Happiness matters: Positive emotions in health and disease

Transcription

1 THE FIRST WORLD CONGRESS ON POSITIVE PSYCHOLOGY These slides are for the personal learning of IPPA members. Please do not use them for any other purpose unless you obtain the express, written consent of the presenter(s). If you decide to use in your own work any of the ideas from these slides, please be sure to include a proper citation. Intellectual Property Notice

2 Happiness matters: Positive emotions in health and disease Sheldon Cohen Department of Psychology Carnegie Mellon University

3 What is Positive Affect? feelings that reflect a level of pleasurable engagement with the environment (Clark, Watson & Leeka, 1989) Such as: happiness, joy, enthusiasm, excitement, contentment

4 What is the Relation between TRAIT PA (PES) and Health? Mortality Less in Community Residing Elderly More in Institutionalized Elderly Morbidity Less Cardiovascular Disease Less Hospitalization Survival (no support) Fewer Symptoms and Less Pain Pressman & Cohen, 2007

5 What are the unanswered questions?

6 1. Are PA and NA independent? Independent or opposite sides of the same continuum? (Bradburn, 1969; Diener & Emmons, 1985; Watson, Clark, & Tellegen, 1988) DEPENDS (Diener & Emmons, 1985; Diener, Larsen, Levine, & Emmons, 1985; Watson, 1988b): Greater length of time Independent

7 2. Is it the valence or activation that matters? Circumplex Model Russell, 1980 Activated tense, angry Happy, excited NA PA Bored, depressed Calm, relaxed Unactivated

8 3. Is Activated PA a measure of perceived health? Activated emotions such as vitality Energetic Full of Pep Vigorous Lively

9 4. Is it PA or just something closely related to PA? Concepts closely related to PA Extraversion Mastery Purpose Self-esteem Optimism

10 5. How could PA influence health?

11 Pressman & Cohen, Psychological Bulletin, 2005 Positive Affect Endogenous Opioids ANS & HPA Activity Social Ties Health Practices Immune & Cardiovascular Systems Disease

12 Pressman & Cohen, Psychological Bulletin, 2005 Positive Affect Stress Endogenous Opioids ANS & HPA Activity Health Practices Immune & Cardiovascular Systems Disease

13 Pressman & Cohen, Psychological Bulletin, 2005 Positive Affect Stress Social, Psychological, & Physical Resources Endogenous Opioids ANS & HPA Activity Health Practices Immune & Cardiovascular Systems Disease

14 What should a study look like? Prospective Assesses both Negative and Positive affect PA spans unactivated activated dimension of affect

15 Controls for cognitive and social measures that correlate with PA (e.g., extraversion, optimism, mastery) Controls for self-reported health Test for mediating pathways: health behaviors, biological pathways

16 Some evidence from our lab I. Colds II. Symptom Reporting III. Longevity

17 I. COLDS

18 Pittsburgh Common Cold Study II N=334 3 Years 2 Viruses VIRUS 7 Evening Interviews 6 Day Quarantine Positive & Negative Emotional Style Clinical Colds

19 Primary Trial Outcome Shed Virus or Ab Increase + Increase in mucus weight or nasal clearance time

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23 Positive Affect Full-of-pep Lively Energetic Happy At ease Calm Cheerful Relaxed Pleased Alphas (7 days)

24 Negative Affect Sad Depressed Unhappy On-edge Tense Hostile Resentful Angry Nervous Alphas (7 days)

25 Controls (3 rd -spurious factors) Age Sex Race Body Mass Season Education Antibody Level Virus

26 Is PA associated with susceptibility to colds?

27 Cohen et al. Psychosomatic Medicine, 2003 Positive Emotional Style (by Interviews) Low (N=112) Middle (N=111) High (N=111) % Colds Low Middle High

28 There may be more of a relationship between Sneezy and Happy than previously thought. A medical study has found that happy folks are less likely to catch colds. National Post, Wednesday, July 23, 2003

29 Is NA associated with susceptibility to colds?

30 Negative Emotional Style (by Interviews) % Colds Low (N=110) Middle (N=111) High (N=113) 5 0 Low Middle High

31 Driven by a single component of PA? Vigor Well-being Calm (lively, full-of-pep, energetic) (happy, pleased, cheerful) (at ease, calm, relaxed) ALL PREDICT

32 Does PA buffer NA? NO

33 Epi, Norepi & Cortisol + Emotional Style Cytokines Susceptibility to Infection Health Practices

34 + Emotions and Pathways to Health Regulation of Cytokines Better Sleep Quality Positive Emotional Style Better Sleep Efficiency More Dietary Zinc More Exercise Lower Cortisol Lower Norepinephrine Lower Epinephrine

35 Epi, Norepi & Cortisol + Emotional Style Cytokines Susceptibility to Infection Health Practices

36 Virus, you re insulting me In retaliation, I ve released the cytokines! V I R U S stimulate vagus nerve IL-1 Inflammation adhesion TNF activate PMNs IL-6 temperature regulation chemotaxis IL-8 Endothelial Cell

37 Daily Adjusted IL6 by PES Level [Infected Ss Only] Adjusted IL-6 (log-10) Low PES Mid PES High PES Study Day Doyle, Cohen & Gentile, Brain, Behavior and Immunity, 2006

38 If only you were happy.

39 Is it a reliable (replicable) effect?

40 PMBC Cold Study 4 Years N=193 2 Viruses (Flu & RV) VIRUS 14 interviews 6 Day Quarantine Positive & Negative Emotional Style Sign/Symptom Severity

41 Standard Controls and NA But also included controls for: Potential Cognitive and Social confounders Self-reported Health

42 40% Cohen et al. Psychosomatic Medicine, 2006 % Colds (Adj. for Controls) 35% 30% 25% 20% Low Middle Positive Emotional Style High

43 40% Cohen et al. Psychosomatic Medicine, 2006 % Colds (Adj. for Controls) 35% 30% 25% 20% Low Middle Negative Emotional Style High

44 Driven by a single component of PA? Vigor Well-being Calm (lively, full-of-pep, energetic) (happy, pleased, cheerful) (at ease, calm, relaxed) Only Activated Emotions (Vigor & Well-Being) Predict

45 Is PA-cold Association Independent of Self-rated Health? In general, would you say your health is: Excellent Very Good Good Fair Poor From SF-36: Ware & Kosinski (2001) PES predicts colds independent of S-R health question!

