Negative Affect and Health: The Importance of Being Earnest

Does Social Pension Expansion Relieve Depression and Decrease Medical Costs? Evidence From the Rural Elderly in China

Objectives: This study was designed to explore the effect of the New Rural Pension Scheme on depressive symptoms or medical costs induced by depression.

Methods: We used the Logit, OLS and 2SLS models to explore the impact of the pension on depression and medical costs. We also adopt the method of quantile regression and discontinuity regression to verify the causal relationship between the New Rural Pension Scheme and depression or medical costs induced by depression of the rural elderly.

Results: We have found that the New Rural Pension Scheme decreases depressive symptoms of elderly in rural China (OR = 0.90), and the medical costs induced by depressive symptoms by 4.6%. Regression discontinuity results showed that pension significantly reduced the depressive symptoms (depression) and the medical expenditure caused by depressive symptoms (depression) by using parametric and non-parametric methods, and performing a placebo test. The mediating effect results showed that pension may improve mental health by increasing confidence about the future.

Conclusion: We demonstrate that the pension significantly decreased both mental health problems and the medical expenses due to depressive symptoms and depression of elderly in rural China. Therefore, our results suggest that the Chinese government should perfect the New Rural Pension Scheme to eliminate barriers to mental health resources, especially for the rural elderly.

Self-Disclosure to a Robot: Only for Those Who Suffer the Most

Social robots may become an innovative means to improve the well-being of individuals. Earlier research has shown that people easily self-disclose to a social robot, even in cases where it was unintended by the designers. We report on an experiment considering self-disclosing in a diary journal or to a social robot after negative mood induction. An off-the-shelf robot was complemented with our in-house developed AI chatbot, which could talk about ‘hot topics’ after training it with thousands of entries on a complaint website. We found that people who felt strongly negative after being exposed to shocking video footage benefited the most from talking to our robot, rather than writing down their feelings. For people less affected by the treatment, a confidential robot chat or writing a journal page did not differ significantly. We discuss emotion theory in relation to robotics and possibilities for an application in design (the emoji-enriched ‘talking stress ball’). We also underline the importance of otherwise disregarded outliers in a data set of therapeutic nature.

Self-perceived irritability among OEF/OIF/OND veterans with a history of deployment-related mTBI: Associations with prospective memory and quality of life

OBJECTIVE

Examine relationships between self-perceived irritability, prospective memory, and quality of life (QOL) following mild traumatic brain injury (mTBI). Methods: 75 OEF/OIF/OND-era Veterans (56 deployment-related mTBI; 19 no history of TBI), were administered a battery of neuropsychological tests and self-report measures of mood and QOL. Self-perceived irritability was measured using the Neurobehavioral Symptom Inventory. Prospective memory (PM) was measured using the Memory for Intentions Test (MIST). Results: Self-perceived irritability was significantly higher for Veterans with, versus without, a history of deployment-related mTBI. Among Veterans with a history of mTBI, self-perceived irritability was inversely associated with PM performance, even after adjusting for PTSD severity. Greater self-perceived irritability was also associated with higher depressive symptoms and reduced QOL for perceived physical health, psychological health, social support, and environmental factors; however, only social support remained significant after adjusting for PTSD severity. Depression symptom severity was not significantly associated with PM, suggesting that PM may be uniquely related to self-perceived irritability rather than mood dysregulation more generally. Conclusions: Findings provide preliminary evidence of a relationship between PM and self-perceived irritability in Veterans with a history of mTBI. PM and irritability may be related via their mutual reliance on high-level cognitive control. Results illustrate possible cognitive and affective factors contributing to psychological and interpersonal challenges for this population. Future investigations with larger and more diverse samples are needed to replicate findings and explore potential mechanisms linking irritability and PM following mTBI.

Examination of the paths between personality, current mood, its evaluation, and emotion regulation

In an ongoing longitudinal study, a Big Five Personality Inventory was completed by 122 men and 126 women at age 33. At age 36, the Brief Mood Introspection Scale, the Meta‐Evaluation Scale, and the Meta‐Regulation Scale were administered to 140 men and 127 women. The results, based on path analyses, lent support to a hypothesized model, according to which current mood (Negative, Positive, Active, Calm) and mood evaluation (Mood Influence, Typicality and Acceptance, Clarity) mediate the relationship between the Big Five personality traits and emotion regulation strategies (Repair, Dampening, Maintenance). For both sexes, Neuroticism was the most significant trait in terms of emotion regulation. A sex difference emerged: in general, personality traits and mood variables explained emotion regulation more significantly in men. Copyright © 2001 John Wiley & Sons, Ltd.

Depressive costs: medical expenditures on depression and depressive symptoms among rural elderly in China

OBJECTIVES

To provide an evaluation of medical expenditures induced by depression and depressive symptoms among rural elderly in China.

STUDY DESIGN

The panel dataset used for this study is taken from the China Family Panel Studies (CFPS) data for the years 2012 and 2016. We examined the case of rural elderly who were 60 years old or older at the time of the 2012 survey and 64 years old or older at the time of the 2016 survey and then created a panel dataset that includes 2938 rural elderly for both years to estimate the influence of depressive symptoms/depression on medical cost.

