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Affectionate Writing Reduces Total Cholesterol: Two Randomized, Controlled Trials
Abstract
In two 5-week trials, healthy college students were randomly assigned either to experimental or control groups. Participants in the experimental groups wrote about their affection for significant friends, relatives, and/or romantic partners for 20 minutes on three separate occasions; on the same schedule, those in the control groups wrote about innocuous topics. Total cholesterol was assessed via capillary blood at the beginning of the trials and again at the end. Participants in the experimental groups experienced statistically significant reductions in total cholesterol. Control participants in the first study experienced a significant increase during the same period, whereas those in the second study did not. Cholesterol changes were largely unmoderated by linguistic features of the writing produced in the intervention. Potential therapeutic implications are discussed.
... A robust literature indicates that both verbal (e.g., Floyd, Mikkelson, Hesse, & Pauley, 2007) and nonverbal (e.g., Jakubiak & Feeney, 2018) communication of affection are associated with a variety of health and well-being outcomes. These effects include increased psychological (e.g., Debrot et al., 2013;Floyd et al., 2005), physiological (e.g., Cohen et al., 2015;Holt-Lunstad et al., 2011) and relational 1 well-being (Floyd et al., 2009;Jakubiak & Feeney, 2019). ...
... These effects include increased psychological (e.g., Debrot et al., 2013;Floyd et al., 2005), physiological (e.g., Cohen et al., 2015;Holt-Lunstad et al., 2011) and relational 1 well-being (Floyd et al., 2009;Jakubiak & Feeney, 2019). With respect to physical wellness, research indicates that an individual's trait affection level-indexing how affectionate that individual typically is with others-is positively associated with natural killer cell toxicity and 24-h cortisol variation (Floyd, 2006b;Floyd & Riforgiate, 2008), and is negatively associated with resting heart rate (Floyd, Mikkelson, Hesse, & Pauley, 2007) and resting blood pressure and blood glucose (Floyd, Hesse, & Haynes, 2007). Indirect/supportive affection, in particular, is further positively associated with a variety of immune markers, including immunoglobulins M and G, T-cells CD3+, CD4+, and CD8+, and the B-cell CD19+ (Floyd et al., 2018). ...
... Although additional pathways are articulated, the focus on stress is notable, given that elevated stress precipitates or intensifies numerous physical and mental detriments (e.g., Marketon & Glaser, 2008). AET, in particular, proposes that affectionate communication improves the body's stress response, buffers against heightened physiological responses to various stressors, and accelerates stress recovery more efficiently than other activities (e.g., Floyd, Hesse, & Haynes, 2007;Floyd, Mikkelson, Hesse, & Pauley, 2007;Floyd & Riforgiate, 2008). To that extent, then, the communication of affection has the potential to improve important cardiovascular, immune, and endocrine parameters that are exacerbated by stress. ...
A robust body of research attests to the mental and physical health correlates and consequences of affectionate communication. Like much research on personal relationships, however, this work may overrepresent certain portions of the population, may underrepresent others, and may not effectively account for intersections of identities. We define intersectionality as comprising the unique effects of two or more social identities interacting with each other. To assess this literature with an eye toward intersectionality and representation, the present article reports a systematic review of 86 individual empirical studies representing 26,013 participants. The review concludes that there is no explicit or implicit attention to intersectionality in the existing research on affectionate communication and health, and that U.S. Americans, women, younger individuals, white individuals, and students are overrepresented in research samples. The review ends with future directions to encourage more inclusive research on this topic.
... For example, two studies offer experimental evidence that affectionate communication in the context of social interaction contributes to maintaining romantic relationships, wherein kissing (Floyd et al., 2009) andcuddling (van Raalte et al., 2021) both contributed to relationship satisfaction. In terms of verbal displays, one study found that writing an affectionate letter to a loved one reduced stress, measured by total cholesterol in blood serum (Floyd et al., 2007). A recent meta-analysis of affection (Hesse et al., 2021) suggests that affectionate verbal communication shows similar benefits as physical displays. ...
... According to CBB theory, this is exactly how such communication behaviors should function in relation to the need to belong. The most consistent negative outcome reduced was a reduction of stress, which suggests a possible mechanism for how these behaviors improve daily well-being (see Floyd et al., 2007). The combination of more connection and less stress both encourages relational connection, boosting wellbeing, while mitigating negative emotions hampering well-being. ...
The associations among the frequency and quality of social interactions and in-the-moment and global well-being have been well-documented. Fewer studies explore whether the content of social interactions is associated with well-being using experimental methods. Drawing from the communicate bond belong theory, seven candidate communication episodes and behaviors were identified. In three studies, participants ( N Study 1 = 347, N Study 2 = 310, N Study 3 = 250) were randomly assigned to engage in one of these communication episodes or behaviors and then completed end-of-day measures of well-being. Compared to participants in the control groups, participants engaging in candidate behaviors experienced increased well-being. MANCOVA results from all studies suggest the frequency of engaging in candidate behaviors was associated with increased well-being. A mini-meta-analysis found a weighted average effect size of d = 0.255. Results suggest that engaging in as little as one communication behavior with one friend in a day can improve daily well-being.
... Affectionate communication is described as the expression and reception of love, support positive regard and fondness from one living entity to another (Floyd, 2006;Floyd, Mikkelson, Hesse, & Pauley, 2007). Receiving affection has been found to beneficially impact mental health outcomes by alleviating loneliness (Downs & Javidi, 1990) and providing relief from depression (Oliver, Raftery, Reeb, & Delaney, 1993). ...
... People who express affection to others report increased happiness and self-esteem, decreased fear of intimacy and exposure to depression, and higher relational satisfaction (Floyd, 2002;Floyd et al., 2005). Individuals with affectionate communication tend to respond to stress better with ameliorating physiological effects of reduced cholesterol (Floyd et al., 2007) and enhanced cortisol levels (Floyd, 2006), which are both associated with decreased depression (Dienes, Hazel, & Hammen, 2013;Lieberman, Kellogg, Kramer, Bathalon, & Lesher, 2012). Receiving affection is positively associated with higher relationship satisfaction (Horan & Booth-Butterfield, 2010) and strongly related to healthy stress hormone levels among couples (Floyd & Riforgiate, 2008). ...
Using social exchange and identity theory, the authors examined the association between marital enqing and depression in 372 Taiwanese couples, and the mediating effects of active and passive sacrifice on that association. Marital enqing is a unique form of affection toward the partner in Taiwanese couples. Data was analyzed by using the actor-partner interdependence model to test for actor and partner effects among study variables. Results indicated that husbands, who reported more marital enqing, tended to have lower levels of depression. Partner effects revealed that couples’ marital enqing decreased their spouse’s depressive symptoms. Husbands’ sacrifice behaviors mediated the association between his marital enqing and depression. However, Taiwanese wives’ sacrifice behavior did not mediate the association between her marital enqing and depression. Chinese cultural principles indeed impacted how couples in Taiwan conceptualized marital affection differently from couples in western cultures, and it provided insights into its relationships with couples’ sacrifices and relational and individual wellbeing.
... Participants randomized to the benefit-finding only condition (men, n = 5; women, n = 6) were only provided with the benefit-finding prompt and were given 20-minutes of writing time during each of the three writing sessions. Lastly, participants randomized to the control condition (men, n = 3; women, n = 8) were told to write about their living space for 20-minutes during each of the three writing sessions (from Floyd, Mikkelson, Hesse, & Pauley, 2007; see Appendix for a full description of each condition). ...
... Testosterone ANCOVA was used to examine the effects of writing condition on testosterone levels (H1-H3). Because of robust sex differences in testosterone levels in this study and in prior work (Neave et al., 1999), and consistent with research on physiology and communication variables (see Floyd et al., 2007), sex was included as a between-subjects factor to investigate its moderating influence on testosterone outcomes. In the first ANCOVA model, sex and condition were included as between-subjects factors, age, sexual activity, and T1 testosterone levels as covariates, and T2 testosterone levels as the dependent variable. ...
This study investigated the longitudinal effects of written disclosure on physiological and communicative health outcomes for victims of severe relational transgressions in dating relationships. Participants were assigned to a two-step writing condition, a benefit-finding condition, or a control condition to write once a day for three consecutive days on the same topic. Testosterone and forgiveness communication were assessed twice over the course of one-month. The results demonstrate that conditional forgiveness levels were higher for participants in both experimental conditions than in the control condition, whereas neither of the experimental conditions reduced testosterone levels. Across the writing conditions, testosterone levels were negatively associated with conditional forgiveness and positively associated with direct forgiveness. Finally, the results revealed that linguistic features in the writing predicted levels of testosterone and conditional forgiveness.
... Coping outcomes can also be influenced by information forwarding behaviors. For example, studies have shown that expressing one's affective states-about traumatic experience and positive emotion-has positive mental and physical health benefits (Floyd, Mikkelson, Hesse, & Pauley, 2007;King, 2001;Radin, 2006). These effects of affective writing are suggested in the framework of Affection Exchange Theory (Floyd, 2002(Floyd, , 2006, which can be applied to online writing contexts. ...
... Furthermore, our study contributes to the body of research on the effects of affective writing (Floyd, 2006) in several ways. First, existing experimental studies that test health outcomes are mainly based on nonclinical populations such as college students (Floyd et al., 2007;King, 2001). Our study examined individuals with self-reported chronic diseases, who are directly involved in health problems. ...
Computer-mediated communication, specifically blogs, has expanded the range of the communicative action of patients with chronic disease from information seeking to information forwarding. The authors examine the effects of these 2 types of communicative action on perceived affective and physical coping outcomes. Using a survey dataset of 254 chronic disease patients, the authors tested 2 models using structural equation modeling: first, the effects of communicative action about chronic illness on coping outcomes; and second, the mediating role of emotion-focused and problem-focused coping processes. Findings indicate overall positive effects of communicative action on coping processes and outcomes, yet with different magnitudes of effects depending on the dimensions of communication behavior, the coping process, and outcome. Implications for patients and health care providers are discussed.
... The control condition utilized in the study is one that is used in prior expressive writing studies. It is meant to reflect a more emotionally neutral writing exercise (see, for instance, Floyd et al., 2007;Kellas et al., 2015). As shown in influential work by Heider and Simmer (1944), people create narratives about inanimate objects even when not explicitly asked to do so. ...
