Trial Outcomes & Findings for Examination of Psychological and Physiological Pathways Linking Gratitude and Pain (NCT NCT06317844)
NCT ID: NCT06317844
Last Updated: 2026-04-17
Results Overview
Self-reported measures of pain will be reported on a numeric scale of 0 (no pain) to 10 (strongest pain imaginable every 15 seconds throughout a cold pressor test and again 1 minute and 10 minutes post cold pressor test.
Recruitment status
COMPLETED
Study phase
NA
Target enrollment
145 participants
Primary outcome timeframe
Baseline to 10 minutes post cold pressor test
Results posted on
2026-04-17
Participant Flow
Participants were recruited through the Black Hills State University community through posting flyers, electronic newsletters, and in-person announcements.
Given that the intervention consisted of a single visit of approximately 45 minutes, there were no significant events that occurred between enrollment and assignment of participants to an intervention group.
Participant milestones
| Measure |
Gratitude Writing
Participants completed baseline questionnaires followed by a 5-minute gratitude writing task, during which time participants wrote continuously for 5 minutes about someone they are grateful for. Participants then underwent a cold pressor test with subjective pain ratings recorded every 15 seconds. Post-task cognitions were assessed. Saliva samples were collected following completion of baseline measures, the writing intervention, and 2- and 10-minutes post-CPT.
|
Neutral Writing
Participants completed baseline questionnaires followed by a 5-minute neutral writing task, during which time participants wrote continuously for 5 minutes about how they got to the research laboratory. Participants then underwent a cold pressor test with subjective pain ratings recorded every 15 seconds. Post-task cognitions were assessed. Saliva samples were collected following completion of baseline measures, the writing intervention, and 2- and 10-minutes post-CPT.
|
|---|---|---|
|
Overall Study
STARTED
|
78
|
67
|
|
Overall Study
COMPLETED
|
77
|
67
|
|
Overall Study
NOT COMPLETED
|
1
|
0
|
Reasons for withdrawal
| Measure |
Gratitude Writing
Participants completed baseline questionnaires followed by a 5-minute gratitude writing task, during which time participants wrote continuously for 5 minutes about someone they are grateful for. Participants then underwent a cold pressor test with subjective pain ratings recorded every 15 seconds. Post-task cognitions were assessed. Saliva samples were collected following completion of baseline measures, the writing intervention, and 2- and 10-minutes post-CPT.
|
Neutral Writing
Participants completed baseline questionnaires followed by a 5-minute neutral writing task, during which time participants wrote continuously for 5 minutes about how they got to the research laboratory. Participants then underwent a cold pressor test with subjective pain ratings recorded every 15 seconds. Post-task cognitions were assessed. Saliva samples were collected following completion of baseline measures, the writing intervention, and 2- and 10-minutes post-CPT.
|
|---|---|---|
|
Overall Study
Adverse Event
|
1
|
0
|
Baseline Characteristics
Examination of Psychological and Physiological Pathways Linking Gratitude and Pain
Baseline characteristics by cohort
| Measure |
Gratitude Writing
n=78 Participants
Participants completed baseline questionnaires followed by a 5-minute gratitude writing task, during which time participants wrote continuously for 5 minutes about someone they are grateful for. Participants then underwent a cold pressor test with subjective pain ratings recorded every 15 seconds. Post-task cognitions were assessed. Saliva samples were collected following completion of baseline measures, the writing intervention, and 2- and 10-minutes post-CPT.
|
Neutral Writing
n=67 Participants
Participants completed baseline questionnaires followed by a 5-minute neutral writing task, during which time participants wrote continuously for 5 minutes about how they got to the research laboratory. Participants then underwent a cold pressor test with subjective pain ratings recorded every 15 seconds. Post-task cognitions were assessed. Saliva samples were collected following completion of baseline measures, the writing intervention, and 2- and 10-minutes post-CPT.
