abstract
The search for the psychological antecedents of medical disorders has focused on the role of stress and negative emotional states. Previous research in this area has investigated relations between negative emotions and physiological adaptations (e.g., blood pressure elevations), adverse health behaviors (e.g., smoking), and social conditions (e.g., social isolation). In this discussion, we argue that more attention is needed to understand the effects of positive emotional states on health enhancement and disease prevention. In each of the areas cited previously, evidence is beginning to emerge that indicates that positive emotions can be associated with health promoting conditions. Interventions using cognitive behavioral strategies or meditation can increase positive emotional states that are maintained over time and that may benefit health and well-being. Implications for behavioral medicine are discussed.
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Alexander, F. (1939). Emotional factors in essential hypertension. Psychosomatic Medicine 1, 173–179.
Antoni, M. H., Baggett, L., Ironson, G., LaPerriere, A., August, S., Klimas, N., Schneiderman, N., & Fletcher, M. H. (1991). Cognitive-behavioral tress management intervention buffers distress responses and immunologic changes following notification of HIV-1 seropositivity. Journal of Consulting and Clinical Psychology 59 906–915.
Bandura, A. (1997). Self-efficacy: The exercise of control New York: Freeman.
Barefoot, J. C., & Schroll, M. (1996). Symptoms of depression, acute myocardial infarction, and total mortality in a community sample. Circulation 93, 1976–1980.
Billings, D. W., Folkman, S., Acree, M., & Moskowitz, J. T. (2000). Coping and physical health during caregiving: The roles of positive and negative affect. Journal of Personality and Social Psychology, 79, 131–142.
Blazer, D. G., Kessler, R. C., McGonagle, K. A., & Swartz, M. S. (1994). The prevalence and distribution of major depression in a national community sample: The National Comorbidity Survey. American Journal of Psychiatry, 151, 979–986.
Bower, J. E., Kemeny, M. E., Taylor, S. E., & Fahey, J. L. (2003). Finding positive meaning and its association with natural killer cell cytotoxicity among participants in a bereavement-related disclosure intervention. Annals of Behavioral Medicine, 25, 146–155.
Bradburn, N., & Caplovitz, D. (1965). Reports on happiness: A pilot study of behavior related to mental health. Chicago: Aldine.
Brassington, G. S., Atienza, A. A., Perczek, R. E., DiLorenzo, T. M., & King, A. C. (2002). Intervention-related cognitive versus social mediators of exercise adherence in the elderly. American Journal of Preventative Medicine, 23(2 Suppl), 80–86.
Brosschot, J. F., & Thayer, J. F. (1998). Anger inhibition, cardiovascular recovery, and vagal function: A model of the link between hostility and cardiovascular disease. Annals of Behavioral Medicine, 20, 326–332.
Brown, E. S., Varghese, F. P., & McEwen, B. S. (2004). Association of depression with medical illness: Does cortisol play a role? Biological Psychiatry, 55, 1–9.
Brummett, B. H., Babyak, M. A., Siegler, I. C., Mark, D. B., Williams, R. B., & Barefoot, J. C. (2003). Effect of smoking and sedentary behavior on the association between depressive symptoms and mortality from coronary heart disease. American Journal of Cardiology, 92, 529–532.
Brummett, B. H., Barefoot, J. C., Vitaliano, P. P., & Siegler, I. C. (2003). Associations among social support, income, and symptoms of depression in an educated sample: The UNC Alumni Heart Study. International Journal of Behavioral Medicine, 10, 239–250.
Bush, D. E., Ziegelstein, R. C., Tayback, M., Richter, D., Stevens, S., Zahalsky, H., & Fauerbach, J. A. (2001). Even minimal symptoms of depression increase mortality risk after acute myocardial infarction. American Journal of Cardiology, 88, 337–341.
Bushman, B. J., & Baumeister, R. (1998). Threatened egotism, narcissism, self-esteem and direct and displaced aggression: Does self-love or self-hate lead to violence? Journal of Personality and Social Psychology, 75, 219–229.
Cacioppo, J. T., Berntson, G. G., & Gardner, W. L. (1999). The affect system has parallel and integrative processing components: Form follows function. Journal of Personality and Social Psychology, 76, 805–819.
Cacioppo, J. T., Berntson, G. G., Larsen, J. T., Poehlmann, K. M., & Ito, T. A. (2000). The psychophysiology of emotion. In M. Lewis & J. M. Haviland-Jones (Eds.), Handbook of emotions (pp. 173–191). New York: Guilford.
