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Published in: Annals of Behavioral Medicine 5/2016

01-10-2016 | Original Article

Forgiveness, Stress, and Health: a 5-Week Dynamic Parallel Process Study

Authors: Loren L. Toussaint, PhD, Grant S. Shields, MA, George M. Slavich, PhD

Published in: Annals of Behavioral Medicine | Issue 5/2016

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Abstract

Background

Psychological stress is a well-known risk factor for poor health, and recent research has suggested that the emotion-focused coping process of forgiveness may help mitigate these effects. To date, however, no studies have examined how levels of forgiveness, stress, and health fluctuate and interrelate over time.

Purpose

We addressed this issue by examining how forgiveness, stress, and mental and physical health symptoms change and relate to one another over 5 weeks. We hypothesized that increases in state levels of forgiveness would be associated with decreases in perceptions of stress, which would in turn be related to decreases in mental and physical health symptoms. A reverse effects model was also tested.

Methods

We recruited a large, community-based sample of 332 young, middle-aged, and older adults (16–79 years old; M age = 27.9). Each week for 5 weeks, participants reported on their levels of state forgiveness, perceived stress, and mental and physical health symptoms.

Results

Levels of forgiveness, stress, and mental and physical health symptoms each showed significant change and individual variability in change over time. As hypothesized, increases in forgiveness were associated with decreases in stress, which were in turn related to decreases in mental (but not physical) health symptoms (i.e., forgiveness → stress → health). The reverse effects model (i.e., health → stress → forgiveness) provided a relatively poorer fit.

