Associations between positive affect and physical activity from young adulthood to midlife: A 25-year prospective study.

OBJECTIVE: Positive affect may influence health by promoting physical activity, but evidence evaluating this association is mostly cross-sectional and cannot discern directionality. This study used a counterfactual-based framework to estimate the causal effect of positive affect on physical activity patterns over 25 years, accounting for potential reverse associations. METHOD: Data were from 3,352 participants in the Coronary Artery Risk Development in Young Adults study. Repeated assessments of positive affect and physical activity were collected from 1990 to 2016. Longitudinal associations were evaluated in two ways: (a) using baseline positive affect in traditional linear mixed models that accounted for reverse causal associations by adjusting for baseline physical activity, and (b) using marginal structural models that treated positive affect as a time-varying exposure, thus accounting for dynamic reverse causal associations due to bidirectional relationships. RESULTS: Fully adjusted traditional models found no association with physical activity at the first follow-up assessment, but positive affect was related to a slower decline in physical activity over time. Marginal structural models similarly found that positive affect was unrelated to physical activity at the first follow-up assessment but robustly associated with a slower decline in activity levels (5-year change: ß = -3.33, 95% confidence interval [CI] = -5.80, -0.86; difference in 5-year change per 1 - SD positive affect: ß = 4.99, 95% CI = 2.52, 7.46). CONCLUSIONS: Positive affect may play a causal role in slowing the decline in physical activity adults generally experience during through midlife. Efforts to enhance positive affect at the population level may be a promising new approach to help individuals stay active as they age. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Positive epidemiology, revisited: The case for centering human rights and economic justice.

In recent years, a growing body of research in positive epidemiology has sought to expand the traditional focus of epidemiologic research beyond risk factors for disease and towards a more holistic understanding of health that includes the study of positive assets that shape well-being more broadly. While this paradigm shift holds great promise for transforming people's lives for the better, it is also critiqued for showcasing decontextualized perspectives that could cause great harm to the public's health if translated uncritically into population-based interventions. In this commentary, we argue for orienting positive epidemiology within a human rights and economic justice framework to mitigate this threat and discuss two examples of previously proposed health assets (religious involvement and marriage) that demonstrate the urgent need for positive epidemiologic research to center health equity. Finally, to advance the field, we provide recommendations for how future research can address shortcomings of the extant literature by moving from individual-level applications to societal-level approaches. In doing so, we believe that positive epidemiology can be transformed into a powerful force for health equity.

Who Benefits and How: Five Dimensions of Adolescent Psychological Well-Being and Their Relative Impact on Cardiometabolic Health in Adulthood.

PURPOSE: Positive dimensions of psychological well-being in adolescence may help youth preserve cardiometabolic health (CMH) as they age, but little is known about which aspects of well-being matter most and for whom. This study examines the differential impact of five dimensions of adolescent psychological well-being on CMH maintenance in adulthood and considers social patterning in both their distribution and respective health benefits. METHODS: Data were from the National Longitudinal Study of Adolescent Health (N = 3,464), five dimensions of psychological well-being were identified at baseline (1994-1995; mean age = 15 years): happiness, optimism, self-esteem, belonging, and feeling loved. CMH was measured using seven biomarkers related to chronic disease risk in 2008 (mean age = 28 years) and 2016-2018 (mean age = 38 years): high-density lipoprotein cholesterol, non-high-density lipoprotein cholesterol, systolic blood pressure, diastolic blood pressure, hemoglobin A1c, C-reactive protein, and body mass index. CMH maintenance in adulthood was characterized as having healthy levels of ≥6 biomarkers at each follow-up. RESULTS: Youth who reported higher levels of belonging in the teen years were more likely to maintain CMH across young adulthood than those who reported lower levels, regardless of one's social standing (ORper 1-standard deviation = 1.23, 95% CI = 1.03-1.46). Associations with other dimensions of well-being were heterogeneous by sex and race and ethnicity, while differences by socioeconomic factors were less apparent. DISCUSSION: Fostering belonging through supportive social environments may help set youth on positive health trajectories and prevent chronic disease across the lifespan.

