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The effects of counting blessings with a visual-reminder on subjective well-being

Dissertation
Author: Pascual Chen
Abstract:
Expressing gratitude can lead to increased subjective well-being and prosocial behavior (Emmons & McCullough, 2003), and decreased depression (Seligman, Steen, Park, & Peterson, 2005) and physical health complaints (Emmons & McCullough, 2003). There are two main obstacles to gratitude, forgetfulness and lack of awareness (Emmons, 2007). Therefore, a common barrier to the success of gratitude interventions is the failure to remember to do the interventions, rendering them useless. This study aimed to address the issue of compliance with a counting blessings exercise by investigating the use of bracelets as a visual reminder to count blessings. Undergraduate psychology courses were randomly assigned to one of two conditions: bracelet condition or non-bracelet condition. Participants in both conditions were asked to count blessings for 2 weeks, but the bracelet group was given bracelets with the word gratitude on it to help them remember to count their blessings. Self-reported data on positive affect, gratitude, life satisfaction, perceived health, prosocial behavior, positive reflection, negative affect, depression, and negative rumination were collected for both conditions at pre-test, post-test, and 2-week follow-up. Intervention compliance and bracelet compliance for those in the bracelet condition were also assessed at mid-intervention, post-test, and 2-week follow-up. Prosocial behavior was measured via a behavioral indicator at 2-week follow-up. It was hypothesized that participants in the bracelet condition would show improvements in gratitude, life satisfaction, positive affect, prosocial behavior, time spent reflecting on positive events, self-perceived health, and decreased negative affect, depression, and negative rumination compared with participants in the non-bracelet condition at post-intervention and 2-week follow-up. It was also predicted that compliance would be higher for the bracelet group as compared with the non-bracelet group and that compliance would mediate the relation between condition and the outcomes at 2-week follow-up. Results showed that participants in the bracelet condition did not significantly differ on the dependent variables when compared to the non-bracelet group. As a result, none of the hypotheses were supported in the present study. The level of motivation, use of other memory aids, bracelet likability, and the use of a student population may have contributed to the lack of between-group differences.

TABLE OF CONTENTS Copyright 11 Abstract iii Acknowledgments v Table of Contents vi List of Tables x List of Figures x i Chapter I. Introduction 1 Theoretical Framework 2 The Psychology of Gratitude 3 Gratitude and Subjective Well-Being 4 Gratitude and Prosocial Behavior 7 Gratitude and Depression 10 Gratitude and Health Perceptions 13 Gratitude Interventions 15 Treatment Compliance 19 Obstacles of Gratitude: Will a Visual Reminder Help? 22 Purpose of the Present Study 24 Hypotheses 24 Research Question 25 Chapter II. Methods 27 Participants 27 Consent Form and Demographics 27 vi

Student consent form 27 Demographics questionnaire 28 Measures 28 The Positive and Negative Affect Schedule 28 The Gratitude Adjective Checklist 29 The Center for Epidemiologic Studies - Depression Scale 29 The Satisfaction with Life Scale 29 Perceived Wellness Survey 30 Rumination About an Interpersonal Offense Scale 30 Prosocial Behaviors 31 Behavioral Measure of Prosocial Behavior 31 Self-report Measure of Prosocial Behavior 32 Additional Item Ratings 33 Self-reported Reflection 33 Self-reported Compliance 33 Bracelet Compliance 34 Self-reported Bracelet Likability 34 Design and Procedure 34 Chapter III. Results 40 Treatment Integrity 40 Data Screening 41 Descriptive Statistics 42 Analysis of Composite Scores 42 vii

Examination of Hypotheses 42 Hypothesis One 42 Hypthesis Two 53 Hypothesis Three 54 Hypothesis Four 54 Hypothesis Five 54 Hypothesis Six 56 Research Question One 56 Research Question Two 56 Research Question Three 59 Additional Analyses 59 Chapter IV. Discussion 61 Discussion of Present Study 62 Preliminary Analyses 62 Additional Analyses 67 Clinical Implications 69 Strengths of the Current Study 71 Limitations of the Current Study 72 Recommendations for Future Research 74 Conclusion 78 References 80 Appendices 95 Appendix A. Consent Form 95 viii