METHODS

Both two part model and four part model were used to estimate the influence of depressive symptoms and depression on medical expenditure. Then a counter-factual method was used to calculate the cost of depressive symptoms and depression among rural elderly in China.

RESULTS

Mental health status has significant effects on individual medical expenses, and they aggregately contribute to 47.26% of total personal expected medical expenditures. Specifically, the rural group, the female group, the widowed group, and the poorly educated group have higher medical expenditures because of depressive status than the other groups.

CONCLUSIONS

Mental health status significantly increased both the chance of undergoing medical care and the degree of medical expenditure among rural elderly in China. This situation is more serious in some vulnerable groups. Therefore, the Chinese government needs to reform its mental health of rural elderly and insurance institutions to eliminate the policy-caused barriers to mental health resources, especially for vulnerable groups.

Work–family conflict, negative affect and psychosomatic health complaints among female physicians in Egypt

Purpose

This study aims to examine the direct relationship between work–family conflict and psychosomatic health complaints among female physicians in Egypt. The study also investigates the mediating role of the negative affect on this relationship.

Design/methodology/approach

Data were collected using a paper and pen questionnaire from 186 female physicians, and structural equation modeling (SEM) was used to analyze the data.

Findings

The study findings revealed that work–family conflict is associated with increased psychosomatic complaints among female physicians in Egypt. The study also found that negative affect partially mediates the relationship between work–family conflict and psychosomatic health complaints.

Research limitations/implications

Because of the cross-sectional research design, causal interpretations could not be made. Further empirical evidence is also needed to ascertain the generalizability of the findings to other contexts.

Practical implications

Organizations need to support their employees in balancing their work and family roles. In addition, employees need to understand how work–family conflict could influence their affect and should try to find ways to cope.

Originality/value

The study addresses calls for research on the relationship between work–family conflict and health in developing countries. It also responds to calls for research on the mechanisms through which work–family conflict relates to employee health.

Affective determinants of physical activity in cancer survivors

Objective: Research with non-cancer survivor populations finds affective variables to be important determinants of physical activity. This study assessed the ability of explicit and implicit affective variables to predict the physical activity of cancer survivors, above that accounted for by cognitive variables. The study also tested whether the affective variables were connected to physical activity directly or indirectly through their association with behavioural intentions. Design: In a cross-sectional design, cancer survivors (n = 122) completed questionnaires and an implicit affect task. Main outcome measures: Self-report measures assessed three affective variables (e.g. positive affective associations), five cognitive variables (e.g. cognitive beliefs), physical activity estimates, behavioural intentions and participants also completed an implicit affect task regarding physical activity. Results: Two of the three explicit affect variables and the implicit affect variable accounted for significant variability in physical activity estimates beyond that accounted for by the cognitive variables. Positive affective associations were the strongest predictor in multivariate analyses. Behavioural intentions did not mediate the link between the affect variables and physical activity estimates. Conclusions: Explicit and implicit affective variables are direct and unique predictors of physical activity in cancer survivors. Physical activity interventions for cancer survivors should target both explicit affect and implicit affect.

Role of personality in cardiovascular diseases: An issue that needs to be focused too!

This review provides a broad overview of the relationship of personality with cardiovascular diseases (CVDs). There has been a sustained interest over the last half a century on the issue of relationship between personality traits and CVDs. Type A behavior was the initial focus of inquiry as it was observed that individuals who were competitive, hostile, and excessively driven were overrepresented among patients seeking treatment for CVDs and also were prone to develop coronary artery disease/syndrome. However, the research gradually expanded to assess the relationship of cardiac morbidity with various other personality facets. Furthermore, studies found out that negative effects (including anger and hostility) were also associated with adverse cardiovascular outcomes. Subsequently, a new personality entity named as the type D ‘distressed’ personality, which combined negative affectivity and social inhibition. type D personality then became the area of research and was demonstrated to be related with poorer cardiac outcomes. Interestingly, the results of various research studies are not equivocal, and hence, there are several critiques related to the current understanding of the link between personality construct and the risk of development as well as the outcome of CVDs. Furthermore, few personality traits such as optimism, conscientiousness, openness to experience, and curiosity have been found to be protective factors against development of CVDs and therefore are called ‘cardioprotective’ personality traits. A detailed discussion on the various aspects of personality in relation to CVDs along with a critical appraisal has been presented in this review.

