Kubzansky LD, Thurston RC. Emotional vitality and incident coronary heart disease: benefits of healthy psychological functioning

Department of Society, Human Development, and Health , Harvard University, Cambridge, Massachusetts, United States
Archives of general psychiatry (Impact Factor: 14.48). 12/2007; 64(12):1393-401. DOI: 10.1001/archpsyc.64.12.1393
Source: PubMed


The potentially toxic effects of psychopathology and poorly regulated emotion on physical health have long been considered, but less work has addressed whether healthy psychological functioning may also benefit physical health. Emotional vitality--characterized by a sense of energy, positive well-being, and effective emotion regulation--has been hypothesized to reduce risk of heart disease, but no studies have examined this relationship.
To examine whether emotional vitality is associated with reduced risk of coronary heart disease (CHD). Secondary aims are to consider whether effects are independent of negative emotion and how they may occur.
A prospective population-based cohort study.
National Health and Nutrition Examination Survey I and follow-up studies (a probability sample of US adults).
Six thousand twenty-five men and women aged 25 to 74 years without CHD at baseline, followed up for a mean 15 years after the baseline interview.
Measures of incident CHD were obtained from hospital records and death certificates. During the follow-up period, 1141 cases of incident CHD occurred.
At the baseline interview (1971-1975), participants completed the General Well-being Schedule from which we derived a measure of emotional vitality. Compared with individuals with low levels, those reporting high levels of emotional vitality had multivariate-adjusted relative risks of 0.81 (95% confidence interval, 0.69-0.94) for CHD. A dose-response relationship was evident (P < .001). Significant associations were also found for each individual emotional vitality component with CHD, but findings with the overall emotional vitality measure were more reliable. Further analyses suggested that one way in which emotional vitality may influence coronary health is via health behaviors. However, the effect remained significant after controlling for health behaviors and other potential confounders, including depressive symptoms or other psychological problems.
Emotional vitality may protect against risk of CHD in men and women.

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    • "Higher levels of positive affect are associated with better concurrent and future health prospects, including reduced mortality (Chida and Steptoe, 2008; Lyyra et al., 2006) and reduced risk of coronary heart disease (Kubzansky and Thurston, 2007) and stroke (Ostir et al., 2001). These effects may be particularly relevant to older adulthood, a time when the accumulation of risk factors coupled with the ageing process contributes to a high incidence of chronic disease (Steptoe and Wardle, 2005). "
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    ABSTRACT: Positive affect and optimism play an important role in healthy ageing and are associated with improved physical and cognitive health outcomes. This study investigated whether it is possible to boost positive affect and associated positive biases in this age group using cognitive training. The effect of computerised imagery-based cognitive bias modification on positive affect, vividness of positive prospective imagery and interpretation biases in older adults was measured. 77 older adults received 4 weeks (12 sessions) of imagery cognitive bias modification or a control condition. They were assessed at baseline, post-training and at a one-month follow-up. Both groups reported decreased negative affect and trait anxiety, and increased optimism across the three assessments. Imagery cognitive bias modification significantly increased the vividness of positive prospective imagery post-training, compared with the control training. Contrary to our hypothesis, there was no difference between the training groups in negative interpretation bias. This is a useful demonstration that it is possible to successfully engage older adults in computer-based cognitive training and to enhance the vividness of positive imagery about the future in this group. Future studies are needed to assess the longer-term consequences of such training and the impact on affect and wellbeing in more vulnerable groups. Copyright © 2015 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.
    Full-text · Article · Jul 2015
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    • "We hypothesized that meditators as compared to controls would be characterized by lower TPR and larger CO during anticipation of negative stimuli. It should be noted, that there is growing evidence that positive emotion has beneficial effects on endocrine, immune and cardiovascular systems (Davidson et al., 2010; Dockray and Steptoe, 2010; Fredrickson, 2000, 2004; Kubzansky and Thurston, 2007; Steptoe et al., 2009; Tindle et al., 2010). So we have included positive stimuli in the experimental procedure. "
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    ABSTRACT: Meditation has been found to be an efficient strategy for coping with stress in healthy individuals and in patients with psychosomatic disorders. The main objective of the present study was to investigate the psychophysiological mechanisms of beneficial effects of meditation on cardiovascular reactivity. We examined effects of long-term Sahaja Yoga meditation on cardiovascular reactivity during affective image processing under "unregulated" and "emotion regulation" conditions. Twenty two experienced meditators and 20 control subjects participated in the study. Under "unregulated" conditions participants were shown neutral and affective images and were asked to attend to them. Under "emotion regulation" conditions they down-regulated negative affect through reappraisal of negative images or up-regulated positive affect through reappraisal of positive images. Under "unregulated" conditions while anticipating upcoming images meditators vs. controls did not show larger pre-stimulus total peripheral resistance and greater cardiac output for negative images in comparison with neutral and positive ones. Control subjects showed TPR decrease for negative images only when they consciously intended to reappraise them (i.e. in the "emotion regulation" condition). Both meditators and controls showed comparable cardiovascular reactivity during perception of positive stimuli, whereas up-regulating of positive affect was associated with more pronounced cardiac activation in meditators. The findings provide some insight into understanding the beneficial influence of meditation on top-down control of emotion and cardiovascular reactivity. Copyright © 2015. Published by Elsevier B.V.
    Full-text · Article · Jan 2015 · International journal of psychophysiology: official journal of the International Organization of Psychophysiology
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    • "Research investigating the role of positive affect on health, however, is less common and has demonstrated mixed findings (for a review, see Pressman & Cohen, 2005). Despite this, it has been suggested that positive affect may directly improve physical and mental health outcomes , even after accounting for other known influences on health (Kubzansky & Thurston, 2007; Chida & Steptoe, 2008). Indeed, positive affect can be valuable to individuals beyond feelings of well-being, as it has been associated with greater healthy life expectancy (Chida & Steptoe, 2008) and improved clinical outcomes in patients with heart failure (Brouwers et al., 2013) and hypertension (Pelle et al., 2011). "
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    ABSTRACT: Although the relationship between negative affect and psychiatric symptoms has been well-demonstrated in research, less is known about positive affect relative to negative affect, and its relationship to psychiatric symptoms, especially among veterans. This study examined how levels of positive and negative affect are associated with symptoms of depression, anxiety, and posttraumatic stress disorder (PTSD). Data were collected in a veteran polytrauma clinic; analyses were conducted using data from 94 veterans (87 males) with and without a mild traumatic brain injury (mTBI) diagnosis. Results demonstrate that positive and negative affect were separate dimensions and that both were independently related to each symptom measure. After removing the contribution of negative affect from symptom reports, strong relationships remained between positive affect and psychiatric symptoms. Furthermore, the magnitude of the associations for positive affect and for negative affect with symptoms of depression, anxiety, and PTSD were not impacted by a mTBI diagnosis. Altogether, findings suggest that both positive and negative affect should be uniquely considered when conceptualizing, assessing, and treating returning service members; in addition, positive affect may be an appropriate target of assessment and interventions of persons who have experienced polytrauma. (PsycINFO Database Record (c) 2014 APA, all rights reserved).
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