14 consecutive days. The results indicated that gratitude was positively related to hedonic and eudaimonic well-being on the same day, and gratitude positively predicted next-day hedonic and eudaimonic well-being, but not vice versa. We also found the reciprocal relation between the cognitive component of daily hedonic well-being (i.e., life satisfaction) and daily gratitude measured by the Gratitude Questionnaire. Moreover, these cross-lagged relations were not moderated by trait gratitude. These results provide supportive and convincing evidence for the positive effect of gratitude at the state level.
... Di Indonesia, hubungan gratitude dengan kesejahteraan psikologis pernah diteliti pada guru honorer dan menunjukkan hasil adanya hubungan antara gratitude dengan kesejahteraan psikologis (Aisyah & Chisol, 2018). Greene & McGovern (2017) menunjukkan bahwa gratitude berkorelasi positif terhadap kesejahteraan psikologis dewasa yang mengalami kematian orang tua di masa kanak-kanak. Penelitian oleh Wijayanti dkk. ...
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Penelitian ini bertujuan mengetahui adanya hubungan antara gratitude dengan kesejahteraan psikologis remaja yang tinggal di panti asuhan. Partisipan pada penelitian ini terdiri dari 100 remaja yang menghuni panti asuhan di Kota Mojokerto, Kabupaten Mojokerto, dan Kota Surabaya. Penelitian menggunakan metode survei. Alat ukur yang digunakan adalah Gratitude Resentment and Apprecitation Test (GRAT) versi short form dan Ryff’s Psychological Well-being Scale yang telah diadaptasi dalam bahasa Indonesia. Analisis data menggunakan uji korelasi Pearson’s product moment dan Spearman’s rank. Hasil analisis menunjukkan bahwa gratitude berkorelasi signifikan dan positif dengan pertumbuhan pribadi (r(100)=0.246, p=0.014), hubungan positif dengan orang lain (r(100)=0.259, p=0.009), tujuan hidup (r(100)=0.205, p=0.041), dan penerimaan diri (r(100)=0.218, p=0.029). Gratitude ditemukan tidak berkorelasi dengan dimensi otonomi dan penguasaan lingkungan dari kesejahteraan psikologis.
... Several previous studies have shown that gratitude has a positive and significant relationship to psychological well-being (Chintya, 2016;Devy & Sugiasih, 2017;Greene & McGovern, 2017;Lee & Lee, 2015;Washizu & Naito, 2015). In addition, research on the same subject showed that gratitude influenced psychological well-being in parents with children with special needs (Nurarini, 2016). ...
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Having a child with an autistic spectrum disorder is a challenge for parents, especially mothers, which can hinder the fulfillment of optimal psychological functions so that the mother’s psychological well-being is disturbed. Internal situations such as gratitude and the presence of external support from the family can be factors that can encourage increased psychological well-being in mothers. This study observed the effects of gratitude and family support on mothers’ psychological well-being with children with an autism spectrum disorder. The instruments in this study used the gratitude scale, the family support scale and Ryff’s Psychological Well-Being Scales-short version distributed online. The subject in this study was 98 people, and the data collected were analyzed using the Doubled Linear Regression test using JASP software. The results showed the significance value of p0.05; thus, gratitude and family support had a role or effect on mothers’ psychological well-being with children with an autism spectrum disorder. Meanwhile, the effective contribution for gratitude was 17.39%, and family support was 21.53%. For future research, gratitude and emotion-based therapies such as emotion regulation training can be used as an intervention in experimental research to improve psychological well-being.
We developed a study to determine perceptions of death education among parents of Spanish schoolchildren aged 3–18 years. We used a qualitative approach, using focus groups and interviews in six state schools. Notable findings were death-related issues are of interest to families, parents recognized the educational potential of teaching death issues, and they called for training in the Pedagogy of Death for both themselves and teachers. In death education, it is important to take families’ views into account, acknowledging their authority and contributions, to improve schools and education for both children and parents.
