Resilience and Hassles Trajectories Among Older Adults during the COVID-19 Pandemic.

OBJECTIVES: Despite higher physical vulnerability to COVID-19, older adults reported less psychological stress than younger and midlife adults during the pandemic. However, little is known about age differences in stress within later life, and most COVID-19 studies have been cross-sectional. We examined weekly hassles exposure and severity trajectories and whether these trajectories differed by age, resilience factors (higher trait resilience and education) and vulnerability factors (identifying as a woman, being a person of color, and having chronic health conditions). METHOD: Community-dwelling adults aged 50+ in Oregon (Mage = 71.1, SD = 7.3; 74% women, 89% non-Hispanic White) completed weekly online surveys across eight weeks (April 28 - June 22, 2020) during the COVID-19 stay-at-home mandate. A two-part model estimated how age, resilience, and vulnerability factors predicted weekly odds of any hassle exposure and level of severity. RESULTS: Across time, hassles exposure decreased and the rate of severity declined, but these patterns differed by age and other demographics. The old-old (estimated at age 78) remained stable in odds of any exposure, while the young-old (estimated at age 64) evidenced a J-shaped curve; age did not moderate the severity slopes. Further, both resilience factors were associated with exposure trajectories, whereas vulnerability factors (race/ethnicity and chronic illness) were associated with levels of hassles severity. DISCUSSION: There were age differences in patterns of hassles during the COVID pandemic. Further, resilience and vulnerability factors also showed complex patterns, underscoring the need for future studies to focus on age differences in well-being in later life.

The Costs of Coping: Long-Term Mortality Risk in Aging Men.

OBJECTIVES: Prospective associations between coping and all-cause mortality risk are understudied, particularly among nonmedical samples. We assessed independent and joint associations of multiple components of the transactional stress and coping model with all-cause mortality in a cohort of community-dwelling men. We were particularly interested in how coping effort related to mortality. METHODS: Participants included 743 men from the Veterans Affairs Normative Aging Study who completed 1+ stress and coping assessment in 1993-2002 (baseline age: M = 68.4, standard deviation [SD] = 7.1) and had mortality follow-up through 2020. The Brief California Coping Inventory assessed coping with a past-month stressor. Cox regression evaluated associations of problem stressfulness, coping strategies, total coping effort, and coping efficiency with all-cause mortality risk. RESULTS: Over a mean follow-up of 16.7 years (SD = 7.1), 473 (64%) men died. Problem stressfulness was not associated with mortality risk (hazard ratio [HR]: 1.07, 95% confidence interval [CI]: 0.98-1.17), adjusted for demographics and health conditions. When examining coping via specific strategies, only social coping was associated with higher mortality risk (HR: 1.15, 95% CI: 1.05-1.26) after Bonferroni correction. Total coping effort was associated with 14% greater risk of all-cause mortality (95% CI: 1.04-1.26), independent of problem stressfulness, demographics, and health conditions. Coping efficiency, a benefit-cost ratio of coping efficacy to total coping effort, was not associated with mortality risk in adjusted models. DISCUSSION: Total coping effort may be an important indicator for longevity among aging men, above and beyond problem stressfulness and specific coping strategies, which have been the foci in prior research.

Adaptation to changes in COVID-19 pandemic severity: Across older adulthood and time scales.

The COVID-19 pandemic has been observed to negatively affect older adults' psychological health compared with prepandemic levels. However, older adults' coping efficacy may differ depending on their age, and little is known about effects of fluctuations in pandemic severity. Two longitudinal studies tested the hypothesis that pandemic severity would affect psychological health and be moderated by age. In Study 1 (N = 111), older adults (aged 62-96) were assessed semiannually before and after the first United States COVID-19 case over up to 10 years. Depressive symptoms and stress, but not cognitive difficulties, were higher during COVID-19; pandemic severity had little effect. Estimated increases were smaller for a 65-year-old than for an 85-year-old. In Study 2 (N = 221), older adults (aged 51-95) were assessed weekly over up to 8 weeks during the COVID-19 pandemic. Higher national pandemic severity was associated with more cognitive difficulties, more depressive symptoms, and more stress. In an opposite pattern from Study 1, estimated increases were larger for a 65-year-old than for an 85-year-old. Old-old adults might be most susceptible to long-term psychological effects of the pandemic era, as in Study 1, but more resilient to short-term effects, as in Study 2. Coping strategies associated with increasing age may be less efficacious for more chronic and severe problems. Conversely, the same coping strategies may be more efficacious for shorter, less severe problems. Differentiating between reactivity to longer term and shorter term pandemic stressors can identify the most resilient or vulnerable ages within older adulthood. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Vulnerability and resilience among older South Korean Vietnam war veterans: A latent profile analysis.

