Effects of a Savoring Intervention on Resilience and Well-Being of Older Adults
Abstract
Savoring is the ability to be mindful of positive experiences and to be aware of and regulate positive feelings about these experiences. Previous research has found that savoring interventions can be effective at improving well-being of younger adults, but findings have not been extended to older populations. This pilot study examined the effects of a 1-week savoring intervention on older adults’ psychological resilience and well-being (i.e., depressive symptoms and happiness). Participants, 111 adults ages 60 or over, completed measures of resilience, depressive symptoms, and happiness pre- and postintervention as well as 1 month and 3 months after the intervention. Analyses revealed that participants who completed the savoring intervention with high fidelity also reported improvements in resilience, depressive symptoms, and happiness over time. These findings suggest that the savoring intervention has the potential to enhance older adults’ resilience and psychological well-being.
Resilience and well-being are important components to successful aging. Theoretical and empirical research supports the belief that positive emotions contribute to greater resilience and well-being (e.g., Cohn, Fredrickson, Brown, Mikels, & Conway, 2009; Fredrickson, 2001). The broaden-and-build theory posits that positive emotions lead people to participate in new experiences, develop skills, and build relationships, which enable them to respond resiliently when challenges arise (Fredrickson, 2001). Accordingly, savoring positive experiences can promote greater resilience and well-being through an increase in positive feelings (Tugade & Fredrickson, 2004). This pilot study examines the link between participating in a savoring intervention and changes in older adults’ resilience and well-being.
Savoring is the ability to focus one’s attention on positive experiences and to modify one’s thoughts and behaviors in ways that intensify and prolong positive feelings (Bryant, Chadwick, & Kluwe, 2011; Bryant & Veroff, 2007). Positive feelings may be increased by reminiscing about past events, savoring the present moment, or anticipating future pleasures. People can savor more by increasing thoughts and behaviors that amplify positive feelings, such as memory building and counting blessings, or by reducing thoughts and behaviors that dampen positive feelings, such as focusing on flaws or thinking about how an experience could be better. Dampening responses, such as distraction and fault finding, have been associated with greater depressive symptoms, lower positive affect, and lower life satisfaction (Quoidbach, Berry, Hansenne, & Mikolajczak, 2010; Raes, Smets, Nelis, & Schoofs, 2012). Greater perceived savoring abilities, measured through self-report, are related to greater resilience, lower depressive symptoms, and higher happiness in older adults (Bryant, 2003; J. L. Smith & Bryant, 2016; J. L. Smith & Hollinger-Smith, 2015). Perceived savoring abilities are positively correlated with reported use of savoring strategies (e.g., Ramsey & Gentzler, 2014).
Previous research has found that savoring interventions contribute to increases in well-being (e.g., Bryant, Smart, & King, 2005; Hurley & Kwon, 2012; McMakin, Siegle, & Shirk, 2011; Quoidbach, Wood, & Hansenne, 2009). For instance, college students (Mage = 19.98) who were instructed to reminisce about past positive experiences using cognitive imagery (twice a day, for 1 week) reported greater increases in happiness compared with comparison conditions (Bryant et al., 2005). Another intervention, focused on savoring the present moment, used audio-recorded and written education to train participants on 10 specific savoring strategies (Hurley & Kwon, 2012). After 2 weeks, college students (Mage = 19.48) who received the savoring the moment intervention reported significantly lower depression and negative affect compared with a control condition, but there was no difference in positive affect. In a separate study, adults who completed a positive mental time travel task (i.e., imagining specific positive events that could happen the next day) reported significantly greater happiness after 2 weeks, and there was no change in happiness for participants in the neutral or negative mental time travel conditions (Quoidbach et al., 2009). A savoring intervention has also been effective at reducing depressive symptoms in college-aged participants with dysphoria (McMakin et al., 2011)
Savoring interventions show promise as a technique for improving psychological well-being; however, research on savoring interventions has primarily focused on younger adult populations. In fact, a recent meta-analytic review found that savoring interventions had a positive effect on happiness and positive affect, and the average age of participants from the studies included in that meta-analysis ranged from 18 to 43 years (J. L. Smith, Harrison, Kurtz, & Bryant, 2014). Overall, the review found that the savoring interventions had a small, positive effect on positive affect (d = .26, 95% confidence interval [CI] = [.11, .41]) and happiness (d = .38, 95% CI = [.24, .53]). Savoring interventions may be particularly well suited for improving the resilience and well-being of older adult populations, because emotion regulation abilities tend to improve with age (Urry & Gross, 2010). In addition, older adults tend to prioritize emotional goals as they become increasingly aware of limitations to their life span (e.g., Carstensen & Charles, 1998; Charles & Carstensen, 2009).