Research has identified that writing can help individuals find forgiveness for their romantic partners in the wake of relational transgressions, but little is known about the actual narrative components that bring about changes in forgiveness. The current study sought to investigate the narrative components that contribute to month-long changes in forgiveness for romantic partners who have recently experienced a relational transgression. It also sought to uncover emotional and biological mechanisms that can help account for the associations between narrative components and forgiveness outcomes. The results revealed components of narratives that may both contribute to an increase and decrease in forgiveness over the course of one-month. Additionally, emotional expression and testosterone were identified as potential mediators and moderators of the associations between narrative components and changes in forgiveness.
... A number of studies by Floyd and colleagues support the contribution of affection to more beneficial physiological functioning. Some of these studies did not distinguish between verbal and physical affection (Floyd, Hesse, & Haynes, 2007;Floyd, Pauley, & Hesse, 2010;Floyd & Riforgiate, 2008), or assigned participants to write about their affectionate ties and did not measure physical affection (Floyd, Mikkelson, Hesse, & Pauley, 2007;Floyd, Mikkelson, Tafoya, Farinelli, La Valley, Judd, Haynes et al., 2007). We focus here primarily on physical affection and its direct or indirect physiological effects. ...
... Although most scholarship examines the beneficial effects of receiving affection or touch (Grewen, Girdler, Amico, & Light, 2005), research has also connected expressed affection to improved health (Floyd et al., 2005. For example, expressing affection through writing a letter to a loved one has been linked with lipid decreases (Floyd, Mikkelson, Hesse, & Pauley, 2007). Even touch that is not intended to be affectionate has been linked to health advantages. ...
This study examined the longitudinal effects of cuddling on relational quality for married couples. In a four-week experiment, 80 adults were randomly assigned to one of three conditions: increased cuddling (treatment), increased time spent together (comparison), or no change in behavior (control). Controlling for the pretest relational quality scores and changes in kissing behavior, individuals in the treatment condition reported more relational satisfaction and lower quality of alternatives after four weeks than did individuals in the comparison and control conditions. The comparison and control conditions did not differ from each other on any relational outcomes.
... For example, expressing affection is related to healthier cortisol rhythms (Floyd, 2006) and lower depression (Floyd, 2002). In addition, research demonstrated that receiving affection improves physical health (Floyd, Mikkelson, Hesse, & Pauley, 2007) and emotional well-being (Floyd et al., 2005). ...
This study examined indicators of psychological well-being as a function of affectionate communication and emotional intelligence. Two hundred and seventeen college-aged students completed measures of expressed and received affection; mental health, happiness, self-esteem, depression, and stress; and emotional intelligence. Results indicated that expressed affection is negatively associated with stress; received affection is positively associated with mental health and self-esteem and negatively associated with depression and stress. Furthermore, results provided support for models in which emotional intelligence impacts psychological well-being after accounting for the variance explained by expressed and received affection.
... In terms of physiological benefits, recent investigations indicate that highly affectionate people have limited cholesterol problems (Floyd, Hesse, & Pauley, 2007). Similarly, Floyd, Hesse, and Haynes (2007) found that trait-expressed affection is inversely associated with systolic blood pressure (i.e. the force against arterial walls when the heart is contracting during beats), diastolic blood pressure (i.e. the force against arterial walls when the heart is at rest between beats), and HbA1c (i.e. ...
This study sought to address Hofstede and McCrae’s (2004) call for systematic cross-cultural comparisons of trait-like attributes. Specifically, we examined the extent to which Danish, Icelandic, Polish, and American adults’ trait affection given and trait affection received are (a) dependent on national origin, and (b) associated with Hofstede’s dimensions of cultures (i.e. individualism-collectivism, masculinity-femininity, power distance, and uncertainty avoidance). The participants (N = 606) completed a questionnaire in English that consisted of the trait affection given and trait affection received scales. Results of a multivariate analysis of variance and linear regression analyses revealed that people’s trait affection given and received are (a) dependent on national origin, and (b) associated with Hofstede’s dimensions of cultures.
... Even further, some research indicates that physical presence may not even be necessary for the beneficial effects of affection. Floyd, Mikkelson, Hesse, and Pauley (2007) found that simply imagining the affection received from a relational partner through writing, positively affects health outcomes due to C reduction. Affection received from others has a direct negative effect on stress and positively influences emotional well-being (Floyd, Hesse, & Haynes, 2007;Floyd & Riforgiate, 2009). ...
The current study assessed the relationship between the core dimensions of interpersonal communication and relationships, power and intimacy, on the activation of individualistic-prosocial affect systems and subsequent interpersonal outcomes. Despite extensive research examining each dimension, mixed findings are prevalent and few have investigated their potential interaction. This study addressed these issues based on current trends in interdisciplinary research. Specifically, manipulated social triumph-defeat was followed by social inclusion-exclusion to examine their combined effect on interpersonal outcomes. Results indicate that the power and intimacy manipulations were successful, however, the relationship between them was not interactive. The current findings contradict the logical expansion of interdisciplinary physiological research (dual-hormone hypothesis) to perceptual-only designs. Both power and intimacy successfully activated individualistic and prosocial affect systems, which directly influenced person perception processes, which then predicted behavioral enactment toward comparison others.
... Thus, highly affectionate people are advantaged compared to their less affectionate counterparts (Floyd, 2002). In terms of physiological benefits of expressing and receiving affection, recent investigations indicate that highly affectionate people have limited cholesterol problems (Floyd, Hesse, & Pauley, 2007) and that writing affectionate letters alleviates stress in that it expedites cortisol recovery among women who are experiencing stressful situations (Floyd, Hesse, & Pauley, 2009). Similarly, Floyd, Hesse, and Haynes (2007) found that trait-expressed affection is inversely associated with systolic blood pressure (i.e. the force against arterial walls when the heart is contracting during beats), diastolic blood pressure (i.e. the force against arterial walls when the heart is at rest between beats), and HbA1c (i.e. ...
Based on the work conducted by trait psychologists, this cross-cultural investigation sought to examine young adults’ trait affection given and trait affection received in the U.S., Russia, and Slovakia as functions of (a) Hofstede’s four primary dimensions of national cultures (i.e. masculinity–femininity, individualism–collectivism, uncertainty avoidance, and power distance), and (b) national origin. Undergraduate students (N = 558) from the U.S. (n = 214), Russia (n = 169), and Slovakia (n = 210) completed a questionnaire in their native languages. The results of regression analyses and analyses of variances supported the notion that the four dimensions of national cultures influence people’s trait-like attributes and therefore also result in significant differences among the three countries examined in this investigation.
... Because generating participatory responses may involve recalling one's own experiences and retelling one's own stories (Coursaris & Liu, 2009), it may help the reinterpretation of the observers' health problems and promote emotional disclosures. Such emotion-focused coping would effectively reduce negative feelings among participants in the online health support groups (Floyd, Mikkelson, Hesse, & Pauley, 2007;Shim, Cappella, & Han, 2011).Furthermore, reappraisals of one's health issue when devising a participatory response may improve problem-focused coping with the health problem, such as altering one's own behavior to overcome the shared health problem (Pennebaker & Seagal, 1999). To determine whether participatory responses result in these outcomes, we investigate the following research questions. ...
This study examines the extent to which message format and social support may affect individuals’ participatory responses in online health support groups and their subsequent affective and attitudinal responses. An experiment with a 2 (message format: narrative vs. nonnarrative) × 2 (social support: emotional support vs. informational support) between-subjects factorial design was conducted among 98 participants. Results indicated that narrative messages facilitated reciprocal communication. In turn, participants who provided such participatory responses reported less fear and sadness, more favorable health attitudes, and greater behavioral intentions.
... Grewen, Girdler, Amico, and Light (2005) similarly found that nonverbal affectionate interaction reduced cortisol levels for both men and women and also elevated levels of the "feel-good" hormone oxytocin in women (see also Turner, Altemus, Enos, Cooper, & McGuinness, 1999), whereas Floyd, Hesse, and Haynes (2007) found a strong negative relationship (β = −.85) between expressed affection and glycohemoglobin (an index of average blood glucose level, which is elevated by stress), after controlling for the effects of received affection. In two experiments, Floyd, Mikkelson, Hesse, and Pauley (2007) also demonstrated that an affectionate writing exercise reduced total serum cholesterol (which is likewise elevated by stress) in a group of otherwise healthy adults. ...
The communication of affection in close relationships has been linked empirically to multiple physical and mental health benefits that are attributable largely to its stress-alleviating effects. Because affectionate communication frequently involves tactile contact of an intimate nature, however, it may also elevate vulnerability to opportunistic illness and infection, increasing the chances for immune system suppression. Using a sample of 52 healthy adults in cohabiting romantic relationships who were seropositive for latent human herpesvirus-4 (also known as the Epstein-Barr virus), the present study documented that self-reported trait expressed affection predicts antibody titers to Epstein-Barr virus viral capsid antigen complex, indicating viral replication and suppressed cell-mediated immunity.
... However, these differences largely occurred in the comparison group, which actually reported a decrease in beneficial communicative coping after the 2-week intervention. To wit, participants consisted of students, whose stress levels commonly increase as the semester progresses; it might be that these stresses caught up with students, such that they led to a depletion of beneficial coping mechanisms, a point that has been made recently by Floyd et al. (2007). ...
Supportive communication, which conveys care, empathy, and encouragement, plays a crucial role in how well people are able to cope with difficult emotions and aversive situations. But supportive communication can be conveyed more or less skilled. One possible mechanism that may link nonverbally and verbally conveyed emotional support and improved affective outcomes is mindfulness, conceived as enhanced nonreactive attention to and awareness of current internal and external stimuli. We present a theoretical model of mindful supportive communication and report the results of three exploratory studies that test the relationship between mindfulness and three factors that influence the supportive communication process, namely social skills, communicative coping, and reappraisals. Study 1 detected relationships between mindfulness facets and social skills. Studies 2 and 3 examine the impact of brief mindful interventions on social skills, communicative coping skills, and reappraisals.
... Despite the heuristic and pragmatic value of AET, however, most investigations of the theory have employed the individual as the unit of analysis, due in large part to its bio-evolutionary roots and to experimental designs that have demonstrated tremendous health benefits from receiving and expressing affection (e.g., Floyd, Mikkelson, Hesse, & Pauley, 2007). One way to extend AET would be to use dyadic data to compare and contrast actor and partner effects of expressed affection on health outcomes in married partners, parent-child dyads, and sibling dyads, to name a few. ...
