Later life health optimism,pessimism and realism: Psychosocial contributors and health correlates

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

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

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

Stress and coping among gay men: age and ethnic differences

Previous studies suggest that perceived stigmatization of sexual minority status, ethnicity, and age are associated with negative mental health outcomes, and other studies suggest that coping styles may influence these outcomes. However, no studies have examined these relationships among gay men of varying ethnicities and age groups. Three hundred eighty-three Black and White, younger, middle-aged, and older adult gay men completed measures of perceived stigmatization, coping style, and mental health outcomes. Black older adult gay men reported significantly higher levels of perceived ageism than the older White group, significantly higher levels of perceived racism than the younger Black group, significantly higher levels of homonegativity than the younger Black and the White groups, and were more likely to use disengaged coping styles than White gay men. However, Black older adult gay men did not experience significantly higher levels of negative mental health outcomes. Results suggest that further research should examine how older Black gay men, who perceive higher levels of stigma while reporting greater use of less effective coping styles, do not appear to be experiencing more negative mental health outcomes as a result.     

Evaluation of a Brief Mindfulness Program for People with Multiple Sclerosis Delivered in the Community Over Five Years

This study evaluated the effectiveness, change mechanisms, and sustainability of a brief mindfulness intervention for people with multiple sclerosis (PwMS) delivered in the community through a frontline service over five years. Participants were 126 PwMS. A single intervention condition design was used with pre-intervention, post-intervention and 2-month follow-up assessments. The primary outcome was distress. Secondary outcomes were perceived stress, quality of life (QoL) and fatigue, and the proposed change mechanisms: mindfulness, self-compassion, psychological inflexibility. Intention-to-treat analyses showed the primary outcome, distress (Cohen’s d = .25), and all secondary outcomes improved: perceived stress (d = .38), mental health QoL (d = .39), physical health QoL (d = .47), fatigue (d = .30), mindfulness (d = .29), self-compassion (d = .37), psychological flexibility (d = .44). Distress, stress and perceived stress continued to improve post-intervention to follow-up. Mindfulness emerged as a temporal mediator of perceived stress (BCa 95% CI). Self-compassion mediated concurrent improvements in distress, perceived stress, fatigue and physical health QoL, while greater psychological flexibility mediated concurrent reductions in distress (BCa 95% CI). Mindfulness home practice was unrelated to improvements on all outcomes except a marginal association with mindfulness. Of the socio-demographic and illness factors, lower disease severity predicted improvements in physical health QoL (p = .046). Improvements in outcomes were supported by qualitative feedback and participant satisfaction ratings. Twenty-one groups were offered with good participant engagement and wide geographical reach, suggesting sustained feasibility of the Mindfulness for MS program over five years. Findings support the delivery of the Mindfulness for MS program through a community-based service in partnership with a local university.

     

Positive facial affect looks healthy

A healthy appearance is linked to important behavioural outcomes. Here we investigated whether positive facial affect is a cue for perceived health. In study one, two groups of participants rated the perceived health or perceived happiness of a large set of faces with neutral expressions. Perceived happiness predicted perceived health, as did anthropometric measures of expression. In a second experimental study, we collected ratings of perceived health for a wide age range of target faces with either neutral or smiling expressions. Smiling faces were rated as being much healthier looking than neutral faces, confirming that facial expression plays a role in the perception of health. A third study investigating attractiveness as a possible mediator found that expression still had a significant direct effect on perceived health, after accounting for attractiveness. Together, these studies systematically show that facial affect plays a critical role in shaping our perceptions of health in others.     

Perceived control and health

Perceived control (PC) is defined as thebelief that one can determine one’s own internal states and behavior, influence one’s environment, and/or bring about desired outcomes. Two important dimensions of PC are delineated: (1) whether the object of control is located in the past or the future and (2) whether the object of control is over outcome, behavior, or process. A variety of constructs and measures of PC (e.g., efficacy, attribution, and locus of control) are discussed in relation to these dimensions and selected studies are reviewed. The issues, controversies, and limits of the research on perceived control and health are addressed in terms of the antecedents and consequences of perceived control. Investigations should clearly conceptualize the object of perceived control, use measures that match the conceptualization, and when attempting to manipulate control, directly measure perceived control. The relation between PC and health outcomes is complex, and different aspects of PC may interact to affect health outcomes.     

