Michael J. Poulin

Caregiving Behavior Is Associated With Decreased Mortality Risk

Traditional investigations of caregiving link it to increased caregiver morbidity and mortality, but do not disentangle the effects of providing care from those of being continuously exposed to an ailing loved one with serious health problems. We explored this possible confound in a national, longitudinal survey of elderly married individuals (N = 3,376). Results showed that spending at least 14 hr per week providing care to a spouse predicted decreased mortality for the caregiver, independently of behavioral and cognitive limitations of the care recipient (spouse), and of other demographic and health variables. These findings suggest that it may be premature to conclude that health risks for caregivers are due to providing active help. Indeed, under some circumstances, caregivers may actually benefit from providing care.

Terrorism, Acute Stress, and Cardiovascular Health: A 3-Year National Study Following the September 11th Attacks

CONTEXT The terrorist attacks of 9/11 (September 11, 2001) present an unusual opportunity to examine prospectively the physical health impact of extreme stress in a national sample. OBJECTIVE To examine the degree to which acute stress reactions to the 9/11 terrorist attacks predict cardiovascular outcomes in a national probability sample over the subsequent 3 years. DESIGN, SETTING, AND PARTICIPANTS A national probability sample of 2729 adults (78.1% participation rate), 95.0% of whom had completed a health survey before 9/11 (final health sample, 2592), completed a Web-based assessment of acute stress responses approximately 9 to 14 days after the terrorist attacks. Follow-up health surveys reassessed physician-diagnosed cardiovascular ailments 1 (n = 1923, 84.3% participation rate), 2 (n = 1576, 74.2% participation rate), and 3 (n = 1950, 78.9% participation rate) years following the attacks. MAIN OUTCOME MEASURES Reports of physician-diagnosed cardiovascular ailments over the 3 years following the attacks. RESULTS Acute stress responses to the 9/11 attacks were associated with a 53% increased incidence of cardiovascular ailments over the 3 subsequent years, even after adjusting for pre-9/11 cardiovascular and mental health status, degree of exposure to the attacks, cardiovascular risk factors (ie, smoking, body mass index, and number of endocrine ailments), total number of physical health ailments, somatization, and demographics. Individuals reporting high levels of acute stress immediately following the attacks reported an increased incidence of physician-diagnosed hypertension (rate ratios, 2.15 at 1 year and 1.75 at 2 years) and heart problems (rate ratios, 2.98 at 1 year and 3.12 at 2 years) over 2 years. Among individuals reporting ongoing worry about terrorism post-9/11, high 9/11-related acute stress symptoms predicted increased risk of physician-diagnosed heart problems 2 to 3 years following the attacks (rate ratios, 4.67 at 2 years and 3.22 at 3 years). CONCLUSION Using health data collected before 9/11 as a baseline, acute stress response to the terrorist attacks predicted increased reports of physician-diagnosed cardiovascular ailments over 3 years following the attacks.

Social closeness increases salivary progesterone in humans

We examined whether interpersonal closeness increases salivary progesterone. One hundred and sixty female college students (80 dyads) were randomly assigned to participate in either a closeness task with a partner versus a neutral task with a partner. Those exposed to the closeness induction had higher levels of progesterone relative to those exposed to the neutral task. Across conditions, progesterone increase one week later predicted the willingness to sacrifice for the partner. These results are discussed in terms of the links between social contact, stress, and health.

The Neurogenetics of Nice Receptor Genes for Oxytocin and Vasopressin Interact With Threat to Predict Prosocial Behavior

Oxytocin, vasopressin, and their receptor genes influence prosocial behavior in the laboratory and in the context of close relationships. These peptides may also promote social engagement following threat. However, the scope of their prosocial effects is unknown. We examined oxytocin receptor (OXTR) polymorphism rs53576, as well as vasopressin receptor 1a (AVPR1a) polymorphisms rs1 and rs3 in a national sample of U.S. residents (n = 348). These polymorphisms interacted with perceived threat to predict engagement in volunteer work or charitable activities and commitment to civic duty. Specifically, greater perceived threat predicted engagement in fewer charitable activities for individuals with A/A and A/G genotypes of OXTR rs53576, but not for G/G individuals. Similarly, greater perceived threat predicted lower commitment to civic duty for individuals with one or two short alleles for AVPR1a rs1, but not for individuals with only long alleles. Oxytocin, vasopressin, and their receptor genes may significantly influence prosocial behavior and may lie at the core of the caregiving behavioral system.

Mental- and Physical-Health Effects of Acute Exposure to Media Images of the September 11, 2001, Attacks and the Iraq War

Millions of people witnessed early, repeated television coverage of the September 11 (9/11), 2001, terrorist attacks and were subsequently exposed to graphic media images of the Iraq War. In the present study, we examined psychological- and physical-health impacts of exposure to these collective traumas. A U.S. national sample (N = 2,189) completed Web-based surveys 1 to 3 weeks after 9/11; a subsample (n = 1,322) also completed surveys at the initiation of the Iraq War. These surveys measured media exposure and acute stress responses. Posttraumatic stress symptoms related to 9/11 and physician-diagnosed health ailments were assessed annually for 3 years. Early 9/11- and Iraq War–related television exposure and frequency of exposure to war images predicted increased posttraumatic stress symptoms 2 to 3 years after 9/11. Exposure to 4 or more hr daily of early 9/11-related television and cumulative acute stress predicted increased incidence of health ailments 2 to 3 years later. These findings suggest that exposure to graphic media images may result in physical and psychological effects previously assumed to require direct trauma exposure.