Appendix B. Demographic Questionnaire 96 Appendix C. The Postive and Negative Affect Schedule 97 Appendix D. The Gratitude Adjective Checklist 98 Appendix E. The Center for Epidemiologic Studies - Depression Scale 99 Appendix F. The Satisfaction with Life Scale 100 Appendix G. Perceived Wellness Survey 101 Appendix H. Rumination About an Interpersonal Offense Scale 102 Appendix I. Behavioral Measure for Prosocial Behavior 103 Appendix J. Pre-test Questionnaire for Bracelet and Non-bracelet Conidition 104 Appendix K. Mid- and Post-test Questionnaire for Bracelet Condition 105 Appendix L. 2-Week Follow-up Questionnaire for Bracelet Condition 106 Appendix M. Mid- and Post-test Questionnaire for Non-bracelet Condition 107 Appendix N. 2-week Follow-up Questionnaire for Non-bracelet Condition 108 Appendix O. In-class Exercise Page for Bracelet Condition 109 Appendix P. In-class Exercise Page for Non-bracelet Condition 110 Appendix Q. Take-home Exercise Packet for Bracelet Condition I l l Appendix R. Take-home Exercise Packet for Non-Bracelet Condition 112 ix

List of Tables Table 1. Frequency Data of Demographic Variables across Conditions 43 Table 2. Means and Standard Deviations across Conditions for Positive Affect on the Positive and Negative Affect Schedule at Pre-Test, Post-Test, and 2-Week Follow- up 44 Table 3. Means and Standard Deviations across Conditions for Negative Affect on the Positive and Negative Affect Schedule at Pre-Test, Post-Test, and 2-Week Follow- up 45 Table 4. Means and Standard Deviations across Conditions for Gratitude on the Gratitude Adjective Checklist at Pre-Test, Post-Test, and 2-Week Follow-up 46 Table 5. Means and Standard Deviations across Conditions for Depression on the Center for Epidemiologic Studies at Pre-Test, Post-Test, and 2-Week Follow-up 47 Table 6. Means and Standard Deviations across Conditions for Life Satisfaction on the Satisfaction with Life Scale at Pre-Test, Post-Test, and 2-Week Follow-up 48 Table 7. Means and Standard Deviations across Conditions for Self-Perceived Health on the Perceived Wellness Survey at Pre-Test, Post-Test, and 2-Week Follow-up...49 Table 8. Means and Standard Deviations across Conditions for Rumination on the Rumination About an Interpersonal Offense Scale at Pre-Test, Post-Test, and 2- Week Follow-up 50 Table 9. Means and Standard Deviations across Conditions for Prosocial Behavior Composite at all Time Points 51 Table 10. Means and Standard Deviations across Conditions for Treatment Compliance Composite at Post-test 52 Table 11. Number of Surveys with Percentages Completed and Emailed Back 3 Days after 2-Week Follow-up By Condition 57 Table 12. Means and Standard Deviations for Participants Who Reported Wearing Bracelets at Least Once and the Non-bracelet Group for Rumination on the Rumination About an Interpersonal Offense Scale at Pre-Test, Post-Test, and 2- Week Follow-up 60 x

Table of Figures Figure 1. Summary of the Administration of Measures, Single Likert-Type Items, and Behavioral Measure for Prosocial Behavior 39 Figure 2. Average Number of Blessing Counted and Returned across Condition at Post- Test 55 Figure 3. Number of Surveys Completed and Emailed Back 3 Days after 2-Week Follow- up By Condition 58 xi

