Psychological Well-Being and Physical Health: Associations, Mechanisms, and Future Directions

“For example, in a representative sample of people living in Germany, Wiest, Schuz, Webster, and Wurm (2011) demonstrated that both life satisfaction (Pavot & Diener, 1993) and positive affect (the PANAS; Watson, Clark, & Tellegen, 1988) independently predict lowered risk of mortality, whereas…”

“As conceptualized by Keyes et al. (2002), eudaimonic indices centering on highly existential domains (e.g., purpose in life) were least correlated to hedonic measures of affect, pleasure, and happiness; correlation coefficients (rs) across well-being domains ranged from as low as .13 to moderate…”

“…affect and psychological well-being and have significantly led to reduced symptoms of depression in heterogeneous samples of mostly healthy adults (Sin & Lyubomirsky, 2009) and reduced depression in women with metastatic breast cancer (Cheung et al., 2016) and people with Type 2 diabetes (Cohn,…”

“…persons with favorable psychological well-being are said to possess more adaptive psychological profiles characterized by healthful coping strategies (e.g., positive reappraisal), increased social connectedness, and reduced cognitive catastrophizing, among others (Folkman & Moskowitz, 2000).”

“…research indicating that constructs such as optimism, positive affect, life satisfaction, and happiness are associated with longer life, independent of the effect of negative constructs (Chida & Steptoe, 2008; Diener & Chan, 2011; Howell, Kern, & Lyubomirsky, 2007; Pressman & Cohen, 2005).”

“Hedonic well-being includes such attributes as pleasure, happiness, positive affect, and life satisfaction, whereas eudaimonic well-being includes life meaning and purpose, self-actualization, and autonomy (Deci & Ryan, 2008).”

“…research indicating that constructs such as optimism, positive affect, life satisfaction, and happiness are associated with longer life, independent of the effect of negative constructs (Chida & Steptoe, 2008; Diener & Chan, 2011; Howell, Kern, & Lyubomirsky, 2007; Pressman & Cohen, 2005).”

“In this evaluative space model (Cacioppo & Berntson, 1994), positive and negative emotions are independent psychological states (Larsen & McGraw, 2014; Larsen, McGraw, & Cacioppo, 2001).”

“Applied studies of people experiencing major life stressors such as caregiving demonstrate that it is common for positive and negative affect to co-occur; to experience positive affect despite high levels of stress and distress (Folkman, 1997).”

“Conversely, eudaimonic well-being involves cognitive appraisals across a larger time frame, incorporating past, present, and future experiences with emphasis on actualization of the self and exercising of generosity toward others (Vallacher & Wegner, 1987).”

“…research indicating that constructs such as optimism, positive affect, life satisfaction, and happiness are associated with longer life, independent of the effect of negative constructs (Chida & Steptoe, 2008; Diener & Chan, 2011; Howell, Kern, & Lyubomirsky, 2007; Pressman & Cohen, 2005).”

“Near the end of the 20th century, Russell and Carroll (1999) stipulated that mixed emotions could not simultaneously be experienced, thus refuting the individual ability to feel both positive and negative emotion at a single point in time.”

“In experimental trials, more long-term and enduring improvements in mental health are documented for interventions seeking to boost eudaimonic well-being versus those emphasizing pursuit of hedonia (Huta & Ryan, 2010).”

“More recently, from a neuroscience perspective, positive and negative emotions are said to process from different brain regions allowing for their simultaneous activation, that is, the mesolimbic dopaminergic pathway versus the amygdala, respectively (Hoebel, Rada, Mark, & Pothos, 1999; Larsen et al., 2001).”

“The origins of eudaimonic well-being are thought to be more complex and are largely dictated by cultural context (Baumeister et al., 2013). Using survey and experimental methodology, Baumeister et al. (2013) found that hedonic wellbeing is linked to acquisition of core desires (both needs and wants) and focuses largel…”

“A multipronged process is hypothesized to underlie the pathway through which psychological well-being protects against incidence and progression of subclinical and clinical disease through promotion of healthy behaviors, augmentation of restorative biological processes, and increased psychosocial and coping resources…”

“We include multiple operationalizations of psychological well-being including life purpose, emotional vitality, positive affect, life satisfaction, happiness, and optimism (Boehm & Kubzansky, 2012; Ryff, Singer, & Love, 2004).”

