Gratitude and health: An updated review

How to improve reward sensitivity - Predictors of long-term effects of a randomized controlled online intervention trial

BACKGROUND

Reward sensitivity is a central maintaining factor of depression. Current treatments fail at sufficiently and reliably modifying reward processing. Therefore, we employed interventions targeting reward sensitivity and evaluated the long-term efficacy of different online interventions, additionally exploring predictors of changes in reward sensitivity.

METHODS

This four-arm randomized controlled trial (RCT) tested the long-term stability of treatment effects during a four-month follow-up in 127 participants of a two-week online intervention (behavioral activation vs. mindfulness and gratitude vs. combination of both). In addition, we investigated predictors of treatment success defined as improvement in reward sensitivity. Predictors we investigated were depressive expectations, stress and the type of reward implemented in the exercises of the intervention (physical activities and social encounters).

RESULTS

The improvement concerning reward sensitivity, as well as the reduction of anhedonia and depressive symptoms was stable over a four-month follow-up. We did not find evidence for differences between the active intervention groups. Positive changes in depressive expectations were a significant predictor of long-term improvements in reward sensitivity.

LIMITATIONS

Only self-report measures were used and the interpretation of the long-term efficacy of the online interventions is limited since the waitlist control condition was not extended to the follow-up.

CONCLUSIONS

Clinicians should focus on violating depressive expectations to facilitate updating the prediction and anticipation of future rewarding experiences. This could be a vital mechanism of change in reward sensitivity. However, future research still needs to unravel what kind of interventions are most effective in targeting reward insensitivity.

Feelings of gratitude to Allah and people and their associations with affect in daily life

Gratitude has been studied in the context of human social relationships primarily, but relatively less is known about gratitude in relation to a deity. We extended this research by studying gratitude among Muslim American adolescents, an understudied population, by comparing feelings of gratitude to Allah with feelings of gratitude to people in their associations with affect in daily life. Muslim adolescents (N = 202) participated in an Ecological Momentary Assessment study by completing up to three momentary reports each day during three separate weeks. Within-person results showed that both forms of gratitude were positively associated with concurrent happiness and calmness and were negatively associated with concurrent anxiety and sadness, though gratitude to people was a stronger predictor of happiness than gratitude to Allah. Most of the associations between gratitude to people and affect were stronger when youth felt less grateful to Allah, thus supporting a compensation model in which one form of gratitude offsets lower levels in the other. Lagged associations indicated that gratitude to people more consistently predicted greater subsequent feelings of happiness and calmness, whereas happiness and calmness consistently predicted greater subsequent feelings of gratitude to Allah. Results have implications for how distinct forms of gratitude may differentially influence affect.

Gratitude and Mortality Among Older US Female Nurses

Importance

Supporting healthy aging is a US public health priority, and gratitude is a potentially modifiable psychological factor that may enhance health and well-being in older adults. However, the association between gratitude and mortality has not been studied.

Objective

To examine the association of gratitude with all-cause and cause-specific mortality in later life.

Design, Setting, and Participants

This population-based prospective cohort study used data from self-reported questionnaires and medical records of 49 275 US older female registered nurses who participated in the Nurses' Health Study (2016 questionnaire wave to December 2019). Cox proportional hazards regression models estimated the hazard ratio (HR) of deaths by self-reported levels of gratitude at baseline. These models adjusted for baseline sociodemographic characteristics, social participation, physical health, lifestyle factors, cognitive function, and mental health. Data analysis was conducted from December 2022 to April 2024.

Exposure

Gratitude was assessed with the 6-item Gratitude Questionnaire, a validated and widely used measure of one's tendency to experience grateful affect.

Main Outcomes and Measures

Deaths were identified from the National Death Index, state statistics records, reports by next of kin, and the postal system. Causes of death were ascertained by physicians through reviewing death certificates and medical records.

Results

Among the 49 275 participants (all female; mean [SD] age at baseline, 79 [6.16] years), 4608 incident deaths were identified over 151 496 person-years of follow-up. Greater gratitude at baseline was associated with a lower hazard of mortality in a monotonic fashion. For instance, the highest tertile of gratitude, compared with the lowest tertile, was associated with a lower hazard of all-cause deaths (HR, 0.91; 95% CI, 0.84-0.99) after adjusting for baseline sociodemographic characteristics, social participation, religious involvement, physical health, lifestyle factors, cognitive function, and mental health. When considering cause-specific deaths, death from cardiovascular disease was inversely associated with gratitude (HR, 0.85; 95% CI, 0.73-0.995).

Conclusions and Relevance

This study provides the first empirical evidence suggesting that experiencing grateful affect is associated with increased longevity among older adults. The findings will need to be replicated in future studies with more representative samples.

Translation and Validation of Iranian Version of the Gratitude at Work Scale (GAWS)

Gratitude in the workplace can enhance work achievements and promote individual well-being in organizational contexts. Although the Gratitude at Work Scale (GAWS) was developed in the USA, it has not been corroborated in the Persian culture. The purpose of this study was to validate the Persian version of the Gratitude at Work Scale (GAWS). Scale validation procedures included linguistic validation and face and content validity assessment by experts and analysis. There was a correlation of approximately 0.592 between two subscales of GAWS-MW and GAWS-SWE, indicating a moderate level of association. Scale validity analysis demonstrated a positive correlation between GAWS and measures gratitude (GQ6), gratitude toward God, subjective happiness and satisfaction with life scales. The Gratitude at Work Scale exhibited good psychometric properties in assessing the sense of gratitude at work in our population. This may contribute to improving overall individual and organizational performance.

Extrinsic goals benefit capitalism but not well-being. Rethinking the economy's goal for a healthier future

The dramatic rise in non-communicable diseases around the world but notably in high-income countries like the UK is a manifestation of a global economic system-capitalism-that prioritizes wealth over health. A decade ago, the former WHO Director-General, Margaret Chan highlighted how 'efforts to prevent non-communicable diseases go against the business interests of powerful economic operators' [United Nations. (2013) Take Action for the Sustainable Development Goals. https://www.un.org/sustainabledevelopment/sustainable-development-goals/ (last accessed 16 February 2024)]. While there is a growing literature on how politics and economics influence population health-for better or worse-less attention has been given to exploring how economic systems like capitalism influence people's psychological well-being. To fill this gap, the following article examines how the continued pursuit of economic growth under capitalism (neoliberal free-market forms especially) impacts well-being through challenging basic psychological needs for security, autonomy, competence and relatedness. In doing so, I hope to shed important light on the sources and possible solutions to our growing health and social problems, and stimulate a conversation on how to achieve a healthier future for us all.