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Parental loss in childhood is a traumatic event, that has emotional and functional implications throughout human life. The present study focuses on positive psychological changes that may develop following parental loss, based on the theory of post-traumatic growth. The study aimed to examine the links between mental help-seeking, the level of mental resilience, and post-traumatic growth, among adolescents in emerging adulthood (ages 29-18), who experienced parental loss during their time as students in the education system (while aged 18-9). A cross-sectional study involved 173 adolescents, who completed four questionnaires: a demographic questionnaire, which describes the characteristics of loss; The Connor Davidson Resilience Scale; A questionnaire regarding willingness for mental help-seeking; And the Posttraumatic Growth Inventory. The study findings indicate a significant positive correlation between resilience and mental help-seeking and post-traumatic growth, among adolescents who experienced parental loss during school. Mental help-seeking and resilience were found to significantly predict the development of post-traumatic growth after parental loss. The study confirmed the hypothesis that the more years pass from the loss, the more post-traumatic growth appears. However, no differences were found between post-traumatic growth after sudden versus expected parent loss. This study highlights the long-term psychological effects of parental loss on adolescent life in emerging adulthood, as well as the implications for the role of psychologists and educational counselors.
Objectives Veterans are at high risk for health morbidities linked to premature mortality. Recently developed ‘epigenetic clock’ algorithms, which compute intra-individual differences between biological and chronological aging, can help inform prediction of accelerated biological aging and mortality risk. To date, however, scarce research has examined potentially modifiable correlates of GrimAge, a novel epigenetic clock comprised of DNA methylation surrogates of plasma proteins and smoking pack-years associated with various morbidities and time-to-death. The objective of the study was to examine psychosocial correlates of this novel epigenetic clock. Design Cross-sectional study. Setting United States veteran population. Participants Participants were male, European American [EA], and derived from a nationally representative sample of U.S. veterans (N=1,135, mean age=63.3, standard deviation (SD)=13.0) Measurements We examined the prevalence of accelerated GrimAge and its association with a broad range of health, lifestyle, and psychosocial variables. Results A total 18.3% of veterans had accelerated GrimAge (≥5 years greater GrimAge than chronological age; mean=8.4 years acceleration, SD=2.2). Fewer days of weekly physical exercise (relative variance explained [RVE]=27%), history of lifetime substance use disorder (RVE=21%), greater number of lifetime traumas (RVE=19%), lower gratitude (RVE=13%), reduced sleep quality (RVE=7%), lower openness to experience (RVE=7%), and unmarried/partnered status (RVE=6%) were independently associated with increased odds of accelerated GrimAge. Increasing numbers of these risk factors were associated with greater odds of accelerated GrimAge, with greatest likelihood of acceleration for veterans with ≥3 risk factors (weighted 21.5%). Conclusions These results suggest that nearly 1-of-5 EA male U.S. veterans have accelerated GrimAge, and highlight a broad range of health, lifestyle, and psychosocial variables associated with accelerated GrimAge. Given that many of these factors are modifiable, these findings provide promising leads for risk stratification models of accelerated biological aging and precision medicine-based targets for interventions to mitigate risk for premature mortality in this population.
