RESUMO
Chronic pain is a prevalent condition with significant impacts on individuals' lives, including heightened stress and impaired physiological functioning. Given that work and family are the two main social domains where stress manifests, this study aimed to investigate the interactions between chronic pain, work-family stressors, and diurnal cortisol patterns to understand how chronic pain affects daily life and physiological stress responses. We identified 1,413 adults with chronic pain and 1,413 matched controls within MIDUS II samples to examine work-family spillover, daily work and home stressors, and cortisol levels across multiple days. The chronic pain group reported more negative work to family spillover and experienced more instances of stressful home events, particularly avoided arguments. These results align with literature suggesting chronic pain exacerbates tensions in close relationships and increases stress. The chronic pain group also had higher cortisol levels cross late-day periods, indicative of hypothalamic-pituitary-adrenal (HPA) axis dysregulation. This dysregulation is associated with poorer health outcomes, including increased inflammation and psychological distress. We did not find any differences in previously identified cortisol profiles, which are higher-level summaries of cortisol levels within each day. We discuss why such difference might not have appeared in this sample.
Assuntos
Dor Crônica , Ritmo Circadiano , Hidrocortisona , Saliva , Estresse Psicológico , Humanos , Hidrocortisona/metabolismo , Masculino , Feminino , Dor Crônica/fisiopatologia , Dor Crônica/psicologia , Pessoa de Meia-Idade , Ritmo Circadiano/fisiologia , Estresse Psicológico/fisiopatologia , Adulto , Saliva/química , Saliva/metabolismo , Família , Sistema Hipotálamo-Hipofisário/fisiopatologia , Sistema Hipotálamo-Hipofisário/metabolismo , Sistema Hipófise-Suprarrenal/fisiopatologiaRESUMO
OBJECTIVE: One large focus of personality psychology is to understand the biopsychosocial factors responsible for adult personality development and well-being change. However, little is known about how macro-level contextual factors, such as rurality-urbanicity, are related to personality development and well-being change. METHOD: The present study uses data from two large longitudinal studies of U.S. Americans (MIDUS, HRS) to examine whether there are rural-urban differences in levels and changes in the Big Five personality traits and well-being (i.e., psychological well-being, and life satisfaction) in adulthood. RESULTS: Multilevel models showed that Americans who lived in more rural areas tended to have lower levels of openness, conscientiousness, and psychological well-being, and higher levels of neuroticism. With the exception of psychological well-being (which replicated across MIDUS and HRS), rural-urban differences in personality traits were only evident in the HRS sample. The effect of neuroticism was fully robust to the inclusion of socio-demographic and social network covariates, but other effects were partially robust (i.e., conscientiousness and openness) or were not robust at all (i.e., psychological well-being). In both samples, there were no rural-urban differences in Big Five or well-being change. CONCLUSIONS: We discuss the implications of these findings for personality and rural health research.
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Transtornos da Personalidade , Personalidade , Adulto , Humanos , Neuroticismo , Estudos Longitudinais , Inventário de PersonalidadeRESUMO
BACKGROUND: Cognitive function is an important component of healthy ageing. However, it is unclear whether relaxation/meditation practices provide cognitive benefits, particularly in midlife and early late life. Meditative practices are associated with higher self-esteem, and self-esteem serves as a general protective factor for many health outcomes. The current study examines associations between meditation practice, self-esteem, and change over 10 years in midlife cognitive performance. METHODS: Data were from waves 2 (2003-2004) and 3 (2013-2014) of the Midlife in the United States (MIDUS) study. We used structural equation modelling to examine whether persistent meditation practice at both waves or episodic practice at one wave is associated with better cognitive function over 10 years, compared to no meditation practice, while controlling for prior cognitive function and covariates (baseline socio-demographics, health, and functional status). Additionally, we assessed if self-esteem mediates the above associations. RESULTS: We included 2168 individuals (Mage = 65 ± 11). After controlling for covariates, the findings revealed that persistent meditation practice in both waves was associated with significantly less decline in episodic memory; however, no such effects were found for executive function. Further, although participants' higher self-esteem was significantly associated with less decline in executive function and episodic memory, it did not mediate the associations between meditation practice and cognitive functions. CONCLUSIONS: While both persistent meditation practice and self-esteem have associations with cognitive outcomes for middle-aged and older adults in MIDUS, self-esteem as a mediator was not supported. Thus, future investigations should examine mechanisms that underlie these protective factors on cognitive performances across adulthood.