In the Words of Early Adolescents: A Novel Assessment of Positive Psychological Well-Being Predicts Young Adult Depressive Symptoms.

PURPOSE: Given the burden of depression in young adulthood, identifying protective early life factors is important. Protective factors like positive psychological well-being may be challenging to assess via conventional methods if early adolescents lack personal insight or informants disagree. We investigated whether essays written by 11-year-olds could indicate the presence of positive psychological well-being and predict depressive symptom levels in young adulthood, beyond informant reports of problematic behaviors. METHODS: Data were from 4,599 individuals in the 1958 National Child Development Study who wrote an essay at age 11 about how they imagined their life at age 25. Coders rated essays for seven facets of positive psychological well-being, which were averaged together (α = 0.92). Participants self-reported depressive symptoms (yes/no) at age 23 on the 24-item Malaise Inventory. Depressive symptoms were modeled as a sum, both continuously (range = 0-24) and dichotomously (depressed: total scores ≥8). Linear and logistic regressions adjusted for relevant age 11 covariates including teacher-reported internalizing and externalizing behaviors. RESULTS: Unadjusted logistic regression showed a 1-SD higher positive psychological well-being score in early adolescence was associated with reduced odds of being depressed 12 years later (odds ratio = 0.83, 95% confidence interval [0.75, 0.93], p = .001). Associations remained when adjusting for all covariates (odds ratio = 0.87, 95% confidence interval [0.78, 0.98], p = .02); patterns were similar with continuous depressive symptoms. DISCUSSION: A well-being measure derived from the words of 11-year-olds was associated with young adult depressive symptoms independent of teacher-reported internalizing and externalizing behaviors. Incorporating early adolescents' perspectives on positive functioning provides valuable information about current and future health beyond problem behaviors.

Synthesis and Characterization of Multicolor Luminescent and Thermally Stable Thioureas and Polythioamides.

Two new polythioamides were prepared through the polycondensation reaction between thiourea monomers and terephthaloyl dichloride, while the thiourea monomers were synthesized by the interaction of aromatic (4,4'-diaminophenylsulfone) or alicyclic (1,2-cyclohexanediamine) diamine with ammonium thiocyanate. The elemental composition of polythioamides was confirmed through CHN microanalysis. The structure and properties of thiourea monomers and polythioamides were determined through proton NMR, UV-Vis, FT-IR spectroscopy, fluorescence, TGA/DTA and SEM. The polythioamides indicated high thermal stabilities which were assessed from their Tmax (temperature indicating highest rate of weight loss) values (670 °C and 346 °C) observed in their DTG graphs. The thioureas and polythioamides were fluorescent and showed multicolor (violet, green, yellow, orange and red) emissions at different excitation wavelengths. All the synthesized compounds were also tested for their antifungal and antibacterial functions and showed antibacterial activity against Salmonella typhi, Bacillus subtilis and Staphylococcus aureus, and antifungal activity against Candida albicans.

Adolescent Psychological Assets and Cardiometabolic Health Maintenance in Adulthood: Implications for Health Equity.

Background Positive cardiometabolic health (CMH) is defined as meeting recommended levels of multiple cardiometabolic risk factors in the absence of manifest disease. Prior work finds that few individuals-particularly members of minoritized racial and ethnic groups-meet these criteria. This study investigated whether psychological assets help adolescents sustain CMH in adulthood and explored interactions by race and ethnicity. Methods and Results Participants were 3478 individuals in the National Longitudinal Study of Adolescent Health (49% female; 67% White, 15% Black, 11% Latinx, 6% other [Native American, Asian, or not specified]). In Wave 1 (1994-1995; mean age=16 years), data on 5 psychological assets (optimism, happiness, self-esteem, belongingness, and feeling loved) were used to create a composite asset index (range=0-5). In Waves 4 (2008; mean age=28 years) and 5 (2016-2018; mean age=38 years), CMH was defined using 7 clinically assessed biomarkers. Participants with healthy levels of ≥6 biomarkers at Waves 4 and 5 were classified as maintaining CMH over time. The prevalence of CMH maintenance was 12%. Having more psychological assets was associated with better health in adulthood (odds ratio [OR]linear trend, 1.12 [95% CI, 1.01-1.25]). Subgroup analyses found substantive associations only among Black participants (OR, 1.35 [95% CI, 1.00-1.82]). Additionally, there was some evidence that racial and ethnic disparities in CMH maintenance may be less pronounced among participants with more assets. Conclusions Youth with more psychological assets were more likely to experience favorable CMH patterns 2 decades later. The strongest associations were observed among Black individuals. Fostering psychological assets in adolescence may help prevent cardiovascular disease and play an underappreciated role in shaping health inequities.