“Since then, the detrimental health effects associated with psychological ill-being (e.g., depression, anxiety) have been well documented (Boehm, Trudel-Fitzgerald, Kivimaki, & Kubzansky, 2015; Cuijpers & Smit, 2002; Suls, 2017).”

“Hill and Turiano (2014) examined the association of purpose in life with mortality in a sample of 6,163 participants of the National Survey of Midlife Development in the United States (MIDUS) study, controlling for hedonic well-being (positive affect), negative affect, and positive relations with…”

“…inflammation (Interleukin 6 and C-reactive protein) is less prevalent among individuals reporting positive psychological well-being (Bacon et al., 2004; Gale, Batty, & Deary, 2008; Rahe, Rubin, Gunderson, & Arthur, 1971; Richman et al., 2005; Roy et al., 2010; Tsenkova, Love, Singer, & Ryff, 2007).”

“Our review of the literature reveals that researchers often statistically control for a number of constructs, including some of the variables that are hypothesized as potential mediators of the association between psychological well-being and health (e.g., B. Liu et al., 2016).”

“Larsen and McGraw (2014) provide evidence that cooccurence of opposite-valenced emotions is not only conceivable but indeed commonplace.”

“…included in the meta-analysis, the effects remain significant even when adjusted for covariates such as age, gender, and negative affect or ill-being (Boyle, Barnes, Buchman, & Bennett, 2009; Gruenewald, Karlamangla, Greendale, Singer, & Seeman, 2007; Hill & Turiano, 2014; Sone et al., 2008).”

“For most of the studies included in the meta-analysis, the effects remain significant even when adjusted for covariates such as age, gender, and negative affect or ill-being (Boyle, Barnes, Buchman, & Bennett, 2009; Gruenewald, Karlamangla, Greendale, Singer, & Seeman, 2007; Hill & Turiano, 2014; Sone et al., 2008).”

“In a recent piece by Okely and Gale (2016), they used data of the English Longitudinal Study of Ageing (ELSA) to examine the prospective relationship of psychological wellbeing and incidence of stroke, myocardial infarction, diabetes, arthritis, chronic lung disease, and cancer.”

“In people living with HIV, positive affect and related positive constructs are uniquely associated with slower disease progression (Ironson et al., 2005; Ironson & Hayward, 2008).”

“In a meta-analysis of 11 total studies, DuBois et al. (2015) found multiple positive psychological constructs (e.g., positive affect, optimism) to confer a protective effect on rates of rehospitalization and mortality among cardiac patients.”

“…inflammation (Interleukin 6 and C-reactive protein) is less prevalent among individuals reporting positive psychological well-being (Bacon et al., 2004; Gale, Batty, & Deary, 2008; Rahe, Rubin, Gunderson, & Arthur, 1971; Richman et al., 2005; Roy et al., 2010; Tsenkova, Love, Singer, & Ryff, 2007).”

“In people living with HIV, positive affect and related positive constructs are uniquely associated with slower disease progression (Ironson et al., 2005; Ironson & Hayward, 2008).”

“A number of studies to examine the impact of psychological well-being interventions on physical health in other chronic conditions are currently underway (e.g., Huffman et al., 2011; Huffman et al., 2015; Moskowitz et al., in press).”

“In the study by Wiest et al. (2011), cited before, the significant effect of life satisfaction and positive affect on longevity fell to nonsignificance when self-rated health and physical activity were included in the model.”

“Using factor analysis on Cantril’s SelfAnchoring Scale and Ryff’s Scales of Psychological Well-Being, Keyes et al. (2002) identified two correlated latent factors reflecting eudaimonic and hedonic aspects. Specifically, the first factor included features of autonomy, purpose in life, personal growth, positive relation…”

“In fact, investigators noted a dose–response relationship whereby a monotonic decrease in heart failure risk was observed with each stepwise increase in optimism (Kim et al., 2014).”

