Characterising trauma-informed aged care: An appreciative inquiry approach.

OBJECTIVE: While Trauma-informed care (TIC) has the potential to improve the quality of aged and dementia care, the challenge remains in translating the principles of TIC into practice. This study aimed to characterise what trauma-informed aged care looks like in practice, by learning from an aged care service acknowledged as delivering trauma-informed aged care effectively. METHOD: We conducted an appreciative inquiry study within a residential aged care service catering for veterans and others with trauma histories. Observation of care behaviours, interviews with staff and residents, and organisational policy mapping were used to identify elements that maximised care safety and accessibility for trauma survivors. Data were analysed and triangulated using a framework analysis approach. RESULTS: The aged care provider embedded the principles of TIC into its staff training (i) to promote understanding of how trauma may affect experiences in care, and (ii) to adapt care when appropriate to promote safety. The service promoted a calm atmosphere where residents could make choices and felt safe. Uniforms and signage provided consistency, clarity, and transparency for residents. Staff behaviours demonstrated respect, fostered trust, and anticipated needs without unnecessarily imposing care. Staff consistently offered choices, used residents' names, sought permission before providing care, and offered reassurance. Staff reported high morale with a commitment to delivering high quality care, and feedback to management. Effective communication promoted information sharing and trust among staff. CONCLUSION: Trauma-informed practice was facilitated through organisational policy, a dignified environment, and thoughtful staff behaviour creating safety, choice, and control for residents.

Rethinking Social Relationships in Adulthood: The Differential Investment of Resources Model.

Empirical evidence about the development of social relationships across adulthood into late life continues to accumulate, but theoretical development has lagged behind. The Differential Investment of Resources (DIRe) model integrates these empirical advances. The model defines the investment of time and energy into social ties varying in terms of emotional closeness and kinship as the core mechanism explaining the formation and maintenance of social networks. Individual characteristics, acting as capacities, motivations, and skills, determine the amount, direction, and efficacy of the investment. The context (e.g., the living situation) affects the social opportunity structure, the amount of time and energy available, and individual characteristics. Finally, the model describes two feedback loops: (a) social capital affecting the individual's living situation and (b) different types of ties impacting individual characteristics via social exchanges, social influences, and social evaluations. The proposed model will provide a theoretical basis for future research and hypothesis testing.

Awareness of age-related change, future time perspective, and implications for goal adjustment in older adulthood.

OBJECTIVES: How people adjust their goals is central to adaptation across the lifespan. However, little is known about individual difference characteristics that predict how and why people use different self-regulatory strategies. The present study investigated associations of perceived age-related gains and losses, and their interaction, as predictors of goal adjustment in older adulthood. Furthermore, we examined whether future time perspective (FTP) mediated relationships between awareness of age-related change (AARC) and goal adjustment. METHOD: A community-based sample of 408 adults (aged 60-88 years) was recruited via an internet-based research platform. Participants completed questionnaire measures of AARC, FTP, goal disengagement, and goal re-engagement. A flexibility index reflecting tendencies toward use of both goal disengagement and goal re-engagement strategies was also analyzed. RESULTS: Although AARC-losses was associated with lower goal re-engagement and goal flexibility, this association was weaker among those with higher AARC-gains, indicating AARC-gains may be protective in the relationship between AARC-losses and goal adjustment. The association between AARC and goal adjustment was also shown to be mediated by FTP. Higher AARC-gains was associated with more expansive FTP, which was associated with lower goal disengagement and higher goal re-engagement. On the other hand, higher AARC-losses was associated with more restricted FTP, which was associated with higher goal disengagement and lower goal re-engagement. DISCUSSION: Results have implications for how we conceptualize the combined effects of age-related gains and losses on developmental outcomes relevant to adaptive aging. Furthermore, perceptions of future time with advancing age may be implicated in processes linking AARC with goal adjustment.

Older and more mindful? Age differences in mindfulness components and well-being.

