Lighten UP! A Community-Based Group Intervention to Promote Eudaimonic Well-Being in Older Adults: A Multi-Site Replication with 6 Month Follow-Up.

Objectives: Eudaimonic well-being (EWB), increasingly recognized as a critical component of health, typically declines in later life, and there are no existing programs to sustain or increase EWB in older adults. Lighten UP! is an 8-week program to promote EWB through facilitated group sessions in community settings and at-home practice. Building on earlier pilot research, the current study assessed the effect of the Lighten UP! Program using a longitudinal, multi-site design. Methods: Men and women (N = 169) aged 60 and over were recruited from three Wisconsin communities. EWB, life satisfaction, depression, and diverse aspects of health were assessed before and after the program and at 6-month follow up. Results: Participants reported significantly increased EWB; these changes were maintained 6 months later. The specific EWB domains of self-acceptance, positive relations, and personal growth showed the most robust gains. Participants also showed significant and sustained declines in depressive symptoms, anxiety, and hostility. Conclusions: Lighten UP! Program confirmed its positive effects for enhancing EWB in older adults living in multiple community settings. Clinical Implications: Programs that sustain or enhance EWB in older adults can be expected to yield improvements in diverse aspects of mental and physical health.

The association of cardiac vagal control and executive functioning--findings from the MIDUS study.

Cardiac vagal control (CVC), an index of parasympathetic contribution to cardiac regulation, has been linked to enhanced executive functioning (EF). However, findings to date have been based on small or unique samples. Additionally, previous studies assessed the CVC-EF link only during rest or recovery period from a cognitive challenge, but not during both states. In the present study, data on 817 socioeconomically diverse participants were obtained from the Midlife Development in the United States (MIDUS) study. As part of this study, participants completed cognitive tests, including EF, along with laboratory-based measures of CVC during rest and following recovery from a cognitive challenge. Regression analyses adjusting for respiratory rate revealed no effect of CVC at rest or during recovery on a global index of EF. However, exploratory post-hoc analyses of the components of the global EF index revealed a significant association between faster vagal recovery and better attention-switching and response inhibition abilities, as indexed by faster reaction time to the mixed SGST. This association remained significant after controlling for demographic, clinical (BMI, diseases and medications altering cardiac autonomic functioning, etc.), and health behavior covariates (Beta = .148, p = .010). Our findings suggest that future studies may need to investigate the links of CVC to specific EF abilities, rather than global measures of EF. Additionally, our results highlight the importance of assessing CVC during both rest and recovery from a cognitive challenge. The authors discuss the putative neurobiological underpinning of this link, as well as suggestions for future basic and clinical research.

Trait anxiety and glucose metabolism in people without diabetes: vulnerabilities among black women.

AIMS: We examined whether the relationship between anxiety and indicators of glucose metabolism in people without diabetes varies by race and gender. METHODS: Participants were 914 adults (777 white, 137 black) without diabetes in the MIDUS (Midlife in the USA) II study. Glucose metabolism was characterized by fasting glucose, insulin, HOMA-IR (homeostasis model of assessment--insulin resistance), and HbA(1c). Hierarchical linear regressions stratified by race and gender examined whether anxiety was associated with glucose metabolism. RESULTS: After adjustment for potential confounders, positive relationships between anxiety and fasting glucose (P = 0.04), insulin (P = 0.01), and HOMA-IR (P = 0.02) but not HbA(1c), were observed in black women only. CONCLUSIONS: Our findings extend previous evidence for the links between psychosocial vulnerabilities and impaired glucose metabolism in black women, by documenting significant associations between anxiety and clinical indicators of glycaemic control among black women without diabetes. Thus, anxiety might constitute an intervention target in black women, a subgroup disproportionately affected by Type 2 diabetes, its complications, and premature mortality.

Measuring psychological well-being in the Canadian Study of Health and Aging.

