Psychological and physical health at age 70 in the Lothian Birth Cohort 1936: Links with early life IQ, SES, and current cognitive function and neighborhood environment.

Objective: Researchers in many fields are interested in the robust observation that higher socioeconomic status (SES) is associated with better mental and physical health. Prominent explanations for the association involve effects of stress due to relative material and social adversity in lower socioeconomic environments, but early-life intelligence may also contribute directly to both later-life socioeconomic status and health. Here, we evaluated the effects of early-life IQ on mental and physical health outcomes at age 70, in the context of effects of SES. Design: The Lothian Birth Cohort of 1936 took part in the Scottish Mental Survey of 1947, providing a measure of IQ at age 11. They have been extensively surveyed at age 70. Main Outcome Measures: Body mass index, constraints on daily life activities, hospital anxiety and depression, number of diseases, level of physical activity, weekly units of alcohol consumption, and pack-years of smoking. Results and Conclusion: SES had apparently direct effects on most outcomes, but age 11 IQ was also involved in several, either directly or because it contributed to SES. Several interactions helped to integrate these associations. High age-11 IQ tended to buffer effects of adverse environments on physical and mental problems in old age. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Short-term course of mental illness in middle age and late life

The heterogeneity in severe mental illnesses means that although some persons exhibit a chronic course in later life, others may recover for long periods or have episodes throughout the lifespan. The challenge to mental health providers is to identify those people most at risk for a chronic or relapsing course in later life. Data described here come from a prospective study of course and adjustment in severe mental illness for persons over age 40. The sample of 313 people, residing in the community and both in treatment and not in treatment, is unique. Six 8-month course patterns were identified; nearly one third of the participants had course patterns that were unstable, and one third were well across the 8 months. Older participants were more stable and less depressed, but otherwise were very similar to those in middle age. Demographic and history variables that predict long-term outcomes were not useful for predicting short-term recovery or relapse.     

World benevolence beliefs and well-being across the life span.

Do people's worldviews change across the life course? Beliefs in the benevolence (goodness) of the world and their relations with age and well-being were examined in a 2-year study of a nationally representative sample (N = 2,138) ranging in age from 18 to 101 years. Multilevel modeling analyses controlling for demographics, mental health history, prior experience with stressful life events, and other key beliefs indicated that benevolence beliefs were positively associated with well-being and that these associations were stronger with increasing age. Analyses also demonstrated that individuals' benevolence beliefs increased during the study, were positively associated with age, and increased with the experience of bereavement, although they declined with the experience of other negative events. Age-related worldview change may be a part of life-span adaptation. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Some everyday life consequences of disability and bereavement for older adults.

The study analyzed daily event differences between groups experiencing the major stressors of conjugal bereavement and physical disability, and analyzed the association of everyday events with self-reports of mental health for different groups across a 3-month time span. Monthly interviews were conducted with 61 recently conjugally bereaved, 62 recently physically disabled, and 123 matched-comparison older adults between the ages of 60 and 80. The purpose of these interviews was to obtain a comprehensive assessment of the monthly frequencies of everyday life events. Self-reports of mental health were obtained from paper-and-pencil measures filled out after each interview. Causal models were used to analyze the best-fitting structure of event/mental health relationships for the first 3 monthly interviews. Undesirable events showed uniformly adverse effects on mental health. Desirable events benefited the psychological well-being of the disabled the most and had no positive effects on the mental health of the bereaved. The bereaved also evidenced less stability over time than other groups in the frequency of small undesirable events. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Understanding negative outcomes following traumatic exposure: The roles of neuroticism and social support.

The established literature indicates that an overwhelming majority of adults will experience at least 1 traumatic stressor during their lifetime. Such stressors have been consistently linked to a range of adverse subsequent conditions and span the mood, anxiety, and personality diagnostic categories. Yet, understanding why some individuals experience traumatic reactions and adverse outcomes and others facing significant stressors do not succumb to such problems remains a challenge. In this study, trauma-exposed participants (natural disaster, n = 51; sexual assault, n = 35) completed measures of neuroticism and social support as well as measures of adverse mental health outcomes known to be associated with traumatic exposure. Results indicate that the personality characteristic of neuroticism is generally significantly correlated with symptoms of posttraumatic stress disorder, depression, and general distress. Social support was found to have no impact alone but a differential impact on these outcomes (sometimes helpful, sometimes harmful) depending on the survivor’s level of neuroticism. In considering social support options following traumatic exposure, providers are therefore encouraged to carefully consider the survivor’s neurotic demeanor. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Social support and undermining in close relationships: Their independent effects on the mental health of unemployed persons.

