Abstract
Outcomes of gratitude interventions are encouraging, but inconsistent across studies. In addition, both mechanisms of change and effect modifiers for these interventions are largely unknown. Recent data point toward potential candidates and suggest reward processing may be a promising mechanism underlying these interventions, while childhood adversity (CA) and trait gratitude may impact on them. However, existing research aimed at investigating these hypotheses is scarce. Building on these, we examined the effectiveness of a gratitude intervention for decreasing depressive symptoms and negative affect and increasing positive affect. We also investigated changes in reward processing following intervention and explored differences in adherence and drop-out between groups. Finally, we investigated the moderating role of CA and trait gratitude.
Participants (N=237, ages between 18–56) were randomly allocated to a gratitude or active control condition (14 days). Following intervention, findings indicated a significant decrease in depressive symptoms and negative affect in both conditions. While positive affect remained stable, a significant time effect emerged for reward processing. CA severity, but not multiplicity, moderated the effectiveness of the intervention, adherence and drop-out. Trait gratitude moderated the effectiveness of the gratitude intervention only on depressive symptoms.
Gratitude interventions may not be the best fit for everyone. Thus, we recommend tailoring interventions, especially in individuals reporting a history of severe CA.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Alkozei, A., Smith, R., & Killgore, W. D. S. (2018). Gratitude and subjective wellbeing: A proposal of two causal frameworks. Journal of Happiness Studies: An Interdisciplinary Forum on Subjective Well-Being, 19(5), 1519–1542. https://doi.org/10.1007/s10902-017-9870-1
Baldwin, J. R., & Esposti, M. D. (2021). Triangulating on the role of perceived versus objective experiences of childhood adversity in psychopathology. JCPP Advances, 1(1), https://doi.org/10.1111/jcv2.12010
Baskin, T. W., Tierney, S. C., Minami, T., & Wampold, B. E. (2003). Establishing specificity in psychotherapy: A meta-analysis of structural equivalence of placebo controls. Journal of Consulting and Clinical Psychology, 71(6), 973–979. https://doi.org/10.1037/0022-006X.71.6.973
Boggiss, A. L., Consedine, N. S., Brenton-Peters, J. M., Hofman, P. L., & Serlachius, A. S. (2020). A systematic review of gratitude interventions: Effects on physical health and health behaviors. Journal of Psychosomatic Research, 135, 110165. https://doi.org/10.1016/j.jpsychores.2020.110165
Carr, A., Cullen, K., Keeney, C., Canning, C., Mooney, O., Chinseallaigh, E., & O’Dowd, A. (2020). Effectiveness of positive psychology interventions: A systematic review and meta-analysis. The Journal of Positive Psychology, 0(0), 1–21. https://doi.org/10.1080/17439760.2020.1818807
Carver, C. S., & White, T. L. (1994). Behavioral inhibition, behavioral activation, and affective responses to impending reward and punishment: The BIS/BAS Scales. Journal of Personality and Social Psychology, 67(2), 319–333. https://doi.org/10.1037/0022-3514.67.2.319
Cheng, S. T., Tsui, P. K., & Lam, J. H. M. (2015). Improving mental health in health care practitioners: Randomized controlled trial of a gratitude intervention. Journal of Consulting and Clinical Psychology, 83(1), 177–186. https://doi.org/10.1037/a0037895
Chopik, W. J., Newton, N. J., Ryan, L. H., Kashdan, T. B., & Jarden, A. J. (2019). Gratitude across the life span: Age differences and links to subjective well-being. The Journal of Positive Psychology, 14(3), 292–302. https://doi.org/10.1080/17439760.2017.1414296
Cole, D. A., & Maxwell, S. E. (2003). Testing mediational models with longitudinal data: Questions and tips in the use of structural equation modeling. Journal of Abnormal Psychology, 112(4), 558–577. https://doi.org/10.1037/0021-843X.112.4.558
Craske, M. G., Meuret, A. E., Ritz, T., Treanor, M., & Dour, H. J. (2016). Treatment for Anhedonia: A Neuroscience Driven Approach. Depression and Anxiety, 33(10), 927–938. https://doi.org/10.1002/da.22490
Cregg, D. R., & Cheavens, J. (2020). Gratitude Interventions: Effective Self-help? A Meta-analysis of the Impact on Symptoms of Depression and Anxiety. https://doi.org/10.1007/s10902-020-00236-6
