the first world congress on positive psychology · what is the relation between ... cohen et al....

THE FIRST WORLD CONGRESS THE FIRST WORLD CONGRESS ON POSITIVE PSYCHOLOGYON POSITIVE PSYCHOLOGY

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“Happiness matters: Positive emotions in health and disease”

Sheldon CohenDepartment of PsychologyCarnegie Mellon University

What is Positive Affect?

“feelings that reflect a level of pleasurable engagement with the environment”

(Clark, Watson & Leeka, 1989)

Such as: happiness, joy, enthusiasm, excitement, contentment

What is the Relation between TRAIT PA (PES) and Health?

• MortalityLess in Community Residing ElderlyMore in Institutionalized Elderly

• MorbidityLess Cardiovascular DiseaseLess Hospitalization

• Survival (no support)• Fewer Symptoms and Less Pain

Pressman & Cohen, 2007

What are the unanswered questions?

1. Are PA and NA independent?

• Independent or opposite sides of the same continuum? (Bradburn, 1969; Diener & Emmons, 1985; Watson, Clark, & Tellegen, 1988)

DEPENDS (Diener & Emmons, 1985; Diener, Larsen, Levine, & Emmons, 1985; Watson, 1988b):

Greater length of time Independent

2. Is it the valence or activation that matters?

Circumplex ModelRussell, 1980 Activated

tense, angry Happy, excited

NA PA

Bored, depressed Calm, relaxed

Unactivated

3. Is Activated PA a measure of perceived health?

• Activated emotions such as vitality—– Energetic– Full of Pep– Vigorous– Lively

4. Is it PA or just something closely related to PA?

Concepts closely related to PA

• Extraversion• Mastery• Purpose• Self-esteem• Optimism

5. How could PA influence health?

Positive Affect

ANS & HPA

Activity

Health Practices

Social Ties

Immune & CardiovascularSystems

Disease

Endogenous Opioids

Pressman & Cohen, Psychological Bulletin, 2005

Stress

ANS & HPA Activity

Health Practices

Endogenous Opioids


Disease

Positive Affect


Stress

ANS & HPA Activity

Health Practices

Endogenous Opioids


Social,Psychological,

& PhysicalResources

Disease

Positive Affect


What should a studylook like?

• Prospective

• Assesses both Negative and Positive affect

• PA spans unactivated – activateddimension of affect

• Controls for cognitive and social measures that correlate with PA(e.g., extraversion, optimism, mastery)

• Controls for self-reported health

• Test for mediating pathways: health behaviors, biological pathways

Some evidence from our lab

I. ColdsII. Symptom ReportingIII. Longevity

I. COLDS

Pittsburgh Common Cold Study II N=334 3 Years 2 Viruses

VIRUSVIRUS

6 Day Quarantine

Positive & Positive & Negative Negative

Emotional StyleEmotional Style

7 Evening Interviews

Clinical ColdsClinical Colds

Primary Trial Outcome

Shed Virus or Ab Increase+

Increase in mucus weightor

nasal clearance time

Positive Affect

• Full-of-pep• Lively• Energetic• Happy• Pleased

• At ease• Calm• Cheerful• Relaxed

Alphas.89-.93 (7 days)

Negative Affect

• Tense• Hostile• Resentful• Angry

• Sad• Depressed• Unhappy• On-edge• Nervous

Alphas.87-.92 (7 days)

Controls (3rd-spurious factors)

• Age• Sex• Race• Body Mass• Season• Education• Antibody Level• Virus

Is PA associated with susceptibility to colds?

Low Middle High0

5

10

15

20

25

30

35

Low (N=112)Middle (N=111)High (N=111)

Positive Emotional Style(by Interviews)

% C

olds

Cohen et al. Psychosomatic Medicine, 2003

There may be more of a relationship between Sneezy and Happy than previously thought. A medical study has found that happy folks are less likely to catch colds.

National Post, Wednesday, July 23, 2003

Is NA associated with susceptibility to colds?

Low Middle High0

5

10

15

20

25

30

Low (N=110)Middle (N=111)High (N=113)

Negative Emotional Style(by Interviews)

% C

olds

Driven by a single component of PA?

• Vigor (lively, full-of-pep, energetic)• Well-being (happy, pleased, cheerful)• Calm (at ease, calm, relaxed)

ALL PREDICT

Does PA buffer NA?

