Summary of Research Findings

The application of character strengths in the domain of health has lagged behind other areas recently, such as business and education. Nevertheless, there are a few notable studies (e.g., Proyer, Gander, Wellenzohn, & Ruch, 2013). In addition, researchers have previously investigated specific character strengths to see what level of impact they have on health/wellness (e.g., hope/optimism, gratitude).

Research Articles

  • In two studies of character strengths and coping with pain, the character strengths most associated with pain self-efficacy was zest; in a follow-up study, a zest intervention was found to improve pain self-efficacy as well as the capacity to function despite pain (Graziosi et al., 2020).
    Graziosi, M., Yaden, D., Clifton, J., Mikanik, N., & Niemiec, R. M. (2020). A strengths-based approach to chronic pain. Journal of Positive Psychology. http://doi.org/10.1080/17439760.2020.1858337
  • Reviews the character strengths profiles of medical professionals showing that the highest means among samples of medical students and physicians were fairness, honesty, judgment, kindness, and love, and when comparing specialties, general surgeons had higher levels of honesty and prudence than psychiatrists (Huber et al., 2020).
    Huber, A., Strecker, C., Kachel, T., Hoge, T., & Hofer, S. (2020). Character strengths profiles in medical professionals and their impact on well-being. Frontiers in Psychology. http://doi.org/10.3389/fpsyg.2020.566728
  • Longitudinal analysis of medical students’ cynicism/burnout levels over three years and finding students with high levels of cynicism and those with changing levels of cynicism perceived higher applicability of signature strengths in private life compared with use in the context of studying (Kachel et al., 2020).
    Kachel, T., Huber, A., Strecker, C., Höge, T., & Höfer, S. (2020). Development of cynicism in medical students: Exploring the role of signature character strengths and well-being. Frontiers in Psychology, 11, Article 328. https://doi.org/10.3389/fpsyg.2020.00328
  • Examined one aspect of character strengths – an orientation to promote goodness – and found across two unique contexts/countries that this orientation was associated with higher levels of physical health, life satisfaction, happiness, mental health, purpose, and social connectedness as well as decreased anxiety, depression, and loneliness (Weziak-Bialowolska et al., 2020).
    Weziak-Bialowolska, D., Bialowolska, P., VanderWeele, T. J., McNeely, E. (2020). Character strengths involving an orientation to promote good can help your health and well-being. Evidence from two longitudinal studies. American Journal of Health Promotion, 1-11. http://doi.org/10.1177/0890117120964083
  • Rigorous review of clinical studies on character strengths-based interventions for patients with chronic illnesses. Results revealed these interventions boosted self-esteem and self-efficacy and reduced depression (Yan et al., 2020).
    Yan, T., Chan, C. W. H., Chow, K. M., Zheng, W., & Sun, M. (2020). A systematic review of the effects of character strengths‐based intervention on the psychological well‐being of patients suffering from chronic illnesses. Journal of Advanced Nursing, 76(7), 1567-1580. https://doi.org/10.1111/jan.14356
  • In a study of 269 individuals with chronic health conditions and disabilities experiencing COVID-19 stress, multiple character strengths significantly (and independently) moderated the relationship between COVID stress and well-being (Umucu et al., 2020).
    Umucu, E., Tansey, T. N., Brooks, J., & Lee, B. (2020). The protective role of character strengths in COVID-19 stress and well-being in individuals with chronic conditions and disabilities: An exploratory study. Rehabilitation Counseling Bulletin. https://doi.org/10.1177/0034355220967093
  • Examined 624 people with multiple sclerosis and found the character strengths that had the strongest association with quality of life (QoL) were zest, hope, and spirituality. Disability was not a mediator for strengths and QoL, and the most endorsed character strengths were honesty, kindness, and fairness. The article concludes noting that character strengths enhance the QoL of people with multiple sclerosis directly and through influence on the negative effects of the disease (Smedema, 2020).
    Smedema, S. M. (2020). An analysis of the relationship of character strengths and quality of life in persons with multiple sclerosis. Quality of Life Research. https://doi.org/10.1007/s11136-019-02397-1
  • In a study of over 400 people with fibromyalgia, an important role in finding “silver linings” was found within the connection between illness impairment and depression. The researchers suggest the potential important impact of identifying positive qualities such as using signature strengths interventions to support treatment (Hirsch et al., 2019).
