Positive Affect Is Inversely Associated with Mortality in Individuals without Depression

Optimism and longevity beyond age 85

BACKGROUND

Optimism is associated with health benefits and improved survival among adults aged >65. Whether or not optimism beyond age 85 continues to confer survival benefits is poorly documented. We examine the hypothesis that being optimistic at ages 85 and 90 is associated with improved survival.

METHODS

The Jerusalem Longitudinal Study (1990-2020) assessed comorbidity, depression, cognition, social and functional status, and 5-year mortality among a representative community sample, born 1920-1921, at age 85 (n=1096) and age 90 (n=533). Overall optimism (Op-Total) was measured using a validated 7-item score from the Scale of Subjective Wellbeing for Older Persons. The four questions concerning positive future expectations (Op-Future) and three questions concerning positive experiences (Op-Happy) were also analyzed separately. We determined unadjusted mortality Hazards Ratios, and also adjusted for gender, financial difficulty, marital status, educational status, ADL dependence, physical activity, diabetes mellitus, hypertension, ischemic heart disease, cognitive impairment and depression.

RESULTS

Between ages 85-90 and 90-95 years, 33.2% (364/1096) and 44.3% (236/533) people died respectively. All mean optimism scores declined from age 85 to 90, with males significantly more optimistic than females throughout. All measures of optimism (Op-Total, Op-Future, Op-Happy) at age 85 and 90 were significantly associated with improved 5-year survival from age 85-90 and 90-95 respectively, in both unadjusted and adjusted models. Findings remained unchanged after separately excluding depressed subjects, cognitively impaired subjects, and subjects dying within 6 months from baseline.

CONCLUSIONS

These finding support the hypothesis that being optimistic continues to confer a survival benefit irrespective of advancing age.

A cross-sectional association of physical fitness with positive and negative affect in children and adolescents: the up & down study

BACKGROUND

Affect and physical fitness play an important role in psychological and physical health; however, the association between those variables in youth remains unknown. The aim of the present study was to examine the influence of physical fitness on positive and negative affect in Spanish children and adolescents.

METHOD

Healthy young Spanish people (n = 1,490) were recruited for the present study: 542 children (n = 272 girls; mean age 9.6 years) and 948 adolescents (n = 454 girls; mean age 14.1 years) with complete baseline data on health-related fitness tests (20 m shuttle run test, 4 × 10 m test, muscular fitness index, and physical fitness index), and positive and negative affect (Positive and Negative Affect Schedule).

RESULTS

Higher performance on physical fitness components was associated with positive affect (β = -0.176-0.118, all P < 0.05). There was no association between all physical fitness components and negative affect (β = -0.100-0.15, all P > 0.05). There were differences on positive affect between the lowest and the highest quartile of the physical fitness index in boys (P = 0.037, Cohen's d 0.60) and girls (P = 0.004, Cohen's d = 0.69), and between the lowest and the highest quartile of muscular fitness index in girls (P < 0.001, Cohen's d = 0.76).

CONCLUSIONS

Promoting physical activity during the school years, including strength exercises to increase muscular fitness, could improve positive affect levels and thus psychological health.

Positive affect and peripheral inflammatory markers among adults: A narrative review

BACKGROUND

Previous research suggests that positive affect (PA) may promote health and longevity and that one potential mechanism involves inflammation. However, it remains unclear to what extent PA is associated with specific inflammatory markers and whether such associations are driven by main effects of PA and/or due to PA operating as a stress-buffer.

METHODS

The present narrative review incorporates studies (N = 28) that have examined the association between PA and peripheral inflammatory markers obtained using venous puncture or dried blood spots. We separate results by whether the study tested direct effects or stress-buffering, and by type of inflammatory marker [including C-reactive protein (CRP), and proinflammatory and anti-inflammatory cytokines], also paying close attention to type of PA assessment (state, aggregated state, or retrospective, the latter involving recall over one to two weeks), and study design (cross-sectional, longitudinal, and experimental).

RESULTS

Limited evidence suggests that studies were more supportive of a stress-buffering association, compared to a relatively direct association. When significant direct associations were observed, results suggested that studies using measures of state/aggregated PA exhibited more consistent associations with inflammatory markers than studies using retrospective PA. When significant, higher PA tended to be associated with lower pro- and anti-inflammatory markers, suggestive of lower overall inflammatory load.

DISCUSSION

Recommendations for the field and future research are discussed, including the value of utilizing state/aggregated PA measures and of examining stress-buffering mechanisms.

Healthier and Happier? A 3-Year Longitudinal Investigation of the Prospective Associations and Concurrent Changes in Health and Experiential Well-Being

Global well-being is positively correlated with health. Moreover, studies suggest that health and global well-being predict changes in one another across time. Fewer studies, however, have examined the extent to which health is associated with daily emotional experiences-especially longitudinally. The present study examined the longitudinal associations between health and both global and experiential well-being, assessed 4 times across 3 years. Moreover, we used advanced analyses-random-intercept cross-lag models-which address limitations of traditional cross-lag models. Results revealed health and well-being generally did not prospectively predict changes in one another across 1 year. In contrast, year-to-year changes in health were correlated with simultaneous changes in well-being-with effect sizes being largest for global well-being. These findings suggest that health and well-being change together in processes that unfold relatively quickly. Finally, using traditional cross-lag models, numerous potentially illusory prospective associations between health and well-being emerged, underscoring the importance of using appropriate longitudinal statistical models.