Structural equation analyses were used to examine the impact of social support vs social undermining (conflict) on mental health in longitudinal data from 1,087 recently unemployed respondents. The results demonstrated that social support and social undermining were not the opposite poles of the same factor, each having some impact independent of the other. Social undermining had statistically significant and strong adverse impact at each concurrent level of mental health. It also predicted improvement (but not a high level) in mental health in subsequent time waves. In contrast, social support had a significant beneficial impact on mental health only at Time 1. Compared with the volatile and extreme effects of social undermining, those of social support appear weaker but more stable. These findings are consistent with literature on the impact of life events (S. E. Taylor, 1991) and on marital interactions and satisfaction (J. M. Gottman and L. J. Krokoff, 1989). (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Major life events and major chronic difficulties are differentially associated with history of major depressive episodes.

Major life events have been found to precede onsets of a 1st lifetime episode of depression more commonly than subsequent recurrences. Despite general empirical support for this finding, few data directly address how the role of major life events may change over successive recurrences. Further, little research has examined major chronic difficulties in relation to a 1st lifetime episode versus a recurrence of depression. The present study tested the associations between major life events and major difficulties in relation to lifetime history of depressive episodes in a sample of 96 individuals diagnosed with major depression. Using investigator-based measures of life stress, the authors found that, whereas major life events were associated with fewer lifetime episodes, major chronic difficulties were related to more prior episodes. These findings are discussed in terms of underlying mechanisms that may account for the changing role of major life stress over successive recurrences of depression. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Spousal similarity in subjective well-being: The cardiovascular health study.

This study examines the extent to which one spouse's subjective well-being predicts that of the partner (N ?=?1,040 spousal pairs, 65 years or older). Prior research is extended in two ways: (a) The similarity of both affective domains (depressive symptoms, feelings about life as a whole, and satisfaction with the meaning and purpose of life) and nonaffective domains (perceived health) are examined, and (b) known predictors of well-being in older adults (sociodemographic variables, self and spouse health status variables, and exposure to common environmental events) are statistically controlled. Results indicate that one spouse's assessments of well-being and depression predict the other's well-being even after controlling for known predictors of these outcomes. Given the similarity of findings for affective and nonaffective domains, multiple mechanisms, including contagion, mate selection, and common environmental influences, are speculated as likely to contribute to this phenomenon. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Pregnancy-specific stress, prenatal health behaviors, and birth outcomes.

Objective: Stress in pregnancy predicts earlier birth and lower birth weight. The authors investigated whether pregnancy-specific stress contributes uniquely to birth outcomes compared with general stress, and whether prenatal health behaviors explain this association. Design: Three structured prenatal interviews (N = 279) assessing state anxiety, perceived stress, life events, pregnancy-specific stress, and health behaviors. Main Outcome Measures: Gestational age at delivery, birth weight, preterm delivery (     

Finding meaning, perceiving growth, and acceptance of tinnitus.

Objectives: The authors test hypotheses derived from current models of growth following adversity in a sample of people with tinnitus. These models assume a process whereby adversity or trauma threatens major assumptions, which, in turn, promotes a search for meaning in the adversity and subsequently growth. Method: Data from a sample of 315 people with tinnitus who completed an online survey were used to assess the relations of reports of negative changes to asking "Why me?" and answering the Why me? question with reports of growth, acceptance, and well-being. Results: indicate that reports of negative changes in goals and philosophy of life predict a search for meaning and that finding meaning is associated with perceived growth. Those who report never searching for meaning are less likely to report growth but report better adjustment and acceptance of their tinnitus than those who have searched for meaning. Discussion: The data are consistent with models of growth that give a central role to meaning-making processes, but they also suggest that a significant minority of people with tinnitus do not report searching for meaning or perceiving growth--yet appear to be coping well. Acceptance of tinnitus is identified as a key construct for future research. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Purpose in life as a system that creates and sustains health and well-being: An integrative, testable theory.

