Skip to main content
SpringerLink
Log in

Longitudinal associations between gratitude and depression 1 year later among adult cystic fibrosis patients

  • Published:
Journal of Behavioral Medicine Aims and scope Submit manuscript

Abstract

Individuals with cystic fibrosis (CF) are confronted by a range of difficult physical and psychosocial sequelae. Gratitude has drawn growing attention as a psychosocial resource, but it has yet to be examined among adults with CF. The current investigation evaluated longitudinal associations between trait gratitude and subsequent outcomes from depression screening 12 months later, adjusting for disease severity (FEV1% predicted) and other significant clinical or demographic covariates. Participants were 69 adult CF patients recruited from a regional adult treatment center. They completed a validated measure of gratitude (Gratitude Questionnaire-6) at baseline and a screening measure of depression (Hospital Anxiety and Depression Scale) at 12-month follow-up. In a logistic regression analysis controlling for disease severity, higher levels of baseline gratitude were associated with reduced likelihood of depression caseness at 12 months (OR .83, 95% CI .73–.91, p = .001). Gratitude remained predictive after adjusting for other psychosocial resource variables (i.e., perceived social support and positive reframing coping). Findings offer an initial indication of the potential salutary role of dispositional gratitude in an understudied clinical population.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  • Aghababaei, N., Blanchnio, A., & Aminikhoo, M. (2018). The relations of gratitude to religiosity, well-being, and personality. Mental Health, Religion & Culture,21, 408–417.

    Google Scholar 

  • Algoe, S. B. (2012). Find, remind, and bind: The functions of gratitude in everyday relationships. Social and Personality Psychology Compass,6, 455–469.

    Google Scholar 

  • Algoe, S. B., & Stanton, A. L. (2012). Gratitude when it is needed: Social functions of gratitude in women with metastatic breast cancer. Emotion,12, 363–368.

    Google Scholar 

  • Backström-Eriksson, L., Sorjonen, K., Bergsten-Brucefors, A., Hjelte, L., & Melin, B. (2015). Anxiety and depression in adults with cystic fibrosis: A comparison between patients and the general population in Sweden and three other European countries. BMC Pulmonary Medicine,15, 121.

    PubMed  PubMed Central  Google Scholar 

  • Beck, A. T., Rush, A. J., Shaw, B. F., & Emery, G. (1979). Cognitive therapy of depression. New York: Guilford.

    Google Scholar 

  • Bjelland, I., Dahl, A. A., Haug, T. T., & Neckelmann, D. (2002). The validity of the Hospital Anxiety and Depression Scale: An updated literature review. Journal of Psychosomatic Research,52, 69–77.

    PubMed  Google Scholar 

  • Card, N. A. (2018). Meta-analyses of the reliabilities of four measures of gratitude. Journal of Positive Psychology. https://doi.org/10.1080/17439760.2018.1497690

  • Carver, C. S., Scheier, M. F., & Weintraub, J. K. (1989). Assessing coping strategies: A theoretically based approach. Journal of Personality and Social Psychology,56, 267–283.

    CAS  PubMed  Google Scholar 

  • Catastini, P., Di Marco, S., Furriolo, M., Genovese, C., Grande, A., Iacinti, E., et al. (2016). The prevalence of anxiety and depression in Italian patients with cystic fibrosis and their caregivers. Pediatric Pulmonology,51, 1311–1319.

    PubMed  Google Scholar 

  • Chun, S., & Lee, Y. (2013). “I am just thankful”: The experience of gratitude following traumatic spinal cord injury. Disability and Rehabilitation,35, 11–19.

    PubMed  Google Scholar 

  • Davis, D. E., Choe, E., Meyers, J., Wade, N., Varjas, K., Gifford, A., et al. (2016). Thankful for the little things: A meta-analysis of gratitude interventions. Journal of Counseling Psychology,63, 20–31.

    PubMed  Google Scholar 

  • Disabato, D. J., Kashdan, T. B., Short, L. J., & Larden, A. (2017). What predicts positive life events that influence the course of depression? A longitudinal examination of gratitude and meaning. Cognitive Therapy and Research,41, 444–458.

    Google Scholar 

  • Duff, A. J., Abbott, J., Cowperthwaite, C., Sumner, C., Hurley, M. A., Quittner, A., et al. (2014). Depression and anxiety in adolescents and adults with cystic fibrosis in the UK: A cross-sectional study. Journal of Cystic Fibrosis,13, 745–753.

