1. Study suggests Industrial Revolution may have left a damaging psychological ‘imprint’ on today’s populations

    December 21, 2017 by Ashley

    From the University of Cambridge press release:

    People living in the former industrial heartlands of England and Wales are more disposed to negative emotions such as anxiety and depressive moods, more impulsive and more likely to struggle with planning and self-motivation, according to a new study of almost 400,000 personality tests.

    The findings show that, generations after the white heat of Industrial Revolution and decades on from the decline of deep coal mining, the populations of areas where coal-based industries dominated in the 19th century retain a “psychological adversity.”

    Researchers suggest this is the inherited product of selective migrations during mass industrialisation compounded by the social effects of severe work and living conditions.

    They argue that the damaging cognitive legacy of coal is “reinforced and amplified” by the more obvious economic consequences of high unemployment we see today. The study also found significantly lower life satisfaction in these areas.

    The UK findings, published in the Journal of Personality and Social Psychology, are supported by a North American “robustness check,” with less detailed data from US demographics suggesting the same patterns of post-industrial personality traits.

    Regional patterns of personality and well-being may have their roots in major societal changes underway decades or centuries earlier, and the Industrial Revolution is arguably one of the most influential and formative epochs in modern history,” says co-author Dr Jason Rentfrow, from the University of Cambridge’s Department of Psychology.

    “Those who live in a post-industrial landscape still do so in the shadow of coal, internally as well as externally. This study is one of the first to show that the Industrial Revolution has a hidden psychological heritage, one that is imprinted on today’s psychological make-up of the regions of England and Wales.”

    An international team of psychologists, including researchers from the Queensland University of Technology, University of Texas, University of Cambridge and the Baden-Wuerttemberg Cooperative State University, used data collected from 381,916 people across England and Wales during 2009-2011 as part of the BBC Lab’s online Big Personality Test.

    The team analysed test scores by looking at the “big five” personality traits: extraversion, agreeableness, conscientiousness, neuroticism and openness. The results were further dissected by characteristics such as altruism, self-discipline and anxiety.

    The data was also broken down by region and county, and compared with several other large-scale datasets including coalfield maps and a male occupation census of the early 19th century (collated through parish baptism records, where the father listed his job).

    The team controlled for an extensive range of other possible influences — from competing economic factors in the 19th century and earlier, through to modern considerations of education, wealth and even climate.

    However, they still found significant personality differences for those currently occupying areas where large numbers of men had been employed in coal-based industries from 1813 to 1820 — as the Industrial Revolution was peaking.

    Neuroticism was, on average, 33% higher in these areas compared with the rest of the country. In the ‘big five’ model of personality, this translates as increased emotional instability, prone to feelings of worry or anger, as well as higher risk of common mental disorders such as depression and substance abuse.

    In fact, in the further “sub-facet” analyses, these post-industrial areas scored 31% higher for tendencies toward both anxiety and depression.

    Areas that ranked highest for neuroticism include Blaenau Gwent and Ceredigion in South Wales, and Hartlepool in England.

    Conscientiousness was, on average, 26% lower in former industrial areas. In the ‘big five’ model, this manifests as more disorderly and less goal-oriented behaviours — difficulty with planning and saving money. The underlying sub-facet of ‘order’ itself was 35% lower in these areas.

    The lowest three areas for conscientiousness were all in Wales (Merthyr Tydfil, Ceredigion and Gwynedd), with English areas including Nottingham and Leicester.

    An assessment of life satisfaction was included in the BBC Lab questionnaire, which was an average of 29% lower in former industrial centres.

    While researchers say there will be many factors behind the correlation between personality traits and historic industrialisation, they offer two likely ones: migration and socialisation (learned behaviour).

    The people migrating into industrial areas were often doing so to find employment in the hope of escaping poverty and distressing situations of rural depression — those experiencing high levels of ‘psychological adversity’.

