Positive emotion and health: going beyond the negative

A review of the literature on wellbeing and modifiable dementia risk factors

Wellbeing-defined broadly as experiencing one's life as enjoyable and fulfilling-has been associated with lower risk for Alzheimer's disease and related dementias. The mechanisms underlying this association are largely unknown. However, prior research and theory suggest that wellbeing impacts health behaviors and biological systems that are relevant to cognitive and brain health. Several of these factors have also been identified by the 2020 Lancet Commission on Dementia Prevention, Intervention, and Care as modifiable dementia risk factors. In the current review, we summarize and evaluate the evidence for associations between wellbeing and each of the 12 Lancet Commission risk factors. We found relatively consistent evidence for associations between higher wellbeing and lower levels of most of the risk factors: physical inactivity, social isolation, smoking, depression, hypertension, diabetes, hearing loss, traumatic brain injury, and air pollution. By contrast, we found evidence for only modest associations between wellbeing and education and mixed evidence for associations of wellbeing with alcohol use and body weight. Although most of the reviewed evidence was observational, longitudinal and experimental evidence suggests that many of the observed associations are likely bidirectional. These findings suggest that modifiable dementia risk factors may be mediators (i.e., intermediate steps in the causal chain) and/or confounders (i.e., variables that impact both wellbeing and dementia, and thus could induce a spurious association) of the association between wellbeing and dementia. We conclude by discussing next steps to test mediation hypotheses and to account for potential confounding in the relation between wellbeing and dementia.

Differences in health utilities between cancer patients and the general population: The case of Quebec using the SF-6Dv2

A considerable debate persists in the literature about whose preferences should be considered in the calculation of quality-adjusted life-years. Some suggest considering only the preferences of the general population, while others advocate for the consideration of those of patients or a combination of both. This study aims to inform and measure the differences in health preferences between cancer patients and the general population in Quebec. A total of 60,976 observations representing the preferences of the general population for various health states were collected and used to develop a new value set using the SF-6Dv2. This value set was generated by combining 34,299 observations with time trade-off (TTO) and 26,677 observations with discrete choice experiment (DCE). Utility scores derived from this value set were compared to those of patients' preferences from a new value set in breast and colorectal patients for the SF-6Dv2. For both patients and the general population, the 'Pain' dimension was the highest contributor to the utility score. However, noticeable differences were observed in the estimates. Estimates of levels 2 and 3 were generally lower for cancer patients, while they were more likely to have greater estimates in severe levels. Significant differences in utility scores were also noticed with the general population showing higher mean utility scores for the same health states. These differences increased as the health states worsened. This study sheds light on the existing differences in preferences between cancer patients and the general population of Quebec for a better consideration in healthcare decision-making.

Putting Emotions in the Health Belief Model: The Role of Hope and Anticipated Guilt on the Chinese's Intentions to Get COVID-19 Vaccination

When promoting COVID-19 vaccination, the media and public figures often mention hope to return to normalcy and sometimes try to elicit guilt by asking people to get vaccinated to protect themselves and others. Situated within the health belief model, the present research aimed to investigate whether hope and anticipated guilt were related to vaccine uptake intent. It postulated that hope and anticipated guilt mediated the relationships between risk perceptions/perceived benefits and vaccine uptake intent. The data were collected via an online survey of 460 Chinese participants in March 2021 and were analyzed using Hayes' PROCESS MACRO. The results revealed that perceived susceptibility and perceived benefits, but not perceived severity, predicted the Chinese's vaccine uptake intent. Furthermore, hope positively predicted vaccine uptake intent and partially mediated the relationship between perceived benefits and vaccination intent and between perceived severity and vaccination intent. Anticipated guilt was a significant, but weak predictor of vaccination intent. Both theoretical and practical implications are discussed.

Outpatient Ketamine Infusions for the Treatment of Fibromyalgia and Chronic Pain Syndrome: A Case Report

Intravenous (IV) ketamine has demonstrable efficacy for chronic pain management. Its use in an outpatient setting has provided relief from myriad pain syndromes and additionally may reduce dependence on opioids. Nevertheless, its long-term ability to provide these benefits is understudied. Here, we present the case of a 68-year-old female who presented to our clinic with persistent fibromyalgia, accompanied by other pain symptoms that had been recalcitrant to traditional pain management therapy including nerve blocks, ablations, spinal cord stimulation, and morphine medication. We administered seven increasing IV ketamine doses over two weeks. The patient reported significant, widespread pain relief. The patient continued to receive IV ketamine twice weekly for over a year and remains on this schedule. Pain relief has persisted under this regimen, along with a demonstrable improvement in quality of life, a reduced use of morphine, and the cessation of anti-depressant medication. This case indicates that long-term ketamine infusions show promise for chronic pain management and that more longitudinal studies on this treatment are warranted.

A theory-based and data-driven approach to promoting physical activity through message-based interventions

Objective

We investigated how physical activity can be effectively promoted with a message-based intervention, by combining the explanatory power of theory-based structural equation modeling with the predictive power of data-driven artificial intelligence.

Methods

A sample of 564 participants took part in a two-week message intervention via a mobile app. We measured participants' regulatory focus, attitude, perceived behavioral control, social norm, and intention to engage in physical activity. We then randomly assigned participants to four message conditions (gain, non-loss, non-gain, loss). After the intervention ended, we measured emotions triggered by the messages, involvement, deep processing, and any change in intention to engage in physical activity.

Results

Data analysis confirmed the soundness of our theory-based structural equation model (SEM) and how the emotions triggered by the messages mediated the influence of regulatory focus on involvement, deep processing of the messages, and intention. We then developed a Dynamic Bayesian Network (DBN) that incorporated the SEM model and the message frame intervention as a structural backbone to obtain the best combination of in-sample explanatory power and out-of-sample predictive power. Using a Deep Reinforcement Learning (DRL) approach, we then developed an automated, fast-profiling strategy to quickly select the best message strategy, based on the characteristics of each potential respondent. Finally, the fast-profiling method was integrated into an AI-based chatbot.

Conclusion

Combining the explanatory power of theory-driven structural equation modeling with the predictive power of data-driven artificial intelligence is a promising strategy to effectively promote physical activity with message-based interventions.

Uncertainty drives exploration of negative information across younger and older adults

Although individuals generally avoid negative information, recent research documents that they voluntarily explore negative information to resolve uncertainty. However, it remains unclear (a) whether uncertainty facilitates exploration similarly when exploration is expected to lead to negative, neutral, or positive information, and (b) whether older adults seek negative information to reduce uncertainty like younger adults do. This study addresses the two issues across four experimental studies (N = 407). The results indicate that individuals are more likely to expose themselves to negative information when uncertainty is high. In contrast, when information was expected to be neutral or positive, the uncertainty surrounding it did not significantly alter individuals' exploration behavior. Furthermore, we found that uncertainty increased the exploration of negative information in both older and younger adults. In addition, both younger and older adults chose to explore negative information to reduce uncertainty, even when there were positive or neutral alternatives. In contrast to the age-related similarities in these behavioral measures, older adults demonstrated reduced scores in questionnaires on sensation seeking and curiosity, relative to their counterparts who were younger. These results suggest that information uncertainty has a selective facilitation effect on exploration for negative information and that normal aging does not alter this tendency, despite age-related reductions in self-reported measures of personality traits relevant to information seeking.