    PubMed  Google Scholar 

  • Eakin, M. N., Patel, Y., Mendez-Tellez, P., Dinglas, V. D., Needham, D. M., & Turnbull, A. E. (2017). Patients’ outcomes after acute respiratory failure: A qualitative study with the PROMIS framework. American Journal of Critical Care,26, 456–465.

    PubMed  PubMed Central  Google Scholar 

  • Eaton, R. J., Bradley, G., & Morrissey, S. (2014). Positive predispositions, quality of life and chronic illness. Psychology Health and Medicine,19, 473–489.

    CAS  Google Scholar 

  • 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, 377–389.

    PubMed  Google Scholar 

  • Fredrickson, B. L. (2004). Gratitude, like other positive emotions, broadens and builds. In R. A. Emmons & M. E. McCullough (Eds.), The psychology of gratitude (pp. 145–166). New York: Oxford University Press.

    Google Scholar 

  • Fredrickson, B. L., & Losada, M. F. (2005). Positive affect and the complex dynamics of human flourishing. American Psychologist,60, 678–686.

    PubMed  Google Scholar 

  • Goldbeck, L., Besier, T., Hinz, A., Singer, S., Quittner, A. L., & TIDES Group. (2010). Prevalence of symptoms of anxiety and depression in German patients with cystic fibrosis. Chest,138, 929–936.

    PubMed  Google Scholar 

  • Hausmann, L. R. M., Youk, A., Kwoh, C. K., Gallagher, R. M., Weiner, D. K., Vina, E. R., et al. (2018). Effect of a positive psychological intervention on pain and functional difficulty among adults with osteoarthritis: A randomized clinical trial. JAMA Network Open,1, e182533.

    PubMed  PubMed Central  Google Scholar 

  • Havermans, T., Colpaert, K., & Dupont, L. J. (2008). Quality of life in patients with cystic fibrosis: Association with anxiety and depression. Journal of Cystic Fibrosis,7, 581–584.

    PubMed  Google Scholar 

  • Hernandez, R., Burrows, B., Wilund, K., Cohn, M., Xu, S., & Moskowitz, J. T. (2018). Feasibility of an internet-based positive psychology intervention for hemodialysis patients with symptoms of depression. Social Work in Health Care,57, 864–879.

    PubMed  PubMed Central  Google Scholar 

  • Hilliard, M. E., Eakin, M. N., Borrelli, B., Green, A. L., & Riekert, K. A. (2015). Medication beliefs mediate between depressive symptoms and medication adherence in cystic fibrosis. Health Psychology,34, 496–504.

    PubMed  Google Scholar 

  • Kashdan, T. B., Mishra, A., Breen, W. E., & Froh, J. J. (2009). Gender differences in gratitude: Examining appraisals, narratives, the willingness to express emotions, and changes in psychological needs. Journal of Personality,77, 3.

    Google Scholar 

  • Knudsen, K. B., Pressler, T., Mortensen, L. H., Skov, M., Quittner, A. L., Katzenstein, T., et al. (2016). Associations between adherence, depressive symptoms and health-related quality of life among young adults with cystic fibrosis. SpringPlus,5, 1216.

    CAS  Google Scholar 

  • Lambert, N. M., Fincham, F. D., & Stillman, T. F. (2012). Gratitude and depressive symptoms: The role of positive reframing and positive emotion. Cognition and Emotion,26, 615–633.

    PubMed  Google Scholar 

  • Lin, C. C. (2017). The effect of higher-order gratitude on mental well-being: Beyond personality and unifactorial gratitude. Current Psychology,26, 127–135.

    Google Scholar 

  • Mc Hugh, R., Mc Feeters, D., Boyda, D., & O’Neil, S. (2016). Coping styles in adults with cystic fibrosis: Implications for emotional and social quality of life. Psychology of Health and Medicine,21, 102–112.

    Google Scholar 

  • 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, 112–127.

    PubMed  Google Scholar 

  • McCullogh, M. E., Tsang, J. A., & Emmons, R. A. (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.

    Google Scholar 

  • Mercon-Vargas, E. A., Poelker, K. E., & Trudge, J. R. H. (2018). The development of the virtue of gratitude: Theoretical foundations and cross-cultural issues. Cross-Cultural Research,52, 3–18.

    Google Scholar 

  • Milbury, K., Engle, R., Tsao, A., Liao, Z., Owens, A., Chaoul, A., et al. (2018). Pilot testing of a brief couple-based mind-body intervention for patients with metastatic non-small cell lung cancer and their partners. Journal of Pain and Symptom Management,55, 953–961.