Gratitude with Bracelets 1 CHAPTER I Introduction Gratitude unlocks the fullness of life. It turns what we have into enough, and more. It turns denial into acceptance, chaos to order, confusion to clarity. It can turn a meal into a feast, a house into a home, a stranger into a friend. Gratitude makes sense of our past, brings peace for today, and creates a vision for tomorrow. - Melody Beattie Gratitude and well-being are robustly related (Emmons & McCullough, 2003; Seligman, Steen, Park, & Peterson, 2005; Sheldon & Lyubomirsky, 2006), and gratitude interventions consistently demonstrate the largest increases in subjective well-being compared with other positive psychology interventions (Emmons & McCullough, 2003; Froh, Sefick, & Emmons, 2008; Seligman et al., 2005). Gratitude can decrease depressive symptoms, suggesting that using gratitude exercises as homework assignments in psychotherapy may prove useful for treating negative symptomolgy (Fredrickson, Tugade, Waugh, & Larkin, 2003; Seligman, Rashid, & Parks, 2006; Tugade & Fredrickson, 2004; Wood, Maltby, Gillett, Linley, & Joseph, 2008). Furthermore, individuals who performed gratitude exercises for 1 week and continued to do them after the intervention period showed improvements in happiness and reductions in depression up to 6-months later (Seligman et al., 2005). Although people can derive many benefits from doing gratitude interventions, they are of no use if they are not done. The purpose of the current study is to examine the effectiveness of using bracelets as behavioral reminders to increase treatment compliance with a gratitude intervention (i.e., counting blessings). Bracelets as a visual memory aid have been used in interventions designed to decrease smoking in teens (Plastini-Mertens, 2006), decrease alcohol consumption among designated drivers (Lang, Reed, & Johnson, 2006), and

Gratitude with Bracelets 2 increase condom use among teens (Dal Cin, MacDonald, & Fong, 2006), supporting its potential usefulness in reminding individuals to count their blessings. The current study aims to provide further support for counting blessings as an intervention to increase subjective well-being, prosocial behavior, self-reported health perceptions, and decrease depressive symptomology (Fredrickson et al., 2003; Seligman et al., 2006; Tugade & Fredrickson, 2004; Wood et al., 2008). Also, this is the first known study to attempt to examine the use of bracelets to increase the reflection of grateful cognitions. Theoretical Framework There are three useful theories that help conceptualize gratitude and its many functions. Traditional models of emotion suggest negative emotions narrow one's focus and restrict one's behavioral range. Conversely, the broaden-and-build theory of positive emotions (Fredrickson, 1998, 2001) suggests that positive emotions broaden momentary thought-action repertoires and enhance enduring physical, intellectual, and social resources, resulting in numerous benefits (Erez & Isen, 2002; Fredrickson et al., 2003; Fredrickson 1998, 2001; Tugade & Fredrickson, 2004). Using gratitude as an example, the broaden-and-build theory helps explain gratitude's connection with the building of durable resources, namely social relationships (Fredrickson, 2004). For instance, an individual feeling grateful for receiving a benefit may experience a broadening of thoughts about how to repay their benefactor, thus returning the favor in a unique, rather than tit-for-tat, fashion. Such behavior is likely to, over time, help strengthen the relationship and, thus, build durable social resources. Positive emotions, therefore, seem essential for human flourishing (Fredrickson, 2009). The second theory describes gratitude as a moral emotion, linking gratitude to

Gratitude with Bracelets 3 morality and submitting that it serves three moral functions: a moral barometer, a moral motive, and a moral reinforcer (McCullough, Kilpatrick, Emmons, & Larson, 2001). Gratitude as a moral affect typically results from and stimulates behavior that is motivated out of concern for another person (McCullough et al., 2001). As a moral barometer, gratitude acts as an affective readout that detects a specific type of change in one's social environment—the provision of a benefit from a benefactor. As a moral motive, gratitude prompts individuals to act prosocially towards their benefactor (McCullough et al.) or others (Nowak & Roch, 2007). As a moral reinforcer, expressions of gratitude encourage benefactors to behave prosocially in the future (McCullough et al.). Finally, reinforcement theory suggests that people's behaviors are controlled by reinforcements or what comes after the behavior, whether positive or negative (O'Donohue & Ferguson, 2001). Therefore, reinforcement theory would suggest that the reason people express gratitude is because of the positive emotions or social status that comes after it (i.e., acting as a moral reinforcer; McCullough et al., 2001). For example, when an individual shows gratitude to a friend for a gift received, the friend is reinforced to behave prosocially or morally in the future. In sum, behaving gratefully seems to usually result in some sort of gain, whether it is intrinsic or extrinsic, such as a feeling of joy or reinforcing a benefactor to behave morally in the future. Thus, according to reinforcement theory, the motive of gratitude may be explained by prior reinforcement history. The Psychology of Gratitude Gratitude can be defined as a positive emotion that a beneficiary feels when

