title: The effects of optimism and gratitude on adherence, functioning and mental health following an acute coronary syndrome.
abstract: 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).
  
  
  
  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.
  
  
  
  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.
  
  
  
  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.
authors: Harvard Medical School, 55 Fruit St., Boston, MA 02114, USA; Department of Psychiatry, Massachusetts General Hospital, 55 Fruit St., Boston, MA 02114, USA. Electronic address: ramillstein@mgh.harvard.edu.
authors: Rachel A
authors: RA
authors: Millstein
authors: Harvard Medical School, 55 Fruit St., Boston, MA 02114, USA; Department of Psychiatry, Massachusetts General Hospital, 55 Fruit St., Boston, MA 02114, USA.
authors: Christopher M
authors: CM
authors: Celano
authors: Harvard Medical School, 55 Fruit St., Boston, MA 02114, USA.
authors: Eleanor E
authors: EE
authors: Beale
authors: Harvard Medical School, 55 Fruit St., Boston, MA 02114, USA; Department of Psychiatry, Massachusetts General Hospital, 55 Fruit St., Boston, MA 02114, USA.
authors: Scott R
authors: SR
authors: Beach
authors: Department of Psychiatry, Massachusetts General Hospital, 55 Fruit St., Boston, MA 02114, USA.
authors: Laura
authors: L
authors: Suarez
authors: Department of Medicine, Division of Cardiology, Massachusetts General Hospital, 55 Fruit St., Boston, MA 02114, USA.
authors: Arianna M
authors: AM
authors: Belcher
authors: Harvard Medical School, 55 Fruit St., Boston, MA 02114, USA; Department of Medicine, Division of Cardiology, Massachusetts General Hospital, 55 Fruit St., Boston, MA 02114, USA.
authors: James L
authors: JL
authors: Januzzi
authors: Harvard Medical School, 55 Fruit St., Boston, MA 02114, USA; Department of Psychiatry, Massachusetts General Hospital, 55 Fruit St., Boston, MA 02114, USA.
authors: Jeff C
authors: JC
authors: Huffman
mesh_terms: D054058:Acute Coronary Syndrome / Q000523:psychology*; D000368:Aged; D000369:Aged, 80 and over; D001007:Anxiety / Q000523:psychology*; D003863:Depression / Q000523:psychology*; D004644:Emotions / Q000502:physiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D000067656:Optimism / Q000523:psychology*; D017063:Outcome Assessment, Health Care; D010349:Patient Compliance / Q000523:psychology*; D011788:Quality of Life / Q000523:psychology*
keywords: Acute coronary syndrome; Adherence; Gratitude; Mental health; Optimism