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.     

Health incongruence in later life: implications for subsequent well-being and health care.

OBJECTIVE: The premise that pessimistic health appraisals compromise well-being whereas optimistic appraisals are compensatory was examined in a longitudinal study of 232 community-dwelling older adults (ages 79-98 years). DESIGN: Subjective health (SH) appraisals were contrasted 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), whose ratings were incongruent. Analyses of covariance were used to examine group differences 2 years later on well-being and health care. MAIN OUTCOME MEASURES: Outcome measures were psychological well-being (life satisfaction, positive and negative emotions), functional well-being (objective and perceived physical activity, activity restriction), and health care (health care management, hospital admissions, length of hospital stays). RESULTS: Compared with realists, pessimists had significantly poorer outcomes and optimists had better outcomes. Because perceived control (PC) was weaker among pessimists and stronger among optimists, supplemental analysis determined whether PC differences explained these findings. When accounting for PC, many pessimism and optimism effects became nonsignificant, yet effects on functional well-being remained unchanged. CONCLUSION: Findings have implications for older adults at risk of functional decline.     

Academic optimistic bias: Implications for college student performance and well-being

Although optimism has several benefits, there are potential drawbacks associated with “too much of a good thing”. Within an academic context, a possible determinant of the adaptiveness of optimistic bias is whether students have a sense of control over academic outcomes: optimistically-biased (OB) achievement expectations paired with perceptions of academic control may enhance performance and well-being; optimistic bias in the absence of perceived control may result in disappointment, poor performance, and diminished well-being. The current longitudinal study examined academic control cognitions (ACC) among OB college students (n = 319) versus non-optimistically biased (non-OB) students (n = 321). We also examined the effects of academic optimistic bias on composite measures of college performance (perceived success, final psychology course grades, cumulative GPA, course attrition) and well-being (positive and negative emotions, health behaviors, future optimism) 6 months later; and determined whether ACC accounted for those associations. Significant MANCOVAs showed OB students had greater ACC, better subsequent well-being, and outperformed their non-OB counterparts. These well-being and performance differences remained significant after statistically accounting for initial aptitude and ACC. Overall, academic optimistic bias was accompanied by perceived controllability over scholastic outcomes, yet beyond the effects of ACC, optimistic bias was associated with better year-end performance and well-being. Findings have implications for maximizing the successful transition of first-year college students.     

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.     

Sense of control in late life: health and survival implications

Believing that one can influence outcomes presumably fosters a psychological sense of control. So too, however, might adaptive ways of thinking known as secondary control (SC) processes that operate when outcomes are believed to be unattainable. Using a 5-year prospective design and a representative sample of adults (ages 79-98), folk beliefs (e.g., "negative experiences can be a blessing in disguise") were used to assess SC processes. The authors expected SC Folk Beliefs would predict Sense of Control (Hypothesis 1) which, in turn, would predict self-rated health, hospital admissions, and survival (Hypothesis 2). An indirect relationship was hypothesized: SC Folk Beliefs were expected to predict outcomes through the Sense of Control (Hypothesis 3). Support was found for all hypotheses providing insights into the antecedents and consequences of a sense of control and about how SC beliefs and a sense of control function in the context of health.     

Sustaining Primary Control Striving for Achievement Goals During Challenging Developmental Transitions: The Role of Secondary Control Strategies

Developmental transitions are imbued with ubiquitous uncertainties that undermine goal striving in many otherwise committed individuals. Our seven-month study examined whether cognitive selective secondary control strategies (motivation-focused thinking) facilitate the enactment of achievement goals among young adults experiencing the landmark school to university transition. Sequential regression analyses demonstrated that (a) achievement goals predicted selective secondary control, (b) selective secondary control predicted behavioral selective primary control striving, and (c) selective primary control predicted final course grades. Findings support Heckhausen et al.'s (2010 Heckhausen , J. , Wrosch , C. , &; Schulz , R. ( 2010 ). A motivational theory of life-span development . Psychological Review , 117 , 32 – 60 .[Crossref], [PubMed], [Web of Science ®] , [Google Scholar]) proposition that selective secondary control bolsters selective primary control striving and enables goal attainment during difficult transitions.     

Attribution-based motivation treatment efficacy in an online learning environment for students who differ in cognitive elaboration

Attribution-based motivation treatments can boost performance in competitive achievement settings (Perry and Hamm 2017), yet their efficacy relative to mediating processes and affect-based treatments remains largely unexamined. In a two-semester, pre-post, randomized treatment study (n?=?806), attributional retraining (AR) and stress-reduction (SR) treatments were administered in an online learning environment to first-year college students who differed in cognitive elaboration (low, high). Low elaborators who received AR outperformed their SR peers by nearly a letter grade on a class test assessed 5 months post-treatment. Path analysis revealed this AR-performance linkage was mediated by causal attributions, perceived control, and positive and negative achievement emotions in a hypothesized causal sequence. Results advance the literature by showing AR (vs. SR) improved performance indirectly via cognitive and affective process variables specified by Weiner’s (1985a, 2012) attribution theory of motivation and emotion.     

Primary and Secondary Control in Achievement Settings: A Longitudinal Field Study of Academic Motivation,Emotions, and Performance1

The present research represents an application of Rothbaum et al.'s (1982) dual‐process model of perceived control to adaptation in achievement settings. This eight‐month longitudinal field study examined how primary and secondary control influenced end‐of‐year academic motivation (e.g., voluntary course withdrawal), emotions (e.g., stress, regret, pride), and performance (e.g., cumulative grade point average) in 703 first‐year college students. For successful students, primary control related to better performance, higher motivation, and more positive affect. For unsuccessful students, the combination of primary and secondary control resulted in optimal academic adjustment. Unsuccessful students who rely on primary at the expense of secondary control risk serious long‐term deficits in motivation and performance. These findings are discussed with respect to academic overconfidence and control‐enhancing treatments.     

Attributions for physical activity in very old adults: predicting everyday physical activity and mortality risk

Objectives: Although physical activity is recognised as a health-promoting behaviour for older adults, notable barriers exist that may reduce physical activity in this age group. Limited research has explored causal beliefs (attributions) as a barrier to physical activity. Our study assessed associations between older adults’ attributions about physical activity and objective health outcomes. Methods: We examined the role of attributions as a predictor of everyday physical activity (EPA) and subsequent mortality risk over a 10-year period (2006–2016) in a sample of older adults (M_age?=?87, N?=?261). Results: OLS and Cox proportional hazard regression analyses revealed older adults who endorsed more internal and uncontrollable attributions for limited activity (physical incapacity) when feeling unwell had lower subsequent EPA (β?=??0.18), and higher 10-year mortality risk (HR?=?1.46). Other attributions with different dimensional properties (e.g. internal and controllable) were not associated with EPA or mortality. Discussion: Findings suggest that causal beliefs older adults have about their physical activity can influence their future behaviour and longevity. Psychological treatments designed to discourage maladaptive attributional thinking for older populations who face barriers to physical activity may be an important avenue for future research.