Noteworthy News Articles on Mental Health Topics, January 5-9, 2007



Lilly Settles With 18,000 Over Zyprexa
Alex Berenson, New York Times- 1/5/2007

Eli Lilly agreed yesterday to pay up to $500 million to settle 18,000 lawsuits from people who claimed they had developed diabetes or other diseases after taking Zyprexa, Lilly’s drug for schizophrenia and bipolar disorder. Including earlier settlements over Zyprexa, Lilly has now agreed to pay at least $1.2 billion to 28,500 people who said they were injured by the drug. At least 1,200 suits are still pending, the company said. About 20 million people worldwide have taken Zyprexa since its introduction in 1996.
      The settlement covers cases filed in state and federal courts by law firms or groups of firms for 18,000 clients, Lilly said. The federal suits have been overseen in Brooklyn by Judge Jack B. Weinstein of the Eastern District of New York. The settlement will not affect continuing civil or criminal investigations of Zyprexa by state attorneys general and federal prosecutors.
     Both Lilly and lawyers for plaintiffs said they were pleased with the agreement. With global sales of roughly $4.2 billion last year, Zyprexa is Lilly’s largest-selling drug and a major contributor to the company’s profits. Lilly shares were relatively flat after the settlement announcement. They rose 11 cents yesterday, to $52.36.
     Zyprexa is the brand name for olanzapine, a potent chemical that binds to receptors in the brain to reduce psychotic hallucinations and delusions. Clinical trials show that in many patients, Zyprexa also causes severe weight gain and increases in cholesterol and blood sugar.
     Documents provided to The New York Times last month by a lawyer who represents mentally ill patients show that Lilly played down the risks of Zyprexa to doctors as the drug’s sales soared after its introduction in 1996. The internal documents show that in Lilly’s clinical trials, 16 percent of people taking Zyprexa gained more than 66 pounds after a year on the drug, a far higher figure than the company disclosed to doctors. The documents also show that Lilly marketed the drug as appropriate for patients who did not meet accepted diagnoses of schizophrenia or bipolar disorder, Zyprexa’s only approved uses. By law, drug makers may promote their drugs only for diseases for which the Food and Drug Administration has found the medicines to be safe and effective, though doctors may prescribe drugs in any way they see fit. In response to questions about the information in the documents, Lilly has denied any wrongdoing and said it provided all relevant information to doctors and the F.D.A. Lilly has also said it did not promote Zyprexa for conditions other than schizophrenia or bipolar disorder.
     In 2004, a panel of the American Diabetes Association found that Zyprexa caused diabetes more than other widely used antipsychotic drugs, in part because it tends to cause much more weight gain. But the F.D.A. has never made a similar finding. Instead, the F.D.A. added a warning in 2003 to the label of Zyprexa and other new antipsychotic drugs about their tendency to cause high blood sugar.
     In 2005, a $700 million agreement covered 8,000 patients, and the company has made 2,500 individual settlements whose total value has not been disclosed, Lilly said. The 2005 settlement valued claims at about $90,000 a plaintiff, while yesterday’s agreement values claims at about $27,000 a plaintiff, at most. The lower value for the new claims comes in part because of the F.D.A. label change, which has allowed Lilly to say that it adequately warned doctors of the risks of Zyprexa after 2003. The label change may also help to protect Lilly from future lawsuits, analysts and lawyers say.
     In its statement, Lilly said the settlement did not change its view that Zyprexa is a safe and effective treatment for mental illness. “We wanted to reduce significant uncertainties involved in litigating such complex cases,” Sidney Taurel, Lilly’s chief executive, said in the statement. Richard Meadow, one of the lead lawyers for the plaintiffs, said the deal was fair to both sides. “Prolonging this litigation further is in no one’s best interest,” he said.

Sedative Withdrawal Made Rehnquist Delusional in '81
Alan Cooperman, Washington Post- 1/5/2007

The late Chief Justice William H. Rehnquist took a powerful sedative during his first decade on the Supreme Court and grew so dependent on it that he became delusional and tried to escape from a hospital in his pajamas when he stopped taking the drug in 1981, according to newly released FBI files. The files also show that during both of Rehnquist's confirmation battles -- when he was first named to the court by President Richard Nixon in 1971 and when President Ronald Reagan nominated him as chief justice in 1986 -- the Justice Department enlisted the FBI to find out what witnesses lined up by Senate Democrats were prepared to say. The FBI this week released 1,561 pages from its files on Rehnquist in response to Freedom of Information Act requests filed after his death in September 2005. Privacy laws forbid disclosure of such files during the person's lifetime.
      The fact that Rehnquist checked into George Washington University Hospital for a week in late December 1981 to be treated for back pain and dependence on a prescription drug was previously known. Journalists had noted that fall that Rehnquist's speech was sometimes slurred on the bench, and The Washington Post reported on the hospitalization.b But the files reveal dramatic new details about the length and intensity of the addiction. During its routine 1986 investigation of Rehnquist's background, the FBI concluded that Rehnquist began taking the drug Placidyl for insomnia after back surgery in 1971, the year before he joined the court. By 1981, he apparently was taking 1,500 milligrams each night, three times the usual starting dose.
     Placidyl, known generically as ethchlorvynol, is a sleep-inducing drug that is not usually prescribed for more than a week at a time. It is not an opiate and is not a painkiller, but it is addictive, and withdrawal can cause hallucinations and temporary memory loss. Doctors interviewed by the FBI told agents that when the associate justice stopped taking the drug, he suffered paranoid delusions. One doctor said Rehnquist thought he heard voices outside his hospital room plotting against him and had "bizarre ideas and outrageous thoughts," including imagining "a CIA plot against him" and "seeming to see the design patterns on the hospital curtains change configuration." At one point, a doctor told the investigators, Rehnquist went "to the lobby in his pajamas in order to try to escape." Ultimately, the doctors concluded that the withdrawal symptoms were so severe that they began giving Rehnquist the drug again and slowly lowered the dosage until he quit taking it entirely Feb. 7, 1982. By 1986, the files show, all the doctors interviewed by the FBI said the former drug dependence should not affect Rehnquist's future work on the court, and it did not become an issue in his confirmation as chief justice.