Child psychological well-being and adult health behavior and body mass index.

OBJECTIVE: Psychological well-being (PWB) is linked with health behaviors among adults, but it is unclear if childhood PWB prospectively predicts healthy adulthood biobehavioral profiles. Such evidence may identify developmental windows for establishing positive health trajectories across the lifespan. Using data spanning 30 years, we investigated whether PWB at age 11 was associated with health behaviors and body mass index (BMI) at ages 33 and 42. We hypothesized children with higher versus lower PWB would engage in healthier behaviors, have lower BMI in adulthood, and be more likely to maintain optimal levels over time. METHOD: Data were from 4,728 participants of the 1958 National Child Development Study. At age 11, participants wrote an essay about how they imagined their lives at age 25. Two judges rated each essay for multiple facets of PWB, which were combined into a summary score (Cronbach's α = .91). At ages 33 and 42, participants reported on cigarette smoking, physical activity, and diet; BMI was also assessed. Regression models evaluated PWB's association with adult outcomes at each follow-up, and with patterns over time. RESULTS: Child PWB was unassociated with smoking in adulthood. However, greater child PWB was associated with healthier adult physical activity, diet, and BMI when adjusting for sex. Child PWB was associated with the likelihood of maintaining optimal BMI in adulthood, but not with maintaining healthy behaviors. Some associations were not independent of other childhood covariates. CONCLUSIONS: Early life lays the foundation for lifelong health. Childhood PWB may contribute to healthier behaviors and BMI in adulthood. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Associations of cord blood leukocyte telomere length with adiposity growth from infancy to adolescence.

OBJECTIVE: Leukocyte telomere length (LTL) may be a biomarker for chronic disease susceptibility, but no work has tested this hypothesis directly. Our study investigated associations of LTL at birth with markers of adiposity growth that are linked with cardiometabolic health later in life. METHODS: Participants were 375 children in Project Viva (48% female, 71% White). Body mass index (BMI) trajectories from birth to 18 years were tracked using repeated measures of BMI collected in physical examinations and via medical records, then used to predict age (months) and magnitude (kg/m2 ) of BMI peak and rebound. LTL was measured from cord blood via duplex quantitative PCR. A binary variable indicating LTL shorter than the reference population average was the primary exposure. RESULTS: LTL was unrelated to BMI at peak or rebound, but associations were apparent with the timing of BMI growth milestones. Short LTL was related to a later age of peak for females (ß = 0.99, 95% CI = 0.16, 1.82; psex interaction  = 0.015) and an earlier age of rebound for both males and females (ßcombined  = -5.26, 95% CI = -9.44, -1.08). CONCLUSION: LTL at birth may be an early biomarker of altered adiposity growth. Newborn telomere biology may shed new insight into the developmental origins of health and disease.

The social determinants of ideal cardiovascular health: A global systematic review.