The savoring intervention in this study builds upon these emotion regulation skills to enhance resilience and well-being. The present study examines whether participation in a daily savoring intervention is associated with changes in resilience and psychological well-being of older adults. We hypothesized that completing the savoring intervention for 1 week would be related to increases in resilience and happiness as well as decreases in depressive symptoms.
Method
Participants
A convenience sample of 111 adults (83% female), between the ages of 60 and 93, participated in this study (Mage = 70.7 years, SD = 7.2). Participants were predominantly White or European American (70%), followed by Black or African American (26%) and other ethnicities (4%). Twenty-five percent of participants completed a high school degree or less education, 35% received an associates or bachelor’s degree, and 40% completed a graduate degree. Approximately one fourth of participants reported an annual household income less than US$25,000 (24%), 31% reported incomes US$25,001 to 50,000, 19% reported incomes US$50,001 to 75,000, and 26% reported incomes over US$75,000. Most participants reported that they were in good to excellent health (48% excellent/very good, 37% good, 15% fair/poor).
Measures
Savoring responses
An abbreviated 19-item Ways of Savoring Checklist (Bryant & Veroff, 2007; Jose, Lim, & Bryant, 2012) assessed the use of thoughts and behaviors that facilitate savoring by amplifying positive feelings (11 items; αs = .85-.86; for example, “I thought about sharing the memory of this later with other people”) and the use of thoughts and behaviors that inhibit savoring by dampening positive emotions (eight items; αs = .79-.83; for example, “I told myself why I didn’t deserve this good thing”). Participants indicated to what extent statements described their thoughts and behaviors during positive experiences over the past week (1 = definitely doesn’t apply, 7 = definitely applies). Amplifying and dampening scores were calculated by averaging the subscale items.
Health
The five-item General Health subscale of the RAND 36-Item Health Survey (Version 1.0; Hays, Sherbourne, & Mazel, 1993; Ware & Sherbourne, 1992; αs = .77-.83) was administered to measure participants’ subjective health ratings (e.g., “In general, would you say your health is: excellent, very good, good, fair, or poor”). The items were rescored on a 100-point scale following RAND’s recommendations (RAND Corporation, n.d.), and the items were averaged together.
Resilience
The six-item Brief Resilience Scale (B. W. Smith et al., 2008; αs = .85-.89) was used to assess participants’ psychological resilience and ability to bounce back from stressful experiences (e.g., “It does not take me long to recover from a stressful event”). Participants indicated the level of their agreement with six statements (1 = strongly disagree, 7 = strongly agree). Negatively worded statements were reverse scored and items were averaged together.
Depressive symptoms
The short 10-item Center for Epidemiologic Studies–Depression Scale (CES-D) (Andresen, Malmgren, Carter, & Patrick, 1994; αs = .83-.90) measured levels of depressive symptoms (e.g., “I was bothered by things that usually don’t bother me”). Participants indicated how frequently they experienced each symptom over the past week (1 = rarely or none of the time, 4 = all of the time). Positively worded items were reverse scored, and items were averaged for an overall score.
Happiness
Participants completed the four-item Subjective Happiness Scale (Lyubomirsky & Lepper, 1999; αs = .82-89) to measure happiness. Participants rated their overall happiness and their happiness compared with others using 7-point scales (e.g., “In general, I consider myself”: 1 = not a very happy person, 7 = a very happy person). One item was reverse scored, and the four items were averaged together.
