{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,1]],"date-time":"2025-11-01T15:59:38Z","timestamp":1762012778060,"version":"build-2065373602"},"reference-count":51,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2019,5,22]],"date-time":"2019-05-22T00:00:00Z","timestamp":1558483200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,1,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Expressing emotions effectively is central to social functioning and has links to health and cardiovascular disease (CVD) risk. Previous work has linked the ability to smile to lower CVD risk in men but has not studied other expressions or considered the context of these skills.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Purpose<\/jats:title>\n                  <jats:p>To test whether the ability to express fear, anger, sadness, happiness, and disgust cross-sectionally predict CVD risk in both genders and whether links are moderated by the ability to decode others\u2019 emotional signals.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>A community sample of 125 men and women (30\u201375 years) provided trait emotion data before a laboratory visit where blood was drawn and performance-based assessments of the ability to signal and decode emotions were administered. Expressive accuracy was scored using FaceReader software. Projected CVD risk was calculated using Framingham, a New Zealand (NZ) specific, and Atherosclerosis CVD (ASCVD) risk algorithms.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Accuracy expressing happiness predicted lower projected risk, whereas greater accuracy expressing fear and sadness predicted higher risk. Gender frequently moderated these links; greater accuracy expressing happiness predicted lower risk in men but not women. Conversely, greater accuracy expressing fear predicted higher risk in men, whereas greater accuracy expressing sadness predicted lower risk in women but, again, higher risk in men. The ability to accurately decode others\u2019 emotions moderated some links.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>The ability to signal emotion has complex links to health parameters. The ability to flexibly regulate expressions in accordance with gender norms may be one useful way of thinking about adaptive expressive regulation.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/abm\/kaz024","type":"journal-article","created":{"date-parts":[[2019,5,22]],"date-time":"2019-05-22T12:54:56Z","timestamp":1558529696000},"page":"49-60","source":"Crossref","is-referenced-by-count":5,"title":["Real Men Don\u2019t Cry: Skill Expressing Discrete Emotions Differentially Predicts Cardiovascular Disease Risk in Men and Women"],"prefix":"10.1093","volume":"54","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4961-4284","authenticated-orcid":false,"given":"Laura M","family":"Thompson","sequence":"first","affiliation":[{"name":"Department of Psychological Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Natalie L","family":"Tuck","sequence":"additional","affiliation":[{"name":"The Auckland Regional Pain Service, Auckland District Health Board, Irvine, CA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarah D","family":"Pressman","sequence":"additional","affiliation":[{"name":"School of Social Ecology, University of California, Irvine, CA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7691-0938","authenticated-orcid":false,"given":"Nathan S","family":"Consedine","sequence":"additional","affiliation":[{"name":"Department of Psychological Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2019,5,22]]},"reference":[{"key":"2019121912172409600_CIT0001","doi-asserted-by":"crossref","first-page":"546","DOI":"10.2188\/jea.JE20150196","article-title":"Laughter is the best medicine? A cross-sectional study of cardiovascular disease among older japanese adults","volume":"26","author":"Hayashi","year":"2016","journal-title":"J Epidemiol."