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Gratitude When It Is Needed Most: Social Functions of Gratitude in
Women With Metastatic Breast Cancer
Sara B. Algoe
University of North Carolina at Chapel Hill Annette L. Stanton
University of California, Los Angeles
Theory and evidence suggest that everyday positive emotions may be potent factors in resilience during
periods of chronic stress, yet the body of evidence is scant. Even less research focuses on the adaptive
functions of specific positive emotions in this critical context. In the current research, 54 women with
metastatic breast cancer provided information about their emotional responses to benefits received to test
hypotheses regarding the social functions of gratitude. One set of analyses provide support for the
hypothesized role of ego-transcendence in feeling gratitude upon receipt of a benefit from another
person. As predicted, in a second set of analyses, grateful responding to received benefits predicted an
increase in perceived social support over three months only for women low in ambivalence over
emotional expression. These findings add to evidence regarding the social causes and consequences of
gratitude, supporting a view of gratitude as an other-focused positive emotion that functions to promote
high-quality relationships. Discussion focuses on the chronically stressful context as an important testing
ground for theory on gratitude and other positive emotions.
Keywords: gratitude, emotional expression, chronic stress, social support, positive emotions
Supplemental materials: http://dx.doi.org/10.1037/a0024024.supp
The past decade has seen an increase in research on positive
emotions in general, and recent years have brought a shift toward
the study of individual positive emotions. One critical testing
ground for theory regarding positive emotional experience and
functions is the context of chronic stress (see Algoe & Fredrickson,
2011). Arguably, all individuals go through phases of chronic
stress in a lifetime, including experiences ranging from new par-
enthood to the profound stress of life-limiting illness. The few
studies to assess effects of positive emotions during chronic stress
show that they are a potent predictor of resilient outcomes, even
beyond the negative emotions experienced during these times (e.g.,
Fredrickson, Tugade, Waugh, & Larkin, 2003; Moskowitz, 2003).
Even so, we know of little research on specific positive emotions
to address whether basic theories hold up when the chips are down.
The purpose of the present study was to examine the emotion of
gratitude in women diagnosed with metastatic breast cancer. A
diagnosis of metastasis means the cancer has spread from the
breast to other parts of the body; just 23% of women diagnosed
with metastatic breast cancer are expected to live for at least five
years (American Cancer Society, 2010). Such an unremitting stres-
sor is profound, prompting confrontation of mortality, introducing
challenges of treatment regimens, and influencing interpersonal
relationships. It is precisely in this context that specific positive
emotions and emotion-related dispositions can reveal their adap-
tive significance. The current investigation focuses on the social
functions of gratitude.
There is wide agreement among emotions scholars that gratitude
arises from an interpersonal context: a benefactor provides a
benefit to a recipient. However, not just any apparent “benefit”
will do (e.g., Algoe, Haidt, & Gable, 2008; Tesser, Gatewood, &
Driver, 1968; Tsang, 2006b). A social evolutionary account of
gratitude (Algoe et al., 2008) integrates prior work on gratitude
with recent theory and evidence on positive emotions (Fredrick-
son, Cohn, Coffey, Pek, & Finkel, 2008) and interpersonal rela-
tionships (Reis, Clark, & Holmes, 2004) to propose that the spe-
cific and immediate function of gratitude is to find, remind, and
bind individuals to personally attentive conspecifics in the envi-
ronment. This is because the emotion of gratitude is reserved for
special occasions: when someone from within one’s sea of social
contacts has demonstrated responsiveness to the needs and pref-
erences of the recipient in the provision of a benefit. Perceived
responsiveness involves feeling understood, validated, or cared for
and the felt gratitude draws attention to responsive individuals,
who would make high-quality interaction partners. As a positive
emotion, gratitude opens one’s eyes to the good qualities of the
interaction partner (Algoe & Haidt, 2009; i.e., finds or reminds)
and intrinsically motivates a variety of prosocial behaviors back
toward the benefactor (Bartlett & DeSteno, 2006; DeSteno et al.,
This article was published Online First June 27, 2011.
Sara B. Algoe, Department of Psychology, University of North Carolina
at Chapel Hill; Annette L. Stanton, Department of Psychology, University
of California, Los Angeles.
This work was supported by a National Institute of Mental Health
(NIMH) Postdoctoral Fellowship in Biobehavioral Issues in Physical and
Mental Health (T32 MH15750) to the first author, as well as by the
California Breast Cancer Research Program of the University of California,
Grant Number 10IB-0079 and the UCLA Jonsson Comprehensive Cancer
Center to the second author. We are grateful to Lahnna Catalino for
comments on a draft of this manuscript.
Correspondence concerning this article should be addressed to Sara B.
Algoe, University of North Carolina, Chapel Hill, Department of Psychol-
ogy, CB #3270 Davie Hall, Chapel Hill, NC 27599. E-mail:
algoe@unc.edu
Emotion © 2011 American Psychological Association
2012, Vol. 12, No. 1, 163–168 1528-3542/11/$12.00 DOI: 10.1037/a0024024
163
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