In this essay, I briefly review some of the methodological concerns and theoretical opportunities that exist when researchers use quantitative methods to analyze dyadic data. First, I review three fundamental concepts inherent to dyadic data analysis. I then discuss three dyadic data designs that are commonly employed within family and interpersonal communication. After highlighting the two most common statistical techniques that researchers use to analyze dyadic data (i.e., multilevel and structural equation modeling), I address some of the theoretical opportunities that exist when family communication scholars shift their thinking away from the individual to the dyad. I conclude with an exhortation to use dyadic data to help advance our theoretical understandings of both the relational and systemic dynamics that animate family interaction.
... At the relational level, affectionate communication is related to investment (Horan & Booth-Butterfield, 2010), decreased jealousy-evoking behaviors (Goodboy, Horan, & Booth-Butterfield, 2012), and following partner transgressions, diminished feelings of hurt, thoughts of rumination, and perceptions of transgression severity (Horan, 2012). Physiologically, affectionate communicators report lower blood pressure (Floyd, Hesse, & Haynes, 2007), decreased cholesterol levels (Floyd, Mikkelson, Hesse, & Pauley, 2007;Floyd et al., 2009), and following stress inductions, better cortisol recovery (Floyd et al., 2007a(Floyd et al., , 2007b. ...
Individuals aged 15-24 years account for half of all new sexually transmitted infections. Such diseases are preventable, and communication lies at the center of this prevention. One safer sex behavior rooted in communication is the disclosure of one’s sexual history. Consistent with this perspective, and utilizing affection exchange theory (AET), this study focused on one aspect of sexual history discussions by examining the (dis)honesty of individuals’ disclosures of their number of previous sexual partners and associated safer sex behavior/communication. Results indicated that roughly two-thirds of participants correctly identified disclosure of the number of previous sexual partners as a safer sex practice. Yet about 60% of participants had, at some point, acted deceptively with their representation of their number of previous partners, and of those, nearly 20% never disclosed their number of previous partners. Deception about number of previous partners accounted for some differences in safer sex behaviors. Additionally, individuals who reported omitting their number of previous partners from all sexual partners also reported being the least comfortable with safer sex communication. Applied implications as well as implications for AET are discussed.
... AET assumes the Darwinian principle of selective fitness and argues that affectionate communication begets both social and physiological benefits that increase an individual's relative likelihood of survival and procreation. Multiple experimental and correlational experiments have confirmed relationships between affectionate communication and relational satisfaction (Floyd, 2002;Morman & Floyd, 1999); management of stress hormones (Floyd, 2006b;Floyd & Riforgiate, 2008); resting blood pressure (Floyd, Hesse, & Haynes, 2007); resting heart rate (Floyd, Mikkelson, Tafoya et al., 2007b); blood lipids (Floyd et al., 2009;Floyd, Mikkelson, Hesse, & Pauley, 2007); and recovery from elevated distress (Floyd, Mikkelson, Tafoya et al., 2007a;Floyd, Pauley, & Hesse, 2010). ...
This article articulates the construct of affection deprivation, the condition of wanting more tactile affectionate communication than one receives. Individual- and group-level variance on the construct is investigated and its social and health correlates are identified in a survey of 509 adults from all 50 U.S. states, the District of Columbia, Puerto Rico, and 16 foreign countries. Affection deprivation shows no correlation with age and no relationship with ethnicity, but men report significantly higher average affection deprivation than women. Moreover, as affection exchange theory predicts, affection deprivation shows positive linear associations with loneliness, depression, stress, alexithymia, preoccupied and fearful avoidant attachment styles, and numbers of personality disorders, mood and anxiety disorders, and secondary immune disorders. Affection deprivation shows negative linear associations with general health, happiness, social support, relationship satisfaction, and attachment security. These findings support the claims of affection exchange theory that the provision and receipt of affection contribute to health and wellness in both mental and physical ways.
... Two other experiments have focused on blood lipids as a health outcome. Floyd, Mikkelson, Hesse, and Pauley (2007) assigned participants either to an experimental group in which they were asked to write about their affection for significant people in their lives for 20 minutes on three separate days or a control group where they were asked to write about innocuous topics. Total cholesterol was assessed at the beginning and end of the trial. ...
A growing literature illuminates the biological and evolutionary antecedents, consequences, and correlates of communication behavior. With few exceptions, however, the researc is conducted outside of the communication discipline and remains unknown within the communication field. This essay offers illustrative literature reviews for several communicative behaviors and argues that the communication discipline should embrace, rather than ignore, the bioevolutionary factors involved in human social behavior.
... Prospective participants were also excluded if they had a medical history of severe asthma, acquired immune deficiency syndrome, cancer, clinical depression, Chrone's disease or ulcerative colitis, Graves' disease, heart disease, hepatitis, high or low blood pressure, lupus, multiple sclerosis, rheumatoid arthritis, and diabetes (type I or type II). These medications and health conditions are shown to influence the accuracy of salivary cortisol values (Floyd, Mikkelson, Hesse, & Pauley, 2007). Eligible participants were contacted and scheduled for a laboratory appointment. ...
This study examined whether expressive writing could help lesbian, gay, bisexual, or queer (LGBQ) hate speech victims increase forgiveness for offenders, and accelerate cortisol recovery following a discussion task in which they recalled the details of their experiences. Participants (N = 46) were assigned to a benefit-finding, traumatic disclosure writing, or control condition. The findings indicate that benefit-finding promoted forgiveness and reduced cortisol values, whereas traumatic disclosure writing only accelerated cortisol recovery. Analyses of the linguistic features of victims' narratives revealed that the amount of emotion-related words related to cortisol recovery, whereas the greater use of cognitive words was related with forgiveness. Implications for theory, methodological comparison, and future research are discussed.
... Research utilizing an AET framework has found support for both direct and indirect effects of affectionate communication. For example trait expressed affection correlates with average daily cortisol, waking cortisol, and diurnal variation of cortisol when controlled for affection received (Floyd, 2006); received affection (independent of sent affection) bolsters health by affecting morning, evening, and diurnal cortisol levels in married couples (Floyd & Riforgiate, 2008); writing down one's affectionate thoughts and feelings for a loved one significantly reduces total serum cholesterol over time (Floyd, Mikkelson, Hesse, & Pauley, 2007) and reduces salivary free cortisol in response to a stressful event (Floyd, Mikkelson, Tafoya, et al., 2007); increased frequency and duration of romantic kissing significantly decreases total cholesterol among cohabiting romantic partners (Floyd et al., 2009); and both state and trait affection affect oxytocin release in response to a stressful event (Floyd, Pauley, & Hesse, 2010). From a communication perspective, the finding that the actual communication of affection produces greater physiological benefits than does simply thinking about affection (a purely psychological act) holds particular importance (Floyd, Mikkelson, Tafoya, et al., 2007). ...
... For example, research indicates that highly affectionate communicators tend to be happier and have higher self-esteem, less fear of intimacy, less susceptibility to depression, healthier attachment styles, and higher relationship satisfaction (Floyd, 2002). Their bodies are better capable of managing stress, and evidence indicates that they have healthier cardiovascular and metabolic systems (Floyd, Hesse, & Haynes, 2007;Floyd, Hesse, & Pauley, 2009;Floyd, Mikkelson, Hesse, & Pauley, 2007). Among the vast array of factors that influence physical well-being, from diet and exercise to dental hygiene and sleep routines, communicating affection seems to be among the most fundamental of these needs. ...
The trait tendency to express affectionate messages is positively related to a range of physical health and well-being indicators. Thus far, the literature on affectionate communication has not examined this trait from a neurological perspective linked to such indicators. Using an approach-avoid framework of temperament, this study tests the notion that high-affection communicators have greater relative electrical activity in the left anterior cortex versus the right anterior cortex, as reflected in baseline electroencephalograph recordings. Results are consistent with the hypothesis that high-affection communicators have greater relative left activity than less affectionate communicators. Discussion centers on what conclusions can be drawn, and how research might be informed by linking trait affection to fundamental temperament reflected in anterior brain asymmetry.
In the past decade, there has been an increased focus on the role of physiology in interpersonal interactions, resulting in a surge of research exploring topics related to communication in close relationships. This growing line of research has explored topics such as affectionate communication, forgiveness, communication apprehension, and social support. Contributing to the increase in physiological research on communication processes is a greater recognition of the bidirectional nature of the associations among communication and the body. Researchers studied both the physiological outcomes of communication episodes (e.g., stress responses to conflict conversations) and the effects of physiology on the communication process (e.g., the influence of hormones on postsex communication). The Oxford Handbook of the Physiology of Interpersonal Communication offers a comprehensive review of the most prolific areas of research investigating both the physiological outcomes of interpersonal communication and the effects of physiology on interpersonal interactions. This edited volume serves as a resource for both researchers and students interested in investigating the mutual influence of physiology and communication in close relationships.
Background
Mental health issues have become critical social problems around the world. Individuals who are suffering from mental health problems tend to obtain health information and social support in the digital media environment. However, there has been little research on how information-seeking and information-forwarding behaviors affect sufferers’ coping processes and outcomes. Based on communicative behaviors of people in online to solve health problmes, this study aims to apply two cybercoping modes proposed by previous reserach to mental health issues.
Method
Using anxiety and depression issues, this study conducted an online survey (N = 560) to examine two cybercoping models with data collected from an online crowdsourcing platform (Amazon’s Mechanical Turk). Structural equation modeling (SEM) was conducted to test the cybercoping models in the context of mental health issues.
Results
Results of the first cybercoping model showed that information seeking was positively associated with coping outcomes, whereas information forwarding was not significant. While information seeking in the second cybercoping model was significantly associated with other factors, information forwarding was not significant. The second model revealed that coping processes fully mediate between information seeking and cybercoping outcomes.
Conclusions
This study contributes to the theoretical building of cybercoping models in the context of mental health issues by illustrating the effects of information seeking on cybercoping outcomes. Health care practitioners may use these results to better understand which communicative processes in online mental health communication are positively associated with specific coping processes and outcomes.
Previous studies have identified associations between affectionate communication and blood lipid levels but been limited by small, homogenous samples and failed replication attempts. Moreover, no study has tested the prediction derived from affection exchange theory that stress mediates the association between affectionate behavior and health. Using secondary analyses of data from the Midlife in the United States (MIDUS) Refresher study Biomarker Project, this paper remedies these limitations by testing the prediction that stress mediates the association between kissing and serum levels of triglycerides, high-density lipoproteins, and low-density lipoproteins using a large probability sample of U.S. American adults (N = 863). Results indicate significant indirect effects of kissing frequency on triglycerides and high-density lipoproteins for participants who reported kissing seven or more times in the previous month.
