The Profile of Stress and Coping Related to Successful Aging Among Chinese Migrant and Nonmigrant Grandparents

BACKGROUND AND OBJECTIVES

Around eight million older adults have internally migrated to take care of grandchildren in China. This study aimed to explore how Chinese migrant and nonmigrant grandparents perceived successful aging and how they coped with challenges to successful aging.

RESEARCH DESIGN AND METHODS

Based on ecological systems theory, semistructured interviews were conducted among 21 grandparents (12 migrants, median age = 59 years old) from urban areas in China who provided noncustodial grandchild care. Deductive content analysis was employed to examine the data pertaining to the definition of successful aging, the stressors encountered, and coping strategies employed by both groups.

RESULTS

Findings revealed that both migrant and nonmigrant grandparents placed a higher emphasis on family prosperity than their own physical health, in their definitions of successful aging. Although both groups experienced common stressors in the microsystem (e.g., intergenerational conflicts), migrant grandparents uniquely encountered stressors in the mesosystem (e.g., hardships in their close relationships) and in the macrosystem (e.g., uncertainty in aging preparation). In terms of coping, migrant grandparents exhibited a distinctive pattern of utilizing avoidant coping strategies when navigating intergenerational conflicts and planning for their later life, compared to nonmigrant grandparents.

DISCUSSION AND IMPLICATIONS

Our findings suggested that although migration was not associated with grandparents' definition of successful aging, migrant grandparents encountered specific challenges in achieving successful aging. This highlights the necessity of providing more support to grandparents through the family, community, or state, particularly to those who are migrants.

The Human Affectome

Over the last decades, theoretical perspectives in the interdisciplinary field of the affective sciences have proliferated rather than converged due to differing assumptions about what human affective phenomena are and how they work. These metaphysical and mechanistic assumptions, shaped by academic context and values, have dictated affective constructs and operationalizations. However, an assumption about the purpose of affective phenomena can guide us to a common set of metaphysical and mechanistic assumptions. In this capstone paper, we home in on a nested teleological principle for human affective phenomena in order to synthesize metaphysical and mechanistic assumptions. Under this framework, human affective phenomena can collectively be considered algorithms that either adjust based on the human comfort zone (affective concerns) or monitor those adaptive processes (affective features). This teleologically-grounded framework offers a principled agenda and launchpad for both organizing existing perspectives and generating new ones. Ultimately, we hope the Human Affectome brings us a step closer to not only an integrated understanding of human affective phenomena, but an integrated field for affective research.

The neuroscience of positive emotions and affect: Implications for cultivating happiness and wellbeing

This review paper provides an integrative account regarding neurophysiological correlates of positive emotions and affect that cumulatively contribute to the scaffolding for happiness and wellbeing in humans and other animals. This paper reviews the associations among neurotransmitters, hormones, brain networks, and cognitive functions in the context of positive emotions and affect. Consideration of lifespan developmental perspectives are incorporated, and we also examine the impact of healthy social relationships and environmental contexts on the modulation of positive emotions and affect. The neurophysiological processes that implement positive emotions are dynamic and modifiable, and meditative practices as well as flow states that change patterns of brain function and ultimately support wellbeing are also discussed. This review is part of "The Human Affectome Project" (http://neuroqualia.org/background.php), and in order to advance a primary aim of the Human Affectome Project, we also reviewed relevant linguistic dimensions and terminology that characterizes positive emotions and wellbeing. These linguistic dimensions are discussed within the context of the neuroscience literature with the overarching goal of generating novel recommendations for advancing neuroscience research on positive emotions and wellbeing.

Relationship quality and 5-year mortality risk

OBJECTIVE

The present study examined positive and negative aspects of relationship quality with one's spouse or partner as predictors of mortality and the role of gender in moderating this link.

METHOD

Data were drawn from 2 waves, 5 years apart, of the National Social Life, Health, and Aging Project (N = 1,734). Positive aspects of relationship quality (frequency of opening up to the partner to talk about worries and relying on the partner) and negative aspects (frequency of the partner making too many demands and criticism by the partner) were assessed. Survival/mortality status was recorded at the time of Wave 2 data collection 5 years later (1,567 alive; 167 deceased). Covariates included sociodemographic variables, relationship type, health status, and the network size of close family relationships and friendships.

