"If you want others to be happy, practice compassion.  If you want to be happy, practice compassion."  Dalai Lama 

I really value how quotes about caring, like this favourite of mine from the Dalai Lama, are increasingly backed up by emerging research.  Here are seven further papers in the general area of the psychological effects of kindness, selfishness & fairness (fuller details, links and abstracts of all studies mentioned are given further down this post).  The first two papers are from the impressive duo, Richard Wilkinson & Kate Pickett.  The first (viewable as free full text) "Equality, sustainability, and quality of life" has the introduction "Action on climate change is hampered by the view that reducing carbon emissions will involve a sacrifice in living standards. But Richard Wilkinson, Kate Pickett, and Roberto De Vogli argue that greater equality will not only help achieve sustainability but also enhance the real quality of life."  The second - "Inequality: an underacknow-ledged source of mental illness and distress" - points out that "Greater income inequality is associated with higher prevalence of mental illness and drug misuse in rich societies. There are threefold differences in the proportion of the population suffering from mental illness between more and less equal countries".  This revisits territory I have written about before on this blog (see, for example, a review of their fine book "The spirit level: Why more equal societies almost always do better").

On a smaller scale, Elovainio et al's study "Organisational justice and cognitive function in middle-aged employees: the Whitehall II study" also highlights the toxic effects of unfairness.  They studied over 4,500 employees and found that "Lower mean levels of (organisational) justice at phases 1 and 2 were associated with worse cognitive function in terms of memory, inductive reasoning, vocabulary and verbal fluency at both phases 5 and 7 (10 to 20 years later). These associations were independent of covariates, such as age, occupational grade, behavioural risks, depression, hypertension and job strain."  Again this underlines the damaging effects of inequality and lack of compassion. 

There is then Teicher et al's study "Hurtful Words: Association of Exposure to Peer Verbal Abuse With Elevated Psychiatric Symptom Scores and Corpus Callosum Abnormalities".  They analysed psychologic & brain findings in 63 young adults with no history of abuse or exposure to parental verbal abuse, selected for varying degrees of exposure to peer verbal abuse.  They found " ... dose-dependent effects of peer verbal abuse on anxiety, depression, anger-hostility, dissociation, "limbic irritability," and drug use. Peer and parental verbal abuse were essentially equivalent in effect size on these ratings ... peer verbal abuse during the middle school years had the most significant effect on symptom scores".  They also found brain changes and concluded "These findings parallel results of previous reports of psychopathology associated with childhood exposure to parental verbal abuse and support the hypothesis that exposure to peer verbal abuse is an aversive stimulus associated with greater symptom ratings and meaningful alterations in brain structure".  Putnam writes, in his linked freely downloadable full text editorial "Sticks and stones", "The investigators found interactions between peer verbal abuse and gender, with females scoring higher on measures of dissociation and "limbic irritability" and males reporting greater drug use. It is interesting that the effects attributable to peer verbal abuse are essentially equivalent to those found in subjects with histories of parental verbal abuse ... the commonality of symptoms and outcomes among the various forms of childhood adversity studied to date suggests that the underlying traumatogenic mechanisms are similar or at least share common developmental pathways. We can hope that a corollary would be that proven treatments for one type of childhood adversity could be successfully adapted for others. To some extent this is proving true, as evidence-based child trauma treatments such as trauma-focused cognitive-behavioral therapy demonstrate efficacy in heterogeneous groups of traumatized youth".  

The last two studies I mention in this blog post are on kindness.  As a student I hitchhiked widely and I was struck by how people in poorer countries often seemed to be more generous than people in richer countries.  Piff & colleagues looked at this more formally in their paper "Having less, giving more: the influence of social class on prosocial behavior" and reported "Across 4 studies, lower class individuals proved to be more generous (Study 1), charitable (Study 2), trusting (Study 3), and helpful (Study 4) compared with their upper class counterparts. Mediator and moderator data showed that lower class individuals acted in a more prosocial fashion because of a greater commitment to egalitarian values and feelings of compassion. Implications for social class, prosocial behavior, and economic inequality are discussed".  While Okun et al explored "Does volunteering moderate the relation between functional limitations and mortality?"  They wrote " ... we tested the hypothesis that volunteering moderates the relation between functional limitations and risk of mortality. This prospective study used baseline survey data from a representative sample of 916 non-institutionalized adults 65 years old and older ... survival analyses revealed that functional limitations were associated with an increased risk of dying only among participants who never or almost never volunteered, suggesting that volunteering buffers the association between functional limitations and mortality. We conclude that although it may be more difficult for older adults with functional limitations to volunteer, they may receive important benefits from doing so".  Well, well!  In the loosely linked post "Egosystem & ecosystem" I quoted the Beatles hopeful last lyrics (and they're appropriate here too) "In the end the love you take is equal to the love you make".   

