Age differences in long-term mortality among male nonveterans, noncombat veterans, and combat veterans.

Research documenting differences in mortality risk across the life course between veterans and nonveterans has not accounted for combat status. To address this gap in the literature, the current study examined differences in long-term mortality among midlife and older-adult male nonveterans, noncombat veterans, and combat veterans. Data were drawn from Wave 2 (2004/2005) of the Midlife Development in the United States survey and linked to 2020 mortality data (N = 2,024). Based on interpretation of a veteran-combat status by age interaction term, compared to nonveterans, noncombat veterans experienced a mortality advantage at younger ages, ORmain effect = 0.12, 95% CI [0.03, 0.54], p = .006, and a mortality disadvantage at older ages, ORinteraction term = 1.06, 95% CI [1.01, 1.05], p = .004, with the crossover occurring at 73.4 years. A similar pattern was present among combat veterans, with the mortality advantage at younger ages not reaching significance, ORmain effect = 0.16; 95% CI [0.02, 1.18], p = .072; a mortality advantage at older ages, ORinteraction term = 1.03, 95% CI [1.00, 1.05], p = .040; and the crossover occurring 4.2 years earlier at 69.2 years. The findings suggest that combat status may accelerate the age-related mortality disadvantage among veterans. Studies of health and mortality outcomes among veterans should, therefore, account for combat status. When data allow, future studies should confirm whether this pattern is present in nationally representative samples.

Age differences in allostatic load among veterans: The importance of combat exposure.

The current study examinedage differences in allostatic load among nonveterans, noncombat veterans, and combat veterans. Participants included 280 individuals from the Midlife Development in the United States (MIDUS) survey, including 164 veterans (n = 48 combat veterans; n = 116 noncombat veterans) and 116 nonveterans. Age differences in allostatic load were similar among nonveterans and noncombat veterans, B = 0.002, SE = .011, p = .878, with older adults showing higher levels of allostatic load than their comparatively younger counterparts. Among combat veterans, however, a different pattern emerged. In this group, levels of allostatic load were similar across age, seemingly due to higher levels of allostatic load among younger combat veterans, B = -0.029, SE = .014, p = .031, ƞp 2  =  .022. Results reveal the importance of considering combat exposure when examining health outcomes of military veterans, particularly in the context of age.

When Emotional Pain Becomes Physical: Adverse Childhood Experiences, Pain, and the Role of Mood and Anxiety Disorders.

OBJECTIVE: We examined the association between retrospective reports of adverse childhood experiences (ACEs) and painful medical conditions. We also examined the mediating and moderating roles of mood and anxiety disorders in the ACEs-painful medical conditions relationship. METHOD: Ten-year longitudinal data were obtained from the National Comorbidity Surveys (NCS-1, NCS-2; N = 5001). The NCS-1 obtained reports of ACEs, current health conditions, current pain severity, and mood and anxiety disorders. The NCS-2 assessed for painful medical conditions (e.g., arthritis/rheumatism, chronic back/neck problems, severe headaches, other chronic pain). RESULTS: Specific ACEs (e.g., verbal and sexual abuse, parental psychopathology, and early parental loss) were associated with the painful medical conditions. Baseline measures of depression, bipolar disorder, and posttraumatic stress disorder were also associated with the number of painful medical conditions. Anxiety and mood disorders were found to partially mediate the ACEs-painful medical conditions relationship. We determined through mediation analyses that ACEs were linked to an increase in anxiety and mood disorders, which, in turn, were associated with an increase in the number of painful medical conditions. We determined through moderation analyses that ACEs had an effect on increasing the painful medical conditions at both high and low levels of anxiety and mood disorders; though, surprisingly, the effect was greater among participants at lower levels of mood and anxiety disorders. CONCLUSION: There are pernicious effects of ACEs across mental and physical domains. Dysregulation of the hypothalamic-pituitary-adrenal stress response and the theory of reserve capacity are reviewed to integrate our findings of the complex relationships.

Looking back, forging ahead: Fifteen years of Strength and Vulnerability Integration (SAVI).

