Optimism and Sleep in Aging Women: Bidirectional Relationships.

OBJECTIVE: Sleep quality and duration are important for biological restoration and promotion of psychological well-being. Optimism may facilitate or result from sufficient sleep, but questions remain as to directionality. The present study tested how optimism is associated with levels of and variability in sleep quantity and quality in a longitudinal burst design. METHODS: Midlife and older women ( N = 199) reported their sleep quantity and quality in online diaries for a 7-day period, every 3 months for 2 years. Optimism was measured at baseline and end-of-study. Multilevel models tested the effects of optimism on sleep. Linear regression models tested the effect of sleep on optimism. RESULTS: Baseline optimism was associated with higher sleep quality ( γ = 2.13 [1.16 to 3.11], p < .0001) and lower intraindividual variability (IIV; night-to-night and wave-to-wave) in sleep quantity (night-to-night: γ = -0.07 [-0.13 to -0.005], p = .03; wave-to-wave: b = -0.07 [-0.12 to -0.02], p = .003). In turn, higher average sleep quality (but not quantity) was associated with higher optimism at end-of-study ( b = 0.02 [0.007 to 0.03], p = .002). Variability in sleep was unrelated to optimism. CONCLUSIONS: Optimism may play an important role in maintaining sleep quality and consistency in sleep quantity, perhaps by buffering stress. Similarly, sleep quality may play an important role in maintaining optimism. The cycle whereby optimism and sleep enhance one another could improve physical health and psychological well-being among aging adults.

Detecting cognitive decline in high-functioning older adults: The relationship between subjective cognitive concerns, frequency of high neuropsychological test scores, and the frontoparietal control network.

OBJECTIVE: Neuropsychologists have difficulty detecting cognitive decline in high-functioning older adults because greater neurological change must occur before cognitive performances are low enough to indicate decline or impairment. For high-functioning older adults, early neurological changes may correspond with subjective cognitive concerns and an absence of high scores. This study compared high-functioning older adults with and without subjective cognitive concerns, hypothesizing those with cognitive concerns would have fewer high scores on neuropsychological testing and lower frontoparietal network volume, thickness, and connectivity. METHOD: Participants had high estimated premorbid functioning (e.g., estimated intelligence ≥75th percentile or college-educated) and were divided based on subjective cognitive concerns. Participants with cognitive concerns (n = 35; 74.0 ± 9.6 years old, 62.9% female, 94.3% White) and without cognitive concerns (n = 33; 71.2 ± 7.1 years old, 75.8% female, 100% White) completed a neuropsychological battery of memory and executive function tests and underwent structural and resting-state magnetic resonance imaging, calculating frontoparietal network volume, thickness, and connectivity. RESULTS: Participants with and without cognitive concerns had comparable numbers of low test scores (≤16th percentile), p = .103, d = .40. Participants with cognitive concerns had fewer high scores (≥75th percentile), p = .004, d = .71, and lower mean frontoparietal network volumes (left: p = .004, d = .74; right: p = .011, d = .66) and cortical thickness (left: p = .010, d = .66; right: p = .033, d = .54), but did not differ in network connectivity. CONCLUSIONS: Among high-functioning older adults, subjective cognitive decline may correspond with an absence of high scores on neuropsychological testing and underlying changes in the frontoparietal network that would not be detected by a traditional focus on low cognitive test scores.

Open Science in Health Psychology and Behavioral Medicine: A Statement From the Behavioral Medicine Research Council.

ABSTRACT: Open Science practices include some combination of registering and publishing study protocols (including hypotheses, primary and secondary outcome variables, and analysis plans) and making available preprints of manuscripts, study materials, de-identified data sets, and analytic codes. This statement from the Behavioral Medicine Research Council (BMRC) provides an overview of these methods, including preregistration; registered reports; preprints; and open research. We focus on rationales for engaging in Open Science and how to address shortcomings and possible objections. Additional resources for researchers are provided. Research on Open Science largely supports positive consequences for the reproducibility and reliability of empirical science. There is no solution that will encompass all Open Science needs in health psychology and behavioral medicine's diverse research products and outlets, but the BMRC supports increased use of Open Science practices where possible.