This study examined the longer-term effects of the COVID-19 lockdowns on relational communication and mental health. Specifically, the study used the theoretic premises of Affection Exchange Theory (AET: Floyd, 2006 ) to hypothesize connections between affection deprivation and several indices of mental health, including loneliness and depression. The study used a panel design to recruit participants at different time points during the COVID-19 lockdowns. We employed growth modeling to examine how affection deprivation influenced mental health outcomes over time. As predicted, affection deprivation was associated with stress, loneliness, and depression. Contrary to our hypotheses, affection deprivation was not associated with life satisfaction and happiness. In addition, the results showed that sex moderated the relationship between affection deprivation and depression. These findings are discussed in detail, including both theoretical and practical implications as well as directions for future research.
The chapter starts by describing what communication is, how it differs from sexual communication, and how sexual communication affects marital relations. It ends with suggestions to improve sexual communication in order to enhance a couple’s bonding.
The current study asked a sample (N = 20) of healthy young adults to report their daily hugging behaviors over a 14-day period and to collect their saliva at the beginning and end of the study. Based on affection exchange theory, we hypothesized that the frequency of hugging would be inversely related to proinflammatory cytokines, including interleukins (IL) 1-β, 6, and 8, and tumor necrosis factor-alpha (TNF-α). Controlling for baseline levels, hugging was significantly and inversely related to IL1-β and TNF-α after the 14-day period. Associations with IL-6 and IL-8, although nonsignificant, were also in the hypothesized direction.
A robust literature documents the health benefits of affectionate communication. The present study offers a meta-analysis of this literature to estimate general effects of affectionate communication on several areas of health, including cardiovascular, stress hormonal, stress reactivity, and mental health. We also examined potential moderators, including the type of affectionate communication and sex, while predicting that the benefits of expressed affection outweigh the benefits of received affection. We found a weighted mean effect of r = .23 for the relationship between affectionate communication and health, with differences based on type of health outcome but none for type of affection or sex. The effect of expressed affection exceeded the effect of received affection. The paper discusses the implications of these results.
The fetal environment has been increasingly implicated in later psychological health, but the role of lipids is unknown. Drawing on the ethnically diverse Born in Bradford (BiB) birth cohort, the current study related levels of high-density lipoprotein (HDL), very-low-density lipoprotein (VLDL), and triglycerides in umbilical cord blood to 1,369 children’s teacher-rated psychosocial competence approximately 5 years later. Results of ordinal logistic regressions indicated that low levels of HDL, high levels of VLDL, and high levels of triglycerides predicted greater likelihood of being rated as less competent in domains of emotion regulation, self-awareness, and interpersonal functioning. Furthermore, these results generalized across ethnic background and children’s sex and were not accounted for by variables reflecting mothers’ psychological or physical health, children’s physical health, or children’s special education status. Together, these results identify fetal exposure to anomalous lipid levels as a possible contributor to subsequent psychological health and social functioning.
Komunikowanie czułości (Floyd, 1997) czy ekspresja uczuć (Greszta, 2000a) są tutaj rozumiane, jako intencjonalne i jawne wyrażanie uczuć bliskości, czułości i zamiłowania do drugiej osoby. W literaturze podkreśla się korzystne efekty okazywania czułości, zarówno na poziomie fizycznym, jak i psychicznym. Czułość staje się szczególnie ważna w sytuacjach trudnych, a do takich należy choroba nowotworowa, zwłaszcza u dziecka. Diagnoza nowotworu jest sytuacją trudną zarówno dla rodziców, jak i młodego pacjenta. Stres, lęk, napięcie mogą istotnie zaburzać proces komunikowania czułości w relacji rodzic-dziecko. Celem badań, których wyniki są przedstawione w niniejszym artykule, było uzyskanie odpowiedzi na pytanie, czy wymiana czułości między rodzicami i dziećmi chorującymi na ostrą białaczkę limfoblastyczną (ALL) różni się od wymiany czułości w rodzinach dzieci zdrowych, a jeżeli tak-to na czym ta różnica polega. Badania zostały przeprowadzone w grupie 134 dzieci (67 dzieci z ALL oraz 67 dzieci zdrowych). Łącznie przebadano 54 dziewczynek i 80 chłopców (po 27 dziewczynek i 40 chłopców w każdej z grup), w wieku 6-16 lat. Zastosowano narracyjne narzędzie, autorstwa E. Greszty, pozwalające na pomiar liczby, przyczyny oraz odczuć towarzyszących wymianie czułości między rodzicami i dziećmi. Uzyskane wyniki ujawniły istotne statystycznie różnice w rozkładach liczby przejawów czułości niewerbalnej oraz średniej ich liczby. Dzieci chorujące na białaczkę uzyskują istotnie niższe wyniki m.in. w zakresie: okazywania czułości niewerbalnej w celu ekspresji miłości w stosunku do matki. Natomiast w przypadku obu grup najczęstszym powodem inicjacji czułości z obojgiem rodziców okazała się potrzeba wsparcia. Słowa kluczowe: komunikowanie czułości, rodzice, dzieci z białaczką, narracje Abstract: Affectionate communication is conscious and overt displays of affection like love, fondness, and positive regard to each other (Floyd, 1997; Greszta, 2000a). The benefits of affectionate communication on both physical and mental levels are emphasized in the literature. Affection exchange is particularly important in difficult situations. Especially essential when a child has leukemia. Diagnosis of cancer is a difficult situation for both parents and young patients. Stress, anxiety and tension can significantly disturb the process of affectionate communication in a parent-child relationship. The aim of the study, the results of which has presented in this article, was to answer whether the affection exchange between parents and children with acute lymphoblastic leukemia (ALL) differs from the affection exchange in families of healthy children, and if so-what is the difference. The study was conducted on the group of 134 children (67 children with ALL and 67 healthy children), including 54 girls and 80 boys (27 girls and 40 boys in each group), aged 6-16 years. The narrative method, by E.Greszta, was
Previous studies have determined that the perception or receipt of social support is correlated with several health outcomes including enhanced immunocompetence. In comparison, fewer studies have examined the effects that the expression of social support has on individuals. Among those studies that have assessed the expression of support, most have examined the deleterious effects on personal health associated with providing long-term care for a partner with a serious illness. On the basis of affection exchange theory, the present study examined the hypothesis that, in non-distressed relationships, the expression of support is associated with immunological health. Thirty-nine healthy adults completed questionnaires designed to assess their levels of expressed and received social support. Afterward, all participants completed a blood draw to assess immunological outcomes. The expression of support was positively associated with six of eight immunological outcomes assessed. Additional analyses revealed that four of those relationships remained significant while controlling for the effects of received support. The results add to our understanding of the dyadic processes involved in the expression of social support and confirm affection exchange theory’s assertion that the expression of support is beneficial to individuals’ relational and physical health.
In the past several decades, a robust line of research has developed in the field of communication exploring the interpersonal outcomes of receiving and giving affection. The present review offers an in-depth examination of research on affectionate communication and its implications for understanding interpersonal acceptance and rejection. The review begins by introducing the primary theoretical framework used to explore affectionate communication, followed by an overview of the benefits of receiving and giving affection. Following this review, the implications of affectionate communication for acceptance–rejection researchers are presented, including a discussion of the complexities of affection and what such intricacies may mean for future theorizing in this domain. Lastly, future directions for acceptance–rejection research in light of this review are presented.
From the perspective of evolutionary psychology, the tendency to communicate affection is adaptive insofar as it contributes directly and indirectly to survival and reproductive success. This article explores this possibility by explaining the principles of evolution and evolutionary psychology and identifying three specific arenas in which survival and procreation are enhanced by affectionate communication.
Affectionate communication is fundamental to the human relational experience. Across cultures, the expression of affection contributes to the formation, maintenance, and satisfaction level of close personal relationships. Floyd's affection exchange theory (AET) proposes that affectionate communication evolved among humans due to its contributions to the important goals of survival and procreation. This article introduces and evaluates AET, and details empirical work identifying the benefits of affectionate behavior for relationships and individual physical and mental health.
The Communicate Bond Belong (CBB) theory is an evolutionary and motivational explanation of human communication's role in the relational functions of social interaction. CBB theory conceives of all social interactions as energy expending, but posits that only some social interactions are striving behaviors (i.e., actions taken to satiate a need). CBB theory proposes that social interaction operates within a homeostatic system, developed from internal pressures to satiate a need to belong, shaped by competing desires to invest and conserve social energy, and adaptable to new social circumstances and technological affordances. The theory bridges gaps among evolutionary and social psychology theories and interpersonal communication theories by attending to the multifunctional nature of everyday talk in relation to fundamental human needs.
Social bonds are necessary for human survival and affectionate communication is paramount for their formation and maintenance. Consequently, affection deprivation—the condition of receiving less affectionate communication than desired—is associated with social pain, and contemporary research indicates that social pain has substantial neurological overlap with physical pain. Thus, it was proposed that affection deprivation would be associated with the sensation of physical pain as well as with poor-quality sleep. Three studies involving a total of 1,368 adults from nearly all U.S. states and several foreign countries revealed significant associations between affection deprivation, physical pain, and multiple facets of disturbed sleep.
So far I have been arguing at the level of ultimate reasoning to address the question why physical activity, aggression, and other components of the soldier behavior syndrome should have a negative relationship with components of the insulin resistance syndrome. Now we need to look at the proximate mechanisms which execute this relationship. In order to understand the mechanisms and pathways involved in this connection, we need to know the physiology of aggression–dominance syndrome first.
The present study investigated the interaction of attachment security and genotype in the oxytocin receptor gene on affectionate communication. Specifically, we predicted that individuals’ genotype for the single-nucleotide polymorphism (SNP) rs53576 on the oxytocin receptor gene would show a stronger influence in individuals with weak attachment security compared to individuals with strong attachment security. One hundred sixty-four participants completed questionnaire measures about their attachment security and affectionate communication and provided saliva samples for genetic analysis. In support of a predicted gene-environment interaction (G x E) interaction, the GG genotype showed a stronger influence on affectionate communication for people low in attachment security than for people high in attachment security. These results support the (G x E) approach to understanding the relationship between genetics and environmental triggers, as the influence of genotype for rs53576 on affectionate communication was moderated by attachment security.
The present pilot study examined the efficacy of a brief expressive writing intervention for helping testicular cancer (TC) survivors manage psychological, relational, and health complications associated with treatment and recovery. 48 men reported on mental health, quality of life, and sexual health, then took part in a 5-week expressive writing intervention. Afterward, all participants again reported on the same measures used in the pre-test. A total of 28 men completed at least two writing sessions and were included in the analysis. Results revealed that, compared to men in both the negative expression and control conditions, men in the positive expression group experienced improvements in their mental health over the course of the 5-week trial.