My experience of person-centered and personalized care in early-stage primary progressive aphasia

Primary progressive aphasia (PPA) is a neurodegenerative brain disorder characterized by declining language ability. It is a rare, often young-onset dementia with a devastating impact on the work and personal activities of those affected. At present there is no cure or disease-modifying therapy for PPA nor any way to arrest or slow the underlying progressive brain degeneration. Throughout the course of the condition any treatment must therefore be palliative-designed to manage symptoms and improve the quality of life of the affected person. The majority of those affected receive little or no follow-up care after diagnosis, particularly in the early stage of the disease. There is very little information in the medical literature about person-centered care designed to improve the quality of life of people with PPA written from the perspective of those living with this condition. I received an early and accurate clinical diagnosis of the nonfluent/agrammatic variant of PPA, supported by imaging. I am fortunate to have benefited from exemplary individualized care from a multidisciplinary medical team from the onset of my difficulties with language. In this paper, I discuss my lived experience of all aspects of this personalized and person-centered care, describing how it was founded on shared decision-making and a holistic, dementia-inclusive approach encompassing the physical, mental, emotional, psychosocial and spiritual dimensions of living with an incurable neurodegenerative disease.

Profiles of well-being and their associations with self-forgiveness, forgiveness of others, and gratitude among patients with rheumatic and musculoskeletal diseases

OBJECTIVES

Patients with rheumatic and musculoskeletal diseases (RMDs) often experience poor well-being. Common limitations of the studies on this topic involve using variable-centred and deficit-based approaches. In this study, we used the person-centred approach to identify profiles of positive (life satisfaction and health status) and negative (depression, anxiety, fatigue, and stress) indicators of well-being among patients with RMDs. Moreover, we tested self-forgiveness, forgiveness of others, gratitude, and sociodemographics as contributors to latent profile membership.

DESIGN

A cross-sectional questionnaire survey.

METHODS

Using a latent profile analysis, we investigated well-being profiles among 892 patients with RMDs (759 patients with arthritis and 133 with fibromyalgia [FM]) and examined the correlates of latent profile membership.

RESULTS

We identified four profiles of well-being: (1) 'life dissatisfaction' (9.2%), (2) 'high well-being' (43.4%), (3) 'suboptimal well-being' (35.2%), and (4) 'very poor well-being' (12.2%). Members of Profile 2 had higher levels of self-forgiveness and gratitude than members of the remaining profiles, had higher levels of forgiveness of others than Profile 3, and were older than members of Profile 4. Moreover, members of Profile 2 had a higher proportion of patients with arthritis relative to those with FM than all other profiles and men to women than Profile 4.

CONCLUSIONS

Patients with RMDs are heterogeneous in terms of well-being. Self-forgiveness, gratitude, and forgiveness of others may serve as psychological capital that enhances patients' well-being. Special attention should be paid to patients with FM, women, and younger patients since they can be especially susceptible to poor well-being.

Stress and hope distinguish individuals with suicidal plan from suicide ideators among Chinese college students

Background

Suicide among college students is a significant public health concern in China. While suicidal ideation serves as a crucial predictor of subsequent suicidal plans and behaviors, it is important to recognize that most instances of suicidal ideation may only be fleeting thoughts that do not progress to an actual plan. Therefore, it is imperative to identify the factors associated with the transition from suicidal ideation to a concrete plan. Consequently, this study aims to investigate whether certain frequently cited factors can differentiate individuals who have formulated a specific suicidal plan from those who have experienced suicidal thoughts without planning, based on data obtained through a cross-sectional survey.

Materials and methods

This survey was conducted as part of routine mental health assessments among second-year college students in October 2023. Data from a total of 4,858 second-year college students were utilized for the final analyses. Two survey questions were employed to identify past-year suicidal ideation and past-year suicidal plan. All participants were required to complete various assessments, including the Chinese version of Depression Anxiety Stress Scale 21 items (DASS-21), the Chinese version of Gratitude Questionnaire-six items (GQ-6), the Chinese version of Meaning in Life Questionnaire (MLQ), and the Chinese version of State Hope Scale (SHS).

Results

Among 4,858 participants, a total of 134 individuals (2.8%) were confirmed to have experienced past-year suicidal ideation. Out of these, 53 (1.1% overall) reported having a past-year suicidal plan, accounting for approximately 39.6% of those with suicidal ideation. Logistic regression analyses revealed that while most potential variables differentiated between students with and without suicidal ideation, only two factors stood out in distinguishing individuals with a suicidal plan from those who had not made such plans despite experiencing suicidal thoughts-presence of stress (OR=2.49, 95% CI: 1.04-5.96) and lower scores of hope agency (OR=0.84, 95% CI: 0.72-0.98).

Conclusion

These findings suggest that the stress may contribute to susceptibility for transitioning from mere thoughts to actual planning regarding suicide; conversely, hope agency appears to offer protection against this transition process. Therefore, we advocate for targeted interventions aimed at fostering hope among individuals who have encountered adverse and stressful life events.

Developing the WE BEAT Well-Being Education Programme to foster resilience and build connection in paediatric heart disease

BACKGROUND

The study of psychological well-being and related resilient outcomes is of increasing focus in cardiovascular research. Despite the critical importance of psychological well-being and related resilient outcomes in promoting optimal cardiac health, there have been very few psychological interventions directed towards children with heart disease. This paper describes the development and theoretical framework of the WE BEAT Wellbeing Education Program, a group-based psychoeducation and coping skills training intervention designed to improve psychological well-being and resilience in adolescents with paediatric heart disease.

METHODS

Program development was informed by patient and family needs and input gathered via large, international survey methods as well as qualitative investigation, a theoretical framework, and related resilience intervention research.

RESULTS

An overview of the WE BEAT intervention components and structure of the programme is provided.

CONCLUSIONS

The WE BEAT Wellbeing Education Program was developed as one of the first resiliency-focused interventions in paediatric heart disease with an overall objective to foster positive psychological well-being and resilient outcomes through a health promotion and prevention lens in an accessible format while providing access to safe, peer-to-peer community building. Feasibility pilot results are forthcoming. Future directions include mobile app-based delivery and larger-scale efficacy and implementation trials.

Emphatic Memories and Their Meaning in Societal and Legal Contexts: A Narrative Review and Position Paper

BACKGROUND

Many past and ongoing conflicts in the world are associated with memories. The role of emphatic memories is however often neglected in conflict solving. Therefore, this narrative review gives a short introduction to the phenomenon of emphatic memories and implications for counteracting dysfunctional effects of emphatic memories.