Justices to Consider Mental Illness and Death Penalty
Linda Greenhouse, New York Times- 1/6/2007

WASHINGTON— The Supreme Court agreed on Friday to use the case of a schizophrenic death row inmate in Texas to set the standard for determining when a mental illness is so severe that execution would be constitutionally impermissible. The question is not a new one for the court or for the criminal justice system, but it has come to the fore recently as a growing number of legal and mental health organizations have joined a call for a moratorium on executing those whose rational judgment has been significantly impaired, including their ability to appreciate why they have been sentenced to death.
      The American Psychiatric Association has expressed specific concern about the competency standard used by the United States Court of Appeals for the Fifth Circuit, which upheld the death sentence for the Texas inmate, Scott L. Panetti, in rejecting his petition for a writ of habeas corpus last May. Mr. Panetti, convicted in 1992 of fatally shooting his in-laws in the presence of his estranged wife and their 3-year-old child, is a 48-year-old Navy veteran who was hospitalized 14 times for schizophrenia and other serious mental disorders in the decade before the crime. A jury nonetheless found him competent to stand trial, and the judge permitted him to represent himself.
     The Supreme Court ruled in 1986 that the Eighth Amendment’s prohibition on cruel and unusual punishment barred the execution of the mentally ill. But the justices who decided that case, Ford v. Wainwright, did not settle on a definition of mental illness for the purpose of determining competency for execution. Most lower courts have adopted, as controlling, a separate opinion by Justice Lewis F. Powell Jr., who said that the “retributive goal of the criminal law” was satisfied as long as defendants were aware of “the punishment they are about to suffer” and “why they are to suffer it.”
     The Fifth Circuit, which supervises the courts in Texas, Louisiana and Mississippi, has boiled this down to what it calls an “awareness” test. In Mr. Panetti’s case, Panetti v. Quarterman, No. 06-6407, the appeals court found the test was satisfied because Mr. Panetti indicated that he understood the state’s intention to execute him for killing his wife’s parents. The fact that he also held the delusional belief that his execution was part of a conspiracy by which the state was trying to prevent him from preaching the Gospel was beside the point, the appeals court said.
     In Mr. Panetti’s appeal to the Supreme Court, his lawyers argue that the appeals court has distorted Justice Powell’s meaning by failing to take the delusions into account. “The moral force of retribution is lost if an inmate believes that his execution is being carried out through a conspiracy of demonic forces rather than as a lawful punishment for a horrific crime,” their brief argues. In a brief urging the justices to accept the appeal, the National Alliance on Mental Illness, an advocacy organization, said “this case exemplifies why mere ‘awareness,’ the test applied by the Fifth Circuit, is not a meaningful requirement for determining whether to execute prisoners who are severely mentally ill.” The brief said the test “makes no sense when applied to a prisoner who is plagued by delusions of grand persecution.” At his trial, Mr. Panetti was often incoherent and tried to issue subpoenas to Jesus, the pope and John F. Kennedy.
     The justices’ decision to hear his appeal was the latest indication of the Supreme Court’s concern about the administration of capital punishment. In recent years, the court has declared unconstitutional the execution of mentally retarded defendants as well as those who committed murder before the age of 18. Some opponents of the death penalty have described mental illness as the next frontier in the debate. Mr. Panetti’s case was one of seven new appeals the court granted on a busy day as the justices returned from a four-week recess. The cases will be heard on dates yet to be determined in March and April.



Support for Problem Gamblers Increases
Paul Pace, NASW News- January '07

The opportunity to gamble legally is at its peak in the nation's history -- and according to the latest figures from problem gambling hotlines, so is the number of people seeking assistance for resulting troubles. Social workers involved in treating problem gamblers say that the trend is more wide-spread than initially believed and that thousands are suffering in silence.
     Part of the challenge, social workers say, is that most problem gamblers won't seek help until it is too late, with financial and personal ruin the result. Also, social workers need to be aware of the growing concern that problem gambling can be the primary factor for people seeking help with other issues, such as alcohol or drug addiction and depression, said Mia Moran-Cooper, executive director of the Problem Gamblers Help Network of West Virginia. "I think we're years away from there being a routine question about problem gambling on initial screenings," she said.
     Social workers involved with problem gamblers note that the behavior disorder affects people of all social classes and income levels. According to Keith Whyte, executive director of the National Council on Problem Gambling based in Washington, D.C., 48 states have some form of legal gambling (Utah and Hawaii are exempt); legal gambling generated $80 billion in 2005; 80 percent of American adults gamble at least once a year, and of that number, 15 percent have gambled in the past week. "It's easier than ever to gamble," he said. "And the youth generation is being saturated by legal gambling in a way no other generation has ever faced." Whyte cited the popularity of Internet gambling and gambling shows on television as factors.
     The number of people who will suffer from problem gambling will likely rise in coming years as a younger generation becomes accustomed to the habit, said Whyte. He said a recent study revealed that 10 percent of boys ages 14 to 16 have gambled for money on the Internet. Also, of those who have played poker in the past month, those age 12 to 17 were the second-largest age group after those 18 to 24.

The silent addiction.
A major obstacle to treating problem gambling is discovering whether a person is afflicted in the first place. In most cases, therapists said, those who finally seek help have reached a financial dead end, not only with their own money, but they are also deeply in debt to banks, family and friends. "We call this the silent addiction," said Moran-Cooper, who is also a board member of the National Council on Problem Gambling. "With alcohol, you can smell it, or if it's drugs, you can see a change in a person's eyes," she said. Problem gamblers tend to devise ways to keep their addiction well hidden, she said. In many cases, loved ones report having no clue they were involved with a problem gambler until the bank repossesses their home, Moran-Cooper said.
     Problem gamblers also face stigma and a fear that their loved ones won't understand their destructive behavior. To those who know a problem gambler, the answer appears simple: Why doesn't the person just quit? "People have a harder time sympathizing with a problem gambler," said Whyte. "Most believe it's a moral issue rather than a mental problem. Problem gamblers face more shame and stigma than other addicts." Moran-Cooper said for every problem gambler in denial there are four or five family members involved by offering loans, believing they are doing the right thing. A lack of money to pay for help can also hinder the recovery process.
     In some states, a portion of gambling taxes is earmarked to support problem gambling recovery programs. Such is the case in West Virginia, for example. Calls to the Problem Gamblers Help Network are directed to trained clinical professionals, including social workers. For those callers who wish to get face-to-face treatment, the program pays for up to 20 sessions with a therapist, since the gambler is usually penniless by the time he or she seeks help, said Moran-Cooper. Those whose lives are affected by a problem gambler can have up to 10 sessions paid for by the service. The staff also makes post-referral calls to help keep problem gamblers in recovery.
     Moran-Cooper takes pride in the program's effectiveness, as shown by its data collection. Calls to the help line have increased an average of 50 percent per year since the service started in 2001, she said. In 2005, 1,337 calls came in to the helpline. Of that number, 67 percent, or 895, were from the gambler. One-hundred and forty-nine of callers were the spouses or significant others of problem gamblers.
     Such programs exist in other states, while still others are working to establish them, said Whyte.
Getting treatment to the addict is important, since studies show problem gamblers have a higher than average suicide-attempt rate, said Whyte. Their continual loses can lead to other problems, like a dependency on drugs and alcohol to alleviate the depression of losing money, or they can resort to illegal activities to raise more money for gambling.
     NASW member Fran Gizzi chairs a special-interest group on compulsive gambling, alcohol and drugs at the NASW New Jersey Chapter. She became a certified compulsive gambling counselor in 2000. New Jersey has a system that directs those who call a hot line for help to counselors like Gizzi. She said treating such problems does require a set of skills for which social workers are ideal.
"The gambling high is like the cocaine high," she said. "It's difficult for them to give it up." The goal of the problem gambler is to recapture the feeling of the first big win. She said in her cases, she tries to get family members involved in the recovery process. "Family members are a turning point for seeking help," she said. "Social workers need to remember this is a family disease whose hallmark is its hiddenness."

