No full-text available
To read the full-text of this research,
you can request a copy directly from the authors.
Is the Glass Half Empty or Half Full? A Prospective Study of Optimism and Coronary Heart Disease in the Normative Aging Study
Abstract
A sense of optimism, which derives from the ways individuals explain causes of daily events, has been shown to protect health, whereas pessimism has been linked to poor physical health. We examined prospectively the relationship of an optimistic or pessimistic explanatory style with coronary heart disease incidence in the Veterans Affairs Normative Aging Study, an ongoing cohort of older men.
In 1986, 1306 men completed the revised Minnesota Multiphasic Personality Inventory, from which we derived the bipolar revised Optimism-Pessimism Scale. During an average of 10 years of follow-up, 162 cases of incident coronary heart disease occurred: 71 cases of incident nonfatal myocardial infarction, 31 cases of fatal coronary heart disease, and 60 cases of angina pectoris. Compared with men with high levels of pessimism, those reporting high levels of optimism had multivariate-adjusted relative risks of 0.44 (95% confidence interval = 0.26-0.74) for combined nonfatal myocardial infarction and coronary heart disease death and 0.45 (95% confidence interval = 0.29-0.68) for combined angina pectoris, nonfatal myocardial infarction, and coronary heart disease death. A dose-response relation was found between levels of optimism and each outcome (p value for trend,.002 and.0004, respectively).
These results suggest that an optimistic explanatory style may protect against risk of coronary heart disease in older men.
... Empirical studies provide evidence for the impact of a NAS on depressive symptoms [for a review see 15]. Further, prior work has described associations of NAS with measures of physical health ranging from self-reported hypertension [16] and general health [17], to specific measures of physical functioning, like the T lymphocyte CD4/CD8 ratio (T-lymphocytes which are part of the immune system) and their response to stimulation by Phytohaemagglutinin [18], to incidents of CVD [19], and death caused by a coronary event [19,20]. However, while both NAS and cortisol are associated with depression [15,28] and CVD [8,9,19], no previous study examined the relation between stressful situations in general and NAS with cortisol nor between cancer caregiver stress and NAS with depressive symptoms and cortisol in particular. ...
... Empirical studies provide evidence for the impact of a NAS on depressive symptoms [for a review see 15]. Further, prior work has described associations of NAS with measures of physical health ranging from self-reported hypertension [16] and general health [17], to specific measures of physical functioning, like the T lymphocyte CD4/CD8 ratio (T-lymphocytes which are part of the immune system) and their response to stimulation by Phytohaemagglutinin [18], to incidents of CVD [19], and death caused by a coronary event [19,20]. However, while both NAS and cortisol are associated with depression [15,28] and CVD [8,9,19], no previous study examined the relation between stressful situations in general and NAS with cortisol nor between cancer caregiver stress and NAS with depressive symptoms and cortisol in particular. ...
... Further, prior work has described associations of NAS with measures of physical health ranging from self-reported hypertension [16] and general health [17], to specific measures of physical functioning, like the T lymphocyte CD4/CD8 ratio (T-lymphocytes which are part of the immune system) and their response to stimulation by Phytohaemagglutinin [18], to incidents of CVD [19], and death caused by a coronary event [19,20]. However, while both NAS and cortisol are associated with depression [15,28] and CVD [8,9,19], no previous study examined the relation between stressful situations in general and NAS with cortisol nor between cancer caregiver stress and NAS with depressive symptoms and cortisol in particular. Considering the relevance of depression [for a review see 5] and cortisol [for a review see 6] and the importance of a modifiable factor like NAS [13] for interventions to improve health in this population, this seems a crucial gap in the literature. ...
Purpose
We examined the effect of informal cancer caregiver stress and negative attribution style (NAS) on depressive symptoms and salivary cortisol.
Method
The sample came from a hospital bone marrow unit and caregiver support organizations and included 60 informal cancer caregivers (51.7% partners) of individuals with cancer (provided care for a median of 27.5 h per week for 12 months) and 46 non-caregiver participants. In this cross-sectional study, participants completed questionnaires assessing NAS and depressive symptoms and provided saliva samples to measure cortisol.
Results
Linear regressions demonstrated that cancer caregiver stress (p = 0.001) and the cancer caregiver stress by NAS interaction (p = 0.017), but not NAS alone (p = 0.152), predicted depressive symptoms. Caregivers independent of their NAS and non-caregivers high in NAS reported high depression while non-caregivers low in NAS reported low depression. Neither cancer caregiver stress (p = 0.920) nor NAS alone (p = 0.114), but their interaction, predicted cortisol (p = 0.036). Higher NAS was associated with a higher cortisol in both groups while non-caregivers had higher cortisol than caregivers.
Conclusions
If the findings can be replicated, consideration of NAS in existing interventions to support informal cancer caregivers in managing chronic stress appears warranted.
... Empirical studies provide evidence for the impact of a NAS on depressive symptoms [for a review see 15]. Further, prior work has described associations of NAS with measures of physical health ranging from self-reported hypertension [16] and general health [17], to specific measures of physical functioning, like the T lymphocyte CD4/CD8 ratio (T-lymphocytes which are part of the immune system) and their response to stimulation by Phytohaemagglutinin [18], to incidents of CVD [19], and death caused by a coronary event [19,20]. However, while both NAS and cortisol are associated with depression [15,28] and CVD [8,9,19], no previous study examined the relation between stressful situations in general and NAS with cortisol nor between cancer caregiver stress and NAS with depressive symptoms and cortisol in particular. ...
... Empirical studies provide evidence for the impact of a NAS on depressive symptoms [for a review see 15]. Further, prior work has described associations of NAS with measures of physical health ranging from self-reported hypertension [16] and general health [17], to specific measures of physical functioning, like the T lymphocyte CD4/CD8 ratio (T-lymphocytes which are part of the immune system) and their response to stimulation by Phytohaemagglutinin [18], to incidents of CVD [19], and death caused by a coronary event [19,20]. However, while both NAS and cortisol are associated with depression [15,28] and CVD [8,9,19], no previous study examined the relation between stressful situations in general and NAS with cortisol nor between cancer caregiver stress and NAS with depressive symptoms and cortisol in particular. ...
... Further, prior work has described associations of NAS with measures of physical health ranging from self-reported hypertension [16] and general health [17], to specific measures of physical functioning, like the T lymphocyte CD4/CD8 ratio (T-lymphocytes which are part of the immune system) and their response to stimulation by Phytohaemagglutinin [18], to incidents of CVD [19], and death caused by a coronary event [19,20]. However, while both NAS and cortisol are associated with depression [15,28] and CVD [8,9,19], no previous study examined the relation between stressful situations in general and NAS with cortisol nor between cancer caregiver stress and NAS with depressive symptoms and cortisol in particular. Considering the relevance of depression [for a review see 5] and cortisol [for a review see 6] and the importance of a modifiable factor like NAS [13] for interventions to improve health in this population, this seems a crucial gap in the literature. ...
Purpose. We examined the effect of cancer caregiver stress and negative attribution style (NAS) on depressive symptoms and salivary cortisol.
Method. The sample came from a hospital bone marrow unit and caregiver support organizations and included 60 informal cancer caregivers (51.7% partners) of cancer patients (provided care for a median of 27.5 hours per week for 12 months) and 46 non-caregiver participants. In this cross-sectional study, participants completed questionnaires assessing NAS and depressive symptoms and provided saliva samples to measure cortisol.
Results. Linear regressions demonstrated that cancer caregiver stress (p=0.001) and the cancer caregiver stress by NAS interaction (p=0.017), but not NAS alone (p=0.152), predicted depressive symptoms. Caregivers independent of their NAS and non-caregivers high in NAS reported high depression while non-caregivers low in NAS reported low depression. Neither cancer caregiver stress (p=0.920) nor NAS alone (p=0.114), but their interaction, predicted cortisol (p=0.036). Higher NAS was associated with a higher cortisol in both groups while non-caregivers had higher cortisol than caregivers.
Conclusions. If the findings can be replicated, the implementation of interventions to support informal caregivers in managing their chronic stress and modify their NAS appears warranted.
... This hypothesis is partially supported by researchers who examined the associations between solely causal attributions and physical health in general. [27][28][29][30] Overall the findings suggest causal attributions are associated with a variety of negative health indicators, including incidents of CVD that occurred over the 10 years after the causal attributions were measured 30 while inferences about consequences of a stressful event and inferences of characteristics of the self were never examined as independent cognitive styles. ...
... 25 While authors of one study found no association between hypertension and a combined score representing cognitive styles, 26 researchers examining associations between causal attributions and general health including CVD found associations. [27][28][29][30] Finally, research examining the associations between the other two proposed cognitive styles (inferences about consequences of a stressful event and inferences of characteristics of the self) and general health including blood pressure is lacking. Based on this overall pattern, one might propose that individual cognitive styles and general health, like blood pressure, might be associate differentially. ...
... As we could not identify previously published research in which individual cognitive styles and blood pressure were examined, our hypotheses were solely based on findings regarding depression and blood pressure 9 and studies of causal attributions and other measures of physical health. [27][28][29][30] Thus, our findings regarding cognitive styles and blood pressure might be only partially consistent with our predictions, but they are not contrary to previous findings. While we did not expect any specific cognitive style would be associated with lower SBP, researchers have found similar patterns in studies across multiple psychological variables and measures of physical health. ...
Objective
We proposed cognitive styles described in the Hopelessness Theory would be associated with depressive symptoms and Systolic Blood Pressure (SBP) and that depressive symptoms mediate these associations.
Participants
This cross-sectional study had 324 community college student participants (ages: 18 to 62 years, M = 24.08, SD = 9.10; 57.3% female; 57.3% White, 29.8% Black, 8.8% Latinx, 8.8% Other).
Methods
Besides self-reports of cognitive styles and depressive symptoms, resting blood pressure was measured three times at 1-min intervals and the mean was used in the analysis.
Results
Path analyses demonstrated differing associations between each cognitive style and SBP and no mediation, suggesting cognitive styles and depressive symptoms are independently associated with SBP.
Conclusions
When conceptualizing and measuring the associations of cognitive styles with depressive symptoms and SBP, the styles should be evaluated individually. Interventions targeting cognitive styles might be especially beneficial as changing them might improve mental and physical health.
... Dispositional optimism, the generalized expectation that good things will happen, has been linked with a broad array of positive intra-and interpersonal outcomes (e.g., Boehm et al., 2018;Srivastava, McGonigal, Richards, Butler, & Gross, 2006). For example, higher levels of optimism are associated with lower illness severity, lower cardiovascular risk, and reduced all-cause mortality (Kim et al., 2017;Kubzansky, Sparrow, Vokonas, & Kawachi, 2001;Mroczek, Spiro, Aldwin, Ozer, & Bossé, 1993). Although individuals vary in how optimistic they are about the future, one assumption that researchers make is that optimism (and other psychological characteristics) are sensitive to changes in life circumstances such as life events (Chopik, Kim, & Smith, 2015;Roberts, Wood, & Smith, 2005). ...
... There have been psychometric studies providing evidence for the two being both separable (Alessandri et al., 2010;Creed, Patton, & Bartrum, 2002) or a single dimension separated by differentially-keyed items (Steca, Monzani, Greco, Chiesi, & Primi, 2015). There are also studies showing that optimism or pessimism occasionally uniquely predict health and well-being outcomes while the other respective dimension does not (e.g., Chang, D'Zurilla, & Maydeu-Olivares, 1994;Kim, Park, & Peterson, 2011;Kubzansky et al., 2001;Marshall, Wortman, Kusulas, Hervig, & Vickers, 1992;Mroczek et al., 1993;Nabi et al., 2010;Roy et al., 2010;Serlachius et al., 2015). Other researchers have tried to make more conceptual distinctions between the two, such that optimists employ active, approach-oriented coping styles and pessimists employ avoiding coping styles, suggesting they are separable in how they approach challenges (Nes & Segerstrom, 2006;Scheier & Carver, 2018). ...
... After settling on the two-factor solution, we tested for weak-, strong-, and strict-invariance over time for the pessimism scale (testing for invariance was not possible for the 2-item optimism scale because models were underidentified-there were more free parameters than observations; Kline, 2015;Yong & Pearce, 2013). The pessimism scales demonstrated strict invariance (e.g., CFIs > 0.98), with minimal changes in model fit across constraining factor loadings, means, variances, intercepts, and residual variances (DCFIs < 0.005, DTLIs < 0.006, DRMSEAs < 0.004, DSRMRs < 0.004). ...
Although individuals vary in how optimistic they are about the future, one assumption that researchers make is that optimism is sensitive to changes in life events and circumstances. We examined how optimism and pessimism changed across the lifespan and in response to life events in three large panel studies (combined N = 74,886). In the American and Dutch samples, we found that optimism increased across younger adulthood, plateaued in midlife, and then decreased in older adulthood. In the German sample, there were inconsistent results with respect to age differences and mean level changes in optimism. Associations between life events and changes in optimism/pessimism were inconsistent across samples. We discuss our results in the context of life events and lifespan development.
... Optimism, defined as confidence and hopefulness for positive future outcomes and a general belief that good things will happen in life [15,16], is typically measured by self-report instruments, such as the Life Orientation Test-Revised (LOT-R) [17]. A large and growing body of prospective studies in diverse populations of individuals with [12,18] or without [19] CVD has examined relationships between optimism (measured via the LOT-R or other instruments) and cardiac outcomes including incident cardiac events [19], stroke [20], heart failure [21], carotid atherosclerosis [22], and all-cause mortality [8]. ...
