Three negative affective dispositions—anger, anxiety, and depression—are hypothesized to increase physical disease risk and have been the subject of epidemiological studies. However, the overlap among the major negative affective dispositions, and the superordinate construct of trait negative affectivity are only beginning to be tested. Presented here is a narrative review of recent prospective studies that simultaneously tested anger, anxiety, depression, and trait NA as risk factors for cardiac outcomes. Anxiety and depression emerged as independent risk factors for premature heart disease (...) in population studies of persons nominally healthy at baseline, and for recurrence/mortality among patients with existing heart disease. General trait NA also was a cardiac risk factor in population samples. (shrink)

The biopsychosocial model of challenge and threat posits that resource and demand appraisals interact in situations of acute stress to determine affective responses, and concomitant physiological responses, motivation, and decisions/behaviors. Regulatory approaches that alter appraisals to regulate challenge and threat affective states have the potential to facilitate coping. This reply clarifies the conceptualization of one such regulatory approach, arousal reappraisal, and suggests avenues for future research. However, it is important to note that arousal reappraisal is not a “silver bullet” for (...) improving stress outcomes, nor should this strategy be expected to positively impact all individuals. More work is needed to better elucidate how psychological and biological stress processes interact to shape health. (shrink)

I agree with the commentators that study of physical disease risk conferred by affective dispositions such as anger/hostility, anxiety, and sadness, should be more cognizant of developments in emotion theory. Emotions differ in their functional value depending on the person’s lifespan trajectory. Discrete emotions have different psychophysiological signatures; and emotional competence, including production, regulation, and knowledge, may be critical in determining whether specific negative affects, or general negative affectivity, are toxic for physical health. Emotion researchers, however, have mainly focused on (...) acute affective experiences and ignored the general effects of negative affectivity, which subsumes the discrete negative affects. Most diseases develop over years so more needs to be known about the biological signatures of chronic specific affects and negative affectivity. (shrink)