    However, people that left these areas, often later on, were likely those with higher degrees of optimism and psychological resilience, say researchers.

    This “selective influx and outflow” may have concentrated so-called ‘negative’ personality traits in industrial areas — traits that can be passed down generations through combinations of experience and genetics.

    Migratory effects would have been exacerbated by the ‘socialisation’ of repetitive, dangerous and exhausting labour from childhood — reducing well-being and elevating stress — combined with harsh conditions of overcrowding and atrocious sanitation during the age of steam.

    The study’s authors argue their findings have important implications for today’s policymakers looking at public health interventions.

    “The decline of coal in areas dependent on such industries has caused persistent economic hardship — most prominently high unemployment. This is only likely to have contributed to the baseline of psychological adversity the Industrial Revolution imprinted on some populations,” says co-author Michael Stuetzer from Baden-Württemberg Cooperative State University, Germany.

    “These regional personality levels may have a long history, reaching back to the foundations of our industrial world, so it seems safe to assume they will continue to shape the well-being, health, and economic trajectories of these regions.”

    The team note that, while they focused on the negative psychological imprint of coal, future research could examine possible long-term positive effects in these regions born of the same adversity — such as the solidarity and civic engagement witnessed in the labour movement.

    The top 10 UK regions near historical coalfields (0-25km distance) that rank highest in Neuroticism among coal regions (ranking in order with Blaenau Gwent having the highest scores in N among the coal regions).

    (UA = Unitary authority)

    Blaenau Gwent

    Hartlepool UA

    Merthyr Tydfil

    Stoke-on-Trent UA

    Newport

    Blackpool UA

    Rhondda Cynon Taf

    Powys

    Halton UA

    Derby UA

    The top 10 UK regions near historical coalfields (0-25 km distance) that rank lowest in Conscientiousness among coal regions (ranking in order with Merthyr Tydfil having the lowest scores in C among the coal regions).

    Merthyr Tydfil

    Ceredigion

    Gwynedd

    Bristol City UA

    Leicester UA

    Nottingham UA

    Blackpool UA

    Cardiff

    Blaenau Gwent

    Middlesbrough UA


  2. New method helps identify causal mechanisms in depression

    December 17, 2017 by Ashley

    From the Elsevier press release:

    People with major depressive disorder have alterations in the activity and connectivity of brain systems underlying reward and memory, according to a new study in Biological Psychiatry: Cognitive Neuroscience and Neuroimaging. The findings provide clues as to which regions of the brain could be at the root of symptoms, such as reduced happiness and pleasure, in depression.

    As the first of its kind, the new study by Prof. Edmund Rolls, Prof. Jianfeng Feng, Dr. Wei Cheng, and colleagues at the University of Warwick, UK uses a new approach to measure the influence of one brain region on another, referred to as effective connectivity, in depression. The approach goes beyond the limitations of previous brain imaging studies, which show if — but not how — activity of different brain regions is related. “The new method allows the effect of one brain region on another to be measured in depression, in order to discover more about which brain systems make causal contributions to depression,” said Prof. Rolls.

    “This represents an exciting new methodological advance in the development of diagnostic biomarkers and the identification of critical brain circuitry for targeted interventions for major depression,” said Dr. Cameron Carter, Editor of Biological Psychiatry: Cognitive Neuroscience and Neuroimaging.

    Rolls and colleagues compared 336 people with major depressive disorder to 350 healthy controls. Brain regions involved in reward and subjective pleasure received less drive (or reduced effective connectivity) in patients, which may contribute to the decreased feeling of happiness in depression.

    In addition, brain regions involved in punishment and responses when a reward is not received had decreased effective connectivity and increased activity, providing evidence for the source of sadness that occurs in the disorder.

    Memory-related areas of the brain had increased activity and connectivity in people with depression, which the authors suggest may be related to heightened memory processing, possibly of unpleasant memories, in depression.