Educating social workers.
Lia Nower, associate professor at Rutgers University School of Social Work, leads the school's Center for Gambling Studies. She said there are few social workers who do research on problem gambling, so she is finishing an article on the subject. "There's a need, because social workers are the front line," she said of why the issue is important for social workers. "There are many problem gamblers with a co-problem."
     The lack of articles and training on the subject inspired Nower to do something. She petitioned the school to open the Center for Gambling Studies. "It's a huge oversight not to include this in social work training," she said. "Gambling addictions can coincide with alcohol or drug addictions, and the amount of relapse is similar." Nower also serves on the National Council on Problem Gambling Certification and Research boards. Part of the center's goal is to educate social workers how to identify and treat problem gamblers.
     Nower said the university has a large continuing education program, so that not only can social work students learn ways to detect and treat problem gamblers, but also social workers already in the field can receive continuing education credits to attain the skills. This year, for the first time, the social work program will offer students a certificate in gambling studies, said Nower.
     The Center for Gambling Studies will fill a void because there exist only a few research centers worldwide devoted to gambling issues, Nower said. Part of the center's goal is to develop standardized gambling treatment protocols and to evaluate gambling prevention and intervention treatment services to meet the needs of special populations, such as women, children and older adults. The center aims to train clinicians and educators in prevention, identification and efficacious treatment of youth and adult problem gamblers, said Nower.
      Whyte at the National Council on Problem Gambling said the lack of federal funding to treat problem gamblers continues to be a serious challenge to the cause. While a bill was introduced in the U.S. House of Representatives last year that proposed federal funds over five years - $1 million for a national problem gambling public awareness campaign, $20 million for research and $50 million a year for four years for prevention and treatment - the bill failed to reach committee in the last congressional session. However, Whyte said he is optimistic the bill will be reintroduced in the new Congress. "One reason the proposal is so important is that the majority of states that have gambling get no funding for problem gambling services," said Whyte. "And the majority of health insurance companies do not reimburse for help with problem gambling. So there are a number of states without resources."

The future of care.
Whyte said that while his organization is the national advocate for treatment of problem gambling, it is not for or against legal gambling. Part of the organization's goal is to ensure a comprehensive set of services available nationwide. "A big part of our job is to work with health care professionals such as social workers and to encourage them to screen and access resources on problem gambling," Whyte said. Therapists need not be experts in treating gambling addictions, but they should know where to find assistance, he added.
     The National Council's tollfree help line is (800) 522-4700. National Council on Problem Gambling: www.ncpgambling.org

