The Positive Side

Question 1

Positive psychology

Answer 1

Are negative thoughts and emotions the only things that matter for health?
Growing interest in positive side of human experience and links with health and well-being

Question 2

Different “flavors” of well-being

Answer 2

Eudaimonic well-being (Aristotle): 
Realization of personal potential
Operationalized as:
-Purpose in life
-Self-acceptance 
-Positive relations with others
-Environmental  mastery
-Autonomy
-Personal growth
Marty Selig calls this the meaningful life

Hedonic well-being (Epicurus):
Experiences of happiness and satisfaction
Operationalized as:
Positive affect (PA)
Life satisfaction
Absence of negative affect
Marty Selig calls this the happy/pleasureful life
-it’s easier to feel happy than to feel like your life has meaning and purpose every day

Question 3

What good are positive emotions?

Answer 3

Negative emotions narrow the scope of people’s actions and thinking, supporting their ability to respond appropriately to threat - focused on the immediate threat and ready to respond to it
Positive emotions expand people’s mindsets, which builds cognitive, emotional, and social resources
-“Broaden and build” theory (Fredrickson)
-a way to open up the thought-action repertoire (scope of thought and action)

Question 4

“Broaden and build” theory

Answer 4

Intellectual Resources
Physical Resources
Psychological Resources
Social Resources

-this is what positive affect does: enhances intellectual, physical, social and psychological resources

Question 5

Intellectual Resources

Answer 5

develop problem-solving skills

learn new info

Question 6

Physical Resources

Answer 6

develop coordination

develop strength and cardiovascular health

Question 7

Psychological Resources

Answer 7

develop resilience and optimism

develop sense of identity and goal orientation

Question 8

Social Resources

Answer 8

solidify bonds

make new bonds

Question 9

Effects on physical health?

Answer 9

Growing evidence for beneficial effect of positive affect (PA) on physical health (Pressman and Cohen, 2005)
PA predicts:
-Lower risk of mortality among people with HIV (Moskowitz, 2003)
-Lower risk of mortality among people with diabetes (Moskowitz et al., 2008)

Question 10

PA predicts:

Answer 10

• Lower risk of mortality among people with HIV (Moskowitz, 2003)
• Lower risk of mortality among people with diabetes (Moskowitz et al., 2008)
• Lower risk of mortality among Catholic nuns (Danner et al., 2001)
• Lower risk of mortality among older individuals (Steptoe & Wardle, 2011)
• dushian smile in HS yearbook predicts higher life satisfaction

Question 11

Lower risk of mortality among Catholic nuns (Danner et al., 2001)

Answer 11

• autobiographical essays written by young catholic nuns and they knew when they died so scored the essays for positive affect
• Positive emotional content in autobiographical essays written by young Catholic nuns linked to longer life 6 decades later - the nuns that expressed more positive affect lived longer

Question 12

Lower risk of mortality among older individuals (Steptoe & Wardle, 2011)

Answer 12

Positive affect assessed over one day associated with lower mortality in 3,853 older men and women followed for 5 years
Effects significant controlling for negative affect, SES, health behaviors
higher PA predicted lower mortality 5 years later

problem: the reason they’re less happy may be because they are less healthy and that may be the reason for the mortality - because they are older participants

Question 13

Positive affect and heart disease

Answer 13

Expression of positive emotions in structured interviews associated with lower rate of coronary heart disease over 10 year follow-up

as PA score increase, less likely to develop coronary heart disease

not a self-report of happiness (based on positive interaction with someone)

Question 14

Positive affect and colds

Answer 14

Sheldon Cohen
Positive Affect (subjective): lower likelihood of developing a cold
Negative Affect (subjective): higher likelihood of developing a cold

Objective negative affect doesn’t predict whether someone gets a cold but objective positive affect does
- this suggests that it is positive affect are more powerful in predicting whether or not you get a cold

Question 15

What about the “Y?” Positive affect and physiology

Answer 15

Positive affect generally associated with:
lower cortisol
lower levels of inflammation

Question 16

Positive affect generally associated with: lower cortisol

Answer 16

Steptoe A et al

• Positive affect assessed over one day associated with lower cortisol in 2,873 healthy men and women
• Participants rated how “happy”, “excited”, and “content” they felt 4x/day (assessed in one day)
• Solid bar shows association after adjustment for depression
• Stress-buffering effect - you’re less responsive when negative things happen (it has less of an influence on you)

