Positive Emotions: Research Article

Psychoimmunology Menu

Positive Affect and Health-Related Neuroendocrine, Cardiovascular, and Inflammatory Processes

CITATION: Steptoe, A., Wardle, J., Marmot, M.  (2005)  Positive Affect And Health-Related Neuroendocrine, Cardiovascular, And Inflammatory Processes.   International Centre for Health and Society, Department of Epidemiology and Public Health, University College London, London.

ABSTRACT:  Negative affective states such as depression are associated with premature mortality and increased risk of coronary heart disease, type 2 diabetes, and disability. It has been suggested that positive affective states are protective, but the pathways through which such effects might be mediated are poorly understood. Here we show that positive affect in middle-aged men and women is associated with reduced neuroendocrine, inflammatory, and cardiovascular activity. Positive affect was assessed by aggregating momentary experience samples of happiness over a working day and was inversely related to cortisol output over the day, independently of age, gender, socioeconomic position, body mass, and smoking. Similar patterns were observed on a leisure day. Happiness was also inversely related to heart rate assessed by using ambulatory monitoring methods over the day. Participants underwent mental stress testing in the laboratory, where plasma fibrinogen stress responses were smaller in happier individuals. These effects were independent of psychological distress, supporting the notion that positive well-being is directly related to health-relevant biological processes.


1.  Cuijpers, P. & Smit, F. (2002) J. Affect. Disord. 72, 227-236. [PubMed] [Full Text].

2.  Golden, S. H., Williams, J. E., Ford, D. E., Yeh, H. C., Paton Sanford, C., Nieto, F. J. & Brancati, F. L. (2004) Diabetes Care 27, 429-435. [PubMed] [Free Full Text].

3.  Penninx, B. W., Leveille, S., Ferrucci, L., van Eijk, J. T. & Guralnik, J. M. (1999) Am. J. Public Health 89, 1346-1352. [PubMed].

4.  Hemingway, H. & Marmot, M. (1999) BMJ 318, 1460-1467. [PubMed] [Free Full Text].

5.  Ryan, R. M. & Deci, E. L. (2001) Annu. Rev. Psychol. 52, 141-166. [PubMed] [Full Text].

6.  Ryff, C. D., Singer, B. H. & Love, G. D. (2004) Philos. Trans. R. Soc. London B 359, 1383-1394.

7.  Danner, D. D., Snowdon, D. A. & Friesen, W. V. (2001) J. Pers. Soc. Psychol. 80, 804-813. [PubMed] [Full Text].

8.  Koivumaa-Honkanen, H., Honkanen, R., Viinamaki, H., Heikkila, K., Kaprio, J. & Koskenvuo, M. (2000) Am. J. Epidemiol. 152, 983-991. [PubMed] [Full Text].

9.  Whittington, J. & Huppert, F. A. (1998) Soc. Sci. Med. 46, 1429-1440. [PubMed] [Full Text].

10. Blazer, D. G. & Hybels, C. F. (2004) J. Am. Geriatr. Soc. 52, 2052-2056. [PubMed] [Full Text].

11. Ostir, G. V., Markides, K. S., Peek, M. K. & Goodwin, J. S. (2001) Psychosom. Med. 63, 210-215. [PubMed] [Free Full Text].

12. Ostir, G. V., Markides, K. S., Black, S. A. & Goodwin, J. S. (2000) J. Am. Geriatr. Soc. 48, 473-478. [PubMed].

13. Jarvis, M. (2002) in Stress and the Heart, eds. Stansfeld, S. & Marmot, M. (BMJ Books, London), pp. 150-157.

14. Biddle, S. J. H. & Mutrie, N. (2001) Psychology of Physical Activity (Routledge, London).

15. Panagiotakos, D. B., Pitsavos, C., Chrysohoou, C., Tsetsekou, E., Papageorgiou, C., Christodoulou, G. & Stefanadis, C. (2004) Eur. Heart J. 25, 492-499. [PubMed] [Free Full Text].

16. Gold, S. M., Zakowski, S. G., Valdimarsdottir, H. B. & Bovbjerg, D. H. (2004) Biol. Psychol. 67, 261-273. [PubMed] [Full Text].

17. Rosenkranz, M. A., Jackson, D. C., Dalton, K. M., Dolski, I., Ryff, C. D., Singer, B. H., Muller, D., Kalin, N. H. & Davidson, R. J. (2003) Proc. Natl. Acad. Sci. USA 100, 11148-11152. [ Free Full text in PMC].