Lifespan socioeconomic context is associated with cytomegalovirus and late-differentiated CD8+ T and NK cells: Initial results in older adults.

OBJECTIVE: Lower socioeconomic status (SES) can accelerate immune aging; however, it is unknown whether and how lifespan socioeconomic context (SEC) -the relative wealth and quality of the communities an individual lives in across their lifespan- impacts immune aging. We examined the effects of childhood and adulthood SEC on late-differentiated immune cells and investigated the mediating and moderating role of cytomegalovirus (CMV), a key driver of immune aging. METHODS: Adults 60 years and older (N = 109) reported their addresses from birth to age 60, which were coded for county-level employment, education, and income to construct a latent SEC variable, averaged across ages 0-18 (childhood SEC) and 19-60 (adulthood SEC). Blood was drawn semiannually over 5 years for CMV serostatus and flow cytometry estimates of late-differentiated CD8+ T and natural killer (NK) cells. Models were adjusted for chronological age, time, gender, and individual SES (current income and education). RESULTS: Lower childhood SEC was associated with higher percentages of late-differentiated CD8+ T and NK cells via CMV seropositivity (indirect effects ps .015-.028). Additionally, an interaction between CMV serostatus and SEC on CD8+ T cell aging (p = .049) demonstrated that adulthood SEC was negatively associated with immune aging among CMV- but not CMV+ adults. CONCLUSIONS: Beyond current SES, socioeconomic context related to immune aging in distinct patterns by lifespan phase. Lower childhood SEC importantly may influence who acquires CMV, which in turn, predicts higher levels of immune aging, whereas higher adulthood SEC was protective against immune aging among CMV- older adults. These initial results need to be explored in larger samples.

Life stressors and immune aging: Protective effects of cognitive reappraisal.

Stressful life events may accelerate aspects of immune aging, but habitual use of an adaptive emotion regulation strategy, cognitive reappraisal, may attenuate these effects. This study examined whether cognitive reappraisal moderates the associations between life stressor frequency and stressor desirability on aspects of immune aging, including late-differentiated CD8+ T and natural killer (NK) cells and inflammatory markers (IL-6, TNF-α, and CRP), both between and within people in a longitudinal sample of 149 older adults (mean age = 77.8, range: 64-92 years). Participants reported stressful life events, use of cognitive reappraisal, and provided blood semiannually for up to 5 years to assess aspects of immune aging. Multilevel models, adjusted for demographic and health covariates, tested the between-person (stable, trait-like differences) and within-person associations (dynamic fluctuations) among life stressors and reappraisal on immune aging. Experiencing more frequent life stressors than usual was associated with higher levels of late-differentiated NK cells within person, but this effect was accounted for by experiencing health-related stressors. Unexpectedly, experiencing more frequent and less desirable stressors were associated with lower average levels of TNF-α. As expected, reappraisal moderated the associations between life stressors and late-differentiated NK cells between people and IL-6 within people. Specifically, older adults who experienced less desirable stressors but also used more reappraisal had significantly lower proportions of late-differentiated NK cells on average and lower levels of IL-6 within-person. These results suggest cognitive reappraisal may play a protective role in attenuating the effects of stressful life events on aspects of innate immune aging in older adults.

Open Science in Health Psychology and Behavioral Medicine: A Statement From the Behavioral Medicine Research Council.

