This article was downloaded by: [McMaster University] On: 09 December 2014, At: 11:29 Publisher: Routledge Informa Ltd Registered in England and Wales Registered Number: 1072954 Registered office: Mortimer House, 37-41 Mortimer Street, London W1T 3JH, UK
Aging & Mental Health Publication details, including instructions for authors and subscription information: http://www.tandfonline.com/loi/camh20
Shifting positivity ratios: emotions and psychological health in later life a
a
Joelle C. Ruthig , Jenna Trisko & Judith G. Chipperfield a
b
Department of Psychology, University of North Dakota, Grand Forks, ND, USA
b
Department of Psychology, University of Manitoba, Winnipeg, MB, Canada Published online: 02 Jan 2014.
To cite this article: Joelle C. Ruthig, Jenna Trisko & Judith G. Chipperfield (2014) Shifting positivity ratios: emotions and psychological health in later life, Aging & Mental Health, 18:5, 547-553, DOI: 10.1080/13607863.2013.866633 To link to this article: http://dx.doi.org/10.1080/13607863.2013.866633
PLEASE SCROLL DOWN FOR ARTICLE Taylor & Francis makes every effort to ensure the accuracy of all the information (the “Content”) contained in the publications on our platform. However, Taylor & Francis, our agents, and our licensors make no representations or warranties whatsoever as to the accuracy, completeness, or suitability for any purpose of the Content. Any opinions and views expressed in this publication are the opinions and views of the authors, and are not the views of or endorsed by Taylor & Francis. The accuracy of the Content should not be relied upon and should be independently verified with primary sources of information. Taylor and Francis shall not be liable for any losses, actions, claims, proceedings, demands, costs, expenses, damages, and other liabilities whatsoever or howsoever caused arising directly or indirectly in connection with, in relation to or arising out of the use of the Content. This article may be used for research, teaching, and private study purposes. Any substantial or systematic reproduction, redistribution, reselling, loan, sub-licensing, systematic supply, or distribution in any form to anyone is expressly forbidden. Terms & Conditions of access and use can be found at http:// www.tandfonline.com/page/terms-and-conditions
Aging & Mental Health, 2014 Vol. 18, No. 5, 547–553, http://dx.doi.org/10.1080/13607863.2013.866633
Shifting positivity ratios: emotions and psychological health in later life Joelle C. Ruthiga*, Jenna Triskoa and Judith G. Chipperfieldb a
Department of Psychology, University of North Dakota, Grand Forks, ND, USA; bDepartment of Psychology, University of Manitoba, Winnipeg, MB, Canada
Downloaded by [McMaster University] at 11:29 09 December 2014
(Received 19 July 2013; accepted 6 November 2013) Objective: A positivity ratio of approximately three positive emotions to one negative emotion has been found to distinguish between flourishing and languishing (optimal vs. poor psychological health). The current study assessed 2-year shifts (2008, 2010) in positivity ratios among 295 older adults and considered whether such shifts were associated with concurrent changes in psychological health (perceived stress, depressive symptoms, and perceived control). Method: Based on participants’ reported positive and negative emotions, we identified two positivity ratio groups who were characterized by ratios that did not change, either remaining persistently optimal (above 2.9) or persistently suboptimal, and two groups that depicted shifts in ratios that either became optimal or became suboptimal. Results: Most participants (67%) remained in their initial group, but shifts between categories did occur in both directions. Ratio groups and time (2008 vs. 2010) were predictor variables in 4 2 generalized estimating equations that were computed for each psychological health measure. The hypothesized positivity ratio group time interaction emerged for each psychological health measure. Ratio shifts that ‘became optimal’ were associated with a significant concurrent decrease in stress and an increase in perceived control; ratio shifts that ‘became suboptimal’ were associated with a significant increase in depression. Conclusion: Although older adults who began with a suboptimal positivity ratio were unlikely to experience a shift to an optimal ratio, findings are more encouraging for those who began with an optimal positivity ratio. The majority of these older adults retained optimal positivity ratios over time and appeared to flourish. Keywords: positivity ratios; flourishing; languishing; psychological health; aging
Introduction Ample research has examined the role that positive emotions play in healthy aging (e.g., Benyamini, Idler, Leventhal, & Leventhal, 2000; Pressman & Cohen, 2005; Sch€ uz, Wurm, Sch€ ollgen, & Tesch-R€ omer, 2011). In particular, positive emotions have been linked to slower physical degeneration, better physical functioning, and increased longevity (Ostir, Markides, Black, & Goodwin, 2000; Penninx et al., 2000). Positive emotions may also protect against the detrimental effects of loneliness in later adulthood (Newall, Chipperfield, Bailis, & Stewart, 2013). The broaden and build theory (Fredrickson, 2001, 2004) provides an empirically supported explanation for these benefits of positive emotions. According to the theory, positive emotions enable the expansion of thought and action resources through higher order cognitive processes (Fredrickson & Losada, 2005). The resulting cognitive expansion and behavioral flexibility gradually build over time. Thus, despite the transient nature of positive emotions, their benefits accumulate and compound to predict resilience and flourishing mental health. Accordingly, positive emotions not only mark current well-being (Diener, 2000) but also contribute to future well-being (Frederickson, 2001; Fredrickson & Joiner, 2002). In contrast to the demonstrated benefits of positive emotions, negative emotions are associated with poorer *Corresponding author. Email: [email protected] Ó 2013 Taylor & Francis
health and well-being in terms of depression, anxiety, poor coping, chronic health conditions, and increased risk of mortality (Chipperfield, Perry, & Weiner, 2003; Hu & Gruber, 2008; Leventhal, Hansell, & Diefenbach, 1996; Newall et al., 2013). In fact, the detriment of negative emotions is thought to be more potent than the benefits of positive emotions (Rozin & Royzman, 2001). This stems from the notion that although people are often exposed to more positive than negative events, experiencing negative events tends to have a ‘contagion and contamination’ effect on previous positivity (Rozin & Royzman, 2001) or more simply put that ‘bad is stronger than good’ (Baumeister, Bratslavsky, Finkenauer, & Vohs, 2001). As a result, positive emotions need to outnumber negative emotions in order for ‘good to overcome bad,’ allowing individuals to flourish and to benefit from positive emotions (Larsen & Prizmic, 2008). Fredrickson and Losada (2005) sought to examine if such a positivity ratio exists at which point an individual can achieve optimal functioning. They identified a critical ratio of positive to negative emotions of 2.9, or approximately three positive emotions to one negative emotion. This positivity ratio was indicative of ‘flourishing,’ depicting the ability ‘to live within an optimal range of human functioning, one that connotes goodness, generativity, growth, and resilience’ (p. 678). In contrast, individuals with a suboptimal positivity ratio below 2.9 were
Downloaded by [McMaster University] at 11:29 09 December 2014
548
J.C. Ruthig et al.
described as ‘languishing’; they perceived their lives as empty and unsatisfying, often felt incapable, and lacked strong social networks (Keyes, 2002). Additional research supports the notion that this ratio (the balance between positive and negative emotions) better predicts optimal functioning than do positive and negative emotions as assessed separately (Schwartz et al., 2002). Moreover, despite recent work (Brown, Sokal, & Friedman, 2013) that questions the validity of the mathematical formulas on which the precise critical ratio of 2.9 is based (Fredrickson & Losada, 2005), studies have indicated that a ratio of approximately three positive emotions to one negative emotion can distinguish between good and poor subjective well-being in a variety of contexts. For example, Shrira et al. (2011) examined positivity ratios among individuals under stress (i.e., cancer patients and hospital personnel exposed to missile attacks). Results for both groups supported Fredrickson and Losada’s (2005) positivity ratio of 2.9 for optimal functioning. Other cross-sectional research by Diehl, Hay, and Berg (2011) determined whether the positivity ratio applied across the adult life span by assessing daily positive and negative emotions among young (18–39), middle aged (40–59), and older adults (60–89). An optimal positivity ratio adequately distinguished mental health status for younger adults more so than for middle aged or older adults. In another study, the critical value of 2.9 adequately differentiated those who were flourishing from those who were languishing in two diverse samples of older adults, those who were living within the community and those who had chronic health conditions and resided in a personal care home (Meeks, Van Haitsma, Kostiwa, & Murrell, 2012). Together, past research demonstrates that a positivity ratio of approximately three positive emotions to one negative emotion is optimal for functioning and well-being among adults. Although prior research has examined changes in emotions throughout adulthood (Carstensen et al., 2011; Charles, Reynolds, & Gatz, 2001; Isaacowitz & Blanchard-Fields, 2012), it is unknown if or how positivity ratios change for older adults. For example, do downward shifts in positivity ratios occur over time so that those who initially have optimal ratios become ‘suboptimal’ by falling below that critical value of 2.9, or can those who initially have suboptimal ratios experience an upward shift to become optimal? More importantly, given that shifts above and below the optimal positivity ratio should also reflect shifts between flourishing and languishing (Fredrickson & Losada, 2005), do shifts in positivity ratios correspond with significant changes in psychological health? To expand upon past positivity ratio research, the current longitudinal study documented intra-individual changes in positivity ratios over a 2-year period among a sample of community-dwelling older adults. The first descriptive objective was to simply determine the extent to which older individuals experience shifts from above the optimal positivity ratio to a suboptimal positivity ratio (from flourishing to languishing) or from a suboptimal to an above-optimal ratio (from languishing to flourishing).
