Development and validation of a scale to assess the belief that 'age causes illness'.

OBJECTIVES: Self-directed ageism is the application of stereotypic age-related beliefs to oneself, and is known to negatively impact health-related motivation (Levy, 2003;  2022). This study focused on the specific self-directed stereotype that 'age causes illness' and aimed to develop and test a multi-item measure to assess this implicit, limiting belief. METHODS AND MEASURES: Survey data was collected from N = 347 adults in southeastern Idaho (ages 45-65 years old, 60% female). A variety of measures were used to assess the discriminant, convergent and predictive validity of the Age Causes Illness scale including: socio-demographics (age, sex, education), psychosocial resources (personality, optimism, social support, depressive symptoms), health/aging expectations, and indicators of physical health. RESULTS: The seven-item Age Causes Illness scale is reliable and shows an expected pattern of discriminant and convergent correlations with relevant socio-demographic, psychosocial, and aging-related measures. The belief that 'age causes illness,' as assessed with this new scale, is related to both objective and subjective indicators of physical health. CONCLUSIONS: The Age Causes Illness scale is a brief screening tool, potentially applicable in behavioral health settings as an initial step toward discussion of the implicit, and often unchallenged, belief that age alone determines the onset, progression, and offset of illness.

Conspiracy beliefs and the impact on health behaviors.

Health-related conspiracy beliefs are widespread, cover a variety of health topics, and can impact behavior. As such, understanding exactly how these beliefs impact health behavior is an important step in developing interventions to increase preventative health behaviors and individuals' overall health and well-being. This review assesses two different widely endorsed health-related conspiracy beliefs using two key health models, the Theory of Planned Behavior (TPB; Ajzen, 1985) and the Health Belief Model (HBM; Rosenstock et al., 1988, https://doi.org/10.1177/109019818801500203), in order to determine how these beliefs may impact health behavior and possible avenues for intervention. Attitudes and subjective norms from the TPB, along with perceived severity, barriers, and benefits from the HBM, were the most salient to conspiracy beliefs. Future research should consider a mixed model approach that utilizes components from both theories in intervention planning and assessment.

A Comparison of Juror Decision Making in Race-Based and Sexual Orientation-Based Hate Crime Cases.

Several constructs have been identified as relevant to the juror decision-making process in hate crime cases. However, there is a lack of research on the relationships between these constructs and their variable influence across victim group. The purpose of the current study was to reexamine factors relevant to the juror decision-making process in hate crime cases within a structural model, and across victim group, to gauge the relative strength and explanatory power of various predictors. In the current study, 313 participants sentenced a perpetrator found guilty of a hate crime committed against either a Black man or a gay man; participants also responded to individual difference measures relevant to mock juror hate crime decision making, including prejudice toward the victim's social group. Using path analysis, we explored the role of juror prejudice on sentencing decisions in hate crime cases as well as similarities and differences based on the victimized group. Results indicated that, when the victim was a Black man, modern racism influenced sentencing both directly and indirectly through perpetrator blame attributions, explaining 18% of the variance in sentencing. In contrast, when the victim was a gay man, modern homophobia did not directly predict sentencing, and the overall model explained only 4% of the variance in sentencing, suggesting variables beyond juror prejudice may be better suited to explain juror decision making in sexual orientation-based hate crimes. The current study suggests that the role of juror prejudice in hate crime cases varies as a function of the victimized group and raises questions about the importance of juror prejudice in the sentencing of hate crime cases, particularly antigay prejudice. The importance of blame attributions, social dominance orientation, and juror beliefs regarding penalty enhancements for hate crime cases, as well as policy implications, are also addressed.

A longitudinal study of the negative impact of falls on health, well-being, and survival in later life: the protective role of perceived control.

Objectives: Falls can have detrimental effects on older adults' psychological well-being, physical health, and survival rates. However, certain psychosocial mediators may lessen the negative impact of suffering a fall on health and well-being. Perceived control is a psychosocial factor that was examined as a mediator of the falls - health and well-being relationship in the current study.Method: Participants were 232 community-dwelling older adults, age 68 or older who took part in a longitudinal study in 2008 and 2010 and completed measures of perceived control, self-rated health, health-care utilization, number of falls, depressive symptomology, and perceived stress. Survival was also tracked for seven years from 2008 through 2015.Results: Older adults who suffered a fall had poorer health and well-being two years later compared to those who did not suffer a fall. Perceived control mediated the negative impact of falls on subsequent health and well-being outcomes two years later. Among older adults who experienced a fall, higher levels of perceived control predicted better subsequent health and well-being. Suffering one or more falls also predicted less likelihood of survival seven years later, beyond the effects of age, gender, marital status, and education.Conclusion: Findings highlight the importance of assessing risk of falling and levels of perceived control in later life.