Davis, D. E., Choe, E., Meyers, J., Wade, N., Varjas, K., Gifford, A. … Worthington, E. L. (2016). Thankful for the little things: A meta-analysis of gratitude interventions. Journal of Counseling Psychology, 63(1), 20–31. https://doi.org/10.1037/cou0000107
DeSteno, D., Li, Y., Dickens, L., & Lerner, J. S. (2014). Gratitude: A Tool for Reducing Economic Impatience. Psychological Science, 25(6), 1262–1267. https://doi.org/10.1177/0956797614529979
Dickens, L. R. (2017). Using Gratitude to Promote Positive Change: A Series of Meta-Analyses Investigating the Effectiveness of Gratitude Interventions. Basic and Applied Social Psychology, 39(4), 193–208. https://doi.org/10.1080/01973533.2017.1323638
Dickens, L. R. (2019). Gratitude Interventions: Meta-analytic Support for Numerous Personal Benefits, with Caveats. In L. E. Van Zyl & S. Rothmann Sr. (Eds.), Positive Psychological Intervention Design and Protocols for Multi-Cultural Contexts (pp. 127–147). Springer International Publishing. https://doi.org/10.1007/978-3-030-20020-6_6
Emmons, R. A., & McCullough, M. E. (2003). Counting blessings versus burdens: An experimental investigation of gratitude and subjective well-being in daily life. Journal of Personality and Social Psychology, 84(2), 377–389. https://doi.org/10.1037//0022-3514.84.2.377
Erbe, D., Eichert, H. C., Rietz, C., & Ebert, D. (2016). Interformat reliability of the patient health questionnaire: Validation of the computerized version of the PHQ-9. Internet Interventions, 5, 1–4. https://doi.org/10.1016/j.invent.2016.06.006
Fareri, D. S., & Tottenham, N. (2016). Effects of early life stress on amygdala and striatal development. Developmental Cognitive Neuroscience, 19, 233–247. https://doi.org/10.1016/j.dcn.2016.04.005
Faul, F., Erdfelder, E., Lang, A. G., & Buchner, A. (2007). G*Power 3: A flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behavior Research Methods, 39(2), 175–191. https://doi.org/10.3758/BF03193146
Froh, J. J., Kashdan, T. B., Ozimkowski, K. M., & Miller, N. (2009). Who benefits the most from a gratitude intervention in children and adolescents? Examining positive affect as a moderator. The Journal of Positive Psychology, 4(5), 408–422. https://doi.org/10.1080/17439760902992464
Geraghty, A. W. A., Wood, A. M., & Hyland, M. E. (2010). Attrition from self-directed interventions: Investigating the relationship between psychological predictors, intervention content and dropout from a body dissatisfaction intervention. Social Science & Medicine (1982), 71(1), 30–37. https://doi.org/10.1016/j.socscimed.2010.03.007
Halahakoon, D. C., Kieslich, K., O’Driscoll, C., Nair, A., Lewis, G., & Roiser, J. P. (2020). Reward-Processing Behavior in Depressed Participants Relative to Healthy Volunteers: A Systematic Review and Meta-analysis. JAMA Psychiatry. https://doi.org/10.1001/jamapsychiatry.2020.2139
Harbaugh, C. N., & Vasey, M. (2014). When do people benefit from gratitude practice? https://doi.org/10.1080/17439760.2014.927905
Hauser, D. J., Ellsworth, P. C., & Gonzalez, R. (2018). Are Manipulation Checks Necessary? Frontiers in Psychology, 9. https://www.frontiersin.org/article/https://doi.org/10.3389/fpsyg.2018.00998
Irvin, K. M., Bell, D. J., Steinley, D., & Bartholow, B. D. (2020). The thrill of victory: Savoring positive affect, psychophysiological reward processing, and symptoms of depression. Emotion (Washington, D.C.). https://doi.org/10.1037/emo0000914
Jans-Beken, L., Jacobs, N., Janssens, M., Peeters, S., Reijnders, J., Lechner, L., & Lataster, J. (2020). Gratitude and health: An updated review. The Journal of Positive Psychology, 15(6), 743–782. https://doi.org/10.1080/17439760.2019.1651888
Jorm, A. F., Christensen, H., Henderson, A. S., Jacomb, P. A., Korten, A. E., & Rodgers, B. (1998). Using the BIS/BAS scales to measure behavioural inhibition and behavioural activation: Factor structure, validity and norms in a large community sample. Personality and Individual Differences, 26(1), 49–58. https://doi.org/10.1016/S0191-8869(98)00143-3
Keren, H., O’Callaghan, G., Vidal-Ribas, P., Buzzell, G. A., Brotman, M. A., Leibenluft, E. … Stringaris, A. (2018). Reward Processing in Depression: A Conceptual and Meta-Analytic Review Across fMRI and EEG Studies. American Journal of Psychiatry, 175(11), 1111–1120. https://doi.org/10.1176/appi.ajp.2018.17101124