A second objective was to examine whether such shifts in positivity ratios are associated with concurrent changes in psychological health. In examining this unexplored topic of within-group change as recommended by Meeks et al. (2012), we hypothesized that individuals who had ratios that ‘became optimal’ would show decreased stress and depression as well as increased perceived control. Conversely, individuals characterized by ratios that ‘became suboptimal’ were expected to have significant increases in stress and depression as well as a diminished sense of control. Because our analysis allowed us to compare the ratio groups both initially (2008) and later (2010), we were also able to examine between group differences in psychological health at each time. This allowed us to ask, for example, do adults who have initially suboptimal ratios but shift to become optimal over time enjoy the same level of psychological health as those with persistently optimal ratios? Likewise, is a shift from an optimal to suboptimal positivity ratio more or less detrimental to psychological health than a persistently suboptimal ratio? Given that the positivity ratio is useful in discriminating psychological health status (Fredrickson & Losada, 2005; Meeks et al., 2012), addressing the current study objectives will enable greater insight into potential shifts in psychological health that may correspond with changing positivity ratios in later adulthood. Method Participants and procedure In 2008, 489 older adults completed written informed consent and measures of their recent positive and negative emotions as part of a larger study on healthy aging (for details see Ruthig, Hanson, Pedersen, Weber, & Chipperfield, 2011). All participants were living independently within the community. Participants provided self-reports during either a 1-hour, in-person interview (82%, n ¼ 400) or a written mailed survey (n ¼ 89) that included identical measures of perceived stress, depressive symptoms, and perceived control. In 2010, 431 (88%) participants were re-interviewed and again completed the same measures of their recent positive and negative emotions, perceived stress, depressive symptoms, and perceived control. Reasons for not completing the follow-up interview varied: 4 participants could not be reached, 11 were deceased, and 43 declined to participate because they were too busy, not interested, or too ill. One-way analyses of variance (ANOVAs) indicated that returning participants did not significantly differ from non-returning participants in their initial (2008) positive emotions [M ¼ 44.94 vs. 44.44, F(1, 479) ¼ 0.19, ns] or negative emotions [M ¼ 12.29 vs. 13.35, F(1, 483) ¼ 0.69, ns]. Of the returning participants, 339 (79%) were interviewed in person and 92 (21%) completed identical mailed surveys. Preliminary ANOVAs indicated that participants who completed interviews vs. mailed surveys did not significantly differ in any of the demographic, emotion, or psychological health variables in either 2008 or 2010. Of those who were re-interviewed, 17 participants did not
Aging & Mental Health complete one or more of the study measures, leaving 414 participants who completed all study measures at both times 1 and 2. Participants received monetary compensation for in each wave of the study.
Downloaded by [McMaster University] at 11:29 09 December 2014
Measures Emotions The study utilized a measure of discrete recent emotions (Chipperfield et al., 2003) consisting of six positive emotions (e.g., happy, proud) and eight negative emotions (e.g., sad, bored). Eight additional emotions were added for the purpose of the current study: four positive emotions (compassion, inspired, excited, and love) and four negative emotions (nervous, irritable, humiliated, and lonely), for a total of 10 positive emotions and 12 negative emotions. For example, participants were asked ‘During the past two days, how often have you felt happy?’ with possible responses ranging from 0 (never) through 6 (almost always). To classify emotions as ‘present’ in our study, we used a less stringent criterion for negative than for positive emotions. This approach is consistent with past positivity ratio research (Diehl et al., 2011; Fredrickson & Losada, 2005) and is justifiable given that older adults typically experience at least mild positive emotion much of the time, whereas negative emotions tend to be stronger than positive emotions (Cacioppo, Gardner, & Berntson, 1999). Specifically, for an emotion to be classified a ‘present,’ we used a cut-off of 3 for positive emotions and 2 for negative emotions. For each participant, we then summed over the positive and negative emotions that were present to create a total positive emotion score (possible range ¼ 0–10) and a total negative emotion score (possible range ¼ 0–12). Separate positivity ratio scores in 2008 and in 2010 were then created for each participant by dividing his/her total negative emotion score by his/her total positive emotion score. For example, a participant with seven positive and two negative emotions would have a ratio of 3.5. Positivity ratios could not be computed for 87 participants in 2008 and 32 participants in 2010 who had a total negative emotions score of 0 (i.e., a number cannot be divided by zero). Consequently, they were excluded from further analysis, leaving a total of 295 participants on which all subsequent analyses are based.
549
The 2008 and 2010 positivity ratios were used to create a four-level variable for subsequent analyses. Optimal ratios (above 2.9) in 2008 that remained optimal in 2010 were labeled as persistently optimal; initial optimal ratios that dropped below 2.9 were categorized as became suboptimal. Of ratios that were suboptimal in 2008, those that remained suboptimal were persistently suboptimal; those that rose above 2.9 by 2010 were categorized as became optimal. Perceived stress Participants’ perceived stress was measured using seven items from Cohen, Kamarck, and Mermelstein’s (1983) measure of global perceived stress. For example, ‘During the last month how often have you been upset because of something that happened unexpectedly?’ Responses to each item ranging from 1 (never) through 5 (very often) were summed so that higher total scores were indicative of higher stress. Depressive symptoms As a measure of depressive symptoms, participants responded to the 10-item Center for Epidemiological Studies Short Depression Scale (CES-D 10; Andresen, Malmgren, Carter, & Patrick, 1994). For example, ‘how often in the past week have you been bothered by things that don’t usually bother you?’ (Response range: 0 ¼ rarely or none of the time; 3 ¼ most or all of the time). After responses to two items (‘felt hopeful about the future’ and ‘were happy’) were reversed, all item responses were summed so that higher total scores reflected more depressive symptoms. Perceived control Participants responded to an 8-item measure of perceptions of control over various aspects of their life (Chipperfield, Campbell, & Perry, 2004). For example, ‘How much influence do you feel you have over your life in general?’ Responses ranged from 1 (almost no influence) through 10 (total influence). Consistent with Chipperfield et al. (2004), each participant’s mean perceived control score was calculated based on their ratings of all eight items. Table 1 presents a summary of the descriptive statistics for all study variables in both 2008 and 2010.
Table 1. Descriptive statistics of all study variables in 2008 and 2010. 2008
2010
Variable
M (n)
SD (%)
Range
alpha
M (n)
SD (%)
Range
alpha
Gender (male) Age Positive emotions Negative emotions Positivity ratio Perceived stress Depressive symptoms Perceived control
(131) 70.03 9.18 4.75 3.53 16.35 4.93 7.76
(44.4%) 7.78 1.36 3.07 3.00 3.97 4.17 1.28
– 56–98 0–10 1–12 0–10 7–34 0–25 2.25–10.00
– – – – – .78 .79 .86
(131) 72.00 8.83 4.64 3.14 16.13 5.84 7.86
(44.4%) 7.74 1.77 3.10 2.67 4.03 4.48 1.12
– 58 0–10 1–12 0–10 7–33 0–23 3.88–10.00
– – – – – .80 .82 .87
550
J.C. Ruthig et al.
Downloaded by [McMaster University] at 11:29 09 December 2014
Results Shifts in positivity ratio Although the theoretical cut-off distinguishing optimal from suboptimal ratios is 2.9 (Fredrickson & Losada, 2005), no participants in the current sample had a positivity ratio within the range of 2.68–2.90 in either 2008 or 2010. Accordingly, optimal positivity ratios were classified as those ratios that were 3.0 or higher and suboptimal positivity ratios were classified as those ratios that were 2.67 or lower. In 2008, fewer participants had optimal positivity ratios than suboptimal ratios (41.7% vs. 58.3%). Regarding whether changes in positivity ratio group membership occurred over time, the majority of participants (66.8%) remained in their initial ratio group over the 2year period; however, there were both upward and downward shifts. Of those older adults with initially optimal ratios, 71 (58%) were persistently optimal and 52 (42%) became suboptimal. Among the group that became suboptimal, downward shifts in ratios over the 2-year period ranged from a minimum decrease of 0.75 to a maximum decrease of 9.20 (mean shift ¼ 4.51, SD ¼ 2.80). For participants whose ratios were suboptimal in 2008, the majority (73% or 126) were persistently suboptimal, while 46 (27%) became optimal by 2010, with their upward shifts in ratios ranging from a minimum increase of 0.75 to a maximum increase of 9.09 (mean shift ¼ 3.21, SD ¼ 2.16).