Purpose—a cognitive process that defines life goals and provides personal meaning—may help explain disparate empirical social science findings. Devoting effort and making progress toward life goals provides a significant, renewable source of engagement and meaning. Purpose offers a testable, causal system that synthesizes outcomes including life expectancy, satisfaction, and mental and physical health. These outcomes may be explained best by considering the motivation of the individual—a motivation that comes from having a purpose. We provide a detailed definition with specific hypotheses derived from a synthesis of relevant findings from social, behavioral, biological, and cognitive literatures. To illustrate the uniqueness of the purpose model, we compared purpose with competing contemporary models that offer similar predictions. Addressing the structural features unique to purpose opens opportunities to build upon existing causal models of “how and why” health and well-being develop and change over time. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Gender, victimization, and outcomes: Reconceptualizing risk.

Large-scale studies of gender differences in psychopathological reactions to victimization have focused on posttraumatic stress disorder, overlooking other trauma-related disorders. The present study expands this literature with a contextualized examination of interpersonal aggression exposure and sequelae. Using k-means cluster analysis on a sample of 16,000, the authors identified 8 distinct profiles of exposure to sexual violence, physical assault, stalking, and emotional abuse. Analyses of covariance then suggested links among victimization profile, gender, and mental and physical health. Results revealed no meaningful interactive effects of gender and interpersonal aggression on outcomes, once lifetime exposure to aggressive events was adequately taken into account. These findings argue against theories of female victims' greater vulnerability to pathological outcomes, instead linking risk to exposure history. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Toward a positive psychology of coping with anticipated events.

Many people appear to be quite resilient to significant stress suggesting that they may possess an orientation to events and life that is resistant to such threats. We propose that one significant aspect of this orientation is the tendency to view adversities as something that can happen to anyone and is reflected in the tendency of people entering uncertain contexts to prepare by imagining a range of possible outcomes, both desired and undesired. This preparatory work facilitates the immediate implementation of effective problem solving and support seeking strategies should the desired outcome seem in doubt. We refer to this orientation as the realistic orientation and review evidence suggesting that such an orientation is associated with realistic—but not unrealistic—optimism and smooth adaptation to adversity. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

The hidden illness of endoscopy patients: mental health disorders, Part I

Because nearly half of all adults experience some mental health disorders in their lifetime, many endoscopy patients must have psychiatric problems along with their gastrointestinal (GI) illnesses. In addition, all patients undergoing an endoscopic procedure experiences some degree of apprehension and worry; anxiety itself is a major factor in most mental illnesses. Endoscopy nurses are very good at establishing rapport quickly with patients and learning about the patient's health history from all the available sources of information. These nurses spend much of their time teaching, listening, reassuring, and caring for people undergoing GI procedure, and these same skills are an important part of the care in mental health disorders. A series of case studies of GI patients in a busy endoscopy department document and summarize the mental health disorder each experienced and the pertinent care given by the GI nurse during an endoscopy or gastric laboratory procedure. Although it is inappropriate for endoscopy nurses to attempt to diagnose major psychiatric disease or provide psychiatric interventions for these patients, their nursing care and reassurance enable the patients to successfully complete their GI procedures.     

Life transitions and mental health in a national cohort of young Australian women.

Young adulthood, a time of major life transitions and risk of poor mental health, may affect emotional well-being throughout adult life. This article uses longitudinal survey data to examine young Australian women's transitions across 4 domains: residential independence, relationships, work and study, and motherhood. Changes over 3 years in health-related quality of life, optimism, depressive symptoms, stress, and life satisfaction, were examined in relation to these transitions among 7,619 young adult participants in the nationally representative Australian Longitudinal Study on Women's Health. Positive changes in mental health occurred for women moving into cohabitation and marriage, whereas reductions were observed among those experiencing marital separation or divorce and those taking on or remaining in traditionally "feminine" roles (out of the workforce, motherhood). The data suggest that women cope well with major life changes at this life stage, but reductions in psychological well-being are associated with some transitions. The findings suggest that preventive interventions to improve women's resilience and coping might target women undergoing these transitions and that social structures may not be providing sufficient support for women making traditional life choices. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Type A behavior, age, and psychological well-being.

Investigated psychological well-being among Type A (coronary prone) and Type B (noncoronary prone) individuals across the age span. It was hypothesized that the hard-driving, achievement-oriented lifestyle exhibited by Type A's would be adaptive in younger age groups but would lead to lower well-being in later life because of increased limitations on the range and level of activities. By contrast, the more relaxed, easygoing style of Type B's would match better the slower pace of old age but would not be as conducive to success in younger age groups. 319 adults (aged 18–89 yrs) completed a battery of instruments that included the Jenkins Activity Survey and scales of life changes and psychopathology. Results confirm the hypotheses but indicate that psychological differences may be mediated in part by differences in physical well-being. Experience with life events and the structure and function of social networks may contribute to the differences in well-being. (59 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Are health and happiness the product of wisdom? The relationship of general mental ability to educational and occupational attainment, health, and well-being.