Gratitude with Bracelets 4 something of value neither earned nor deserved is given to them from a benefactor (Bartlett & DeSteno, 2006; Emmons & McCullough 2003; McCullough et al., 2001; McCullough & Tsang, 2004). Gratitude can also be thought of as a sense of thankfulness and joy in response to receiving a favor, gift, or moment of bliss (Emmons, 2004). In addition to being an emotion, gratitude has been conceptualized as a signature strength (Peterson, Park, & Seligman, 2005; Peterson & Seligman, 2004; Seligman et al., 2005), moral affect (McCullough et al., 2001), personality trait (Lararus & Lararus, 1994; McCullough, Emmons, & Tsang, 2002), and coping response (Fredrickson et al., 2003). Gratitude as a signature strength, listed under the virtue transcendence in the Values in Action classification of strengths (Peterson & Seligman, 2004), which is a classification of character strengths, "forges connections to the larger universe and provides meaning" (Seligman et al., 2005, p. 412). For instance, gratitude permeates religious texts, prayers, and teachings, helping people find meaning and purpose in life (Emmons, 2005, Emmons & Kneezel, 2005; Plantinga, 2000). The many conceptualizations of gratitude make it difficult for easy classification (Emmons & McCullough, 2003). Nonetheless, the research clearly suggests that gratitude helps promote subjective well-being, prosocial behavior, and physical health (see Emmons, 2007 for a review). Gratitude and Subjective Weil-Being Subjective well-being (SWB) has three core features: high positive affect, low negative affect, and high life satisfaction (Diener, 2000). In colloquial terms, SWB is known as "happiness" (Diener, 2000). The architecture of sustainable happiness model

Gratitude with Bracelets 5 suggests that a person's sustainable happiness level is governed by three major factors: a genetically determined set point for happiness, happiness-relevant circumstantial factors, and happiness-relevant activities (Lyubomirsky, Sheldon, & Schkade, 2005). Happiness-relevant activities, which are within an individual's power to control, account for 40% of an individual's happiness (Lyubomirsky et al., 2005), suggesting that consistently engaging in happiness-inducing activities, such as counting blessings (Emmons & McCullough, 2003; Froh, Sefick, & Emmons, 2008), can promote sustainable happiness. Therefore, engaging in gratitude exercises seems like a good prescription for individuals interested in boosting their happiness—and keeping it elevated—for extended periods of time. Grateful people tend to be happier than less grateful people (Emmons & McCullough, 2003; Seligman et al., 2005; Sheldon & Lyubomirsky, 2006). There are at least eight ways in which adopting an "attitude of gratitude" promotes SWB (Lyubomirsky, 2008). When grateful people reflect upon things for which they are grateful, their thoughts are focused on positive life events. Focusing on positive life events interferes with and temporarily arrests negative rumination and emotions. Gratitude also fosters the savoring of life's pleasures, which leads to increased happiness. Another way gratitude bolsters happiness is by increasing people's self- esteem and self-worth. For instance, when people reflect upon the gifts in their lives, self-worth is bolstered because the benefits received remind them that others care for them. The expression of gratitude also strengthens relationships. For example, when people contemplate the goodness of their friendships, they are more likely to treat their friends better. Gratitude also promotes prosocial and moral behavior. Moreover,

Gratitude with Bracelets 6 gratitude enhances coping with life's challenges by helping people re frame their challenges in a more positive manner and prompting them to be grateful for areas of life that are going well. Also, when people think about how others have been kind to them, the likelihood of comparing themselves to those more fortunate is reduced. Finally, grateful people tend to adapt to new circumstances or situations, whether good or bad. For instance, people adapt to marriage quickly (Lucas, Clark, Georgellis, & Diener, 2003). Grateful people, however, are more likely able to thwart this hedonic adaption by continually appreciating and expressing gratitude for being married. Gratitude, therefore, seems to boost well-being because it positively impacts on one's cognitions, behaviors, and emotions. In one study, college students completed self-report measures of gratitude, positive and negative emotions, life satisfaction, and prosocial behavior (McCullough, Emmons, & Tsang, 2002). Results indicated that gratitude was positively related with happiness and life satisfaction (McCullough et al., 2002). In addition, gratitude was positively related with vitality, hope, optimism, and negatively related with depression and anxiety, thus demonstrating its link with well-being. Other studies with university students corroborate these findings (Joseph, Linley, Harwood, Lewis, & McCollam, 2004; Pavot & Diener, 1993; Wood, Joseph, & Linley, 2007). Together, these studies demonstrate that gratitude may be a key ingredient for well-being. It therefore makes sense to investigate gratitude interventions and examine their effect on immediate and long-term well-being. That is one of the main purposes of the present study. There are now nine published studies examining gratitude interventions (see Froh, Kashda, Ozimkowski, & Miller, 2009 for a review). Overall, gratitude

