Printer Friendly

Happiness and health in psychiatry; what are their implications?

Introduction

Happiness is the main objective of human existence (1). According to many authorities including Greek philosopher Aristotle, all human behavior aims to achieve happiness (2,3). However, Seneca pointed out that reaching happiness is a challenging task, since it is difficult to find what makes life happy; and, many times, the more happiness is searched for, more elusive it becomes (4). In this sense, Socrates explained to Fedro that reflection about the truth would nourish the soul; whereas philosophy would be the adequate tool to achieve this goal (5).

Happiness was first investigated as an object of philosophical study. Only in the middle of the last century some empirical studies within the health and associated fields of knowledge started to appear (6,7). For this reason, the World Health Organization (WHO) has included and emphasized happiness as an important factor within the concept of health (1,8,9). Most studies on happiness are in the field of psychology (10) and economics (10,11). In psychology, for example, the concept of positive psychology has emerged (12,13); according to Seligman (2011), this is an area that studies what is right in humans as their positive attributes, that is, their active psychological characteristics and strengths. Positive psychology advocates that promoting mental health involves the promotion of psychological resources, improving the quality of life and preventing mental disorders, especially those disorders that have a strong environmental burden, thereby promoting happiness. Thus, the contributions of positive psychology can and should be considered by psychiatric clinicians and those in general medicine (15,16).

In this context, happiness can be defined as a fundamental emotion characterized as a lasting state which is combined with: (i) the absence of negative emotions; (ii) the presence of positive emotions; (iii) life satisfaction; (iv) social engagement and (v) objectives in life (8,17-19). Another concept that has been largely used for defining happiness within the specialized literature is subjective well-being (6,8,13,19). It is relevant to mention that the concept of quality of life is a broader terminology, also involving happiness itself (19).

In order to use a holistic approach to promote health (i.e., taking into account all factors that influence health), it is important to understand how a healthy person behaves and how positive emotions can contribute to this process. In this sense, as proposed by Seligman (2011), treatment is not just fixing what is broken; rather, it involves nurturing what is best within ourselves (19). Undoubtedly, the actual psychiatric medical model that mainly focuses on the diagnosis and treatment of mental disorders, has been immensely helpful to many patients; nevertheless, it is believed that it is necessary to move forwards, and this will bring benefits to all, including those with a psychiatric diagnosis (15).

Based on this, the main goal of this paper is to conduct a critical literature review concerning happiness and health which may be useful for the expansion of psychiatric practice, and also to update the article published in 2007 in the Revista de Psiquiatria Clinica titled "Happiness: a review" (18).

Methods

Computer searches were carried out within the PubMed data basis, using the keywords "happiness" and "health", during August, 2014; and in the SciELO data basis with the same keywords during November, 2014. Filters were applied, requiring that the keywords appeared in the title or abstract and that the articles had been published between September 2004 and February 2014. From the PubMed, initially 80 papers were related to this topic. After a preliminary analysis, ten papers were excluded from this sample because of the following reasons: (i) four did not cite the word happiness either in their titles or in their abstracts; (ii) two concerned topics only related to, but did not directly concern, happiness and health; (iii) four were informative articles (Figure 1). Regarding the SciELO data basis, 47 papers were found; however, only six contained the word happiness in their titles and/or abstracts.

In addition to these searches, another was performed using the reference lists of the papers already selected. This was rewarding in allowing us to identify the classic work provided by significant authors in this field, such as Martin Seligman, Robert Clonniger anda Ruut Veenhoven, as well as the importance in this context of the WHO (Table 1).

[FIGURE 1 OMITTED]

Based on the results from these searches, it was possible to identify six core aspects related to the keywords "happiness" and "health", namely:

1. Aspects of happiness;

2. Biology of happiness;

3. Psychology of happiness;

4. Sociodemography of happiness;

5. Health, mental health and happiness;

6. Positive implications for psychiatry.

Each of these aspects is described further in the following section.

Results

Aspects of happiness

The scientific literature often refers to two types of happiness: psychological well-being and hedonic well-being. The term psychological well-being, or eudaimonia, has been used to refer to a combination of character strengths involving self-direction (e.g., autonomy, purpose of life, environmental and self-acceptance), cooperatives (i.e., positive relationships with others) and self-transcendence (i.e., personal growth and self-realization) (8,12). Hedonic well-being, or hedonia, is associated with: (i) a pleasurable life; (ii) life satisfaction; (iii) presence of positive feelings and (iv) absence of negative feelings (20). It can be said, therefore, that psychological well-being is connected to the personal fulfillment of one's own potential, while hedonic well-being is linked to the experience of satisfaction.

Although these are two different ways to experience happiness, they are strongly related (8,12,20). However, from a historical point of view, they have different origins. Aristotle postulated that every human being had unique capabilities, called daimon, that should be recognized and developed (3). Similar to this idea are the concepts/ theories of: (i) self-actualization, described by Maslow; (ii) the individualization theory developed by Jung; and (iii) Antonovsky's theory of existential coherence; all are related to the concept of eudaimonia (20,21). It is relevant to note that Epicurus provided the basis for the later development of hedonism. (20) The biological differences between each type are discussed further below.

Besides these two types of happiness, it is important to distinguish two types of emotions or affects that are connected to the understanding of happiness: positive affect and negative affect. These are independent variables and may or may not be in opposition (18); it is possible to feel positive and negative emotions at the same time, as well as being in a neutral state. These emotions/affects might seem to have different determinants, consequences and correlations (14), and it is relevant to note that happiness itself is related to the frequency of positive emotions and not to their intensity (14,18). Negative emotions, such as fear and anger, are recognizably beneficial as they help people to ensure their survival and safety. Nevertheless, these are short-term benefits; the Broaden and Build Theory states that positive emotions amplify cognition and behavior, providing intellectual, social and physical resources for optimum performance. Thus, the long term benefits of positive emotions contribute to the individual's ability to continue his/her development (14).

Biology of happiness

Trying to understand the complex link between psychological factors and biological change, scientists have studied the effects on health of negative emotions. For example, it is known that stress, depression and anxiety generate changes in the hypothalamic-pituitary-adrenal axis, with a consequent increase of cortisol, sympathetic stimulation and elevation of proinflammatory markers. If these negative stimuli persist, the risk increases of developing cardiovascular disease, cancer and/or infections (22,23). However, only recently has scientific interest focused on verifying that positive emotions could also induce biological changes. Some studies have demonstrated that the two types of happiness (eudaimonia and hedonia) can cause biological changes that promote positive emotions (24); however, most of this research has shown that only eudaimonia is statistically related to biological changes (12,20,22). In general, the changes found in the neuroendocrine, immune and cardiovascular systems secondary to positive emotions are beneficial and protective effect (12,23).

First, positive emotions can quickly cancel the adverse effects of body stress reaction, and thus return the body to a steady state (14). It may be interesting to see how this biological characteristic of positive emotions corresponds to the observation that many people say they feel good, even through times of suffering, if adverse events are interpreted as having a purpose or meaning (8). Perhaps this search for meaning is a psychic attempt to maintain an emotional balance.

Second, higher levels of eudaimonia are related to lower levels of salivary cortisol and proinflammatory cytokines, a lower cardiovascular disease risk, longer duration of REM sleep (20,23), higher levels of immunoglobulin A, and higher HDL cholesterol levels (12) compared to those with low levels of eudaimonia. There are, however, differences between men and women in this regard; for example, inflammatory markers such as C-reactive protein and fibrinogen are lower in happy women than in happy men (24).

These alterations have been found regardless of the presence of negative emotions, suggesting that happiness has a direct effect on the body, regardless of the absence of negative affect (23). On the other hand, in the same manner as tobacco and some physical leisure activities are found in stressed individuals, depression and anxiety and their associated behaviors contribute to increased rates of diseases and adverse biological changes; part of the positive biological findings in happy individuals is also due to their tendency towards healthier habits and more prudent lifestyles (23).

