Stephanie J. Wilson, Alex Woody, and Janice K. Kiecolt-Glaser
Inflammatory markers provide invaluable tools for studying health and disease across the lifespan. Inflammation is central to the immune system’s response to infection and wounding; it also can increase in response to psychosocial stress. In addition, depression and physical symptoms such as pain and poor sleep can promote inflammation and, because these factors fuel each other, all contribute synergistically to rising inflammation. With increasing age, persistent exposure to pathogens and stress can induce a chronic proinflammatory state, a process known as inflamm-aging.
Inflammation’s relevance spans the life course, from childhood to adulthood to death. Infection-related inflammation and stress in childhood, and even maternal stress during pregnancy, may presage heightened inflammation and poor health in adulthood. In turn, chronically heightened inflammation in adulthood can foreshadow frailty, functional decline, and the onset of inflammatory diseases in older age.
The most commonly measured inflammatory markers include C-reactive protein (CRP) and proinflammatory cytokines interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-α). These biomarkers are typically measured in serum or plasma through blood draw, which capture current circulating levels of inflammation. Dried blood spots offer a newer, sometimes less expensive collection method but can capture only a limited subset of markers. Due to its notable confounds, salivary sampling cannot be recommended.
Inflammatory markers can be added to a wide range of lifespan developmental designs. Incorporating even a single inflammatory assessment to an existing longitudinal study can allow researchers to examine how developmental profiles and inflammatory status are linked, but repeated assessments must be used to draw conclusions about the associations’ temporal order and developmental changes. Although the various inflammatory indices can fluctuate from day to day, ecological momentary assessment and longitudinal burst studies have not yet incorporated daily inflammation measurement; this represents a promising avenue for future research.
In conclusion, mounting evidence suggests that inflammation affects health and disease across the lifespan and can help to capture how stress “gets under the skin.” Incorporating inflammatory biomarkers into developmental studies stands to enhance our understanding of both inflammation and lifespan development.
Heather N. Schuyler, Brieanne R. Seguin, Nicole Anne Wilkins, and J. Jordan Hamson-Utley
The practice of athletic training involves both physical and psychological strategies when leading patients through the injury recovery process. Research on the psychology of injury offers theoretical foundations that guide the application of strategies to assist the patient with stressors that emerge during rehabilitation. This article applies theory to athletic training practice during injury recovery by examining the stressors that patients experience across the phases of rehabilitation. Addressing both physical and psychological aspects of injury recovery is expected by patients and provides a holistic care model for healthcare practitioners.
Shevaun D. Neupert and Jennifer A. Bellingtier
Daily diary designs allow researchers to examine processes that change together on a daily basis, often in a naturalistic setting. By studying within-person covariation between daily processes, one can more precisely establish the short-term effects and temporal ordering of concrete daily experiences. Additionally, the daily diary design reduces retrospective recall bias because participants are asked to recall events that occurred over the previous 24-hour period as opposed to a week or even a year. Therefore, a more accurate picture of individuals’ daily lives can be captured with this design. When conclusions are drawn between people about the relationship between the predictors and outcomes, the covariation that occurs within people through time is lost. In a within-person design, conclusions can be made about the simultaneous effects of within-person covariation as well as between-person differences. This is especially important when many interindividual differences (e.g., traits) may exist in within-person relationships (e.g., states).
Daily diary research can take many forms. Diary research can be conducted with printed paper questionnaires, divided into daily booklets where participants mail back each daily booklet at the end of the day or entire study period. Previous studies have called participants on the telephone to respond to interview questions each day for a series of consecutive days, allowing for quantitative as well as qualitative data collection. Online surveys that can be completed on a computer or mobile device allow the researcher to know the specific day and time that the survey was completed while minimizing direct involvement with the collection of each daily survey. There are many opportunities for lifespan developmental researchers to adopt daily diary designs across a variety of implementation platforms to address questions of important daily processes. The benefits and drawbacks of each method along with suggestions for future work are discussed, noting issues of particular importance for aging and lifespan development.