Open Science practices include some combination of registering and publishing study protocols (including hypotheses, primary and secondary outcome variables, and analysis plans) and making available preprints of manuscripts, study materials, de-identified data sets, and analytic codes. This statement from the Behavioral Medicine Research Council (BMRC) provides an overview of these methods, including preregistration; registered reports; preprints; and open research. We focus on rationales for engaging in Open Science and how to address shortcomings and possible objections. Additional resources for researchers are provided. Research on Open Science largely supports positive consequences for the reproducibility and reliability of empirical science. There is no solution that will encompass all Open Science needs in health psychology and behavioral medicine's diverse research products and outlets, but the BMRC supports increased use of Open Science practices where possible.

Psychosomatic Medicine: Looking Forward.

ABSTRACT: The new Editor-in-Chief of Psychosomatic Medicine thanks the outgoing editorial team, reflects on the longevity and impact of the journal, and looks forward to challenges and opportunities. Science-and scientific publications-must address and embrace reproducibility and replication, inclusivity and diversity, statistical advances, and more.

Cytomegalovirus and Toxoplasma Gondii Serostatus Prospectively Correlated With Problems in Self-Regulation but not Executive Function Among Older Adults.

OBJECTIVE: Cytomegalovirus (CMV) and Toxoplasma gondii are organisms that may infect the brain and have cognitive and behavioral consequences. We hypothesized that these latent infections would be prospectively associated with poorer cognition and more problems in self-regulation among older adults. METHODS: Older adults (n = 138, mean age = 75.5 years, 59% women) had CMV and T. gondii serostatus tested, crystallized intelligence estimated (North American Adult Reading Test), and executive function (EF; e.g., Trail Making Test) and self-regulation (Behavior Regulation Inventory of Executive Function-Adult) assessed in visits occurring every 6 months (mean visits = 16). RESULTS: CMV+ people (79%) had significantly poorer self-regulation versus CMV- people (21%; behavioral regulation: γ = 0.108, 95% confidence interval [CI] = 0.009-0.206; metacognition: γ = 0.117, 95% CI = 0.005-0.229), but not intelligence or EF. T. gondii+ people (24%) were not significantly different from T. gondii- people (76%) on any outcome. However, T. gondii+ men had better self-regulation versus T. gondii- men, and the opposite was true of women (behavioral regulation interaction: γ = 0.267, 95% CI = 0.093-0.441). CONCLUSIONS: CMV latent infection was associated with more problems in self-regulation, and the magnitude of this difference was clinically significant. T. gondii latent infection was associated with more problems, but only for women. Latent infection might associate with self-regulation but not EF because of factors influencing self-regulation but not neuropsychological test performance, such as values and emotion. Efforts to link latent infection with EFs might, in the future, include the application of those functions to self-regulation in daily life.

Sleep Variability and Inflammation in Midlife and Older Women.

OBJECTIVE: Shorter sleep duration and more sleep disturbances, in addition to greater night-to-night fluctuations in sleep (intraindividual variability; IIV), have been associated with elevated inflammation. However, these associations were only at the between-person level. The current study examined the within-person relationship between mean levels and IIV of sleep duration and sleep disturbances and C-reactive protein (CRP) in healthy, aging women. METHODS: Participants ( N = 179) from a longitudinal study of activity and well-being in middle-aged and older women (mean age = 62 years; range = 50-75 years) completed a 7-day daily diary, every 3 months, for 2 years (up to nine bursts). Sleep was assessed each day asking participants how many hours of sleep they got the night before and with the four-item PROMIS Sleep Disturbance Short Form. Finger-stick dried blood spot samples were collected after each 7-day daily diary. RESULTS: In bursts when women experienced greater than average variability in sleep duration, they had higher CRP ( γ = 0.06, p = .004). Within-person changes in mean sleep duration were not associated with CRP. In addition, neither mean sleep disturbances nor sleep disturbance IIV were associated with CRP. CONCLUSIONS: This study is the first to show that within-person changes in variable sleep duration are related to changes in inflammation. Findings from the current study suggest that greater variability in sleep duration is related to higher CRP, which may increase risk for early morbidity and mortality. Future studies should investigate inflammation as a pathway linking sleep variability and health.