Maladaptive Eating in Posttraumatic Stress Disorder: A Population-Based Examination of Typologies and Medical Condition Correlates

Posttraumatic stress disorder (PTSD) and eating pathology are frequently comorbid, and both are independent risk factors for various medical conditions. Using population-based data collected as part of the 2012-2013 National Epidemiologic Survey on Alcohol and Related Conditions (NESARC-III; N = 36,309), the primary objectives of this study were to (a) identify eating pathology classes among PTSD and (b) investigate associations between maladaptive eating and medical conditions among PTSD. Using the Alcohol Use Disorder and Associated Disabilities Interview Schedule (AUDADIS-5), we assessed PTSD and maladaptive eating symptoms in accordance with the DSM-5. We used a latent class analysis to identify maladaptive eating typologies among adults with lifetime PTSD (n = 2,339; 6.1%) and multivariable logistic regression models to examine associations between each of the six emergent maladaptive eating typologies and medical conditions. Results revealed that over 40% of individuals with PTSD endorsed indicators of maladaptive eating. In addition, each maladaptive eating typology among PTSD was significantly associated with unique sociodemographic characteristics and increased odds of medical conditions relative to no PTSD and no eating disorder, adjusted odds ratios (AORs) = 1.34-6.55, and PTSD with no eating psychopathology, AORs = 1.43-5.11. Results of this study provide a better understanding of maladaptive eating in adults with PTSD and potential medical sequelae. Results indicate maladaptive eating may be an important mechanism in the association between PTSD and medical conditions, which may inform targeted interventions among individuals with these comorbidities.

Factors associated with professional healthcare advice seeking in women at risk for developing breast cancer-related lymphedema

OBJECTIVES

Approximately 6-20% of breast cancer patients undergoing lymph node surgery will develop lymphedema. At-risk individuals are encouraged to seek professional healthcare advice if symptoms arise. This study aimed to identify cognitive and affective factors associated with professional healthcare advice (PHCA) seeking behavior in women with heightened lymphedema risk.

METHODS

Women with increased lymphedema risk (N=462) completed an online survey measuring cognitive and affective responses to lymphedema risk, including the Illness Perception Questionnaire (Revised), and adherence to seeking PHCA.

RESULTS

Overall, 62% of women reported seeking professional healthcare advice if symptoms arose. Logistic regression analysis indicated that adherence to seeking PHCA if lymphedema symptoms arise was associated with greater illness coherence, belief in the efficacy of seeking PHCA, and lymphedema risk-related emotional distress.

CONCLUSION

Women were more likely to seek PHCA if symptoms arose if they held a coherent understanding of lymphedema and believed in the usefulness of seeking PHCA. For these women, psychological distress associated with lymphedema risk was associated with enhanced adherence to seeking PHCA.

PRACTICE IMPLICATIONS

Health professionals should target lymphedema education to ensure at-risk women have a coherent understanding of lymphedema and that they believe in the effectiveness of seeking PHCA to help manage lymphedema symptoms.

Does the ability to express different emotions predict different indices of physical health? A skill-based study of physical symptoms and heart rate variability

OBJECTIVES

The outward expression of emotion has been frequently associated with better health outcomes, whereas suppressing emotion is thought to contribute to worse physical health. However, work has typically focused on trait expressive tendencies and the possibility that individual differences in the ability to express specific emotions may also be associated with health has not been widely tested.

DESIGN

A cross-sectional study of community dwelling adults.

METHODS

One hundred and twenty-eight participants aged 18-88 years completed questionnaires assessing demographics and health status, before attending a testing session in which resting heart rate variability (HRV) was assessed. Participants then completed a performance-based test of expressive regulatory skill in which they were instructed to enhance and suppress their emotional expressions while they watched film clips validated to elicit amusement, sadness, and anger. Participants rated subjective emotional experience before and after each clip, and their degree of expressivity was scored using FACS-based Noldus FaceReader.

RESULTS

Missing data resulted in a final sample size of 117. Linear regressions controlling for age, sex, diagnoses, and trait emotion revealed that greater ability to enhance sad expressions was associated with higher HRV while the ability to enhance expressions of joy was associated with lower symptom interference. In parallel models, the ability to flexibly regulate (both enhance and suppress) expressions of joy and sadness was also associated with lower symptom interference.

CONCLUSIONS

Findings suggest that the ability to regulate expressions of both sadness and joy is associated with health indices even when controlling for trait affect and potential confounds. The present findings offer early evidence that individual differences in the ability to regulate the outward expression of emotion may be relevant to health and suggest that expressive regulatory skills offer a novel avenue for research and intervention. Statement of contribution What is already known on this subject The tendency to outwardly express felt emotion generally predicts better health, whereas expressive suppression typically predicts worse health outcomes. Most work has been based on trait assessments; however, the ability to regulate the expression of felt emotion can be objectively assessed using performance-based tests. Prior work in mental health suggests that the ability to flexibly up- and downregulate the expression of emotion predicts better outcomes. What does this study add The first evidence that the ability to flexibly regulate expressions predicts indices of health. Skill in both expressing and suppressing facial expressions predicts better reported health. Skills with different emotions differentially predict symptom interference and cardiac vagal tone.

Worry as an Uncertainty-Associated Emotion: Exploring the Role of Worry in Health Information Seeking

This study was carried out to understand how and why worry motivates health-related information seeking, and whether worry decreases after obtaining health-related information. It was proposed that worry influences health-related information-seeking behavior indirectly through cancer patients' desire for obtaining additional information. It was further expected that perceived knowledge about cancer could be increased after 2 months of searching for health information over the Internet, which would subsequently affect levels of worry. Using panel data collected from 224 women diagnosed with breast cancer, worry was found to predict patients' health information seeking via the perceived need for additional information. The results further showed significant increases in patients' perceived knowledge about breast cancer and decreased levels of worry after the seeking of health information for 2 months. Theoretical and practical implications of the findings are discussed.