|
Total
n=145 Participants
Total of all reporting groups
|
|---|---|---|---|
|
Self-Reported Smoking
Non-Smoker
|
69 Participants
n=130 Participants
|
63 Participants
n=132 Participants
|
132 Participants
n=130 Participants
|
|
Self-Reported Smoking
Data Missing
|
1 Participants
n=130 Participants
|
0 Participants
n=132 Participants
|
1 Participants
n=130 Participants
|
|
Age, Continuous
|
22.27 Years
STANDARD_DEVIATION 8.79 • n=130 Participants
|
22.69 Years
STANDARD_DEVIATION 7.13 • n=132 Participants
|
22.46 Years
STANDARD_DEVIATION 8.04 • n=130 Participants
|
|
Sex: Female, Male
Female
|
55 Participants
n=130 Participants
|
49 Participants
n=132 Participants
|
104 Participants
n=130 Participants
|
|
Sex: Female, Male
Male
|
23 Participants
n=130 Participants
|
18 Participants
n=132 Participants
|
41 Participants
n=130 Participants
|
|
Race (NIH/OMB)
American Indian or Alaska Native
|
6 Participants
n=130 Participants
|
4 Participants
n=132 Participants
|
10 Participants
n=130 Participants
|
|
Race (NIH/OMB)
Asian
|
0 Participants
n=130 Participants
|
5 Participants
n=132 Participants
|
5 Participants
n=130 Participants
|
|
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
|
0 Participants
n=130 Participants
|
0 Participants
n=132 Participants
|
0 Participants
n=130 Participants
|
|
Race (NIH/OMB)
Black or African American
|
1 Participants
n=130 Participants
|
2 Participants
n=132 Participants
|
3 Participants
n=130 Participants
|
|
Race (NIH/OMB)
White
|
64 Participants
n=130 Participants
|
48 Participants
n=132 Participants
|
112 Participants
n=130 Participants
|
|
Race (NIH/OMB)
More than one race
|
4 Participants
n=130 Participants
|
5 Participants
n=132 Participants
|
9 Participants
n=130 Participants
|
|
Race (NIH/OMB)
Unknown or Not Reported
|
3 Participants
n=130 Participants
|
3 Participants
n=132 Participants
|
6 Participants
n=130 Participants
|
|
Socioeconomic Status
Lower Class
|
10 Participants
n=130 Participants
|
7 Participants
n=132 Participants
|
17 Participants
n=130 Participants
|
|
Socioeconomic Status
Working Class
|
16 Participants
n=130 Participants
|
17 Participants
n=132 Participants
|
33 Participants
n=130 Participants
|
|
Socioeconomic Status
Middle Class
|
38 Participants
n=130 Participants
|
28 Participants
n=132 Participants
|
66 Participants
n=130 Participants
|
|
Socioeconomic Status
Upper Middle and Upper Class
|
13 Participants
n=130 Participants
|
14 Participants
n=132 Participants
|
27 Participants
n=130 Participants
|
|
Socioeconomic Status
Not Reported
|
1 Participants
n=130 Participants
|
1 Participants
n=132 Participants
|
2 Participants
n=130 Participants
|
|
Perceived Stress Scale
|
13.29 Units on a Scale
STANDARD_DEVIATION 6.40 • n=130 Participants
|
15.27 Units on a Scale
STANDARD_DEVIATION 6.86 • n=132 Participants
|
14.21 Units on a Scale
STANDARD_DEVIATION 6.67 • n=130 Participants
|
|
GAD-7
|
4.69 Units on a Scale
STANDARD_DEVIATION 4.36 • n=130 Participants
|
5.97 Units on a Scale
STANDARD_DEVIATION 4.54 • n=132 Participants
|
5.28 Units on a Scale
STANDARD_DEVIATION 4.48 • n=130 Participants
|
|
Coping Strategies Questionnaire 24
|
10.28 Units on a Scale
STANDARD_DEVIATION 4.33 • n=130 Participants
|
11.85 Units on a Scale
STANDARD_DEVIATION 5.47 • n=132 Participants
|
11.01 Units on a Scale
STANDARD_DEVIATION 4.94 • n=130 Participants
|
|
Self-Reported Smoking
Current Smoker
|
8 Participants
n=130 Participants
|
4 Participants
n=132 Participants
|
12 Participants
n=130 Participants
|
PRIMARY outcome
Timeframe: Baseline to 10 minutes post cold pressor testPopulation: Individuals were included in the repeated-measures analysis only if they completed the 90-second cold-pressor test (CPT)
Self-reported measures of pain will be reported on a numeric scale of 0 (no pain) to 10 (strongest pain imaginable every 15 seconds throughout a cold pressor test and again 1 minute and 10 minutes post cold pressor test.