    Hirsch, J. K., Treaster, M. K., Kaniuka, A. R., Brooks, B. D., Sirois, F. M., Kohls, N., Nöfer, E., Toussaint, L. L., & Offenbächer, M. (2019). Fibromyalgia impact and depressive symptoms: Can perceiving a silver lining make a difference? Scandinavian Journal of Psychology. https://doi.org/10.1111/sjop.12598
  • Argues for character as one of several key elements of flourishing for patients in medical/healthcare settings (VanderWeele, 2019).
    VanderWeele, T. J. (2019). Reimagining health – Flourishing. Journal of the American Medical Association (JAMA). E1-E2. http://doi.org/10.1001/jama.2019.3035
  • Study of hospital physicians with 6 month follow-up showing the positive impact of signature strengths application on perceived socio-moral climate as well as the impact of socio-moral climate on signature strengths application (Höge et al., 2019).
    Höge, T., Strecker, C., Hausler, M., Huber, A., & Höfer, S. (2019). Perceived socio-moral climate and the applicability of signature character strengths at work: A study among hospital physicians. Applied Research in Quality of Life. http://doi.org/10.1007/s11482-018-9697-x
  • Study showing a variety of findings regarding character strengths application among physicians. For example, fairness, honesty, judgment, and love were important for work engagement and psychological well-being (Huber et al., 2019).
    Huber, A., Strecker, C., Hausler, M., Kachel, T., Höge, T., & Höfer, S. (2019). Possession and applicability of signature character strengths: What is essential for well-being, work engagement, and burnout? Applied Research in Quality of Life. http://doi.org/10.1007/s11482-018-9699-8
  • Cross-sectional and longitudinal data showing several important findings in regard to physicians’ use of character strengths at work, including the importance of autonomy in promoting character strengths use over a 6 month period (Strecker et al., 2019).
    Strecker, C., Huber, A., Höge, T., Hausler, M., & Höfer, S. (2019). Identifying thriving workplaces in hospitals: Work characteristics and the applicability of character strengths at work. Applied Research in Quality of Life. http://doi.org/10.1007/s11482-018-9693-1
  • Introduction to a special issue on character strength for health, vocation, and other applications, emphasizing the contributions of character strengths to the “good life” (Höfer et al., 2019). Each article summary can be found in its appropriate subsection.
    Höfer, S., Gander, F., Höge, T., & Ruch, W. (2019). Special Issue: Character strengths, well-being, and health in educational and vocational settings. Applied Research in Quality of Life. http://doi.org/10.1007/s11482-018-9688-y
  • Character strengths vary by context. It is most common for participants to report using their character strengths “in general” (no specific context) and at work, as opposed to while exercising or eating. Across eating, exercising, and working, a set of almost all character strengths were beneficially related to competence, relatedness, and autonomy (Stuntz, 2018).
    Stuntz, C. P. (2018). Differences in character strengths levels and associations with positive outcomes across contexts. Journal of Positive Psychology and Wellbeing, 3(1), 45-61.
  • Case study of a patient suffering after eye surgery and subsequently experienced a character strengths intervention involving identifying and appreciating strengths, reviewing success stories and peak experiences with strengths, and implementation intentions with strengths (Shinichiro et al., 2018).
    Shinichiro, M., Kawashima, M., Uchino, M., & Tsubota, K. (2018). Value of considering psychological strengths in patients with eye pain. American Journal of Ophthalmology Case Reports, 12, 91-92. https://doi.org/10.1016/j.ajoc.2018.10.003
  • Offers a review of character strengths studies relating to physical health. Focuses on general health findings with character strengths, studies of specific character strengths, and multi-step programs, as well as physicians and the patient-provider relationship (Niemiec & Yarova, 2018).