The Canadian Study of Health and Aging (CHSA) provided an opportunity to examine the positive aspects of aging. CHSA-2 included the 18-item Ryff multidimensional measure of well-being, which taps six core theoretical dimensions of positive psychological functioning. The measure was administered to 4,960 seniors without severe cognitive impairment or dementia at CSHA-2. Intercorrelations across scales were generally low. At the same time, the internal consistency reliability of each of the 6 subscales was not found to be high. Confirmatory factor analyses provide support for a 6-factor model, although some items demonstrate poor factor loadings. The well-being measures in CSHA-2 provide an opportunity to examine broad, descriptive patterns of well-being in Canadian seniors.

Hierarchies of life histories and associated health risks.

Widely documented inverse associations between socioeconomic standing and incident chronic disease and mortality invite explanation in terms of pathways to these outcomes. Empirical identification of pathways, or histories, requires measures that assess cumulative wear and tear on physiological systems following from psychosocial adversity and genetic predispositions. Such an assessment, allostatic load, has been shown to predict later life mortality, incident cardiovascular disease, and decline in physical and cognitive functioning. Using data from the Wisconsin Longitudinal Study (WLS), we seek precursors to allostatic load via ordered categories of cumulative adversity relative to advantage over the life course. We operationalize these histories via unfolding economic circumstances and social relationship experiences (e.g., parent-child interactions, quality of spousal ties). Findings reveal a strong direct association between the extent of adversity relative to advantage in an ordering of these histories and likelihood of high allostatic load. Importantly, resilient individuals with economic disadvantage, but compensating positive social relationship histories also show low prevalence of high allostatic load.

Contribution of psychosocial factors to socioeconomic differences in health.

The National Survey of Mid-life Developments in the United States (MIDUS) is one of several studies that demonstrate socioeconomic gradients in mortality during midlife. When MIDUS findings on self-reported health, waist to hip ratio, and psychological well-being were analyzed for their possible roles in generating socioeconomic differences in health, they revealed clear educational gradients for women and men (i.e., higher education predicted better health). Certain potential mediating variables, like household income, parents' education, smoking behavior, and social relations contributed to an explanation of the socioeconomic gradient. In addition, two census-based measures, combined into an area poverty index, independently predicted ill health. The results suggest that a set of both early and current life circumstances cumulatively contribute toward explaining why people of lower socioeconomic status have worse health and lower psychological well-being.

Personality and well-being: reexamining methods and meanings.

Because measures of personality and well-being share common affective underpinnings and items, previously reported links between these domains may be tautological. To explicate the connections between personality and well-being, 2 samples of midlife adults (N = 215 and N = 139) completed measures of personality (NEO Five Factor Inventory; P.T. Costa & R.R. McCrae, 1992) and psychological well-being (C. D. Ryff's, 1989b, Psychological Well-Being [PWB] inventory) that were maximally distinct, both conceptually and methodologically. Analyses included additional controls for source overlap, common affective underpinnings, and shared item content. Distinctive personality correlates were observed for the 6 PWB outcomes: self-acceptance, environmental mastery, and purpose in life were linked with Neuroticism (N) Extraversion (E) and Conscientiousness (C); personal growth was linked with Openness to Experience (O) and E; positive relations with others was linked with Agreeableness (A) and E; autonomy was linked with N. Psychological wellness and its personality correlates may be more complex than prior studies suggest.

Distinctive late-life challenges: implications for coping and well-being.

Two distinctive late-life challenges, community relocation and caring for an adult child with mental retardation, were studied to determine their influence on coping and well-being. These challenges differ in terms of their normativeness, duration, and whether they were expected. Data from 2 ongoing longitudinal studies (N = 449) were used to test the hypotheses that women experiencing residential relocation would report higher well-being and use problem-focused coping more frequently than women with long-term caregiving responsibilities. As predicted, more positive changes in well-being across time were reported by the relocation sample, which also showed more problem-focused coping. Women in the caregiving sample, however, showed stronger relationships between coping and well-being, underscoring possible gains in expertise that accompany challenges of lengthy duration.