Another important point is that studies of monozygotic twins, separated and raised in different environments, have shown that happiness has a genetic component of 35%-50% in humans (6,14,25). In this regard, it is suggested that the long allele of the promoter region of the 5-HTT gene (5-HTTLPR long) could be associated with optimism. The 5-HTT gene encodes serotonin transporters; this type of polymorphism in the promoter region is called a functional polymorphism (26). De Neve found that individuals satisfied or very satisfied with life have a statistically significant higher percentage of this genotype (long 5-HTTLPR homozygous), compared to people dissatisfied with life. Recently, it was discovered that, in women, a low MAO gene expression is significantly associated with increased levels of happiness. This finding, however, was not present in men (26).

It is important to consider that many of these studies have some limitations such as small sample sizes, cross-sectional designs or bivariate analyses. Still, the studies are promising and already point us in several directions.

Psychology of happiness

If 35%-50% of happiness depends on a genetic influence, at least 30%-40% are represented other variables, suggesting that the environment and life events also have a large influence on subjective well-being. However, this influence varies from event to event; personal interpretations may be the key to understanding the link between life events and subjective well-being (6). In this sense, character has a strong impact on the perception of all aspects of health, including physical, social and emotional well-being. For example, self-direction is measured by levels of responsibility, ingenuity and ability to find meaning, and has a strong connection with all aspects of health. Changes in self-direction explain about 32% of the variations in the risk of disease and about 45% of the variations in subjective well-being.

The way in which an individual sees life can predict his/her health outcomes. For example, pessimists need to visit four times as many doctors in one year than optimists (17). Similarly, the link between success and happiness exists not only because success makes people happy, but because positive attitudes engender success (27). A concept that may explain these relationships is emotional competence (EC), also known as emotional intelligence. This concept relates to how the individual deals with emotional information, intrapersonally and interpersonally. High EC is associated with greater happiness, and higher mental and physical health, greater professional success and greater satisfaction in social relationships and marriage (28).

Christakis and Fowler used the Framingham study to try to answer the following question: can the happiness of others influence personal happiness? The study was based on the theory that emotional states can be transferred interpersonally through mimicry, by copying emotionally relevant bodily actions, especially facial expressions, and it concluded positively. The authors suggested that happiness may be seen as a network phenomenon; happiness clusters resulted from the spread of happiness and not only by the tendency of people to associate with similar individuals (29). Although this theory of social contagion has also been replicated in disorders such as depression, a study involving roommates in college resulted in different findings, arguing that happiness and mental disorders have low social contagion (30). Perhaps the last word on the subject has not yet been given, but there is no doubt that this is an exciting area.

Sociodemography of happiness

Several factors associated with happiness have been studied. Below we describe some that appear in more recent studies and have not been reported in other review articles on happiness.

Economic factors

The first modern economist to study happiness found a paradox (i.e., the Easterlin paradox) in which groups of richer countries are happier than groups of poorer countries, but this difference is not so clear between rich and Latin American countries where there are larger social differences. Even in poor countries, the relationship between money and happiness is not linear. Deprivation and poverty are less associated with happiness (31) however, after reaching a level of care that meets basic needs, other factors, such as people's increased aspirations and concerns about their own heritage come into play (10,32). Indeed, despite the economic changes, happiness levels have remained relatively stable in countries such as Ireland and the United States (17,33); a study linking retirement and welfare showed that monetary gain increased financial well-being, but the benefits of retirement on health and subjective and social welfare were transient (34). Another binding factor between economic issues and happiness seems to be social inequality, since individuals living in areas of great social inequality tend to describe themselves as unhappy and unhealthy (35). From the individual point of view, however, people who are paid by the hour appear to be happier (36). In addition, informal workers tend to report higher levels of happiness related to their professional activity (37). Another factor that may explain this lack of linearity between economic issues and subjective well-being levels is that happy people tend to focus more on social ideals and moral goals than just monetary achievement (7).

Age

With increasing age, happiness tends to decrease in the population as a whole (38,39). However, from the individual point of view, centenarians who have high levels of satisfaction with their lives in the past tend in their old age to make the best personal assessments of their own health, economic security and happiness (40). Therefore, there is a protective relationship between happiness and physical decline that occurs in old age (41,42). In this age group, contentment related to the children and the health of the family is associated with a higher level of happiness (43). Moreover, happiness is related to longevity, independent of family genetic and environmental issues (44). Finally, a rather curious result was obtained from a longitudinal study that found a positive association between chocolate consumption, optimism, better health and greater psychological well-being (45).

Interpersonal relationships

People living in minority groups tend to report less happiness than those who belong to majority groups (7). For example, after the tragic events of September 11, 2001 in the United States, Arab Americans reported a greater perception of abuse and discrimination; this perception was related to higher levels of psychological stress, worse health outcomes and a lower sense of happiness (46).

Married people tend to experience better health and happiness than unmarried people. This relationship has been found in various countries, within various health parameters and in both men and women (47). This association, however, extends beyond marital status, because the quality of marriage also has a great influence on it (47-49). There is also a positive relationship between happiness and sexual satisfaction in women and men, although that relationship is stronger in women (50).

Religiosity and volunteering

It is well established that people who identify themselves as religious tend to report better health and more happiness, regardless of their religious affiliation, performance of the religious activities, work, family, social support or financial situation (51). The studies that have reached these conclusions were mostly carried out in the western population. However, research on Islamic and Egyptian students also found a positive relationship between religious affiliation and happiness (52-54). Seen as human dimensions by many researchers, these aspects tend to be increasingly taken into consideration in the treatment and development of people (15,55), especially considering that the humans are religious beings, since they spend more time praying than having sex (15).

Another related aspect is the issue of volunteering and altruism. People who engage in volunteer work and altruistic behaviors tend to be healthier, live longer, and to be happier (56-58). However, when this type of activity becomes too arduous, occupying more than 11 hours per week, the happiness levels tend to decrease (56,58).

Educational level, sports and leisure

The positive relationship has long been recognized between education levels, intelligence quotient (IQ) and health levels. More recently, a positive relationship has also been found between educational levels, IQ and the happiness index (10,59,60).

Other factors studied in recent years include physical leisure activities that have been shown to increase subjective well being, both in the short and long term (61). Involvement in sport also appears to have a causal relationship with higher levels of happiness (62).

Finally, it is worth remembering the psychological theory of the set point of happiness, according to which people have a basal level of happiness that they tend to return to over time, even after major events such as winning the lottery or divorce. However, unemployment is one of the events that has a negative impact on happiness that people tend not to adapt to (10).

Health, mental health and happiness

Happiness and health are closely related, both on an individual and population basis; happier people and communities tend to be healthier, and the inverse relationship is also true (63). This relationship was also found in adolescents (64), the young (65,66) and the elderly (67). However, in the elderly, a study found that health predicted subjective well-being, but the reverse was not true (68), perhaps because, in this population, other factors previously listed in the sociodemography of happiness subsection (3,4) came into play. As examples, the happiest nations tend to have lower levels of blood pressure (69); a study of coronary artery disease (CAD) found that optimistic men had a lower risk of developing CAD17; and happier people recovered better from sickness (70).

It is well known that chronic diseases are associated with negative impacts on various aspects of the quality of life, including happiness, and increase the risk of depression (71). However, different chronic diseases seem to impact differently on subjective well-being (71). In the elderly, for example, the physical diseases that impose decreased happiness were disabling pain and urinary incontinence; these disturb the activities of daily living and are associated with social stigmas (67).

Furthermore, mental disorders in general, and specifically depression, alcohol and drug abuse (72) and anxiety (72,73) more negatively affect happiness than does physical illness. Similarly, there is an inverse relationship between suicide and the subjective well-being index, and also between the presence of mental disorders and happiness (74). For this reason, it has been proposed that happiness indices could be used as population markers for mental disorders (74). In this sense, the ability to exercise control over adaptive negative emotions is associated with beneficial results in mental health (75). However, excessively large or small variations in positive emotions are associated with poorer mental health, particularly depression and anxiety disorders, lower life satisfaction and more unhappiness (76). Perhaps this issue of emotional control can also explain the association between mental disorders and unhappiness, and the large presence of negative emotions that mental disorders cause.

