Expression of anger and ill health in two cultures: an examination of inflammation and cardiovascular risk

Anger Expression Styles, Cynical Hostility, and the Risk for the Development of Type 2 Diabetes or Diabetes-Related Heart Complications: Secondary Analysis of the Health and Retirement Study

OBJECTIVE

Limited research has examined associations between trait anger and hostility and incident type 2 diabetes (T2D) and diabetes-related heart complications. However, anger expression styles (i.e., anger-in, anger-out) have not been examined. The present study used secondary data to examine the associations between anger expression styles, cynical hostility, and the risk of developing T2D (objective 1) or diabetes-related heart complications (objective 2).

METHODS

Self-report data came from participants aged 50 to 75 years in the Health and Retirement Study. Anger-in (anger that is suppressed and directed toward oneself, anger-out (anger directed toward other people or the environment), and cynical hostility were measured at baseline (2006 or 2008). Follow-up data (i.e., diabetes status or diabetes-related heart complications status) were collected every 2 years thereafter until 2020. The objective 1 sample included 7898 participants without T2D at baseline, whereas the objective 2 sample included 1340 participants with T2D but without heart complications at baseline.

RESULTS

Only anger-in was significantly associated with incident T2D after controlling for sociodemographic characteristics (hazard ratio = 1.08, 95% confidence interval = 1.01-1.16), but the association did not hold after further adjustment for depressive symptoms. Only anger-out was significantly associated with incident diabetes-related heart complications after adjusting for sociodemographic characteristics, health-related covariates, and depressive symptoms (hazard ratio = 1.21, 95% confidence interval = 1.02-1.39).

CONCLUSIONS

Anger expression styles were differentially related to diabetes outcomes. These findings demonstrate the value of expanding the operationalization of anger beyond trait anger in this literature and encourage further investigation of anger expression styles.

When High Subjective Social Status Becomes a Burden: A Japan-U.S. Comparison of Biological Health Markers

High subjective social status (SSS) is believed to protect health in the current literature. However, high SSS entails social responsibilities that can be stressful in collectivistic cultural contexts. Here, we tested the hypothesis that those socialized in collectivistic societies (e.g., Japan) recognize their high social status as entailing social duties difficult to ignore even when they are excessive. Using cross-cultural survey data (N = 1,289) and a measure of biological health risk (BHR) by biomarkers of inflammation and cardiovascular malfunction, we found that higher SSS predicted lower BHR for American males. In contrast, higher SSS predicted higher BHR for Japanese males, mediated by the perceived difficulty of disengaging from their current goals. In both cultural groups, females showed no association between SSS and BHR. These findings suggest that social status has differing health implications, depending on the relative salience of privileges and burden-producing responsibilities in different cultural contexts.

The Association Between Witnessing Interparental Violence and Adolescents' Anger Expression Styles

The purpose of this research was to determine the association between witnessing interparental violence and anger expression styles in adolescents. Previous studies have generally focused on the attitudes to violence of individuals witnessing it. However, the present research specifically investigated the association between witnessing interparental violence and anger. The research was performed as a descriptive and correlational study. The research sample consisted of 1,000 adolescents aged 15 to 19 contacted via social media platforms using the convenience sample method. An online data collection form containing questions was prepared to determine adolescents' sociodemographic characteristics and contained questions from the Witnessing Interparental Violence Scale and Trait Anger Expression Inventory. Statistical analysis was performed on SPSS 21.0 software. In all, 446 (44.6%) adolescents had witnessed interparental violence. Trait, externalized, and internalized anger scores were higher among adolescents who had witnessed interparental violence compared to those who had not. This research shows that witnessing interparental violence has significant effects on the individual's trait anger and anger expression styles. We recommend that the effects of exposure to violence and witnessing interparental violence be compared and that witnessing violence in different cultural environments be evaluated in future studies.

Cultural evolution needed to complete the Grossmann theory

Grossmann used evolutionary analysis to argue for the adaptive nature of fearfulness. This analysis, however, falls short of addressing why negative affectivity is maladaptive in contemporary Western societies. Here, we fill the gap by documenting the implied cultural variation and considering cultural (rather than biological) evolution over the last 10,000 years to explain the observed cultural variation.

Longitudinal associations between specific types of emotional reactivity and psychological, physical health, and school adjustment

Using a multimethod, multiinformant longitudinal design, we examined associations between specific forms of positive and negative emotional reactivity at age 5, children's effortful control (EC), emotion regulation, and social skills at age 7, and adolescent functioning across psychological, academic, and physical health domains at ages 15/16 (N = 383). We examined how distinct components of childhood emotional reactivity directly and indirectly predict domain-specific forms of adolescent adjustment, thereby identifying developmental pathways between specific types of emotional reactivity and adjustment above and beyond the propensity to express other forms of emotional reactivity. Age 5 high-intensity positivity was associated with lower age 7 EC and more adolescent risk-taking; age 5 low-intensity positivity was associated with better age 7 EC and adolescent cardiovascular health, providing evidence for the heterogeneity of positive emotional reactivity. Indirect effects indicated that children's age 7 social skills partially explain several associations between age 5 fear and anger reactivity and adolescent adjustment. Moreover, age 5 anger reactivity, low-, and high-intensity positivity were associated with adolescent adjustment via age 7 EC. The findings from this interdisciplinary, long-term longitudinal study have significant implications for prevention and intervention work aiming to understand the role of emotional reactivity in the etiology of adjustment and psychopathology.

Social Safety Theory: Conceptual foundation, underlying mechanisms, and future directions

Classic theories of stress and health are largely based on assumptions regarding how different psychosocial stressors influence biological processes that, in turn, affect human health and behavior. Although theoretically rich, this work has yielded little consensus and led to numerous conceptual, measurement, and reproducibility issues. Social Safety Theory aims to address these issues by using the primary goal and regulatory logic of the human brain and immune system as the basis for specifying the social-environmental situations to which these systems should respond most strongly to maximize reproductive success and survival. This analysis gave rise to the integrated, multi-level formulation described herein, which transforms thinking about stress biology and provides a biologically based, evolutionary account for how and why experiences of social safety and social threat are strongly related to health, well-being, aging, and longevity. In doing so, the theory advances a testable framework for investigating the biopsychosocial roots of health disparities as well as how health-relevant biopsychosocial processes crystalize over time and how perceptions of the social environment interact with childhood microbial environment, birth cohort, culture, air pollution, genetics, sleep, diet, personality, and self-harm to affect health. The theory also highlights several interventions for reducing social threat and promoting resilience.

