Positive Psychology and Physical Health: Research and Applications.

Positive psychology is the scientific study of a healthy and flourishing life. The goal of positive psychology is to complement and extend the traditional problem-focused psychology that has proliferated in recent decades. Positive psychology is concerned with positive psychological states (eg, happiness), positive psychological traits (eg, talents, interests, strengths of character), positive relationships, and positive institutions. We describe evidences of how topics of positive psychology apply to physical health. Research has shown that psychological health assets (eg, positive emotions, life satisfaction, optimism, life purpose, social support) are prospectively associated with good health measured in a variety of ways. Not yet known is whether positive psychology interventions improve physical health. Future directions for the application of positive psychology to health are discussed. We conclude that the application of positive psychology to health is promising, although much work remains to be done.

Risk factors for accident death in the U.S. Army, 2004-2009.

BACKGROUND: Accidents are one of the leading causes of death among U.S. active-duty Army soldiers. Evidence-based approaches to injury prevention could be strengthened by adding person-level characteristics (e.g., demographics) to risk models tested on diverse soldier samples studied over time. PURPOSE: To identify person-level risk indicators of accident deaths in Regular Army soldiers during a time frame of intense military operations, and to discriminate risk of not-line-of-duty from line-of-duty accident deaths. METHODS: Administrative data acquired from multiple Army/Department of Defense sources for active duty Army soldiers during 2004-2009 were analyzed in 2013. Logistic regression modeling was used to identify person-level sociodemographic, service-related, occupational, and mental health predictors of accident deaths. RESULTS: Delayed rank progression or demotion and being male, unmarried, in a combat arms specialty, and of low rank/service length increased odds of accident death for enlisted soldiers. Unique to officers was high risk associated with aviation specialties. Accident death risk decreased over time for currently deployed, enlisted soldiers and increased for those never deployed. Mental health diagnosis was associated with risk only for previous and never-deployed, enlisted soldiers. Models did not discriminate not-line-of-duty from line-of-duty accident deaths. CONCLUSIONS: Adding more refined person-level and situational risk indicators to current models could enhance understanding of accident death risk specific to soldier rank and deployment status. Stable predictors could help identify high risk of accident deaths in future cohorts of Regular Army soldiers.

Suicide in happy places revisited: the geographical unit of analysis matters.

BACKGROUND: A recent study reported that the highest suicide rates in the US occurred in the happiest states. This is a counter-intuitive finding. The present research investigated whether the same result occurred when the unit of analysis was city. The association between happiness (of most) and suicide (by some) might differ in cities versus states because those in a city provide a more immediate influence. METHODS: Suicide rates were examined in 44 large US cities as a function of the average happiness reported by residents. RESULTS: According to our results, happier cities had lower suicide rates (Spearman's rho = -.37, p < .014), implying that cities may be a more meaningful unit of analysis than states for studies of suicide risk. CONCLUSIONS: The appropriate geographical unit of analysis needs to be considered seriously in psychological studies.

Life satisfaction and frequency of doctor visits.

OBJECTIVE: Identifying positive psychological factors that reduce health care use may lead to innovative efforts that help build a more sustainable and high-quality health care system. Prospective studies indicate that life satisfaction is associated with good health behaviors, enhanced health, and longer life, but little information about the association between life satisfaction and health care use is available. We tested whether higher life satisfaction was prospectively associated with fewer doctor visits. We also examined potential interactions between life satisfaction and health behaviors. METHODS: Participants were 6379 adults from the Health and Retirement Study, a prospective and nationally representative panel study of American adults older than 50 years. Participants were tracked for 4 years. We analyzed the data using a generalized linear model with a gamma distribution and log link. RESULTS: Higher life satisfaction was associated with fewer doctor visits. On a 6-point life satisfaction scale, each unit increase in life satisfaction was associated with an 11% decrease in doctor visits--after adjusting for sociodemographic factors (relative risk = 0.89, 95% confidence interval = 0.86-0.93). The most satisfied respondents (n = 1121; 17.58%) made 44% fewer doctor visits than did the least satisfied (n = 182; 2.85%). The association between higher life satisfaction and reduced doctor visits remained even after adjusting for baseline health and a wide range of sociodemographic, psychosocial, and health-related covariates (relative risk = 0.96, 95% confidence interval = 0.93-0.99). CONCLUSIONS: Higher life satisfaction is associated with fewer doctor visits, which may have important implications for reducing health care costs.