This systematic review synthesizes research published from January 2010-July 2022 on the social determinants of ideal cardiovascular health (CVH) carried out around the world and compares trends in high-income countries (HICs) to those in low- and middle-income countries (LMICs). 41 studies met inclusion criteria (n = 28 HICs, n = 13 LMICs). Most were from the United States (n = 22) and cross-sectional (n = 33), and nearly all evaluated associations among adults. Among studies conducted in LMICs, nearly all were from middle-income countries and only one was carried out in low-income country. Education (n = 24) and income/wealth (n = 17) were the most frequently examined social determinants in both HICs and LMICs. Although most studies assessed ideal CVH using reliable and valid methods (n = 24), only 7 used criteria pre-defined by the American Heart Association to characterize ideal levels of each CVH metric. Despite heterogeneity in how outcome measures were derived and analyzed, consistent associations were evident between multiple markers of higher social status (i.e. greater education, income/wealth, socioeconomic status, racial/ethnic majority status) and greater levels of ideal CVH across both country contexts. Gaps in the literature include evidence from LMICs and HICs other than the United States, longitudinal research, and investigations of a wider array of social determinants beyond education and income/wealth.

Adverse Childhood Experiences and Cardiovascular Risk among Young Adults: Findings from the 2019 Behavioral Risk Factor Surveillance System.

Background: Heart disease is the fourth leading cause of death for young adults aged 18-34 in the United States. Recent research suggests that adverse childhood experiences (ACEs) may shape cardiovascular health and its proximate antecedents. In the current study, we draw on a contemporary, national sample to examine the association between ACEs and cardiovascular health among young adults in the United States, as well as potential mediating pathways. Methods: The present study uses data from the 2019 Behavioral Risk Factor Surveillance System (BRFSS) to examine associations between ACEs and cardiovascular risk, as well as the role of cumulative disadvantage and poor mental health in these associations. Results: Findings indicate that young adults who have experienced a greater number of ACEs have a higher likelihood of having moderate to high cardiovascular risk compared to those who have zero or few reported ACEs. Moreover, both poor mental health and cumulative disadvantage explain a significant proportion of this association. Conclusions: The present findings suggest that young adulthood is an appropriate age for deploying prevention efforts related to cardiovascular risk, particularly for young adults reporting high levels of ACEs.

Prospective associations between coffee consumption and psychological well-being.

OBJECTIVE: Prior work indicates a robust relationship between coffee consumption and lower depression risk, yet no research has examined links with psychological well-being (e.g., happiness, optimism). This study tested whether coffee intake is prospectively associated with greater psychological well-being over time. Secondarily, associations in the reverse direction were also examined to determine whether initial levels of psychological well-being were related to subsequent coffee consumption. METHODS: Among women in the Nurses' Health Study, coffee consumption was examined in 1990 and 2002 in relation to sustained levels of happiness reported across multiple assessments from 1992-2000 (N = 44,449) and sustained levels of optimism assessed from 2004-2012 (N = 36,729). Associations were tested using generalized estimating equations with a Poisson distribution adjusted for various relevant covariates. Bidirectional relationships were evaluated in secondary analyses of baseline happiness (1992) and optimism (2004) with sustained moderate coffee consumption across multiple assessments through 2010. RESULTS: Compared to minimal coffee consumption levels (<1 cup/day), moderate consumption (1-3 cups/day) was unrelated to happiness, whereas heavy consumption (≥4 cups/day) was associated with a 3% lower likelihood of sustained happiness (relative risk, RR = 0.97, 95% CI = 0.95-0.99). Only moderate coffee consumption was weakly associated with a greater likelihood of sustained optimism (RR1-3cups/day = 1.03, 95% CI = 1.00-1.06). Secondary analyses showed high levels of optimism but not happiness levels were modestly associated with increased likelihood of sustained moderate coffee intake (RRoptimism = 1.06, 95% CI = 1.02-1.10; RRhappiness = 1.01, 95% CI = 0.99-1.04). CONCLUSIONS: Associations between psychological well-being and coffee consumption over up to two decades were largely null or weak. Although coffee consumption may protect individuals against depression over time, it may have limited impact on facets of psychological well-being.

Psychological Well-Being in Childhood and Cardiometabolic Risk in Middle Adulthood: Findings From the 1958 British Birth Cohort.

