Happy People Live Longer: Subjective Well‐Being Contributes to Health and Longevity

Seven types of evidence are reviewed that indicate that high subjective well-being (such as life satisfaction, absence of negative emotions, optimism, and positive emotions) causes better health and longevity. For example, prospective longitudinal studies of normal populations provide evidence that various types of subjective well-being such as positive affect predict health and longevity, controlling for health and socioeconomic status at baseline. Combined with experimental human and animal research, as well as naturalistic studies of changes of subjective well-being and physiological processes over time, the case that subjective well-being influences health and longevity in healthy populations is compelling. However, the claim that subjective well-being lengthens the lives of those with certain diseases such as cancer remains controversial. Positive feelings predict longevity and health beyond negative feelings. However, intensely aroused or manic positive affect may be detrimental to health. Issues such as causality, effect size, types of subjective well-being, and statistical controls are discussed.

BackgroundHappiness is often conceptualized as subjective well-being, which comprises people's evaluations of emotional experiences (i.e., the affective dimension: positive and negative feelings and emotions) and judgements of a self-imposed ideal (i.e., the cognitive dimension: life satisfaction). Recent research has established these two dimensions as primary parts of a higher order factor. However, theoretical, conceptual, and empirical work suggest that people's evaluations of harmony in their life (i.e., the sense of balance and capacity to behave and adapt with both acceptance and flexibility to inter- and intrapersonal circumstances) constitutes a third dimension (i.e., the behavioral dimension). This tridemensional conceptualization of subjective well-being has recently been verified using Unidimensional Item Response Theory (UIRT) and Classical Test Theory (CTT). Here, we use a recently developed and more robust approach that combines these two methods (i.e., Multidimensional Item Response Theory, MIRT) to simultaneously address the complex interactions and multidimensionality behind how people feel, think, and behave in relation to happiness in their life. MethodA total of 435 participants (197 males and 238 females) with an age mean of 44.84 (sd = 13.36) responded to the Positive Affect Negative Affect Schedule (10 positive affect items, 10 negative affect items), the Satisfaction with Life Scale (five items), and the Harmony in life Scale (five items). We used Bifactor-Graded Response MIRT for the main analyses. ResultAt the general level, each of the 30 items had a strong capacity to discriminate between respondents across all three dimensions of subjective well-being. The investigation of different parameters (e.g., marginal slopes, ECV, IECV) strongly reflected the multidimensionality of subjective well-being at the item, the scale, and the model level. Indeed, subjective well-being could explain 64 % of the common variance in the whole model. Moreover, most of the items measuring positive affect (8/10) and life satisfaction (4/5) and all the items measuring harmony in life (5/5) accounted for a larger amount of variance of subjective well-being compared to that of their respective individual dimensions. The negative affect items, however, measured its own individual concept to a lager extent rather than subjective well-being. Thus, suggesting that the experience of negative affect is a more independent dimension within the whole subjective well-being model. We also found that specific items (e.g., “Alert”, “Distressed”, “Irritable”, “I am satisfied with my life”) were the recurrent exceptions in our results. Last but not the least, experiencing high levels in one dimension seems to compensate for low levels in the others and vice versa. ConclusionAs expected, the three subjective well-being dimensions do not work separately. Interestingly, the order and magnitude of the effect by each dimension on subjective well-being mirror how people define happiness in their life: first as harmony, second as satisfaction, third as positive emotions, and fourth, albeit to a much lesser degree, as negative emotions. Ergo, we argue that subjective well-being functions as a complex biopsychosocial adaptive system mirroring our attitude towards life in these three dimensions (A: affective dimension; B: behavioral dimension; C: cognitive dimension). Ergo, researchers and practitioners need to take in to account all three to fully understand, measure, and promote people's experience of the happy life. Moreover, our results also suggest that negative affect, especially regarding high activation unpleasant emotions, need considerable changes and further analyses if it is going to be included as a construct within the affective dimension of a general subjective well-being factor.