Fidelity check
Postintervention, participants were asked to report how frequently (0-7 days) they completed the daily activity. This information was used to examine whether the association between the intervention and study outcomes differed based on the amount of the intervention that the participants completed (i.e., intervention fidelity). Specifically, participants who completed 6 or 7 days were coded as high intervention fidelity (+1) and participants who completed the intervention for 5 or fewer days were coded as low intervention fidelity (−1).
Continuation of the activity
In follow-up surveys, participants were asked whether they continued the activity and the frequency (e.g., “Over the last month, have you continued your daily activity” [yes or no] and “On average, how many days per week do you complete the daily activity” [0-7 days]).
Savoring Intervention
Participants were asked to set aside 5 min in the morning and 5 min in the evening each day to complete the positive experiences activity for 1 week. Participants were encouraged to focus more on positive experiences using the following three steps:
First, think of something positive (something good that’s happening right now, a pleasant memory, or something positive that will happen in the future). What is it about the experience that you find so enjoyable? Next, notice the positive feelings that occur when you think about the experience (e.g., amusement, interest, excitement, contentment). Finally, take a moment to appreciate the experience. Think about how special the experience is and how grateful you are for it.
Procedure
The study used a pretest with multiple posttest within-participant design. Participants were recruited through emails and flyers distributed throughout the community. Participants completed paper-based or online surveys at four time points. Preintervention, participants completed a baseline survey that included savoring responses, the outcome measures (resilience, depressive symptoms, and happiness), and demographic items. They then received written instructions for the daily positive experiences activity. Postintervention, participants completed measures to assess savoring responses and study outcomes followed by the intervention fidelity check. Follow-up surveys, which included measures of the outcomes (resilience, depressive symptoms, and happiness) and whether participants continued the activity, were distributed 1 month and 3 months postintervention. Participants received a US$20 gift card for submitting the postintervention survey, and they were entered into a drawing for a US$100 gift card for each follow-up survey. Mather LifeWays Institutional Review Board reviewed and approved the research protocol (#15-001).
Results
Preliminary Analyses
Ninety-nine (89%) participants completed the 1-month follow-up survey, and 81 participants (73%) completed the 3-month follow-up. There were no significant differences between participants who completed all four surveys and participants who missed follow-up surveys on study variables at baseline or postintervention. Participants reported completing the positive experiences activity for an average of 5.5 days (SD = 1.96). After 1 month, 91 participants (82%) reported that they continued the activity (M = 5.16 days/week, SD = 1.95). After 3 months, 65 participants (59%) reported that they continued the activity (M = 5.22 days/week, SD = 1.93). The means and standard deviations of study variables and the bivariate correlations are presented in Table 1.
| M (SD) | 1 | 2 | 3 | 4 | 5 | 6 | 7 | |
|---|---|---|---|---|---|---|---|---|
| 1. Health | 67.95 (19.64) | .77 | ||||||
| 2. Amplifying responses | 4.52 (1.21) | .20* | .86 | |||||
| 3. Dampening responses | 2.75 (1.22) | −.11 | −.02 | .83 | ||||
| 4. Resilience | 5.05 (1.18) | .27* | .34* | −.20* | .87 | |||
| 5. Depression | 1.70 (0.52) | −.28* | −.28* | .39* | −.65* | .83 | ||
| 6. Happiness | 5.57 (1.30) | .42* | .42* | −.24* | .71* | −.67* | .87 | |
| 7. Age | 70.69 (7.19) | −.06 | .01 | .07 | .23* | −.15 | .15 | — |
Note. Cronbach’s alpha is displayed on the diagonal for each measure.
*
Correlations are statistically significant, p < .05.