Subjective Happiness, Frequency of Laughter, and Hypertension: A Cross-Sectional Study Based on the Japan Gerontological Evaluation Study (JAGES)

In recent years, positive psychological factors, such as subjective happiness and laughter, have been reported to be associated with cardiovascular disease. In this study, we examined the relationship of hypertension with subjective happiness and frequency of laughter using the data from the Japan Gerontological Evaluation Study (JAGES). Of the 138,294 respondents, 26,368 responded to a version of the self-administered questionnaire that included a question about the frequency of laughter in the JAGES 2013. In total, 22,503 (10,571 men and 11,932 women) were included in the analysis after excluding those with missing responses regarding a history of hypertension, frequency of laughter, and subjective happiness. The prevalence of hypertension in this study was 10,364 (46.1%). Multivariate logistic regression analysis showed that age, female sex, obesity, infrequent chewing, former and current drinker, seeing three to five friends, and the absence of hobbies were positively associated with hypertension. However, infrequent laughter/high level of subjective happiness, frequent laughter/high level of subjective happiness, being underweight, and current smoker were negatively associated with hypertension. As per the findings of this study, it was determined that subjective happiness was negatively associated with hypertension. Therefore, this study suggests that having more opportunities to feel happiness may be important in preventing hypertension.

Resilient phenotypes among bereaved youth: a comparison of trajectory, relative, and cross-domain approaches

BACKGROUND

Bereavement is a common traumatic event associated with adverse health outcomes across the life course. Despite these risks, not all bereaved individuals experience these negative effects. Limited scientific consensus exists on how to define resilience in individuals who have experienced the death of a loved one.

METHODS

Using a sample of N = 3766 youth from the Avon Longitudinal Study of Parents and Children birth cohort, we identified bereavement of a family member between ages 7 and 8.5. We derived and compared three different approaches to assess resilience among bereaved youth. Trajectory-based psychological resilience identified sub-groups with similar psychological symptom profiles between ages 6 and 16 using latent growth mixture models. Relative psychological resilience at age 16 leveraged standardized residuals from a model regressing psychological symptoms on bereavement to determine better-than-expected psychological functioning relative to bereavement status. Relative cross-domain resilience around age 16 was a sum score of the residuals approach applied to eight unique domains of health. Predictive validity of each approach was assessed using depressive symptoms at age 17.5 RESULTS: Overall, N = 877 (23%) youth were bereaved of a family member between ages 7 and 8.5. Using latent growth mixture models, a three-class solution described 84% of bereaved youth with low and stable psychological symptoms over time, 8% with worsening symptoms, and 8% with improving yet elevated symptoms. Each relative resilience score was largely concordant with the trajectory-based approach in identifying individuals as resilient or not, though relative psychological resilience demonstrated a stronger degree of concordance than the cross-domain score. Relative psychological and cross-domain resilience exhibited moderate to low correlation, depending on the domains included (r = 0.14-0.43). For each approach, resilience significantly predicted lower depressive symptoms at age 17.5, highlighting predictive validity of these measures.

CONCLUSIONS

Psychological symptom trajectories among bereaved youth aligned with those previously identified among bereaved adults. The residual-based approach to defining resilience exhibited limited utility in the context of bereavement. When identifying risk and resilience after bereavement, researchers and clinicians must address the interplay across psychosocial and physical health domains, as bereaved youth considered resilient from a mental health perspective may benefit from intervention in other domains.

The Effects of Physical Activity on Positive Emotions in Children and Adolescents: A Systematic Review and Meta-Analysis

BACKGROUND

Positive emotions help children and adolescents develop good personalities and interpersonal relationships. Evidence shows that participation in physical activity is associated with positive emotions in young people. However, there is still a lack of studies on the effects of physical activity on positive emotions in children and adolescents.

OBJECTIVE

The purpose of this systematic review and meta-analysis was to examine the effects of physical activity on positive emotions in children and adolescents.

METHODS

Online databases (Scopus, PubMed, Web of Science, EBSCOhost, and APA PsycInfo) were searched from inception to August 2022.

RESULT

A total of 24 articles were eventually included representing 3907 participants from 14 different countries. Overall, the effect of physical activity interventions on positive emotions was significant. The studies revealed that positive emotions were statistically better in the physical activity participation group than in the control group without physical activity (SMD = 0.62, 95% CI: (0.24, 1.01), (p < 0.01). Based on subgroup analyses, we found that participation in aerobic exercise for 30-60 min in adolescents aged ≥12 years had a more significant intervention effect on positive emotions.

CONCLUSION

These findings indicate that the moods of children and adolescents who participate in physical activity significantly improved compared with the moods of those who do not participate in physical activity. The age, exercise type, and exercise duration of adolescents are important factors influencing the positive emotions resulting from physical activity interventions.

Global diabetes burden: analysis of regional differences to improve diabetes care

INTRODUCTION

The current evaluation processes of the burden of diabetes are incomplete and subject to bias. This study aimed to identify regional differences in the diabetes burden on a universal level from the perspective of people with diabetes.

RESEARCH DESIGN AND METHODS

We developed a worldwide online diabetes observatory based on 34 million diabetes-related tweets from 172 countries covering 41 languages, spanning from 2017 to 2021. After translating all tweets to English, we used machine learning algorithms to remove institutional tweets and jokes, geolocate users, identify topics of interest and quantify associated sentiments and emotions across the seven World Bank regions.

RESULTS

We identified four topics of interest for people with diabetes (PWD) in the Middle East and North Africa and another 18 topics in North America. Topics related to glycemic control and food are shared among six regions of the world. These topics were mainly associated with sadness (35% and 39% on average compared with levels of sadness in other topics). We also revealed several region-specific concerns (eg, insulin pricing in North America or the burden of daily diabetes management in Europe and Central Asia).

CONCLUSIONS

The needs and concerns of PWD vary significantly worldwide, and the burden of diabetes is perceived differently. Our results will support better integration of these regional differences into diabetes programs to improve patient-centric diabetes research and care, focused on the most relevant concerns to enhance personalized medicine and self-management of PWD.

Sense of Coherence as a Mediator in the Association Between Empathy and Moods in Healthcare Professionals: The Moderating Effect of Age

While empathy is considered a critical determinant of the quality of medical care, growing evidence suggests it may be associated with both one’s own positive and negative moods among healthcare professionals. Meanwhile, sense of coherence (SOC) plays an essential role in the improvement of both psychological and physical health. Reportedly, individual SOC reaches full stability after around age 30. The aim of this study was first to evaluate the mediatory role of SOC on the association between empathy and individual moods among 114 healthcare professionals in a general hospital, and then to examine the moderating effect of age on this association. Participants completed a range of self-report demographic questionnaires, Empathy Process Scale (EPS), the 13-item Antonovsky’s SOC, and Profile of Mood States (POMS). Findings showed that SOC mediated the relations between empathy (EPS) and both POMS-Vigor (POMS-V: self-vigor mood) and POMS-Depression (POMS-D: self-depression mood). Notably, moderated mediation analysis revealed that there was a significant interaction (age × SOC) on self-vigor mood (POMS-V) in healthcare professionals. The indirect effect of empathy (EPS) on self-vigor mood (POMS-V) through SOC was significant at over mean age “32.83.” Although there was no significant interaction with age regarding the indirect effect of empathy (EPS) on self-depression mood (POMS-D), in the sub-category level analysis of empathy (EPS), we found a significant interaction item [age × empathy for other’s negative affect (EPS-N)] on SOC. This indirect effect was also significant at over mean age “32.83.” Taken, together, the current study highlighted the significant mediator of SOC on that empathy amplifies self-vigor mood and attenuates self-depression mood as a protective factor among the Japanese healthcare professionals. Some components of these processes may depend on the moderating role of age, indicating that we may need to consider the SOC development with age for more effective empathy performance interventions among healthcare professionals.