Cannon, W. B. (1929). Bodily changes in pain, hunger, fear and rage. New York: Appleton.
Carney, R. M., Rich, M. W., Tevelde, A., Saini, J., Clark, K., & Jaffe, A. S. (1995). Depression as a risk factor or cardiac events in established coronary heart disease: A review of possible mechanisms. Annals of Behavioral Medicine, 17, 142–149.
Castro, C. M., Wilcox, S., O’Sullivan, P., Baumann, K., & King, A. C. (2002). An exercise program for women who are caring for relatives with dementia. Psychosomatic Medicine, 64, 458–468.
Chesney, M. A., Chambers, D. B., Taylor, J. M., Johnson, L. S., & Folkman, S. (2003). Coping effectiveness training for men living with HIV: Results from a randomized clinical trial testing a group-based intervention. Psychosomatic Medicine, 65, 1038–1046.
Chesney, M. A., & Folkman, S. (1994). Psychological impact of HIV disease and implications for intervention. Psychiatric Clinics of North America, 17, 163–182.
Chesney, M., Folkman, S., & Chambers, D. (1996). Coping effectiveness training for men living with HIV: Preliminary findings. International Journal of STD & AIDS, 7(Suppl 2), 75–82.
Cohen, S. (1988). Psychosocial models of the role of social support in the etiology of physical disease. Health Psychology, 7, 269–297.
Cohen, S., Doyle, W. J., Turner, R., Alper, C. M., & Skoner, D. P. (2003). Sociability and susceptibility to the common cold. Psychological Science, 14, 389–395.
Cohen, S., Karmarck, T., & Mermelstein, R. (1983). A global measure of perceived stress. Journal of Health and Social Behavior, 24, 385–396.
Cruess, D. G., Antoni, M. H., McGregor, B. A., Kilbourn, K. M, Boyers, A. E., Alferi, S. M., Carver, C. S., & Kumar, M. (2000). Cognitive-behavioral stress management reduces serum cortisol by enhancing benefit finding among women being treated for early stage breast cancer. Psychosomatic Medicine, 62, 304–308
Danner, D. D., Snowdon, D. A., & Friesen, W. V. (2001). Positive emotions in early life and longevity: Findings from the nun study. Journal of Personality and Social Psychology, 80, 804–813.
Davidson, R. J., Coe, C. C., Dolski, I., & Donzella, B. (1999). Individual differences in prefrontal activation asymmetry predict natural killer cell activity at rest and in response to challenge. Brain, Behavior, and Immunity, 13, 93–108.
Davidson, R. J., Kabat-Zinn, J., Schumacher, J., Rosenkranz, M., Muller, D., Santorelli, S. F., Urbanowski, F., Harrington, A., Bonus, K., & Sheridan, J. F. (2003). Alterations in brain and immune function produced by mindfulness meditation. Psychosomatic Medicine, 65, 564–570.
Diener, E., & Emmons, R. A. (1985). The independence of positive and negative affect. Journal of Personality and Social Psychology, 47, 1105–1117.
DiMatteo, M. R., Lepper, H. S., & Croghan, T. W. (2000). Depression is a risk factor for noncompliance with medical treatment: Meta-analysisofthe effectsofanxiety and depressiononpatient adherence. Archives of Internal Medicine, 160, 2101–2107.
Eaker, E. D., Pinsky, J., & Castelli, W. P. (1992). Myocardial infarction and coronary death among women: Psychosocial predictors from a 20-year follow-up of women in the Framingham Study. American Journal of Epidemiology, 135, 854–864.
Emmons, R. A., & Paloutzian, R. F. (2003). The psychology of religion. Annual Review of Psychology, 54, 377–402.
Engel, G. L. (1971). Sudden and rapid death during psychological stress. Annals of Internal Medicine, 74, 771–782.
Fawzy, F. I., Namir, S., & Wolcott, D. L. (1989). Structured group intervention model for AIDS patients. Psychiatric Medicine, 7(2), 35–45.
Folkman, S. (1997). Positive psychological states and coping with severe stress. Social Science & Medicine, 45, 1207–1221.
Folkman, S., & Chesney, M. (1995). Coping with HIV infection. In M. Stein & A. Baum (Eds.), Chronic diseases (pp. 115–134). Mahwah, NJ: Lawrence Erlbaum Associates, Inc.
