Positive affect predicts lower risk of AIDS mortality

Does positive affect influence health?

This review highlights consistent patterns in the literature associating positive affect (PA) and physical health. However, it also raises serious conceptual and methodological reservations. Evidence suggests an association of trait PA and lower morbidity and of state and trait PA and decreased symptoms and pain. Trait PA is also associated with increased longevity among older community-dwelling individuals. The literature on PA and surviving serious illness is inconsistent. Experimentally inducing intense bouts of activated state PA triggers short-term rises in physiological arousal and associated (potentially harmful) effects on immune, cardiovascular, and pulmonary function. However, arousing effects of state PA are not generally found in naturalistic ambulatory studies in which bouts of PA are typically less intense and often associated with health protective responses. A theoretical framework to guide further study is proposed.

A LONGITUDINAL STUDY OF THE RELATIONSHIP BETWEEN POSITIVE AFFECT AND BOTH PROBLEM- AND EMOTIONFOCUSED COPING STRATEGIES

The relationship between positive affect (PA), negative affect (NA) and reported use of problem-focused or emotion-focused coping strategies was investigated in a longitudinal study. Japanese undergraduates (200 men and 270 women) completed a version of the PANAS (Watson, Clark, & Tellegen, 1988) and the situational version of the General Coping Questionnaire (Sasaki & Yamasaki, 2004). These two measures were administered twice, five weeks apart (T1 and T2). The results showed some significant sex differences. Higher PA at T1 was associated with greater reported use of cognitive reinterpretation as a coping strategy at T2 only for men, whereas greater use of cognitive reinterpretation at T1 was associated with higher PA at T2 only for women. These results suggest that there is no mutually reciprocal relationship between PA and use of cognitive reinterpretation as a coping strategy.

Dynamic approaches to emotions and stress in everyday life: Bolger and Zuckerman reloaded with positive as well as negative affects

A decade ago, Bolger and Zuckerman (1995) incorporated personality into the study of daily life events and psychological distress. Their approach put an entirely new cast on research and theorizing in this area. In their work, they focused on the predominantly negative personality trait of Neuroticism. In this article we extend their work to include theory and measurement of positive events and indicators of well-being. Integrating these research strands offers the possibility of a comprehensive yet highly sensitive and dynamic approach to the study of emotions, stress, and health in everyday life.

Positive affect and the complex dynamics of human flourishing

Extending B. L. Fredrickson's (1998) broaden-and-build theory of positive emotions and M. Losada's (1999) nonlinear dynamics model of team performance, the authors predict that a ratio of positive to negative affect at or above 2.9 will characterize individuals in flourishing mental health. Participants (N=188) completed an initial survey to identify flourishing mental health and then provided daily reports of experienced positive and negative emotions over 28 days. Results showed that the mean ratio of positive to negative affect was above 2.9 for individuals classified as flourishing and below that threshold for those not flourishing. Together with other evidence, these findings suggest that a set of general mathematical principles may describe the relations between positive affect and human flourishing.

Development of structured support groups for HIV-positive women in South Africa

Women living with HIV in a stigmatising community need support to cope with their HIV status. In a process of action research, a structured support group programme was designed to meet the needs of women to cope with their diagnosis and interpersonal relationships. The emphasis was on identifying their needs and developing programme material to address those needs through group participation and interaction. The programme was pilot-tested at two sites located in two townships in Tshwane, South Africa. Feedback after each session made it possible to adjust the programme to the needs of the participants. In a formative evaluation, audio-taped sessions, process notes of facilitators, and experiences of the participants were used to identify therapeutic elements, the value of the groups and the problems in the implementation process. Women reported benefit from participation in the support groups. A 10-session structured programme to be used in support groups addressing the most important needs of HIV-positive women was developed.

Perceptions of positive meaning and vulnerability following breast cancer: Predictors and outcomes among long-term breast cancer survivors

BACKGROUND

Survival rates for women with early-stage breast cancer have increased significantly in recent years. However, little is known about the long-term impact of the cancer experience on women's psychological functioning. Theoretical and descriptive accounts suggest that cancer may evoke both perceptions of vulnerability and positive meaning, with potentially different effects on mental health.

PURPOSE

This study was designed to evaluate the prevalence and stability of these perceptions in a large sample of breast cancer survivors, to identify their antecedents, and to determine their impact on long-term adjustment.

METHODS

Breast cancer survivors (N = 763) were assessed longitudinally at 1 to 5 years and 5 to 10 years postdiagnosis. Participants completed surveys assessing perceptions of positive meaning and vulnerability and standard measures of psychological adjustment and quality of life.

RESULTS

The majority of women reported positive changes in outlook and priorities as well as feelings of vulnerability at both assessment points. Consistent with hypotheses, results showed that perceptions of positive meaning and vulnerability were positively correlated and were both associated with factors that increased the disruptiveness of the cancer experience. Vulnerability was strongly associated with negative affect, whereas meaning was associated with positive affect in cross-sectional and longitudinal analyses.

CONCLUSIONS

Results suggest that a cancer diagnosis may lead to enduring feelings of vulnerability as well as positive changes in meaning; however, these perceptions have very different mental health correlates.

Positive emotions: exploring the other hemisphere in behavioral medicine

The search for the psychological antecedents of medical disorders has focused on the role of stress and negative emotional states. Previous research in this area has investigated relations between negative emotions and physiological adaptations (e.g., blood pressure elevations), adverse health behaviors (e.g., smoking), and social conditions (e.g., social isolation). In this discussion, we argue that more attention is needed to understand the effects of positive emotional states on health enhancement and disease prevention. In each of the areas cited previously, evidence is beginning to emerge that indicates that positive emotions can be associated with health promoting conditions. Interventions using cognitive behavioral strategies or meditation can increase positive emotional states that are maintained over time and that may benefit health and well-being. Implications for behavioral medicine are discussed.