Childhood adversity is linked to poor cardiometabolic outcomes, but less is known about positive childhood factors. Using data from 4,007 members of the 1958 British Birth Cohort, we investigated whether children with greater psychological well-being had lower adulthood cardiometabolic risk. At age 11, participants wrote essays about their future. Two judges rated each essay for nine psychological well-being items (Finn's r = .82-.91), which were combined into a standardized overall score (Cronbach's α = .91). When participants reached age 45, nurses assessed their blood pressure, heart rate, lipids, glycosylated hemoglobin, fibrinogen, and C-reactive protein, which were standardized and summed for total cardiometabolic risk. Regressions indicated that children with greater psychological well-being had lower cardiometabolic risk (b = -0.14, 95% confidence interval [CI] = [-0.28, -0.006]): specifically, healthier total cholesterol (b = -0.04, 95% CI = [-0.07, -0.003]) and triglycerides (b = -0.06, 95% CI = [-0.09, -0.02]). Childhood psychological well-being may promote adulthood cardiometabolic health.

Is more, better? Relationships of multiple psychological well-being facets with cardiometabolic disease.

OBJECTIVE: Cardiometabolic disease (CMD) is a leading cause of death and disability worldwide. Assessments of psychological well-being taken at one time point are linked to reduced cardiometabolic risk, but psychological well-being may change over time and how longitudinal trajectories of psychological well-being may be related to CMD risk remains unclear. Furthermore, psychological well-being is a multidimensional construct comprised of distinct facets, but no work has examined whether sustaining high levels of multiple facets may confer additive protection. This study tested if trajectories of four psychological well-being facets would be associated with lower risk of self-reported nonfatal CMD. METHOD: Participants were 4,006 adults aged ≥50 years in the English Longitudinal study of Ageing followed for 18 years at biyearly intervals. Psychological well-being facets were measured in Waves 1-5 using subscales of the Control, Autonomy, Satisfaction, and Pleasure scale. Latent class growth modeling defined trajectories of each facet. Incident CMD cases were self-reported at Waves 6-9. Cox regression models estimated likelihood of incident CMD associated with trajectories of each facet individually and additively (i.e., having persistently high levels on multiple facets over time). RESULTS: After adjusting for relevant covariates, CMD risk was lower for adults with persistently high versus persistently low levels of control and autonomy. When considering potential additive effects, lower CMD risk was also related to experiencing persistently high levels of ≥2 versus 0 psychological well-being facets. CONCLUSIONS: Findings suggest having and sustaining multiple facets of psychological well-being is beneficial for cardiometabolic health, and that effects may be additive. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Optimism and Lipid Profiles in Midlife: A 15-Year Study of Black and White Adults.

INTRODUCTION: Optimism is associated with better cardiovascular health, yet little is known about the underlying mechanisms and whether protective relationships are consistently observed across diverse groups. This study examines optimism's association with lipid profiles over time and separately among Black and White men and women. METHODS: Data were from 3,206 middle-aged adults in the Coronary Artery Risk Development in Young Adults study. Optimism was measured in 2000-2001 using the Revised Life Orientation Test. Triglyceride, total cholesterol, high-density lipoprotein cholesterol, and low-density lipoprotein cholesterol measurements were obtained at 5-year intervals through 2015-2016. Linear mixed models evaluated relationships between optimism and lipids, adjusting for covariates, including prebaseline lipids. Subgroup differences were examined using interaction terms and stratification. All analyses were conducted in 2020. RESULTS: Higher optimism was associated with both lower baseline total cholesterol (ß= -2.33, 95% CI= -4.31, -0.36) and low-density lipoprotein cholesterol levels (ß= -1.93, 95% CI= -3.65, -0.21) and a more rapid incremental increase in both markers over time (total cholesterol: ß=0.09, 95% CI=0.00, 0.18; low-density lipoprotein cholesterol: ß=0.09, 95% CI=0.01, 0.16). No associations were apparent with baseline triglycerides, high-density lipoprotein cholesterol, or changes in either lipid over time. Tests for interaction only found evidence of heterogeneous associations with baseline triglyceride levels, but stratified models hinted at stronger protective associations with baseline levels of total cholesterol and low-density lipoprotein cholesterol among White women. CONCLUSIONS: Optimism may help diverse individuals establish healthy total cholesterol and low-density lipoprotein cholesterol levels before midlife. Although associations were largely consistent across subgroups, stronger associations among White men and White women highlight a need to study optimism's health impact in diverse samples.