    “These findings are part of a concerted approach to better understand the brain mechanisms related to depression, and thereby to lead to new ways of understanding and treating depression,” said Prof. Rolls.


  3. Study suggests lack of sleep could cause mood disorders in teens

    December 14, 2017 by Ashley

    From the American College of Neuropsychopharmacology press release:

    Chronic sleep deprivation — which can involve staying up late, and waking up early for work or school — has become a way of life for both kids and adults, especially with the increasing use of phones and tablets late into the night. But this social jet lag poses some serious health and mental health risks: new research finds that for teenagers, even a short period of sleep restriction could, over the long-term, raise their risk for depression and addiction.

    University of Pittsburgh’s Peter Franzen and Erika Forbes invited 35 participants, aged 11.5-15 years, into a sleep lab for two nights. Half the participants slept for 10 hours, while the other half slept only four hours. A week later, they came back to the lab for another two nights and adopted the opposite sleep schedule from their initial visit.

    Each time they visited the lab, the participants underwent brain scans while playing a game that involved receiving monetary rewards of $10 and $1. At the end of each visit, the teens answered questions that measured their emotional functioning, as well as depression symptoms.

    The researchers found that sleep deprivation affected the putamen, an area of the brain that plays a role in goal-based movements and learning from rewards. When participants were sleep-deprived and the reward in the game they played was larger, the putamen was less responsive. In the rested condition, the brain region didn’t show any difference between high- and low-reward conditions.

    Franzen and Forbes also found connections between sleep restriction and mood: after a night of restricted sleep, the participants who experienced less activation in the putamen also reported more symptoms of depression. This is consistent with findings, from a large literature of studies on depression and reward circuitry, that depression is characterized by less activity in the brain’s reward system.

    The results suggest that sleep deprivation in the tween and teen years may interfere with how the brain processes rewards, which could disrupt mood and put a person at risk of depression, as well as risk-taking behavior and addiction.


  4. Study suggests surrogate decision makers experience psychological distress

    December 13, 2017 by Ashley

    From the Regenstrief Institute press release:

    Nearly half of the 13 million older adults hospitalized annually in the United States are unable to make their own medical decisions and rely on surrogates, usually close family members, to make decisions for them. However little is known about how these surrogates respond to the demands put upon them. A new study from the Indiana University Center for Aging Research and the Regenstrief Institute explores predictors and frequency of surrogate decision-maker distress and has found high levels of both anxiety and depression.

    The researchers report that provision of high levels of emotional support to surrogates during their family member’s hospitalization was associated with more effective decisions and lower surrogate anxiety, depression and post-traumatic stress.

    While emotional support (such as, “hospital staff really listened to me when we talked”) was associated with decision quality, surprisingly provision of information (“I [surrogate] received as much detail about my loved one’s care as I needed”) was less important.

    The researchers note that their study provides a detailed look at the relationship between clinician communication and psychological well-being of the family member. While this observational study does not prove causation, it raises the question of whether improved emotional support of surrogates could lead to both better decisions for the patient and better psychological outcomes for the surrogate.

    “Family decision makers face emotional, ethical and communication challenges that differ from personal decision making. It is not enough to provide good information; family members also need emotional support when making difficult decisions,” said corresponding author Alexia Torke, MD, the IU Center for Aging Research associate director, Regenstrief Institute investigator and IU School of Medicine associate professor of medicine, who led the study.

    “As the population ages and more and more family members are thrust into the role of surrogate decision makers, appropriately supporting these family members will become a public health imperative,” she said. Dr. Torke is the associate division chief of general internal medicine and geriatrics at IU School of Medicine and is also affiliated with the IU Health Fairbanks Center for Medical Ethics and Daniel F. Evans Center for Spiritual and Religious Values in Healthcare.

    A total of 364 patient-surrogate pairs from three hospitals were enrolled in the study. The average patient age was 82. Six out of ten patients were female and nearly three out of ten were African-American. Surrogates’ average age was 58 and 71 percent were female. Two thirds of surrogates were the patient’s adult children; 17 percent were the patient’s spouse.

