A five-year study of older adults' health incongruence: consistency, functional changes and subsequent survival

In later life, optimistic health appraisals promote well-being and survival, whereas pessimistic appraisals can be harmful. This study contrasted subjective health (SH) appraisals with objective health (OH) to identify realists, whose ratings were congruent (SH?=?OH), distinguishing them from health pessimists (SH??OH) with incongruent ratings. Health congruence and functional well-being of 757 older adults were assessed via two interviews conducted 5 years apart. We examined consistency in health congruence, and among those with persistent OH, we examined 5-year functional well-being changes that corresponded with SH shifts and determined whether SH shifts predicted 30-month survival. Most realists remained realists; health optimists and pessimists tended to become realists. Increased health optimism corresponded with enhanced functioning; increased pessimism corresponded with decreased functioning. Among realists, increasingly positive SH predicted survival. Findings have implications for quality and length of life among older adults with chronic health conditions.     

A five-year study of older adults’ health incongruence: Consistency,functional changes and subsequent survival

In later life, optimistic health appraisals promote well-being and survival, whereas pessimistic appraisals can be harmful. This study contrasted subjective health (SH) appraisals with objective health (OH) to identify realists, whose ratings were congruent (SH?=?OH), distinguishing them from health pessimists (SH?<?OH) and health optimists (SH?>?OH) with incongruent ratings. Health congruence and functional well-being of 757 older adults were assessed via two interviews conducted 5 years apart. We examined consistency in health congruence, and among those with persistent OH, we examined 5-year functional well-being changes that corresponded with SH shifts and determined whether SH shifts predicted 30-month survival. Most realists remained realists; health optimists and pessimists tended to become realists. Increased health optimism corresponded with enhanced functioning; increased pessimism corresponded with decreased functioning. Among realists, increasingly positive SH predicted survival. Findings have implications for quality and length of life among older adults with chronic health conditions.     

Comparative risk and perceived control: implications for psychological and physical well-being among older adults

As older adults become more susceptible to certain health crises, their preoccupation with their risk of suffering such events increases. Understanding the implications of risk perceptions is critical because they may have consequences for psychological and physical well-being in later life. In the present study of older adults living in the community, the authors examined participants' comparative risk estimates (CREs)--their perceptions of their own risk relative to a similar other's risk--of suffering a hip fracture. Using multiple regression analyses, the authors examined the role of CREs on psychological well-being (negative emotions, life satisfaction) and self-rated physical well-being (general physical health, recent physical health). The authors expected perceived control (PC) to moderate the relationship between CREs and well-being. The predicted interaction did occur: Among individuals with high PC, comparative optimism (perceiving a comparatively low risk) was associated with better psychological well-being (fewer negative emotions and greater life satisfaction) and better physical well-being (general and recent physical health) relative to comparative pessimism (perceiving a comparatively high risk). Among individuals with low PC, there were no differences in well-being between comparative optimists and comparative pessimists. These findings suggest that the protective effect of comparative optimism on well-being is limited to older adults who have a strong sense of control.     

How Dispositional Optimists and Pessimists Evaluate their Past,Present and Anticipated Future Life Satisfaction: A Lifespan Approach

Dispositional optimism is typically conceptualized with respect to generalized positive expectancies for personal future outcomes. The present work draws on lifespan development theory to evaluate how dispositional optimists and pessimists from across the lifespan evaluate their past, present and anticipated future life satisfaction (LS). Using data from an American probability sample (n = 3871, ages = 30–84 years, 55% female), I compared dispositional optimists and pessimists across six age decades. Subjective LS trajectories reflected in mean trends in ratings of past, present and future LS were contoured by lifestage, revealing inclining trajectories among young dispositional optimists and pessimists and declining trajectories among older optimists and pessimists. After adjusting for age‐specific normative trends, however, differences between dispositional optimists and pessimists in subjective LS trajectories were consistent across lifestage, revealing a single dissociative pattern wherein optimists rated their past, present and anticipated future LS more positively than did pessimists. Of the three temporal perspectives, evaluations of present (rather than past or future) LS were most consistently related to dispositional optimism. Copyright © 2012 John Wiley & Sons, Ltd.     

Risk perception and behavior: Pessimism,realism, and optimism about aids-related health behavior

Abstract

This study investigates the perceived risk of becoming infected with HIV for heterosexuals with multiple sexual partners, examines cognitive and motivational antecedents of biases in risk perception, and relates these biases to behavior. We obtained a moderate degree of optimism in a longitudinal study based on a sample of 535 visitors of a STD clinic. Further analyses—after classifying subjects as “pessimists”, “realists”, or “optimists”—revealed that pessimists were extremely pessimistic and optimists remarkably optimistic. Optimism increased with perceived control and decreased with prior experience, supporting a cognitive explanation of optimism. The data also provided some support for a motivational explanation: optimists who scored higher on a defensive coping style were more optimistic about their risks. Contrary to other findings, we found a positive relation between optimism and intentions to reduce risks. Furthermore, results revealed that optimists showed lower levels of subsequent behavioral risk. It was concluded that optimists were not unrealistically optimistic about their personal vulnerability. but rather that pessimists were unrealistically pessimistic. Previous behavior was found to be the best predictor of subsequent behavior. Although measures of perceived risk were also related to subsequent behavior, their predictive power was rather modest.     