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Meditação , Memória Episódica , Humanos , Estados Unidos , Pessoa de Meia-Idade , Idoso , Adulto , Cognição , Função Executiva , AutoimagemRESUMO
OBJECTIVE: To understand the relationship between mortality and three types of perceived discrimination (lifetime, daily, chronic job) using a nationally representative sample of U.S. adults. METHODS: Data from 4562 adults in the Midlife in the United States (MIDUS) between 2004 and 2006 (MIDUS II and MIDUS African American sample) were analyzed. Unadjusted associations between primary independent discrimination variables (lifetime, chronic job, daily) and mortality were analyzed using univariate Cox's proportional hazards regression models. Covariates were added to the models by group: predisposing (sex, age, race/ethnicity, education, marital status); enabling (household income, employment status, insurance status); and need factors (body mass index, diabetes, hypertension, stroke, cancer) to estimate hazard ratios. RESULTS: After adjusting for all covariates, hazard ratios for lifetime discrimination (HR: 1.09, p = 0.034) and daily discrimination (HR: 1.03, p = 0.030) were statistically significant. There was no relationship between mortality and chronic job discrimination (HR:1.03, p = 0.15). CONCLUSIONS: Adults experiencing lifetime and daily discrimination had significantly increased risk of mortality after adjusting for predisposing, enabling, and need factors. The findings highlight the importance of screening patients during clinical encounters for experiences of discrimination and providing appropriate resources to mitigate the negative impact of discriminatory events on mortality. Future research should work to fully understand the mechanism by which discrimination increases risk of mortality. These future findings should be used to develop targets for interventions designed to decrease mortality among adults who have experienced discrimination.
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Etnicidade , Discriminação Percebida , Humanos , Estados Unidos/epidemiologia , Escolaridade , Emprego , Negro ou Afro-AmericanoRESUMO
Negative perceptions of aging and older adulthood, including the idealization of youth, are common in the United States. Past work has found that holding negative perceptions of aging is closely associated with poor mental and physical health consequences, yet few studies have examined how these perceptions impact day-to-day experiences. The current study had two objectives: (1) investigate whether age discrepancy (specifically desiring to be younger than one's chronological age) was related to daily negative affect and (2) examine whether this relationship changed as participants aged over time. We utilized the Midlife in the United States (MIDUS) diary study, a longitudinal measurement burst study with three waves of 8-day daily diaries indexing approximately 20 years. Participants (N = 2398; Mage [baseline] = 46.85, SD = 12.24; 54.7% women; 92.4% White) reported their desired age as well as daily negative affect at each wave. Using multilevel modeling, we examined whether age discrepancy predicted daily negative affect across 3 waves of observation. Results supported a significant relationship between age discrepancy and daily negative affect. However, no interactions among age discrepancy and baseline age or time across study were found. This suggests that the relationship between age discrepancy and daily negative affect was consistent across waves and participants over a 20-year period and provides evidence for the pernicious effect of deidentifying with one's real age on daily life. Daily experiences can act as potential risk or protective factors and shape developmental trajectories. Reducing ageism through societal interventions or increasing personal acceptance of aging through targeted interventions are two potential pathways of promoting health and well-being across the lifespan.
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Afeto , Envelhecimento , Adolescente , Humanos , Feminino , Estados Unidos , Idoso , MasculinoRESUMO
Even before increased social isolation associated with the COVID-19 pandemic, 43% of adults aged 60 and older reported experiencing loneliness. Depression and loneliness often co-exist and are significant issues faced by middle-aged as well as older adults because each condition is likely to worsen health outcomes. This study of middle-aged and older adults examined how depression and loneliness affect diabetes (DM) control (A1C levels). This study is a secondary analysis of data from the Midlife in the United States Refresher (MIDUS-R) survey, a national survey of adults aged 25-74 years. Correlation analyses were conducted, and a hierarchical logistic regression was estimated to predict A1C levels ≤7% (recommended goal) or >7 using 1) demographics and physical health (ethnicity, gender, education, age, and comorbidities), 2) family and friend support, and 3) depression and loneliness. The sample of 92 participants with DM and A1C data from the MIDUS-R had mean age = 57.37, were 51% male, 68% non-Hispanic White; 39.1% had A1C >7. The average level of depression was low (CES-D mean 9.42) and loneliness was moderate (UCLA scale mean 12.43). Loneliness was correlated with A1C (r= .26, p< .05); depressive symptoms (r= .71, p< .001), family and friends support (r= -.36, r= -.38, respectively, both p< .001). Only loneliness significantly predicted higher A1C levels. People with higher levels of loneliness had increased odds of having A1C >7 (OR = 1.18, p < .05) after controlling for depression and all other variables. Loneliness had a greater impact than depression on A1C level among persons with DM. Healthcare providers should assess patients for loneliness as well as depression and reduce adverse health impacts by referring to psychosocial support as needed.
