Postponing old age: Evidence for historical change toward a later perceived onset of old age.

"At what age would you describe someone as old?" Perceptions of when old age begins might be prone to upward shifts because of historical increases in life expectancy and in retirement age, as well as because of better psychosocial functioning in later life. We investigated historical changes in within-person trajectories of the perceived onset of old age using data from 14,056 participants who entered the German Ageing Survey at age 40-85 years and who completed up to eight assessments across 25 years. Using longitudinal multilevel regression models, we found that at age 64, the average perceived onset of old age is at about age 75 years. Longitudinally, this perceived onset age increased by about 1 year for every 4-5 years of actual aging. We also found evidence for historical change. Compared to the earliest-born cohorts, later-born cohorts reported a later perceived onset of old age, yet with decelerating trend among more recent birth cohorts. Within-person increases of the perceived onset of old age were steeper in later-born cohorts. The described cohort trends were only slightly reduced when controlling for covariates. Being younger, male, living in East Germany, feeling older, reporting more loneliness, more chronic diseases, and poorer self-rated health were each associated with a perceived earlier onset of old age. Our results suggest that there is a nonlinear historical trend toward a later perceived onset of old age, which might have meaningful implications for individuals' perspectives on aging and old age. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Loneliness in midlife: Historical increases and elevated levels in the United States compared with Europe.

Loneliness is gaining attention globally as a public health issue because elevated loneliness increases one's risk for depression, compromised immunity, chronic illness, and mortality. Our objective is to zoom into how loneliness has historically evolved through midlife and investigate whether elevations in loneliness are confined to the United States or are similarly transpiring across peer European nations. We use harmonized data on loneliness from nationally representative longitudinal panel surveys from the United States and 13 European nations to directly quantify similarities and differences in historical change of midlife loneliness trajectories. Compared with any other European nation/region, overall levels of loneliness in the United States are consistently higher by a magnitude of 0.3-0.8 SDs. Middle-aged adults in the United States, England, and Mediterranean Europe today report higher levels of loneliness than earlier born cohorts, whereas no historical changes (if not historically lower levels) were observed in Continental and Nordic Europe. Our discussion focuses on possible reasons for cross-national differences in midlife loneliness, including cultural factors, social and economic inequalities, and differences in social safety nets. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Change in body weight of older adults before and during the COVID-19 pandemic: longitudinal results from the Berlin Aging Study II.

OBJECTIVES: Change in body weight during the COVID-19 pandemic as an unintended side effect of lockdown measures has been predominantly reported for younger and middle-aged adults. However, information on older adults for which weight loss is known to result in adverse outcomes, is scarce. In this study we describe the body weight change in older adults before, during, and after the COVID-19 lockdown measures and explore putative associated factors with a focus on the period that includes the first six months of the COVID-19 containment measures. DESIGN: Prospective cohort study with three follow-up examinations over the course of 10 years. SETTING AND PARTICIPANTS: In this study, we analyzed the longitudinal weight change of 472 participants of the Berlin Aging Study II (mean age of 67.5 years at baseline). MEASUREMENTS: Body weight was assessed at four time points. Additionally, differences between subgroups characterized by socio-economic, cognitive, and psychosocial variables as well as morbidity burden, biological age markers (epigenetic clocks, telomere length), and frailty were compared. RESULTS: On average, women and men lost 0.87% (n = 227) and 0.5% (n = 245) of their body weight per year in the study period covering the first six months of the COVID-19 pandemic. Weight loss among men was particularly pronounced among groups characterized by change in physical activity due to COVID-19 lockdown, low positive affect, premature epigenetic age (7-CpG clock), diagnosed metabolic syndrome, and a more masculine gender score (all variables: p < 0.05, n = 245). CONCLUSION: During the COVID-19 pandemic, older participants lost weight with a 2.5-times (women) and 2-times (men) higher rate than what is expected in this age.

Stability and change of optimism and pessimism in late midlife and old age across three independent studies.

