@2024 Afarand., IRAN
ISSN: 2383-2150 Journal of Education and Community Health 2019;6(2):87-93
ISSN: 2383-2150 Journal of Education and Community Health 2019;6(2):87-93
Effect of Gratitude on Mental Health with Mediating Role of Positive and Negative Affect
ARTICLE INFO
Article Type
Descriptive & Survey StudyAuthors
Shakerifard M. (1)Mohamadzadeh Ebrahimi A. (*2 )
Rahimi Pordanjani T. (2)
(*2 ) Psychology Department, Humanities Sciences Faculty, University of Bojnord, Bojnord, Iran
(1) Counseling Department, Humanities Sciences Faculty, University of Bojnord, Bojnord, Iran
(2) Psychology Department, Humanities Sciences Faculty, University of Bojnord, Bojnord, Iran
Correspondence
Article History
Received: November 10, 2018Accepted: January 16, 2019
ePublished: June 20, 2019
BRIEF TEXT
[1]. ... [2]. … [3, 4]. Gratitude, as one of the newest constructs of the positive psychology approach, has attracted the attention of many researchers.
... [5-8]. Studies have shown that gratitude is associated with life satisfaction [11-19], happiness, quality of sleep and reduction of mental disorders [10], higher mental health [9], lower depression [11-13], sociable behavior [14], sense of cohesion [15], positive interpersonal performance [16], protection from illness and suffering financial stress [12] and greater well-being in adolescence and adulthood. In addition, experimental studies show that gratitude training significantly improves mental health [5, 18, 19]. ... [20]. Although the role of gratitude in mental health and other positive psychological functions has confirmed, the mechanisms that link gratitude to mental health are still unknown and have not been systematically investigated. According to Broaden-and-Build Theory, gratitude can lead to spreading and expanding positive emotions [21]. Studies have also shown that individuals experience higher levels of positive emotions, such as happiness, vitality, positive affection, and optimism and gratitude as a qualification, protects us from negative emotions, such as jealousy, anger and anxiety [6, 22, 23]. ... [24]. … [25]. ... [26]. It has indicated that the positive affect has a negative relationship and negative affect has a significant positive relationship with the dimensions of mental illness [27]. … [28]. … [29]. ... [30, 31].
The aim of this study was to investigate the effect of gratitude on mental health with the mediating role of positive and negative affect.
The present research is a descriptive-correlational study through the structural equation model (SEM)
The statistical population included all students of medical sciences university of Sabzevar in the academic year of 2017-18
Stratified random sampling was used to select the sample. … [32, 33]. Given the number of variables in the present study, the minimum sample size should be 120 subjects. However, 250 questionnaires were distributed among participants to ensure validity and reliability of data as well as the possible fall, failure to respond, and outliers. Finally, after eliminating incomplete questionnaires and outliers, 242 individuals were studied.
Data were collected using the gratitude questionnaire-6 (GQ-6) [6, 34], the 28-item General Health Questionnaire (GHQ-28) [35-42], and the Positive and Negative Affective Scale (PANAS) [43, 44]. The obtained data were analyzed by SPSS 24 software. Pearson correlation test was used to examine the correlation between variables. The proposed SEM-based model fitness was evaluated using AMOS 24 software for maximum likelihood estimation. According to Bentler & Hu [45], the cutoff point to determine the fitness of different indices in SEM is as follows: 0CFI>0.95, TLI>0.95, X2/df=2-3, RMSEA<0.06, GFI>0.95, IFI>0.95 and NFI>0.95. Bootstrap method (5000 replicates or re-sampling) was used to evaluate the indirect paths of the model.