To examine the link between the intervention and savoring responses, analyses were conducted to assess whether the intervention was associated with changes in the use of savoring responses that amplify or dampen positive emotions. Participants reported a significant decrease in thoughts and behaviors that dampen positive feelings after the intervention (M = 2.44, SD = 1.01) compared with baseline (M = 2.75, SD = 1.23), t(109) = −2.96, p = .004. There was not a significant difference in amplifying strategies before (M = 4.44, SD = 1.21) and after the intervention (M = 4.53, SD = 1.22), t(107) = −0.86, p = .393. These results indicate that the savoring intervention was associated with reductions in the types of thoughts and behaviors that inhibit savoring and decrease positive emotions, but it was not related to increases in thoughts and behaviors that enhance positive feelings.
All participants were instructed to complete the savoring intervention for 7 days, but only 46% of participants completed the full intervention. Participants were categorized to a high intervention fidelity (6 or 7 intervention days; n = 67) or a low intervention fidelity (5 or fewer days; n = 44) group based on their reports of the number of days they completed the intervention. Analyses were conducted to compare the high and low intervention fidelity groups on baseline variables. Participants in the high intervention fidelity group (M = 4.75, SD = 1.25) reported significantly higher levels of amplifying responses at baseline compared with the low fidelity group (M = 4.17, SD = 1.07), t(107) = 2.53, p = .013. The two groups did not significantly differ on any other variables of interest.
Intervention Outcomes
Given that participants completed surveys at four time points, linear multilevel modeling (MIXED procedure in SPSS, v. 22) was used to examine the relationship between the savoring intervention and changes in resilience, depression, and happiness across time. Time (continuous), intervention fidelity (effects-coded), and Time × Intervention Fidelity interaction were included to determine whether outcomes differed for participants who completed high or low levels of the intervention and whether the effects differed over time. Gender, health, baseline amplifying responses, and baseline dampening responses were entered as covariates. The following predictors were entered in the mixed-effects model: time point and health (Level 1 predictors); intervention fidelity, gender, baseline amplifying, and baseline dampening (Level 2 predictors); and Time × Intervention Fidelity (cross-level interaction term). The intercept was modeled as both a fixed and random effect. To facilitate interpretation of the results, health, baseline dampening, and baseline amplifying were group-mean centered and gender was effects-coded. Simple slope analyses were conducted to determine the nature of significant Time × Intervention Fidelity interactions. Specifically, the effects of the intervention over time were examined separately for people with high and low intervention fidelity.
The results of the mixed-effects model predicting resilience are presented in Table 2. Better health, higher baseline amplifying scores, and lower baseline dampening scores were associated with higher resilience. In addition, resilience scores significantly increased over time, and this effect was qualified by a significant Time × Intervention Fidelity interaction on resilience (see Figure 1). Resilience significantly increased across time for participants in the high intervention fidelity group, but there was no change for participants in the low intervention fidelity group, b = .14, SE = .04, p < .001 and b = −.01, SE = .05, p = .837, respectively.
| Parameter | Estimate | SE | p value |
|---|---|---|---|
| Intercept | 5.16 | .13 | <.001 |
| Level 1 (repeated measures) | |||
| Time | .07 | .03 | .030 |
| Health | .01 | .00 | .013 |
| Level 2 (participant level) | |||
| Gender | −.16 | .13 | .207 |
| Baseline amplifying | .29 | .08 | <.001 |
| Baseline dampening | −.22 | .08 | .004 |
| Intervention fidelity | −.12 | .10 | .267 |
| Cross-level interaction | |||
| Time × Intervention Fidelity | .08 | .03 | .012 |
Note. Gender: 1 = female, −1 = male; intervention fidelity: 1 = high, −1 = low.