    Niemiec, R. M., & Yarova, A. (2018). Character strengths and health: Research summary (part 1). Chronicle of Advances in Positive Health and Well-being, 1(1). Available at: http://www.ippanetwork.org/positive-health/character-strengths-and-health-research-summary-part-1/
  • Examined the stages of change (transtheoretical) model and character strengths and found that later stage of change was connected with numerous character strengths of fortitude, cognition, and interpersonal relating. Character strengths are better predictors of specific processes of change than the reverse. It’s hypothesized that focusing on fortitude strengths (e.g., perseverance, zest, etc.) may increase positive change behaviors for physically active people (Stuntz, 2017).
    Stuntz, C. P. (2017). Linking positive psychology and the transtheoretical model: How character strengths and processes of change relate to each other and to exercise. Journal of Positive Psychology and Wellbeing, 1(2), 85–108.
  • Reviews the positive interventions that have been studied in chronic illness patients and notes gratitude and kindness are two of the most frequent areas for intervention focus and a need to target other strengths with these populations such as perseverance, love, and hope (Ghosh & Deb, 2017).
    Ghosh, A., & Deb, A. (2017). Positive psychology interventions for chronic physical illnesses: A systematic review. Psychological Studies. http://doi.org/10.1007/s12646-017-0421-y
  • The use of signature strengths at work was positively linked with well-being and mental health but not with physical health among medical students and resident physicians (Hausler et al 2017).
    Hausler, M., Strecker, C., Huber, A., Brenner, M., Höge, T., & Höfer, S. (2017). Associations between the application of signature character strengths, health and well-being of health professionals. Frontiers in Psychology, 8. http://doi.org/10.3389/fpsyg.2017.01307
  • A program in Kenya has placed character strengths development at the core of a community-based program for youth in under-resourced primary school communities. When youth learn about and reflect on their character strengths and share them publicly, their health and hygiene habits/behaviors increase in frequency, in addition to several other outcomes such as missing less school and having less water-related illness (Fialkov, Haddad, & Gowan, 2017).
    Fialkov, C., Haddad, D., & Gowan, M. (2017). Unpublished findings.
  • Patients suffering from acute coronary syndrome benefitted from an 8-week phone intervention which included identifying and using a signature strength. Another study of cardiac patients combined the use of three character strengths (gratitude, hope, and kindness) and found that patients experienced increases in health-related quality of life compared to a relaxation group and to controls (Huffman et al. 2011, 2016)
    1. Huffman, J. C., Mastromauro, C. A., Boehm, J. K., Seabrook, R., Fricchione, G. L., Denninger, J. W., et al. (2011). Development of a positive psychology intervention for patients with acute cardiovascular disease. Heart International, 6(2), e14.
    2. Huffman, J.C., Millstein, R.A., Mastromauro, C.A., Shannon V. Moore, Christopher M. Celano, C. Andres Bedoya, Laura Suarez, Julia K. Boehm, James L. Januzzi. (2016). A Positive Psychology Intervention for Patients with an Acute Coronary Syndrome: Treatment Development and Proof-of-Concept Trial. Journal of Happiness Studies, 17(5), 1985-2006. http://doi.org/10.1007/s10902-015-9681-1
  • In randomized controlled trials involving thousands of girls in poverty in India, girls who received a curriculum which incorporated character strengths (identification and use of signature strengths and concrete examples of other strengths) exhibited significantly greater physical health (and psychosocial health) benefits in comparison to those girls who received a similar curriculum which did not include character strengths as well as a control group (Leventhal et al., 2015, 2016).
    1. Leventhal, K. S., DeMaria, L. M., Gillham, J. E., Andrew, G., Peabody, J., & Leventhal, S. M. (2016). A psychosocial resilience curriculum provides the “missing piece” to boost adolescent physical health: A randomized controlled trial of Girls First in India. Social Science & Medicine, 161, 37–46. http://doi.org/10.1016/j.socscimed.2016.05.004
    2. Leventhal, K. S., Gillham, J., DeMaria, L., Andrew, G., Peabody, J., & Leventhal, S. (2015). Building psychosocial assets and wellbeing among adolescent girls: A randomized controlled trial. Journal of Adolescence, 45, 284–295. http://doi.org/10.1016/j.adolescence.2015.09.011
  • Among medical students in Australia who completed a course that integrated the VIA Classification virtues in a clinical context using personal narratives, experiential exercises, contemplative practices, and reflective practices, the students self-reported improved understanding of the virtues and their importance to the practice of medicine (Seoane et al 2016).