    PubMed  Google Scholar 

  • Mills, P. J., Redwine, L., Wilson, K., Pung, M. A., Chinh, K., Greenberg, B. H., et al. (2015). The role of gratitude in spiritual well-being in asymptomatic heart failure patients. Spirituality in Clinical Practice,2, 5–17.

    PubMed  PubMed Central  Google Scholar 

  • Millstein, R. A., Celano, C. M., Beale, E. E., Beach, S. R., Suarez, L., Belcher, A. M., et al. (2016). The effects of optimism and gratitude on adherence, functioning and mental health following an acute coronary syndrome. General Hospital Psychiatry,43, 17–22.

    PubMed  PubMed Central  Google Scholar 

  • Mitmansgruber, H., Smrekar, U., Rabanser, B., Beck, T., Eder, J., & Ellemunter, H. (2016). Psychological resilience and intolerance of uncertainty in coping with cystic fibrosis. Journal of Cystic Fibrosis,15, 689–695.

    PubMed  Google Scholar 

  • Ng, M. Y., & Wong, W. S. (2013). The differential effects of gratitude and sleep on psychological distress in patients with chronic pain. Journal of Health Psychology,18, 263–271.

    PubMed  Google Scholar 

  • O’Connell, B. H., O’Shea, D., & Gallagher, S. (2017). Feeling thanks and saying thanks: A randomized controlled trial examining if and how socially oriented gratitude journals work. Journal of Clinical Psychology,73, 1280–1300.

    PubMed  Google Scholar 

  • O’Connell, B. H., O’Shea, D. O., & Gallagher, S. (2018). Examining psychosocial pathways underlying gratitude interventions: A randomized controlled trial. Journal of Happiness Studies,19, 2421–2444.

    Google Scholar 

  • Olveira, C., Sole, A., Girón, R. M., Quintana-Gallego, E., Mondejar, P., Baranda, F., et al. (2016). Depression and anxiety symptoms in Spanish adult patients with cystic fibrosis: Associations with health-related quality of life. General Hospital Psychiatry,40, 39–46.

    CAS  PubMed  Google Scholar 

  • Otto, A. K., Szczesny, E. C., Soriano, E. C., Laurenceau, J. P., & Siegel, S. D. (2016). Effects of a randomized gratitude intervention on death-related fear of recurrence in breast cancer survivors. Health Psycholology,35, 1320–1328.

    Google Scholar 

  • Petrocchi, N., & Couyoumdjian, A. (2016). The impact of gratitude on depression and anxiety: The mediating role of criticizing, attacking, and reassuring the self. Self and Identity,15, 191–205.

    Google Scholar 

  • Quittner, A. L., Abbott, J., Georgiopoulos, A. M., Goldbeck, L., Smith, B., Hempstead, S. E., et al. (2016). International Committee on Mental Health in Cystic Fibrosis: Cystic Fibrosis Foundation and European Cystic Fibrosis Society consensus statements for screening and treating depression and anxiety. Thorax,71, 26–34.

    PubMed  Google Scholar 

  • Quittner, A. L., Goldbeck, L., Abbott, J., Duff, A., Lambrecht, P., Solé, A., et al. (2014). Prevalence of depression and anxiety in patients with cystic fibrosis and parent caregivers: Results of The International Depression Epidemiological Study across nine countries. Thorax,69, 1090–1097.

    PubMed  Google Scholar 

  • Quon, B. S., Bentham, W. D., Unutzer, J., Chan, Y. F., Goss, C. H., & Aitken, M. L. (2015). Prevalence of symptoms of depression and anxiety in adults with cystic fibrosis based on the PHQ-9 and GAD-7 screening questionnaires. Psychosomatics,56, 345–353.

    PubMed  Google Scholar 

  • Riekert, K. A., Bartlett, S. J., Boyle, M. P., Krishnan, J. A., & Rand, C. S. (2007). The association between depression, lung function, and health-related quality of life among adults with cystic fibrosis. Chest,132, 231–237.

    PubMed  Google Scholar 

  • Rosmarin, D. H., Pirutinsky, S., Greer, D., & Korbman, M. (2016). Maintaining a grateful disposition in the face of distress: The role of religious coping. Psychology of Religion and Spirituality,8, 134–140.

    Google Scholar 

  • Ruini, C., & Vescovelli, F. (2013). The role of gratitude in breast cancer: Its relationships with post-traumatic growth, psychological well-being and distress. Journal of Happiness Studies,14, 263–274.

    Google Scholar 

  • Sacco, S. J., Park, C. L., Suresh, D. P., & Bliss, D. (2014). Living with heart failure: Psychosocial resources, meaning, gratitude and well-being. Heart and Lung,43, 213–218.