Figure 1. Positivity ratio (PR) group differences and changes in perceived stress across a 2-year period.
corresponds with reduced stress: those whose ratios became optimal across the 2-year period experienced a significant decrease in stress [time 1: M ¼ 17.40, 95% CI (11.29, 46.08) vs. time 2: M ¼ 15.42, 95% CI (13.12, 43.96), p < .001]. Moreover, despite having similarly high levels of initial stress, the between-group comparisons at time 2 revealed that those who became optimal experienced significantly less stress than the persistently suboptimal group [M ¼ 15.42, 95% CI (13.12, 43.96) vs. M ¼ 17.81, 95% CI (10.44, 46.070], p < .001. Depressive symptoms
Shifts in positivity ratios and psychological health To establish whether shifts in positivity ratios were associated with corresponding changes in psychological health, positivity ratio group (i.e., persistently optimal, persistently suboptimal, became optimal, became suboptimal) served as a predictor, along with time (2008 vs. 2010), in separate 4 2 generalized estimating equations (GEEs; Zeger & Liang, 1986) that were computed for each psychological-health-dependent measure of perceived stress, depressive symptoms, and perceived control. Each GEE also included participants’ age and gender as covariates. These equations enabled the examination of possible differences in psychological health between the positivity groups (between group differences) and over time (within group change), as well as whether the group differences interact with time. When significant interactions emerged, select post hoc tests were conducted to better understand where the differences occurred.
The overall model for depressive symptoms yielded significant main effects for time: Wald x2(1) ¼ 6.30, p ¼ .012; gender: Wald x2(1) ¼ 5.15, p ¼ .023; age: Wald x2(1) ¼ 5.97, p ¼ .015; and positivity ratio group: Wald x2(3) ¼ 82.28, p < .001. Participants reported more depressive symptoms at time 2, and women, older participants, and the persistently suboptimal group reported more depressive symptoms overall. Similar to the findings for perceived stress, there was a significant interaction between positivity ratio group and time on depressive symptoms: Wald x2(3) ¼ 13.08, p ¼ .004 (see Figure 2). Pairwise comparisons indicated that those whose positivity ratios became suboptimal experienced a significant
Perceived stress The overall GEE for perceived stress indicated significant main effects for gender and positivity ratio group. The highest levels of stress were found for women (Wald x2(1) ¼ 7.45, p ¼ .006) and for those with persistently suboptimal ratios (Wald x2(3) ¼ 68.60, p < .001). As shown in Figure 1, a significant between group by within group interaction emerged for positivity ratio group and time: Wald x2(3) ¼ 19.80, p ¼ .001. As expected, pairwise comparisons suggest that becoming optimal
Figure 2. Positivity ratio (PR) group differences and changes in depressive symptoms across a 2-year period.
Aging & Mental Health increase in depression from time 1 to time 2 [M ¼ 3.68, 95% CI (25.70, 33.05) vs. M ¼ 5.38, 95% CI (23.89, 34.64), p ¼ .004]. Although the group whose positivity ratios became optimal did not experience a significant decrease in depressive symptoms from time 1 to time 2, at time 2, they did report significantly fewer depressive symptoms than the persistently suboptimal group [became optimal: M ¼ 17.40, 95% CI (11.29, 46.08) vs. persistently suboptimal: M ¼ 7.63, 95% CI (21.53, 36.78), p ¼ .001]. Thus, a suboptimal positivity ratio was associated with greater depressive symptomology and ratios that became suboptimal were associated with a significant increase in depressive symptoms over the 2-year time frame.
Downloaded by [McMaster University] at 11:29 09 December 2014
Perceived control The overall GEE for perceived control indicated significant main effects for age: Wald x2(1) ¼ 15.94, p ¼ .015 and positivity ratio group: Wald x2(3) ¼ 51.15, p < .001. Younger participants and those whose positivity ratios were persistently optimal reported greater perceived control overall. The pattern of the interaction between positivity ratio group and time on perceptions of control was consistent with the findings for perceived stress and depressive symptoms (see Figure 3), but the interaction was not statistically significant [Wald x2(3) ¼ 6.79, p ¼ .079]. Importantly, at time 2, participants whose positivity ratios became optimal enjoyed high levels of perceived control that did not differ from those whose ratios were persistently optimal (M ¼ 8.10 vs. 8.37, p ¼ .11). This is notable in light of the significantly lower time 1 perceived control for the group that became optimal [M ¼ 7.85, 95% CI (1.12, 16.83)] vs. the persistently optimal group [M ¼ 8.34, 95% CI (0.63, 17.32), p ¼ .004]. Thus, optimal positivity ratios were associated with higher levels of perceived control.
Discussion Our examination of intra-individual shifts in older adults’ positivity ratios over a 2-year period builds upon past cross-sectional research (Diehl et al., 2011; Shrira et al., 2011). Initially, more participants were classified as
Figure 3. Positivity ratio (PR) group differences and changes in perceived control across a 2-year period.
551
suboptimal than optimal in their positivity ratios. Stability over the 2 years was more likely than change, with the majority of participants remaining in their initial optimal or suboptimal category. An encouraging message from these findings is that older adults who are experiencing the benefits of an optimal positivity ratio have a good chance of continuing to enjoy those benefits, at least over the next couple of years. Nonetheless, a less encouraging message is implied in the stability over time that was shown for 73% of those initially classified as being suboptimal. Despite the majority of older adults remaining in the persistently optimal or suboptimal ratio groups, shifts did occur in both directions. Notably, many older adults with suboptimal ratios (approximately 43%) shifted toward becoming optimal within the 2-year period of the study. Also, as subsequently discussed, our analyses suggest that shifts toward optimal ratios are adaptive and shifts toward suboptimal ratios are maladaptive in terms of psychological health. Positivity ratios and psychological health Consistent with past research (Meeks et al., 2012), our findings support using a positivity ratio of approximately three positive emotions to one negative emotion as an indicator of psychological health that distinguishes older adults who are flourishing from those who are languishing (Fredrickson & Losada, 2005). Overall, optimal ratios corresponded to better psychological health in terms of lower stress, fewer depressive symptoms, and greater perceived control, and those with persistently optimal ratios had the best psychological health. In contrast, suboptimal positivity ratios were associated with greater stress, more depressive symptoms, and low perceived control, and those with persistently suboptimal ratios had the worst psychological health over the 2-year period. Moreover, despite being based on a convenience sample of older adults, these findings are consistent with other research on positivity ratios among larger representative samples of older adults residing in the community (e.g., Meeks et al., 2012). Importantly, because none of the current participants had a positivity ratio of 2.8, we could not assess psychological health differences based on the critical ‘tipping point’ of ratios directly above or below 2.9 (Fredrickson & Losada, 2005) that has been questioned in recent research (Brown et al., 2013). It should also be acknowledged that the way in which positivity ratios are calculated has varied across studies in terms of the number, types, and frequency of positive and negative emotions assessed (e.g., Diehl et al., 2011; Fredrickson & Losada, 2005; Meeks et al., 2012); thus, a cut-off score of 2.9 is unlikely to represent precisely the same thing across different studies. As Fredrickson (2013) conceded, further research is needed to better understand the exact ‘tipping’ points of positivity ratios. Nonetheless, our research adds to the growing empirical support for the value of using positivity ratios as an index of psychological health among older adults.
Downloaded by [McMaster University] at 11:29 09 December 2014
552
J.C. Ruthig et al.
Unique to our study was the assessment of whether shifts in positivity ratios corresponded with changes in psychological health over the 2-year period. We showed that individuals can shift upward to an optimal positivity ratio and that such shifts correspond to enhanced psychological health. Therefore, as Meeks et al. (2012) suggested, if positivity ratios can be manipulated via directly targeting positive or negative emotions, older adults with suboptimal ratios and poor initial psychological health have the possibility of experiencing improved psychological health and ‘flourishing’ in the future. Contrary to the psychological benefits of ratios that became optimal, downward shifts from optimal to suboptimal ratios were associated with significantly diminished psychological health over the 2-year period in terms of increased depressive symptoms. This increase reflects either additional or more frequent depressive symptoms such as restless sleep, trouble concentrating, and inability to ‘get going’. Moreover, this ‘became suboptimal’ group also reported significantly more stress and less perceived control at time 2 compared to those whose ratios were persistently optimal. Together, these findings indicate that some older adults who are flourishing may be in danger of a decline in psychological health that accompanies downward shifts in positivity ratios. Given that positivity ratios can shift in either direction, and that such shifts are accompanied by enhanced or diminished psychological health, a critical next step in this research is to identify the mechanisms that cause changes in ratios. In particular, coping strategies, social support, changes in physical health, or certain life events may impact the balance of some older individuals’ positive and negative emotions. For example, diagnosis of a terminal illness or experiencing the death of a loved one may cause a shift from an optimal to suboptimal positivity ratio in some older adults. Another possibility pertains to changes in older adults’ cognitive processing of emotionally positive and negative stimuli. Brain imaging research indicates that older adults’ amygdala showed heightened activity in response to positive but not negative materials, suggesting that there is an age-related decline in encoding of negative stimuli (Carstensen, 2006). Perhaps the rate at which older adults diminish encoding of negative stimuli varies and such variability may explain individual differences in positivity ratio shifts. Further research on these and other possible mechanisms of change in positivity ratios would help to distinguish between adults who will continue to enjoy the psychological benefits of optimal ratios and those whose ratios will become suboptimal. This distinction would facilitate anticipating which older adults are at risk of experiencing a downward shift in positivity ratio and shielding them from corresponding harm to their psychological health. This research would also help to distinguish among individuals with suboptimal ratios, in terms of who will shift towards optimal ratios and who will retain suboptimal ratios. Together, these next steps will be valuable in identifying older adults who will be in need of psychological support and those who are likely to be more resilient.
