Effects of Awe on Mental Health and Well-Being
Phase: NA
Conditions: Awe, Compassion, Anxiety
Sponsor: University of California, San Francisco

Effects of Awe on Health
11/22/2016

8.9 * PROCEDURES / METHODS: (REQUIRED)
Describe the research methods and study activities taking place at each site (e.g. what will participants be asked to
do and what will members of the study team do?). If there will be multiple participant groups or study sites, explain
what will happen with each group or study sites.   If some of the activities would occur even if the person were not
in the study, as in the case of treatment or tests performed for diagnostic purposes, clearly differentiate
between those activities that will be done solely for research purposes and those that are happening as part
of routine care.   Please call our office at 415-476-1814 and ask to speak to someone on the Expedited Review
team if you need help differentiating between what parts are research and what parts aren't.
Aim 1. To examine the relationship that emotional reactivity has with mental health symptoms in older adults
Methods
Laboratory Assessment of Emotion
Tasks. We will use a laboratory-based approach to measure emotional reactivity (i.e., ANS reactivity, facial
expression, and subjective experience) in response to film clips. After sitting quietly through a 60-second
pre-film resting baseline period, participants will watch a 90-second film clip that elicits either a negative or
positive emotion. For example, the film clips will depict a doctor cleaning earwax from a girl's ear (disgust),
babies playing (love), sweeping views of broad landscapes (awe), and a woman reading a sad letter from an
admirer (sadness). After film viewing, participants will be asked questions about their subjective experience.
IRB approval date: 11/22/2016

ANS Physiology. We will obtain continuous recordings of the following ANS measures: (1) skin conductance
level, (2) pre-ejection period, (3) respiratory sinus arrhythmia, (4) heart rate, (5) finger pulse amplitude, (6)
finger pulse transmission time, (7) respiration period, (8) respiration depth, and (9) finger temperature. The
participant will sit in a chair while the study staff first cleans the area where the EKG sensors will be placed
with rubbing alcohol and light exfoliating gel. This is done to remove dead skin cells from the area that the
sensors will be placed. Then electrode gel will be placed on the back of the sensors, and the sensors will be
placed on the participant. For measures of breathing, a breathing belt will be placed around the participant's
midsection, ensuring it is not too tight for the participant. For sensors placed on the hand, electrodes and
electrode gel will be placed on the fingers. Mean baseline levels will be used to investigate resting ANS
activity, and reactivity scores will be calculated by subtracting the mean level of activity during a resting
baseline period from the mean level during a trial.
Facial Expression. Participants will be videotaped using a remote-controlled, high-resolution video camera in
the experiment room. Trained coders will use a modified version of the Emotional Expressive Behavior
coding system. Coders, who will be unaware of the nature of the trial, will code each second for ten
emotional behaviors (anger, disgust, happiness/amusement, contempt, sadness, embarrassment, fear,
surprise, sleepiness, confusion, and interest) on an intensity scale ranging from 0 (not present) to 3
(maximum intensity). We will sum the intensity scores for each emotional code during the most intense 30
seconds of each film.
Subjective Experience. Participants will be asked to report on their subjective experience before the testing
session begins and after each trial. They will be asked, “Did you feel ___ while watching the movie?” and will
be given the following response choices: 0= no, 1= a little, 2= moderately, 3= quite a bit, or 4= extremely.
Baseline questions
Physical Health
Physical Symptoms. Participants will indicate whether they have experienced any of the following
sensations: headaches, faintness/dizziness, stomachache/pain, shortness of breath, chest pain, acne/skin
irritation, runny/congested nose, stiff or sore muscles, stomach upset/nausea, irritable bowels, hot or cold
spells, poor appetite, coughing/sore throat, or other in the past month. Previous studies have found this
approach is a reliable and valid index of self-perceived health status. We will sum the 13 items within the
report to create a total physical symptom score.
Physical Exercise. The Godin Leisure-Time Exercise Questionnaire will be used to measure the frequency of
strenuous, moderate, and mild exercise that participants have engaged in over the past week. Body Mass
Index will be calculated from height and weight measurements obtained during the laboratory visit.
Sleep. Selected questions from the Pittsburgh Sleep Quality Index will be used to assess subjective sleep
latency, duration, calculated sleep efficiency, and overall sleep quality.
Mental Health
Emotional Symptoms. Participants will complete questionnaires to assess the following domains: anxiety
(i.e., Generalized Anxiety Disorder- 7 Item Scale and State-Trait Anxiety State subscale), depression (i.e.,
Center for Epidemiologic Studies Depression Scale), obsessions and compulsions (i.e., Yale-Brown
Obsessive Compulsive Scale), mania (i.e., Altman Self-Rating Mania Scale), emotion dysregulation (i.e.,
Difficulty in Emotion Regulation Scale), irritability (i.e., Irritability Subscale of the Buss Durkee Hostility
Inventory), lability (i.e., Center for Neurological Study Lability Scale), rumination (i.e., Rumination-Reflection
Questionnaire), subjective emotional experience (i.e., Positive and Negative Affect Schedule), and intensity
of emotional experience (i.e., Affect Intensity Measure Simplified).
Well-Being. Participants will complete measures that assess their social network size and complexity (i.e.,
Social Network Index), loneliness (i.e., The Revised UCLA Loneliness Scale), subjective happiness (i.e.,
Subjective Happiness Scale), and life satisfaction (i.e., The Satisfaction With Life Scale).
Prosociality. We will measure trait levels of positive emotional experience (i.e., Dispositional Positive
Emotions Scale), compassion (i.e., compassion subscale of the Big Five Inventory-2), and empathy (i.e.,
Empathic Concern subscale from the Interpersonal Reactivity Index).
Aim 2. To determine whether a novel awe intervention improves subjective experience and reduces
symptoms in older adults
Methods

Awe Walk Intervention
After the laboratory assessment, participants will be randomized into one of two 8-week conditions: (1) awe
condition or (2) control condition. All participants will be instructed to take a weekly 15-minute walk. In the
awe condition, participants will be instructed to pay attention to the vastness and novelty of the environment
around them. In the control condition, participants will receive no additional instructions.
Daily questions
Daily Emotional Experience, Life Satisfaction, Prosociality
Emotional Experience. On each day of the 8-week intervention, participants will report how much they
experienced awe, wonder, and amazement in addition to admiration, amusement, anger, annoyance,
appreciation, anxiety, compassion, fear, happiness, pride, sadness, relaxed, and warmth. Items will be
measured on 10-point Likert scales (1= not at all, 10= as much as I’ve ever felt).
Life Satisfaction and Prosociality. Participants will also respond on a daily basis to statements assessing
their life satisfaction (“Today I felt that my life was... terrible to terrific”) and prosociality (“How much did you
engage in acts today that involved helping someone else or doing something for a good cause?”). Both
items will be measured on 10-point Likert scales (1= not at all, 10= as much as I’ve ever felt/done). At the
beginning of the study, participants will recreive an email from study staff to an address the participants
designate as an email in which they would like to maintain study correspondance. In this first email, there will
be a personalized link in which they will open and it will direct them to the secure UCSF-supported Qualtrics
platform where they can access all study questionnaires. All answers will be securely stored on the private,
secure Qualtrics account managed by study staff.
Post-Intervention Follow-Up Assessment
At the conclusion of the 8-week intervention and at 3- and 6-months post-intervention, participants will again
complete the physical and mental health questionnaires that they completed during their baseline visit.