Health Psychology

Aging does not occur in isolation, but often involves significant others such as spouses. Whether such dyadic associations involve gains or losses depends on a myriad of factors, including the time frame under consideration. What is beneficial in the short term may not be so in the long term, and vice versa. Similarly, what is beneficial for one partner may be costly for the other, or the couple unit over time. Daily dynamics between partners involving emotion processes, health behaviors, and collaborative cognition may accumulate over years to affect the longer-term physical and mental health outcomes of either partner or both partners across adulthood and into old age. Future research should move beyond an individual-focused approach to aging and consider the importance of and interactions among multiple time scales to better understand how, when, and why older spouses shape each other’s aging trajectories, both for better and for worse.

Issues associated with athletics, alcohol abuse, and drug use continue to be salient aspects of popular culture. These issues include high-profile athletes experiencing public incidents as a direct or indirect result of alcohol and/or drug use, the role that performance-enhancing drugs play in impacting outcomes across a variety of professional and amateur contests, and the public-health effects alcohol abuse and drug use can have among athletes at all competitive levels. For some substances, like alcohol abuse, certain groups of athletes may be particularly at-risk relative to peers who are not athletes. For other substances, participating in athletics may serve as a protective factor. Unique considerations are associated with understanding alcohol abuse and drug use in sport. These include performance considerations (e.g., choosing to use or not use a certain substance due to concerns about its impact on athletic ability), the cultural context of different types of sporting environments that might facilitate or inhibit alcohol and/or drug use, and various internal personality characteristics and traits that may draw one toward both athletic activity and substance use. Fortunately, there are several effective strategies for preventing and reducing alcohol abuse and drug use, some of which have been tested specifically among athlete populations. If such strategies were widely disseminated, they would have the potential to make a significant impact on problems associated with alcohol abuse and drug use in sport and athletics.

The term Awareness of Aging (AoA) incorporates all aspects of individuals’ perceptions, behavioral experiences, and subjective interpretations related to their process of growing older. In this regard, AoA goes beyond objective descriptions of the aging process, such as calendar age or biological age. Commonly used AoA constructs referring to the ongoing experience of the aging process encompass concepts such as subjective age, attitudes toward one’s own aging, self-perceptions of aging, and awareness of age-related change. AoA also incorporates elements that are more pre-conscious in nature, such as age stereotypes and culturally held notions about the aging process. Despite their theoretically broad common foundation, AoA constructs differ according to their specific frames of reference, such as whether and how they take into account the multidimensionality and multi-directionality of development. Examining the existing body of empirical work identifies several antecedents of AoA, such as sociodemographic “background” variables, physical health and physical functioning, cognition, psychological well-being and mental health, psychological variables (e.g., personality, anxiety), and life events. In general, more positive manifestations on these variables are accompanied by a more positive perception and evaluation of the aging process. Moreover, AoA is longitudinally linked to important developmental outcomes, such as health, cognition, subjective well-being, and mortality. Overall, the study of AoA has developed as a promising area of psychological aging research that has grown in its conceptual and empirical rigor during recent years.

This is an advance summary of a forthcoming article in the Oxford Research Encyclopedia of Psychology. Please check back later for the full article.

The assessment of cardiovascular (CV) responses associated with behavioral phenomena has long been an important component of psychological research seeking to better understand the physiological underpinnings of behavior. Within the field of gerontology, there has historically been much interest in CV responses. Much of this work has focused on blood pressure as an important reflection of CV functioning that is relatively simple to assess. An examination of the gerontological literature reveals at least three different ways in which researchers have used blood pressure to examine aging-related processes. One approach is to use blood pressure as a measure of health, either in terms of the level of functioning of the CV system or as a reflection of various disease-related processes, and examine its relationship to other aspects of functioning. For example, blood pressure has been frequently examined in relation to cognitive decline. A second approach has been to examine blood pressure reactivity as a reflection of physiological responses to stress. Aging has been associated with higher levels of reactivity to the emotionally evocative, and thus an examination of normative changes in reactivity may be useful in understanding the impact of aging on the ability to deal with stress. Reactivity is also potentially useful in understanding the impact of stress on health, with high levels of reactivity along with high frequency of such incidences being associated with negative health outcomes. In the field of gerontology, the additional burden associated with elevated levels of reactivity in later life is of particular interest. Finally, recent work has also focused on blood pressure as a measure of an individual’s attempts to actively cope with challenging situations, broadly defined. Building off the active coping model of Obrist, blood pressure responses in a given situation are viewed as direct reflections of active coping as the cardiovascular system is energized to provide the resources needed by the body and nervous system to deal with a given situation. The level of response has been shown to reflect both the difficulty of the task and the individual’s motivation, and thus is a relatively reliable indicator of (a) an individual’s engagement in a particular task and (b) the resources necessary to perform that task. Recent work on aging has focused on the utility of this measure as a reflection of the costs associated with cognitive engagement and the extent to which variation in these costs might predict both between-individual and age-related normative variation in participation in cognitively demanding—but potentially beneficial—activities.