The relationship between habitual use and real-time emotion regulation strategies in adolescents: Evidence from frontal EEG asymmetry

Past research on emotion regulation has shown that cognitive reappraisal is a healthier and more effective emotion regulation strategy than expressive suppression. However, there are few studies in this field that combine real-time emotion regulation with the use of habitual emotion regulation strategies to observe the patterns of brain activity, and fewer studies focusing on adolescents. Frontal electroencephalography (EEG) asymmetry reflects the difference between brain activation in left and right frontal areas and is widely viewed as an effective biomarker of emotional reactivity and regulation. The present study investigated the asymmetry of the frontal EEG activity during adolescents' emotional regulation, and explored its relationship with adolescents' habitual use of emotional regulation strategies. Habitual use of cognitive reappraisal and expressive suppression was measured with the emotion regulation questionnaire (ERQ). EEG was recorded from 54 adolescents (24 boys & 30 girls, M_age = 12.59), during the Reactivity and Regulation-Image Task. Results showed that adolescents who used cognitive reappraisal strategies more habitually exhibited greater left frontal asymmetry during real-time enhancement or reduction of negative emotions. In contrast, no significant correlation was found between habitual use of suppression and frontal alpha asymmetry. The results provide neurological evidence that, for adolescents, the use of habitual emotion regulation strategies may affect real-time emotion regulation, adolescents who use cognitive reappraisal more frequently are more capable or more prone to recruit appropriate brain regions in situations that need to regulate negative emotions. This reinforces the importance of the formation and use of correct emotion regulation habits for adolescents.

Applying theoretical models of positive emotion to improve pediatric asthma: A positive psychology approach

Positive emotion, encompassing feelings such as joy and happiness, has been shown to predict a multitude of health outcomes. However, the role of positive emotion in pediatric asthma is not understood. No work to date has examined how positive emotion may offer benefits to children and adolescents with asthma. Based on theory and models of positive emotion and health, we hypothesize that positive emotion may improve asthma outcomes through mediators such as health behaviors and health-relevant physiological functioning. Moreover, boosting positive emotion during times of stress may be particularly relevant in mitigating asthma symptoms. In the present commentary, we elaborate on the hypothesized mechanisms behind such associations grounded within positive emotion theoretical frameworks. Additionally, we summarize the methodologically rigorous work of positive emotion interventions in other clinical settings to propose that positive emotion could be a useful tool in the management of pediatric asthma.

Exploring the sentiment of entrepreneurs on Twitter

Sentiment analysis is an evolving field of study that employs artificial intelligence techniques to identify the emotions and opinions expressed in a given text. Applying sentiment analysis to study the billions of messages that circulate in popular online social media platforms has raised numerous opportunities for exploring the emotional expressions of their users. In this paper we combine sentiment analysis with natural language processing and topic analysis techniques and conduct two different studies to examine whether engagement in entrepreneurship is associated with more positive emotions expressed on Twitter. In study 1, we investigate three samples with 6.717.308, 13.253.244, and 62.067.509 tweets respectively. We find that entrepreneurs express more positive emotions than non-entrepreneurs for most topics. We also find that social entrepreneurs express more positive emotions, and that serial entrepreneurs express less positive emotions than other entrepreneurs. In study 2, we use 21.491.962 tweets to explore 37.225 job-status changes by individuals who entered or quit entrepreneurship. We find that a job change to entrepreneurship is associated with a shift in the expression of emotions to more positive ones.

Chronic Illness, Subjective Wellbeing, and Health Services Availability: A Study of Older Adults in Australia

Chronic illness is prevalent in older adults. While current scholarship has examined how various factors may be associated with the onset of chronic illnesses, fewer scholars have examined the role of health services availability. Drawing on a sample of older adults aged 50 and above from wave 16 of the Household, Income, and Labour Dynamics in Australia survey and geo-coded information of general practitioners (GPs) from the Australian Medical Directory, 2016, we investigated whether living in areas with a greater number of GPs is related to reports of living with a chronic illness. Contrary to our hypothesis, we did not find an association between the availability of health services and reports of chronic illnesses, though factors such as better socioeconomic status and better subjective wellbeing are related to lower likelihoods of reporting a chronic illness. We concluded that, while easy access to local health services may be important for the diagnosis and treatment of chronic illnesses, it is less persuasive to attribute the availability of health services to the likelihood of older adults reporting chronic illnesses without knowing how much or how often they use the services.

Smart integration of sensors, computer vision and knowledge representation for intelligent monitoring and verbal human-computer interaction

The details presented in this article revolve around a sophisticated monitoring framework equipped with knowledge representation and computer vision capabilities, that aims to provide innovative solutions and support services in the healthcare sector, with a focus on clinical and non-clinical rehabilitation and care environments for people with mobility problems. In contemporary pervasive systems most modern virtual agents have specific reactions when interacting with humans and usually lack extended dialogue and cognitive competences. The presented tool aims to provide natural human-computer multi-modal interaction via exploitation of state-of-the-art technologies in computer vision, speech recognition and synthesis, knowledge representation, sensor data analysis, and by leveraging prior clinical knowledge and patient history through an intelligent, ontology-driven, dialogue manager with reasoning capabilities, which can also access a web search and retrieval engine module. The framework’s main contribution lies in its versatility to combine different technologies, while its inherent capability to monitor patient behaviour allows doctors and caregivers to spend less time collecting patient-related information and focus on healthcare. Moreover, by capitalising on voice, sensor and camera data, it may bolster patients’ confidence levels and encourage them to naturally interact with the virtual agent, drastically improving their moral during a recuperation process.

Exploring the Psychological Effects of COVID-19 Home Confinement in China: A Psycho-Linguistic Analysis on Weibo Data Pool

BACKGROUNDS

With the rapid spread of COVID-19, strict home confinement has been implemented in most parts of Chinese regions. Millions of people were not allowed to leave their homes except for special reasons. Home confinement plays an essential role in curbing pandemic and promoting preventive behaviors, but it may affect individuals' mental health as well.

OBJECTS

The objective of this study was to explore the psychological impacts of home confinement.

MATERIALS AND METHODS

We collected more than 150,360 Weibo messages from 5,370 Chinese active users, and then extracted psycho-linguistic features from these messages. Psycho-linguistic analysis was carried out using the 2 (confinement vs. non-confinement) × 2 (before vs. after confinement) repeated measure analysis of variance (RM ANOVA).

RESULTS

The results showed that the frequency of positive emotion words was remarkably decreased during home confinement [F (1,5368) = 7.926, p = 0.005, η2 = 0.001]. In high-endemic subgroup, home confinement also reduced the frequency of exclusion words [F (1,3445) = 4.518, p = 0.034, η2 = 0.001] and inhibition words [F (1,3445) = 10.154, p = 0.001, η2 = 0.003].

CONCLUSION

Home confinement caused a decline in the use of positive emotion words. This indicates that home confinement can increase the frequency of negative emotions. The changes of exclusion words and inhibition words in high-endemic areas may be related to the high epidemic threat and the urgent need for social distancing in these areas.