The goal of the present study was to understand the relationships between alexithymia, relational maintenance, and relational quality. Data from 143 heterosexual married couples were analyzed utilizing the actor-partner interdependence model. Actors' levels of alexithymia exerted a negative effect on relational quality, while husbands' alexithymia was related to wives' relational quality. Each relational maintenance behavior at least partially mediated the actor effects of trait alexithymia on relational quality. In addition, task sharing, assurances, and positivity mitigated the effects of alexithymia on the partner's assessments of relational quality. Results reveal that relational maintenance can significantly minimize the negative effects that alexithymia plays in romantic relationships.
Previous research has implicated both affectionate communication and adult attachment styles as important elements of individual ability to grow and maintain successful relationships. The current study sought to understand the relationship between those two concepts. As hypothesized, trait given affection, while controlling for trait received affection, was positively related to the secure attachment style and inversely related to the three insecure attachment styles. Secure individuals also significantly communicated more affection than any of the three insecure styles. Several implications and directions for future research are discussed.
The present study analyzed the role that trait affectionate communication, an individual-level trait, plays in dyads’ enactment of relational maintenance behaviors. We hypothesized that trait affection positively predicts both husbands and wives’ enactment of relational maintenance behaviors. In addition, we hypothesized that the relative contribution of wives’ trait affection to relational maintenance would be stronger than that of husbands. One hundred and forty-three married heterosexual couples completed questionnaires, and data were analyzed using the actor-partner interdependence model. Results revealed significant actor effects in 9 out of 10 cases. Results also revealed four partner effects. Husbands and wives’ trait affection mutually influenced their enactment of assurances, and husbands’ trait affection positively predicted wives’ enactment of positivity and network sharing. Results are discussed in terms of relational maintenance research and theories of affectionate interaction.
By investigating social-media-based public forums and using network and content analyses, this study explores how political discussions flow, how diverse they are, and what forms of political discussions are influential. The results suggest that the flow of political discussions is not notably centralized and cliquish. Participants refer primarily to the remarks of like-minded fellow citizens. Political discussions are more emotional than cognitive and express more anger than anxiety, but it appears that cognitive discussions are more influential than emotional ones. Among cognitive components, assertive and strong discussions have greater influence than analytical ones. These results have implications for the practice of citizenship and the theory of selective exposure as well as for future directions in political communication research.
Affection has long been found to be a foundational force in any sort of human relationship, influencing such areas as relational closeness, stress, and depression. One psychological condition that may influence the communication of affection is alexithymia, which hinders the ability of an individual both to experience and to express emotion. On the basis of affection exchange theory, we hypothesized a mediating effect of affectionate communication on the association between alexithymia and relational and mental health indices. Participants (N = 347) provided self-reports of alexithymia, affectionate communication, depression, stress, relational closeness, nonverbal immediacy, happiness, and relational affection. Findings implicated affectionate communication as a mediator of the relationships between alexithymia and several of the outcome measures.
The present study tested the prediction that affectionate communication is positively associated with the release of oxytocin in response to stressors. One hundred participants completed questionnaire measures about their personal relationships prior to participation in a laboratory session that included a series of standard laboratory stressors. Both state and trait affectionate communication predicted increases in oxytocin during exposure to stressors, an effect that was not moderated by sex. The results demonstrate the stress-buffering effect of affectionate interaction.
Recent research on the communication of affection illuminates its implications for mental and physical health. In particular, affectionate communication has been shown to covary with healthy hormonal variation and accelerated recovery from stress. The present study focuses on the association between marital affection and hormonal markers of stress regulation, including cortisol, dehydroepiandrosterone-sulfate (DHEA-S), and their ratio. Twenty healthy adults and spouses provided independent reports of their propensity for verbal, nonverbal, and support-based expressions of affection prior to providing saliva samples that were assayed for cortisol and DHEA-S. As hypothesized, spouses' reports of verbal, nonverbal, and supportive affection significantly predicted participants' waking cortisol levels, cortisol change, and cortisol:DHEA-S ratio. Participants' own reports of affection were predictive of cortisol:DHEA-S ratio for verbal affection behaviors only, and were not predictive of participants' waking cortisol, cortisol change, or DHEA-S. In addition, spouses' reports of verbal, nonverbal, and supportive affection predicted participants' evening cortisol levels. Results illustrate that affectionate communication from one's spouse is related to hormonal stress regulation and suggest the possibility that interventions designed to increase affectionate behavior in romantic relationships may have stress-ameliorating physiological effects.
In this article, we attempt to distinguish between the properties of moderator and mediator variables at a number of levels. First, we seek to make theorists and researchers aware of the importance of not using the terms moderator and mediator interchangeably by carefully elaborating, both conceptually and strategically, the many ways in which moderators and mediators differ. We then go beyond this largely pedagogical function and delineate the conceptual and strategic implications of making use of such distinctions with regard to a wide range of phenomena, including control and stress, attitudes, and personality traits. We also provide a specific compendium of analytic procedures appropriate for making the most effective use of the moderator and mediator distinction, both separately and in terms of a broader causal system that includes both moderators and mediators. (46 ref) (PsycINFO Database Record (c) 2012 APA, all rights reserved)
The following is an abstract of the winning paper submitted for the 1989 Student Research Award Competition in association with the 97th annual meeting of the American Psychological Association. Ms. Greenberg’s paper was presented as a poster at the meeting.
In a variation on Pennebaker's writing paradigm, a sample of 81 undergraduates wrote about one of four topics for 20 minutes each day for 4 consecutive days. Participants were randomly assigned to write about their most traumatic life event, their best possible future self, both of these topics, or a nonemotional con- trol topic. Mood was measured before and after writing and health center data for illness were obtained with participant con- sent. Three weeks later, measures of subjective well-being were obtained. Writing about life goals was significantly less upset- ting than writing about trauma and was associated with a sig- nificant increase in subjective well-being. Five months after writ- ing, a significant interaction emerged such that writing about trauma, one's best possible self, or both were associated with decreased illness compared with controls. Results indicate that writing about self-regulatory topics can be associated with the same health benefits as writing about trauma.
This study investigated whether emotional expression of traumatic experiences influenced the immune response to a hepatitis B vaccination program. Forty medical students who tested negative for hepatitis B antibodies were randomly assigned to write about personal traumatic events or control topics during 4 consecutive daily sessions. The day after completion of the writing, participants were given their first hepatitis B vaccination, with booster injections at 1 and 4 months after the writing. Blood was collected before each vaccination and at a 6-month follow-up. Compared with the control group, participants in the emotional expression group showed significantly higher antibody levels against hepatitis B at the 4 and 6-month follow-up periods. Other immune changes evident immediately after writing were significantly lower numbers of circulating
T helper lymphocytes and basophils in the treatment group. The finding that a writing intervention influences immune response provides further support for a link between emotional disclosure and health. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
This study sought to replicate previous findings that disclosing traumas improves physical health and to compare the effects of revealing previously disclosed versus undisclosed traumas. According to inhibition theory, reporting about undisclosed traumas should produce greater health benefits. Sixty healthy undergraduates wrote about undisclosed traumas, previously disclosed traumas, or trivial events. Contrary to expectations, there were no significant between-groups differences on longer term health utilization and physical symptom measures. However, Ss who disclosed more severe traumas reported fewer physical symptoms in the months following the study, compared with low-severity trauma Ss, and tended to report fewer symptoms than control Ss. Results suggest that health benefits occur when severe traumas are disclosed, regardless of whether previous disclosure has occurred.
This article defines stress and related concepts and reviews their historical development. The notion of a stress system as the effector of the stress syndrome is suggested, and its physiologic and pathophysiologic manifestations are described. A new perspective on human disease states associated with dysregulation of the stress system is provided.
Published original articles from human and animal studies and selected reviews. Literature was surveyed utilizing MEDLINE and the Index Medicus.
Original articles from the basic science and human literature consisted entirely of controlled studies based on verified methodologies and, with the exception of the most recent studies, replicated by more than one laboratory. Many of the basic science and clinical studies had been conducted in our own laboratories and clinical research units. Reviews cited were written by acknowledged leaders in the fields of neurobiology, endocrinology, and behavior.
Independent extraction and cross-referencing by the authors.
Stress and related concepts can be traced as far back as written science and medicine. The stress system coordinates the generalized stress response, which takes place when a stressor of any kind exceeds a threshold. The main components of the stress system are the corticotropin-releasing hormone and locus ceruleus-norepinephrine/autonomic systems and their peripheral effectors, the pituitary-adrenal axis, and the limbs of the autonomic system. Activation of the stress system leads to behavioral and peripheral changes that improve the ability of the organism to adjust homeostasis and increase its chances for survival. There has been an exponential increase in knowledge regarding the interactions among the components of the stress system and between the stress system and other brain elements involved in the regulation of emotion, cognitive function, and behavior, as well as with the axes responsible for reproduction, growth, and immunity. This new knowledge has allowed association of stress system dysfunction, characterized by sustained hyperactivity and/or hypoactivity, to various pathophysiologic states that cut across the traditional boundaries of medical disciplines. These include a range of psychiatric, endocrine, and inflammatory disorders and/or susceptibility to such disorders.
We hope that knowledge from apparently disparate fields of science and medicine integrated into a working theoretical framework will allow generation and testing of new hypotheses on the pathophysiology and diagnosis of, and therapy for, a variety of human illnesses reflecting systematic alterations in the principal effectors of the generalized stress response. We predict that pharmacologic agents capable of altering the central apparatus that governs the stress response will be useful in the treatment of many of these illnesses.
The measurement of cortisol in saliva provides the basic scientist as well as the clinician with a reliable tool for investigations of hypothalamus-pituitary-adrenal axis activity. Since saliva samples can be obtained stress-free and independent from medically trained personnel this method may be well suited for use in psychobiological studies. This overview intends to give a comprehensive introduction to the method of salivary cortisol assessment and to briefly discuss its application in different scientific disciplines.
