While a large body of social psychological literature is devoted to studying helping behavior between social groups, the study of gratitude as the most common reaction to help is virtually absent from the intergroup literature. However, gratitude has been a constant theme in the history of intergroup relations, particularly in the history of the systematic oppression of socially disadvantaged groups by socially advantaged groups. The “grateful slave” trope that justified the oppression of Black people in North America or modern narratives of “ungrateful” immigrants in Europe exemplify advantaged groups’ attempts to evoke gratitude among disadvantaged groups to secure their conformity and loyalty, or to receive recognition for apparent benefits they provide - even for equal rights. Not only do these examples question the undisputed positivity of gratitude, but they also suggest that disadvantaged groups’ gratitude expressions might be involved in the regulation of power relations between social groups. The present research introduces the empirical study of gratitude to intergroup relations. The specific aim of this dissertation was to examine how disadvantaged groups’ gratitude expressions in response to advantaged group help might function to promote social inequality. At the same time, the present work addresses gaps within previous research that studies how advantaged group help itself affects status relations. Based on a synthesis of the literature on gratitude and intergroup relations, across three manuscripts, it was examined whether disadvantaged groups’ gratitude expressions, alongside advantaged group help, affect intergroup power relations through a) influencing psychological pathways to social change, b) regulating group-specific needs, and c) enacting and transmitting paternalistic ideology. In Manuscript #1, the novel idea of a potentially harmful side of gratitude expressions for low power groups was tested. Using correlational, experimental, between- and within-subjects designs, the results from five studies showed across different contexts that when low-power group members expressed gratitude for a high-power group member’s help, they were less willing and less likely to protest against the high power group members’ previous transgression. Forgiveness and system justification mediated this pacifying effect, providing insights into the underlying psychological process. In Manuscript #2, results from two correlational studies demonstrate that ideological beliefs can guide advantaged groups to provide help that differs in its potential to bring about social change. Paternalistic beliefs parsimoniously distinguished whether members of the receiving society provide dependency- or autonomy-oriented help to refugees. Both groups indicated that autonomy-oriented help has a higher potential for social change than dependency-oriented help. Reflecting group-specific needs and convictions that underlie paternalism, receiving society members’ concern for a positive moral image of the ingroup was positively related to their willingness to provide dependency-oriented help, and beliefs about refugees’ competence were positively related to their willingness to provide autonomy-oriented help. In Manuscript #3, it was investigated why advantaged group members react negatively to refugee protests and demand more gratitude from the refugees. The results of two experiments showed that refugees’ protest decreased perceptions among receiving society members that they are socially valued, but expressions of gratitude from refugees increased perceptions of being socially valued. Refugees were perceived as more agentic when they protested, however, not when they expressed gratitude. Perceptions of social worth determined receiving society members’ attitudes toward refugees on other dimensions. In a third experiment, the underpinnings of gratitude demands were examined. The results of a third experiment showed that receiving society members, who endorsed paternalistic beliefs, labeled protesting refugees as ungrateful and demanded gratitude from them. In sum, besides theoretically and empirically advancing several areas of intergroup relations (e.g., intergroup helping, intergroup contact, intergroup reconciliation, and paternalism), the present research suggests that gratitude expressions, which occur in intergroup contexts that are characterized by social injustice, can have negative consequences for disadvantaged groups. Implications for theory and social change are discussed, and promising avenues for future research are suggested.

Utan ett hjärta kan inte livet fortskrida. Ibland händer det att enda utvägen för att överleva är att genomgå en hjärttransplantation. Kan en hjärttransplantation genomföras utan psykisk påverkan och hur finner mottagarna tillbaka till det liv de hade innan hjärtsjukdomen. Syftet med denna litteraturstudie var att belysa hjärttransplanterade individers psykologiska upplevelser efter en hjärttransplantation. Frågeställningarna var: Hur beskriver mottagaren som genomgått en hjärttransplantation upplevelsen av att ha en annan människas hjärta? Hur beskriver mottagaren sin strategi för att hitta tillbaka till det liv han/hon hade innan hjärttransplantationen? Hur beskriver mottagaren upplevelsen över att de fick leva på grund av någon annans död. Genom systematisk litteraturgranskning har nio vetenskapliga artiklar valts ut som kritiskt granskats enligt Carlsson och Eiman (2003) och sedan analyserats och bearbetats. I resultatet redovisas fyra teman som har identifierats: skuldkänslor gentemot donatorn och dennes familj, tacksamhet för en andra chans, coping för att hantera känslor och återgå till det dagliga livet, attityder mot det nya hjärtat och donatorn. Studien visar att det finns psykologiska aspekter såsom förnekelse och fantasier som sjuksköterskan bör ha i åtanke. / Without a heart life cannot continue. Sometimes undergoing heart transplantation is the only way to survive. Can a heart transplantation be done without psychological influence and how does the receiver find the way back to life as it was before the heart disease. The aim of this literature study was to illuminate heart transplantated individual’s psychological experiences after heart transplantation. The research questions were: How does the receiver who went through heart transplantation describe the experience of having another person’s heart? How does the receiver describe ones strategy to find the way back to the life he/she had before the heart transplantation? How does the receiver describe the experience that they live because of somebody else’s death? Through systematic literature review nine scholarly articles have been chosen and critically examined according to Carlsson and Eiman (2003) then analysed and processed. Four themes were identified and are presented under findings: feelings of guilt towards the donor and his/her family, gratitude for a second chance, coping to handle feelings and returning to daily life, attitudes towards the new heart and the donor. This study shows various psychological aspects such as denial and fantasies, which nurses should consider.

