Alice M. L. Chong

Optimism, positive affectivity, and salivary cortisol

OBJECTIVES Research on stress and salivary cortisol has focused almost exclusively on the effects of negative psychological conditions or emotional states. Little attention has been drawn to the impact associated with positive psychological conditions, which have been shown recently to have significant influences on neuroendocrine regulation. The aim of this study is to examine the impact of optimism and positive affect on salivary cortisol with the effects of their negative counterparts controlled for. DESIGN Optimism and pessimism, and positive and negative affectivity were studied in relation to the diurnal rhythm of salivary cortisol in a group of 80 Hong Kong Chinese, who provided six saliva samples over the course of a day on two consecutive days. The separate effects of optimism and positive affect on two dynamic components of cortisol secretion, awakening response, and diurnal decline were examined. METHODS Optimism and pessimism were measured using the Chinese version of the revised Life Orientation Test while generalized affects and mood states were assessed by the Chinese Affect Scale. An enzyme-linked immunoabsorbent assay kit (EIA) developed for use in saliva was adopted for the biochemical analysis of cortisol. Testing of major group differences associated with positive psychological conditions was carried out using two-way (group by saliva collection time) ANOVAs for repeated measures with negative psychological conditions and mood states as covariates. RESULTS Participants having higher optimism scores exhibited less cortisol secretion in the awakening period when the effect of pessimism and mood were controlled. This effect was more apparent in men than in women who had higher cortisol levels in the awakening period. Optimism did not have similar effect on cortisol levels during the underlying period of diurnal decline. On the other hand, higher generalized positive affect was associated with lower cortisol levels during the underlying period of diurnal decline after the effects of negative affect and mood states had been controlled. Generalized positive affect did not significantly influence cortisol secretion during the awakening period. CONCLUSIONS These findings suggest that positive psychological resources including optimism and generalized positive affect had higher impact on cortisol secretion than their negative counterparts, and point to the need for increased attention to the potential contribution of positive mental states to well-being.

Positive ageing: the views of middle-aged and older adults in Hong Kong

Life expectancy has been increasing rapidly in many parts of the world, including Hong Kong. A longer life can be welcome as an opportunity to fulfil as yet unmet aspirations, or to take up new challenges and projects, but it may also be a burden, especially for individuals who are unprepared. A pressing question for longer-life societies is: how may older people live their longer lives to the full positively? This article reports a qualitative study of Hong Kong Chinese peoples views about ‘positive ageing’, as expressed and discussed in 15 focus groups of middle-aged and older people. Two themes emerged: first, the participants considered that positive ageing should comprise good health, having a positive life attitude, active engagement with an activity or with society, feeling supported by their families and friends, being financially secure, and living in a place with emotional ties; and secondly, several key factors that enable positive ageing were identified, namely, adopting a healthy lifestyle, thinking positively, promoting family and inter-personal relationships, and building up financial resources. The views of the participants about ‘positive ageing’ are compared with those reported from western studies, and the policy implications are considered.

ATTITUDES TOWARD EUTHANASIA IN HONG KONG—A COMPARISON BETWEEN PHYSICIANS AND THE GENERAL PUBLIC

ABSTRACT This article reports the findings of a cross-sectional study that compared the attitudes of 618 respondents of a general household survey and a random sample of 1,197 physicians toward different types of euthanasia in Hong Kong. The general public was found to agree with active euthanasia and non-voluntary euthanasia and was neutral about passive euthanasia. On the other hand, physicians agreed with passive euthanasia, were neutral about non-voluntary euthanasia, and disagreed with active euthanasia. Factors affecting the respondents’ attitudes were also explored. The article ends with policy and research implications of the findings.

Aging Well Socially through Engagement with Life: Adapting Rowe and Kahn's Model of Successful Aging to Chinese Cultural Context.

Although aging well socially (Engagement with Life) is as important as aging well personally (Illness Avoidance and Functioning) (Rowe & Kahn, 1998), it has received less research attention. A Caring (CE) and a Productive (PE) form of Engagement were derived from an analysis of Chinese cultural meanings of engagement, and combined with Illness Avoidance and Functioning to form a 4-factor model. Confirmatory factor analysis based on 2,970 Hong Kong Chinese (40 to 74 years) showed a good model fit that was replicated a year later with 2,120 of the original sample. Further analysis led to a more parsimonious model where Illness Avoidance and Functioning converged into a single second-order factor whereas CE and PE remained as distinct first-order factors. The results supported the differentiation of Rowe and Kahns Engagement with Life component into Caring and Productive Engagements.

Social Network Characteristics and Salivary Cortisol in Healthy Older People

Psychobiological research on aging in humans has been confounded by individual differences that have not been adequately characterized in the literature. This paper is an attempt to shed light on this issue by examining the impact of social network characteristics predictive of successful aging on salivary cortisol among 78 older Chinese people in Hong Kong. Eight salivary cortisol samples were collected each day for two consecutive days from immediately after awakening to 12 hours later. Two components of the cortisol diurnal cycle, response to awakening and diurnal decline, were examined in relation to social network characteristics including size, emotional support, and cultivation. ANOVAs with repeated measured were run to examine influences of the three social network characteristics on the cortisol awakening response and diurnal decline, with the effects of gender, age, socioeconomic status, and waking time controlled. Results indicated that those who spent more time and effort in developing and strengthening their social ties (i.e., those high in “cultivation”) exhibited a significantly greater rise in cortisol in the morning and a significantly steeper decline over the day, thus attesting to more effective activation and deactivation of the HPA axis. Network cultivation reflected a positive motivation to nurture social relationships more than the other two network characteristics. Its effect on cortisol might stem from the positivity underlying the motivation.