This study tested a structural model explaining the effects of general mental ability on economic, physical, and subjective well-being. A model was proposed that linked general mental ability to well-being using education, unhealthy behaviors (smoking and excessive drinking), occupational prestige, and health as mediating variables. The sample consisted of 398 individuals, from whom measures were collected across 4 periods. The results supported a model that includes direct and indirect (through unhealthy behaviors and occupational prestige) links from mental ability to physical well-being (i.e., health) and economic well-being. Furthermore, the results supported the relationships of economic well-being and physical well-being to subjective well-being. Overall, the study underscores the importance of general mental ability to work and nonwork outcomes, including physical, economic, and psychological well-being. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychosocial adjustment among cancer survivors: Findings from a national survey of health and well-being.

Objective: The current study examined whether cancer survivors showed impairment, resilience, or growth responses relative to a sociodemographically matched sample in four domains: mental health and mood, psychological well-being, social well-being, and spirituality. The impact of aging on psychosocial adjustment was also investigated. Design: Participants were 398 cancer survivors who were participants in the MIDUS survey (Midlife in the United States) and 796 matched respondents with no cancer history. Psychosocial assessments were completed in 1995–1996 and 2004–2006. Main Outcome Measures: Outcomes including self-report measures of mental health and mood, psychological well-being, social well-being, and spirituality. Results: Findings indicated that cancer survivors demonstrated impairment relative to the comparison group in mental health, mood, and some aspects of psychological well-being. Longitudinal analyses spanning pre- and postdiagnosis clarified that while mental health declined after a cancer diagnosis, poorer functioning in other domains existed prior to diagnosis. However, survivors exhibited resilient social well-being, spirituality, and personal growth. Moreover, age appeared to confer resiliency; older survivors were more likely than younger adults to show psychosocial functioning equivalent to their peers. Conclusion: While younger survivors may be at risk for disturbances in mental health and mood, cancer survivors show resilience in other important domains of psychosocial adjustment. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Insomnia and well-being.

Most Americans have occasional problems with insomnia. The relationship of insomnia to illness is well known. However, insomnia may also relate to lower levels of well-being. Although there are various definitions of well-being, one of the most clearly articulated and comprehensive models identifies 2 overarching constructs, psychological well-being and subjective well-being. The purpose in the present study was to assess the relationship between insomnia symptoms and the dimensions of psychological and subjective well-being, adjusting for the potential confound of comorbid physical and psychological illness. The data for the present study came from the National Survey of Midlife Development in the United States, a survey of community-dwelling adults. After adjustment for demographic characteristics and a wide range of chronic mental and physical health conditions, insomnia symptoms were found to have a significant relationship with both psychological and subjective well-being but a stronger relationship to subjective well-being. These data suggest that insomnia symptoms have a stronger relationship to enjoying life than to the perception that one has a meaningful life. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Plasma interleukin-6 and soluble IL-6 receptors are associated with psychological well-being in aging women.

Objective: This study tested the hypothesis that psychological well-being would predict lower plasma levels of inflammatory factors in aging women. Design: One hundred thirty-five women ages 61-91 years (M = 74.5 years) participated in this study. After completing self-administered questionnaires in their homes, participants stayed overnight at the General Clinical Research Center (GCRC) at the University of Wisconsin-Madison. Blood samples for cytokine analyses were obtained in participants' homes after the GCRC visit. Main Outcome Measures: Psychological well-being and ill-being, history of health problems, and health behaviors were assessed via self-administered questionnaires. Detailed medical history and concurrent health measures were obtained during the GCRC stay. Enzyme-linked immunosorbent assays were used to determine interleukin-6 (IL-6) and soluble IL-6 receptor (sIL-6R) concentrations in plasma. Results and Conclusion: Regression analyses showed that plasma IL-6 levels were lower in women scoring higher on positive relationships, whereas sIL-6R levels were lower in women scoring higher on purpose in life, even after a variety of sociodemographic and health factors were controlled. These outcomes, combined with the absence of significant links with other measures of well-being and ill-being, suggest selective patterns of association between later life inflammatory processes and psychological factors, particularly those focused on positive ties with others and purposeful engagement. (PsycINFO Database Record (c) 2010 APA, all rights reserved)