The influences of reappraisal and suppression instructions on memory for neutral words in negative background

Previous studies have investigated the influences of emotion regulation on memory for emotional stimuli. However, whether and how emotion regulation impacts recognition memory for neutral items in negative background is still unclear. Thus, the present study used event-related potentials and the study-recognition memory task to examine the effects of the two commonly used emotion regulation strategies, cognitive reappraisal and expressive suppression, on recognition memory of neutral words centrally presented on negative pictures. The behavior results showed that, compared with suppression, the reappraisal strategy enhanced the neutral words memory. Moreover, the event-related potential data demonstrated larger FN400 old/new effect indexing familiarity and late positive component old/new effect presenting episodic information recollection for the reappraisal condition relative to view and suppression conditions. These might be due to significant elaboration encouraged by this strategy.

Deconstructing Positive Affect in Later Life: A Differential Functionalist Analysis of Joy and Interest

Positive affect, an index of psychological well-being, is a known predictor of functionality and health in later life. Measures typically studied include joy, happiness, and subjective well-being, but less often interest—a positive emotion with functional properties that differ from joy or happiness. Following differential emotions theory, the present study measured trait joy and interest in a population-based sample of 1,118 adults aged 65–86 years. As predicted, trait joy was associated with greater religious participation, while trait interest was associated with greater education. Joy was associated with lower morbidity and stress while interest was not. Interest was, in fact, associated with greater stress. Both emotions were positively associated with social support. We use the pattern of predictors to develop a functionalist conceptualization of these two emotions in later life, concluding that it is worthwhile to treat interest and joy as partially-independent positive affects contributing differentially to human emotionality and later life adaptation.

Anger Experience and Anger Inhibition in Sub-Populations of African American and European American Older Adults and Relation to Circulatory Disease

This study examined ethnic differences in the link between anger experience and anger inhibition and that of circulatory disease (CD). To ascertain the effects of anger inhibition in older persons, health data from groups of African American, African Caribbean, Eastern European and European American adults were collected. Experienced anger and anger inhibition were significant predictors of CD only for the African American group and the relation between experienced anger and CD was mediated by anger inhibition. The data suggest that cultural factors play a role in the development of an angerinhibitory style and that this trait may pose a serious risk factor for circulatory disease.

Personality and Disease: Correlations of Multiple Trait Scores with Various Illnesses

Correlations between personality measures and self-reported data on health status were examined in a sample of 5133 men and women, aged between 40 and 65. A wider range of diseases was studied than is typical. Small but theoretically meaningful correlations with personality were found for some diseases. Personality syndromes of Emotional Lability, Type A Behaviour, Behavioural Control, Locus of Control over Diseases and Psychoticism were distinguished factorially. Emotional Lability appeared to be the most robust predictor of general disease vulnerability. Some small but significant associations between specific illnesses and Type A and Behavioural Control were also found.

A longitudinal examination of anxiety disorders and physical health conditions in a nationally representative sample of U.S. older adults

BACKGROUND

There has been growing interest in the relation between anxiety disorders and physical conditions in the general adult population. However, little is known about the nature of this association in older adults. Understanding the complex relationship between these disorders can help to inform prevention and treatment strategies unique to this rapidly growing segment of the population.

METHODS

A total of 10,409 U.S. adults aged 55+ participated in Wave 1 (2001-2002) and Wave 2 (2004-2005) of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC). Lifetime and past-year DSM-IV anxiety, mood, and substance use disorders, and lifetime personality disorders, were assessed in both waves. Participants self-reported on whether they had been diagnosed by a healthcare professional with a broad range of physical health conditions; this study focuses on cardiovascular disease, gastrointestinal disease, and arthritis. Multivariable logistic regressions adjusted for sociodemographics, comorbid mental disorders, and number of physical health conditions assessed: (1) the relation between past-year physical conditions at Wave 1 and incident past-year anxiety disorders at Wave 2 and; (2) the relation between individual lifetime anxiety disorders at Wave 1 and incident physical conditions at Wave 2. A second set of adjusted multinomial logistic regressions examined Wave 1 sociodemographic and physical and mental health risk factors associated with incident physical condition alone, anxiety disorder alone, and comorbid anxiety and physical condition at Wave 2.

RESULTS

Past-year arthritis at Wave 1 was significantly associated with increased odds of incident generalized anxiety disorder at Wave 2. Further, any lifetime anxiety disorder and posttraumatic stress disorder at Wave 1 were significantly associated with increased odds of incident gastrointestinal disease at Wave 2. Differential sociodemographic and physical and mental health predictors were significantly associated with increased odds of incident comorbid anxiety disorder and physical conditions.

CONCLUSION

Results of the current study elucidate the longitudinal bidirectional relationships between anxiety disorders and physical health conditions in a large, nationally representative sample of older adults. These results have important implications for identifying at risk older adults, which will not only impact this growing segment of the population directly, but will also potentially lessen burden on the healthcare system as a whole.