Perceived neighborhood social cohesion and stroke.

Research in the last three decades has shown that negative neighborhood factors such as neighborhood violence, noise, traffic, litter, low neighborhood socioeconomic status, and poor air quality increase the risk of poor health. Fewer studies have examined the potential protective effect that neighborhood factors can have on health, particularly stroke. We examined whether higher perceived neighborhood social cohesion was associated with lower stroke incidence after adjusting for traditional risk and psychological factors that have been linked with stroke risk. Prospective data from the Health and Retirement Study--a nationally representative panel study of American adults over the age of 50--were used. Analyses were conducted on a subset of 6740 adults who were stroke-free at baseline. Analyses adjusted for chronic illnesses and relevant sociodemographic, behavioral, and psychosocial factors. Over a four-year follow-up, higher perceived neighborhood social cohesion was associated with a lower risk of stroke. Each standard deviation increase in perceived neighborhood social cohesion was associated with a multivariate-adjusted odds ratio (O.R.) of 0.85 for stroke incidence (95% CI, 0.75-0.97, p < 0.05). The effect of perceived neighborhood social cohesion remained significant after adjusting for a comprehensive set of risk factors. Therefore, perceived neighborhood social cohesion plays an important role in protecting against stroke.

Christopher M. Peterson (1950-2012).

Presents an obituary for Christopher M. Peterson. "Other people matter. Period," said Christopher M. Peterson when asked for a concise definition of "positive psychology," the field he helped to found and then helped to guide through the first decade of the 21st century. He researched, taught, and lived positive psychology. When Chris died prematurely on October 9, 2012, in Ann Arbor, Michigan, from sudden heart failure, the world lost a distinguished scholar, an inspirational teacher, and a wonderful human being. Chris loved people. He was genuinely interested in getting to know others. He made everyone around him feel comfortable and respected. An understated, humble, and generous person, it was no accident that his nickname was "Mother Theresa." He always found joy in letting other people shine and sharing the credit with them. He had a gift for seeing the best in each person. He also had a strong sense of fairness and duty without being rigid or allowing his personal feelings to obscure his judgment. He had fun whatever he did and brought fun for others. Although his scholarly contributions are significant, his lasting legacy will be what he shared with other people. So many of us are indebted to him for making us better researchers, better teachers, and better people. (PsycINFO Database Record (c) 2013 APA, all rights reserved).

Purpose in life and reduced incidence of stroke in older adults: 'The Health and Retirement Study'.

OBJECTIVE: To determine whether purpose in life is associated with reduced stroke incidence among older adults after adjusting for relevant sociodemographic, behavioral, biological, and psychosocial factors. METHODS: We used prospective data from the Health and Retirement Study, a nationally representative panel study of American adults over the age of 50. 6739 adults who were stroke-free at baseline were examined. A multiple imputation technique was used to account for missing data. Purpose in life was measured using a validated adaptation of Ryff and Keyes' Scales of Psychological Well-Being. After controlling for a comprehensive list of covariates, we assessed the odds of stroke incidence over a four-year period. We used psychological and covariate data collected in 2006, along with occurrences of stroke reported in 2008, 2010, and during exit interviews. Covariates included sociodemographic factors (age, gender, race/ethnicity, marital status, education level, total wealth, functional status), health behaviors (smoking, exercise, alcohol use), biological factors (hypertension, diabetes, systolic blood pressure, diastolic blood pressure, BMI, heart disease), negative psychological factors (depression, anxiety, cynical hostility, negative affect), and positive psychological factors (optimism, positive affect, and social participation). RESULTS: Greater baseline purpose in life was associated with a reduced likelihood of stroke during the four-year follow-up. In a model that adjusted for age, gender, race/ethnicity, marital status, education level, total wealth, and functional status, each standard deviation increase in purpose was associated with a multivariate-adjusted odds ratio of 0.78 for stroke (95% CI, 0.67-0.91, p=.002). Purpose remained significantly associated with a reduced likelihood of stroke after adjusting for several additional covariates including: health behaviors, biological factors, and psychological factors. CONCLUSION: Among older American adults, greater purpose in life is linked with a lower risk of stroke.