Strength and Vulnerability Integration (SAVI) describes age-related patterns of emotional well-being. Since its initial publication, studies have tested the model, supporting its original tenets and also identifying areas needing refinement. The current review provides an updated description of SAVI, describing how age differences in well-being vary based on the proximity to acute stressors and the proposed underlying mechanisms. SAVI also addresses questions regarding why we sometimes observe increases in distress among older adults over time. In this description, we clarify predictions of SAVI, as well as suggest places where more research is needed.

Too little, too much, and "just right": Exploring the "goldilocks zone" of daily stress reactivity.

Hormetic models of stress resilience describe nonlinear relations for exposure to adversity and health outcomes, where exposure induces salutary changes up to a threshold, with changes becoming deleterious afterward. Here we apply a hormetic model of stress to reactivity to daily stressors, examining whether mental and physical health benefits arise from low-to-moderate reactivity but then decrease at higher levels. Data are from the second wave of the National Study of Daily Experiences (NSDE). Adults (N = 2,022; Mage = 58.61, SD = 12.12, age range: 35-86; 57% female) completed telephone interviews detailing their stressors and affect on eight consecutive evenings. A series of multilevel structural equation models estimated within-person associations between daily stressors and negative affect (i.e., stress reactivity), and between-person linear and quadratic effects of stress reactivity on mental and physical health outcomes (i.e., life satisfaction, psychological distress, and number of chronic conditions). Findings reveal a significant quadratic effect for each outcome, indicating a U-shaped pattern (inverse U for positively valenced life satisfaction), such that low and high levels of stress reactivity were associated with poorer health and well-being, whereas moderate levels of daily stress reactivity predicted better health outcomes. These findings suggest that individuals who display either very low- or very high-stress reactivity may benefit from interventions that target their emotion regulation skills and coping resources. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Perceived control across the adult lifespan: Longitudinal changes in global control and daily stressor control.

Perceived control is an important psychosocial resource for health and well-being across the lifespan. Global control (i.e., overall perceived control) decreases over time in studies following people every few years to upwards of 10 years. Changes across wider intervals of the lifespan, however, have yet to be examined. Further, how perceived control changes for specific aspects of daily life, such as stressors, remains comparatively less clear. Using data from the Midlife in the United States National Study of Daily Experiences (NSDE, N = 1,940, M = 56.25 years, SD = 12.20, 57% female), we examined longitudinal changes in global control across 20 years and daily stressor control across 10 years. Global control was assessed in the first wave of the NSDE (∼1996). In follow-up waves, conducted in ∼2008 and ∼2017, participants again not only reported their global control but also reported their perceived control over stressors they experience across 8 consecutive days. Longitudinal analyses revealed differential change trajectories for global control across 20 years and stressor control across 10 years (ps < .001). Global control declined for younger and older adults but stayed relatively stable for individuals in midlife. The rate of decline in daily stressor control was steeper than the decline in global control and did not vary by age at baseline. In addition, declines were amplified among individuals with higher global control at baseline. Results suggest that daily stressor control is a specific aspect of control beliefs that follows a different rate of change than global control. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Preserving What Matters: Longitudinal Changes in Control Over Interpersonal Stress and Noninterpersonal Stress in Daily Life.

OBJECTIVES: Theoretical perspectives on aging suggest that when people experience declines in later life, they often selectively focus on maintaining aspects of their lives that are most meaningful and important to them. The social domain is one of these selected areas. The current study examines people's reports of control over their daily stressors over 10 years, predicting that the declines in control that are often observed in later life will not be observed for stressors involving interpersonal conflict and tensions with social partners. METHODS: Adults ranging from 35 to 86 years old at baseline (N = 1,940), from the National Study of Daily Experiences, reported control over interpersonal and noninterpersonal daily stressors across 8 consecutive days at 2 time points, about 10 years apart. RESULTS: Findings from multilevel models indicate that for noninterpersonal stressors, perceived control decreased over time. In contrast, perceived control over interpersonal conflicts and tensions remained robust over time. No cross-sectional baseline age differences were found for levels of interpersonal and noninterpersonal stressor control. DISCUSSION: Results are consistent with socioemotional selectivity and underscore the importance of interpersonal relationships in later adulthood. Understanding how people select and preserve certain aspects of control in their daily life can help guide efforts toward maximizing gains and minimizing losses in domains that matter most to people as they grow older.

