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Positive Emotional Style Predicts Resistance to Illness After Experimental Exposure to Rhinovirus or Influenza A Virus

Cohen, Sheldon PhD; Alper, Cuneyt M. MD; Doyle, William J. PhD; Treanor, John J. MD; Turner, Ronald B. MD

doi: 10.1097/01.psy.0000245867.92364.3c
Original Articles

Objective: In an earlier study, positive emotional style (PES) was associated with resistance to the common cold and a bias to underreport (relative to objective disease markers) symptom severity. This work did not control for social and cognitive factors closely associated with PES. We replicate the original study using a different virus and controls for these alternative explanations.

Methods: One hundred ninety-three healthy volunteers ages 21 to 55 years were assessed for a PES characterized by being happy, lively, and calm; a negative emotional style (NES) characterized by being anxious, hostile, and depressed; other cognitive and social dispositions; and self-reported health. Subsequently, they were exposed by nasal drops to a rhinovirus or influenza virus and monitored in quarantine for objective signs of illness and self-reported symptoms.

Results: For both viruses, increased PES was associated with lower risk of developing an upper respiratory illness as defined by objective criteria (adjusted odds ratio comparing lowest with highest tertile = 2.9) and with reporting fewer symptoms than expected from concurrent objective markers of illness. These associations were independent of prechallenge virus-specific antibody, virus type, age, sex, education, race, body mass, season, and NES. They were also independent of optimism, extraversion, mastery, self-esteem, purpose, and self-reported health.

Conclusions: We replicated the prospective association of PES and colds and PES and biased symptom reporting, extended those results to infection with an influenza virus, and “ruled out” alternative hypotheses. These results indicate that PES may play a more important role in health than previously thought.

BMI = body mass index; CI = confidence interval; NES = negative emotional style; PES = positive emotional style; RV = rhinovirus; TCID = Tissue Culture Infectious Dose.

From the Department of Psychology, Carnegie Mellon University, Pittsburgh, Pennsylvania (S.C.); the Departments of Otolaryngology, Children’s Hospital of Pittsburgh and the University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania (W.J.D., C.M.A.); the Infectious Disease Unit, University of Rochester School of Medicine and Dentistry, Rochester, New York (J.J.T.); and the Department of Pediatrics, University of Virginia Health Sciences Center, Charlottesville, Virginia (R.B.T.).

Address correspondence and reprint requests to Sheldon Cohen, PhD, Department of Psychology, Carnegie Mellon University, 5000 Forbes Avenue, Pittsburgh, PA 15213-3890. E-mail:

Received for publication May 24, 2006; revision received July 5, 2006.

Research reported here was funded by grants to the Pittsburgh Mind–Body Center from the National Heart, Lung and Blood Institute (HL65111; HL65112) and by supplementary funds provided by the John D. and Catharine T. MacArthur Foundation Network on Socioeconomic Status and Health. The influenza virus was provided by the National Institute of Allergy and Infectious Diseases, Division of Microbiology and Infectious Diseases.

Copyright © 2006 by American Psychosomatic Society
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