Happiness 101
D.T. Max, New York Times- 1/7/2007

One Tuesday last fall I sat in on a positive-psychology class called the Science of Well-Being — essentially a class in how to make yourself happier — at George Mason University in Fairfax, Va. George Mason is a challenge for positive psychologists because it is one of the 15 unhappiest campuses in America, at least per The Princeton Review. Many students are married and already working and commute to school. It’s a place where you go to move your career forward, not to find yourself.
      The class was taught by Todd Kashdan, a 32-year-old psychology professor whose area of research is “curiosity and well-being.” Kashdan bobbed around the room or sat, legs dangling, on his desk beneath a big PowerPoint slide that said “The Scientific Pursuit of Happiness” as he took the students, a few older than he, through the various building blocks of positive psychology: optimism, gratitude, mindfulness, hope, spirituality. Though the syllabus promised to “approach every topic in this class as scientists” and the assigned readings were academic, the classroom discussion was Oprah-ish. The students seemed intrigued by the research Kashdan presented mostly in relation to their own lives.
     The focus of Kashdan’s class that day was the distinction between feeling good, which according to positive psychologists only creates a hunger for more pleasure — they call this syndrome the hedonic treadmill — and doing good, which can lead to lasting happiness. The students had been asked first to do something that gave them pleasure and then to perform an act of selfless kindness. They approached the first part of the assignment eagerly. One student recounted having sex with her boyfriend 30 feet underwater while scuba diving. Another said he “went to Coastal Flats and got hammered.” A third attended a Nascar race in North Carolina, smoked, drank and had sex. Some also watched favorite TV shows; others chatted with friends.
     When it came time to talk about the second part of the assignment, the students were excited, too. The Nascar attendee, who was afraid of needles, gave blood. Another collected clothes from family members and donated them to a shelter for battered women. The boy who had gotten hammered bought a homeless person a 12-pack of “Natty Ice” at a 7-Eleven, wondering if it was the right thing to do. A fourth gave her waiter at Denny’s a $50 tip. At times, Kashdan, who ran the class in the nonjudgmental manner of a ’70s rap-session leader — he used the word “cool” a lot — would compliment them on their behavior and pull out a moral. In this case, as one student wrote in a summary she submitted to Kashdan, comparing “a day at the spa covered in really expensive French” stuff and “a day of community improvement covered in horse” manure, the smile on the community organizer’s face “beat out the smile on the masseur’s face any day.” That is, she had learned that doing good is good for you.
     Though Kashdan brought up published studies that optimistic people live longer and that certain regions of the brains of positive people show more activity (“Have a very active left prefrontal lobe day,” he joked at one point), in class they didn’t spend a lot of time on clinical research. Absent were the rats with electrodes, data charts, syndromes and neuroses. The main experimental corpus seemed to be the students themselves, with Kashdan assuming the role of therapist, asserting that pleasure isn’t enough. True happiness comes with meaning, he said, and the students agreed.
     I sat in on the course a few more times during the semester, and when Kashdan was done with pleasure versus selfless giving, he took up gratitude and forgiveness, close relationships and love, then spirituality and well-being and finally “meaning and purpose in life.” “I never use the word morality,” Kashdan said. Rather his goal was to show that “there are ways of living that research shows lead to better outcomes.”
     More than 200 colleges and graduate schools in the United States offer classes like the one at George Mason. At the University of North Carolina at Chapel Hill, Barbara Fredrickson passes out notebooks with clouds on a powdery blue cover for each student. At the University of Wisconsin-Stevens Point, students pass out chocolates and handwritten notes to school custodians and secretaries. The introductory positive-psychology class at Harvard attracted 855 students last spring, making it the most popular class at the school. “I teach my class on two levels,” says Tal Ben-Shahar, the instructor. “It’s like a regular academic course. The second level is where they ask the question, How can I apply this to my life?” True, the course is known as a gut, but it is also significant that 23 percent of the students who commented on it in the undergraduate evaluation guide said that it had improved their lives. “It wasn’t until my senior year that I started thinking maybe law school wasn’t for me,” wrote one graduate, Elizabeth Peterson, in her biographical précis for the masters program in applied positive psychology at the University of Pennsylvania. She had decided to take the class on a whim. “I was pretty much hooked from there. I realized that what I loved the most was talking to people about their problems.”
     Positive psychology brings the same attention to positive emotions (happiness, pleasure, well-being) that clinical psychology has always paid to the negative ones (depression, anger, resentment). Psychoanalysis once promised to turn acute human misery into ordinary suffering; positive psychology promises to take mild human pleasure and turn it into a profound state of well-being. “Under certain circumstances, people — they’re not desperate or in misery — they start to wonder what’s the best thing life can offer,” says Martin Seligman, one of the field’s founders, who heads the Positive Psychology Center at the University of Pennsylvania. Thus positive psychology is not only about maximizing personal happiness but also about embracing civic engagement and spiritual connectedness, hope and charity. “Aristotle taught us virtue isn’t virtue unless you choose it,” Seligman says.
     Sitting in Kashdan’s classroom, you might wonder whether psychology had abandoned its proper territory or found a new one, and if a new one, whether it owed more to science or to Sunday school. Perhaps that was because the class reflected the discipline’s own tension between simplicity and complexity, “good tough science,” as Seligman calls it, and airier talk of values. With its emphasis on the self in the world, positive psychology is already an ethics seminar. Which is fitting, given that it has its roots in a Socratic dialogue of sorts. Seligman likes to tell the story of how his daughter Nikki, when she was 5, accused him of being a grouch. She reminded him that he had criticized her for being whiny and that she had worked hard to stop whining. If she could stop being whiny, he could stop being grumpy. He realized, he says, that she was right, that he was “a pessimist and depressive and someone of high critical intelligence” and that he needed to change. Seligman, who at 54 had just been elected president of the American Psychological Association and was renowned for his hard science — most of his research had been in depression — decided to put his considerable talents into finding out “what made life worth living.”
     Though positive psychology is only beginning to be used as an educational tool in classrooms and secondary schools, in the nine years since Seligman’s epiphany it has taken a firm hold in academia. The field’s steering committee includes a number of psychologists and psychiatrists who have done highly regarded clinical work: Ed Diener of the University of Illinois at Urbana-Champaign, whose specialty is “subjective well-being”; Christopher Peterson at the University of Michigan, who has made a study of admired character traits around the world; George Vaillant, who has long headed a Harvard project tracking success and failure among the college’s graduates; and Mihaly Csikszentmihalyi of Claremont Graduate University, who has spent years studying “optimal functioning,” or the state of being intensely absorbed in a task, what he calls “flow.” Seligman’s book, “Authentic Happiness,” published in 2002, lays out the field’s fundamental principles and has been translated into nearly 20 languages. Last year’s annual positive-psychology summit in Washington attracted hundreds of academics working in the field or interested in doing so, as well as a children’s programming director, who was working to imbue her cartoons with positive psychology messages, and the Nobel Prize-winning economist Daniel Kahneman, who studies the relationship between economics and perceptions of happiness. In addition there were a lot of “life coaches,” independent consultants who hire themselves out to help clients achieve their life goals.
     Despite its seemingly American emphasis on self-reliance and self-expression, positive psychology is also proving popular in England and the British Commonwealth. Nick Baylis, a psychologist at Cambridge University, helped found the Well-being Institute there last year and is consulting with Wellington College, a private boarding and day school, on how to apply positive psychology to its curriculum. The Geelong Grammar School, a prestigious boarding and day school in Australia, is planning to shape its curriculum around the precepts of positive psychology in 2008, and the government of Scotland has also been in touch with Seligman to see whether the discipline might help its citizens. “Our old nation has been renewed through our new Parliament, and if we can embrace this new science of positive psychology, we have the opportunity to create a new Enlightenment,” one government official announced.
     Positive psychology is popular with educators because if happiness is something that can be learned, it can be taught. And because being happier seems to have positive long-term effects not just on well-being but also on health and life span. In one often-cited study, researchers at the University of Kentucky analyzed the essays novices born before 1917 wrote on entering the School Sisters of Notre Dame and correlated them to the nuns’ life spans. They found that 9 out of 10 of the most positive 25 percent of the nuns were still alive at 85, while only one-third of the least positive 25 percent were. Overall, their study showed positive emotions correlated to a 10-year increase in life span, greater even than the differential between smokers and nonsmokers. Another study, by Dacher Keltner, a psychology professor at U.C. Berkeley, correlated the smiles that the female graduates of Mills College in Oakland, Calif., displayed in two mid-20th-century yearbooks with life satisfaction and found that the bigger the smile, the more satisfying the marriage and the greater their well-being. Inspired by studies like these, positive psychologists have developed “interventions,” or practices, designed to maximize positive emotions and have tested them on thousands of people. One such intervention is to think every night about the good things that happened to you that day. Another is to make sure in any given day that you either work or play in a new area that draws on what positive psychologists call your “signature strengths” to create a sense of well-being. Gratitude visits — looking up someone who has taught or mentored you and thanking him or her — are important in positive psychology, too; this last intervention, studies show, gives the biggest increase in happiness of all.
     In the first few weeks of the semester, Kashdan asked his students to keep a record of their thoughts and experiences. He then gave them “experiential assignments” to make them happier, working their emotions the way an athletic coach might work their muscles. One week they were to report on attempts to go into “flow.” “Sex, drugs and chocolate are all highly useful avenues for people to attain flow states,” Kashdan said. To enter flow, students were asked to do something that they were good at, be it writing, playing basketball or talking to their friends. According to positive psychology, your signature strengths play a special role in building your confidence and thus bringing you happiness. Seligman’s Web site, authentichappiness.org, has a 240-question test to help determine whether your gift is for creativity, bravery, love or something else. In class, one student recounted going into flow during a fistfight; another told of being at her father’s grave. A third talked about being with a friend watching TV and suddenly having a profound conversation. “We had so much love for each other,” the student remembered in class, “and suddenly we were crying.”
     Several studies undertaken by positive psychologists have suggested that meditation enhances well-being, so another class assignment was to meditate for 15 minutes three days in a row, attend a free yoga class (Kashdan’s wife, a yoga instructor, arranged this with her studio), be mindful twice a day and report on the results. The mindfulness exercises — excercises in heightened awareness and openness to experience — are central to positive psychology and made a big impression, according to Kashdan: “Some said they just noticed for the first time how many types of trees there are on the way to campus.”