A limitation of this study is that it only included two assessments of positivity ratios and psychological health. Despite evidence that emotions become increasingly stable in later adulthood (Carstensen, Pasupathi, Mayr, & Nesselroade, 2000; Mroczek, 2001), the day-to-day stability of older individuals’ positivity ratios is unknown. Thus, the fundamental meaning of a single shift in positivity ratios over a 2-year period remains unclear. For example, some older adults’ ratios may remain fairly stable from day to day whereas others may experience recurrent shifts. A longitudinal study that incorporates more frequent assessments could determine whether some older adults’ positivity ratios shift multiple times, as well as the frequency and degree of those shifts. Such research could also identify how such patterns in positivity ratio shifts relate to older adults’ psychological health. Another limitation of the present study is that all measures of emotion and psychological health were based on self-reports. As such, it is possible that some responses to the psychological health measures were biased by participants’ current emotional states. Moreover, one would expect, and past research (Lyubomirsky, King, & Diener, 2005) would suggest, some overlap between our emotion measures and psychological health measures. However, supplemental analyses indicated that correlations between participants’ positivity ratios and their psychological health measures were small in magnitude (i.e., ranging from .23 to .35). This suggests that responses to the psychological health measures were not overly biased by current emotional states and that the measures of emotion and well-being, though related, were conceptualized as separate constructs by our respondents. Nonetheless, subsequent research should incorporate non-self-report measures of emotion and psychological health when attempting to replicate the current findings. Lastly, because we assessed emotions and psychological health at the same points in time, the causal direction of the relationship between shifts in positivity ratios and corresponding changes in psychological health cannot be determined by the present findings. It is possible that changes in psychological health preceded shifts in positivity ratios and the direction of this causal relationship needs to be clarified in subsequent studies. Although more research is needed, the current findings indicate that positivity ratios do change for some older adults and these ratio shifts can signal enhanced or diminished psychological health over time. These findings are congruent with the notion that positivity ratios effectively capture flourishing or languishing.
References Andresen, E.M., Malmgren, J.A., Carter, W.B., & Patrick, D.L. (1994). Screening for depression in well older adults: Evaluation of a short form of the CES-D. American Journal of Preventative Medicine, 10, 77–84. Baumeister, R.F., Bratslavsky, E., Finkenauer, C., & Vohs, K.D. (2001). Bad is stronger than good. Review of General Psychology, 5, 323–370. Benyamini, Y., Idler, E.L., Leventhal, H., & Leventhal, E.A. (2000). Positive affect and function as influences on
Downloaded by [McMaster University] at 11:29 09 December 2014
Aging & Mental Health self-assessments of health: Expanding our view beyond illness and disability. Journal of Gerontology: Psychological Sciences, 55B, 107–116. Brown, N.J.L., Sokal, A.D., & Friedman, H.L. (2013). The complex dynamics of wishful thinking: The critical positivity ratio. American Psychologist. Advance online publication. doi:10.1037/a0032850 Cacioppo, J.T., Gardner, W.L., & Berntson, G.G. (1999). The affect system has parallel and integrative processing components: Form follows function. Journal of Personality and Social Psychology, 76, 839–855. Carstensen, L.L. (2006). The influence of a sense of time on human development. Science, 312, 1913–1915. Carstensen, L.L., Pasupathi, M., Mayr, U., & Nesselroade, J.R. (2000). Emotional experience in everyday life across the adult life span. Journal of Personality and Social Psychology, 79, 644–655. Carstensen, L.L., Turan, B., Scheibe, S., Ram, N., Ersner-Hershfield, H., Samanez-Larkin, . . . Nesselroade, J.R. (2011). Emotional experience improves with age: Evidence based on over 10 years of experience sampling. Psychology and Aging, 26, 21–33. Charles, S.T., Reynolds, C.A., & Gatz, M. (2001). Age-related differences and change in positive and negative affect over 23 years. Journal of Personality and Social Psychology, 80, 136–151. Chipperfield, J.G., Campbell, D.W., & Perry, R.P. (2004). Stability in perceived control: Implications for health among very old community-dwelling adults. Journal of Aging and Health, 16, 116–147. Chipperfield, J.G., Perry, R.P., & Weiner, B. (2003). Discrete emotions in later life. The Journals of Gerontology – Series B, 58, 23–34. Cohen, S., Kamarck, T., & Mermelstein, R. (1983). A global measure of perceived stress. Journal of Health and Social Behavior, 24, 385–396. Diehl, M., Hay, E.L., & Berg, K.M. (2011). The ratio between positive and negative affect and flourishing mental health across adulthood. Aging & Mental Health, 15, 882–893. Diener, E. (2000). Subjective well-being: The science of happiness and a proposal for a national index. American Psychologist, 55, 34–43. Fredrickson, B.L. (2001). The role of positive emotions in positive psychology: The broaden-and-build theory of positive emotions. American Psychologist, 56, 218–226. Fredrickson, B.L. (2004). The broaden-and-build theory of positive emotions. Philosophical Transactions: Biological Sciences, 359, 1367–1377. Fredrickson, B.L. (2013). Updated thinking on positivity ratios. American Psychologist. Advance online publication. doi:10.1037/a0033584 Fredrickson, B.L., & Joiner, T. (2002). Positive emotions trigger upward spirals toward emotional well-being. Psychological Science, 13, 172–175. Fredrickson, B.L., & Losada, M.F. (2005). Positive affect and the complex dynamics of human flourishing. American Psychologist, 60, 678–686. Hu, J., & Gruber, K.J. (2008). Positive and negative affect and health functioning indicators among older adults with chronic illnesses. Issues in Mental Health Nursing, 29, 895–911.
553
Isaacowitz, D.M., & Blanchard-Fields, F. (2012). Linking process and outcome in the study of emotion and aging. Perspectives on Psychological Science, 7, 3–17. Keyes, C.L.M. (2002). The mental health continuum: From languishing to flourishing in life. Journal of Health and Social Behavior, 43, 207–222. Larsen, R.J., & Prizmic, Z. (2008). Regulation of emotional well-being: Overcoming the hedonic treadmill. In M. Eid & R.J. Larson (Eds.), The science of subjective well-being (pp. 258–289). New York: Guilford. Leventhal, E.A., Hansell, S.H., & Diefenbach, D. (1996). Negative affect and self-report of symptoms: Two longitudinal studies of older adults. Health Psychology, 15, 193–199. Lyubomirsky, S., King, L., & Diener, E. (2005). The benefits of frequent positive affect: Does happiness lead to success? Psychological Bulletin, 131, 803–855. Meeks, S., Van Haitsma, K., Kostiwa, I., & Murrell, S.A. (2012). Positivity and well-being among community-residing elders and nursing home residents: What is the optimal affect balance? Journal of Gerontology: Psychological Sciences, 67B, 460–467. Mroczek, D.K. (2001). Age and emotion in adulthood. Current Directions in Psychological Science, 10, 87–90. Newall, N.E., Chipperfield, J.G., Bailis, D.S., & Stewart, T.L. (2013). Consequences of loneliness on physical activity and mortality in older adults and the power of positive emotions. Health Psychology, 32, 921–924. Ostir, G.V., Markides, K.S., Black, S.A., & Goodwin, J.S. (2000). Emotional well-being predicts subsequent functional independence and survival. Journal of the American Geriatrics Society, 48, 473–478. Penninx, B.W., Guralnik, J.M., Bandeen-Roche, K., Kasper, J.D., Simonsick, E.M., Ferrucci, L., & Fried, L.P. (2000). The protective effect of emotional vitality on adverse health outcomes in disabled older women. Journal of the American Geriatric Society, 48, 1359–1366. Pressman, S.D., & Cohen, S. (2005). Does positive affect influence health? Psychological Bulletin, 131, 925–971. Rozin, P., & Royzman, E.B. (2001). Negativity bias, negativity dominance, and contagion. Personality and Social Psychology Review, 5, 296–320. Ruthig, J.C., Hanson, B.L., Pedersen, H., Weber, A., & Chipperfield, J.G. (2011). Later life health optimism, pessimism and realism: Psychosocial contributors and health correlates. Psychology & Health, 26, 835–853. Sch€ uz, B., Wurm, S., Sch€ ollgen, I., & Tesch-R€ omer, C. (2011). What do people include when they self-rate their health? Differential associations according to health status in community-dwelling older adults. Quality of Life Research, 20, 1573–1580. Schwartz, R.M., Reynolds, C.F., III, Thase, M.E., Frank, E., Fasiczka, A.L., & Haaga, D.A.F. (2002). Optimal and normal affect balance in psychotherapy of major depression: Evaluation of the balanced states of mind model. Behavioral and Cognitive Psychotherapy, 30, 439–450. Shrira, A., Palgi, Y., Wolf, J.J., Haber, Y., Goldray, O., ShachamShmueli, E., & Ben-Ezra, M. (2011). The positivity ratio and functioning under stress. Stress and Health, 27, 265–271. Zeger, S.L., & Liang, K-Y. (1986). Longitudinal data analysis for discrete and continuous outcomes. Biometrics, 42, 121–130.