Relatively little is known about South Korean Vietnam War veterans, despite their being the second largest contingent of troops during the Vietnam War. Earlier research found elevated levels (39%) of post-traumatic stress disorder (PTSD) in this older population, due to high exposure to combat and malevolent environments (Lee et al., 2020). The present study investigated classes of vulnerability and resilience among older South Korean Vietnam War veterans, using a latent profile analysis (LPA) on PTSD symptoms, late onset stress symptomology (LOSS), and mental well-being (MWB). The sample consisted of 367 older male veterans from South Korea (Mage = 72, SD = 2.66) who completed surveys. The LPA yielded five classes. The largest (38%) was Average (average PTSD, LOSS, and MWB levels), and the second largest (31%) was characterized by Moderate Distress (moderately high PTSD and LOSS, average MWB). A small group (13%) reported Low Affect (low PTSD, LOSS, and MWB levels), and 7% expressed Severe Distress (high LOSS and PTSD levels, average MWB). Only a small percentage (12%) were characterized by Resilience (low PTSD, average LOSS, high MWB). Optimism, positive appraisals of military service, and social support from family, significant others, friends, and military peers were highest among veterans in the Resilience class. To our knowledge, this is the first study of resilience among East Asian military veterans, and more research is needed on how resilience can be improved. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Do different types of war stressors have independent relations with mental health? Findings from the Korean Vietnam Veterans Study.

OBJECTIVE: South Korea had the second largest contingent of soldiers in the Vietnam War, but little is known about their adaptation, especially in later life. Previous work in a different sample found very high rates of posttraumatic stress disorder (PTSD; 41%) among Korean Vietnam veterans (KVVs; Kang, Kim, & Lee, 2014), compared to 19-31% for American Vietnam veterans. We explored possible reasons for this high rate of PTSD, as well as anxiety and depressive symptoms, utilizing both vulnerability factors (e.g., war stressors) and protective factors (optimism, unit cohesion, and homecoming experiences). METHOD: The sample included 367 male KVVs surveyed by mail (M age = 72, SD = 2.66). Using hierarchical regressions controlling for demographics, we examined the relative contributions of different types of war stressors and then the protective factors. RESULTS: Combat exposure was significantly associated with the three types of negative psychological symptoms, but their associations became nonsignificant when "subjective" war stressors (malevolent environments, perceived threat, and moral injury) were added. In the final models, malevolent environments were the strongest predictor for all three outcomes. In addition, moral injury was independently associated with PTSD symptoms, while perceived threat was marginally associated with depressive and anxiety symptoms. Among psychosocial factors, only optimism was negatively associated with the mental health outcomes. CONCLUSION: KVVs had very high rates of combat exposure, but malevolent environments played a more important role in their mental health in later life. These findings suggest the importance of considering adverse environmental factors in understanding PTSD in future studies. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Resilience in Older Adults During the COVID-19 Pandemic: A Socioecological Approach.