Conclusions

This study is the first to provide prospective, longitudinal evidence showing that greater forgiveness is associated with less stress and, in turn, better mental health. Strategies for cultivating forgiveness may thus have beneficial effects on stress and health.
Literature
1.
go back to reference McCullough ME, Root LM. Forgiveness as change. In: Worthington EL, ed. Handbook of Forgiveness. New York: Brunner-Routledge; 2005: 91-107. McCullough ME, Root LM. Forgiveness as change. In: Worthington EL, ed. Handbook of Forgiveness. New York: Brunner-Routledge; 2005: 91-107.
2.
go back to reference Rye MS, Loiacono DM, Folck CD, et al. Evaluation of the psychometric properties of two forgiveness scales. Curr Psychol. 2001; 20(3): 260-277.CrossRef Rye MS, Loiacono DM, Folck CD, et al. Evaluation of the psychometric properties of two forgiveness scales. Curr Psychol. 2001; 20(3): 260-277.CrossRef
3.
go back to reference Berry JW, Worthington EL Jr, O’Connor LE, et al. Forgivingness, vengeful rumination, and affective traits. J Pers. 2005; 73(1): 183-226.PubMedCrossRef Berry JW, Worthington EL Jr, O’Connor LE, et al. Forgivingness, vengeful rumination, and affective traits. J Pers. 2005; 73(1): 183-226.PubMedCrossRef
4.
go back to reference Lawler KA, Younger JW, Piferi RL, et al. The unique effects of forgiveness on health: An exploration of pathways. J Behav Med. 2005; 28(2): 157-167.PubMedCrossRef Lawler KA, Younger JW, Piferi RL, et al. The unique effects of forgiveness on health: An exploration of pathways. J Behav Med. 2005; 28(2): 157-167.PubMedCrossRef
5.
go back to reference McCullough ME, Fincham FD, Tsang J-A. Forgiveness, forbearance, and time: The temporal unfolding of transgression-related interpersonal motivations. J Pers Soc Psychol. 2003; 84(3): 540-557.PubMedCrossRef McCullough ME, Fincham FD, Tsang J-A. Forgiveness, forbearance, and time: The temporal unfolding of transgression-related interpersonal motivations. J Pers Soc Psychol. 2003; 84(3): 540-557.PubMedCrossRef
6.
go back to reference McCullough ME, Bono G, Root LM. Rumination, emotion, and forgiveness: Three longitudinal studies. J Pers Soc Psychol. 2007; 92(3): 490-505.PubMedCrossRef McCullough ME, Bono G, Root LM. Rumination, emotion, and forgiveness: Three longitudinal studies. J Pers Soc Psychol. 2007; 92(3): 490-505.PubMedCrossRef
7.
go back to reference McCullough ME, Luna LR, Berry JW, et al. On the form and function of forgiving: Modeling the time-forgiveness relationship and testing the valuable relationships hypothesis. Emotion. 2010; 10(3): 358-376.PubMedCrossRef McCullough ME, Luna LR, Berry JW, et al. On the form and function of forgiving: Modeling the time-forgiveness relationship and testing the valuable relationships hypothesis. Emotion. 2010; 10(3): 358-376.PubMedCrossRef
8.
go back to reference Lazarus RS, Folkman S. Stress, appraisal, and coping. New York: Springer; 1984. Lazarus RS, Folkman S. Stress, appraisal, and coping. New York: Springer; 1984.
9.
go back to reference Strelan P, Covic T. A review of forgiveness process models and a coping framework to guide future research. J Soc Clin Psychol. 2006; 25(10): 1059-1085.CrossRef Strelan P, Covic T. A review of forgiveness process models and a coping framework to guide future research. J Soc Clin Psychol. 2006; 25(10): 1059-1085.CrossRef
10.
go back to reference Worthington EL. Forgiving and reconciling: Bridges to wholeness and hope. Downers Grove: InterVarsity Press; 2003. Worthington EL. Forgiving and reconciling: Bridges to wholeness and hope. Downers Grove: InterVarsity Press; 2003.
11.
go back to reference Worthington EL, Scherer M. Forgiveness is an emotion-focused coping strategy that can reduce health risks and promote health resilience: Theory, review, and hypotheses. Psychol Health. 2004; 19(3): 385-405.CrossRef Worthington EL, Scherer M. Forgiveness is an emotion-focused coping strategy that can reduce health risks and promote health resilience: Theory, review, and hypotheses. Psychol Health. 2004; 19(3): 385-405.CrossRef
12.
go back to reference Cohen S, Janicki-Deverts D, Miller GE. Psychological stress and disease. JAMA. 2007; 298(14): 1685-1687.PubMedCrossRef Cohen S, Janicki-Deverts D, Miller GE. Psychological stress and disease. JAMA. 2007; 298(14): 1685-1687.PubMedCrossRef
13.
go back to reference Slavich GM, Irwin MR. From stress to inflammation and major depressive disorder: A social signal transduction theory of depression. Psychol Bull. 2014; 140: 774-815.PubMedPubMedCentralCrossRef Slavich GM, Irwin MR. From stress to inflammation and major depressive disorder: A social signal transduction theory of depression. Psychol Bull. 2014; 140: 774-815.PubMedPubMedCentralCrossRef