Does life satisfaction reduce risk of incident hypertension and stroke? Evidence from the Whitehall II cohort

BACKGROUND

Previous studies showed life satisfaction is related to reduced risk of coronary heart disease and diabetes, but its association with other cardiometabolic endpoints including hypertension and stroke remains unexplored. This study examined life satisfaction's prospective association with incident hypertension and stroke in middle-aged adults.

METHODS

At baseline (1985-1988), 6225 healthy British civil servants aged 35-55 from the Whitehall II cohort completed the validated Satisfaction with Life Scale and provided information regarding sociodemographics, a range of health-related factors, and psychological distress. Incident hypertension was ascertained according to clinic-derived measures of systolic or diastolic blood pressure of ≥140/90 mmHg, respectively, or self-reports of either physician-diagnosed hypertension or hypertensive medication use. Incident stroke and transient ischemic attack (TIA) were ascertained by self-reported physician diagnosis. Follow-up assessments occurred every 2-5 years through 2017. Cox proportional hazards regression models estimated hazard ratios (HR) and 95% confidence intervals (CI) of hypertension and stroke/TIA risk separately.

RESULTS

Over a 31-year follow-up, 2703 cases of hypertension and 370 cases of stroke/TIA occurred. Life satisfaction was not related to risk of developing hypertension but was associated with 12% decreased risk of stroke/TIA after controlling for sociodemographics, health status, and health behaviors (HR_{per 1-SD} = 0.88; 95%CI = 0.79-0.98). However, the association was attenuated after adjustment for psychological distress.

CONCLUSIONS

No robust associations were found between life satisfaction and incident hypertension and stroke/TIA, respectively, after accounting for well-established risk factors and psychological distress. More research is needed to understand why associations of life satisfaction with cardiometabolic health seem to vary across endpoints.

Subjective Psychophysical Experiences in the Course of Inflammatory Bowel Disease-A Comparative Analysis Based on the Polish Pediatric Crohn's and Colitis Cohort (POCOCO)

No gold standard is available to evaluate subjective psychophysical experiences in pediatric inflammatory bowel disease (IBD). We aimed to assess pain, anxiety, and limitations in social activities at diagnosis and the worst flare of the disease in relation to clinical expression, treatment and IBD severity. A total of 376 children completed the survey (Crohn’s disease (CD) n = 196; ulcerative colitis (UC) n = 180). The questionnaire included 12 questions regarding pain, anxiety, and social activity, all assessed at recruitment and retrospectively at diagnosis and worst flare using a numeric rating scale. Patients that had ever been treated with systemic glucocorticosteroids scored higher in pain (p < 0.001), anxiety (p = 0.015), and social activity domains (p < 0.016) at worst flare, and the answers correlated with the number of steroid courses (p < 0.0392). The perception of social activity limitations also correlated independently with the number of immunosuppressants (p < 0.0433) and biological agents (p < 0.0494). There was no difference in retrospective perception of pain, anxiety and social activity limitations between CD and UC patients at diagnosis and the worst flare. The level of limitations in social activity correlated with hospitalisations due to relapse, days spent in the hospital, number of relapses, and severe relapses with the strongest association of rho = 0.39 (p = 0.0004). Subjective and retrospective perception of pain, anxiety, and limitations in social activity differs depending on therapy, correlates with treatment modalities, and severity measures such as hospitalisations.

A 6-Week Worksite Positivity Program Leads to Greater Life Satisfaction, Decreased Inflammation, and a Greater Number of Employees With A1C Levels in Range

OBJECTIVE

To determine whether a 6-week Positivity Program could impact employee cardiovascular inflammation, blood sugars, cortisol, dehydroepiandrosterone (DHEA), and/or life satisfaction.

METHODS

Pre- and post-study blood draw and life satisfaction questionnaire tracked changes in 10 cardiovascular and inflammatory biomarkers for 63 employees who participated in a 6-week Positivity Program comprised of three interventions: gratitude, HeartMath's Heart Lock-In, and yoga stretches with guided imagery.

RESULTS

Improvements were recorded in life satisfaction as well as in seven of 10 cardiovascular and inflammatory biomarkers, including high sensitivity C-reactive protein (HsCRP) (-27%), hemoglobin A1c (HbA1c) (-1%), glucose (-2%), myeloperoxidase (MPO) (-5%), lipoprotein-associated phospholipase-A2 (Lp-PLA2) (-9%), apolipoprotein B (ApoB) (-6%), and DHEA (1%). No improvements were recorded in cortisol (11%), small-dense LDL (sdLDL) (0%), or oxidized LDL (OxLDL) (7%).

CONCLUSIONS

Data suggest that engaging in 6 weeks of a workplace Positivity Program may improve employee life satisfaction, blood sugar levels, and some markers of cardiovascular inflammation.

How Do Positive Psychological Constructs Affect Physical Activity Engagement Among Individuals at High Risk for Chronic Health Conditions? A Qualitative Study

BACKGROUND

Positive psychological constructs (eg, optimism, positive affect) may help people engage in physical activity, though the details of these relationships and their directionality have not been studied in depth in people with cardiovascular risk factors. The objectives of this study were to use qualitative research to explore the relationships of positive psychological constructs with physical activity among people with metabolic syndrome.

METHODS

Participants with metabolic syndrome and low physical activity from an academic medical center completed semistructured phone interviews about associations between physical activity and positive psychological constructs, and perceptions about benefits, motivation, and barriers to physical activity.

RESULTS

The participants (n = 21) were predominantly older (mean age = 63 y) white (95.2%) women (61.9%). Engaging in physical activity was commonly associated with enjoyment, energy, relaxation, accomplishment, and determination. Experiencing positive psychological constructs like enjoyment, energy, connectedness, optimism, and determination also helped them engage in physical activity. Perceived benefits, facilitators, and barriers of physical activity engagement were noted.

CONCLUSIONS

The participants at high risk for chronic diseases described many specific positive psychological constructs that both promote and result from physical activity. Testing ways to increase positive psychological constructs may be a novel way to help people at high risk of chronic diseases become more active.

Emotional Self-Regulation through Introjective Practices in Physical Education

This study analyzed emotional self-regulation in relation to K-9 and K-10 school children’s emotional intelligence defined on three dimensions: Emotional attention, clarity of feelings, and emotional repair. The objective was to analyze the students’ perceptions of skills and capacities that promoted the awareness of emotions when performing introjective motor practices, i.e., motor skill exercises in which the inner logic provokes a process of sensorial self-awareness and psychosomatic balance. A total of 90 fourth-year primary school students from four different schools participated in the study and a reduced version of the Trait-Meta Mood Scale (TMMS) questionnaire was used to measure students’ individual self-regulation. First, pre- and post-test results showed significant differences with a 20.1% improvement in the three dimensions of intrapersonal emotional attention (emotional attention, clarity of feeling, and emotional repair) after having performed a set of in-class introjective practices. Second, while there were no significant differences between the boys and girls during the pre-test, significant changes—an 8.1% difference—were found in the post-test results for girls.