SUMMARY

Memory has two connotations. One is remembering and knowing (I can remember when I got married) and on the other is reminding and emphasizing memories (I remind my partner of our wedding day). Memories are less a report on the past but result of current emotions and motives. Emphatic memories serve for self-portrayal and distinction from others, self-exculpation, accusation of others, justification of claims. They are regularly reproachful, have an aggressive character, and are distorted and pseudologic. This is also true on a societal level, as memories are used for defining social groups, and by this for political purposes, in order to juxtapose one group against the other. If memories are revoked, they are regularly accompanied with the very emotions, which were associated with the past event. Corresponding behavior is motivated. Many people suffer from memories and associated emotions and dysfunctional behavior, as is well described in the context of post-traumatic stress disorders. Also, social groups can as a whole suffer from negative emotions because of memories, which may go back up to thousand years. To ensure that memories do not adversely affect individuals and social groups, they should best be forgotten, or at least rescripted, in a way that they are disentangled from negative emotions and motives. An important psychological process in this regard is wisdom and forgiveness, which must not be confused with understanding, justification, tolerating, or reconciliation. Wisdom and forgiveness allow persons to close the books, act self-determined, find freedom from external events, and end suffering because of the past. It is a rational and emotional act.

KEY MESSAGES

Emphatic memories can cause that individuals and groups do not find peace and persistently provoke new conflicts. Internal and interactional peace can be found if memories are let alone and fade away. Forgiveness and wisdom describe avenues to let dysfunctional memories go.

Counteract Anhedonia! Introducing an Online-Training to Enhance Reward Experiencing - A Pilot Study

Background

Anhedonia is a risk factor for a severe course of depression but is often not adequately addressed in psychotherapy. This study presents the Training to Enhance Reward Experience (T-REx), a novel self-help approach that uses savoring and mental imagery to target impairments in reward experience associated with anhedonia. We aimed to examine feasibility and acceptability of T-REx and exploratively investigated its effects on anhedonia and other clinical variables.

Method

In an online, randomized controlled trial, 79 subjects participated for five days in T-REx or the active control condition Gratitude Writing (GW). We assessed changes in anhedonia, depression, and active behavior at inclusion, after the waiting period, post-intervention and at follow-up. The intervention effects were examined for the full sample and an anhedonic sub-sample.

Results

T-REx and GW were equally feasible and clearly accepted by the sample. Both interventions significantly reduced depressive symptoms and increased behavioral activation. Although there was no significant main effect of the interventions, between-group differences were observed for depressive symptoms and active behavior at post-intervention and follow-up, favoring T-REx. Further, within-group changes for T-REx were larger than for GW. The observed effects had a greater magnitude in the anhedonic sub-sample, suggesting that individuals with more pronounced anhedonic symptoms derived greater benefit from the interventions.

Discussion

This first study of T-REx provides promising results that should prompt further investigations of T-REx in clinical samples. The results suggest that T-REx has a positive effect on depression symptoms and active behavior. Further, its potential as a valuable adjunct to behavioral activation interventions is discussed.

Gratitude predicts prosocial tendency through psychological resilience-cross-sectional study in Arab cultures

This study aimed to investigate the relationship between gratitude and prosocial tendency and the potential mediating role of psychological resilience in this association. Six hundred and seventy-six Saudi Arabia and Egyptian students completed the Gratitude Scale, Prosocial tendency Scale and Psychological Resilience Scale. The results showed no significant differences in gratitude, prosocial tendency and psychological resilience according to culture or gender in both countries. Moreover, gratitude positively correlated with prosocial tendency and psychological resilience. Furthermore, the results revealed that psychological resilience significantly mediated the association between gratitude and prosocial tendency. We conclude that gratitude predicts prosocial tendency and psychological resilience plays a mediating role in this association among Arab societies.

Understanding and optimising gratitude interventions: the right methods for the right people at the right time

OBJECTIVE

Gratitude has consistently been associated with various beneficial health-related outcomes, including subjective wellbeing, positive mental health, and positive physical health. In light of such effects, positive psychology researchers and practitioners have often implemented gratitude interventions in an attempt to build individuals' orientations toward appreciation and thankfulness. Recent meta-analyses and reviews have revealed, however, that these interventions often have mixed effects on gratitude or other health outcomes. With this issue in mind, we aimed to identify (a) contextual considerations that may impact the effectiveness of these approaches, and (b) recommendations for the optimisation of gratitude interventions.

METHODS AND MEASURES

Seventeen mental health professionals or experienced health psychology researchers engaged in semi-structured interviews to address the research questions.

RESULTS

Thematic analysis of the data resulted in three contextual themes-cultural considerations, personal characteristics, and life experience-that were discussed as factors likely to influence intervention effectiveness. With respect to recommendations, participants highlighted the importance of encouraging deep engagement in gratitude tasks, consistent repetition of those tasks, and the value of interpersonal expressions of gratitude.

CONCLUSION

Discussion is centred on suggestions for future research on gratitude and on implications for the implementation of gratitude interventions.

The relationships between work-family conflict and life satisfaction and happiness among nurses: a moderated mediation model of gratitude and self-compassion

Background

Researchers and practitioners are concerned with the impact of work-family conflict on the well-being of workers, including those in the health care sector, and previous research suggested that nurses were experiencing a range of negative outcomes.

Aim

To investigate the potentially mediating role of self-compassion and moderating role of gratitude in the relationships between work-family conflict and both life satisfaction and happiness among Saudi nurses.

Method

A cross-sectional survey was conducted with 368 nurses (men age = 35.18, SD = 6.67, 70.65% of females). Nurses were recruited via social media using convenience sampling techniques. They completed the Satisfaction with Life Scale, the Subjective Happiness Scale, the Gratitude Questionnaire-6, the Self-Compassion Scale, and the Work-Family Conflict Scale, as well as a set of demographic questions. The data were analyzed using PROCESS MACRO model 4 and 8, and the reporting followed STROBE checklist.

Results

As expected, the study found a negative relationship between work-family conflict and both life satisfaction and happiness. These relationships were mediated by self-compassion. For the relationships between work-family conflict and life satisfaction and happiness, and between family-work conflict and happiness, this mediation was moderated by gratitude.

Conclusion

This study built on positive psychology and demonstrated that the positive personality traits of self-compassion and gratitude can engender enhanced life satisfaction and happiness among Saudi nurses.

Effectiveness of behavioral activation and mindfulness in increasing reward sensitivity and reducing depressive symptoms - A randomized controlled trial

Reward insensitivity is a potential key mechanism regarding the maintenance of depression. However, there is a lack of research examining and comparing the effectiveness of different psychological interventions in modifying reward insensitivity. This four-arm randomized controlled trial (RCT) investigated a two-week online intervention. After screening for eligibility, a total of 336 participants were randomized, and 224 participated per-protocol. Participants were assigned to either a) behavioral activation, b) mindfulness and gratitude, c) a combination of both, or d) a waitlist control condition. They received videos and implemented daily exercises. Reward sensitivity and depressive symptoms served as primary outcomes. Behavioral activation and mindfulness significantly improved depressive symptoms and reward sensitivity. However, the effects of behavioral activation were not superior. The combination treatment versus the waiting group was insignificant regarding reward insensitivity. Explorative analyses revealed that all intervention groups reduced anhedonia substantially. Our findings imply that brief online interventions with behavioral activation and mindfulness-based approaches can impact reward insensitivity, while effects for a combination were less clear. Nonetheless, our results do not allow us to infer the differential effectiveness of the interventions. There is a clear need for treatments better targeting maintaining factors of depression, such as reward insensitivity. Clinical trial registration number: NCT05402150.