Adverse intergenerational effects of ethnically-divisive social contexts on children's mental health: A prospective cohort study in the Netherlands.

BACKGROUND: Around the world, international migration and growing economic inequality have contributed to heightened perceptions of intergroup threat (i.e., feeling that people outside of one's social group are hostile to their physical or emotional well-being). Exposures related to intergroup threat, like negative intergroup contact, are inherently stressful and may contribute to higher levels of psychological distress in the population. This longitudinal study investigated whether maternal experiences of negative intergroup contact are related to poor mental health outcomes among ethnically diverse children in The Netherlands. METHODS: Data are from 4025 mother-child pairs in the Generation R Study, a multi-ethnic Dutch birth cohort initiated in 2005. Mothers' experiences of negative intergroup contact were assessed during pregnancy. Child mental health was indexed by problem behavior reported by parents and teachers using the Child Behavior Checklist. Linear mixed-effects models tested longitudinal associations of maternal-reported negative intergroup contact with child problem behavior reported by mothers at ages 3, 5, and 9 years, considering a range of potential confounders. Sensitivity analyses examined whether results were replicated using child data from other informants. RESULTS: In fully adjusted models, higher levels of negative intergroup contact were associated with more problem behavior averaged across childhood for both non-Dutch (standardized B = 0.10, 95% CI = 0.05, 0.14) and Dutch children (standardized B = 0.12, 95% CI = 0.08, 0.15). Sensitivity analyses with data from other informants largely supported primary findings. CONCLUSIONS: Comparable adverse intergenerational effects on mental health were observed among both ethnic minority and majority children whose mothers experienced negative intergroup contact. These findings suggest that ethnically divisive social contexts may confer widespread risks, regardless of a child's ethnic background. To our knowledge, this study is the first to examine exposures related to intergroup threat from an epidemiologic perspective and provides proof of principle that such exposures may be informative for population health.

Mental Health in Early Childhood and Changes in Cardiometabolic Dysregulation by Preadolescence.

OBJECTIVE: Poor mental health in childhood is associated with a greater risk of cardiometabolic disease in adulthood, but less is known about when these associations begin to emerge. This study tests whether poor mental health (indexed by emotional and behavioral problems) in early childhood predicts increases in cardiometabolic dysregulation over 4 years of follow-up. METHODS: Data are from 4327 participants in the Generation R Study. Problem behaviors were reported by mothers using the Child Behavior Checklist at age 6 years. Repeated measurements of six cardiometabolic parameters were collected at ages 6 and 10 years: high-density lipoprotein cholesterol, non-high-density lipoprotein cholesterol, systolic and diastolic blood pressures, C-reactive protein, and body mass index. Standardized measures were used to create continuous cardiometabolic dysregulation scores at ages 6 and 10 years. Change in dysregulation was defined as the difference in dysregulation scores over time. Cross-sectional and prospective associations were tested using linear regression, sequentially adjusting for relevant confounders. Additional analyses examined whether prospective relationships were robust to adjustment for baseline levels of dysregulation. RESULTS: There was no association between child problem behaviors and cardiometabolic dysregulation at age 6 years. However, higher levels of problem behaviors predicted increases in cardiometabolic dysregulation (ß = 0.12, 95% confidence interval = 0.00-0.23) from ages 6 to 10 years. CONCLUSIONS: Worse child mental health may be associated with increases in cardiometabolic dysregulation by preadolescence. To our knowledge, this is the first study to demonstrate that adverse physiologic effects of psychological distress identified in adult populations may be observed as early as childhood.

Telomere length shortening in hospitalized preterm infants: A pilot study.