    As many as 15 percent of the surrogate decision makers were found to suffer from clinically high levels of anxiety, depression or post-traumatic stress even six to eight weeks after the family member’s hospitalization. Some of the surrogate distress experienced during the acute illness resolved, but remained high for over 10 percent of surrogates. Surprisingly, anxiety and depression was not significantly higher for those making decisions for ICU patients than for other inpatients.

    “Even though high quality information is associated with overall satisfaction with the hospital stay, information without emotional support may be harmful to surrogates,” said Dr. Torke. “Improved emotional support could lead to both better decisions for the patient and better psychological outcomes for the surrogate. Physicians, nurses, chaplains and social workers can provide emotional support to family members. This study points to the fact that this support is very important.”


  5. Study examines which adolescents benefit most from sleep interventions

    December 3, 2017 by Ashley

    From the Wiley press release:

    In a recent study of adolescents, the benefits of cognitive-behavioral sleep interventions were greatest among individuals with higher levels of anxiety and depressive symptoms. The results, which are published in the Journal of Child Psychology and Psychiatry, were consistent across genders.

    “We know there is a strong link between emotional problems, like anxiety and depression, and sleep problems. In the past some researchers and clinicians have thought that these emotional problems might interfere with sleep improvement treatments, but our results with adolescents show that the opposite is the case,” said senior author Dr. Nicholas Allen, of the University of Oregon. “Those with higher levels of emotional problems were actually more likely to benefit from sleep interventions. This opens up new opportunities to use sleep improvement as a way to address mental health.”


  6. Study links teenage depression to father’s depression

    November 28, 2017 by Ashley

    From the University College London press release:

    Adolescents whose fathers have depressive symptoms are more likely to experience symptoms of depression themselves, finds a new study led by UCL researchers.

    While the link between mothers’ depression and depression in their children is well-established, the new Lancet Psychiatry study is the first to find an association between depression in fathers and their teenaged children, independent of whether the mother has depression, in a large sample in the general population. The effects of fathers’ and mothers’ depression on their children’s symptoms were similar in magnitude.

    “There’s a common misconception that mothers are more responsible for their children’s mental health, while fathers are less influential — we found that the link between parent and teen depression is not related to gender,” said the study’s lead author, Dr Gemma Lewis (UCL Psychiatry).

    “Family-focused interventions to prevent depression often focus more on mothers, but our findings suggest we should be just as focused on fathers,” she said.

    The researchers drew on two large longitudinal studies of children: Growing up in Ireland, and the Millennium Cohort Study in England and Wales, using data from 6070 and 7768 families from the two studies, respectively. Parental depressive symptoms were assessed using a questionnaire when the children were 9 and 7 years old in the two cohorts, and then adolescent depressive symptoms were assessed when the children were 13 and 14 years old. The study samples were population-based, meaning they included people who experienced symptoms of depression but had not sought treatment.

    After adjusting for confounding factors such as maternal depression, family income and parental alcohol use, the researchers found that for every 3-point (one standard deviation) increase on the Mood and Feelings Questionnaire (MFQ; a commonly-used measure of depressive symptoms) on the part of fathers, there was an associated 0.2-point increase in the adolescent’s MFQ score. The findings were replicated in both independent study samples.

    Incidence of depression increases markedly at the beginning of adolescence, so the researchers say that understanding the risk factors at that age can be key to preventing depression later in life.

    “Men are less likely to seek treatment for depression. If you’re a father who hasn’t sought treatment for your depression, it could have an impact on your child. We hope that our findings could encourage men who experience depressive symptoms to speak to their doctor about it,” said Dr Lewis.

    Previous studies have shown links between paternal depression and poor behavioural and emotional outcomes in their children, but no large study in the general population (as opposed to a clinical population) has looked at the link with adolescent depression while taking into account maternal depression as well.