14.
go back to reference Baum A, Trevino LA, Dougall AL. Stress and the cancers. In: Contrada RJ, Baum A, eds. The Handbook of Stress Science: Biology, psychology, and health. New York: Springer; 2011: 411-423. Baum A, Trevino LA, Dougall AL. Stress and the cancers. In: Contrada RJ, Baum A, eds. The Handbook of Stress Science: Biology, psychology, and health. New York: Springer; 2011: 411-423.
15.
go back to reference Phillips AC, Carroll D, Der G. Negative life events and symptoms of depression and anxiety: Stress causation and/or stress generation. Anxiety Stress Coping. 2015; 28(4): 357-371.PubMedPubMedCentralCrossRef Phillips AC, Carroll D, Der G. Negative life events and symptoms of depression and anxiety: Stress causation and/or stress generation. Anxiety Stress Coping. 2015; 28(4): 357-371.PubMedPubMedCentralCrossRef
16.
go back to reference Enright RD, Fitzgibbons RP. Forgiveness in depressive disorders. In: Enright RD, Fitzgibbons RP, eds. Helping clients forgive: An empirical guide for resolving anger and restoring hope. Washington, DC: American Psychological Association; 2000: 113-133.CrossRef Enright RD, Fitzgibbons RP. Forgiveness in depressive disorders. In: Enright RD, Fitzgibbons RP, eds. Helping clients forgive: An empirical guide for resolving anger and restoring hope. Washington, DC: American Psychological Association; 2000: 113-133.CrossRef
17.
go back to reference Toussaint L, Friedman P. Forgiveness, gratitude, and well-being: The mediating role of affect and beliefs. J Happiness Stud. 2009; 10(6): 635-654.CrossRef Toussaint L, Friedman P. Forgiveness, gratitude, and well-being: The mediating role of affect and beliefs. J Happiness Stud. 2009; 10(6): 635-654.CrossRef
18.
go back to reference Toussaint L, Webb JR. Theoretical and empirical connections between forgiveness and mental health and well-being. In: Worthington EL, ed. Handbook of Forgiveness. New York: Brunner-Routledge; 2005: 349-362. Toussaint L, Webb JR. Theoretical and empirical connections between forgiveness and mental health and well-being. In: Worthington EL, ed. Handbook of Forgiveness. New York: Brunner-Routledge; 2005: 349-362.
19.
go back to reference Witvliet CV, Ludwig TE, Vander Laan KL. Granting forgiveness or harboring grudges: Implications for emotion, physiology, and health. Psychol Sci. 2001; 12(2): 117-123.CrossRef Witvliet CV, Ludwig TE, Vander Laan KL. Granting forgiveness or harboring grudges: Implications for emotion, physiology, and health. Psychol Sci. 2001; 12(2): 117-123.CrossRef
20.
go back to reference Worthington EL Jr, Witvliet CV, Pietrini P, et al. Forgiveness, health, and well-being: A review of evidence for emotional versus decisional forgiveness, dispositional forgivingness, and reduced unforgiveness. J Behav Med. 2007; 30(4): 291-302.PubMedCrossRef Worthington EL Jr, Witvliet CV, Pietrini P, et al. Forgiveness, health, and well-being: A review of evidence for emotional versus decisional forgiveness, dispositional forgivingness, and reduced unforgiveness. J Behav Med. 2007; 30(4): 291-302.PubMedCrossRef
22.
go back to reference Orcutt HK. The prospective relationship of interpersonal forgiveness and psychological distress symptoms among college women. J Couns Psychol. 2006; 53(3): 350-361.CrossRef Orcutt HK. The prospective relationship of interpersonal forgiveness and psychological distress symptoms among college women. J Couns Psychol. 2006; 53(3): 350-361.CrossRef
23.
go back to reference Seawell AH, Toussaint LL, Cheadle ACD. Prospective associations between unforgiveness and physical health and positive mediating mechanisms in a nationally representative sample of older adults. Psychol Health. 2014; 29(4): 375-389.PubMedCrossRef Seawell AH, Toussaint LL, Cheadle ACD. Prospective associations between unforgiveness and physical health and positive mediating mechanisms in a nationally representative sample of older adults. Psychol Health. 2014; 29(4): 375-389.PubMedCrossRef
24.
go back to reference Toussaint LL, Marschall JC, Williams DR. Prospective associations between religiousness/spirituality and depression and mediating effects of forgiveness in a nationally representative sample of United States adults. Depress Res Treat. 2012. doi:10.1155/2012/267820.PubMedPubMedCentral Toussaint LL, Marschall JC, Williams DR. Prospective associations between religiousness/spirituality and depression and mediating effects of forgiveness in a nationally representative sample of United States adults. Depress Res Treat. 2012. doi:10.​1155/​2012/​267820.PubMedPubMedCentral
