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Emotional Style and Susceptibility to the Common Cold

Cohen, Sheldon PhD; Doyle, William J. PhD; Turner, Ronald B. MD; Alper, Cuneyt M. MD; Skoner, David P. MD

doi: 10.1097/01.PSY.0000077508.57784.DA

Objective: It has been hypothesized that people who typically report experiencing negative emotions are at greater risk for disease and those who typically report positive emotions are at less risk. We tested these hypotheses for host resistance to the common cold.

Methods: Three hundred thirty-four healthy volunteers aged 18 to 54 years were assessed for their tendency to experience positive emotions such as happy, pleased, and relaxed; and for negative emotions such as anxious, hostile, and depressed. Subsequently, they were given nasal drops containing one of two rhinoviruses and monitored in quarantine for the development of a common cold (illness in the presence of verified infection).

Results: For both viruses, increased positive emotional style (PES) was associated (in a dose-response manner) with lower risk of developing a cold. This relationship was maintained after controlling for prechallenge virus-specific antibody, virus-type, age, sex, education, race, body mass, and season (adjusted relative risk comparing lowest-to-highest tertile = 2.9). Negative emotional style (NES) was not associated with colds and the association of positive style and colds was independent of negative style. Although PES was associated with lower levels of endocrine hormones and better health practices, these differences could not account for different risks for illness. In separate analyses, NES was associated with reporting more unfounded (independent of objective markers of disease) symptoms, and PES with reporting fewer.

Conclusions: The tendency to experience positive emotions was associated with greater resistance to objectively verifiable colds. PES was also associated with reporting fewer unfounded symptoms and NES with reporting more.

From the Department of Psychology (S.C.), Carnegie Mellon University, Pittsburgh; Departments of Otolaryngology (W.J.D., C.M.A.) and Pediatrics (D.P.S.) Children's Hospital of Pittsburgh and the University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania; and the Department of Pediatrics (R.B.T.), Medical University of South Carolina, Charleston, South Carolina (now at the University of Virginia Health Sciences Center, Charlottesville, Virginia).

Address reprint requests to: Sheldon Cohen, PhD, Carnegie Mellon University, Department of Psychology, 5000 Forbes Ave., Pittsburgh, PA 15213-3890. Email:

Received publication July 11, 2002; revision received October 23, 2002.

This study was supported by National Institute of Mental Health Grant MH-50429, a Senior Scientist Award to Dr. Cohen from the National Institute of Mental Health MH-00721, and by a supplemental grant from the John D. and Catherine T. MacArthur Foundation Network on Socioeconomic Status and Health. The collaboration was facilitated by the Pittsburgh National Institutes of Health Mind-Body Center (HL-65111 and HL-65112). We are indebted to Janet Schlarb, Jeffrey Best, James Seroky, Drs. Bill MacDonald, Clemens Kirschbaum, Andrew Baum, and the volunteers for their contributions to the research, and Dr. Richard Schulz for comments on an earlier draft.

Copyright © 2003 by American Psychosomatic Society
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