Benefit Finding and Physical Health: Positive Psychological Changes and Enhanced Allostasis

Many individuals who undergo stressful life events report that they have derived some positive benefit from the experience. Although the majority of research on benefit finding has focused on its psychological correlates, there is intriguing evidence that benefit finding may also have effects on physical health. In this paper, we review the emerging literature on benefit finding and physical health and present an integrative model in which we identify specific psychological and physiological pathways through which benefit finding may influence physical health outcomes. In particular, we consider the hypothesis that benefit finding may involve changes in a number of psychological domains – namely, changes in appraisal and coping processes, relationships, goals and priorities, and positive affect – that lead to a state of enhanced allostasis, buffering against negative effects of catabolic stress responses and promoting activity in restorative physiological systems. Empirical evidence for this model is reviewed, focusing on studies that have examined positive psychological constructs relevant to benefit finding and their effects on stress reactivity, recovery, and habituation, as well as restorative processes.

[1]  E. González-Bono,et al.  Testosterone, Cortisol, and Mood in a Sports Team Competition , 1999, Hormones and Behavior.

[2]  N. Schneiderman,et al.  A path model of the effects of spirituality on depressive symptoms and 24-h urinary-free cortisol in HIV-positive persons. , 2006, Journal of psychosomatic research.

[3]  J W Rowe,et al.  Allostatic load as a marker of cumulative biological risk: MacArthur studies of successful aging , 2001, Proceedings of the National Academy of Sciences of the United States of America.

[4]  Sharon Danoff-Burg,et al.  Randomized, controlled trial of written emotional expression and benefit finding in breast cancer patients. , 2002, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[5]  B. McEwen Protective and damaging effects of stress mediators. , 1998, The New England journal of medicine.

[6]  G. Affleck,et al.  Benefit-finding and benefit-reminding. , 2002 .

[7]  M. Lauer,et al.  Heart-rate recovery immediately after exercise as a predictor of mortality. , 1999, The New England journal of medicine.

[8]  Sharon Danoff-Burg,et al.  Expressive disclosure and benefit finding among breast cancer patients: mechanisms for positive health effects. , 2006, Health psychology : official journal of the Division of Health Psychology, American Psychological Association.

[9]  S. Cole,et al.  Psychological risk factors for HIV pathogenesis: mediation by the autonomic nervous system , 2003, Biological Psychiatry.

[10]  S. Dickerson,et al.  Acute stressors and cortisol responses: a theoretical integration and synthesis of laboratory research. , 2004, Psychological bulletin.

[11]  Charles A Morgan,et al.  Neuropeptide-Y, cortisol, and subjective distress in humans exposed to acute stress: replication and extension of previous report , 2002, Biological Psychiatry.

[12]  Clemens Kirschbaum,et al.  Persistent High Cortisol Responses to Repeated Psychological Stress in a Subpopulation of Healthy Men , 1995, Psychosomatic medicine.

[13]  D Shapiro,et al.  Striking a chord: moods, blood pressure, and heart rate in everyday life. , 2001, Psychophysiology.

[14]  D. Hellhammer,et al.  Habituation of cortisol responses to repeated psychosocial stress—further characterization and impact of genetic factors , 2005, Psychoneuroendocrinology.

[15]  J. Campisi,et al.  Catecholamines mediate stress-induced increases in peripheral and central inflammatory cytokines , 2005, Neuroscience.

[16]  Traci Mann,et al.  Affirmation of Personal Values Buffers Neuroendocrine and Psychological Stress Responses , 2005, Psychological science.

[17]  Jason C. Allaire,et al.  Cardiovascular intraindividual variability in later life: the influence of social connectedness and positive emotions. , 2005, Psychology and aging.

[18]  S. Manuck,et al.  Acute psychophysiologic reactivity and risk of cardiovascular disease: a review and methodologic critique. , 1984, Psychological bulletin.

[19]  B. Uchino,et al.  The Availability of Social Support Reduces Cardiovascular Reactivity to Acute Psychological Stress , 1997, Journal of Behavioral Medicine.

[20]  A. Maercker,et al.  Neural correlates of posttraumatic growth after severe motor vehicle accidents. , 2006, Journal of consulting and clinical psychology.

