Gratitude is considered a protective factor regarding major depression, generalized anxiety disorder and phobias and therefore may be regarded as transdiagnostic protective resource. Fostering gratitude appears promising not only for detaching from repetitive negative thoughts, which have been identified as risk factor in several varieties of psychopathology, but also for strengthening well-being by perceiving the positive and building up new resources. In our previous research, a combined online- and app-based training was found to be efficient in reducing perseverative thinking.
This study aims at evaluating a gratitude app as stand-alone intervention and drawing valuable conclusions regarding low-threshold formats of evidence-based methods for mental health promotion. Hence, a randomized controlled trial was conducted investigating whether an app-based gratitude intervention may reduce perseverative thinking and strengthen resilience.
352 participants from the general population were randomly assigned to the condition of either getting immediate or delayed access to the gratitude intervention after four weeks. Primary outcome was perseverative thinking four weeks after randomization. Secondary outcomes consisted of resilience, gratitude, worry, rumination and depression. Results were reported according CONSORT guidelines. (registration: https://doi.org/10.17605/OSF.IO/MV4B5)
Participants of the intervention group showed decreased perseverative thinking and increased resilience compared to the waitlist-control group from baseline to post-assessment. ANCOVA showed that the decrease on perseverative thinking was significant (F=36.99; p<.001;d=0.33;95%-CI=0.22-0.43) as well as the increase of resilience (F=21.16;p<.001;d=0.25;95%-CI=0.14-0.35). Both maintained in the intervention group at 3MFU. Besides, we can state that the intervention appeared effective regarding the secondary outcomes gratitude, depression, worry, rumination.
To the best of our knowledge this is the first trial demonstrating a gratitude app to be effective in reducing perseverative thinking and strengthening resilience. Additional to findings on efficacy, the talk will refer to participants’ experiences with the app-based implementation and provides further insight into sample characteristics.
While previous meta-analyses on low-threshold gratitude interventions showed heterogenous results, the present trial suggests that these might represent an user-friendly and effective way to increase mental health.