Mindful gratitude journaling: psychological distress, quality of life and suffering in advanced cancer: a randomised controlled trial

CONTEXT

Numerous studies have shown that gratitude can reduce stress and improve quality of life.

OBJECTIVE

Our study aimed to examine the effect of mindful gratitude journaling on suffering, psychological distress and quality of life of patients with advanced cancer.

METHODS

We conducted a parallel-group, blinded, randomised controlled trial at the University of Malaya Medical Centre, Malaysia. Ninety-two adult patients with advanced cancer, and an overall suffering score ≥4/10 based on the Suffering Pictogram were recruited and randomly assigned to either a mindful gratitude journaling group (N=49) or a routine journaling group (N=43).

RESULTS

After 1 week, there were significant reductions in the overall suffering score from the baseline in both the intervention group (mean difference in overall suffering score=-2.0, 95% CI=-2.7 to -1.4, t=-6.125, p=0.000) and the control group (mean difference in overall suffering score=-1.6, 95% CI=-2.3 to -0.8, t=-4.106, p=0.037). There were also significant improvements in the total Hospital Anxiety and Depression Scale score (mean difference=-3.4, 95% CI=-5.3 to -1.5, t=-3.525, p=0.000) and the total Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being score (mean difference=7.3, 95% CI=1.5 to 13.1, t=2.460, p=0.014) in the intervention group after 7 days, but not in the control group.

CONCLUSION

The results provide evidence that 7 days of mindful gratitude journaling could positively affect the state of suffering, psychological distress and quality of life of patients with advanced cancer.

TRIAL REGISTRATION NUMBER

The trial was registered with the Australian and New Zealand Clinical Trials Registry (ACTRN1261800172191) and conducted in accordance with the Declaration of Helsinki.

Emotional and relational protective factors during pregnancy and psychological well-being and personal growth after childbirth

BACKGROUND

Studies in the perinatal literature tend to focus on potential negative outcomes, but little attention has been paid to the protective factors that may be associated with better psychological well-being or positive mental changes, such as personal growth.

OBJECTIVE

Drawing on the Broaden and Build Theory of Positive Emotions, the study employed a prospective design and a sequential mediation model to examine the mechanism by which protective factors during pregnancy (dispositional gratitude, perceived relationship quality with the partner, perceived maternal-foetal bonding) may be associated, in sequence, with higher psychological well-being and personal growth after childbirth among first-time mothers.

METHODS

The sample consisted of 515 women who were recruited through social media and completed questionnaires in two phases: Time 1, during the second half of their pregnancy; and Time 2, around 12 weeks after the birth of their first baby.

RESULTS

Results show that gratitude was associated with higher perceived relationship quality during pregnancy, which was associated with higher maternal-foetal bonding, which in turn was associated with higher psychological well-being and personal growth after childbirth. The indirect effects were significant.

CONCLUSION

The study expands knowledge of positive outcomes in the transition to motherhood, and demonstrates that positive emotions, such as gratitude, may be the first link in the chain of factors predicting better outcomes from pregnancy to childbirth.

The perks of being grateful to partners: Expressing gratitude in relationships predicts relational self-efficacy and life satisfaction during the COVID-19 pandemic

Being grateful to one's partner matters for a diverse range of interpersonal and individual well-being outcomes. However, there is little investigation on the psychological benefits of expressing gratitude to partners during the coronavirus 2019 (COVID-19) pandemic. Using a short-term longitudinal design, this study of undergraduate students (Mage  = 20.31; SDage  = 1.81; n = 268) in the United States explores the link between expressing gratitude in romantic relationships, subsequent relationship self-efficacy, life satisfaction, psychological well-being, and the COVID-19 anxiety. Results demonstrated that expressing gratitude in relationships positively predicted subsequent relationship self-efficacy and life satisfaction even after controlling for age, gender, ethnic background, trait gratitude, and auto-regressor effects. These findings show that relational gratitude had incremental validity in predicting relational self-efficacy and subjective well-being above and beyond the effects of demographic factors and dispositional gratitude. This research emphasizes the psychological payoffs of cultivating gratitude in relational contexts.

Heart rate reactivity mediates the relationship between trait gratitude and acute myocardial infarction

OBJECTIVE

This study examines the relationship between trait gratitude and acute myocardial infarction. A burgeoning body of literature suggests that gratitude can play a role in regulating individual's cardiovascular responses to stress which in turn, may reduce the incidence of cardiovascular disease such as acute myocardial infarction. However, to date no research has examined these effects.

METHOD

This study used the Mid-Life in the United States dataset (MIDUS; N = 1031) to assess these relationships. Participants completed a standardised cardiovascular stress-testing laboratory protocol and were assessed at a second time-point; on average 6.7 years later.

RESULTS

Results from logistic parallel mediation models suggest that trait gratitude was found to be significantly associated with reduced risk of acute myocardial infarction through the mechanism of increased heart rate reactivity, β = -0.098, 95%CI [- 0.331, - 0.010]. However, neither systolic nor diastolic blood pressure reactivity mediated this relationship.

CONCLUSIONS

These findings suggest that gratitude may be associated with certain aspects of physical health. Specifically, our study reveals a potential link between gratitude and cardiovascular reactivity, which could be a mechanism through which trait gratitude contributes to reductions in the risk of myocardial infarction. As such, this study highlights the potential utility of positive psychological factors, such as gratitude, in promoting cardiovascular health.

State of Mental Health, Healthy Behaviors, and Wellness Support in Big 10 University Nursing and Health Sciences Faculty, Staff, and Students During COVID-19

BACKGROUND

Federal and national entities urge organizations to assess healthcare professionals' mental health and well-being as the COVID-19 pandemic has compounded the issue.

AIMS

This study aimed to (1) describe rates of mental health issues, healthy lifestyle behaviors, and perceptions of COVID-19's impact among Big 10 University nursing and health sciences faculty, staff, and students; (2) identify predictors of depression, anxiety, stress, and burnout; and (3) assess the relationships among perceived school wellness support, healthy lifestyle behaviors, physical/mental health, and mattering.

METHODS

A cross-sectional descriptive correlational design was used. Nursing and health science deans emailed invitations to faculty, staff, and students concerning an anonymous wellness assessment survey. Correlation coefficients tested associations among mental health indicators and wellness cultures. Multiple linear regression examined factors associated with mental health indicators.

