the number of adults diagnosed with high blood pressure (BP) is increasing (Ayala et al.,2002). High BP is a major risk factor for deathand disability related to coronary heart disease,heart attacks, strokes, kidney disease, and vas-cular complications (National Heart, Lung, andBlood Institute, 1997). In addition, high systolicBP has been linked with decreased cognitiveperformance, memory loss, and the loss ofhealthy brain tissue (Launer et al., 1995; Swanet al., 1998). Conversely, reducing BP in hy-pertensive individuals has been found to re-duce the risk of death and disability signifi-cantly, and is therefore a critically importantfactor in employee health (Hypertension De-tection and Follow-up Program CooperativeGroup, 1979; Launer et al., 1995; MacMahon etal., 1990; Thijs et al., 1992).There is considerable evidence to suggest thathigh BP is linked to persistent stress and the wayin which people cope (Henry et al., 1986; Linden,1984; Markovitz et al., 1993; Shapiro, 1996; Step-toe, 1986). Chronic psychological stress is asso-ciated with increased activation of the sym-pathetic-adrenomedullary axis and increasedcirculating levels of adrenaline and noradrena-line. Chronically elevated adrenaline levels have been implicated in the development and pro-gression of hypertension (Julius et al., 1988; Ru-mantir et al., 2000; Schalekamp et al., 1983), andhypertensive subjects have been demonstratedto have increased sympathetic and reducedparasympathetic tone compared to healthy con-trols (Guzzetti et al., 1988; Langewitz et al., 1994).Conversely, behavioral interventions that reducestress and sympathetic arousal have been shownto be effective nonpharmacologic treatments forhypertension; such treatments have been associ-ated with clinically significant and sustainableBP reductions as well as lowered health carecosts (Charlesworth et al., 1984; Chesney et al.,1987; Linden and Chambers, 1994; Mathias, 1991;Ward et al., 1987; Weiss, 1988).In addition to being implicated in the de-velopment and aggravation of hypertensionand other health problems, employee stressand emotional well-being have also beenidentified as important determinants of orga-nizational health, performance, and produc-tivity. For example, high levels of emotionaldistress have been found to be among themost costly health problems to employers interms of absenteeism, disability, and failureto meet productivity standards (Burton et al.,1999). Depression, a common problem amongworkers, costs the United States $44 billionper year in lost productivity, according to aNational Foundation for Brain Research sur-vey of human resource professionals con-ducted in 1999. Another nationwide surveyconducted by the New York Business Groupon Health revealed that each employee suf-fering from stress, anxiety, or depression isestimated to lose 16 days of work per yearcompared to an average of 4–6 lost workdaysfor all employees. Additionally, in a recent 3-year analysis of more than 46,000 workersfrom six major companies, depression andunmanaged stress emerged as the top twomost costly risk factors in terms of medicalexpenditures—increasing health care costs by2–7 times as much as physical risk factorssuch as smoking, obesity, and poor exercisehabits. In this study, combined psychosocialproblems, including stress and depression,led to costs nearly 2.5 times higher than thoseof workers who did not report these concerns(Goetzel et al., 1998).In contrast, studies conducted across a broadrange of settings have linked positive emotionand psychological well-being to numerous or-ganizationally relevant benefits, including re-duced absenteeism (Iverson et al., 1998), in-creased cognitive flexibility and innovativeproblem solving (Ashby et al., 1999; Isen,1998), and improved negotiation style(Carnevale and Isen, 1986), creativity (Isen,1998; Isen et al., 1987), decision-making (Isen,2000), job performance (Staw and Barsade,1993; Wright and Staw, 1999), job achievement(Staw et al., 1994), and job satisfaction (Wood-ward and Chen, 1994). The growing body ofresearch demonstrating the favorable impactof positive emotions on performance andhealth (Blakeslee, 1997; Danner et al., 2001; Sa-lovey et al., 2000) has recently fueled an inter-est in developing and implementing interven-tions that cultivate positive emotions in theworkplace (Childre and Cryer, 2000; Cooper-rider and Whitney, 2000; Fredrickson, 2000b)
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