Every year, nearly 800,000 Americans endure a first myocardial infarction (MI), and over half of those will have a recurrent event. There are numerous factors that influence prognosis following an MI. In addition to physical factors, such as initial MI severity and adherence to medication and cardiac rehabilitation programs, psychosocial factors are highly predictive of future clinical course. Positive affect, finding meaning in the MI event, and in life in general, and managing the consequences and emotional distress of the MI are highly important. Gratitude is typically defined as a feeling or attitude in acknowledgment of a benefit that one has received or will receive, a habitual focusing on and appreciating the positive aspects of life. It is associated with higher levels of subjective well-being, and people who are more grateful experience less stress, are less depressed, have higher levels of control over their environment, have more positive ways of coping with life's difficulties, and have fewer negative coping strategies. Gratitude is correlated with self-reported physical health, and this link is mediated by psychological health, healthy activities, and willingness to seek help for health. Interventions to clinically increase gratitude have shown great promise, demonstrating the ability to increase overall sense of well-being, meaning in life, and potential associations with improved health. In 113 patients within 30 days of a first-time MI, this proposed exploratory intervention study will examine whether an eight-week gratitude journaling intervention coupled with standard of care (SOC), as compared to SOC plus journaling memorable events and SOC alone will increase positive health behaviors, psychological health, and physical functioning. Psychosocial and clinical assessments will be performed over a six-month period, with testing occurring before, immediately after, and four months after treatment. We envision the study's findings will (a) scientifically show evidence of causality in the relationship between gratitude and our clinically relevant endpoints, (b) therapeutically provide a new intervention methodology to harness these benefits in this cardiac population, and (c) show mechanisms that underlie both the natural and therapeutic effects, both to improve scientific understanding and to allow more tailored interventions to be developed at a later date.

Public Health Relevance

Psychosocial factors, including positive affect, finding meaning in the event, and managing emotional distress, influence prognosis following a myocardial infarction (MI). Gratitude, typically defined as a feeling or attitude in acknowledgment of a benefit that one has received or will receive, is associated with higher levels of subjective well-being, and people who are more grateful experience less stress, are less depressed, have higher levels of control over their environment and more positive ways of coping. The present project will examine the potential benefits of a gratitude intervention to increase positive health behaviors, psychological health, and physical functioning in post-MI patients.

Agency
National Institute of Health (NIH)
Type
Exploratory/Developmental Grants (R21)
Project #
1R21AT008033-01A1
Application #
8769400
Study Section
Biobehavioral Mechanisms of Emotion, Stress and Health Study Section (MESH)
Program Officer
Weber, Wendy J
Project Start
Project End
Budget Start
Budget End
Support Year
1
Fiscal Year
2014
Total Cost
Indirect Cost
Name
University of California San Diego
Department
Psychiatry
Type
Schools of Medicine
DUNS #
City
La Jolla
State
CA
Country
United States
Zip Code
92093