The results of the mixed-effects model predicting depression are presented in Table 3. Worse health, lower baseline amplifying, and higher baseline dampening were related to higher depression. There was a significant Time × Intervention Fidelity interaction on depression (see Figure 2). There was a significant decrease in depression across time for participants with high intervention fidelity, but there was no change for participants with low intervention fidelity, b = −.04, SE = .02, p = .025 and b = .02, SE = .02, p = .392, respectively.
| Parameter | Estimate | SE | p value |
|---|---|---|---|
| Intercept | 1.65 | .06 | <.001 |
| Level 1 (repeated measures) | |||
| Time | −.01 | .01 | .490 |
| Health | −.00 | .00 | .001 |
| Level 2 (participant level) | |||
| Gender | .06 | .05 | .233 |
| Baseline amplifying | −.12 | .03 | .001 |
| Baseline dampening | .15 | .03 | <.001 |
| Intervention fidelity | .00 | .04 | .962 |
| Cross-level interaction | |||
| Time × Intervention Fidelity | −.03 | .01 | .041 |
Note. Gender: 1 = female, −1 = male; intervention fidelity: 1 = high, −1 = low.
The results of the mixed-effects model predicting happiness are presented in Table 4. Men and participants with better health, higher baseline amplifying, and lower baseline dampening tended to report greater happiness. There was not a statistically significant main-level increase in happiness for the whole sample, and the Time × Intervention Fidelity interaction did not reach statistical significance at the .05 level (see Figure 3). However, the simple slopes were examined to determine whether the pattern in the data was consistent with previous analyses. There were significant increases in happiness over time for participants with high intervention fidelity; however, happiness did not significantly vary across time for participants with low intervention fidelity, b = .11, SE = .05, p = .018 and b = −.02, SE = .06, p = .726, respectively.
| Parameter | Estimate | SE | p value |
|---|---|---|---|
| Intercept | 5.74 | .13 | <.001 |
| Level 1 (repeated measures) | |||
| Time | .05 | .04 | .244 |
| Health | .01 | .00 | .001 |
| Level 2 (participant level) | |||
| Gender | −.31 | .12 | .011 |
| Baseline amplifying | .31 | .07 | <.001 |
| Baseline dampening | −.22 | .07 | .003 |
| Intervention fidelity | −.11 | .11 | .291 |
| Cross-level interaction | |||
| Time × Intervention Fidelity | .07 | .04 | .085 |
Note. Gender: 1 = female, −1 = male; intervention fidelity: 1 = high, −1 = low.
Discussion
This pilot study examined the connection between participating in a 1-week savoring intervention and changes in resilience, depressive symptoms, and happiness of older adults. Consistent with hypotheses, this study revealed that the savoring intervention was associated with increases in psychological resilience and happiness and decreases in depressive symptoms for participants who completed the intervention for at least 6 days. The intervention was not associated with increases in resilience or well-being for participants who completed the intervention for 5 days or less.
Unexpectedly, the savoring intervention was more strongly related to reductions in dampening responses than it was to increases in amplifying responses. Previous research suggests that some savoring strategies may be more effective at reducing negative feelings than at increasing positive feelings (Hurley & Kwon, 2012). One potential explanation for the lack of increase in amplifying responses may have to do with the age of the participants. Older adults tend to display a preference for low or moderate affective stimuli rather than intense affective stimuli (Grühn & Scheibe, 2008; Keil & Freund, 2009). Instead of enhancing positive emotions, older adults may prefer to savor by focusing on a positive experience without dampening the positive emotions that occur (e.g., through fault finding or imagining the moment ending). In addition, we speculate that the savoring intervention led participants to be more mindful of positive experiences that occurred in their daily lives. It may have enabled them to stay in the moment during the positive experiences more than they may have otherwise due to competing demands or the perception that lingering in positive experiences is indulgent. In this way, the savoring intervention may have reduced thoughts and behaviors that inhibit savoring, but not increased the use of thoughts and behaviors that amplify positive feelings (e.g., telling others about the experience).
There are several potential mechanisms that may account for the association between savoring and increased resilience and well-being. For instance, positive mindfulness is a key component of savoring, and increases in mindfulness have been linked to increases in subjective well-being and a greater ability to regulate responses to stress (e.g., Keng, Smoski, & Robins, 2011). Furthermore, the savoring intervention may increase the salience of positive experiences and increase memory building for those experiences. Savoring may also improve one’s ability to notice and appreciate positive moments during difficult times, which may contribute to greater resilience by counteracting some of the effects of negative emotions (e.g., Zautra, Smith, Affleck, & Tennen, 2001). By increasing the duration, frequency, and intensity of positive emotions, savoring may contribute to the development of resources, such as strong relationships and skills, that enable people to respond resiliently when challenges arise (Fredrickson, 2001; Tugade & Fredrickson, 2007).
