Racial and Educational Disparities in Cumulative Exposure to Hardships of the 2008 Great Recession and Inflammation.

OBJECTIVE: This cross-sectional analysis examined self-reported economic hardships of the 2008 Great Recession, race/ethnicity, educational attainment, and psychological well-being (PWB) as predictors of systemic inflammatory physiology at midlife. We also tested for differential vulnerability in the relationship between recession hardship and inflammatory physiology by race/ethnicity, education, and PWB. METHODS: Adults from the Midlife in the United States Refresher sample completed a survey and biomedical assessments after the recession ( n = 592 non-Hispanic White respondents, n = 158 Black/African American respondents, n = 108 respondents with other race/ethnicity). Cumulative recession hardship was the sum of financial, housing, and employment-related events. Outcomes included circulating levels of interleukin 6 and C-reactive protein. General linear regression models tested main effects interactions between primary predictor variables. RESULTS: Educational attainment was inversely associated with recession hardships ( b = -0.18, 95% confidence interval = -0.26 to -0.11, p < .001). Black/African American respondents reported more recession hardships than White respondents ( b = 1.17, 95% confidence interval = 0.67 to 1.68, p < .001). More recession hardships predicted higher levels of interleukin 6 ( b = 0.06, p < .001) and C-reactive protein ( b = 0.04, p = .004). Analyses did not support race/ethnicity, education, and PWB as moderators of the association between recession hardship and inflammatory markers. CONCLUSIONS: Race/ethnicity and education independently predicted disparities in cumulative recession hardship exposure. Recession hardship predicted higher blood levels of inflammatory proteins associated with long-term health. The lack of findings for differential vulnerability in the relationship between recession hardship and inflammatory markers by race/ethnicity, education, or PWB was possibly due to the limited sample size.

Linking Amygdala Persistence to Real-World Emotional Experience and Psychological Well-Being.

Neural dynamics in response to affective stimuli are linked to momentary emotional experiences. The amygdala, in particular, is involved in subjective emotional experience and assigning value to neutral stimuli. Because amygdala activity persistence following aversive events varies across individuals, some may evaluate subsequent neutral stimuli more negatively than others. This may lead to more frequent and long-lasting momentary emotional experiences, which may also be linked to self-evaluative measures of psychological well-being (PWB). Despite extant links between daily affect and PWB, few studies have directly explored the links between amygdala persistence, daily affective experience, and PWB. To that end, we examined data from 52 human adults (67% female) in the Midlife in the United States study who completed measures of PWB, daily affect, and functional MRI (fMRI). During fMRI, participants viewed affective images followed by a neutral facial expression, permitting quantification of individual differences in the similarity of amygdala representations of affective stimuli and neutral facial expressions that follow. Using representational similarity analysis, neural persistence following aversive stimuli was operationalized as similarity between the amygdala activation patterns while encoding negative images and the neutral facial expressions shown afterward. Individuals demonstrating less persistent activation patterns in the left amygdala to aversive stimuli reported more positive and less negative affect in daily life. Further, daily positive affect served as an indirect link between left amygdala persistence and PWB. These results clarify important connections between individual differences in brain function, daily experiences of affect, and well-being.SIGNIFICANCE STATEMENT At the intersection of affective neuroscience and psychology, researchers have aimed to understand how individual differences in the neural processing of affective events map onto to real-world emotional experiences and evaluations of well-being. Using a longitudinal dataset from 52 adults in the Midlife in the United States (MIDUS) study, we provide an integrative model of affective functioning: less amygdala persistence following negative images predicts greater positive affect (PA) in daily life, which in turn predicts greater psychological well-being (PWB) seven years later. Thus, day-to-day experiences of PA comprise a promising intermediate step that links individual differences in neural dynamics to complex judgements of PWB.

Race and sex differences in HDL peroxide content among American adults with and without type 2 diabetes.