Research across a number of different areas in psychology has long shown that optimism and pessimism are predictive of a number of important future life outcomes. Despite a vast literature on the correlates and consequences, we know very little about how optimism and pessimism change across adulthood and old age and the sociodemographic factors that are associated with individual differences in such trajectories. In the present study, we conducted (parallel) analyses of standard items from the Life Orientation Test (Scheier & Carver, 1985) in three comprehensive data sets: Two-wave data from both the Berlin Aging Study II (N = 1,423, aged 60-88; M = 70.4, SD = 3.70) and the Midlife in the U.S. Study (N = 1,810 aged 60-84; M = 69.12, SD = 6.47) as well as cross-sectional data from the Survey of Health, Aging, and Retirement (N = 17,087, aged 60-99; M = 70.19, SD = 7.53). Using latent change-regression models and locally weighted smoothing curves revealed that optimism is on average very stable after age 60, with some evidence in Survey of Health, Aging, and Retirement of lowered optimism in very old age. Consistent across the three independent studies, pessimism evinced on average modest increases, ranging between .25 and .50 SD per 10 years of age. Of the sociodemographic factors examined, higher levels of education revealed the most consistent associations with lower pessimism, whereas gender evinced more study-specific findings. We take our results to demonstrate that age-related trajectories and correlates thereof differ for optimism and pessimism. Older adults appear to preserve into older ages those levels of optimistic expectations they have had at 60 years of age and show only modest increases in pessimism. We discuss possible reasons for these findings. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Let's Enjoy an Evening on the Couch? A Daily Life Investigation of Shared Problematic Behaviors in Three Couple Studies.

Symptom-system fit theory proposes that problematic behaviors are maintained by the social system (e.g., the couple relationship) in which they occur because they help promote positive relationship functioning in the short-term. Across three daily life studies, we examined whether mixed-gender couples reported more positive relationship functioning on days in which they engaged in more shared problematic behaviors. In two studies (Study 1: 82 couples who smoke; Study 2: 117 couples who are inactive), days of more shared problematic behavior were accompanied by higher daily closeness and relationship satisfaction. A third study with 79 couples post-stroke investigating unhealthy eating failed to provide evidence for symptom-system fit. In exploratory lagged analyses, we found more support for prior-day problematic behavior being associated with next-day daily relationship functioning than vice-versa. Together, findings point to the importance of a systems perspective when studying interpersonal dynamics that might be involved in the maintenance of problematic behaviors.

Three facets of emotion regulation in old and very old age: Strategy use, effectiveness, and variability.

The ability to regulate emotions in stressful situations is an important building block for high well-being across the lifespan. Yet, very little is known about how old and very old adults regulate their emotions. In this study, 123 young old adults (Mage = 67.18, SD = 0.94) and 47 very old adults (Mage = 86.70, SD = 1.46) were prompted 6 times a day for 7 consecutive days to report both their stressors and 10 emotion regulation strategies. Overall, there was little indication of age differences in the use of emotion regulation strategies during exposure to stressors, but very old, as compared with young old, individuals used three of the 10 strategies considered here more intensively. The 10 emotion regulation strategies were similarly effective across age groups based on their association with perceived overall emotion regulation success. We also did not find age group differences in within-strategy variability, defined as the variation in using a given strategy across stressor situations. By contrast, between-strategy variability, defined as the selective use of fewer rather than many strategies across stressor situations, was lower for very old participants. Only between-strategy, and not within-strategy, variability contributed to overall emotion regulation success. There was no age group difference in this regard. Taken together, the evidence suggests small age differences in emotion regulation if at all. This is noteworthy given the advanced age of the very old subsample in this study and the deficits in multiple domains of functioning reported in the literature for this advanced age. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Codevelopment of life goals and the Big Five personality traits across adulthood and old age.

Since the new millennium, research in the field of personality development has focused on the stability and change of basic personality traits. Motivational aspects of personality and their longitudinal association with basic traits have received comparably little attention. In this preregistered study, we applied bivariate latent growth curve model to investigated the codevelopment of nine life goals and the Big Five traits. We tested age, perceived control, gender, educational background, and regional socialization as potential moderators of codevelopment. Data came from the German Socio-Economic Panel study (N = 55,040, age range: 18-103 years) and span a study period of 13 years. During this period, the Big Five traits and life goals were assessed four times. Our findings suggest that development in broader life goal domains (e.g., self-fulfillment) is more strongly connected to personality development across the life span, whereas changes in specific goals (e.g., having children) are more closely tied to trait changes during young and middle adulthood. The strongest codevelopment was found between Openness and agentic goals with a focus on personal growth followed by codevelopment between Agreeableness and communal goals. Developmental stage and educational background moderated the codevelopment of Conscientiousness and economic achievement as well as family-related goals. Contrary to the previous research, we found that Neuroticism codeveloped with communal life goals (i.e., having a happy relationship/marriage). Our findings reinforce theoretical frameworks that highlight the role of changing opportunities, constraints, and developmental tasks across adulthood. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Daily solitude and well-being associations in older dyads: Evidence from daily life assessments.