Gratitude with Bracelets 7 interventions are robustly related with social, emotional, and physical well-being (Emmons & McCullough, 2003; Froh et al., 2008; Seligman et al., 2005). Specifically, counting blessings has been found to be related to higher life satisfaction, increased gratitude, fewer physical complaints (Emmons & McCullough, 2003), and decreased depression (Seligman et al., 2005). Other gratitude interventions, such as writing or thinking about someone for whom one is grateful, has also been related to increased positive affect. In one study, increases in positive affect from pre-treatment to post- treatment were higher for a group of college students who either wrote or thought about someone for whom they were grateful compared with a group that wrote about the layout of their living room (Watkins et al., 2003, Study 4). In addition to being related to SWB—and in some instances seeming to cause SWB— gratitude is also related with fewer depressive symptoms (Fredrickson et al., 2003; Seligman et al., 2006; Tugade & Fredrickson, 2004; Wood et al., 2008), better perceived health (Emmons & McCullough, 2003, Study 1), and prosocial behavior (Barlett & DeSteno, 2006; Tsang, 2006). Gratitude and Prosocial Behavior Cicero called gratitude "the parent of all other virtues" and believed that gratitude enhances relationships by activating prosocial behavior (Cicero, 1851, p. 139). Similarly, Simmel said that gratitude was "the moral memory of mankind" (Simmel, 1908/1996, p. 139) because remembering one's blessings prompts prosocial behavior. Supporting these claims, research has demonstrated that gratitude can operate as a moral motive for individuals to act prosocially after having received a benefit (Barlett & Desteno, 2006; McCullough et al., 2001; Tsang, 2006). Furthermore, grateful individuals engage more

Gratitude with Bracelets 8 frequently in prosocial behavior than do less grateful individuals (Emmons & McCullough, 2003; McCullough, Emmons, & Tsang, 2002). The link between gratitude and prosocial behavior has been supported by correlational (McCullough, Emmons, & Tsang, 2002) and experimental research (Barlett & Desteno, 2006; Emmons & McCullough, 2003). In one study, participants were assigned to one of three conditions: gratitude, amusement, and neutral. The procedure for all three conditions was the same for the first part of the study. Trained confederates and participants performed several problem-solving tasks on the computer. After the tasks were completed, however, the procedure for each condition differed from one another Barlett & Desteno, 2006). In the gratitude condition, immediately after completing the tasks, the participant encountered a problem with the computer, unknowingly orchestrated by the confederate, posing as another participant. The confederate, who was blind to the purpose of the study, assisted the participant by fixing the computer problem. In the amusement condition, after the completion of the computer tasks, both the confederate and participant watched a short comedy clip. In the neutral condition, the participant and confederate worked on the computer task separately and exchanged a few words before leaving the room. After the mood manipulations, participants were asked to complete a questionnaire that assessed their emotional state and feelings toward the confederate. Shortly after completing the questionnaire, the participant left the lab to receive course credit and obtain an experiment-evaluation form from the experimenter. While completing the form, the confederate approached the participant and asked if they would be willing to help with a survey that was designed to be tedious. The confederate made it

Gratitude with Bracelets 9 clear to the participant that completing the survey would take at least half an hour. The participant could do as much as they wanted; however, the more questions completed, the more helpful it would be. The experimenter inconspicuously timed how long the participant spent working on the task, which served as the primary measure for the helping behavior. Participants in the gratitude condition reported feeling more grateful than those in the amusement and neutral conditions. Furthermore, those in the gratitude condition were more likely to help and spend more time helping the confederate than those in the other two groups (Barlett & Desteno, 2006). The findings in the aforementioned study coincide with another experiment that was conducted examining gratitude's effect on prosocial behavior. In this study, a behavioral measure was also used for prosocial behavior (Tsang, 2006). Specifically, participants were induced to feel grateful in a resource distribution task consisting of three rounds. For each round, $10 was distributed between the participant and another participant who was fictitious. In some rounds the participant got to choose how the money would be distributed and in other rounds the fictitious partner decided how the money was distributed. The participant and the fictitious partner communicated by passing a note via the experimenter. For Round 1, all participants were led to believe that they received $3 by "chance," while their fictitious partner received $7, also by "chance". Participants were then randomly assigned to either the favor condition or chance condition for Round 2. Participants in the favor condition were told that in Round 2, their fictitious partner gave them $9, while keeping only $1 for themselves, with a note saying they felt bad about how they got little money in the last round. On the contrary, those in the chance group