    Seoane L., Tompkins L. M., De Conciliis A, Boysen P. G. (2016). Virtues education in medical school: The foundation for professional formation. The Ochsner Journal, 16(1), 50-55.
  • A study by Hanks and colleagues examined a group of patients with traumatic brain injury and found that character strengths and virtues showed unique value in predicting physical health and disability (Hanks et al, 2014).
    Hanks, R. A., Rapport, L. J., Waldron-Perrine, B., Millis, S. R. (2014). Role of character strengths in outcome after mild complicated to severe traumatic brain injury: a positive psychology study. Archives of Physical Medicine and Rehabilitation, 95(11), 2096-2102, ISSN 0003-9993, https://doi.org/10.1016/j.apmr.2014.06.017.
  • Children with a life-threatening illness were studied and it was found that higher benefit-finding and character strengths (love and gratitude) predicted positive changes in life satisfaction over time, and in turn, positive emotions predicted changes in benefit-finding over time through various character strengths such as zest and gratitude (Chaves, Hervas, Garcia, & Vazquez, 2016). These researchers also studied a positive intervention (granting a wish) among seriously ill children and compared to a waitlist control group, the children had increased levels of strengths, life satisfaction, positive emotions, and less nausea (Chaves, Vazquez, & Hervas, 2016).
    1. Chaves, C., Hervas, G., García, F. E., & Vazquez, C. (2016). Building life satisfaction through well-being dimensions: A longitudinal study in children with a life-threatening illness. Journal of Happiness Studies, 17(3), 1051-1067. http://doi.org/10.1007/s10902-015-9631-y
    2. Chaves, C., Vázquez, C., & Hervás, G. (2016). Positive interventions in seriously-ill children: Effects on well-being after granting a wish. Journal of Health Psychology, 21(9), 1870-1883. http://doi.org/10.1177/1359105314567768  
  • Discusses the need for strengths-based technology tools in healthcare, including the use of technology to identify and discuss strengths in clinical consultation, alignment with patient issues/context, in preconsultation, and other situations in healthcare/medical settings (Mirkovic et al. 2016).
    Mirkovic, J.,  Kristjansdottir, O. B., Stenberg, U., Krogseth, T., Stange, K., C., & Ruland, C. M. (2016). Patient insights into the design of technology to support a strengths-based approach to health care. JMIR Research Protocols, 5(3), e175. http://doi.org/10.2196/resprot.5906  
  • Character strengths are discussed as an integral part of the wellness coaching program at a large university (Gibbs & Larcus, 2014; Larcus, Gibbs, & Hackmann, 2016)
    1. Gibbs, T., & Larcus, J. (2014-2015). Wellness coaching: Helping student thrive. Journal of Student Affairs, 24, 23-34.
    2. Larcus, J., Gibbs, T., & Hackmann, T. (2016). Building capacities for change: Wellness coaching as a positive approach to student development. Philosophy of Coaching: An International Journal, 1(1), 43-62. http://dx.doi.org/10.22316/poc/01.1.05  
  • Qualitative study examining an exercise program that is tailored to each individual’s signature strengths. Results showed improvements in exercise adherence, enjoyment of exercise, and achievement (Stocker & Hefferon, 2016).
    Stocker, S., & Hefferon, K., (2016). The development of a character strengths based exercise program for exercise adherence. A qualitative inquiry. Unpublished manuscript.  
