Efficacy of an internet and app-based gratitude intervention in reducing repetitive negative thinking and mechanisms of change in the intervention's effect on anxiety and depression
A five-week app-based gratitude programme substantially reduced repetitive negative thinking - the rumination and worry loop underlying both anxiety and depression - with effects that grew by three months (d = 0.75) and were sustained at six.
The most interesting result here is not that gratitude helped - it is how.
Two hundred and sixty people with elevated repetitive negative thinking were randomised to a five-week internet and app-based gratitude intervention with adherence-focused guidance, or to a wait list.
The intervention group reported significantly less repetitive negative thinking immediately afterwards (d = 0.61) and more at three-month follow-up (d = 0.75), with improvements sustained to six months.
Mediation analysis then found that the gratitude intervention reduced anxiety and depression by reducing repetitive negative thinking - not directly. The authors propose gratitude works along two parallel routes: building resources, and removing a risk factor.
The caveat that matters. A wait-list control is the weakest comparison available: some of this effect is the difference between doing something and doing nothing. Cheng et al. used a hassle-diary control and Tolcher et al. used an activity-matched control - compare the three and you can see how much the control condition shapes the answer.
The comparison was a wait-list control, which reliably inflates effect sizes relative to an active control, so these numbers are not comparable to trials using a matched activity. Participants were selected for elevated repetitive negative thinking rather than drawn from the general population, and the six-month follow-up was collected for the intervention group only.
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Summarized by Tiago Martins · Last updated: · How we write these