},{"key":"2019121912172409600_CIT0002","doi-asserted-by":"crossref","first-page":"92","DOI":"10.1037\/a0018420","article-title":"Expressive flexibility","volume":"10","author":"Westphal","year":"2010","journal-title":"Emotion."},{"key":"2019121912172409600_CIT0003","doi-asserted-by":"crossref","first-page":"502","DOI":"10.1111\/bjhp.12242","article-title":"Does the ability to express different emotions predict different indices of physical health? A skill-based study of physical symptoms and heart rate variability","volume":"22","author":"Tuck","year":"2017","journal-title":"Br J Health Psychol."},{"key":"2019121912172409600_CIT0004","doi-asserted-by":"crossref","first-page":"1852","DOI":"10.1111\/psyp.12755","article-title":"Higher resting heart rate variability predicts skill in expressing some emotions","volume":"53","author":"Tuck","year":"2016","journal-title":"Psychophysiology."},{"key":"2019121912172409600_CIT0005","doi-asserted-by":"crossref","first-page":"855","DOI":"10.1007\/s10865-017-9852-0","article-title":"Greater ability to express positive emotion is associated with lower projected cardiovascular disease risk","volume":"40","author":"Tuck","year":"2017","journal-title":"J Behav Med."},{"key":"2019121912172409600_CIT0006","first-page":"114","article-title":"The evolutionary psychology of the emotions and their relationship to internal regulatory variables","volume-title":"Handbook of Emotions","author":"Tooby","year":"2008"},{"key":"2019121912172409600_CIT0007","doi-asserted-by":"crossref","first-page":"385","DOI":"10.1080\/02699931.2012.665029","article-title":"The social signal value of emotions","volume":"26","author":"Hareli","year":"2012","journal-title":"Cogn Emot."},{"key":"2019121912172409600_CIT0008","doi-asserted-by":"crossref","first-page":"204","DOI":"10.1037\/1089-2680.6.2.204","article-title":"Moderators of the emotion inhibition-health relationship: A review and research agenda","volume":"6","author":"Consedine","year":"2002","journal-title":"Rev Gen Psychol"},{"key":"2019121912172409600_CIT0009","doi-asserted-by":"crossref","first-page":"1372","DOI":"10.1177\/0956797612445312","article-title":"Grin and bear it: The influence of manipulated facial expression on the stress response","volume":"23","author":"Kraft","year":"2012","journal-title":"Psychol Sci."},{"key":"2019121912172409600_CIT0010","first-page":"25","article-title":"Going beyond the ability-trait debate: The three-level model of emotional intelligence","volume":"5","author":"Mikolajczak","year":"2009","journal-title":"J Appl Psychol"},{"key":"2019121912172409600_CIT0011","doi-asserted-by":"crossref","first-page":"669","DOI":"10.1037\/emo0000270","article-title":"Suppression and expression of emotion in social and interpersonal outcomes: A meta-analysis","volume":"17","author":"Chervonsky","year":"2017","journal-title":"Emotion."},{"key":"2019121912172409600_CIT0012","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1016\/S0022-3999(00)00161-6","article-title":"Alexithymia and negative emotional conditions","volume":"49","author":"Lumley","year":"2000","journal-title":"J Psychosom Res."},{"issue":"1","key":"2019121912172409600_CIT0013","doi-asserted-by":"crossref","first-page":"128","DOI":"10.1080\/02699930802613828","article-title":"What emotional reactions can tell us about the nature of others: An appraisal perspective on person perception","volume":"24","author":"Hareli","year":"2010","journal-title":"Cogn Emot"},{"key":"2019121912172409600_CIT0014","doi-asserted-by":"crossref","first-page":"161","DOI":"10.1080\/02699930500260427","article-title":"Predicting facial valence to negative stimuli from resting RSA: Not a function of active emotion regulation","volume":"20","author":"Demaree","year":"2006","journal-title":"Cogn Emot"},{"key":"2019121912172409600_CIT0015","doi-asserted-by":"crossref","first-page":"823","DOI":"10.1007\/s12160-016-9809-5","article-title":"Beyond self-report: Performance measures of emotional competencies predict symptoms of depression and anxiety, physical symptoms, self-rated health, and immunoregulatory molecules","volume":"50","author":"Tuck","year":"2016","journal-title":"Ann Behav Med."