OBJECTIVES: Empirical research on the processes through which mindfulness affects well-being is in its infancy. Furthermore, few studies have considered the positive effects of mindfulness on psychological functioning from a lifespan perspective. The present study aimed to examine the role of age in moderating associations of mindfulness components with well-being in the context of a proposed model of mindfulness. METHODS: A community-based sample of 623 participants aged between 18 and 86 years (M = 48.78, SD = 16.74) was recruited via an internet-based research platform. Participants completed questionnaire measures of mindful characteristics (i.e. present-moment attention, nonjudgment, interoception, acceptance, nonattachment, and decentering), flexible goal adjustment, and well-being. RESULTS: Parallel mediation analyses showed that both present-moment attention and nonjudgment provided significant pathways to (a) flexible goal adjustment through nonattachment and decentering; and (b) well-being through acceptance, nonattachment, and decentering. Furthermore, present-moment attention, nonjudgment, acceptance, nonattachment, and decentering were all positively associated with age. Conditional process analyses revealed that the direct relationships between (1) present-moment attention and well-being, (2) nonjudgment and well-being, and (3) decentering and flexible goal adjustment became stronger with age and were significant for adults from around 40 years of age and older. CONCLUSIONS: The findings suggest that the tendency to focus on the present-moment and adopt a nonjudgmental orientation may become especially important for well-being with advancing age, and the ability to appreciate the transitory nature of personal experiences may be particularly important for flexible employment of both goal disengagement and reengagement strategies across the second half of life.

The Increasing Importance of Friendship in Late Life: Understanding the Role of Sociohistorical Context in Social Development.

Historically, family ties have been understood as the primary source of support for aging adults, and past empirical and theoretical work has highlighted the tendency of older adults to focus on close family. However, in line with demographic changes and historical increases in the diversity of social structures, friendships are increasing in importance in recent generations of older adults. Given the powerful role of context in shaping these changes, this paper offers a conceptual analysis linking individual agency to sociohistorical context as a way to understand this increasing diversity of social ties. More specifically, we propose that the individual invests time and energy to form and maintain social ties, and that each individual has a specific social opportunity structure (all potential ties that are available to invest in, as well as the costs of those investments). Furthermore, this investment of time and energy is determined in part by individual differences in capacities and motivations. We argue that sociohistorical context influences this process in three important ways: (1) in its effect on the social opportunity structure; (2) in its direct effect on time and energy; and (3) in its effect on individuals' capacities and motivations. We believe that these mechanisms can account for the increasing diversity of social ties across adulthood, as well as the potential for future historical changes.

Perceived ease of activity (but not strategy use) mediates the relationship between self-efficacy and activity engagement in midlife and older adults.

Objectives: Activity participation is associated with a range of positive outcomes in older adults but tends to decline with age. Understanding protective factors is important to facilitate activity in later life. Social cognitive theory suggests that having high self-efficacy may promote activity because individuals with higher self-efficacy perceived their activities to be easier and use adaptive strategies to overcome barriers to activity. Despite considerable research linking self-efficacy and activity, limited research has examined the proposed mechanisms behind this association. This study therefore examined whether perceived ease of activity and use of adaptive strategies account for the association between self-efficacy and activity. Method: Participants were 412 adults aged 50-93 years who completed a cross-sectional survey. Structural equation modelling was used to examine whether the effects of self-efficacy on activity were mediated by perceived ease of activity and use of adaptive strategies. Results: Perceived ease of activity mediated the positive associations between self-efficacy and social (0.04 [0.02, 0.07]) and physical activity (0.16 [0.08, 0.25]), but not mental activity (0.01 [0.000, 0.03]). For physical activity, this effect was stronger for adults aged 70+ years than those aged 50-69 years (older a2*b2 - younger a2*b2 0.13 [0.04, 0.24]). Use of adaptive strategies was not a significant mediator in any model. Conclusion: This study suggests that self-efficacy may influence older adults' perception of activities and, in turn, the activities they choose to participate in. This has potential implications for the development of interventions aimed at promoting activity engagement in later life.

Is Occupational Complexity Associated with Cognitive Performance or Decline? Results from the Australian Longitudinal Study of Ageing.