Happiness and Health

Research into the relationship between happiness and health is developing rapidly, exploring the possibility that impaired happiness is not only a consequence of ill-health but also a potential contributor to disease risk. Happiness encompasses several constructs, including affective well-being (feelings of joy and pleasure), eudaimonic well-being (sense of meaning and purpose in life), and evaluative well-being (life satisfaction). Happiness is generally associated with reduced mortality in prospective observational studies, albeit with several discrepant results. Confounding and reverse causation are major concerns. Associations with morbidity and disease prognosis have also been identified for a limited range of health conditions. The mechanisms potentially linking happiness with health include lifestyle factors, such as physical activity and dietary choice, and biological processes, involving neuroendocrine, inflammatory, and metabolic pathways. Interventions have yet to demonstrate substantial, sustained improvements in subjective well-being or direct impact on physical health outcomes. Nevertheless, this field shows great potential, with the promise of establishing a favorable effect on population health.

Mediterranean diet and wellbeing: evidence from a nationwide survey

OBJECTIVE

Although there is some evidence of the association between specific food groups, such as plant foods, and subjective wellbeing, this is the first study to assess the relationship between adherence to the Mediterranean dietary pattern and subjective wellbeing.

DESIGN

Data were collected in 2014-2015, within the Edad con Salud project, a follow-up study of a multistage clustered survey on a representative sample of the population of Spain. The final sample comprised 2397 individuals with ages ranging from 21 to 101 years.

MAIN OUTCOME MEASURES

Experienced wellbeing (positive and negative affect) was measured using the Day Reconstruction Method, and evaluative wellbeing was assessed with the Cantril Self-Anchoring Striving Scale.

RESULTS

A higher adherence to the Mediterranean diet showed a small but statistically significant inverse relationship with negative affect (β = -0.076, p=.001), and direct with evaluative wellbeing (β = 0.053, p=.015), whereas it was not related to positive affect. Several components of the Mediterranean diet were independently associated with wellbeing.

CONCLUSION

The results suggest that adherence to a dietary pattern such as the Mediterranean diet, and not only the isolated consumption of its components, is associated with a better subjective wellbeing.

Psychometric Properties of the Perceived Stress Questionnaire (PSQ) in 15-16 Years Old Norwegian Adolescents

A better understanding about prerequisites of health and well-being in adolescents is important to prevent chronicity and comorbidities of stress and to improve health promotion in this group. For this purpose, useful instruments are required. The Perceived Stress Questionnaire (PSQ) is developed for research, with an emphasis on predictive validity. The PSQ comprises different components of stress, and the instrument might be useful in studying prerequisites and predictors of health and well-being in adolescents. However, the instrument has not been evaluated in Norwegian psychosomatic populations and in adolescents. Moreover, the factor structure of the PSQ seems to vary between populations, and invariance across gender and concurrent validity regarding mindfulness are not previously tested. The objective of this study were to evaluate the psychometric properties of the Norwegian version of the PSQ in adolescents, including evaluate the fit of previously proposed PSQ-models in females and males and test measurement invariance across gender. Concurrent validity with respect to mindfulness (Mindful Attention Awareness Scale- Adolescent [MAAS-A]) was preliminary evaluated. Confirmatory factor analysis for each previously proposed model was conducted, separately for females and males. Multi-group factor analyses were performed to test measurement invariance of the different PSQ-models across gender. The associations between the PSQ and the MAAS-A and inter-scale correlations were preliminary evaluated. Preceding the data collection and main analyses, the instruments were translated to Norwegian following standardized procedures. The participants in study were Norwegian adolescents aged 15-16 years (N = 524). The overall PSQ performance seemed to correspond to previous findings, and internal consistency was supported across gender. A four-factor model of the PSQ showed best fit to the data in both females and males and configural and metric invariance seemed supported. Full scalar invariance was not supported for the four-factor model, implying that cross-group comparisons (between females and males) on latent means may be uncertain and must be interpreted with caution. Concurrent validity with respect to mindfulness (MAAS-A) was preliminary supported. Further studies might be needed to confirm the findings from this study.

Resonance and dissonance asymmetry in effective physician-patient relationships

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

Association of experienced and evaluative well-being with health in nine countries with different income levels: a cross-sectional study

BACKGROUND

It is important to know whether the relationships between experienced and evaluative well-being and health are consistent across countries with different income levels. This would allow to confirm whether the evidence found in high income countries is the same as in low- and middle-income countries and to suggest policy recommendations that are generalisable across countries. We assessed the association of well-being with health status; analysed the differential relationship that positive affect, negative affect, and evaluative well-being have with health status; and examined whether these relationships are similar across countries.

METHODS

In this cross-sectional study, interviews were conducted amongst 53,269 adults from nine countries in Africa, Asia, Europe, and Latin America. Evaluative well-being was measured with a short version of the World Health Organization (WHO) Quality of Life instrument, and experienced well-being was measured with the Day Reconstruction Method. Decrements in health were assessed with the 12-item version of WHO Disability Assessment Schedule 2.0. Block-wise linear regression and structural equation models were employed.

RESULTS

Considering the overall sample, evaluative well-being was more strongly associated with health (β = -0.35) than experienced well-being (β = -0.14), and negative affect was more strongly associated with health (β = 0.10) than positive affect (β = -0.02). The relationship between health and well-being was similar across countries. Lower scores in evaluative well-being and a higher age were the factors more strongly related with a worse health.

CONCLUSIONS

The different patterns observed across countries may be related to differences in the countries' gross domestic product, social protection system, economic situation, health care provision, lifestyle behaviours, or living conditions. The fact that evaluative well-being is more predictive of health than experienced well-being suggests that our level of satisfaction with our lives might be more important for our health than the actual emotions than we experience in our day-to-day lives and points out the need of interventions that improve the way people evaluate their lives.