Can psychotherapy reduce the incidence of health problems? A general model of psychosomatics assumes that inhibiting or holding back one's thoughts, feelings, and behaviors is associated with long-term stress and disease. Actively confronting upsetting experiences--through writing or talk- ing-is hypothesized to reduce the negative effects of inhibition. Fifty healthy undergraduates were assigned to write about either traumatic experiences or superficial topics for 4 consecutive days. Two measures of cellular immune-system function and health center visits suggested that confronting traumatic experiences was physically beneficial. The implications for psychotherapy as a preventive treatment for health problems are discussed. There is little doubt that psychotherapy reduces subjective distress and yields positive behavioral outcomes. In recent years, a small group of researchers has sought to learn whether psychotherapy can also reduce health problems. Two promising reviews have indicated that the use of mental health services is associated with fewer medical visits, fewer days of hospitaliza- tion, and lower overall medical costs. In a summary of 15 stud- ies published between 1965 and 1980, Mumford, Schlesinger, and Glass (1981) found that individuals who underwent psy- chotherapy evidenced a 13% decrease in medical utilization rel- ative to nonpsychotherapy control subjects. Similarly, in a re- view of 13 studies of mental health services that were intro- duced into organizations, Jones and Vischi (1980) found that psychotherapy was associated with a 20% drop in medical utili- zation.
A theory of inhibition and psychosomatic disease suggests that the failure to confide traumatic events is stressful and associated with long-term health problems. We investigated the short-term autonomic correlates of disclosing personal and traumatic experiences among two samples of healthy undergraduates. In Experiment 1, subjects talked into a tape recorder about extremely stressful events that had occurred in their lives, as well as what they planned to do following the experiment. Skin conductance, blood pressure, and heart rate were continuously measured. Based on judges' ratings of subjects' depth of disclosure, subjects were classified as high or low disclosers. Talking about traumatic events was associated with decreased behavioral inhibition, as measured by lower skin conductance levels among high disclosers. Disclosing traumatic material was also associated with increased cardiovascular activity. In Experiment 2, subjects both talked aloud and thought about a traumatic event and about plans for the day. Half of the subjects were alone in an experimental cubicle and talked into a tape recorder; the remaining subjects talked to a silent "confessor" who sat behind a curtain. Among high disclosers, both talking and thinking about traumatic events produced lower skin conductance levels than did thinking or talking about plans for the day. The presence of a confessor inhibited subjects' talking. Implications for understanding the nature of confession and the development of an inhibitory model for psychosomatic processes are discussed.
In this article, we attempt to distinguish between the properties of moderator and mediator variables at a number of levels. First, we seek to make theorists and researchers aware of the importance of not using the terms moderator and mediator interchangeably by carefully elaborating, both conceptually and strategically, the many ways in which moderators and mediators differ. We then go beyond this largely pedagogical function and delineate the conceptual and strategic implications of making use of such distinctions with regard to a wide range of phenomena, including control and stress, attitudes, and personality traits. We also provide a specific compendium of analytic procedures appropriate for making the most effective use of the moderator and mediator distinction, both separately and in terms of a broader causal system that includes both moderators and mediators.
A hypothesized need to form and maintain strong, stable interpersonal relationships is evaluated in light of the empirical literature. The need is for frequent, nonaversive interactions within an ongoing relational bond. Consistent with the belongingness hypothesis, people form social attachments readily under most conditions and resist the dissolution of existing bonds. Belongingness appears to have multiple and strong effects on emotional patterns and on cognitive processes. Lack of attachments is linked to a variety of ill effects on health, adjustment, and well-being. Other evidence, such as that concerning satiation, substitution, and behavioral consequences, is likewise consistent with the hypothesized motivation. Several seeming counterexamples turned out not to disconfirm the hypothesis. Existing evidence supports the hypothesis that the need to belong is a powerful, fundamental, and extremely pervasive motivation.
While there is substantial evidence that psychological stress enhances risk for coronary artery disease, the mechanisms underlying such an influence remain unclear. We examined the effects of short-term psychological stress on serum lipid levels, hemoconcentration, fibrinogen level, and plasma viscosity.
Forty-four healthy young adults were randomly assigned to perform a distinctly frustrating cognitive task for 20 minutes (stress condition) or to rest quietly for the same period (control condition).
Relative to controls, stressed subjects showed significant increases in blood pressure and heart rate; total, low-density, and high-density lipoprotein cholesterol levels; hematocrit; hemoglobin level; and total protein concentration. Stressed subjects also showed significant reductions in plasma volume and increased plasma viscosity and estimated whole-blood viscosity compared with controls. A similar trend in fibrinogen level was not statistically significant. Individual differences in blood pressure and heart rate response to stress correlated highly with changes in total cholesterol levels and hematocrit.
Our investigation provides further evidence that exposure to short-term mental stress elicits hemoconcentration with associated increases in serum lipid concentrations, hemostatic factors, and blood viscosity.
Healthy Epstein-Barr virus (EBV) seropositive undergraduates (N = 57) completed a personality inventory, provided blood samples, and were randomly assigned to write or talk about stressful events, or to write about trivial events, during three weekly 20-min sessions, after which they provided a final blood sample. Individuals assigned to the verbal/stressful condition had significantly lower EBV antibody titers (suggesting better cellular immune control over the latent virus) after the intervention than those in the written/stressful group, who had significantly lower values than those in the written/trivial control group. Subjects assigned to the written/stressful condition expressed more negative emotional words than the verbal/stressful and control groups and more positive emotional words than the verbal/stressful group at each time point. The verbal/stressful group expressed more negative emotional words compared with the control group at baseline. Content analysis indicated that the verbal/stressful group achieved the greatest improvements in cognitive change, self-esteem, and adaptive coping strategies.
We examined the analytical performance of eight compact systems for measuring total cholesterol: AccuMeter, Cobas Ready, Discovery f2, DT60, L-D-X, Reflotron, QCA, and Vision. We determined average bias at two decision levels, the mean absolute bias, and the percentage of results differing from the comparison method results by > 8.9% allowable total error limit for multiple reagent lots. Average bias was < 3% for all lots tested for AccuMeter, Discovery f2, and DT60, but > 3% for one or more lots or sample types tested with the other systems. Of results from each reagent lot, > 95% were within the 8.9% total error specifications with Discovery f2, DT60, and QCA, whereas the performance of L-D-X, Vision, and Reflotron depended on reagent lot and (or) sample type. Of all results from each lot tested with AccuMeter and Cobas Ready, > 5% exceeded the total allowable error limit. We determined imprecision for five systems: Cobas Ready, Discovery f2, and QCA had CVs < 3%, whereas CVs for AccuMeter and L-D-X were > 3% but < 5%.
We assessed the performance of seven Cholestech L.D.X lipid analyzers under tightly controlled laboratory conditions for accuracy and precision in accordance with analytical guidelines of the National Cholesterol Education Program (NCEP). Venous heparinized whole blood (VB) and plasma (VP), venous serum (VS), and capillary fingerstick whole blood (FB) were collected from 18 individuals. Total cholesterol (TC) concentration was measured in VB, VP, and VS on all seven instruments. Three instruments were used for TC measurements of FB. Reference cholesterol values for each individual were generated in the same laboratory with a standardized method. The within-run coefficients of variation (CVs) for all instruments with a Level I pool (1560 mg/L, n = 10) ranged from 1.3% to 1.8% (mean = 1.59%). The between-run CVs with the same pool ranged from 2.2% to 3.4% (mean = 2.84%, n = 10). Correlation coefficients derived from comparison of total cholesterol values generated by the instruments for each specimen type vs the reference cholesterol values were all > 0.97. The average bias for all instruments for each sample type was 1.9% (FB), 4.3% (VB), 6.6% (VP), and 7.0% (VS). Predicted cholesterol concentration for each sample type from regression curves for total cholesterol at the suggested NCEP clinical decision cutoff values of 2000 and 2400 mg/L, respectively, were 2049 and 2431 mg/L for FB, 2081 and 2469 mg/L for VB, 2122 and 2522 mg/L for VP, and 2121 and 2521 mg/L for VS.
The words people use in disclosing a trauma were hypothesized to predict improvements in mental and physical health in 2 studies. The first study reanalyzed data from 6 previous experiments in which language variables served as predictors of health. Results from 177 participants in previous writing studies showed that increased use of words associated with insightful and causal thinking was linked to improved physical but not mental health. Higher use of positive relative to negative emotion words was also associated with better health. An empirical measure that was derived from these data correlated with subsequent distress ratings. The second study tested these models on interview transcripts of 30 men who had lost their partners to AIDS. Cognitive change and empirical models predicted postbereavement distress at 1 year. Implications of using computer-based text analyses in the study of narratives are discussed.
Nonpharmacological treatments with little patient cost or risk are useful supplements to pharmacotherapy in the treatment of patients with chronic illness. Research has demonstrated that writing about emotionally traumatic experiences has a surprisingly beneficial effect on symptom reports, well-being, and health care use in healthy individuals.
To determine if writing about stressful life experiences affects disease status in patients with asthma or rheumatoid arthritis using standardized quantitative outcome measures.
Randomized controlled trial conducted between October 1996 and December 1997.
Outpatient community residents drawn from private and institutional practice.
Volunteer sample of 112 patients with asthma (n = 61) or rheumatoid arthritis (n = 51) received the intervention; 107 completed the study, 58 in the asthma group and 49 in the rheumatoid arthritis group.
Patients were assigned to write either about the most stressful event of their lives (n = 71; 39 asthma, 32 rheumatoid arthritis) or about emotionally neutral topics (n = 41; 22 asthma, 19 rheumatoid arthritis) (the control intervention).
Asthma patients were evaluated with spirometry and rheumatoid arthritis patients were clinically examined by a rheumatologist. Assessments were conducted at baseline and at 2 weeks and 2 months and 4 months after writing and were done blind to experimental condition.
Of evaluable patients 4 months after treatment, asthma patients in the experimental group showed improvements in lung function (the mean percentage of predicted forced expiratory volume in 1 second [FEV1] improved from 63.9% at baseline to 76.3% at the 4-month follow-up; P<.001), whereas control group patients showed no change. Rheumatoid arthritis patients in the experimental group showed improvements in overall disease activity (a mean reduction in disease severity from 1.65 to 1.19 [28%] on a scale of 0 [asymptomatic] to 4 [very severe] at the 4-month follow-up; P=.001), whereas control group patients did not change. Combining all completing patients, 33 (47.1%) of 70 experimental patients had clinically relevant improvement, whereas 9 (24.3%) of 37 control patients had improvement (P=.001).
Patients with mild to moderately severe asthma or rheumatoid arthritis who wrote about stressful life experiences had clinically relevant changes in health status at 4 months compared with those in the control group. These gains were beyond those attributable to the standard medical care that all participants were receiving. It remains unknown whether these health improvements will persist beyond 4 months or whether this exercise will prove effective with other diseases.