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COVID-19 , Diabetes Mellitus , Pessoa de Meia-Idade , Humanos , Masculino , Idoso , Feminino , Solidão/psicologia , Hemoglobinas Glicadas , Depressão/epidemiologia , Depressão/psicologia , Pandemias , COVID-19/epidemiologia , Isolamento Social/psicologia , Diabetes Mellitus/epidemiologiaRESUMO
Cognitive function is a vital component of healthy aging. However, whether a persistently high optimism benefits late-life cognitive function is debatable. The current study examined associations between high optimism status, perceived generativity, and cognitive functions across adulthood. Data were from waves 2 and 3 (2004-14) of the Midlife in the United States study. We used structural equation modeling to examine whether participants' (N = 2,205; Mage = 65 ± 11) persistent high optimism predicts better cognitive functions over time, compared to high optimism at only one time-point or not at all while controlling for covariates; we also examined whether individuals' perceived generativity mediates the above association. The findings revealed that persistent high optimism was significantly associated with better episodic memory and executive function. Further, perceived generativity positively mediated the association between persistent high optimism and episodic memory. Future research should examine mechanisms for potential aspects of high optimism and perceived generativity on late-life cognitive performances.
RESUMO
The present study examined longitudinal associations of distinct dimensions of perceived control (i.e., perceived mastery and constraints) with approach and avoidance coping relating to functional health for aging adults, which had not been well studied previously. Using data from two waves of Midlife in the United States (N = 4,963, whose mean age was 55.4 [SD = 12.5]), a longitudinal path model was analyzed for direct and indirect effects among perceived mastery and constraints, approach and avoidance coping, and functional limitations. Bidirectional associations were observed between perceived mastery and approach coping and between perceived constraints and avoidance coping. Moreover, perceived constraints not only were directly associated with functional limitations but also mediated the longitudinal associations of the other factors of interest with functional limitations. These findings can inform future research on perceived control and coping in the context of promoting functional health.
Assuntos
Adaptação Psicológica , Envelhecimento , Humanos , Estados Unidos , Nível de Saúde , Estudos LongitudinaisRESUMO
Memory decline is a concern for aging populations across the globe. Positive affect plays an important role in healthy aging, but its link with memory decline has remained unclear. In the present study, we examined associations between positive affect (i.e., feeling enthusiastic, attentive, proud, active) and memory (i.e., immediate and delayed recall), drawing from a 9-year longitudinal study of a national sample of 991 middle-age and older U.S. adults. Results revealed that positive affect was associated with less memory decline across 9 years when analyses controlled for age, gender, education, depression, negative affect, and extraversion. Findings generalized across another measure that assessed additional facets of positive affect, across different (but not all) facets of positive affect and memory, and across age, gender, and education; findings did not emerge for negative affect. Reverse longitudinal associations between memory and positive affect were not significant. Possible pathways linking positive affect and memory functioning are discussed.