[21]  Burton H Singer,et al.  Combinations of biomarkers predictive of later life mortality , 2006, Proceedings of the National Academy of Sciences.

[22]  R. Yehuda,et al.  Plasma Neuropeptide Y Concentrations in Combat Exposed Veterans: Relationship to Trauma Exposure, Recovery from PTSD, and Coping , 2006, Biological Psychiatry.

[23]  R. Dienstbier,et al.  Arousal and physiological toughness: implications for mental and physical health. , 1989, Psychological review.

[24]  J Blascovich,et al.  Cognitive and physiological antecedents of threat and challenge appraisal. , 1997, Journal of personality and social psychology.

[25]  K. Pakenham Benefit finding in multiple sclerosis and associations with positive and negative outcomes. , 2005, Health psychology : official journal of the Division of Health Psychology, American Psychological Association.

[26]  A. Stanton,et al.  Posttraumatic Growth After Cancer. , 2006 .

[27]  Laura M. Glynn,et al.  The Role of Rumination in Recovery from Reactivity: Cardiovascular Consequences of Emotional States , 2002, Psychosomatic medicine.

[28]  O. Wolkowitz,et al.  Neuropsychiatric Effects of Dehydroepiandrosterone (DHEA) , 2000 .

[29]  Shelley E. Taylor Adjustment to threatening events: A theory of cognitive adaptation. , 1983 .

[30]  M. Roy Patterns of cortisol reactivity to laboratory stress , 2004, Hormones and Behavior.

[31]  B. Appelhans,et al.  Heart Rate Variability as an Index of Regulated Emotional Responding , 2006 .

[32]  Valentin Fuster,et al.  Thrombus Formation on Atherosclerotic Plaques: Pathogenesis and Clinical Consequences , 2001, Annals of Internal Medicine.

[33]  R. Tedeschi,et al.  Handbook of posttraumatic growth : research and practice , 2006 .

[34]  T. Seeman,et al.  RR Interval Variability Is Inversely Related to Inflammatory Markers: The CARDIA Study , 2007, Molecular medicine.

[35]  B. Fredrickson,et al.  The Undoing Effect of Positive Emotions , 2000, Motivation and emotion.

[36]  Belinda Campos,et al.  Romantic love and sexual desire in close relationships. , 2006, Emotion.

[37]  Shelley E. Taylor,et al.  Cognitive processing, discovery of meaning, CD4 decline, and AIDS-related mortality among bereaved HIV-seropositive men. , 1998, Journal of consulting and clinical psychology.

[38]  T. Kamarck,et al.  Exaggerated Blood Pressure Responses During Mental Stress Are Prospectively Related to Enhanced Carotid Atherosclerosis in Middle-Aged Finnish Men , 2004, Circulation.

[39]  L. Hawkley,et al.  Autonomic, Neuroendocrine, and Immune Responses to Psychological Stress: The Reactivity Hypothesis a , 1998, Annals of the New York Academy of Sciences.

[40]  R. Yehuda,et al.  Clinical correlates of DHEA associated with post‐traumatic stress disorder , 2006, Acta psychiatrica Scandinavica.

[41]  J W Rowe,et al.  Self-esteem and neuroendocrine response to challenge: MacArthur studies of successful aging. , 1995, Journal of psychosomatic research.

[42]  K. Matthews,et al.  Blood Pressure Reactivity to Psychological Stress and Coronary Calcification in the Coronary Artery Risk Development in Young Adults Study , 2006, Hypertension.

[43]  B. Fredrickson The role of positive emotions in positive psychology. The broaden-and-build theory of positive emotions. , 2001, The American psychologist.

[44]  P. Sterling,et al.  Allostasis: A new paradigm to explain arousal pathology. , 1988 .

[45]  T. Wills,et al.  Stress, social support, and the buffering hypothesis. , 1985, Psychological bulletin.

[46]  R. Davidson,et al.  Individual Differences in Prefrontal Activation Asymmetry Predict Natural Killer Cell Activity at Rest and in Response to Challenge , 1999, Brain, Behavior, and Immunity.

[47]  Matthew D. Lieberman,et al.  Neural pathways link social support to attenuated neuroendocrine stress responses , 2007, NeuroImage.

[48]  J. Bower,et al.  Effects of acceptance-oriented versus evaluative emotional processing on heart rate recovery and habituation. , 2008, Emotion.

