6I will say almost nothing about really serious mental illness.
7Psychosis occurs in about 1% of the population. I will say almost nothing about really serious mental illness.Psychosis occurs in about 1% of the population.
8Instead we can think of mental ill-health (depression, anxiety, and mental strain).
9Happiness and life-satisfaction equations typically have similar structures to mental-health equations.
10A psychological-ill-health measure used a lot in the psychiatry literature is a GHQ score (which stands for General Health Questionnaire).
11Typical GHQ mental-strain questions Have you:Lost much sleep over worry?
12Typical GHQ mental-strain questions Have you:Lost much sleep over worry?Felt constantly under strain?
13Typical GHQ mental-strain questions Have you:Lost much sleep over worry?Felt constantly under strain?Felt you could not overcome your difficulties?
14Typical GHQ mental-strain questions Have you:Lost much sleep over worry?Felt constantly under strain?Felt you could not overcome your difficulties?Been feeling unhappy and depressed?
15It was developed as a way to judge who needs psychiatric treatment.
16The exact 12 questions that make up a GHQ score “Have you lost much sleep over worry?”; “Been able to concentrate on things?”; “Felt you are playing a useful part in things?”; “Felt capable of making decisions about things?”; “Felt constantly under strain?”; “Felt you could not overcome your difficulties?”;
17“Been able to enjoy your normal day-to-day activities”; “Been able to face up to your problems”; “Been feeling unhappy and depressed?”; “Been losing confidence in yourself?”; “Been thinking of yourself as a worthless person?”; “Been feeling reasonably happy all things considered?”.
31We are interested in equations for Heart rate Systolic blood pressure Diastolic blood pressure C-reactive protein Fibrinogen
32Blood pressure = cardiac output X peripheral resistance.
33Systolic pressure is the force of blood in the arteries as the heart beats. It is shown as the top number in a blood pressure reading. High blood pressure is 140 and higher for systolic pressure.
34Diastolic pressure is the force of blood in the arteries as the heart relaxes between beats. It's shown as the bottom number in a blood pressure reading.
35C-reactive protein (CRP) is a protein found in the blood, the levels of which rise in response to inflammation (i.e. C-reactive protein is an acute-phase protein). It is synthesized in the liver.
36Fibrinogen is a protein that plays a key role in blood clotting Fibrinogen is a protein that plays a key role in blood clotting. Fibrinogen is a sticky, fibrous coagulant in the blood that increases the risk of experiencing one of the leading causes of death and disability - stroke.
51Nicolas Troubat et al (2009) European Journal of Applied Physiology 20 chess players – international and national-level players. They all played against a computer.
52The computer standard was deliberately set one level higher.
53The computer standard was deliberately set one level higher. So all the players lost against the computer.
54What happened? Average heart-rate rose 11 beats a minute On average, players used up 140 calories playing the gameOverall, the physiological changes were “similar…those … in moderate physical exercise”.
55QuestionCould physiological measures -- biomarkers -- be used as proxies for well-being?
57Or maybe in the long run in western society we can blend well-being survey responses with biomarker data.
58For exampleCortisol is produced by the adrenal gland in the zona fasciculata, the second of three layers comprising the outer adrenal cortex. This release is controlled by the hypothalamus, a part of the brain.
59Main functions of cortisol in the body increasing blood sugar through glycogenolysis and reduction of glucose uptake into cells.suppressing the immune systemaiding in fat, protein, and carbohydrate metabolism
60The amount of cortisol present in the blood undergoes diurnal variation; the level peaks in the early morning (approximately 8 am) and reaches its lowest level at about midnight-4 am, or three to five hours after the onset of sleep.
61Important work by Andrew Steptoe of UCL: Whitehall II data
62Salivary cortisol (Steptoe data) Cortisol across the working day by happiness quintile8 samples (08:00 – 22:30)Adjusted for gender, age, occupational grade, smoking, bmi, and GHQ
63Heart rateP = .017 in menAdjusted for age, occupational grade, concurrentphysical activity, smoking, bmi, and GHQ scoreSteptoe et al, 2005PNAS
64Some of our latest work: Joint with Nicholas Christakis (Harvard) and David Blanchflower (Dartmouth)Statistical links between the heart and income and happiness.
65Pulse: Average heart rate is about 72 beats per minute.