Various forms of psychological distress, including depression and anxiety, are known to increase risk for cardiovascular disease (CVD). However, most people are not actively distressed; rather, they experience varying levels of positive psychological well-being (PPWB), which includes such constructs as life satisfaction, positive emotions, optimism, and vitality. Up until relatively recently, the role of PPWB in cardiovascular disease (CVD) has not garnered as much attention as the role of psychological distress. This chapter assesses the current state of knowledge on the topic by reviewing the evidence for an association between facets of PPWB and CVD, with a particular focus on whether the association exists above and beyond known associations with psychological distress. To this end, we identified prospective longitudinal studies of both healthy and patient populations that measured initial levels of PPWB and development of an objective CVD-related endpoint after some period of follow-up. Results suggest that in healthy populations, PPWB and CVD are reliably related such that enhanced PPWB is associated with reduced risk of incident CVD and mortality. In patient populations, the relationship is somewhat less consistent but still points to a potentially protective relationship between higher levels of PPWB and subsequent progression of CVD. This review also highlights important considerations for future research including isolating the critical aspect of PPWB related to CVD health, identifying modifiers of the relationship (including gender, ethnicity, and disease severity), and exploring possible mechanisms (including health behaviors and biological markers). To conclude, we discuss implications of our findings for CVD prevention and intervention.KeywordsCardiovascular diseasePsychological well-beingOptimismPositive affect

Fredrickson and Branigan (2005) define emotions as short lived experiences that produce changes in physiology, thoughts, and behaviours. In the academic literature, the term positive emotions is included within the broad term positive affect which also includes longer lasting positive moods (Diener, 2000). Positive emotions are more than the absence of negative emotions. For example, feeling happy or excited is more than not feeling sad or bored.Evidence suggests that people who experience frequent positive emotions tend to be successful and proficient across many spheres of life. This means that happiness is linked to successful outcomes. This is not merely because success leads to happiness, but because positive affect bring about success. Positive moods and emotions lead people to think, feel, and act in ways that promote both resource building and involvement with approach goals. This is explained by the broaden-and-build theory of positive emotions (Fredrickson, 1998; 2001). The theory suggests that positive emotions (viz. enjoyment, happiness, joy, pride, interest) broaden one's awareness and encourage new, diverse, and exploratory thoughts and actions. Over time, these novel experiences collectively build up consequential resources and skills that can change people's lives. For example, idle curiosity can become expert knowledge, or affection and shared amusement can become a lifelong supportive relationship.Positive emotions influence a number of positive outcomes in life. People who experience and express positive emotions more often are likely to be satisfied with their lives and have more fulfilling interpersonal relationships. They are more satisfied at their job, are helpful to other people, and are more likely to reach desired goals in life. (Diener, Suh, Lucas, &Smith, 1999).Positive emotions and subjective well-being are closely linked. Positive emotions are believed to be powerful indicators of wellbeing (Fredrickson, 2009). Frequently experiencing positive affect is proposed to be one of the three components of subjective well-being (along with infrequent experience of negative affect and feeling satisfied with life) which is considered an important outcome in psychological research (Diener, 2000).Attachment is basically the strong emotional bonds that are formed between an individual and his/her significant others (Green & Scholes, 2004). These bonds develop from the fundamental bond that a child forms with his/her first and primary caregiver (Broberg, Mothander, Granqvist, & Ivarsson, 2008) and remain relatively stable throughout adulthood (Shaver & Brennan, 1992).Bartholomew and Horowitz (1991) propose four different adult attachment styles based on individual's level of avoidance and anxiety. The first style, includes individuals who have a sense of worthiness as well as a perception of others being responsive and accepting. Secure individuals experience low anxiety and low avoidance. The remaining three styles, learful-avoidant, and dismissive avoidant, are insecure styles of attachment. The first insecure style, includes individuals who show low avoidance and high anxiety and view themselves as being unworthy of love. The fearful-avoidant style include individuals who feel unworthy and have distrust in intimacy. They experience high anxiety and avoidance and feel that by avoiding intimacy with others, they are protected from the rejection they expect in close relationships. Finally, the dismissive-avoidant style includes individuals who protect themselves against disappointment by avoiding close relationships.In short, adults low on both anxiety and avoidance as described as secure, adults high on attachment anxiety but low on avoidance as preoccupied, those high on avoidance but low on anxiety as dismissive, and those high on both anxiety and avoidance as fearful.Life satisfaction is the person's evaluation of his or her life as a whole. …

Two studies were carried out on a Spanish population to explore the extent to which different self-efficacy beliefs in managing positive emotions are associated with common indicators of wellbeing, such as positive and negative affect or life satisfaction. The first study was conducted on 483 participants and attested to the factorial structure of three different self-efficacy beliefs: (a) perceived self-efficacy in expressing positive emotions; (b) perceived self-efficacy in retrieving memories of positive emotional experiences; and (c) perceived self-efficacy in using humor. The second study was carried out on 1,087 individuals between 19 and 80 years of age, and it provided evidence of the factorial invariance of the scales across age and gender. Furthermore, this latter study showed the association of self-efficacy in managing positive affect (SEMPA) with high chronic positive and low negative affect, and with high life satisfaction, controlling for gender and age. In younger participants, stronger associations were found between perceived self-efficacy in using humor and life satisfaction compared to older subjects. These findings may guide the design of interventions aimed at enhancing the potential benefits that could be drawn from the proper management of positive emotions.