La psicología positiva: investigación y aplicaciones / Positive psychology: research and practice

Construir y mantener una buena vida son objetivos compartidos por todos los individuos y sociedades. La buena vida es feliz, saludable, productiva y con significado, e implica más que la mera ausencia de enfermedades, trastornos y problemas. Los enfoques tradicionales de la psicología se centran principalmente en identificar y reducir los problemas. Esos enfoques son útiles hasta cierto punto, pero muestran limitaciones al abordar la cuestión de cómo construir y mantener una buena vida, lo cual requiere capacidades y condiciones adicionales. Resulta por tanto necesario un nuevo tipo de ciencia y práctica que amplíe y complemente los enfoques centrados en los problemas y el nuevo campo de la psicología positiva tiene el potencial para cubrir esta necesidad. En este artículo, ofrecemos una descripción de la psicología positiva, sus conceptos principales, los resultados de las investigaciones actuales y las implicaciones prácticas para la construcción de una buena vida.

Building and sustaining a good life are goals shared by all individuals and societies. The good life is happy, healthy, productive and meaningful, and it entails more than the mere absence of disease, disorder, and problems. Traditional approaches in psychology largely focus on identifying problems and reducing them. What is needed is a new kind of science and practice that expands and complements existing problem-focused approaches. The new field of positive psychology has the potential to fill this need. In this article, we provide an overview of positive psychology, its main concepts, current research findings, and practical implications for building a good life.

Purpose in life and reduced risk of myocardial infarction among older U.S. adults with coronary heart disease: a two-year follow-up.

This study examined whether purpose in life was associated with myocardial infarction among a sample of older adults with coronary heart disease after adjusting for relevant sociodemographic, behavioral, biological, and psychological factors. Prospective data from the Health and Retirement Study-a nationally representative panel study of American adults over the age of 50-were used. Analyses were conducted on the subset of 1,546 individuals who had coronary heart disease at baseline. Greater baseline purpose in life was associated with lower odds of having a myocardial infarction during the 2-year follow-up period. On a six-point purpose in life measure, each unit increase was associated with a multivariate-adjusted odds ratio of 0.73 for myocardial infarction (95% CI, 0.57-0.93, P = .01). The association remained significant after controlling for coronary heart disease severity, self-rated health, and a comprehensive set of possible confounds. Higher purpose in life may play an important role in protecting against myocardial infarction among older American adults with coronary heart disease.

Dispositional optimism protects older adults from stroke: the Health and Retirement Study.

BACKGROUND AND PURPOSE: Although higher optimism has been linked to an array of positive health outcomes, the association between optimism and incidence of stroke remains unclear, especially among older adults. We examined whether higher optimism was associated with a lower incidence of stroke. METHOD: Prospective data from the Health and Retirement Study--a nationally representative panel study of American adults aged>50 years--were used. Analyses were conducted for a 2-year follow-up on the subset of 6044 adults (2542 men, 3502 women) who were stroke-free at baseline. Analyses adjusted for chronic illnesses, self-rated health, and relevant sociodemographic, behavioral, biological, and psychological factors. RESULTS: Higher optimism was associated with a lower risk of stroke. On an optimism measure ranging from 3 to 18, each unit increase in optimism was associated with an age-adjusted OR of 0.90 for stroke (95% CI, 0.84 to 0.97; P<0.01). The effect of optimism remained significant even after fully adjusting for a comprehensive set of sociodemographic, behavioral, biological, and psychological stroke risk factors. CONCLUSIONS: Optimism may play an important role in protecting against stroke among older adults.