Positive implications for psychiatry

Given all of the above, a question must be raised: is possible and is it desirable to promote happiness? The evidence appears to say yes. Happiness does not cure the disease but makes people less sick and the size of this effect appears to be comparable to smoking or not (77). In mental health, in particular, the study of factors that lead to happiness can be particularly beneficial in those at higher risk of developing mental disorders (18). In fact, positive psychological interventions have already been successfully tested in patients with depressive disorders (78). Furthermore, investment in approaches that increase subjective well-being may be cheaper for the public purse. For example, a study comparing psychotherapy versus paying monetary damages in legal compensation cases showed that psychological approaches may be up to 32 times cheaper than financial compensation, as well as being more effective in promoting health and happiness in patients potentially involved in litigation (79). The understanding of what promotes happiness in people can also be useful for mental health professionals themselves since they are at risk of decreased life satisfaction and burnout syndrome; this can have negative consequences for psychiatric patients, since high levels of stress in these professionals predict therapeutic problems in general (80).

Positive psychology contains the concept of flourish. This concept suggests five features found in happy people (PERMA) that should be promoted to increase levels of subjective well-being in people in general:

1. Positive emotions (P)

2. Engagement (E; being in the flow)

3. Relationships (R; having healthy relationships)

4. Meaning (M; purpose in life)

5. Accomplishment (A)

Investment in any of these areas promotes the others and helps develop happiness (81,82).

In addition to increasing happiness, feeding positive emotions such as gratitude, kindness, perseverance, optimism and creativity, contributes to increased resilience, buffers psychological stress and promotes mental health. Programs such as the Penn Resiliency Program (PRP), developed for this purpose, have been successfully implemented in the United States, the United Kingdom, Australia, Portugal and China. In this program, participants learn to adopt more optimistic explanatory styles, detecting inaccurate thoughts, challenging negative beliefs and considering alternative interpretations. In addition, a task force made up of several positive psychology professionals developed an inventory to help people identify their character strengths; this is called the Values in Action Inventory of Strengths (VIA-IS). Despite its limitation of being based on self-report, the simple application of this instrument has been shown to be therapeutic in itself and has brought positive results. The VIA -IS and the PRP are intended for use by adults and children. There is also a tool named Appreciative Inquiry, used in institutions, that aligns with positive psychology. By means of this instrument, groups are helped to refocus problems towards the identification of existing strengths in group members, thus providing a starting point for positive change (14).

Discussion

We have critically reviewed the literature on the relationship between happiness and health in order to identify the most relevant information for psychiatry. We especially considered data that were also being studied in the latest research, and not only the findings of classical studies. Studies are numerous; nevertheless, we realize that many studies on the topic of happiness are transversal; this, despite the use of large samples, diminishes the robustness of some conclusions. In addition, the measurement scales are often limited by being of the self-report variety. In a sense, we already find this difficulty in psychiatry itself in its use of subjective medical measurements, such as pain. However, analysis of the concept of happiness and its associated emotions may be more complex than describing the symptoms ofpsychiatric disorders, which can expose us to some difficult biases that are difficult to bypass. Another limitation of some studies seems to lie in their contained psychotherapeutic interventions. Although there are well-established interventions within positive psychology (some have been reported in this article) as well an interesting proposal for psychoeducation made by Clonniger (2006), progress in the expansion of clinical approaches seems to be necessary. In addition, most therapeutic interventions proposed have comprised a more psychoeducative approach. Certainly, some of these limitations exist because the interest of the health sciences in this topic is relatively recent. Moreover, is an area that is more linked to the formulation of psychotherapeutic approaches and this tends to discourage investment in the development of new psychoactive drugs.

The study of happiness from a scientific perspective, together with a realization of its implications for health is promising and fascinating, especially if we believe our medical indices of good health are not always in agreement with the perceptions of the patient or society. For example, consider the population of Matsigenka in the Peruvian Amazon; over the past 30 years health indicators have improved greatly, but during the same time period this population reported itself as sicker and unhappier (83). Perhaps for similar reasons psychiatry has failed to increase subjective well-being in the general population, despite extensive pharmacological advances and new psychotherapeutic techniques. Probably, the focus has been almost exclusively pathological (15).

The immediate goal of all medicine is to alleviate suffering. To achieve this in psychiatry, accurate diagnostic, psychopharmacological advances and psychotherapeutic techniques are fundamental. However, identify what makes life happy can be useful in various types of health prevention (primary, secondary and tertiary) (84). This particularly applies to promoting mental health as specified in the WHO parameters: a state of well-being in which people can understand and use their own skills, deal with the stresses of life, work and love, and may contribute to their communities (8,9). Furthermore, the promotion of mental health may contribute to reducing the stigma towards psychiatry and psychiatric patients (15).

Conclusion

Positive emotions related to happiness generate beneficial alterations in the neuroendocrine, immune and cardiovascular systems. Aspects of character, such as self-direction, are strongly linked to higher levels of happiness. According to the Easterlin paradox, the relationship between money and happiness is not linear. Levels of happiness tend to fall with increasing age; however, the previous level of subjective well-being is a major predictor of happiness in this age group. Religious people who practice physical leisure activities, who have high educational levels or higher IQs, who are married, who are involved in sports, or do up to 11 hours of volunteer work per week tend to report higher levels of happiness. In addition, higher levels of happiness are related to lower physical and mental illness, as well better coping abilities in adversity For this reason, the study of happiness brings several positive implications for psychiatry that should be considered in clinical practice and in future research.

DOI: 10.1590/0101-60830000000058

Received; 7/4/2015--Accepted; 4/29/2015

Acknowledgements

The corresponding author thanks Dr. Rodrigo Tavares, Ph.D., for the academic tips.

Conflicts of interest

Dr. Amaury Cantilino received lecture fees from Abbott Brazil. Dr. Hermano Tavares is a research productivity fellow from the National Council on Research (CNPq).

References

(1.) Fowler JH, Christakis NA. Dynamic spread of happiness in a large social network: longitudinal analysis over 20 years in the Framingham Heart Study. BMJ. 2008;337:a2338.

(2.) Allmark P. Health, happiness and health promotion. J Appl Philos 2005;22(1):1-15.

(3.) Aristoteles. Etica a Nicomaco. 1a ed. Traducao do grego: Antonio de Castro Caeiro. Sao Paulo: Atlas; 2009. 280p.

(4.) Seneca. Da vida retirada, da tranquilidade da alma e da felicidade. 1a ed. Traducao: Lucia Sa Rebello. Porto Alegre: L&PM Pocket; 2009.

(5.) Platao. Fedro. 3a ed. Traducao: Carlos Alberto Nunes. Belem: EDUFPA; 2011.

(6.) Tay L, Kuykendall L. Promoting happiness: the malleability of individual and societal subjective wellbeing. Int J Psychol. 2013;48(3):159-76.

(7.) Veenhoven R. Questions on happiness: classical topics, modern answers, blind spots. In: Strack F, Argyle M, Schwarz N, editors. Subjective well-being, an interdisciplinary perspective. London: Pergamon Press; 1991. p. 7-26.

(8.) Cloninger CR, Zohar AH. Personality and the perception of health and happiness. J Affect Disord. 2011;128(1-2):24-32.

(9.) WHO. The world health report 2001. Mental health: new understanding, new hope. Geneva: World Health Organization; 2001. 5p.

(10.) Graham C. Happiness and health: lessons--and questions-for public policy. Health Aff (Millwood). 2008;27(1):72-87.

(11.) Karlsson M, Lyttkens CH, Nilsson T. Health. Happiness. Inequality. Expert Rev Pharmacoecon Outcomes Res. 2010;10(5):497-500.