66Interesting patterns emerge First, there are well-determined income gradients in (and only in) heart-rate and C-reactive protein equations.
67Second, heart rate seems to have potential as a proxy measure for mental strain, so might eventually be usable as a measure of negative ‘utility’ in an economist’s framework.
68Third, education has little effect within biomarker equations.
69Fourth, it is more important to control for diet than has been traditionally recognized in the health-economics literature.
70Fifth, biomarker variables work powerfully in well-being equations.
71To cliniciansHigh blood pressure is potentially a sign of mental strain and low well-being
72But how about high blood pressure as a national measure of well-being?
73Across nations, hypertension and happiness are inversely correlated (Blanchflower and Oswald, 2008 Journal of Health Economics)
74Happiness and mental well-being are of interest in themselves.
75But, more broadly, there seem to be deep links between mind and body.
76Author(s): Ebrecht M, Hextall J, Kirtley LG, Taylor A, Dyson M, Weinman J PSYCHONEUROENDOCRINOLOGY Volume: 29 Issue: 6 Pages: Published: JUL 2004
77“Every subject received a standard 4mm-punch biopsy, and the healing progress was monitored via high-resolution ultrasound scanning.”
78“Every subject received a standard 4mm-punch biopsy, and the healing progress was monitored via high-resolution ultrasound scanning.”
79Ebrecht et al 2004The overall results showed a significant negative correlation between speed of wound healing and GHQ scores (r = -.59; p < .01)
80In other words, happier human beings heal more quickly.
82A more recent paper“Enhanced wound healing after emotional disclosure intervention”Weinman, Ebrecht et alBRITISH JOURNAL OF HEALTH PSYCHOLOGY Volume: 13 Pages: Part: Part 1 Published: FEB 2008
83Participants who wrote about traumatic events had significantly smaller wounds 14 and 21 days after the biopsy compared with those who wrote about time management.
84AlsoThere is some evidence that happiness seems to make you live longer.
85Journal of Personality and Social Psychology, 2001 The ‘Nuns Study’Journal of Personality and Social Psychology, 2001
86“Positive emotions in early life and longevity: Findings from the nun study.” By Danner, Deborah D.; Snowdon, David A.; Friesen, Wallace V. Journal of Personality and Social Psychology, Vol 80(5), May 2001,
87Handwritten autobiographies from 180 Catholic nuns, composed when participants were a mean age of 22 years, were scored for emotional content and related to survival during ages 75 to 95.
88One of the nuns wrote:“God started my life off well by bestowing upon me grace of inestimable value… The past year which I spent as a candidate studying at Notre Dame has been a very happy one. Now I look forward with eager joy to receiving the Holy Habit of Our Lady and to a life of union with Love Divine”
89Whilst another nun wrote: “I was born on September 26, 1909, the eldest of seven children, five girls and two boys… My candidate year was spent in the motherhouse, teaching chemistry and second year Latin at Notre Dame Institute. With God’s grace, I intend to do my best for our Order, for the spread of religion and for my personal sanctification.”
90After joining the order their lives were almost exactly the same - same food, same work, same routineBut not the same life expectancy…Among the less-positive nuns, 65% died before their 85th birthday. Among the happy nuns, 90% were still alive.
91A strong inverse association was found between positive emotional content in these writings and risk of mortality in late life (p < .001).
92As the quartile ranking of positive emotion in early life increased, there was a stepwise decrease in risk of mortality resulting in a 2.5-fold difference between the lowest and highest quartiles.
93Positive emotional content in early-life autobiographies was strongly associated with longevity 6 decades later.
94An early, famous paperTitle: PSYCHOLOGICAL STRESS AND SUSCEPTIBILITY TO THE COMMON COLD Author(s): COHEN S, TYRRELL DAJ, SMITH AP Source: NEW ENGLAND JOURNAL OF MEDICINE Volume: 325 Issue: 9 Pages: Published: AUG
95Researchers need to understand these mind-body interconnections better.
96Another interesting issue is how we might match (or validate) well-being data with measures of mental health.
97Consider the famous U shape in well-being through life. Say a sceptic disbelieved all well-being data and just would not change his or her mind.
98One route would be to use data that independently confirm the patterns in happiness regression equations.
99One route would be to use data that independently confirm the patterns in happiness regression equations. Here is an example.
100AntidepressantsWork joint with Blanchflower on antidepressant consumption in Europe.