Tara L. Stewart

Attributing illness to ‘old age:’ Consequences of a self-directed stereotype for health and mortality

Stereotypic beliefs about older adults and the aging process have led to endorsement of the myth that ‘to be old is to be ill.’ This study examined community-dwelling older adults’ (N = 105, age 80+) beliefs about the causes of their chronic illness (ie, heart disease, cancer, diabetes, etc.), and tested the hypothesis that attributing the onset of illness to ‘old age’ is associated with negative health outcomes. A series of multiple regressions (controlling for chronological age, gender, income, severity of chronic conditions, functional status and health locus of control) demonstrated that ‘old age’ attributions were associated with more frequent perceived health symptoms, poorer health maintenance behaviours and a greater likelihood of mortality at 2-year follow-up. The probability of death was more than double among participants who strongly endorsed the ‘old age’ attribution as compared to those who did not (36% vs. 14%). Findings are framed in the context of self-directed stereotypes and implications for potential interventions are considered.

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.

Sustaining Primary Control Striving for Achievement Goals During Challenging Developmental Transitions: The Role of Secondary Control Strategies

Developmental transitions are imbued with ubiquitous uncertainties that undermine goal striving in many otherwise committed individuals. Our seven-month study examined whether cognitive selective secondary control strategies (motivation-focused thinking) facilitate the enactment of achievement goals among young adults experiencing the landmark school to university transition. Sequential regression analyses demonstrated that (a) achievement goals predicted selective secondary control, (b) selective secondary control predicted behavioral selective primary control striving, and (c) selective primary control predicted final course grades. Findings support Heckhausen et al.s (2010) proposition that selective secondary control bolsters selective primary control striving and enables goal attainment during difficult transitions.

Attributing heart attack and stroke to “Old Age”: Implications for subsequent health outcomes among older adults

This study assessed the extent to which older adults attribute a recent heart attack/stroke to “old age,” and examined consequences for subsequent lifestyle behavior and health-care service utilization. Community-dwelling adults (N = 57, ages 73–98 years) were interviewed about their heart attack/stroke, and an objective health registry provided data on health-care utilization over a 3-year period. Endorsement of “old age” as a cause of heart attack/stroke negatively predicted lifestyle behavior change, and positively predicted frequency of physician visits and likelihood of hospitalization over the subsequent 3 years. Findings suggest the importance of considering “old age” attributions in the context of cardiovascular health events.

Downward social comparison and subjective well-being in late life: The moderating role of perceived control

Objective: Drawing from Heckhausen and Schulzs Motivational Theory of Life-span Development, this study examined perceived control as a moderator of the protective relationship between downward social comparison and subjective well-being among older adults. Methods: Community-dwelling older adults (N = 97, 63% female, ages 79–97) were interviewed in their own homes at three time-points over a nine-year period. Interviews assessed older adults’ perceived control over daily tasks, their use of downward social comparison in response to task restriction, and their subjective well-being. Results: Regression analyses yielded a significant interaction between downward social comparison and perceived control for three subjective well-being outcomes: life satisfaction, perceived stress, and depressive symptoms. Follow-up analyses revealed that downward social comparison was associated with greater subjective well-being at low levels of perceived control; but was unrelated to subjective well-being at high levels of perceived control. Conclusion: These findings corroborate Heckhausen and Schulzs theorized goal-opportunity congruence premise and have implications for quality-of-life interventions to assist community-dwelling older adults.

Motivation-focused thinking: Buffering against stress-related physical symptoms and depressive symptomology

Developmental transitions are experienced throughout the life course and necessitate adapting to consequential and unpredictable changes that can undermine health. Our six-month study (n = 239) explored whether selective secondary control striving (motivation-focused thinking) protects against the elevated levels of stress and depressive symptoms increasingly common to young adults navigating the challenging school-to-university transition. Path analyses supplemented with tests of moderated mediation revealed that, for young adults who face challenging obstacles to goal attainment, selective secondary control indirectly reduced long-term stress-related physical and depressive symptoms through selective primary control and previously unexamined measures of discrete emotions. Results advance the existing literature by demonstrating that (a) selective secondary control has health benefits for vulnerable young adults and (b) these benefits are largely a consequence of the process variables proposed in Heckhausen et al.’s (2010) theory.