RESULTS

Faculty, staff, and students responded (N = 1345). Findings indicated that most respondents were not getting adequate sleep, meeting physical activity recommendations, or eating the daily recommended number of fruits/vegetables. Fourteen to 54.9 % of participants reported depression, anxiety, and burnout. Overall, students, faculty and staff at colleges that operated under a strong wellness culture had better outcomes.

CONCLUSION

Wellness cultures impact the mental and physical health of faculty, staff, and students.

Gratitude intersects with affect as a boundary condition for daily satisfaction: An affective dynamics perspective

This study is based on the affective events theory to investigate the situational predictors for gratitude-related differences in daily affect and satisfaction. We tested a moderated mediation model in which daily microevents (daily hassles and uplifts) were related to satisfaction through affect, at the within-person level. We also tested the cross-level interaction of gratitude on this indirect relationship. A total of 195 participants participated in a 5-day diary study (195 * 5 = 975 measurement occasions). Multilevel modeling showed that, at the person-level of analysis, daily microevents were significantly related to daily affect and, in turn, to daily satisfaction. At the daily level of analysis, trait-based gratitude moderated the mediation of daily positive affect on the relationship between daily uplifts and daily satisfaction, such that it become stronger for individuals who scored lower on gratitude, but gratitude did not moderate the relationship between daily hassles, negative affect, and satisfaction. These findings make relevant theoretical contributions to understanding the power of gratitude for daily affective dynamics. These results also expand knowledge on within-person processes that explain daily affect and satisfaction, in addition to more traditional between-person factors. In sum, the present research demonstrates that "being grateful" may be associated with being happy and that individuals who are less grateful need to experience more daily uplifts and positive affect to feel satisfied.

From fearful to hopeful: A thematic content analysis of COVID-19 survivors' YouTube videos

COVID-19 survivors experienced a spectrum of emotions as a result of surviving the said disease. Employing thematic content analysis, the researchers characterized the various emotional manifestations among recovered COVID-19 patients, which are crucial indicators of their mental well-being postinfection. From March 2020 to June 2021, data was collated from 31 Filipino COVID-19 Survivors' YouTube videos. 51.61% of the videos were posted in 2020 and 48.39% were posted in 2021 where 70.97% of the survivors were female while 29.03% were male. 579 primary codes emerged and were narrowed down into sixteen themes where Hope (18.83%) arose as the most predominant emotion followed by Gratitude (14.68%), Joy and Relief (14.16%), Faith (11.57%), Plight Response (10.88%), Sadness (10.88%), Fear (6.39%), and nine others (12.61%).

An encounter with the self: A thematic and content analysis of the DMT experience from a naturalistic field study

Introduction

N,N-Dimethyltryptamine (DMT) is an endogenous serotonergic psychedelic capable of producing radical shifts in an experience that have significant implications for consciousness and its neural correlates, especially given the “disconnected consciousness” suggested by the “breakthrough” DMT state. Its increasing usage and clinical trial indicate the growing importance of a thorough elucidation of the experience's qualitative content, over and above the phenomenological structure. This is particularly in light of the intensely pervasive effects of DMT occasions in all dimensions of the self, which are often ontologically challenging yet potentially transformative.

Methods

This is the second report on the first naturalistic field study of DMT use exploring its qualitative analysis. Screened, healthy, anonymized, and experienced DMT users were observed during their non-clinical use of the drug at home (40–75-mg inhaled). In-depth semi-structured interviews, inspired by the micro-phenomenological technique, were employed immediately after their experience. This study reports on the thematic and content analysis of one major domain of the breakthrough experiences elicited, the “self”; where analyses of the “other” were previously reported. A total of 36 post-DMT experience interviews with mostly Caucasian (83%) men (eight women) of a mean of 37 years were predominantly inductively coded.

Results

Invariably, profound and highly intense experiences occurred. The first overarching category comprised the onset of effects, encompassing super-ordinate themes including sensory, emotion and body, and space-time shifts; the second category comprised bodily effects, encompassing themes including pleasurable, neutral/both, and uncomfortable; the third category comprised the sensorial effects, encompassing open-eye, visual, and cross-modal and other; the fourth comprised the psychological effects, encompassing memory and language, awareness and sense of self, and time distortions; and the fifth comprised the emotional effects, encompassing positive, neither/both, and challenging experiences. Many further subthemes also illuminate the rich content of the DMT experience.

Discussion

The present study provides a systematic and nuanced analysis of the content of the breakthrough DMT state pertaining to one's personal and self-referential experiences of the body, senses, psychology, and emotions. The resonances both with previous DMT studies and other types of extraordinary experiences, such as the alien abduction, shamanic and near-death experiences, are also elaborated upon. Putative neural mechanisms and their promise as a psychotherapeutic agent, especially owing to deep emotional impact, are discussed.

Pilot Study on the Impact of Gratitude Journaling or Cognitive Strategies on Health Care Workers

INTRODUCTION

The COVID-19 pandemic has significantly impacted the mental well-being of health care workers (HCWs). This study assessed the feasibility, acceptability, and preliminary efficacy of two psychological interventions, gratitude journaling or cognitive strategies, on pediatric HCWs.

METHOD

A pilot randomized parallel repeated measures design was used, with a convenience sample of 59 HCWs. Data were collected before and after the intervention period, 2 weeks after, and again 6 months later. Outcomes included depression, anxiety, meaning and purpose, feasibility, and acceptability.

RESULTS

Thirty-seven participants completed the study. The majority were nurses (registered nurses and advanced practice registered nurses) and physicians. In both groups, depression and anxiety scores diminished, but changes were not statistically significant. The study was feasible to conduct, and subjects reported high acceptability.

DISCUSSION

Gratitude journaling and cognitive strategies may help mental well-being in HCWs; however, future studies with larger samples are needed.

Psychosocial Factors Associated With Accelerated GrimAge in Male U.S. Military Veterans

OBJECTIVE

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

U.S. 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.

Dear technology, you are not welcome: exploring ungratefulness towards technology

Purpose

Technology has become all-pervasive and one of the essential requirements of life. The blessings of science and technology are countless, and today, it is almost impossible to imagine life without applications of technology. And at the same time, positive psychologists have advocated practicing gratitude for the betterment of personal and professional growth and development. But ironically, the area of gratitude toward technology remains unexplored. The purpose of this study is to investigate the difference in gratitude for the technological and non-technological aspects of life.

Design/methodology/approach

The first study compared gratitude for three parameters – sense of abundance, social appreciation and appreciation for others. The second study was based on the “counting blessing” exercise, in which respondents were asked to write five things for which they feel grateful in life. The Friedman test and Wilcoxon signed-rank test were used to compare the ranked data. In the third study, respondents were distributed into two groups. Both groups were given a puzzle to solve; first, group members were informed that they would interact with other human beings, and the second group was informed that they would interact with bots.