The mean age of participants was 21.30 ± 1.98 years. Of the 242 participants, 35.0% (87) were men and 64.0% (155) were women. Moreover, 67.4% (163 subjects) were single and 32.6% (79 subjects) were married. Of the participants, 42.1% (102 subjects) were in the paramedical faculty, 14.9% (36 subjects) were in the medical school, 22.3% (54 subjects) were in the faculty of nursing and midwifery, and 20.7% (50 subjects) were in the Faculty of Health. There was a significant correlation between all studied variables (p <0.01; Table 1). In evaluating the fitness indices, some of the parameters of the proposed model were not desirable and indicated that the model needs to be improved. Therefore, in order to improve the fitness indices, a covariance was established between the variables of positive affect and negative affect and the dimensions of physical symptoms and anxiety of the mental health variable. The second model the final model was resulted from recent modifications, which showed all the fit indices were better fitted to the final modified model (Table 2).According to the final model, the standard coefficients of direct paths of gratitude for positive affect, negative affect and mental health, as well as the standard coefficients of positive and negative affect path for mental health were all significant (p <0.05). It should be noted that the lower scores of the mental health questionnaire represented a higher mental health in individuals and vice versa (Figure 2).The indirect effect of gratitude on mental health through positive and negative affect was also significant and confirmed (p<0.05; Table 3).
The results showed that gratitude has a direct effect on increasing mental health. This result is in line with the findings of previous relevant studies [9-13, 17, 19]. In this regard, experimental studies have also shown that gratitude interventions are effective in enhancing mental health [5, 19, 46]. ... [47, 48]. The results also showed that gratitude indirectly enhances mental health by increasing positive affect and decreasing negative affect. Consistent with this finding, Lambert et al. [13] showed that gratitude through an increase in positive emotions and positive marketability indirectly had an effect on decreasing depressive symptoms. Other studies that have examined the direct and two-way relationship between gratitude, positive affect, negative affect, and mental health have shown that gratitude is associated with increased positive emotions and mental health. Chan's study on teachers, in line with the results of the present study, showed that gratitude has a positive relationship with mental health and positive affect, and has a negative significant relationship with negative affect [51]. In addition, in another study conducted on students, the results showed that gratitude training increases happiness and life satisfaction and decreases depression, stress and negative affect [52]. ... [53, 54].
It is suggested that the subject of this study be conducted on a larger sample size.
Since the present study is a cross-sectional study, acknowledging the relationships between variables cannot be conclusive.
Gratitude, directly and indirectly, by increasing the positive affect and decreasing the negative affect, is associated with higher mental health.
We would like to thank and thank all the students who participated in this research.
None declared.
This research has been approved by Ethics Code of 1311044.
This study was supported by authors.
TABLES and CHARTS
Show attach fileCITIATION LINKS
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[6]McCullough ME, Emmons RA, Tsang J-A. The grateful disposition: a conceptual and empirical topography. J Pers Soc Psychol. 2002;82(1):112-27.
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[9]Watkins PC, Woodward K, Stone T, Kolts RL. Gratitude and happiness: Development of a measure of gratitude, and relationships with subjective well-being. Soc Behav Pers. 2003;31(5):431-51.
[10]Wood AM, Froh JJ, Geraghty AW. Gratitude and well-being: a review and theoretical integration. Clin Psychol Rev. 2010;30(7):890-905.
[11]Wood AM, Joseph S, Maltby J. Gratitude uniquely predicts satisfaction with life: Incremental validity above the domains and facets of the five factor model. Pers Individ Dif. 2008;45(1):49-54.
[12]Krause N. Religious involvement, gratitude, and change in depressive symptoms over time. Int J Psychol Relig. 2009;19(3):155-72.
[13]Lambert NM, Fincham FD, Stillman TF. Gratitude and depressive symptoms: the role of positive reframing and positive emotion. J Cogn Emot. 2012;26(4):615-33.
[14]McCullough ME, Kilpatrick SD, Emmons RA, Larson DB. Is gratitude a moral affect? Psychol Bull. 2001;127(2):249-66.
[15]Lambert NM, Graham SM, Fincham FD, Stillman TF. A changed perspective: How gratitude can affect sense of coherence through positive reframing. J Posit Psychol. 2009;4(6):461-70.
[16]Lambert NM, Clark MS, Durtschi J, Fincham FD, Graham SM. Benefits of expressing gratitude: expressing gratitude to a partner changes one's view of the relationship. Psychol Sci. 2010;21(4):574-80.
[17]Hill PL, Allemand M. Gratitude, forgivingness, and well-being in adulthood: Tests of moderation and incremental prediction. J Posit Psychol. 2011;6(5):397-407.