25.
go back to reference Ortha U, Berking M, Walkerc N, et al. Forgiveness and psychological adjustment following interpersonal transgressions: A longitudinal analysis. J Res Pers. 2008; 42(2): 365-385.CrossRef Ortha U, Berking M, Walkerc N, et al. Forgiveness and psychological adjustment following interpersonal transgressions: A longitudinal analysis. J Res Pers. 2008; 42(2): 365-385.CrossRef
26.
go back to reference Cohen S. Perceived stress in a probability sample of the United States. In: Spacapan S, Oskamp S, eds. The Social Psychology of Health. Thousand Oaks: Sage Publications; 1988: 31-67. Cohen S. Perceived stress in a probability sample of the United States. In: Spacapan S, Oskamp S, eds. The Social Psychology of Health. Thousand Oaks: Sage Publications; 1988: 31-67.
27.
go back to reference Cohen ST, Kamarck T, Mermelstein R. A global measure of perceived stress. J Health Soc Behav. 1983; 24(4): 385-396.PubMedCrossRef Cohen ST, Kamarck T, Mermelstein R. A global measure of perceived stress. J Health Soc Behav. 1983; 24(4): 385-396.PubMedCrossRef
28.
go back to reference Kessler RC, Andrews G, Colpe LJ, et al. Short screening scales to monitor population prevalences and trends in non-specific psychological distress. Psychol Med. 2002; 32(6): 959-976.PubMedCrossRef Kessler RC, Andrews G, Colpe LJ, et al. Short screening scales to monitor population prevalences and trends in non-specific psychological distress. Psychol Med. 2002; 32(6): 959-976.PubMedCrossRef
29.
go back to reference Kessler RC, Green JG, Gruber MJ, et al. Screening for serious mental illness in the general population with the K6 screening scale: Results from the WHO World Mental Health (WMH) survey initiative. Int J Methods Psychiatr Res. 2010; 19(S1): 4-22.PubMedPubMedCentralCrossRef Kessler RC, Green JG, Gruber MJ, et al. Screening for serious mental illness in the general population with the K6 screening scale: Results from the WHO World Mental Health (WMH) survey initiative. Int J Methods Psychiatr Res. 2010; 19(S1): 4-22.PubMedPubMedCentralCrossRef
30.
go back to reference Schat ACH, Kelloway EK, Desmarais S. The Physical Health Questionnaire (PHQ): Construct validation of a self-report scale of somatic symptoms. J Occup Health Psychol. 2005; 10(4): 363-381.PubMedCrossRef Schat ACH, Kelloway EK, Desmarais S. The Physical Health Questionnaire (PHQ): Construct validation of a self-report scale of somatic symptoms. J Occup Health Psychol. 2005; 10(4): 363-381.PubMedCrossRef
31.
go back to reference Spence JT, Helmreich RL, Pred RS. Impatience versus achievement strivings in the type A pattern: Differential effects on students’ health and academic achievement. J Appl Psychol. 1987; 72(4): 522-528.PubMedCrossRef Spence JT, Helmreich RL, Pred RS. Impatience versus achievement strivings in the type A pattern: Differential effects on students’ health and academic achievement. J Appl Psychol. 1987; 72(4): 522-528.PubMedCrossRef
32.
go back to reference Kline RB. Principles and practice of structural equation modeling. Guilford: New York, NY; 2005. Kline RB. Principles and practice of structural equation modeling. Guilford: New York, NY; 2005.
33.
go back to reference Slater MD, Hayes AF. The influence of youth music television viewership on changes in cigarette use and association with smoking peers: A social identity, reinforcing spirals perspective. Commun Res. 2010; 37(6): 751-773.CrossRef Slater MD, Hayes AF. The influence of youth music television viewership on changes in cigarette use and association with smoking peers: A social identity, reinforcing spirals perspective. Commun Res. 2010; 37(6): 751-773.CrossRef
34.
go back to reference Little RJA. A test of missing completely at random for multivariate data with missing values. J Am Stat Assoc. 1988; 83(404): 1198-1202.CrossRef Little RJA. A test of missing completely at random for multivariate data with missing values. J Am Stat Assoc. 1988; 83(404): 1198-1202.CrossRef
35.
go back to reference Burnham KP, Anderson DR. Model selection and multimodel inference: A practical information-theoretic approach. New York: Springer Science & Business Media; 2002. Burnham KP, Anderson DR. Model selection and multimodel inference: A practical information-theoretic approach. New York: Springer Science & Business Media; 2002.