Findings

All three studies concluded that respondents are relatively less grateful for the contributions of technologies.

Originality/value

This is probably the first study that investigated gratefulness for technology.

Validity and reliability of the Persian version of the Short-Form Adolescent Health Promotion scale: Methodological study

Background and Aim

Assessing health promotion among adolescents is vital to identify healthy and unhealthy behaviors and to evaluate health promotion interventions. This study aimed to determine the validity and reliability of the Persian version of the Short-Form Adolescent Health Promotion scale.

Methods

Three hundred and twenty-seven adolescents were recruited through a multistage sampling method in this methodological study. The original version of the Adolescent Health Promotion scale was translated from English to Persian using the Backward-Forward translation protocol. Then, the scale's validity and reliability, including the face, content, construct validity, and reliability indices, were evaluated. The statistical analysis was performed using SPSS software version 24.

Results

The mean CVI and CVR were 0.99. The exploratory factor analysis revealed four factors covering 42.57% of the total variance. The factor loading order of the items did not exactly correspond to the order obtained in the English version of the scale's validity and reliability analysis. The obtained factors called included: life appreciation, stress management, nutrition, and health responsibility. In the current study, both Cronbach's ɑ and the intraclass correlation coefficient were calculated at 0.84 and 0.99.

Conclusion

The Persian version of the Adolescent Health Promotion scale developed in the present study is acceptable for the validity of the content, face, and reliability. However, the construct validity of this scale should be checked in other samples.

Are Some Ways of Expressing Gratitude More Beneficial Than Others? Results From a Randomized Controlled Experiment

Gratitude activities have been shown to increase well-being and other positive outcomes in numerous experiments to date. The current study tested whether self-directed gratitude interventions that vary by type (i.e., social vs. nonsocial) and format (i.e., long-form letters vs. shorter lists) produce differential benefits. To that end, 958 Australian adults were assigned to one of six activities to complete each day for 1 week, including five gratitude activities that varied by type and format and an active control condition (i.e., keeping track of daily activities). Regressed change analyses revealed that, overall, long-form writing exercises (i.e., essays and letters) resulted in greater subjective well-being and other positive outcomes than lists. Indeed, those who were instructed to write social and nonsocial gratitude lists did not differ from controls on any outcomes. However, participants who wrote unconstrained gratitude lists—that is, those who wrote about any topics they wanted—reported greater feelings of gratitude and positive affect than did controls. Finally, relative to the other gratitude conditions, participants who wrote gratitude letters to particular individuals in their lives not only showed stronger feelings of gratitude, elevation, and other positive emotions but also reported feeling more indebted. This study demonstrates that not only does gratitude “work” to boost well-being relative to an active neutral activity, but that some forms of gratitude may be more effective than others. We hope these findings help scholars and practitioners to develop, tailor, implement, and scale future gratitude-based interventions.

Identifying factors associated with elevated suicidal intent among U.S. military veterans

OBJECTIVE

Suicidal intent is a risk factor for engagement in suicidal behavior, use of violent means, and suicide mortality. Yet, scarce research has examined factors associated with suicidal intent among U.S. military veterans, a population at high risk for suicide. This study examined vulnerability factors associated with suicidal intent in a population-based sample of U.S. veterans.

METHODS

Data were analyzed from the 2019-2020 National Health and Resilience in Veterans Study, which surveyed a representative sample of 4069 U.S. veterans. Analyses estimated the prevalence of current suicidal intent (i.e., veterans' report that they would likely attempt suicide in the future) and examined factors most strongly associated with suicidal intent.

RESULTS

Forty-nine veterans (1.4%; 95% confidence interval = 1.0-1.8%) reported suicidal intent. Recurrent past-year suicidal ideation (≥2 times), low dispositional gratitude, current depression, current insomnia, childhood sexual abuse, and a prior suicide attempt were most strongly associated with suicidal intent (7.1-50.1% of the total explained variance). Veterans with several of these co-occurring factors were at highest risk for suicidal intent; of veterans with 0, ≥1, ≥2, ≥3, and ≥4 of these factors, 0.1%, 4.4%, 10.8%, 19.5%, and 28.1% reported suicidal intent, respectively.

DISCUSSION

Specific vulnerability factors, particularly when co-occurring, may increase veterans' intention of attempting suicide. Findings underscore the importance for clinicians to continuously assess suicidal intent when working with this population, particularly as veterans' reports of suicidal thinking increases.

How the Brain Becomes the Mind: Can Thermodynamics Explain the Emergence and Nature of Emotions?

The neural systems' electric activities are fundamental for the phenomenology of consciousness. Sensory perception triggers an information/energy exchange with the environment, but the brain's recurrent activations maintain a resting state with constant parameters. Therefore, perception forms a closed thermodynamic cycle. In physics, the Carnot engine is an ideal thermodynamic cycle that converts heat from a hot reservoir into work, or inversely, requires work to transfer heat from a low- to a high-temperature reservoir (the reversed Carnot cycle). We analyze the high entropy brain by the endothermic reversed Carnot cycle. Its irreversible activations provide temporal directionality for future orientation. A flexible transfer between neural states inspires openness and creativity. In contrast, the low entropy resting state parallels reversible activations, which impose past focus via repetitive thinking, remorse, and regret. The exothermic Carnot cycle degrades mental energy. Therefore, the brain's energy/information balance formulates motivation, sensed as position or negative emotions. Our work provides an analytical perspective of positive and negative emotions and spontaneous behavior from the free energy principle. Furthermore, electrical activities, thoughts, and beliefs lend themselves to a temporal organization, an orthogonal condition to physical systems. Here, we suggest that an experimental validation of the thermodynamic origin of emotions might inspire better treatment options for mental diseases.

Appreciating the Good Things in Life During the Covid-19 Pandemic: A Randomized Controlled Trial and Evaluation of a Gratitude App

The Covid-19 pandemic has had many negative consequences on the general public mental health. The aim of this study was to test the effectiveness of and satisfaction with an app with gratitude exercises to improve the mental health of people with reduced mental well-being due to the Covid-19 pandemic, as well as potential mechanisms of well-being change and dose-response relationships. A two-armed randomized controlled trial design was used, with two groups receiving the 6-week gratitude intervention app either immediately (intervention group, n = 424) or after 6 weeks (waiting list control group, n = 425). Assessments took place online at baseline (T0), six weeks later (T1) and at 12 weeks (T2), measuring outcomes (i.e., mental well-being, anxiety, depression, stress), and potential explanatory variables (i.e., gratitude, positive reframing, rumination). Linear mixed models analyses showed that when controlled for baseline measures, the intervention group scored better on all outcome measures compared to the control group at T1 (d = .24-.49). These effects were maintained at T2. The control group scored equally well on all outcome measures at T2 after following the intervention. Effects of the intervention on well-being were partially explained by gratitude, positive reframing, and rumination, and finishing a greater number of modules was weakly related to better outcomes. The intervention was generally appealing, with some room for improvement. The results suggest that a mobile gratitude intervention app is a satisfactory and effective way to improve the mental health of the general population during the difficult times of a pandemic.