Older adults spend significant time by themselves, especially since COVID-19. Solitude has been associated with positive and negative outcomes. Partners need to balance social connectedness with time for one's own needs. This project examines how individual and partner solitude are associated with daily affect and relationship quality in dyads of older adults and a close other. One-hundred thirty-six older adults plus a close other rated their relationship quality and reported affect, solitude, and its characteristics (desired and bothersome) every evening for 10 days. Over and above overall associations, individual and partner effects emerged; when individual desired solitude was up, participants reported more positive affect and their partners less negative affect. When bothersome solitude was up, participants and their partners alike reported more negative affect and less positive affect. Desired solitude was associated with more support, whereas bothersome solitude was associated with less partner support. Findings provide further evidence on the potential benefits of solitude, highlighting the importance of considering the social context of what is often believed to be an individual-level phenomenon.

Sex differences in the age-related decrease of spontaneous baroreflex function in healthy individuals.

The baroreflex is a powerful physiological mechanism for rapidly adjusting heart rate in response to changes in blood pressure. Spontaneous baroreflex sensitivity (BRS) has been shown to decrease with age. However, studies of sex differences in these age-related changes are rare. Here we investigated several markers of spontaneous baroreflex function in a large sample of healthy individuals. Cardiovascular signals were recorded in the supine position under carefully controlled resting conditions. After quality control, n = 980 subjects were divided into five age groups [age < 30 yr (n = 612), 30-39 yr (n = 140), 40-49 yr (n = 95), 50-59 yr (n = 61), and >60 yr (n = 72)]. Spontaneous baroreflex function was assessed in the time domain (bradycardic and tachycardic slope) and in the frequency domain in the low- and high-frequency band (LF-α, HF-α) applying the transfer function. General linear models showed a significant effect of factor age (P < 0.001) and an age × sex interaction effect (P < 0.05) on each indicator of the baroreflex function. Simple main effects showed a significantly higher BRS as indicated by tachycardic slope, LF-α and HF-α in middle-aged women compared with men (30-39 yr) and higher LF-α, bradycardic and tachycardic slope in men compared with women of the oldest age group (>60 yr). Changes in BRS over the lifespan suggest that baroreflex function declines more slowly but earlier in life in men than in women. Our findings could be linked to age-related changes in major sex hormone levels, suggesting significant implications for diverse cardiovascular outcomes and the implementation of targeted preventive strategies.NEW & NOTEWORTHY In this study, we demonstrate that the age-related decrease of spontaneous baroreflex sensitivity is different in men and women by analyzing resting state cardiovascular data of a large sample of healthy individuals.

Daily Rumination-Affect Associations in Dyads During the COVID-19 Pandemic.

OBJECTIVES: Negative and repetitive self-oriented thinking (rumination) is associated with lower well-being and health. The social context of rumination remains underexplored and mostly centers on marital relationships. To embrace the diversity of older adult relationships, this study includes a range of different relationships (e.g., spouses, siblings, friends, etc.) and examines the role of rumination by close others on individual well-being during the coronavirus disease 2019 pandemic. METHODS: Using daily diary data from 140 Canadian older adults (M = 72.21 years, standard deviation [SD] = 5.39, range: 63-87 years, 47% women, 71% university educated) and a close other of their choice (M = 59.95 years, SD = 16.54, range: 18-83 years, 78% women, 81% university educated), this project builds on past research examining daily life rumination dynamics from a dyadic perspective. For 10 days, both dyad members reported their daily rumination and affect quality in the evening. RESULTS: Multilevel models replicate past work showing that individual rumination was associated with higher negative affect (within-person: b = 0.27, p < .001, between-person: b = 0.57, p < .001) and lower positive affect (within-person: b = -0.18, p < .001, between-person: b = -0.29, p < .001). Importantly, we additionally observed that partner rumination was associated with higher negative affect (b = 0.03, p = .038) and lower positive affect (b = -0.04, p = .023), highlighting the social context of rumination. DISCUSSION: Findings illustrate the significance of rumination for the self and others and underline the merit of taking a dyadic perspective on what is typically viewed as an individual-level phenomenon.

Differences in self-perceptions of aging across the adult lifespan: The sample case of awareness of age-related gains and losses.