Bostock et al (2011)

• Positive affect assessed daily over 7-day period associated with reduced cortisol response to stress
• Low PA higher cortisol response
• High PA almost no cortisol response
• on days when you’re in a good mood, stress may have less of an effect on you

Question 17

Positive affect generally associated with: lower levels of inflammation

Answer 17

in healthy men and women - neuroendocrine and inflammatory factors associated with positive affect
you want low levels of CRP
low PA - 23% had high CRP
high and moderate PA - 17%
-Low PA seems to be more at risk of inflammation
-possibly buffering stress response

Positive affect and inflammation in breast cancer survivors

• high PA - lower levels of inflammatory marker
• potentially linked to lower risk of mortality

Question 18

Is it better to be happy or fulfilled?

Answer 18

Recent study compared effects of hedonic and eudaimonic well-being on inflammation
-Hedonic: “How often did you feel happy?”
-Eudaimonic: “How often did you feel that you had something to contribute to society?”
Results showed that eudaimonic well-being was associated with reduced inflammatory signaling
-happiness (Hedonic) was associated with HIGHER inflammation

proinflammatory gene (CTRA) is upregulated in hedonic (more inflammation) and downregulated in eudaimonic (less inflammation)

to do this you have pull apart “happiness” and “meaning” in life to figure out what are the unique effects of these 2 things
-hedonic “I’m so happy but my life has no meaning” - focused only on my self-satisfaction - these people don’t really occur in real life
-eudaimonic “I care nothing about my personal happiness, all I care about is my meaning in life”
these 2 things usually go together - they aren’t usually seperate in the real world

Question 19

Can we make ourselves happier?

Answer 19

Judy Moskowitz has designed an intervention to increase positive affect
Based on theoretical and empirical literature on positive affect and coping with stress

Intervention components:

• Noting positive events - we pay a lot of attention to negative events
• Capitalizing on positive events - telling someone about the positive event
• Gratitude
• Positive reappraisal - put a positive spin on things
• Personal strengths
• Goal setting
• Acts of kindness
• Mindfulness

Methods
Conducted non-randomized pilot study with men and women newly diagnosed with HIV
-high level of stress/distress
-idea is: can we introduce positive affect and decrease negative affect?
Delivered intervention in individual sessions over 5 weeks

Results
Looked at effects on psychological outcomes
-Increased positive affect
-Decreased negative affect

Needs to be tested in randomized controlled design

• has never been validated
• she’s too busy giving this intervention everywhere to do a test in randomized design

Question 20

Self-affirmation theory

Answer 20

Affirming valued sources of self-worth such as important personal qualities, values, or relationships can buffer threats to the self, reducing the impact that these threats have on both physiological and psychological responses

which value is most import to you?

• art & creativity
• politics
• religion
• social issues
• science & theory

rate these and then expose them to these and look at how this influences their response to stress

Question 21

Does self-affirmation buffer physiological stress responses?

Answer 21

Undergraduates at UCSB selected their two most important and two least important values from a list of 11 values (Sherman et al., 2009)
-Artistic skills, Athletics, Business/earning money, Creativity, Independence, Musical ability/appreciation, Politics, Relations with friends/family, Religion, Sense of Humor, Spontaneity/living life in the moment
Affirmation condition: write about most important value
No affirmation condition: write about least important value

Results:
Self-affirmation buffers SNS response to midterm stress
-no affirmation group has increase in Epinephrine from baseline to midterm exam
-self-affirmation group has no increase from baseline to midterm: buffers the INCREASE in epinephrine levels in response to stress
-may have enhanced studying, could have allowed them to see that there is more to life than this exam

Creswell et al (2005)
TSST and salivary cortisol response to stress in the value-affirmation and control groups
-affirmation group: TSST wasn’t stressful
-control group: spikes in cortisol during the TSST

Question 22

Optimism

Answer 22

Optimism = generalized positive outcome expectancies (disposition)
-Typically assessed with Life Orientation Test (LOT)

Question 23

Optimism and mental health

Answer 23

Optimism is generally related to lower distress

-Mediated by use of active, approach oriented coping strategies - they are better copers