OBJECTIVES: We examined sources of vulnerability and resilience among older adults early in the coronavirus disease 2019 (COVID-19) pandemic. METHODS: We surveyed 235 respondents, 51-95 years old (M = 71.35; SD = 7.39; 74% female), including 2 open-ended questions concerning COVID-19-related difficulties and positive experiences during the past week. Using inductive coding, we found 9 final codes for difficulties and 12 for positives and grouped them into socioecological levels: personal, interpersonal, and societal. RESULTS: Difficulties were reported by 94% of the sample, while 63% described positives. Difficulties and positive responses were made at all socioecological levels and illustrated a dialectic between personal-level constraints and opportunities, interpersonal-level social isolation and integration, and societal-level outrage, sorrow, and social optimism. DISCUSSION: Respondents described sources of vulnerabilities and resilience that supported a socioecological approach to understand resilience during this pandemic. A notable example was resilience derived from witnessing and contributing to the community and social solidarity, highlighting the potential of older adults as resources to their communities during the global pandemic.

Life satisfaction of Korean Vietnam War Veterans in later life: A lifespan approach.

The current study examined correlates of life satisfaction among Korean Vietnam War Veterans. The sample included 450 male Veterans from the Korean Vietnam War Veterans Study, surveyed by mail in 2013 (Mean age = 67.4 years old, SD = 3.0). A hierarchical analysis was conducted by entering four blocks of variables: first demographic factors, and then pre-military service, military service, and post-military service variables. Each successive regression analysis showed a significant additional contribution to the variance in life satisfaction. In the final model, Korean Veterans had higher life satisfaction when they were married, had higher monthly income and poorer childhood family environment, appraised their military service in a positive light, and had less stressors after homecoming and better perceived physical health. However, combat exposure and social support after homecoming were not independently associated with life satisfaction in the final model. These results imply that both pre- and post-military service factors, as well as cognitive appraisals of military service, should be considered in understanding the subjective well-being of Korean Vietnam War Veterans in later life.

Charting adult development through (historically changing) daily stress processes.

This article views adult development through the lens of daily life experiences and recent historical changes in these experiences. In particular, it examines whether theories that postulate general linear increases in well-being throughout adulthood still hold during times of less prosperity and more uncertainty. Descriptive analyses of the National Study of Daily Experiences chart show how stress in the daily lives of Americans may have changed from the 1990s (N = 1,499) to the 2010s (N = 782). Results revealed that adults in the 2010s reported experiencing stressors on 2% more days than in the 1990s, which translates to an additional week of stressors across a year. Participants in the 2010s also reported that stressors were more severe and posed more risks to future plans and finances and that they experienced more distress. These historical changes were particularly pronounced among middle-aged adults (e.g., proportion of stressor days increased by 19%, and perceived risks to finances and to future plans rose by 61% and 52%, respectively). As a consequence, age-related linear increases in well-being observed from young adulthood to midlife in the 1990s were no longer observed in the 2010s. If further studies continue to replicate our findings, traditional theories of adult well-being that were developed and empirically tested during times of relative economic prosperity may need to be reevaluated in light of the changes in middle adulthood currently observed in this historic period. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

The long arm of childhood experiences on longevity: Testing midlife vulnerability and resilience pathways.

Adverse early experiences have been associated with higher mortality risk, but evidence varies by type of experiences, and relatively little is known about the role of favorable early experiences on health in later life. This study evaluated the independent contributions to longevity of favorable and unfavorable early experiences, including psychosocial stressors, childhood socioeconomic status (SES), and close relationships. We also examined 4 midlife psychosocial factors as vulnerability and resilience pathways potentially mediating these associations. The sample included 1,042 men from the VA Normative Aging Study. Early experiences were assessed retrospectively in 1961-1970 and 1995. Midlife psychosocial factors were measured in 1985-1991 and included stressful life events (SLEs), negative affect, life satisfaction, and optimism. Mortality was assessed through 2016. In multiple mediator structural equation models, which account for the overlap among pathways, higher number of SLEs in midlife mediated the association of having more childhood psychosocial stressors to reduced longevity, supporting stress continuity as a vulnerability pathway. Higher optimism in midlife also mediated the association of higher childhood SES to greater longevity. In single mediator models, higher life satisfaction in midlife transmitted the benefits of higher childhood SES and presence of close relationships onto longevity. Higher optimism also mediated the association of fewer childhood psychosocial stressors to longevity. However, these indirect effects were attenuated when accounting for shared variance among mediators, suggesting overlapping pathways. Findings offer novel evidence on unique and shared pathways linking specific dimensions of early experiences to longevity. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Impact of combat exposure on mental health trajectories in later life: Longitudinal findings from the VA Normative Aging Study.