(12.) Barak Y, Achiron A. Happiness and neurological diseases. Expert Rev Neurother. 2009;9(4):445-59.

(13.) Scorsolini-Comin F, Santos MA. O estudo cientifico da felicidade e a promocao da saude: revisao integrativa da literatura. Rev Latino-Am Enfermagem. 2010;18(3):188-95.

(14.) Kobau R, Seligman MEP, Peterson C, Diener E, Zack MM, Chapman D, et al. Mental health promotion in public health: perspectives and strategies from positive psychology. Am J Public Health. 2011;101(8):e1-9.

(15.) Cloninger CR. The science of well-being: an integrated approach to mental health and its disorders. World Psychiatry. 2006;5(2):71-6.

(16.) Hershberger PJ. Prescribing happiness: positive psychology and family medicine. Fam Med. 2005;37(9):630-4.

(17.) Allen D, Carlson D, Ham C. Well-being: new paradigms of wellness--inspiring positive health outcomes and renewing hope. Am J Health Promot. 2007;21(3):1-9, iii.

(18.) Ferraz RB, Tavares H, Zilberman ML. Happiness: a review. Rev Psiquiatr Clin. 2007;34(5):234-42.

(19.) Bekhet AK, Zauszniewski JA, Nakhla WE. Happiness: theoretical and empirical considerations. Nurs Forum. 2008;43(1):12-23.

(20.) Ryff CD, Singer BH, Love GD. Positive health: connecting well-being with biology. Philos Trans R Soc Lond B Biol Sci. 2004;359(1449):1383-94.

(21.) Ventegodt S, Flensborg-Madsen T, Andersen NJ, Merrick J. The life mission theory VII. Theory of existential (Antonovsky) coherence: a theory of quality of life, health, and ability for use in holistic medicine. Scientific World Journal. 2005;5:377-89.

(22.) Barak Y. The immune system and happiness. Autoimmun Rev. 2006;5(8):523-7.

(23.) Steptoe A, Wardle J, Marmot M. Positive affect and health-related neuroendocrine, cardiovascular, and inflammatory processes. Proc Natl Acad Sci USA. 2005;102(18):6508-12.

(24.) Steptoe A, Demakakos P, de Oliveira C, Wardle J. Distinctive biological correlates of positive psychological well-being in older men and women. Psychosom Med. 2012;74(5):501-8.

(25.) Chen H, Pine DS, Ernst M, Gorodetsky E, Kasen S, Gordon K, et al. The The MAOA gene predicts happiness in women. Prog Neuropsychopharmacol Biol Psychiatry. 2013;40:122-5.

(26.) De Neve JE. Functional polymorphism (5-HTTLPR) in the serotonin transporter gene is associated with subjective well-being: evidence from a US nationally representative sample. J Hum Genet. 2011;56(6):456-9.

(27.) Lyubomirsky S, King L, Diener E. The benefits of frequent positive affect: does happiness lead to success? Psychol Bull. 2005;131(6):803-55.

(28.) Brasseur S, Gregoire J, Bourdu R, Mikolajczak M. The Profile of Emotional Competence (PEC): development and validation of a self-reported measure that fits dimensions of emotional competence theory. PLoS One. 2013;8(5):e62635.

(29.) Christakis NA, Fowler JH. Social contagion theory: examining dynamic social networks and human behavior. Stat Med. 2013;32(4):556-77.

(30.) Eisenberg D, Golberstein E, Whitlock JL, Downs MF. Social contagion of mental health: evidence from college roommates. Health Econ. 2013;22(8):965-86.

(31.) Mitchell L, Frank MR, Harris KD, Dodds PS, Danforth CM. The geography of happiness: connecting twitter sentiment and expression, demographics, and objective characteristics of place. PLoS One. 2013;8(5):e64417.

(32.) Smith DM, Langa KM, Kabeto MU, Ubel PA. Health, wealth, and happiness: financial resources buffer subjective well-being after the onset of a disability. Psychol Sci. 2005;16(9):663-6.

(33.) Doherty AM, Kelly BD. When Irish eyes are smiling: income and happiness in Ireland, 2003-2009. Ir J Med Sci. 2013;182(1):113-9.

(34.) Schatz E, Gomez-Olive X, Ralston M, Menken J, Tollman S. The impact of pensions on health and wellbeing in rural South Africa: does gender matter? Soc Sci Med. 2012;75(10):1864-73.

(35.) Oshio T, Kobayashi M. Income inequality, perceived happiness, and self-rated health: evidence from nationwide surveys in Japan. Soc Sci Med. 2010;70(9):1358-66.

(36.) DeVoe SE, Pfeffer J. When is happiness about how much you earn? The effect of hourly payment on the money--happiness connection. Pers Soc Psychol Bull. 2009;35(12):1602-18.

(37.) Diaz E, Guevara R, Lizana J. Trabajo informal: motivos, bienestar subjetivo, salud, y felicidad en vendedores ambulantes. Psicol Estud. 2008;13(4):693-701.

(38.) Bjornskov C. Healthy and happy in Europe? On the association between happiness and life expectancy over time. Soc Sci Med. 2008;66(8):1750-9.

(39.) Lehmann BA, Bos AE, Rijken M, Cardol M, Peters GJ, Kok G, et al. Ageing with an intellectual disability: the impact of personal resources on well-being. J Intellect Disabil Res. 2013;57(11):1068-78.

(40.) Bishop AJ, Martin P, MacDonald M, Poon L; Georgia Centenarian Study. Predicting happiness among centenarians. Gerontology. 2010;56(1):88-92.

(41.) Collins AL, Goldman N, Rodriguez G. Is positive well-being protective of mobility limitations among older adults? J Gerontol B Psychol Sci Soc Sci. 2008;63(6):P321-7.

(42.) Lima MG, Barros MBA, Alves MCGP. Sentimento de felicidade em idosos: uma abordagem epidemiologica, ISA-Camp 2008. Cad Saude Publica. 2012;28(12):2280-92.

(43.) Llobet MP, Avila NR, Farras J, Canut MTL. Qualidade de vida, felicidade e satisfacao com a vida em anciaos com 75 anos ou mais, atendidos num programa de atencao domiciliaria. Rev Latino-Am Enfermagem. 2011;19(3).

(44.) Sadler ME, Miller CJ, Christensen K, McGue M. Subjective well-being and longevity: a cotwin control study. Twin Res Hum Genet. 2011;14(3):249-56.

(45.) Strandberg TE, Strandberg AY, Pitkala K, Salomaa VV, Tilvis RS, Miettinen TA. Chocolate, well-being and health among elderly men. Eur J Clin Nutr. 2008;62(2):247-53.

(46.) Padela AI, Heisler M. The association of perceived abuse and discrimination after September 11, 2001, with psychological distress, level of happiness, and health status among Arab Americans. Am J Public Health. 2010;100(2):284-91.

(47.) Proulx CM, Snyder-Rivas LA. The longitudinal associations between marital happiness, problems, and self-rated health. J Fam Psychol. 2013;27(2):194-202.

(48.) Lam WW, Fielding R, McDowell I, Johnston J, Chan S, Leung GM, et al. Perspectives on family health, happiness and harmony (3H) among Hong Kong Chinese people: a qualitative study. Health Educ Res. 2012;27(5):767-79.

(49.) Chan SS, Viswanath K, Au DW, Ma CM, Lam WW, Fielding R, et al. Hong Kong Chinese community leaders' perspectives on family health, happiness and harmony: a qualitative study. Health Educ Res. 2011;26(4):664-74.

(50.) Rosen RC, Bachmann GA. Sexual well-being, happiness, and satisfaction, in women: the case for a new conceptual paradigm. J Sex Marital Ther. 2008;34(4):291-7.

(51.) Green M, Elliott M. Religion, health, and psychological well-being. J Relig Health. 2010;49(2):149-63.