Folkman, S., Chesney, M. A., Collette, L., Boccellari, A., & Cooke, M. (1996). Postbereavement depressive mood and its prebereavement predictors in HIV + and HIV- gay men. Journal of Personality and Social Psychology, 70, 336–348.
Folkman, S., Chesney, M., McKusick, L., Ironson, G., Johnson, D., & Coates, T. (1991). Translating coping theory into intervention. In J. Eckenrode (Ed.), The social context of stress (pp. 239–260). New York: Plenum.
Folkman, S., & Moskowitz, J. T. (2000). Positive affect and the other side of coping. American Psychologist, 55, 647–654.
Frank, J. D. (1961). Persuasion and healing. New York: Schocken.
Fredrickson, B. L. (2000). Cultivating positive emotions to optimize health and well-being. Retrieved March 27, 2003 from the World Wide Web: http://www.journals.apa.org/prevention/volume3/pre0030001a.html
Fredrickson, B. L., & Levenson, R. W. (1998). Positive emotions speed recovery from the cardiovascular sequelae of negative emotions. Cognition and Emotion, 12, 191–220.
Gorham, G. (1994). Mind-body dualism and the Harvey-Descartes controversy. Journal of History of Ideas, 55, 211–234.
Henriques, J., & Davidson, R. J. (1991). Left frontal hypoactivation in depression. Journal of Abnormal Psychology, 99, 22–31.
Hobfoll, S. E. (1989). Conservation of resources: A new attempt at conceptualizing stress. American Psychologist, 44, 513–524.
Hobfoll, S. E., Johnson, R. J., Ennis, N., & Jackson, A. P. (2003). Resource loss, resource gain, and emotional outcomes among inner city women. Journal of Personality and Social Psychology, 84, 632–43.
Horowitz, M., Adler, N.,; & Kegeles, S. (1988). A scale for measuring the occurrence of positive states of mind: A preliminary report. Psychosomatic Medicine, 50, 477–483.
IOM (Institute of Medicine) (2001). Health and behavior: The interplay of biological, behavioral, and societal influences. Washington, DC: National Academy Press.
Ironson, G, Solomon, G. F., Balbin, E. G., O’Cleirigh, C., George, A., Kumar, M., Larson, D., & Woods, T. E. (2002). The Ironson-Woods Spirituality/Religiousness Index is associated with long survival, health behaviors, less distress, and low cortisol in people with HIV/AIDS. Annals of Behavioral Medicine, 24, 34–48.
Kabat-Zinn, J., Massion, A. O., Kristeller, J., Peterson, L. G., Fletcher, K. E., Pbert, L., Lenderking, W. R., & Santorelli, S. F. (1992). Effectiveness of a meditation-based stress reduction program in the treatment of anxiety disorders. American Journal Of Psychiatry, 149, 936–943.
Kalin, N., Larson, C., Shelton, S., & Davidson, R. (1998). Asymmetric frontal brain activity, cortisol, and behavior associated with fearful temperament in Rhesus monkeys. Behavioral Neuroscience, 112, 286–292.
King, A. C., Porter, L. A., & Rowe, M. A. (1994). Functional, social, and emotional outcomes in women and men in the first year following coronary artery bypass surgery. Journal of Women’s Health, 3, 347–354.
King, A. C., Taylor, C. B., Haskell, W. L., & De Busk, R. F. (1990). Identifying strategies for increasing employee physical activity levels: Findings from the Stanford/Lockheed Exercise Survey. Health Education Quarterly, 17, 269–285.
Kritz-Silverstein, D., Barrett-Connor, E., & Corbeau, C. (2001). Cross-sectional and prospective study of exercise and depressed mood in the elderly: The Rancho Bernardo study. American Journal of Epidemiology, 153, 596–603.
Kubzansky, L. D., & Kawachi, I. (2000). Going to the heart of the matter: Do negative emotions cause coronary heart disease? Journal of Psychosomatic Research, 48(4-5), 323–337.
Kubzansky, L. D., Kawachi, I., Weiss, S. T., & Sparrow, D. (1998). Anxiety and coronary heart disease: A synthesis of epidemiological, psychological, and experimental evidence. Annals of Behavioral Medicine, 20, 47–58.
Lazarus, R. S. (1991). Emotion and adaptation. New York: Oxford University Press.