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Envelhecimento , Extroversão Psicológica , Adulto , Idoso , Escolaridade , Humanos , Estudos Longitudinais , Transtornos da Memória , Pessoa de Meia-IdadeRESUMO
The effect of caffeine on sleep has been well documented. However, most studies examined this relationship in laboratories or used a cross-sectional design analysing between-person differences. This study investigated the within-person relationship between caffeine intake and sleep duration at home. In a national database, 377 participants (aged 35-85 years) completed a 7-day diary study. Sleep duration was measured by Actigraphy and caffeine intake was self-reported in sleep logs. Three analytic strategies were used. The average sleep duration and the average caffeine intake were not significantly correlated. Multilevel regressions using daytime caffeine intake to predict night-time sleep, and using night-time sleep to predict next day caffeine intake, also did not detect any significant effect. Then dynamical systems analysis was performed, where the daily change rate and change tendency of caffeine and sleep were estimated, and the relationship among these momentums was examined. Results revealed a significant effect of sleep duration on the change tendency of caffeine use: a shorter sleep duration predicted a stronger tendency to consume caffeine, and this phenomenon was only found in middle-aged adults (aged 35-55 years) not in older adults (aged 55+). This study did not detect any effect of daily caffeine intake on sleep duration, implying that habitual use of caffeine in real life may not coincide with laboratory findings, and that using caffeine to compensate for sleep loss is the habit of middle-aged adults, not the elderly. The advantage of using a dynamic approach to analyse interrelated processes with uncertain time lags is also highlighted.
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Actigrafia/métodos , Cafeína/efeitos adversos , Distúrbios do Início e da Manutenção do Sono/etiologia , Sono/efeitos dos fármacos , Adulto , Idoso , Idoso de 80 Anos ou mais , Cafeína/farmacologia , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Autorrelato , Fatores de TempoRESUMO
BACKGROUND: The multiple-indicator, multiple-cause model (MIMIC) incorporates covariates of interest in the factor analysis. It is a special case of structural equation modeling (SEM), which is modeled under latent variable framework. The MIMIC model provides rigorous results and becomes broadly available in multiple statistical software. The current study introduces the MIMIC model and how it can be implemented using statistical software packages SAS CALIS procedure, R lavaan package, and Mplus version 8.0. METHODS: In this paper, we first discussed the formulation of the MIMIC model with regard to model specification and identification. We then demonstrated the empirical application of the MIMIC model with the Midlife in the United States II (MIDUS II) Study (N = 4109) using SAS CALIS procedure, R lavaan package and Mplus version 8.0 to examine gender disparities in cognitive functioning. The input, output, and diagram syntaxes of the three statistical software packages were also presented. RESULTS: In terms of data structure, all three statistical programs can be conducted using both raw data and empirical covariance matrix. SAS and R are comprehensive statistical analytic packages and encompass numerous data manipulation capacities. Mplus is designed primarily for latent variable modeling and has far more modeling flexibility compared to SAS and R, but limited in data manipulation. Differences in model results from the three statistical programs are trivial. Overall, the results show that while men show better performance in executive function than women, women demonstrate better episodic memory than men. CONCLUSIONS: Our study demonstrates the utility of the MIMIC model in its empirical application, fitted with three popular statistical software packages. Results from our models align with empirical findings from previous research. We provide coding procedures and examples with detailed explanations in the hopes of providing a concise tutorial for researchers and methodologists interested in incorporating latent constructs with multiple indicators and multiple covariates in their research projects. Future researchers are encouraged to adopt this flexible and rigorous modeling approach.
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Modelos Estatísticos , Software , Adulto , Cognição , Análise Fatorial , Feminino , Humanos , Masculino , Estados UnidosRESUMO
PURPOSE: Little is known about the work environmental risk factors for opioid use disorder (OUD) in working populations. The purpose of this study is to examine whether adverse physical and psychosocial working conditions are associated with OUD in a working population of the United States (US). METHODS: Among the participants of the National Survey of Midlife Development in the United States (MIDUS) II Study (2004-2006), 2134 workers (1059 men and 1075 women; mean age, 51 years) were chosen for this study. OUD was measured with self-administered questions in line with the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSD-5). Physical demands (physical efforts, heavy lifting, and crouching/stooping/kneeling) and psychosocial work stressors (skill discretion, decision authority, job control, psychological job demands, supervisor and coworker support at work, job insecurity, and work hours) were measured with a standard questionnaire. RESULTS: The prevalence of OUD was 3.8%. In multivariate analyses, low skill discretion, high psychological job demands, job strain (a combination of low control and high demands), and high physical job demands were significantly associated with OUD. The multivariate prevalence ratios for OUD by job strain and frequent heavy lifting were 1.98 (1.27-3.10) and 2.23 (1.22-4.10), respectively. Job strain was more strongly associated with OUD in men, while high physical job demands were more strongly associated with OUD in women. CONCLUSION: This study implies that adverse physical and psychosocial working conditions may be important risk factors for OUD in US working populations. Future longitudinal and mechanistic studies are urgently warranted.