Kerr, S. L., O’Donovan, A., & Pepping, C. A. (2015). Can Gratitude and Kindness Interventions Enhance Well-Being in a Clinical Sample? Journal of Happiness Studies, 16(1), 17–36. https://doi.org/10.1007/s10902-013-9492-1
Kim, S. W., Kang, H. J., Kim, S. Y., Kim, J. M., Yoon, J. S., Jung, S. W. … Jun, T. Y. (2013). Impact of Childhood Adversity on the Course and Suicidality of Depressive Disorders: The Crescend Study. Depression and Anxiety, 30(10), 965–974. https://doi.org/10.1002/da.22088
Klein, D. N., Arnow, B. A., Barkin, J. L., Dowling, F., Kocsis, J. H., Leon, A. C. … Wisniewski, S. R. (2009). Early adversity in chronic depression: Clinical correlates and response to pharmacotherapy. Depression and Anxiety, 26(8), 701–710. https://doi.org/10.1002/da.20577
Kroenke, K., Spitzer, R. L., & Williams, J. B. W. (2001). The PHQ-9. Journal of General Internal Medicine, 16(9), 606–613. https://doi.org/10.1046/j.1525-1497.2001.016009606.x
Lavelock, C., Griffin, B., Worthington, E., Benotsch, E., Lin, Y., Greer, C. … Hook, J. (2016). A Qualitative Review and Integrative Model of Gratitude and Physical Health. Journal of Psychology and Theology, 44, 55–86. https://doi.org/10.1177/009164711604400105
Lecomte, T., Spidel, A., Leclerc, C., MacEwan, G. W., Greaves, C., & Bentall, R. P. (2008). Predictors and profiles of treatment non-adherence and engagement in services problems in early psychosis. Schizophrenia Research, 102(1–3), 295–302. https://doi.org/10.1016/j.schres.2008.01.024
Levis, B., Benedetti, A., & Thombs, B. D. (2019). Accuracy of Patient Health Questionnaire-9 (PHQ-9) for screening to detect major depression: Individual participant data meta-analysis. BMJ, l1476. https://doi.org/10.1136/bmj.l1476
Lippard, E. T. C., & Nemeroff, C. B. (2020). The Devastating Clinical Consequences of Child Abuse and Neglect: Increased Disease Vulnerability and Poor Treatment Response in Mood Disorders. The American Journal of Psychiatry, 177(1), 20–36. https://doi.org/10.1176/appi.ajp.2019.19010020
Löwe, B., Kroenke, K., Herzog, W., & Gräfe, K. (2004). Measuring depression outcome with a brief self-report instrument: Sensitivity to change of the Patient Health Questionnaire (PHQ-9). Journal of Affective Disorders, 81(1), 61–66. https://doi.org/10.1016/S0165-0327(03)00198-8
Ma, L. K., Tunney, R. J., & Ferguson, E. (2017). Does gratitude enhance prosociality?: A meta-analytic review. Psychological Bulletin, 143(6), 601–635. https://doi.org/10.1037/bul0000103
Maxwell, S. E., & Cole, D. A. (2007). Bias in cross-sectional analyses of longitudinal mediation. Psychological Methods, 12(1), 23–44. https://doi.org/10.1037/1082-989X.12.1.23
McCullough, M. E., Emmons, R. A., & Tsang, J. A. (2002). The grateful disposition: A conceptual and empirical topography. Journal of Personality and Social Psychology, 82(1), 112–127. https://doi.org/10.1037//0022-3514.82.1.112
McCullough, M., Tsang, J. A., & Emmons, R. (2004). Gratitude in Intermediate Affective Terrain: Links of Grateful Moods to Individual Differences and Daily Emotional Experience. Journal of Personality and Social Psychology, 86, 295–309. https://doi.org/10.1037/0022-3514.86.2.295
Merchán-Clavellino, A., Alameda-Bailén, J. R., Zayas García, A., & Guil, R. (2019). Mediating Effect of Trait Emotional Intelligence Between the Behavioral Activation System (BAS)/Behavioral Inhibition System (BIS) and Positive and Negative Affect. Frontiers in Psychology, 10, 424. https://doi.org/10.3389/fpsyg.2019.00424
Morelli, S. A., Knutson, B., & Zaki, J. (2018). Neural sensitivity to personal and vicarious reward differentially relate to prosociality and well-being. Social Cognitive and Affective Neuroscience, 13(8), 831–839. https://doi.org/10.1093/scan/nsy056
Morris, S., & Cuthbert, B. (2012). Research Domain Criteria: Cognitive systems, neural circuits, and dimensions of behavior. Dialogues in Clinical Neuroscience, 14, 29–37
Nanni, V., Uher, R., & Danese, A. (2012). Childhood maltreatment predicts unfavorable course of illness and treatment outcome in depression: A meta-analysis. The American Journal of Psychiatry, 169, 141–151. https://doi.org/10.1176/appi.ajp.2012.169.4.439b
Nelson, J., Klumparendt, A., Doebler, P., & Ehring, T. (2017). Childhood maltreatment and characteristics of adult depression: Meta-analysis. The British Journal of Psychiatry, 210(2), 96–104. https://doi.org/10.1192/bjp.bp.115.180752