Outcome measures
| Measure |
Gratitude Writing
n=43 Participants
Participants completed baseline questionnaires followed by a 5-minute gratitude writing task, during which time participants wrote continuously for 5 minutes about someone they are grateful for. Participants then underwent a cold pressor test with subjective pain ratings recorded every 15 seconds. Post-task cognitions were assessed. Saliva samples were collected following completion of baseline measures, the writing intervention, and 2- and 10-minutes post-CPT.
|
Neutral Writing
n=45 Participants
Participants completed baseline questionnaires followed by a 5-minute neutral writing task, during which time participants wrote continuously for 5 minutes about how they got to the research laboratory. Participants then underwent a cold pressor test with subjective pain ratings recorded every 15 seconds. Post-task cognitions were assessed. Saliva samples were collected following completion of baseline measures, the writing intervention, and 2- and 10-minutes post-CPT.
|
|---|---|---|
|
Change in Subjective Pain Ratings From Baseline to 10-minutes Post Cold Pressor Test
Baseline Pain Rating
|
.002 Units on a Scale
Standard Error .015
|
.020 Units on a Scale
Standard Error .015
|
|
Change in Subjective Pain Ratings From Baseline to 10-minutes Post Cold Pressor Test
Pain Rating at 15 Seconds
|
3.23 Units on a Scale
Standard Error .309
|
2.55 Units on a Scale
Standard Error .302
|
|
Change in Subjective Pain Ratings From Baseline to 10-minutes Post Cold Pressor Test
Pain Rating at 30 Seconds
|
4.63 Units on a Scale
Standard Error .34
|
3.86 Units on a Scale
Standard Error .33
|
|
Change in Subjective Pain Ratings From Baseline to 10-minutes Post Cold Pressor Test
Pain Rating at 45 Seconds
|
5.86 Units on a Scale
Standard Error .37
|
5.00 Units on a Scale
Standard Error .36
|
|
Change in Subjective Pain Ratings From Baseline to 10-minutes Post Cold Pressor Test
Pain Rating at 60 Seconds
|
6.52 Units on a Scale
Standard Error .38
|
5.73 Units on a Scale
Standard Error .37
|
|
Change in Subjective Pain Ratings From Baseline to 10-minutes Post Cold Pressor Test
Pain Rating at 75 Seconds
|
6.98 Units on a Scale
Standard Error .36
|
6.23 Units on a Scale
Standard Error .36
|
|
Change in Subjective Pain Ratings From Baseline to 10-minutes Post Cold Pressor Test
Pain Rating at 90 Seconds
|
7.32 Units on a Scale
Standard Error .36
|
6.36 Units on a Scale
Standard Error .35
|
|
Change in Subjective Pain Ratings From Baseline to 10-minutes Post Cold Pressor Test
Pain Rating 2-Minutes Post-CPT
|
1.42 Units on a Scale
Standard Error .21
|
1.52 Units on a Scale
Standard Error .21
|
|
Change in Subjective Pain Ratings From Baseline to 10-minutes Post Cold Pressor Test
Pain Rating 10-Minutes Post-CPT
|
.07 Units on a Scale
Standard Error .04
|
.05 Units on a Scale
Standard Error .04
|
PRIMARY outcome
Timeframe: Up to 1.5 minutes of Cold Pressor TestPopulation: Participants were excluded from the data analysis if they were missing data on covariates.
Pain tolerance will be measured in terms of how many seconds individuals can keep their hand submerged in near-freezing water, for a maximum of up to 90 seconds (the task will be ended at that point).