A Web-Based Positive Psychological Intervention to Improve Blood Pressure Control in Spanish-Speaking Hispanic/Latino Adults With Uncontrolled Hypertension: Protocol and Design for the ¡Alégrate! Randomized Controlled Trial

BACKGROUND

Growing evidence links psychological well-being and resilience with superior cardiac health, but there remains a critical scientific gap about whether (or how) interventions that aim to cultivate psychological well-being reduce cardiac risk. Hispanic/Latino people in the United States have high cardiovascular disease risk and poorly controlled blood pressure (BP) compared with their peers of European ancestry, and they represent a population in need of new and innovative therapeutic approaches. As such, a focused intervention to boost psychological well-being holds promise as a novel therapeutic target for hypertension in Hispanic/Latino adults; to date, however, no research has explored whether a causal link is evident.

OBJECTIVE

The aim of this paper is to detail the protocol for the ¡Alégrate! (Be Happy!) intervention, a Phase II randomized controlled trial testing initial efficacy in improving BP of a web-based positive psychological intervention designed to boost psychological well-being in Spanish-speaking Hispanic/Latino people with hypertension.

METHODS

A total of 70 Hispanic/Latino people aged ≥18 years, fluent in Spanish, and with elevated BP (≥140/90 mm Hg) will be recruited in person from a single Federally Qualified Health Center in Chicago. Enrollees will be randomly assigned to 1 of 2 trial arms: (1) web-based positive psychological intervention or (2) an active control condition (eg, 3 times weekly emotion reporting). Our 5-week Spanish-language ¡Alégrate! intervention is web-based and delivers curricular content via didactic instruction, journaling, and assigned at-home practice-all accessed via our website using investigator-purchased tablet computers, with a unique username and password assigned to each enrollee. Targeted skills include noting daily positive events, positive reappraisal of stressful events, effective expression of gratitude, performing acts of kindness, and regular practice of mindfulness and meditation. The primary outcome is improvement in BP, both sitting values and 24-hour ambulatory readings, as measured at baseline and 5 and 12 weeks from baseline. Secondary outcomes include psychological well-being, engagement in healthy behaviors, and circulating levels of inflammatory markers. The outcomes of interest are collected by trained research staff through in-person interviews using the REDCap software.

RESULTS

Activities of the ¡Alégrate! intervention were funded in August 2017, and data collection is ongoing. We expect to submit trial results for peer-reviewed publications in 2021, soon after recruitment has been concluded and statistical analyses are finalized.

CONCLUSIONS

Findings will provide evidence on whether interventions to boost psychological well-being and resilience have downstream effects on BP control and cardiovascular health, particularly as they are deployed in the Spanish language with cultural tailoring and via a web-based platform. If effective, we will have an easily disseminatable application that can positively impact well-being profiles and BP control in Hispanic/Latino people, with the possibility of addressing health disparities of this US racial/ethnic minority group.

TRIAL REGISTRATION

ClinicalTrials.gov NCT03892057; https://clinicaltrials.gov/ct2/show/NCT03892057.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

PRR1-10.2196/17721.

Insulin pricing and other major diabetes-related concerns in the USA: a study of 46 407 tweets between 2017 and 2019

INTRODUCTION

Little research has been done to systematically evaluate concerns of people living with diabetes through social media, which has been a powerful tool for social change and to better understand perceptions around health-related issues. This study aims to identify key diabetes-related concerns in the USA and primary emotions associated with those concerns using information shared on Twitter.

RESEARCH DESIGN AND METHODS

A total of 11.7 million diabetes-related tweets in English were collected between April 2017 and July 2019. Machine learning methods were used to filter tweets with personal content, to geolocate (to the USA) and to identify clusters of tweets with emotional elements. A sentiment analysis was then applied to each cluster.

RESULTS

We identified 46 407 tweets with emotional elements in the USA from which 30 clusters were identified; 5 clusters (18% of tweets) were related to insulin pricing with both positive emotions (joy, love) referring to advocacy for affordable insulin and sadness emotions related to the frustration of insulin prices, 5 clusters (12% of tweets) to solidarity and support with a majority of joy and love emotions expressed. The most negative topics (10% of tweets) were related to diabetes distress (24% sadness, 27% anger, 21% fear elements), to diabetic and insulin shock (45% anger, 46% fear) and comorbidities (40% sadness).

CONCLUSIONS

Using social media data, we have been able to describe key diabetes-related concerns and their associated emotions. More specifically, we were able to highlight the real-world concerns of insulin pricing and its negative impact on mood. Using such data can be a useful addition to current measures that inform public decision making around topics of concern and burden among people with diabetes.

Changes in Emotional Vitality as a Predictor of Levels and Change in Allostatic Load: Longitudinal Results From the Whitehall II Cohort Study

OBJECTIVE

Increasing evidence has shown an association between reduced psychological well-being and long-term morbidity. However, longitudinal studies addressing potential biobehavioral mechanisms, such as physiological function, are lacking. The aim of this study is to examine the association between changes in emotional vitality on levels and changes in allostatic load (AL), a measure of multisystem physiological dysregulation, as well as its composite risk markers.

METHODS

Participants comprised 5919 British civil servants from phases 3, 5, and 7 of the Whitehall II study. Psychological well-being was operationalized as emotional vitality. AL was measured using nine biomarkers of the cardiovascular, metabolic, and immune system. Linear mixed-effect models were used to determine the association between changes in emotional vitality between phases 3 and 5 and subsequent levels and change in AL from phases 5 to 7. Generalized linear models were used to address the association between changes in emotional vitality and individual risk markers.

RESULTS

Increase in emotional vitality was associated with a lower mean level of AL, whereas the AL slope was not markedly affected. Among the included risk markers, only interleukin-6 was weakly associated with changes in emotional vitality, with a 7% reduced risk of high levels of interleukin-6 per one-unit increase in emotional vitality.

CONCLUSION

This study found that an increase in emotional vitality was associated with subsequent lower levels, but not rate of change, of AL over time. Further research is needed to address the relationship between trajectories of psychological well-being and physiological dysregulation.

Building Wellbeing in People With Chronic Conditions: A Qualitative Evaluation of an 8-Week Positive Psychotherapy Intervention for People Living With an Acquired Brain Injury

Research indicates that Acquired Brain Injury (ABI) is associated with significant and chronic impairment across multiple areas of functioning including physical, cognitive, emotional and behavioral domains. Whilst impairments associated with ABI can be ameliorated, cure is seldom possible. The emergence of positive psychology reflects a paradigm shift in health and wellbeing research, highlighting the role of character strengths, positive emotions, meaning, and resilience. Positive psychology interventions have been demonstrated to improve wellbeing in a variety of populations, although research investigating the impact of positive psychotherapy for people living with ABI are sparse. Here we characterize the experience of an 8-week positive psychotherapy intervention for 13 people living with ABI including four mentors and nine participants using thematic analysis of transcripts collected during mini-groups and one-to-one interviews. Six main themes were identified including empowerment, social opportunity, coping, cultivation of positive emotion, consolidation of skills and barriers. Results indicated that wellbeing can be promoted and improved in individuals with ABI. Recent theoretical developments in wellbeing science highlight scope to improve the intervention by connecting individuals to their communities and spending time in nature.

Supportive Social Interactions in Infertility Treatment Decrease Cortisol Levels: Experimental Study Report

PURPOSE

The aim of the research project was to analyze the importance of supportive social interactions in the process of infertility treatment. The acceptance rates of ART (Assisted Reproductive Technology) in Poland are lower than in western European countries and the social stigma of infertility exists. The research project draws attention to the issue of disclosure of fertility problems and the ability to seek support in Polish couples.