The spirited, the observant, and the disheartened: social concepts of optimism, realism, and pessimism

The social concepts of optimism, pessimism, and realism were investigated by assessing the prototypical acts (thoughts, feelings, goals, and actions) that laypersons assign to optimists, pessimists, and realists responding to a controllable and an uncontrollable situation. Optimists and realists, but not pessimists, were seen as adjusting their behavior to the situation. However, whereas optimists were characterized by flexibility in thoughts and feelings but invariance in goals and actions (i.e., they pursued their goals in both controllable and uncontrollable situations), the act profiles assigned to realists varied on all of these dimensions. The profile assigned to pessimists was characterized by cognitive, affective, motivational, and behavioral invariance, encompassing negative construals of the situation, giving up, and a focus on distress.     

Optimism and social support: The providers’ perspective

It has been presumed that the beneficial health effects of optimism are mediated by social support provided by the social environment. To further analyze this assumption, in two experiments (N?=?240 and N?=?120) social responses toward optimists, pessimists, and realists were examined. Participants listened to tape-recorded conversations in which optimistic, pessimistic and realistic targets reported how they were dealing with a stressful situation before completing a questionnaire assessing (a) their evaluation of the target's behavior and personality, (b) their attraction to the target, and (c) their willingness to provide the target with social support. Optimistic and realistic targets were viewed more favorably than pessimistic targets, while the behavior of realists was regarded as being more adequate than that of optimists. However, the more positive evaluation of optimists and realists compared to pessimists was not accompanied by a greater willingness to provide them with social support.     

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.     

Optimism, pessimism, and gambling: the downside of optimism

Three studies examined the relation between dispositional optimism and gambling. In Study 1, optimists were more likely than pessimists to have positive gambling expectations and report maintaining these expectations following losses. They also were more likely to indicate that winning money was a primary motivation for their gambling. Study 2 demonstrated that pessimists but not optimists reduce their betting and expectations after poor gaming performance. Study 3 replicated this effect using a more controlled experiment and showed that after losing, optimists report remembering more near wins than do pessimists. Thus, all three studies suggest that optimists, more than pessimists, maintain positive expectations and continue gambling after experiencing negative gaming outcomes. The authors suggest that despite optimism's many benefits, there are common situations in which the pessimistic tendency to disengage is beneficial.     

Optimism, pessimism, and false failure feedback: Effects on vigilance performance

Following the logic of a prior experiment (Seligman et al., 1990) with varsity collegiate swimmers, sixty student volunteers performed a brief, but highly stressful vigilance task. Half were then given false feedback indicating poor performance; the others experienced a non-evaluative display at that point. All were then asked to repeat the vigil. Half the observers were assessed as high optimists and half as high pessimists. The pessimists showed a steeper vigilance decrement than the optimists, consistent with a model (Scheier and Carver, 1987) that proposes that pessimists are more emotion-focused under stress than optimists, and hence would be less attentive to the vigilance display, regardless of feedback condition. The false negative feedback actually turned out to be ineffective; hence, based on Seligman's account of the swimmer study, which requires effective negative feedback, there should have been no vigilance performance difference between optimists and pessimists, either pre- or post-feedback.     

The Role of Optimism/Pessimism in HRQOL in Chronic Hepatitis C Patients

One hundred and twenty three outpatients with compensated chronic hepatitis C (CHC) completed the SF-36, BSI, and questions regarding the expected impact of CHC on their health. Respondents were categorized as optimists (N = 17, 13.8%), realists (N = 98, 79.6%), and pessimists (N = 8, 6.5%). Pessimism was associated with lower scores on nearly all SF-36 subscales (p < .001 –.03) and higher scores on 6 BSI subscales indicative of greater emotional distress (p < .05). Pessimism was not associated with demographics, liver disease severity, substance abuse, or comorbid medical conditions. However, pessimism was associated with the presence of a psychiatric comorbidity and self-reported health status (p < .05). We conclude that optimism/pessimism may be an important determinant of QOL and emotional status in CHC patients and that additional studies of cognitive predispositions and coping skills in CHC patients are warranted.     

Optimism, pessimism, and false failure feedback: Effects on vigilance performance

Following the logic of a prior experiment (Seligman et al., 1990) with varsity collegiate swimmers, sixty student volunteers performed a brief, but highly stressful vigilance task. Half were then given false feedback indicating poor performance; the others experienced a non-evaluative display at that point. All were then asked to repeat the vigil. Half the observers were assessed as high optimists and half as high pessimists. The pessimists showed a steeper vigilance decrement than the optimists, consistent with a model (Scheier and Carver, 1987) that proposes that pessimists are more emotion-focused under stress than optimists, and hence would be less attentive to the vigilance display, regardless of feedback condition. The false negative feedback actually turned out to be ineffective; hence, based on Seligman's account of the swimmer study, which requires effective negative feedback, there should have been no vigilance performance difference between optimists and pessimists, either pre- or post-feedback.     