To review systematically prospective, observational, cohort studies of the association between positive well-being and mortality using meta-analytic methods. Recent years have witnessed increased interest in the relationship between positive psychological well-being and physical health. We searched general bibliographic databases: Medline, PsycINFO, Web of Science, and PubMed up to January 2008. Two reviewers independently extracted data on study characteristics, quality, and estimates of associations. There were 35 studies (26 articles) investigating mortality in initially healthy populations and 35 studies (28 articles) of disease populations. The meta-analyses showed that positive psychological well-being was associated with reduced mortality in both the healthy population (combined hazard ratio (HR) = 0.82; 95% Confidence Interval (CI) = 0.76-0.89; p < .001) and the disease population (combined HR = 0.98; CI = 0.95-1.00; p = .030) studies. There were indications of publication bias in this literature, although the fail-safe numbers were 2444 and 1397 for healthy and disease population studies, respectively. Intriguingly, meta-analysis of studies that controlled for negative affect showed that the protective effects of positive psychological well-being were independent of negative affect. Both positive affect (e.g., emotional well-being, positive mood, joy, happiness, vigor, energy) and positive trait-like dispositions (e.g., life satisfaction, hopefulness, optimism, sense of humor) were associated with reduced mortality in healthy population studies. Positive psychological well-being was significantly associated with reduced cardiovascular mortality in healthy population studies, and with reduced death rates in patients with renal failure and with human immunodeficiency virus-infection. The current review suggests that positive psychological well-being has a favorable effect on survival in both healthy and diseased populations.

Introduction to the Special Section

Introduction International medical graduates (IMGs) constitute a significant proportion of the global physician workforce, with Pakistan as a leading source country. Despite many Pakistani physicians emigrating for training and employment, limited research exists on the well-being of those who return. This study aimed to assess satisfaction with life (SWL) in foreign-trained, repatriated Pakistani physicians and examine its associations with affect balance and flourishing. Methods A cross-sectional survey was conducted between April 2022 and November 2023, recruiting 109 repatriated physicians via purposive sampling. Data was collected using the Scale of Positive and Negative Emotions (SPANE), the Flourishing Scale, and the SWL Scale. Relationships among these variables were assessed using correlation analysis, and logistic regression was used to identify predictors of SWL. Results Of the 109 participants, 70.6% were male, 83.5% resided in Punjab, 68.8% had trained in the US/Canada, and 69.7% worked in the private sector. The mean age was 47.31 (SD=7.9) years, and 58.7% held dual nationality. Overall, 90.8% reported being satisfied with life. Men (p=0.03) and married individuals (p=0.04) demonstrated higher SWL, whereas participants from Sindh and Khyber Pakhtunkhwa scored lower (p=0.007). SWL correlated moderately with flourishing (r=0.488), positive emotions (r=0.391), and affect balance (r=0.327). Each one-unit increase in flourishing was associated with a 1.236-fold higher odds of SWL (p=0.005). Conclusions Foreign-trained, repatriated Pakistani physicians in this study exhibited high SWL, closely linked to flourishing and positive affect. The repatriated physicians may significantly contribute to healthcare systems in lower-middle-income countries. Future research should examine broader samples, include locally trained or expatriated comparison groups, and explore repatriation challenges to further elucidate factors that influence physician well-being.

Based on a sample of Israeli adolescents living in a city which was under missile attack 2½ months prior to this study, we examined the possible affective and cognitive mechanisms through which gratitude may serve as a protective factor against PTSD symptoms. Specifically, we focused on how this process might be mediated by positive affect, negative affect, and life satisfaction. These are widely understood as the emotional and cognitive components of subjective well-being and have each been significantly associated with gratitude and with pathology in the literature. Using pathway analysis, our findings revealed that life satisfaction and negative affect, but not positive affect, mediated the relationship between gratitude and PTSD symptoms. Our study suggests that gratitude may serve as a protective factor primarily through cognitive appraisal processes tied to greater appreciation of life in a way that distinguishes it from other positive emotions.

ABSTRACTThe present study sought to determine if the positive association between positive emotions and life satisfaction can be understood as a function of hope in Chinese. Consistent with the broaden-and-build model of positive emotions, we tested the hypothesis that positive affectivity, the disposition to experience positive emotions, would be associated with broadening hope agency, building hope pathways, or both, in a sample of 212 Chinese college students. Results examining for bootstrapped mediation testing with multiple mediators indicated that positive affectivity was indirectly associated with life satisfaction through hope agency, but not through hope pathways. In support for partial mediation, however, the association between positive affectivity and life satisfaction remained significant even after including hope components in the model. Some implications of the present findings are discussed.