RESULTS

Logistic regression analyses showed that negative relationship quality with one's spouse or partner was associated with significantly higher odds for mortality after 5 years (odds ratio [OR] = 1.20, 95% CI [1.03, 1.38], p < .001), after including the statistical covariates. Also, age, gender, education, self-rated health, and medication use were significantly related to mortality. Propensity score matching replicated these findings. Follow-up analyses revealed that criticism from one's spouse or partner, in particular, was linked to a higher mortality risk (OR = 1.44, 95% CI [1.10, 1.88]). Gender did not moderate the relationship-quality-mortality link.

CONCLUSIONS

Negative relationship quality, notably, criticism received from one's spouse or partner, heightens older adults' risk of mortality. These results suggest the value of developing interventions that target reducing expressed criticism in couple relationships. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Confidant Availability (In)Stability and Emotional Well-Being in Older Men and Women

Purpose of the study

The present study examined the role of stability and change in the availability of a family member and a friend as a confidant in older adults' emotional well-being.

Method

Participants in two waves of the Wisconsin Longitudinal Study (N = 4,631; M = 64.3, 53.7% female) were assessed on depressive symptoms and the availability of a family member and friend as confidant. Using mixed linear effects models, four groups were compared over time and across gender on depressive symptoms: those with and without a family/friend confidant at both waves and those who lost and gained a family/friend confidant.

Results

Those with stable availability of a family or friend confidant consistently scored the lowest on depressive symptoms; the gain of a family or friend confidant corresponded with a decrease in depressive symptoms, with a larger effect seen for the gain of a family confidant; the loss of a family confidant was associated with an increase in depressive symptoms over time; and stable availability of a family or friend confidant was more strongly linked to lower levels of depressive symptoms among women, whereas stable unavailability of a family confidant was linked to higher levels of depressive symptoms.

Implications

Stable availability of either a family or friend confidant in late life is especially salient to emotional well-being, notably among women. Emotional well-being benefits from the gain of a confidant highlight the importance of supplementing or substituting a loss, especially of a family confidant, which is associated with a significant increase in depressive symptoms.

The Role of Marital Quality in Physical Health During the Mature Years

Objective: This study examined the role of marital quality in the physical health of mature adults. Method: Participants were from the National Survey of Midlife Development in the United States aged 50+ years who were in their first marriage. Five dimensions of marital quality and four indicators of physical health were used. Results: Regression analyses indicated that marital quality indices accounted fora significant amount of explained variance in physical health. Most notably, higher levels of negative spousal behaviors uniquely contributed to physical health, predicting more physical symptoms, chronic health problems, and physical disability, and poorer perceived health. Discussion: The occurrence of negative spousal behaviors was consistently associated with poorer physical health. The negativity effect observed regarding the costs and benefits of social support in general also applies to the context of marriage in that negative spousal behaviors outweigh positive spousal behaviors in contributing to mature adults’ physical health.

Body Objectification, Social Pressure, and Disordered Eating Behavior in College Women: The Role of Sorority Membership

Social pressure to conform to the thin ideal is believed to play a decisive role in the development of eating disorders. In this field study at a college with only sophomore rush, 99 sorority women, 80 nonsorority women past their first year, and 86 first-year women completed three subscales of the Eating Disorders Inventory-2 ( Garner, 1991 ), the Objectified Body Consciousness Scale ( McKinley & Hyde, 1996 ), and a measure of peer social pressure. It was hypothesized that women belonging to sororities as well as those who intended to join would score higher than nonsorority and first-year women with no intention to join on these measures of disordered eating, body objectification, and social pressure. It also was predicted that the amount of time spent living in a sorority house as well as degree of social pressure would correlate positively with higher scores on body objectification and disordered eating. Results supported nearly all hypotheses, suggesting both that sororities attract at-risk women and that living in a sorority house is associated with increased likelihood of disordered eating.