Rooted in the premises of lifespan developmental theory, the concept of awareness of age-related change (AARC) posits that growing older comes with both experiences of gains and losses across different behavioral domains. However, little is known about how age-related change is perceived across the entire adult lifespan, provided that respective measures can be validly compared. Further, few studies have adopted an approach that examines gains and losses simultaneously to study a potential shift in the ratio of perceived age-related gains and losses from adolescence to advanced old age. Using cross-sectional data from the German Socio-Economic Panel, this study tested the measurement invariance of the 10-item AARC short form and examined age differences in the awareness of age-related changes across 1,612 participants aged 16-93 years. First, partial measurement invariance of the AARC-Gains and AARC-Losses scales was established, allowing for valid group comparisons across young adulthood, midlife, and old age. Second, results indicated that people experience more AARC-Gains than AARC-Losses throughout the adult lifespan. However, older adults exhibited an increasingly less favorable gains-to-losses ratio, primarily driven by more loss experiences. Gain experiences were mostly stable across age groups. Third, differences in levels of AARC were related to individuals' background characteristics relevant at the respective time of life, such as education (early adulthood), employment (midlife), and social resources (old age). These results highlight the utility of considering a broad age range when examining the nature and correlates of age differences in perceived age-related gains and losses. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Levels of awareness of age-related gains and losses throughout adulthood and their developmental correlates.

Views of aging predict key developmental outcomes. Less is known, however, about the consequences of constellations of domain-specific perceived gains and losses across the full adult lifespan. First, we explored levels of awareness of age-related gains (AARC-gains) and losses (AARC-losses) in five behavioral domains across adulthood. Second, we identified the number and types of profiles of AARC-gains and AARC-losses in young adulthood, midlife, young-old age, and old-old age. Third, we investigated whether the identified profiles differed in their associations with developmental correlates. Data came from the 2018 German Socio-Economic Panel Innovation Sample (SOEP-IS), comprising 403 young, 721 middle-aged, 260 young-old and 228 old-old individuals. We assessed AARC, physical and mental functioning, information processing speed, social relations, lifestyle, and engagement. At the sample level, AARC-losses were higher in old age, whereas AARC-gains did not differ across adulthood. Latent profile analyses revealed two distinguishable constellations of AARC-gains and AARC-losses that characterize young adulthood and old-old age, whereas four and three gains-to-losses constellations are needed to characterize midlife and young-old age, respectively. In middle, young-old, and old-old age, profiles with more AARC-losses were associated with poorer scores on all developmental correlates. Overall, study results suggest that age-related experiences are most diversified in midlife and young-old age. Asking individuals about their negative age-related experiences may help identify those individuals who are doing less well in important developmental correlates. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Long-term aging trajectories of the accumulation of disease burden as predictors of daily affect dynamics and stressor reactivity.

Multiple-timescale studies provide new opportunities to examine how developmental processes that evolve at different cadences are intertwined. Developmental theories of emotion regulation suggest that the long-term, slowly evolving age-related accumulation of disease burden should shape short-term, faster evolving (daily) affective experiences. To empirically examine this proposition, we combined data from 123 old adults (65-69 years, 47% women) and 32 very old adults (85-88 years, 59% women) who provided 20 + year within-person longitudinal data on physician-rated morbidity and subsequently also completed repeated daily-life assessments of stress and affect six times a day over 7 consecutive days as they were going about their daily-life routines. Results from models that simultaneously articulate growth and intraindividual variability processes (in a dynamic structural equation modeling framework) revealed that individual differences in long-term aging trajectories of the accumulation of disease burden were indeed predictive of differences in three facets of affective dynamics that manifest in everyday life. In particular-over and above mean levels of disease burden-older adults whose disease burden had increased more over the past 20 years had higher base level of negative affect in their daily lives, more emotional reactivity to the experience of daily stressors, and more moment-to-moment fluctuations in negative affect that was unrelated to stressors (affective systemic noise). We highlight that developmental processes evolving over vastly different timescales are intertwined, and speculate how new knowledge about those relations can inform developmental theories of emotion regulation and daily-life functioning. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Explaining Variation in Individual Aging, Its Sources, and Consequences: A Comprehensive Conceptual Model of Human Aging.