NO

+ EmotionalStyle

HealthPractices

Cytokines Susceptibilityto Infection

Epi, Norepi & Cortisol

+ Emotions and Pathways to Health+ Emotions and Pathways to Health

Better Sleep Quality

Lower Cortisol

More Dietary Zinc

Lower Epinephrine

Better Sleep Efficiency

Positive EmotionalStyle

More Exercise

Lower Norepinephrine

Regulation of Cytokines

+ EmotionalStyle

HealthPractices

Cytokines Susceptibilityto Infection

Epi, Norepi & Cortisol

Virus, you’re insulting me…In retaliation, I’ve releasedthe cytokines!

V I R U S

IL-1

TNF

IL-6

-----

IL-8

Endothelial Cell

stimulate

vagus nerve

adhesion

activate PMNs

temperatureregulation

chemotaxis

Inflammation

Daily Adjusted IL6 by PES Level[Infected Ss Only]

1 2 3 4 50.0

0.1

0.2

0.3

0.4

0.5

0.6

0.7Low PESMid PESHigh PES

Study Day

Adj

uste

d IL

-6 (l

og-1

0)

Doyle, Cohen & Gentile, Brain, Behavior and Immunity, 2006

If only you were happy.

Is it a reliable (replicable) effect?

PMBC Cold Study 4 Years N=193 2 Viruses (Flu & RV)

6 Day Quarantine

VIRUSVIRUS

14 interviews14 interviews

Positive & Negative Positive & Negative Emotional StyleEmotional Style

Sign/Symptom Sign/Symptom SeveritySeverity

• Standard Controls and NA

• But also included controls for:Potential Cognitive and Social

confounders Self-reported Health

HighMiddleLow

Positive Emotional Style

40%

35%

30%

25%

20%

% C

olds

(Adj

. for

Con

trol

s)


HighMiddleLow

Negative Emotional Style

40%

35%

30%

25%

20%

% C

olds

(Adj

. for

Con

trol

s)


Driven by a single component of PA?

• Vigor (lively, full-of-pep, energetic)• Well-being (happy, pleased, cheerful)• Calm (at ease, calm, relaxed)

Only Activated Emotions (Vigor & Well-Being) Predict

Is PA-cold Association Independent of Self-rated

Health?In general, would you say your health is:

Excellent Very Good GoodFair Poor

From SF-36: Ware & Kosinski (2001)

PES predicts colds independent of S-R health question!

Is the PA-Cold Association Independent of Related

Traits?

Associations between PA and Colds are INDEPENDENT of

• Trait Negative Affect• Self-esteem (Rosenberg)• Extraversion (Goldberg Big 5)• Optimism (LOT)• Purpose (LET)• Mastery(Pearlin)

COLDS SummaryThose high in PES are less susceptible to

colds.

Independent of NES social & cognitive variables self-reported health

Activated PA May Be Key

II. SYMPTOMS

I’m not as sick as I look!

Is PA Associated with Unfound Symptoms?

Unfound Symptoms=Symptom reports that exceed what one would predict from objective signs of illness

(mucus weights and mucuciliaryclearance)

Pittsburgh Common Cold Study II N=334 3 Years 2 Viruses

VIRUSVIRUS

6 Day Quarantine

Positive & Positive & Negative Negative

Emotional StyleEmotional Style

7 Evening Interviews

Infection Infection Signs of IllnessSigns of Illness

SymptomsSymptoms

Covariates in Regression

• Standard Controls (age, sex, race, BMI, virus, season, education, Ab)

• Mucus Weights• Mucuciliary Clearance

Cohen, at al. Psychosomatic Medicine 2003

NA and PA effects overlap

A Replication: PMBC Cold Study 4 Years N=195 2 Viruses

6 Day Quarantine

VIRUSVIRUS

14 interviews14 interviews

Positive & Negative Positive & Negative Emotional StyleEmotional Style

Sign/Symptom Sign/Symptom Severity Among Severity Among

InfectedInfected

HighMiddleLow

Positive Emotional Style

0.15

0.10

0.05

0.00

-0.05

-0.10

-0.15

Unf

ound

ed S

ympt

oms

Scor

e

These association are independent of

• Standard Controls• NA (PA wipes out NA)• Mastery• Control• Optimism• Self-esteem• Self-reported Health

Symptoms Summary

Higher PES is associated with reporting fewer symptoms than one would expect.