},{"issue":"1\u20132","key":"2019121912172409600_CIT0016","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1023\/B:SERS.0000011073.44105.6f","article-title":"Hostility and anxiety differentially predict cardiovascular disease in men and women","volume":"50","author":"Consedine","year":"2004","journal-title":"Sex Roles"},{"key":"2019121912172409600_CIT0017","doi-asserted-by":"crossref","first-page":"305","DOI":"10.1037\/0033-2909.129.2.305","article-title":"The contingent smile: A meta-analysis of sex differences in smiling","volume":"129","author":"LaFrance","year":"2003","journal-title":"Psychol Bull."},{"key":"2019121912172409600_CIT0018","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1177\/1754073914544408","article-title":"Gender and emotion expression: A developmental contextual perspective","volume":"7","author":"Chaplin","year":"2015","journal-title":"Emot Rev."},{"key":"2019121912172409600_CIT0019","doi-asserted-by":"crossref","first-page":"258","DOI":"10.1037\/1528-3542.5.3.258","article-title":"Anger and social appraisal: A \u201cspicy\u201d sex difference?","volume":"5","author":"Evers","year":"2005","journal-title":"Emotion."},{"key":"2019121912172409600_CIT0020","first-page":"152","article-title":"The evolution of emotional expression: A \u201cselfish-gene\u201d account of smiling and laughter in early hominids and humans","volume-title":"Emotions: Current Issues and Future Directions","author":"Owren","year":"2001"},{"key":"2019121912172409600_CIT0021","doi-asserted-by":"crossref","first-page":"241","DOI":"10.1111\/1469-7610.00715","article-title":"The \u201cReading the mind in the eyes\u201d test revised version: A study with normal adults, and adults with asperger syndrome or high\u2010functioning autism","volume":"42","author":"Baron\u2010Cohen","year":"2001","journal-title":"J Child Psychol Psychiat."},{"key":"2019121912172409600_CIT0022","doi-asserted-by":"crossref","first-page":"246","DOI":"10.1007\/s12160-014-9600-4","article-title":"Divergent associations of antecedent- and response-focused emotion regulation strategies with midlife cardiovascular disease risk","volume":"48","author":"Appleton","year":"2014","journal-title":"Ann Behav Med."},{"key":"2019121912172409600_CIT0023","doi-asserted-by":"crossref","first-page":"709","DOI":"10.1136\/bmj.320.7236.709","article-title":"Updated new zealand cardiovascular disease risk-benefit prediction guide","volume":"320","author":"Jackson","year":"2000","journal-title":"BMJ."},{"key":"2019121912172409600_CIT0024","doi-asserted-by":"crossref","first-page":"743","DOI":"10.1161\/CIRCULATIONAHA.107.699579","article-title":"General cardiovascular risk profile for use in primary care: The framingham heart study","volume":"117","author":"D\u2019Agostino","year":"2008","journal-title":"Circulation."},{"key":"2019121912172409600_CIT0025","doi-asserted-by":"crossref","first-page":"722","DOI":"10.1016\/j.ahj.2007.02.027","article-title":"Prediction of first coronary events with the Framingham score: A systematic review","volume":"153","author":"Eichler","year":"2007","journal-title":"Am Heart J."},{"key":"2019121912172409600_CIT0026","doi-asserted-by":"crossref","first-page":"1631","DOI":"10.1002\/sim.1742","article-title":"Presentation of multivariate data for clinical use: The Framingham Study risk score functions","volume":"23","author":"Sullivan","year":"2004","journal-title":"Stat Med."