The impact of positive affect on health cognitions and behaviours: a meta-analysis of the experimental evidence

Several reviews suggest that positive affect is associated with improved longevity, fewer physical symptoms, and biological indicators of good health. It is possible that positive affect could influence these outcomes by promoting healthful cognitions and behaviours. The present review identified conceptual pathways from positive affect to health cognitions and behaviour, and used random effects meta-analysis to quantify the impact of positive affect inductions (versus neutral affect conditions) on these outcomes. Literature searches located 54 independent tests that could be included in the review. Across all studies, the findings revealed no reliable effects on intentions (d+ = -.12, 95% CI = -.32 to .08, k = 15) or behaviour (d+ = .15, 95% CI = -.03 to .33, k = 23). There were four reliable effects involving specific cognitions and behaviours, but little clear evidence for generalised benefits or adverse effects of positive emotions on health-related cognitions or actions. Conclusions must be cautious given the paucity of tests available for analysis. The review offers suggestions about research designs that might profitably be deployed in future studies, and calls for additional tests of the impact of discrete positive emotions on health cognitions and behaviour.

The benefits and risks of telling and listening to stories of difficulty over time: experimentally testing the expressive writing paradigm in the context of interpersonal communication between friends

The overarching goal of the current study was to determine the impact of talking interpersonally over time on emerging adults' individual and relational health. Using an expressive writing study design (see Frattaroli, 2006), we assessed the degree to which psychological health improved over time for college students who told and listened to stories about friends' current difficulties in comparison with tellers in control conditions. We also investigated the effects on tellers' and listeners' perceptions of each other's communication competence, communicated perspective-taking, and the degree to which each threatened the other's face during the interaction over time to better understand the interpersonal communication complexities associated with talking about difficulty over time. After completing prestudy questionnaires, 49 friend pairs engaged in three interpersonal interactions over the course of 1 week wherein one talked about and one listened to a story of difficulty (treatment) or daily events (control). All participants completed a poststudy questionnaire 3 weeks later. Tellers' negative affect decreased over time for participants exposed to the treatment group, although life satisfaction increased and positive affect decreased across time for participants regardless of condition. Perceptions of friends' communication abilities decreased significantly over time for tellers. The current study contributes to the literature on expressive writing and social support by shedding light on the interpersonal implications of talking about difficulty, the often-overlooked effects of disclosure on listeners, and the health effects of talking about problems on college students' health.

Emotion: The Self-regulatory Sense

While emotion is a central component of human health and well-being, traditional approaches to understanding its biological function have been wanting. A dynamic systems model, however, broadly redefines and recasts emotion as a primary sensory system-perhaps the first sensory system to have emerged, serving the ancient autopoietic function of "self-regulation." Drawing upon molecular biology and revelations from the field of epigenetics, the model suggests that human emotional perceptions provide an ongoing stream of "self-relevant" sensory information concerning optimally adaptive states between the organism and its immediate environment, along with coupled behavioral corrections that honor a universal self-regulatory logic, one still encoded within cellular signaling and immune functions. Exemplified by the fundamental molecular circuitry of sensorimotor control in the E coli bacterium, the model suggests that the hedonic (affective) categories emerge directly from positive and negative feedback processes, their good/bad binary appraisals relating to dual self-regulatory behavioral regimes-evolutionary purposes, through which organisms actively participate in natural selection, and through which humans can interpret optimal or deficit states of balanced being and becoming. The self-regulatory sensory paradigm transcends anthropomorphism, unites divergent theoretical perspectives and isolated bodies of literature, while challenging time-honored assumptions. While suppressive regulatory strategies abound, it suggests that emotions are better understood as regulating us, providing a service crucial to all semantic language, learning systems, evaluative decision-making, and fundamental to optimal physical, mental, and social health.

Negative affect predicts adults' ratings of the current, but not childhood, impact of adverse childhood events

Adverse childhood events (ACE's) have been empirically related to a wide range of negative health and mental health outcomes. However, not all individuals who experience ACE's follow a trajectory of poor outcomes, and not all individuals perceive the impact of ACE's as necessarily negative. The purpose of this study was to investigate positive and negative affect as predictors of adults' ratings of both the childhood and adult impact of their childhood adversity. Self-report data on ACE experiences, including number, severity, and 'impact' were collected from 158 community members recruited on the basis of having adverse childhood experiences. Results indicated that, regardless of event severity and number of different types of adverse events experienced, high levels of negative affect were the strongest predictor of whether the adult impact of the adverse childhood events was rated as negative. All individuals rated the childhood impact of events the same. Implications are discussed.

Predictors of Online Health Information Seeking Among Women with Breast Cancer: The Role of Social Support Perception and Emotional Well-Being

This study attempts to examine the role of social support perception and emotional well-being on online information seeking among cancer patients within the context of CHESS, a well-established Interactive Cancer Communication System (ICCS). Factor and regression analyses conducted among 231 breast cancer patients revealed that social support perception and emotional well-being interacted with each other to influence online health information seeking. Patients with low social support perception and high emotional well-being were most likely to seek health information, whereas patients with high social support perception and high emotional well-being sought out the same information least. Practical implications of the study findings were further discussed.