Role of the valuation of nervousness in cortisol responses to psychosocial stress task and task performance in European American and East Asian students

How people perceive and value negative affective states is associated with physiological responses to stressful events and moderates the association between negative feelings and physiological and behavioral outcomes. However, previous studies on valuation of negative affective states have been conducted mostly in Western cultures. Different cultural backgrounds shape how people view negative emotions as well as how people attend to internal emotional states, which may change the effects of valuing negative emotions. The present study thus examined whether valuation of nervousness was associated with the magnitude and duration of cortisol responses to a standardized laboratory stressor and task performance in East Asian and European American students. Two hundred undergraduate students were recruited through a large pool of students taking psychology courses. They engaged in demanding speech and arithmetic tasks as part of the Trier Social Stress Test (TSST). European American participants who had a higher valuation of nervousness showed lower cortisol reactivity. Valuing nervousness was associated with better speech performance in students from both cultural backgrounds, and the strength of this association was moderated by cortisol level. Our findings call attention to the importance of considering whether negative emotions are viewed as beneficial or an impediment, as well as the cultural context when responding to demanding and threatening situations.

The NLRP3 inflammasome is involved in resident intruder paradigm-induced aggressive behaviors in mice

Background: Aggressive behaviors are one of the most important negative behaviors that seriously endangers human health. Also, the central para-inflammation of microglia triggered by stress can affect neurological function, plasticity, and behavior. NLRP3 integrates stress-related signals and is a key driver of this neural para-inflammation. However, it is unclear whether the NLRP3 inflammasome is implicated in the development of aggressive behaviors. Methods: First, aggressive behavior model mice were established using the resident intruder paradigm. Then, aggressive behaviors were determined with open-field tests (OFT), elevated plus-maze (EPM), and aggressive behavior tests (AT). Moreover, the expression of P2X7R and NLRP3 inflammasome complexes were assessed by immunofluorescence and Western blot. The levels of NLRP3 and inflammatory cytokines were evaluated using enzyme-linked immunosorbent assay (ELISA) kits. Finally, nerve plasticity damage was observed by immunofluorescence, transmission electron microscope, and BrdU staining. Results: Overall, the resident intruder paradigm induced aggressive behaviors, activated the hippocampal P2X7R and NLRP3 inflammasome, and promoted the release of proinflammatory cytokines IL-1β in mice. Moreover, NLRP3 knockdown, administration of P2X7R antagonist (A804598), and IL-1β blocker (IL-1Ra) prevented NLRP3 inflammasome-driven inflammatory responses and ameliorated resident intruder paradigm-induced aggressive behaviors. Also, the resident intruder paradigm promoted the activation of mouse microglia, damaging synapses in the hippocampus, and suppressing hippocampal regeneration in mice. Besides, NLRP3 knockdown, administration of A804598, and IL-1Ra inhibited the activation of microglia, improved synaptic damage, and restored hippocampal regeneration. Conclusion: The NLRP3 inflammasome-driven inflammatory response contributed to resident intruder paradigm-induced aggressive behavior, which might be related to neuroplasticity. Therefore, the NLRP3 inflammasome can be a potential target to treat aggressive behavior-related mental illnesses.

Are coping strategies and variability in their use associated with lifespan?

OBJECTIVES

Some stress-related coping strategies contribute to survival among medical populations, but it is unclear if they relate to longevity in the general population. While coping strategies are characterized as being adaptive or maladaptive, whether capacity to tailor their implementation to different contexts (i.e., flexibility of use) may influence lifespan is unknown.

METHOD

In 2004-2006, participants from the Midlife Development in the United States study completed a validated coping inventory including 6 strategies and provided information on sociodemographics, health status, and biobehavioral factors (N = 4398). Deaths were ascertained from death registries with follow-up until 2018. Accelerated failure time models estimated percent changes and 95% confidence intervals (CI) in predicted lifespan associated with use of individual coping strategies. As a proxy for flexibility, participants were also classified as having lower, moderate, or greater variability in strategies used, using a standard deviation-based algorithm.

RESULTS

After controlling for sociodemographics and health status, maladaptive strategies (e.g., per 1-SD increase in Denial = -5.50, 95%CI = -10.50, -0.21) but not adaptive strategies (e.g., Planning) were related to shorter lifespan. Greater versus moderate variability levels were related to a 15% shorter lifespan. Estimates were somewhat attenuated when further controlling for lifestyle factors.

CONCLUSION

Although most associations were of modest magnitude, use of some maladaptive coping strategies appeared related to shorter lifespan. Compared to moderate levels, greater coping variability levels were also clearly detrimental for lifespan. Although adaptive strategies were unrelated to longevity, future work should examine other favorable strategies (e.g., acceptance) and more direct measures of flexibility (e.g., experience sampling methods).

Monoamine Neurotransmitters Control Basic Emotions and Affect Major Depressive Disorders

Major depressive disorder (MDD) is a common and complex mental disorder, that adversely impacts an individual’s quality of life, but its diagnosis and treatment are not accurately executed and a symptom-based approach is utilized in most cases, due to the lack of precise knowledge regarding the pathophysiology. So far, the first-line treatments are still based on monoamine neurotransmitters. Even though there is a lot of progress in this field, the mechanisms seem to get more and more confusing, and the treatment is also getting more and more controversial. In this study, we try to review the broad advances of monoamine neurotransmitters in the field of MDD, and update its effects in many advanced neuroscience studies. We still propose the monoamine hypothesis but paid special attention to their effects on the new pathways for MDD, such as inflammation, oxidative stress, neurotrophins, and neurogenesis, especially in the glial cells, which have recently been found to play an important role in many neurodegenerative disorders, including MDD. In addition, we will extend the monoamine hypothesis to basic emotions; as suggested in our previous reports, the three monoamine neurotransmitters play different roles in emotions: dopamine—joy, norepinephrine—fear (anger), serotonins—disgust (sadness). Above all, this paper tries to give a full picture of the relationship between the MDD and the monoamine neurotransmitters such as DA, NE, and 5-HT, as well as their contributions to the Three Primary Color Model of Basic Emotions (joy, fear, and disgust). This is done by explaining the contribution of the monoamine from many sides for MDD, such the digestive tract, astrocytes, microglial, and others, and very briefly addressing the potential of monoamine neurotransmitters as a therapeutic approach for MDD patients and also the reasons for its limited clinical efficacy, side effects, and delayed onset of action. We hope this review might offer new pharmacological management of MDD.