... Several studies over the past two decades have examined associations between optimism, major adverse cardiac events, and CVD-related death [19,22]. In a systematic review and meta-analysis of 15 studies (total N = 229,391), optimism was linked with a lower risk of all-cause mortality (relative risk [RR] 0.86; 95% CI, 0.80-0.92; ...
Purpose of Review
Does optimism contribute to superior cardiovascular health? We examined prospective studies investigating the connections between optimism and cardiovascular health and examining the biological and behavioral mechanisms that may mediate such connections.
Recent Findings
Optimism, independent of sociodemographic, medical, and negative psychological factors, has been prospectively associated with a lower risk of cardiovascular disease and lower rates of cardiac and all-cause mortality. The mechanisms by which optimism may prevent cardiovascular disease remain unclear, but one mechanism may be through health behaviors. Indeed, optimism has been linked with physical activity, healthy diet, and smoking cessation, all of which are associated with better cardiovascular health.
Summary
Additional studies are needed to: (1) understand the relationships between more dynamic measures of optimism and health outcomes, (2) delineate the mechanisms underlying the relationships between optimism and cardiovascular health, and (3) assess the potential for interventions to modify optimism.
... Uno de los rasgos independientes de la personalidad que ha recibido mayor evidencia es el optimismo disposicional, entendido como la tendencia a creer que los eventos presentes o futuros tendrán desenlaces favorables (Scheier y Carver, 1985;Scheier, Carver y Bridges, 1994). Se ha encontrado que este rasgo se asocia con un menor riesgo de eventos cardíacos en población con antecedentes cardiovasculares (Bedi y Brown, 2005), así como en muestras epidemiológicas generales (Kubzansky, Sparrow, Vokonas y Kawachi, 2001). Desde la psicología positiva se afirma que el optimismo sería un mediador del proceso de valoración del estímulo en el proceso de estrés (Moore, 2002). ...
... Además, se ha encontrado que actitudes intrínsecas a este rasgo independiente se asocian con mayores niveles de colesterol hdl y con niveles bajos de triglicéridos (Boehm et al., 2013). A nivel comportamental se ha sugerido que tal rasgo puede permitir a los individuos movilizar estrategias de afrontamiento adaptativas como la adopción de conductas saludables y la evitación de conductas menos saludables como el consumo de licor (Fitzgerald et al., 2000;Kubzansky et al., 2004;Kubzansky et al., 2001). Sin embargo, hay evidencia contradictoria o [13] Los modelos dimensionales de la personalidad y su importancia en la psicología de la salud doi: https://doi.org/10.17533/udea.rp ...
La psicología de la salud es un campo de aplicación de la psicología en el que el estudio de los factores de riesgo y protección de enfermedades crónicas tiene una alta importancia. En este campo los estudios señalan la importancia de la personalidad como un factor de vulnerabilidad para el desarrollo y el mal pronóstico de diferentes enfermedades crónicas. Esta revisión de la literatura presenta algunos de los modelos dimensionales de la personalidad y su relación con la salud/enfermedad, haciendo hincapié en el efecto de ciertos rasgos de personalidad en la enfermedad cardiovascular. Se discute la validez de conceptos como el de personalidad tipo d, la relación de los modelos dimensionales con los temperamentales y se enfatiza en la importancia del modelo de cinco factores, específicamente del neuroticismo y de la extraversión, como factores de alta relevancia para la psicología de la salud.
... Prior research has also found that optimism correlates with better physical and psychological well-being constructs compared to pessimism (Conversano et al., 2010). For instance, high optimism is associated with various physical health outcomes, such as lower cardiovascular disease (Kubzansky et al., 2001) and respiratory disorders (Kim et al., 2017), exceptional longevity (L. O. Lee et al., 2019), and low acute stress-induced inflammatory effects (Brydon et al., 2009), as well as mental health constructs, such as higher life satisfaction (Ju et al., 2013) and greater social networks (Andersson, 2012). ...
Objectives: Mid- or early-late-life cognitive function is an indicator for developing late-life dementia. However, it is still unclear whether rural/urban living contexts provide cognitive benefits across adulthood. Further, higher optimism serves as a general protective factor for many health outcomes. The present study examines associations between rurality/urbanicity, optimism, and change in mid/late-life cognitive functions over time. Methods: Data were from waves 1 to 3 (1995–2015) of the Midlife in the United States (MIDUS) study (N = 2,507). Structural equation models examine whether long-term rural living across both waves (1–2) or intermittent rural living at one wave is associated with better cognitive function over 20 years, compared to no rural living, while controlling for prior cognitive function and covariates (baseline socio-demographics, health, and functional status). Additionally, we assessed if optimism mediates the above associations. Results: After controlling for covariates, long-term rural living (waves 1–2) was indirectly (through less optimism) associated with significantly lower levels of cognitive executive function and episodic memory in wave 3. Conclusions: While long-term rural living and cognitive outcomes have no direct association for MIDUS middle-aged and older adults, mediating roles of optimism in these associations were evident. Future investigations could examine mechanisms that underlie these risk/protective factors on late-life cognition.
... Especialistas em meditação submetidos a estímulos dolorosos durante sua prática de meditação revelaram que não sentem dor como no estado de vigília.Durante o EAC, observou-se predominância de frequência alfa com picos máximos de 10 Hz nos lobos occipital, parietal e nas regiões temporais, sugerindo estado de relaxamento profundo sem caracterização do sono.Convergindo com achados anteriores sobre a representação da percepção sensorial/emocional da dor(Rainville et al., 2002), o estado meditativo revelou significativa diminuição da atividade no tálamo, no córtex somatossensorial secundário, na ínsula e no córtex cingulado quando comparado com o estado não meditativo. Uma vez que a dor é uma experiência sensorial e emocional complexa, esse, entre outros estudos com métodos eletrofisiológicos e de neuroimagem, esclareceu que estados alterados de consciência podem gerar mudanças na atividade dos circuitos relacionados à percepção da dor(Kubzansky et al., 2001;Rainville et al., 2002). Mudanças no fluxo sanguíneo cerebral foram também observadas durante as preces (verbais repetitivas) de freiras franciscanas. ...
This study investigated the association between Spirituality/Religiosity (S/R) and depressive and anxiety symptoms in 1,342 Brazilians during the COVID-19 pandemic. Participants completed an online protocol that included the Beck Depression Inventory-Primary Care (BDI-PC) to screen for depression, the State-Trait Anxiety Inventory-Trait (IDATE-T-E) to measure anxiety, the Brief Religious-Spiritual Coping Scale (SRCOPE-14), and a sociodemographic questionnaire.
Results:
Prayer Practices: Analysis of variance (ANOVA) revealed significant differences in depressive symptoms related to individual prayer frequency (F (8,1329) = 8.773, p < 0.001). Individuals who reported praying alone displayed lower mean depressive symptoms (delta = -1.097, p < 0.05) compared to those who indicated never praying.
Spirituality: The group endorsing "high spirituality" exhibited a lower mean BDI-PC score (M = 2.57, SD = 2.88) compared to the "no spirituality" group (M = 4.29, SD = 4.07, p < 0.001).
Religiosity: No significant differences were found in depressive or anxiety symptoms between the "highly religious" and "not religious" groups.
Correlation: Correlation analysis indicated a positive association between S/R and better mental health outcomes.
Conclusion:
These findings suggest that S/R, particularly individual prayer practices, and high self-reported spirituality, might be associated with protection against depressive symptoms among Brazilians during the COVID-19 pandemic. However, further studies employing more robust methodologies are needed to confirm this association.
... There is compelling evidence, for example, that resilience plays a crucial role in recovering from posttraumatic stress disorder (Atkinson et al., 2009;Paton, 2006). However, while many assessments of resilience correlate with health and well-being outcomes (Kubzansky et al., 2001), more studies should be done to ascertain if resilience causes health and well-being improvements for host community members. ...
Positive psychology is a growing global research field of psychology that has flourished in the last two decades. Positive psychology suggests that the positive human future depends not only on minimising inextricable suffering but also on focusing on personal growth, well-being, and flourishing. Researchers in positive psychology have focused their investigations on topics such as well-being, happiness, optimism, humour, positive emotions, and character strengths that broadly relate to quality of life research. This chapter aims to provide a review of developments in positive psychology and presents an overview of the development of positive psychology, specifically in tourism research. First, a link is made to the central theme of the handbook by exploring how positive psychology as a domain of inquiry links to the broader world of quality of life research. This discussion is followed by a general examination of the historical development of positive psychology as a research field and the discussion of hedonic and eudaimonic well-being as the core focus of positive psychology research. A brief overview of recent developments in positive psychology and tourism research, positive tourism research, is then presented. A discussion of positive tourism studies relating to tourists and their experiences, host communities, and tourism workers is provided for the readers. Ideas for the future development of positive tourism research are outlined.
... In fact resilient people possess higher mental health level, more expansive self-control skills, more self-confidence and social protection and less get involved in risky conditions (Zemmerman & Fergus, 2005). Researches show that resilience lead to faster recuperation and better adaptation with cardiovascular diseases (Kubzansky, Sparrow, Vokonas, & Kawachi, 2001;Davydov, Stewart, Ritchie, & Chaudieu, 2010;Fathi, Khayer, & Atigh, 2012). Various treatment methods to cure the accompanying symptoms of cardiovascular diseases have been created. ...
Rapid advances in health sciences and technology have led to massive changes in health care systems particularly in terms of work overload and job stress, which increased health related errors and in turn negatively affected the quality of care. OBJECTIVES: This study was performed to explore the influence of nurses’ burnout, nurses’ characteristics and work related conditions on the quality of nursing care. METHODS: A cross-sectional correlational designs were employed. The Maslach Burnout Inventory (MBI) was used to collect data from a convenience sample of 270 registered nurse participants. Completed MBIs were matched to 270 Service Quality Scale (SERVQUAL) questionnaires which were completed by patient participants who received care by those nurses who completed MBIs during their hospitalization. Nurse and patient participants were recruited from eight hospitals in Jordan. RESULTS: A stepwise regression model was significant for three variables (hospital type, census rate, and rotating shift worked). These variables were accounted for approximately 58% of the variance in the quality of nursing care. Although burnout and some nurses’ characteristics were having a significant moderate correlation with the quality of nursing care, but they were not having a significant prediction performance of the quality of nursing care in selected Jordanian hospitals. CONCLUSION: This study provides an insight for leaders in health care organizations that “work conditions” is the main factor influencing different work variables. Improvement in work conditions may decrease burnout, and consequently increase quality of care provided.
... According to reports, a limited number of personality traits, including optimism, conscientiousness, openness, and curiosity, are linked to favorable health outcomes in individuals with CVD, and are therefore deemed as cardio-protective personality traits [38]. Identified as a defensive factor against CAD risk, optimism is a positive personality trait characterized by the inclination to anticipate favorable outcomes [39]. ...
Background
Many mental problems lead to the occurrence of physical diseases, causing worse consequences of diseases. Despite many studies in the field of personality types and types of mental disorders, this relationship and the mediating role of coping styles in cardiovascular patients are still not well known. Therefore, the present study was conducted to investigate the mediating role of coping styles in the relationship between personality types and mental disorders in cardiovascular patients.
Method
The present study is a cross-sectional study that was conducted on 114 cardiovascular patients at the heart center in Bushehr, Iran. The sampling method is simple random sampling. Demographic information form, MCMI-III questionnaire, NEO-FFI questionnaire, and Lazarus and Folkman coping styles questionnaire were used to collect data. Data were analyzed using SPSS 22 and Amos 24 software. Descriptive statistics methods (mean, variance and percentage), Pearson correlation, and structural equation model (SEM) were applied to analyze the data.
Results
The findings showed that the two variables of personality types and problem-oriented explain 15.2% of the variable of mental disorders, of which 10.7% is related to the variable of personality types and 4.5% is related to the intermediate variable of problem-oriented. Among the personality types, the neurotic personality type has the biggest role (0.632) and has a direct and significant effect on mental disorders. Also, the personality types of extroversion (-0.460), agreeableness (-0.312), and responsibility (-0.986) exert inverse and significant effects on mental disorders.
Conclusion
The results of the present study showed the frequency of personality disorders and other mental disorders among heart patients. Problem-oriented coping style plays a mediating role between personality types and mental disorders.
... En cambio, las personas que poseen redes sociales importantes tendrán un menor riesgo de enfermedad cardiaca crónica (Smith y Ruiz, 2002). Además, el funcionamiento psicosocial positivo ayuda a promover la vitalidad (es decir, un sentido innato de la energía), que a su vez produce una mayor sensación de bienestar, una búsqueda más activa de objetivos y una mayor capacidad de recuperación (Rozanski, Blumenthal y Kaplan, 1999;Kubzansky et al., 2001). ...