BACKGROUND: Long-term protective associations proposed between previous complex occupational tasks and cognitive functioning in later life point to work roles contributing to cognitive reserve. OBJECTIVE: To examine occupational complexity involving data, people, and things in relation to the level of, and rate of change in, cognitive functioning. METHODS: Participants were 1,290 members of the Australian Longitudinal Study of Ageing and initially aged 65-102 years (mean = 79). Information about main lifetime occupation was collected retrospectively. Cognition was assessed 4 times over a 13-year interval. RESULTS: In multilevel models adjusted for demographics, medical conditions, and depressive symptoms, higher complexity involving data was associated with faster speed (ß = 0.73, p < 0.001), better memory (ß = 0.32, p < 0.05), and mental status (ß = 0.40, p < 0.001) at baseline. These associations remained statistically reliable after adjusting for complexity with people and things, sedentary and heavy physical work, retirement age, and leisure activity. Complexity with things was associated with slower speed (ß = -0.50, p < 0.001) and poorer mental status (ß = -0.26, p < 0.01) and was not explained by other variables. There were no associations of occupational complexity with rates of cognitive decline over time. CONCLUSION: Older individuals retired from occupations characterized by higher complexity with data maintain their cognitive advantage over those with lower complexity into older adulthood, although without additional moderation of this advantage in terms of less postretirement cognitive decline. Complexity of work with things confers a negative relation to cognition whilst also not affecting postretirement cognitive change. Although the relative contributions of occupation or other early life influences for cognition remain to be established, it nevertheless may be beneficial to promote workplace design strategies and interventions that incorporate complex activities, particularly tasks involving data.

There's More than Meets the Eye: Complex Associations of Daily Pain, Physical Symptoms, and Self-Efficacy with Activity in Middle and Older Adulthood.

BACKGROUND: Participation in activities is associated with a range of positive outcomes in adulthood. Research has shown that pain and physical symptoms are associated with less activity in older adults, whereas higher self-efficacy is associated with more activity. Such research tends to examine cross-sectional or long-term between-person change, limiting the opportunity to explore dynamic within-person processes that unfold over shorter time periods. OBJECTIVES: This study aimed to (1) replicate previous between-person associations of self-efficacy with engagement in activity and (2) examine whether daily variation in pain, physical symptoms, and self-efficacy corresponded with daily within-person variation in different types of activity. We predicted that participants would engage in less activity on days when they experienced more pain or physical symptoms than their average (a negative within-person association) and that participants would engage in more activity on days when self-efficacy was higher than average (a positive within-person association). METHODS: This study used an online diary study to assess self- reported daily pain, physical symptoms, self-efficacy, and engagement in activity among 185 adults aged 51-84 years for up to 7 days. Multilevel modelling was used to examine whether between-person (average) and daily within-person variability in pain, physical symptoms, and self-efficacy were associated with social, physical, and mental activity. RESULTS: In line with previous research, between-person self-efficacy was positively associated with social and physical activity. Supporting the hypotheses, within-person self-efficacy was also positively associated with social and physical activity. The results for pain and physical symptoms were less consistent. Between-person pain was positively associated with social activity. Age interactions indicated that within-person pain was negatively associated with social activity and positively associated with physical activity among older adults. Within-person physical symptoms were positively related to social and mental activity. CONCLUSION: Stable individual differences as well as short-term within-person variation in physical and psychological functioning are associated with day-to-day variation in activity. Between-person associations did not always reflect within-person associations (e.g., for pain). These complex associations may be influenced by a range of factors including the type of activity and how it is defined (e.g., specific activities and their difficulty), the type of physical symptoms experienced, and age.

Structural and functional social network attributes moderate the association of self-rated health with mental health in midlife and older adults.

BACKGROUND: Social relationships are multifaceted, and different social network components can operate via different processes to influence well-being. This study examined associations of social network structure and relationship quality (positive and negative social exchanges) with mental health in midlife and older adults. The focus was on both direct associations of network structure and relationship quality with mental health, and whether these social network attributes moderated the association of self-rated health (SRH) with mental health. METHODS: Analyses were based on survey data provided by 2001 (Mean age = 65, SD = 8.07) midlife and older adults. We used Latent Class Analysis (LCA) to classify participants into network types based on network structure (partner status, network size, contact frequency, and activity engagement), and used continuous measures of positive and negative social exchanges to operationalize relationship quality. Regression analysis was used to test moderation. RESULTS: LCA revealed network types generally consistent with those reported in previous studies. Participants in more diverse networks reported better mental health than those categorized into a restricted network type after adjustment for age, sex, education, and employment status. Analysis of moderation indicated that those with poorer SRH were less likely to report poorer mental health if they were classified into more diverse networks. A similar moderation effect was also evident for positive exchanges. CONCLUSIONS: The findings suggest that both quantity and quality of social relationships can play a role in buffering against the negative implications of physical health decline for mental health.