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Estresse Ocupacional/psicologia , Transtornos Relacionados ao Uso de Opioides/epidemiologia , Carga de Trabalho , Adulto , Estudos Transversais , Feminino , Humanos , Remoção , Masculino , Pessoa de Meia-Idade , Esforço Físico/fisiologia , Autonomia Profissional , Fatores de Risco , Apoio Social , Estados Unidos/epidemiologia , Local de Trabalho/psicologiaRESUMO
This study explores the potential to consolidate a broad range of activity items to create more manageable measures that could be used in statistical modeling of multi-activity engagement. We utilized three datasets in the United States: Panel Study of Income Dynamics, Health and Retirement Study, and Midlife in the United States. After identifying activity items, exploratory and confirmatory factor analysis were used to empirically explore composite activity measures. Findings suggest that discrete activity items can be consolidated into activity domains; however, activity domains differ across datasets depending on availability of activity items. Implications for research and practice are further discussed.
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Análise de Dados , Exercício Físico , Atividades de Lazer , Humanos , Renda , Pessoa de Meia-Idade , Modelos Estatísticos , Aposentadoria , Inquéritos e Questionários , Estados UnidosRESUMO
BACKGROUND: Psychological correlates of blood lipid levels have been previously evaluated mostly in cross sectional studies. However, prospectively measured psychological factors might also predict favorable blood lipid profiles, thereby indicating a healthy mind/body interplay that is associated with less disease, better health and longer lives. METHODS: This paper examined whether longitudinal profiles of psychological well-being over 9-10 years are predictors of blood lipid profiles. Using the MIDUS (Midlife in the U.S.) biological subsample (n = 1054, aged 34 to 84, 55% female), cross-time trajectories of well-being were linked with three lipid outcomes (i.e., HDL cholesterol, triglycerides, and LDL cholesterol), measured for the first time at the 2nd wave of the study. RESULTS: Most adults showed largely stable profiles of well-being, albeit at different levels. Some showed persistently high well-being over time, while others revealed persistently low or moderate well-being. After adjusting for the effect of demographics, health behaviors, medications, and insulin resistance, adults with persistently high levels of environmental mastery and self-acceptance-two components of psychological well-being-had significantly higher levels of HDL as well as significantly lower levels of triglycerides compared to adults with persistently low levels of well-being. Converging with prior findings, no association was found between well-being and LDL cholesterol. CONCLUSIONS: Over 9-10 years, persistently high levels of psychological well-being measures predicted high HDL cholesterol and low triglycerides. These findings add longitudinal evidence to the growing body of research showing that positive psychological factors are linked with better lipoprotein profiles. A better blood lipid profile, particularly higher HDL-C, may be key in mediating how psychological well-being positively impacts health and length of life. Additional research is required to further validate this hypothesis as well as to establish potential underlying mechanisms.
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HDL-Colesterol/sangue , LDL-Colesterol/sangue , Qualidade de Vida/psicologia , Resiliência Psicológica , Triglicerídeos/sangue , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Feminino , Humanos , Resistência à Insulina , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Fatores de Risco , AutoimagemRESUMO
PURPOSE: To investigate whether chronic psychosocial work stressors (low job control, high job demands, job strain, low supervisor and coworker support, job insecurity, and long work hours) are longitudinally associated with suicidal ideation in a working population. METHODS: Five-hundred seventy-eight workers (aged 34-69) were chosen for this analysis from those who participated in both project 1 (2004-2006 at baseline) and project 4 (2004-2009 at follow-up) of the Midlife Development in the United States II study. The median time interval between the two projects was 26 months (range 2-62 months). RESULTS: About 11% of the workers reported suicidal ideation at follow-up, while 3% of them reported moderate/severe suicidal ideation at follow-up. After controlling for age, marital status, race, family history of suicide, and suicidal ideation at baseline, low skill discretion and job strain (a combination of low job control and high job demands) were associated with total suicidal ideation. After excluding those with suicidal ideation at baseline from analysis and further controlling for other work stressors, job strain was strongly associated with moderate/severe suicidal ideation: ORs, 4.29 (1.30-14.15) for quartile-based job strain and 3.77 (1.21-11.70) for median-based job strain. Long work hours (> 40 h/week vs. ≤ 40 h/week) also increased the likelihood for moderate/severe suicidal ideation: OR 4.06 (1.08-15.19). CONCLUSIONS: Job strain and long work hours were longitudinally associated with moderate/severe suicidal ideation. Increasing job control and ensuring optimal level of work demands, including 40 h or less of work per week may be an important strategy for the prevention of suicide in working populations.