Spouse health status, depressed affect, and resilience in mid and late life: a longitudinal study

This study used longitudinal data to examine the effects of spousal illness on depressive symptoms among middle-aged and older married individuals and the extent to which the adverse effects of illness in a spouse were mitigated by 2 psychological resources, mastery and self-esteem. Using 1,704 married participants who were 51 years of age on average, depressive symptoms were compared in 4 groups varying in their experience of spousal health transitions: those whose spouse remained ill at T1 and T2, those whose spouse declined in health from T1 to T2, those whose spouse's health improved from T1 to T2, and those whose spouse remained healthy at both time points. Mixed analyses of covariance showed that, as hypothesized, having a spouse who became or remained ill over time was linked to greater depressed affect by T2, whereas having a spouse improve in health was associated with a decline in depressive symptomatology. Moderated regression analyses indicated that while higher mastery and self-esteem were linked to lower depressed affect in general, these resources were especially protective against depressed affect for those whose spouse remained ill at both time points. These findings are at the intersection of life course theory and the stress process model highlighting the contextual forces in and the interconnectedness of individual development as well as the plasticity and resilience evident in adaptation to stress during mid and late life.

Marital quality as a moderator of the effects of poor vision on quality of life among older adults

OBJECTIVES

This study assessed the moderating role of marital quality in the effects of subjective and objective vision on functional limitations, social isolation, and depressive symptomatology.

METHOD

Data from 738 married older adults drawn from a probability-based representative sample of elders residing in the United States were used. Assessments included subjective and objective vision, marital quality variables (relationship satisfaction, supportive spouse behaviors, and free time spent with one's spouse), and three aspects of quality of life (functional limitations, social isolation, and depressive symptomatology).

RESULTS

Moderated regression analyses found that relationship satisfaction and supportive spouse behaviors moderated the effects of poor self-reported vision on functional limitations and depressive symptoms and the effects of poor visual acuity on functional limitations. As hypothesized, poorer vision was unrelated to functional limitations and depressive symptoms in more satisfying marriages but predicted higher levels of both outcomes in less satisfying marriages. Contrary to expectations, higher levels of supportive spouse behaviors were associated with more functional limitations in respondents who reported poorer subjective and objective vision.

DISCUSSION

A marriage that is highly satisfying can mitigate the adverse effects of poor vision on functional limitations and depressive symptomatology in late life. The moderating role of supportive spouse behaviors in the link between poor vision and quality of life is less intuitive, however. Whereas relationship satisfaction may operate as a traditional buffer in the context of poor vision, supportive spouse behaviors may increase in response to or be ineffective in this context.

Poor vision, functioning, and depressive symptoms: a test of the activity restriction model

PURPOSE

This study tested the applicability of the activity restriction model of depressed affect to the context of poor vision in late life. This model hypothesizes that late-life stressors contribute to poorer mental health not only directly but also indirectly by restricting routine everyday functioning.

METHOD

We used data from a national probability-based sample of older adults (N = 1,178; M = 69.2 years, approximately 50% female). Vision was assessed both subjectively (via self-report) and objectively (via a visual acuity test). Respondents also reported on their levels of physical and driving limitations, feelings of social isolation, and symptoms of depression.

RESULTS

Path analyses indicated a strong fit of the data to the activity restriction model for subjective vision. In addition to directly contributing to higher depressive symptomatology, subjective vision contributed to depressive symptoms indirectly by predicting more physical limitations and feelings of social isolation that, in turn, contributed to more symptoms of depression; driving limitations did not mediate the relationship between subjective vision and depressive symptomatology. Objective vision contributed significantly to physical and driving limitations but was unrelated to feelings of social isolation and depressive symptomatology. 

IMPLICATIONS

Supporting the activity restriction model, poorer self-rated vision in late life contributes to lower mental health directly and also indirectly by restricting individuals' ability to carry out routine day-to-day physical activities and increasing their feelings of social isolation. Interventions for older adults with vision-related problems could focus on maintaining or enhancing their physical and social functioning in order to promote their adaptation to poor vision.

The role of psychological resources in the affective well-being of never-married adults

We compared psychological resources between heterosexual never-married and married adults and their group-specific role in positive and negative affect after controlling for social resources. Although never-married respondents scored slightly lower than married adults on social resources and affective well-being, the two groups were comparable on psychological resources. Moderated regression analysis indicated that psychological resources were more strongly related to negative affect for never-married than married adults. In addition, never-married respondents with lower personal mastery scored higher on negative affect than did married adults, and higher levels of self-sufficiency contributed to lower negative affect for never-married adults but to higher negative affect among married individuals. Psychological resources appear to have a differential role in shaping negative affect between never-married and married individuals.