(52.) Abdel-Khalek AM. Quality of life, subjective well-being, and religiosity in Muslim college students. Qual Life Res. 2010;19(8):1133-43.

(53.) Sahraian A, Gholami A, Javadpour A, Omidvar B. Association between religiosity and happiness among a group of Muslim undergraduate students. J Relig Health. 2013;52(2):450-3.

(54.) Abdel-Khalek AM. Subjective well-being and religiosity in Egyptian college students. Psychol Rep. 2011;108(1):54-8.

(55.) Vayalilkarottu J. Holistic health and well-being: a psycho-spiritual/religious and theological perspective. Asian J Psychiatr. 2012;5(4):347-50.

(56.) Post SG. Altuism, happiness, and health: it's good to be good. Int J Behav Med. 2005;12(2):66-77.

(57.) Borgonovi F. Doing well by doing good. The relationship between formal volunteering and self-reported health and happiness. Soc Sci Med. 2008;66(11):2321-34.

(58.) van Campen C, de Boer AH, Iedema J. Are informal caregivers less happy than noncaregivers? Happiness and the intensity of caregiving in combination with paid and voluntary work. Scand J Caring Sci. 2013;27(1):44-50.

(59.) Ali A, Ambler G, Strydom A, Rai D, Cooper C, McManus S, et al. The relationship between happiness and intelligent quotient: the contribution of socio-economic and clinical factors. Psychol Med. 2013;43(6):1303-12.

(60.) Judge TA, Ilies R, Dimotakis N. Are health and happiness the product of wisdom? The relationship of general mental ability to educational and occupational attainment, health, and well-being. J Appl Psychol. 2010;95(3):454-68.

(61.) Wang F, Orpana HM, Morrison H, de Groh M, Dai S, Luo W. Long-term association between leisure-time physical activity and changes in happiness: analysis of the Prospective National Population Health Survey. Am J Epidemiol. 2012;176(12):1095-100.

(62.) Ruseski JE, Humphreys BR, Hallman K, Wicker P, Breuer C. Sport participation and subjective well-being: instrumental variable results from German survey data. J Phys Act Health. 2014;11(2):396-403.

(63.) Subramanian S, Kim D, Kawachi I. Covariation in the socioeconomic determinants of self rated health and happiness: a multivariate multilevel analysis of individuals and communities in the USA. J Epidemiol Community Health. 2005;59(8):664-9.

(64.) Mahon NE, Yarcheski A, Yarcheski TJ. Happiness as related to gender and health in early adolescents. Clin Nurs Res. 2005;14(2):175-90.

(65.) Piqueras JA, Kuhne W, Vera-Villarroel P, van Straten A, Cuijpers P. Happiness and health behaviours in Chilean college students: a cross-sectional survey. BMC Public Health. 2011;11:443.

(66.) Silva RA, Horta BL, Pontes LM, Faria AD, Souza LDM, Cruzeiro ALS, et al. Bem-estar psicologico e adolescencia: fatores associados. Cad Saude Publica. 2007;23(5):1113-8.

(67.) Angner E, Ray MN, Saag KG, Allison JJ. Health and happiness among older adults: a community-based study. J Health Psychol. 2009;14(4):503-12.

(68.) Gana K, Bailly N, Saada Y, Joulain M, Trouillet R, Herve C, et al. Relationship between life satisfaction and physical health in older adults: a longitudinal test of cross-lagged and simultaneous effects. Health Psychol. 2013;32(8):896-904.

(69.) Blanchflower DG, Oswald AJ. Hypertension and happiness across nations. J Health Econ. 2008;27(2):218-33.

(70.) Cooper C, Bebbington P, King M, Jenkins R, Farrell M, Brugha T, et al. Happiness across age groups: results from the 2007 National Psychiatric Morbidity Survey. Int J Geriatr Psychiatry. 2011;26(6):608-14.

(71.) Wikman A, Wardle J, Steptoe A. Quality of life and affective well-being in middle-aged and older people with chronic medical illnesses: a cross-sectional population based study. PLoS One. 2011;6(4):e18952.

(72.) Binder M, Coad A. "I'm afraid I have bad news for you ..." Estimating the impact of different health impairments on subjective well-being. Soc Sci Med. 2013;87:155-67.

(73.) Graham C, Higuera L, Lora E. Wich health conditions cause the most unhappiness? Health Econ. 2011;1447:1431-47.

(74.) Bray I, Gunnell D. Suicide rates, life satisfaction and happiness as markers for population mental health. Soc Psychiatry Psychiatr Epidemiol. 2006;41(5):333-7.

(75.) Kang Y, Gruber J. Harnessing happiness? Uncontrollable positive emotion in bipolar disorder, major depression, and healthy adults. Emotion. 2013;13(2):290-301.

(76.) Gruber J, Kogan A, Quoidbach J, Mauss IB. Happiness is best kept stable: positive emotion variability is associated with poorer psychological health. Emotion. 2013;13(1):1-6.

(77.) Veenhoven R. Healthy happiness: effects of happiness on physical health and the consequences for preventive health care. J Happiness Stud. 2007;9(3):449-69.

(78.) Layous K, Chancellor J, Lyubomirsky S, Wang L, Doraiswamy PM. Delivering happiness: translating positive psychology intervention research for treating major and minor depressive disorders. J Altern Complement Med. 2011;17(8):675-83.

(79.) Boyce CJ, Wood AM. Money or mental health: the cost of alleviating psychological distress with monetary compensation versus psychological therapy. Health Econ Policy Law. 2010;5(4):509-16.

(80.) Baruch Y, Swartz M, Sirkis S, Mirecki I, Barak Y. Staff happiness and work satisfaction in a tertiary psychiatric centre. Occup Med (Lond). 2013;63(6):442-4.

(81.) Croom AM. Music, neuroscience, and the psychology of well-being: a precis. Front Psychol. 2012;2:393.

(82.) Seligman MEP. Flourish: a visionary new understanding of happiness and well-being. Policy. 2011;27(3):60-1.

(83.) Izquierdo C. When "health" is not enough: societal, individual and biomedical assessments of well-being among the Matsigenka of the Peruvian Amazon. Soc Sci Med. 2005;61(4):767-83.

(84.) Tessier P, Lelorain S, Bonnaud-Antignac A. A comparison of the clinical determinants of health-related quality of life and subjective well-being in long-term breast cancer survivors. Eur J Cancer Care (Engl). 2012;21(5):692-700.

LEONARDO MACHADO [1], HERMANO TAVARES [2], KATIA PETRIBU [3], MONICA ZILBERMAN [2], RENATA FERRAZ TORRES [4], AMAURY CANTILINO [1]

[1] Post-Graduate Program in Neuropsychiatry and Behavioral Sciences, Federal University of Pernambuco (UFPE).

[2] Institute of Psychiatry, Hospital of the Faculty of Medicine, University of Sao Paulo (IPq-HOFMUSP).

[3] Post-Graduate Program in Health Sciences, Faculty of Medical Sciences, University of Pernambuco (UPE).

[4] Analytical Psychology Society of Sao Paulo.

Address correspondence to: Leonardo Machado. Rua Francisco da Cunha, 796, sala 9, Boa Viagem--51020-041--Recife, PE, Brazil. E-mail: leomachadoT@gmail.com
Table 1. Papers from 2013 to 2014 selected for this review

Author                 Title                   Year

Ali A, Ambler G,       The relationship        2013
Strydom A, Rai D,      between happiness
Cooper C, McManus S,   and intelligent
et al.                 quotient; the
                       contribution of
                       socioeconomic and
                       clinical factors

Baruch Y, Swartz M,    Staff happiness and     2013
Sirkis S, Mirecki I,   work satisfaction in
Barak Y                a tertiary
                       psychiatric centre

Binder M, Coad A       "I'm afraid I have      2013
                       bad news for you ..."
                       Estimating the
                       impact of different
                       health impairments
                       on subjective well-
                       being

Brasseur S, Gregoire   The Profile of          2013
J, Bourdu R,           Emotional Competence
Mikolajczak M          (PEC): development
                       and validation of a
                       selfreported measure
                       that fits dimensions
                       of emotional
                       competence theory

Chen H, Pine DS,       The MAOA gene           2013
Ernst M, Gorodetsky    predicts happiness
E, Kasen S, Gordon     in women
K, et al.

