Gratitude in Post MI Patients Effects on Health Related Mood and Clinical Outcome

描述（由申请人提供）：每年，近80万美国人遭受首次心肌梗死（MI），其中一半以上将有复发事件。有许多因素影响MI后的预后。除了身体因素，如初始MI严重程度和坚持药物治疗和心脏康复计划，心理社会因素是高度预测未来的临床进程。积极的影响，在MI事件中找到意义，在生活中，以及管理MI的后果和情绪困扰是非常重要的。感恩通常被定义为一种感觉或态度， 对自己已经得到或将要得到的好处的承认，一种习惯性的关注和欣赏生活的积极方面。它与更高水平的主观幸福感有关，更感恩的人经历的压力更少，抑郁程度更低，对环境的控制水平更高，应对生活困难的方式更积极，消极应对策略更少。感恩与自我报告的 心理健康、健康活动和寻求健康帮助的意愿是这种联系的中介。临床上增加感恩的干预措施已经显示出很大的希望，证明了增加整体幸福感，生活意义以及与改善健康的潜在关联的能力。在113例首次心肌梗死30天内的患者中， 该提议的探索性干预研究将检查与标准护理（SOC）相结合的八周感恩日志干预与SOC加日志难忘事件和单独SOC相比是否会增加积极的健康行为、心理健康和身体功能。心理社会和临床评估将在六个月内进行，测试发生在治疗前，治疗后立即和治疗后四个月。我们设想这项研究的结果将（a）科学地显示感恩与我们的临床相关终点之间的因果关系的证据，（B）治疗上提供一种新的干预方法来利用这些好处在这个心脏病人群中，（c）显示自然和治疗效果的机制，这既有助于提高科学认识，也有助于日后制定更有针对性的干预措施。

DESCRIPTION (provided by applicant): Every year, nearly 800,000 Americans endure a first myocardial infarction (MI), and over half of those will have a recurrent event. There are numerous factors that influence prognosis following an MI. In addition to physical factors, such as initial MI severity and adherence to medication and cardiac rehabilitation programs, psychosocial factors are highly predictive of future clinical course. Positive affect, finding meaning in the MI event, and in life in general, and managing the consequences and emotional distress of the MI are highly important. Gratitude is typically defined as a feeling or attitude in acknowledgment of a benefit that one has received or will receive, a habitual focusing on and appreciating the positive aspects of life. It is associated with higher levels of subjective well-being, and people who are more grateful experience less stress, are less depressed, have higher levels of control over their environment, have more positive ways of coping with life's difficulties, and have fewer negative coping strategies. Gratitude is correlated with self-reported physical health, and this link is mediated by psychological health, healthy activities, and willingness to seek help for health. Interventions to clinically increase gratitude have shown great promise, demonstrating the ability to increase overall sense of well-being, meaning in life, and potential associations with improved health. In 113 patients within 30 days of a first-time MI, this proposed exploratory intervention study will examine whether an eight-week gratitude journaling intervention coupled with standard of care (SOC), as compared to SOC plus journaling memorable events and SOC alone will increase positive health behaviors, psychological health, and physical functioning. Psychosocial and clinical assessments will be performed over a six-month period, with testing occurring before, immediately after, and four months after treatment. We envision the study's findings will (a) scientifically show evidence of causality in the relationship between gratitude and our clinically relevant endpoints, (b) therapeutically provide a new intervention methodology to harness these benefits in this cardiac population, and (c) show mechanisms that underlie both the natural and therapeutic effects, both to improve scientific understanding and to allow more tailored interventions to be developed at a later date.