Measures of Daily Activities Associated With Mental Health (Things You Do Questionnaire): Development of a Preliminary Psychometric Study and Replication Study

Background

A large body of research has identified modifiable cognitions and behaviors (actions) associated with psychological health. However, little is known regarding the actions that are most strongly associated with psychological health or the frequency with which they should be performed.

Objective

This paper described 2 studies that used survey methodology to create the Things You Do Questionnaire (TYDQ), which aims to identify and rank actions (items) and domains of actions (factors) most strongly associated with psychological health.

Methods

We used digital marketing strategies to recruit Australian adult participants, who were asked to complete 2 web-based surveys comprising versions of the TYDQ; validated measures of depression, anxiety, and satisfaction with life; and demographic questions. In study 1, a total of 3040 participants rated how often they performed each of the 96 items comprising the TYDQ. This design was replicated in study 2, in which a 59-item version of the TYDQ was completed by 3160 participants. In both studies, the factor structure and validity were examined, as were the associations between individual TYDQ items and 3 mental health outcomes: depression, anxiety, and satisfaction with life.

Results

In study 1, factor analyses revealed that a 5-factor model comprising 27 items achieved an optimum balance between brevity and variance and accounted for 38.1%, 31.4%, and 33.2% of the variance in scores on measures of depression, anxiety, and satisfaction with life, respectively. The factors were interpreted as realistic thinking, meaningful activities, goals and plans, healthy habits, and social connections. These 5 factors were more strongly associated with psychological health than those such as practicing kindness, exercising gratitude, and practicing spirituality. This pattern of results was replicated across gender, age groups, and depression severity. The 5-factor solution found in study 1 was replicated in study 2. Analyses revealed that a 21-item version accounted for 46.8%, 38.2%, and 38.1% of the variance in scores on measures of depression, anxiety, and satisfaction with life, respectively.

Conclusions

These findings indicate that some actions are more strongly associated with psychological health than others and that these activities fall within 5 broad domains, which represent skills often taught in psychological treatments. Subsequent studies are planned to explore the reliability of these items and results in other samples and to examine patterns of change in scores during treatment for anxiety and depression. If replicated, these efforts will assist in the development of new psychological interventions and provide an evidence base for public mental health campaigns designed to promote good mental health and prevent the emergence of common mental disorders.

Student Academic Engagement and Burnout Amidst COVID-19: The Role of Purpose Orientations and Disposition Towards Gratitude in Life

The current study considered the role of broad life orientations of university students on their academic engagement and burnout within the context of COVID-19 pandemic. Specifically, the purpose of this study was to examine whether life purpose orientations predicted student academic engagement and burnout directly and indirectly through disposition towards gratitude. University students completed questionnaires assessing academic engagement, burnout (reduced sense of schoolwork accomplishment, schoolwork devaluation, mental exhaustion from schoolwork), life purpose orientations (others-growth, self-growth, career-focused), and disposition towards gratitude. Structural equation modeling showed that academic engagement and two dimensions of burnout (reduced sense of schoolwork accomplishment, schoolwork devaluation) were negatively predicted by career-focused purpose orientation and by disposition towards gratitude. Additionally, reduced sense of schoolwork accomplishment was predicted indirectly by others-growth purpose orientation through disposition towards gratitude. Overall, findings highlight that broad life orientations may play salient roles in student academic success.

Dispositional gratitude predicts the development of psychopathology and suicidal behaviors: Results from a 7-year population-based study of U.S. military veterans

BACKGROUND

Dispositional gratitude has been implicated as a psychological characteristic that may modulate risk for mental health outcomes. Using a population-based sample of U.S. military veterans, this study evaluated the association between dispositional gratitude and the development of psychopathology and suicidal behaviors over a 7-year period.

METHODS

A nationally representative sample of U.S. veterans was surveyed at four timepoints across seven years. Analyses were restricted to veterans without incident outcomes at baseline. Multivariable analyses were conducted to examine the relation between baseline levels of dispositional gratitude and risk of developing (a) major depressive disorder (MDD), generalized anxiety disorder (GAD), or posttraumatic stress disorder (PTSD); (b) suicidal ideation; and (c) suicide attempts.

RESULTS

A total 9.6% of veterans developed MDD, GAD, and/or PTSD, 9.5% developed suicidal ideation, and 2.8% reported having attempted suicide over the 7-year follow-up period. Among veterans with high levels of dispositional gratitude, incidence was lower for MDD/GAD/PTSD (8.0%), suicidal ideation (6.8%), and suicide attempts (1.5%). Conversely, veterans with low dispositional gratitude were at substantially higher risk of developing MDD/GAD/PTSD (27.7%), suicidal ideation (33.6%), and suicide attempts (20.3%).

CONCLUSIONS

High dispositional gratitude may help protect against the development of psychopathology and suicidal behaviors in U.S. military veterans, whereas low gratitude may increase risk of developing these outcomes. Collectively, these results support the potential utility of enhancing gratitude as part of primary prevention efforts for veterans, service members, and other populations at heightened risk for adverse mental health outcomes.

Gratitude for Categories of Needs Before and During the COVID-19 Pandemic

This naturalistic observation study investigated the influence of broad societal events such as the COVID-19 pandemic on public expressions of gratitude. Spontaneously produced gratitude expressions posted by individuals (N = 159) in an online discussion forum were extracted at three time periods (during the pandemic, one year pre-pandemic, and 2 years pre-pandemic). The gratitude expressions were coded for the categories of deficiency and growth needs based on Maslow's Theory of Motivation. The results demonstrate a higher frequency of gratitude expressions for growth opportunities during the COVID-19 pandemic compared to 2 years prior. The results also demonstrate a higher frequency of gratitude for the fulfillment of deficiency needs compared to growth needs within each of the years, highlighting the overall salience of this category. These findings reveal the capacity of broad societal events to impact public gratitude expressions for needs fulfilment, which has implications for policies and programs intended to meet needs during a global crisis.

Long-term impact of implant-supported oral rehabilitation on quality of life: A 5 years prospective study

BACKGROUND

This study analyzed the impact of oral rehabilitation with implant-supported fixed complete dentures (IFCDs) on the oral health-related quality of life (OHRQoL) and its relationship with self-esteem and gratitude.

METHODS

66 patients were interviewed to collect data on OHRQoL (OHIP-14), gratitude, and self-esteem, after denture delivery. OHIP-14 scores were analyzed over time and contrasted between groups with IFCD complication or not.