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Estresse Ocupacional/psicologia , Ideação Suicida , Tolerância ao Trabalho Programado/psicologia , Trabalho/psicologia , Adulto , Idoso , Feminino , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Fatores de Tempo , Estados UnidosRESUMO
Some studies document racial disparities in self-reported health associated with alcohol use and abuse. However, few studies examined biomarkers that underlie the onset of alcohol-related chronic diseases. We investigated whether the association between alcohol abuse and five biomarkers of inflammation (CRP, IL-6, fibrinogen, E-selectin, sICAM-1) vary between Black and White Americans aged 35 to 84 (n = 1173) from the Midlife in the United States Biomarker Study. Multivariable Ordinary Least Squares regressions were used to assess Black-White differences in the association between alcohol abuse and the biomarkers. Race moderated the association between alcohol abuse and CRP (b = 0.56, SE = 0.28, p = 0.048), IL-6 (b = 0.65, SE = 0.22, p = 0.004), and a composite inflammation score (b = 0.014, SE = 0.07, p = 0.041). These findings potentially shed light for why alcohol has a stronger negative association with poorer health for Blacks compared to Whites. Analysis should be replicated in larger prospective cohorts.
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Alcoolismo/sangue , Proteína C-Reativa/metabolismo , Selectina E/sangue , Fibrinogênio/metabolismo , Inflamação/sangue , Molécula 1 de Adesão Intercelular/sangue , Interleucina-6/sangue , Adulto , Negro ou Afro-Americano , Idoso , Idoso de 80 Anos ou mais , Alcoolismo/complicações , Biomarcadores/sangue , Biomarcadores/metabolismo , Feminino , Humanos , Inflamação/induzido quimicamente , Inflamação/complicações , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Autorrelato , Estados Unidos , População BrancaRESUMO
OBJECTIVE: Personality traits are characterized by both stability and change across the life span. Many of the mechanisms hypothesized to cause personality change (e.g., the timing of various social roles, physical health, and cultural values) differ considerably across culture. Moreover, personality consistency is valued highly in Western societies, but less so in non-Western societies. Few studies have examined how personality changes differently across cultures. METHOD: We employed a multilevel modeling approach to examine age-related changes in Big Five personality traits in two large panel studies of Americans (n = 6,259; Mage = 46.85; 52.5% female) and Japanese (n = 1,021; Mage = 54.28; 50.9% female). Participants filled out personality measures twice, over either a 9-year interval (for Americans) or a 4-year period (for Japanese). RESULTS: Changes in Agreeableness and Openness to Experience did not systematically vary across cultures; changes in Extraversion, Neuroticism, and Conscientiousness did vary across cultures. Further, Japanese show significantly greater fluctuation in the level of all the traits tested over time than Americans. CONCLUSIONS: The culture-specific social, ecological, and life-course factors that are associated with personality change are discussed.