46 Is the PA-Cold Association Independent of Related Traits?

47 Associations between PA and Colds are INDEPENDENT of Trait Negative Affect Self-esteem (Rosenberg) Extraversion (Goldberg Big 5) Optimism (LOT) Purpose (LET) Mastery(Pearlin)

48 COLDS Summary Those high in PES are less susceptible to colds. Independent of NES social & cognitive variables self-reported health Activated PA May Be Key

49 II. SYMPTOMS I m not as sick as I look!

50 Is PA Associated with Unfound Symptoms? Unfound Symptoms= Symptom reports that exceed what one would predict from objective signs of illness (mucus weights and mucuciliary clearance)

51 Pittsburgh Common Cold Study II N=334 3 Years 2 Viruses VIRUS 7 Evening Interviews 6 Day Quarantine Positive & Negative Emotional Style Infection Signs of Illness Symptoms

52 Covariates in Regression Standard Controls (age, sex, race, BMI, virus, season, education, Ab) Mucus Weights Mucuciliary Clearance

53 Cohen, at al. Psychosomatic Medicine 2003

54 NA and PA effects overlap

55 A Replication: PMBC Cold Study 4 Years N=195 2 Viruses VIRUS 14 interviews 6 Day Quarantine Positive & Negative Emotional Style Sign/Symptom Severity Among Infected

56 Unfounded Symptoms Score Low Middle Positive Emotional Style High

57 These association are independent of Standard Controls NA (PA wipes out NA) Mastery Control Optimism Self-esteem Self-reported Health

58 Symptoms Summary Higher PES is associated with reporting fewer symptoms than one would expect. stronger than the NES-symptom association. independent of social and cognitive variables. activation doesn t matter.

59 III. LONGEVITY Emotional Word Use in Autobiographies & Longevity Sheldon s Autobiography

60 Danner, Snowden, & Friesen, JPSP, Nun Study 180 Catholic Nuns wrote autobiographies at mean age of 22. Followed for mortality for 6 decades. Biographies were coded for # positive emotion words, # sentences using positive emotion words # different positive emotion words

61 3.5 Relative Risk of Mortality (low) (High) Positive Emotion Words Danner, Snowden, & Friesen, JPSP, 2001.

62 4.5 Relative Risk of Mortality (low) (High) Different Positive Emotions Danner, Snowden, & Friesen, JPSP, 2001.

63 Nun Study Negative emotion words and sentences were not associated with mortality

64 Longevity of Famous (DEAD) Psychologists 96- psychologists included in series: A History of Psychology in Autobiography Average age ~65 when autobio written Computerized text counts of positive and negative emotion words Pressman & Cohen, under review

65 New Questions Include What types of PA matter (circumplex approach)? Is the association independent of author s health and health history? Is the association independent of potential social and cognitive confounds?

66 Examples of Psychologists Allport Boring Broadbent Cattell Eysenck Guilford Hebb Helson Hilgard Murray Newcomb Osgood Simon Skinner Terman Tolman

67 Circumplex Emotions (examples) Positive Activated active lively energetic Positive Unactivated calm contented relaxed Negative Activated tense uneasy distressed Negative Unactivated tired sleepy passive

68 COVARIATES Demographic Controls Date of birth Sex Age at autobio writing Native language Health and Health History Control (Self references to illness terms, e.g., sick, ill, blood pressure, cancer, heart disease, stroke)

69 The association between high and low usage of affect words with longevity in psychologists Low High 80 Years Lived Activated PA Activated NA Unactivated NA Unactivated PA

70 Which Quadrant is Most Important? Activated PA* Activated NA Activated PA* Activated NA Unactivated PA Unactivated NA

71 Additional Controls Based on WORD COUNTS Cognitive Factors Optimism (optimism, hope, win) Control/Certainty (certain, control, definite) Self-Assuredness (proud, strong, fearless) Social factors Use of we and they Use of social roles (spouse, friend, relatives, group members, etc.)

72 Activated PA Longevity is Independent of ALL THE COGNITIVE AND SOCIAL FACTORS

73 LONGEVITY Summary Use of activated positive affective terms is associated with living longer. independent of the use of negative terms social and cognitive variables

74 TALK SUMMARY (for multiple choice test) There is promising evidence linking Trait PA to: morbidity mortality symptoms, and pain PA may be more important then NA in predicting health.

75 Activated PA is more important in predicting objective outcomes but not symptom reporting. More sophisticated studies are needed to establish these relationships to clarify the types of PA that matter to distinguish between effects of PA and other related variables to determine how PA could influence health

76 THE END And I seem to find the happiness I seek, when we re out dancing cheek to cheek Irving Berlin

77 Positive Affect and Antibody Response 0.3 Positive Affect Scores Low Ab High Ab Marsland, Cohen et al. Brain, Behavior & Immunity, in press.

78 Is PA associated with resting cortisol? Cortisol (Log mg/mol Low PA Medium PA High PA 1 Hour 4 Hours 9 Hours 11 Hours Time after wake-up Pressman, Cohen et al. Unpublished manuscript