    “The mental health of both parents should be a priority for preventing depression among adolescents. There has been far too much emphasis on mothers but fathers are important as well,” said the study’s senior author, Professor Glyn Lewis (UCL Psychiatry).


  7. Study looks at mental health risks of too much screen time

    November 24, 2017 by Ashley

    From the San Diego State University press release:

    Increased time spent in front of a screen — in the form of computers, cell phones and tablets — might have contributed to an uptick in symptoms of depression and suicide-related behaviors and thoughts in American young people, especially girls, according to a new study by San Diego State University professor of psychology Jean Twenge. The findings point to the need for parents to monitor how much time their children are spending in front of media screens.

    “These increases in mental health issues among teens are very alarming,” Twenge said. “Teens are telling us they are struggling, and we need to take that very seriously.”

    Twenge, along with SDSU graduate student Gabrielle Martin and colleagues Thomas Joiner and Megan Rogers at Florida State University, looked at questionnaire data from more than 500,000 U.S. teens found in two anonymous, nationally representative surveys that have been conducted since 1991. They also looked at data suicide statistics kept by the U.S. Centers for Disease Control and Prevention.

    They found that the suicide rate for girls aged 13-18 increased by 65 percent between 2010 and 2015, and the number of girls experiencing so-called suicide-related outcomes — feeling hopeless, thinking about suicide, planning for suicide or attempting suicide — rose by 12 percent. The number of teen girls reporting symptoms of severe depression increased by 58 percent.

    “When I first saw these sudden increases in mental health issues, I wasn’t sure what was causing them,” said Twenge, author of iGen: Why Today’s Super-Connected Kids Are Growing Up Less Rebellious, More Tolerant, Less Happy — And Completely Unprepared for Adulthood. “But these same surveys ask teens how they spend their leisure time, and between 2010 and 2015, teens increasingly spent more time with screens and less time on other activities. That was by far the largest change in their lives during this five-year period, and it’s not a good formula for mental health.”

    The researchers returned to the data and looked to see if there was a statistical correlation between screen-time and depressive symptoms and suicide-related outcomes. They found that 48 percent of teens who spent five or more hours per day on electronic devices reported at least one suicide-related outcome, compared to only 28 percent of those who spent less than an hour a day on devices. Depressive symptoms were more common in teens who spent a lot of time on their devices, as well.

    The findings fit with previous studies that have linked spending more time on social media to unhappiness.

    On the positive side, the researchers found that spending time away from screen and engaging in in-person social interaction, sports and exercise, doing homework, attending religious services, etc., was linked to having fewer depressive symptoms and suicide-related outcomes. The researchers reported their findings today in the journal Clinical Psychological Science.

    While economic struggles are generally thought to be linked to depression and suicide, the U.S. economy was improving between 2010 and 2015, so that is unlikely to be the primary driver of these increases, Twenge noted.

    “Although we can’t say for sure that the growing use of smartphones caused the increase in mental health issues, that was by far the biggest change in teens’ lives between 2010 and 2015,” she said.

    The good news? You don’t have to totally give up on electronic devices to lower your risk for depression and suicide-relayed outcomes. Twenge said that limiting screen-time to one or two hours per day would statistically fall into the safe zone for device usage.


  8. Study suggests brain activity buffers against worsening anxiety

    November 21, 2017 by Ashley

    From the Duke University press release:

    Boosting activity in brain areas related to thinking and problem-solving may also buffer against worsening anxiety, suggests a new study by Duke University researchers.

    Using non-invasive brain imaging, the researchers found that people at-risk for anxiety were less likely to develop the disorder if they had higher activity in a region of the brain responsible for complex mental operations. The results may be a step towards tailoring psychological therapies to the specific brain functioning of individual patients.