Daily Dynamics of Awareness of Aging and Basic Psychological Need Satisfaction and Frustration in Middle and Older Adulthood.

OBJECTIVES: This daily diary study examined associations between awareness of age-related change (AARC) and satisfaction/frustration of basic psychological needs of autonomy, competence, and relatedness in a sample of midlife and older adults. We expected that greater satisfaction and lower frustration of needs would be associated with higher AARC-gains and lower AARC-losses. We also examined whether within-person associations of need satisfaction/frustration with AARC were moderated by age. METHODS: Participants (N = 152; aged 53+) completed measures of AARC and basic psychological need satisfaction and frustration on their smartphones for 10 consecutive days. Data were analyzed using multilevel models, with time-varying basic need satisfaction/frustration variables disaggregated into between-person and within-person components. RESULTS: On days participants reported higher than usual overall satisfaction of needs, and lower than usual frustration of needs, AARC-gains was higher, and AARC-losses was lower. Analysis of individual needs showed that autonomy and competence were more consistently related to higher AARC-gains and lower AARC-losses than relatedness. Within-person autonomy satisfaction was more strongly (negatively) associated with AARC-losses at older ages. DISCUSSION: Findings suggest that daily experiences related to satisfaction and frustration of goals related to autonomy and competence in particular may be proximal antecedents of short-term variation in AARC.

Using experience sampling methodology (ESM) to improve our understanding of day-to-day intrusion frequency and related distress in survivors of trauma.

BACKGROUND AND OBJECTIVES: Cognitive models of posttraumatic stress disorder (PTSD) suggest that appraisals of traumatic sequelae and subsequent distress drive the development and maintenance of PTSD. Posttraumatic research has relied heavily on macro-longitudinal designs, with weeks or months between assessments of trauma-related cognitions and symptoms. The present study uses experience sampling methodology (ESM) better understand the day-to-day experiences of trauma exposed individuals. METHODS: One-hundred trauma exposed adults reported their posttraumatic symptoms, interpretations, and behaviours four times a day over a 10-day ESM period. RESULTS: As anticipated, within-person fluctuations in negative appraisals of intrusions and maladaptive coping strategies (e.g., thought suppression) were significantly positively associated with intrusion frequency and related distress. In all cases, the associations for negative appraisals and maladaptive coping were stronger with intrusion related distress than intrusion frequency. LIMITATIONS: The observed contemporaneous associations only demonstrate that variables reliably fluctuated together and cannot indicate causality. CONCLUSIONS: The findings demonstrate that day-to-day fluctuations in trauma related perceptions and sequelae are significant and should be explored alongside broader individual differences to advance our understanding of the development, maintenance, and treatment of PTSD.

Self-compassion, stressor exposure and negative affect: A daily diary study of older adults.

OBJECTIVES: Self-compassion has been identified as a psychological resource for ageing well. To date, self-compassion among older adults has typically been conceptualised as a trait variable. This study examined whether day-to-day (state) variability in sef-compassion was associated with negative affective reactivity to daily stressors. METHODS: Daily diary assessment methods were used to examine the potential moderating role of between- and within-person self-compassion on the relationship between daily stressors and negative affect. A community-based sample of 107 older adults aged 65+ completed questionnaires once daily over 14 days. RESULTS: Multilevel modelling revealed that 37% of the variance in self-compassion occurred within-persons. Daily self-compassion moderated the relationship between daily stressor exposure and daily negative affect. On days with greater stressor exposure than usual, older adults showed less negative affective reactivity on days when self-compassion was higher, compared with days when self-compassion was lower. No modertaing effects were observed for between-person (trait) self-compassion. DISCUSSION: These findings suggest that self-compassion in older adults should be conceptualised as both a state and trait variable and that state self-compassion may be protective in the stress-reactivity pathway. Future research should investigate whether brief self-compassion interventions might help older adults to avoid or down-regulate negative emotions in response to stressors.