Aging & Mental Health Publication details, including instructions for authors and subscription information: http://www.tandfonline.com/loi/camh20
Shifting positivity ratios: emotions and psychological health in later life a
a
Joelle C. Ruthig , Jenna Trisko & Judith G. Chipperfield a
b
Department of Psychology, University of North Dakota, Grand Forks, ND, USA
b
Department of Psychology, University of Manitoba, Winnipeg, MB, Canada Published online: 02 Jan 2014.
To cite this article: Joelle C. Ruthig, Jenna Trisko & Judith G. Chipperfield (2014) Shifting positivity ratios: emotions and psychological health in later life, Aging & Mental Health, 18:5, 547-553, DOI: 10.1080/13607863.2013.866633 To link to this article: http://dx.doi.org/10.1080/13607863.2013.866633
PLEASE SCROLL DOWN FOR ARTICLE Taylor & Francis makes every effort to ensure the accuracy of all the information (the “Content”) contained in the publications on our platform. However, Taylor & Francis, our agents, and our licensors make no representations or warranties whatsoever as to the accuracy, completeness, or suitability for any purpose of the Content. Any opinions and views expressed in this publication are the opinions and views of the authors, and are not the views of or endorsed by Taylor & Francis. The accuracy of the Content should not be relied upon and should be independently verified with primary sources of information. Taylor and Francis shall not be liable for any losses, actions, claims, proceedings, demands, costs, expenses, damages, and other liabilities whatsoever or howsoever caused arising directly or indirectly in connection with, in relation to or arising out of the use of the Content. This article may be used for research, teaching, and private study purposes. Any substantial or systematic reproduction, redistribution, reselling, loan, sub-licensing, systematic supply, or distribution in any form to anyone is expressly forbidden. Terms & Conditions of access and use can be found at http:// www.tandfonline.com/page/terms-and-conditions
Aging & Mental Health, 2014 Vol. 18, No. 5, 547–553, http://dx.doi.org/10.1080/13607863.2013.866633
Shifting positivity ratios: emotions and psychological health in later life Joelle C. Ruthiga*, Jenna Triskoa and Judith G. Chipperfieldb a
Department of Psychology, University of North Dakota, Grand Forks, ND, USA; bDepartment of Psychology, University of Manitoba, Winnipeg, MB, Canada
Downloaded by [McMaster University] at 11:29 09 December 2014
(Received 19 July 2013; accepted 6 November 2013) Objective: A positivity ratio of approximately three positive emotions to one negative emotion has been found to distinguish between flourishing and languishing (optimal vs. poor psychological health). The current study assessed 2-year shifts (2008, 2010) in positivity ratios among 295 older adults and considered whether such shifts were associated with concurrent changes in psychological health (perceived stress, depressive symptoms, and perceived control). Method: Based on participants’ reported positive and negative emotions, we identified two positivity ratio groups who were characterized by ratios that did not change, either remaining persistently optimal (above 2.9) or persistently suboptimal, and two groups that depicted shifts in ratios that either became optimal or became suboptimal. Results: Most participants (67%) remained in their initial group, but shifts between categories did occur in both directions. Ratio groups and time (2008 vs. 2010) were predictor variables in 4 2 generalized estimating equations that were computed for each psychological health measure. The hypothesized positivity ratio group time interaction emerged for each psychological health measure. Ratio shifts that ‘became optimal’ were associated with a significant concurrent decrease in stress and an increase in perceived control; ratio shifts that ‘became suboptimal’ were associated with a significant increase in depression. Conclusion: Although older adults who began with a suboptimal positivity ratio were unlikely to experience a shift to an optimal ratio, findings are more encouraging for those who began with an optimal positivity ratio. The majority of these older adults retained optimal positivity ratios over time and appeared to flourish. Keywords: positivity ratios; flourishing; languishing; psychological health; aging
Introduction Ample research has examined the role that positive emotions play in healthy aging (e.g., Benyamini, Idler, Leventhal, & Leventhal, 2000; Pressman & Cohen, 2005; Sch€ uz, Wurm, Sch€ ollgen, & Tesch-R€ omer, 2011). In particular, positive emotions have been linked to slower physical degeneration, better physical functioning, and increased longevity (Ostir, Markides, Black, & Goodwin, 2000; Penninx et al., 2000). Positive emotions may also protect against the detrimental effects of loneliness in later adulthood (Newall, Chipperfield, Bailis, & Stewart, 2013). The broaden and build theory (Fredrickson, 2001, 2004) provides an empirically supported explanation for these benefits of positive emotions. According to the theory, positive emotions enable the expansion of thought and action resources through higher order cognitive processes (Fredrickson & Losada, 2005). The resulting cognitive expansion and behavioral flexibility gradually build over time. Thus, despite the transient nature of positive emotions, their benefits accumulate and compound to predict resilience and flourishing mental health. Accordingly, positive emotions not only mark current well-being (Diener, 2000) but also contribute to future well-being (Frederickson, 2001; Fredrickson & Joiner, 2002). In contrast to the demonstrated benefits of positive emotions, negative emotions are associated with poorer *Corresponding author. Email: [email protected] Ó 2013 Taylor & Francis
health and well-being in terms of depression, anxiety, poor coping, chronic health conditions, and increased risk of mortality (Chipperfield, Perry, & Weiner, 2003; Hu & Gruber, 2008; Leventhal, Hansell, & Diefenbach, 1996; Newall et al., 2013). In fact, the detriment of negative emotions is thought to be more potent than the benefits of positive emotions (Rozin & Royzman, 2001). This stems from the notion that although people are often exposed to more positive than negative events, experiencing negative events tends to have a ‘contagion and contamination’ effect on previous positivity (Rozin & Royzman, 2001) or more simply put that ‘bad is stronger than good’ (Baumeister, Bratslavsky, Finkenauer, & Vohs, 2001). As a result, positive emotions need to outnumber negative emotions in order for ‘good to overcome bad,’ allowing individuals to flourish and to benefit from positive emotions (Larsen & Prizmic, 2008). Fredrickson and Losada (2005) sought to examine if such a positivity ratio exists at which point an individual can achieve optimal functioning. They identified a critical ratio of positive to negative emotions of 2.9, or approximately three positive emotions to one negative emotion. This positivity ratio was indicative of ‘flourishing,’ depicting the ability ‘to live within an optimal range of human functioning, one that connotes goodness, generativity, growth, and resilience’ (p. 678). In contrast, individuals with a suboptimal positivity ratio below 2.9 were
Downloaded by [McMaster University] at 11:29 09 December 2014
548
J.C. Ruthig et al.
described as ‘languishing’; they perceived their lives as empty and unsatisfying, often felt incapable, and lacked strong social networks (Keyes, 2002). Additional research supports the notion that this ratio (the balance between positive and negative emotions) better predicts optimal functioning than do positive and negative emotions as assessed separately (Schwartz et al., 2002). Moreover, despite recent work (Brown, Sokal, & Friedman, 2013) that questions the validity of the mathematical formulas on which the precise critical ratio of 2.9 is based (Fredrickson & Losada, 2005), studies have indicated that a ratio of approximately three positive emotions to one negative emotion can distinguish between good and poor subjective well-being in a variety of contexts. For example, Shrira et al. (2011) examined positivity ratios among individuals under stress (i.e., cancer patients and hospital personnel exposed to missile attacks). Results for both groups supported Fredrickson and Losada’s (2005) positivity ratio of 2.9 for optimal functioning. Other cross-sectional research by Diehl, Hay, and Berg (2011) determined whether the positivity ratio applied across the adult life span by assessing daily positive and negative emotions among young (18–39), middle aged (40–59), and older adults (60–89). An optimal positivity ratio adequately distinguished mental health status for younger adults more so than for middle aged or older adults. In another study, the critical value of 2.9 adequately differentiated those who were flourishing from those who were languishing in two diverse samples of older adults, those who were living within the community and those who had chronic health conditions and resided in a personal care home (Meeks, Van Haitsma, Kostiwa, & Murrell, 2012). Together, past research demonstrates that a positivity ratio of approximately three positive emotions to one negative emotion is optimal for functioning and well-being among adults. Although prior research has examined changes in emotions throughout adulthood (Carstensen et al., 2011; Charles, Reynolds, & Gatz, 2001; Isaacowitz & Blanchard-Fields, 2012), it is unknown if or how positivity ratios change for older adults. For example, do downward shifts in positivity ratios occur over time so that those who initially have optimal ratios become ‘suboptimal’ by falling below that critical value of 2.9, or can those who initially have suboptimal ratios experience an upward shift to become optimal? More importantly, given that shifts above and below the optimal positivity ratio should also reflect shifts between flourishing and languishing (Fredrickson & Losada, 2005), do shifts in positivity ratios correspond with significant changes in psychological health? To expand upon past positivity ratio research, the current longitudinal study documented intra-individual changes in positivity ratios over a 2-year period among a sample of community-dwelling older adults. The first descriptive objective was to simply determine the extent to which older individuals experience shifts from above the optimal positivity ratio to a suboptimal positivity ratio (from flourishing to languishing) or from a suboptimal to an above-optimal ratio (from languishing to flourishing).