Question 24

Are there risks to an optimistic outlook in the context of serious illness? Optimism and physical health

Answer 24

Does it interfere with adherence to medical recommendations? no it doesn’t interfere with health behaviors
What if you get worse? they continue to have optimistic tendency

-Evidence that optimism does not compromise health behavior and promotes positive behaviors

Recent meta-analysis concludes that optimism is associated with better physical health (Rasmussen et al., 2009)
-Optimism associated with lower mortality, longer survival, and lower incidence of cardiovascular disease
Small effect

Question 25

Optimism and CHD

Answer 25

Prospective study examined association between optimism and CHD in 97,253 women studied for 8 years (Tindle et al., 2009)

• Optimism associated with lower risk of CHD-related mortality and total mortality
• Optimists were also younger, higher SES, and healthier at baseline
• Mortality effect remained significant controlling for baseline health status

Question 26

Benefit finding/finding meaning

Answer 26

Positive life change after stress
Traditionally, researchers have focused on negative psychological effects of stressful events
However, many individuals also report positive changes in important life domains
Changes described in various ways:
-Post-traumatic growth, finding meaning, benefit finding (BF)

Question 27

Domains of BF

Answer 27

Strengthened relationships
Sense of self
Outlook on life

Question 28

Strengthened relationships

Answer 28

Feel closer to family and friends, greater compassion for other

Question 29

Sense of self

Answer 29

Feel stronger, better able to deal with life’s challenges

Question 30

Outlook on life

Answer 30

Greater appreciation for life, reordering of goals and priorities, enhanced spirituality
-when you think everyday may be your last, you have a greater appreciation for the little things

Question 31

Effects of BF on health: Heart attack patients

Answer 31

patients (Affleck, Tennen, Croog, & Levine, 1987):

• Men who reported benefits following their attack were less likely to have another attack and had lower levels of morbidity 8 years later
• Benefits included changes in health behaviors, life-style changes to promote enjoyment, and changes in values/philosophy of life

Question 32

Effects of BF on health: HIV+ individuals

Answer 32

(Bower et al., 1998):
-Men who reported “finding meaning” from death of close friend/lover to AIDS showed positive changes in immune status and survival
-Changes included greater appreciation for loved ones, perception of life as fragile and precious, commitment to enjoying life, enhanced personal growth/understanding
Not mediated by health behaviors
Results:
-ability to find meaning buffered CD4 declined and were more likely to be alive
-Finding meaning predicts slower CD4 T cell decline
-Finding meaning predicts lower rate of AIDS-related mortality

BF associated with positive health outcomes in other HIV+ samples:

• Women who endorsed more HIV-related positive changes showed slower T cell decline and a lower rate of AIDS-related mortality (Ickovics et al., 2006)
• Hispanic men who reported more HIV-related growth showed less rapid immune decline (Milam, 2006)
• BF associated with lower cortisol in HIV+ men (Carrico et al., 2006)

Question 33

BF and cancer

Answer 33

measured change in proliferation (immune related variables)

• BF associated with improved lymphocyte proliferation in breast cancer patients
• Benefits included interpersonal growth, sense of purpose in life
• helps them to find something positive from their illness experience
• Also correlated with lower cortisol

Breast cancer survivors who reported positive life changes after cancer diagnosis showed lower levels of IL-6 (inflammation)
Positive changes included stronger sense of self, improved relationships, greater life appreciation

Question 34

How does benefit finding influence health?

Answer 34

“Enhanced allostasis” - don’t sweat the small stuff

• Allostasis
• Allostatic load
• Enhanced allostatis

Question 35

Allostasis

Answer 35

the adaptive processes that maintain homeostasis through the production of mediators such as adrenalin, cortisol and other chemical messengers

Question 36

Allostatic load

Answer 36

the wear and tear on the body and brain that result from chronic activation of these processes

Question 37

Enhanced allostatis

Answer 37

more efficient, adaptive, and circumscribed physiological responses to stress (rapid habituation)
-fewer hits
-rapid habituation
-rapid recovery
-lower tonic arousal under baseline conditions
(look at slide 52 for image)

evidence:
BF associated with more rapid cortisol habituation to repeated stress