[18]Seligman ME, Steen TA, Park N, Peterson C. Positive psychology progress: empirical validation of interventions. Am Psychol. 2005;60(5):410-21.
[19]Froh JJ, Sefick WJ, Emmons RA. Counting blessings in early adolescents: an experimental study of gratitude and subjective well-being. J Sch Psychol. 2008;46(2):213-33.
[20]Chan DW. Gratitude, gratitude intervention and subjective well‐being among Chinese school teachers in Hong Kong. J Educ Psychol. 2010;30(2):139-53.
[21]Fredrickson BL. The role of positive emotions in positive psychology: the broaden-and-build theory of positive emotions. Am Psychol. 2001;56(3):218-26.
[22]Rash JA, Matsuba MK, Prkachin KM. Gratitude and well‐being: who benefits the most from a gratitude intervention? J Appl Psychol. 2011;3(3):350-69.
[23]Emmons RA, Stern R. Gratitude as a psychotherapeutic intervention. J Clin Psychol. 2013;69(8):846-55.
[24]Owens RL, Patterson MM. Positive psychological interventions for children: a comparison of gratitude and best possible selves approaches. J Genet Psychol. 2013;174(4):403-28.
[25]Pavot W, Diener E. The satisfaction with life scale and the emerging construct of life satisfaction. J Posit Psychol. 2008;3(2):137-52.
[26]Chida Y, Steptoe A. Positive psychological well-being and mortality: a quantitative review of prospective observational studies. J Psychosom Med. 2008;70(7):741-56.
[27]Mandal SP, Arya YK, Pandey R. Mental health and mindfulness: mediational role of positive and negative affect. J Proj Psychol. 2012;19(2):150-9.
[28]Spindler H, Denollet J, Kruse C, Pedersen SS. Positive affect and negative affect correlate differently with distress and health-related quality of life in patients with cardiac conditions: Validation of the Danish Global Mood Scale. J Psychosom Res. 2009;67(1):57-65.
[29]Kalokerinos EK, Greenaway KH, Denson TF. Reappraisal but not suppression downregulates the experience of positive and negative emotion. Emotion. 2015;15(3):271-5.
[30]Tugade MM, Fredrickson BL. Resilient individuals use positive emotions to bounce back from negative emotional experiences. J Pers Soc Psychol. 2004;86(2):320-33.
[31] Cohen S, Pressman SD. Positive affect and health. J Curr Dir Psychol Sci. 2006;15(3):122-5.
[32]Kline RB. Convergence of structural equation modeling and multilevel modeling. In: The SAGE handbook of innovation in social research methods. Williams M, Vogt WP, editors. 1st Edition. London: SAGE Publications; 2011.
[33]Bentler PM, Chou C-P. Practical issues in structural modeling. J Sociol Methods Res. 1987;16(1):78-117.
[34]Aghababaei N, Farahani H, Fazeli Mehrabadi A. Measuring gratitude among university and religious students: an enquiry into the psychometric features of the gratitude questionnaire. Stud Islam Psychol. 2010;4(6):75-88. [Persian]
[35]Goldberg DP, Blackwell B. Psychiatric illness in general practice: a detailed study using a new method of case identification. Br Med J. 1970;2(5707):439-43.
[36]Goldberg DP, Hillier VF. A scaled version of the General Health Questionnaire. Psychol Med. 1979;9(1):139-45.
[37]Aderibigbe YA, Gureje O. The validity of the 28-item General Health Questionnaire in a Nigerian antenatal clinic. Soc Psychiatry Psychiatr Epidemiol. 1992;27(6):280-3.
[38]Cheung P, Spears G. Reliability and validity of the Cambodian version of the 28-item General Health Questionnaire. Soc psychiatry psychiatr Epidemiol. 1994;29(2):95-9.
[39]Bridges KW, Goldberg DP. The validation of the GHQ-28 and the use of the MMSE in neurological in-patients. Br J Psychiatry. 1986;148:548-53.