Psychological contract breach and outcomes: Combining meta-analysis and structural equation models

In this study, meta-analytic procedures were used to examine the relationships between psychological contract perceived breach and certain outcome variables, such as organizational commitment, job satisfaction and organizational citizenship behaviours (OCB). Our review of the literature generated 41 independent samples in which perceived breach was used as a predictor of these personal and organizational outcomes. A medium effect size (ES) for desirable outcomes (job satisfaction, organizational commitment, organizational trust, OCB and performance) was obtained (r=-.35). For undesirable outcomes (neglect in role duties and intention to leave), ES were also medium (r=.31). When comparing attitudinal (job satisfaction, organizational commitment, organizational trust) and behavioural outcomes (OCB, neglect in role duties and performance), a stronger ES was found for attitudinal (r=-.24) than for behavioural outcomes (r=-.11). Potential moderator variables were examined, and it was found that they explained only a percentage of variability of primary studies. Structural equation analysis of the pooled meta-analytical correlation matrix indicated that the relationships of perceived breach with satisfaction, OCB, intention to leave and performance are fully mediated by organizational trust and commitment. Results are discussed in order to suggest theoretical and empirical implications.     

Just world beliefs,perceived stress,and health behavior: The impact of a procedurally just world∗

Recent research suggests that a just world view may promote good health while low belief in a just world may deleteriously affect well-being. However, this research is limited in that specific components of justice beliefs that are important to health are not well articulated. Additionally, many potential pathways linking perceived fairness to physical health remain largely unexplored. In the present study, we examined how individual differences in both distributive (outcomes and allocations) and procedural (rules and processes) just world beliefs are associated with stress and health behavior. Participants were recruited from two universities (N = 426) to complete individual differences measures of procedural and distributive just world beliefs, and also measures of perceived stress, health behavior, and physical symptoms. Results suggested that procedural, but not distributive just world views were important to well-being. In particular, belief in a procedurally just world was associated directly with lower perceived stress, and also indirectly with adaptive health behaviors and fewer physical health complaints. In general, these results suggest that beliefs about a procedurally just world may be particularly important to well-being, while also suggesting specific directions and mechanisms for future attempts at developing justice-oriented health interventions.     

Mental and physical health of spouse caregivers: the role of personality.

Although personal resources of caregivers, such as coping skills and social support, have been shown to be important in understanding caregiver stress and health outcomes, personality traits have not previously been considered. The purpose of this study was to examine the association between the personality traits of neuroticism and dispositional optimism and mental and physical health outcomes. It was predicted that personality would have direct effects, and indirect effects through perceived stress, on health outcomes. Participants were spouse caregivers of patients diagnosed with Alzheimer's disease. Results showed that neuroticism and optimism were significantly related to mental and physical health. Furthermore, neuroticism had significant direct effects on all of the health outcomes, and substantial indirect effects, through perceived stress, on mental health outcomes. Optimism showed stronger indirect than direct effects on all health outcomes. These findings demonstrate the importance of including personality of the caregiver in theoretical and empirical models of the caregiving process.     

Perceived control and health

Perceived control (PC) is defined as thebelief that one can determine one’s own internal states and behavior, influence one’s environment, and/or bring about desired outcomes. Two important dimensions of PC are delineated: (1) whether the object of control is located in the past or the future and (2) whether the object of control is over outcome, behavior, or process. A variety of constructs and measures of PC (e.g., efficacy, attribution, and locus of control) are discussed in relation to these dimensions and selected studies are reviewed. The issues, controversies, and limits of the research on perceived control and health are addressed in terms of the antecedents and consequences of perceived control. Investigations should clearly conceptualize the object of perceived control, use measures that match the conceptualization, and when attempting to manipulate control, directly measure perceived control. The relation between PC and health outcomes is complex, and different aspects of PC may interact to affect health outcomes.     