Introducción: El apoyo social se ha reportado como una variable que coadyuva a una mejor adaptación psicosocial en la población con enfermedades cardiovasculares. Objetivo: Determinar las propiedades psicométricas del Cuestionario de Apoyo Social en una muestra de pacientes con enfermedades cardiovasculares. Método: Se empleó un diseño transversal, por disponibilidad y con un muestreo no probabilístico. Participaron 229 pacientes diagnosticados con enfermedades cardiovasculares, con edades de 25 a 80 años, 43.2% de los cuales eran mujeres. Instrumento: Cuestionario MOS de Apoyo Social. Análisis estadístico: Se realizaron modelos factoriales exploratorio y confirmatorio. Resultados: Se identificaron cuatro factores con 19 reactivos, con elevadas consistencias internas en cada subescala que explicaron 87.48% de la varianza. El análisis factorial confirmatorio mostró índices ideales, mismos que indican un ajuste equilibrado y parsimonioso de la estructura del modelo a los datos, con error de medición muy cercano a cero. Discusión: La versión usada del Cuestionario MOS de Apoyo Social es un instrumento válido y confiable para su uso en la atención clínica y la investigación dirigidas a pacientes con enfermedades cardiovasculares. Esta población puede requerir atención psicosocial a lo largo de la atención de su salud, por lo que se requieren desarrollar programas de atención psicológica oportuna.
... A systematic review and exploratory metaanalysis on 11 studies with little suggestion of publication bias showed that positive psychological constructs were associated with reduced rates of rehospitalization or mortality of all causes, both in either unadjusted or adjusted analysis [87]. Several strong bodies of evidence have also consistently supported the beneficial association of optimism on cardiovascular health, although current explanations regarding its mechanism remain unclear [88][89][90][91][92] [93]. Longitudinal findings over a 10-year follow-up showed that optimism was significantly correlated with a better cardiovascular health score, which encompasses blood pressure, lipids, body mass index, diabetes, and smoking status [94]. ...
Objective
Coronary artery bypass graft (CABG) is a major surgery conducted in coronary heart disease management. Postoperative recovery is a crucial process for patients undergoing CABG. This systematic review evaluates current evidence regarding the association between trait optimism and recovery outcomes in patients following coronary artery bypass graft surgery.
Methods
This review followed the Preferred Reporting Items of Systematic Review and Meta-Analysis (PRISMA) 2020 Guideline. The inclusion criteria focused on observational study that examined study participants aged ≥18 years old undergoing elective CABG and measurement of trait optimism with validated methods (i.e. LOT, LOT-R) and at least one recovery outcome. Studies in non-English languages and duplicates were excluded. A systematic literature search was carried out on PubMed, Scopus, and Web of Science electronic databases. Search results were screened based on the eligibility criteria. The Newcastle-Ottawa Scale was used to assess the quality of each included study.
Results
The search yielded a total of 1853 articles, in which 7 articles fulfilled the eligibility criteria and were subsequently included in the analysis. Measurement of trait optimism was conducted on 1276 patients who underwent a non-emergency/elective CABG. Optimism was significantly associated with several categories of recovery, including reduced rehospitalization rate, complications, pain, and physical symptoms along with improved quality of life, rate of return to normal life, and psychological status.
Conclusion
Our review showed that trait optimism was associated with recovery outcomes following CABG surgery. However, the heterogeneity of recovery outcomes may hamper the clinical benefit of trait optimism in CABG. (PROSPERO CRD42022301882).
... In addition to diligence and sociability, another potentially protective trait was warmth. Although not directly targeted in the key questions for warmth (Table 1), the closely related trait optimism, may be contributing to the slight protection from MI 46 . In contrast to Lee et al. (2014), curiosity, the proxy for openness, was not a significant predictor for risk or protection against MI prevalence or incidence in any of the adjusted models 17 . ...
Personality is a strong determinant for several health-related behaviours and has been linked to the development of cardiovascular diseases. However, the reports of personality’s mediating role have been inconsistent with no data available from large population-based cohorts. The study aimed to create proxies for the Big Five personality traits, extraversion, agreeableness, conscientiousness, openness and neuroticism, to examine the longitudinal relationship between personality and myocardial infarction in the UK Biobank. The study sample comprised of 484,205 participants (55% female, 45% male, mean age 56.4 ± 8.1 years) from UK Biobank cohort with a mean follow-up of 7 years. The personality proxies sociability, warmth, diligence, curiosity and nervousness were created using self-reported data on psychological factors, mental health and social support, to match the facets of the Big Five traits. As neuroticism is the only Big Five personality trait available in the UK Biobank, it was included to validate the personality proxies. Myocardial infarction outcome information was collected from hospital records, death registries or was self-reported. Logistic regression and Cox proportional hazard regression were used to estimate odds ratio (OR) and hazard ratios (HR), respectively with 95% confidence intervals (CI) adjusted for demographics (age, sex, socioeconomic status, ethnicity), health-related factors (BMI, diabetes, systolic and diastolic blood pressure) and lifestyle factors (alcohol intake, smoking, and moderate-to-vigorous physical activity). Diligence was found to be significantly associated with lower prevalent myocardial infarction [OR: 0.87; (CI 0.84–0.89)] and lower incident myocardial infarction [HR: 0.88; (CI 0.85–0.92)]. Sociability was also protective against prevalent [OR: 0.89; (CI 0.87–0.92)] and incident [HR: 0.90; (CI 0.87–0.93)] myocardial infarction. Conversely, nervousness inferred a higher risk for both prevalent [OR: 1.10; (CI 1.08–1.12)] and incident [HR: 1.07; (CI 1.04–1.09)] myocardial infarction during follow-up. Sex-stratified analyses revealed that nervousness significantly increases the risk for incident myocardial infarction among women [HR: 1.13; (CI 1.08–1.19)] compared to men [HR: 1.05; (CI 1.02–1.08)]. By using our created proxies, we were able to investigate the impact of personality on the development of myocardial infarction. Persons with higher levels of diligence and sociability mimicking predominantly conscientiousness and extraversion personalities respectively are less likely to experience myocardial infarction, while personalities predominantly characterised by nervousness pose higher risk for developing myocardial infarction. These initial findings invite further validation of the use of the personality proxies in UK Biobank cohort.
... Another review of 15 studies focused on optimism and cardiovascular diseases, dispositional optimism is associated with improved cardiovascular health, decreased mortality risk, and better well-being (Boehm et al., 2018). These findings have been reported in populations such as initially healthy community samples, coronary heart disease patients, patients with heart failure, and patients undergoing coronary artery bypass surgery, and patients with heart failure (Huffman et al., 2016, Kubzansky et al., 2001, Giltay et al., 2006, Scheier et al., 1999, Kim et al., 2014. In patients with CHD, higher levels of optimism were associated with positive health behaviors such as physical activity (Huffman et al., 2016), and with outcomes such as CHD morbidity and mortality, fewer hospitalizations, improved functional status, and reduced symptoms. ...
Cardiovascular disorders are the leading causes of death in developed countries. The chapter provides an overview of behavioral and psychosocial influences on cardiovascular disorders, with an emphasis on coronary heart disease (CHD) and hypertension. This chapter reviews the pathophysiology of CHD, the role played by standard biological, behavioral, and psychosocial risk factors, including social determinants of health, environmental and psychological stress, individual psychological characteristics, and psychosocial protective factors such as social support. The chapter provides a summary of research examining the utility of interventions targeted at reducing risks of cardiovascular disease associated with psychosocial risk factors.
... Although pessimism and optimism do not anchor the two ends of one spectrum, 83 empirical evidence suggests that the former is associated with increases in CAD, stroke, all-cause mortality, [84][85][86] and the latter with increased protection against CVD. 87,88 Many of the protective effects of optimism can be attributed to indirect, positive behavioral changes including increased PA levels, better diet quality, and reductions in smoking. ...
Traditional risk factors for cardiovascular disease (CVD) have long been the focus of preventive strategies. The impact of family stress, depression, anxiety, hostility, pessimism, job strain, social isolation, lack of purpose in life and social support, are well recognized risks for CVD development, however they are under-appreciated in clinical practice guidelines. The purpose of this article is to review the impact of acute and chronic stress on CVD risk, elaborate repositioning in guidelines, with emphasis to approaches for stress reduction. Regular exercise, both aerobic and resistance, leads to better adaptiveness to other types of stress, however, it remains unknown whether the total amount of stress one can receive before negative health effects is unlimited. Evidently, marked reductions in stress related disorders are shown following formal cardiac rehabilitation programs. Attendance of cardiac rehabilitation is highly recommended for the stress-related mortality risk reduction. Innovative approaches to offset the broad challenges that CVD pose, augmented by sustained exposure to stress, are desperately needed, but hindered by a lack of successful population-level interventions that promote lasting change.
... Also, in another study, which involved patients with heart disease, the results indicated that those who scored higher in positive emotions had fewer mortality possibilities (Scherer & Hermann-Lingen, 2009). Also, a study conducted in individuals with coronary heart disease showed that those who adopted a more optimistic explanatory style had a lower risk of developing coronary heart disease than those who were more pessimistic (Kubzansky et al., 2001). In the same direction, Davidson et al. (2010) found in their preliminary research that positive emotions had a protective role and acted preventively in the coronary heart disease onset. ...
... ( Carver and Scheier, 2014 ;Scheier and Carver, 2018 ). Independent protective relationships have been found between dispositional optimism and subsequent CVD morbidity and mortality in several prospective cohort studies, both in women ( Kim et al., 2017 ;Tindle et al., 2009 ), men ( Giltay et al., 2006 ;Kubzansky et al., 2001 ), and mixed cohorts ( Anthony et al., 2016 ;Giltay et al., 2004 ). In a meta-analysis ( 2019 ) of 15 studies comprising 229,391 patients, high dispositional optimism was associated with a 35% lower risk of cardiovascular events, but again with large heterogeneity across studies ( Rozanski et al., 2019 ). ...
Background
Mental well-being, characterized by low depressive symptoms and high dispositional optimism, is a protective factor against (cardiovascular) mortality in the general population. We aimed to assess whether such a relationship is also present in patients who have a history of MI, and whether it is independent of classic CVD risk factors.
Methods
A secondary analysis of the Alpha Omega Trial cohort study was carried out, including 3566 patients with MI in their medical history and a mean follow-up period of 9.0 (SD 2.6) years. The 4Q and GDS were analysed in relation to (cause-specific) mortality using Cox proportionalhazards models adjusted for demographic and classic CVD risk factors.
Results
Patients were on average 71.2 years old (SD 5.4), and 20.5% were women. During the follow-up period, there were 1,219 deaths of which 448 (46.7%) as a result of CVD. For the allcause and CVD mortality, the multivariate-adjusted HR for depressive symptoms was 1.85 and 1.90 for the upper tertile versus the lower tertile (95% CI: 1.47-2.33; P for trend <.001; and 95%CI: 1.31-2.76; P for trend <.001). For non-cardiovascular/non-cancer mortality the relationship was even stronger (HR 2.16; 95%CI: 1.51-3.09; P for trend <.001). Although similar protective trend relationships were observed for dispositional optimism, these were not independent of depressive symptoms.
Conclusions
Depressive symptoms, rather than dispositional optimism, were independently predictive of all-cause, cardiovascular, and non-cardiovascular/non-cancer mortality in older post-MI patients.
... Pre-existing conditions as well as/or health status were considered as potential confounders, and subsequently adjusted for in eight out of 16 population-based studiesincluding cancer, diabetes, hypertension, dyslipidemia, depression, circulatory disease, lung disease and non-fatal chronic disease. Additionally, Kubzansky et al. (2001) screened participants at entry, and excluded those individuals with chronic disease. A further four studies also adjusted specifically for biomedical risk factors including Body Mass Index, obesity and blood pressure. ...
Research suggests that optimism and pessimism should be studied as two distinct constructs rather than as unidimensional, at opposing ends of a continuum. Optimism and pessimism have different associations with health-related behaviours, coping style, and a number of health outcomes. This study aimed to systematically review the evidence on the association of optimism and pessimism and all-cause mortality. A systematic search of MEDLINE, EMBASE and PsycINFO was conducted following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. From 6837 retrospective/prospective cohort studies identified, 25 were included, with a total of 217,256 participants. Eleven of the 18 studies assessing optimism reported that optimism was associated with lower risk of mortality, while seven of eight studies measuring pessimism and the two assessing unrealistic optimism reported that higher pessimism/unrealistic optimism was associated with an increased mortality risk. Results of a meta-analysis indicated that optimism measured categorically was associated with lower risk of mortality (pooled RR = 0.85, 95% CI: 0.79-0.91). We suggest optimism and pessimism be measured as separate constructs, as both of these have distinct effects on mortality risk. Future research is required to investigate whether psychological interventions to increase optimism or decrease pessimism can reduce risk of all-cause mortality.
... Many epidemiological studies have shown a strong relationship between chronic diseases occurrence and treatment with the mental health of the patients [7]. In fact, depression has been found to be associated with the increased complications of several chronic diseases including diabetes, heart disease, hypertension, cancer, and obesity [8]. ...
Background: Diabetes is a highly prevalent chronic disease that is associated with major complications. Findings regarding risk of depression among patients with diabetes are controversial. This study aimed to determine the prevalence and determinants of depressive symptoms among Qatari patients with type 2 diabetes. Methods: This cross-sectional study was based on Qatar Biobank (QBB) data of 2448 Qatari adults with diabetes aged 21–60 years old. Data regarding age, gender, education, income, body mass index (BMI), medication use, glycated hemoglobin (HbA1c) were retrieved. Patients’ responses to the Patient Health Questionnaire-9 (PHQ-9) were also obtained. Data analyses was performed using STATA 16, and statistical significance was considered at a p-value of <0.05. Results: Of the 2448 participants, 15.4% (n = 378) had self-reported depressive symptoms. Depressive symptoms were frequent among females (69.6%), smokers (15.9%), and participants with a higher level of education (47.1%). Average age of participants who reported depressive symptoms was significantly less that among participants without depressive symptoms (44.8 vs. 52.9 years). Qatari women with diabetes seem to be at higher risk of depression when compared to men (OR = 1.819, 95% CI: 1.42–2.33); The odds of reporting depressive symptoms were 35% higher among patients with more advanced educational qualifications (OR = 1.351, 95% CI: 1.00, 1.82). Smokers were twice as likely to report depressive symptoms as their non-smoking counterparts. There was no significant relationship between depression and poor glycemic control, physical activity, BMI, or insulin use. Conclusions: In summary, the study results suggest that several sociodemographic factors, such as age, gender, and level of education were associated with the risk of depressive symptoms among Qataris with diabetes.