The wear and tear of daily stressors on mental health.

Researchers assert that affective responses to seemingly minor daily events have long-term implications for mental health, yet this phenomenon has rarely been investigated. In the current study, we examined how levels of daily negative affect and affective reactivity in response to daily stressors predicted general affective distress and self-reported anxiety and depressive disorders 10 years after they were first assessed. Across eight consecutive evenings, participants (N = 711; age = 25 to 74 years) reported their daily stressors and their daily negative affect. Increased levels of negative affect on nonstressor days were related to general affective distress and symptoms of an affective disorder 10 years later. Heightened affective reactivity to daily stressors predicted greater general affective distress and an increased likelihood of reporting an affective disorder. These findings suggest that the average levels of negative affect that people experience and how they respond to seemingly minor events in their daily lives have long-term implications for their mental health.

Affective reactivity to daily stressors and long-term risk of reporting a chronic physical health condition.

BACKGROUND: Daily stressors, such as an argument with a spouse or an impending deadline, are associated with short-term changes in physical health symptoms. Whether these minor hassles have long-term physical health ramifications, however, is largely unknown. PURPOSE: The current study examined whether exposure and reactivity to daily stressors is associated with long-term risk of reporting a chronic physical health condition. METHODS: Participants (N = 435) from the National Study of Daily Experiences completed a series of daily diary interviews between 1995 and 1996 and again 10 years later. RESULTS: Greater affective (i.e., emotional) reactivity to daily stressors at time 1 was associated with an increased risk of reporting a chronic physical health condition at time 2. CONCLUSION: Results indicate that how people respond to the daily stressors in their lives is predictive of future chronic health conditions.

Growing old and being old: Emotional well-being across adulthood.

The present study examines change in reports of daily, weekly, and monthly psychological distress over 20 years, and of negative and positive affect over 10 years, using data from the Midlife in the United States study. The study includes three waves of data collection on adults ranging from 22 to 95 years old. Cross-sectional findings reveal that older age is related to lower levels of psychological distress and negative affect and to higher levels of positive affect across each successive age group. Yet, longitudinal findings vary across younger, middle-aged, and older adults. Psychological distress decreases over time among younger adults (although only until age 33 for weekly reports), remains stable in midlife, and is stable (monthly) or slightly increases (daily and weekly) among older adults. For negative affect, levels decrease over time for younger and middle-aged adults, and only increase for the oldest adults for daily and monthly affect. Positive affect is stable over time among younger adults, but decreases in midlife starting in the mid-fifties. In conclusion, overall patterns of findings suggest that being old (assessed cross-sectionally) is related to higher levels of emotional well-being. Growing old (assessed longitudinally) is related to improvements in emotional well-being across younger and early middle adulthood, which mirrors cross-sectional findings. There is relative stability in later midlife, however, and continued stability or slight declines across older age. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Longitudinal change in daily stress across 20 years of adulthood: Results from the national study of daily experiences.

This study examined age-related patterns in exposure and affective reactivity to daily stressors across a 20-year time span among adults who were between 22 and 77 years old at their baseline interview. Longitudinal data from the National Study of Daily Experiences (NSDE) consisted of three bursts of eight consecutive nightly interviews of stress and affect. Analyses made use of all available data from a U.S. National sample of respondents who participated in any of the three NSDE bursts (N = 2,845; number of daily assessments = 33,688). Findings revealed increasing age-related benefits. Younger adults (< 30 years) reported the highest levels of stressor exposure and reactivity, but their stress profile improved with age. Over time, adults averaged an 11% reduction in the occurrence of stressor days, and the younger adults exhibited an even steeper decline (a 47% reduction) in their levels of stressor reactivity. For people in midlife and old age, stressor occurrence continued to decrease over time, yet among adults aged 54 years or older at baseline, stress reactivity remained stable across time. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Neighborhood safety concerns and daily well-being: A national diary study.