METHODS

An experimental study was conducted with 51 heterosexual couples who qualified for IVF. The participants were randomly divided into an experimental and control group. The first stage of the research procedure, with all the couples, was to extract a saliva (cortisol) sample as a biomarker for stress. In the second stage the control group viewed an informational (non-emotional) video about human embryology. The experimental group took part in a supportive social interaction process. In the supportive social interaction process, a maximum of five couples, were led through a broad general understanding of their IVF experience by an experienced group psychologist. The third stage of the research involved the second extraction of a saliva (cortisol) sample form all participants. In addition, demographic and medical history related to fertility was collected.

RESULTS

The statistical analysis indicates a significant decrease in the level of stress experienced after the supportive social interaction. The reported differences between the experimental group and the control group indicated a larger decrease of cortisol level for women and men.

CONCLUSION

In the current study, the hypothesis that taking part in supportive social interaction significantly lowers stress levels (measured via cortisol) of infertile couples (men and women) was supported. Further the project indicates that a supportive social interaction has a beneficial effect on infertile couple's health and well-being. The results of the study clearly point to the benefits of couples involved in infertility treatment to express and share their experience, and in doing so, provides measurable physiological and psychological benefits.

Positive affect and functional somatic symptoms in young adults

BACKGROUND

Functional Somatic Symptoms (FSS) are symptoms for which an underlying pathology cannot be found. High negative affect (NA) has been linked to the etiology of FSS, but little is known about the role of Positive Affect (PA).

OBJECTIVE

The aim of this study was to test if PA is related to current and future lower levels of FSS. We also examined the interactions between PA and NA, and PA and sex on FSS.

METHOD

Data from the Dutch Tracking Adolescents' Individual Lives Survey (TRAILS) cohort were used (N = 1247 cases, 60% females, mean age T5 = 22.2, T6 = 25.6). PA was measured with the PANAS schedule and FSS with the Adult Self Report questionnaire (ASR). A Principal Component Analysis (PCA) was performed on the physical complaints subscale of the ASR. Regression analyses with bootstrapping were performed to assess the associations and interactions.

RESULTS

PA had a significant negative association with current FSS when adjusted for NA, age, sex and socioeconomic status (B = -0.004; BCa 95% CI = [-0.006; -0.002]), but the association was not significant longitudinally. No interactions were found. In secondary analysis, PA was significantly related to the component "General Physical Symptoms" (B = -0.019; BCa 95% CI = [-0.0028; -0.011]) but not to the component "Gastrointestinal Symptoms" (B = -0.008; BCa 95% CI = [-0.016;0.001]) in the cross-sectional analysis.

CONCLUSION

In conclusion, high PA was significantly related to current lower levels of FSS, but the effect was small. Further research on individual variations in affect is needed to obtain more insight in their contribution to FSS.

Psychosocial interventions for cancer survivors: A meta-analysis of effects on positive affect

PURPOSE

Positive affect has demonstrated unique benefits in the context of health-related stress and is emerging as an important target for psychosocial interventions. The primary objective of this meta-analysis was to determine whether psychosocial interventions increase positive affect in cancer survivors.

METHODS

We coded 28 randomized controlled trials of psychosocial interventions assessing 2082 cancer survivors from six electronic databases. We calculated 76 effect sizes for positive affect and conducted synthesis using random effects models with robust variance estimation. Tests for moderation included demographic, clinical, and intervention characteristics.

RESULTS

Interventions had a modest effect on positive affect (g = 0.35, 95% CI [0.16, 0.54]) with substantial heterogeneity of effects across studies ([Formula: see text]; I² = 78%). Three significant moderators were identified: in-person interventions outperformed remote interventions (P = .046), effects were larger when evaluated against standard of care or wait list control conditions versus attentional, educational, or component controls (P = .009), and trials with survivors of early-stage cancer diagnoses yielded larger effects than those with advanced-stage diagnoses (P = .046). We did not detect differential benefits of psychosocial interventions across samples varying in sex, age, on-treatment versus off-treatment status, or cancer type. Although no conclusive evidence suggested outcome reporting biases (P = .370), effects were smaller in studies with lower risk of bias.

CONCLUSIONS

In-person interventions with survivors of early-stage cancers hold promise for enhancing positive affect, but more methodological rigor is needed.

IMPLICATIONS FOR CANCER SURVIVORS

Positive affect strategies can be an explicit target in evidence-based medicine and have a role in patient-centered survivorship care, providing tools to uniquely mobilize human strengths.

Associations Between Characteristics of Web-Based Diabetes News and Readers' Sentiments: Observational Study in the Netherlands

Background

Although experts agree that Web-based health information often contains exaggeration and misrepresentation of science, it is not yet known how this information affects the readers’ sentiments.

Objective

This study aimed to investigate whether specific aspects of Web-based diabetes research news are associated with positive or negative sentiments in readers.

Methods

A retrospective observational study of the comments on diabetes research news posted on Facebook pages was conducted as a function of the innovations’ developmental phase, the intended treatment effect, and the use of strong language to intensify the news messages (superlatives). Data for the investigation were drawn from the diabetes research news posted between January 2014 and January 2018 on the two largest Dutch Facebook pages on diabetes and the corresponding reader comments. By manually coding these Facebook user comments, three binary outcome variables were created, reflecting the presence of a positive sentiment, the presence of a negative sentiment, and the presence of a statement expressing hopefulness.

Results

Facebook users made a total of 3710 comments on 173 diabetes research news posts that were eligible for further analysis. Facebook user comments on posts about diabetes prevention (odds ratio [OR] 0.55, 95% CI 0.37-0.84), improved blood glucose regulation (OR 0.68, 95% CI 0.56-0.84), and symptom relief (OR 0.31, 95% CI 0.21-0.44) were associated with less positive sentiments as compared with potential diabetes cures. Furthermore, comments on innovations supported by preclinical evidence in animals were associated with more positive sentiments (OR 1.46, 95% CI 1.07-1.99) and statements expressing hope (OR 1.47, 95% CI 1.01-2.14), when compared with innovations that have evidence from large human trials. This study found no evidence for the associations between language intensification of the news posts and the readers’ sentiments.

Conclusions

Our finding that the attitudes toward diabetes research news on Facebook are most positive when clinical efficacy is not (or not yet) proven in large patient trials suggests that news authors and editors, as well as medical professionals, must exercise caution when acting as a conduit for diabetes research news.

Resilience and well-being after traumatic brain injury

Purpose: This study examined the extent to which resilience is associated with well-being outcomes after traumatic brain injury, and whether those relationships are independent of global personality traits, such as affectivity.Materials and methods: Sixty-seven adults with complicated-mild to severe traumatic brain injury participated. Measures included the Connor-Davidson Resilience Scale, Modified Cumulative Illness Rating Scale, Disability Rating Scale, SF-12 Health Survey, Satisfaction with Life Scale, and Community Integration Measure.Results: Objective physical health and disability showed modest relation to resilience, indicating that adverse health conditions and disability decreased with increasing resilience. The three measures of subjective well-being showed modest-to-strong positive relation to resilience. These correlations between resilience and well-being generally remained significant after accounting for negative and positive affectivity. Results also suggest that the influence of resilience on well-being has a threshold effect: a greater influence on outcome among people with low or inadequate resilience than among people with average or high resilience.Conclusion: The experience of brain injury does not diminish the positive influence resilience may have on long-term well-being. Resilience may function as a buffer to trauma even in the challenging context of cognitive insult. Routine assessment of resilience might be beneficial to the rehabilitation team.Implications for rehabilitationResilience is positively associated with subjective and objective well-being among adults with moderate-to-severe traumatic brain injury, and it appears to function among adults with traumatic brain injury similarly to adults without cognitive disabilities.Resilience overlaps with overarching trait personality constructs such as affectivity; yet, it has unique characteristics and unique value in understanding well-being.The adverse effects of low resilience show stronger influence on well-being than do the positive effects of high resilience.Routine assessment of resilience might be beneficial to the rehabilitation team in understanding patients and their families, especially in discharge planning, where beliefs about personal capabilities to rebound from adversity shape likely future behavior.