... In contrast, positive psychological well-being (e.g., positive affect, optimism) has been associated with superior cardiac health, independent of the adverse effects of depression and anxiety [4]. Psychological well-being is broadly defined as optimal or ideal psychological functioning and has been prospectively linked to decreased risk of developing CAD [10,11] and lower rates of mortality [12]. Such effects may be mediated by increased vagal control [13], lower levels of inflammatory markers [14], and beneficial effects on lipid levels and endothelial function [15][16][17][18]. ...
... Патологична ЕКГ ос на сърцето се установява достоверно по-чес- казани. Стабилната психологична функция, например оптимизмът (позитивните вярвания), се свързват с намален риск от редица остри сърдечно-съдови инциденти (3,(5)(6)(7)(8)(9)(10)13). Нашите резултати сочат, че тя е в основата на мотивация за здравословен начин на живот. ...
... Hardier individuals generally experience few psychosomatic symptoms (Florian et al., 1995;Maddi, 2016;Maddi et al., 2006;Ng & Lee, 2020), are more likely to engage in socially supportive interactions (Lavoie et al., 2016;Maddi, 2013a;Masten & Obradovic, 2006), have more effective problem-solving skills (Abdollahi et al., 2018a;2018b), are more engaged in beneficial self-care behaviors (Tellegen, 1985), have increased self-regulation and inhibitory capabilities (Abdollahi et al., 2018a;Maddi, 2013a;Sansone et al., 1999;Werner & Johnson, 1982), are more innovative (Sansone et al., 1999;Maddi et al., 2006), and typically have more optimal reactions to stress (Abdollahi et al., 2018a(Abdollahi et al., , 2018bEpel et al., 2004;Keller et al., 2012;Mroczek et al., 2015). Together, the patterns of responding are predictive of better job performance Johnsen et al., 2013;Maddi et al., 2006), greater physical well-being (Lavoie et al., 2016;Kubzansky et al., 2001;Sandvik et al., 2013;Stern & Dhanda, 2001), greater subjective well-being, (Martin et al., 2015;Ryff, 2014;Taylor et al., 2011), generally higher levels of resilience and recovery from stressors (ten Broeke et al., 2017;Waysman et al., 2001;Vogt et al., 2018); greater life satisfaction and overall better quality of life (Diener, et al., 2003;Martin et al., 2015;Oliver, 2009). ...
Hardiness, or the combination of personality traits, dispositions, and response patterns which are typical of individuals who generally remain healthy and continue to perform well under a range of stressful conditions and reinterpret stressful life events into opportunities for personal growth, is thought to have a buffering effect on stress and is often associated with greater psychological and emotional well-being. As such, hardiness has been touted as a potentially malleable construct which can lead to improved quality of life for individuals in high-stress occupations using emotion regulation strategies. Using an integrative data analytic approach (N = 1,342), I analyzed a series of models to investigate (1) the relationship between hardiness and emotion regulation; (2) age-related and occupation-related differences in endorsement patterns; and (3) the differential effects of hardiness and emotion regulation on a variety of socioemotional and physiological outcomes, including stress frequency, stress severity, depressive symptoms, and life satisfaction. Findings showed significant relationships between hardiness and emotional expression, indicating that those who endorse positive hardiness traits at a greater rate tend to endorse more optimal emotion regulation strategies and fewer less optimal emotion regulation strategies whereas those who endorse negative hardiness traits at higher rates tend to have the opposite experience. These patterns extend to predict depressive symptoms and life satisfaction, with negative hardiness and affect predicting depressive symptoms and positive hardiness predicting life satisfaction. Furthermore, although service members and civilians had different rates of endorsement, the relationship between hardiness, regulation, stress, depressive symptoms, and life satisfaction was similar across
... Research shows that higher optimism, a psychological trait characterized by the expectation of a positive future, is associated with reduced risk of age-related morbidity (e.g., cardiovascular disease, cognitive impairment) and premature mortality (Gawronski et al., 2016;Giltay et al., 2004;Kim et al., 2014Kim et al., , 2017Kubzansky et al., 2001;Sims et al., 2019). However, the populations examined in these studies have been predominantly White, although the existing studies conducted in African Americans have reported similar protective relations between higher optimism and reduced risk of morbidity/mortality (Chopik et al., 2015;James et al., 2019;Kim et al., 2019a;Tindle et al., 2009). ...
Background
Optimism is linked with greater longevity in both White and African American populations. Optimism may enhance longevity by slowing cellular aging, for which leukocyte telomere shortening is a biomarker. However, limited studies have examined the association of optimism with leukocyte telomere length among African Americans.
Methods
Data are from 723 men and 1,244 women participating in the Jackson Heart Study (age=21-93 years). We used multivariable linear regression models to conduct cross-sectional analyses examining whether higher optimism was associated with longer mean absolute leukocyte telomere length (assayed with Southern blot analysis). Models adjusted for sociodemographic characteristics, depressive symptomatology, health conditions, and health behavior-related factors. We also considered potential effect modification by key factors.
Results
In the age-adjusted model, optimism, measured as a continuous variable, was not associated with leukocyte telomere length (β=0.01, 95%CI: -0.02, 0.04). This association remained null in the fully-adjusted model (β=0.02, 95%CI: -0.02, 0.05) and was also null when considering optimism as a binary measure (higher vs. lower optimism). We found no evidence of effect modification by sex, age, body mass index, income, or chronic conditions.
Conclusions
Optimism was not associated with leukocyte telomere length among African American adults. Future studies should investigate alternate biological and behavioral mechanisms that may explain the optimism-health association.
... The accumulated effects of being loaded with stressors increase allostatic load [99]. These psychological traits and states are related to reducing the incidence of, and mortality from, cardiovascular disease [110][111][112][113] and dementia [114,115]. Creating an environment that can readily foster rich social connection, positive emotions and enhance stress-coping skills may be an important measure for preventing dementia. ...
Dementia is considered to be one of the greatest global challenges for health and social care in the twenty-first century. The condition is associated with physical, psychosocial, and economic burdens on individuals and society (Scholzel-Dorenbos et al., Int J Geriatr Psychiatry 22(6):511–9, 2007; Tariq and Barber, J Neurochem 144(5):565–81, 2018) and it is one of the principal causes of disability and dependency among older populations. Dementia is a significant public health issue all over the world, as well as in Japan, given the growing incidence and high prevalence rate, primarily due to the worldwide ageing population. It is reported that about 47.5 million people were living with dementia in 2015, and the number is projected to reach 75.6 million in 2030 and 135.5 million by 2050 (Livingston et al., Lancet 390(10113):2673–734, 2017; Prince et al., Alzheimers Res Ther 8(1):23, 2016). Furthermore, the total global cost of dementia was US$818 billion in 2015, and this is also expected to continue to increase (Prince et al., Alzheimers Res Ther 8(1):23, 2016). However, an unexpected decline in age-specific new dementia incidence has been reported, despite the increase in the absolute number of people with dementia in some high-income countries, such as the USA, UK, Netherland and Sweden (Okamura et al., Dement Geriatr Cogn Disord 36(1–2):111–8, 2013; Ahmadi-Abhari et al., BMJ 358:j2856, 2017; Wu et al., Nat Rev Neurol 13(6):327–39, 2017; Matthews et al., Nat Commun 7:11398, 2016; Satizabal et al., N Engl J Med 374(6):523–32, 2016; Stephan et al., J Alzheimers Dis 66(2):653–80, 2018; Schrijvers et al., Neurology 78(19):1456–63, 2012; Qiu et al., Neurology 80(20):1888–94, 2013). This may indicate possibility of preventing dementia by targeting modifiable risk factors including social determinants of dementia. A paper in Lancet Commissions reported that 35% of dementia incidence is attributable to modifiable risk factors such as education, occupation, life-style, metabolic and psychiatric factors (Livingston et al., Lancet 390(10113):2673–734, 2017). About 85% of dementia costs are related to family and social care rather than medical costs. People who live with dementia lose potential opportunities to participate in social and economic activities and increasingly require health and social care. Thus, preventing dementia by reducing the social determinants of disease is important for society, since it affects not only the individual but also their family, the community, and society in general.
... Few personality traits have been associated with positive health outcomes in subjects with CVD and can be regarded as cardioprotective personality traits [157]. Optimism, which is defined as the tendency to expect good experiences in the future, has been found to be a protective factor against the risk of CAD in elderly [158]. Additionally, it seemed to predict better physical health and reduction of depressive symptoms after an acute coronary syndrome, and has been associated with reduced pain intensity and physical symptom after coronary artery bypass graft surgery [159]. ...
For several centuries the connection between mind and heart has been debated among scholars. Particularly, it has been noticed that several psychopathological conditions might predispose to the onset and progression of cardiovascular diseases. The present chapter moves through the different aspects of this association. First, the role of anxiety in the etiopathogenesis of heart diseases has been discussed. Second, the prevalence and therapeutic options of anxiety disorders in individuals already suffering from a cardiovascular disease, as well as their role in the progression of these health conditions, have been explored. Finally, we described the interaction between some personality traits and cardiovascular health. Our chapter underlines the importance of investigating the presence of anxiety and personality disorders in people suffering from heart disease. Clinicians should accurately recognize mental health conditions and promptly treat them in cardiac patients who manifest psychological distress. Additionally, the prevention and the timely identification of cardiovascular issues in psychiatric patients appear to be of primary importance for limiting their progression and improving the short- and long-term outcome.
... www.nature.com/scientificreports/ Several previous studies have found associations between the personality characteristics of optimism and pessimism, or a combination of the two, and all-cause or cause-specific mortality [3][4][5][6][8][9][10] . Our results suggest that combining optimism and pessimism into a single score and testing this against an outcome is inappropriate, at least when using the LOT questions. ...
Scores on an optimistic-pessimistic personality scale have been associated with mortality, but optimism and pessimism scores are separable traits and it is unclear which has effects on health or longevity. The Life Orientation Test (LOT), containing items for optimism and pessimism, was included in a twin study on health of Australians aged over 50 in 1993–1995. After a mean of 20 years, participants were matched against death information from the Australian National Death Index. 1,068 out of 2,978 participants with useable LOT scores had died. Survival analysis tested for associations between separate optimism and pessimism scores and mortality from any cause, and from cancers, cardiovascular diseases or other known causes. Age-adjusted scores on the pessimism scale were associated with all-cause and cardiovascular mortality (Hazard Ratios per 1 standard deviation unit, 95% confidence intervals and p-values 1.134, 1.065–1.207, 8.85 × 10–5 and 1.196, 1.045–1.368, 0.0093, respectively) but not with cancer deaths. Optimism scores, which were only weakly correlated with pessimism scores (age-adjusted rank correlation = − 0.176), did not show significant associations with overall or cause-specific mortality. Reverse causation (disease causing pessimism) is unlikely because in that case both cardiovascular diseases and cancers would be expected to lead to pessimism.
Background: Long-term chronic diseases such as AIDS, cancer and heart disease affect
patients’ attitude, always create crises in individuals’ life. The main purpose of this study was
to compare the situation resiliency and depression in cardiac patients with healthy People.
Methods: During a descriptive of causal–comparative study and using convenience sampling
106 cardiac patients (58 women and 48 men) were selected from Motahari Hospital in
Jahrom city in 2013. Also 102 healthy volunteers (52 females and 50 males) based on
demographic variables matched with the patient groups were selected. Beck Depression
Inventory and Resiliency Scale and Connor Davison were administered to participants. Data
based on level of 95% were analyzed using SPSS v.16.
Results: Independent t-test revealed a significant increase in depression scores and
significant reduction in resiliency between people with heart disease and normal samples
(p<0.001). In addition, analysis of variances revealed that women are better than men at
resiliency (p<0.003). The education level was positively associated with resiliency in coping
with the diseases (p<0.011).
Conclusion: resiliency plays mediating role in heart disease outset, and its low levels are as a
risk factor for people with cardiovascular disease.
BACKGROUND: It is asserted that the positive outcomes from employees are a result of positive gestures initiated by the organization. Consequently, organizations can strategize their practices in such a manner that would stimulate and amplify positive behavioral outcomes from employees ultimately leading to organizational effectiveness and ameliorated organizational sustainability. OBJECTIVE: The objective of the present study is to investigate the relationship between Perceived Organizational Virtuousness (POV) and Workplace Happiness (WPH), mediated by Job Satisfaction (JS) for creating sustainable organizations. METHOD: Quantitative research approach was adopted following a conclusive research design. Purposive (Non-probability) sampling technique was used, and data was collected from 470 employees from IT and ITeS sector companies of Delhi-NCR (India) using questionnaire. The statistical analysis was done using SmartPLS 4 for the data. RESULTS: The results revealed that employees, who perceive organizations as virtuous, tend to feel happy at the workplace. Also, the perceptions of Organizational Virtuousness were found to amplify the experiences of Workplace Happiness and it was also found that Job Satisfaction significantly mediates the stated relationship. CONCLUSIONS: The results of the study could help the managers and strategy makers to ensure well-being of employees and adding to their performance and effectiveness.