Research suggests a link between gratitude and subjective well-being exists. Research on gratitude practices have shown to increase gratitude, subjective well-being, and other related outcomes. However, the efficacy of gratitude practices may be limited by the rote application of the gold standard gratitude practice--the gratitude journal. Such findings suggest that a more comprehensive, adaptable, and flexible gratitude practice may be needed. This study examined the efficacy of the My Best Self 101 (MBS101) gratitude module: an online gratitude resource that provides psychoeducation about gratitude along with a menu of empirically based gratitude practices. Using a randomized controlled design method, this study compared using the MBS101 gratitude module to using a gratitude journal for 21 days. The sample consisted of 225 adults recruited online and through university research systems. Seemingly unrelated regression models were used to analyze gratitude and subjective well-being outcomes between groups as well as the interaction between time spent on gratitude practice and group assignment. Compared to the gratitude journaling group, the MBS101 group had significantly better outcomes on gratitude and subjective well-being. Additionally, when the time and group interaction was added, the MBS101 group had greater increases in benefits for gratitude and subjective well-being with increased time spent. Further research is required to support these findings.

Bakgrund: Närmare hälften av de som drabbas av cancer i Sverige är kvinnor, och vissa av dessa kvinnor är mödrar som fått diagnosen obotlig cancer. När en patient drabbats av obotlig cancer blir den palliativa vården central. De fyra hörnstenarna tillsammans med den personcentrerade modellen de 6 S:n blir grunden i hur vården kan utformas. Syfte: Examensarbetets syfte var att belysa mödrars upplevelse av att leva med obotlig cancer. Metod: En kvalitativ metod där datainsamlingen bestod av sju bloggar. En analys av narrativer användes enligt Dahlborgs modell. Resultat: Resultatet utgjordes av tre huvudkategorier; Känslan av maktlöshet, Livets oundvikliga förändring och, Leva i nuet, tillsammans med sex underkategorier. Konklusion: Obotlig cancer medförde både fysiskt och psykiskt lidande för mödrarna där de upplevde begränsningar i sin roll som mamma. Detta medförde att de existentiella tankarna och känslorna blev oundvikliga och svårhanterliga. Samtidigt visade resultatet att mödrarna fick livskraft genom förmågan att leva i nuet och reflektera kring vad som var viktigt och värdefullt för dem. Sjuksköterskor behöver vidareutveckla sin kompetens kring den personcentrerade palliativa vården för att kunna vårda och bemöta denna patientgrupp på bästa möjliga sätt. / Background: Almost half of those affected by cancer in Sweden are women, and some of these women are mothers who have been diagnosed with incurable cancer. When a patient suffers from incurable cancer, palliative care becomes central. The four cornerstones, together with the person-centered model of the 6 S's, will form the basis of how care will be designed. Aim: The purpose of the thesis was to shed light on mothers' experience of living with incurable cancer. Method: A qualitative method where the data collection consisted of seven blogs. An analysis of narratives was used according to Dahlborg's model. Findings: The results were identified by three main categories; The feeling of powerlessness, Life's inevitable change and Living in the moment, along with six subcategories. Conclusion: Incurable cancer caused both physical and psychological suffering for the mothers and they experienced limitations in their role as mothers. This meant that the existential thoughts and feelings became unavoidable and difficult to handle. At the same time, the results showed that the mothers gained vitality through the ability to live in the present and reflect on what was important and valuable to them. Nurses need to further develop their competence in person-centred palliative care in order to care for and respond to this patient group in the best possible way.