We assessed the performance of seven Cholestech L.D.X lipid analyzers under tightly controlled laboratory conditions for accuracy and precision in accordance with analytical guidelines of the National Cholesterol Education Program (NCEP). Venous heparinized whole blood (VB) and plasma (VP), venous serum (VS), and capillary fingerstick whole blood (FB) were collected from 18 individuals. Total cholesterol (TC) concentration was measured in VB, VP, and VS on all seven instruments. Three instruments were used for TC measurements of FB. Reference cholesterol values for each individual were generated in the same laboratory with a standardized method. The within-run coefficients of variation (CVs) for all instruments with a Level I pool (1560 mg/L, n = 10) ranged from 1.3% to 1.8% (mean = 1.59%). The between-run CVs with the same pool ranged from 2.2% to 3.4% (mean = 2.84%, n = 10). Correlation coefficients derived from comparison of total cholesterol values generated by the instruments for each specimen type vs the reference cholesterol values were all > 0.97. The average bias for all instruments for each sample type was 1.9% (FB), 4.3% (VB), 6.6% (VP), and 7.0% (VS). Predicted cholesterol concentration for each sample type from regression curves for total cholesterol at the suggested NCEP clinical decision cutoff values of 2000 and 2400 mg/L, respectively, were 2049 and 2431 mg/L for FB, 2081 and 2469 mg/L for VB, 2122 and 2522 mg/L for VP, and 2121 and 2521 mg/L for VS.
The statistical term “regression,” from a Latin root meaning “going back,” was first used by Francis Galton in his paper “Regression towards Mediocrity in Hereditary Stature.”1 Galton related the heights of children to the average height of their parents, which he called the mid- parent height (figure). Children and parents had the same mean height of 68.2 inches. The ranges differed, however, because the mid-parent height was an average of two observations and thus had its range reduced. Now, consider those parents with a mid-height between 70 and 71 inches. The mean height of their children was 69.5 inches, which was closer to the mean height of all children than the mean height of their parents was to the mean height of all parents. Galton called this phenomenon “regression towards mediocrity”; we now call it “regression towards the mean.” The same thing happens if we start with the children. For the children with height between 70 and 71 inches, the mean height of their parents was 69.0 inches. This is a statistical, not a genetic phenomenon.If we take each group of mid-parents by height and calculate the mean height of their children, these means will lie close to a straight line. This line came to be called the regression line, and hence the process of fitting such lines became known as “regression.”In mathematical terms, if variables X and Y have standard deviations sX and sY, and correlation r, the slope of the familiar least squares regression line can be written rsy/sx. Thus a change of one standard deviation in X is associated with a change of r standard deviations in Y. Unless X and Y are exactly linearly related, so that all the points lie along a straight line, r is less than 1. For a given value of X the predicted value of Y is always fewer standard deviations from its mean than is X from its mean. Regression towards the mean occurs unless r=1, perfect correlation, so it always occurs in practice. We give some examples in a subsequent note.
Few behavioral processes are more central to the development and maintenance of intimate relationships than the communication of affection. Indeed, affectionate expressions often initiate and accelerate relational development. By contrast, their absence in established relationships frequently coincides with relational deterioration. This text explores the scientific research on affection exchange to emerge from the disciplines of communication, social psychology, family studies, psychophysiology, anthropology, and nursing. Specific foci include the individual and relational benefits (including health benefits) of affectionate behavior, as well as the significant risks often associated with expressing affection. A new, comprehensive theory of human affection exchange is offered, and its merits relative to existing theories are explored. © Cambridge University Press 2006 and Cambridge University Press, 2009.
Previous studies have found that writing about upsetting experiences can improve physical health. In an attempt to explain this phenomenon, 72 first-year college students were randomly assigned to write about either their thoughts and feelings about coming to college or about superficial topics for three consecutive days. Measures of language use within the writing samples and cognitive measures of accessibility and schematic organisation were collected in the weeks before and after writing. As in previous studies, writing about college was found to reduce health centre visits for illness and to improve subjects' grade point average. Text analyses indicated that the use of positive emotion words and changes in words suggestive of causal and insightful thinking were linked to health change. Improved grades, although not linked to these language dimensions, were found to correlate with measures of schematic organisation of college-relevant themes. Implications for using written language to understand cognitive and health processes are discussed.
The present study examines differences in the individual‐and social‐level characteristics of high‐affection and low‐affection communicators. One hundred nine adults completed extensive questionnaires about their happiness, attachment patterns, susceptibility to depression and stress, mental health, social activity, relationship satisfaction, and other variables. Results revealed that highly affectionate people are advantaged in numerous psychological, mental, emotional, social, and relational characteristics, relative to those who communicate little affection to others.
Recent research on the communication of affection has begun to illuminate its implications for mental and physical health. Specifically, when compared to non-affectionate people, self-report studies have indicated that highly affectionate people are less susceptible to depression and stress, and endocrine studies have shown that highly affectionate people have more differentiated 24-hour cortisol rhythms (a pattern indicative of adaptive physiological stress management). The present studies extend this knowledge by focusing on the associations that trait affection has with cardiologic (resting heart rate), vascular (resting blood pressure), and metabolic (glycosylated hemoglobin) properties of physical health. Participants in both studies provided self-assessments of their trait levels of expressed affection and received affection (the latter for use as a covariate). Resting heart rate and blood pressure were assessed in the first study, and glycosylated hemoglobin was assessed in the second study. Results indicate that when the influence of received affection is controlled for, trait expressed affection was inversely related to resting blood pressure and glycosylated hemoglobin (but not heart rate), suggesting that the expression of affection is associated with a healthy vascular and metabolic profile.
The present study tested the general hypothesis that, irrespective of the amount of affectionate communication one typically receives, the amount of affectionate communication one typically expresses to others is associated with the body's ability to handle stress. Twenty healthy young adults reported on their trait levels of expressed and received affection and then took four saliva samples over the course of a normal workday. The saliva samples were assayed for levels of free cortisol, an adrenal steroid hormone associated with physiological responses to stress. Controlling for received affection, expressed affection was strongly and positively associated with waking cortisol values and with aggregate values. It was also strongly and positively related to the magnitude of morning-to-evening decrease in cortisol levels, a rhythm indicative of an adaptive ability to handle stress. Theoretic and methodological implications are discussed.
Research by James J. Lynch and his colleagues demonstrates that as people speak, their blood pressure rises. Factors which accelerate or diminish this association include the social status of the listener, rate of speaking and resting blood pressure level. Another group of studies indicates that people high in social support are buffered from the negative health consequences of stressful life events. Is talking a stressor? Does social support mediate the effects of talking on blood pressure? Using procedures similar to those of Lynch, the study compared the cardiovascular responses of people high and low in perceived satisfaction with support provided by social contacts. Analysis of variance and simple correlations indicated that cardiovascular reactivity during both resting and talking states was negatively associated with social support.
Utilizing the interpersonal needs and gratifications perspective as the framework for this investigation, two studies investigated the link between interpersonal communication motives and the development of loneliness in the lives of older adults. Results suggest that (a) the interpersonal communication motives are a viable construct to be studied within this target population, (b) a significant relationship does exist between interpersonal communication motives (escape, pleasure, relaxation, cntrol, affection, and inclusion) and feelings of loneliness, and (c) communication is a significant factor in the development of loneliness within the lives of older adults. Implications of these results are discussed, and suggestions for future research are proposed.
Affection exchange theory speaks to the benefits that affectionate communication elicits, not only when it is received but also when it is communicated to others. Previous research has provided evidence for the individual and relational benefits of having a high trait affection level, yet these benefits may partially be accounted for by the affectionate behavior one elicits from others by being affectionate in the first place. We addressed the validity of this alternative hypothesis in this project, first by re-analyzing data in which we compared correlations between trait affection level and various benefits with the same correlations after controlling for received affection. Next, in three studies involving a total sample of 1,144 people, we further investigated the benefits of expressed affection, both on its own and when received affection is covaried out. Results indicated that affection expressed to others is associated with numerous individual and relational benefits, including increased happiness and self esteem, decreased fear of intimacy and susceptibility to depression, and higher relationship satisfaction. Many of these effects are attenuated—and some are intensified—when affection received from others is held constant.
The relationship of free salivary cortisol stress recovery and basal cortisol with psychological, cardiovascular and metabolic factors was investigated in 82 healthy young men. Blood pressure, heart rate, cortisol and mood were assessed during a single laboratory session involving mental arithmetic and speech tasks, and lipid profiles were analysed from a fasting blood sample. Participants were divided into high (n=31) and low (n=51) cortisol stress recovery groups on the basis of the magnitude of changes between the peak cortisol responses to tasks and the lowest levels recorded at the end of a 30 min post-stress rest period. The high recovery group showed consistent increases in cortisol following each of the tasks, while the low recovery group showed little change across the session. Cortisol levels in the two groups did not differ at the end of the post-stress recovery period. The groups were indistinguishable in age, body mass index, smoking and alcohol consumption, and did not differ in psychological characteristics including anxiety, depression and perceived social support. However, the high stress recovery group had elevated low density lipoprotein cholesterol and total cholesterol/high density lipoprotein ratios, suggesting raised cardiovascular disease risk. The high stress recovery group also reported greater psychological activation during tasks, and greater recent minor life stress, than did the low recovery group. There was no association between rate of cortisol recovery and cardiovascular responses to tasks. But resting cortisol was related to blood pressure stress reactivity, suggesting that cortisol played a permissive role in augmenting sympathetically-driven cardiovascular responses. The results suggest that the rate of cortisol stress recovery is associated with variations in metabolic risk, and with differences in psychological state but not trait characteristics.
On the basis of a theory of inhibition and psychosomatics, it was predicted that the more individuals disclosed personally traumatic experiences, the better their long-term health following the disclosure. Thirty-three Holocaust survivors talked for 1-2 hours about their personal experiences during World War II while skin conductance level (SCL) and heart rate (HR) were continuously monitored. Each videotaped interview was rated by independent judges once every minute on the degree to which the survivor's experience was traumatic. For each subject, the trauma ratings were correlated with minute-by-minute SCL and HR readings. Based on previous research, negative trauma-SCL correlations are indicative of high personal disclosure, whereas positive trauma-SCL correlations suggest low disclosure, whereas positive trauma-SCL correlations suggest low disclosure. Approximately 14 months after the interview, self-reports of the subjects' health were collected. Controlling for pre-interview health problems, degree of disclosure during the interview was found to be positively correlated with long-term health after the interview. The possible health benefits of disclosure are discussed.