"iAlegrate!"-A culturally adapted positive psychological intervention for Hispanics/Latinos with hypertension: Rationale, design, and methods

Growing evidence links psychological well-being (e.g., optimism) with superior cardiac health, but there remains a critical scientific gap as we do not know whether (or how) interventions to cultivate emotional well-being may reduce cardiac risk. Hispanics/Latinos in the U.S. have high cardiovascular disease risk and poorly controlled blood pressure (BP) compared to peers of European ancestry, and represent a population in need of new and innovative therapeutic approaches. This paper details the "¡Alégrate!" study, a cluster-randomized Phase II trial testing efficacy in improving BP of a culturally tailored positive psychological intervention designed to boost emotional well-being in Hispanics/Latinos with hypertension. A total of 126 Hispanics/Latinos aged ≥18 years, fluent in English or Spanish, and with elevated sitting BP (≥140/90 mmHg) will participate in one of two trial arms: (1) a positive psychological intervention, or (2) a wait-list control condition. The "¡Alégrate!" group-based intervention consists of 8 weekly 90-120-min sessions delivered in-person by a psychologist/social worker. Targeted skills include noting daily positive events, positive reappraisal of stressful events, effective expression of gratitude, performing acts of kindness, and regular practice of mindfulness and meditation, among others. The primary outcome is improvement in BP, both sitting values and 24-h ambulatory readings, as measured at baseline and 8- and 12-weeks post-baseline. Secondary outcomes include emotional well-being, engagement in healthful behaviors, and circulating levels of inflammatory markers. We hypothesize that BP control, psychological well-being, healthful behaviors, and chronic inflammation will be significantly better in the "¡Alégrate!" arm at follow up compared to the wait-list control group.

Relative sensitivity of cortisol indices to psychosocial and physical health factors

OBJECTIVE

Regulation of cortisol under resting conditions is widely used to assess physical and psychological status, but due to the diversity of possible assessments (e.g., cumulative levels; diurnal patterns), considering one or a few at a time hampers understanding and interpretation. Moreover, most studies of cortisol regulation focus on negatively-valanced experiences. This study examined the inter-correlations among cortisol indices and their relative contribution to the explained variance in diverse psychosocial and health factors, including positive functioning.

METHODS

Data are from midlife and older adults (N = 513; 47.2% male). Cortisol was assessed in urine (overnight) and saliva (at rest and over 4 consecutive days). Positive and negative psychosocial and health factors were assessed by self-report. In addition to examining associations among cortisol indices, relative weight analysis was used to determine which indices were most robustly linked to specific psychosocial factors.

RESULTS

Inter-correlations among indices were weak-to-moderate, suggesting that they measure different aspects of hypothalamic-pituitary-axis activity. Overall variance in psychosocial and health factors (R2) explained by the cortisol indices ranged from 0.01 to 0.07. Of this explained variance, relative weight analysis showed that waking cortisol contributed most to the variance in hedonic well-being (32.1%-38.2%), bedtime cortisol to depression-related factors (32.1%-46.9%), the cortisol awakening response to eudaimonic well-being (35.8%-50.5%), cortisol slope to perceived stress (29.2%), and urinary cortisol to physical factors (38.5% and 62.7%).

CONCLUSIONS

Positive and negative factors were related to largely non-overlapping cortisol indices. This study illuminates nuanced associations among cortisol indices and diverse aspects of mental and physical health, facilitating thoughtful examination of the complex role of hypothalamic-pituitary-axis activity in health.

A contextual identification of home-living older adults' positive mealtime practices: A honeycomb model as a framework for joyful aging and the importance of social factors

In this study, we outlined contextual identifications within positive mealtime practices among home-living older adults in Denmark. We aimed to understand and facilitate optimal dietary intake and to promote well-being for older adults who live at home. We used data from 22 participants, who wrote diary entries and took photos of their meal experiences over a 6-day period. We followed this with in-depth interviews, using the photos as mediators within a photo-elicitation framework. The results revealed that social factors play a major role in positive mealtime practices and that the types of commensal eating vary based on the contextual setting. Furthermore, we found that, in the new generation of older adults, some men have extremely good cooking skills and are interested in contextual food matters. Meeting older adults' needs for adequate nutrition requires in-depth knowledge, including a complex understanding of individual preferences and contextual everyday practices.

Generativity Among Elderly in a Rural Area of Maharashtra, India: Correlates and Relationship With Quality of Life Approved

Generativity, "a concern for others and a need to contribute something to the next generation," is a dimension of successful aging in and of itself, but also predicts other positive health outcomes. We examine its manifestations and correlates among elderly in rural India and assess the association between generativity and quality of life (QoL). Three hundred and forty-eight rural Indian elderly completed an interviewer-assisted questionnaire assessing generativity, QoL, and other personal and familial factors. Regression models were used to examine potential correlates of generativity and the relationship between generativity and QoL. Higher education, inheritance income, more living children, and a son/daughter living in the home predicted higher levels of generativity. Higher levels of generativity were associated with higher QoL. There are both personal and familial correlates of generativity, and family relationships are important for generative development. Family-oriented interventions to increase generativity among elderly Indians could improve QoL.

Resonance and dissonance asymmetry in effective physician-patient relationships

This paper examines the proposed asymmetry that should occur between resonance and dissonance in physician-patient relationships in favour of resonance to facilitate an effective relationship. Resonance is represented by the positive emotional attractor, which comprises patients' conscious preferred future or ideal self, and dissonance is expressed by the negative emotional attractor and consists of the gaps between patients' ideal and real self or their fears, problems, and shortfalls. Intentional change theory is reviewed to optimise the physician-patient relationship. Concepts from complexity theory and recent research on emotions are used to explain positive and negative emotional attractors. The role of resonance and dissonance in physician-patient relationships is discussed along with how behaviour can be changed with positive and negative emotional attractors. This paper focuses on the quality and effectiveness of physician-patient relationships for physicians who create high versus low positive emotional attractor/negative emotional attractor ratios. Two theoretical propositions are offered and the research and practice implications are explained.

Curiosity in old age: A possible key to achieving adaptive aging

Curiosity is a fundamental part of human motivation that supports a variety of human intellectual behaviors ranging from early learning in children to scientific discovery. However, there has been little attention paid to the role of curiosity in aging populations. By bringing together broad but sparse neuroscientific and psychological literature on curiosity and related concepts (e.g., novelty seeking in older adults), we propose that curiosity, although it declines with age, plays an important role in maintaining cognitive function, mental health, and physical health in older adults. We identify the dopaminergic reward system and the noradrenergic system as the key brain systems implicated in curiosity processing and discuss how these brain systems contribute to the relationship between curiosity and adaptive aging.