Social inequalities in health: next questions and converging evidence.

Mortality studies show that social inequalities in health include, but are not confined to, worse health among the poor. There is a social gradient: mortality rises with decreasing socio-economic status. Three large sample studies, one British and two American, brought together for their complementarity in samples, measures, and design, all show similar social gradients for adult men and women in physical and mental morbidity and in psychological well-being. These gradients are observed both with educational and occupational status and are not explained by parents' social status or lack of an intact family during childhood. They are also not accounted for by intelligence measured in school. This suggests that indirect selection cannot account for inequalities in health. Possible mediators that link social position to physical and mental health include smoking and features of psycho-social environment at work and outside.

Family climate and parent-child relationships: recollections from a nonclinical sample of adult children of alcoholic fathers.

Past family climate and past parent-child relationships of a nonclinical sample of young adult children of alcoholic fathers (n = 87) were compared to a sociodemographically similar sample of young adults with nonalcoholic parents (n = 106). Self-reports indicated that, compared to respondents from nonalcoholic families, respondents with alcoholic fathers described a more negative family climate with higher levels of conflict and lower levels of cohesion and expressiveness. Adult children of alcoholics described more negative relationships with their alcoholic fathers. However, contrary to clinical literature, adult children of alcoholics' descriptions of their relationships with their nonalcoholic mothers did not differ from the descriptions provided by young adults with nonalcoholic parents. Daughters of alcoholic fathers reported more negative relationships with their fathers in the areas of role performance, affective expression, and control than did sons. Implications for practice include reinforcing the nurturing relationship between nonalcoholic mothers and their children in families with alcoholic fathers.

Adaptation to community relocation: the interactive influence of psychological resources and contextual factors.

This longitudinal study examined the interactive influences of psychological resources and contextual factors on short-term adaptation to community relocation in a sample of older women (N = 102, mean age = 71.6). The effects of three psychological resources (environmental mastery, autonomy, and personal growth) and three contextual factors (pressure to move, difficulty of the move, and unexpected gains experienced) on emotional reactions to relocation were examined. The pattern of findings suggests that women with greater psychological resources were more resilient in the face of negative circumstances but that the emotional "boost" of unexpected gains was greatest for women with lower premove resources. These results underscore the importance of considering event-relevant psychological resources and contextual factors and including both negative and positive aspects of the adaptational process.

Psychological well-being: meaning, measurement, and implications for psychotherapy research.

A model of positive psychological functioning that emerges from diverse domains of theory and philosophy is presented. Six key dimensions of wellness are defined, and empirical research summarizing their empirical translation and sociodemographic correlates is presented. Variations in well-being are explored via studies of discrete life events and enduring human experiences. Life histories of the psychologically vulnerable and resilient, defined via the cross-classification of depression and well-being, are summarized. Implications of the focus on positive functioning for research on psychotherapy, quality of life, and mind/body linkages are reviewed.

The structure of psychological well-being revisited.

A theoretical model of psychological well-being that encompasses 6 distinct dimensions of wellness (Autonomy, Environmental Mastery, Personal Growth, Positive Relations with Others, Purpose in Life, Self-Acceptance) was tested with data from a nationally representative sample of adults (N = 1,108), aged 25 and older, who participated in telephone interviews. Confirmatory factor analyses provided support for the proposed 6-factor model, with a single second-order super factor. The model was superior in fit over single-factor and other artifactual models. Age and sex differences on the various well-being dimensions replicated prior findings. Comparisons with other frequently used indicators (positive and negative affect, life satisfaction) demonstrated that the latter neglect key aspects of positive functioning emphasized in theories of health and well-being.

My children and me: midlife evaluations of grown children and of self.

