Is Benefit Finding Good for Your Health?

 Is Benefit Finding Good for Your Health?

Pathways Linking Positive Life changes After Stress and Physical Health Outcomes

After experiencing a stressful or traumatic event, many individuals report positive changes in their lives, or benefit finding. Preliminary evidence suggests that benefit finding may lead to improvements in physical health. However, the mechanisms linking benefit finding to physical health outcomes have not been determined. This article describes an integrative model that identifies specific psychological and physiological pathways through which benefit finding may affect physical health. The underlying premise of the model is that benefit finding leads to more adaptive, efficient responses to future stressors, limiting exposure to stress hormones that may have damaging effects on long-term health.

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"How did cancer change you?" The real question is how didn't it change me? (...) The truth is that cancer was the best thing that ever happened to me. I don't know why I got the illness, but it did wonders for me, and I wouldn't want to walk away from it. Why would I want to change, even for a day, the most important and shaping event of my life? - Lance Armstrong

Although researchers have typically focused on negative effects of stressful life events, the last decade has seen a growing interest in positive effects of stressful experiences. Individuals who have undergone stressors ranging from diagnoses of serious medical conditions to bereavement to war or terrorism report that these experiences have changed their lives in positive ways. Typical changes include positive changes in views of the self (e.g., feeling stronger and wiser), in relationships with others (e.g., feeling closer with friends and family), and in priorities and goals (e.g., reordering goals and priorities to emphasize enjoyment of life, relationships, and personal growth). In addition, positive changes in health behaviors are frequently reported by individuals facing health-related stressors. Various terms have been used to describe these positive changes including posttraumatic growth, stress-related growth, or benefit finding; we use the term benefit finding here to refer to the variety of positive changes that can accompany stressful life events.

The literature on benefit finding has evolved from a descriptive account of positive changes in various stressed populations to an examination of predictors and correlates of benefit finding. In this article, we briefly review the literature on benefit finding. In this article, we briefly review the literature on benefit finding and mental health. We then focus on the association between benefit finding and physical health and specifically the psychological and physiological mechanisms through which benefit finding may "get under the skin" to influence health outcomes.

BENEFIT FINDING AND MENTAL HEALTH

There is evidence from both cross-sectional and longitudinal studies that benefit finding is associated with increases in measures of positive well-being, particularly positive effect (Algoe & Stanton, 2009; Helgeson, Reynolds, & Tomich, 2006). Positive affect is an umbrella term for positively valenced emotions and moods that includes subjective feelings such as happiness, contentment, joy, and excitement. Effects on negative psychological states are mixed. Although a handful of longitudinal studies have found that benefit finding is associated with decreases in depressive symptoms and distress, these effects have not been consistently observed and may depend on sample characteristics, measures used to assess benefit finding, and timing of assessment (acute vs. years after the event). Of note, theoretical models do not predict that benefit finding will lead to reductions in distress (Tedeschi & Calhoun, 2004). Benefit finding is thought to be prompted by more severe threatening events that challenge one's assumptions about oneself and the world, creating an opportunity for reevaluation and positive change. These types of events also cause more severe distress, which may co-occur with benefit finding, particularly when benefit finding is measure closer to the event.

BENEFIT FINDING AND PHYSICAL HEALTH

There is growing interest in the effects of positive psychological states, including benefit finding, on physical health. Although this literature is still limited in size, results have consistently shown a positive association between benefit finding and objective measures of physical health. One of the first studies in this area was conducted with 287 men who had recently experienced their first heart attack (Affleck, Tennen, Croog, & Levine, 1987). Over 50% of men reported benefits from the attack, including changes in philsophy of life or values. Those who perceived benefits were significantly less likely to have a subsequent heart attack and exhibited less morbidity 8 years later, controlling for age, socioeconomic status, and disease severity.

Subsequent studies have shown positive effects of benefit finding on physical health and related physiological systems in individuals with HIV. For example, in a sample of 40 HIV-positive men who had recently lost a close friend or partner to AIDS, those who reported finding some benefit from the loss, including greater appreciation for loved ones, increased value in and enjoyment of life, and new growth goals, showed a less rapid decline in CD4 T-cells over a 2- to 3-year follow-up period. CD4 T-cells are a critical part of the immune system and their loss is associated with faster disease progression in the context of HIV/ AIDS. Indeed, benefit finding was associated with a lower rate of AIDS-related mortality in this sample (Bower, Kemeny, Taylor, & Fahey, 1998). Benefit finding, in combination with other positive psychological resources, was also associated with slower CD4 T-cell decline and lower AIDS-related mortality in a sample of 773 HIV-positive women (Ickovics et al., 2006). Importantly, both of these studies controlled for disease status and other biobehavioral factors that might account for effects of benefit finding on physical health outcomes.

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Pathways linking benefit finding and physical health

What are the psychological and physiological pathways that link benefit finding and physical health? We have developed an integrative conceptual model to address this question (Fig. 1). At the broadest level, the model suggests that benefit finding is associated with the development of intra- and interpersonal resources that promote more adaptive responses to future stressors. This leads to reduced activity in the body's stress response systems, minimizing the deleterious effects of excessive or prolonged exposure to stress hormones on the body. In addition, benefit finding may reduce physiological arousal at rest by increasing activity in the body's restorative systems (e.g., para-sympathetic nervous system, sleep).

We begin with the hypothesis that the construct of benefit finding can be broken down into changes in particular aspects of psychological functioning, including changes in people's perceptions of future stressors (appraisal processes); their ability to manage these stressors (coping strategies and resources); their relationships with others; and/or their pri