Joelle C. Ruthig

Primary and secondary control in academic development: gender-specific implications for stress and health in college students

Abstract During the first year of college, students are faced with numerous educational and personal stressors which can negatively impact their psychological and physical health. The present study examined the benefits of primary and secondary control for self-rated health in students based on Rothbaum, Weisz, and Synders (1982) dual-process model of control, and examined stress and gender as potential mediating variables. College students’ (n=888) primary and secondary academic control and perceived stress were assessed in the first semester, and self-rated global health, illness symptoms, and illness-related behaviors were assessed at the end of the academic year. For males, primary control was indirectly related to better overall health and fewer symptoms through lower stress levels, and both primary and secondary control directly corresponded to lower illness behaviors. For females, only secondary control was related to better overall health and illness symptoms, albeit indirectly through reduced stress. The mediational roles of stress and gender in health research on primary/secondary control and potential control-enhancing interventions are discussed.

Gender differences in use of primary and secondary control strategies in older adults with major health problems

The present study examined primary and secondary control strategies among 143 men and women (73–98 years) who either reported having had or not had an acute event (heart attack or stroke), all of whom had health-related restrictions on everyday tasks and activities. Repeated measures of ANCOVAs tested the between-group effects of gender (men, women) and Acute Event (no, yes) and the within-subject effect, strategy type, on the frequency ratings of multiple control strategies. For men, having suffered an acute health event was unrelated to their use of primary control strategies. In contrast, women who had experienced an acute health event reported significantly less frequent use of primary control strategies than their counterparts who had not, perhaps suggesting that acute health events undermine proactive control striving and precipitate a shift to secondary control. Moreover, women differed significantly from men in their use of secondary control strategies, using them more often and displaying more diversity in their use. By demonstrating that womens use of primary control strategies is related to their past health events and that they adopt secondary control strategies more often than men and in a more differentiated or selective way, our findings underscore the importance of examining gender differences in strategy use during later life.

Detrimental effects of falling on health and well-being in later life: the mediating roles of perceived control and optimism.

Falling is common among older adults, often resulting in decreased functional ability and quality of life. To understand processes underlying the fall/health and well-being relationship, it is important to identify psychosocial mediators. The current study examined the impact of falling on subsequent physical health, negative emotions and physical activity among 231 young-old (<85) and old-old (85+) community-dwelling adults, and the mediating effects of global perceived control (PC) and optimism. Regression results indicated that falling predicted poorer physical health, greater negative emotions and less physical activity among old-old but not young-old adults. Falling negatively predicted PC and optimism, which mediated the effects of falling on health and well-being among the old-old group. Findings have implications for enhancing recovery from falling via bolstering PC and optimism.

Causal beliefs, social participation, and loneliness among older adults: A longitudinal study

Loneliness can be seen as a social failure subject to causal search: Why am I lonely? Why do I lack friends? According to attribution theory, answers to these questions can influence emotions, motivation, and behaviours. This study examined the relationships between various affiliative causal beliefs (i.e., beliefs about loneliness and friendship development), social participation, and loneliness among older adults (72+ years). Cross-sectional and longitudinal (over five years) results showed that more strongly endorsing internal/controllable causal beliefs (i.e., believing that making friends depends on effort) related to greater social participation. Moreover, greater social participation related to less loneliness. External/uncontrollable causal beliefs predicted greater loneliness. In fully addressing loneliness, it may be important to focus on peoples causal beliefs.

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.

A Longitudinal Examination of Sleep Quality and Physical Activity in Older Adults

The relationship between sleep quality and physical activity is bidirectional, yet prior research on older adults has mainly focused on investigating whether increasing levels of physical activity leads to improvements in sleep quality. The current longitudinal study examined both directional relationships by assessing sleep quality and physical activity twice over a two-year period among 426 community-dwelling older adults (ages 61-100). A cross-lagged panel analysis that included age, gender, perceived stress, functional ability, and severity of chronic health conditions as covariates, revealed that better initial sleep quality predicted higher levels of later physical activity beyond the effects of prior physical activity; whereas initial physical activity did not predict later sleep quality after accounting for prior sleep quality. These findings highlight sleep quality as an important contributor to a physically active lifestyle among older adults.

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.

Changes in College Student Health: Implications for Academic Performance

This study investigated the longitudinal associations of health perceptions and behaviors with subsequent academic performance among college students. Multiple health perceptions and behaviors were assessed for 203 college students both at the beginning and end of an academic year. Students’ academic performance was also measured at the end of the year. Separate regression analyses were conducted for men and women to examine changes in health perceptions and behaviors as predictors of yearend performance. Significant gender differences were found for initial health symptoms, perceived stress, exercise, and nutrition. After controlling for prior achievement, increased binge drinking negatively predicted female students’ academic performance and feelings of success; increased tobacco use negatively predicted male students’ performance. Male and female college students appear to differ in the ways that their health changes over an academic year as well as how such changes impact their later academic performance. Implications for devising health promotion programs that specifically target male and female college students’ health risks are discussed.

Later life health optimism, pessimism and realism: Psychosocial contributors and health correlates

Prior research has established positive outcomes of health optimism (appraising ones health as good despite poor objective health (OH)) and negative outcomes of health pessimism (appraising health as poor despite good OH), yet little is known about their contributors. We examined the role of psychosocial factors (life event stress, depression, dispositional optimism, perceived social support) in health realism (appraising health in accordance with OH), optimism and pessimism among 489 older men and women. We then accounted for the psychosocial factors when examining multiple health correlates of health realism, optimism and pessimism. Controlling for age, gender and income, regression results indicate that depression and social support were associated with less health optimism, while dispositional optimism was associated with greater health optimism among those in poor OH. Dispositional optimism was associated with less health pessimism and life event stress was associated with greater pessimism among those in good OH. Beyond the effects of the psychosocial factors, structural equation model results indicate that health optimism was positively associated with healthy behaviours and perceived control over ones health; health pessimism was associated with poorer perceived health care management. Health optimism and pessimism have different psychosocial contributors and health correlates, validating the health congruence approach to later life well-being, health and survival.

Perceived control and risk characteristics as predictors of older adults' health risk estimates.

Overestimating ones own health risks is associated with negative affect and decreased well-being. To identify psychosocial factors that reduce pessimistic risk estimates, the authors examined global perceived (primary and secondary) control as a predictor of health risk (hip fracture) estimates among 222 community-dwelling older adults. To determine whether characteristics of the health risk moderated the effects of perceived control on risk estimates, the authors manipulated risk level (low, high) and risk attribution (controllable, uncontrollable). The effects of perceived control differed as a function of risk attribution: Regardless of implied risk level, perceived primary control significantly predicted lower risk estimates in the controllable condition but not in the uncontrollable condition. In contrast, perceived secondary control significantly predicted lower risk estimates in the uncontrollable condition but not in the controllable condition, emphasizing its importance when direct influence is not feasible. The authors discuss implications for anticipating how older adults estimate their health risks.