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Envelhecimento/psicologia , Personalidade/fisiologia , Adulto , Idoso , Comparação Transcultural , Feminino , Humanos , Japão , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Inventário de Personalidade , Meio Social , Estados Unidos , Adulto JovemRESUMO
OBJECTIVES: Health outcomes, including chronic disease and mortality, attributed to or associated with alcohol abuse are discrepant between African Americans and Whites. To date, the topic is not fully understood and few studies conducted have used biomarker indicators of health. We investigated whether the association between alcohol abuse and biomarkers of the neuroendocrine system vary between black or African American and White respondents aged 34-84 from the Midlife in the United States Study (MIDUS) II (2004-2006) (n=1129). Alcohol abuse was assessed with a modified version of the Michigan Alcohol Screening Test. Ordinary least squared (OLS) regression was used to evaluate whether race moderated the associations between alcohol abuse and four biomarkers-urinary cortisol and serum dehydroepiandrosterone sulfate (DHEA-S), epinephrine and norepinephrine-and two composite summary scores, each consisting of two components that characterize the hypothalamic pituitary adrenal (HPA)-axis and sympathetic nervous systems (SNS), respectively. Covariates included age, sex, education, income, current drinking, smoking, exercise, fast food consumption, heart disease, blood pressure, diabetes, body mass index, medication use, anxiety/depression, sleep duration, and cholesterol markers. Race significantly moderated the associations between alcohol abuse and norepinephrine concentration (χ2 [1]=4.48, p=0.034) and the SNS composite score (χ2 [1]=5.83, p=0.016). Alcohol abuse was associated with higher mean norepinephrine levels (b=0.26, standard error (SE)=0.12, p=0.034) and SNS composite score (b=0.23, SE=0.11, p=0.016) for African Americans compared to Whites. Interestingly, for Whites a paradoxical association between alcohol abuse, norepinephrine and SNS levels was observed; those who abused alcohol had lower mean norepinephrine levels than non-abusers. Race differences in neuroendocrine response could be biological pathways that contribute the excess risk of chronic disease and mortality attributed to alcohol abuse among African Americans compared to Whites. Replication of these analyses in larger cohorts are warranted in addition to further studies of underlying mechanisms among Blacks and Whites separately.
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Alcoolismo/etnologia , Alcoolismo/fisiopatologia , Sistema Hipotálamo-Hipofisário/fisiopatologia , Sistema Hipófise-Suprarrenal/fisiopatologia , Sistema Nervoso Simpático/fisiopatologia , Adulto , Negro ou Afro-Americano/etnologia , Idoso , Idoso de 80 Anos ou mais , Alcoolismo/sangue , Biomarcadores/sangue , Epinefrina/sangue , Feminino , Humanos , Hidrocortisona/sangue , Masculino , Pessoa de Meia-Idade , Norepinefrina/sangue , Estados Unidos , População BrancaRESUMO
PURPOSE: The experiences, skills, and internal resources that informal caregivers bring into their role may play a critical part in their mental health and well-being. This study examined how caregiver internal resources changed over a 10 year period, and how this was related to caregivers' well-being. METHODS: Data are from the Midlife in the United States (MIDUS) study, a national sample of adults, at two time points: 1995-1996 (T1) and 2004-2006 (T2). We identified subjects who reported being a caregiver at T2 and starting care after T1 (mean age = 56; 65% female). We examined internal resources: sense of control (personal mastery); primary and secondary control strategies (persistence in goal striving, positive reappraisal, and lowering expectations); and social support seeking, and psychological and subjective well-being. We evaluated how internal resources changed over time, and how these trajectories were associated with well-being at T2 using multivariable linear regressions. RESULTS: Most caregivers had stable levels of internal resources (between 4 and 13% showed an increase or decrease). Caregivers with increasing or high-stable levels of personal mastery had significantly better well-being scores on 6 out of 8 subscales compared with low-stable levels [effect sizes (ES) between 0.39 and 0.79]. Increasing persistence was associated with better personal growth and environmental mastery (ES = 0.96 and 0.91), and increasing and high-stable positive reappraisals were associated with better affect (ES = 0.63 and 0.48) compared with low-stable levels. Lowering aspirations and support seeking were not associated with well-being outcomes. CONCLUSIONS: Practices or interventions that support or improve internal resources could potentially improve caregiver well-being.
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Cuidadores/psicologia , Recursos em Saúde/normas , Qualidade de Vida/psicologia , Apoio Social , Feminino , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
This study investigated the relationship between childhood misfortune and 10-year change in health and whether this relationship was mediated by the quality of social relations. We used data from the Midlife in the United States (MIDUS) national longitudinal study, 1995-1996 (Time 1) and 2005-2006 (Time 2). Childhood misfortune was measured at Time 1 using indicators of financial strain, family structure, and abuse. Self-rated physical and mental health indicators were obtained at both occasions. The measure of quality of social relations was based on items relative to social support and social strain from spouse, friends, and family at Time 1. Mediational models showed that a higher level of childhood misfortune was associated with low-quality family relations which in turn tend to account for change in mental health. These findings suggest that childhood misfortune is associated with the quality of social relations, which in turn explain individual changes in mental health in adulthood.