A second objective was to examine whether such shifts in positivity ratios are associated with concurrent changes in psychological health. In examining this unexplored topic of within-group change as recommended by Meeks et al. (2012), we hypothesized that individuals who had ratios that ‘became optimal’ would show decreased stress and depression as well as increased perceived control. Conversely, individuals characterized by ratios that ‘became suboptimal’ were expected to have significant increases in stress and depression as well as a diminished sense of control. Because our analysis allowed us to compare the ratio groups both initially (2008) and later (2010), we were also able to examine between group differences in psychological health at each time. This allowed us to ask, for example, do adults who have initially suboptimal ratios but shift to become optimal over time enjoy the same level of psychological health as those with persistently optimal ratios? Likewise, is a shift from an optimal to suboptimal positivity ratio more or less detrimental to psychological health than a persistently suboptimal ratio? Given that the positivity ratio is useful in discriminating psychological health status (Fredrickson & Losada, 2005; Meeks et al., 2012), addressing the current study objectives will enable greater insight into potential shifts in psychological health that may correspond with changing positivity ratios in later adulthood. Method Participants and procedure In 2008, 489 older adults completed written informed consent and measures of their recent positive and negative emotions as part of a larger study on healthy aging (for details see Ruthig, Hanson, Pedersen, Weber, & Chipperfield, 2011). All participants were living independently within the community. Participants provided self-reports during either a 1-hour, in-person interview (82%, n ¼ 400) or a written mailed survey (n ¼ 89) that included identical measures of perceived stress, depressive symptoms, and perceived control. In 2010, 431 (88%) participants were re-interviewed and again completed the same measures of their recent positive and negative emotions, perceived stress, depressive symptoms, and perceived control. Reasons for not completing the follow-up interview varied: 4 participants could not be reached, 11 were deceased, and 43 declined to participate because they were too busy, not interested, or too ill. One-way analyses of variance (ANOVAs) indicated that returning participants did not significantly differ from non-returning participants in their initial (2008) positive emotions [M ¼ 44.94 vs. 44.44, F(1, 479) ¼ 0.19, ns] or negative emotions [M ¼ 12.29 vs. 13.35, F(1, 483) ¼ 0.69, ns]. Of the returning participants, 339 (79%) were interviewed in person and 92 (21%) completed identical mailed surveys. Preliminary ANOVAs indicated that participants who completed interviews vs. mailed surveys did not significantly differ in any of the demographic, emotion, or psychological health variables in either 2008 or 2010. Of those who were re-interviewed, 17 participants did not
Aging & Mental Health complete one or more of the study measures, leaving 414 participants who completed all study measures at both times 1 and 2. Participants received monetary compensation for in each wave of the study.
Downloaded by [McMaster University] at 11:29 09 December 2014
Measures Emotions The study utilized a measure of discrete recent emotions (Chipperfield et al., 2003) consisting of six positive emotions (e.g., happy, proud) and eight negative emotions (e.g., sad, bored). Eight additional emotions were added for the purpose of the current study: four positive emotions (compassion, inspired, excited, and love) and four negative emotions (nervous, irritable, humiliated, and lonely), for a total of 10 positive emotions and 12 negative emotions. For example, participants were asked ‘During the past two days, how often have you felt happy?’ with possible responses ranging from 0 (never) through 6 (almost always). To classify emotions as ‘present’ in our study, we used a less stringent criterion for negative than for positive emotions. This approach is consistent with past positivity ratio research (Diehl et al., 2011; Fredrickson & Losada, 2005) and is justifiable given that older adults typically experience at least mild positive emotion much of the time, whereas negative emotions tend to be stronger than positive emotions (Cacioppo, Gardner, & Berntson, 1999). Specifically, for an emotion to be classified a ‘present,’ we used a cut-off of 3 for positive emotions and 2 for negative emotions. For each participant, we then summed over the positive and negative emotions that were present to create a total positive emotion score (possible range ¼ 0–10) and a total negative emotion score (possible range ¼ 0–12). Separate positivity ratio scores in 2008 and in 2010 were then created for each participant by dividing his/her total negative emotion score by his/her total positive emotion score. For example, a participant with seven positive and two negative emotions would have a ratio of 3.5. Positivity ratios could not be computed for 87 participants in 2008 and 32 participants in 2010 who had a total negative emotions score of 0 (i.e., a number cannot be divided by zero). Consequently, they were excluded from further analysis, leaving a total of 295 participants on which all subsequent analyses are based.
549
The 2008 and 2010 positivity ratios were used to create a four-level variable for subsequent analyses. Optimal ratios (above 2.9) in 2008 that remained optimal in 2010 were labeled as persistently optimal; initial optimal ratios that dropped below 2.9 were categorized as became suboptimal. Of ratios that were suboptimal in 2008, those that remained suboptimal were persistently suboptimal; those that rose above 2.9 by 2010 were categorized as became optimal. Perceived stress Participants’ perceived stress was measured using seven items from Cohen, Kamarck, and Mermelstein’s (1983) measure of global perceived stress. For example, ‘During the last month how often have you been upset because of something that happened unexpectedly?’ Responses to each item ranging from 1 (never) through 5 (very often) were summed so that higher total scores were indicative of higher stress. Depressive symptoms As a measure of depressive symptoms, participants responded to the 10-item Center for Epidemiological Studies Short Depression Scale (CES-D 10; Andresen, Malmgren, Carter, & Patrick, 1994). For example, ‘how often in the past week have you been bothered by things that don’t usually bother you?’ (Response range: 0 ¼ rarely or none of the time; 3 ¼ most or all of the time). After responses to two items (‘felt hopeful about the future’ and ‘were happy’) were reversed, all item responses were summed so that higher total scores reflected more depressive symptoms. Perceived control Participants responded to an 8-item measure of perceptions of control over various aspects of their life (Chipperfield, Campbell, & Perry, 2004). For example, ‘How much influence do you feel you have over your life in general?’ Responses ranged from 1 (almost no influence) through 10 (total influence). Consistent with Chipperfield et al. (2004), each participant’s mean perceived control score was calculated based on their ratings of all eight items. Table 1 presents a summary of the descriptive statistics for all study variables in both 2008 and 2010.
Table 1. Descriptive statistics of all study variables in 2008 and 2010. 2008
2010
Variable
M (n)
SD (%)
Range
alpha
M (n)
SD (%)
Range
alpha
Gender (male) Age Positive emotions Negative emotions Positivity ratio Perceived stress Depressive symptoms Perceived control
(131) 70.03 9.18 4.75 3.53 16.35 4.93 7.76
(44.4%) 7.78 1.36 3.07 3.00 3.97 4.17 1.28
– 56–98 0–10 1–12 0–10 7–34 0–25 2.25–10.00
– – – – – .78 .79 .86
(131) 72.00 8.83 4.64 3.14 16.13 5.84 7.86
(44.4%) 7.74 1.77 3.10 2.67 4.03 4.48 1.12
– 58 0–10 1–12 0–10 7–33 0–23 3.88–10.00
– – – – – .80 .82 .87
550
J.C. Ruthig et al.
Downloaded by [McMaster University] at 11:29 09 December 2014
Results Shifts in positivity ratio Although the theoretical cut-off distinguishing optimal from suboptimal ratios is 2.9 (Fredrickson & Losada, 2005), no participants in the current sample had a positivity ratio within the range of 2.68–2.90 in either 2008 or 2010. Accordingly, optimal positivity ratios were classified as those ratios that were 3.0 or higher and suboptimal positivity ratios were classified as those ratios that were 2.67 or lower. In 2008, fewer participants had optimal positivity ratios than suboptimal ratios (41.7% vs. 58.3%). Regarding whether changes in positivity ratio group membership occurred over time, the majority of participants (66.8%) remained in their initial ratio group over the 2year period; however, there were both upward and downward shifts. Of those older adults with initially optimal ratios, 71 (58%) were persistently optimal and 52 (42%) became suboptimal. Among the group that became suboptimal, downward shifts in ratios over the 2-year period ranged from a minimum decrease of 0.75 to a maximum decrease of 9.20 (mean shift ¼ 4.51, SD ¼ 2.80). For participants whose ratios were suboptimal in 2008, the majority (73% or 126) were persistently suboptimal, while 46 (27%) became optimal by 2010, with their upward shifts in ratios ranging from a minimum increase of 0.75 to a maximum increase of 9.09 (mean shift ¼ 3.21, SD ¼ 2.16).