BACKGROUND: High-density lipoprotein (HDL) plays a critical role in protection against atherosclerosic and cardiovascular disease (ASCVD). In addition to contributing to clearing excess vascular cholesterol, HDL particles exhibit antioxidative functions, helping to attenuate adverse effects of oxidized low-density lipoproteins. However, these beneficial properties can be undermined by oxidative stress, inflammation, and unhealthy lifestyles and diet, as well as influenced by race and sex. Thus, when assessing cardiovascular risk, it is important to consider multifactorial aspects of HDL, including antioxidant activity rather than just total amount and type of HDL-cholesterol (HDL-C) particles. Because prior research showed HDL peroxide content (HDLperox) can be inversely associated with normal anti-oxidant HDL activity, elevated HDLperox may serve as a bioindicator of HDL dysfunction. METHODS: In this study, data from a large national cohort of Americans was utilized to determine the impact of sex, race, and diabetes status on HDLperox in middle-aged and older adults. A previously developed cell-free fluorometric method was utilized to quantify HDLperox in serum depleted of apo-B containing lipoproteins. RESULTS: In keeping with predictions, white men and diabetics exhibited HDLperox in the atypical upper range, suggestive of less functional HDL. White men had higher HDLperox levels than African American males (13.46 ± 6.10 vs. 10.88 ± 5.81, p < .001). There was also a significant main effect of type 2 diabetes (F(1,1901) = 14.9, p < .0001). Overall, African Americans evinced lower HDLperox levels, despite more obesity (10.3 ± 4.7 vs.11.81 ± 5.66 for Whites) suggesting that other aspects of lipid metabolism and psychosocial factors account for the higher prevalence of ASCVD in African Americans. CONCLUSION: This research helps to provide a more comprehensive understanding of HDL function in a racially and metabolically diverse adult population. HDLperox content was significantly different in adults with type 2 diabetes, and distinctive in nondiabetic White males, and suggests other processes account for the higher prevalence of ASCVD among African Americans.

The pandemic and social experience: For whom did discrimination and social isolation increase?

OBJECTIVE: The objective of this study was to examine whether experiences of discrimination have increased during the pandemic, particularly among negatively stigmatized racial/ethnic groups, and whether such experiences have exacerbated feelings of social isolation. METHOD: Discrimination and social isolation were assessed before and during the pandemic in a sample of 263 Black and White young adults attending a large, predominantly White 4-year research university in the Southeastern region of the United States (52% Black, 48% White, 53% female, mean age = 19.2). RESULTS: Increases in discrimination were evident among Black but not White participants. Black participants also reported greater increases in social isolation than White participants, and changes in discrimination partially mediated the emergent racial disparity in social isolation. CONCLUSIONS: Findings are consistent with theoretical perspectives on discrimination during times of stress and suggest the need for broader attention to the impact of the pandemic on unfair treatment of stigmatized groups. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

A Changing Landscape of Health Opportunity in the United States: Increases in the Strength of Association Between Childhood Socioeconomic Disadvantage and Adult Health Between the 1990s and the 2010s.

Understanding the changing health consequences of childhood socioeconomic disadvantage (SED) is highly relevant to policy debates on inequality and national and state goals to improve population health. However, changes in the strength of association between childhood SED and adult health over historic time are largely unexamined in the United States. The present study begins to address this knowledge gap. Data were from 2 national samples of adults collected in 1995 (n = 7,108) and 2012 (n = 3,577) as part of the Midlife in the United States study. Three measures of childhood SED (parents' occupational prestige, childhood poverty exposure, and parents' education) were combined into an aggregate index and examined separately. The association between childhood SED (aggregate index) and 5 health outcomes (body mass index, waist circumference, chronic conditions, functional limitations, and self-rated health) was stronger in the 2012 sample than the 1995 sample, with the magnitude of associations being approximately twice as large in the more recent sample. Results persisted after adjusting for age, sex, race, marital status, and number of children, and were similar across all 3 measures of childhood SED. The findings suggest that the socioeconomic circumstances of childhood might have become a stronger predictor of adult health in recent decades.

An Integrated Look at Well-Being: Topological Clustering of Combinations and Correlates of Hedonia and Eudaimonia.

Subjective measures of well-being are increasingly seen by scholars and policy makers as valuable tools to assess quality of life. Hedonic accounts focus on people's experience of life in positive ways while eudaimonic accounts are concerned with realization of personal potential. However, to what extent do an "enjoyable" and a "flourishing" life overlap? Using an innovative clustering-and-projection technique (Self-Organized Map), the joint distributional patterns of multiple hedonic and eudaimonic well-being indicators were examined in a nationally representative longitudinal study of US adults (MIDUS). Results show that the two accounts largely converged with about 70% of the sample observations registering high/low scores in both well-being dimensions. However, the remaining 30% of respondents experienced divergent well-being levels. Association between these combined profiles and a series of socio-demographic characteristics and social stratification factors were investigated. Findings showed that chances of uniformly high well-being increase with age, while higher income, educational level, marriage, and being a female are linked to lesser probabilities of experiencing joint low well-being patterns. Experiencing a combination of high hedonic / low eudaimonic well-being was more frequent for less educated individuals, and men. Finally, the persistence over time of these combined well-being profiles was more frequent in case of convergent hedonic/eudaimonic levels. For divergent patterns we revealed substantial changes over a 10-year period with respondents registering low hedonic / high eudaimonic well-being at time t having greater chances of upward movement toward improved well-being compared to individuals who experienced high hedonic / low eudaimonic levels in the first time period.