Meta-Analysis of Cognition in Parkinson's Disease Mild Cognitive Impairment and Dementia Progression.

Mild cognitive changes, including executive dysfunction, are seen in Parkinson's Disease (PD). Approximately 30% of individuals with PD develop Parkinson's disease dementia (PDD). Mild cognitive impairment (MCI) has been identified as a transitional state between normal cognition and dementia. Although PD-MCI and its cognitive correlates have been increasingly studied as a risk indicator for development of PDD, investigations into the PD-MCI construct have yielded heterogeneous findings. Thus, a typical PD-MCI cognitive profile remains undefined. The present meta-analysis examined published cross-sectional studies of PD-MCI and cognitively normal PD (PD-CN) groups to provide aggregated effect sizes of group test performance by cognitive domain. Subsequently, longitudinal studies examining PD-MCI to PDD progression were meta-analyzed. Ninety-two cross-sectional articles of PD-MCI vs. PD-CN were included; 5 longitudinal studies of PD-MCI conversion to PDD were included. Random effects meta-analytic models were constructed resulting in effect sizes (Hedges' g) for cognitive domains. Overall performance across all measures produced a large effect size (g = 0.83, 95% CI [0.79, 0.86], t2 = 0.18) in cross-sectional analyses, with cognitive screeners producing the largest effect (g = 1.09, 95% CI [1.00, 1.17], t2 = 0.19). Longitudinally, overall measures produced a moderate effect (g = 0.47, 95% CI [0.40, 0.53], t2 = 0.01), with measures of executive functioning exhibiting the largest effect (g = 0.70, 95% CI [0.51, 0.89], t2 = 0.01). Longitudinal effects were made more robust by low heterogeneity. This report provides the first comprehensive meta-analysis of PD-MCI cognitive outcomes and predictors in PD-MCI conversion to PDD. Limitations include heterogeneity of cross-sectional effect sizes and the potential impact of small-study effects. Areas for continued research include visuospatial skills and visual memory in PD-MCI and longitudinal examination of executive dysfunction in PD-MCI.

Daily Stressors, Emotion Dynamics, and Inflammation in the MIDUS Cohort.

BACKGROUND: The current study (1) examined links between daily stressors and inflammation and (2) tested whether negative emotion dynamics (emotional variability) is one pathway through which stressors are linked to inflammation. METHOD: A cross-sectional sample of 986 adults (aged 35-86 years, 57% female) from MIDUS reported daily stressor frequency and severity and negative emotions on 8 consecutive nights. Negative emotion variability (intraindividual standard deviation), controlling for overall mean level (intraindividual mean), was the focus of the current study. Interleukin-6 (IL-6) and C-reactive protein (CRP) were assayed from blood drawn at a clinic visit. Regression models adjusted for demographics, health factors, and the time between assessments. RESULTS: More severe daily stressors were associated with higher CRP, but this effect was accounted for by covariates. More frequent daily stressors were associated with lower IL-6 and CRP. In follow-up analyses, significant interactions between stressor severity and frequency suggested that participants with lower stressor severity and higher stressor frequency had the lowest levels of IL-6 and CRP, whereas those with higher stressor severity had the highest levels of IL-6 and CRP, regardless of frequency. Daily stressor frequency and severity were positively associated with negative emotion variability, but variability was not linearly associated with inflammation and did not operate as a mediator. CONCLUSION: Among midlife and older adults, daily stressor frequency and severity may interact and synergistically associate with inflammatory markers, potentially due to these adults being advantaged in other ways related to lower inflammation, or in a pattern aligning with hormetic stress, where frequent but manageable stressors may yield physiological benefits, or both. Negative emotion variability does not operate as a mediator. Additional work is needed to reliably measure and test other emotion dynamic metrics that may contribute to inflammation.

Mean Levels and Variability in Psychological Well-Being and Associations With Sleep in Midlife and Older Women.