Socioeconomic status, resources, psychological experiences, and emotional responses: a test of the reserve capacity model

The current study used ecological momentary assessment to test several tenets of the reserve capacity model (L.C. Gallo & K. A. Matthews, 2003). Women (N = 108) with varying socioeconomic status (SES) monitored positive and negative psychosocial experiences and emotions across 2 days. Measures of intrapsychic and social resources were aggregated to represent the reserve capacity available to manage stress. Lower SES was associated with less perceived control and positive affect and more social strain. Control and strain contributed to the association between SES and positive affect. Lower SES elicited greater positive but not negative emotional reactivity to psychosocial experiences. Women with low SES had fewer resources relative to those with higher SES, and resources contributed to the association between SES and daily experiences.

Caregiver burden and depressive symptoms: analysis of common outcomes in caregivers of elderly patients

Despite widespread use of caregiver burden and depressive symptoms in caregiving research, the relationship between these two concepts and the way in which burden and depressive symptoms are affected are not clear.

METHODS

The authors used structural equation modeling with an inception cohort of 488 family caregivers to examine the relationship between care recipients' mental and functional status and recency of care demands and caregivers' burden and depressive symptoms.

RESULTS

Care recipients' mental and functional status and recency of care demands predicted caregiver burden; burden, in turn, was nearly significant in predicting depressive symptoms. Care recipients' mental status and recency of care demands had a near significant indirect effect on caregiver depressive symptoms. There were no significant direct paths between care recipients' mental status, functional status, recency of care demands, and caregivers' depressive symptoms.

DISCUSSION

Health care practitioners should assist caregivers with new care demands stemming from care recipients' mental and functional status to decrease burdens and should monitor caregivers with higher levels of burden for the development of depressive symptoms.

Positive emotions broaden the scope of attention and thought-action repertoires

The broaden-and-build theory (Fredrickson, 1998, 2001) hypothesises that positive emotions broaden the scope of attention and thought-action repertoires. Two experiments with 104 college students tested these hypotheses. In each, participants viewed a film that elicited (a) amusement, (b) contentment, (c) neutrality, (d) anger, or (e) anxiety. Scope of attention was assessed using a global-local visual processing task (Experiment 1) and thought-action repertoires were assessed using a Twenty Statements Test (Experiment 2). Compared to a neutral state, positive emotions broadened the scope of attention in Experiment 1 and thought-action repertoires in Experiment 2. In Experiment 2, negative emotions, relative to a neutral state, narrowed thought-action repertoires. Implications for promoting emotional well-being and physical health are discussed.

The Healthy Living Project: an individually tailored, multidimensional intervention for HIV-infected persons

The NIMH Healthy Living Project (HLP), a randomized behavioral intervention trial for people living with HIV, enrolled 943 individuals, including women, heterosexual men, injection drug users, and men who have sex with men from Los Angeles, Milwaukee, New York, and San Francisco. The intervention, which is based on qualitative formative research and Ewart's Social Action Theory, addresses three interrelated aspects of living with HIV: stress and coping, transmission risk behavior, and medication adherence. Fifteen 90-minute structured sessions, divided into 3 modules of five sessions each, are delivered to individuals. Sessions are tailored to individuals within a structure that uses role-plays, problem solving, and goal setting techniques. A 'Life Project'--or overarching goal related to personal striving-provides continuity throughout sessions. Because this is an ongoing project with efficacy yet to be established, we do not report intervention outcomes. However, the intervention was designed to be useful for prevention case management, settings where repeated one-on-one contact is possible, and where a structured but highly individualized intervention approach is desired.

Psychological resilience and positive emotional granularity: examining the benefits of positive emotions on coping and health

For centuries, folk theory has promoted the idea that positive emotions are good for your health. Accumulating empirical evidence is providing support for this anecdotal wisdom. We use the broaden-and-build theory of positive emotions (Fredrickson, 1998; 2001) as a framework to demonstrate that positive emotions contribute to psychological and physical well-being via more effective coping. We argue that the health benefits advanced by positive emotions may be instantiated in certain traits that are characterized by the experience of positive emotion. Towards this end, we examine individual differences in psychological resilience (the ability to bounce back from negative events by using positive emotions to cope) and positive emotional granularity (the tendency to represent experiences of positive emotion with precision and specificity). Individual differences in these traits are examined in two studies, one using psychophysiological evidence, the second using evidence from experience sampling, to demonstrate that positive emotions play a crucial role in enhancing coping resources in the face of negative events. Implications for research on coping and health are discussed.

The broaden-and-build theory of positive emotions

The broaden-and-build theory describes the form and function of a subset of positive emotions, including joy, interest, contentment and love. A key proposition is that these positive emotions broaden an individual's momentary thought-action repertoire: joy sparks the urge to play, interest sparks the urge to explore, contentment sparks the urge to savour and integrate, and love sparks a recurring cycle of each of these urges within safe, close relationships. The broadened mindsets arising from these positive emotions are contrasted to the narrowed mindsets sparked by many negative emotions (i.e. specific action tendencies, such as attack or flee). A second key proposition concerns the consequences of these broadened mindsets: by broadening an individual's momentary thought-action repertoire--whether through play, exploration or similar activities--positive emotions promote discovery of novel and creative actions, ideas and social bonds, which in turn build that individual's personal resources; ranging from physical and intellectual resources, to social and psychological resources. Importantly, these resources function as reserves that can be drawn on later to improve the odds of successful coping and survival. This chapter reviews the latest empirical evidence supporting the broaden-and-build theory and draws out implications the theory holds for optimizing health and well-being.