Self-Acceptance and Purpose in Life Are Mechanisms Linking Adverse Childhood Experiences to Mortality Risk.

OBJECTIVE: Adverse childhood experiences (ACEs) are associated with an increased risk of premature mortality, but it is not clear why. Individuals with ACEs tend to have lower self-acceptance and purpose in life, which may be pathways between ACEs and risk of premature mortality. As such, we tested whether purpose and self-acceptance are mechanisms that link ACEs to mortality risk. METHODS: We used the Midlife in the United States Survey ( N = 6218; mean [standard deviation] = 46.89 [12.94] years) to test whether these factors were indirect pathways between ACEs and mortality hazards over 24 years of follow-up. We used a comprehensive ACE measure that included 20 possible childhood adversities including emotional and physical abuse, household instability, socioeconomic climate, and ill health. RESULTS: ACEs significantly increased mortality risk (hazard ratio = 1.028, 95% confidence interval = 1.008-1.047, p = .006). Self-acceptance and purpose accounted for an estimated 15% and 4% of the ACEs-mortality relation, respectively. These effects withstood a range of adjustments and sensitivity analyses. CONCLUSIONS: ACEs may affect mortality risk partially through lower self-acceptance and purpose during adulthood. Given that self-acceptance and purpose may change through intervention, these factors may be useful targets for individuals with ACEs that could lead to a longer life.

Factors associated with transitions in tobacco product use states among young adults aged 18-29 years.

BACKGROUND AND OBJECTIVES: This study examined young adults' tobacco use transitions based on their past 30-day use states, and identified factors associated with their transitions. METHODS: Participants (N = 12377) were young adults aged 18-29 years at Wave 1 of the Population Assessment of Tobacco and Health (PATH) study. Self-reported tobacco use states were categorized by the number of past-month use days (0, 1-4, 5-8, 9-12, 13-30 days) for cigarettes, electronic cigarettes [e-cigarettes], traditional cigars, filtered cigars, cigarillos, smokeless tobacco (SLT), and hookah. Multistate Markov models examined transitions between use states across Waves 1-5 of unweighted PATH data and multinomial logistic regressions examined predictors of transitions. RESULTS: Most young adults remained nonusers across adjacent waves for all products (88%-99%). Collapsed across waves, transitioning from use at any level to nonuse (average 46%-67%) was more common than transitioning from nonuse to use at any level (average 4%-10%). Several factors that predicted riskier patterns of use (i.e., transitioning to use and/or remaining a user across adjacent waves) were similar across most products: male, Black, Hispanic, lower education levels, and lower harm perceptions. In contrast, other factors predicted riskier patterns for only select products (e.g., e-cigarette and SLT use among Whites). DISCUSSION AND CONCLUSIONS: Few sampled young adults escalated their tobacco use over time, and escalations for many products were predicted by similar factors. SCIENTIFIC SIGNIFICANCE: Prevention and regulatory efforts targeted towards adolescents should continue, but also be expanded into young adulthood. These same efforts should consider both shared and unique factors that influence use transitions.

The balance of giving versus receiving social support and all-cause mortality in a US national sample.

While numerous studies exist on the benefits of social support (both receiving and giving), little research exists on how the balance between the support that individuals regularly give versus that which they receive from others relates to physical health. In a US national sample of 6,325 adults from the National Survey of Midlife Development in the United States, participants were assessed at baseline on hours of social support given and received on a monthly basis, with all-cause mortality data collected from the National Death Index over a 23-y follow-up period. Participants who were relatively balanced in the support they gave compared to what they received had a lower risk of all-cause mortality than those who either disproportionately received support from others (e.g., received more hours of support than they gave each month) or disproportionately gave support to others (e.g., gave many more hours of support a month than they received). These findings applied to instrumental social support (e.g., help with transportation, childcare). Additionally, participants who gave a moderate amount of instrumental social support had a lower risk of all-cause mortality than those who either gave very little support or those who gave a lot of support to others. Associations were evident over and above demographic, medical, mental health, and health behavior covariates. Although results are correlational, one interpretation is that promoting a balance, in terms of the support that individuals regularly give relative to what they receive in their social relationships, may not only help to strengthen the social fabric of society but may also have potential physical health benefits.