Christakis NA,         Social contagion        2013
Fowler JH              theory: examining
                       dynamic social
                       networks and human
                       behavior

Doherty M, Kelly BD    When Irish eyes are     2013
                       smiling: income and
                       happiness in
                       Ireland, 2003-2009

Eisenberg D,           Social contagion of     2013
Golberstein E,         mental health:
Whitlock J L, Downs    evidence from
MF                     college roommates

Gana K, Bailly N,      Relationship between    2013
Saada Y, Joulain M,    life satisfaction
Trouillet R, Herve     and physical health
C, Alaphilippe D       in older adults: a
                       longitudinal test of
                       cross-lagged and
                       simultaneous effects

Gruber J, Kogan A,     Happiness is best       2013
Quoldbach J, Mauss     kept stable: positive
IB                     emotion variability
                       is associated with
                       poorer psychological
                       health

Kang Y, Gruber J       Harnessing              2013
                       happiness?
                       Uncontrollable
                       positive emotion in
                       bipolar disorder,
                       major depression,
                       and healthy adults

Lehmann BA, Bos AER,   Ageing with an          2013
Rijken M, Cardol M,    intellectual
Peters GJY, Kok G,     disability: the
Curfs LMG              impact of personal
                       resources on
                       well-being

Mitchell L, Frank      The geography of        2013
MR, Harris KD, Dodds   happiness:
PS, Danforth CM        connecting twitter
                       sentiment and
                       expression,
                       demographics, and
                       objective
                       characteristics of
                       place

Proulx CM, Snyder-     The longitudinal        2013
Rivas LA               associations between
                       marital happiness,
                       problems, and
                       selfrated health

Ruseski JE,            Sport participation     2014
Humphreys BR,          and subjective
Hallman K, Wicker P,   wellbeing;
Breuer C               instrumental
                       variable results
                       from German survey
                       data

Sahraian A, Gholami    Association between     2013
A, Javadpour A,        religiosity and
Omivadir B             happiness among a
                       group of Muslim
                       undergraduate
                       students

Tay L, Kuykendall L    Promoting happiness;    2013
                       the malleability of
                       individual and
                       societal subjective
                       wellbeing

Van Campen C, de       Are informal            2013
Boer AH, Iedema J      caregivers less
                       happy than
                       noncaregivers?
                       Happiness and the
                       intensity of
                       caregiving in
                       combination with
                       paid and voluntary
                       work

Author                 Sample                 Main findings

Ali A, Ambler G,       The authors analysed   Those in the lowest
Strydom A, Rai D,      data from the 2007     IQ range (70-99)
Cooper C, McManus S,   Adult Psychiatric      reported the lowest
et al.                 Morbidity Survey in    levels of happiness
                       England (6870          compared with the
                       participantes aged     highest IQ group
                       16 years or over and   (120-129)
                       living in private
                       households were
                       included in the
                       study)

Baruch Y, Swartz M,    209 staff (185         Highest levels of
Sirkis S, Mirecki I,   nurses, 110            happiness were
Barak Y                administrative         reported by
                       staff, 61              psychologists and
                       psychiatrists, 35      social workers and
                       psychologists, 20      the lowest by
                       social workers and     nursing staff. Work
                       39 others) at a        orientations as a
                       large university-      "job", "career" and
                       affiliated tertiary    a "calling" also
                       care psychiatric       differed between
                       centre                 sectors with the
                                              highest levels of
                                              work as a "calling"
                                              reported by
                                              psychiatrists and
                                              the lowest by
                                              administrative staff

Binder M, Coad A       100,265 observations   The strongest
                       from the British       negative effect in
                       Household Panel        happiness is for
                       Survey (BHPS)          alcohol and drug
                       database (1996-        abuse, followed by
                       2006)                  anxiety, depression
                                              and other mental
                                              illnesses, stroke
                                              and cancer A
                                              puzzling asymmetry
                                              was detected: strong
                                              adverse reactions to
                                              deteriorations in
                                              health appear
                                              alongside weak
                                              increases in well-
                                              being after health
                                              improvements

Brasseur S, Gregoire   Five samples for a     The authors
J, Bourdu R,           total of 5676          developed and
Mikolajczak M          subjects (4753 women   validated in four
                       and 923 men, aged 15   steps a complete
                       to 84 years) in USA    (albeit short: 50
                                              items) self-
                                              reported measure of
                                              EC: the Profile of
                                              Emotional Competence

Chen H, Pine DS,       Data (The Children     In women, low
Ernst M, Gorodetsky    in the Community-      expression of MAOA
E, Kasen S, Gordon     CIC) for this study    (MAOA-L) was related
K, et al.              were drawn from the    significantly to
                       345 Caucasian          greater happiness
                       subjects include 193   after adjusting for
                       women and 152 men      the potential
                       who were assessed      effects of age,
                       for MAOA genotype in   education, household
                       2010 at mean age of    income, marital
                       38 and happiness in    status, employment
                       2004 at mean age of    status, mental
                       33                     disorder, physical
                                              health, relationship
                                              quality,
                                              religiosity, abuse
                                              history, recent
                                              negative life events
                                              and self-esteem use
                                              in linear regression
                                              models. In contrast,
                                              no such association
                                              was found in men

Christakis NA,         The authors describe   The authors describe
Fowler JH              the methods we have    the regularities
                       employed (and the      that led them to
                       assumptions they       propose that human
                       have entailed) to      social networks may
                       examine several        exhibit a "three
                       datasets with          degrees of
                       complementary          influence" property,
                       strengths and          and they review
                       weaknesses,            statistical
                       including the          approaches we have
                       Framingham Heart       used to characterize
                       Study, the National    interpersonal
                       Longitudinal Study     influence with
                       of Adolescent          respect to phenomena
                       Health, and other      as diverse as
                       observational and      obesity, smoking,
                       experimental           cooperation, and
                       datasets that we and   happiness
                       others have
                       collected

Doherty M, Kelly BD    Data from the          There was a slight
                       European Social        decline in happiness
                       Survey (ESS)           between 2005 and
                       relating to self-      2009, as mean self-
                       rated happiness and    rated happiness
                       social and             score changed from
                       psychological          7.94 (2005) to 7.55
                       correlates of          (2009).
                       happiness in Ireland   Satisfaction with
                       in 2003 (n = 2,046),   health had the
                       2005 (n  = 2,274),     strongest
                       2007 (n = 1,794) and   association with
                       2009 (n = 1,764)       happiness in 2003,
                                              2005 and 2007.
                                              Satisfaction with
                                              income, relative to
                                              other variables,
                                              increased over time
                                              and in 2009 had the
                                              strongest
                                              association with
                                              happiness

Eisenberg D,           Data come from         Findings are
Golberstein E,         online surveys of      consistent with no
Whitlock J L, Downs    first-year college     significant overall
MF                     students. The          contagion of mental
                       authors conducted      health and no more
                       the surveys at two     than small contagion
                       large and              effects for specific
                       academically           mental health
                       competitive            measures, with no
                       universities: one      evidence for
                       public school with     happiness contagion
                       approximately 6000     and modest evidence
                       first-year students    for anxiety and
                       (hereafter             depression
                       "university A"), and   contagion. The
                       one private school     similarity of
                       with approximately     baseline mental
                       4000 first-year        health predicts the
                       students               closeness of
                       ("university B").      roommate
                       The authors fielded    relationships, which
                       the baseline survey    highlights the
                       in August 2009,        potential for
                       shortly before         selection biases in
                       students arrived at    studies of peer
                       college, and the       effects that do not
                       follow-up survey in    have a clearly
                       March-April 2010,      exogenous source of
                       shortly before the     variation
                       end of the academic
                       year

