This thesis includes a literature review that summarises the types of psychological research that have been conducted into gratitude, including the research conceptualising and developing assessments around it and exploring its associations with wellbeing, personality, social interaction, and health. The review focuses specifically on the research examining the relationship of gratitude to anxiety, depression and sleep, providing an outline of current theories about the relationship of positive affect to wellbeing, and a summary of the evidence to date. It is noted that there is comparatively little research on the impact of gratitude on anxiety and sleep but promising findings about the role of gratitude in the treatment of depression. Taken together, it is argued, the current research supported the need for trials of gratitude interventions specifically with clinical populations. Finally, the review looks at the literature of experimental interventions using gratitude. Particular emphasis is given to what has been learnt through these trials that might guide the focus and design of future research.
There follows the report of a randomized wait-list controlled pre-post trial of a gratitude diary intended to extend the research into the efficacy of gratitude diaries in the treatment of clinical populations with depression, anxiety and sleep difficulties. It was hypothesised that after completing a brief gratitude diary for three weeks, participants would have lower scores on measures of depression, anxiety, and perceived sleep difficulties, and higher scores on a measure of life satisfaction. These results were also expected to be evident at three-week follow-up. In a randomised waitlist-controlled trial with repeated measures pre-, post- and follow-up design, participants (N=109, from Australia) aged 18-64 years with a current self-reported diagnosis of an anxiety disorder and/or depression, took part in a self-help study via the internet. After completing the diary participants had lower scores on measures of depression, anxiety and perceived sleep difficulties and higher scores on a measure of subjective wellbeing than immediately pre-intervention. In addition, they had improved scores on a measure of stress. At three-week follow-up scores on depression and perceived sleep difficulties were no longer significantly different from pre-intervention, however improvements for subjective wellbeing and stress at post-intervention were maintained. At follow-up scores for anxiety had not only been maintained but had improved significantly beyond post-intervention results. This trial provides support for the use of gratitude diaries as a short-term intervention with a clinical population. Different patterns of anxiety and depression scores raise the possibility that gratitude interventions work differently to address depression and anxiety symptoms and provide support for the idea that gratitude interventions may have sustainable effects on anxiety symptoms.
Field of Research
170106 Health, Clinical and Counselling Psychology
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