Cross-sectional studies have shown contradictory results concerning the impact of combat exposure on mental health in later life. We examined whether combat exposure influences trajectories of mental health symptoms in older male veterans using longitudinal data collected from 1985 to 1991 in the Veterans Affairs Normative Aging Study (N = 1,105, age range = 40-86 years in 1985). Noncombat veterans showed little systematic change in depressive and anxiety symptoms with age, whereas combat veterans showed U-shaped nonlinear changes, with higher levels in midlife decreasing until the mid-60s and then increasing again in the 70s and 80s. These findings support the notion that military service, and especially combat exposure, is a hidden variable in aging research. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Considerations for Research and Development of Culturally Relevant Mindfulness Interventions in American Minority Communities.

As many health disparities in American minority communities (AMCs) are stress-related, there has been an increased interest in the development of mindfulness programs as potential stress reduction measures in these communities. However, the bulk of the extant literature on mindfulness research and mindfulness interventions is based upon experiences with the larger White community. The intent of this commentary is to share a framework that includes key cultural considerations for conducting research and developing culturally-salient mindfulness programs with AMCs. We build on our experiences and the experiences of other researchers who have explored mindfulness in African and Native American communities; in particular, we examine issues around community outreach with an emphatic gesture toward emphasizing protection of AMCs and their participants. Discussed are considerations with respect to attitudinal foundations in mindfulness-based research and program development with these communities. However, the overall message of this paper is not to provide a "to-do" list of research steps, but to rather, encourage researchers to turn inward and consider the development of skillful characteristics that will increase the likelihood of a successful research venture while also protecting the cultural traditions of the AMC of interest.

The Development of Wisdom: A Social Ecological Approach.

Objectives: This study examined the development of wisdom within the context of difficult life events (DLEs), and the importance of individuals and their social environments in this process of growth. Social support has long been studied in adulthood, yet less is known about the ways social transactions can promote wisdom. Method: Semi-structured interviews were conducted with men (n = 14) and women (n = 36), ages 56-91 years (M = 71.71; SD = 8.8) who described a DLE and how they coped with it. The analysis was guided by constructivist grounded theory. Results: DLEs included those from childhood through later life. When personal meaning was disrupted by adversity, the social environment played a key role in facilitating new perspectives that corresponded with aspects of wisdom: self-knowledge, compassion, comfort with uncertainty, and accepting complexity. Discussion: Wisdom is often studied as an individual characteristic, but this study highlighted the relevance of a social ecological perspective to understanding how wisdom development is also facilitated through social transactions.

Does combat exposure affect well-being in later life? The VA Normative Aging Study.

OBJECTIVE: Combat exposure can have long-term negative effects in later life; although aspects of service may be appraised positively, the long-term positive effects of combat on well-being in later life is largely unknown. METHOD: The sample included 1,006 male veterans from the VA Normative Aging Study, surveyed by mail in 1986, 1990, and 1991 (Mage = 65.5 years, SD = 7.3). They reported on their combat exposure, desirable appraisals of military service, unit cohesion, dispositional optimism, self-rated health, and psychological well-being (PWB), as well as age, military rank, and education. Perceived positive aspects (PPA) of military service was postulated to mediate the effects of combat exposure on PWB. Structural equation modeling was used to examine both mediating and moderating effects. RESULTS: Age, combat exposure, and optimism had independent effects on PPA, but optimism did not moderate the effect of combat exposure on PPA. Combat exposure had only indirect effects on PWB through PPA, controlling for the direct effects of optimism. Education had no direct effects on the positive outcomes but did have indirect effects through optimism. CONCLUSION: Combat exposure contributes to positive well-being in later life, indirectly through positive appraisals, and this effect was independent of optimism. Thus, these results support the idea that combat veterans should be encouraged to focus on positive aspects of military service, which may serve as resilience resources to facilitate optimal aging. (PsycINFO Database Record

Do hassles and uplifts trajectories predict mortality? Longitudinal findings from the VA Normative Aging Study.