Cultural and life style practices associated with low inflammatory physiology in Japanese adults.

Japan is an exceptionally healthy East Asian country with extended longevity. In addition, the typical levels of several proinflammatory proteins, including both C-reactive protein (CRP) and interleukin-6 (IL-6), are often reported to be low when compared to American and European populations. This analysis determined if blood levels of CRP and IL-6 were associated with 4 cultural practices reflective of Japanese behavior and customs -- drinking tea, eating seafood, consuming vegetables, and partaking in relaxing baths regularly - among 382 adults living in Tokyo. Regression models controlled for demographic factors, adiposity (BMI), physical exercise, smoking, alcohol use, and chronic illness (e.g., diabetes). Consuming a Japanese diet was associated with significantly lower CRP and IL-6 levels. More frequent bathing was associated with lower IL-6, but not specifically predictive of low CRP. This study has confirmed prior evidence for low inflammatory activity in Japanese adults and its association with several behavioral practices common in Japan.

Habitual sleep as a contributor to racial differences in cardiometabolic risk.

Insufficient and disrupted sleep is linked with cardiovascular and metabolic dysregulation and morbidity. The current study examines the degree to which differences in sleep between black/African American (AA) and white/European American (EA) adults explain racial differences in cardiometabolic (CMB) disease risk. Total sleep time and sleep efficiency (percent of time in bed asleep) were assessed via seven nights of wrist actigraphy among 426 participants in the Midlife in the United States Study (31% AA; 69% EA; 61% female; mean age = 56.8 y). CMB risk was indexed as a composite of seven biomarkers [blood pressure, waist circumference, hemoglobin A1c (HbA1c), insulin resistance, triglycerides, HDL cholesterol (HDL-C), and C-reactive protein]. Covariates included sociodemographic characteristics and relevant health behaviors. Results indicated that AAs relative to EAs obtained less sleep (341 vs. 381 min) and had lower sleep efficiency (72.3 vs. 82.2%) (P values < 0.001). Further, 41% and 58% of the racial difference in CMB risk was explained by sleep time and sleep efficiency, respectively. In models stratified by sex, race was indirectly associated with CMB risk via sleep time and efficiency only among females (explaining 33% and 65% of the race difference, respectively). Indirect effects were robust to alternative model specifications that excluded participants with diabetes or heart disease. Consideration of sleep determinants and sleep health is therefore needed in efforts to reduce racial differences in CMB disease.

Individual Differences in the Association Between Subjective Stress and Heart Rate Are Related to Psychological and Physical Well-Being.

The physiological response to stress is intertwined with, but distinct from, the subjective feeling of stress, although both systems must work in concert to enable adaptive responses. We investigated 1,065 participants from the Midlife in the United States 2 study who completed a self-report battery and a stress-induction procedure while physiological and self-report measures of stress were recorded. Individual differences in the association between heart rate and self-reported stress were analyzed in relation to measures that reflect psychological well-being (self-report measures of well-being, anxiety, depression), denial coping, and physical well-being (proinflammatory biomarkers interleukin-6 and C-reactive protein). The within-participants association between heart rate and self-reported stress was significantly related to higher psychological well-being, fewer depressive symptoms, lower trait anxiety, less use of denial coping, and lower levels of proinflammatory biomarkers. Our results highlight the importance of studying individual differences in coherence between physiological measures and subjective mental states in relation to well-being.

Neural, Hormonal, and Cognitive Correlates of Metabolic Dysfunction and Emotional Reactivity.