People living in unsafe neighborhoods often report poor health. The reasons for this are multi-faceted, but one possibility is that unsafe neighborhoods create a situation of chronic stress, which may deplete people's resources to cope with the daily stressors of life. How people respond to daily stressors (e.g., with increased self-reported negative affect and physical symptoms) is positively associated with health problems and may thus be one pathway linking perceptions of neighborhood safety to poor health. The current study investigated the relationship between neighborhood safety concerns, daily stressors, affective well-being, and physical health symptoms in a national sample of adults from the Midlife in the United States Study II (n = 1748). In 2004, participants reported neighborhood safety concerns and history of chronic stress exposure. Across eight days, they also reported daily stressors, physical symptoms and negative affect. Greater neighborhood safety concerns were associated with higher negative affect and more physical symptoms, adjusting for other sources of chronic stress. Moreover, lower perceived neighborhood safety was related to greater increases in negative affect and physical symptoms on days during which stressors were reported, even after accounting for established interactions between daily stressors and other sources of chronic stress. Exposure to neighborhoods perceived as unsafe is associated with poorer daily well-being and exacerbated responses to daily stressors, which may serve as an individual-level pathway contributing to poorer health among people living in neighborhoods perceived as unsafe.

Going the distance: The diurnal range of cortisol and its association with cognitive and physiological functioning.

Cortisol features prominently in theories describing how chronic stress wears away at physical and cognitive health. The current study examines composite measures of physiological and cognitive functioning in relation to two aspects of daily cortisol: total daily output and change in levels throughout the day. Participants (N = 1001; aged 28-84 years-old) from the Midlife Development in the United States (MIDUS) study provided 4 daily saliva samples across four consecutive days and underwent a physical exam that provided information about six inter-related physiological systems that were combined into a measure of allostatic load. They also completed a phone-based battery of cognitive tasks, which provided a composite score combining memory, reasoning, and speed of processing performance. Total daily cortisol output was captured using area under the curve with respect to ground (AUCg). Change in cortisol levels was assessed using two methods: slope, calculated through piecewise spline models, and dynamic range, calculated by the difference between the day's highest and lowest log-cortisol levels. Findings indicate that, when examined together, overall cortisol output was not associated with either outcome, but a greater range in cortisol throughout the day was associated with both lower allostatic load and higher cognitive functioning. Results emphasize the importance of dynamic daily processes, assessed either using slopes or dynamic range, to both physiological and cognitive functioning.

Now you see it, now you don't: age differences in affective reactivity to social tensions.

When faced with interpersonal conflict, older adults report using passive strategies more often than do young adults. They also report less affective reactivity in response to these tensions. We examined whether the use of passive strategies may explain age-related reductions in affective reactivity to interpersonal tensions. Over 8 consecutive evenings, participants (N = 1,031; 25-74 years-old) reported daily negative affect and the occurrence of tense situations resulting in an argument or avoidance of an argument. Older age was related to less affective reactivity when people decided to avoid an argument but was unrelated to affective reactivity when people engaged in arguments. Findings suggest that avoidance of negative situations may largely underlie age-related benefits in affective well-being.

Age, Daily Stress Processes, and Allostatic Load: A Longitudinal Study.

Objective: The present study examined age differences in the association between daily stressors and allostatic load. Method: Participants consisted of 317 adults (34-84 years) who participated in Waves 1 (1996-1997) and 2 (between 2005 and 2009) of the Midlife Development in the United States Survey. During Wave 1, participants reported the stressors they encountered across eight consecutive days. Within-person affective reactivity slopes indexing change in negative affect from a nonstressor day to a stressor day were calculated for each participant. Affective reactivity and stressor exposure scores at Wave 1 were used to predict allostatic load at Wave 2. Results: Heightened levels of affective reactivity at Wave 1 predicted elevated levels of allostatic load at Wave 2 but only among older adults who also reported high levels of stressor exposure. No significant associations emerged for younger adults. Discussion: Daily stress processes may be one pathway through which age-related physical health declines occur.

Adverse childhood experiences and coping strategies: identifying pathways to resiliency in adulthood.