36.
go back to reference Conway CC, Slavich GM, Hammen C. Daily stress reactivity and serotonin transporter gene (5-HTTLPR) variation: Internalizing responses to everyday stress as a possible transdiagnostic phenotype. Biol Mood Anxiety Disord. 2014; 4: 2.PubMedPubMedCentralCrossRef Conway CC, Slavich GM, Hammen C. Daily stress reactivity and serotonin transporter gene (5-HTTLPR) variation: Internalizing responses to everyday stress as a possible transdiagnostic phenotype. Biol Mood Anxiety Disord. 2014; 4: 2.PubMedPubMedCentralCrossRef
37.
go back to reference Conway CC, Slavich GM, Hammen C. Dysfunctional attitudes and affective responses to daily stressors: Separating cognitive, genetic, and clinical influences on stress reactivity. Cogn Ther Res. 2015; 39(3): 366-377.CrossRef Conway CC, Slavich GM, Hammen C. Dysfunctional attitudes and affective responses to daily stressors: Separating cognitive, genetic, and clinical influences on stress reactivity. Cogn Ther Res. 2015; 39(3): 366-377.CrossRef
38.
go back to reference Halfon N, Hochstein M. Life course health development: An integrated framework for developing health, policy, and research. Milbank Q. 2002; 80: 433-479.PubMedPubMedCentralCrossRef Halfon N, Hochstein M. Life course health development: An integrated framework for developing health, policy, and research. Milbank Q. 2002; 80: 433-479.PubMedPubMedCentralCrossRef
40.
go back to reference Green M, DeCourville N, Sadava S. Positive affect, negative affect, stress, and social support as mediators of the forgiveness-health relationship. J Soc Psychol. 2012; 152(3): 288-307.PubMedCrossRef Green M, DeCourville N, Sadava S. Positive affect, negative affect, stress, and social support as mediators of the forgiveness-health relationship. J Soc Psychol. 2012; 152(3): 288-307.PubMedCrossRef
41.
go back to reference Seybold KS, Hill PC, Neumann JK, et al. Physiological and psychological correlates of forgiveness. J Psychol Christ. 2001; 20(3): 250-259. Seybold KS, Hill PC, Neumann JK, et al. Physiological and psychological correlates of forgiveness. J Psychol Christ. 2001; 20(3): 250-259.
42.
go back to reference Lutgendorf SK et al. Non-cancer life stressors contribute to impaired quality of life in ovarian cancer patients. Gynecol Oncol. 2013; 131(3): 667-673.PubMedCrossRef Lutgendorf SK et al. Non-cancer life stressors contribute to impaired quality of life in ovarian cancer patients. Gynecol Oncol. 2013; 131(3): 667-673.PubMedCrossRef
43.
44.
go back to reference Monroe SM, Slavich GM, Georgiades K. The social environment and depression: The roles of life stress. In: Gotlib IH, Hammen CL, eds. Handbook of Depression. 3rd ed. New York: The Guilford Press; 2014: 296-314. Monroe SM, Slavich GM, Georgiades K. The social environment and depression: The roles of life stress. In: Gotlib IH, Hammen CL, eds. Handbook of Depression. 3rd ed. New York: The Guilford Press; 2014: 296-314.
45.
go back to reference Antonovsky A. The salutogenic model as a theory to guide health promotion. Health Promot Int. 1996; 11(1): 11-18.CrossRef Antonovsky A. The salutogenic model as a theory to guide health promotion. Health Promot Int. 1996; 11(1): 11-18.CrossRef
46.
go back to reference Bandura A. Self-efficacy: Toward a unifying theory of behavioral change. Psychol Rev. 1977; 84(2): 191-215.PubMedCrossRef Bandura A. Self-efficacy: Toward a unifying theory of behavioral change. Psychol Rev. 1977; 84(2): 191-215.PubMedCrossRef
47.
go back to reference Maier SF, Seligman ME. Learned helplessness: Theory and evidence. J Exp Psychol Gen. 1976; 105(1): 3-46.CrossRef Maier SF, Seligman ME. Learned helplessness: Theory and evidence. J Exp Psychol Gen. 1976; 105(1): 3-46.CrossRef
49.
go back to reference Miller G, Chen E, Cole SW. Health psychology: Developing biologically plausible models linking the social world and physical health. Annu Rev Psychol. 2009; 60: 501-524.PubMedCrossRef Miller G, Chen E, Cole SW. Health psychology: Developing biologically plausible models linking the social world and physical health. Annu Rev Psychol. 2009; 60: 501-524.PubMedCrossRef
50.
Metadata
Title
Forgiveness, Stress, and Health: a 5-Week Dynamic Parallel Process Study
Authors
Loren L. Toussaint, PhD
Grant S. Shields, MA
George M. Slavich, PhD
Publication date
01-10-2016
Publisher
Springer US
Published in
Annals of Behavioral Medicine / Issue 5/2016
Print ISSN: 0883-6612
Electronic ISSN: 1532-4796
DOI
https://doi.org/10.1007/s12160-016-9796-6

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