Primary and secondary control strategies and psychological well-being among familial caregivers of older adults with dementia.

Caring for an older family member with dementia can be extremely challenging, often resulting in diminished psychological well-being. A wide range of both internally and externally directed behavioral strategies may serve to protect well-being among caregivers. Specifically, primary control strategies involve direct attempts to change one's current situation, while secondary control strategies are attempts to inwardly adjust cognitions to align with the current situation. This study examined the use of multiple primary and secondary control strategies among familial caregivers (n = 110), as well as their associations with several indices of psychological well-being. Results showed that the most common primary and secondary control strategies, namely task persistence and positive reappraisal, were used with approximately equal frequency. Furthermore, the specific strategy of positive reappraisal seemed to bolster psychological well-being among caregivers. Findings indicate that primary control strategies might be less effective than secondary control strategies within the context of caregiving for a person with dementia.

Examining Positivity Effect and Working Memory in Young-Old and Very Old Adults Using EEG-Derived Cognitive State Metrics.

The positivity effect among older adults is a tendency to process more positive and/or less negative emotional stimuli compared to younger adults, with unknown upper age boundaries. Cognitive and emotional working memory were assessed in young-old adults (60-75) and very old adults (VOAs; 80+) to determine whether emotional working memory declines similar to the age-related decline of cognitive working memory. The moderating role of valence on the link between age and emotional working memory was examined to identify change in positivity effect with advanced age. Electroencephalography (EEG) markers of cognitive workload and engagement were obtained to test the theory of cognitive resource allocation in older adults' emotional stimuli processing. EEG recordings were collected during cognitive memory task and emotional working memory tasks that required rating emotional intensity of images pairs. Results indicate a positivity effect among VOAs that does not require additional cognitive effort and is not likely to diminish with age.

A healthy dose of realism: The role of optimistic and pessimistic expectations when facing a downward spiral in health.

RATIONALE AND OBJECTIVES: Whether expectations about future health are adaptive or maladaptive in late life likely depends on the extent to which they conform to or defy a future reality of declining health. Our premise was that, when adults face a downward spiral in health, it can be adaptive to realistically expect poorer future health and maladaptive to unrealistically expect good health. METHOD: This 18-year-long study of community-dwelling older Canadians (n = 132, 72-98 years) involved a baseline interview to identify those who anticipated heath would decline (pessimistic expectation) or improve/remain stable (optimistic expectation). We determined initial (baseline) health status by assessing the severity of chronic conditions. An objective within-person measure of actual health change was derived by documenting hospital admissions (HAs) over time to capture a continuum that ranged from no declines (HAs remained stable) to greater declines in health (increasing numbers of HAs). Our a priori hypotheses examined the effects of health expectations (pessimistic, optimistic) and actual health change on the outcomes of depressive symptoms and mortality. RESULTS: Support was found for our premise that it is adaptive to be realistic when forecasting future health, at least at low levels of initial chronic condition severity. Regression analyses showed that realistically pessimistic (vs. unrealistically optimistic) expectations predicted significantly fewer depressive symptoms and a lower risk of death. The results also supported our premise that it is maladaptive to be unrealistically optimistic when health subsequently declines in reality: The risk of death was 313% higher for those with optimistic expectations that were unrealistic (vs. realistic). CONCLUSION: These findings provide insights for health care professionals regarding the messages they communicate to their patients. Together, they imply that, when good health is slipping away, it seems optimal to encourage a healthy dose of realism.

Comparative optimism in older adults' future health expectations.