Humor attenuates the cortisol awakening response in healthy older men

This study examined the impact of an important factor contributing to successful aging, humor, on post-awakening cortisol levels among a group of 45 older men whose ages ranged from 64 years to 86 years (mean=73.6 years). Four saliva samples were collected from the participants for 2 days immediately after waking and every 15 min thereafter for three times. Cortisol data of the 2 days were aggregated for analysis. Two separate indices of cortisol awakening response reflecting the mean level of secretion and the rise from immediately to 45 min post-awakening, AUC(G) and AUC(I), were computed using the trapezoid formula. The relation of these two indices to humor (operationalized as coping) was examined in a multiple regression analysis while controlling for the effect of age, socioeconomic status, and self-esteem. Results indicated that higher humor scores were associated with lower AUC(G) but had no relation with AUC(I). Findings of the present study suggest that the hypothalamic-pituitary-adrenocortical axis is the major pathway whereby positive psychological dispositions, such as humor, exert their health effects in the aging population. Moreover, cortisol levels in the awakening period may be particularly sensitive to the influences of psychosocial factors.

Leisure, functional disability and depression among older Chinese living in residential care homes

Objectives: Previous research has rarely examined the intervening and buffering effects of leisure on the relationship between age-related stress and health among institutionalized elders, especially in the Chinese context. This study thus examines the extent to which participation in leisure activities mediates and moderates the impact of functional disability on depression among older adults living in residential care homes in China. Method: A total of 1429 participants (858 men) aged over 60 living in residential care homes, of which 46.1% experienced depression using a cut-off score ≥ 5 on the 15-item Geriatric Depression Scale, were selected from a national survey across China by using the probability proportional to size sampling method. Results: The findings showed that depression was positively predicted by functional disability and negatively predicted by participation in leisure activities. The results of the mediation analysis showed that participation in leisure activities partially mediated the relationship between functional disability and depression. Functional disability predicted depression both directly and indirectly through its negative influence on participation in leisure activities. Participation in leisure activities also significantly buffered the relationship between functional disability and depression such that the impact of functional disability was weaker for those who participated in leisure activities more frequently. Conclusion: These results provide support for the mediating and moderating roles of leisure in the stress–health relationship among institutionalized elders. To enhance residents’ psychological health, residential care homes are recommended to organize more leisure activities.

Promoting the psychosocial health of the elderly- the role of social workers

Abstract With the ageing of the global population, the wellbeing of older people in different parts of the world merits special attention. However, recent findings on certain aspects of the psychosocial health of the elderly are far from reassuring. The first problem is the inconsistency in psychosocial indicators, which give simultaneous high life satisfaction scores and high suicide rates. The second problem is the significant weakening of the social support network of the elderly. This article analyses the service and policy implications of these two problems. Suggestions are then made on the role of social workers in promoting the psychosocial health of the elderly at different levels of intervention, which include the individual level, the family and social network level, the community level and the international level.

Volunteerism and positive aging in Hong Kong: a cultural perspective.

This study aims to examine factors related to volunteerism and explore the relationship between volunteerism and positive aging across three age groups. A total of 1,170 Hong Kong Chinese respondents aged between 15 years and 79 years were recruited for the study via a random household survey. Results found that age was negatively related to participation in voluntary work. Older adults aged 60 years to 75 years demonstrated the lowest volunteer participation rate compared with younger adults (aged 15 years to 39 years) and midlife adults (aged 40 years to 59 years). Paradoxically, older volunteers exhibited the highest frequency of volunteering, operationalized as spending 10 hours or more on volunteer work in the past month. Compared with younger and midlife adults, older adults were motivated to volunteer by societal concern and esteem enhancement. Participation in voluntary work was associated with three positive aging outcomes: good health, caring engagement with significant others, and productive engagement in the community. The findings suggest great potential in promoting volunteering in old age because older volunteers tend to contribute more hours than younger volunteers do, and volunteering is associated with positive aging.

Promoting volunteerism in later life in Hong Kong

Volunteering offers great promise for the productive engagement of Hong Kongs ageing population. This paper begins with an overview of older adult volunteering in Hong Kong, including policy development and volunteer management. The focus of the paper is the low participation rate, which is the lowest among all age groups in Hong Kong, and is also lower than those of most developed societies. The reasons for this low level of participation will be examined by drawing on empirical studies and considering cultural factors. The goal is to identify the pull and push factors in the recruitment and retention of older volunteers. The paper concludes with recommendations on promoting volunteerism that is a win-win situation, both meeting older volunteers’ self-oriented needs (e.g. acquiring new knowledge, contributing their own skills) and serving society through helping others.