OBJECTIVE: Prediabetes and type 2 diabetes (i.e., hyperglycemia) are characterized by insulin resistance. These problems with energy metabolism may exacerbate emotional reactivity to negatively valenced stimuli and related phenomena such as predisposition toward negative affect, as well as cognitive deficits. Higher emotional reactivity is seen with hyperglycemia and insulin resistance. However, it is largely unknown how metabolic dysfunction correlates with related neural, hormonal, and cognitive outcomes. METHODS: Among 331 adults from the Midlife in the United States study, eye-blink response (EBR) we cross sectionally examined to gauge reactivity to negative, positive, or neutrally valenced pictures from international affect picture system stimuli proximal to an acoustic startle probe. Increased EBR to negative stimuli was considered an index of stress reactivity. Frontal alpha asymmetry, a biomarker of negative affect predisposition, was determined using resting electroencephalography. Baseline urinary cortisol output was collected. Cognitive performance was gauged using the Brief Test of Adult Cognition by telephone. Fasting glucose and insulin characterized hyperglycemia or the homeostatic model assessment of insulin resistance. RESULTS: Higher homeostatic model assessment of insulin resistance corresponded to an increased startle response, measured by EBR magnitude, for negative versus positive stimuli (R = 0.218, F(1,457) = 5.48, p = .020, euglycemia: M(SD) = .092(.776), hyperglycemia: M(SD) = .120(.881)). Participants with hyperglycemia versus euglycemia showed greater right frontal alpha asymmetry (F(1,307) = 6.62, p = .011, euglycemia: M(SD) = .018(.167), hyperglycemia: M(SD) = -.029(.160)), and worse Brief Test of Adult Cognition by telephone arithmetic performance (F(1,284) = 4.25, p = .040, euglycemia: M(SD) = 2.390(1.526), hyperglycemia: M(SD) = 1.920(1.462)). Baseline urinary cortisol (log10 µg/12 hours) was also dysregulated in individuals with hyperglycemia (F(1,324) = 5.09, p = .025, euglycemia: M(SD) = 1.052 ± .332, hyperglycemia: M(SD) = .961 (.362)). CONCLUSIONS: These results suggest that dysmetabolism is associated with increased emotional reactivity, predisposition toward negative affect, and specific cognitive deficits.

Persistently high psychological well-being predicts better HDL cholesterol and triglyceride levels: findings from the midlife in the U.S. (MIDUS) longitudinal study.

BACKGROUND: Psychological correlates of blood lipid levels have been previously evaluated mostly in cross sectional studies. However, prospectively measured psychological factors might also predict favorable blood lipid profiles, thereby indicating a healthy mind/body interplay that is associated with less disease, better health and longer lives. METHODS: This paper examined whether longitudinal profiles of psychological well-being over 9-10 years are predictors of blood lipid profiles. Using the MIDUS (Midlife in the U.S.) biological subsample (n = 1054, aged 34 to 84, 55% female), cross-time trajectories of well-being were linked with three lipid outcomes (i.e., HDL cholesterol, triglycerides, and LDL cholesterol), measured for the first time at the 2nd wave of the study. RESULTS: Most adults showed largely stable profiles of well-being, albeit at different levels. Some showed persistently high well-being over time, while others revealed persistently low or moderate well-being. After adjusting for the effect of demographics, health behaviors, medications, and insulin resistance, adults with persistently high levels of environmental mastery and self-acceptance-two components of psychological well-being-had significantly higher levels of HDL as well as significantly lower levels of triglycerides compared to adults with persistently low levels of well-being. Converging with prior findings, no association was found between well-being and LDL cholesterol. CONCLUSIONS: Over 9-10 years, persistently high levels of psychological well-being measures predicted high HDL cholesterol and low triglycerides. These findings add longitudinal evidence to the growing body of research showing that positive psychological factors are linked with better lipoprotein profiles. A better blood lipid profile, particularly higher HDL-C, may be key in mediating how psychological well-being positively impacts health and length of life. Additional research is required to further validate this hypothesis as well as to establish potential underlying mechanisms.

Linking Positive Affect to Blood Lipids: A Cultural Perspective.

Higher levels of positive affect have been associated with better physical health. While positive affect is seen as highly desirable among Westerners, East Asians tend to deemphasize positive affect. Using large probability samples of Japanese and U.S. adult populations, the present study examined the relations of positive affect with serum lipid profiles, known to be strongly predictive of risk for cardiovascular disease, and tested whether their associations depend on cultural contexts. As predicted, positive affect was associated with healthier lipid profiles for Americans but not for Japanese. Further analyses showed that this cultural moderation was mediated by body mass index. This study highlights the role of culture in the link between positive emotions and key biological risk factors of cardiovascular disease.

Purpose in life and use of preventive health care services.