Personality Traits Predict Long-Term Physical Health via Affect Reactivity to Daily Stressors.

Researchers hypothesize that how people react to daily stressful events partly explains the relationship between personality and health, yet no study has examined longitudinal associations between these factors. The current study focused on the role of negative affect reactivity to daily stressful events as a mediating pathway between personality and physical health outcomes using three waves of data spanning 20 years from a nationwide probability sample of 1,176 adults. Results indicated that negative affect reactivity partially mediated personality and physical health. Wave 1 neuroticism was associated with greater negative affect reactivity at Wave 2, which predicted the development of chronic conditions and functional limitations at Wave 3. Higher conscientiousness at Wave 1 was associated with less negative affect reactivity at Wave 2, which predicted better physical health at Wave 3. These findings highlight the usefulness of using a daily-stress framework for understanding how personality impacts health over time, which has important implications for stress management and disease prevention.

Personality pathways to mortality: Interleukin-6 links conscientiousness to mortality risk.

Personality is associated consistently with mortality hazards, but the physiological pathways are not yet clear. Immune system dysregulation may be one such pathway due to its role in age-related morbidity and mortality. In this preregistered study, we tested whether interleukin-6 (IL-6) and C-reactive protein (CRP) mediated the associations between personality traits and mortality hazards. The sample included 957 participants (M ± SD = 58.65 ± 11.51 years; range = 35-86 years) from the Midlife in the United States Survey that had 14 years of follow-up. Higher conscientiousness was associated with lower mortality hazards, with each one standard deviation higher conscientiousness associated with a 35% lower mortality risk. IL-6, but not CRP, partially mediated this association, with IL-6 accounting for 18% of this association in the fully adjusted model. While there was initial evidence that the biomarkers mediated both neuroticism and agreeableness and mortality risk, the indirect effects were not significant when controlling for the sociodemographic variables. Taken together, higher conscientiousness may lead to a longer life partially as a result of lower IL-6. This work highlights the importance of biological pathways that link personality to future mortality risk.

Associations Between Peer Use, Costs and Benefits, Self-Efficacy, and Adolescent E-cigarette Use.

OBJECTIVE: Prior research identified peer use as a salient risk factor of adolescent electronic cigarette (e-cigarette) use, but has not expanded on the mechanisms of this association. METHODS: Participants were 562 adolescents recruited from rural and suburban public high schools and an adolescent medicine clinic in the mid-Atlantic United States. Participants completed a packet of questionnaires that assessed demographics, substance use, expectations about the consequences of e-cigarette use, and perceptions of their own self-efficacy to resist using e-cigarettes. We estimated a series of mediation models using the MODEL INDIRECT command in MPLUS statistical software. In all models, significance of indirect effects from peer e-cigarette use to self-reported e-cigarette use were tested via two variables: (a) expected costs, (b) benefits of e-cigarette use, and (c) the perceived self-efficacy of the individual to refrain from e-cigarette use. RESULTS: Adolescents with more peers using e-cigarettes were more likely to have ever used an e-cigarette and perceived greater benefits and fewer costs, which was associated with a reduced self-efficacy to refrain from e-cigarette smoking (Model 1). Those with more peers using e-cigarettes were more likely to be currently using e-cigarettes themselves because they perceived greater benefits and fewer costs, which was associated with a reduced self-efficacy to refrain from e-cigarette smoking (Model 2). CONCLUSION: Peer use, self-efficacy to resist use, and expectations of cost and benefits of e-cigarette use should be considered as possible targets when devising tailored interventions and policies to prevent or reduce negative health consequences of long-term e-cigarette use.