[49]  J. Thayer,et al.  Expanding stress theory: Prolonged activation and perseverative cognition , 2005, Psychoneuroendocrinology.

[50]  I. M. Neiman,et al.  [Inflammation and cancer]. , 1974, Patologicheskaia fiziologiia i eksperimental'naia terapiia.

[51]  V. Helgeson,et al.  A meta-analytic review of benefit finding and growth. , 2006, Journal of consulting and clinical psychology.

[52]  Lawrence G. Calhoun,et al.  Trauma and Transformation: Growing in the Aftermath of Suffering , 1995 .

[53]  P. Zak,et al.  Oxytocin is associated with human trustworthiness , 2005, Hormones and Behavior.

[54]  J. Thayer,et al.  Anxiety and autonomic flexibility: a cardiovascular approach. , 1998, Biological psychology.

[55]  D. Hellhammer,et al.  A new view on hypocortisolism , 2005, Psychoneuroendocrinology.

[56]  T. Revenson,et al.  Does coping help? A reexamination of the relation between coping and mental health. , 1987, Journal of personality and social psychology.

[57]  T. Seeman,et al.  Aging and hypothalamic-pituitary-adrenal response to challenge in humans. , 1994, Endocrine reviews.

[58]  Regulatory control and adults' stress-related responses to daily life events. , 1997, Journal of personality and social psychology.

[59]  J. Wardle,et al.  Positive affect and health-related neuroendocrine, cardiovascular, and inflammatory processes. , 2005, Proceedings of the National Academy of Sciences of the United States of America.

[60]  C. R. Snyder,et al.  Handbook of positive psychology , 2002 .

[61]  B. Carr,et al.  Posttraumatic Growth, Immunity and Survival in Patients with Hepatoma , 2007, Digestive Diseases and Sciences.

[62]  A. Stanton,et al.  The yellow brick road and the emerald city: benefit finding, positive reappraisal coping and posttraumatic growth in women with early-stage breast cancer. , 2003, Health psychology : official journal of the Division of Health Psychology, American Psychological Association.

[63]  S. Puttonen,et al.  Cardiac autonomic reactivity and recovery in predicting carotid atherosclerosis: the cardiovascular risk in young Finns study. , 2007, Health psychology : official journal of the Division of Health Psychology, American Psychological Association.

[64]  Jonathan Rottenberg,et al.  Cardiac vagal control in depression: A critical analysis , 2007, Biological Psychology.

[65]  J L Schuler,et al.  Cardiovascular recovery from stress and hypertension risk factors: a meta-analytic review. , 1997, Psychophysiology.

[66]  Andrew H. Miller,et al.  When not enough is too much: the role of insufficient glucocorticoid signaling in the pathophysiology of stress-related disorders. , 2011, The American journal of psychiatry.

[67]  Mary-Frances O'Connor,et al.  Autonomic and emotion regulation in bereavement and depression. , 2002, Journal of psychosomatic research.

[68]  B. Fredrickson,et al.  Positive Emotions Speed Recovery from the Cardiovascular Sequelae of Negative Emotions. , 1998, Cognition & emotion.

[69]  R. Repetti,et al.  Marital satisfaction, recovery from work, and diurnal cortisol among men and women. , 2008, Health psychology : official journal of the Division of Health Psychology, American Psychological Association.

[70]  C. A. Morgan,et al.  Relationship Among Plasma Cortisol, Catecholamines, Neuropeptide Y, and Human Performance During Exposure to Uncontrollable Stress , 2001, Psychosomatic medicine.

[71]  Amy Boyers,et al.  Cognitive-behavioral stress management increases benefit finding and immune function among women with early-stage breast cancer. , 2004, Journal of psychosomatic research.

[72]  C. Carver,et al.  Cognitive-behavioral stress management intervention decreases the prevalence of depression and enhances benefit finding among women under treatment for early-stage breast cancer. , 2001, Health psychology : official journal of the Division of Health Psychology, American Psychological Association.

[73]  R. Tedeschi,et al.  The Posttraumatic Growth Inventory: Measuring the positive legacy of trauma , 1996, Journal of traumatic stress.

[74]  J. Milam Posttraumatic growth and HIV disease progression. , 2006, Journal of consulting and clinical psychology.