OBJECTIVES: Despite a common belief that health declines with age, many older adults remain optimistic about their future health. However, the longitudinal impact of personal and comparatively optimistic future health estimates (FHEs) is unclear. METHOD: Among 408 older adults (Mage  = 70.32 years), this study identified the prevalence, source, and two-year stability of comparatively optimistic FHEs; examined demographic, psychosocial, and health correlates of comparative FHEs; and assessed the role of comparative FHEs in predicting eight-year survival odds. RESULTS: Nearly half of participants were comparatively optimistic due to interpersonal pessimism more so than personal optimism. Regarding stability, comparative optimism declined over the two-year period. Being younger and having more perceived control, dispositional optimism, and recent positive emotions were associated with better FHEs for oneself and a similar other. Beyond effects of age, gender, relationship status, and dispositional optimism, optimistic personal FHEs predicted eight-year survival odds. CONCLUSIONS: Findings have implications for predicting survival and advancing the conceptual understanding of comparative FHEs. Statement of contribution What is already known on the subject? Previous research has demonstrated that older adults tend to believe diminished health accompanies increasing age. Despite this notion, older adults remain comparatively optimistic about their health. What does this study add? The longitudinal results of the current study indicated that nearly half of participants were categorized as comparative optimists, primarily due to interpersonal pessimism. The current study demonstrated that there is little distinction between personal FHEs and those for a similar other in terms of demographic, psychosocial, and health correlates. The current study identified factors that predicted eight-year survival among older adults, such as being female, younger, in a committed relationship, and better personal FHEs.

Concurrently examining unrealistic absolute and comparative optimism: Temporal shifts, individual-difference and event-specific correlates, and behavioural outcomes.

Researchers have spent considerable effort examining unrealistic absolute optimism and unrealistic comparative optimism, yet there is a lack of research exploring them concurrently. This longitudinal study repeatedly assessed unrealistic absolute and comparative optimism within a performance context over several months to identify the degree to which they shift as a function of proximity to performance and performance feedback, their associations with global individual difference and event-specific factors, and their link to subsequent behavioural outcomes. Results showed similar shifts in unrealistic absolute and comparative optimism based on proximity to performance and performance feedback. Moreover, increases in both types of unrealistic optimism were associated with better subsequent performance beyond the effect of prior performance. However, several differences were found between the two forms of unrealistic optimism in their associations with global individual difference factors and event-specific factors, highlighting the distinctiveness of the two constructs.

Health Risk Perceptions and Exercise in Older Adulthood: An Application of Protection Motivation Theory.

Protection Motivation Theory (PMT) was applied to explore the relationship between perceived risk of acute health crises and intent to exercise. Interviews of 351 community-living older adults assessed prior physical activity (PPA), all PMT components, and exercise intent. A multi-group structural equation model revealed gender differences in PMT predictors of exercise intent. PPA, age, self-efficacy, and response efficacy directly predicted men's intent. Women's PPA and age predicted PMT components of self-efficacy and response costs, which predicted intent. Findings have implications for devising interventions to enhance physical activity in later life by targeting different PMT components for older men and women.

Positive Thinking and Social Perceptions of a Male vs. Female Peer's Cancer Experience.

Positive thinking (PT; i.e., sustaining positive thoughts and suppressing negative thoughts to "fight" cancer) is often equated with direct control over one's cancer trajectory. It was determined whether PT exposure enhanced the effort, control, and responsibility attributions ascribed to a peer for his/her cancer trajectory, and whether those ascriptions varied as a function of the peer's or participant's gender. Within a hypothetical online blog, a peer described a personal experience with bone cancer. Undergraduate participants (N = 630) were randomly administered one of 12 experimental conditions that varied in terms of the peer's gender, PT exposure, and cancer outcome. MANCOVA results indicated that PT exposure enhanced the effort, control, and responsibility attributions assigned to the peer for an unsuccessful cancer outcome, regardless of the peer's or participant's gender. Moreover, the male peer was perceived as more accountable for still having cancer but the female peer received more "credit" for being cancer-free. The notion of PT may contribute to overestimating cancer patients' personal influence over their disease trajectory and social perceptions of successful or unsuccessful cancer outcomes vary as a function of the patient's gender.

A longitudinal examination of sleep quality and physical activity in older adults.