Cross-lagged relationships between sense of purpose in life, memory performance, and subjective memory beliefs in adulthood over a 9-year interval.

OBJECTIVES: Previous studies have found a positive association between having a sense of purpose in life and memory functioning in old age. We extend these findings by examining the relationships between sense of purpose, memory performance, and subjective memory beliefs over time in a large sample of adults in mid to later adulthood. METHOD: We used data from 3633 participants of the second and third wave of the MIDUS study. Cross-lagged panel analysis investigated the relationships between the variables at the two points, which were approximately 9 years apart, while controlling for gender, age, education, positive and negative affect, and self-rated health. RESULTS: Sense of purpose in life, memory performance, and subjective memory beliefs were all cross-sectionally related to each other at both times. Longitudinally, sense of purpose was a positive predictor of subjective memory beliefs. Memory performance and subjective memory beliefs positively predicted each other over time. Furthermore, all three variables showed correlated changes over time. Exploratory analyses suggest that the covariates of affect and self-rated health are possible mediators or confounders in respectively the relationship between subjective memory beliefs and later sense of purpose, and sense of purpose and later objective memory performance. CONCLUSION: Our findings underscore once more the relevance of sense of purpose in life as a predictor of positive late life functioning, as it is related to both performance-based and subjective cognitive outcomes. More work is needed to understand mechanisms underlying the purpose-memory association in order to develop and implement purpose interventions.

Predictors of Initial Status and Change in Self-Control During the College Transition.

Although self-control tends to increase through late adolescence, there are individual differences in patterns of growth. Latent growth modeling was used to investigate change in self-control across students' first year of college (N = 569, M age = 18.03; 70.3% female; 89.6% White), and whether attachment to parents predicted this change when controlling for personality and demographic variables. Self-control decreased linearly across five assessments, with significant heterogeneity in intercepts and slopes. Personality was associated with initial self-control, and greater avoidant attachment to mothers and openness to experience predicted greater declines. Overall, self-control changes across late adolescence, and attachment and personality explain individual differences in that change, indicating potential intervention targets during emerging adulthood.

Positive Affect Is Associated With Less Memory Decline: Evidence From a 9-Year Longitudinal Study.

Memory decline is a concern for aging populations across the globe. Positive affect plays an important role in healthy aging, but its link with memory decline has remained unclear. In the present study, we examined associations between positive affect (i.e., feeling enthusiastic, attentive, proud, active) and memory (i.e., immediate and delayed recall), drawing from a 9-year longitudinal study of a national sample of 991 middle-age and older U.S. adults. Results revealed that positive affect was associated with less memory decline across 9 years when analyses controlled for age, gender, education, depression, negative affect, and extraversion. Findings generalized across another measure that assessed additional facets of positive affect, across different (but not all) facets of positive affect and memory, and across age, gender, and education; findings did not emerge for negative affect. Reverse longitudinal associations between memory and positive affect were not significant. Possible pathways linking positive affect and memory functioning are discussed.

Personality and impulsivity as predictors of tobacco use among emerging adults: A latent class analysis.

The tobacco industry markets their products toward emerging adults (18-29), with the goal of increasing use among this age group. To inform prevention efforts, researchers are investigating how specific demographic and psychological traits may predict tobacco initiation and continuation. Participants were 578 incoming university freshmen from the Appalachian region. Participants provided information on demographics, personality traits, impulsivity characteristics, lifetime use of cigarettes and electronic cigarettes (ECIGs), and current use of cigarettes, ECIGs, small cigars/cigarillos, large cigars, smokeless tobacco, and waterpipe. Latent class analysis identified tobacco-use classes and regressions identified psychological predictors of class membership. Participants were Nonusers, Experimenters, and Polytobacco Users. Lower agreeableness and conscientiousness as well as higher extraversion and neuroticism were associated with being Experimenters or Polytobacco Users. Lower impulsivity was associated with being Nonusers. Distinct types of emerging adults belong to each tobacco use class, suggesting that individual differences be incorporated in prevention efforts.