We examined whether longitudinal patterns of hassles and uplifts trajectories predicted mortality, using a sample of 1315 men from the VA Normative Aging Study (mean age = 65.31, SD = 7.6). In prior work, we identified different trajectory classes of hassles and uplifts exposure and intensity scores over a period of 16 years. In this study, we used the probabilities of these exposure and intensity class memberships to examine their ability to predict mortality. Men with higher probabilities of high hassle intensity trajectory class and high uplift intensity class had higher mortality risks. In a model combining the probabilities of hassle and uplift intensities, the probability of high intensity hassle class membership significantly increased the risk of mortality. This suggests that appraisals of hassles intensity are better predictors of mortality than simple exposure measures, and that uplifts have no independent effects.

Spiritual peace predicts 5-year mortality in congestive heart failure patients.

OBJECTIVE: Spirituality is favorably related to depression, quality of life, hospitalizations, and other important outcomes in congestive heart failure (CHF) patients but has not been examined as a predictor of mortality risk in this population. Given the well-known difficulties in managing CHF, we hypothesized that spirituality would be associated with lower mortality risk, controlling for baseline demographics, functional status, health behaviors, and religiousness. METHOD: Participants were 191 CHF patients (64% male; M age = 68.6 years, SD = 10.1) who completed a baseline survey and were then followed for 5 years. RESULTS: Nearly 1/3 of the sample (32%) died during the study period. Controlling for demographics and health status, smoking more than doubled the risk of mortality, whereas alcohol consumption was associated with slightly lower risk of mortality. Importantly, adherence to healthy lifestyle recommendations was associated with halved mortality risk. Although both religion and spirituality were associated with better health behaviors at baseline in bivariate analyses, a proportional hazard model showed that only spirituality was significantly associated with reduced mortality risk (by 20%), controlling for demographics, health status, and health behaviors. CONCLUSIONS: Experiencing spiritual peace, along with adherence to a healthy lifestyle, were better predictors of mortality risk in this sample of CHF patients than were physical health indicators such as functional status and comorbidity. Future research might profitably examine the efficacy of attending to spiritual issues along with standard lifestyle interventions.

A Life-span Perspective on Combat Exposure and PTSD Symptoms in Later Life: Findings From the VA Normative Aging Study.

PURPOSE OF THE STUDY: We tested a life-span model of combat exposure on posttraumatic stress disorder (PTSD) symptoms in later life, examining the direct and indirect effects of prewar, warzone, and postwar factors. DESIGN AND METHODS: The sample included 947 male World War II and Korean War veterans from the VA Normative Aging Study (Mage = 65, SD = 7). They completed mail surveys on childhood family environment, military service and postwar experience, stressful life events, and PTSD symptoms (response rates > 80%). RESULTS: We constructed an initial path model testing cumulative advantage and disadvantage pathways. Although all hypothesized relationships were significant, the model was not a good fit to the data. Subsequent models showed that all three life-span periods had both direct and indirect effects on PTSD symptoms and that there were interesting cross-links between the two sets of pathways. IMPLICATIONS: The life-span perspective provides a useful heuristic to model various developmental effects on later-life outcomes. A supportive childhood family environment can have lifelong protective effects, whereas a conflictual one can set up lifelong patterns of pessimistic appraisals.

Long-term Outcomes of Military Service in Aging and the Life Course: A Positive Re-envisioning.

Most research on military service focuses on its short-term negative consequences, especially the mental and physical injuries of those deployed in warzones. However, studies of long-term outcomes reveal surprisingly positive effects of military service--both those early in adulthood that grow over time and others that can emerge later in life. These multidomain effects have been found in veterans of World War II and the Korean War and are now being seen in veterans of the Vietnam War. Although some are directly attributable to public policies such as the GI Bill, which facilitate educational and economic gains, there are personal developmental gains as well, including autonomy, emotional maturity and resilience, mastery, and leadership skills, that lead to better health and well-being in later life. These long-term effects vary across persons, change over time within persons, and often reflect processes of cumulative advantage and disadvantage. We propose a life-span model of the effects of military service that provides a perspective for probing both long-term positive and negative outcomes for aging veterans. We further explicate the model by focusing on both sociocultural dynamics and individual processes. We identify public-use data that can be examined to evaluate this model, and offer a set of questions that can be used to assess military service. Finally, we outline an agenda for dedicated inquiry into such effects and consider policy implications for the health and well-being of aging veterans in later life.