Perceived Health Barriers and Health Value in Seniors: Implications for Well-Being and Mortality1

There is growing evidence to suggest that the ways in which people think about their health problems may have significant implications for psychological and physical well-being. This possibility has the greatest consequences for those groups facing health problems on a daily basis, in particular, the elderly. This study examined the role of perceived health barriers and value for health in later life. A Perceived Health Barriers (absent, present) by Health Value (low, medium, high) 2.3 factorial design was analyzed for younger and older seniors on: number of life-threatening diseases, need for health care, and life satisfaction. In addition, a longitudinal design was used to examine the joint roles of perceived health barriers (PHBs) and health value (HV) on mortality. Findings generally indicated that individuals’ PHBs and HV are associated with health-related outcomes; however, the results differed for young and old elders. Among young elders, those with PHBs and those with high HV had the most negati e profile. That is, they had more diseases, higher health care needs, and lower life satisfaction. Among older elders, the findings were more complicated in that the relationship between PHB and the outcomes depended on HV. Overall, the patterns for old elders suggest that perceived health barriers are most relevant among those with medium value for health and least relevant among those with low value for health.     

Social support,social integration,and health-related quality of life over time: Results from the Fitness and Arthritis in Seniors Trial (FAST)

The present study tested whether baseline perceived social support and social integration predicted baseline and follow-up measures of health-related quality of life for 364 older adults with osteoarthritis. The findings are secondary analyses of a randomized controlled trial of an exercise intervention. Multiple regression analyses indicate that perceived social support was related to baseline measures of functioning in psychological (depressive symptoms, social functioning, and life satisfaction) and physical domains (self-rated disability, observed physical function, and perceived health), after accounting for demographic and clinical status factors. At 18-month follow-up (additionally controlling for exercise intervention and baseline outcomes), social support significantly predicted changes in psychosocial functioning, but was unrelated to changes in self-reported and observed physical health. The findings indicate that social support is an important predictor of long-term psychosocial outcomes, but is less important than baseline clinical status for physical health endpoints in this cohort of older adults. In contrast, social integration was not a consistent predictor of outcomes.     

Parentification and mental health symptoms: mediator effects of perceived unfairness and differentiation of self

Existing research indicates that parentification can result in positive and negative outcomes for individuals; however, little is known about the mechanisms that account for the variability. This study tested a theoretical model of the relation between parentification tasks and mental health symptoms, with perceived unfairness and differentiation of self (DoS) as mediators. The results supported the proposed model in a sample of 783 college students. A significant total indirect effect existed between the latent construct of parentification and that of mental health symptoms. Significant specific indirect effects were observed between parentification and mental health symptoms with perceived unfairness as a mediator; between parentification and DoS with perceived unfairness as a mediator and between perceived unfairness and mental health symptoms mediated by DoS. Implications for clinical work with adult clients who have experienced parentification in their family of origin are addressed.     

The impact of perceived racial discrimination on the mental health of Asian American and Latino college students

The authors examined the impact of perceived racial discrimination on various mental health outcomes for Asian American and Latino college students within an emic and etic framework. Results indicate that Asian American and Latino college students experienced similar exposure and reactions to various kinds of discrimination. However, Latino students were more likely than Asian American students to have been accused of doing something wrong, such as cheating and breaking the law, and more likely to appraise these experiences as stressful. Asian Americans evidenced higher risk for trait anxiety. Regardless of ethnicity, perceived racial discrimination was associated with several negative mental health outcomes, including higher psychological distress, suicidal ideation, state anxiety, trait anxiety, and depression. Findings highlight the need to address discrimination across multiple social and professional settings and to understand the broad array of mental health outcomes.     

A multidimensional analysis of internal health locus of control beliefs: separating the wheat from the chaff?

The current study examined the hypotheses that internal health locus of control comprises multiple dimensions and that these dimensions are differentially associated with physical health status. As expected, using covariance structure modeling of data derived from 181 medical outpatients, internal health locus of control was found to be multidimensional. Predicted dimensions included recognition that illness prevention is contingent on successful execution of potential health actions, recognition that illness management is contingent on successful execution of potential health actions, and self-mastery over health outcomes (i.e., the perceived capacity to achieve desired health outcomes). A 4th dimension (i.e., self-blame for negative health outcomes) also emerged. Moreover, as predicted, only perceptions of self-mastery were independently associated with indexes of physical health and well-being.     