BACKGROUND: Disturbed sleep is prevalent in older adulthood and particularly among women. Greater psychological well-being (PWB) is associated with better sleep, but intraindividual variability in PWB has not been examined. PURPOSE: The current study examined whether mean levels and variability in PWB were associated with sleep disturbances in midlife and older women. METHODS: Participants (N = 189) completed up to seven daily diaries and an end of the week assessment every 3 months for nine waves. Participants answered questions about their nightly sleep disturbances and reported their PWB using Ryff's six dimensions of PWB. RESULTS: Regression models indicated that greater variability in one aspect of PWB, positive relations with others, was related to greater sleep disturbance even after adjusting for mean levels of well-being. Greater variability in environmental mastery, purpose in life, and self-acceptance were also associated with sleep disturbance, but these associations were no longer significant after adjusting for mean levels of well-being. CONCLUSIONS: Results suggest that fluctuations in positive relations with others are related to sleep in adult women above and beyond mean levels of well-being. Results highlight the importance of considering variability in addition to mean levels of PWB.

Expected Estimation Errors in Studies of the Cortisol Awakening Response: A Simulation.

OBJECTIVE: Misestimation as a consequence of small sample sizes, small effect sizes, and noisy measurement may be particularly problematic in biomarker studies, the cost of which can adversely affect design decisions. This simulation study used real study designs reported in a meta-analysis of psychosocial correlates of the cortisol awakening response to investigate the probability that the results of these designs would yield misestimates in a cross-sectional study. METHODS: For each of the 212 designs, 100,000 simulated data sets were produced and the percentages of effects that were in the wrong direction and/or that differed by more than 0.10 from the true effect (b = 0.10) were calculated. RESULTS: As expected, small samples (n < 100) and noisy measurement contributed to higher probability of errors. The average probability of an effect being in the wrong direction was around 20%, with some designs reaching 40%; misestimation probabilities were around 40%, with some designs reaching 80%. This was true for all studies as well as those reporting statistically significant effects. CONCLUSION: Results call for better study designs, and this article provides suggestions for how to achieve more accurate estimates.

Optimism and Pain Interference in Aging Women.

BACKGROUND: Pain interferes with people's daily lives and often limits the extent to which they can pursue goals and engage in activities that promote well-being. However, people vary in how much interference they experience at a given level of pain. PURPOSE: The present study tested how optimism affects and is affected by pain interference and goal-directed activity among older women. METHODS: Every 3 months for 2 years, community-dwelling middle- and older-age women (N = 199) completed online daily diaries at home for a 7 day period, in which they reported their daily pain, pain interference, and goal-directed activity. Optimism was measured at the start and end of the study. Multilevel models tested the between- and within-person relationships among pain, optimism, and pain interference or goal-directed activity. Linear regression predicted change in optimism over 2 years from pain interference and goal-directed activity. RESULTS: Pain best predicted pain interference and optimism best predicted goal-directed activity. There were subtle interactions between optimism and pain-predicting interference and goal-directed activity. Accumulated goal-directed activity and pain interference across the study predicted longitudinal changes in optimism, with higher activity and lower pain interference predicting increased optimism over 2 years. CONCLUSIONS: Optimism may play a protective role in disruptions caused by pain on a day-to-day basis, leading to increased goal-directed activity and possibly decreased pain interference. In turn, less interference and more goal-directed activity feed forward into increased optimism, resulting in a virtuous cycle that enhances optimism and well-being among older women.

Personality and Coping: Individual Differences in Responses to Emotion.

Abundant evidence links personality with emotion via coping. Alternatively, personality can be viewed as an emergent property of responses to the experience of emotion. Dispositions to control, approach, escape, and avoid one's emotional experience underlie diverse traits, including positive and negative urgency, trait emotional approach and avoidance, alexithymia, and emotional expressiveness. In this review, we consider the neurobiological underpinnings of these dispositions and the nature (e.g., stability) and adaptiveness of the associated traits. Important future directions for research in this area include the roles of development, intraindividual variability and flexibility, and the intensity and structure of emotional experience.