Midlife parents (N = 215, M age = 53.7 years) were interviewed about how their adult children (M age = 27.6 years) had "turned out". These assessments were then related to parents' views of themselves. Perceived accomplishments and adjustment of children were expected to be positively linked with parents' well-being (e.g., self-acceptance, environmental mastery, purpose in life), and social comparisons were hypothesized to contribute to the link between parents' assessments of children and their own well-being. Multiple regression analyses revealed that children's perceived adjustment significantly predicted 6 of 7 well-being outcomes for mothers and fathers. Children's attainment was less strongly linked with parental outcomes. Personal comparisons were significant negative predictors--parents who saw their children as better adjusted than themselves had lower well-being.

Physical and mental health in later life: the self-system as mediator.

The purpose of this research was to investigate how the self-system mediates the relationship between physical health and mental health in elderly women. Three theoretical perspectives were examined: social integration (self in relationship to the social structure), social comparisons (self in relationship to others), and self-discrepancies (internal self-evaluations). Community-dwelling elderly women (N = 243) completed self-report instruments measuring the various self-assessments, physical health, and 3 mental health outcomes: psychological distress, well-being, and developmental outcomes. Social integration and social comparisons mediated the effects of physical health on all 3 outcomes.

The role of social comparisons processes in the psychological adaptation of elderly adults.

Social comparison processes were investigated as mechanisms by which elderly women maintain or enhance their psychological well-being in the face of health-related threats or loss. In Study 1, a measure of social comparisons was tested, and a preliminary model of the effects of health and social comparisons on depression was examined (N = 42). In Study 2, a separate sample of elderly women (N = 243) completed self-report measures concerning physical health, upward and downward social comparison processes, and positive and negative aspects of psychological adaptation. As predicted, worse physical health status was linked to more frequent social comparisons; however, more positive social comparisons were related to better mental health outcomes, even for women in poor health. In fact, the effects of social comparisons were strongest for women in the poorest health, resulting in psychological outcomes similar to women in good health. Thus, social comparisons appear to play a significant role in psychological well-being in old age. The findings also point to the importance of distinguishing between frequency and consequences of social comparison processes.

The interpretation of life experience and well-being: the sample case of relocation.

Social psychological theories of the self postulate mechanisms through which individuals interpret their life experiences to ensure positive self-evaluation. This framework was applied to a sample of aging women (N = 120, M age = 74.9 years) who had experienced community relocation. The authors measured their reasons for moving (push factors), reasons for selecting the new setting, (pull factors), and interpretive mechanisms, including how they compared with others in their new setting, how they were viewed by significant others following the move, how their behaviors changed following relocation, and whether the above evaluations occurred in life domains central to their sense of self. Regression analyses showed that push-pull factors and interpretive mechanisms accounted for substantial variance in multiple aspects of psychological well-being, particularly environmental mastery, purpose in life, and positive relations with others.

How elderly women cope: concerns and strategies.

Forty-two elderly women were asked to describe the problems they faced with aging, and how they coped with both real-life and hypothetical problems in seven areas. Content analysis indicated that their spontaneously reported ongoing strategies were consistent with current theoretical formulations, the strategies differed by area of concern and for real-life versus hypothetical problems, and direct action strategies were related to lower levels of psychologic distress. These results have implications for nursing research and practice.

Possible selves in adulthood and old age: a tale of shifting horizons.

Young, middle-aged, and elderly adults (N = 308) evaluated themselves on 6 dimensions of psychological well-being according to present, past, future, and ideal self-assessments. Young and middle-aged adults saw considerable improvement in themselves from the past to the present on all dimensions of well-being. The elderly, however, indicated largely a perception of stability with prior levels of functioning. Future ratings showed that the 2 younger groups expected continued gains in the years ahead, whereas the oldest respondents foresaw decline on most aspects of well-being. The comparison of present and ideal self-ratings supported (cross-sectionally) the hypothesis that with age, individuals achieve a closer fit between their ideal and their actual self-perceptions.