     The following week, students were asked to watch “Before Sunrise” and “Before Sunset,” movies starring Ethan Hawke and Julie Delpy. In the former, the two fall in love through intense conversation during one long evening in Vienna and then part. The sequel catches up with them nine years later. The students had to write about the first time they fell in love. The next assignment was to pay a gratitude visit or write a gratitude letter. After that, the students were to exercise their curiosity by doing something “novel, complex, and uncertain . . . epistemic, sensory and social” — that is, they were to use their signature strengths to try something new. One student tasted a pomegranate for the first time; another went to a book reading by Carly Fiorina, the former C.E.O. of Hewlett-Packard. Finally, the students were asked to select one memory they would be willing to spend an eternity with, an intervention inspired by the Japanese movie “After Life.”
     Kashdan’s enthusiasm — he is a passionate teacher — ate up class time, and so the students never got to other parts of the syllabus, among them optimism exercises and exercises that would make them better teammates. On the last week, students handed in their final papers, describing how they had tried to enhance their lives toward, in Kashdan’s words, “a specific, personally meaningful positive outcome” during the semester. There was no final exam; the students’ grades were based in large part on the paper and class participation.
     In an era when psychology is seeking to become a hard science of M.R.I.’s and evidence-based therapies, when, as Seligman says, “if it doesn’t plug into the wall, it’s not science,” positive psychology can seem like a retro endeavor with the appeal of a cure that fits on a recipe card. While this may make it particularly adaptable for use in the classroom, critics are often most disturbed by what they perceive as its prescriptive nature. “There is way too little evidence of stable, long-term benefits — and lack of harm — to justify large-scale incorporation of positive psychology programs into schools,” Julie Norem, chairwoman of the psychology department at Wellesley College in Massachusetts, said in an e-mail message. “It pays scant attention to individual differences.” For all that the open, 1960s-style classroom has fallen out of favor, it allowed a child to find his or her own way. In the words of the founder of the famous Summerhill school in England, a child should be free “to live his own life — not the life that his anxious parents think he should live, nor a life according to the purpose of the educator who thinks he knows best.” Children were treated as unique, which you might think would result in a more capable, independent adults. By comparison, positive psychology can seem as if it is laying out a road and asking the adherent to follow. “If I could wave my magic wand, there would be no positive psychology — there would be positive psychologists,” says Daniel Gilbert, a professor of psychology at Harvard, whose own work in the science of affective forecasting suggests that what we think will make us happy rarely does, or at least not for long. “I guess I just wish it didn’t look so much like a religion.”
     Indeed, the sectlike feel of positive psychology can be hard to shake off when watching classes like Kashdan’s or even when reviewing the record of the field’s beginnings. When Seligman was first trying to establish the discipline, he and his colleagues invited 25 young psychologists to the Yucatán to discuss the positive side of life. They snorkeled and talked philosophy and then swam some more. They summarized their work and listened to others’ reactions. One evening, the group devoted itself to poetry and song. Seligman recited Ezra Pound’s “Immorality”; a colleague named Sonja Lyubomirsky read some of Prospero’s speeches from “The Tempest.” Seligman’s daughter Lara — Seligman educates his five younger children in part by traveling with them — recited a Delmore Schwartz poem, “I Am Cherry Alive.”
     The talk under the palapas was not just about happiness but also about engagement. Participants contrasted the “hedonic treadmill” with “the meaningful life.” To find the qualities that gave life purpose, the team examined Western religions, Buddhism, Hinduism, Confucianism and Bushido as well as the mores of 70 nations. Over time, positive psychologists, led by Christopher Peterson, settled on 24 virtues — or character strengths, as they prefer to call them — including courage, modesty, spirituality and leadership. “The agenda comes from the world,” Seligman told me. “These are universals we’re after.”
     The search for what unites humans in virtue was an ambitious effort to integrate psychology with those fields that have long sat alongside it: ethics, religion, philosophy. Before the retreat in Mexico, Seligman met with one of his former professors, the Harvard philosopher Robert Nozick. His book “The Examined Life,” written late in his career, looked at how questions of value might be related to everyday experience. It was Nozick who suggested a “taxonomy of character,” by which he meant, as Seligman put it, a list of “those abiding moral traits that everyone values.” Lyubomirsky remembers that many of the young scientists were uncomfortable doing so. “There was a lot of debate about it,” she said. “We were trained as hard scientists.” Seligman wasn’t so sure himself that he wanted virtue to be part of positive psychology either: he was wary of science becoming prescriptive, but Csikszentmihalyi was enthusiastic, Seligman recalled, and in the end Seligman agreed.
     Two criticisms as troubling as the problem of positive psychology’s religiosity are 1) that it is not new — psychology always cared about happiness and 2) that the publicity about the field has gotten ahead of the science, which may be no good anyway. True, there have been attempts to marry psychology to ethics, to enlist it in the service of decoding what it means to be fully human, throughout its history. In the 1950s and ’60s, for instance, Abraham Maslow and Carl Rogers, among others, established humanistic psychology to focus on what gave meaning to life, looking at the very subjects positive psychologists now take as their own. But where Maslow and Rogers relied primarily on qualitative research for their theories, Seligman and his colleagues hope to establish positive psychology — and thus the nature of happiness itself — on firmer scientific ground. The idea that whatever science there is may not yet be first-class troubles Seligman, too. “I have the same worry they do. That’s what I do at 4 in the morning,” he says.
     When Todd Kashdan asked his students at George Mason to tell him which they liked better, experiencing pleasure or doing good, he cautioned, “Don’t give me the Miss Universe answers.” But when I met the participants in the nation’s only master’s program in applied positive psychology, at the University of Pennsylvania, I felt the spirit of Gandhi was hovering over us. One woman wrote in her application essay, “My strange and energetic career has included activism for peace and justice; teaching safety and self-defense skills to 10,000 students.” She was also a founder of two nonprofit organizations and taught “Swedish massage and stress-reduction skills.” Another sold her Mercedes and was using her savings to pay for the course. A third left banking to find the meaning in life.
     There were, in all, about 30 students in the master’s class at Penn on the Saturday in September I attended. MAPP, as the program is known, is organized around intensive days of class time, online work and conference calls. Seligman, who runs the program, says that he likes to invite others to lecture so he can learn what’s going on in the field, and so that day Barbara Fredrickson of the University of North Carolina was presenting her “broaden and build” theory, while Seligman sat at a little table nodding and taking notes. “It’s a neat design that allows humans and other organisms to grow and become more resourceful versions of themselves,” she told the class.
     The first part of her theory stems from a series of experiments that she published in 2005 in which five groups of 20 people each watched short film clips. The clips were meant to elicit negative, positive or neutral emotions. The participants were given a sheet ruled with 20 blank lines and asked to write down what they were feeling. Those who had just had positive emotions induced were able to provide more ideas about what their responses would be than those with either negative or neutral ones. For Fredrickson, this was evidence that positive emotions lead to broader thinking. The participants were also tested for what is called global-local-visual processing. When asked to look at a design on a computer of three squares arranged in a triangle, those who had watched happy-making film clips tended to see the broader pattern — i.e. the triangular pattern — while the angrier subjects saw only the squares. (The neutral ones saw some of each.)
     This was only the first part of Fredrickson’s theory. But it could be that thinking broadly has no effect on happiness or well-being — it might even be a deficit. To show that broadening led to building, she then described an experiment she had undertaken on a group of employees at Compuware, a progressive information-technology firm in Detroit. With the company’s assistance, she followed two groups — one that was taught a loving-kindness meditation (a meditation in which the practitioner repeats phrases that cultivate a caring attitude toward all life) and one that was wait-listed for the meditation. After eight weeks, she compared the two groups’ responses to questions about well-being. Those who meditated reported higher mental resources than before; their mindfulness, freedom from illness and connectedness to others all increased. But interestingly, their sense of well-being hadn’t, at least not immediately. It dropped at first. “It’s like you started a gym membership and then you realize you have to go,” Fredrickson theorized. But once their sense of well-being increased, they retained their edge over those who only wanted to meditate even after the meditation program was over.
     All this interested Seligman’s students, but what Fredrickson says always catches their attention most is a study Fredrickson did with a Brazilian workplace psychologist named Marcia Losada, who observed annual strategic-review meetings of employees through one-way mirrors. The data she collected showed that the most effective teams — the criteria were customer satisfaction, profitability and internal review — were the ones who had more positive meetings. There was even a number that corresponded to the minimum amount of positive to negative feedback necessary to encourage successful functioning. That number, Fredrickson told the class, was three positive comments to one negative comment. “The ratio lady,” one student called her.
     With its emphasis on universals and practical applications, positive psychology fits these divided times: it preaches values without linking them to a particular value system and embraces spirituality without making you go to church. When positive psychology was introduced into the language-arts program at Strath Haven High School outside Philadelphia in 2003, the left-leaning parents welcomed it because the values were internationally accepted; all but the most conservative ones were reassured that there were values at all.
     Seligman recently held a meeting with the leaders from the Lawrenceville School in New Jersey, the Episcopal Academy in Merion, Pa., the Riverdale Country School in the Bronx and the KIPP program, a national network of public charter schools, at which the educational leaders discussed introducing positive psychology into their schools. They are all looking to restore “wholeness” to the teenage years, to replace the supposed sense of certainty that the ’60s removed and that returned in the ’80s as a national political objective but that teachers are now too bogged down in the fundamentals to teach and adults, working longer and longer hours, are simply too busy to shore up at home. A follow-up meeting is scheduled for June, this time with a dozen schools; one item on the agenda is to add personal strengths and virtues to admissions criteria. (Educational Testing Service is exploring a test that students wouldn’t be able to fake.) “What this is about is building character,” Seligman says.
     Currently, the biggest project on positive psychology’s drawing board is at the Geelong School. “As a school, we would like to know how to make all students more resilient, how to turn depressing thoughts into positive ones,” Charles Scudamore, the head of the project at what Seligman calls “Australia’s Eton,” wrote in an e-mail message. That there is a need for a curriculum to promote engagement and happiness among teenagers is obvious, and Geelong is the first school to give positive psychologists a chance to show that they can really change teaching. According to Scudamore, “When we adopt a positive-psychology approach, it will be seen and practiced in all that we do.” The Australians “have had a lot of depression in kids, that’s half the reason they want it,” said Ed Diener, the professor of psychology at the University of Illinois.