Karen Z. H. Li, Halina Bruce, and Rachel Downey
Research on the interplay of cognition and mobility in old age is inherently multidisciplinary, informed by findings from life span developmental psychology, kinesiology, cognitive neuroscience, and rehabilitation sciences. Early observational work revealed strong connections between sensory and sensorimotor performance with measures of intellectual functioning. Subsequent work has revealed more specific links between measures of cognitive control and gait quality. Convergent evidence for the interdependence of cognition and mobility is seen in patient studies, wherein cognitive impairment is associated with increased frequency and risk of falling. Even in cross-sectional studies involving healthy young and older adults, the effects of aging on postural control and gait are commonly exacerbated when participants perform a motor task with a concurrent cognitive load. This motor-cognitive dual-task method assumes that cognitive and motor domains compete for common capacity, and that older adults recruit more cognitive capacity than young adults to support gait and posture.
Neuroimaging techniques such as magnetic resonance imaging (MRI) have revealed associations between measures of mobility (e.g., gait velocity and postural control) and measures of brain health (e.g., gray matter volumes, cortical thickness, white matter integrity, and functional connectivity). The brain regions most often associated with aging and mobility also appear to subserve high-level cognitive functions such as executive control, attention, and working memory (e.g., dorsolateral prefrontal cortex, anterior cingulate). Portable functional neuroimaging has allowed for the examination of neural functioning during real-time walking, often in conjunction with detailed spatiotemporal measures of gait. A more recent strategy that addresses the interdependence of cognitive and motor processes in old age is cognitive remediation. Cognitive training has yielded promising improvements in balance, walking, and overall mobility status in healthy older adults, and those with age-related neurodegenerative conditions such as Parkinson’s Disease.
Steven J. Petruzzello
A historically popular research topic in exercise psychology has been the examination of the exercise-anxiety relationship, with an ever-growing literature exploring the link between exercise and anxiety. In addition to its potential for preventing anxiety and anxiety disorders, an increasing number of studies have examined the utility of physical activity and exercise interventions for the treatment of elevated anxiety and clinical anxiety disorders. A National Institute of Mental Health “state-of-the-art workshop” in 1984 was the first significant call put forth that understanding the anxiety-reducing potential of exercise was important and required further investigation. Since the publication of the evidence that came out of that NIMH workshop in Morgan and Goldston’s 1987 book, “Exercise and Mental Health,” a great deal more has been learned yet key aspects of the relationship between exercise and anxiety remain unknown. There is a great deal of work that remains to make good on the “potential efficacy of exercise.”
This article aims to provide a narrative overview on injury prevention in sport and performance psychology. Research and applied interest in psychological injury prevention in sport and performance psychology has risen in popularity over the past few decades. To date, existing theoretical models, pure and applied research, and practice-based evidence has focused on conceptualizing and examining psychological injury occurrence and prevention through stress-injury mechanisms, and predominantly in sport injury settings. However, given the inherited similarities across the different performance domains however, it is the authors’ belief that existing injury prevention knowledge can be transferable beyond sport but should be done with caution. A range of cognitive-affective-behavioral strategies such as goal setting, imagery, relaxation strategies, self-talk, and social support have been found beneficial in reducing injuries, particularly when used systematically (a) prior to injury occurrence as part of performance enhancement program and/or as a specific injury prevention measure, (b) during injury rehabilitation, and (c) as part of a return-to-activity process to minimize the risk of secondary injuries and reinjuries. Existing theoretical and empirical evidence also indicates that using cognitive-affective-behavioral strategies for injury prevention are effective when used as part of a wider, multi-modal intervention. Equally, such interventions may also need to address possible behavioral modifications required in sleep, rest, and recovery. Considering the existing empirical and anecdotal evidence to date, this paper argues that injury prevention efforts in sport and performance psychology should be cyclical, biopsychosocial, and person-centered in nature. In short, injury prevention should be underpinned by recognition of the interplay between personal (both physical and psychological), environmental, and contextual characteristics, and how they affect the persons’ cognitive-affective-behavioral processes before, during, and after injury occurrence, at different phases of rehabilitation, and during the return to activity or retirement from activity process. Moreover, these holistic injury prevention efforts should be underpinned by a philosophy that injury prevention is inherently intertwined with performance enhancement, with the focus being on the individual and their overall well-being.
Idan Shalev and Waylon J. Hastings
Stress is a multistage process during which an organism perceives, interprets, and responds to threatening environmental stimuli. Physiological activity in the nervous, endocrine, and immune systems mediates the biological stress response. Although the stress response is adaptive in the short term, exposure to severe or chronic stressors dysregulates these biological systems, promoting maladaptive physiology and an accelerated aging phenotype, including aging on the cellular level. Two structures implicated in this process of stress and cellular aging are telomeres, whose length progressively decreases with age, and mitochondria, whose respiratory activity becomes increasingly inefficient with advanced age. Stress in its various forms is suggested to influence the maintenance and stability of these structures throughout life. Elucidating the interrelated connection between telomeres and mitochondria and how different types of stressors are influencing these structures to drive the aging process is of great interest. A better understanding of this subject can inform clinical treatments and intervention efforts to reduce (or even reverse) the damaging effects of stress on the aging process.