Do cherished children age successfully? Longitudinal findings from the Veterans Affairs Normative Aging Study.

Although early adversity has been linked to worse mental and physical health in adulthood, few studies have investigated the pathways through which positive and negative dimensions of early experiences can jointly influence psychological well-being in later life. This study examined: (a) profiles of early experiences across multiple domains, (b) the relations of these profiles to hedonic and eudaimonic well-being in later life, and (c) whether midlife social support mediated these relations. We first conducted latent class analysis of early experiences using data from 1,076 men in the VA Normative Aging Study who completed the Childhood Experiences Scale (age: M = 69, SD = 7). Analyses yielded 3 profiles of early experiences, labeled as cherished (strong support and some losses), harshly disciplined (harsh parental discipline, low positive reinforcement, and nonnormative stressors), and ordinary (few stressors and low parental attention). Next, we applied structural equation modeling to data on a subset of this sample assessed 7 years later on hedonic and eudaimonic well-being (n = 496; age: M = 76, SD = 7). In general, the cherished group reported stronger qualitative social support in midlife than the harshly disciplined and ordinary groups, which in turn was related to greater hedonic (life satisfaction, positive affect) and eudaimonic (competence, positive relations with others) well-being in later life. The cherished group also reported higher autonomy than the ordinary group, but this association was independent of midlife social support. Our findings suggest that experiencing adversity in the context of a nurturing early environment can promote successful aging through the maintenance of supportive relationships in midlife.

Cross-cultural comparison of self-transcendent wisdom between the United States and Korea.

Whether wisdom is a culturally-specific or universal construct is a matter of some debate (see Curnow 1999; Grossman et al. Psychological Science, 2012). This study compared similarities and differences in the factor structure of a measure of wisdom focused on self-transcendence in U.S. (n = 305, M(age) = 33.99) and Korean samples (n = 838, M(age) = 30.28), with ages ranging from 20 to 73). The Adult Self-Transcendence Inventory (ASTI; Levenson et al. International Journal of Aging and Human Development, 60, 127-143, 2005) has two factors, self-transcendence and alienation, the latter of which was included to differentiate between social withdrawals due to contemplative practices versus that due to depression. Confirmatory factor analyses found a partial scalar factorial invariance model fit the data best, indicating that the factor structure of the ASTI is largely equivalent and that the construct is comparable across the two cultures. Regression analyses showed that age and religiousness were related to self-transcendence and alienation. Education was related to self-transcendence only. The interaction between age and culture was significant on alienation; alienation was higher in mid-life Koreans but not in Americans, which may reflect either age or cohort effects. Thus, self-transcendence may be a more universal measure of wisdom than those based on pragmatics or cognitive functioning.

How can Developmental Systems Theories Cope with Free Will? The importance of stress-related growth and mindfulness.

Science is in the midst of a Kuhnian paradigm shift, from causal, deterministic models to more probabilistic ones that emphasize systems approaches. However, systems theory is still primarily deterministic and does not readily integrate the construct of free will. In the developmental sciences, this shift has been manifesting in relational developmental systems theories (RSDTs) which highlight multi-level analyses, interindividual differences in intraindividual change, and co-action with the context. While agency is an important component in RSDTs, it is unclear how it develops. We argue that free will is a developmental construct, and that the process of the development of free will can arise in two ways: from life-changing encounters with major stressors which result in recognizing limiting influences on one's life and the development of greater self-awareness; and purposive development to increase self-regulation and mindfulness. Through purposive, mindful co-action, the individual and the network can co-evolve in positive ways.