Positive Affect Uniquely Predicts Lower Risk of Mortality in People With Diabetes

Osher Center for Integrative Medicine, University of California, San Francisco, CA 94115, USA.
Health Psychology (Impact Factor: 3.59). 02/2008; 27(1 Suppl):S73-82. DOI: 10.1037/0278-6133.27.1.S73
Source: PubMed


To determine whether positive affect predicts mortality among people with diabetes and among a comparison group of people with no chronic health conditions.
Longitudinal cohort study.
Positive affect was significantly associated with lower risk of all-cause mortality in people with diabetes (N = 715). Enjoyed life was associated with lower risk of mortality over and above the effects of negative affect or other significant predictors of mortality. In a comparison sample without chronic illness (N = 2,673), positive affect was not associated with mortality. However, when the analysis was restricted to those over the age of 65, specific positive affects, in particular hopeful and enjoyed life were significantly associated with lower risk of mortality, again independent of negative affect. Enjoyed life remained significantly predictive of lower risk of mortality in the older sample when other predictors of mortality were statistically controlled. Positive affect was particularly protective among those over the age of 65 who reported higher levels of stress.
These findings are discussed in light of possible stress-buffering functions of positive affect.

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    • "However, since Cochrane systematic review showed no evidence that specific diets improve diabetes outcomes and dietary restrictions appear to impose substantial burdens on NH residents, more permissive diets may be most appropriate in most NH residents with diabetes[17]. A second notable finding was the relationship between NH residents' attitude and engagement in their own care18192021. The NH residents reporting a more positive outlook also reported being more engaged and were the same residents trying to set a good example for their fellow NH residents. "
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    ABSTRACT: Background To explore the perspectives of nursing home (NH) residents with diabetes and their doctors regarding the burdens of living with diabetes and diabetes treatments. Methods Qualitative study of nursing home residents aged 65 and older with diabetes (n = 14) and nursing home physicians (n = 9) at a Department of Veterans Affairs nursing home (known as the Community Living Center). A semi-structured interview was used to elicit nursing home residents’ and physicians’ perspectives on the burden of diabetes and diabetes treatments. Transcripts were analyzed using constant comparative methods. Results The mean age of the nursing home residents was 74; Most (93 %) were male and 50 % self-identified themselves as white. The mean age of nursing home physicians was 39 and 55 % were geriatricians. Dietary restrictions, loss of independence and fingersticks/insulin were noted to be the most burdensome aspects of diabetes. Nursing home residents with a more positive outlook were generally more engaged in their care, while nursing home residents with a more pessimistic outlook were less engaged, allowing their physicians to assume complete control of their care. While physicians noted the potential negative impact of dietary restrictions, nursing home residents’ comments suggest that physicians underestimate the burden of dietary restrictions. Conclusions Veterans Affairs nursing home residents were substantially burdened by their diabetes treatments, especially dietary restrictions and fingerstick monitoring. Since there is little evidence that dietary restrictions improve outcomes, fewer dietary restrictions may be appropriate and lead to lower treatment burdens for nursing home residents with diabetes. Electronic supplementary material The online version of this article (doi:10.1186/s12877-016-0199-0) contains supplementary material, which is available to authorized users.
    Full-text · Article · Dec 2016 · BMC Geriatrics
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    • "The provider training process (completed via a training manual, role play, and audiotaped practice sessions for PP) is much simpler than that required for MBSR, improving applicability to real-world settings. Finally, as opposed to a focus on mindfulness, PP specifically targets behaviors (e.g., leveraging past success) and positive attributes (e.g., positive affect and optimism) that have been associated with increased participation in health behaviors and superior medical outcomes[26,28,29]. Social cognitive theory interventions that focus on selfefficacy , outcome expectations, barriers, and goal setting are also similar to PP[107,108]. "
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    ABSTRACT: Most patients with type 2 diabetes (T2D) have suboptimal adherence to recommended diet, physical activity, and/or medication. Current approaches to improve health behaviors in T2D have been variably effective, and successful interventions are often complex and intensive. It is therefore vital to develop interventions that are simple, well-accepted, and applicable to a wide range of patients who suffer from T2D. One approach may be to boost positive psychological states, such as positive affect or optimism, as these constructs have been prospectively and independently linked to improvements in health behaviors. Positive psychology (PP) interventions, which utilize systematic exercises to increase optimism, well-being, and positive affect, consistently increase positive states and are easily delivered to patients with chronic illnesses. However, to our knowledge, PP interventions have not been formally tested in T2D. In this paper, we review a theoretical model for the use of PP interventions to target health behaviors in T2D, describe the structure and content of a PP intervention for T2D patients, and describe baseline data from a single-arm proof-of-concept ( N = 15 ) intervention study in T2D patients with or without depression. We also discuss how PP interventions could be combined with motivational interviewing (MI) interventions to provide a blended psychological-behavioral approach.
    Full-text · Article · Jun 2015 · Journal of Diabetes Research
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    • "Recent theories have begun to place more importance on the role of positive emotions during stress independent of negative affect (Folkman, 2008). Moreover, positive, but not negative affect, has been linked to a decreased risk of mortality (Moskowitz et al., 2008; Davis, 2009). Thus, an ability to maintain greater positive mood during stress exposure among regular exercisers may serve a protective function, minimizing the accumulation of stress burden with repeated exposures that is linked with the development of disease. "
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    ABSTRACT: Physical activity has long been considered beneficial to health and regular exercise is purported to relieve stress. However empirical evidence demonstrating these effects is limited. In this study, we compared psychophysiological responses to an acute psychosocial stressor between individuals who did, or did not, report regular physical exercise. Healthy men and women (N = 111) participated in two experimental sessions, one with the Trier Social Stress Test (TSST) and one with a non-stressful control task. We measured heart rate, blood pressure, cortisol, and self-reported mood before and at repeated times after the tasks. Individuals who reported physical exercise at least once per week exhibited lower heart rate at rest than non-exercisers, but the groups did not differ in their cardiovascular responses to the TSST. Level of habitual exercise did not influence self-reported mood before the tasks, but non-exercisers reported a greater decline in positive affect after the TSST in comparison to exercisers. These findings provide modest support for claims that regular exercise protects against the negative emotional consequences of stress, and suggest that exercise has beneficial effects in healthy individuals. These findings are limited by their correlational nature, and future prospective controlled studies on the effects of regular exercise on response to acute stress are needed.
    Full-text · Article · May 2014 · Frontiers in Physiology
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