Psychological Well-being and Physical Health: Associations, Mechanisms, and Future Directions

A paradigm shift in public health and medicine has broadened the field from a singular focus on the ill effects of negative states and psychopathology to an expanded view that examines protective psychological assets that may promote improved physical health and longevity. We summarize recent evidence of the link between psychological well-being (including positive affect, optimism, life meaning and purpose, and life satisfaction) and physical health, with particular attention to outcomes of mortality and chronic disease incidence and progression. Within this evolving discipline there remain controversies and lessons to be learned. We discuss measurement-related challenges, concerns about the quality of the evidence, and other shortcomings in the field, along with a brief discussion of hypothesized biobehavioral mechanisms involved. Finally, we suggest next steps to move the field forward.

Parental History of Diabetes, Positive Affect, and Diabetes Risk in Adults: Findings from MIDUS

BACKGROUND

Family history of diabetes is one of the major risk factors for diabetes, but significant variability in this association remains unexplained, suggesting the presence of important effect modifiers.

PURPOSE

To our knowledge, no previous work has examined whether psychological factors moderate the degree to which family history of diabetes increases diabetes risk.

METHODS

We investigated the relationships among parental history of diabetes, affective states (positive affect, negative affect, and depressed affect), and diabetes in 978 adults from the MIDUS 2 national sample.

RESULTS

As expected, parental history of diabetes was associated with an almost threefold increase in diabetes risk. We found a significant interaction between positive affect and parental history of diabetes on diabetes (p = .009): higher positive affect was associated with a statistically significant lower relative risk for diabetes in participants who reported having a parental history of diabetes (RR = .66 per unit increase in positive affect; 95 % CI = .47; .93), but it did not influence diabetes risk for participants who reported no parental history of diabetes (p = .34). This pattern persisted after adjusting for an extensive set of health and sociodemographic covariates and was independent of negative and depressed affect.

CONCLUSIONS

These results suggest that psychological well-being may protect individuals at increased risk from developing diabetes. Understanding such interactions between non-modifiable risk factors and modifiable psychological resources is important for delineating biopsychosocial pathways to diabetes and informing theory-based, patient-centered interventions to prevent the development of diabetes.

Predictors of post-traumatic growth in stroke survivors

PURPOSE

The development of post-traumatic growth was studied longitudinally within 14 months poststroke. The predictions of two models of post-traumatic growth were examined.

METHOD

Forty-three stroke survivors were investigated at two time points (i.e., time 1 and time 2), six months apart. Each completed the Post-traumatic Growth Inventory, Rumination Scale, Impact of Events Scale, Multidimensional Scale of Social Support, the Barthel Index and the COPE scale.

RESULTS

Post-traumatic growth was evident four to five months after stroke, increasing significantly over the next six months at which point levels resembled those reported in cross-sectional stroke studies. Active and denial coping and rumination at time 1 were positively associated, and age was negatively associated, with post-traumatic growth at time 2, but acceptance coping was not associated. Neither active coping nor rumination mediated the effect of social support on post-traumatic growth as predicted. As predicted, rumination mediated the relationship between post-traumatic stress and post-traumatic growth. Exploratory stepwise regression demonstrated rumination and active coping at time 1 accounted for 45% of variance in post-traumatic growth at time 2.

CONCLUSIONS

Post-traumatic growth can develop soon after stroke. Deliberate rumination is a key factor in post-traumatic growth. Both active coping and denial coping were associated with post-traumatic growth demonstrating the psychological complexity of poststroke adjustment. Implications for rehabilitation Therapists can expect stroke survivors to show post-traumatic growth in the first months after stroke. Therapists should look to promote post-traumatic growth and positive adjustment through working with survivors to increase active coping (attempts to deal effectively with the impact of stroke) and rumination (cognitive processing of the impact of the stroke). Since denial coping was also associated with posttraumatic growth, stroke survivors who maintain overly optimistic views about the severity and impact of their stroke are likely to benefit from therapists continually facilitating capacity for growth and well-being.

Non-Digital Game Playing by Older Adults

Research on video games' effect on cognition and behaviour has been extensive, yet little research has explored non-digital forms of game playing, especially among older adults. As part of a larger survey on game playing, 886 respondents (≥ age 55) filled out questionnaires about non-digital game play. The study aims were to determine perceived benefits of non-digital game play and to determine socio-demographic factors that might predict perceived benefits. Survey results indicate that non-digital game playing is social in nature and common (73% of respondents) among older adults. Older adults play for fun, but also to help maintain their cognition. Regression analyses indicated various socio-demographic factors - age, education, gender, and race - were independently associated with perceived benefits from game playing. The results thus emphasize the importance of non-digital game playing in this population and suggest that efforts to facilitate game playing may improve social interactions and quality of life.

Neighborhood conditions, religious coping, and uncontrolled hypertension

The purpose of this study is to see whether God-mediated control beliefs moderate the relationship between living in rundown neighborhoods and uncontrolled hypertension. God-mediated control refers to the belief that God will help people handle the stressors that arise in life. Data are provided by a nationwide survey of adults (N = 1919). Three ways of assessing uncontrolled hypertension are examined: a binary format contrasting people with and without uncontrolled hypertension, systolic and diastolic blood pressure scored continuously, and a four ordinal category scheme recommended by the American Heart Association. The data suggest that stronger God-mediated control beliefs moderate the relationship between neighborhood conditions and uncontrolled blood pressure when blood pressure is scored continuously and when the American Heart Association scheme are used as outcomes.

Optimism and Hope in Chronic Disease: A Systematic Review

There is a growing recognition that positive psychological functioning (which includes constructs such as optimism and hope) influences health. However, the understanding of these underlying mechanisms in relation to health is limited. Therefore, this review sought to identify what the scientific literature says about the influence of optimism and hope on chronic disease treatment. A search was conducted in the PsycINFO, Scopus, Pubmed, and Web of Science databases using the indexing terms optimism, hope, chronic diseases, randomized controlled trial, and treatment between 1998 and 2015. In the articles, we identified the most studied diseases in context, the assessment instruments used, the participant characteristics investigated, the results found, and the publication dates. From our analysis of the articles that met our inclusion criteria, it appears that the study of these constructs is recent and there is evidence that individuals with greater optimism and hope seek to engage in healthier behaviors, regardless of their clinical status, and that this contributes to chronic disease treatment. More research is needed so that targeted interventions can be carried out effectively in chronic disease treatment.

Review of Positive Psychology Applications in Clinical Medical Populations

This review examines the application of positive psychology concepts in physical health care contexts. Positive psychology aims to promote well-being in the general population. Studies identifying character strengths associated with well-being in healthy populations are numerous. Such strengths have been classified and Positive Psychology Interventions (PPIs) have been created to further develop these strengths in individuals. Positive psychology research is increasingly being undertaken in health care contexts. The review identified that most of this research involves measuring character strengths and their association with health outcomes in patients with a range of different conditions, similar to the position in positive psychology research on non-clinical populations. More recently, PPIs are beginning to be applied to clinical populations with physical health problems and this research, although relatively scarce, is reviewed here for cancer, coronary heart disease, and diabetes. In common with PPIs being evaluated in the general population, high quality studies are scarce. Applying PPIs to patients with serious health conditions presents significant challenges to health psychologists. They must ensure that patients are dealt with appropriately and ethically, given that exaggerated claims for PPIs are made on the internet quite frequently. This is discussed along with the need for more high quality research.