Kahramanmaraş depremleri ve önceki depremlerin sağ kurtulanlar üzerinde derin psikolojik etkiler bıraktığı bilinmektedir. Travma sonrası stres bozukluğu, depresyon, anksiyete, madde kötüye kullanımı, depremzedelerin psikolojik sorunların önde gelenlerindendir. Afet sonrası manevi müdahale yöntem ve teknikleri ile ilgili ulusal literatürde sınırlı sayıda araştırmanın olduğu görülmektedir. Bu bağlamda çalışmanın temel amacı, depremin neden olduğu psikolojik sorunların iyileştirilmesi odağında depremzedelerin sağlıklı başa çıkma becerilerini geliştirmek için manevi yaklaşımları güncel literatür ışığında açıklamaktır. Bu çerçevede dinî ve manevi kaynaklardan yararlanarak işlevsiz, uyumsuz ve yanlış algıları değiştirmek, felaketi öğrenme merkezli olarak değerlendirmek, umut duygusunu güçlendirmek gibi teknikler deprem sonrası yaşanan olumsuz duygularının iyileşmesinde etkili olacaktır. Derleme niteliğinde yapılan çalışma üç bölümden oluşmaktadır. Birinci bölümde depremin bireyler üzerindeki psikolojik ve sosyal etkileri incelenecek. İkinci bölümde maneviyatın psikolojik iyi oluş üzerindeki etkileri ele alınacak son bölümde ise manevi müdahale tekniklerine yer verilecektir. Böylelikle çalışmanın, manevi destek alanında verilecek hizmetlere kaynaklık etmesine katkı sağlanacaktır.
We examined relationships between resilience resources (optimism, social support, and neighborhood social cohesion) and CVD incidence, and assessed for effect measure modification (EMM) by psychosocial risks (e.g., stress, depression) among adults without CVD in three cohort studies (2000-2018): Jackson Heart Study, Multi-Ethnic Study of Atherosclerosis, and Mediators of Atherosclerosis in South Asians Living in America. We fitted adjusted Cox models accounting for within-neighborhood clustering while censoring at dropout or non-CVD death. We assessed for EMM by psychosocial risks. Secondary analyses estimated standardized risk ratios (RRs) using inverse probability-weighted Aalen-Johansen estimators to account for confounding, dropout, and competing risks (non-CVD deaths). Secondary analyses obtained 95% confidence intervals (CIs) using cluster bootstrapping. For high and medium (versus low) optimism (n=6,243), adjusted hazard ratios (HRs) (95% CIs) for incident CVD were 0.94 (0.78-1.13) and 0.90 (0.75-1.07), respectively. Corresponding findings for social support (n=7,729) and social cohesion (n=7,557) were 0.88 (0.74-1.04), 0.92 (0.79-1.06), 1.10 (0.94-1.29), and 0.99 (0.85-1.16), respectively. Some psychosocial risks modified CVD HRs. Secondary analyses yielded similar findings. For optimism and social support, an inverse relationship was frequently most compatible with the data, but a positive relationship was also compatible. For neighborhood social cohesion, a positive and null relationship was most compatible. Thus, specific resilience resources may be potential intervention targets, especially among certain subgroups.
The purpose of this study was to investigate the validity of the Revised Optimism-Pessimism Scale (PSM-R) as a measure of attributional style, and the incremental utility of optimism and pessimism as predictors of seizure group, in an intractable seizure disorder sample. Participants included adult patients with epileptic seizures (ES; n = 151) and psychogenic nonepileptic seizures (PNES; n = 173) whose diagnoses were confirmed by prolonged video/EEG monitoring (PVEM). Optimism and pessimism scores were computed from abbreviated versions of the MMPI for all participants. Analyses were conducted to examine the relationships between optimism, pessimism, and MMPI clinical scale scores. Logistic regression analyses were conducted to generate a model for the prediction of seizure group. Results supported the validity of the PSM-R as a measure of attributional style in an intractable seizure disorder sample. Both optimism and pessimism provided significant incremental predictive utility over and above other predictors of seizure group. There are advantages of using the proposed prediction model over other alternative differential diagnostic procedures, including lower cost, greater availability, and increased standardization. Overall, results indicated that attributional style is a clinically relevant index of personality and cognitive response to stress among an intractable seizure disorder sample.
The COVID-19 pandemic placed older adults at a disproportionate risk of experiencing social isolation and loneliness and subsequent reduced wellbeing. Evidence suggests companion animals may have the capacity to provide social support, reduce loneliness, and improve wellbeing in older adults. Using a cross-sectional design and online/phone semi-structured survey methodology, this qualitative study explored how companion animal ownership impacted the subjective wellbeing of 177 (89.8% female) older adult companion animal owners aged 65–84 years (M = 70.72, SD = 4.5) during the COVID-19 pandemic in Australia. A template thematic analysis indicated older adult companion animal owners perceived their companion animals to provide mental, social, and physical wellbeing benefits during the pandemic. Participants found providing care for their companion animals offered a light-hearted reprieve from pandemic fears while bringing a crucial sense of motivation and purpose to their days. Participants considered that their companion animals provided “COVID-safe” tactile comfort, social support, and companionship, while older adults also found pleasure forming attachments with wild animals during the pandemic, a novel finding in companion animal research. Our findings suggest that older adults facing barriers to companion animal ownership, including those living in retirement villages, residential aged care facilities, and hospital settings, may gain mental health benefits from forming attachments with wild animals, without being burdened with the sole responsibility of providing full time care for a companion animal. Furthermore, our findings provide evidence to support the creation of two novel theoretical mechanisms of human–animal interactions for further investigation: the motivation and purpose theory and the reprieve theory.
Objective:
Higher optimism is associated with reduced mortality and a lower risk of age-related chronic diseases. DNA methylation (DNAm) may provide insight into mechanisms underlying these relationships. We hypothesized DNAm would differ among older individuals who are more versus less optimistic.
Methods:
Using cross-sectional data from two population-based cohorts of women with diverse races/ethnicities (N = 3,816) and men (only white, N = 667), we investigated the associations of optimism with epigenome-wide leukocyte DNAm. Random-effects meta-analyses were subsequently used to pool the inabldividual results. Significantly differentially methylated cytosine-phosphate-guanines (CpGs) were identified by the number of independent degrees of freedom approach: effective degrees of freedom correction using the number of principal components (PCs), explaining>95% of the variation of the DNAm data (PC-correction). We performed regional analyses using comb-p and pathways analyses using the Ingenuity Pathway Analysis software.
Results:
We found essentially all CpGs (total probe N = 359,862) were homogeneous across sex and race/ethnicity in the DNAm~optimism association. In the single CpG site analyses based on homogeneous CpGs, we identified 13 significantly differentially methylated probes using PC-correction. We found four significantly differentially methylated regions and two significantly differentially methylated pathways. The annotated genes from the single CpG site and regional analyses are involved in psychiatric disorders, cardiovascular disease, cognitive impairment, and cancer. Identified pathways were related to cancer, neurodevelopmental and neurodegenerative disorders.
Conclusion:
Our findings provide new insights into possible mechanisms underlying optimism and health.
COVID-19 has redefined flexible working arrangements. Work from home (WFH) has emerged as a reality, and most of the organizations in Saudi Arabia also adopted WFH, allowing employees to work from home or other locations. This research explores WFH and its impact on the wellbeing and the work family reconciliation of female workers in Saudi Arabia. This is a case study based on the unstructured in-depth interview of 13 women workers employed in the public and private sector in Saudi Arabia in the last two years. The study concluded that work from home has improved the overall wellbeing of the women workers because of the flexibility and freedom this type of work arrangement is offering. The women workers had better work-life balance (WLB) despite having higher level of stress and working longer hours.
Background
Negative emotional eating (EE) is associated with unfavorable behavioral and health outcomes. Understanding its association with positive factors, such as optimism, may shed light into novel interventions. We examined the association between optimism and negative EE in US Caribbean Latinx adults, a population disproportionately exposed to adversity.Method
This cross-sectional analysis used data from the Latino Health and Well-being Study (21–84 years; n = 579). Optimism was measured with the Life Orientation Test-Revised version. EE was measured with the Three-Factor Eating Questionnaire R18-V2. Adjusted Poisson models with robust error variance estimated prevalence ratios (PR).ResultsThe proportion of individuals reporting high EE was greater in the low (39.0%) and moderate (36.8%) optimism groups than that in the high optimism group (24.8%; p = 0.011). Individuals with high optimism (vs. low) were less likely to report high EE over no EE (PR = 0.68; 95% CI = 0.53–0.88).Conclusion
High optimism was negatively associated with high EE. Future studies are needed to confirm our findings and test interventions promoting optimism for preventing negative EE in US Caribbean Latinx adults.
In our study within the European Union, we examine the countries of the Visegrád Four in terms of climate change and sustainability. The Visegrád countries (also known as V4) have gone through great changes during the last two decades. The four countries – the Czech Republic, Poland, Hungary and Slovakia – have invested/are investigating great power in the regulation, mitigation of climate change and in sustainable development. It is
essential to examine how the V4s adapt to climate change and what strategies they have put in place to reduce the problems and extent to which this is related to their sustainable development programs. The most important goal of the study is to identify the similarities and differences between the V4 countries in their climate change and sustainable development strategies and to provide insight into progress in the relevant indicators using simple statistical methods. The question is: do we find any difference from the indicators used to measure progress in the strategies or are they the same as the
sustainable development indicators for SDGs?
Work-life balance and its link to positive outcomes have been limited to the micro-level analysis. This study focuses on it from a macro perspective. Our dataset is a balanced panel composed of 48 countries with 143 observations, combining developing and developed countries and spanning from 2016 to 2018. Only for health variable, data for 2018 is not published yet, and hence, analysis for health includes only 96 observations. Work-life balance is approximated by average work hours per capita data obtained from the International Labour Organization. Happiness is obtained from the World Poll Survey. Finally, wealth and health conditions, approximated by income per capita and life expectancy at birth, respectively, are retrieved from the World Bank. Innovation level is approximated by the Global Innovation Index which is estimated by the World Intellectual Property Organization. Work-life balance was found to be a predictor of health, wealth, and innovation as mediated by happiness.KeywordsWork-life balanceHappinessInnovationWealthHealth
Today the goal of companies in the market continues to be to
maximize profit.The main research elements in this work were
aimed at systematizing theoretical concepts of how various aspects
of increasing and assessing customer satisfaction in the economic
activities performed at the level of society can be improved.One of
the elements sought was the analysis of the evolution of customer
satisfaction, the determination of mechanisms for assessing
customer satisfaction by applying their own methods in relation to
the classical economic indicators (profit, productivity, cost),
develop and propose solutions for growth and economic
development at society level by increasing customer satisfaction
based on the results of this research. The general methodology of
research was based on three types of research: fundamental,
applied and empirical. Analytical procedures such as observation
and reasoning have been used. This is why we have put a new system into the fore in the form of
an indicator that involves both customer satisfaction and economic
elements that measure economic activity itself so that we can talk
about economic sustainability based on continuous innovation
This study brings to the fore a topical issue in today’s society,
namely the importance of emotional intelligence in interpersonal
relationships and especially in an organization, the link between
emotional intelligence and job satisfaction and occupational stress.
Any organization carries out a succession of activities, stages,
operations through which economic goods are obtained for
customer satisfaction. In any organization, the role of the manager
is to make decisions and for the employees to start actions for its
operationalization.
Due to the fact that the term emotional intelligence has been
introduced on the market for several years, this notion is
substantiated and has a special efficiency in managerial activity.
The scientific issue is argued by the possibility of establishing the
limits of the theoretical bases, the methodological representations
of the identification of the organizational stress and of the
emotional intelligence in the circumstances of the application of a
certain managerial behavior.
Sustainability is a “wicked” subject – which most people automatically relate to energy. But it’s more. Locally – here specially for the area of district heating – it has many relationships within several areas. The article will try to shed some light how the 17 SDGs are related to a local district heating company, the local sugar factory, public transportation and the local grid. To use wood chips for a district heating system seems very common but using a waste product such as methane gas (or something close to it) and converting it into better Compressed Natural Gas (CNG) instead of creating only energy out of it, is a local novum. Sustainable urbanization – mainly heating in this article - is a term – the wickedness comes with implementation. While agriculture and urbanization fight for the same resource as the woodchip powered heating source – the forestation.
Objective:
Optimism is modifiable and may be associated with healthy ageing. We aim to investigate whether dispositional optimism is associated with all-cause mortality in adults aged 70 years and older.
Methods:
Between 2010 and 2014, older adults free of serious cardiovascular disease and dementia were recruited through primary care physicians, and enrolled in the Aspirin Reducing Events in the Elderly (ASPREE) clinical trial. Australian ASPREE participants were invited to participate in the ASPREE Longitudinal Study of Older Persons (ALSOP) that was running in parallel to ASPREE. Optimism was assessed at baseline using the Life Orientation Test - Revised (LOT-R). The association between optimism, divided into quartiles, and all-cause mortality was assessed using Cox Proportional Hazard models.
