The effects of optimism and gratitude on adherence, functioning and mental health following an acute coronary syndrome

Gen Hosp Psychiatry. 2016 Nov-Dec:43:17-22. doi: 10.1016/j.genhosppsych.2016.08.006. Epub 2016 Aug 30.


Objective: This study examined the effects of optimism and gratitude on self-reported health behavior adherence, physical functioning and emotional well-being after an acute coronary syndrome (ACS).

Methods: Among 156 patients, we examined associations between optimism and gratitude measured 2 weeks post-ACS and 6-month outcomes: adherence to medical recommendations, mental and physical health-related quality of life (HRQoL), physical functioning, depressive symptoms and anxiety. Multivariable linear regression models were used, controlling for increasing levels of adjustment.

Results: Optimism [β=.11, standard error (S.E.)=.05, P=.038] and gratitude (β=.10, S.E.=.05, P=.027) at 2 weeks were associated with subsequent self-reported adherence to medical recommendations (diet, exercise, medication adherence, stress reduction) at 6 months in fully adjusted models. Two-week optimism and gratitude were associated with improvements in mental HRQoL (optimism: β=.44, S.E.=.13, P=.001; gratitude: β=.33, S.E.=.12, P=.005) and reductions in symptoms of depression (optimism: β=-.11, S.E.=.05, P=.039; gratitude: β=-.10, S.E.=.05, P=.028) and anxiety (optimism: β=-.15, S.E.=.05, P=.004; gratitude: β=-.10, S.E.=.05, P=.034) at 6 months.

Conclusion: Optimism and gratitude at 2 weeks post-ACS were associated with higher self-reported adherence and improved emotional well-being 6 months later, independent of negative emotional states. Optimism and gratitude may help recovery from an ACS. Interventions promoting these positive constructs could help improve adherence and well-being.

Trial registration: NCT01709669.

Keywords: Acute coronary syndrome; Adherence; Gratitude; Mental health; Optimism.

Publication types

  • Observational Study

MeSH terms

  • Acute Coronary Syndrome / psychology*
  • Aged
  • Aged, 80 and over
  • Anxiety / psychology*
  • Depression / psychology*
  • Emotions / physiology*
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Optimism / psychology*
  • Outcome Assessment, Health Care*
  • Patient Compliance / psychology*
  • Quality of Life / psychology*

Associated data