Wilkinson, R. G., K. E. Pickett, et al. (2010). "Equality, sustainability, and quality of life." BMJ 341: c5816.  [Free Full Text] 
Action on climate change is hampered by the view that reducing carbon emissions will involve a sacrifice in living standards. But Richard Wilkinson, Kate Pickett, and Roberto De Vogli argue that greater equality will not only help achieve sustainability but also enhance the real quality of life.  When former US vice president Al Gore produced his hard hitting documentary on the dangers of climate change, he called it "An Inconvenient Truth," because dealing with climate change was likely to require unwelcome changes in our way of life. And yet it is clear, from research that we summarise in our report for the London Sustainable Development Commission and in The Spirit Level, that not only is greater equality a prerequisite for coping with climate change, it is essential for future improvements in the overall quality of life of whole populations. Physical and mental health are better and a wide range of social problems are less prevalent in more equal societies ... The evidence suggests greater equality has benefits in terms of fewer health and social problems and stronger, more cohesive societies. We can also expect that policies to reduce carbon emissions and climate change will improve health and wellbeing. Energy production will be cleaner, waste managed more efficiently, people will walk or bicycle more frequently, and an emphasis on contraction and convergence could provide sustainable development opportunities for the world's poorest. Although change will take time, the convenient truth is that greater equality offers not only the possibility of a reduction in consumerism and status competition, but also the development of a more cohesive, sociable, and sustainable society, which may be essential for our future health and wellbeing

Pickett, K. E. and R. G. Wilkinson (2010). "Inequality: an underacknowledged source of mental illness and distress." British Journal of Psychiatry 197(6): 426-428.  [Abstract/Full Text] 
Greater income inequality is associated with higher prevalence of mental illness and drug misuse in rich societies. There are threefold differences in the proportion of the population suffering from mental illness between more and less equal countries. This relationship is most likely mediated by the impact of inequality on the quality of social relationships and the scale of status differentiation in different societies.

Elovainio, M., A. Singh-Manoux, et al. (2010). "Organisational justice and cognitive function in middle-aged employees: the Whitehall II study." Journal of epidemiology and community health.  [PubMed] 
Background Little is known about the role that work-related factors play in the decline of cognitive function. This study examined the association between perceived organisational justice and cognitive function among middle-aged men and women. Methods Perceived organisational justice was measured at phases 1 (1985-8) and 2 (1989-90) of the Whitehall II study when the participants were 35-55 years old. Assessment of cognitive function at the screening clinic at phases 5 (1997-9) and 7 (2003-4) included the following tests in the screening clinic: memory, inductive reasoning (Alice Heim 4), vocabulary (Mill Hill), and verbal fluency (phonemic and semantic). Mean exposure to lower organisational justice at phases 1 and 2 in relation to cognitive function at phases 5 and 7 were analysed using linear regression analyses. The final sample included 4531 men and women. Results Lower mean levels of justice at phases 1 and 2 were associated with worse cognitive function in terms of memory, inductive reasoning, vocabulary and verbal fluency at both phases 5 and 7. These associations were independent of covariates, such as age, occupational grade, behavioural risks, depression, hypertension and job strain. Conclusions This study suggests an association between perceived organisational justice and cognitive function. Further studies are needed to examine whether interventions designed to improve organisational justice would affect employees' cognition function favourably.

Teicher, M. H., J. A. Samson, et al. (2010). "Hurtful Words: Association of Exposure to Peer Verbal Abuse With Elevated Psychiatric Symptom Scores and Corpus Callosum Abnormalities." Am J Psychiatry 167(12): 1464-1471.  [Abstract/Full Text] 
Objective: Previous studies have shown that exposure to parental verbal abuse in childhood is associated with higher rates of adult psychopathology and alterations in brain structure. In this study the authors sought to examine the symptomatic and neuroanatomic effects, in young adulthood, of exposure to peer verbal abuse during childhood. Method: A total of 848 young adults (ages 18-25 years) with no history of exposure to domestic violence, sexual abuse, or parental physical abuse rated their childhood exposure to parental and peer verbal abuse and completed a self-report packet that included the Kellner Symptom Questionnaire, the Limbic Symptom Checklist-33, and the Dissociative Experiences Scale. Diffusion tensor images were collected for a subset of 63 young adults with no history of abuse or exposure to parental verbal abuse selected for varying degrees of exposure to peer verbal abuse. Images were analyzed using tract-based spatial statistics. Results: Analysis of covariance revealed dose-dependent effects of peer verbal abuse on anxiety, depression, anger-hostility, dissociation, "limbic irritability," and drug use. Peer and parental verbal abuse were essentially equivalent in effect size on these ratings. Path analysis indicated that peer verbal abuse during the middle school years had the most significant effect on symptom scores. Degree of exposure to peer verbal abuse correlated with increased mean and radial diffusivity and decreased fractional anisotropy in the corpus callosum and the corona radiata. Conclusions: These findings parallel results of previous reports of psychopathology associated with childhood exposure to parental verbal abuse and support the hypothesis that exposure to peer verbal abuse is an aversive stimulus associated with greater symptom ratings and meaningful alterations in brain structure.