Limitations and Future Directions
There are limitations to this pilot study that should be addressed in future research. Without a control group, we are unable to rule out the possibility that the changes in the outcome variables are due to external factors. It is also important to note there were no main effects of the savoring intervention on resilience, depression, or happiness for the sample as a whole. Participants who partially completed the intervention were included as a comparison group (i.e., low intervention fidelity group), and their reported outcomes differed from participants who completed the full intervention. This suggests that the findings are not simply due to involvement in the study, effects of repeated measurement, or natural changes over time. Nevertheless, this is not a substitute for random assignment to condition. Randomized control trials are needed to further test the effectiveness of the intervention. In addition, the study used self-report measures, which are at risk for response bias and self-presentation. Another limitation of the study is that participants were predominantly women. Previous research has found that women tend to have a higher perceived savoring ability compared with men (Bryant, 2003). The analyses controlled for gender, but the savoring intervention should be further tested with a more diverse sample of participants. Finally, participants received the savoring instructions, but they were not provided explicit training on the savoring intervention. Participants may have interpreted and executed the protocol in different ways, which may have reduced the strength of the intervention.
The temporal focus of the savoring intervention was not restricted to allow participants to choose whether they savored through positive reminiscence, savoring the moment, or positive anticipation. There was an assumption inherent in that decision that participants would focus on the time orientation that would cultivate the most savoring; however, this may not have been the case. In the current study, we cannot determine whether the effects of savoring past, present, or future positive experiences (or a mixture) were related to different outcomes. This is an interesting avenue to explore for future research. Previous research has found that perceived ability to savor the present moment is more strongly related to happiness compared with the ability to savor through positive reminiscence or anticipation (Bryant, 2003). Therefore, we would predict that strongest effects would be found for present-focused savoring.
Additional research is needed to determine whether the effects of the savoring intervention for older adults vary based on the types of positive experiences that are savored (e.g., relationship vs. achievement focus). The savoring intervention could be extended to include relational savoring, which is a form of savoring that focuses on attachment-related experiences in relationships (e.g., Borelli, Rasmussen, Burkhart, & Sbarra, 2015; Burkhart, Borelli, Rasmussen, & Sbarra, 2015). Previous research suggests that relational savoring is associated with higher quality relationships and greater relationship satisfaction (e.g., Borelli et al., 2015; Gable, Reis, Impett, & Asher, 2004).
Future research is needed to understand how to best tailor interventions to the needs of individual users. Some participants completed the intervention for fewer days than instructed, which suggests that the savoring intervention may be a better fit for some participants than others. There are many reasons that participants may have skipped days of the intervention (e.g., forgetfulness, other commitments), and participants who completed the intervention may have found the positive experiences activity easier to complete or inherently more interesting. It is important to keep in mind that the savoring activity, and other positive interventions, should be tailored to fit the needs and interests of the user (Sheldon & Lyubomirsky, 2007).
Conclusion
Overall, this pilot study demonstrates that teaching older adults to savor may have the potential to positively affect their psychological well-being and resilience. For participants who completed at least 6 days of the intervention, the savoring intervention was associated with increases in resilience and happiness as well as decreases in depression. Additional research is needed to further examine the effectiveness of the intervention as well as to identify individual characteristics of older adults who would benefit most from the intervention. Based on the current findings, the savoring intervention shows promise as a low-cost technique for enhancing resilience and well-being.
Declaration of Conflicting Interests
The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Funding
The authors received no financial support for the research, authorship, and/or publication of this article.
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Article first published online: February 10, 2017
Issue published: January 2019
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PubMed: 28380722
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This article was published in Journal of Applied Gerontology.
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