“A number of studies to examine the impact of psychological well-being interventions on physical health in other chronic conditions are currently underway (e.g., Huffman et al., 2011; Huffman et al., 2015; Moskowitz et al., in press).”

“…significantly led to reduced symptoms of depression in heterogeneous samples of mostly healthy adults (Sin & Lyubomirsky, 2009) and reduced depression in women with metastatic breast cancer (Cheung et al., 2016) and people with Type 2 diabetes (Cohn, Pietrucha, Saslow, Hult, & Moskowitz, 2014).”

“For example, Ickovics et al. (2006) found in a sample of 773 women living with HIV, that positive resources, a scale that combined the hedonic index of positive affect items (e.g., joyful, hopeful, happy), positive expectancies regarding HIV (“If I take care of myself, I will not get sick with…”

“As early as the 3rd century BC, work by the classic Greek philosophers like Aristotle and Socrates offered thoughtful discourse regarding the link of mental states and physiological processes (Menninger & Menninger, 1936).”

“beneficial effects of positive psychological constructs (Boehm & Kubzansky, 2012; Labarthe, 2012; Labarthe et al., 2016).”

“Psychological wellbeing is also associated with lower risk for development of diabetes (Boehm et al., 2015).”

“Wakai et al. (2007) studied the well-being indicator of “ikigai” (defined as “presence of something that makes one’s life worth living”) and its prospective role in the incidence of breast cancer in 34,497 Japanese women.”

“Hernandez et al. (2016) recently explored the conception of well-being in U.S. Hispanic/Latino adults and concluded that programs aimed at increasing well-being may need to be adapted before administration in Hispanics/Latinos to include a heightened focus on interpersonal factors with inclusion of religious/spiritual…”

“Near the end of the 20th century, Russell and Carroll (1999) stipulated that mixed emotions could not simultaneously be experienced, thus refuting the individual ability to feel both positive and negative emotion at a single point in time.”

“…and markers of inflammation (Interleukin 6 and C-reactive protein) is less prevalent among individuals reporting positive psychological well-being (Bacon et al., 2004; Gale, Batty, & Deary, 2008; Rahe, Rubin, Gunderson, & Arthur, 1971; Richman et al., 2005; Roy et al., 2010; Tsenkova, Love,…”

“In a recent piece by Okely and Gale (2016), they used data of the English Longitudinal Study of Ageing (ELSA) to examine the prospective relationship of psychological wellbeing and incidence of stroke, myocardial infarction, diabetes, arthritis, chronic lung disease, and cancer.”

“…prospective analyses women with high positive affect (when compared to those with low positive affect scores) were twice as likely to have undetectable viral load classifications (OR = 1.92, 95% CI [1.34, 2.74]), particularly when accompanied by low negative affect profiles (Wilson et al., 2016).”

“Similarly, Ronaldson et al. (2014) found greater levels of optimism, as measured preoperatively, to be inversely associated with self-reported pain intensity and adverse physical symptoms (e.g., bruising, numbness, swelling) in patients who underwent coronary artery bypass graft (CABG) surgery. In this prospective stu…”

“beneficial effects of positive psychological constructs (Boehm & Kubzansky, 2012; Labarthe, 2012; Labarthe et al., 2016).”

“Wakai et al. (2007) studied the well-being indicator of “ikigai” (defined as “presence of something that makes one’s life worth living”) and its prospective role in the incidence of breast cancer in 34,497 Japanese women.”

“…some controversy, eudaimonic well-being was associated with decreased expression of genes involved in inflammation and increased expression in genes associated with antiviral response (Brown, MacDonald, Samanta, Friedman, & Coyne, 2014; Cole & Fredrickson, 2014; Fredrickson et al., 2013).”

“The findings of Nilsson et al. (2011) and Wiest et al. (2011) suggest that well-being may exert health effects through improved health behaviors and aspects of social support.”

“…it also generates conceptual confusion because the relevance of findings relating to one term to findings related to others is unclear, especially given that various approaches to understanding psychological aspects of well-being have different philosophical underpinnings (Hernandez et al., 2018).”