Do Positive Psychological Factors Equally Predict Resistance to Upper Respiratory Infections in African and European Americans?

Research has consistently shown that positive psychological constructs are linked to better physical health, but few studies have examined the role that race plays in this connection. We explored whether positive self-evaluations were equally protective against upper respiratory infection for 271 African American adults and 700 European American adults in a series of virus-exposure studies. Participants were assessed at baseline for psychological functioning and physical health, quarantined and exposed experimentally to a respiratory virus, and then monitored for infection and symptoms. Regression analyses revealed significant interactions between race and multiple positive psychological factors; several factors that were helpful to European Americans were unhelpful or even harmful to African Americans. Building on past work showing cross-cultural variation in the health correlates of affect, this study provides evidence that the health benefits of positive psychological constructs may not be universal and points to the need to explore factors that underpin these observed differential patterns.

Help-Seeking Tendencies and Subjective Well-Being: A Cross-Cultural Comparison of the United States and Japan

Help-seeking is commonly conceived as an instrumental behavior that improves people’s subjective well-being. However, most findings supporting a positive association between help-seeking and subjective well-being are observed in independence-preferring countries. Drawing from research demonstrating that the pathways to subjective well-being are culturally divergent, we posit that help-seeking tendencies may be detrimental to subjective well-being for members in interdependence-preferring countries where norms for preserving relational harmony and face concerns are prevalent. This study tested the moderating role of country in the relationship between help-seeking tendencies and subjective well-being using data from 5,068 American and Japanese participants. Results revealed that although help-seeking tendencies were associated with greater life satisfaction, higher positive affect, and lower negative affect among Americans, help-seeking tendencies were associated with poorer life satisfaction and lower positive affect among Japanese. We discuss the importance of adopting culturally sensitive perspectives when examining antecedents of subjective well-being.

Couples' Anger Dynamics during Conflict: Interpersonal Anger Regulation, Relationship Satisfaction, and Intimate Partner Violence

We tested hypotheses about moment-to-moment interpersonal influences on anger during couples' conflict, and the association of those anger dynamics with relationship satisfaction and intimate partner violence (IPV). Displayed anger was coded from laboratory observations of cohabiting couples (N = 197); experienced anger was assessed via a video-recall procedure. Credible, but variable, associations were found in which a person's anger display at one moment was linked to change in the partner's anger display and experience in the next moment. Women's anger experience was more strongly influenced by men's anger displays in couples with higher levels of IPV and couples with lower levels of relationship satisfaction. The displayed anger of men who perpetrated higher levels of IPV was more strongly influenced by women's anger displays. Overall, when individuals displayed higher intensity anger, partners reacted with increasingly angry feelings but decreasingly angry displays. Results suggest that anger dynamics relate to dyadic processes and that dynamics relate to important relationship outcomes. Dyadic anger dynamics might prove a worthy intervention target.

Networks, cultures, and institutions: Toward a social immunology

This paper calls for increased attention to the ways in which immune function – including its behavioral aspects – are responsive to social contexts at multiple levels. Psychoneuroimmunology has demonstrated that the quantity and quality of social connections can affect immune responses, while newer research is finding that sickness temporarily affects these same social networks and that some aspects of culture can potentially “get under the skin” to affect inflammatory responses. Social immunology, the research framework proposed here, unifies these findings and also considers the effects of structural factors – that is, a society's economic, political, and environmental landscape – on exposure to pathogens and subsequent immune responses. As the COVID-19 pandemic has highlighted, a holistic understanding of the effects of social contexts on the patterning of morbidity and mortality is critically important. Social immunology provides such a framework and can highlight important risk factors related to impaired immune function.

Culture and Health: Recent Developments and Future Directions 1

Evidence of cultural differences in relationships and emotions has accumulated over the past few decades. As findings on cultural differences in psychological processes have accumulated, there has been growing interest in investigating whether they have implications for other phenomena such as health. Using scientific advances from the MIDUS and MIDJA studies, both publicly available, we examine links between culture and health. We first briefly review the accumulated evidence on cultural influences on health correlates of psychosocial factors. We then feature two recent developments - a more micro-level perspective on biological factors that may be involved in the culture and health linkage, and a more macro-level view of socioeconomic inequality, which also matters for health. Both perspectives inform the pathways through which health effects occur. Finally, we conclude our review by highlighting the changing historical contexts surrounding these cross-cultural investigations. Specifically, we draw attention to widening of economic inequality across cultures and the world-wide COVID-19 pandemic. These happenings bring notable implications for future research on health across cultural contexts.

Subjective age and inflammation risk in midlife adults: Findings from the Midlife in the United States (MIDUS) studies

Recent studies have suggested that subjective age—a subjective evaluation of one's own age—is a promising construct in gerontology that may contribute our understanding of risk for immune dysfunction. Nevertheless, studies documenting the association between subjective age and inflammatory biomarkers remain limited and provide mixed findings. In the present study, we revisited the relation between subjective age and systemic inflammation by utilizing a range of well-established inflammatory biomarkers (C-reactive protein, interleukin-6, fibrinogen, E-selectin, and intercellular adhesion molecule 1) through the collection of fasting blood samples before breakfast. In a large-scale dataset of midlife adults (N = 1800), we found some evidence that an older subjective age is associated with elevated inflammation when indexed by C-reactive protein and fibrinogen, as well as a composite inflammation score. However, these relations were not significant when health variables were controlled for, suggesting that the association between subjective age and systemic inflammation is fully accounted for by better health profiles among those with a younger subjective age. Additionally, the subjective age-inflammation association was influenced by slight variations in the analytic method, highlighting the importance of sensitivity analyses in this area.

•

Subjective age predicted a composite score comprising five inflammatory biomarkers.

•

Subjective age is linked with elevated C-reactive protein and fibrinogen.

•

Subjective age-systemic inflammation link is fully accounted by health profiles.

•

Subjective age predicted the composite score and fibrinogen after correcting for multiple comparisons.

•

Variation in analyses can influence subjective age-inflammation associations.

Specificity in Associations of Anger Frequency and Expression With Different Causes of Mortality Over 20 Years

OBJECTIVE

Although evidence has linked anger and hostility with all-cause mortality risk, less research has examined whether anger frequency and expression (outwardly expressing angry feelings) are linked to all-cause and cause-specific mortality.