• stronger than the NES-symptom association.

• independent of social and cognitive variables.

• activation doesn’t matter.

III. LONGEVITY

Emotional Word Use in Autobiographies & Longevity

Sheldon’sAutobiography

Nun Study

• 180 Catholic Nuns wrote autobiographies at mean age of 22.

• Followed for mortality for 6 decades.

•Biographies were coded for # positive emotion words,# sentences using positive

emotion words# different positive emotion words

Danner, Snowden, & Friesen, JPSP, 2001.

0.0

0.5

1.0

1.5

2.0

2.5

3.0

3.5R

elat

ive

Ris

k of

Mor

talit

y

1 (low) 2 3 4 (High)Positive Emotion Words


0.0

0.5

1.0

1.5

2.0

2.5

3.0

3.5

4.0

4.5R

elat

ive

Ris

k of

Mor

talit

y

1 (low) 2 3 4 (High)Different Positive Emotions


Nun Study

• Negative emotion words and sentences were not associated with mortality

Longevity of Famous (DEAD) Psychologists

• 96- psychologists included in series:A History of Psychology in Autobiography

• Average age ~65 when autobio written

• Computerized text counts of positive and negative emotion words

Pressman & Cohen, under review

New Questions Include

• What types of PA matter (circumplexapproach)?

• Is the association independent of author’s health and health history?

• Is the association independent of potential social and cognitive confounds?

Examples of Psychologists

• Hilgard• Murray • Newcomb• Osgood• Simon • Skinner• Terman• Tolman

• Allport• Boring• Broadbent• Cattell• Eysenck• Guilford• Hebb• Helson

Circumplex Emotions (examples)

Positive Activated• active• lively• energetic

Positive Unactivated• calm• contented• relaxed

Negative Activated• tense• uneasy• distressed

Negative Unactivated• tired• sleepy• passive

COVARIATESDemographic Controls– Date of birth– Sex– Age at autobio writing– Native language

Health and Health History Control(Self references to illness terms, e.g., sick, ill, blood pressure, cancer, heart disease, stroke)

The association between high and low usage of affect words with longevity in psychologists

70

72

74

76

78

80

82

84

Activated PA Activated NA Unactivated NA Unactivated PA

Year

s Li

ved

Low

High

Which Quadrant is Most Important?

Activated PA*Activated NA

Activated PA*Activated NAUnactivated PAUnactivated NA

Additional Controls Based on WORD COUNTS

• Cognitive Factors– Optimism (optimism, hope, win)– Control/Certainty (certain, control, definite)– Self-Assuredness (proud, strong, fearless)

• Social factors– Use of we and they– Use of social roles (spouse, friend, relatives,

group members, etc.)

Activated PA – Longevity

is Independent ofALL THE COGNITIVE AND

SOCIAL FACTORS

LONGEVITY Summary

Use of activated positive affective terms is associated with living longer.

independent of

• the use of negative terms

• social and cognitive variables

TALK SUMMARY (for multiple choice test)

• There is promising evidence linking Trait PA to:

morbiditymortalitysymptoms, and pain

• PA may be more important then NA in predicting health.

• Activated PA is more important in predicting objective outcomes but not symptom reporting.

• More sophisticated studies are needed – to establish these relationships– to clarify the types of PA that matter– to distinguish between effects of PA and other

related variables – to determine how PA could influence health

THE END

“And I seem to find the happiness I seek, when we’re out dancing cheek to cheek”

Irving Berlin

Positive Affect and Antibody Response

-0.3

-0.2

-0.1

0

0.1

0.2

0.3Po

sitiv

e A

ffect

Sco

res

Low Ab High Ab

Marsland, Cohen et al. Brain, Behavior & Immunity, in press.

Is PA associated with resting cortisol?

0.7

0.8

0.9

1

1.1

1.2

1.3

1.4

1.5

1 Hour 4 Hours 9 Hours 11 HoursTime after wake-up

Cor

tisol

(Log

mg/

mol

Low PA

Medium PA

High PA

Pressman, Cohen et al. Unpublished manuscript

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