Figure 1. Positivity ratio (PR) group differences and changes in perceived stress across a 2-year period.
corresponds with reduced stress: those whose ratios became optimal across the 2-year period experienced a significant decrease in stress [time 1: M ¼ 17.40, 95% CI (11.29, 46.08) vs. time 2: M ¼ 15.42, 95% CI (13.12, 43.96), p < .001]. Moreover, despite having similarly high levels of initial stress, the between-group comparisons at time 2 revealed that those who became optimal experienced significantly less stress than the persistently suboptimal group [M ¼ 15.42, 95% CI (13.12, 43.96) vs. M ¼ 17.81, 95% CI (10.44, 46.070], p < .001. Depressive symptoms
Shifts in positivity ratios and psychological health To establish whether shifts in positivity ratios were associated with corresponding changes in psychological health, positivity ratio group (i.e., persistently optimal, persistently suboptimal, became optimal, became suboptimal) served as a predictor, along with time (2008 vs. 2010), in separate 4 2 generalized estimating equations (GEEs; Zeger & Liang, 1986) that were computed for each psychological-health-dependent measure of perceived stress, depressive symptoms, and perceived control. Each GEE also included participants’ age and gender as covariates. These equations enabled the examination of possible differences in psychological health between the positivity groups (between group differences) and over time (within group change), as well as whether the group differences interact with time. When significant interactions emerged, select post hoc tests were conducted to better understand where the differences occurred.
The overall model for depressive symptoms yielded significant main effects for time: Wald x2(1) ¼ 6.30, p ¼ .012; gender: Wald x2(1) ¼ 5.15, p ¼ .023; age: Wald x2(1) ¼ 5.97, p ¼ .015; and positivity ratio group: Wald x2(3) ¼ 82.28, p < .001. Participants reported more depressive symptoms at time 2, and women, older participants, and the persistently suboptimal group reported more depressive symptoms overall. Similar to the findings for perceived stress, there was a significant interaction between positivity ratio group and time on depressive symptoms: Wald x2(3) ¼ 13.08, p ¼ .004 (see Figure 2). Pairwise comparisons indicated that those whose positivity ratios became suboptimal experienced a significant
Perceived stress The overall GEE for perceived stress indicated significant main effects for gender and positivity ratio group. The highest levels of stress were found for women (Wald x2(1) ¼ 7.45, p ¼ .006) and for those with persistently suboptimal ratios (Wald x2(3) ¼ 68.60, p < .001). As shown in Figure 1, a significant between group by within group interaction emerged for positivity ratio group and time: Wald x2(3) ¼ 19.80, p ¼ .001. As expected, pairwise comparisons suggest that becoming optimal
Figure 2. Positivity ratio (PR) group differences and changes in depressive symptoms across a 2-year period.
Aging & Mental Health increase in depression from time 1 to time 2 [M ¼ 3.68, 95% CI (25.70, 33.05) vs. M ¼ 5.38, 95% CI (23.89, 34.64), p ¼ .004]. Although the group whose positivity ratios became optimal did not experience a significant decrease in depressive symptoms from time 1 to time 2, at time 2, they did report significantly fewer depressive symptoms than the persistently suboptimal group [became optimal: M ¼ 17.40, 95% CI (11.29, 46.08) vs. persistently suboptimal: M ¼ 7.63, 95% CI (21.53, 36.78), p ¼ .001]. Thus, a suboptimal positivity ratio was associated with greater depressive symptomology and ratios that became suboptimal were associated with a significant increase in depressive symptoms over the 2-year time frame.
Downloaded by [McMaster University] at 11:29 09 December 2014
Perceived control The overall GEE for perceived control indicated significant main effects for age: Wald x2(1) ¼ 15.94, p ¼ .015 and positivity ratio group: Wald x2(3) ¼ 51.15, p < .001. Younger participants and those whose positivity ratios were persistently optimal reported greater perceived control overall. The pattern of the interaction between positivity ratio group and time on perceptions of control was consistent with the findings for perceived stress and depressive symptoms (see Figure 3), but the interaction was not statistically significant [Wald x2(3) ¼ 6.79, p ¼ .079]. Importantly, at time 2, participants whose positivity ratios became optimal enjoyed high levels of perceived control that did not differ from those whose ratios were persistently optimal (M ¼ 8.10 vs. 8.37, p ¼ .11). This is notable in light of the significantly lower time 1 perceived control for the group that became optimal [M ¼ 7.85, 95% CI (1.12, 16.83)] vs. the persistently optimal group [M ¼ 8.34, 95% CI (0.63, 17.32), p ¼ .004]. Thus, optimal positivity ratios were associated with higher levels of perceived control.
Discussion Our examination of intra-individual shifts in older adults’ positivity ratios over a 2-year period builds upon past cross-sectional research (Diehl et al., 2011; Shrira et al., 2011). Initially, more participants were classified as
Figure 3. Positivity ratio (PR) group differences and changes in perceived control across a 2-year period.
551
suboptimal than optimal in their positivity ratios. Stability over the 2 years was more likely than change, with the majority of participants remaining in their initial optimal or suboptimal category. An encouraging message from these findings is that older adults who are experiencing the benefits of an optimal positivity ratio have a good chance of continuing to enjoy those benefits, at least over the next couple of years. Nonetheless, a less encouraging message is implied in the stability over time that was shown for 73% of those initially classified as being suboptimal. Despite the majority of older adults remaining in the persistently optimal or suboptimal ratio groups, shifts did occur in both directions. Notably, many older adults with suboptimal ratios (approximately 43%) shifted toward becoming optimal within the 2-year period of the study. Also, as subsequently discussed, our analyses suggest that shifts toward optimal ratios are adaptive and shifts toward suboptimal ratios are maladaptive in terms of psychological health. Positivity ratios and psychological health Consistent with past research (Meeks et al., 2012), our findings support using a positivity ratio of approximately three positive emotions to one negative emotion as an indicator of psychological health that distinguishes older adults who are flourishing from those who are languishing (Fredrickson & Losada, 2005). Overall, optimal ratios corresponded to better psychological health in terms of lower stress, fewer depressive symptoms, and greater perceived control, and those with persistently optimal ratios had the best psychological health. In contrast, suboptimal positivity ratios were associated with greater stress, more depressive symptoms, and low perceived control, and those with persistently suboptimal ratios had the worst psychological health over the 2-year period. Moreover, despite being based on a convenience sample of older adults, these findings are consistent with other research on positivity ratios among larger representative samples of older adults residing in the community (e.g., Meeks et al., 2012). Importantly, because none of the current participants had a positivity ratio of 2.8, we could not assess psychological health differences based on the critical ‘tipping point’ of ratios directly above or below 2.9 (Fredrickson & Losada, 2005) that has been questioned in recent research (Brown et al., 2013). It should also be acknowledged that the way in which positivity ratios are calculated has varied across studies in terms of the number, types, and frequency of positive and negative emotions assessed (e.g., Diehl et al., 2011; Fredrickson & Losada, 2005; Meeks et al., 2012); thus, a cut-off score of 2.9 is unlikely to represent precisely the same thing across different studies. As Fredrickson (2013) conceded, further research is needed to better understand the exact ‘tipping’ points of positivity ratios. Nonetheless, our research adds to the growing empirical support for the value of using positivity ratios as an index of psychological health among older adults.
Downloaded by [McMaster University] at 11:29 09 December 2014
552
J.C. Ruthig et al.
Unique to our study was the assessment of whether shifts in positivity ratios corresponded with changes in psychological health over the 2-year period. We showed that individuals can shift upward to an optimal positivity ratio and that such shifts correspond to enhanced psychological health. Therefore, as Meeks et al. (2012) suggested, if positivity ratios can be manipulated via directly targeting positive or negative emotions, older adults with suboptimal ratios and poor initial psychological health have the possibility of experiencing improved psychological health and ‘flourishing’ in the future. Contrary to the psychological benefits of ratios that became optimal, downward shifts from optimal to suboptimal ratios were associated with significantly diminished psychological health over the 2-year period in terms of increased depressive symptoms. This increase reflects either additional or more frequent depressive symptoms such as restless sleep, trouble concentrating, and inability to ‘get going’. Moreover, this ‘became suboptimal’ group also reported significantly more stress and less perceived control at time 2 compared to those whose ratios were persistently optimal. Together, these findings indicate that some older adults who are flourishing may be in danger of a decline in psychological health that accompanies downward shifts in positivity ratios. Given that positivity ratios can shift in either direction, and that such shifts are accompanied by enhanced or diminished psychological health, a critical next step in this research is to identify the mechanisms that cause changes in ratios. In particular, coping strategies, social support, changes in physical health, or certain life events may impact the balance of some older individuals’ positive and negative emotions. For example, diagnosis of a terminal illness or experiencing the death of a loved one may cause a shift from an optimal to suboptimal positivity ratio in some older adults. Another possibility pertains to changes in older adults’ cognitive processing of emotionally positive and negative stimuli. Brain imaging research indicates that older adults’ amygdala showed heightened activity in response to positive but not negative materials, suggesting that there is an age-related decline in encoding of negative stimuli (Carstensen, 2006). Perhaps the rate at which older adults diminish encoding of negative stimuli varies and such variability may explain individual differences in positivity ratio shifts. Further research on these and other possible mechanisms of change in positivity ratios would help to distinguish between adults who will continue to enjoy the psychological benefits of optimal ratios and those whose ratios will become suboptimal. This distinction would facilitate anticipating which older adults are at risk of experiencing a downward shift in positivity ratio and shielding them from corresponding harm to their psychological health. This research would also help to distinguish among individuals with suboptimal ratios, in terms of who will shift towards optimal ratios and who will retain suboptimal ratios. Together, these next steps will be valuable in identifying older adults who will be in need of psychological support and those who are likely to be more resilient.