Healthy psychological functioning and incident coronary heart disease: the importance of self-regulation.

CONTEXT: Studies have documented effects of positive and negative emotion on the risk of developing coronary heart disease (CHD), leading investigators to speculate about the importance of effective self-regulation for good health. Little work has directly assessed the role of self-regulation in risk of incident CHD. OBJECTIVE: To examine whether self-regulation is associated with reduced risk of coronary heart disease (CHD). Secondary aims were to consider whether the effects are independent of other measures of psychological functioning and how they may occur. DESIGN: A prospective population-based cohort study. SETTING: The Normative Aging Study, an ongoing cohort study of community-dwelling men in the Boston area. PARTICIPANTS: One thousand one hundred twenty-two men aged 40 to 90 years without CHD or diabetes mellitus at baseline, followed up for an average of 12.7 years. MAIN OUTCOME MEASURES: Measures of incident CHD obtained from hospital records, medical history, physical examination, and death certificates. During follow-up, 168 cases of incident CHD occurred, including 56 cases of incident nonfatal myocardial infarction (MI), 44 cases of fatal CHD, and 68 cases of angina pectoris. RESULTS: In 1986, 1122 men completed the revised Minnesota Multiphasic Personality Inventory, from which we derived a measure of self-regulation. Compared with men with lower levels, those reporting higher levels of self-regulation had an age-adjusted hazard ratio of 0.38 (95% confidence interval, 0.22-0.64) for combined nonfatal MI and CHD death. Moreover, a dose-response relation was evident, as each 1-SD increase in self-regulation level was associated with a 20% decreased risk of combined angina, nonfatal MI, and CHD death. Significant associations were also found after adjusting for anxiety, anger, or depression and after controlling for positive affect. The association could not be explained by known demographic factors, health behaviors, or biological factors. CONCLUSION: Findings suggest that self-regulation may protect against risk of CHD in older men.

Assessment for the U.S. Army Comprehensive Soldier Fitness program: the Global Assessment Tool.

Psychology and the U.S. military have a long history of collaboration. The U.S. Army Comprehensive Soldier Fitness (CSF) program aims to measure the psychosocial strengths and assets of soldiers as well as their problems, to identify those in need of basic training in a given domain as well as those who would benefit from advanced training, and then to provide that training. The goals of the CSF program include the promotion of well-being as well as the prevention of problems. Assessment is the linchpin of the CSF program, and the Global Assessment Tool (GAT) is a self-report survey that measures psychosocial fitness in emotional, social, family, and spiritual domains. We review the history of psychological assessment in the military and the lessons taught by this history. Then we describe the process by which the GAT was developed and evaluated. We conclude with a discussion of pending next steps in the development and use of the GAT.

Military children and families: strengths and challenges during peace and war.

Throughout history, military children and families have shown great capacity for adaptation and resilience. However, in recent years, unprecedented lengthy and multiple combat deployments of service members have posed multiple challenges for U.S. military children and families. Despite needs to better understand the impact of deployment on military children and families and to provide proper support for them, rigorous research is lacking. Programs exist that are intended to help, but their effectiveness is largely unknown. They need to be better coordinated and delivered at the level of individuals, families, and communities. Research and programs need to take a comprehensive approach that is strengths based and problem focused. Programs for military children and families often focus on the prevention or reduction of problems. It is just as important to recognize their assets and to promote them. This article reviews existing research on military children and families, with attention to their strengths as well as their challenges. Issues in need of further research are identified, especially research into programs that assist military children and families. Military children and families deserve greater attention from psychology.

Does it matter where we live?: The urban psychology of character strengths.