Putnam, F. W. (2010). "Beyond Sticks and Stones." Am J Psychiatry 167(12): 1422-1424.  [Free Full Text] 
The study by Teicher and colleagues in this issue opens another window on how adverse interpersonal experiences hurt children. In many respects, however, the results reveal a disturbingly familiar picture similar to that first sketched by the seminal Adverse Childhood Experiences study. In the Teicher et al. study, as in prior research, there is evidence of a dose-dependent relationship between the severity of the childhood adversity and negative adult outcomes. Adverse childhood experiences are associated with a broad array of comorbid symptoms, including anxiety, depression, somatization, anger and hostility, dissociation, and substance abuse, with somewhat different outcomes in women and men. Finally, as a number of prior studies have found, there is a graded relationship between level of childhood adversity and structural changes in the brain.  What Teicher and colleagues in the Developmental Biopsychiatry Research Program at McLean Hospital add to this picture is evidence for an interaction between the child's age at the time of peer verbal abuse and a range of symptomatic outcomes. The middle school years appear to be an especially sensitive period for the pernicious effects of peer verbal abuse. The investigators found interactions between peer verbal abuse and gender, with females scoring higher on measures of dissociation and "limbic irritability" and males reporting greater drug use. It is interesting that the effects attributable to peer verbal abuse are essentially equivalent to those found in subjects with histories of parental verbal abuse but not other forms of abuse or neglect.  Peer verbal abuse, sometimes dismissed as an inevitable rite of passage, joins the growing list of childhood adversities, including physical and sexual abuse, neglect, exposure to domestic violence, and parental depression, shown to have long-term detrimental effects, extensive psychiatric comorbidity, and significant effects on brain development and cognitive function ... The commonality of symptoms and outcomes among the various forms of childhood adversity studied to date suggests that the underlying traumatogenic mechanisms are similar or at least share common developmental pathways. We can hope that a corollary would be that proven treatments for one type of childhood adversity could be successfully adapted for others. To some extent this is proving true, as evidence-based child trauma treatments such as trauma-focused cognitive-behavioral therapy demonstrate efficacy in heterogeneous groups of traumatized youth.

Piff, P. K., M. W. Kraus, et al. (2010). "Having less, giving more: the influence of social class on prosocial behavior." Journal of personality and social psychology 99(5): 771-784.  [PubMed]          
Lower social class (or socioeconomic status) is associated with fewer resources, greater exposure to threat, and a reduced sense of personal control. Given these life circumstances, one might expect lower class individuals to engage in less prosocial behavior, prioritizing self-interest over the welfare of others. The authors hypothesized, by contrast, that lower class individuals orient to the welfare of others as a means to adapt to their more hostile environments and that this orientation gives rise to greater prosocial behavior. Across 4 studies, lower class individuals proved to be more generous (Study 1), charitable (Study 2), trusting (Study 3), and helpful (Study 4) compared with their upper class counterparts. Mediator and moderator data showed that lower class individuals acted in a more prosocial fashion because of a greater commitment to egalitarian values and feelings of compassion. Implications for social class, prosocial behavior, and economic inequality are discussed.

Okun, M. A., K. J. August, et al. (2010). "Does volunteering moderate the relation between functional limitations and mortality?" Social Science & Medicine 71(9): 1662-1668.  [Abstract/Full Text] 
Previous studies have demonstrated that functional limitations increase, and organizational volunteering decreases, the risk of mortality in later life. However, scant attention has been paid to investigating the joint effect of functional limitations and organizational volunteering on mortality. Accordingly, we tested the hypothesis that volunteering moderates the relation between functional limitations and risk of mortality. This prospective study used baseline survey data from a representative sample of 916 non-institutionalized adults 65 years old and older who lived in the continental United States. Data on mortality were extracted six years later from the National Death Index. Survival analyses revealed that functional limitations were associated with an increased risk of dying only among participants who never or almost never volunteered, suggesting that volunteering buffers the association between functional limitations and mortality. We conclude that although it may be more difficult for older adults with functional limitations to volunteer, they may receive important benefits from doing so.