Gana K, Bailly N,      The study included     Both cross-lagged
Saada Y, Joulain M,    899 participants       and simultaneous
Trouillet R, Herve     aged 64 to 97 years    coefficients
C, Alaphilippe D       and assessed 5 times   indicated that poor
                       over an 8-year         health significantly
                       period                 predicted subsequent
                                              levels of life
                                              dissatisfaction, but
                                              life satisfaction
                                              did not predict
                                              subsequent levels of
                                              health

Gruber J, Kogan A,     Study 1 included a     Greater macro- and
Quoldbach J, Mauss     sample of 244 adult    microlevel
IB                     participants from      variability in
                       the Denver,            positive emotion was
                       Colorado, community.   associated with
                       Study 2 consisted of   worse psychological
                       2,391 francophone      health, including
                       adults recruited       lower well-being and
                       through a large        life satisfaction
                       online study           and greater
                       mentioned during the   depression and
                       French TV show Leurs   anxiety (Study 1),
                       Secrets du Bonheur     and lower daily
                                              satisfaction, life
                                              satisfaction, and
                                              happiness (Study 2)

Kang Y, Gruber J       Participants           Across all
                       included adults with   participants,
                       bipolar 1 disorder     reliving a
                       (BD; n = 32), major    controllable
                       depression (MDD; n =   positive emotion
                       32), and or            experience was
                       nonpsychiatric         associated with
                       controls (CTLs; n =    exhibited increased
                       31)                    respiratory sinus
                                              arrhythmia, an
                                              autonomic marker of
                                              regulatory control.
                                              Interestingly, only
                                              the MDD group
                                              reported increased
                                              positive emotion and
                                              decreased
                                              cardiovascular
                                              arousal when
                                              reliving an event
                                              involving
                                              uncontrollable
                                              positive emotion,
                                              compared to the BD
                                              and CTL groups

Lehmann BA, Bos AER,   Longitudinal survey    Age is positively
Rijken M, Cardol M,    data on 667 people     related to decreased
Peters GJY, Kok G,     with a mild or         mobility and
Curfs LMG              moderate               auditory
                       intellectual           disabilities and
                       disabilities (ID)      negatively related
                       were acquired via      to independent
                       interviews in 2006     living, autonomy in
                       and 2010               how one spends one's
                                              leisure time and
                                              autonomy in
                                              decision-making.
                                              Longitudinal
                                              analyses
                                              demonstrated that,
                                              with the exception
                                              of health that
                                              deteriorated, and
                                              social satisfaction
                                              that improved,
                                              almost all variables
                                              remained stable over
                                              the 4-year period.
                                              Further, good
                                              physical health in
                                              2006 predicted
                                              happiness in 2010

Mitchell L, Frank      This article           Happiness within the
MR, Harris KD, Dodds   combining (1) a        US was found to
PS, Danforth CM        massive, geo-tagged    correlate strongly
                       data set comprising    with wealth, showing
                       over 80 million        large positive
                       words generated in     correlation with
                       2011 on the social     increasing house-
                       network service        hold income and
                       Twitter and (2)        strong negative
                       annually-surveyed      correlation with
                       characteristics of     increasing poverty.
                       all 50 states and      Happiness
                       close to 400 urban     anticorrelates
                       populations            significantly with
                                              obesity

Proulx CM, Snyder-     The sample included    Unidirectional
Rivas LA               707 continuously       coupling existed for
                       married adults who     marital happiness
                       participated in all    and self-rated
                       six waves of the       health only, such
                       Marital Instability    that higher levels
                       Over the Life Course   of marital happiness
                       panel study.           predicted subsequent
                       Participants           elevations in self-
                       averaged 35 years in   rated health over
                       age at the first       time. No evidence
                       wave and were          was found for
                       continuously married   bidirectional
                       to the same spouse     coupling between
                       over the 20-year       marital problems and
                       period                 self-rated health

Ruseski JE,            The sample used in     Individuals who
Humphreys BR,          the empirical          participate in sport
Hallman K, Wicker P,   analysis contains      have higher life
Breuer C               1238 adults between    happiness. The
                       the ages of 18-70      results suggest a U-
                       who responded to the   shaped relationship
                       question about         between age and
                       happiness              self-reported
                                              happiness. Higher
                                              income is associated
                                              with greater
                                              selfreported
                                              happiness, males are
                                              less happy than
                                              females, and single
                                              individuals are less
                                              happy than
                                              nonsingles

Sahraian A, Gholami    271 undergraduates     It was found that
A, Javadpour A,        medical students       higher score on
Omivadir B             attending Shiraz       religious belief was
                       University of          significantly linked
                       Medical Sciences in    to the level of
                       Iran                   happiness

Tay L, Kuykendall L    Literature review on   Research now shows
                       subjective wellbeing   that although
                                              subjective wellbeing
                                              is heritable and
                                              stable, it can
                                              change substantially
                                              over time. Long-
                                              term changes can be
                                              affected by positive
                                              or negative life
                                              events; subjective
                                              wellbeing
                                              interventions have
                                              also proved to be
                                              effective for
                                              boosting wellbeing
                                              for as long as six
                                              months. At the
                                              societal level,
                                              economic factors
                                              matter for the
                                              subjective wellbeing
                                              of citizens.
                                              Economic wealth is
                                              shown to be a
                                              predictor of
                                              societal wellbeing
                                              across countries and
                                              over time. Also,
                                              high unemployment
                                              severely lowers the
                                              wellbeing of
                                              individuals and has
                                              spillover effects on
                                              other societal
                                              members, such as the
                                              employed

Van Campen C, de       The sample consisted   Caregivers are
Boer AH, Iedema J      of 336 informal        happier than
                       caregivers and 1765    noncaregivers when
                       noncaregivers in the   they provide care
                       Dutch population       for < 6 hours a
                                              week; and in line
                                              with the burden
                                              assumption, the
                                              results show that
                                              providing care for
                                              more than 11 hours a
                                              week is associated
                                              with lower levels of
                                              happiness. Other
                                              results contradicted
                                              the burden
                                              assumption that
                                              combining caregiving
                                              with paid or
                                              voluntary work is
                                              associated with more
                                              time burden and less
                                              happiness. The
                                              result that
                                              combining caregiving
                                              with paid employment
                                              or volunteering is
                                              related to higher
                                              rates of happiness
                                              confirms the
                                              subjective well-
                                              being assumption

Author                 Main limitations       Conclusion

Ali A, Ambler G,       The use of a single    Those with lower IQ
Strydom A, Rai D,      question to measure    are less happy than
Cooper C, McManus S,   happiness. It is       those with higher
et al.                 easier for people      IQ. Interventions
                       with lower IQ to       that target
                       understand compared    modifiable variables
                       with using a           such as income and
                       detailed inventory,    neurotic symptoms
                       however the            may improve levels
                       subjective nature of   of happiness in the
                       the happiness          lower IQ groups
                       measure may affect
                       its validity and the
                       use of a single-
                       item question may be
                       less valid in those
                       with higher IQ

Baruch Y, Swartz M,    Less than half of      Satisfaction with
Sirkis S, Mirecki I,   all staff              life is not "driven"
Barak Y                participated, the      by work orientation.
                       questionnaires         Psychiatrists
                       chosen were brief      perceive their work
                       and designed for       as a calling but do
                       survey purposes        not seem to benefit
                       rather than in-        from this in their
                       depth evaluations      satisfaction with
                                              life Improving staff
                                              happiness may
                                              contribute to
                                              increase in moral
                                              and counter burnout

Binder M, Coad A       The measure of life    Bad health decreases
                       satisfaction was       individuals'
                       made from a single     happiness
                       question. Subjective   differently
                       well-being questions
                       were elicited via
                       self-completion,
                       while health
                       condition answers by
                       an interviewer. Bias
                       could result if
                       individuals
                       systematically
                       answer health
                       questions
                       differently in the
                       interviewer's
                       presence