Results:
11,701 participants (mean age: 75.1 years, SD 4.24; 46.6% men) returned the ALSOP Social questionnaire and completed the LOT-R. During the median 4.7 years follow-up, 469 deaths occurred. The fully adjusted model was not significant (HR 0.78, 95% CI 0.58-1.06). There was evidence that age was an effect modifier of the association between optimism and longevity. Higher optimism was associated with lower mortality risk in the oldest individuals only (77+ years) (HR 0.61, 95% CI 0.39-0.96).
Conclusions:
We observed no independent relationship between optimism and all-cause mortality in the total sample, although optimism appeared to be associated with lower risk among oldest old (adults aged 77 years and over).
Postoperative depression is a multifaceted condition that can limit quality of life and potentially decrease the survival benefits of open heart surgery (OHS). We postulated that sex, pre-event character strengths, medical, and certain surgery indicators would predict post-event/myocardial infarction depression. To identify predictors, we collected three-wave survey data from 481 OHS patients at a large academic referral institution (age, 62+; female, 42%) and included key medical and surgical information. The final model (F[7, N = 293] = 28.15, p < 0.001, R = 0.408) accounted for over two fifths of the variance in post-OHS depression. Pre-event/OHS optimism mitigated post-OHS depression. Being female, older, living alone, longer surgical perfusion time, absence of left main disease greater than 50%, and pre-OHS depression were associated with the increased likelihood of post-OHS depression. Our findings suggest that teaching optimism to OHS patients might be beneficial in reducing the risk of postoperative depression and that female patients should be monitored more closely for the development of depression through an interdisciplinary approach.
Anxiety can contribute to poor prognosis in cardiac patients. Few studies have examined the role of optimism in anxiety after open heart surgery (OHS). This study investigated the influence of preoperative optimism on post-OHS anxiety, adjusting cardiac indices used by cardiac surgeons. Data were collected before and 1 month after OHS in 481 patients (58% men; age, 62.4 ± 11.94 years). Optimism was measured using the Life Orientation Test. Anxiety was measured using the Trait Anxiety Inventory. Medical and cardiac indices were retrieved from the Society of Thoracic Surgeon's national database. Multiple regression analyses showed that greater pre-OHS optimism was associated with lower levels of post-OHS anxiety (F[6, N = 306] = 50.18, p < 0.001, R = 0.502). No other factors showed similar protection. Pre-OHS anxiety, younger age, and minority status were associated with anxiety in the critical recovery month. The findings demonstrate the potential benefit of optimism against post-OHS anxiety, which may have clinical implications for improving disease management.
Prayer is an important experience in the lives of many people. We introduce the Using Private Prayer for Coping (UPPC) scale, based on William James’s (1902/1958) concept of personal religious experiences as “a study of human nature” (p. 350) and prayer as an “inward communion or conversation with the power recognized as divine” (p. 352). The UPPC is a consciousness-based scale to assess the use of private prayer for coping in crisis or distress, involving: (a) belief in its importance, (b) faith in its efficacy based on previous experiences, and (c) intention to use this as a means to cope with distress. Three studies in samples with diverse demographic characteristics, belief patterns, and crisis contexts were used to establish the satisfactory psychometric properties of the UPPC, including its association with or predictive value for hedonic and eudaemonic wellbeing following traumatic events or collective disasters.
Recent behavioral and biomedical research has suggested that psychophysiologic responsiveness (reactivity) to emotional stress may be a marker of processes involved in the development of cardiovascular disorders. The assessment of reactivity focuses on acute changes in functioning as opposed to the sole assessment of resting levels of variables. This article reviews evidence linking behaviorally induced cardiovascular and endocrine changes to coronary heart disease and essential hypertension. Particular attention is given to methodologic issues involving measurement. It is concluded that reactivity to stress is a construct with multiple dimensions: Different tasks and situations appear to elicit different patterns of physiologic responses. Further, an evaluation of evidence reveals that reactivity per se should currently not be regarded as a proven risk factor.Promising evidence does, however, justify continued laboratory and naturalistic, hypothesis-testing research. Recommended are methodologic studies to identify(a) the psychologic dimensions of stimuli that elicit reactivity in different subject groups, and (b) the patterns of physiologic responses produced. Such research would set the stage for epidemiologic studies to further examine relations between behavior and disease processes.
A large-scale questionnaire study was conducted to test several aspects of different attributional models of everyday problems in living. College students completed scales assessing depression, loneliness, and shyness. In addition, they completed a questionnaire that measured attributional style on five causal dimensions (locus, stability, controllability, globality, and intentionality) for four types of situations (interpersonal success and failure, noninterpersonal success and failure. The results of a series of regression and correlation analyses led to the following major conclusions: (1) Globality, intentionality, and stability may be dropped from attributional models of depression, loneliness, and shyness with little loss of predictive power; (2) controllability is the single most important dimension in predicting a person's level of depression, loneliness, or shyness; (3) locus adds to the prediction of these symptoms only w hen assessed by failure items; and (4) attributional style predicts these ...
The prediction that depressive symptoms are preceded by internal, stable, and global attributions for bad events was tested during the psychotherapy sessions of a 22-yr-old male who showed strong mood swings. His attributions, scored by a new method that analyzes freely occurring causal statements for internality, stability, and globality, predicted mood swings as measured by the symptom-context method. Findings suggest that attributions can be assessed with predictive validity using verbatim transcripts of verbal material. (45 ref)
In recent studies of the structure of affect, positive and negative affect have consistently emerged as two dominant and relatively independent dimensions. A number of mood scales have been created to measure these factors; however, many existing measures are inadequate, showing low reliability or poor convergent or discriminant validity. To fill the need for reliable and valid Positive Affect and Negative Affect scales that are also brief and easy to administer, we developed two 10-item mood scales that comprise the Positive and Negative Affect Schedule (PANAS). The scales are shown to be highly internally consistent, largely uncorrelated, and stable at appropriate levels over a 2-month time period. Normative data and factorial and external evidence of convergent and discriminant validity for the scales are also presented. (PsycINFO Database Record (c) 2010 APA, all rights reserved)
Contrary to unidimensional conceptions of optimism and pessimism, factor analysis of 2 widely used instruments revealed that optimism and pessimism are empirically differentiable, but related, constructs. Moreover, consistent with expectations, optimism and pessimism were differentially linked with fundamental dimensions of mood and personality. Pessimism was principally associated with neuroticism and negative affect. Optimism was primarily associated with extraversion an positive affect. Findings are discussed with reference to current conceptual and measurement models of optimism and pessimism and their relations to broad dimensions of mood and personality. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Cognitive therapy (CT) for depression has generated considerable interest in recent years. Comparisons with tricyclic pharmacotherapy in nonbipolar outpatients have suggested that (a) CT may be roughly comparable in the treatment of the acute episode; (b) combined CT-pharmacotherapy does not appear to be clearly superior to either modality (although indications of potential enhancement do exist to justify additional studies with larger samples), and (c) treatment with CT during the acute episode (either alone or with medications) may reduce the risk of subsequent relapse following termination. Nonetheless, for a variety of reasons (e.g., limitations in study design and execution, inadequate design power, and possible differential retention), these conclusions can be considered only suggestive at this time. More than a decade after the publication of the first controlled study involving CT, the approach remains a promising, but not adequately tested, alternative to pharmacotherapy in the treatment of depression. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
This article explores the implications that dispositional optimism holds for physical well-being. Research is reviewed that links optimism to a number of different positive health-relevant outcomes, ranging from the development of physical symptoms to recovery from coronary artery bypass surgery. Additional findings are described which suggest that these beneficial effects are partly due to differences between optimists and pessimists in the strategies that they use to cope with stress. A number of other potential mediators are also discussed, including some that are physiologic in nature. The article closes with a discussion of the relationships between our own theoretical account of the effects of optimism and several other conceptual approaches.
Criticizes and reformulates the learned helplessness hypothesis. It is considered that the old hypothesis, when applied to learned helplessness in humans, has 2 major problems: (a) It does not distinguish between cases in which outcomes are uncontrollable for all people and cases in which they are uncontrollable only for some people (universal vs personal helplessness), and (b) it does not explain when helplessness is general and when specific, or when chronic and when acute. A reformulation based on a revision of attribution theory is proposed to resolve these inadequacies. According to the reformulation, once people perceive noncontingency, they attribute their helplessness to a cause. This cause can be stable or unstable, global or specific, and internal or external. The attribution chosen influences whether expectation of future helplessness will be chronic or acute, broad or narrow, and whether helplessness will lower self-esteem or not. The implications of this reformulation of human helplessness for the learned helplessness model of depression are outlined. (92 ref)
The effect of dispositional optimism on recovery from coronary artery bypass surgery was examined in a group of 51 middle-aged men. Patients provided information at three points in time--(a) on the day before surgery, (b) 6-8 days postoperatively, and (c) 6 months postoperatively. Information was obtained relating to the patient's rate of physical recovery, mood, and postsurgical quality of life. Information was also gathered regarding the manner in which the patients attempted to cope with the stress of the surgery and its aftermath. As expected, dispositional optimism proved to be an important predictor of coping efforts and of surgical outcomes. More specifically, dispositional optimism (as assessed prior to surgery) correlated positively with manifestations of problem-focused coping and negatively with the use of denial. Dispositional optimism was also associated with a faster rate of physical recovery during the period of hospitalization and with a faster rate of return to normal life activities subsequent to discharge. Finally, there was a strong positive association between level of optimism and postsurgical quality of life at 6 months.
Found in two studies that the Life Orientation Test (LOT) had limited discriminant validity relative to measures of neuroticism. Furthermore, although previous correlations of the LOT with measures of symptom reports and coping behaviors were replicated, these correlations were eliminated when neuroticism was controlled. In contrast, the correlations of symptoms and coping with neuroticism remained significant when LOT scores were controlled. Thus, the LOT is virtually indistinguishable from measures of neuroticism, and previously reported findings using this scale are perhaps more parsimoniously interpreted as reflecting neuroticism rather than optimism. These findings are discussed in terms of existing support for models of optimism and self-control and general methodological issues in studies of personality and health.
Explanatory style, the habitual ways in which individuals explain bad events, was extracted from open-ended questionnaires filled out by 99 graduates of the Harvard University classes of 1942-1944 at age 25. Physical health from ages 30 to 60 as measured by physician examination was related to earlier explanatory style. Pessimistic explanatory style (the belief that bad events are caused by stable, global, and internal factors) predicted poor health at ages 45 through 60, even when physical and mental health at age 25 were controlled. Pessimism in early adulthood appears to be a risk factor for poor health in middle and late adulthood.
Recent behavioral and biomedical research has suggested that psychophysiologic responsiveness (reactivity) to emotional stress may be a marker of processes involved in the development of cardiovascular disorders. The assessment of reactivity focuses on acute changes in functioning as opposed to the sole assessment of resting levels of variables. Evidence is reviewed that links behaviorally induced cardiovascular and endocrine changes to coronary heart disease and essential hypertension. Particular attention is given to methodologic issues involving measurement. Different tasks and situations appear to elicit different patterns of physiologic responses. Reactivity per se should currently not be regarded as a proven risk factor. It is suggested that evidence does, however, justify continued laboratory and naturalistic hypothesis-testing research. The authors recommend methodologic studies to identify (a) the psychologic dimensions of stimuli that elicit reactivity in different subject groups, and (b) the patterns of physiologic responses produced. Such research would set the stage for epidemiologic studies to further examine relations between behavior and disease processes. (5 ½ p ref) (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Research on dispositional optimism as assessed by the Life Orientation Test (Scheier & Carver, 1985) has been challenged on the grounds that effects attributed to optimism are indistinguishable from those of unmeasured third variables, most notably, neuroticism. Data from 4,309 subjects show that associations between optimism and both depression and aspects of coping remain significant even when the effects of neuroticism, as well as the effects of trait anxiety, self-mastery, and self-esteem, are statistically controlled. Thus, the Life Orientation Test does appear to possess adequate predictive and discriminant validity. Examination of the scale on somewhat different grounds, however, does suggest that future applications can benefit from its revision. Thus, we also describe a minor modification to the Life Orientation Test, along with data bearing on the revised scale's psychometric properties.
Several studies have found that depression is an independent predictor of poor outcome after the onset of clinical coronary artery disease. There are few data concerning depression as a risk factor for the development of coronary artery disease.
To determine if clinical depression is an independent risk factor for incident coronary artery disease.
The Johns Hopkins Precursors Study is a prospective, observational study of 1190 male medical students who were enrolled between 1948 and 1964 and who continued to be followed up. In medical school and through the follow-up period, information was collected on family history, health behaviors, and clinical depression. Cardiovascular disease end points have been assessed with reviews of annual questionnaires, National Death Index searches, medical records, death certificates, and autopsy reports.
The cumulative incidence of clinical depression in the medical students at 40 years of follow-up was 12%. Men who developed clinical depression drank more coffee than those who did not but did not differ in terms of baseline blood pressure, serum cholesterol levels, smoking status, physical activity, obesity, or family history of coronary artery disease. In multivariate analysis, the men who reported clinical depression were at significantly greater risk for subsequent coronary heart disease (relative risk [RR], 2.12; 95% confidence interval [CI], 1.24-3.63) and myocardial infarction (RR, 2.12; 95% CI, 1.11-4.06). The increased risk associated with clinical depression was present even for myocardial infarctions occurring 10 years after the onset of the first depressive episode (RR, 2.1; 95% CI, 1.1-4.0).
Clinical depression appears to be an independent risk factor for incident coronary artery disease for several decades after the onset of the clinical depression.