  • There are a number of studies that infuse strengths (generic strengths, not character strengths per se) into a larger positive intervention (multi-week) protocol in an effort to help the coping and psychological distress of medical patients, such as type 2 diabetes, HIV, and health-related stress (see Cohn et al., 2014; Moskowitz et al., 2012; Moskowitz et al., 2014). 1. Cohn, M. A., Pietrucha, M. E., Saslow, L. R., Hult, J. R., & Moskowitz, J. T. (2014). An online positive affect skills intervention reduces depression in adults with type 2 diabetes. Journal of Positive Psychology, 9(6), 523–534. http://doi.org/10.1080/17439760.2014.920410
    2. Moskowitz, J. T., Carrico, A. W., Cohn, M. A., Duncan, L. G., Bussolari, C., Layous, L. K., et al. (2014). Randomized controlled trial of a positive affect intervention to reduce stress in people newly diagnosed with HIV; protocol and design for the IRISS study. Open Access Journal of Clinical Trials, 6, 85–100. http://doi.org/10.2147/OAJCT.S64645
    3. Moskowitz, J. T., Hult, J. R., Duncan, L. G., Cohn, M. A., Maurer, S., Bussolari, C., et al. (2012). A positive affect intervention for people experiencing health-related stress: Development and nonrandomized pilot test. Journal of Health Psychology, 17(5), 676–692. http://doi.org/10.1177/1359105311425275
  • In a study of character strengths, big 5 personality traits, contact with nature, and well-being, it was character strengths that had the biggest impact on wellness (Korotkov & Godbout, 2014).
    Korotkov, D., & Godbout, A. (2014). Personality, motivation, nature, and well-being. Personality and Individual Differences, 60, S65.  
  • Character strengths, resilience, and positive mood were related to primary factors of treatment success (including treatment expectations and perception of functional ability) in rehabilitation medicine settings (among a group of individuals with acquired brain injury) (Bertisch et al., 2014).
    Bertisch, H., Rath, J., Long, C., Ashman, T., & Rashid, T. (2014). Positive psychology in rehabilitation medicine: A brief report. NeuroRehabilitation, 34(3), 573-585.  
  • Greater endorsement of character strengths is associated with a number of health behaviors, such as feeling healthy, leading an active way of life (e.g., zest), the pursuit of enjoyable activities, healthy eating, watching one’s food, and physical fitness. All character strengths (except humility and spirituality) were associated with multiple health behaviors. While self-regulation had the highest associations overall, curiosity, appreciation of beauty/excellence, gratitude, hope, and humor also displayed strong connections with health behaviors (Proyer, Gander, Wellenzohn, & Ruch, 2013).
    Proyer, R. T., Gander, F., Wellenzohn, S., & Ruch, W. (2013). What good are character strengths beyond subjective well-being? The contribution of the good character on self-reported health-oriented behavior, physical fitness, and the subjective health status. Journal of Positive Psychology.
  • Small study of chronic back pain patients finding that a character strengths and gratitude intervention led to improved daily happiness and less daily anger (Baxter, Johnson, & Bean, 2012).
    Baxter, H. J., Johnson, M. H., & Bean, D. (2012). Efficacy of a character strengths and gratitude intervention for people with chronic back pain. The Australian Journal of Rehabilitation Counseling, 18(2), 135-147. https://doi.org/10.1017/jrc.2012.14
  • Character strengths were highly correlated with well-being subscales of self-acceptance, purpose, and environmental mastery, as well as good physical and mental health (Leontopoulou & Triliva, 2012).
    Leontopoulou, S. & Triliva, S. (2012). Explorations of subjective wellbeing and character strengths among a Greek University student sample. International Journal of Wellbeing, 2 (3), 251-270.  
  • Older adult patients with a chronic physical disability at an inpatient rehabilitation facility were randomly assigned to a 7-day strengths-based intervention group or a control group and significant improvement on distress was found for the treatment group (O'Donnell, 2013).
    O’Donnell, P. J. (2013). Psychological effects of a strength-based intervention among inpatients in rehabilitation for pain and disability. (Doctoral dissertation). ProQuest Dissertations and Theses. ISBN: 978-1-303-53639-7.
  • Individuals who use their character strengths experienced greater well-being, which was related to both physical and mental health. Strengths use was a unique predictor of subjective well-being after self-esteem and self-efficacy were controlled for (Proctor, Maltby, & Linley, 2009).
    Proctor, C., Maltby, J., & Linley, P. A. (2009) Strengths use as a predictor of well-being and health-related quality of life. Journal of Happiness Studies, 10, 583-630.
  • Character strengths were associated with lower levels of sexual behaviors and sex-related beliefs among African-American adolescents. Specifically on the VIA, higher love of learning was related to boys’ self-reported abstinence from sexual intercourse and boys’ & girls’ self-reported abstinence from drug use; higher curiosity was related to boys’ & girls’ belief in no premarital sex (love of learning was also significant for boys); prudence was related to reported abstinence from sexual intimacy; judgment was related to sexual initiation efficacy for girls & boys (leadership was also significant for girls; Ma et al., 2008).
