How Do You Feel About...? Health Outcomes in Late Life and Self-Perceptions of Health and Well-Being

Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA.
The Gerontologist (Impact Factor: 3.21). 09/2008; 48(4):415-22. DOI: 10.1093/geront/48.4.415
Source: PubMed


Research has shown over the years that the self-perceptions of older adults about their health and well-being may be at least as important as objective data for predicting the course of their health over time. I review a series of studies that span 30 years in which I and my colleagues have asked older adults in the community about their self-rated health and well-being across a spectrum of parameters, including self-rated health, social support, and mood (both negative and positive), and about whether their basic needs are being met. The social environment shapes perceptions of health and well-being, as does the body. Feelings, such as feelings about health and well-being, are therefore a key (but not the only) psychological-behavioral bridge between the body (genome and physiology) and society (environmental stressors and social context). Following a review of these studies, I attempt to place these perceptions of health and well-being in a social context, a context critical to understanding the consistency and strength of these studies (and others performed over many years) documenting the association between answers to the question "How do you feel about...?" and health outcomes over time.

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    • "Attitudes include perceived effectiveness of treatment, preferences for types of treatment, and patient resistance to viewing depression as a medical disease [17, 18]. Social norms including stigma of the depression diagnosis and the impact of caregivers' agreement with treatment recommendations influence treatment compliance [16, 19, 20]. "
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    ABSTRACT: Objectives. Describe older patients' perceptions about depression and characteristics associated with acceptance of treatments. Design. Cross-sectional study. Setting. Three primary care clinics in Iowa. Participants. Consecutive sample of 529 primary care patients. Measurements. Depression screening tool (a 9-item patient health questionnaire [PHQ-9]) and questionnaire including sociodemographic data, patient attitudes about depression, and acceptability of different treatments. Results. Mean age was 71.9 years (range 60-93 years), 314 (59%) female. Among the 529 participants, 93 (17.5%) had history of depression and 60 (11.3%) had PHQ-9 scores of 10 or greater. Participants believed depression is a disease for which they would use medication and counseling. Accepting medications from primary physicians was strongly associated with a past history of depression (P < 0.01) and with agreeing that depression needs treatment (P < 0.01). Counseling was not acceptable for those believing that they can control depression on their own (P < 0.01). Older patients (P < 0.001) and those with higher education levels (P < 0.01) were less likely to accept herbs or supplements as treatment options. Willingness to discuss treatments with family was associated with not using alcohol as a treatment and acceptance of all other treatment options (P < 0.001). Conclusions. Attitude that depression is a disease and the willingness to discuss depression with family may enhance treatment acceptance.
    The Scientific World Journal 10/2013; 2013(3):207493. DOI:10.1155/2013/207493 · 1.73 Impact Factor
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    • "Research has consistently demonstrated the relationship between global selfrated health and mortality, both in the short and long term (Blazer, 2008). Perceived health is also closely linked to health behaviors and is predictive of health care utilization (Schneider et al., 2004). "
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    ABSTRACT: Previous findings suggest that self-perception of health relates to many physical health outcomes, including mortality. Many factors appear to shape health perceptions, such as personality. Little research, however, has focused on whether personality pathology may affect perceived health. This preliminary study examined the unique effects of personality pathology on health perceptions beyond those of objective health and normal personality factors. As part of an ongoing longitudinal study, the authors examined data from a representative sample (N = 697) of St. Louis residents (ages 55-64) who were identified using standard epidemiological methods. The Diagnostic Interview Schedule and the Health Status Inventory were used to collect reports of health perceptions, chronic illnesses, and physical functioning. Personality traits were measured with the revised NEO Personality Inventory, and personality disorders were assessed using the Structured Interview for DSM-IV Personality. Number of physical illnesses, physical functioning, normal personality, and personality disorders all predicted self-perception of health separately. Personality disorders also predicted health perception above and beyond objective health and personality variables. These findings elucidate the importance of personality pathology in understanding perceived health and suggest that certain patterns of pathology may be particularly detrimental to subjective health.
    Journal of personality disorders 02/2013; 27(3). DOI:10.1521/pedi_2013_27_083 · 3.08 Impact Factor
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    • "As people get older, the likelihood of experiencing stressors such as the death of a partner or friend, health problems, and lowered ability to engage in enjoyable and fulfilling activities increases (Baltes & Baltes, 1990; Lee & Markides, 1990). Yet, despite the physical, mental, and social challenges that often accompany aging, people show great variability in how they cope with these changes, and many older adults report high subjective well-being (Blazer, 2008; George, Okun, & Landerman, 1985; Kunzmann, Little, & Smith, 2000; Strawbridge, Wallhagen, & Cohen, 2002). Thus, researchers have been interested in factors that are associated with taking a proactive approach to staying healthy and maintaining wellbeing (Kahana & Kahana, 2003). "
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    ABSTRACT: Purpose: Evidence suggests that self-compassion may be beneficial to older adults who are struggling to cope with the aging process. The purpose of this study was to assess the thoughts of self-compassionate older adults and to determine whether self-compassionate thoughts relate to positive responses to aging. Design and methods: Participants (n = 121, M = 76.2 years, approximately 65% female) completed measures of self-compassion and self-esteem; were randomly assigned to write about a positive, negative, or neutral age-related event; and completed questions about the event and their reactions. Responses were coded for self-compassionate themes and emotional tone. Results: Analyses indicated that self-compassion predicted positive responses to aging and that self-compassionate thoughts explained the relationship between trait self-compassion and emotional tone as well as the belief that one's attitude helped them cope with age-related events. Implications: Although older adults who were low versus high in self-compassion experienced similar age-related events, participants high in self-compassion thought about these events in ways that predicted positive outcomes. Encouraging older adults to be more self-compassionate may improve well-being in old age.
    The Gerontologist 02/2013; 54(2). DOI:10.1093/geront/gns204 · 3.21 Impact Factor
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