The relationship between sleep quality and physical activity is bidirectional, yet prior research on older adults has mainly focused on investigating whether increasing levels of physical activity leads to improvements in sleep quality. The current longitudinal study examined both directional relationships by assessing sleep quality and physical activity twice over a two-year period among 426 community-dwelling older adults (ages 61-100). A cross-lagged panel analysis that included age, gender, perceived stress, functional ability, and severity of chronic health conditions as covariates, revealed that better initial sleep quality predicted higher levels of later physical activity beyond the effects of prior physical activity; whereas initial physical activity did not predict later sleep quality after accounting for prior sleep quality. These findings highlight sleep quality as an important contributor to a physically active lifestyle among older adults.

Shifting positivity ratios: emotions and psychological health in later life.

OBJECTIVE: A positivity ratio of approximately three positive emotions to one negative emotion has been found to distinguish between flourishing and languishing (optimal vs. poor psychological health). The current study assessed 2-year shifts (2008, 2010) in positivity ratios among 295 older adults and considered whether such shifts were associated with concurrent changes in psychological health (perceived stress, depressive symptoms, and perceived control). METHOD: Based on participants' reported positive and negative emotions, we identified two positivity ratio groups who were characterized by ratios that did not change, either remaining persistently optimal (above 2.9) or persistently suboptimal, and two groups that depicted shifts in ratios that either became optimal or became suboptimal. RESULTS: Most participants (67%) remained in their initial group, but shifts between categories did occur in both directions. Ratio groups and time (2008 vs. 2010) were predictor variables in 4 × 2 generalized estimating equations that were computed for each psychological health measure. The hypothesized positivity ratio group × time interaction emerged for each psychological health measure. Ratio shifts that 'became optimal' were associated with a significant concurrent decrease in stress and an increase in perceived control; ratio shifts that 'became suboptimal' were associated with a significant increase in depression. CONCLUSION: Although older adults who began with a suboptimal positivity ratio were unlikely to experience a shift to an optimal ratio, findings are more encouraging for those who began with an optimal positivity ratio. The majority of these older adults retained optimal positivity ratios over time and appeared to flourish.

Downward social comparison and subjective well-being in late life: the moderating role of perceived control.

OBJECTIVE: Drawing from Heckhausen and Schulz's Motivational Theory of Life-span Development, this study examined perceived control as a moderator of the protective relationship between downward social comparison and subjective well-being among older adults. METHODS: Community-dwelling older adults (N = 97, 63% female, ages 79-97) were interviewed in their own homes at three time-points over a nine-year period. Interviews assessed older adults' perceived control over daily tasks, their use of downward social comparison in response to task restriction, and their subjective well-being. RESULTS: Regression analyses yielded a significant interaction between downward social comparison and perceived control for three subjective well-being outcomes: life satisfaction, perceived stress, and depressive symptoms. Follow-up analyses revealed that downward social comparison was associated with greater subjective well-being at low levels of perceived control; but was unrelated to subjective well-being at high levels of perceived control. CONCLUSION: These findings corroborate Heckhausen and Schulz's theorized goal-opportunity congruence premise and have implications for quality-of-life interventions to assist community-dwelling older adults.

Sense of control in late life: health and survival implications.

Believing that one can influence outcomes presumably fosters a psychological sense of control. So too, however, might adaptive ways of thinking known as secondary control (SC) processes that operate when outcomes are believed to be unattainable. Using a 5-year prospective design and a representative sample of adults (ages 79-98), folk beliefs (e.g., "negative experiences can be a blessing in disguise") were used to assess SC processes. The authors expected SC Folk Beliefs would predict Sense of Control (Hypothesis 1) which, in turn, would predict self-rated health, hospital admissions, and survival (Hypothesis 2). An indirect relationship was hypothesized: SC Folk Beliefs were expected to predict outcomes through the Sense of Control (Hypothesis 3). Support was found for all hypotheses providing insights into the antecedents and consequences of a sense of control and about how SC beliefs and a sense of control function in the context of health.

The role of positive thinking in social perceptions of cancer outcomes.

Pressure for 'positive thinking' (PT; i.e., focusing on positive thoughts/suppressing negative thoughts to 'fight' cancer) burdens cancer patients facing health deterioration. It was determined whether PT exposure enhanced effort, control and responsibility attributions assigned to an individual for his/her cancer trajectory. Within an online blog a hypothetical same-gender person describes a personal cancer experience. 482 participants were assigned to one of six experimental conditions in which we manipulated PT exposure (blogger learns about 'power of PT' but does not try it, blogger tries PT, control/no PT) and cancer outcome (successful/unsuccessful treatment). A 3 × 2 × 2 multivariate analysis of covariance (with personal cancer experience covariates) tested PT exposure × cancer outcome × gender effects on attributions for the blogger's cancer outcome. Results indicate that PT exposure enhanced effort and responsibility attributions assigned to individuals for their cancer outcomes and that responsibility attributions differed as a function of gender. Findings suggest that exposure to the idea of PT may lead to cancer patients being perceived as culpable if they do not recover from the disease.