A limitation of this study is that it only included two assessments of positivity ratios and psychological health. Despite evidence that emotions become increasingly stable in later adulthood (Carstensen, Pasupathi, Mayr, & Nesselroade, 2000; Mroczek, 2001), the day-to-day stability of older individuals’ positivity ratios is unknown. Thus, the fundamental meaning of a single shift in positivity ratios over a 2-year period remains unclear. For example, some older adults’ ratios may remain fairly stable from day to day whereas others may experience recurrent shifts. A longitudinal study that incorporates more frequent assessments could determine whether some older adults’ positivity ratios shift multiple times, as well as the frequency and degree of those shifts. Such research could also identify how such patterns in positivity ratio shifts relate to older adults’ psychological health. Another limitation of the present study is that all measures of emotion and psychological health were based on self-reports. As such, it is possible that some responses to the psychological health measures were biased by participants’ current emotional states. Moreover, one would expect, and past research (Lyubomirsky, King, & Diener, 2005) would suggest, some overlap between our emotion measures and psychological health measures. However, supplemental analyses indicated that correlations between participants’ positivity ratios and their psychological health measures were small in magnitude (i.e., ranging from .23 to .35). This suggests that responses to the psychological health measures were not overly biased by current emotional states and that the measures of emotion and well-being, though related, were conceptualized as separate constructs by our respondents. Nonetheless, subsequent research should incorporate non-self-report measures of emotion and psychological health when attempting to replicate the current findings. Lastly, because we assessed emotions and psychological health at the same points in time, the causal direction of the relationship between shifts in positivity ratios and corresponding changes in psychological health cannot be determined by the present findings. It is possible that changes in psychological health preceded shifts in positivity ratios and the direction of this causal relationship needs to be clarified in subsequent studies. Although more research is needed, the current findings indicate that positivity ratios do change for some older adults and these ratio shifts can signal enhanced or diminished psychological health over time. These findings are congruent with the notion that positivity ratios effectively capture flourishing or languishing.
References Andresen, E.M., Malmgren, J.A., Carter, W.B., & Patrick, D.L. (1994). Screening for depression in well older adults: Evaluation of a short form of the CES-D. American Journal of Preventative Medicine, 10, 77–84. Baumeister, R.F., Bratslavsky, E., Finkenauer, C., & Vohs, K.D. (2001). Bad is stronger than good. Review of General Psychology, 5, 323–370. Benyamini, Y., Idler, E.L., Leventhal, H., & Leventhal, E.A. (2000). Positive affect and function as influences on
Downloaded by [McMaster University] at 11:29 09 December 2014
Aging & Mental Health self-assessments of health: Expanding our view beyond illness and disability. Journal of Gerontology: Psychological Sciences, 55B, 107–116. Brown, N.J.L., Sokal, A.D., & Friedman, H.L. (2013). The complex dynamics of wishful thinking: The critical positivity ratio. American Psychologist. Advance online publication. doi:10.1037/a0032850 Cacioppo, J.T., Gardner, W.L., & Berntson, G.G. (1999). The affect system has parallel and integrative processing components: Form follows function. Journal of Personality and Social Psychology, 76, 839–855. Carstensen, L.L. (2006). The influence of a sense of time on human development. Science, 312, 1913–1915. Carstensen, L.L., Pasupathi, M., Mayr, U., & Nesselroade, J.R. (2000). Emotional experience in everyday life across the adult life span. Journal of Personality and Social Psychology, 79, 644–655. Carstensen, L.L., Turan, B., Scheibe, S., Ram, N., Ersner-Hershfield, H., Samanez-Larkin, . . . Nesselroade, J.R. (2011). Emotional experience improves with age: Evidence based on over 10 years of experience sampling. Psychology and Aging, 26, 21–33. Charles, S.T., Reynolds, C.A., & Gatz, M. (2001). Age-related differences and change in positive and negative affect over 23 years. Journal of Personality and Social Psychology, 80, 136–151. Chipperfield, J.G., Campbell, D.W., & Perry, R.P. (2004). Stability in perceived control: Implications for health among very old community-dwelling adults. Journal of Aging and Health, 16, 116–147. Chipperfield, J.G., Perry, R.P., & Weiner, B. (2003). Discrete emotions in later life. The Journals of Gerontology – Series B, 58, 23–34. Cohen, S., Kamarck, T., & Mermelstein, R. (1983). A global measure of perceived stress. Journal of Health and Social Behavior, 24, 385–396. Diehl, M., Hay, E.L., & Berg, K.M. (2011). The ratio between positive and negative affect and flourishing mental health across adulthood. Aging & Mental Health, 15, 882–893. Diener, E. (2000). Subjective well-being: The science of happiness and a proposal for a national index. American Psychologist, 55, 34–43. Fredrickson, B.L. (2001). The role of positive emotions in positive psychology: The broaden-and-build theory of positive emotions. American Psychologist, 56, 218–226. Fredrickson, B.L. (2004). The broaden-and-build theory of positive emotions. Philosophical Transactions: Biological Sciences, 359, 1367–1377. Fredrickson, B.L. (2013). Updated thinking on positivity ratios. American Psychologist. Advance online publication. doi:10.1037/a0033584 Fredrickson, B.L., & Joiner, T. (2002). Positive emotions trigger upward spirals toward emotional well-being. Psychological Science, 13, 172–175. Fredrickson, B.L., & Losada, M.F. (2005). Positive affect and the complex dynamics of human flourishing. American Psychologist, 60, 678–686. Hu, J., & Gruber, K.J. (2008). Positive and negative affect and health functioning indicators among older adults with chronic illnesses. Issues in Mental Health Nursing, 29, 895–911.
553
Isaacowitz, D.M., & Blanchard-Fields, F. (2012). Linking process and outcome in the study of emotion and aging. Perspectives on Psychological Science, 7, 3–17. Keyes, C.L.M. (2002). The mental health continuum: From languishing to flourishing in life. Journal of Health and Social Behavior, 43, 207–222. Larsen, R.J., & Prizmic, Z. (2008). Regulation of emotional well-being: Overcoming the hedonic treadmill. In M. Eid & R.J. Larson (Eds.), The science of subjective well-being (pp. 258–289). New York: Guilford. Leventhal, E.A., Hansell, S.H., & Diefenbach, D. (1996). Negative affect and self-report of symptoms: Two longitudinal studies of older adults. Health Psychology, 15, 193–199. Lyubomirsky, S., King, L., & Diener, E. (2005). The benefits of frequent positive affect: Does happiness lead to success? Psychological Bulletin, 131, 803–855. Meeks, S., Van Haitsma, K., Kostiwa, I., & Murrell, S.A. (2012). Positivity and well-being among community-residing elders and nursing home residents: What is the optimal affect balance? Journal of Gerontology: Psychological Sciences, 67B, 460–467. Mroczek, D.K. (2001). Age and emotion in adulthood. Current Directions in Psychological Science, 10, 87–90. Newall, N.E., Chipperfield, J.G., Bailis, D.S., & Stewart, T.L. (2013). Consequences of loneliness on physical activity and mortality in older adults and the power of positive emotions. Health Psychology, 32, 921–924. Ostir, G.V., Markides, K.S., Black, S.A., & Goodwin, J.S. (2000). Emotional well-being predicts subsequent functional independence and survival. Journal of the American Geriatrics Society, 48, 473–478. Penninx, B.W., Guralnik, J.M., Bandeen-Roche, K., Kasper, J.D., Simonsick, E.M., Ferrucci, L., & Fried, L.P. (2000). The protective effect of emotional vitality on adverse health outcomes in disabled older women. Journal of the American Geriatric Society, 48, 1359–1366. Pressman, S.D., & Cohen, S. (2005). Does positive affect influence health? Psychological Bulletin, 131, 925–971. Rozin, P., & Royzman, E.B. (2001). Negativity bias, negativity dominance, and contagion. Personality and Social Psychology Review, 5, 296–320. Ruthig, J.C., Hanson, B.L., Pedersen, H., Weber, A., & Chipperfield, J.G. (2011). Later life health optimism, pessimism and realism: Psychosocial contributors and health correlates. Psychology & Health, 26, 835–853. Sch€ uz, B., Wurm, S., Sch€ ollgen, I., & Tesch-R€ omer, C. (2011). What do people include when they self-rate their health? Differential associations according to health status in community-dwelling older adults. Quality of Life Research, 20, 1573–1580. Schwartz, R.M., Reynolds, C.F., III, Thase, M.E., Frank, E., Fasiczka, A.L., & Haaga, D.A.F. (2002). Optimal and normal affect balance in psychotherapy of major depression: Evaluation of the balanced states of mind model. Behavioral and Cognitive Psychotherapy, 30, 439–450. Shrira, A., Palgi, Y., Wolf, J.J., Haber, Y., Goldray, O., ShachamShmueli, E., & Ben-Ezra, M. (2011). The positivity ratio and functioning under stress. Stress and Health, 27, 265–271. Zeger, S.L., & Liang, K-Y. (1986). Longitudinal data analysis for discrete and continuous outcomes. Biometrics, 42, 121–130.