METHODS

In 1996, men (n = 17,352) free of medical conditions from the Health Professionals Follow-Up Study reported anger frequency and aggressive expression levels. Deaths were ascertained from participants' families, postal authorities, and death registries. Cox proportional hazards regression models estimated hazard ratios (HRs) and 95% confidence intervals (CIs) of mortality risk until 2016 with a 2-year lag, adjusting for a range of relevant covariates.

RESULTS

There were 4881 deaths throughout follow-up. After adjustment for sociodemographics and health status, moderate and higher (versus lower) levels of anger frequency and aggressive expression were generally unrelated to the risk of death from all-cause, neurological, or respiratory diseases. However, cardiovascular mortality risk was greater with higher anger frequency (HR = 1.17, 95% CI = 1.01-1.34), whereas cancer mortality risk was greater with higher anger expression (HR = 1.14, 95% CI = 0.98-1.33). Results were similar after including all covariates and stronger when considering anger expression's interaction with frequency.

CONCLUSIONS

In this cohort of men, experiencing angry feelings and expressing them aggressively were related to an increased risk of dying from cardiovascular disease and cancer but not from other specific causes, over two decades. These results suggest that not only the experience of negative emotions but also how they are managed may be critical for some but not all health outcomes, highlighting the importance of considering causes of death separately when investigating psychosocial determinants of mortality.

Physical Aggression and Coronary Artery Calcification: A North Texas Healthy Heart Study

BACKGROUND

The purpose of this study was to determine the association between aspects of hostility and coronary artery calcification (CAC) scores. Specifically, analyses differentiated between subtypes of hostility and their relation to CAC.

METHODS

A sample of 571 patients aged 45 or older with no history of cardiovascular disease completed assessments of demographic, psychosocial, and medical history, along with a radiological CAC determination. Logistic regression was used to determine the association between hostility and CAC. Hostility was measured using the Aggression Questionnaire, which measured total aggression and how aggression is manifested on four scales: Physical, Verbal, Anger, and Hostility Aggression.

RESULTS

Regression analyses indicated that only the physical aggression parameter was related to CAC: a 5% increase in odds of CAC presence was indicated for every point increase in physical aggression. The association remained significant in adjusted analyses. Other factors associated with CAC in adjusted analyses included: age, gender, race/ethnicity, BMI, and dyslipidemia.

CONCLUSIONS

Psychosocial factors, such as physical aggression, are emerging factors that need to be considered in cardiovascular risk stratification.

Association Between Anger and Mortality in Women and Men: A Prospective Cohort Study in a Japanese Community

Background: Anger is a common problem in society, and anger's relationship with mortality, in particular with cardiovascular mortality, has been studied mainly in male western population. There are no prospective studies in Japan, about the association between anger and mortality. Materials and Methods: This study examined the association of anger with all-cause and cause-specific mortality in a Japanese community. Data came from the Takayama Study, which recruited residents aged ≥35 years in 1992 from Takayama City in Gifu, Japan. The current study used information on anger that was obtained from the second survey in 2002. A total of 11,902 healthy participants aged ≥45 years completed a self-administered questionnaire. Anger was assessed using the Spielberger Trait Anger Scale. Results: The main causes of deaths during the follow-up period from 2002 to 2013 were 460 for neoplasm, 254 for cardiovascular, and 435 for other causes. After adjusting for potential confounders, we found a significant positive association between the trait anger score and the risk of cardiovascular mortality for women, with a hazard ratio for high versus low score of trait anger of 1.81 (95% confidence interval 0.91-3.63, p for trend = 0.04), but not for men. Conclusions: Data suggest that for Japanese women, high trait anger score may be associated with an increased risk of cardiovascular mortality. Potential gender differences in the association between trait anger and mortality should be further studied from the cultural context.

The effectiveness of sensory integration intervention on the emotional-behavioral problems of children with autism spectrum disorder

Purpose

Autism spectrum disorder is a kind of neurodevelopmental disorder characterized by persistent deficits in social communication and interaction across multiple contexts, and restricted, repetitive patterns of behavior, interests or activities. The purpose of this paper is to determine the effectiveness of sensory integration intervention on emotional-behavioral problems in children with autism spectrum disorder.

Design/methodology/approach

This research was conducted in a pretest-posttest design with control group. The participants were 30 children with autism spectrum disorder (6–11 years old) who were selected through convenience sampling from among children with autism spectrum disorder in Zeinab center of Isfahan and were randomly divided into two groups of 15 subjects. The children of the experimental group received 14 sessions of sensory integration intervention while the control group did not receive this intervention. To measure emotional-behavioral problems, the Behavior Assessment System for Children-Second Edition was used. To analyze the data, ANCOVA and MANCOVA tests were used.

Findings

The results showed that sensory integration intervention improves emotional-behavioral problems and its subscales (hyperactivity, aggression, behavioral problems, anxiety, depression, somatization, attention problems, learning difficulties, atypicality and withdrawal) in children with autism spectrum disorder.

Research limitations/implications

Therefore, it can be concluded that sensory integration intervention can be a suitable treatment for reducing sensory problems and improving emotional-behavioral problems in children with autism spectrum disorder.

Originality/value

The study of the effect of sensory integration on emotional-behavioral problems in children with autism spectrum disorder is necessary as a simple and non-side-effect educational and therapeutic method, both as a step to fill the research gap in this field, besides being a cheap and affordable way for improving the various skills of children with autism spectrum disorder for professionals, teachers, parents and educators.

Paying the price for anger: Do women bear greater costs?

Prior research shows that the social costs of expressing anger may be greater for women than for men. However, less is known about whether anger expression is also associated with greater intrapersonal costs for women relative to men. We tested the hypothesis that outward anger expression would be related to greater depressive symptoms over time for women, but not men. A nationally representative sample of 942 community-dwelling adults reported on their frequency of anger expression and completed diagnostic interviews to assess depressive symptoms at baseline and 9-year follow-up. Moderation analyses using bootstrapping revealed a significant main effect of anger-out on depression. As predicted, gender moderated the effects of anger-out on depression, such that greater anger-out at baseline predicted greater depression in women 9 years later, even after controlling for baseline depression. Findings add to the literature by revealing the intrapersonal costs women may incur from anger expression.