Normative data and longitudinal invariance of the Life Engagement Test (LET) in a community sample of older adults.

PURPOSE: Interest in evaluating purpose in life as an important component of ageing well is growing; however, investigation into the appropriate measurement of this construct is required. The purpose of this paper was to examine the measurement properties of the Life Engagement Test (LET) and to provide normative data for a non-clinical sample of community-dwelling older adults. METHODS: A random sample of 545 adults, aged 55-94 years, completed the LET twice over a 12-month period as part of a larger survey on relocation in later life. RESULTS: Consistent with previous research, participants typically reported high levels of purpose in life. Scores were also observed to vary over the 12-month duration, with, on average, an increase in purpose in life at Time 2. However, tests of longitudinal invariance were inconclusive. CONCLUSIONS: Future research is needed to further examine the content validity of the LET, and its factorial invariance over longer measurement intervals, and across different populations including non-residential/aged care settings.

Can positive social exchanges buffer the detrimental effects of negative social exchanges? Age and gender differences.

BACKGROUND: Findings from existing research exploring whether positive social exchanges can help to offset (or 'buffer' against) the harmful effects of negative social exchanges on mental health have been inconsistent. This could be because the existing research is characterized by different approaches to studying various contexts of 'cross-domain' and 'within-domain' buffering, and/or because the nature of buffering effects varies according to sociodemographic characteristics that underlie different aspects of social network structure and function. OBJECTIVE: The purpose of this study was to examine whether the buffering effects of global perceptions of positive exchanges on the link between global negative exchanges and mental health varied as a function of age and gender. METHOD: We used a series of regressions in a sample of 556 Australian older adults (ages 55-94) to test for three-way interactions among gender, positive social exchanges, and negative social exchanges, as well as age and positive and negative social exchanges, in predicting mental health, controlling for years of education, partner status, and physical functioning. RESULTS: We found that positive exchanges buffered against negative exchanges for younger old adults, but not for older old adults, and for women, but not for men. CONCLUSIONS: Our findings are interpreted in light of research on individual differences in coping responses and interpersonal goals among late middle-aged and older adults. Our findings are in line with gerontological theories (e.g., socioemotional selectivity theory), and imply that an intervention aimed at using positive social exchanges as a means of coping with negative social exchanges might be more successful among particular populations (i.e., women, 'younger' old adults).

Does Awareness of Aging Matter? The Moderating Function of Awareness of Age-Related Change on the Relationships Between COVID-19 Disruption, Perceived Stress, and Affect.

OBJECTIVES: How people reflect on their own age may influence their well-being in the face of disruptions associated with the coronavirus (COVID-19). Subjective aging was operationalized in terms of one's awareness of age-related change (AARC), specifically, the gains and losses associated with aging. We developed a measure assessing disruptions to daily life associated with the COVID-19 pandemic across 3 dimensions (i.e., Social and Lifestyle Disruption, Work and Health Disruption, and Others Contracting COVID-19). We hypothesized that COVID-19 disruption would be positively associated with both AARC-losses and AARC-gains. Greater COVID-19 disruption would also be associated with poorer psychosocial outcomes (higher perceived stress and negative affect [NA] and lower positive affect [PA]) and these associations would be stronger for those reporting greater AARC-losses and weaker for those reporting greater AARC-gains. METHODS: Cross-sectional questionnaire data were collected from 263 participants from the United States (aged 40-83; mean age: 62.88 years, standard deviation = 9.00; 56.3% females). RESULTS: After controlling for age, gender, education, employment, socioeconomic status, and physical functioning, greater Work and Health Disruption was associated with greater AARC-losses. Greater Social and Lifestyle Disruption was associated with both greater AARC-gains and AARC-losses. Moderation effects showed an exacerbating effect of AARC-losses on NA in the face of Work and Health Disruption and a protective effect of AARC-gains on PA in the context of Social and Lifestyle Disruption. DISCUSSION: We extend research detailing antecedents of AARC and highlight the need for longitudinal research that considers the ever-changing nature of the pandemic.

Barriers to activity engagement in older adulthood: Results of a community survey.