Sense of Purpose Moderates the Associations Between Daily Stressors and Daily Well-being.

Background: Having a sense of purpose in life has been consistently demonstrated as a predictor of positive health outcomes, including less perceived stress, yet, little is known about the role of sense of purpose on stressful days. Purpose: The current study investigated the sense of purpose as a moderator of stressor-related changes in daily physical symptoms, positive affect, and negative affect. Methods: A subset of the Midlife in the United States study (n = 1949, mage: 56.4 years) reported their sense of purpose, along with up to eight daily assessments of stressors, affect, and physical symptoms. Multilevel models evaluated whether sense of purpose was associated with deviations in affect or physical symptom reporting on days when participants reported a stressor versus days when stressors did not occur. Results: Sense of purpose was associated with higher daily positive affect, lower daily negative affect, and fewer daily physical symptoms. Compared with individuals who reported lower levels of purpose, those reporting higher levels encountered the same number of daily stressors, yet showed less of an increase in negative affect and physical symptoms on stressor days than on stressor-free days. Purpose did not predict changes in positive affect in response to daily stressors. Conclusions: Findings provide evidence that a purposeful life may be characterized by lower negative affect and physical symptom reporting on stressful days.

Socioeconomic Status Interacts with Conscientiousness and Neuroticism to Predict Circulating Concentrations of Inflammatory Markers.

BACKGROUND: Socioeconomic health disparities research may benefit from further consideration of dispositional factors potentially modifying risk associated with low socioeconomic status, including that indexed by systemic inflammation. PURPOSE: This study was conducted to investigate interactions of SES and the Five-Factor Model (FFM) personality traits in predicting circulating concentrations of the inflammatory markers interleukin-6 (IL-6) and C-reactive protein (CRP). METHOD: Using a sample of middle-aged and older adults from the Midlife in the United States Survey (MIDUS) biomarker project (N = 978), linear regression models tested interactions of each FFM trait with a composite measure of SES in predicting IL-6 and CRP, as well as the explanatory role of medical morbidity, measures of adiposity, and health behaviors. RESULTS: SES interacted with conscientiousness to predict levels of IL-6 (interaction b = .03, p = .002) and CRP (interaction b = .04, p = .014) and with neuroticism to predict IL-6 (interaction b = -.03, p = .004). Socioeconomic gradients in both markers were smaller at higher levels of conscientiousness. Conversely, the socioeconomic gradient in IL-6 was larger at higher levels of neuroticism. Viewed from the perspective of SES as the moderator, neuroticism was positively related to IL-6 at low levels of SES but negatively related at high SES. Interactions of SES with both conscientiousness and neuroticism were attenuated upon adjustment for measures of adiposity. CONCLUSIONS: Conscientiousness may buffer, and neuroticism amplify, excess inflammatory risk associated with low SES, in part through relationships with adiposity. Neuroticism may be associated with lower levels of inflammation at high levels of SES.

Retrospective Reports of Childhood Misfortune Are Associated With Positive and Negative Affect in Adulthood.

Childhood misfortune refers to nonnormative experiences individuals encounter at younger ages that affect development across the life span. This study examined whether retrospectively reported childhood misfortune was associated with negative and positive affect in adulthood. In addition, we explored whether perceived control beliefs would moderate these associations. We used archival data from 6,067 adults ( Mage = 46.86; range = 20-75) from the Midlife Development in the United States study. Higher levels of misfortune were associated with higher levels of negative affect and lower levels of positive affect in adulthood. However, control beliefs moderated this association such that the combination of higher perceived control and misfortune resulted in less of a decrease in positive affect and less of an increase in negative affect. Overall, early life events were associated with later life emotional health, and control beliefs were an important psychological resource that buffered the negative effects of childhood misfortune.