O’Connell, B. H., O’Shea, D., & Gallagher, S. (2018). Examining Psychosocial Pathways Underlying Gratitude Interventions: A Randomized Controlled Trial. Journal of Happiness Studies, 19(8), 2421–2444. https://doi.org/10.1007/s10902-017-9931-5
Patalano, A. L., Lolli, S. L., & Sanislow, C. A. (2018). Gratitude intervention modulates P3 amplitude in a temporal discounting task. International Journal of Psychophysiology, 133, 202–210. https://doi.org/10.1016/j.ijpsycho.2018.06.002
Rash, J. A., Matsuba, M. K., & Prkachin, K. M. (2011). Gratitude and Well-Being: Who Benefits the Most from a Gratitude Intervention? Applied Psychology: Health and Well-Being, 3(3), 350–369. https://doi.org/10.1111/j.1758-0854.2011.01058.x
Sava, F. A., & Sperneac, A-M. (2006). Sensitivity to reward and sensitivity to punishment rating scales: A validation study on the Romanian population. Personality and Individual Differences, 41(8) 1445-1456. https://doi.org/10.1016/j.paid.2006.04.024
Smith, K. E., & Pollak, S. D. (2020). Rethinking Concepts and Categories for Understanding the Neurodevelopmental Effects of Childhood Adversity. Perspectives on Psychological Science, 1745691620920725. https://doi.org/10.1177/1745691620920725
Teicher, M. H., & Parigger, A. (2015). The ‘Maltreatment and Abuse Chronology of Exposure’ (MACE) Scale for the Retrospective Assessment of Abuse and Neglect During Development. PLOS ONE, 10(2), e0117423. https://doi.org/10.1371/journal.pone.0117423
Toepfer, S. M., Cichy, K., & Peters, P. (2012). Letters of gratitude: Further evidence for author benefits. Journal of Happiness Studies: An Interdisciplinary Forum on Subjective Well-Being, 13(1), 187–201. https://doi.org/10.1007/s10902-011-9257-7
Toth, S. L., Handley, E. D., Manly, J. T., Sturm, R., Adams, T. R., Demeusy, E. M., & Cicchetti, D. (2020). The Moderating Role of Child Maltreatment in Treatment Efficacy for Adolescent Depression. Journal of Abnormal Child Psychology, 48(10), 1351–1365. https://doi.org/10.1007/s10802-020-00682-z
Watkins, P. C. (2004). Gratitude and Subjective Well-Being. In The psychology of gratitude (pp. 167–192). Oxford University Press. https://doi.org/10.1093/acprof:oso/9780195150100.003.0009
Watson, D., Clark, L. A., & Tellegen, A. (1988). Development and validation of brief measures of positive and negative affect: The PANAS scales. Journal of Personality and Social Psychology, 54(6), 1063–1070. https://doi.org/10.1037//0022-3514.54.6.1063
Wood, A. M., Froh, J. J., & Geraghty, A. W. A. (2010). Gratitude and well-being: A review and theoretical integration. Clinical Psychology Review, 30(7), 890–905. https://doi.org/10.1016/j.cpr.2010.03.005
Worthen, V. E., & Isakson, R. L. (2007). The Therapeutic Value of Experiencing and Expressing Gratitude. 31, 15
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflicts of interest
The authors have no relevant financial or non-financial interests to disclose and no conflicts of interest to declare that are relevant to the content of this article. All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest or non-financial interest in the subject matter or materials discussed in this manuscript.
The authors have no financial or proprietary interests in any material discussed in this article.
Compliance of ethical standard statement
The authors assert that all procedures contributing to this work comply with the ethical standards of the relevant national and institutional committees on human experimentation and with the Helsinki Declaration of 1975, as revised in 2008. The present manuscript is original, has not been previously published, and is not under consideration at another journal. The manuscript meets the guidelines for ethical conduct and report of research.
Informed consent
The authors affirm that informed consent was obtained from all individual participants included in the study.
Additional information
Publisher’s Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
Oltean, LE., Miu, A.C., Șoflău, R. et al. Tailoring Gratitude Interventions. How and for Whom Do They Work? The Potential Mediating Role of Reward Processing and the Moderating Role of Childhood Adversity and Trait Gratitude. J Happiness Stud 23, 3007–3030 (2022). https://doi.org/10.1007/s10902-022-00530-5
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10902-022-00530-5