OBJECTIVES: Losses that occur with age can create barriers to meaningful activity engagement, a crucial aspect of ageing well. Research on this topic is frequently qualitative, with few studies accessing large community samples. This study (a) assessed the frequency specific personal and environmental barriers (such as poor health and limited transport access), identified by older adults in previous research, were endorsed; (b) used latent class analysis (LCA) to identify population subgroups based on combinations of these barriers, and (c) examined associations of subgroups with purpose in life and quality of life. METHODS: Four hundred and thirty-two randomly selected Australian adults aged 65+ years (average age 76.7, 58% female) completed a telephone survey. They were asked whether certain barriers affected engagement and provided data on sense of purpose and quality of life. RESULTS: Physical health/mobility were the most frequently reported barriers, followed by sensory difficulties, financial limitations, and caring responsibilities. The LCA revealed up to three subgroups/classes of participants according to the barriers endorsed. Class 1 had low endorsement of all barriers, including physical health. The majority of Class 2 endorsed physical health barriers and other barriers more frequently than Class 1. Class 3 were comparable to Class 2, but also frequently endorsed community access barriers. Class 1 were younger and reported a greater sense of purpose and higher quality of life. CONCLUSIONS: Physical health/mobility barriers to engagement are those most frequently endorsed by older adults. These barriers may increase vulnerability to, or exacerbate the impact of additional barriers, such as sensory difficulties, access to transport and lack of finances.

Bidirectional Associations of Awareness of Age-Related Change and Attitudes Toward Own Aging With Social Media Use.

OBJECTIVES: We test whether higher awareness of age-related gains (AARC-gains), lower awareness of age-related losses (AARC-losses), and more positive attitudes toward own aging (ATOA) are cross-sectionally related to more frequent social media use. We also investigate the strength and direction of the associations of AARC-gains, AARC-losses, and ATOA with social media use over 1 year, from before to after the onset of the coronavirus 2019 pandemic. METHODS: We used cross-sectional data from 8,320 individuals (mean age = 65.95 years; standard deviation = 7.01) and longitudinal data from a subsample of 4,454 individuals participating in the UK PROTECT study in 2019 and 2020. We used ordered regression models, linear regression models, and tests of interaction. Models were adjusted for age, sex, education, and employment. RESULTS: Higher AARC-gains and more positive ATOA, but not AARC-losses, were cross-sectionally associated with more frequent social media use. Social media use became more frequent at follow-up. In the longitudinal models controlling for baseline levels of the outcome variable, more frequent baseline social media use predicted increases in AARC-gains, whereas baseline AARC-gains did not significantly predict the frequency of social media use at follow-up. Baseline frequency of social media use did not significantly predict AARC-losses, nor ATOA at follow-up, whereas lower levels of AARC-losses and more positive ATOA predicted more frequent social media use at follow-up. DISCUSSION: Although effect sizes were small, decreasing negative views on aging may help increase the engagement of middle-aged and older people with social media. At the same time, fostering social media use could promote positive self-perceptions of aging.

Barriers and enablers for the implementation of trauma-informed care in healthcare settings: a systematic review.

BACKGROUND: Healthcare services can be re-traumatising for trauma survivors where they trigger memories of past distressing events and exert limits to a survivor's sense of autonomy, choice, and control. The benefits of receiving trauma-informed healthcare are well established; however, factors that promote or impede the implementation of trauma-informed care are not yet well characterised and understood. The aim of this review was to systematically identify and synthesise evidence regarding factors that promote or reduce the implementation of TIC in healthcare settings. METHODS: This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) 2.0 guidelines. Scopus, MEDLINE, Proquest, PsycINFO and grey literature were searched for original research or evaluations published between January 2000 and April 2021 reporting barriers and/or facilitating factors for the implementation of trauma-informed care in a healthcare setting. Two reviewers independently assessed the quality of each included study using the Mixed Methods Appraisal Tool (MMAT) Checklist. RESULTS: Twenty-seven studies were included, 22 of which were published in the USA. Implementation occurred in a range of health settings, predominantly mental health services. The barriers and facilitators of implementing trauma-informed care were categorised as follows: intervention characteristics (perceived relevance of trauma-informed care to the health setting and target population), influences external to the organisation (e.g. interagency collaboration or the actions of other agencies) and influences within the organisation in which implementation occurred (e.g. leadership engagement, financial and staffing resources and policy and procedure changes that promote flexibility in protocols). Other factors related to the implementation processes (e.g. flexible and accessible training, service user feedback and the collection and review of initiative outcomes) and finally the characteristics of individuals within the service or system such as a resistance to change. CONCLUSIONS: This review identifies key factors that should be targeted to promote trauma-informed care implementation. Continued research will be helpful for characterising what trauma-informed care looks like when it is delivered well, and providing validated frameworks to promote organisational uptake for the benefit of trauma survivors. REGISTRATION: The protocol for this review was registered on the PROSPERO database (CRD42021242891).