Training Community-Based Clinicians in Parent-Child Interaction Therapy: The Interaction Between Expert Consultation and Caseload.

Professional psychologists are increasingly encouraged to utilize evidence-based treatments (EBTs), and therefore have a need to participate and provide the most efficient training methods for these treatments. Multicomponent trainings, which commonly include ongoing support, are more effective than brief methods such as 1-day workshops or reading treatment manuals. The present study examined the effectiveness of 1 form of ongoing support, consultation, as part of a multicomponent training protocol. Thirty-two community-based clinicians were trained in Parent-Child Interaction Therapy (PCIT) as part of a statewide implementation effort, and data were collected on clinician and implementation outcomes at pre-, mid-, and posttraining. Simple and multiple linear regression analyses were conducted to predict posttraining knowledge, skill, acceptability, and feasibility, as well as to examine clinician variables that might moderate these relations. Greater consultation call attendance significantly predicted higher posttraining skill; however, this association was qualified by a significant interaction with PCIT caseload. Implications for training guidelines are discussed.

Purpose in life as a predictor of mortality across adulthood.

Having a purpose in life has been cited consistently as an indicator of healthy aging for several reasons, including its potential for reducing mortality risk. In the current study, we sought to extend previous findings by examining whether purpose in life promotes longevity across the adult years, using data from the longitudinal Midlife in the United States (MIDUS) sample. Proportional-hazards models demonstrated that purposeful individuals lived longer than their counterparts did during the 14 years after the baseline assessment, even when controlling for other markers of psychological and affective well-being. Moreover, these longevity benefits did not appear to be conditional on the participants' age, how long they lived during the follow-up period, or whether they had retired from the workforce. In other words, having a purpose in life appears to widely buffer against mortality risk across the adult years.

Age as a Moderator of Health Outcomes and Trust in Physicians.

Objectives: Patient trust in physicians is associated with patient satisfaction with healthcare, patients engaging in follow-up care, and positive health-related outcomes. The current study investigated whether age moderated the relation between trust in physicians and four health outcome variables, including patient satisfaction, doctor visits, emergency room visits, and hospital admissions. Methods: 398 English-speaking, community-dwelling adults completed measures of physician trust and important health outcome variables via Amazon Mechanical Turk. Results: Age significantly moderated relations between trust in physicians and hospital admissions, and trust in physicians and patient satisfaction, with both positive relations becoming stronger with increasing age. Discussion: The results highlight the need for a lifespan approach to the study of physician trust and related health outcomes. They offer an avenue for increasing physician trust, engagement with the healthcare system prior to the need for hospitalization, and the reduction of healthcare costs.

A Greater Variety of Social Activities Is Associated With Lower Mortality Risk.

OBJECTIVES: More frequent engagement in social activity is often associated with better physical health outcomes. Yet, less is known about whether engagement in a greater variety of social activities such as a mix of volunteering and attending club meetings (social activity variety) is important for health. The current study assessed whether social activity variety relates to mortality risk after adjusting for social activity frequency, nonsocial activity frequency and variety, and sociodemographic covariates, and how this relationship varies depending on age. METHODS: Using data from the Health and Retirement Study, we included 5,017 adults aged 51 and older who completed questions about social activity participation in 2008 and whose mortality status was recorded up to 2019. We also examined whether age moderated the relationship between social activity variety and mortality risk. RESULTS: Cox proportional hazard model analyses revealed that those with higher activity variety in social activities were more likely to survive over the following 11 years than those with low social activity variety. Moreover, age moderation indicated that the association between social activity variety with mortality risk was stronger among the oldest adults. DISCUSSION: Findings suggest that a greater variety of social activities is linked to mortality risk even after adjusting for social activity frequency, nonsocial activities, and health status across adulthood.

Lifetime trauma and mortality risk: A systematic review.