Purpose in life has been linked with better health (mental and physical) and health behaviors, but its link with patterns of health care use are understudied. We hypothesized that people with higher purpose would be more proactive in taking care of their health, as indicated by a higher likelihood of using preventive health care services. We also hypothesized that people with higher purpose would spend fewer nights in the hospital. Participants (n = 7,168) were drawn from the Health and Retirement Study, a nationally representative panel study of American adults over the age of 50, and tracked for 6 y. After adjusting for sociodemographic factors, each unit increase in purpose (on a six-point scale) was associated with a higher likelihood that people would obtain a cholesterol test [odds ratio (OR) = 1.18, 95% confidence interval (CI) = 1.08-1.29] or colonoscopy (OR = 1.06, 95% CI = 0.99-1.14). Furthermore, females were more likely to receive a mammogram/X-ray (OR = 1.27, 95% CI = 1.16-1.39) or pap smear (OR = 1.16, 95% CI = 1.06-1.28), and males were more likely to receive a prostate examination (OR = 1.31, 95% CI = 1.18-1.45). Each unit increase in purpose was also associated with 17% fewer nights spent in the hospital (rate ratio = 0.83, 95% CI = 0.77-0.89). An increasing number of randomized controlled trials show that purpose in life can be raised. Therefore, with additional research, findings from this study may inform the development of new strategies that increase the use of preventive health care services, offset the burden of rising health care costs, and enhance the quality of life among people moving into the ranks of our aging society.

Lighten UP! A community-based group intervention to promote psychological well-being in older adults.

OBJECTIVES: Aging is often characterized by declines in physical and mental health and increased risk for depression and social isolation. A protective factor that has been found to effectively moderate these phenomena is psychological well-being. The aim of his study was to pilot test a novel group intervention (Lighten UP! program) for the promotion of psychological well-being in older adults living in the community. METHODS: Lighten UP! is an eight-week program consisting of 90-minute group session designed to teach participants to identify and savor positive experiences across multiple domains of eudaimonic well-being. It was delivered to a sample of 103 men and women aged 60 or over, that were assessed pre- and post-intervention with Ryff's Psychological Well-being Scale (PWB), Life Satisfaction scale, Geriatric Depression Scale, Symptom Questionnaire, and items measuring sleep complaints and social well-being. RESULTS: At the end of the eight weeks, participants reported significantly increased PWB, life satisfaction, and social well-being along with lower levels of depression and fewer physical symptoms and sleep complaints. These gains were particularly robust for individuals with lower pre-program levels of PWB. CONCLUSIONS: This pilot investigation suggests the feasibility of a short group program for enhancing well-being in older adults. Future controlled investigations with long-term follow-up assessment are needed to confirm the effectiveness and sustained benefits of the Lighten UP!

Racial discrimination mediates race differences in sleep problems: A longitudinal analysis.

OBJECTIVES: To examine changes in sleep problems over a 1.5-year period among Black or African American (AA) and White or European American (EA) college students and to consider the role of racial discrimination as a mediator of race differences in sleep problems over time. METHOD: Students attending a large, predominantly White university (N = 133, 41% AA, 57% female, mean age = 18.8, SD = .90) reported on habitual sleep characteristics and experiences of racial discrimination at baseline and follow-up assessments. A latent variable for sleep problems was assessed from reports of sleep latency, duration, efficiency, and quality. Longitudinal models were used to examine race differences in sleep problems over time and the mediating role of perceived discrimination. Covariates included age, gender, parent education, parent income, body mass index, self-rated physical health, and depressive symptoms. Each of the individual sleep measures was also examined separately, and sensitivity analyses were conducted using alternative formulations of the sleep problems measure. RESULTS: AAs had greater increases in sleep problems than EAs. Perceived discrimination was also associated with increases in sleep problems over time and mediated racial disparities in sleep. This pattern of findings was similar when each of the sleep indicators was considered separately and held with alternative sleep problems measures. CONCLUSIONS: The findings highlight the importance of racial disparities in sleep across the college years and suggest that experiences of discrimination contribute to group disparities. (PsycINFO Database Record

Parental History of Diabetes, Positive Affect, and Diabetes Risk in Adults: Findings from MIDUS.