We define aging as a characteristic deterioration in one (or more) observable attributes of an organism that typically occurs during later life. With this narrow functional definition, we gain the freedom to separate aging from other processes of age-related change (e.g., maturation, growth, illness, terminal decline). We introduce a structural model that distinguishes between (1) the phenomenon of aging, (2) the subjective experience of aging, (3) sources of aging, and (4) consequences of aging. A core focus of the model is on the role of buffering mechanisms of biological repair and personal adaptation that regulate the relations between sources of aging, aging proper, and its consequences. The quality and level of functioning of these buffering mechanisms also varies across the life span, which directly affects the sources of aging, resulting in either resilience against or accelerated aging, and thus can be considered to be a major source of the variation in aging processes among different individuals. External factors comprising attributes of the physical environment and sociocultural characteristics are considered as contexts in which aging occurs. These contextual factors are assumed to feed into the various components of the model. Our model provides an interdisciplinary account of human aging, its sources and consequences, and also its subjective experience, by integrating biological, psychological, lifestyle, and sociocultural factors, and by specifying their interrelations and interactions. The model provides a comprehensive understanding of individual human aging, its underlying processes, and modulating factors. It allows for the derivation of empirically testable hypotheses, and it helps practitioners to identify elements that lend themselves to targeted intervention efforts aimed at increasing the resilience of individuals against aging and buffering its negative consequences.

Everyday Pain in Middle and Later Life: Associations with Daily and Momentary Present-Moment Awareness as One Key Facet of Mindfulness.

This study investigated everyday associations between one key facet of mindfulness (allocating attention to the present moment) and pain. In Study 1, 89 community-dwelling adults (33-88 years; Mage = 68.6) who had experienced a stroke provided 14 daily end-of-day present-moment awareness and pain ratings. In Study 2, 100 adults (50-85 years; Mage = 67.0 years) provided momentary present-moment awareness and pain ratings three times daily for 10 days. Multi-level models showed that higher trait present-moment awareness was linked with lower overall pain (both studies). In Study 1, participants reported less pain on days on which they indicated higher present-moment awareness. In Study 2, only individuals with no post-secondary education reported less pain in moments when they indicated higher present-moment awareness. Findings add to previous research using global retrospective pain measures by showing that present-moment awareness might correlate with reduced pain experiences, assessed close in time to when they occur.

Between-person and within-person associations among sensory functioning and attitude toward own aging in old age: Evidence for mutual relations.

Late-life hearing loss and vision loss might prompt more negative attitudes toward one's own aging because older adults may interpret impaired sensory functioning as a sign of aging. At the same time, more positive attitudes toward own aging might, via various mechanisms, be associated with better sensory functioning. We investigated how objective hearing and vision are associated with attitude toward own aging (ATOA) over time. Our sample comprised 497 participants from the Berlin Aging Study (mean baseline age: 85.15 years, SD = 8.58 years) who provided up to six observations over an average time span of 3.73 years (range 0-15 years). We computed longitudinal multilevel regression models, specifying vision, hearing, and age as within-person and between-person predictors of ATOA, and ATOA and age as between- and within-person predictors of vision and hearing. Covariates were sex, socioeconomic status, suspected dementia, chronic physical diseases, and depression. Significant within-person age effects indicated that vision and hearing declined over time, and ATOA became less favorable over time. At the between-person level, we found that participants with a more favorable ATOA exhibited better hearing, but not better vision, at baseline. Between-person associations of vision and hearing with ATOA were not significant. At the within-person level, there was only one significant effect across all models: On measurement occasions when individuals' vision was better, they also reported more favorable ATOA. This association was stronger among older individuals. Improving prevention and treatment of vision loss could thus help older adults to maintain positive views on their own aging. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Daily Affect and Daily Prospective Memory in People after Stroke and Their Partners: The Moderating Role of Resting Heart Rate.

INTRODUCTION: Experimental research suggests that affect may influence prospective memory performance, but real-life evidence on affect-prospective memory associations is limited. Moreover, most studies have examined the valence dimension of affect in understanding the influence of affect on cognitive performance in daily life, with insufficient consideration of the arousal dimension. To maximize ecological validity, the current study examined the relationships between daily affect and daily prospective memory using repeated daily assessments and the role of resting heart rate on these relationships. We examined both valence and arousal of daily affect by categorizing affect into four dimensions: high-arousal positive affect, low-arousal positive affect, high-arousal negative affect, and low-arousal negative affect. METHOD: We examined existing data collected from community-dwelling couples, of which at least one partner had a stroke history. The analytic sample included 111 adults (Mage = 67.46 years, SD = 9.64; 50% women) who provided 1,274 days of data. Among the participants, 58 were living with the effects of a stroke and 53 were partners. Participants completed daily event-based prospective memory tasks (in morning and/or evening questionnaires), reported daily affect in the evening, and wore a wrist-based Fitbit device to monitor resting heart rate over 14 consecutive days. RESULTS: Results from multilevel models show that, within persons, elevated high-arousal negative affect was associated with worse daily prospective memory performance. In addition, lower resting heart rate attenuated the inverse association between high-arousal negative affect and lowered prospective memory performance. We did not find significant associations of high- or low-arousal positive affect and low-arousal negative affect with daily prospective memory. DISCUSSION: Our findings are in line with the resource allocation model and the cue-utilization hypothesis in that high-arousal negative affect is detrimental to daily prospective memory performance. Lower resting heart rate may buffer individuals' prospective memory performance from the influence of high-arousal negative affect. These findings are consistent with the neurovisceral integration model on heart-brain connections, highlighting the possibility that cardiovascular fitness may help maintain prospective memory into older adulthood.