Brasseur S, Gregoire   --                     Analyses performed
J, Bourdu R,                                  on a representative
Mikolajczak M                                 sample of 5676
                                              subjects revealed
                                              promising
                                              psychometric
                                              properties. The
                                              internal consistency
                                              of scales and
                                              subscales alike was
                                              satisfying,
                                              factorial structure
                                              was as expected, and
                                              concurrent/
                                              discriminant
                                              validity was good

Chen H, Pine DS,       There is no single     This new finding may
Ernst M, Gorodetsky    "happiness" gene and   help explain the
E, Kasen S, Gordon     likely to be a set     gender difference on
K, et al.              of genes whose         happiness and
                       expression             provide a link
                       influences             between MAOA and
                       subjective well-       human happiness
                       being. Future work
                       should attempt to
                       identify other genes
                       that are associated
                       with human happiness

Christakis NA,         --                     The authors do not
Fowler JH                                     claim that this work
                                              is the final word,
                                              but they do believe
                                              that it provides
                                              some novel,
                                              informative, and
                                              stimulating evidence
                                              regarding social
                                              contagion in
                                              longitudinally
                                              followed networks.
                                              Along with other
                                              scholars, they are
                                              working to develop
                                              new methods for
                                              identifying causal
                                              effects using social
                                              network data, and
                                              they believe that
                                              this area is ripe
                                              for statistical
                                              development as
                                              current methods have
                                              known and often
                                              unavoidable
                                              limitations

Doherty M, Kelly BD    Absence of data        Despite dramatic
                       relating to certain    changes in economic
                       variables that have    circumstances and a
                       been associated with   slight decline in
                       happiness in           happiness, the Irish
                       previous studies.      continued an
                       This study was also    historic tradition
                       limited in its         of rating ourselves
                       ability to assess      as generally very
                       religiosity in         happy
                       people of no
                       religion, but this
                       is due to the
                       limitations of the
                       ESS

Eisenberg D,           Perhaps the most       These results
Golberstein E,         important question     suggest that mental
Whitlock J L, Downs    about the results of   health contagion is
MF                     this study is how      lower, or at least
                       they generalize to     more context
                       other social           specific, than
                       contexts. Contagion    implied by the
                       may be quite           recent studies in
                       different across       the medical
                       other social ties,     literature
                       particularly more
                       intimate
                       relationships such
                       as spouses,
                       siblings, and
                       longtime friends.
                       Contagion may also
                       vary considerably by
                       age group,
                       considering how
                       people's social
                       relationships and
                       networks evolve
                       during their

Gana K, Bailly N,      Cross-lagged and       These findings
Saada Y, Joulain M,    simultaneous           contradict, at least
Trouillet R, Herve     structural models      in this older
C, Alaphilippe D       provide tests of       sample, the
                       reciprocal             postulates of
                       influences between     positive psychology,
                       constructs over        and support the
                       time, not of           bottom-up approach
                       causality. The         to well-being as
                       assessment of self-    well as the popular
                       perceived health       adage, "As long as
                       with a one-item        you've got your
                       question is also       health"
                       disputed

Gruber J, Kogan A,     Cross-sectional        Taken together,
Quoldbach J, Mauss     study                  these findings
IB                                            support the notion
                                              that positive
                                              emotion variability
                                              plays an important
                                              and incremental role
                                              in psychological
                                              health above and
                                              beyond overall
                                              levels of happiness,
                                              and that too much
                                              variability might be
                                              maladaptive

Kang Y, Gruber J       Emotion control was    These findings
                       self-defined by the    suggest that
                       participants in this   although
                       study, so we cannot    controllable
                       know precisely how     positive emotion
                       successful people      experiences may be
                       actually were in       adaptive for most,
                       controlling their      individuals with a
                       emotions in the        history of
                       recalled events        restricted affect
                                              and depressed mood
                                              may actually derive
                                              more pleasure from
                                              times of unharnessed
                                              happiness

Lehmann BA, Bos AER,   Most of the items      Despite the fact
Rijken M, Cardol M,    were dichotomous as    that age is
Peters GJY, Kok G,     asking people with     associated with
Curfs LMG              ID to answer           poorer physical and
                       questions is not       mental health and a
                       always easy Some       smaller social
                       associations were      network, this study
                       barely significant     showed that older
                       and had weak effect    people with ID have
                       sizes and should       relatively high
                       therefore be           levels of well-
                       interpreted with       being
                       caution

Mitchell L, Frank      There are a number     The results show how
MR, Harris KD, Dodds   of legitimate          social media may
PS, Danforth CM        concerns to be         potentially be used
                       raised about how       to estimate real-
                       well the Twitter       time levels and
                       data set can be said   changes in
                       to represent the       population-scale
                       happiness of the       measures such as
                       greater population.    obesity rates
                       Furthermore, the
                       fact that the
                       authors collected
                       only around 10% of
                       all tweets during
                       the calendar year
                       2011 means that
                       their data set is a
                       nonuniform subsample
                       of statements made
                       by a
                       nonrepresentative
                       portion of the
                       population

Proulx CM, Snyder-     Findings cannot be     Similar to human
Rivas LA               generalized to all     development
                       married individuals,   scholars' assertion
                       a focus on people      that aging
                       who were married       adults are survivors
                       continuously across    of conditions and
                       20 years provides      events related to an
                       evidence of the        increased risk of
                       associations between   mortality,
                       marital happiness      individuals in long-
                       and self-rated         term marriages may
                       health in long-term    be considered
                       marriages. All         survivors of
                       health and marital     relationship
                       quality variables      problems and other
                       were self-reports,     challenges that
                       and objective and      could have
                       observational          contributed to
                       measures,              marital dissolution
                       respectively, may
                       yield different
                       results

Ruseski JE,            Cross-sectional        This broader impact
Humphreys BR,          study                  of sport
Hallman K, Wicker P,   Telephone interview    participation on
Breuer C                                      general happiness
                                              lends support to the
                                              policy priority of
                                              many governments to
                                              increase sport
                                              participation at all
                                              levels of the
                                              general population

Sahraian A, Gholami    Cross-sectional        The result confirms
A, Javadpour A,        study                  that individuals
Omivadir B                                    with a more
                                              religious attitude
                                              experience more
                                              happiness. The
                                              result of this study
                                              should be considered
                                              in programs designed
                                              to improve overall
                                              well-being of
                                              university students

Tay L, Kuykendall L    Is not a systematic    For practitioners,
                       review article         policy makers, and
                                              economists
                                              interested in the
                                              wellbeing of
                                              individuals, this
                                              article propose that
                                              these findings have
                                              implications for
                                              mental health
                                              practice and
                                              economic policies

Van Campen C, de       The variables of       It is concluded that
Boer AH, Iedema J      burden and happiness   these cross-
                       were measured with     sectional results
                       single items. Cross-   open ways to
                       sectional study        longitudinal
                                              research that can
                                              inform governments
                                              in the development
                                              of policies to
                                              support informal
                                              caregivers
COPYRIGHT 2015 Universidade de Sao Paulo, Facultade de Medicina
No portion of this article can be reproduced without the express written permission from the copyright holder.
Copyright 2015 Gale, Cengage Learning. All rights reserved.

Article Details
Printer friendly Cite/link Email Feedback
Title Annotation:texto en ingles
Author:Machado, Leonardo; Tavares, Hermano; Petribu, Katia; Zilberman, Monica; Torres, Renata Ferraz; Canti
Publication:Archives of Clinical Psychiatry
Date:May 1, 2015
Words:9980
Previous Article:Social support and bipolar disorder.
Next Article:Transcultural adaptation of the Amyotrophic Lateral Sclerosis Depression Inventory to Brazilian Portuguese.
Topics:

Terms of use | Privacy policy | Copyright © 2019 Farlex, Inc. | Feedback | For webmasters