Negative Emotion and Health: why do we Keep Stalking Bears, When we Only Find Scat?

Abstract

Background Researchers have stalked an elusive bear, a modifiable connection between negative emotion and morbidity and mortality. What is initially thought to be a bear in the woods (modifiable risk factor) turns out to be mere scat (uninformative risk marker). Discoveries are proclaimed, only to prove eventually false. Method. Narrative review of succession of variables deemed risk factors that went into decline, replaced by others. Results. Negative affect has been related to numerous morbidities and mortality. Discoveries often fail independent replication. Most candidates are statistically indistinguishable. Initial enthusiasm is due to artificial distinctions; capitalization on chance; flexibility in analysis and interpretation of data; and significance chasing. Conclusions. Each new false discovery scrambles research and clinical priorities and squanders resources. Future false alarms can be avoided with greater appreciation of the historical record. Preventive measures include recognizing false distinctions among concepts and appreciating the role of residual confounding and the inadequacy of statistical control for resolving causal issues in observational studies.