In it Together: Relationship Transitions and Couple Concordance in Health and Well-Being.

Events that change the family system have the potential to impact couple dynamics such as concordance, that is, partner similarity in health and well-being. This project analyzes longitudinal data (≥ two decades) from both partners of up to 3,501 German and 1,842 Australian couples to investigate how couple concordance in life satisfaction, self-rated health, mental health, and physical health might change with transitioning to parenthood and an empty nest. Results revealed couple concordance in intercepts (averaged r = .52), linear trajectories (averaged r = .55), and wave-specific fluctuations around trajectories (averaged r = .21). Concordance in linear trajectories was stronger after transitions (averaged r = .81) than before transitions (averaged r = .43), whereas no systematic transition-related change in concordance of wave-specific fluctuations was found. Findings emphasize that shared transitions represent windows of change capable of sending couples onto mutual upward or downward trajectories in health and well-being.

The mediating role of personality traits in the association between childhood trauma and depressive symptoms in young adulthood.

BACKGROUND: The aim of this study was to investigate the mediating role of the Big 5 personality traits (extraversion, neuroticism, openness, agreeableness, conscientiousness) in the association between early traumatization and depressive symptoms in early adulthood (20-25-year-olds) in a German population-based sample. METHODS: A total of 3176 participants from the German National Cohort (NAKO) baseline with an age between 20 and 25 years were included in this investigation. The sum score of the 9-item-version of the Patient Health Questionnaire was used for assessment of depressive symptoms. A structural equation model was built to test the paths between childhood trauma, Big 5 personality traits and depressive symptoms. RESULTS: Overall, 10.7 % of the young adult sample had a PHQ-9 sum score of ten or higher. The final mediation model fitted well for young adults. We found evidence for a partial mediating effect of Big 5 personality traits. LIMITATIONS: We only adjusted for age, sex, and year of data collection and did not include biological factors in the model. CONCLUSION: Young adults with early trauma experiences have a risk for developing depressive symptoms in young adulthood. Personality traits, especially neuroticism, partially mediated the association between early trauma and depressive symptoms for young adults and should be recognized in preventive strategies.

Personality traits and health care use: A coordinated analysis of 15 international samples.

Some people use health care services more than others. Identifying factors associated with health care use has the potential to improve the effectiveness, efficiency, and equity of health care. In line with the Andersen behavioral model of health care utilization and initial empirical findings, personality traits may be key predisposing factors associated with health care use. Across 15 samples, the present study examined cross-sectional and prospective associations between Big Five personality traits and the likelihood of dental visits, general medical practitioner visits, and hospitalizations. Using coordinated data analysis, we estimated models within each of 15 samples individually (sample Ns ranged from 516 to 305,762), and then calculated weighted mean effect sizes using random-effects meta-analysis across samples (total N = 358,803). According to the synthesized results, people higher in conscientiousness, agreeableness, extraversion, and openness, and lower in neuroticism were more likely to visit the dentist; people higher in neuroticism were more likely to visit general medical practitioners; and people lower in conscientiousness and agreeableness and higher in neuroticism were more likely to be hospitalized. Associations tended to be small with odds ratios around 1.20 (rs ≈ .05). These findings provide evidence across 15 international samples for small but consistent associations between personality traits and health care use and demonstrate that personality-health care associations differ by type of care. We discuss directions for future research, including examining more specific personality facets (e.g., productiveness vs. responsibility) as well as important dimensions of health care (e.g., preventative vs. reactive care; acute vs. chronic care). (PsycInfo Database Record (c) 2023 APA, all rights reserved).