This study investigated the role of optimism (OP) and distraction in cardiovascular reactivity; it also assessed the relationship between hostility, as measured by the Cook-Medley Hostility Scale (Ho), and OP. Fifty-six students formed two groups of high optimistic (HIOP) and low optimistic (LOWOP) subjects based upon scores on the Life Orientation Test (LOT). One half of the subjects in each group were randomly assigned to a distractor (DIS) or a nondistractor (NODIS) condition. All groups participated in two consecutive laboratory challenges, a Mental Arithmetic (MA) task and Simon Says game (SIM). Subjects in the two DIS groups were given both stress tasks coupled with an intermittent, auditory distractor, whereas the two NODIS groups received each stress task with white noise only. Systolic (SBP) and diastolic (DBP) blood pressure and heart rate (HR) were recorded before, during, and after stress. Results indicated that (a) pessimists displayed greater DBP reactivity to the MA task than did optimists (p <.01), (b) pessimism was significantly associated with increased Ho (p <.02), and (c) pessimists reported reliably more fatigue (p <.05) and anxiety (p <.04) than did optimists. Results were interpreted within a vigilance-reactivity framework.
The learned helplessness hypothesis is criticized and reformulated. The old hypothesis, when applied to learned helplessness in humans, has two major problems: (a) It does not distinguish between cases in which outcomes are uncontrollable for all people and cases in which they are uncontrollable only for some people (univervsal vs. personal helplessness), and (b) it does not explain when helplessness is general and when specific, or when chronic and when acute. A reformulation based on a revision of attribution theory is proposed to resolve these inadequacies. According to the reformulation, once people perceive noncontingency, they attribute their helplessness to a cause. This cause can be stable or unstable, global or specific, and internal or external. The attribution chosen influences whether expectation of future helplessness will be chronic or acute, broad or narrow, and whether helplessness will lower self-esteem or not. The implications of this reformulation of human helplessness for the learned helplessness model of depression are outlined.
The effect of dispositional optimism on recovery from coronary artery bypass surgery was examined in a group of 51 middle-aged men. Patients provided information at three points in time--(a) on the day before surgery, (b) 6-8 days postoperatively, and (c) 6 months postoperatively. Information was obtained relating to the patient's rate of physical recovery, mood, and postsurgical quality of life. Information was also gathered regarding the manner in which the patients attempted to cope with the stress of the surgery and its aftermath. As expected, dispositional optimism proved to be an important predictor of coping efforts and of surgical outcomes. More specifically, dispositional optimism (as assessed prior to surgery) correlated positively with manifestations of problem-focused coping and negatively with the use of denial. Dispositional optimism was also associated with a faster rate of physical recovery during the period of hospitalization and with a faster rate of return to normal life activities subsequent to discharge. Finally, there was a strong positive association between level of optimism and postsurgical quality of life at 6 months.
Contrary to unidimensional conceptions of optimism and pessimism, factor analysis of 2 widely used instruments revealed that optimism and pessimism are empirically differentiable, but related, constructs. Moreover, consistent with expectations, optimism and pessimism were differentially linked with fundamental dimensions of mood and personality. Pessimism was principally associated with neuroticism and negative affect. Optimism was primarily associated with extraversion and positive affect. Findings are discussed with reference to current conceptual and measurement models of optimism and pessimism and their relations to broad dimensions of mood and personality.
The Normative Aging Study is a comprehensive interdisciplinary longitudinal study located in the VA Outpatient Clinic in Boston, Mass. The study was inaugurated in 1963 by the VA because of its statutory responsibility for the medical care of 25 million war veterans of whom 2 million are now 65 years of age and over, a figure which will rise to over 7 million in the next 20 years. Approximately 2,000 male veterans are enrolled for their lifetime as research subjects and undergo recurrent examinations administered on an outpatient basis. The focus of the study is on non-pathological aging, so that the subjects were carefully screened in advance to satisfy rigid health criteria regardless of age. The study is distinctive because of its large N and the socioeconomic diversity of its population. Parameters include clinical medicine, biochemistry, special senses, oral medicine, anthropometry and behavior. The study is designed to investigate the relationship between normal aging and the natural history of chronic diseases. The investigation of environmental correlates of age change throughout the logitudinal design will also suggest the intrinsic or extrinsic nature of the aging process. The hybrid cross-sectional-longitudinal design will also enable the partialing of secular from true aging effects. Functional ages pertaining to various aspects of aging are being developed as a tool for assessing relative aging rates and the relationship among such differences in aging.
College students completed questionnaires measuring their explanatory style and health status. Four weeks later, they completed questionnaires measuring major life events, hassles, and health status. Contrary to the prediction of the reformulated helplessness model, the occurrence of bad life events did not interact with explanatory style to predispose poor health. However, the tendency to explain bad events with stable and global causes was related to reports of hassles. Reports of hassles were in turn related to poor health status. These results were obtained even when initial health status was held constant. Implications of these results were discussed, particularly with regard to the helplessness reformulation as a diathesis-stress model.
Participants in the Terman Life-Cycle Study completed open-ended questionnaires in 1936 and 1940, and these responses were blindly scored for explanatory style by content analysis. Catastrophizing (attributing bad events to global causes) predicted mortality as of 1991, especially among males, and predicted accidental or violent deaths especially well. These results are the first to show that a dimension of explanatory style is a risk factor for mortality in a large sample of initially healthy individuals, and they imply that one of the mechanisms linking explanatory style and death involves lifestyle.
Presents an animal model of how learned helplessness may manifest itself as depression and anxiety. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Reviews studies that compared cognitive therapy (COT) and pharmacotherapy (PHT), alone or combined, for the treatment of depression. Evidence suggests that COT is comparable to tricyclic PHT in the treatment of nonpsychotic, nonbipolar depressed outpatients, although no evidence favors either single modality over the other. COT appears to provide some protection against relapse following termination of treatment, and combined COT/PHT treatment appears to provide as much protection against subsequent relapse as COT alone. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
The purpose of this review is to examine the epidemiological, psychological, and experimental evidence for an association
between anxiety and coronary heart disease (CHD). Papers published during the years 1980–1996 on anxiety and CHD and relevant
publications from earlier years were selected for this review. Epidemiologic evidence suggests that anxiety may be a risk
factor for the development of CHD. Chronic anxiety may increase the risk of CHD by: (a) influencing health behaviors (e.g.
smoking); (b) promoting atherogenesis (e.g. via increased risk of hypertension); and (c) triggering fatal coronary events,
either through arrhythmia, plaque rupture, coronary vasospasm, or thrombosis. Electrophysiologic evidence is particularly
compelling: anxiety appears to be associated with abnormal cardiac autonomic control, which may indicate increased risk of
fatal ventricular arrhythmias. The strength, consistency, and dose-response gradient of the association between anxiety and
CHD, together with the biologic plausibility of the experimental evidence, suggest that anxiety may contribute to risk of
CHD and that the relationship warrants further investigation.
Explanatory style, the habitual way an individual explains the causes of bad and good events, is reliably associated with
future health. In this article, we review evidence from three studies which demonstrate a significant relationship between
pessimism (the belief that bad events are caused by internal, stable, and global factors and good events are caused by external,
unstable, and specific factors) and an increased risk for infectious disease, poor health, and early mortality. We suggest
two possible mechanisms which might mediate the link between pessimism and poor health. Finally, we propose that interventions
aimed at changing a pessimistic outlook might lower the probability of future illness.
Two studies tested the hypothesis that certain positive emotions speed recovery from the cardiovascular sequelae of negative emotions. In Study 1, 60 subjects (Ss) viewed an initial fear-eliciting film, and were randomly assigned to view a secondary film that elicited: (a) contentment; (b) amusement; (c) neutrality; or (d) sadness. Compared to Ss who viewed the neutral and sad secondary films, those who viewed the positive films exhibited more rapid returns to pre-film levels of cardiovascular activation. In Study 2, 72 Ss viewed a film known to elicit sadness. Fifty Ss spontaneously smiled at least once while viewing this film. Compared to Ss who did not smile, those who smiled exhibited more rapid returns to pre-film levels of cardiovascular activation. We discuss these findings in terms of emotion theory and possible health-promoting functions of positive emotions.
This article opens by noting that positive emotions do not fit existing models of emotions. Consequently, a new model is advanced to describe the form and function of a subset of positive emotions, including joy, interest, contentment, and love. This new model posits that these positive emotions serve to broaden an individual's momentary thought-action repertoire, which in turn has the effect of building that individual's physical, intellectual, and social resources. Empirical evidence to support this broaden-and-build model of positive emotions is reviewed, and implications for emotion regulation and health promotion are discussed.
Some have speculated that explanatory style puts an individual at risk for illness. Study 1 supports this hypothesis by showing that college students who believe that stable + global factors caused bad events experienced more days of illness in the following month and visited physicians more frequently in the following year than students who explain bad events with unstable + specific causes. These findings held even when level of previous illness was controlled. Study 2 explores some of the possible links between explanatory style and poor health. College students who believe that stable + global factors caused bad events reported more unhealthy habits, lower efficacy to change these habits, and more stressful occurrences than students who explain bad events with unstable + specific causes. Peer Reviewed http://deepblue.lib.umich.edu/bitstream/2027.42/44333/1/10608_2005_Article_BF01204926.pdf
Correlations were determined for male (n = 225) and female (n = 242) college students between sets of undesirable personality traits (anxiety, stress reactivity, anger, and alienation) and desirable personality traits (instrumentality, achievement strivings, and optimism measured by the Scheier-Carver [1987] Life Orientation Test), and a series of outcome variables related to health (self-reported health complaints and health maintenance behaviors and beliefs) and academic performance (academic expectations and actual grade point average). Significant correlations were found between many of the personality variables and the outcome variables. However, partial correlations revealed different relationships for the various criteria. With other variables held constant, health complaints were related to several undesirable characteristics, whereas health maintenance behaviors and beliefs were related to several desirable attributes. Only achievement strivings made an independent contribution in both sexes to the 2 measures of academic performance. The theoretical and methodological wisdom of using measures of multiple personality constructs and outcome variables is discussed.
Studies in animals have suggested that increases in blood flow result in dilation of large arteries by an endothelium-dependent mechanism. Atherosclerosis can impair endothelium-dependent vasodilation to vasoactive agents. The purpose of this study was to determine whether or not large coronary arteries in humans exhibit dilation with increases in blood flow and to test the hypothesis that this response is impaired in the presence of atherosclerosis. Graded concentrations of adenosine were infused into the distal left anterior descending (LAD) coronary artery to test the dilator response of the proximal LAD to increases in blood flow. The proximal LAD was thereby exposed to changes in blood flow, but not directly to adenosine. Ten patients with angiographically smooth proximal LAD segments (group 1) and seven patients with irregularities in the proximal LAD consistent with mild atherosclerosis (group 2) were studied. Infusions of adenosine throughout the range of 0.022 to 2.2 mg/min into the LAD produced a dose-dependent increase in estimated coronary blood flow and a mean increase of 305 +/- 27% at 2.2 mg/min adenosine. At 2.2 mg/min adenosine, a striking difference (p less than 0.001) occurred between the significant flow-mediated dilation of the proximal LAD observed in group 1 (+13.2 +/- 1.3% from 2.63 +/- 0.16 mm, p less than 0.001), and the lack of dilation in group 2 (+1.8 +/- 1.5% from 3.20 +/- 0.17 mm, p = NS), despite a greater increase in coronary blood flow in group 2 (+387 +/- 29%) than in group 1 (+230 +/- 36%).(ABSTRACT TRUNCATED AT 250 WORDS)
Altered arterial wall shear stress may adversely affect vascular endothelium and contribute to atherogenesis. This study examined the hypothesis that, in humans, dilation of normal coronary arteries with increased flow limits increases in shear stress and that loss of flow-mediated dilation in atherosclerosis results in failure to control shear stress. Coronary blood flow was increased by infusing adenosine (0.022 to 2.2 mg/min) through a 2.5F Doppler flow catheter positioned in the middle segment of the left anterior descending coronary artery in 8 patients with mild atherosclerosis but no flow-limiting stenosis and in 10 patients with entirely smooth coronary arteries. Quantitative angiography and coronary flow velocity were used to estimate shear stress in a proximal segment of the left anterior descending artery exposed to increased flow, but not to adenosine. The peak increase in blood flow was the same in smooth (371 +/- 65%) and irregular (377 +/- 50%) arteries. However, at peak flow, dilation was greater in smooth segments (16.3 +/- 2.7%) than in irregular segments (2.0 +/- 1.5%) (p less than 0.001). In each patient, smooth segments dilated with increasing shear stress (slope 7.4 +/- 0.9%), whereas irregular segments dilated less (slope 0.9 +/- 0.6%) and showed greater increases in shear stress (p less than 0.01). The peak increase in shear stress was less in smooth (189 +/- 23%) than in irregular (365 +/- 52%) segments (p less than 0.01). These results suggest a control mechanism in normal coronary arteries whereby increases in shear stress stimulate vasodilation and thus limit further increases in this force at the endothelial surface.(ABSTRACT TRUNCATED AT 250 WORDS)
We compare two methods of assessing explanatory style--the content analysis of verbatim explanations (CAVE) and the Attributional Style Questionnaire (ASQ). The CAVE technique is a method that allows the researcher to analyze any naturally occurring verbatim materials for explanatory style. This technique permits the measurement of various populations that are unwilling or unable to take the ASQ. We administered the ASQ and Beck Depression Inventory (BDI) to 169 undergraduates and content analyzed the written causes on the ASQ for explanatory style by the CAVE technique. The CAVE technique correlated 0.71 with the ASQ (P less than 0.0001, n = 159) and -0.36 with BDI (P less than 0.0001, n = 159). The ASQ correlated -0.51 with the BDI (P less than 0.0001, n = 160). Both the CAVE technique and the ASQ seem to be valid devices for assessing explanatory style.