Lazarus, R., & Folkman, S. (1984). Stress, appraisal, and coping. New York: Springer.
Lorant, V., Deliege, D., Eaton, W., Robert, A., Philippot, P., & Ansseau, M. (2003). Socioeconomic inequalities in depression: A metaanalysis. American Journal of Epidemiology, 157, 98–112.
Maruta, T., Colligan, R. C., Malinchoc, M., & Offord, K. P. (2000). Optimists vs pessimists: Survival rate among medical patients over a 30-year period. Mayo Clinic Proceedings, 75, 140–143.
McCullough, M. E., Emmons, R. A., & Tsang, J. (2002). The grateful disposition: A conceptual and empirical topography. Journal of Personality and Social Psychology, 82, 112–127.
Merchant, A., Pitiphat, W., Ahmed, B., Kawachi, I.,; & Joshipura, K. (2003). A prospective study of social support, anger expression and risk of periodontitis in men. Journal of the American Dental Association, 134, 1591–1596.
Miller, T. Q., Smith, T. W., Turner, C. W., Guijarro, M. L., & Hallet, A. J. (1996). A meta-analytic review of research on hostility and physical health. Psychological Bulletin, 119, 322–348.
Moskowitz, J. T. (2003). Positive affect predicts lower risk of AIDS mortality. Psychosomatic Medicine, 65, 620–626.
O’Brien, J. T., Lloyd, A., McKeith, I., Gholkar, A., & Ferrier N. (2004). A longitudinal study of hippocampal volume, cortisol levels, and cognition in older depressed subjects. American Journal of Psychiatry, 161, 2081–290.
Ostir, G. V., Markides, K. S., Black, S. A., & Goodwin, J. S. (2000). Emotional well-being predicts subsequent functional independ- ence and survival. Journal American Geriatric Society, 48, 473–478.
Park, C. L., & Blumberg, C. J. (2002). Disclosing trauma through writing: Testing the meaning-making hypothesis. Cognitive Therapy and Research, 26, 597–616.
Penninx, B. W., Beekman, A. T., Honig, A., Deeg, D. J., Schoevers, R. A., van Eijk, J. T., & van Tilburg, W. (2001). Depression and cardiac mortality: Results from a community-based longitudinal study. Archives of General Psychiatry, 58, 221–227.
Peterson, C., Seligman, M. E. P., Yurko, K. H., Martin, L. R., & Friedman, H. S. (1998). Catastrophizing and untimely death. Psychological Science, 9, 127–130.
Powell, L. H., Shahabi, L., & Thoresen, C. E. (2003). Religion and spirituality: Linkages to physical health. American Psychologist, 58, 36–52
Räikkōnen, K., Matthews, K. A., Flory, J. D., & Owens, J. F. (1999). Effects of hostility on ambulatory blood pressure and mood duringdailylivinginhealthyadults. HealthPsychology, 18, 44–53.
Rosenkranz, M. A., Jackson, D. C., Dalton, K. M., Dolski, I., Ryff, C. D., Singer, B. H., Muller, D., Kalin, N. H., & Davidson, R. J. (2003). Affective style and in vivo immune response: Neuro- behavioral mechanisms. Proceedings of the National Academy of Science of the United States of America, 100, 11148–11152.
Rosenman, R. H., Brand, R. J., Jenkins, D., Friedman, M., Straus, R., & Wurm, M. (1975). Coronary heart disease in Western Collaborative Group Study. Final follow-up experience of 8–1/2 years. Journal of the American Medical Association, 233, 872–877.
Russell, J. A., & Barrett, L. F. (1999). Core affect, prototypical emotional episodes, and other things called emotion: Dissecting the elephant. Journal of Personality and Social Psychology, 76, 805–819.
Salovey, P., Rothman, A. J., Detweiler, J. B., & Steward, W. T. (2000). Emotional states and physical health. American Psychologist, 55, 110–121.
Selye, H. (1956). The stress of life. New York: McGraw-Hill.
Siegler, I. C., Costa, P. T., Brummett, B. H., Helms, M. J., Barefoot, J. C., Williams, R. B., Dahlstrom, W. G., Kaplan, B. H., Vitaliano, P. P., Nichaman, M. Z., Day, R. S., & Rimer, B. K. (2003). Patterns of change in hostility from college to midlife in the UNC Alumni Heart Study predict high-risk status. Psychosomatic Medicine, 65, 738–745.