The impact of parent care on marital quality and well-being in adult daughters and sons

This study prospectively examined the long-term impact of providing parent care using data from a probability-based U.S. sample of adult daughters and sons who had varying parent care experiences over time (N = 716). Parent care x Gender x Time mixed multivariate analyses of covariance using marital quality and well-being indicators as outcomes showed that, on average, experienced caregivers reported less marital happiness, more marital role inequity, and greater hostility than recent adult child caregivers. Significant three-way interactions indicated that experienced and recent caregiving daughters, respectively, showed an increase over time in depressive symptomatology and long-term depression, whereas their male counterparts showed a decline over the same period. Findings are discussed in terms of gender differences in the relative applicability of the wear-and-tear versus adaptation models of caregiving outcomes.

Identity development and psychological well-being in Korean-born adoptees in the U.S

Because adult Korean-born adoptees have unique experiences, the factors that contribute to their psychological well-being need to be studied separately from both Caucasian and Korean Americans. In this Internet-based study with 83 adult Korean-born adoptees in the United States, both ethnic identity and adjustment to adoption (considered a component of adoptive identity) were expected to predict psychological well-being. Results supported predictions: Each measure of psychological well-being (personal growth, self-acceptance, and positive relationships with others) was affected by the predictive variables in unique ways. Cultural socialization experiences also were related to personal growth, but this association was fully mediated by strength of ethnic identity. Implications for adoptive parents and counselors are discussed.

Gender, Excessive Body Weight, and Psychological Well-Being in Adulthood

We examined gender differences in the association between body mass index (BMI) and psychological well-being. Regression analysis involving 3,251 adults indicated that gender moderated the BMI–psychological well-being link. In follow-up analyses, higher BMI predicted lower psychological well-being only among women. When participants were categorized into 5 BMI groups, women reported lower psychological well-being than men in the overweight and obese I groups, but no gender differences were observed in the more seriously obese or normal-weight groups. Also, among women, all 4 groups with higher-than-normal BMI had lower psychological well-being than normal-weight women; for men, no significant differences were found across the 5 groups. These findings are discussed in relation to research on stigma theory and gender-differentiated cultural norms regarding weight.

Moderating role of marital quality in older adults' depressed affect: beyond the main-effects model

We examine the role of three indicators of marital quality (marital disagreement, marital happiness, and time spent together) as moderators of the association between physical disability and depressed affect among married older individuals (N=1,044). We found support for the moderating role of marital disagreement wherein the detrimental effect of disability on depressed affect was significantly heightened among older adults with more disagreements with their spouse; a moderating effect was not detected for marital happiness or time spent together. We conclude that, in addition to its main effect on older adults' depressed affect, marital quality (as indicated by marital disagreement) plays a significant stress-moderating role in the physical disability-depressed affect link.

Age, Marital Processes, and Depressed Affect

PURPOSE

We examined age-cohort differences in the interrelationships among marital processes and depressed affect.

DESIGN AND METHODS

We used data from individuals in first marriages that participated in the National Survey of Families and Households (NSFH). The NSFH interviewed one adult per household of a nationally representative sample. Participants were categorized into young (n = 2,289), middle-aged (n = 1,145), and older adult (n = 691) age cohorts.

RESULTS

The three age cohorts did not differ on negative marital processes (NMP), but older adults scored significantly higher on marital satisfaction than young and middle-aged adults. Marital satisfaction mediated the link between NMP and depressed affect for young adults and older adults. NMP were more strongly related to depressed affect for young adults than middle-aged adults, whereas marital satisfaction was more strongly related to depressed affect for older adults than young adults.

IMPLICATIONS

Our findings on age-cohort differences in the salience of marital processes to depressed affect are discussed in light of socioemotional selectivity theory.

Concurrent and long-term predictors of older adults' use of community-based long-term care services: the Caregiver Health Effects Study

OBJECTIVE

This study examined concurrent and long-term associations between caregiver-related characteristics and the use of community long-term care services in a sample of 186 older adults caring for a disabled spouse.

