Suls provides a useful review of research interested in the contribution of chronic negative emotions to coronary heart disease. Despite widespread support for a link between negative emotions and the etiology of disease, it is largely unknown if discrete negative emotions, particularly anger, sadness, and anxiety contribute to the development of physical disease in different ways. In this comment, we argue that answering this question will require a more comprehensive analysis of the unique characteristics of discrete emotions as well as (...) conceptually refined assumptions about how discrete emotions develop and change across the adult lifespan. (shrink)

I focus on some differences between negative emotional states and how they are coped with in explaining different cardiac risks. The different cognitive, motivational, and physiological characteristics of emotions imply different appraisals of the negative event, and different resources to cope with the event. Cardiovascular activity depends on these different appraisals and coping strategies. For example, cortisol levels have shown to be differently associated with anger and fear responses to social stress. In addition, different ways to regulate one’s emotions are (...) also associated with different bodily responses that may increase or decrease cardiac risks. Future research should not only examine different emotions to stressors, but also more long-term regulation strategies and coping resources, such as self-esteem. (shrink)

I strongly endorse many of the suggestions made by the authors of the extremely useful reviews in this issue. In particular, the need to identify the complex causal mechanisms underlying the major health risk factors requires urgent attention of the research community. I suggest considering the important role of emotional disturbances as contributors to health risks given the empirically established comorbidity between mental and somatic illness. Better knowledge of these mechanisms is an essential prerequisite to develop tailored personalized prevention and (...) intervention programs, including reliable and valid assessment of deficits. (shrink)