# Comparing the effectiveness of gratitude intervention and behavioral activation technique in breast cancer patients: a randomized trial

## TL;DR

A study compared gratitude and behavioral activation interventions for reducing anxiety in breast cancer patients, finding behavioral activation more effective.

## Contribution

Demonstrates the relative effectiveness of gratitude and behavioral activation in reducing anxiety among breast cancer patients.

## Key findings

- Behavioral activation led to greater reduction in anxiety scores compared to gratitude intervention.
- Neither intervention significantly reduced depression scores.
- Both interventions showed statistically significant reductions in anxiety.

## Abstract

Breast cancer diagnosis and treatment can lead to significant psychological distress, including anxiety and depression. Positive psychology interventions, such as Gratitude Intervention (GI) and Behavioral Activation (BA), have shown promise in managing mental health issues. This study aims to evaluate and compare the effects of GI and BA on anxiety and depression levels among women with breast cancer.

This study randomly assigned 45 breast cancer patients from a hospital in Mashhad, Iran, into two groups: the gratitude group (n = 22) and the BA group (n = 23). The participants underwent six weekly 45-minute sessions of their respective interventions. The Hospital Anxiety and Depression Scale (HADS) was employed to assess anxiety and depression levels prior to and following the intervention. Statistical analyses were conducted to ascertain the relative effectiveness of the two. methods.

Following the intervention, both the GI and BA groups exhibited a statistically significant reduction in anxiety scores. However, neither intervention led to a statistically significant reduction in depression scores. The mean anxiety scores in the GI group decreased from 19.54 ± 3.63 to 17.00 ± 1.79, while in the BA group, anxiety scores decreased from 21.43 ± 3.65 to 18.73 ± 2.94. The BA group demonstrated a greater reduction in anxiety scores compared to the GI group, with a mean change of 2.70 ± 0.71 versus 2.54 ± 1.84, respectively. This difference was statistically significant (p =.022).

The study suggests that both gratitude exercises and BA may be beneficial in mitigating anxiety among breast cancer patients, with BA demonstrating potentially greater efficacy. However, no significant changes were observed in depression scores. Future studies should include patients with higher levels of depression and longer interventions to more accurately measure the effects of these interventions on depression.

This trial has been retrospectively registered with the Iranian Registry of Clinical Trials (IRCT) under the registration number IRCT20241020063430N1. The registration date is November 21, 2024. The registration can be verified on the IRCT website at [https//irct.behdasht.gov.ir].