Psychology has neglected the study of variation across cities. An urban psychology is needed that takes seriously such variation and focuses on strengths and assets contributing to the good life as much as on problems of urbanization. To illustrate the value of an urban psychology, we describe studies of character strengths among residents in the 50 largest U.S. cities (N = 47,369). Differences in character strengths were found to exist across cities, were robustly related to important city-level outcomes such as entrepreneurship and 2008 presidential election voting, and were associated in theoretically predicted ways with city-level features. We propose a framework that distinguishes between strengths of the "head," which are intellectual and self-oriented, and strengths of the "heart," which are emotional and interpersonal. Cities whose residents had higher levels of head strengths were those rated as creative and innovative. Head strengths predicted the likelihood of a city voting for Barack Obama, whereas heart strengths predicted voting for John McCain. More than half of the world's population now resides in cities, and urban psychology deserves greater attention.

What Happened to Self-Actualization? Commentary on Kenrick et al. (2010).

Abraham Maslow's hierarchy of needs is one of psychology's genuinely good ideas and has had a sustained impact in and out of psychology. The revision of the hierarchy by Kenrick, Griskevicius, Neuberg, and Schaller (2010, this issue) is overdue and makes an important contribution by grounding the hierarchy in modern evolutionary thought. However, we suggest that it may be premature to remove self-actualization from the hierarchy by reducing it to other needs associated with status and reproduction.

Achieving and Sustaining a Good Life.

How can we live well? To answer this question, psychology must acknowledge and integrate its descriptive and prescriptive components. One of psychology's strengths has been its willingness to embrace different purposes, perspectives, and approaches, and this recommendation is in the spirit of the field's history. At present, psychology knows more about people's problems and how to solve them than it does about what it means to live well and how to encourage and maintain such a life. Moreover, what is known is often fragmented because of psychology's specialization. Our article calls for further discussion in psychological terms of what it means to live well; the study of actual people and how they behave; multivariate, multimethod, and longitudinal research; more sophisticated interventions; interdisciplinary collaboration; and translational research.

Strengths of character and posttraumatic growth.

How are strengths of character related to growth following trauma? A retrospective Web-based study of 1,739 adults found small, but positive associations among the number of potentially traumatic events experienced and a number of cognitive and interpersonal character strengths. It was concluded that growth following trauma may entail the strengthening of character.

Moral competence and character strengths among adolescents: the development and validation of the Values in Action Inventory of Strengths for Youth.

Moral competence among adolescents can be approached in terms of good character. Character is a multidimensional construct comprised of a family of positive traits manifest in an individual's thoughts, emotions and behaviours. The Values in Action Inventory for Youth (VIA-Youth) is a self-report questionnaire suitable for adolescents that measures 24 widely valued strength of character. Data from several samples bearing on the internal consistency, stability, and validity of the VIA-Youth are described, along with what is known about the prevalence and demographic correlates of the character strengths it measures. Exploratory factor analysis revealed an interpretable four-factor structure of the VIA-Youth subscales: temperance strengths (e.g., prudence, self-regulation), intellectual strengths (e.g., love of learning, curiosity), theological strengths (e.g., hope, religiousness, love), and other-directed (interpersonal) strengths (e.g., kindness, modesty). The uses of the VIA-Youth in research and practise are discussed along with directions for future research.

Positive psychology progress: empirical validation of interventions.

Positive psychology has flourished in the last 5 years. The authors review recent developments in the field, including books, meetings, courses, and conferences. They also discuss the newly created classification of character strengths and virtues, a positive complement to the various editions of the Diagnostic and Statistical Manual of Mental Disorders (e. g., American Psychiatric Association, 1994), and present some cross-cultural findings that suggest a surprising ubiquity of strengths and virtues. Finally, the authors focus on psychological interventions that increase individual happiness. In a 6-group, random-assignment, placebo-controlled Internet study, the authors tested 5 purported happiness interventions and 1 plausible control exercise. They found that 3 of the interventions lastingly increased happiness and decreased depressive symptoms. Positive interventions can supplement traditional interventions that relieve suffering and may someday be the practical legacy of positive psychology.