OBJECTIVE: Various literature are suggestive of a relation between lifetime trauma and mortality risk in adulthood, however, findings seem unclear and inconsistent. In our preregistered review, we conducted a systematic review to examine the association between lifetime trauma and mortality risk in adulthood. METHOD: Six databases (Scopus, Web of Science, CINAHL [EBSCO], PsycInfo [EBSCO], Embase, and Medline [PubMed]); were searched up to April 2023 for studies reporting adult mortality outcomes associated with traumatic events accumulated across the lifespan. Five studies were found, and a narrative review of the literature was conducted. RESULTS: Five studies met the inclusion criteria, including 5,506 individuals. Two studies with men/male-only samples reported no relation between lifetime trauma and mortality risk; however, three studies with a mixed-sex sample found a positive relation between lifetime trauma and mortality risk, indicating that the more traumatic events a person has across their lifespan, the greater their mortality risk. CONCLUSION: Lifetime trauma appears to be associated with mortality risk during adulthood. The strongest evidence stems from larger samples. However, research is sparse and inconclusive. A plethora of additional research is needed to address several limitations within the current literature, which includes utilizing standardized measures of lifetime trauma, replication of effects, and the examination of vulnerable and underrepresented populations. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Personality traits and mediating pathways to mortality risk: A systematic review.

OBJECTIVE: Personality traits have been regularly linked with all-cause mortality risk. However, what mechanisms may provide an indirect pathway from personality traits to mortality is unclear. We sought to systematically review the literature and provide an overview of the potential mechanisms that have been identified in the literature. METHOD: Five electronic databases (PubMed, Web of Science, CINAHL, PsycInfo, and PsycArticles) were searched from inception to January 27, 2023. From 611 studies initially identified, seven studies met the final inclusion criteria. These seven papers have a combined sample of 60,104 individuals (M = 8,585, SD = 14,600; range 957-44,094). RESULTS: These papers found that several variables, such as smoking, inflammation biomarkers, blood pressure, and sleep, mediated the relationship between various personality traits and mortality. There was considerable variation in the impact of results across cohorts, even when looking at similar variables, and notable differences in methodological approaches and reporting were discussed. CONCLUSIONS: This review identified a small pool of research looking at a range of indirect pathways (mediating variables). The review identified traits with well-established associations with mortality risk, such as neuroticism, do not have consistent findings in the mediation literature and a high level of variance in the degree to which mediators account for the personality-mortality relation between different cohorts. Despite these limitations, it is clear that examining indirect effects (mediation) has a crucial role to play in developing our understanding of the complex pathways that connect personality-mortality risk. We identify several avenues and considerations for future research. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Big 5 personality traits and interleukin-6: evidence for "healthy Neuroticism" in a US population sample.

The current study investigated if the Big 5 personality traits predicted interleukin-6 (IL-6) levels in a national sample over the course of 5years. In addition, interactions among the Big 5 were tested to provide a more accurate understanding of how personality traits may influence an inflammatory biomarker. Data included 1054 participants in the Midlife Development in the U.S. (MIDUS) biomarkers subproject. The Big 5 personality traits were assessed in 2005-2006 as part of the main MIDUS survey. Medication use, comorbid conditions, smoking behavior, alcohol use, body mass index, and serum levels of IL-6 were assessed in 2005-2009 as part of the biomarkers subproject. Linear regression analyses examined personality associations with IL-6. A significant Conscientiousness*Neuroticism interaction revealed that those high in both Conscientiousness and Neuroticism had lower circulating IL-6 levels than people with all other configurations of Conscientiousness and Neuroticism. Adjustment for health behaviors diminished the magnitude of this association but did not eliminate it, suggesting that lower comorbid conditions and obesity may partly explain the lower inflammation of those high in both Conscientiousness and Neuroticism. Our findings suggest, consistent with prior speculation, that average to higher levels of Neuroticism can in some cases be associated with health benefits - in this case when it is accompanied by high Conscientiousness. Using personality to identify those at risk may lead to greater personalization in the prevention and remediation of chronic inflammation.