[75]  Ned H Kalin,et al.  Affective style and in vivo immune response: Neurobehavioral mechanisms , 2003, Proceedings of the National Academy of Sciences of the United States of America.

[76]  Kevin J. Tracey,et al.  The inflammatory reflex , 2002, Nature.

[77]  T. Kamarck,et al.  Social support reduces cardiovascular reactivity to psychological challenge: a laboratory model. , 1990, Psychosomatic medicine.

[78]  D. Levy,et al.  Impact of reduced heart rate variability on risk for cardiac events. The Framingham Heart Study. , 1996, Circulation.

[79]  C. Kirschbaum,et al.  Chronic psychological stress and the regulation of pro-inflammatory cytokines: a glucocorticoid-resistance model. , 2002, Health psychology : official journal of the Division of Health Psychology, American Psychological Association.

[80]  K. Mccaul,et al.  Winning, losing, mood, and testosterone , 1992, Hormones and Behavior.

[81]  C. Kirschbaum,et al.  Clinical Depression and Regulation of the Inflammatory Response During Acute Stress , 2005, Psychosomatic medicine.

[82]  W T Boyce,et al.  Psychobiologic Reactivity to Stress and Childhood Respiratory Illnesses: Results of Two Prospective Studies , 1995, Psychosomatic medicine.

[83]  D. Vlahov,et al.  Psychological resources protect health: 5-year survival and immune function among HIV-infected women from four US cities , 2006, AIDS.

[84]  E. Schrimshaw,et al.  The Stress Moderating Role of Benefit Finding on Psychological Distress and Well-being among Women Living with HIV/AIDS , 2007, AIDS and Behavior.

[85]  Michael H. Antoni,et al.  Cognitive-Behavioral Stress Management Reduces Serum Cortisol By Enhancing Benefit Finding Among Women Being Treated for Early Stage Breast Cancer , 2000, Psychosomatic medicine.

[86]  D. Carroll,et al.  Blood Pressure Reactions to Acute Psychological Stress and Future Blood Pressure Status: A 10-Year Follow-Up of Men in the Whitehall II Study , 2001, Psychosomatic medicine.

[87]  T. Kamarck,et al.  The effects of the social environment on stress-related cardiovascular activation: Current findings, prospects, and implications , 1998, Annals of behavioral medicine : a publication of the Society of Behavioral Medicine.

[88]  Stephen N. Haynes,et al.  Psychophysiological assessment of poststress recovery , 1991 .

[89]  B. Fredrickson,et al.  Resilient individuals use positive emotions to bounce back from negative emotional experiences. , 2004, Journal of personality and social psychology.

[90]  Lisa M. Johnson,et al.  Positive affect as a source of resilience for women in chronic pain. , 2005, Journal of consulting and clinical psychology.

[91]  M. Marmot,et al.  Psychosocial, Hemostatic, and Inflammatory Correlates of Delayed Poststress Blood Pressure Recovery , 2006, Psychosomatic medicine.

[92]  Bruce S. McEwen,et al.  Embodying Psychological Thriving: Physical Thriving in Response to Stress , 2010 .

[93]  C. Carver,et al.  Cognitive-behavioral stress management intervention decreases the prevalence of depression and enhances benefit finding among women under treatment for early-stage breast cancer. , 2001 .

[94]  Brigitte M. Kudielka,et al.  Exhaustion is associated with reduced habituation of free cortisol responses to repeated acute psychosocial stress , 2006, Biological Psychology.

[95]  M. Irwin,et al.  Inflammatory responses to psychological stress in fatigued breast cancer survivors: Relationship to glucocorticoids , 2007, Brain, Behavior, and Immunity.

[96]  R. Janoff-Bulman Schema-Change Perspectives on Posttraumatic Growth. , 2006 .

[97]  G. Affleck,et al.  Causal attribution, perceived benefits, and morbidity after a heart attack: an 8-year study. , 1987, Journal of consulting and clinical psychology.

[98]  C S Bergeman,et al.  PERSONALITY PROCESSES AND INDIVIDUAL DIFFERENCES Psychological Resilience , Positive Emotions , and Successful Adaptation to Stress in Later Life , 2006 .

[99]  U. Fischbacher,et al.  Oxytocin increases trust in humans , 2005, Nature.