Cultural and life style practices associated with low inflammatory physiology in Japanese adults

Japan is an exceptionally healthy East Asian country with extended longevity. In addition, the typical levels of several proinflammatory proteins, including both C-reactive protein (CRP) and interleukin-6 (IL-6), are often reported to be low when compared to American and European populations. This analysis determined if blood levels of CRP and IL-6 were associated with 4 cultural practices reflective of Japanese behavior and customs -- drinking tea, eating seafood, consuming vegetables, and partaking in relaxing baths regularly - among 382 adults living in Tokyo. Regression models controlled for demographic factors, adiposity (BMI), physical exercise, smoking, alcohol use, and chronic illness (e.g., diabetes). Consuming a Japanese diet was associated with significantly lower CRP and IL-6 levels. More frequent bathing was associated with lower IL-6, but not specifically predictive of low CRP. This study has confirmed prior evidence for low inflammatory activity in Japanese adults and its association with several behavioral practices common in Japan.

Race, Obesity, and Mental Health Among Older Adults in the United States: A Literature Review

Rising rates of obesity among older adults in the United States are a serious public health concern. While the physical health consequences of obesity are well documented, the mental health consequences are less understood. This is especially the case among older adults in general and among racial and ethnic minority older adults in particular. Available studies document a link between obesity and a variety of mental health disorders. However, findings from this body of evidence are inconsistent, especially when race and ethnicity are considered. This article examines research on obesity and mental health among older adults and identifies risk factors, causal mechanisms, and methodological approaches that help clarify the equivocal nature of the literature. Promising research and future directions include studies that consider a wide array of contextual factors and population heterogeneity.

Is Conscientiousness Always Associated With Better Health? A U.S.-Japan Cross-Cultural Examination of Biological Health Risk

In Western societies, conscientiousness is associated with better health. Here, we tested whether this pattern would extend to East Asian, collectivistic societies. In these societies, social obligation motivated by conscientiousness could be excessive and thus health-impairing. We tested this prediction using cross-cultural surveys of Americans (N = 1,054) and Japanese (N = 382). Biomarkers of inflammation (interleukin-6 and C-reactive protein) and cardiovascular malfunction (systolic blood pressure and total-to-HDL cholesterol ratio) were adopted to define biological health risk (BHR). Among Americans, conscientiousness was associated with lower BHR. Moreover, this relationship was mediated by healthy lifestyle. In contrast, among Japanese, the relationship between conscientiousness and BHR was not significant. Further analysis revealed, however, that conscientiousness was associated with a greater commitment to social obligation, which in turn predicted higher BHR. These findings suggest that conscientiousness may or may not be salubrious, depending on health implications of normatively sanctioned behaviors in varying cultures.

Feeling excited or taking a bath: Do distinct pathways underlie the positive affect-health link in the U.S. and Japan?

Feeling good is linked to better health in Western contexts. Recent studies show, however, that the affect-health link is not consistent across cultures. We suggest two reasons for such inconsistency. The first follows from research showing that North American (vs. East Asian) cultures tend to value high arousal positive (HAP) states, for example, excited, more than low arousal positive (LAP) states, for example, calm. The second is one we propose for the first time. Positive affective experience is manifest in internal feelings but also in affective practices, such as taking a bath (a highly valued affective experience in Japan) or a fitness workout (a highly valued affective experience in the United States). We hypothesized that the HAP feelings/practices-health link would be stronger in the United States versus Japan, and the LAP feelings/practices-health link would be stronger in Japan versus the United States. Using survey samples from the United States (N = 640) and Japan (N = 382), we examined how health outcomes are shaped by positive affective feelings and practices varying in arousal. In a first set of analyses, HAP feelings predicted better physical and biological health in the United States but not in Japan. No cultural differences were consistently found for the effect of LAP feelings on health. In addition, engaging in HAP practices predicted better physical and biological health in the United States whereas engaging in LAP practices predicted better physical health in Japan but not in the United States. These findings suggest that the pathways underlying the culture-health link are culturally variable. (PsycINFO Database Record (c) 2020 APA, all rights reserved).

Culture moderates the link between perceived obligation and biological health risk: Evidence of culturally distinct pathways for positive health outcomes

RATIONALE

Although perceived obligations to meet the expectations of family, friends, and society can be detrimental to physical health, much research in this area has thus far been conducted exclusively on Western samples. Cross-cultural research importantly suggests that positive health can be dependent on whether one engages in modes of being that are sanctioned by one's culture. Specifically, studies show that better health is predicted when people from cultures that value independence are able to exercise their personal autonomy and when people from cultures that value interdependence are able to maintain relational harmony (Kitayama et al., 2010).

OBJECTIVE

Based on these lines of research, as the fulfillment of perceived obligations can facilitate relational harmony but infringe on personal autonomy, we posit that culture will moderate the impact of perceived obligations on health outcomes. To gain further insight, we additionally examined people's goal disengagement tendency as an individual difference that may influence their likelihood of shunning perceived obligations in order to avoid associated stressors.

METHOD

Drawing from the parallel biomarker projects of Midlife in the United States and Midlife in Japan, we examined the interaction between perceived obligations and goal disengagement tendency on health among American and Japanese middle-aged adults. Health outcomes were indexed by biomarkers of inflammation (interleukin-6 and C-reactive protein levels) and cardiovascular risk (systolic blood pressure and total/high-density lipoprotein cholesterol).

RESULTS

We found that a higher tendency to disengage from stressful social obligations is associated with better health for Americans. In contrast, we found poorer health outcomes amongst Japanese participants who tend to disengage from their perceived obligations.

CONCLUSIONS

Our results highlight the importance of examining how perceived obligations influence physical health from a cultural perspective. The current study supports the hypothesis that culturally distinct pathways underlie health outcomes.

Prediction of Anger Expression of Individuals with Psychiatric Disorders using the Developed Computational Codes based on the Various Soft Computing Algorithms

Anger is defined as a psychobiological emotional state that consists of feelings varying in intensity from mild irritation or annoyance to intense fury and rage. Dysfunction in anger regulation is marker of most psychiatric disorders. The most important point about anger regulation by the individuals is how to express anger and control it. The purpose of the present study is to predict the anger expression from the anger experience in individuals with psychiatric disorder for assessment of how to express and control the anger. To this end, the number of 3,000 subjects of individuals with clinical disorders had filled in the State-Trait Anger Expression Inventory-II (STAXI-II). After removing the uncertain diagnoses (900 subjects), the number of 2,100 data was considered in the analysis. Then, the computational codes based on three soft computing algorithms, including Radial Basis Function (RBF), Adaptive Neuro-Fuzzy Inference System (ANFIS) and Decision Tree (DT) were developed to predict the scales of anger expression of the individuals with psychiatric disorders. The scales of anger experience were used as input data of the developed computational codes. Comparison between the results obtained from the DT, RBF and ANFIS algorithms show that all the developed soft computing algorithms forecast the anger expression scales with an acceptable accuracy. However, the accuracy of the DT algorithm is better than the other algorithms.