Gratitude with Bracelets 10 were told that they got $9 by chance, whereas their partner got only $1 by chance. In Round 3, participants in both groups had the opportunity to decide how the $10 got distributed. In this round, those in the favor condition gave significantly more money to their fictitious partner compared with those in the chance condition. This study suggests those in the favor condition gave more money than those in the chance condition because they were grateful for receiving a favor from their fictitious partner in the previous round. Prosocial responses to gratitude as measured by the distribution of resources to another were paired with a self-report measure of gratitude. The results showed that participants in the favor condition helped more and reported more gratitude compared with participants in the chance condition. Thus, the distribution of money seems to have been influenced by gratitude's function as a moral motive. An important limitation in many studies examining the relation between gratitude and prosocial behavior is the lack of a behavioral measure; many of the studies used only self-report measures. Apart from three studies (Barlett & Desteno, 2006; Tsang, 2006, 2007), the rest of the known studies restricted the prosocial measures to self-report. Therefore, it is questionable whether the participants in those studies who reported themselves as more prosocial would have actually behaved prosocially given the opportunity. The current study hopes to expand the literature on gratitude and prosocial behavior by using a behavioral measure of prosocial behavior. Gratitude and Depression Gratitude and depression are inversely related, and gratitude has shown to buffer against and decrease depressive symptoms (Fredrickson et al., 2003; Seligman et al., 2006; Tugade & Fredrickson, 2004; Wood et al., 2008). One explanation for the inverse

Gratitude with Bracelets 11 relation between gratitude and depression may be that grateful people tend to remember past positive events more easily than less grateful people, suggesting that grateful people have a positive memory bias (Watkins, Grimm, & Kots, 2004). Having a grateful outlook and positive memory bias contrasts that of a depressive outlook, which tends to worsen depressive symptoms (Beck, 1963; Lyubomirsky, 2008). For example, grateful people tend not to be self-focused, are more likely to have a positive interpretation of past life events, and are keenly aware when they are the beneficiaries of other people's prosocial behavior (Fredrickson et al., 2003; Watkins et al., 2004). In contrast, depressed people are negatively self-focused, have a pessimistic outlook about the world and their future, and tend to ruminate about past negative events (Beck, 1963; Stark, Schmidt, & Joiner, 1996). Therefore, being grateful seems incompatible with being depressed. Two studies investigating the relation between gratitude and the autobiographical memory of positive and negative life events found a significant positive relation between trait gratitude and a positive memory bias (Watkins et al., 2004, Study 1) even after controlling for depression (Watkins et al., 2004, Study 2). Specifically, memories of past positive life events came to mind more easily and frequently for grateful people compared with less grateful people. When grateful people were asked to recall negative events, they had more intrusive positive memories come to mind compared with less grateful people. Grateful people also tended to generally interpret life events positively. Furthermore, grateful people were more likely to find positive outcomes from past negative memories, which lessened the aversive emotional impact of the negative memory. This suggests that gratitude had a positive impact on the closure of negative memories. Finally, when grateful people recalled a positive life event, they experienced