Leukocyte telomere length is a biomarker of aging-related health risks. Hospitalized preterm infants frequently experience elevated oxidative stress and inflammation, both of which contribute to telomere shortening. Our aim was to examine changes in telomere length during neonatal intensive care unit (NICU) hospitalization in a cohort of preterm infants <32 weeks' gestation. We conducted a longitudinal study of 10 infants (mean gestational age 27 weeks, range 23.5 to 29, at birth). We isolated DNA from dried blood spots and used Real Time Quantitative PCR to measure relative leukocyte telomere length in triplicate at three time points for each participant. From birth to discharge, infants experienced an average decline in relative telomere length of 0.021 units per week (95% CI -0.040, -0.0020; p = 0.03), after adjustment for gestational age at birth. Our results suggest a measurable decline in telomere length during NICU hospitalization. We speculate that telomere length change may convey information about NICU exposures that carry short- and long-term health risks.

Optimism and Cardiovascular Health: Longitudinal Findings From the Coronary Artery Risk Development in Young Adults Study.

OBJECTIVE: Favorable cardiovascular health is associated with greater longevity free of cardiovascular disease. Although the prevalence of cardiovascular health decreases with age, less is known about protective factors that promote and preserve it over time. We investigated whether optimism was associated with better cardiovascular health over a 10-year period. METHODS: Participants included 3188 Black and White men and women from the Coronary Artery Risk Development in Young Adults study. Self-reported optimism was assessed in 2000 (this study's baseline) with the revised Life Orientation Test. Favorable cardiovascular health was defined by healthy status on five components of cardiovascular functioning that were repeatedly assessed through 2010 either clinically or via self-report (blood pressure, lipids, body mass index, diabetes, and smoking status). Linear mixed-effects models examined whether optimism predicted cardiovascular health over time, adjusting for covariates such as sociodemographic characteristics, health behaviors, health status, and depression diagnosis. RESULTS: In models adjusting for sociodemographic characteristics, optimism was associated with better cardiovascular health across all time points (ß = 0.08, 95% confidence interval = 0.04-0.11, p ≤ .001) but not with rate of change in cardiovascular health. Findings were similar when adjusting for additional covariates. Optimism did not interact significantly with race (p = .85) but did with sex, such that associations seemed stronger for women than for men (p = .03). CONCLUSIONS: Optimism may contribute to establishing future patterns of cardiovascular health in adulthood, but other factors may be more strongly related to how slowly or quickly cardiovascular health deteriorates over time.

Positive emotions and favorable cardiovascular health: A 20-year longitudinal study.

No studies have examined whether positive emotions lead to favorable cardiovascular health (CVH) early in the lifespan, before cardiovascular disease is diagnosed. Moreover, the direction of the association has not been thoroughly investigated. Among younger adults, we investigated whether baseline positive emotions were associated with better CVH over 20 years. We also considered whether baseline CVH was associated with subsequent positive emotions during the same period. Participants included 4196 Black and White men and women from the Coronary Artery Risk Development in Young Adults Study. Positive emotions and cardiovascular-related parameters were each assessed in 1990 (this study's baseline), with repeated assessment through 2010. CVH was defined by blood pressure, lipids, body mass index, diabetes, and smoking status. Primary analyses used linear mixed effects models adjusting for potential confounders; secondary analyses stratified by race and sex. Controlling for sociodemographic factors, greater baseline positive emotions were associated with better CVH across time (ß = 0.03, 95% confidence interval = 0.007-0.06). However, positive emotions were unrelated to rate of change in CVH across time. Baseline CVH was also associated with greater average positive emotions across time (ß = 0.09, 95% confidence interval = 0.02-0.15), but not rate of change. Positive emotions' association with CVH was stronger for women than men, but race did not modify associations. Positive emotions in early to middle adulthood were associated with better CVH across several decades. Baseline CVH was also associated with greater positive emotions during follow-up. Future research may be able to disentangle these relationships by assessing positive emotions and CVH earlier in life.