Are we looking for positivity or similarity in a partner's outlook on life? Similarity predicts perceptions of social attractiveness and relationship quality

Previous research has shown that people with an optimistic life orientation are perceived as socially more attractive than pessimists. However, following the similarity-attraction hypothesis, we assumed that both the perceiver's and the target's life orientation affects perceptions of social attractiveness. Moreover, we were interested in how the composition of romantic partners’ life orientation (similar vs. dissimilar) affects perceived relationship quality. The results of an experimental online study (N?=?316) confirmed previous findings: Overall, optimists were perceived as socially more attractive than pessimists. Furthermore, perceivers’ life orientation moderated that effect, which was larger with optimistic than with pessimistic perceivers. Moreover, with respect to ongoing relationships optimistic participants indicated higher relationship quality if they perceived their partners as similarly optimistic. The findings are in line with the similarity-attraction hypothesis. They are discussed with regard to the benefits of optimism in social interactions and relationships.     

How young and older adults differ in their responses to perceived age discrimination

The authors examined the consequences of perceived age discrimination for well-being and group identification. The rejection-identification model suggests that perceived discrimination harms psychological well-being in low status groups but that group identification partially alleviates this effect. The authors hypothesized that this process model would be confirmed among older adults because their low status group membership is permanent but not confirmed among young adults whose low status is temporary. Using structural equation modeling, the authors found support for the hypothesized direct negative link between perceived age discrimination and well-being among older adults, with increased age group identification partially attenuating this effect. For young adults, these relationships were absent. Differences in responses to discrimination appear to be based on opportunities for leaving a low status group.     

Dispositional Optimism and Physical Well-Being: The Influence of Generalized Outcome Expectancies on Health

This article explores the implications that dispositional optimism holds for physical well-being. Research is reviewed that links optimism to a number of different positive health-relevant outcomes, ranging from the development of physical symptoms to recovery from coronary artery bypass surgery. Additional findings are described which suggest that these beneficial effects are partly due to differences between optimists and pessimists in the strategies that they use to cope with stress. A number of other potential mediators are also discussed, including some that are physiologic in nature. The article closes with a discussion of the relationships between our own theoretical account of the effects of optimism and several other conceptual approaches.     

Lifespan Differences in a Self Determination Theory Model of Eudaimonia: A Cross-Sectional Survey of Younger,Middle-Aged,and Older Adults

Despite the myriad physical, cognitive, and social losses that are increasingly common as we age, a growing body of evidence suggests that aging is positively associated with mental health and well-being. The majority of this evidence is in the form of mental health, personality, and subjective/hedonic well-being outcomes; far less is known about lifespan differences in eudaimonic well-being. The objective of this study was to examine differences across three age groups in a relatively recent model of eudaimonia informed by self-determination theory that focuses on the process of living well, but also acknowledges outcomes of that process. In comparison to young (n = 66) and middle-aged adults (n = 66), older adults (n = 66) were especially likely to be living eudaimonically (i.e., to have intrinsic aspirations, goal autonomy, mindfulness, and basic psychological need fulfillment). The effect of age on well-being outcomes was mixed; the oldest group reported the highest levels of life satisfaction (hedonic well-being) but the lowest levels of purpose and growth (eudaimonic well-being) in comparison to their younger counterparts. As predicted by the model, basic psychological need fulfillment mediated the relationship between motivational constructs and well-being outcomes. Furthermore, the model applied equally well to younger, middle-aged, and older adults. Our results are consistent with recent theoretical models emphasizing the socioemotional benefits of aging, as well as potential challenges to well-being that exist in later life.     

The motivational and emotional consequences of considering positive or negative possibilities for an upcoming event.

The hypothesis that attention to negative possibilities for an upcoming event can have advantages for performance in comparison with a more optimistic approach was examined in 2 studies. Focus of attention to positive or negative possibilities for a social interaction was manipulated for Ss previously identified as optimists or defensive pessimists in the social domain. In Study 1, negatively focused defensive pessimists performed better in their conversations than positively focused defensive pessimists on several dimensions (e.g., talk time, perceived effort, and sociability). Optimists' behavior was unaffected by the focus manipulation. However, all negatively focused Ss felt worse after their conversations than did positively focused subjects. Study 2 examined the cognitive process by which a negative focus may lead to positive behaviors. Some pessimists may benefit from an initial negative focus that is not accompanied by lowered expectations and that actually facilitates positive thoughts about the self.     

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.     

Subjective well-being evaluations among older black Americans

The causal relations among social status and resource, health, and stress factors, and a single-item measure of subjective well-being (i.e., happiness) were examined among a national sample of 581 Black adults aged 55 years and over. Results indicated that although social status and resource factors had a limited impact on happiness ratings, these measures were important in predicting intermediate factors related to health status and satisfaction and stress. Happiness was directly influenced by stress and reported satisfaction with health, whereas the effect of health disability was mediated by stress and health satisfaction. The findings suggest that certain groups of older Blacks (i.e., relatively younger, widowed, and separated) may be at specific risk for diminished well-being. However, adverse health and life conditions, which are determined by status and resources, represent circumstances that further jeopardize the well-being of older Black adults.