Disability and disasters: the role of self-efficacy in emergency preparedness

Although individuals with physical disabilities have special needs regarding preparedness for a natural or human-made disaster, little is known about the factors involved in motivating members of this population to engage in behaviors which reduce the probability of negative health outcomes. This study proposes and empirically tests an integrated theory-based model for individuals with physical disabilities in which perceived self-efficacy for emergency preparedness moderates the relationship between perceived threat and emergency preparedness behaviors. A nationwide convenience cross-sectional sample of 294 adults self-identifying as having a physical disability completed an online survey. The general linear model was used to assess the effects on preparedness of perceived threat, perceived self-efficacy, and their interaction. In addition to the hypothesized moderating effect of self-efficacy, it was found that minimal (if any) relationship exists between perceived threat and preparedness among those who reported low levels of self-efficacy. Results suggest that self-efficacy and perceived threat operate jointly to motivate individuals with physical disabilities to take precautionary steps to reduce the consequential adverse health effects of natural and human-made disasters. These findings have important implications for the design of effective interventions for individuals with disabilities.     

The impact of psychological distress and university counselling on academic outcomes: Analysis of a routine practice-based dataset

Whole university approaches to student mental health and well-being increasingly involve university counselling and mental health services (UCMHSs) as key stakeholders in higher education and the fulfilment of good academic outcomes. However, previous research using routine outcome measures has focussed on psychological distress only. Research is needed to demonstrate the value of university counselling on academic outcomes. This study aimed at profiling the psychological distress of a student sample according to the Clinical Outcomes in Routine Evaluation—Outcome Measure (CORE-OM); measuring the change in perceived impact of problems on academic outcomes, and measuring the perceived impact of counselling on academic outcomes. Students from two UK university counselling services completed the CORE-OM and the Counselling Impact on Academic Outcomes (CIAO) questionnaire as part of routine practice. After counselling, 67.4% (n = 323) of students with planned endings to counselling showed at least reliable improvement on the CORE-OM. Significant reductions in the perceived impact of problems on all academic outcomes were also found. On average, 83% (n = 398) of students found counselling helpful for academic outcomes to at least a limited extent. University counselling was found to reduce psychological distress and the impact of problems on academic outcomes. Psychometric examination of the CIAO tool is warranted to strengthen its use. The need for robust data across UCMHSs is demonstrated by both the strengths and limitations of this study.     

Perceptions of the Efficacy of Prayer and Conventional Medicine for Health Concerns

Previous research has associated prayer practices with positive health outcomes, but few studies have examined: (a) the perceptions of prayer in relation to perceptions of the efficacy of conventional medicine, and (b) whether the perceptions of prayer efficacy differ based on illness type, context of prayer, and whether prayer is for the self or someone else. The current study surveyed 498 emerging adults at a public university. Conventional medicine was perceived as more effective for alleviating health concerns overall, but participants perceived prayer as most effective when performed in a group setting for someone else. Individuals perceived prayer as more effective than conventional medicine when they reported greater religious activity, lower health locus of control, and higher spiritual locus of control.

     

Perfectionism and health: a mediational analysis of the roles of stress, social support and health-related behaviours

This study tested a model derived from personality theory in which perceived stress, perceived social support, health-risk and health-promotion behaviours mediate the relationship between perfectionism and perceived physical health. A sample of 538 undergraduate students completed a web-based survey assessing multi-dimensional perfectionism, perceived stress, perceived social support, health behaviours, physical health and a scale tapping elements of the five-factor model of personality. Analyses that account for the effects of traits from the five-factor model (e.g., neuroticism, conscientiousness and extraversion) indicated that socially prescribed perfectionism was associated with poorer physical health and this association was fully mediated by higher levels of perceived stress and lower levels of perceived social support. Self-oriented perfectionism was related complexly to health such that it was related to poorer health via higher levels of perceived stress, but was also related to better health via higher levels of perceived social support. Our findings illustrate the need for considering key mediators of the link between perfectionism and poor health outcomes.