A paradigm shift in public health and medicine has broadened the field from a singular focus on the ill effects of negative states and psychopathology to an expanded view that examines protective psychological assets that may promote improved physical health and longevity. We summarize recent evidence of the link between psychological well-being and physical health, with particular attention to outcomes of mortality and chronic disease incidence and progression. Within this evolving discipline there remain controversies and lessons to be learned. We (...) discuss measurement-related challenges, concerns about the quality of the evidence, and other shortcomings in the field, along with a brief discussion of hypothesized biobehavioral mechanisms involved. Finally, we suggest next steps to move the field forward. (shrink)

Hernandez et al.’s review provides clear evidence that positive affect can contribute to well-being and fits nicely within the positive psychology framework. The emergence of positive psychology has been valuable for understanding well-being, but I suggest that a balanced psychology can prove even more valuable in the years to come. A balanced psychology requires giving as much attention to negative emotion as to positive emotion. It also requires considering whether there are circumstances in which positive emotions can be detrimental and (...) negative emotions can be beneficial. Along those lines, evidence reviewed here indicates that healthy coping with severe stressors involves experiencing a combination of positive and negative emotions. (shrink)

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)

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)

Theories of the structure of affect make competing predictions about whether people can feel happy and sad at the same time. Considerable evidence that happiness and sadness can co-occur has accumulated in the past 15 years, but holes in the case remain. I describe those holes and suggest strategies for testing them in future research. I also explore the possibility that the case may never be closed, in part because the competing hypotheses may not be entirely falsifiable. Fortunately, hypotheses need (...) not be falsifiable to be useful. Research on mixed emotions has been generative and the body of research will continue to shed light on the structure of affect. (shrink)