Gratitude with Bracelets 12 the positive effect of that event more intensely. These studies help explain why gratitude and depression are inversely related and how gratitude may buffer against depressive symptoms. Support for gratitude helping reframe past negative memories more positively and decreasing the aversive emotions associated with the negative memories was also found in another study (Watkins, Cruz, Holben, & Kolts, 2008). The study investigated the impact gratitude had on the processing of unpleasant memories. Participants were randomly assigned to one of three writing conditions: control, emotional control, and gratitude. In each condition, participants were first asked to recall an open unpleasant memory, defined as a troubling memory from the past that has not yet been completely closed or understood. After recalling the open memory, participants in the control condition were asked to write about their plans for the following day. For the emotional control condition, participants wrote about the unpleasant event itself. Finally, participants in the gratitude condition wrote about positive consequences that resulted from the event of the open memory. Results indicated that those in the grateful condition were more able to move past the unpleasant memory and have closure, be less emotionally affected by the unpleasant memory, and be less interrupted in their daily thoughts by the unpleasant memory compared with the other writing conditions. Thus, gratitude's positive impact on the processing of unpleasant memories may be another reason why grateful people tend to be happy people. These studies provide a possible explanation for the inverse relationship between gratitude and depression: grateful people tend to remember more positive life events compared with negative ones, which in turn increases positive emotions. Grateful people

Gratitude with Bracelets 13 also tend to reframe negative emotional memories in ways that decrease the emotional trauma associated with the memory (Watkins et al., 2004). Finally, grateful people seem to find and remember positive consequences from negative events thereby encoding life events in a more positive manner compared with less grateful people (Masingale et al., 2001; Watkins et al., 2004). The relation between gratitude and depression has clinical implications. Incorporating gratitude exercises into clinical settings might augment traditional psychotherapeutic techniques (Seligman et al., 2006). Indeed, people experiencing either mild-to-moderate depression or major depressive disorder (fourth edition of the Diagnostic and Statistical Manual of Mental Disorder; American Psychiatric Association, 2000) who received positive psychotherapy (PPT) reported significantly less depression compared with controls (Seligman et al., 2006). Although it is impossible to identify any one exercise in the PPT condition as the sole cause for these effects, it is possible that participants receiving PPT experienced a decrease in depressive symptoms because the two gratitude exercises (one being "counting blessings) helped them stop ruminating about negative events and, instead, focused them on positive consequences that resulted from the negative events (Seligman et al., 2006). This is in-line with findings that grateful people have a positive memory bias (Watkins et al., 2008; Watkins et al., 2003). Gratitude and Health Perceptions Gratitude is also related to better self-perceived health (Emmons & McCullough, 2003, Study 1; Froh et al., 2008). This may be because gratitude buffers against negative emotions, which are related to health problems such as coronary artery disease (Stewart, Janicki, & Kamarck, 2006; Tugade & Fredrickson, 2004;

Full document contains 124 pages
Abstract: Expressing gratitude can lead to increased subjective well-being and prosocial behavior (Emmons & McCullough, 2003), and decreased depression (Seligman, Steen, Park, & Peterson, 2005) and physical health complaints (Emmons & McCullough, 2003). There are two main obstacles to gratitude, forgetfulness and lack of awareness (Emmons, 2007). Therefore, a common barrier to the success of gratitude interventions is the failure to remember to do the interventions, rendering them useless. This study aimed to address the issue of compliance with a counting blessings exercise by investigating the use of bracelets as a visual reminder to count blessings. Undergraduate psychology courses were randomly assigned to one of two conditions: bracelet condition or non-bracelet condition. Participants in both conditions were asked to count blessings for 2 weeks, but the bracelet group was given bracelets with the word gratitude on it to help them remember to count their blessings. Self-reported data on positive affect, gratitude, life satisfaction, perceived health, prosocial behavior, positive reflection, negative affect, depression, and negative rumination were collected for both conditions at pre-test, post-test, and 2-week follow-up. Intervention compliance and bracelet compliance for those in the bracelet condition were also assessed at mid-intervention, post-test, and 2-week follow-up. Prosocial behavior was measured via a behavioral indicator at 2-week follow-up. It was hypothesized that participants in the bracelet condition would show improvements in gratitude, life satisfaction, positive affect, prosocial behavior, time spent reflecting on positive events, self-perceived health, and decreased negative affect, depression, and negative rumination compared with participants in the non-bracelet condition at post-intervention and 2-week follow-up. It was also predicted that compliance would be higher for the bracelet group as compared with the non-bracelet group and that compliance would mediate the relation between condition and the outcomes at 2-week follow-up. Results showed that participants in the bracelet condition did not significantly differ on the dependent variables when compared to the non-bracelet group. As a result, none of the hypotheses were supported in the present study. The level of motivation, use of other memory aids, bracelet likability, and the use of a student population may have contributed to the lack of between-group differences.