The nature of anger in people with multiple sclerosis: a qualitative study

Objective: People with multiple sclerosis (pwMS) who experience higher levels of anger also report poorer quality of life (QoL). This qualitative study explored the subjective experience of anger amongst pwMS, and how anger influenced their lives.Methods: A series of semi-structured, face-to-face interviews were conducted with 20 pwMS. Interviews were recorded, transcribed and then Interpretative Phenomenological Analysis was used to analyse the emerging themes.Results: The most common experience of anger was frustration that MS-related symptoms restricted participation in everyday activities. Also, some experiences of anger-with-self were focused on frustration at the inability to overcome symptom-related activity limitations. Participants reported frustration with others' insensitivity to the effects of the disease process, as well as usual daily irritations with family and colleagues. Some of the participants reported the use of coping strategies to deal with anger episodes.Conclusion: Many pwMS experience frustration at the restrictions that the disease places on them, self-directed anger, and irritation with others' attitude towards them. Much research in MS focuses on physical symptoms, but current results indicate that there is a need to better understand the emotional challenges faces by pwMS, and to provide more support for those who are experiencing frustration.

Perfectionism and Precompetition Emotions in Youth Footballers: A Three-Wave Longitudinal Test of the Mediating Role of Perfectionistic Cognitions

Perfectionism is related to precompetition emotions in athletes. However, it is unclear why this is the case. In the present study, the authors sought to determine whether perfectionistic cognitions explain this relationship and mediate the relationships between self-oriented perfectionism (SOP), socially prescribed perfectionism (SPP), and general precompetition emotions and multidimensional anxiety and anger. The authors adopted a three-wave longitudinal design and examined between- and within-person effects in a sample of 352 youth footballers (Mage = 14.03 years, SD = 2.30). At the between-person level, perfectionistic cognitions mediated the relationships between SOP, SPP, and all general precompetition emotions plus multidimensional anxiety and anger. At the within-person level, perfectionistic cognitions mediated the relationships between SOP, SPP, and general anxiety and anger plus multidimensional anxiety and anger. Our findings imply that athletes higher in SOP and SPP experience more anxiety and anger when the frequency of perfectionistic cognitions increases in the lead-up to competition.

A biocultural approach to psychiatric illnesses

RATIONALE

As a species, humans are vulnerable to numerous mental disorders, including depression and schizophrenia. This susceptibility may be due to the evolution of our large, complex brains, or perhaps because these illnesses counterintuitively confer some adaptive advantage. Additionally, cultural and biological factors may contribute to susceptibility and variation in mental illness experience and expression. Taking a holistic perspective could strengthen our understanding of these illnesses in diverse cultural contexts.

OBJECTIVES

This paper reviews some of these potential factors and contextualizes mental disorders within a biocultural framework.

RESULTS

There is growing evidence that suggests cultural norms may influence inflammation, neurotransmitters, and neurobiology, as well as the illness experience. Specific examples include variation in schizophrenia delusions between countries, differences in links between inflammation and emotion between the United States and Japan, and differences in brain activity between Caucasian and Asian participants indicating that cultural values may moderate cognitive processes related to social cognition and interoception.

CONCLUSIONS

Research agendas that are grounded in an appreciation of biocultural diversity as it relates to psychiatric illness represent key areas for truly interdisciplinary research that can result in culturally sensitive treatments and highlight possible biological variation affecting medical treatment.

Emotions in Social Relationships and Their Implications for Health and Disease: Introduction to the Special Issue of Psychosomatic Medicine

Social relationships and emotions are important to health and disease, but research in this area has largely progressed along parallel and distinct historical paths. These areas are critically linked because relationships are among the most powerful elicitors of health-relevant emotions and emotions can in turn influence relationships for better or worse. Conceptually, relationships and emotions can have mediational, reciprocal, and interactive influences on health outcomes, associations that seem dependent on the broader sociocultural context. The articles in this issue of Psychosomatic Medicine are based on a joint meeting of the American Psychosomatic Society and the Society for Affective Science titled "Emotions in social relationships: implications for health and disease." Recent research and conceptual models that fall at the interface of relationships, emotions, and health are highlighted in this special issue. Future work that capitalizes on these links will be critical if this area is to fulfill its potential in terms of new scientific insights and intervention opportunities.

Neuroticism polygenic risk score predicts 20-year burden of depressive symptoms for Whites but not Blacks

BACKGROUND

Black-White differences are reported in social, psychological, behavioral, medical, and biological correlates of depression. This study was conducted to compare Black and White older adults for the association between neuroticism polygenic risk score (N-PRS) and chronicity of depressive symptoms over 20 years.

METHODS

Data came from the Health and Retirement Study (HRS), 1990 - 2012, a nationally representative sample of Americans above age 50. Current analysis followed 9,249 individuals (7,924 Whites and 1,325 Blacks) for up to 22 years. Depressive symptoms were measured every two years between 1992 and 2012 using the 8-item Center for Epidemiological Studies-Depression Scale (CES-D-8). The independent variable was N-PRS. The dependent variable was average depressive symptoms between 1992 and 2012. Linear regression was used for data analysis.

RESULTS

In the pooled sample, higher N-PRS was associated with higher average depressive symptoms over the 20-year follow up period [b=0.01, 95%CI=0.00 to 0.04], net of all covariates. We also found an interaction between race and N-PRS [b=-0.02, 95%CI=-0.03 to 0.00], suggesting a stronger effect of N-PRS on 20-year average depressive symptoms for Whites than Blacks. Based on our race-specific linear regression models, higher N-PRS was associated with higher depressive symptoms from 1992 to 2012 for Whites [b=0.01, 95%CI=0.01 to 0.02] but not Blacks [b=0.00, 95%CI=-0.02 to 0.02].