    Ma, M., Kibler, J. L., Dollar, K. M., Sly, K., Samuels, D., Benford, M. W., Coleman, M., Lott, L., Patterson, K., & Wiley, F. (2008). The relationship of character strengths to sexual behaviors and related risks among African American adolescents. International Journal of Behavioral Medicine, 15 (4), 319-327.
  • Adolescent students who counted blessings reported higher levels of optimism and life satisfaction, less negative affect, and fewer physical symptoms (Froh, Sefick, & Emmons, 2008).
    Froh, J. J., Sefick, W. J., & Emmons, R. A. (2008). Counting blessings in early adolescents: An experimental study of gratitude and subjective well-being. Journal of School Psychology, 46, 213-233.
  • Hope was a significant predictor of medication adherence among asthma patients between 8 and 12 (Berg, Rapoff, Snyder, & Belmont, 2007).
    Berg, C. J., Rapoff, M. A., Snyder, C. R., & Belmont, J. M. (2007). The relationship of children’s hope to pediatric asthma treatment adherence. Journal of Positive Psychology, 2, 176-184.
  • When an individual has a physical disorder, there is less of a toll on life satisfaction if they are high on the character strengths of bravery, kindness, and humor (Peterson, Park, & Seligman, 2006).
    Peterson, C., Park, N., & Seligman, M. E. P. (2006). Greater strengths of character and recovery from illness. The Journal of Positive Psychology, 1 (1), 17–26.
  • When an individual has a psychological disorder, there is less of a toll on life satisfaction if they are high on the character strengths of appreciation of beauty & excellence and love of learning (Peterson, Park, & Seligman, 2006).
    Peterson, C., Park, N., & Seligman, M. E. P. (2006). Greater strengths of character and recovery from illness. The Journal of Positive Psychology, 1 (1), 17–26.
  • The strengths of the “heart” (e.g., love, gratitude) are more strongly associated with well-being than are strengths of the “head” (e.g., creativity, open-mindedness/judgment, appreciation of beauty and excellence; Park & Peterson, 2008b; Park, Peterson, & Seligman, 2004).
    Park, N., & Peterson, C. (2008b). The cultivation of character strengths. In M. Ferrari & G. Poworowski (Eds.), Teaching for wisdom (pp. 57-75). Mahwah, NJ: Erlbaum.
    Park, N., Peterson, C., & Seligman, M. E. P. (2004). Strengths of character and well-being. Journal of Social & Clinical Psychology, 23, 603–619.
  • The practice of gratitude (counting blessings) is linked to fewer physical symptoms, more optimistic life appraisals, and more time exercising and improved well-being and optimal functioning (Emmons & McCullough, 2003).
    Emmons, R. A., & McCullough, M. E. (2003). Counting blessings versus burdens: An experimental investigation of gratitude and subjective well-being in daily life. Journal of Personality and Social Psychology, 84, 377–389.
  • The practice of gratitude is linked to increases in well-being among those with neuromuscular disease (Emmons & McCullough, 2003).
    Emmons, R. A., & McCullough, M. E. (2003). Counting blessings versus burdens: An experimental investigation of gratitude and subjective well-being in daily life. Journal of Personality and Social Psychology, 84, 377–389.
  • Grateful individuals report higher positive mood, optimism, life satisfaction, vitality, religiousness and spirituality, and less depression and envy than less grateful individuals (McCullough, Emmons, & Tsang, 2002).
    McCullough, M. E., Emmons, R. A., & Tsang, J. (2002). The grateful disposition: A conceptual and empirical topography. Journal of Personality and Social Psychology, 82, 112-127.
  • Grateful people tend to be more helpful, supportive, forgiving, empathic, and agreeable (McCullough, Emmons, & Tsang, 2002).
    McCullough, M. E., Emmons, R. A., & Tsang, J. (2002). The grateful disposition: A conceptual and empirical topography. Journal of Personality and Social Psychology, 82, 112-127.

Updated May 2021