Howard Friedman - The Longevity Project

Dr. David Snowdon has been running another rare long-term study—the Nun Study—that has information on about seven hundred women across many decades. Needless to say, the nuns, of the School Sisters of Notre Dame, were not smokers, drinkers, or sexual adventurers. They had adequate housing, medical care, and social relations. Yet they did show individual differences. 22 22 For an overview of the Nun Study, see David Snowdon’s Aging with Grace: What the Nun Study Teaches Us about Leading Longer, Healthier, and More Meaning ful Lives (New York: Bantam, 2002). Those with higher verbal skills, more education, and positive emotions in young adulthood did better and lived longer. The young women who expressed more hope and gratitude in their diaries went on to live healthier lives than those revealing sadness and fear. But some nuns showed dips and declines in their moods, language, and health. Happiness and health often shifted in parallel. For example, those who would eventually develop Alzheimer’s disease articulated less and less positive emotion as their mental functions got worse and worse. Surely their poor moods were not causing their rapid mental decline.

We thus needed to understand much more about grumpiness, happiness, and anxiety across long periods of time. So we next turned our attention directly to issues of mood, worrying, and mental health across the decades.

Fidgety Philip was moody, tense, and high-strung. Full of “tireless” energy, he was well liked by his schoolmates despite tending to seek the attention of others through his behaviors. Philip was not especially conscientious, applying himself diligently only to tasks that interested him. His mother noted that he was more nervous than the average child, prone to worry about many things including burglars and being alone. In 1922, the Terman subjects’ parents and teachers rated them on how moody they were. Were their moods very changeable—that is, often alternating between joy and sadness? Or were they more decidedly stable and permanent? Philip’s mother responded, “moods extremely changeable,” when describing her son. Dr. Terman thought that these reactions might be relevant to their later lives, and he turned out to be correct.

As we consistently found with our Terman studies, answers never wrapped up neatly. So while moodiness often had a negative impact on health and longevity, sometimes this worrying nature helped out later in life. In 1940, the Terman subjects were about thirty years old. Philip, it turns out, had grown up to be quite a worrier. Now married, he was the proud father of a daughter, but he remained moody and cared a good deal about what others thought of him. James, too, was rather anxious and uptight, but in a more focused way. A sensitive child, he’d become a sensitive adult, frequently keyed-up and restless, worrying about his financial planning and various other hassles of living through turbulent times. Although these characteristics were telling, we wanted to create a more formal measure of what scientists term neuroticism— the tendency to worry and be moody, tense, and at risk of rage or depression. We needed a scale that was reliable and valid, and so we sorted through dozens of Terman’s questionnaire items, scrutinized how they related to each other, and used advanced statistical analysis to extract items for a reliable scale. We then validated the scale against modern measures of neuroticism.

Here is a self-assessment scale that yields some insight into the relationship between moody worrying and longevity.

Are you very affected by praise or blame?

3 – Yes

2 – ?

1 – No

Do you often feel just miserable?

3 – Yes

2 – ?

1 – No

Are you touchy on certain topics?

3 – Yes

2 – ?

1 – No

Does some particularly useless thought keep coming into your mind to bother you?

3 – Yes

2 – ?

1 – No

Are you frequently burdened by a sense of remorse or regret?

3 – Yes

2 – ?

1 – No

Do you worry too long over humiliating experiences?

3 – Yes

2 – ?

1 – No

Do your feelings alternate between happiness and sadness without apparent reason?

3 – Yes

2 – ?

1 – No

Are your feelings easily hurt?

3 – Yes

2 – ?

1 – No

Are you moody?

3 – Yes

2 – ?

1 – No

Do you tend to be quite emotional?

3 – Yes

2 – ?

1 – No

To score this quiz, do the following. For each of the ten questions, assign a score of 3 for “yes,” 1 for “no,” and 2 for any question mark that you circled. Now add up your total score. The lowest possible score is 10 and highest possible is 30. If you scored 18 or below you are clearly a relaxed, laid-back kind of person—you are in the bottom quartile of this neuroticism scale, based on our data. If your score is 23 or above, however, you’re something of a neurotic (you are scoring in the upper quartile).

The term “neurotic” here isn’t being used in the clinical sense but rather to describe a normal personality characteristic that everyone possesses to one degree or another. If you scored in the middle, you are probably rather high-strung at times and appear a bit neurotic, but at other times you are more calm and serene.

As young and middle-aged adults, the Terman participants were asked whether they were generally in a good mood, calm and relaxed, and satisfied with their lives. We also knew whether, late in life, they reported declining health, a heart condition, cancer, or difficulty in completing daily tasks without assistance. Emma (who was serious as a child), for example, was retired and living alone, but said she was happy—at the time of her report she estimated that she had been “fairly cheerful” and “fairly relaxed” over the prior couple of months. She had successfully battled breast cancer not long after her retirement, remained energetic, and even did a bit of traveling from time to time. Her health story was typical of some but contrasted with other Terman subjects, who needed considerable help to care for themselves, were anxious and depressed, or saw their lives as “not too happy.”

When we homed in on adult personality, later-life happiness, and health and longevity, we found that the Terman women who were worriers in young adulthood went on to later report being sicker and unhappier; and they were more likely to die at a younger age. This was especially true if they were not prudent and conscientious. If the women were conscientious and in control of their lives and had a good group of friends, then their worrying proved to be much less of a health threat.

For men, the results were dramatically different. The Terman men who were worriers in young adulthood went on to later report being sicker and unhappier on average, but they were less likely to die. If the neurotic individuals were also conscientious, things got even better. The men who were conscientious and neurotic, like James, did quite well as they aged—at least in terms of their length of life. Older men who are neurotic worriers may be especially motivated to take care of themselves, in part due to a preoccupation with bodily symptoms. Rather than fretting themselves to death, they are concerned enough to keep themselves alive.

At first we were a bit suspicious of this clear but unexpected benefit to neurotic men, though it is hard to argue with death certificates. But then two studies by other researchers appeared, finding the same pattern. One showed that elderly men (over age seventy) who were neurotic were less likely to die during the next four years, and the other, a study of elderly Medicare patients, found that neuroticism was health protective. 23 23 For more information on the first study we mention on the protective effect of neuroticism, see A. E. Korten, A. F. Jorm, Z. Jiao, L. Letenneur, P. A. Jacomb, A. S.Henderson, H. Christensen, and B. Rodgers, “Health, Cognitive, and Psychosocial Factors as Predictors of Mortality in an Elderly Community Sample,” Journal of Epidemiology and Community Health 53 (1999): 83-88. The second study, of (older) Medicare patients, is A. Weiss and P. T. Costa, Jr., “Domain and Facet Personality Predictors of All-Cause Mortality among Medicare Patients Aged 65 to 100,” Psychosomatic Medicine 67 (2005): 724-33. We also became believers when we saw that our discovery was especially true of the Terman men who were widowed—a time when it becomes especially important to take care of oneself.