What the psychologists have in mind for Geelong is very much the sort of intervention Kashdan was teaching at George Mason. The draft proposal by which they secured Geelong’s support included gratitude exercises, exercises in the “three pathways of happiness,” “the four ways to promote savoring” and “the five ways to overcome” adversity. To teach savoring, the teacher would explain mindfulness and show the students how to taste their food more thoroughly and then instruct them to try “savoring with a friend.” The students would have journals to record their emotions, their “grudges and gratitudes.” They would mentor a younger student too. Scudamore says he hopes that even the teachers will feel “their well-being” and their teaching skills enhanced. Seligman and his family are scheduled to make a six-month visit. An American-trained positive-psychology instructor will be in residence to provide training and real-time feedback.
      This endeavor outstrips the ongoing Strath Haven experiment. The effort there, financed by a $2.8 million grant from the U.S. Department of Education, is limited to the ninth-grade language-arts program. At the school last year, the positive psychologists interwove their teachings with the literature classes. The idea was to buffer the lessons from bleak books like “Lord of the Flies” and “Romeo and Juliet” with some reassuring thoughts — or at least a more positive framework for understanding human behavior than the classics offer. Thus, according to Mark Linkins, now coordinator of the Swarthmore school district’s curriculum, who helped teach the classes, the animalistic and murderous Jack in “Lord of the Flies” shows “what happens when someone is lacking in signature strengths.” And when reading “The Odyssey,” students were asked: “What are the signature strengths that Odysseus lived and breathed? What are the things he might have improved on to make things go better?” It is too soon to know the effect of these stratagems on the school’s students, since part of the protocol agreed to with the Department of Education requires that they be followed for four years. The results will be compared with a control group that received the standard curriculum. (For his part, Seligman home-schools the children he had with his second wife. He says he likes to balance the standard high-school fare he gives the older ones with “books in which notions of virtue and nobility do not end in humiliation and death,” like Harper Lee’s “To Kill a Mockingbird” and Arthur C. Clarke’s “Childhood’s End.”)
     Not all positive psychologists are sure educational interventions are a good idea. Lyubormisky, for instance, turned down a similar request from the Compton school system in California. “I did not think the science was ready to be applied in that big a way,” she told me. Linkins acknowledges that happiness may come at the cost of a full understanding of literature and human complexity. But, he said, “it’s preferable to be happy than not, even if that means the potential for creative output is diminished.”
     The question is, Can positive psychology actually fulfill its promise of making people happier? If positive emotions widen the sphere of what it is to be human, as positive psychology asserts, then positive psychology, at least as it is taught in the classroom, can seem to narrow it. If you are not optimistic, fake it. If you do not have friends, make some. I wondered what sort of student positive psychology would create. Was he or she more likely to be a future Nobel Peace Prize winner or J. P. (Gus) Godsey, the Virginia Beach stockbroker, dad and Craftsmen-tool enthusiast whom USA Weekend Magazine declared in 2003 “the happiest person in America” (“You are a blessed, happy person, Gus,” Martin Seligman commented in the article. “You’ve created many of your blessings on your own.”)
      When I e-mailed various graduates of Penn’s first master’s class, I found that they continued to take positive psychology’s emphasis on the engaged life very seriously. One woman was using positive psychology to teach first-year medical students better patient-communication skills, citing Fredrickson’s optimal flourishing ratio as a benchmark. John Yeager, who has a doctorate in education and runs the Center for Character Excellence at the Culver Academies, a boarding school in Indiana, wants to “help teachers ‘broaden and build’ character strengths and positive emotions in children, young adults and themselves.”
     Of course the master’s students were a self-selected group, willing to pay almost $40,000 for a degree with no clear career track. The students at George Mason, though they, too, had chosen the course, were perhaps more relevant to the question of what positive psychology can really teach. There I found a mixed response. They seemed remarkably sure that they had undergone an important experience but less sure what the nature of that experience had been. Had they saved the world or themselves? I spoke to Brandon Rasmussen, an easygoing student who seemed to me like a surfer dude washed up on some New Age shore. The class had energized him, and he had been a vigorous participant — earning an A. His final paper was about learning to really be with his friends, going into flow with them, something he had long had difficulty doing. “My personal satisfaction is the personal measure for me, and my personal satisfaction is great,” he explained. “I hate to say this, but really in the scheme of things we’re not going to change the war in Iraq.” Then he paused and thought how that sounded. “We can only fix the world one person at a time.”