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HIV/AIDS-related deaths often result in emotional turmoil in youths and added responsibilities by their parents, such as taking care of siblings. Youths may respond in various manners, such as increased alcohol use, and relationships with their siblings may be positively or negatively affected. There is also a high incidence of depression in people who are distressed, making them less likely to engage in active self- management strategies such as exercise. Youths visit public hospitals for various reasons, including panic attacks and anxiety, which are often experienced after the passing of a family member. The researcher has observed an increase in youths visiting a Comprehensive Primary Healthcare clinic in Cape Town after being traumatized due to the passing of a family member. The purpose of this study was to develop guidelines for nurses at a Comprehensive Primary Healthcare clinic in Cape Town, with which to advise youths on self- management following the loss of a family member with HIV/AIDS. A descriptive phenomenological design was followed for a study at Khayelitsha Site B Comprehensive Primary Healthcare in the Western Cape Province of South Africa. The sample was selected through purposive sampling until data saturation was achieved. Individual semi-structured interviews with 11 participants were conducted, after which data saturation was established. An interview schedule and field notes were used during the interviews, which were conducted in a private room with youth aged between 18 and 25 years who visited a Comprehensive Primary Healthcare clinic in Cape Town after the lost a family member to HIV/AIDS. Interpretative phenomenological analysis was conducted and findings indicated that time related circumstances define behaviour with which to manage death. Someone who unexpectedly loses a family member goes through specific stages of grief, ranging from emotions such as denial to acceptance. This grieving person also has to deal with difficult changes in daily lives and therefore need support measures. In the process of taking ownership of their new role of supporting others (who were previously supported by the departed person), they sometimes give up their own dreams. Sad experiences blocked out memories of good times with the deceased and participants focused mainly on obtaining support systems to move forward. iv The findings of the study could benefit the broader community of nurses and provide self-management guidelines for youths visiting a Comprehensive Primary Healthcare clinic in Cape Town after losing a family member to HIV/AIDS. KEY WORDS: HIV/AIDS, family, outpatient, youths, Comprehensive Primary Healthcare (CHC)
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.
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.
This article describes the concept of posttraumatic growth, its conceptual foundations, and supporting empirical evidence. Posttraumatic growth is the experience of positive change that occurs as a result of the struggle with highly challenging life crises. It is manifested in a variety of ways, including an increased appreciation for life in general, more meaningful interpersonal relationships, an increased sense of personal strength, changed priorities, and a richer existential and spiritual life. Although the term is new, the idea that great good can come from great suffering is ancient. We propose a model for understanding the process of posttraumatic growth in which individual characteristics, support and disclosure, and more centrally, significant cognitive processing involving cognitive structures threatened or nullified by the traumatic events, play an important role. It is also suggested that posttraumatic growth mutually interacts with life wisdom and the development of the life narrative, and that it is an on-going process, not a static outcome.
This chapter examines how the conscious practice of gratitude can help transform individuals' emotional lives. It evaluates previous research that indicates that gratitude has a causal influence on mood, especially positive mood. It stresses the need for a critical examination of research on gratitude and well-being and argues that the cultivation of grateful emotions might be efficacious in the treatment and prevention of depressed affect.
Existing literature suggests that the children of ill parents are susceptible to anxiety and depression. However, some may respond to threatening circumstances such as chronic illness or grief with positive emotions and finding benefits, including appreciation of life and greater emotional strength. We explored the college-age child response to parental illness by examining the relationship of dispositional gratitude, family variables, and characteristics of parental illness to college-age child depression and anxiety. College students completed self-report measures examining dispositional gratitude, family quality of life, depression, and anxiety. In comparison to the healthy parent group, the ill parent group experienced lower family quality of life. There were no significant between group differences in depression or anxiety levels. Dispositional gratitude moderated the relationship between parental health status and college-age child anxiety and depression. This suggests that dispositional gratitude may have served as a buffer against internalizing symptoms within the college-age children of ill parents.
• We examine the relationship between parental loss prior to age 17 years and adult psychopathology in 1018 pairs of female twins from a population-based registry. The relationship between loss and adult psychopathology varied as a function of the kind of loss (death vs separation), the parent involved, and the form of psychopathology. Increased risk for major depression and generalized anxiety disorder was associated with parental separation but not parental death and with separation from either mother or father. Panic disorder was associated with parental death and maternal, but not paternal, separation. Increased risk for phobia was associated with parental death and not parental separation. Risk for eating disorder was unrelated to the experience of parental loss. A model that includes parental loss as a form of "specified" family environment shows that, if it is truly an environmental risk factor for adult psychopatholgic conditions, it can account for between 1.5% and 5.1% of the total variance in liability to these disorders and is responsible for between 7.0% and 20.5% of the tendency for these disorders to aggregate in siblings.