A five-year study of older adults' health incongruence: consistency, functional changes and subsequent survival.

In later life, optimistic health appraisals promote well-being and survival, whereas pessimistic appraisals can be harmful. This study contrasted subjective health (SH) appraisals with objective health (OH) to identify realists, whose ratings were congruent (SH = OH), distinguishing them from health pessimists (SH < OH) and health optimists (SH > OH) with incongruent ratings. Health congruence and functional well-being of 757 older adults were assessed via two interviews conducted 5 years apart. We examined consistency in health congruence, and among those with persistent OH, we examined 5-year functional well-being changes that corresponded with SH shifts and determined whether SH shifts predicted 30-month survival. Most realists remained realists; health optimists and pessimists tended to become realists. Increased health optimism corresponded with enhanced functioning; increased pessimism corresponded with decreased functioning. Among realists, increasingly positive SH predicted survival. Findings have implications for quality and length of life among older adults with chronic health conditions.

Later life health optimism, pessimism and realism: psychosocial contributors and health correlates.

Prior research has established positive outcomes of health optimism (appraising one's health as good despite poor objective health (OH)) and negative outcomes of health pessimism (appraising health as poor despite good OH), yet little is known about their contributors. We examined the role of psychosocial factors (life event stress, depression, dispositional optimism, perceived social support) in health realism (appraising health in accordance with OH), optimism and pessimism among 489 older men and women. We then accounted for the psychosocial factors when examining multiple health correlates of health realism, optimism and pessimism. Controlling for age, gender and income, regression results indicate that depression and social support were associated with less health optimism, while dispositional optimism was associated with greater health optimism among those in poor OH. Dispositional optimism was associated with less health pessimism and life event stress was associated with greater pessimism among those in good OH. Beyond the effects of the psychosocial factors, structural equation model results indicate that health optimism was positively associated with healthy behaviours and perceived control over one's health; health pessimism was associated with poorer perceived health care management. Health optimism and pessimism have different psychosocial contributors and health correlates, validating the health congruence approach to later life well-being, health and survival.

Learning effects in the block design task: a stimulus parameter-based approach.

Learning effects were assessed for the block design (BD) task, on the basis of variation in 2 stimulus parameters: perceptual cohesiveness (PC) and set size uncertainty (U). Thirty-one nonclinical undergraduate students (19 female) each completed 3 designs for each of 4 varied sets of the stimulus parameters (high-PC/high-U, high-PC/low-U, low-PC/high-U, and low-PC/low-U), ordered randomly within a larger set of designs with mixed stimulus characteristics. Regression analyses revealed significant, although modest, learning effects in all conditions. Negative-logarithmic learning slopes (growth factors) were greatest for high-U/high-PC designs and smallest for low-U/low-PC designs. Comparison of these slopes with known Wechsler Adult Intelligence Scale (3rd ed.; D. Wechsler, 1997; and 4th ed.; D. Wechsler, 2008) BD subtest gain scores demonstrated that presenting novel test items matched on stimulus parameters in multiple administrations reduced learning effects compared with the repeated use of the same test items. The results suggest that repeated administration of novel test items of the BD subtest, matched for PC and U, would result in more accurate assessments of changes in examinees' abilities over time than would the use of the same items. Difficulties inherent in implementing this method are also discussed.

Perceived barriers to health care and health behaviours: implications for Native American elders' self-rated health.

Little is known about how Native American adults appraise their health in later life. Perceived barriers to health care and health behaviours were examined among 6813 Native elders to determine their unique associations with self-rated health (SRH). Hierarchical regression results showed inability to access needed medical care predicted poorer SRH. Statistically accounting for sociodemographics and barriers to care, health behaviours predicted SRH. The current findings suggest opportunities to improve Native elders' SRH particularly via exercise and good nutrition. In turn, enhanced SRH may lead to improved quality of life.