Analyzed explanatory style across the life span. 30 Ss whose average age was 72 responded to questions about their current life and provided diaries or letters written in their youth, an average of 52 years earlier. A blind content analysis of explanatory style derived from these 2 sources revealed that explanatory style for negative events was stable throughout adult life (r = .54, p less than .002). In contrast, there appeared to be no stability of explanatory style for positive events between the same 2 time periods. These results suggest that explanatory style for negative events may persist across the life span and may constitute an enduring risk factor for depression, low achievement, and physical illness.
Atherosclerosis affects the major elastic and muscular arteries, but some vessels are largely spared while others may be markedly diseased. The carotid bifurcation, the coronary arteries, the infrarenal abdominal aorta, and the vessels supplying the lower extremities are at highest risk. The propensity for plaque formation at bifurcations, branchings, and curvatures has led to conjectures that local mechanical factors such as wall shear stress and mural tensile stress potentiate atherogenesis. Recent studies of the human vessels at high risk, and of corresponding models, have provided quantitative evidence that plaques tend to occur where flow velocity and shear stress are reduced and flow departs from a laminar, unidirectional pattern. Such flow characteristics tend to increase the residence time of circulating particles in susceptible regions while particles are cleared rapidly from regions of relatively high wall shear stress and laminar unidirectional flow. The flow patterns associated with plaque localization are most prominent during systole. Long-term consequences are therefore likely to be greatly enhanced by elevated heart rate and may exert a selective effect on the coronary arteries. The point-by-point redistribution of wall tension at regions of geometric transition has not been quantitatively related to plaque localization. Enlargement of arteries as plaques increase in size and the associated modeling of plaque and wall configuration tend to preserve an adequate and regular lumen cross section. Hemodynamic forces appear to determine changes in vessel diameter so as to restore normal levels of wall shear stress, while wall thickness architecture, and composition are closely related to tensile stress. Hemodynamic forces may also be implicated in the symptom-producing destabilization of plaques, especially in relation to wall instabilities near stenoses. The relative roles of wall shear stress, tensile stress, and the metabolism of the artery wall in the progression and complication of atherosclerosis remain to be clarified. Development of clinical techniques for relating hemodynamic and tensile properties to plaque location, stenosis, and composition should permit pathologists to provide new insights into the bases for the topographic and individual differences in plaque progression and outcome.
The cynomolgus macaque provides a suitable primate model for studying how psychosocial factors contribute to coronary artery atherogenesis. Important interactions with diet, sex, and behaviorally elicited cardiovascular reactivity are described.
In recent studies of the structure of affect, positive and negative affect have consistently emerged as two dominant and relatively independent dimensions. A number of mood scales have been created to measure these factors; however, many existing measures are inadequate, showing low reliability or poor convergent or discriminant validity. To fill the need for reliable and valid Positive Affect and Negative Affect scales that are also brief and easy to administer, we developed two 10-item mood scales that comprise the Positive and Negative Affect Schedule (PANAS). The scales are shown to be highly internally consistent, largely uncorrelated, and stable at appropriate levels over a 2-month time period. Normative data and factorial and external evidence of convergent and discriminant validity for the scales are also presented.
Sixty-six adults wrote essays describing the two worst events that had occurred to them during the preceding year and then completed the short-form of the Beck Depression Inventory (BDI). Causal explanations for bad events were extracted from the essays and rated by judges for internality (vs externality), stability (vs instability) and globality (vs specificity). Ratings were consistent across different attributions made by the same individual. Further, the internality, stability and globality of these unprompted attributions correlated with depressive symptoms as measured by the BDI. Taken together, the results support the attributional reformulation of the learned-helplessness model of depression.
The attributional reformulation of the learned helplessness model as outlined by L. Y. Abramson et al (see record 1979-00305-001) claims that an explanatory style in which bad events are explained by internal, stable, and global causes is associated with depressive symptoms. This style is claimed to be a risk factor for subsequent depression when bad events are encountered. A variety of new investigations of the helplessness reformulation are described that have employed 5 research strategies: cross-sectional correlational studies, longitudinal studies, experiments of nature, laboratory experiments, and case studies. Ss in these investigations included children, college students, poor women, depressed patients, and prisoners. Most of these studies involved the use of the Attributional Style Questionnaire and measures such as the Beck Depression Inventory and Multiple Affect Adjective Check List. These studies converge in their support for the learned helplessness reformulation. (120 ref) (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Atherosclerosis is an ubiquitous disease effecting degenerative, proliferative and atrophic changes in the vessel wall. Preoccupation with intramural lipid accumulation has been at the expense of studies concerning other aspects of atherosclerosis including the complications. The current view of the lipid hypothesis fails to explain the localization or the complications. They can be accounted for by the thesis that atherosclerosis is due to hemodynamically-induced engineering fatigue. In animal models, in which gross disturbances of flow occur, the disease morphologically similar to atherosclerosis in man, together with the complications, can be reproduced at an accelerated rate, thus substantiating the fatigue hypothesis. Moreover, hemodynamics appears to govern dietary-induced lipid accumulation, but these two factors acting in concert will not reproduce atherosclerosis as it occurs in man.
The Revised Optimism-Pessimism (PSM-R) scale was developed for use with either the MMPI-2 or the MMPI. The scale measures explanatory style on a continuum from optimistic to pessimistic by using 263 MMPI items of the original 298-item Optimism-Pessimism (PSM) scale. These 263 items are common to both the MMPI-2 and MMPI. PSM-R norms are based on a random sample of 1,408 normal adults who also were used for developing norms for the original PSM scale. Reliability estimates (.93 for men; .94 for women) indicate that the PSM-R scale is as accurate as the original PSM scale.
Several studies have suggested an increased risk of fatal coronary heart disease (CHD) among patients with panic disorder, phobic anxiety, and other anxiety disorders. We prospectively examined this association in the Normative Aging Study.
An anxiety symptoms scale was constructed out of five items from the Cornell Medical Index, which was administered to the cohort at baseline. During 32 years of follow-up, we observed 402 cases of incident coronary heart disease (137 cases of nonfatal myocardial infarction, 134 cases of angina pectoris, and 131 cases of fatal CHD: made up of 26 cases of sudden cardiac death and 105 cases of nonsudden death). A nested case-control design (involving 1869 control subjects who remained free of diagnosed CHD) was used to assess the association between anxiety and risk of CHD. Compared with men reporting no symptoms of anxiety, men reporting two or more anxiety symptoms had elevated risks of fatal CHD (age-adjusted odds ratio [OR] = 3.20, 95% confidence interval [CI]: 1.27 to 8.09), and sudden death (age-adjusted OR = 5.73, 95% CI: 1.26 to 26.1). The multivariate OR after adjusting for a range of potential confounding variables was 1.94 (95% CI: 0.70-5.41) for fatal CHD and 4.46 (95% CI: 0.92-21.6) for sudden death. No excess risks were found for nonfatal myocardial infarction or angina.
These data suggest an association between anxiety and fatal coronary heart disease, in particular, sudden cardiac death.
Research based on Seligman's model indicates that a pessimistic explanatory style predicts increased frequency of depression, poorer physical health, and lower levels of achievement. The data show that persons who have a pessimistic outlook on life are more frequent users of the medical and mental health care delivery systems. This paper describes the development of a bipolar MMPI Optimism-Pessimism (PSM) scale that is based on the results of a technique--Content Analysis of Verbatim Explanation (CAVE)--applied to the MMPI. Reliability and validity indices show that the PSM scale is highly accurate and consistent with Seligman's theory. Identification of the patient's explanatory style may lead to improved management because intervention measures can be directed more accurately according to the patient's personality style. The new scale also will allow researchers to use existing MMPI data to explore relationships between explanatory style and various outcome variables and behavioral correlates.
We examined the relationship among low, moderate, and high levels of hopelessness, all-cause and cause-specific mortality, and incidence of myocardial infarction (MI) and cancer in a population-based sample of middle-aged men. Participants were 2428 men, ages 42 to 60, from the Kuopio Ischemic Heart Disease study, an ongoing longitudinal study of unestablished psychosocial risk factors for ischemic heart disease and other outcomes. In 6 years of follow-up, 174 deaths (87 cardiovascular and 87 noncardiovascular, including 40 cancer deaths and 29 deaths due to violence or injury), 73 incident cancer cases, and 95 incident MI had occurred. Men were rated low, moderate, or high in hopelessness if they scored in the lower, middle, or upper one-third of scores on a 2-item hopelessness scale. Age-adjusted Cox proportional hazards models identified a dose-response relationship such that moderately and highly hopeless men were at significantly increased risk of all-cause and cause-specific mortality relative to men with low hopelessness scores. Indeed, highly hopeless men were at more than three-fold increased risk of death from violence or injury compared with the reference group. These relationships were maintained after adjusting for biological, socioeconomic, or behavioral risk factors, perceived health, depression, prevalent disease, or social support. High hopelessness also predicted incident MI, and moderate hopelessness was associated with incident cancer. Our findings indicate that hopelessness is a strong predictor of adverse health outcomes, independent of depression and traditional risk factors. Additional research is needed to examine phenomena that lead to hopelessness.
Recent laboratory and epidemiological studies have suggested that high levels of anger may increase the risk of coronary heart disease (CHD).
We examined prospectively the relationship of anger to CHD incidence in the Veterans Administration Normative Aging Study, an ongoing cohort of older (mean age, 61 years) community-dwelling men. A total of 1305 men who were free of diagnosed CHD completed the revised Minnesota Multiphasic Personality Inventory (MMPI-2) in 1986. Subjects were categorized according to their responses to the MMPI-2 Anger Content Scale, which measures the degree to which individuals have problems controlling their anger. During an average of 7 years of follow-up, 110 cases of incident CHD occurred, including 30 cases of nonfatal myocardial infarction hostility. (MI), 20 cases of fatal CHD, and 60 cases of angina pectoris. Compared with men reporting the lowest levels of anger, the multivariate-adjusted relative risks among men reporting the highest levels of anger were 3.15 (95% confidence interval) [CI]: 0.94 to 10.5) for total CHD (nonfatal MI plus fatal CHD) and 2.66 (95% CI: 1.26 to 5.61) for combined incident coronary events including angina pectoris. A dose-response relation was found between level of anger and overall CHD risk (P for trend, .008).
These data suggest that high levels of expressed anger may be a risk factor for CHD among older men.
The importance of hope has long been recognized, whereas a lack of hope, or "giving up," is generally believed to have a negative impact on psychological well-being and physical health. Recently, hopelessness has been identified as a strong, independent predictor of cardiovascular disease morbidity and mortality in both American and Finnish populations. In this study we examined the association between high levels of hopelessness and progression of carotid atherosclerosis in participants (n = 942) in the Kuopio Ischemic Heart Disease Study, a population-based study of middle-aged men from eastern Finland who underwent carotid ultrasonography at baseline and 4 years later. Men reporting high levels of hopelessness at baseline had faster progression of carotid atherosclerosis, assessed by four measures of intima-media thickening (IMT), than men reporting low to moderate levels of hopelessness. Further analyses revealed significant interactions between hopelessness and initial level of atherosclerosis, such that the effects of high hopelessness on progression were greatest among men who had baseline mean IMT values at or above the median. Moreover, progression was greatest among men reporting high levels of hopelessness at both baseline and follow-up. Traditional coronary risk factors and use of cholesterol-lowering and antihypertensive medications did not account for much variance in the observed relationships. These findings indicate that hopelessness contributes to accelerated progression of carotid atherosclerosis, particularly among men with early evidence of atherosclerosis, and that chronically high levels of hopelessness may be especially detrimental. Additional research is needed to identify the contributory pathways and/or mechanisms underlying these relationships.
Increasing evidence supports an association between symptomatic depression and the risk of coronary heart disease (CHD), although no single study has compared multiple depression scales. We hypothesized that higher levels of symptomatic depression assessed from different depression scales were associated with the risk of CHD. We examined this relation in the Normative Aging Study, a prospective cohort of older men. A total of 1,305 men free of diagnosed CHD in 1986 completed the revised Minnesota Multiphasic Personality Inventory (MMPI-2). We categorized scores for the MMPI-2 D, MMPI-2 DEP, and Symptom Checklist-90 (SCL-90) depression scales. During an average 7.0 years of follow-up, 110 cases of incident CHD occurred, including 30 cases of nonfatal myocardial infarction, 20 cases of fatal CHD, and 60 cases of angina pectoris. Compared with men reporting the lowest level of depression, men in the highest level of depression had multivariate-adjusted relative risks of incident CHD (total CHD and angina) of 1.46 (95% confidence interval 0.83 to 2.57), 2.07 (95% confidence interval 1.13 to 3.81), and 1.73 (95% confidence interval 0.97 to 3.10) for the MMPI-2 D, MMPI-2 DEP, and SCL-90 scales, respectively. Similar RRs were obtained for each CHD subtype according to each depression scale. We found strong dose-response relations between level of depression measured by the MMPI-2 DEP scale and incidence of both angina pectoris (p value for trend, 0.039) and CHD (p value for trend, 0.016). Among older men, symptomatic depression measured by any of 3 depression scales may be positively associated with the risk of CHD.