METHOD

We used two waves of data from the Caregiver Health Effects Study, an ancillary study of the Cardiovascular Health Study. Caregiver-related need variables as predictors of service use were of primary interest and included caregiving demands, caregiver mental and physical health, and mastery. Their contribution to service use was examined after controlling for known predictors of service use.

RESULTS

At Time 1, more caregiver depressive symptoms predicted greater service use; at Time 2, more caregiver activity restriction and depressive symptoms predicted greater formal service use; increases in caregiver activity restriction and depressive symptomatology over time predicted increases in service use.

DISCUSSION

Caregiver-related need variables play a significant role in defining utilization patterns of community-based long-term care services among older adults.

Effects of Pain on Functioning and Well-Being in Older Adults With Osteoarthritis of the Knee

The effects of pain on functioning and well-being were examined in 367 older adults with osteoarthritis (OA) of the knee. The relationship of OA-related pain to depressive symptoms and perceived health was hypothesized to be direct as well as mediated by physical and social functioning. Results showed that OA-related pain was related to poorer physical and social functioning, had a direct effect on depressive symptoms, and direct and indirect effects on perceived health. Lower social functioning was related to more depressive symptoms, and both lower social and physical functioning predicted worse perceived health. Thus, distinguishing between physical and social functioning when examining the costs of OA-related pain is useful. Moreover, existing pain-psychological well-being models can be generalized to perceived health.

Older adults' attitudes toward death: links to perceptions of health and concerns about end-of-life issues

The current study had two primary goals, to determine whether: 1) self-rated mental and physical health, pain, and experience with health problems were predictors of elderly adults' attitudes toward death; and 2) death attitudes predict end-of-life medical treatment concerns. Participants were 109 adults, 65 years of age or older (M=78.74 years), recruited from the local community. Regression analysis indicated that poorer perceived physical health predicted a greater likelihood of viewing death as an escape, and poorer perceived mental health predicted a greater fear of death. Viewing death as an escape and fearing death predicted end-of-life medical treatment concerns; a greater endorsement of either attitude predicted more concern. Possible explanations for the links between perceived health, attitudes toward death, and concern about end-of-life issues are suggested.

Gender differences in older adults' preferences for life-sustaining medical treatments and end-of-life values

In the present study, we examined gender differences in preferences for life sustaining treatments in response to various health state scenarios and the endorsement of end-of-life values in 99 older adults. Men preferred life-sustaining treatments more than women overall, for specific treatments (i.e., CPR, surgery, and artificial feeding), and in response to specific health scenarios (i.e., current health, Alzheimer's disease, coma with a slight chance of recovery). In terms of values, women indicated a greater desire for a dignified death than men.

A comparison of primary stressors, secondary stressors, and depressive symptoms between elderly caregiving husbands and wives: the Caregiver Health Effects Study

The present study examined gender differences in the experience of primary and secondary caregiving stressors, depressive symptoms, and their interrelationships using a sample of 283 elderly spouse caregivers (145 women, 138 men). Two primary stressors, two secondary stressors, and depressive symptoms were assessed. In general, t-tests indicated that caregiving husbands experience fewer stressors and depressive symptoms than their female counterparts. Multiple group analysis revealed that the primary stressors were more useful in explaining variance associated with the secondary stressors for women than men and that the path coefficients linking amount of caregiving assistance to caregivers' activity restriction was significantly different across men and women. Other paths linking primary stressors, secondary stressors, and depressive symptoms, however, were statistically equivalent across men and women. Hence, although caregiving women and men may vary in their reports of caregiving stressors, the complexity of the caregiving experience appears to be quite uniform for both groups.

Advance directives as acts of communication: a randomized controlled trial

BACKGROUND

Instructional advance directives are widely advocated as a means of preserving patient self-determination at the end of life based on the assumption that they improve surrogates' understanding of patients' life-sustaining treatment wishes. However, no research has examined whether instructional directives are effective in improving the accuracy of surrogate decisions.

PARTICIPANTS AND METHODS

A total of 401 outpatients aged 65 years or older and their self-designated surrogate decision makers (62% spouses, 29% children) were randomized to 1 of 5 experimental conditions. In the control condition, surrogates predicted patients' preferences for 4 life-sustaining medical treatments in 9 illness scenarios without the benefit of a patient-completed advance directive. Accuracy in this condition was compared with that in 4 intervention conditions in which surrogates made predictions after reviewing either a scenario-based or a value-based directive completed by the patient and either discussing or not discussing the contents of the directive with the patient. Perceived benefits of advance directive completion were also measured.