[40] Naeinian MR, Nikazin A, Shairi MR. Factor structure, validity, and reliability of General Health Questionnaire (GHQ-28) in Iranian adolescents. J Clin Psychol Pers. 2014;2(10):159-72. [Persian]
[41]Nazifi M, Mokarami H, Akbaritabar A, Faraji Kujerdi M, Tabrizi R, Rahi A. Reliability, validity and factor structure of the Persian translation of General Health Questionnire (GHQ-28) in hospitals of Kerman University of Medical Sciences. J Fasa Univ Med Sci. 2014;3(4):336-42. [Persian]
[42] Noorbala AA, Bagheri Yazdi SA, Mohammad K. The validation of General Health Questionnaire- 28 as a psychiatric screening tool. J Hakim. 2009;11(4):47-53. [Persian]
[43]Watson D, Clark LA, Tellegen A. Development and validation of brief measures of positive and negative affect: the PANAS scales J Pers Soc Psychol. 1988;54(6):1063-70.
[44]Bakhshipour Roodsari A, Dezhkam M. A confirmatory factor analysis of the positive affect and negative affect scales (PANAS). J Psychol. 2006;9(4):351-65. [Persian]
[45]Hu Lt, Bentler PM. Cutoff criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternatives. J Struct Equat Model. 1999;6(1):1-55.
[46]Lin C-C, Yeh Y-C. How gratitude influences well-being: a structural equation modeling approach. Soc Indicat Res. 2014;118(1):205-17.
[47]Ma M, Kibler JL, Sly K. Gratitude is associated with greater levels of protective factors and lower levels of risks in African American adolescents. J Adolesc. 2013;36(5):983-91.
[48]Wilson JT. Brightening the mind: the impact of practicing gratitude on focus and resilience in learning. J Scholarsh Teach Learn. 2016;16(4):1-13
[49] Fredrickson BL, Cohn MA, Coffey KA, Pek J, Finkel SM. Open hearts build lives: positive emotions, induced through loving-kindness meditation, build consequential personal resources. J Pers Soc Psychol. 2008;95(5):1045-62.
[50]Kirgiz OG. Effects of gratitude on subjective well-being, self-construal, and memory. Washington D.C: American University; 2007.
[51]Chan DW. Subjective well-being of Hong Kong Chinese teachers: The contribution of gratitude, forgiveness, and the orientations to happiness. Teach Teach Educ. 2013;32:22-30.
[52]Renshaw TL, Rock DK, Prevention. Effects of a brief grateful thinking intervention on college students’ mental health. Ment Health Prev. 2018;9:19-24.
[53]Kerr SL, O’Donovan A, Pepping CA. Can gratitude and kindness interventions enhance well-being in a clinical sample? J Happiness Stud. 2015;16(1):17-36.
[54]Catalino LI, Fredrickson BL. A Tuesday in the life of a flourisher: The role of positive emotional reactivity in optimal mental health. Emotion. 2011;11(4):938-50.
[2]Kawachi I, Berkman LF. Social ties and mental health. J Urban Health. 2001;78(3):458-67.
[3]Ryan RM, Deci EL. On happiness and human potentials: A review of research on hedonic and eudaimonic well-being. Annu Rev Psychol. 2001;52(1):141-66.
[4]Seligman MEP, Csikszentmihalyi M. Positive psychology: an introduction. Am Psychol. 2000;55(1):5-14.
[5]Emmons RA, McCullough M. Counting blessings versus burdens: an experimental investigation of gratitude and subjective well-being in daily life. J Pers Soc Psychol. 2003;84(2):377-89.
[6]McCullough ME, Emmons RA, Tsang J-A. The grateful disposition: a conceptual and empirical topography. J Pers Soc Psychol. 2002;82(1):112-27.
[7]Peterson C, Seligman MEP. Character strengths and virtues: a handbook and classification: New York: Oxford University Press; 2004.
[8]Emmons RA. Thanks! How the new science of gratitude can make you happier. Boston/ New York: Houghton Mifflin Harcourt; 2007.
[9]Watkins PC, Woodward K, Stone T, Kolts RL. Gratitude and happiness: Development of a measure of gratitude, and relationships with subjective well-being. Soc Behav Pers. 2003;31(5):431-51.
[10]Wood AM, Froh JJ, Geraghty AW. Gratitude and well-being: a review and theoretical integration. Clin Psychol Rev. 2010;30(7):890-905.