When Feeling Bad Can Be Good: Mixed Emotions Benefit Physical Health Across Adulthood

Traditional models of emotion-health interactions have emphasized the deleterious effects of negative emotions on physical health. More recently, researchers have turned to potential benefits of positive emotions on physical health as well. Both lines of research, though, neglect the complex interplay between positive and negative emotions and how this interplay affects physical well-being. Indeed, recent theoretical work suggests that a strategy of "taking the good with the bad" may benefit health outcomes. In the present study, the authors assessed the impact of mixed emotional experiences on health outcomes in a 10-year longitudinal experience-sampling study across the adult life span. The authors found that not only were frequent experiences of mixed emotions (co-occurrences of positive and negative emotions) strongly associated with relatively good physical health, but that increases of mixed emotions over many years attenuated typical age-related health declines.

Mixed emotional experience is associated with and precedes improvements in psychological well-being

Background

The relationships between positive and negative emotional experience and physical and psychological well-being have been well-documented. The present study examines the prospective positive relationship between concurrent positive and negative emotional experience and psychological well-being in the context of psychotherapy.

Methods

47 adults undergoing psychotherapy completed measures of psychological well-being and wrote private narratives that were coded by trained raters for emotional content.

Results

The specific concurrent experience of happiness and sadness was associated with improvements in psychological well-being above and beyond the impact of the passage of time, personality traits, or the independent effects of happiness and sadness. Changes in mixed emotional experience preceded improvements in well-being.

Conclusions

Experiencing happiness alongside sadness in psychotherapy may be a harbinger of improvement in psychological well-being.

Emotional complexity and emotional well-being in older adults: risks of high neuroticism

Older and midlife adults tend to report greater emotional complexity and greater emotional well-being than younger adults but there is variability in these factors across the lifespan. This study determined how the personality trait of neuroticism at baseline predicts emotional complexity and emotional well-being 10 years later; a goal was to determine if neuroticism is a stronger predictor of these emotion outcomes with increasing age in adulthood. Data were obtained from two waves of the MIDUS projects (N = 1503; aged 34-84). Greater neuroticism predicted less emotional complexity as indicated by associations between positive and negative affect, particularly for older participants. Neuroticism predicted lower emotional well-being and this association was stronger for older and midlife than for younger adults. Overall, high neuroticism may be a greater liability for poor emotion outcomes for older and perhaps for midlife adults than for younger persons. Clinical and theoretical implications of this conclusion are discussed.

Pathways underlying somatic complaints in children and adolescents who are deaf or hard of hearing

Frequent somatic complaints are not only a problem in themselves but also related to other difficulties. So far, no conclusive findings have been reported about the prevalence of and factors underlying these complaints in children and adolescents who are deaf or hard of hearing (DHH). Such information would be valuable for prevention and intervention. Therefore, the aim of this study was to examine the prevalence of somatic complaints and their relation with emotional functioning in DHH youngsters, as compared with hearing youngsters. This was established by assessing how somatic complaints, mood states, and sense of coherence were experienced by 186 Dutch participants (mean age = 11;07 years). DHH and hearing groups were compared using multivariate analysis of variance and structural equation modeling. The results showed that somatic complaints were reported equally often for both groups, but that the pathways leading to these complaints were partly different. Only in DHH participants were feelings of fear associated with more somatic complaints. The results suggest that DHH children and adolescents would benefit from support in the regulation of fear and its causes. Other aspects affecting adjustment outcomes of DHH youngsters were education type and communication mode.

Affect and loneliness among centenarians and the oldest old: the role of individual and social resources

OBJECTIVES

Affect and loneliness are important indicators of mental health and well-being in older adulthood and are linked to significant outcomes including physical health and mortality. Given a large focus on young-old adults within gerontological research, the primary aim of this study was to examine the ability of individual and social resources in predicting affect and loneliness within a sample of oldest-old individuals including centenarians, an understudied population.

METHODS

Participants were assessed during the most recent cross-sectional data collection of the Georgia Centenarian Study. The eligible sample included 55 octogenarians (M = 83.70 years, SD = 2.68; range = 81-90) and 77 centenarians (M = 99.78 years, SD = 1.64; range = 98-109). Subjects scored 17 or greater on the Mini-Mental Status Exam and completed mental health assessments.

RESULTS

Hierarchical regression analyses were conducted to examine the relation of affect and loneliness with demographic characteristics, physical and social functioning, cognition, and personality. Within this sample of cognitively intact oldest old, measures of executive control and cognitive functioning demonstrated limited association with mental health. Personality, specifically neuroticism, was strongly related to mental health indicators for both age groups and social relations were particularly important associates of centenarians' mental health.

DISCUSSION

Findings indicate the distinctiveness of mental health indicators and the need to distinguish differential roles of individual and social resources in determining these outcomes among octogenarians and centenarians.

Bummed out now, feeling sick later: weekday versus weekend negative affect and physical symptom reports in high school freshmen

PURPOSE

This study examined adolescent negative affect (NA) in daily life on school days and weekend days during the spring and associations with physical symptoms during the following summer.