RESULTS

None of the interventions produced significant improvements in the accuracy of surrogate substituted judgment in any illness scenario or for any medical treatment. Discussion interventions improved perceived surrogate understanding and comfort for patient-surrogate pairs in which the patient had not completed an advance directive prior to study participation.

CONCLUSIONS

Our results challenge current policy and law advocating instructional advance directives as a means of honoring specific patient wishes at the end of life. Future research should explore other methods of improving surrogate decision making and consider the value of other outcomes in evaluating the effectiveness of advance care planning.

A comparison of primary stressors, secondary stressors, and depressive symptoms between elderly caregiving husbands and wives: the Caregiver Health Effects Study

The present study examined gender differences in the experience of primary and secondary caregiving stressors, depressive symptoms, and their interrelationships using a sample of 283 elderly spouse caregivers (145 women, 138 men). Two primary stressors, two secondary stressors, and depressive symptoms were assessed. In general, t-tests indicated that caregiving husbands experience fewer stressors and depressive symptoms than their female counterparts. Multiple group analysis revealed that the primary stressors were more useful in explaining variance associated with the secondary stressors for women than men and that the path coefficients linking amount of caregiving assistance to caregivers' activity restriction was significantly different across men and women. Other paths linking primary stressors, secondary stressors, and depressive symptoms, however, were statistically equivalent across men and women. Hence, although caregiving women and men may vary in their reports of caregiving stressors, the complexity of the caregiving experience appears to be quite uniform for both groups.

Elderly adults' preferences for life-sustaining treatments: the role of impairment, prognosis, and pain

Elderly adults' preferences for life-sustaining treatment are known to vary by type of medical condition and treatment. Less is known about how treatment preferences vary based on underlying health dimensions, such as the nature of the impairment, prognostic information, and the experience of pain. Fifty elderly adults stated preferences for 4 life-sustaining treatments in response to 4 pairs of health state scenarios. Overall, life-sustaining treatments were preferred less in response to (a) cognitive versus physical impairment, (b) when the prognosis described no chance versus a very slight chance of recovery/improvement, and (c) if pain was present. These findings have implications for the way in which preferences for life-sustaining treatments are recorded in advance directives. Historically, advance directives have been limited by overly broad or overly specific statements about treatment preferences. Recording underlying health dimensions that guide treatment decisions may allow decision makers to generalize and apply patient preferences to novel health conditions.

The role of neuroticism and mastery in spouse caregivers' assessment of and response to a contextual stressor

Data from more than 300 spousal caregivers and their care recipients were analyzed to demonstrate the effects of caregivers' personality attributes--neuroticism and mastery--on their assessment of a contextual stressor (the care recipient's behavioral and functional impairment) and on their experience of distress associated with that stressor. Caregivers who were high in neuroticism and/or low in mastery reported higher levels of behavioral and functional impairment in their disabled spouse and experienced more strain and depressive symptoms associated with caregiving relative to caregivers with lower neuroticism or higher mastery scores. We further showed that the widely reported association between caregiver-assessed impairment of the care recipient and caregiver outcomes can in part be explained by caregivers' personality attributes, such as neuroticism and mastery. Our findings that caregivers' personality variables are related to their assessment of a given objective stressor and their response to a given level of stress have implications for interventions targeting caregivers and for the use of caregivers as proxy informants.

Spousal similarity in subjective well-being: the Cardiovascular Health Study

This study examines the extent to which one spouse's subjective well-being predicts that of the partner (N = 1,040 spousal pairs, 65 years or older). Prior research is extended in two ways: (a) The similarity of both affective domains (depressive symptoms, feelings about life as a whole, and satisfaction with the meaning and purpose of life) and nonaffective domains (perceived health) are examined, and (b) known predictors of well-being in older adults (sociodemographic variables, self and spouse health status variables, and exposure to common environmental events) are statistically controlled. Results indicate that one spouse's assessments of well-being and depression predict the other's well-being even after controlling for known predictors of these outcomes. Given the similarity of findings for affective and nonaffective domains, multiple mechanisms, including contagion, mate selection, and common environmental influences, are speculated as likely to contribute to this phenomenon.