Although acute stress has been associated with transient immunosuppression, little is known about the immunologic consequences of chronic stress in humans. In order to investigate possible health-related consequences of a long-term stressor, we obtained blood samples for immunologic and nutritional analyses and psychologic data from 34 family caregivers of Alzheimer's disease (AD) victims and 34 sociodemographically matched comparison subjects. Family caregivers for AD victims were more distressed than comparison subjects without similar responsibilities. Greater impairment in the AD victim was associated with greater distress and loneliness in caregivers. Caregivers had significantly lower percentages of total T lymphocytes and helper T lymphocytes than did comparison subjects, as well as significantly lower helper-suppressor cell ratios; caregivers also had significantly higher antibody titers to Epstein-Barr virus than did comparison subjects, presumably reflecting poorer cellular immune system control of the latent virus in caregivers. The percentages of natural killer cells and suppressor T lymphocytes did not differ significantly. These data suggest that chronically stressed AD family caregivers do not show immunologic or psychologic adaptation to the level of their well-matched age peers.
This paper presents evidence from three samples, two of college students and one of participants in a community smoking-cessation program, for the reliability and validity of a 14-item instrument, the Perceived Stress Scale (PSS), designed to measure the degree to which situations in one's life are appraised as stressful. The PSS showed adequate reliability and, as predicted, was correlated with life-event scores, depressive and physical symptomatology, utilization of health services, social anxiety, and smoking-reduction maintenance. In all comparisons, the PSS was a better predictor of the outcome in question than were life-event scores. When compared to a depressive symptomatology scale, the PSS was found to measure a different and independently predictive construct. Additional data indicate adequate reliability and validity of a four-item version of the PSS for telephone interviews. The PSS is suggested for examining the role of nonspecific appraised stress in the etiology of disease and behavioral disorders and as an outcome measure of experienced levels of stress.
This study examined whether psychological stress and the infusion of epinephrine increase plasma lipid and apoprotein concentrations in normolipidemic and hyperlipidemic men. Subjects were studied during three separate 6-hour laboratory sessions: a control session, during which subjects rested quietly while blood samples and hemodynamic measurements were obtained; a stress session, during which subjects were presented with two challenging mental tasks, followed by quiet rest; and an epinephrine infusion session, during which subjects received a low-dose infusion of epinephrine followed by quiet rest. The stress and epinephrine infusion manipulations produced the expected changes in plasma epinephrine and norepinephrine levels, blood pressure, and heart rate. Free fatty acid concentration increased markedly during epinephrine infusion and less dramatically but consistently during mental stress. Both stress and epinephrine infusion produced acute increases in plasma total, low-density lipoprotein, very low-density lipoprotein, and high-density lipoprotein cholesterol and apoprotein B concentrations, but comparable increases during the control session were not observed. Changes in albumin concentration (an index of plasma volume) were associated with changes in lipid concentrations during psychological stress. Epinephrine increases during psychological stress were correlated with increases in free fatty acid and triglyceride levels both during and after task administration. It was concluded that psychological or pharmacological stress induced in the laboratory produces changes in lipid concentrations, which at least during psychological stress, may be attributed to concomitant changes in plasma volume. The association between task-induced changes in epinephrine and changes in free fatty acid and triglyceride levels, also supports the hypothesis that psychological stress increases lipolysis.
When individuals are asked to write or talk about personally upsetting experiences, significant improvements in physical health are found. Analyses of subjects' writing about traumas indicate that those whose health improves most tend to use a higher proportion of negative emotion words than positive emotion words. Independent of verbal emotion expression, the increasing use of insight, causal, and associated cognitive words over several days of writing is linked to health improvement. That is, the construction of a coherent story together with the expression of negative emotions work together in therapeutic writing. Evidence of these processes are also seen in specific links between word production and immediate autonomic nervous system activity. Implications for therapy and for considering the mind and body as fluid, dynamic systems are discussed.
Synopsis
It has been well established that individuals with a history of depression report their parents as being less caring and more overprotective of them than do controls. ‘Affectionless control’ in childhood has thus been proposed as a risk factor for depression. Evidence is presented from a logistic regression analysis of data from a volunteer community sample that lack of care rather than over-protection is the primary risk factor. No evidence for an interaction effect of low care and over-protection was found.
One objective of the present research was to examine the immunological effects of self-disclosing personal information regarding a traumatic or stressful experience. A second objective was to examine the hypothesis that the effect of self-disclosure on immune function is moderated by individual differences in cynical hostility. Forty-three male college undergraduates, classified as high or low on the Cook-Medley Hostility scale were randomly assigned to either a verbal self-disclosure or a nondisclosure discussion condition. Task-induced change in natural killer (NK) cell activity (i.e., cytotoxicity) served as the dependent variable. As predicted, a significant interaction between discussion condition and hostility was obtained. Among subjects in the self-disclosure condition, high hostility subjects exhibited a significantly greater increase in NK cell cytotoxicity than low hostility subjects. The effect of self-disclosure on NK cell activity is moderated by an individual's level of cynical hostility. The greater short term enhancement in NK cell activity observed for hostile persons is a likely correlate of a more pronounced acute arousal response elicited by the self-disclosure task.
A research synthesis was conducted to examine the relationship between a written emotional expression task and subsequent health. This writing task was found to lead to significantly improved health outcomes in healthy participants. Health was enhanced in 4 outcome types--reported physical health, psychological well-being, physiological functioning, and general functioning--but health behaviors were not influenced. Writing also increased immediate (pre- to postwriting) distress, which was unrelated to health outcomes. The relation between written emotional expression and health was moderated by a number of variables, including the use of college students as participants, gender, duration of the manipulation, publication status of the study, and specific writing content instructions.
Three questionnaire studies involving 101, 270, and 144 college students examined the relationship between affectionate behaviors and aggressive behaviors in the family environment as rated by the college students. Measures of affection and aggression were significantly negatively associated in nearly all analyses. Participants' ratings of parental alcohol abuse were positively associated with measures of parental aggression and negatively correlated with measures of parental affection. Southeastern.
For the present purpose, love is defined as one's having stimulation that one desires. The nature of the stimulation can range on a continuum from the most abstract cognitive, to the most direct sensory, forms. Thus, this definition of love encompasses having an emotional bond with a person for whom one yearns, as well as having sensory stimulation that one desires. We address some of the physiological and perceptual consequences both of having, and of not having, love. We propose a neural mechanism by which deprivation of love may generate endogenous, compensatory sensory stimulation that manifests itself as psychosomatic illness. In addition, we propose a neuroendocrine mechanism underlying sexual response and orgasm. The latter includes vaginocervical sensory pathways to the brain that can produce analgesia, release oxytocin, and/or bypass the spinal cord via the vagus nerve. We present evidence of the existence of non-genital orgasms, which suggests that genital orgasm is a special case of a more pervasive orgasmic process. Through recent studies, the mechanisms and manifestations of love and its deprivation are becoming better understood. The better is our understanding of love, the greater is our respect for the significance and potency of its role in mental and physical health.
Lipids increase during psychological stress, but no studies have compared the effects of acute and chronic stressors on lipid responsivity in the same individuals. One hundred middle-aged men (n = 92) and women (n = 8) were examined during high chronic occupational stress, low chronic stress, and acute laboratory stressors. In addition to measures of perceived stress and affect, an extensive battery of lipid and lipoprotein measures was undertaken at each time point. Most lipid parameters were significantly increased during the chronic and acute stressors, although the responses to the different stressors were not consistently associated. For example, significant correlations among the chronic and acute stress responses were apparent for the apoproteins, but not for total, low density lipoprotein, or high density lipoprotein cholesterol. The factors and processes regulating these variables during stress may be different during acute and chronic stressors.
The neurohormone oxytocin is responsible for initiating childbirth and the let-down reflex in lactating women and is released during sexual orgasm. Oxytocin has been thought of as an affiliation hormone because research on nonhuman mammals has demonstrated that it plays a key role in the initiation of maternal behavior and the formation of adult pair bonds. It has been speculated that social stimuli may induce oxytocin release and that oxytocin may make positive social contact more rewarding. Data are presented from an initial study to examine change in plasma oxytocin in response to a standard imagery task that elicits emotion related to attachment. Twenty-five normal cycling, healthy women underwent imagery tasks and completed questionnaires on attachment and interpersonal problems. Blood draws (5 ml) were bone via an indwelling catheter before, during, and after three interventions (massage, positive emotion, and negative emotion) and to establish baselines. Overall, the data showed a tendency for oxytocin levels to be elevated in response to relaxation massage and decreased in response to sad emotion. There were individual differences in response to the interventions. Those who showed evidence of increased oxytocin levels for positive emotion and massage and who maintained oxytocin levels during negative emotion were less likely to report interpersonal problems associated with intrusiveness. Maintaining oxytocin levels during sadness was also correlated with lower anxiety in close relationships. Women who were in a couple relationship had greater increases in oxytocin in response to positive emotion. In contrast, higher basal levels of oxytocin were associated with greater interpersonal distress. These data suggest that peripheral secretion of oxytocin in response to emotional stimuli is associated with the individual's interpersonal characteristics.
Representing a challenge for current concepts of stress research, a number of studies have now provided convincing evidence that the adrenal gland is hypoactive in some stress-related states. The phenomenon of hypocortisolism has mainly been described for patients, who experienced a traumatic event and subsequently developed post-traumatic stress disorder (PTSD). However, as presented in this review, hypocortisolism does not merely represent a specific correlate of PTSD, since similar findings have been reported for healthy individuals living under conditions of chronic stress as well as for patients with several bodily disorders. These include chronic fatigue syndrome, fibromyalgia, other somatoform disorders, rheumatoid arthritis, and asthma, and many of these disorders have been related to stress. Although hypocortisolism appears to be a frequent and widespread phenomenon, the nature of the underlying mechanisms and the homology of these mechanisms within and across clinical groups remain speculative. Potential mechanisms include dysregulations on several levels of the hypothalamic-pituitary adrenal axis. In addition, factors such as genetic vulnerability, previous stress experience, coping and personality styles may determine the manifestation of this neuroendocrine abnormality. Several authors proposed theoretical concepts on the development or physiological meaning of hypocortisolism. Based on the reviewed findings, we propose that a persistent lack of cortisol availability in traumatized or chronically stressed individuals may promote an increased vulnerability for the development of stress-related bodily disorders. This pathophysiological model may have important implications for the prevention, diagnosis and treatment of the classical psychosomatic disorders.