    “These findings help reinforce a strategy whereby individuals may be able to improve their emotional functioning — their mood, their anxiety, their experience of depression — not only by directly addressing those phenomena, but also by indirectly improving their general cognitive functioning,” said Ahmad Hariri, a professor of psychology and neuroscience at Duke. The results are published Nov. 17 in the journal Cerebral Cortex.

    Previous findings from Hariri’s group show that people whose brains exhibit a high response to threat and a low response to reward are more at risk of developing symptoms of anxiety and depression over time.

    In the current work, Hariri and Matthew Scult, a clinical psychology graduate student in the department of psychology and neuroscience at Duke, wanted to investigate whether higher activity in a region of the brain called the dorsolateral prefrontal cortex could help shield these at-risk individuals from future mental illness.

    “We wanted to address an area of understanding mental illness that has been neglected, and that is the flip side of risk,” Hariri said. “We are looking for variables that actually confer resiliency and protect individuals from developing problems.”

    The dorsolateral prefrontal cortex is our brain’s “executive control” center, helping us focus our attention and plan complex actions. It also plays a role in emotion regulation, and well-established types of psychotherapy, including cognitive behavioral therapy, engage this region of the brain by equipping patients with strategies to reframe or re-evaluate their emotions.

    The team drew on data from 120 undergraduate students who participated in the Duke Neurogenetics Study. Each participant completed a series of mental health questionnaires and underwent a type of non-invasive brain scan called functional Magnetic Resonance Imaging (fMRI) while engaged in tasks meant to activate specific regions of the brain.

    The researchers asked each participant to answer simple memory-based math problems to stimulate the dorsolateral prefrontal cortex. Participants also viewed angry or scared faces to activate a region of the brain called the amygdala, and played a reward-based guessing game to stimulate activity in the brain’s ventral striatum.

    Scult was particularly interested in “at-risk” individuals with the combination of high threat-related activity in the amygdala and low reward-related activity in the ventral striatum. By comparing participants’ mental health assessments at the time of the brain scans, and in a follow-up occurring on average seven months later, he found that these at-risk individuals were less likely to develop anxiety if they also had high activity in the dorsolateral prefrontal cortex.

    “We found that if you have a higher functioning dorsolateral prefrontal cortex, the imbalance in these deeper brain structures is not expressed as changes in mood or anxiety,” Hariri said.

    The dorsolateral prefrontal cortex is especially skilled at adapting to new situations, the researchers say. Individuals whose brains exhibit the at-risk signatures may be more likely to benefit from strategies that boost the brain’s dorsolateral prefrontal activity, including cognitive behavioral therapy, working memory training, or transcranial magnetic stimulation (TMS).

    But, the researchers warn, the jury is still out on whether many brain-training exercises improve the overall functioning of the dorsolateral prefrontal cortex, or only hone its ability to complete the specific task being trained. Additional studies on more diverse populations are also needed to confirm their findings.

    “We are hoping to help improve current mental health treatments by first predicting who is most at-risk so that we can intervene earlier, and second, by using these types of approaches to determine who might benefit from a given therapy,” Scult said.


  9. Study suggests hair cortisol levels predict which mothers are more likely to suffer postpartum depression

    November 19, 2017 by Ashley

    From the University of Granada press release:

    Researchers from the University of Granada (UGR), who belong to the Brain, Mind and Behavior Research Center (CIMCYC, from its abbreviation in Spanish) and the Faculty of Psychology, have proven that cortisol levels (a steroid hormone secreted as a response to stress) present in the hair of pregnant women during the first or third trimesters of pregnancy may indicate which of them are more likely to suffer postpartum depression.

    Their work, published in the PLoS ONE journal, showed that hair cortisol levels in women who developed postpartum depression were higher throughout pregnancy than those seen in women who hadn’t developed it, being that difference statistically more significant during the first and third trimesters.

    The UGR researchers carried out their study doing a follow-up on 44 pregnant women throughout the whole gestation period and after giving birth. Each trimester the mothers underwent a series of tests that evaluated their stress and psychopathological symptoms while simultaneously taking hair samples from which the researchers extracted the cortisol corresponding to the last three months.