CONCLUSION

Black and White older adults may differ in the salience of the existing N-PRS for depressive symptoms, which better reflects the burden of depression for Whites than Blacks. This may be because the existing PRSs are derived from mostly or exclusively White samples, limiting their applicability in other race groups. Racial variation in psychosocial, clinical, and biological correlates of depression needs further research.

Temperamental vulnerability to emotion dysregulation and risk for mental and physical health challenges

Emotion dysregulation characterizes many forms of psychopathology. Patterns of dysregulation occur as a function of a developmental process in which normative and adaptive emotion regulation skills fail to become part of the child's behavioral repertoire due to biological, psychological, and contextual processes and experiences. Here we highlight the processes involved in the dysregulation of temperamental anger and frustration that become core features of externalizing problems and place children at risk for more serious forms of psychopathology. We imbed these processes in a larger self-regulatory framework, and we discuss how they influence mental as well as physical health, using data from our 20-year longitudinal study following a large cohort of children into young adulthood. Recommendations are made for future research involving the integration of biological systems with mental and physical health outcomes.

Expression of anger in university students according to perceived quality of sleep

Objective

We analyzed the expression of anger according to the perceived quality of sleep in university students.

Methods

A total sample of 1252 students participated in the study, with an average age of 23.58 years. Using an ex-post facto design and an incidental sampling procedure, the Pittsburgh Sleep Quality Index and the State-Trait Anger Expression Inventory-2 were applied.

Results

Students with poor sleep quality (PSQI scores> 5) scored higher on the subscales of STAXI-2, showing higher risk of obtaining superior values in Trait Anxiety [OR=1.90] and in the Index of Expression of Anger [OR=1.56], but not in Internal Control of Anger.

Conclusions

There appears to be a marked relationship between quality of sleep and anger, and it is suggested that sleep hygiene programs can help to reduce the negative consequences of poor sleep quality in terms of health and academic performance in students.

Feeling bad is not always unhealthy: Culture moderates the link between negative affect and diurnal cortisol profiles

Prior research has demonstrated that the daily experience of negative affect is associated with increased levels of proinflammatory activity as evidenced by higher interleukin-6 among Americans but not among Japanese. This cultural difference may be driven by culturally divergent beliefs about negative affect as a source of threat to self-image versus as natural and integral to life. Here, we examined whether culture may moderate the relationship between negative affect and biological stress responses, with a focus on the hypothalamic-pituitary-adrenal (HPA) axis activity. By using culturally matched surveys of Americans (N = 761) and Japanese (N = 328), we found that negative affect was associated with a flattening of the diurnal cortisol slope among Americans after controlling for demographic variables, personality traits, sleep patterns, and health behaviors. In contrast, the association between negative affect and the HPA axis activity was negligible among Japanese. Moreover, we assessed biological health risk with biomarkers of both inflammation (interleukin-6 and C-reactive protein levels) and cardiovascular function (higher systolic blood pressure and total-to-HDL cholesterol ratio) and found that the relationship between negative affect and increased biological health risk, which was observed only among Americans, was mediated by the flattening of the diurnal cortisol rhythm. These findings suggest that cultural differences in how emotions are construed may make the experience of negative affect more or less stressful and differentially consequential for health. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Comparative Network Research in China

Using recent substantive results on China and the West, we highlight some virtues to Mill's method of residues for comparative network research. The result is research that combines the emic-etic approaches discussed by Leung (2009) with the spirit of Whetten's (2009: 49) efforts to make ‘theory borrowing more context sensitive’. We draw on recent comparative research about the competitive advantage enjoyed by network brokers, trust facilitated by embedding a relationship in a closed network, the subset of Chinese relations that constitute guanxi, the idea of American and European guanxi, different business environments maintained by the same network mechanism, cocoon networks, small-world networks, the longer history apparent in Chinese networks, and job search via colleagues, friends, and family. We also illustrate the value of data graphs for the expository value of the method of residuals in comparative network analyses.

No Evidence of "healthy neuroticism" in the Hawaii Personality and Health Cohort

BACKGROUND

Heterogeneity in the effects of trait neuroticism on mortality has inspired recent theories of "healthy neuroticism," or the possibility that neuroticism can lead people down either healthy or unhealthy behavioral pathways. The logical extension of this theory is that some construct-perhaps another trait, financial resource, or health-relevant situation-changes the relationship between neuroticism and health. The other possibility is that different components of neuroticism lead to different health behaviors and therefore different outcomes.

PURPOSE

The current study systematically examines the relationship between child and adult neuroticism and various health indicators including perceptions of health, behaviors, health outcomes, and biomarkers of health. Finally, we examine both potential moderators of the associations with neuroticism and examine its facet structure.

METHODS

The current study utilizes data from the Hawaii Longitudinal Study of Personality and Health, which includes both adult (IPIP-NEO) and childhood (teacher-reported) measures of personality and socioeconomic status, as well as a variety of health outcomes, from self-reported health and health behavior to biological markers, such as cholesterol and blood glucose levels. Sample sizes range from 299 to 518.

RESULTS

The relationship between neuroticism and health was not consistently moderated by any other variable, nor were facets of neuroticism differentially related to health.

CONCLUSIONS

Despite a systematic investigation of the potential "paths" which may differentiate the relationship of neuroticism to health, no evidence of healthy neuroticism was found.

Anger, hostility and risk of stroke: a meta-analysis of cohort studies

OBJECTIVE

A growing number of studies have been conducted on the relationship between anger and hostility and the risk of stroke, and their conclusions are not consistent. Accordingly, we performed a meta-analysis to evaluate the relationship between anger and hostility and the risk of stroke.

METHODS

We searched the PubMed and Embase databases for cohort studies, focusing on the relationship between anger and hostility and risk of stroke. Then studies were selected according to the inclusion and exclusion criteria. Study results were pooled using a random effects model.

RESULTS

Ten studies from seven articles involving 52,277 participants were included in this meta-analysis. No significant association was found between anger and hostility level and risk of stroke (hazard ratio 1.08; 95% confidence interval 0.79-1.47). However, a positive association was seen when people with high socioeconomic status were excluded (hazard ratio 1.30; 95% confidence interval 1.06-1.59).

CONCLUSION

A higher level of anger and hostility is not associated with elevated risk of stroke. However, the association is positive among people with lower socioeconomic status.