Sarah E. Hampson
Although the belief that personality is linked to health goes back at least to Greek and Roman times, the scientific study of these links began in earnest only during the last century. The field of psychosomatic medicine, which grew out of psychoanalysis, accepted that the body and the mind were closely connected. By the end of the 20th century, the widespread adoption of the five-factor model of personality and the availability of reliable and valid measures of personality traits transformed the study of personality and health. Of the five broad domains of personality (extraversion, agreeableness, conscientiousness, emotional stability, and intellect/openness), the most consistent findings in relation to health have been obtained for conscientiousness (i.e., hard-working, reliable, self-controlled). People who are more conscientious have better health and live longer lives than those who are less conscientious. These advantages are partly explained by the better health behaviors, good social relationships, and less stress that tend to characterize those who are more conscientious. The causal relation between personality and health may run in both directions; that is, personality influences health, and health influences personality. In addition to disease diagnoses and longevity, changes on biomarkers such as inflammation, cortisol activity, and cellular aging are increasingly used to chart health in relation to personality traits and to test explanatory models. Recognizing that both personality and health change over the life course has promoted longitudinal studies and a life-span approach to the study of personality and health.
Stuart Linke and Elizabeth Murray
Alcohol-use disorders are widespread and associated with a greatly increased risk of health-related and societal harms. The majority of harms associated with consumption are experienced by those who drink above recommended guidelines, rather than those who are alcohol dependent. Brief interventions and treatments based on screening questionnaires and feedback have been developed for this group, which are effective tools for reducing consumption in primary care and in other settings. Most people who drink excessively do not receive help to reduce the risks associated with excessive consumption. Digital versions of brief and extended interventions have the potential to reach populations that might derive benefit from them. Digital interventions utilize the same principles as do traditional face-to-face versions, but they have the advantages of availability, confidentiality, flexibility, low marginal costs, and treatment integrity. The evidence for the feasibility, acceptability, costs, and effectiveness of digital interventions is encouraging, and the evidence for effectiveness is particularly strong in studies of student populations. There are, however, a number of unresolved questions. It is not clear which components of interventions are required to maximize effectiveness, whether digital versions are enhanced by the addition of personal contact from a facilitator or a health professional, or how to increase take up of the offer of a digital intervention and reduce attrition from a program. These questions are common to many online behavior-change interventions and there are opportunities for cross-disciplinary learning between psychologists, health professionals, computer scientists, and e-health researchers.
Amy E. Richardson and Elizabeth Broadbent
Cognitions about illness have been identified as contributors to health-related behavior, psychological well-being, and overall health. Several different theories have been developed to explain how cognitions may exert their impact on health outcomes. This article includes three theories: the Health Belief Model (HBM), the Theory of Planned Behavior (TPB), and the Common Sense Model (CSM), with the primary focus on the CSM. The HBM posits that cognitions regarding susceptibility to a health threat, the severity of the threat, and the benefits and costs associated with behavior, will determine whether or not a behavior is performed. In the TPB, behavior is thought to be a consequence of intention to act, which is shaped by attitudes regarding a behavior, subjective norms, and perceived behavioral control. The Common Sense Model (CSM) proposes that individuals form cognitive representations of illness (known as illness perceptions) as well as emotional representations, which are key determinants of coping behaviors to manage the illness. Coping behaviors are theorized to have direct relationships with physical and psychological health outcomes. Cognitive representations encompass perceptions regarding the consequences posed by the illness, its timeline, personal ability to control the illness, whether the illness can be cured or controlled by treatment, and the identity of the illness (including its label and symptoms). Emotional representations reflect feelings such as fear, anger, and depression about the illness. The development of illness representations is influenced by a number of factors, including personal experience, the nature of physical symptoms, personality traits, and the social and cultural context. Illness cognitions can vary considerably between patients and health care professionals. There are a number of methods to assess illness-related cognitions, and increasing evidence that modifying negative or inaccurate cognitions can improve health outcomes.