OBJECTIVE: The current study examined whether coping strategies mediate the link between adverse childhood experiences (ACEs) and adult psychiatric and physical health outcomes. METHODS: Data were drawn from wave I (N = 7108), wave II (N = 4963), and wave III (N = 3294) of the Midlife Development in the United States (MIDUS) Survey. An ACE count was created using seven aspects of early adversity based on prior literature. Coping variables were created using subscales of the COPE inventory. Psychiatric and health outcomes were assessed at baseline and at the 20-year follow-up. Bootstrapping mediation analyses were conducted using MPLUS to examine the link between ACEs and health outcomes and to determine if coping strategies mediate these relationships. RESULTS: Results of path analyses in Mplus showed that ACEs, reported at Wave I, were associated with worse psychiatric and physical health outcomes at Wave III. ACEs at Wave I were associated with greater use of avoidant emotion-focused coping and lower use of problem-focused strategies at Wave II. Avoidant emotion-focused coping at Wave II partially mediated the relationship between ACEs, reported at Wave I, and psychiatric and physical health outcomes reported at Wave III. No significant mediation was detected for problem-focused coping. CONCLUSIONS: Coping strategies may be an important point target for prevention or intervention for individuals who have experienced ACEs.

Diurnal cortisol profiles, inflammation, and functional limitations in aging: Findings from the MIDUS study.

OBJECTIVE: The current study examined the association between diurnal cortisol profiles, inflammation, and functional limitations, among adults ranging in age from 34-84 years. METHOD: Participants (N = 799) completed Waves 2 (between 2004 and 2006) and 3 (between 2014 and 2016) of the Midlife Development in the United States Survey. At Wave 2, participants provided saliva samples across 4 consecutive days, from which cortisol was assayed. Previously validated diurnal cortisol profiles (i.e., normative, flattened, or elevated) were examined in relation to concurrent inflammation risk burden and to predict long-term changes in functional limitations. RESULTS: Compared with participants with normative profiles across all interview days, participants with dysregulated profiles across all interview days (i.e., all days elevated, flattened, or a combination of elevated and flattened) showed greater concurrent inflammation risk burden and more functional limitations at follow-up. Regions of significance testing indicated that the association was significant beginning at age 60 for inflammation risk burden and beginning at age 66 for functional limitations. Variable profiles (i.e., a mix of normative and flattened and/or elevated across the four days of assessment) were not significantly associated with these health indices. CONCLUSIONS: Findings, consistent with the theoretical model of Strength and Vulnerability Integration, illustrate the importance of considering age when examining cortisol and its association with other health indices. (PsycINFO Database Record

Memories of social interactions: age differences in emotional intensity.

The current study examined age differences in the intensity of emotions experienced during social interactions. Because emotions are felt most intensely in situations central to motivational goals, age differences in emotional intensity may exist in social situations that meet the goals for one age group more than the other. Guided by theories of emotional intensity and socioemotional selectivity, it was hypothesized that social partner type would elicit different affective responses by age. Younger (n = 71) and older (n = 71) adults recalled experiences of positive and negative emotions with new friends, established friends, and family members from the prior week. Compared with younger adults, older adults reported lower intensity positive emotions with new friends, similarly intense positive emotions with established friends, and higher intensity positive emotions with family members. Older adults reported lower intensity negative emotions for all social partners than did younger adults, but this difference was most pronounced for interactions with new friends.

Living with chronic health conditions: age differences in affective well-being.

The current study examined age differences in affective well-being and reactivity to daily stressors among people varying in health status. Participants (N = 3,493), aged 25 to 74 years, reported global affective well-being in the Midlife Development in the United States survey, and a subset (n = 983) reported their affective reactivity to stressors across eight consecutive evenings in the National Study of Daily Experiences. Across groups of people varying in number of chronic conditions, older adults reported higher levels of global affective well-being and lower levels of affective reactivity than did younger adults, with one exception. Among people reporting four or more chronic conditions, older adults were just as reactive to daily stressors as were younger adults.

Mixed Emotions Across Adulthood: When, Where, and Why?

Psychologists often interpret mixed emotional experiences, defined as experiencing more than one emotion over a given period of time, as indicative of greater emotional complexity and more adaptive functioning. In the present paper, we briefly review studies that have examined these experiences across adulthood. We describe how mixed emotions have been defined in the lifespan literature, and how the various studies examining age differences in this phenomenon have yielded discrepant results. We then discuss future research directions that could clarify the nature of mixed emotions and their utility in adulthood, including the assessment of situational context, understanding when mixed emotions are adaptive in daily life, and determining how cognitive functioning is involved in these experiences.