The Effects of Journaling on Health-Related Mood and Clinical Outcomes in Post-MI Patients

The Effects of Journaling on Health-Related Mood and Clinical Outcomes in Post-MI Patients

Psychosocial factors, including positive affect, finding meaning in the event, and managing emotional distress, influence prognosis following a heart attack or myocardial infarction (MI). Gratitude, typically defined as a feeling or attitude in acknowledgment of a benefit that one has received or will receive, is associated with higher levels of well-being, and people who are more grateful experience less stress, are less depressed, have higher levels of control over their environment, and more positive ways of coping. The present project will examine the potential benefits of a gratitude intervention (i.e., 8 weeks of gratitude journaling) to increase positive health behaviors, psychological health, and physical functioning in post-MI patients as compared to journaling about memorable events as well as care as usual alone. The investigators will study psychological and physical functioning at baseline, following 8 weeks of gratitude journaling or care as usual, and at 4-month follow-up.

Inclusion criteria:

1. Suffered an MI (ST Elevation MI (STEMI) or Non-ST Elevation MI (NSTEMI) with creatine kinase MB fraction elevation 3 times the upper limits of normal and with ischemic ECG changes within 12 months of baseline testing;
2. An EF less than 50% on echocardiogram;
3. Clinically stable defined as, no active arrhythmia, no residual ischemia;
4. Able to perform light to moderate exercise;
5. Able to give informed consent in English;
6. Medical clearance by their cardiologist;
7. > 35 years of age.

Exclusion criteria:

1. Unstable angina;
2. Severe valvular disease;
3. Oxygen-dependent COPD;
4. Recent stroke or significant cerebral neurologic impairment;
5. Suicidality with intent or plan;
6. Current cancer;
7. Currently taking mood stabilizers, benzodiazepines or antipsychotics;
8. Medications (e.g., systemic steroids) and conditions affecting immune status (e.g., rheumatoid arthritis, hepatitis C, HIV) (Anti-depressant medication is allowed);
9. Currently enrolled in another clinical trial.