[11]Wood AM, Joseph S, Maltby J. Gratitude uniquely predicts satisfaction with life: Incremental validity above the domains and facets of the five factor model. Pers Individ Dif. 2008;45(1):49-54.
[12]Krause N. Religious involvement, gratitude, and change in depressive symptoms over time. Int J Psychol Relig. 2009;19(3):155-72.
[13]Lambert NM, Fincham FD, Stillman TF. Gratitude and depressive symptoms: the role of positive reframing and positive emotion. J Cogn Emot. 2012;26(4):615-33.
[14]McCullough ME, Kilpatrick SD, Emmons RA, Larson DB. Is gratitude a moral affect? Psychol Bull. 2001;127(2):249-66.
[15]Lambert NM, Graham SM, Fincham FD, Stillman TF. A changed perspective: How gratitude can affect sense of coherence through positive reframing. J Posit Psychol. 2009;4(6):461-70.
[16]Lambert NM, Clark MS, Durtschi J, Fincham FD, Graham SM. Benefits of expressing gratitude: expressing gratitude to a partner changes one's view of the relationship. Psychol Sci. 2010;21(4):574-80.
[17]Hill PL, Allemand M. Gratitude, forgivingness, and well-being in adulthood: Tests of moderation and incremental prediction. J Posit Psychol. 2011;6(5):397-407.
[18]Seligman ME, Steen TA, Park N, Peterson C. Positive psychology progress: empirical validation of interventions. Am Psychol. 2005;60(5):410-21.
[19]Froh JJ, Sefick WJ, Emmons RA. Counting blessings in early adolescents: an experimental study of gratitude and subjective well-being. J Sch Psychol. 2008;46(2):213-33.
[20]Chan DW. Gratitude, gratitude intervention and subjective well‐being among Chinese school teachers in Hong Kong. J Educ Psychol. 2010;30(2):139-53.
[21]Fredrickson BL. The role of positive emotions in positive psychology: the broaden-and-build theory of positive emotions. Am Psychol. 2001;56(3):218-26.
[22]Rash JA, Matsuba MK, Prkachin KM. Gratitude and well‐being: who benefits the most from a gratitude intervention? J Appl Psychol. 2011;3(3):350-69.
[23]Emmons RA, Stern R. Gratitude as a psychotherapeutic intervention. J Clin Psychol. 2013;69(8):846-55.
[24]Owens RL, Patterson MM. Positive psychological interventions for children: a comparison of gratitude and best possible selves approaches. J Genet Psychol. 2013;174(4):403-28.
[25]Pavot W, Diener E. The satisfaction with life scale and the emerging construct of life satisfaction. J Posit Psychol. 2008;3(2):137-52.
[26]Chida Y, Steptoe A. Positive psychological well-being and mortality: a quantitative review of prospective observational studies. J Psychosom Med. 2008;70(7):741-56.
[27]Mandal SP, Arya YK, Pandey R. Mental health and mindfulness: mediational role of positive and negative affect. J Proj Psychol. 2012;19(2):150-9.
[28]Spindler H, Denollet J, Kruse C, Pedersen SS. Positive affect and negative affect correlate differently with distress and health-related quality of life in patients with cardiac conditions: Validation of the Danish Global Mood Scale. J Psychosom Res. 2009;67(1):57-65.
[29]Kalokerinos EK, Greenaway KH, Denson TF. Reappraisal but not suppression downregulates the experience of positive and negative emotion. Emotion. 2015;15(3):271-5.
[30]Tugade MM, Fredrickson BL. Resilient individuals use positive emotions to bounce back from negative emotional experiences. J Pers Soc Psychol. 2004;86(2):320-33.
[31] Cohen S, Pressman SD. Positive affect and health. J Curr Dir Psychol Sci. 2006;15(3):122-5.
[32]Kline RB. Convergence of structural equation modeling and multilevel modeling. In: The SAGE handbook of innovation in social research methods. Williams M, Vogt WP, editors. 1st Edition. London: SAGE Publications; 2011.
[33]Bentler PM, Chou C-P. Practical issues in structural modeling. J Sociol Methods Res. 1987;16(1):78-117.