METHODS

Using experience sampling methodology (ESM), participants provided electronic diary (eDiary) reports of NA on weekdays (Thursday and Friday) and weekend days during their 9th grade year. In telephone interviews during the winter and summer months they reported physical symptoms. Multiple regression analyses were conducted to examine associations between weekday NA, weekend NA, and their interaction and four constellations of physical symptoms reported in summer (pain, respiratory, gastrointestinal, and immune symptoms).

RESULTS

Findings indicated that weekend NA was associated with later reports of pain, respiratory, and immune symptoms. For gastrointestinal symptoms only adolescents who reported low NA on both weekend and school days reported fewer gastric symptoms than other adolescents.

CONCLUSIONS

Mapping the predictors and correlates of weekend NA may be important not only for understanding teenage mood patterns but also for enhancing the interpretation of physical symptom reporting by adolescents.

Integrating co-morbid depression and chronic physical disease management: identifying and resolving failures in self-regulation

Research suggests that treatments for depression among individuals with chronic physical disease do not improve disease outcomes significantly, and chronic disease management programs do not necessarily improve mood. For individuals experiencing co-morbid depression and chronic physical disease, demands on the self-regulation system are compounded, leading to a rapid depletion of self-regulatory resources. Because disease and depression management are not integrated, patients lack the understanding needed to prioritize self-regulatory goals in a way that makes disease and depression management synergistic. A framework in which the management of co-morbidity is considered alongside the management of either condition alone offers benefits to researchers and practitioners and may help improve clinical outcomes.

Bodily embarrassment and judgment concern as separable factors in the measurement of medical embarrassment: psychometric development and links to treatment-seeking outcomes

OBJECTIVES

Understanding why people do not always engage in medical examinations that might benefit them is a public health issue which is receiving increased attention. One area of promise involves the study of medical embarrassment, although current studies are weakened in that they measure medical embarrassment in a theoretically naïve and unidimensional manner and have assumed that embarrassment is exclusively a barrier to the timely seeking of treatment.

DESIGN

Convenience sampling was used to recruit 116 male and 134 female students (mean age = 19.94 years, 47.2% Caucasian, 20.4% African-American, 32.4% Asian) from two large universities in different parts of the United States.

METHODS

Participants completed a comprehensive measure of medical embarrassment, reported on previous treatment avoidance because of embarrassment, and recorded the frequency of psychological, general and sex-related visits across the previous 5 years.

RESULTS

As expected, medical embarrassment was not unidimensional and appeared to have two distinct factors--bodily embarrassment and judgment concern. Bodily embarrassment generally predicted less frequent medical contact although not equally so across domains and it interacted with judgment concern in several cases, providing preliminary evidence that there are situations in which aspects of medical embarrassment may actually facilitate greater medical contact.

CONCLUSIONS

The data highlight the importance of considering the role of emotions other than fear in health behaviour and the means by which they may facilitate or deter the timely seeking of diagnosis and treatment.

Common psychosocial factors underlying breast cancer screening and breast cancer treatment adherence: a conceptual review and synthesis

In this paper, we review the literature on psychosocial influences on breast cancer screening and treatment adherence with an eye to identifying common cognitive, emotional, and social network factors that may lead to poor screening adherence and suboptimal treatment in the case of diagnosed breast cancer. Nonadherence to breast cancer screening and treatment guidelines can significantly and negatively impact the prospects for prevention and control of breast cancer. Psychosocial factors are an especially important focus for research, inasmuch as belief structures and psychosocial characteristics (such as patterns of emotion regulation and the quality of social relations) are modifiable and are, thus, eminently suitable to intervention.

Stress versus discrete negative emotions in the prediction of physical complaints: Does predictive utility vary across ethnic groups?

Reports of stress and negative emotion are important predictors of health. However, whether discrete emotions or stress measures are more useful, whether they contribute independently to outcome, and whether they relate to health equally across ethnic groups remain unclear. In the current study, 207 US-born European American, US-born African American, Black English-speaking Caribbean, and Dominican men aged 40 years and older completed measures of somatic symptoms, trait emotions, and stress. Sadness and stress independently predicted symptom reports, even when examined concurrently, and with demographics controlled; trait anger did not predict symptoms. Moreover, the relations between trait emotions and symptoms varied across groups. Levels of sadness were associated with greater symptoms among US-born European American and Dominican men, but negatively associated among Black English-speaking Caribbean men, and the relations for anger also differed marginally across groups. The results underscore the importance of differentiating among discrete emotions and stress and considering ethnic interactions when examining reports of somatic symptomology. We suggest that the impact of psychological characteristics on health must be considered within cultural and ethnic contexts to be fully understood.

Ethnic Variation in the Impact of Emotion and Emotion Regulation on Health: A Replication and Extension

Although emotions and patterns of emotion regulation are central to models linking personality and health, the generalizability of these models to diverse populations of older adults remains untested. In this study, 1,364 community-dwelling women (aged 50-70 years) from six ethnic groups completed self-report measures of trait anger, inhibition, defensiveness, and health. As expected, reports of trait anger and emotion inhibition predicted poorer health (and defensiveness better health), even when demographics and health behaviors were controlled. However, these characteristics related to outcome differently across ethnic groups; greater anger was related to better health in all groups other than U.S-born European Americans, and increased emotion inhibition was associated with better health among immigrant Eastern European women. Results are discussed within a contextualistic model of emotions and health, and directions for future research are given.