Spousal similarity in subjective well-being: the Cardiovascular Health Study

This study examines the extent to which one spouse's subjective well-being predicts that of the partner (N = 1,040 spousal pairs, 65 years or older). Prior research is extended in two ways: (a) The similarity of both affective domains (depressive symptoms, feelings about life as a whole, and satisfaction with the meaning and purpose of life) and nonaffective domains (perceived health) are examined, and (b) known predictors of well-being in older adults (sociodemographic variables, self and spouse health status variables, and exposure to common environmental events) are statistically controlled. Results indicate that one spouse's assessments of well-being and depression predict the other's well-being even after controlling for known predictors of these outcomes. Given the similarity of findings for affective and nonaffective domains, multiple mechanisms, including contagion, mate selection, and common environmental influences, are speculated as likely to contribute to this phenomenon.

Pessimism, age, and cancer mortality

Cancer patients (N = 238) receiving palliative radiation treatment were followed for 8 months; 70 patients had died by the 8-month follow-up. Controlling for site of cancer and level of symptomatology at baseline, the authors studied the independent effects on mortality of pessimism, optimism, and depression. The findings show that the endorsement of a pessimistic life orientation is an important risk factor for mortality, but only among younger patients (ages 30-59). Attempts to replicate this finding with conceptually related constructs such as depression or optimism did not yield significant associations for either younger or older patients, suggesting that negative expectations about the future may contribute to mortality in unique ways. The authors conclude that attempts to link psychosocial factors to mortality should focus on specific psychological constructs instead of diffuse, global measures that cover many psychological phenomena and that the role of psychological processes in mortality may vary dramatically depending on age.

Pessimism, age, and cancer mortality

Cancer patients (N = 238) receiving palliative radiation treatment were followed for 8 months; 70 patients had died by the 8-month follow-up. Controlling for site of cancer and level of symptomatology at baseline, the authors studied the independent effects on mortality of pessimism, optimism, and depression. The findings show that the endorsement of a pessimistic life orientation is an important risk factor for mortality, but only among younger patients (ages 30-59). Attempts to replicate this finding with conceptually related constructs such as depression or optimism did not yield significant associations for either younger or older patients, suggesting that negative expectations about the future may contribute to mortality in unique ways. The authors conclude that attempts to link psychosocial factors to mortality should focus on specific psychological constructs instead of diffuse, global measures that cover many psychological phenomena and that the role of psychological processes in mortality may vary dramatically depending on age.

Psychiatric and physical morbidity effects of dementia caregiving: prevalence, correlates, and causes

The dementia caregiving literature is reviewed with the goals of (a) assessing the prevalence and magnitude of psychiatric and physical morbidity effects among caregivers, (b) identifying individual and contextual correlates of reported health effects and their underlying causes, and (c) examining the policy relevance of observed findings. Virtually all studies report elevated levels of depressive symptomatology among caregivers, and those using diagnostic interviews report high rates of clinical depression and anxiety. The evidence is more equivocal and generally weaker for the association between caregiving and physical morbidity, such as self-rated health, number of illnesses, symptomatology, health care utilization, preventive health behaviors, and cardiovascular functioning. Across studies, psychiatric morbidity in caregivers was linked to patient problem behaviors, income, self-rated health, perceived stress, and life satisfaction. Physical morbidity was associated with patient problem behaviors and cognitive impairment, and with caregiver depression, anxiety, and perceived social support. Possible causes of reported effects and policy implications are discussed.

Predictors of perceived health status in elderly men and women. The Cardiovascular Health Study

Baseline data on the perceived health status of participants (N = 5,201) in the Cardiovascular Health Study of the Elderly (CHS) are reported. The authors examined the predictive utility of health-related factors representing eight different domains, assessed gender differences in the prediction of perceived health, and tested a hypothesis regarding the role of known clinical conditions versus subclinical disease in predicting perceived health. Multivariate analyses showed that the majority of the explained variance in self-assessed health is accounted for by variables that fall into four general categories. Although gender differences were small, the analysis showed that the relative importance of several predictor variables did vary by gender.