Baseline Body Mass Predicts Average Depressive Symptoms over the Next Two Decades for White but Not Black Older Adults

Background: Although obesity and depression have a bidirectional association, this link may vary based on race. The current study tested racial variation in bidirectional links between depressive symptoms and body mass index (BMI) over 24 years of follow-up in older adults over the age of 50 in the United States. We hypothesized weaker bidirectional links in Blacks compared to Whites. Methods: Data came from waves 1 to 12 (1990 to 2014) of the Health and Retirement Study (HRS), an ongoing state-of-the-art national cohort. The study followed a representative sample of Americans (n = 15,194; 2,200 Blacks and 12,994 Whites) over the age of 50. Dependent variables were average depressive symptoms and BMI over 24 years, based on measurements every other year, from 1990 to 2014. Independent variables included baseline depressive symptoms and BMI. Covariates included age, gender, marital status, veteran status, and activities of daily living. Structural equation models were fitted to the data for data analysis. Results: In the pooled sample, bidirectional associations were found between BMI and depressive symptoms as baseline BMI predicted average depressive symptoms over time and baseline depressive symptoms predicted average BMI over 24 years. Racial differences were found in the bidirectional association between BMI and depressive symptoms, with both directions of the associations being absent for Blacks. For Whites, baseline BMI predicted average depressive symptoms over the next 24 years. Conclusion: Reciprocal associations between BMI and depressive symptoms over a 24-year period among individuals over the age of 50 vary for Blacks and Whites. As these associations are stronger for Whites than Blacks, clinical and public health programs that simultaneously target comorbid obesity and depression may be more appropriate for Whites than Blacks.

Negative Reflections About Positive Psychology: On Constraining the Field to a Focus on Happiness and Personal Achievement

“Positive” psychology has gained a dominant voice within and outside the field of psychology. Although critiques of this perspective have been rendered, including by humanistic psychologists, psychology scholars have offered minimum space for critical reflections of this movement in contrast to its critiques existing inside and outside the academia in other fields. Therefore, this contribution seeks to explicate emerging systematic critiques of positive psychology by scholars and practitioners from within mental health fields as well as from philosophy, medicine, education, business, and cultural studies and to highlight sociocultural discussions of positive movement by the culture critics. Last, we offer reflections on positive psychology as immigrant professionals from non-Western backgrounds with an emphasis on existential and humanities-based perspectives. We also highlight that the tenets and experiments based on “positive” psychological practices may have especially detrimental effect on marginalized individuals and communities. This contribution seeks to invite a critical dialogue in the field regarding positive psychology within and outside humanistic psychology and psychology in general.

When anger expression might be beneficial for African Americans: The moderating role of chronic discrimination

OBJECTIVES

Anger expression is assumed to have mostly negative health effects. Yet, evidence is mixed on how anger expression influences African Americans' cardiovascular health. The present research aimed to clarify this link by examining moderating effects of chronic discrimination on the relationship between anger expression and cardiovascular risk among African Americans in experimental (Study 1) and epidemiological (Study 2) studies.

METHOD

Study 1 examined how African Americans' trait anger expression was linked to (a) physiologic reactivity to acute social rejection during an interracial encounter (Session 1); and (b) total/HDL cholesterol assessed two months later (Session 2). Study 2 examined the relationship between anger expression and total/HDL cholesterol with a larger sample of African Americans from the Midlife in the United States (MIDUS) survey. Both studies examined perceptions of chronic discrimination as a moderator of the relationships between anger expression and biological responses.

RESULTS

In Study 1 higher anger expression was associated with quicker cortisol recovery and greater testosterone reactivity following outgroup social rejection in Session 1 and lower total/HDL cholesterol in Session 2. Study 2 replicated the relationship between anger expression and lower total/HDL cholesterol and further showed that this relationship was unique to the expressive aspect of anger. Importantly, in both studies, these potentially beneficial effects of anger expression were only evident among individuals with lower perceptions of chronic discrimination.

CONCLUSIONS

These findings suggest that anger expression, when coupled with low levels of chronic discrimination, is associated with adaptive patterns of physiologic responses among African Americans. (PsycINFO Database Record

Behavioral Adjustment Moderates the Link Between Neuroticism and Biological Health Risk: A U.S.-Japan Comparison Study

Neuroticism, a broad personality trait linked to negative emotions, is consistently linked to ill health when self-report is used to assess health. However, when health risk is assessed with biomarkers, the evidence is inconsistent. Here, we tested the hypothesis that the association between neuroticism and biological health risk is moderated by behavioral adjustment, a propensity to flexibly adjust behaviors to environmental contingencies. Using a U.S.-Japan cross-cultural survey, we found that neuroticism was linked to lower biological health risk for those who are high, but not low, in behavioral adjustment. Importantly, Japanese were higher in behavioral adjustment than European Americans, and as predicted by this cultural difference, neuroticism was linked to lower biological health risk for Japanese but not for European Americans. Finally, consistent with prior evidence, neuroticism was associated with worse self-reported health regardless of behavioral adjustment or culture. Discussion focused on the significance of identifying sociocultural correlates of biological health.

Leaders in Interdependent Contexts Suppress Nonverbal Assertiveness: A Multilevel Analysis of Japanese University Club Leaders' and Members' Rank Signaling

Previous research has shown that leadership is signaled through nonverbal assertiveness. However, those studies have been mostly conducted in individualistic cultural contexts, such as in the U.S. Here, we suggest that one important strategy for goal attainment in collectivistic cultures is for leaders to self-regulate their behaviors. Thus, contrary to the previous evidence from individualistic cultural contexts, in collectivistic cultural contexts, leaders might suppress nonverbal assertiveness. To test this possibility, we assessed nonverbal behaviors (NVB) of Japanese leaders and members, and how they were evaluated by observers. We recruited Japanese leaders and members of university clubs and video-recorded them while introducing their club. Then, we coded their nonverbal rank signaling behavior. Finally, we asked a new set of naïve observers to watch these video-clips and to judge targets' suitability for being possible club leaders. Results of a multilevel analysis (level 1: individual participants, level 2: clubs) suggested that the more the club culture focused on tasks (rather than relationships), the more likely were leaders (but not members) of those clubs to suppress their nonverbal assertiveness. Naïve observers judged individuals who restrained from emitting nonverbal assertiveness as being more suitable and worthy club leaders. Thus, our findings demonstrate the cultural fit between contextual effects at the collective level (i.e., cultural orientation of a group) and the signaling and perceiving of social ranks at the individual level (i.e., suppression of nonverbal assertiveness). We discuss the importance of studying the cultural fit between the collective reality that people inhabit and people's psychology for future research in cultural psychology.