},{"key":"2019121912172409600_CIT0027","first-page":"S49","article-title":"On the assessment of cardiovascular risk: A report of the American College of Cardiology\/American Heart Association Task Force on Practice Guidelines","volume":"129","author":"Goff","year":"2013","journal-title":"J Am Coll Cardiol"},{"key":"2019121912172409600_CIT0028","doi-asserted-by":"publisher","first-page":"27","DOI":"10.1136\/heart.85.1.37","article-title":"Comparative accuracy of cardiovascular risk prediction methods in primary care patients","volume":"85","author":"Jones","year":"2001","journal-title":"Heart"},{"volume-title":"Reference Manual FaceReader Version 6","year":"2014","author":"Loijens","key":"2019121912172409600_CIT0029"},{"volume-title":"Facial Action Coding System: A Technique for the Measurement of Facial Action","year":"1978","author":"Ekman","key":"2019121912172409600_CIT0030"},{"issue":"4","key":"2019121912172409600_CIT0031","doi-asserted-by":"crossref","first-page":"227","DOI":"10.1037\/npe0000028","article-title":"Automated facial coding: Validation of basic emotions and FACS AUs in FaceReader","volume":"7","author":"Lewinski","year":"2014","journal-title":"J Neurosci Psychol Econ"},{"key":"2019121912172409600_CIT0032","doi-asserted-by":"crossref","first-page":"1386","DOI":"10.3389\/fpsyg.2015.01386","article-title":"Automated facial coding software outperforms people in recognizing neutral faces as neutral from standardized datasets","volume":"6","author":"Lewinski","year":"2015","journal-title":"Front Psychol."},{"key":"2019121912172409600_CIT0033","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1016\/j.schres.2013.05.003","article-title":"Computerized facial analysis for understanding constricted\/blunted affect: Initial feasibility, reliability, and validity data","volume":"148","author":"Cohen","year":"2013","journal-title":"Schizophr Res."},{"key":"2019121912172409600_CIT0034","doi-asserted-by":"crossref","first-page":"106","DOI":"10.1007\/s11886-016-0792-z","article-title":"The protective role of positive well-being in cardiovascular disease: Review of current evidence, mechanisms, and clinical implications","volume":"18","author":"Sin","year":"2016","journal-title":"Curr Cardiol Rep."},{"key":"2019121912172409600_CIT0035","doi-asserted-by":"crossref","first-page":"260","DOI":"10.1037\/0033-2909.131.2.260","article-title":"Anger, anxiety, and depression as risk factors for cardiovascular disease: The problems and implications of overlapping affective dispositions","volume":"131","author":"Suls","year":"2005","journal-title":"Psychol Bull."},{"key":"2019121912172409600_CIT0036","doi-asserted-by":"crossref","first-page":"847","DOI":"10.1037\/0022-3514.64.5.847","article-title":"Stability of emotion experiences and their relations to traits of personality","volume":"64","author":"Izard","year":"1993","journal-title":"J Pers Soc Psychol."},{"key":"2019121912172409600_CIT0037","doi-asserted-by":"crossref","first-page":"190","DOI":"10.1016\/B978-0-12-386915-9.00008-5","article-title":"Measures of affect dimensions","volume-title":"Measures of Personality and Social Psychological Constructs","author":"Boyle","year":"2015"},{"key":"2019121912172409600_CIT0038","unstructured":"Bloom\n              P\n            \n          . Empathy and its discontents. Trends Cogn Sci.. 2017;21:24\u201331. Available at http:\/\/www.sciencedirect.com\/science\/article\/pii\/S1364661316301930. Accessibilty verified January 18, 2018."},{"key":"2019121912172409600_CIT0039","doi-asserted-by":"crossref","first-page":"60","DOI":"10.1097\/PSY.0000000000000254","article-title":"Risk of coronary heart disease in men with poor emotional control: A prospective study","volume":"78","author":"Potijk","year":"2016","journal-title":"Psychosom Med."},{"key":"2019121912172409600_CIT0040","doi-asserted-by":"crossref","first-page":"1123","DOI":"10.1177\/0956797612470827","article-title":"How positive emotions build physical health: Perceived positive social connections account for the upward spiral between positive emotions and vagal tone","volume":"24","author":"Kok","year":"2013","journal-title":"Psychol Sci."},{"key":"2019121912172409600_CIT0041","doi-asserted-by":"crossref","first-page":"1009","DOI":"10.1136\/heartjnl-2015-308790","article-title":"Loneliness and social isolation as risk factors for coronary heart disease and stroke: Systematic review and meta-analysis of longitudinal observational studies","volume":"102","author":"Valtorta","year":"2016","journal-title":"Heart."