Statistical Guideline #6. Indicate magnitude and precision in your estimation and use "new statistics".

This is one in a series of statistical guidelines designed to highlight common statistical considerations in behavioral medicine research. The goal is to briefly discuss appropriate ways to analyze and present data in the International Journal of Behavioral Medicine (IJBM). Collectively, the series will culminate in a set of basic statistical guidelines to be adopted by IJBM and integrated into the journal's official Instructions for Authors, and also to serve as an independent resource. If you have ideas for a future topic, please email the Statistical Editor, Suzanne Segerstrom at segerstrom@uky.edu.

Statistical Guideline No. 5. Include Results of a Power Analysis; if a Power Analysis Was Not Performed, Describe the Stopping Rule for Recruitment.

This is one in a series of statistical guidelines designed to highlight common statistical considerations in behavioral medicine research. The goal is to briefly discuss appropriate ways to analyze and present data in the International Journal of Behavioral Medicine (IJBM). Collectively the series will culminate in a set of basic statistical guidelines to be adopted by IJBM and integrated into the journal's official Instructions for Authors, and also to serve as an independent resource. If you have ideas for a future topic, please email the Statistical Editor, Suzanne Segerstrom at segerstrom@uky.edu.

Physiometrics in Salivary Bioscience.

BACKGROUND: Accurate estimation in statistical models depends on sample size but also, critically, reliability of the measure. Physiometrics is the equivalent of psychometrics for measures such as sex hormones, catabolic hormones, and products of the immune system. METHOD: There are multiple ways to measure physiometrics, from simple correlation to complex generalizability theory designs. Depending on the design, these estimates can provide information about equivalency (e.g., the correlation between two measurements taken close together in time) or stability (e.g., the correlation between two measurements taken farther apart in time). RESULTS: The physiometrics of salivary measures including cortisol, α-amylase, testosterone, and cytokines range from highly stable, requiring only a single sample, to highly unstable, requiring multiple samples to achieve generalizability to longer periods of time. However, generalizability is relative to the study design, and only some designs call for stable and generalizable measures. CONCLUSION: Both dedicated physiometric studies and more reporting of physiometrics in psychoneuroendocrinology and psychoneuroimmunology will improve the quality of salivary bioscience study designs in the future.

Statistical Guideline #4. Describe the Nature and Extent of Missing Data and Impute Where Possible and Prudent.

From the Editors: This is one in a series of statistical guidelines designed to highlight common statistical considerations in behavioral medicine research. The goal is to briefly discuss appropriate ways to analyze and present data in the International Journal of Behavioral Medicine (IJBM). Collectively the series will culminate in a set of basic statistical guidelines to be adopted by IJBM and integrated into the journal's official Instructions for Authors, but also to serve as an independent resource. If you have ideas for a future topic, please email the Statistical Editor Suzanne Segerstrom at segerstrom@uky.edu.

Between the Error Bars: How Modern Theory, Design, and Methodology Enrich the Personality-Health Tradition.

The study of relationships between personality traits and health has a long history in psychosomatic research. However, personality science has evolved from an understanding of personality as fixed traits to one that acknowledges that personality is dynamic. Dynamic approaches to conceptualizing and measuring personality and individual differences can enrich personality-health research. In this Presidential Address (American Psychosomatic Society, 2018), I consider how different formulations of personality-stable traits, stable signals in a noisy or variable measure, within-person changes, and intraindividual variability-can be implemented to better understand how personality is related to health and particularly to immune function. These approaches recognize and, in some cases, capitalize on the fact that personality factors can display variability as well as stability over time. They also require repeated measurement and therefore greater methodological sophistication that considers reliability and generalizability, Simpson's paradox, and the difference between variability and flexibility. Dynamic qualities of personality and individual differences potentially influence health, and designs and methodology that incorporate them can illuminate the important processes that occur inside the error bars.