Survey Illuminates Teen Social Networks
Associated Press, 1/7/2007

For 17-year-old Amanda Sanchez, social networking is an obsession, a distraction -- and when she moved to a new town last summer, it was her lifeline. ''Over the summer, MySpace was my best friend,'' says the high school junior, who lives in San Dimas, Calif. ''I didn't know anybody after I moved, so I was on there all the time.'' She usually checks her page a couple times a day -- and keeps in touch with old friends and those she's made at her new high school. So preferred is this form of communication among people her age that guys ask her for her MySpace address more often than her phone number.
      It's pretty typical behavior, according to a new survey from the Pew Internet & American Life Project. The survey of 12- to 17-year-olds provides some of the first independent numbers on social networking for that age group -- and found that older girls, in particular, are the most likely to have used social networking sites, such as MySpace or Facebook. The popular sites are among those that allow users to create profiles, swap messages and share photos and video clips, with the goal of expanding their circle of online friends.
     The Pew survey, released Sunday, found that 70 percent of teen girls, ages 15 to 17, had profiles on social networking sites, compared with 57 percent of boys in that age bracket. The numbers remained much the same across racial and economic lines. ''Most teens realize how much of social life is happening in these networks -- and that's something they often want to be a part of,'' says Amanda Lenhart, a senior research specialist at Pew.
     The survey also found that MySpace was, by far, the most popular site. Of the youth who'd used social networking, 85 percent said they used MySpace, while 7 percent had done the same on Facebook and 1 percent on Xanga. The survey of 935 U.S. youth, ages 12 to 17, was done by telephone in October and November. The results have a margin of sampling error of plus or minus 3.7 percentage points.
     When looking at the entire age bracket -- 12 to 17 -- Lenhart and her colleagues found that 55 percent said they used social networking sites. Not surprisingly, she said, younger children in that age range were the least likely to do so, with just over a third of 12- and 13-year-olds saying they'd created a profile. Experts say this is partly due to the fact that sites such as MySpace require users to be 14 (though they can lie about their age to gain access).
     Danah Boyd, a researcher at the University of Southern California, says the survey results largely match what she's found in the field when interviewing teens. That includes findings that girls are most likely to use social networking as a way to maintain contact with current friends, as well as those they rarely see. ''Our brains are attuned to social data. We love gossip. We love details about one another,'' Boyd says. ''In the process, we build friendships.''
     Meanwhile, the survey found that older boys who use social networking were more than twice as likely as older girls to say they use the sites to flirt -- 29 percent of older boys, compared with 13 percent of older girls. ''One of the things to take away from this report should be a sense of 'the kids are alright,' says Steve Jones, a communications professor at the University of Illinois at Chicago who studies new media. ''It's clear that teens are not just willy-nilly using social networking sites and making themselves vulnerable to predators. ''That is not to say, of course, that there are not some who are careless or even some who seem to invite trouble,'' he adds, but says many young people appear to be aware of security. In the survey, for instance, two-thirds of teens who've created profiles said only allowed friends they approved to access their profiles. And most teens knew the difference between a public and private profile. About half said they used social networking to make new friends -- but Boyd says she's found that, in many instances, that means they're getting to know ''friends of friends,'' not strangers.
     Pew researchers say they will release more survey data on issues of privacy and security in the months to come. While private messaging within social networks is common, the survey found that 84 percent of young social networkers also regularly post messages on friends' pages -- or on their ''walls,'' as they're commonly known. Anyone with access to that page can view the messages, which could include anything from a teasing comment to plans to meet up. In her research, Boyd has found that these public displays of conversation ''are genuinely unique to this age group.'' ''They're looking for validation from their peer group -- but aren't we all?'' she says.
     Still, not everyone is convinced that the social networking trend is a good one. ''Each year, incoming students are more distracted than ever,'' says Michael Bugeja, director of Iowa State University's journalism school and author of the book ''Interpersonal Divide: The Search for Community in a Technological Age.'' ''These data from the Pew survey verify what we already know -- that the situation will get worse before it improves.''
     On the Net: Pew: http://www.pewinternet.org/

Mysteries of the Brain and the Science of Sleep, Brought to Life in a Barn
Katie Zezima, New York Times- 1/9/2007

EAST BURKE, Vt. — Amber Powers, 13, thought about sleep only when she didn’t get enough, which was most of the time. A trip to a remote barn here, however, left her spending many of her waking hours mulling over the time she spends sleeping.

The barn’s owner, Dr. J. Allan Hobson, a psychiatry professor and sleep researcher at Harvard Medical School, has converted part of it into a small, interactive sleep museum that students visit after four weeks of lessons on brain function and sleep. Dr. Hobson is working with the Caledonia North school district in the northeast corner of the state to develop a sleep curriculum that he hopes to eventually distribute nationwide to different grade levels. The museum is a resurrection of Dreamstage, a multimedia exhibition on sleep and dreams that Dr. Hobson took on an international tour from 1977 to 1982.

The museum includes a sleep chamber, a small, windowed room where subjects sleep as their brain rhythms are recorded; a preserved brain; and multimedia presentations about the brain and dreams. It is also, in many ways, a showcase for the brain as a work of art, with scientists’ detailed sketches and a framed painting of a human brain.

Dr. Hobson, 73, said the museum “won’t truly be a public institution,” but rather an opportunity for students to supplement classroom lessons with a three-dimensional view of the brain and its activities, helping them grasp its complexity and its functions.

The idea of preparing students with lessons before they visit came during Dreamstage. Dr. Hobson said most students arrived with minimal knowledge of the brain and left without a full appreciation of it.

“The school visits were all poorly organized,” he said. “They’d get out of the yellow buses like locusts and push every button to see if things moved. They didn’t understand everything. I said, ‘These kids should be coming to the museum after they’ve had a unit on a subject like sleep.’ ”

About two years ago, Dr. Hobson, who bought a farm in Caledonia County in the 1960s, took the idea to Scott Graham, the superintendent of the Caledonia North school district. Mr. Graham immediately agreed to go along with the experiment and allowed two middle school science teachers, Lois Michaud and Alison Chadboard, to develop a curriculum with Dr. Hobson.

“Our kids hadn’t had anything about the brain previous to this,” Ms. Michaud said. “The question was, how do we have them experience what Allan is trying to get them to understand, that during sleep there is a lot of stuff going on in your brain?