Silverman, M. E., Murray, T. J., & Brian, C. S. (2003). The quotable Osler. Philadelphia: American College of Physicians.
Smith, T. W., & Gallo, L. C. (1999). Hostility and cardiovascular reactivity during marital interaction. Psychosomatic Medicine, 61, 436–445.
Smith, T. W., & Ruiz, J. M. (2002). Psychosocial influences on the development and course of coronary heart disease: Current status and implications for research and practice. Journal of Consulting and Clinical Psychology, 70, 548–68
Solomon, R. C. (1977). The passions. New York: Anchor.
Spielberger, C. D., Gorsuch, R. L., & Lushene, R. E. (1974). STAI manual for the state-trait anxiety inventory. Palo Alto, CA: Consulting Psychologists Press.
Sternberg, E. M. (2001). Neuroendocrine regulation of autoimmune/inflammatory disease. Journal of Endocrinology, 169, 429–435.
Suarez, E. C., & Blumenthal, J. A. (1991). Ambulatory blood pressure responses during daily life in high and low hostile patients with a recent myocardial infarction. Journal of Cardiopulmonary Rehabilitation, 11, 169–175.
Takkouche, B., Regueira, C., & Gestal-Otero, J. J. (2001). A cohort study of stress and the common cold. Epidemiology, 12, 345–349.
Taylor, S. E., & Brown, J. D. (1988). Illusion and well-being: A social psychological perspective on mental health. Psychological Bulletin, 103, 193–210.
Taylor, S. E., Kemeny, M. E., Reed, G. M., Bower, J. E., & Gruenewald, T. L. (2000). Psychological resources, positive illusions, and health. American Psychologist, 55, 99–109.
Taylor, S. E., Lerner, J. S., Sherman, D. K., Sage, R. M., & McDowell, N. K. (2003). Are self-enhancing cognitions associ- ated with healthy or unhealthy biological profiles? Journal of Personality and Social Psychology, 85, 605–615.
Taylor, S. E., & Seeman, T. E. (1999). Psychosocial resources and the SES-health relationship. Annals of the New York Academy of Sciences, 896, 210–225.
Tomarken, A. J., Davidson, R. J., Wheeler, R. E., & Kinney, L. (1992). Psychometric properties of resting anterior EEG asymmetry: Temporal stability and internal consistency. Psychophysiology, 29, 576–592.
Vitaliano, P., Dougherty, C., & Siegler, I. C. (1994). Biopsychosocial risks for cardiovascular disease in spouse caregivers of persons with Alzheimer’s disease. New York: Springer.
Watson, D., Clark, L. A., & Tellegen, A. (1988). Development and validation of brief measures of positive and negative affect: The PANAS scales. Journal of Personality and Social Psychology, 6, 1063–1070.
Williams, R. B., Barefoot, J. C., & Schneiderman, N. (2003). Psychosocial risk factors for cardiovascular disease: More than one culprit at work. Journal of the American Medical Association, 290, 2190–2192.
Wilson, R. S., Bienias, J. L., Mendes de Leon, C. F., Evans, D. A., & Bennett, D. A. (2003). Negative affect and mortality in older persons. American Journal of Epidemiology, 158, 827–835.
Wortman, C., & Silver, R. (1987). Coping with irrevocable loss. In G. R. Vandenbos & B. K. Bryand (Eds.), Cataclysms, crises and catastrophes: Psychology in action (pp. 189–235). Washington, DC: American Psychological Association.
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This article is based on a presentation given by the first author at the International Congress of Behavioral Medicine, Helsinki, Finland, August 2002. This work was supported by grants R01 MH57233 (Margaret A. Chesney, principal investigator) and P30-MH62246 (Thomas J. Coates, principal investigator) from the National Institute of Mental Health. The authors thank Susan Folkman and Judith Moskowitz at the Osher Center for Integrative Medicine at the University of California, San Francisco, for their collaboration and guidance in the theoretical aspects of enhancing positive affect and meaning through coping effectiveness training (CET). We also thank the dedicated staff members and participants of the CET research trials.
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Chesney, M.A., Darbes, L.A., Hoerster, K. et al. Positive emotions: exploring the other hemisphere in behavioral medicine. Int. J. Behav. Med. 12, 50–58 (2005). https://doi.org/10.1207/s15327558ijbm1202_2
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DOI: https://doi.org/10.1207/s15327558ijbm1202_2