    PubMed  Google Scholar 

  • Sherman, A. C., Simonton-Atchley, S., Campbell, D., Reddy, R. M., O’Brien, C. E., Guinee, B., et al. (2019). Persistent adherence to airway clearance therapy in adults with cystic fibrosis. Respiratory Care, 64, 778–785.

    PubMed  Google Scholar 

  • Sirois, F. M., & Wood, A. M. (2017). Gratitude uniquely predicts lower depression in chronic illness populations: A longitudinal study of inflammatory bowel disease and arthritis. Health Psychology,36, 122–132.

    PubMed  Google Scholar 

  • Snell, C., Fernandes, S., Bujoreanu, I. S., & Garcia, G. (2014). Depression, illness severity, and healthcare utilization in cystic fibrosis. Pediatric Pulmonology,49, 1177–1181.

    PubMed  Google Scholar 

  • Tulbure, B. T. (2015). Appreciating the positive protects us from negative emotion: The relationship between gratitude, depression and religiosity. Procedia-Social and Behavioral Sciences,187, 475–480.

    Google Scholar 

  • Watkins, P. C., Woodward, K., Stone, T., & Kolts, R. L. (2003). Gratitude and happiness: Development of a measure of gratitude, and relationships with subjective well-being. Social Behavior and Personality,31, 431–452.

    Google Scholar 

  • Wood, A. M., Frohm, J. J., & Geraghty, A. W. (2010). Gratitude and well-being: A review and theoretical integration. Clinical Psychology Review,30, 890–905.

    PubMed  Google Scholar 

  • Wood, A. M., Joseph, S., & Linley, P. A. (2007). Coping style as a psychological resource of grateful people. Journal of Social and Clinical Psychology,26, 1076–1093.

    Google Scholar 

  • Wood, A. M., Joseph, S., & Maltby, J. (2009). Gratitude predicts psychological well-being above the Big Five facets. Personality and Individual Differences,46, 443–447.

    Google Scholar 

  • Wood, A. M., Maltby, J., Gillett, R., Linley, P. A., & Joseph, S. (2008). The role of gratitude in the development of social support, stress, and depression: Two longitudinal studies. Journal of Research in Personality,42, 854–871.

    Google Scholar 

  • Yohannes, A. M., Willgoss, T. G., Fatoye, F. A., Dipp, M. D., & Webb, K. (2012). Relationship between anxiety, depression, and quality of life in adult patients with cystic fibrosis. Respiratory Care,57, 550–556.

    PubMed  Google Scholar 

Download references

Author information

Author notes

  1. Dianne Campbell

    Present address: Social Work Services, Central Arkansas Veterans Healthcare System, Little Rock, AR, USA

  2. Raghu M. Reddy

    Present address: St. Vincent’s Hospital, Little Rock, AR, USA

Authors and Affiliations

  1. Behavioral Medicine Division, University of Arkansas for Medical Sciences, #756, 4301 W. Markham Street, Little Rock, AR, 72205, USA

    Allen C. Sherman, Stephanie Simonton-Atchley & Laura D. Wagner

  2. Department of Pharmacy Practice, University of Arkansas for Medical Sciences, Little Rock, AR, USA

    Catherine E. O’Brien & Bethany Guinee

  3. Cystic Fibrosis Clinic, University of Arkansas for Medical Sciences, Little Rock, AR, USA

    Dianne Campbell

  4. Department of Internal Medicine, University of Arkansas for Medical Sciences, Little Rock, AR, USA

    Raghu M. Reddy & Paula J. Anderson

Authors
  1. Allen C. Sherman
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Stephanie Simonton-Atchley
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Catherine E. O’Brien
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Dianne Campbell
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Raghu M. Reddy
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Bethany Guinee
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Laura D. Wagner
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Paula J. Anderson
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Allen C. Sherman.

Ethics declarations

Conflict of interest

Allen C. Sherman, Stephanie Simonton-Atchley, Catherine E. O’Brien, Dianne Campbell, Raghu M. Reddy, Bethany Guinee, Laura D. Wagner, Paula J. Anderson declare that they have no conflicts of interest.

Human and animal rights and Informed consent

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000. Informed consent was obtained from all patients for being included in the study. This article does not contain any studies with animals performed by any of the authors.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Sherman, A.C., Simonton-Atchley, S., O’Brien, C.E. et al. Longitudinal associations between gratitude and depression 1 year later among adult cystic fibrosis patients. J Behav Med 43, 596–604 (2020). https://doi.org/10.1007/s10865-019-00071-y

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10865-019-00071-y

Keywords

Search

Navigation