Outcome measures
| Measure |
Gratitude Writing
n=74 Participants
Participants completed baseline questionnaires followed by a 5-minute gratitude writing task, during which time participants wrote continuously for 5 minutes about someone they are grateful for. Participants then underwent a cold pressor test with subjective pain ratings recorded every 15 seconds. Post-task cognitions were assessed. Saliva samples were collected following completion of baseline measures, the writing intervention, and 2- and 10-minutes post-CPT.
|
Neutral Writing
n=65 Participants
Participants completed baseline questionnaires followed by a 5-minute neutral writing task, during which time participants wrote continuously for 5 minutes about how they got to the research laboratory. Participants then underwent a cold pressor test with subjective pain ratings recorded every 15 seconds. Post-task cognitions were assessed. Saliva samples were collected following completion of baseline measures, the writing intervention, and 2- and 10-minutes post-CPT.
|
|---|---|---|
|
Differences in Pain Tolerance to Cold Pressor Test
|
73.310 Seconds
Standard Error 2.855
|
76.817 Seconds
Standard Error 3.604
|
PRIMARY outcome
Timeframe: Up to 1.5 minutes of Cold Pressor TestPopulation: Participants were excluded from the data analysis if they did not report pain onset or if they were missing values on covariates.
Pain onset will be measured in seconds between participants submerging their hands into near-freezing water and the self-reported beginning of pain.
Outcome measures
| Measure |
Gratitude Writing
n=64 Participants
Participants completed baseline questionnaires followed by a 5-minute gratitude writing task, during which time participants wrote continuously for 5 minutes about someone they are grateful for. Participants then underwent a cold pressor test with subjective pain ratings recorded every 15 seconds. Post-task cognitions were assessed. Saliva samples were collected following completion of baseline measures, the writing intervention, and 2- and 10-minutes post-CPT.
|
Neutral Writing
n=54 Participants
Participants completed baseline questionnaires followed by a 5-minute neutral writing task, during which time participants wrote continuously for 5 minutes about how they got to the research laboratory. Participants then underwent a cold pressor test with subjective pain ratings recorded every 15 seconds. Post-task cognitions were assessed. Saliva samples were collected following completion of baseline measures, the writing intervention, and 2- and 10-minutes post-CPT.
|
|---|---|---|
|
Differences in Pain Onset to Cold Pressor Test
|
14.847 Seconds
Standard Error 2.359
|
18.521 Seconds
Standard Error 3.062
|
SECONDARY outcome
Timeframe: Immediately after the Cold Pressor TestPopulation: Participants were excluded from the data analysis if they were missing data on covariates.
The Rumination and Reappraisal subscales from the Pain-Related Cognitive Processes Questionnaire were used to assess the extent to which individuals engaged in various thought processes during the cold pressor test. Each subscale is comprised of 6-items and answered on a 0 (Not at all) to 4 (All or most of the time) scale. Scores on each item are summed to calculate an overall score which can range from 0 to 24, with higher scores indicative of greater use of each cognitive process.
Outcome measures
| Measure |
Gratitude Writing
n=75 Participants
Participants completed baseline questionnaires followed by a 5-minute gratitude writing task, during which time participants wrote continuously for 5 minutes about someone they are grateful for. Participants then underwent a cold pressor test with subjective pain ratings recorded every 15 seconds. Post-task cognitions were assessed. Saliva samples were collected following completion of baseline measures, the writing intervention, and 2- and 10-minutes post-CPT.
|
Neutral Writing
n=65 Participants
Participants completed baseline questionnaires followed by a 5-minute neutral writing task, during which time participants wrote continuously for 5 minutes about how they got to the research laboratory. Participants then underwent a cold pressor test with subjective pain ratings recorded every 15 seconds. Post-task cognitions were assessed. Saliva samples were collected following completion of baseline measures, the writing intervention, and 2- and 10-minutes post-CPT.
|
|---|---|---|
|
Differences in Pain-Related Cognition
Pain-Related Cognition Scale: Rumination Subscale
|
12.457 Units on a Scale
Standard Error .784
|
12.454 Units on a Scale
Standard Error 1.045
|
|
Differences in Pain-Related Cognition
Pain-Related Cognition Scale: Reappraisal Subscale
|
9.065 Units on a Scale
Standard Error .829
|
9.572 Units on a Scale
Standard Error 1.104
|
SECONDARY outcome
Timeframe: Baseline to 10 minutes post cold pressor testPopulation: Participants were excluded from the data analysis if they were missing data on covariates.