The associations of emotion regulation and dysregulation with the metabolic syndrome factor

OBJECTIVE

Emotion regulation has been associated with good, and dysregulation with poor subjective health; but it is unclear if emotion regulation is related to metabolic syndrome.

METHODS

Associations between the metabolic syndrome factor (systolic and diastolic blood pressure, waist circumference, high-density lipoprotein, triglycerides, and glucose), emotion regulation (the strategies of repair and maintenance, self-perceived emotion regulation) and dysregulation (emotional ambivalence); and subjective health (self-rated health and psychosomatic symptoms) were studied using a structural equation modelling (SEM) approach. The participants (96 women, 85 men) were drawn from the Jyväskylä Longitudinal Study of Personality and Social Development (JYLS).

RESULTS

High repair was associated directly to the low metabolic syndrome factor, while high maintenance, high self-perceived emotion regulation, and low emotional ambivalence were related indirectly to the low metabolic syndrome factor through good subjective health.

CONCLUSIONS

Successful emotion regulation may have an association not only with the subjective experience of health, but also with physiological regulation systems, leading to a reduced risk for metabolic syndrome.

Where's Maria? A video to increase awareness about breast cancer and mammography screening among low-literacy Latinas

BACKGROUND

The need exists to educate and motivate medically disadvantaged Latinas to engage in regular mammography screening to reduce their high breast cancer (BC) mortality risk due to the illness' late detection.

METHODS

Qualitative research methods [e.g., focus groups, key informants] were primarily used during the basic and formative research phases in preproducing and producing a breast cancer educational video for low-literacy Latinas.

RESULTS

An 8-min video was created in an Entertainment-Education soap opera format. The purpose of the video is to create awareness about breast cancer and to motivate low-literacy Latinas who are at the precontemplation stage of behavior change to consider engaging in mammography screening. Thus, the video presents a compelling story of a Latina with whom the target audience can identify and become involved with the unfolding events of her story as she realizes her risk for breast cancer and struggles with the decision to engage in mammography. The content and format of the video include culturally relevant clues and modeling to influence Latinas' cognitive and subjective processes involved in making the decision to change.

CONCLUSIONS

Complex attitudinal and behavioral issues can be effectively targeted to decrease the influence that psychological barriers exert in Latinas low breast cancer screening rates.

Self-injurious behaviors, PTSD arousal, and general health complaints within a treatment-seeking sample of sexually abused women

Eighty-nine adult female survivors of childhood sexual abuse, presenting for psychological treatment, were assessed for self-reported rates of self-injurious behaviors (SIB), health complaints, and posttraumatic stress disorder (PTSD) symptoms of physiological arousal. A composite measure of current SIB was significantly and positively associated with health complaints, PTSD arousal, and three measures of sexual abuse severity: age of onset for sexual abuse, injury experienced during the sexual abuse, and perceived life threat. Tests of mediation revealed that symptoms of PTSD arousal mediated the relationship between earlier age of onset for sexual abuse and SIB. PTSD arousal moderated the relationship between sexual-abuse-related injury and SIB. SIB was a unique predictor of health complaints, even after controlling for sexual abuse severity and PTSD arousal.

Fear, Anxiety, Worry, and Breast Cancer Screening Behavior: A Critical Review

Anxiety, fear, and worry are variously described as facilitators and barriers of breast cancer screening. However, several contradictions are evident in this research. A review article described the literature regarding the relations among fear, anxiety, and worry, along with emotion regulatory styles, and breast cancer screening behaviors before critiquing it in an attempt to uncover preliminary explanations for these discrepancies. Three main conclusions are drawn. First, it is suggested that researchers need to clearly define the components of cancer and the screening process that women are afraid of as each may bear a different relation to screening behavior. Second, greater care needs to be taken to employ psychometrically valid and reliable measures of fear and anxiety. Third, studies need to more systematically test findings across the minority and ethnic groups at greatest risk. A framework is presented and suggestions regarding the continued development of this promising area of research are made.

Physical Hardiness and Styles of Socioemotional Functioning in Later Life

Although the aging literature suggests that there are many paths to later life adjustment, there have been few empirical attempts to identify different patterns of adaptation, or their relation to adaptive outcome. As a way to identify patterns of socioemotional functioning in later life associated with physical hardiness, a cluster analysis was applied to 11 measures of socioemotional functioning in a large sample (N = 1,085) of older adults (65-86 years). Ten subgroups were extracted, with clusters of individuals being primarily defined by social network variables, religious characteristics, and emotion profiles. Groups were then compared on a measure of physical hardiness. Patterns of adaptation characterized by high levels of negative emotions tended to represent less hardy adaptation, although there were nonetheless some patterns of noteworthy exception. In contrast, however, patterns of adaptation characterized by religiosity were typically associated with greater hardiness. Finally, physical hardiness was not exclusively the province of individuals exhibiting close social networks, with some groups high in connectedness being less likely to report high hardiness.