Sleep disturbances are prevalent among primary care patients, and psychological dysfunction, including stress, anxiety, and depression, are robust contributors to poor sleep health. Yet, the presence of potential protective characteristics, such as health self-efficacy and engaging in adaptive health behaviors, may mitigate such outcomes. Gratitude (i.e., recognition and appreciation of experiences, relationships, and surroundings), a positive psychological cognitive-emotional characteristic, may serve as a catalyst of these beneficial downstream effects, given its association with improved health functioning and sleep. In a sample of primary care patients (N = 869) from 50 urban and 30 rural practices in Germany, health self-efficacy (i.e., belief in ability to perform necessary actions to manage health) and constructive health behaviors (i.e., actions taken to modify health positively), separately and together as parallel first-order mediators, and stress, anxiety, and depression, as parallel second-order mediators, were investigated as potential serial mediators of the association between gratitude and sleep disturbances. Participants completed self-report measures in person and online. Significant serial mediation was observed across models, although effects varied. In the first model, gratitude was associated with greater health self-efficacy and, in turn, to less stress, anxiety, and depression, and fewer consequent sleep disturbances. In the second model, health behaviors, and anxiety and depression, were serial mediators, but health behaviors and stress were not. In a final combined model, serial mediation occurred on two pathways, health self-efficacy and anxiety, and health self-efficacy and depression, and a specific indirect effect was found for health behaviors, but not self-efficacy. Gratitude was associated with reduced sleep disturbances through positive health behavior engagement, and via the serial mediation effects of greater health self-efficacy and lower psychological distress. Clinical interventions that enhance gratitude (e.g., gratitude listing or diaries), self-efficacy (e.g., disease self-management programs), or health behavior engagement (e.g., weight management programs) may promote favorable downstream effects on psychological distress and sleep disturbances among primary care patients.

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Yes / Many governments including Malaysia imposed movement restrictions as public health measure to minimize COVID-19 (coronavirus) risks. Due to prolonged isolation, poorer physical and mental health is expected in the general population. Our aims were to examine (1) the mediating role of perceived social isolation (SI) and fear of social isolation (FSI) on the relationship between gratitude and anxiety, and (2) to explore the moderating role of age, education and socioeconomic status (SES) on the mediation model. A total of 427 participants currently living in Malaysia (Mage = 37.90, SD = 16.51, 313 females) completed a survey on isolation, gratitude and anxiety during a period of national lockdown. Results showed that that those with higher gratitude reported having less SI and FSI and less anxiety (Model 1). In Model 2 with age as moderator, young adults (YA) and middle-aged adults (MA) who had higher gratitude experienced lower SI and in turn had lowered anxiety, but such mediating role of SI was not observed among older adults (OA). As for FSI, MA who had higher gratitude had lower FSI and also lower anxiety but this relationship was not observed in YA or OA. We also examined the role of education and SES as moderators in the parallel mediation analysis. Results showed that the indirect association of gratitude with anxiety via FI and FSI was moderated by both education and SES. Specifically, among those with low education levels (regardless of SES), those with higher gratitude had lower SI and FSI which in turn reduced anxiety. This relationship is similar for those with medium level of education and from low and middle level of SES as well. Our findings highlight the importance of having some coping mechanism e.g., gratitude and social connection during the pandemic to have higher wellbeing and quality of life, especially for MA sample and people from low education and SES background. / This work was supported by Newton Fund Institutional Links grant ID: 331745333, under Newton-Ungku Omar Fund partnership to MHY. The grant is funded by the UK Department for Business, Energy and Industrial Strategy and Malaysian Industry-Government Group for High Technology (MIGHT) and delivered by the British Council. For further information, please visit www.newtonfund.ac.uk . The Newton Fund played no role in the planning and conceptualization of the manuscript, did not participate in the writing of the manuscript, and played no role in the decision to submit the manuscript.

Gratitude is an emotion with a number of positive benefits for both individuals and organizations; however, very little research has addressed the role of leaders in influencing the gratitude of those they lead. Organizational leaders can increase the gratitude levels of the leaders who report to them, who then can influence the gratitude of their own subordinates. This study addresses how the emotion of gratitude can trickle-down through two levels of an organizational hierarchy. There are two potential theories to support such trickle-down effects of gratitude: a behavioral explanation in social learning theory and an affective explanation in gratitude as an emotional contagion. Social learning theory can explain how gratitude trickles via the influence role models (i.e., leaders) have on the behavior of those below them. In addition, gratitude as an emotional contagion can unconsciously increase feelings of gratitude after experiencing gratitude expressions and these feelings of gratitude should increase the spread of gratitude to others. An experimental study design consisting of students acting as supervisors and subordinates evaluating email manipulations was used to test the hypotheses. The results from this study support the idea that gratitude can spread from upper-level leaders to lower levels in an organizational hierarchy. In addition, results suggest that this relationship is positively mediated by role modeling effects supporting the behavioral explanation of trickle-down effects. However, results did not support emotional contagion theory as a mechanism that explains trickle-down effects. Such findings offer important implications as leaders can play a significant role in spreading the positive effects of gratitude throughout their organization.