Giving to Others and the Association Between Stress and Mortality

OBJECTIVES We sought to test the hypothesis that providing help to others predicts a reduced association between stress and mortality. METHODS We examined data from participants (n = 846) in a study in the Detroit, Michigan, area. Participants completed baseline interviews that assessed past-year stressful events and whether the participant had provided tangible assistance to friends or family members. Participant mortality and time to death was monitored for 5 years by way of newspaper obituaries and monthly state death-record tapes. RESULTS When we adjusted for age, baseline health and functioning, and key psychosocial variables, Cox proportional hazard models for mortality revealed a significant interaction between helping behavior and stressful events (hazard ratio [HR] = 0.58; P < .05; 95% confidence interval [CI] = 0.35, 0.98). Specifically, stress did not predict mortality risk among individuals who provided help to others in the past year (HR = 0.96; 95% CI = 0.79, 1.18), but stress did predict mortality among those who did not provide help to others (HR = 1.30; P < .05; 95% CI = 1.05, 1.62). CONCLUSIONS Helping others predicted reduced mortality specifically by buffering the association between stress and mortality.

Finding social benefits after a collective trauma: Perceiving societal changes and well-being following 9/11

Individuals frequently perceive positive changes in themselves following adversity; after a collective trauma, they may perceive such benefits in others or in their society as well. We examined perceived benefits of the September 11, 2001 (9/11) terrorist attacks in a 3-year study of a national sample of adults (N = 1382). Many individuals (57.8%) perceived social benefits of 9/11, including increased prosocial behavior, religiousness, or political engagement. Individuals who found increased national religiosity as a benefit 2 months post-9/11 reported greater positive affect and life satisfaction and lower distress and posttraumatic stress up to 3 years post-9/11. Pre-9/11 religiousness and Republican political affiliation predicted perceiving religion-related social benefits post-9/11. Perceptions of social change are important but understudied responses to stressful events.

9/11: Mental Health in the Wake of Terrorist Attacks: Coping with a national trauma: a nationwide longitudinal study of responses to the terrorist attacks of September 11

The terrorist attacks of September 11, 2001, exposed every person in the USA to an experience that, in recent decades, was unprecedented in its scope and traumatic impact. Perhaps over 100,000 individuals directly witnessed these events, and many others viewed the attacks and their aftermath via the media (Yehuda, 2002). It has been argued that this national trauma “influenced and will continue to influence the clinical presentation of patients seeking health care services” in the USA (Yehuda, 2002, p. 108). A wide range of responses can be expected following traumatic life events. Research conducted after the Oklahoma City, OK, bombing indicates that responses to a terrorist attack are likely to be highly variable (North et al. , 1999). Research in the broader field of stress and coping has also demonstrated considerable variability in emotional and cognitive responses to stressful experiences (Silver & Wortman, 1980;Wortman & Silver, 1989, 2001). Despite advances in understanding reactions to traumatic events, our understanding of responses to community-level events in general, and terror attacks in particular, is limited. Progress in understanding the social and psychological process following such occurrences requires examination of how responses to a variety of stressful events are similar and different at both the group and individual level. Research has matured to the point that large-scale, prospective, longitudinal studies with the scope to examine mediators and moderators of adjustment processes are not only possible, but also necessary (North & Pfefferbaum, 2002). Moreover, the threat of future terrorist attacks demands that a higher level of urgency and research sophistication be directed not only at understanding the effects of such attacks, but also at the individual and social variables that predict psychological outcomes to such events over time.

A Lifespan Perspective on Terrorism: Age Differences in Trajectories of Response to 9/11.

A terrorist attack is an adverse event characterized by both an event-specific stressor and concern about future threats. Little is known about age differences in responses to terrorism. This longitudinal study examined generalized distress, posttraumatic stress responses, and fear of future attacks following the September 11, 2001 (9/11) terrorist attacks among a large U.S. national sample of adults (N = 2,240) aged 18-101 years. Individuals completed Web-based surveys up to 6 times over 3 years post 9/11. Multilevel models revealed different age-related patterns for distress, posttraumatic stress, and ongoing fear of future attacks. Specifically, older age was associated with lower overall levels of general distress, a steeper decline in posttraumatic stress over time, and less change in fear of future terrorist attacks over the 3 years. Understanding age differences in response to the stress of terrorism adds to the growing body of work on age differences in reactions to adversity.

Happiness as a Motivator Positive Affect Predicts Primary Control Striving for Career and Educational Goals

What motivates individuals to invest time and effort and overcome obstacles (i.e., strive for primary control) when pursuing important goals? We propose that positive affect predicts primary control striving for career and educational goals, and we explore the mediating role of control beliefs. In Study 1, positive affect predicted primary control striving for career goals in a two-wave longitudinal study of a U.S. sample. In Study 2, positive affect predicted primary control striving for career and educational goals and objective career outcomes in a six-wave longitudinal study of a German sample. Control beliefs partially mediated the longitudinal associations with primary control striving. Thus, when individuals experience positive affect, they become more motivated to invest time and effort, and overcome obstacles when pursuing their goals, in part because they believe they have more control over attaining their goals.