Positive emotions and life satisfaction in Palestinian children growing up amid political and military violence: a pilot study

Appropriate regulation of emotions is vital to daily functioning. Previous studies have shown that regulating negative emotions can improve health and wellbeing. However, the relationship between positive and negative emotion regulation and their interactions with positive and negative affect, life satisfaction, and health is not well understood. In addition, no studies have investigated the role of attention control and trait mindfulness in positive and negative emotion regulation. This study examined the associations between positive and negative emotion regulation abilities and health, affect, life satisfaction, attention control, and trait mindfulness. A total of 490 participants (284 females and 206 males, mean age = 25.8 ± 2.9 years, range = 20–29 years) completed questionnaires and attention measuring tasks. Multiple regression analyses revealed that negative emotion regulation ability was associated with affect, life satisfaction, and health, whereas positive emotion regulation ability was related to negative affect and mental and physical health. Additionally, negative rather than positive emotion regulation ability was more strongly associated with trait mindfulness and attention control. Positive emotion regulation may benefit those who have difficulty in regulating negative emotions. By focusing on both negative and positive emotion regulation, this study elucidates the relationship between emotion regulation ability, positive and negative affect, life satisfaction, health, mindfulness, and attention control.

The National Heart, Lung, and Blood Institute (NHLBI) has a longstanding appreciation of the value of behavioral research. From the earliest days, when the concept of “coronary prone” behavior was introduced, to the growing recognition of the need for strategies to encourage health-promoting behaviors and lifestyles, to more recent efforts to incorporate health-related quality of life measures into our clinical studies, behavioral research has contributed much to our understanding of cardiovascular disease (CVD). Although still in its infancy, the application of this discipline to lung and blood diseases, sleep disorders, and transfusion medicine issues clearly offers much promise for advances in treatment and prevention. Acknowledging that many opportunities lie in biobehavioral research, in November 1995 the NHLBI convened the Task Force on Behavioral Research in Cardiovascular, Lung, and Blood Health and Disease to chart a course for future research efforts. Composed of national experts, it was charged to review the state of knowledge in biobehavioral research in cardiovascular, lung, and blood diseases and sleep disorders over the past 5 years; identify research opportunities; and develop a comprehensive plan, including scientific priorities, for NHLBI support of research on health and behavior for the next several years. During a series of meetings that spanned nearly 2 years, the task force worked to develop a report of its findings and conclusions. The report provides a detailed summary of accomplishments to date, highlights new scientific opportunities, and identifies specific recommendations for future research. The full text, with graphics, is available on the NHLBI Web site at http://www.nhlbi.nih.gov/nhlbi/sciinf/taskforc.htm. The synopsis that follows was excerpted from the executive summary of the task force report. The Institute is very pleased to have this task force report to guide its activities with respect to research on health and behavior. We are grateful to the task force chair, Dr …

Objective To explore the effect of mental toughness level on positive and negative emotion and mental health in children with epilepsy. Methods In accordance with the International League against epilepsy and epilepsy syndrome in 1989 International Classification of young children with epilepsy, 160 cases were sampled. Based on the Adolescent Resilience Scale ( HKRA ) score, according to the 27% principles of delimitation, the patients were divided into high HKRA score group and low HKRA score group, 43 cases in each group.Then positive emotions and negative affect scale (PANAS), mental health test (MHT) were applied to two groups. Results , Except family support dimension, the others HKRA dimension and total score were higher in female children with epilepsy than those in male patients, there was significant difference (P<0.01). The positive affect score were higher in high HKRA score group than that of low HKRA group; and negative emotion was significantly lower than that in low HKRA group (P<0.01). Except physical symptom dimension, other dimensions and total score of HKRA in high HKRA score group were higher than those in low HKRA group, there was significant difference (P<0.01). Children with epilepsy HKRA score was positive correlation with positive emotion score but negative correlation with negative affect scores (P<0.01); in addition to physical symptom, HKRA score and MHT score, and all the other dimensions were negatively related (P<0.01 or 0.015). Conclusion The mental toughness level are significantly related to children's epilepsy patients with positive and negative emotion and mental health status.A high level of mental toughness can increase positive emotional experience, and reduce the negative emotional experience of children with epilepsy. Key words: Mental toughness; Epilepsy; Young children's; Positive/negative emotional; Psychology health

Positive emotion regulation and well-being: Comparing the impact of eight savoring and dampening strategies