Awareness of Age-Related Gains and Losses and Their Associations With Psychological Well-Being: A Longitudinal Examination.

OBJECTIVES: How people experience their own aging is more strongly linked to well-being than chronological age. This study examined associations of awareness of age-related change (AARC) with between-person differences and longitudinal changes in psychological well-being (PWB). We expected that higher AARC gains would be associated with higher PWB and increases in PWB over time. Conversely, we expected higher AARC losses would be associated with lower PWB and a steeper decline in PWB over time. Furthermore, we tested the interaction of AARC gains and AARC losses to examine whether negative associations between AARC losses and PWB would be weaker among those reporting higher AARC gains. METHODS: Data were collected in 3 waves from a 12-month longitudinal study of 408 community-dwelling older adults (aged 60 and older). Multilevel growth models were used to analyze associations between AARC and a composite measure of PWB which included key components of PWB identified in self-determination theory (satisfaction and frustration of basic psychological needs), as well as vitality, and life engagement. RESULTS: At the between-person level, higher AARC gains and lower AARC losses was consistently associated with higher PWB. Furthermore, associations between AARC losses and lower PWB were weaker among those with higher AARC gains. There was no evidence to suggest the interplay of AARC gains and AARC losses had implications for change in PWB over time. DISCUSSION: Appreciation of age-related gains may buffer the impact of AARC losses on PWB. However, longitudinal studies conducted over varying macro- and micro-time scales are needed to better understand the developmental significance of AARC for later life.

Awareness of age-related gains and losses as moderators of daily stress reactivity in middle- and older-adulthood.

Objectives: Associations between awareness of one's own aging and wellbeing have received increasing attention in the field of gerontology over the last decade. The current study examines how between-person differences and within-person fluctuations of awareness of age-related change (AARC) relate to daily negative affect and vitality. Of key interest was the extent to which fluctuations in AARC moderated reactivity to stressor exposure. We predicted that higher positive perceptions of aging (AARC-gains) would buffer the relationship between daily stressors and negative affect/vitality. Conversely, we expected that higher negative perceptions (AARC-losses) may exacerbate the relationship between daily stressors and the outcome variables. Methods: Data were collected from a community-based sample of 152 Australian adults aged 53-86 (M = 69.18, SD = 5.73). For 10 consecutive days, participants completed surveys on their smartphones measuring daily stressors, AARC, and affect (positive and negative). Bayesian hierarchical linear models were used to examine whether AARC-gains and AARC-losses moderated within-person associations of daily stressors and affect (i.e., stress reactivity). Results: At the between-person level, higher AARC-gains was associated with lower negative affect and higher vitality, whereas those reporting higher AARC-losses scored higher on negative affect and lower on vitality. Within-person variables revealed that on days when AARC-gains was higher and AARC-losses was lower, this corresponded with lower negative affect and higher vitality. There was no evidence in support of individual moderating effects of within-person AARC-losses or within-person AARC-gains on stress reactivity. A trend was evident in support of a three-way WP Stress severity × WP AARC-gains × WP AARC-losses interaction in the prediction of negative affect, indicating that on days when AARC-losses was higher, the association of stress severity with negative affect was weaker if AARC-gains was higher. Follow-up analyses modeling quadratic stress severity revealed a trend suggesting an interaction of within-person stress severity and within-person AARC-losses. Discussion: Results indicate that both individual differences and short-term fluctuations in AARC are associated with daily negative affect and vitality. The results provided qualified support for a possible protective role of AARC-gains in the context of stress reactivity.