From the Department of Psychology, University of California, Berkeley, Berkeley, California.
Psychosom Med. 2019 Oct;81(8):720-730. doi: 10.1097/PSY.0000000000000736.
Research on stress and disease has often afforded an important role to emotion, typically conceptualized in broad categories (e.g., negative emotions), viewed as playing a causal role (e.g., anger contributing to pathophysiology of cardiovascular disease), and measured using self-report inventories. In this article, I argue for the value of evaluating specific emotions, considering bidirectional causal influences, and assessing actual emotional responding when considering the role that emotions play in the stress-disease relationship. In terms of specificity, specific emotions (e.g., anger, sadness, and embarrassment) can be linked with particular health outcomes (e.g., cardiovascular disease and musculoskeletal disease). In terms of bidirectionality, the influences of emotions on disease as well as the influences of disease on emotional functioning can be considered. In terms of assessing actual emotional responding, emotions can be studied in vivo under controlled conditions that allow behavioral, physiological, and subjective responses to be measured during different kinds of emotional functioning (e.g., responding to emotional stimuli, interacting with relationship partners, and downregulating emotional responses). With these considerations in mind, I review early theories and empirical studies in psychosomatic medicine that considered the role of specific emotions and emotion-related behaviors. Studies from our laboratory are presented that illustrate a) differences in patterns of autonomic nervous system responding associated with specific emotions, b) relationships between specific emotions and particular health outcomes in the context of social relationships, c) age as a moderator of the relationship between specific emotions and well-being, d) bidirectional influences (emotions influencing disease and disease influencing emotional functioning), and e) impact of changes in emotional functioning in individuals with neurodegenerative diseases on the health of familial caregivers.
研究压力与疾病的关系时，情绪通常占据重要地位，其概念通常较为宽泛（如负性情绪），被视为致病因素（如愤怒会导致心血管疾病的病理生理学变化），并通过自陈式量表进行测量。本文中，我将论证评估特定情绪、考虑双向因果关系以及评估实际情绪反应在情绪与压力-疾病关系中所起作用的价值。在特异性方面，特定情绪（如愤怒、悲伤和尴尬）可与特定健康结果（如心血管疾病和肌肉骨骼疾病）相关联。在双向性方面，情绪对疾病的影响以及疾病对情绪功能的影响都需要被考虑。在评估实际情绪反应方面，可以在受控条件下对情绪进行研究，以便在不同的情绪功能（如对情绪刺激的反应、与人际关系伙伴的互动以及情绪反应的调节）期间测量行为、生理和主观反应。基于这些考虑，我回顾了心身医学中早期考虑特定情绪和情绪相关行为作用的理论和实证研究。本文展示了我们实验室的研究，这些研究表明：a）特定情绪与自主神经系统反应模式相关；b）在社会关系背景下，特定情绪与特定健康结果之间的关系；c）年龄是特定情绪与幸福感之间关系的调节因素；d）情绪对疾病的影响和疾病对情绪功能的影响之间存在双向关系；e）神经退行性疾病患者情绪功能变化对其家族照顾者健康的影响。