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.

In 2016, Statistics Canada released the results of the most recent census. For the first time ever, the proportion of Canadians aged 65-plus years surpassed the proportion aged 15 and under. The increase in the proportion of older adults was viewed as further evidence of the faster rate of aging of Canada’s population. Such demographic shifts are not unique to Canada; many industrialized nations around the world are experiencing similar changes in their populations. Increases in the older adult population in many countries might produce beneficial outcomes by increasing the potential for intergenerational contact and exposure to exemplars of successful aging. Such positive intergenerational contact could counter prevailing age stereotypes and improve intergenerational relations. On the other hand, such increases in the number of older adults could be viewed as a strain and potential threat to resources shared with younger age groups. The possibility of increased intergenerational conflict makes it more important than ever before to understand how older adults are stereotyped, how those stereotypes can produce different kinds of biased behavior toward them, and what the impact of those stereotypes are on older adults themselves.

Social-cognitive age representations are complex and multifaceted. A common stereotype applied to older people is one of warmth but incompetence, often resulting in paternalistic prejudice toward them. However, such benevolent prejudice, characterized by warm overtones, can change to hostile bias if older adults are perceived to violate prescriptive norms about age-appropriate behavior. In addition to coping with age prejudice, older adults also have to deal with the deleterious effects of negative age stereotypes on their day-to-day function. Exposure to negative aging stereotypes can worsen older adults’ cognitive performance in a number of contexts. As well, age stereotypes can be incorporated into older adults’ own views of aging, also leading to poorer outcomes for them in a variety of domains. A number of interventions to counteract the effects of negative aging stereotypes appear promising, but more work remains to be done to reduce the impact of negative aging stereotypes on daily function in later life.

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.

There is no doubt that exercise, a vital health-promoting activity, regardless of health status, produces numerous well-established physical, functional, and mental health benefits. Many people, however, do not adhere to medical recommendations to exercise consistently, especially if they have chronic illnesses. Put forth to explain this conundrum are numerous potential explanatory factors. Among these are mental health correlates such as anxiety, fear, fatigue, pain, motivation, and depression, as well as various self-efficacy perceptions related to exercise behaviors, which may be important factors to identify and intervene upon in the context of promoting adherence to physical activity recommendations along with efforts to reduce the cumulative health and economic burden of exercise non-adherence among the chronically ill and those at risk for chronic illnesses.

This is an advance summary of a forthcoming article in the Oxford Research Encyclopedia of Psychology. Please check back later for the full article.

Within psychology, the term habit is most often used to refer to a process whereby situations prompt action automatically, through activation of mental situation-action associations acquired through prior performances. Unlike consciously intended behavior, which proceeds via a cognitively effortful reflective processing system, behavior that is directed by habit is regulated by an impulsive processing system, and so can be elicited with minimal cognitive effort, awareness, control, or intention. The habit formation process involves a gradual transferral of action initiation from the conscious attentional or motivational processes involved in reflective processing, to external cuing mechanisms characteristic of impulsive processing. Behavior thus becomes detached from motivational or volitional control, freeing finite cognitive resources for unfamiliar or otherwise more demanding tasks. Upon encountering associated situations, habitual tendencies dominate action regulation, and alternative actions become less readily accessible.

By virtue of these characteristics, habit theory proposes that habit strength will predict the likelihood of enactment of habitual behavior, and that strong habitual tendencies will dominate over motivational tendencies. Evidence of these effects, albeit predominantly observational and correlational, has been found for many everyday socially significant and health-relevant behaviors, such as physical activity, healthy eating, alcohol consumption, TV viewing, and travel mode choice. Such findings have stimulated interest in habit formation as a behavior change mechanism—commentators have argued that adding habit formation components into behavior change interventions should sustain what are otherwise typically only short-term effects, by shielding new behaviors against potential motivational lapses. Habit-based interventions differ from non-habit-based interventions in that they include elements that promote context-dependent repetition, with the explicit aim of developing situation-action associations, and thus, situationally cued automatic behavioral responses. A wealth of habit-based behavior change interventions have been studied in clinical trials and have mostly shown positive effects on behavior. However, due to the methodological limitations of these trials, the longevity of such effects, and the unique impact on behavior of habit-focused components are not yet known. As an intervention strategy, habit formation has been shown to be acceptable to intervention recipients, who report that, through repetition, behaviors gradually become routinized and “second nature.” Whether habit formation interventions truly offer a route to long-lasting behavior change, however, remains unclear.

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.