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 Health, Well-Being, and the Mind-Heart-Body Connection: A Scientific Statement From the American Heart Association.

As clinicians delivering health care, we are very good at treating disease but often not as good at treating the person. The focus of our attention has been on the specific physical condition rather than the patient as a whole. Less attention has been given to psychological health and how that can contribute to physical health and disease. However, there is now an increasing appreciation of how psychological health can contribute not only in a negative way to cardiovascular disease (CVD) but also in a positive way to better cardiovascular health and reduced cardiovascular risk. This American Heart Association scientific statement was commissioned to evaluate, synthesize, and summarize for the health care community knowledge to date on the relationship between psychological health and cardiovascular health and disease and to suggest simple steps to screen for, and ultimately improve, the psychological health of patients with and at risk for CVD. Based on current study data, the following statements can be made: There are good data showing clear associations between psychological health and CVD and risk; there is increasing evidence that psychological health may be causally linked to biological processes and behaviors that contribute to and cause CVD; the preponderance of data suggest that interventions to improve psychological health can have a beneficial impact on cardiovascular health; simple screening measures can be used by health care providers for patients with or at risk for CVD to assess psychological health status; and consideration of psychological health is advisable in the evaluation and management of patients with or at risk for CVD.

Positive Psychological Well-Being and Cardiovascular Disease: JACC Health Promotion Series.

Facets of positive psychological well-being, such as optimism, have been identified as positive health assets because they are prospectively associated with the 7 metrics of cardiovascular health (CVH) and improved outcomes related to cardiovascular disease. Connections between psychological well-being and cardiovascular conditions may be mediated through biological, behavioral, and psychosocial pathways. Individual-level interventions, such as mindfulness-based programs and positive psychological interventions, have shown promise for modifying psychological well-being. Further, workplaces are using well-being-focused interventions to promote employee CVH, and these interventions represent a potential model for expanding psychological well-being programs to communities and societies. Given the relevance of psychological well-being to promoting CVH, this review outlines clinical recommendations to assess and promote well-being in encounters with patients. Finally, a research agenda is proposed. Additional prospective observational studies are needed to understand mechanisms underlying the connection between psychological well-being and cardiovascular outcomes. Moreover, rigorous intervention trials are needed to assess whether psychological well-being-promoting programs can improve cardiovascular outcomes.

Well-being measurement and the WHO health policy Health 2010: systematic review of measurement scales.

BACKGROUND: Subjective well-being (SWB) contributes to health and mental health. It is a major objective of the new World Health Organization health policy framework, 'Health 2020'. Various approaches to defining and measuring well-being exist. We aimed to identify, map and analyse the contents of self-reported well-being measurement scales for use with individuals more than 15 years of age to help researchers and politicians choose appropriate measurement tools. METHODS: We conducted a systematic literature search in PubMed for studies published between 2007 and 2012, with additional hand-searching, to identify empirical studies that investigated well-being using a measurement scale. For each eligible study, we identified the measurement tool and reviewed its components, number of items, administration time, validity, reliability, responsiveness and sensitivity. RESULTS: The literature review identified 60 unique measurement scales. Measurement scales were either multidimensional (n = 33) or unidimensional (n = 14) and assessed multiple domains. The most frequently encountered domains were affects (39 scales), social relations (17 scales), life satisfaction (13 scales), physical health (13 scales), meaning/achievement (9 scales) and spirituality (6 scales). The scales included between 1 and 100 items; the administration time varied from 1 to 15 min. CONCLUSIONS: Well-being is a higher order construct. Measures seldom reported testing for gender or cultural sensitivity. The content and format of scales varied considerably. Effective monitoring and comparison of SWB over time and across geographic regions will require further work to refine definitions of SWB. We recommend concurrent evaluation of at least three self-reported SWB measurement scales, including evaluation for gender or cultural sensitivity.

Gender differences in religious practices, spiritual experiences and health: results from the US General Social Survey.

Even though a majority of Americans report having spiritual/religious beliefs, the role of different dimensions of spirituality/religiosity in health is not well understood. Moreover, given that the experience of spirituality/religiosity differs for men and women, it is possible that the strength of the association between spirituality/religiosity and health may also differ by gender. The purpose of this study is to examine the relationship between spirituality/religiosity and three markers of health and well-being, and any gender differences in these relationships. First, we test the hypothesis that engagement with formal religious institutions (i.e. public religious activity) will be more beneficial for men than for women and we examine the role of denominational affiliation in any observed differences. Second, we directly compare effects of three different kinds of religious activities (public and private religious activity and spiritual experience) on health and well-being. Data are from the 1998 US General Social Survey, a nationally representative sample of non-institutionalized adults. Participants were asked about the frequency of engaging in public and private religious activities and having spiritual experiences. Psychological distress, happiness and self-rated health were used as indicators of health and well-being. Results suggest that weekly public religious activity was significantly associated with better health and well-being. Furthermore, this relationship was stronger for men than women and was influenced by denominational affiliation. When public religious activity, private religious activity and spiritual experiences were considered simultaneously, public religious activity emerged as the most consistent predictor of health and well-being among men. Among women, both public religious activity and spiritual experiences maintained an independent association with the health and well-being. These results suggest that it may not be appropriate to generalize findings about the relationship between spirituality/religiosity and health from one form of spirituality/religiosity to another, across denominations, or to assume effects are uniform for men and women.

Psychologic functioning and physical health: a paradigm of flexibility.

Recent evidence suggests that positive psychologic factors may be protective against coronary artery disease (CAD). We consider this possibility through a paradigm that explores three interrelated factors that may promote healthy psychologic functioning: vitality, emotional flexibility, and coping flexibility. Vitality is a positive and restorative emotional state that is associated with a sense of enthusiasm and energy. Flexibility is related both to the ability to regulate emotions effectively and cope effectively with challenging daily experiences. A variety of factors may diminish vitality, including chronic stress and negative emotions. Pathophysiologically, chronic stress and negative emotional states can both invoke a "chronic stress response" characterized by increased stimulation of the sympathetic nervous system and hypothalamic-pituitary-adrenal axis, with resultant peripheral effects, including augmented heart rate and blood pressure responsiveness and delayed recovery to stressful stimuli. Research indicates a wide array of stressful conditions--associated with either elements of relative inflexibility in psychologic functioning and/or relatively unabated stressful stimulation--that are associated with this type of exhausting hyperarousal. Conversely, new data suggest that positive psychologic factors, including positive emotions, optimism, and social support, may diminish physiological hyperresponsiveness and/or reduce adverse clinical event rates. Still other positive factors such as gratitude and altruistic behavior have been linked to a heightened sense of well-being but have not yet been tested for beneficial physiological effects. Pending further study, these observations could serve as the basis for expanding the potential behavioral interventions that may be used to assist patients with psychosocial risk factors for CAD.