RESULTS

OHIP-14 changed from 22.1 ± 13.8 at baseline to 1.8 ± 2.3 after rehabilitation. Gratitude and self-esteem mean scores were 38.6 ± 3.0 and 36.9 ± 3.8, respectively. OHIP-14 was statistically different from baseline (22.1 ± 13.8) and 1, 3 and 5 years after rehabilitation (2.3 ± 3.7; 1.9 ± 3.1, and 1.8 ± 2.3). No difference was found between the follow-up times and among OHIP-14 domains. Thirteen out of 66 patients (19.7%) had repairable prosthetic complications, but OHIP-14 did not differ between patients with or without complications. Gratitude and self-esteem showed a moderate association (rs = 0.36; p = 0.003), but no association with OHIP-14.

CONCLUSIONS

IFCD treatment has a long-term positive impact on patient's OHRQoL, even among patients who had prosthetic complications. The long-term stability in improved OHRQoL is not associated with self-esteem and gratitude. © 2022 Australian Dental Association.

Parental Autonomy Support and Pathological Internet Use among Chinese Undergraduate Students: Gratitude Moderated the Mediating Effect of Filial Piety

Applying an integrated theoretical model consisting of the socioecological theory, the self-determination theory, and the broaden-and-build theory, the present study tested a moderated mediation model of parental autonomy support, filial piety, and gratitude to study how these factors are jointly related to pathological Internet use (PIU) in Chinese undergraduate students. A total of 1054 Chinese undergraduate students (M age = 20.35, SD = 1.00, 34.7% females) aged between 16 and 24 years participated in this study. They were instructed to complete self-reported questionnaires on parental autonomy support, filial piety, gratitude, and PIU. The results showed that parental autonomy support was negatively associated with PIU, and filial piety partially mediated this relation. Specifically, parental autonomy support was positively related to filial piety, which, in turn, was negatively associated with PIU. In addition, gratitude moderated the first path of the indirect relation and the direct relation of this mediation effect. To be specific, undergraduate students with higher gratitude showed high filial piety and low PIU, in the context of low parental autonomy support, than those with lower gratitude. Taken together, the current study contributes to extant research by highlighting the vital role of parental autonomy support in mitigating undergraduate students' PIU and illustrating how filial piety explains the underlying mechanism of this association. This study also provides novel insights into intervention or prevention programs by demonstrating that gratitude alleviates the adverse effect of low parental autonomy support on students' PIU.

Does Gratitude Promote Resilience During a Pandemic? An Examination of Mental Health and Positivity at the Onset of COVID-19

Researchers have emphasized the detrimental effects of COVID-19 on mental health, but less attention has been given to personal strengths promoting resilience during the pandemic. One strength might be gratitude, which supports wellbeing amidst adversity. A two-wave examination of 201 college students revealed anxiety symptom severity increased to a lesser extent from pre-COVID (January-March 2020) to onset-COVID (April 2020) among those who reported greater pre-COVID gratitude. A similar trend appeared for depression symptom severity. Gratitude was also correlated with less negative changes in outlook, greater positive changes in outlook, and endorsement of positive experiences resulting from COVID-19. Thematic analysis showed "strengthened interpersonal connections" and "more time" were the most commonly reported positive experiences. Overall findings suggest gratitude lessened mental health difficulties and fostered positivity at the onset of the pandemic, but more research is needed to determine whether gratitude and other strengths promote resilience as COVID-19 continues.

Gratitude Moderates the Relation between Daily Hassles and Satisfaction with Life in University Students

Satisfaction with life as a judgmental cognitive process can be negatively influenced by appraisals of daily events such as hassles. Trait-gratitude-a tendency to appraise, recognize and respond to life events through being grateful-is a determinant of mental health and well-being, and has been shown to be related to the positive appraisal of life. The aim of the current study was to investigate the moderating role of trait-gratitude in the relationship between daily hassles and satisfaction with life. In the process of carrying out this study, the French version of the Gratitude Questionnaire (GQ-6) was validated. A total of 328 French undergraduates completed questionnaires measuring gratitude, satisfaction with life, and daily hassles to test the main hypothesis. They also completed optimism, coping strategies, depression, and anxiety questionnaires in order to assess the convergent validity of the French version of the GQ-6. First, the results showed satisfactory psychometric properties of the Gratitude Questionnaire. Second, the results indicated the moderating role of trait-gratitude in the relationship between daily hassles disturbance and satisfaction with life. This study further documents the role of gratitude as a determinant of well-being and provides French-speaking clinicians and researchers with a useful tool to measure grateful disposition.

Nursing Students' Experiences of Gratitude Journaling during the COVID-19 Pandemic

Gratitude journaling has been used to improve grateful disposition. However, there is only limited data available on its application experience. This study aimed to: (1) explore the experiences of nursing students who have participated in gratitude journaling; and (2) assess students’ views of gratitude journaling as a nursing intervention. This study implemented an eight-week program of gratitude journaling with fourth-year nursing students who took a mental health psychiatric nursing course at a South Korean university. Following the eight weeks, students reflected on their gratitude journaling experience in a reflective essay. Using content analysis, 53 essays were analyzed. Five categories were identified from the reflective essay, as follows: “A new beginning”, “The engine that motivates continued participation: gratitude sharing”, “The process driving change”, “Changes brought about by gratitude”, and “Self-reflection”. Based on this experience, nursing students believed that it is important to promote steady participation when administering gratitude journaling as a nursing intervention. The study findings suggest that the gratitude journaling not only helped with nursing students’ perspective, emotional, and behavioral aspects and stress management, but also provided an opportunity to advance a step further based on self-reflection.

Coping during COVID-19: The Impact of Cognitive Appraisal on Problem Orientation, Coping Behaviors, Body Image, and Perceptions of Eating Behaviors and Physical Activity during the Pandemic

Large surveys indicate that many people perceive that their health behaviors (i.e., eating behaviors, physical activity, and self-care routines) and body image have changed during COVID-19; however, large individual variation exists. A person’s cognitive appraisal of COVID-19 disruptions may help account for individual differences. Those with a negative problem orientation perceive problems as “threats”, whereas those with a positive problem orientation reframe problems as “opportunities”. The present experimental study examined the impact of appraisals, specifically being prompted to reflect on the changes in health routines precipitated by COVID-19 restrictions as either “threats” or “opportunities”, on problem orientation, coping behaviours, body image, and perceptions of eating behaviors and physical activity in a sample of female undergraduate students (N = 363). The group that reflected on challenges/barriers reported having a more negative problem orientation, being more negatively impacted by COVID-19, engaging in more maladaptive coping behaviors, and having less positive body image compared to participants who reflected on opportunities presented during the pandemic. Findings suggest that appraisals and problem orientation are malleable, and that people who tend to fixate on the challenges associated with COVID-19 may benefit from strategically reflecting on their own resilience and new opportunities that have arisen for engaging in health behaviors.