},{"key":"2019121912172409600_CIT0042","doi-asserted-by":"crossref","first-page":"e27939","DOI":"10.1371\/journal.pone.0027939","article-title":"The monkey puzzle: A systematic review of studies of stress, social hierarchies, and heart disease in monkeys","volume":"7","author":"Petticrew","year":"2012","journal-title":"PLoS One."},{"key":"2019121912172409600_CIT0043","doi-asserted-by":"crossref","first-page":"648","DOI":"10.1126\/science.1106477","article-title":"The influence of social hierarchy on primate health","volume":"308","author":"Sapolsky","year":"2005","journal-title":"Science."},{"key":"2019121912172409600_CIT0044","doi-asserted-by":"crossref","first-page":"1242","DOI":"10.1111\/j.1530-0277.2008.00679.x","article-title":"Gender differences in response to emotional stress: An assessment across subjective, behavioral, and physiological domains and relations to alcohol craving","volume":"32","author":"Chaplin","year":"2008","journal-title":"Alcohol Clin Exp Res."},{"key":"2019121912172409600_CIT0045","doi-asserted-by":"crossref","first-page":"154","DOI":"10.1097\/00006842-199903000-00006","article-title":"Impact of gender, menstrual cycle phase, and oral contraceptives on the activity of the hypothalamus-pituitary-adrenal axis","volume":"61","author":"Kirschbaum","year":"1999","journal-title":"Psychosom Med."},{"key":"2019121912172409600_CIT0046","doi-asserted-by":"crossref","first-page":"183","DOI":"10.1177\/0022146513485244","article-title":"Social isolation and adult mortality: The role of chronic inflammation and sex differences","volume":"54","author":"Yang","year":"2013","journal-title":"J Health Soc Behav."},{"key":"2019121912172409600_CIT0047","first-page":"1137","article-title":"Gender and emotion in the united states: Do men and women differ in Self\u2010Reports of feelings and expressive behavior?","volume":"5","author":"Simon","year":"2004","journal-title":"AJS."},{"key":"2019121912172409600_CIT0048","doi-asserted-by":"crossref","first-page":"116","DOI":"10.1037\/0022-3514.81.1.116","article-title":"Who attains social status? Effects of personality and physical attractiveness in social groups","volume":"81","author":"Anderson","year":"2001","journal-title":"J Pers Soc Psychol."},{"key":"2019121912172409600_CIT0049","doi-asserted-by":"crossref","first-page":"534","DOI":"10.1371\/journal.pbio.0020106","article-title":"A pacific culture among wild baboons: Its emergence and transmission","volume":"2","author":"Sapolsky","year":"2004","journal-title":"PLoS Biol."},{"key":"2019121912172409600_CIT0050","doi-asserted-by":"crossref","first-page":"815","DOI":"10.1037\/emo0000134","article-title":"Predicting stress from the ability to eavesdrop on feelings: Emotional intelligence and testosterone jointly predict cortisol reactivity","volume":"16","author":"Bechtoldt","year":"2016","journal-title":"Emotion."},{"key":"2019121912172409600_CIT0051","doi-asserted-by":"crossref","first-page":"1383","DOI":"10.1093\/scan\/nsw052","article-title":"Are strong empathizers better mentalizers? Evidence for independence and interaction between the routes of social cognition","volume":"11","author":"Kanske","year":"2016","journal-title":"Soc Cogn Affect Neurosci."}],"container-title":["Annals of Behavioral Medicine"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/abm\/article-pdf\/54\/1\/49\/31571013\/kaz024.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/abm\/article-pdf\/54\/1\/49\/31571013\/kaz024.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2019,12,19]],"date-time":"2019-12-19T12:17:59Z","timestamp":1576757879000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/abm\/article\/54\/1\/49\/5497216"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,5,22]]},"references-count":51,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2019,5,22]]},"published-print":{"date-parts":[[2020,1,1]]}},"URL":"https:\/\/doi.org\/10.1093\/abm\/kaz024","relation":{},"ISSN":["0883-6612","1532-4796"],"issn-type":[{"type":"print","value":"0883-6612"},{"type":"electronic","value":"1532-4796"}],"subject":[],"published-other":{"date-parts":[[2020,1]]},"published":{"date-parts":[[2019,5,22]]}}}