18. Urry, H. L., Nitschke, J. B., Dolski, I., Jackson, D. C., Dalton, K. M., Mueller, C. J., Rosenkranz, M. A., Ryff, C. D., Singer, B. H. & Davidson, R. J. (2004) Psychol. Sci. 15, 367-372. [PubMed] [Full Text].

19. Tugade, M. M. & Fredrickson, B. L. (2004) J. Pers. Soc. Psychol. 86, 320-333. [PubMed] [Full Text].

20. Lindfors, P. & Lundberg, U. (2002) Stress and Health 18, 153-160.

21. Hayney, M. S., Love, G. D., Buck, J. M., Ryff, C. D., Singer, B. & Muller, D. (2003) Vaccine 21, 2428-2432. [PubMed] [Full Text].

22. Stone, A. A. & Shiffman, S. (2002) Ann. Behav. Med. 24, 236-243. [PubMed].

23. Goldberg, D. (1972) Manual of the General Health Questionnaire (NFER-Nelson, Windsor, U.K.).

24. Stansfeld, S. A., Fuhrer, R., Shipley, M. J. & Marmot, M. G. (2002) Int. J. Epidemiol. 31, 248-255. [PubMed] [Free Full Text].

25. Marmot, M. G., Davey Smith, G., Stansfeld, S., Patel, C., North, F., Head, J., White, I., Brunner, E. & Feeney, A. (1991) Lancet 337, 1387-1393. [PubMed].

26. Steptoe, A., Feldman, P. M., Kunz, S., Owen, N., Willemsen, G. & Marmot, M. (2002) Eur. Heart J. 23, 1757-1763. [PubMed] [Free Full Text].

27. Steptoe, A., Kunz-Ebrecht, S., Owen, N., Feldman, P. J., Willemsen, G., Kirschbaum, C. & Marmot, M. (2003) Psychosom. Med. 65, 461-470. [PubMed] [Free Full Text].

28. Baumgart, P. & Kamp, J. (1998) Blood Press Monit. 3, 303-307. [PubMed].

29. Stansfeld, S. A., Sharp, D. S., Gallacher, J. E. & Yarnell, J. W. (1992) Psychol. Med. 22, 939-949. [PubMed].

30. Steptoe, A., Kunz-Ebrecht, S., Rumley, A. & Lowe, G. D. (2003) Thromb Haemostasis 89, 83-90.

31. Imholz, B. P., Langewouters, G. J., van Montfrans, G. A., Parati, G., van Goudoever, J., Wesseling, K. H., Wieling, W. & Mancia, G. (1993) Hypertension 21, 65-73. [PubMed].

32. Gaffney, P. J. & Wong, M. Y. (1992) Thromb. Haemostasis 68, 428-432.

33. Schwartz, J. E., Warren, K. & Pickering, T. G. (1994) Ann. Behav. Med. 16, 210-220.

34. McEwen, B. S., Biron, C. A., Brunson, K. W., Bulloch, K., Chambers, W. H., Dhabhar, F. S., Goldfarb, R. H., Kitson, R. P., Miller, A. H., Spencer, R. L. & Weiss, J. M. (1997) Brain Res. Rev. 23, 79-133. [PubMed].

35. Bjorntorp, P. (2001) Obes. Rev. 2, 73-86. [PubMed] [Full Text].

36. Brown, E. S., Varghese, F. P. & McEwen, B. S. (2004) Biol. Psychiatry 55, 1-9. [PubMed] [Full Text].

37. Dyer, A. R., Persky, V., Stamler, J., Paul, O., Shekelle, R. B., Berkson, D. M., Lepper, M., Schoenberger, J. A. & Lindberg, H. A. (1980) Am. J. Epidemiol. 112, 736-749. [PubMed].

38. Kannel, W. B., Kannel, C., Paffenbarger, R. S., Jr., & Cupples, L. A. (1987) Am. Heart J. 113, 1489-1494. [PubMed].

39. Schneiderman, N., Weiss, S. M. & Kaufman, P. G. (1989) Handbook of Research Methods in Cardiovascular Behavioral Medicine (Plenum, New York).

40. Danesh, J., Collins, R., Appleby, P. & Peto, R. (1998) J. Am. Med. Assoc. 279, 1477-1482.

41. Rauch, U., Osende, J. I., Fuster, V., Badimon, J. J., Fayad, Z. & Chesebro, J. H. (2001) Ann. Intern. Med. 134, 224-238. [PubMed] [Free Full Text].

42. Baylis, N., Huppert, F. A. & Kaverne, B. (2004) The Science of Well-Being (Royal Society, London).