BACKGROUND: Family history of diabetes is one of the major risk factors for diabetes, but significant variability in this association remains unexplained, suggesting the presence of important effect modifiers. PURPOSE: To our knowledge, no previous work has examined whether psychological factors moderate the degree to which family history of diabetes increases diabetes risk. METHODS: We investigated the relationships among parental history of diabetes, affective states (positive affect, negative affect, and depressed affect), and diabetes in 978 adults from the MIDUS 2 national sample. RESULTS: As expected, parental history of diabetes was associated with an almost threefold increase in diabetes risk. We found a significant interaction between positive affect and parental history of diabetes on diabetes (p = .009): higher positive affect was associated with a statistically significant lower relative risk for diabetes in participants who reported having a parental history of diabetes (RR = .66 per unit increase in positive affect; 95 % CI = .47; .93), but it did not influence diabetes risk for participants who reported no parental history of diabetes (p = .34). This pattern persisted after adjusting for an extensive set of health and sociodemographic covariates and was independent of negative and depressed affect. CONCLUSIONS: These results suggest that psychological well-being may protect individuals at increased risk from developing diabetes. Understanding such interactions between non-modifiable risk factors and modifiable psychological resources is important for delineating biopsychosocial pathways to diabetes and informing theory-based, patient-centered interventions to prevent the development of diabetes.

Racial and socioeconomic disparities in body mass index among college students: understanding the role of early life adversity.

The role of early life adversity (ELA) in the development of health disparities has not received adequate attention. The current study examined differential exposure and differential vulnerability to ELA as explanations for socioeconomic and racial disparities in body mass index (BMI). Data were derived from a sample of 150 college students (M age  = 18.8, SD = 1.0; 45 % African American; 55 % European American) who reported on parents' education and income as well as on exposure to 21 early adverse experiences. Body measurements were directly assessed to determine BMI. In adjusted models, African American students had higher BMI than European Americans. Similarly, background socioeconomic status was inversely associated with BMI. Significant mediation of group disparities through the pathway of ELA was detected, attenuating disparities by approximately 40 %. Furthermore, ELA was more strongly associated with BMI for African Americans than for European Americans. Efforts to achieve health equity may need to more fully consider early adversity.

Psychological well-being and metabolic syndrome: findings from the midlife in the United States national sample.

OBJECTIVES: Psychological well-being predicts favorable cardiovascular outcomes, but less evidence addresses biological mediators underlying these effects. Therefore, associations among well-being and metabolic syndrome (MetSyn) were examined in a national sample. METHODS: Survey of Midlife in the US participants (MIDUS; n = 1205) provided survey assessments of hedonic (positive affect, life satisfaction) and eudaimonic well-being (e.g., personal growth and purpose in life) at two waves 9 to 10 years apart. MetSyn components were measured during an overnight clinic visit at Time 2 only. Outcomes included the number of MetSyn risk factors and a binary outcome reflective of MetSyn status. RESULTS: The unadjusted prevalence of MetSyn was 36.6%. Life satisfaction (B [standard error {SE}] = -0.12 [0.04], p = .005), positive affect (B [SE] = -0.10 [0.04], p = .009), and personal growth (B [SE] = -0.10 [0.04], p = .012) predicted fewer MetSyn components and lower risk of meeting diagnostic criteria in fully adjusted models. Results were unchanged by adjustments for depressive symptoms, and were not moderated by age, sex, race, or socioeconomic status. Life satisfaction (B [SE] = -0.11 [0.05], p = .023) and a eudaimonic well-being composite (B [SE] = -0.11 [0.05], p = .045) also predicted fewer components and lower risk of meeting diagnostic criteria in longitudinal models. CONCLUSIONS: Psychosocial resources, including positive affect, life satisfaction, and personal growth, predicted reduced risk for MetSyn both cross sectionally and longitudinally. Further work should examine consequences of these linkages for cardiovascular outcomes in intervention contexts.

Expression of anger and ill health in two cultures: an examination of inflammation and cardiovascular risk.

Expression of anger is associated with biological health risk (BHR) in Western cultures. However, recent evidence documenting culturally divergent functions of the expression of anger suggests that its link with BHR may be moderated by culture. To test this prediction, we examined large probability samples of both Japanese and Americans using multiple measures of BHR, including pro-inflammatory markers (interleukin-6 and C-reactive protein) and indices of cardiovascular malfunction (systolic blood pressure and ratio of total to HDL cholesterol). We found that the link between greater expression of anger and increased BHR was robust for Americans. As predicted, however, this association was diametrically reversed for Japanese, among whom greater expression of anger predicted reduced BHR. These patterns were unique to the expressive facet of anger and remained after we controlled for age, gender, health status, health behaviors, social status, and reported experience of negative emotions. Implications for sociocultural modulation of bio-physiological responses are discussed.