    The following days after labor the researchers evaluated the mothers’ emotional state in order to assess who among them had developed postpartum depression.

    Quarterly psychopathological symptoms

    Additionally, the results of the study showed that the participants which developed postpartum depression showed higher levels of somatization during the first trimester. During the second trimester they showed higher levels of somatization, obsession-compulsion, depression and anxiety, and during the third trimester they showed higher levels of somatization and pregnancy-specific stress. Therefore, all those symptoms along with higher levels of cortisol would be indicators of a future postpartum depression.

    As María Isabel Peralta Ramírez, lead researcher of the project says, the consequences of those results are very important in the prevention of postpartum depression, “since they show that there are various altered psychological and hormonal variables throughout the whole gestation period in comparison to those women who will not suffer postpartum depression. Detecting those differences is the key to anticipate the psychological state of the mother as well as the consequences for the baby that said state could mean.”

    This study belongs to the GESTASTRESS research project, in the research excellence framework of the Spanish Ministry of Economy and Competitiveness. Its primary goal has been to assess the effects of psychological stress on the mother throughout the whole gestation period as well as on birth variables, and on the baby’s stress and neurodevelopment.


  10. Study suggests optimists and happy people are healthier overall

    November 14, 2017 by Ashley

    From the University of Michigan press release:

    Research shows that optimists and happy people are healthier overall, enjoying lower blood pressure and less depression and anxiety, among other measures.

    However, data on the effect of weight and Body Mass Index on physical and mental health are rare — especially among college students, who suffer high rates of anxiety and depression and often neglect physical self-care and exercise.

    To that end, researchers from the University of Michigan and Fudan University in China set out to learn the extent to which BMI and positive outlook affect the physical and mental health of college students in China’s Fudan University.

    They found that a positive outlook and BMI both contributed significantly to good health, said Weiyun Chen, associate professor of health and fitness at the U-M School of Kinesiology.

    Researchers asked 925 students to rate four indicators of psychological well-being: hope, gratitude, life satisfaction and subjective happiness. They also calculated students’ BMI based on self-reported body weight and height. To assess physical and mental health, researchers asked students various questions about their sleep quality and how often they felt healthy, energized, worthless, fidgety, anxious or depressed.

    Chen said that taken together, the four psychological variables and BMI accounted for 41 percent of the total variance in health. Individually, subjective happiness had the most significant impact, followed by hope, and then BMI.

    By themselves, gratitude and life satisfaction didn’t influence overall health. Also, interestingly, BMI was correlated with physical and overall health, but not with hope, gratitude, life satisfaction or mental health.

    In light of the intense academic pressure Chinese college students face, especially at elite institutions like Fudan, Chen said she was surprised by how many students rated themselves happy and healthy. This could point to China’s emphasis on well-being in schools.

    “They have structured, organized physical educations classes,” Chen said. “It’s not just fitness, it’s a variety of things so you can meet different people’s needs. They realized that emphasizing only academics isn’t good for overall health, and that they needed to emphasize the wellness part.”

    These numbers might look different for college students in the U.S., where two of three adults are overweight or obese, and 17 percent of youth ages 2-19 are considered obese, according to the CDC.

    By contrast, 714 Fudan students, or 77.2 percent, were classified as normal body weight, while only 83 students were overweight, and just 5 students were obese, with 123 students considered underweight.

    “Over the past 20 years, the United States has shrunk physical education in elementary school and in college,” Chen said. “In China, especially in the past decade, they have started to emphasize physical education, and they are taking a holistic, whole person approach.”

    Chen said the findings suggest that universities should creatively design wellness programs and centers that dynamically integrate body, mind and spirit into a seamless unit.

    The study has several limitations: all students were recruited from one university, and the results cannot be generalized; the research design prevented establishing causal effects; and the study did not account for gender differences.