“There is a lot going on,” she added, “and so we had them do activities like keep a sleep log, but with no dream stuff because it might not be appropriate to talk about in school. They could say they had a dream but not talk about the content, and how they went to sleep, whether they stayed asleep and how they felt the next day.”

The goal was to get students to demonstrate an understanding of how bodily systems are connected and how that plays out during sleep. Students were also expected to learn what happens when the sleep cycle is disrupted and how the body adapts to changes in its equilibrium, like sleep deprivation.

The four-week lesson starts with a two-week introduction to the brain and its structure and what functions are controlled by different parts of the brain. Students become familiar with neurotransmitters and how they affect mood and hunger, and with dendrites, fibers that receive and transfer information.

The following weeks focus on the sleep cycle. Students learn that they sleep so much because growth hormone is secreted during sleep, and if they do not sleep they will have shorter attention spans and use calories less efficiently. The lesson also covers disorders like narcolepsy and sleep apnea and their consequences.

Students also learn about dreams, and they are encouraged to discuss three theories about why people dream: to reorganize and refresh the brain; to help people remember things; and, Freud’s notion, to help people work out unsolved problems. Students also explore the psychology of dreams, including possible reasons for nightmares and dream content, but they are urged not to analyze one another’s dreams.

Ms. Michaud and Ms. Chadboard selected students to visit the barn, where they climbed into the sleep chamber and viewed sketches of the brain and frame-by-frame photos of people sleeping. They peppered Dr. Hobson with questions at a discussion in a silo he has converted into a five-story library that holds thousands of slides and books.

Dr. Hobson said the visit was exactly what he had imagined — students with a working knowledge of the brain, sleep and dreams excited to watch interviews of sleep subjects and analyze their dreams. They asked dozens of questions, including the theoretical, like how animals dream, and the personal, like how Dr. Hobson got into the field. “Allan gave them permission to just take out of it whatever they could,” Ms. Michaud said, “and I think each kid did in their own way take something very different out of it.”

Amber Powers said she enjoyed learning about the intricacies of the brain. “The thing I found interesting was that I saw a lot of pictures of different brain stems, things done by hand, very detailed drawings done with a camel-hair brush. A couple of them almost looked like frogs, they were so detailed,” she said. “It was really cool to see the sleep chamber where these experiments took place and the monitors that showed the waves of the brain in different stages of sleep. You could really see how they differed.”

She said the lessons showed her that she was sleeping a few hours less than the 11 hours recommended for a 13-year-old. Her sleep journal showed that she played with her cats, getting hyped up before bed, or watched television and was unable to turn it off. She has since started reading or doing other relaxing activities to help her slow down before bedtime.

School officials said Dr. Hobson was giving students in this rural part of the state an opportunity to see in their backyard things that usually require a trip to a city. “It was kind of like, wow, this kind of thing is going on right here; I thought this kind of thing happened in big cities,” Amber said. “It was really neat that all of this is in a barn.”

The study, led by Dr. Erik J. Giltay of the Psychiatric Center GGZ Delfland and published in The Archives of General Psychiatry, followed 941 Dutch subjects, ages 65 to 85, from 1991 to 2001. Subjects were ranked in quartiles as pessimistic or optimistic on the basis of their reactions to statements like, “I still have positive expectations concerning my future” and, “I often feel that life is full of promises.”

Dr. Giltay and his colleagues found that subjects with the highest level of optimism were 45 percent less likely than those with the highest level of pessimism to die of all causes during the study. For those in the quartile with the highest optimism score, the death rate was 30.4 percent; those in the most pessimistic quartile had a death rate of 56.5 percent. There were 397 deaths in the study, and prevention of cardiovascular mortality accounted for nearly half of the protective effects of optimism.

This is the kind of study that worries me. Not personally, though — I’m as optimistic as they come. No, I’m worried about my pessimistic friends and patients who will get hold of this article. After all, if the findings are valid, how much can anyone really do about a gloomy disposition?

Up to this point there has been solid evidence that certain pathological mental states, like depression, are linked with a significantly higher risk of cardiovascular death, but the relationship between normal personality traits like optimism and health have not been as thoroughly studied.

For example, there have been several well-controlled studies showing that depression can as much as double the relative risk of having a first heart attack or dying of heart disease, independent of other factors. And for people who already have well-documented heart disease, depression increases the risk of death about threefold.

But finding a correlation between certain attitudes and health outcomes doesn’t, of course, prove causality. Maybe pessimists have shorter lives because they are sicker to start with than optimists; that may be why they feel bleaker about their future in the first place.

Dr. Giltay carefully controlled for baseline risk factors like blood pressure, cholesterol, smoking and alcohol consumption in his study. Even after controlling for these confounding variables, there was still a significant excess of mortality in the pessimists compared with the optimists. And when he factored in the subjects’ own perception of their health — optimists, not surprisingly, report feeling better — pessimists still had higher morbidity and mortality.

What about the possibility that some of the pessimistic subjects were simply suffering from undiagnosed depression? After all, depression is a strong risk factor for cardiovascular mortality.

Dr. Giltay conceded that the subjects were not psychiatrically screened for depression or any other mental disorder, so this is a possibility. But he said depression was unlikely to explain the correlation between pessimism and mortality.

Perhaps, but we know that depression exists, too, on a spectrum. Mild chronic depressive states like dysthymia could easily masquerade as everyday pessimism, so this study cannot rule out mild depression as a contributor to excess mortality in the pessimistic subjects.

Still, assuming that these findings are replicated and optimism does indeed confer a survival advantage, what mechanism could explain it?

One possibility is that optimists may simply cope better with adversity than pessimists do and engage in behaviors that are more likely to promote health. It is well known, for example, that optimism is strongly associated with seeking social support and coping better with stress. There might even be biological differences between optimistic and pessimistic people that give optimists an edge. This is not so far-fetched if you consider that depression is associated with alterations in many neurotransmitters and hormones like cortisol, which can adversely affect physical health.

At this point, pessimism in the absence of clinical depression is not considered a disease or a risk factor for developing one. But if these data are replicated, perhaps it should be. If that’s the case, then trials of optimism-enhancing treatments, including psychotherapies and probably antidepressants, won’t be far behind. After all, there is already preliminary evidence that serotonin-enhancing antidepressants can alter normal personality traits like sociability, even in people without depression.

But even if pessimism could be “treated,” would that guarantee a longer life? Judging from recent research in depression, it may be no slam dunk. Efforts to decrease heart disease and mortality by treating depression have been disappointing. Two large randomized trials involving depressed heart-attack patients found no survival benefit in treating them with either cognitive behavior therapy or serotonin-enhancing antidepressants, though their depression did improve. (There is some debate about the findings.)

In the end, pessimists have enough to fret about without worrying that their own temperament will doom them to a short life. If pessimists should worry about anything, though, it’s that they may have an undiagnosed — and treatable — depression. Treating depression may not guarantee a longer life. But it will certainly make it a happier one.