Autonomic nervous system responsivity will be assessed using levels of salivary alpha-amylase. Unstimulated whole saliva samples will be collected using the passive drool technique at the following time points: 1) immediately following completion of baseline surveys, 2) immediately following the experimental writing task, 3) 1-minute post-cold pressor test, and 4) 10-minutes post-cold pressor test.
Outcome measures
| Measure |
Gratitude Writing
n=67 Participants
Participants completed baseline questionnaires followed by a 5-minute gratitude writing task, during which time participants wrote continuously for 5 minutes about someone they are grateful for. Participants then underwent a cold pressor test with subjective pain ratings recorded every 15 seconds. Post-task cognitions were assessed. Saliva samples were collected following completion of baseline measures, the writing intervention, and 2- and 10-minutes post-CPT.
|
Neutral Writing
n=58 Participants
Participants completed baseline questionnaires followed by a 5-minute neutral writing task, during which time participants wrote continuously for 5 minutes about how they got to the research laboratory. Participants then underwent a cold pressor test with subjective pain ratings recorded every 15 seconds. Post-task cognitions were assessed. Saliva samples were collected following completion of baseline measures, the writing intervention, and 2- and 10-minutes post-CPT.
|
|---|---|---|
|
Differences in Autonomic Nervous System Responsivity
sAA Post-Writing
|
86.083 U/mL
Standard Error 5.679
|
78.708 U/mL
Standard Error 6.690
|
|
Differences in Autonomic Nervous System Responsivity
sAA 2-Minutes Post-CPT
|
96.388 U/mL
Standard Error 7.264
|
80.264 U/mL
Standard Error 8.829
|
|
Differences in Autonomic Nervous System Responsivity
sAA 10-Minutes Post-CPT
|
95.039 U/mL
Standard Error 5.583
|
81.157 U/mL
Standard Error 7.086
|
Adverse Events
Gratitude Writing
Serious events: 0 serious events
Other events: 1 other events
Deaths: 0 deaths
Neutral Writing
Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths
Serious adverse events
Adverse event data not reported
Other adverse events
| Measure |
Gratitude Writing
n=78 participants at risk
Participants completed baseline questionnaires followed by a 5-minute gratitude writing task, during which time participants wrote continuously for 5 minutes about someone they are grateful for. Participants then underwent a cold pressor test with subjective pain ratings recorded every 15 seconds. Post-task cognitions were assessed. Saliva samples were collected following completion of baseline measures, the writing intervention, and 2- and 10-minutes post-CPT.
|
Neutral Writing
n=67 participants at risk
Participants completed baseline questionnaires followed by a 5-minute neutral writing task, during which time participants wrote continuously for 5 minutes about how they got to the research laboratory. Participants then underwent a cold pressor test with subjective pain ratings recorded every 15 seconds. Post-task cognitions were assessed. Saliva samples were collected following completion of baseline measures, the writing intervention, and 2- and 10-minutes post-CPT.
|
|---|---|---|
|
Cardiac disorders
Participant experienced lightheadedness, nausea, and dizziness.
|
1.3%
1/78 • Adverse events were monitored from baseline through completion of the intervention. Participants reporting an adverse event during the intervention were followed for up to 24 hours after completion.
|
0.00%
0/67 • Adverse events were monitored from baseline through completion of the intervention. Participants reporting an adverse event during the intervention were followed for up to 24 hours after completion.
|
Additional Information
Results disclosure agreements
- Principal investigator is a sponsor employee
- Publication restrictions are in place