[34]Aghababaei N, Farahani H, Fazeli Mehrabadi A. Measuring gratitude among university and religious students: an enquiry into the psychometric features of the gratitude questionnaire. Stud Islam Psychol. 2010;4(6):75-88. [Persian]
[35]Goldberg DP, Blackwell B. Psychiatric illness in general practice: a detailed study using a new method of case identification. Br Med J. 1970;2(5707):439-43.
[36]Goldberg DP, Hillier VF. A scaled version of the General Health Questionnaire. Psychol Med. 1979;9(1):139-45.
[37]Aderibigbe YA, Gureje O. The validity of the 28-item General Health Questionnaire in a Nigerian antenatal clinic. Soc Psychiatry Psychiatr Epidemiol. 1992;27(6):280-3.
[38]Cheung P, Spears G. Reliability and validity of the Cambodian version of the 28-item General Health Questionnaire. Soc psychiatry psychiatr Epidemiol. 1994;29(2):95-9.
[39]Bridges KW, Goldberg DP. The validation of the GHQ-28 and the use of the MMSE in neurological in-patients. Br J Psychiatry. 1986;148:548-53.
[40] Naeinian MR, Nikazin A, Shairi MR. Factor structure, validity, and reliability of General Health Questionnaire (GHQ-28) in Iranian adolescents. J Clin Psychol Pers. 2014;2(10):159-72. [Persian]
[41]Nazifi M, Mokarami H, Akbaritabar A, Faraji Kujerdi M, Tabrizi R, Rahi A. Reliability, validity and factor structure of the Persian translation of General Health Questionnire (GHQ-28) in hospitals of Kerman University of Medical Sciences. J Fasa Univ Med Sci. 2014;3(4):336-42. [Persian]
[42] Noorbala AA, Bagheri Yazdi SA, Mohammad K. The validation of General Health Questionnaire- 28 as a psychiatric screening tool. J Hakim. 2009;11(4):47-53. [Persian]
[43]Watson D, Clark LA, Tellegen A. Development and validation of brief measures of positive and negative affect: the PANAS scales J Pers Soc Psychol. 1988;54(6):1063-70.
[44]Bakhshipour Roodsari A, Dezhkam M. A confirmatory factor analysis of the positive affect and negative affect scales (PANAS). J Psychol. 2006;9(4):351-65. [Persian]
[45]Hu Lt, Bentler PM. Cutoff criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternatives. J Struct Equat Model. 1999;6(1):1-55.
[46]Lin C-C, Yeh Y-C. How gratitude influences well-being: a structural equation modeling approach. Soc Indicat Res. 2014;118(1):205-17.
[47]Ma M, Kibler JL, Sly K. Gratitude is associated with greater levels of protective factors and lower levels of risks in African American adolescents. J Adolesc. 2013;36(5):983-91.
[48]Wilson JT. Brightening the mind: the impact of practicing gratitude on focus and resilience in learning. J Scholarsh Teach Learn. 2016;16(4):1-13
[49] Fredrickson BL, Cohn MA, Coffey KA, Pek J, Finkel SM. Open hearts build lives: positive emotions, induced through loving-kindness meditation, build consequential personal resources. J Pers Soc Psychol. 2008;95(5):1045-62.
[50]Kirgiz OG. Effects of gratitude on subjective well-being, self-construal, and memory. Washington D.C: American University; 2007.
[51]Chan DW. Subjective well-being of Hong Kong Chinese teachers: The contribution of gratitude, forgiveness, and the orientations to happiness. Teach Teach Educ. 2013;32:22-30.
[52]Renshaw TL, Rock DK, Prevention. Effects of a brief grateful thinking intervention on college students’ mental health. Ment Health Prev. 2018;9:19-24.
[53]Kerr SL, O’Donovan A, Pepping CA. Can gratitude and kindness interventions enhance well-being in a clinical sample? J Happiness Stud. 2015;16(1):17-36.
[54]Catalino LI, Fredrickson BL. A Tuesday in the life of a flourisher: The role of positive emotional reactivity in optimal mental health. Emotion. 2011;11(4):938-50.