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A lifetime of exposure to ageism may be internalized in older adults, and these ageist beliefs that are directed inwards can have severe consequences. However, research on reducing internalized ageism is scarce. To address this, we designed and implemented a six-week online process-based intervention to reduce internalized ageism and to assess its feasibility. The intervention utilized a process-based therapy approach targeting psychological, behavioral, and physiological pathways through which internalized ageism negatively impacts health, as specified by stereotype embodiment theory. Intervention components included education, acceptance and commitment therapy techniques, and attributional retraining. A total of 81 older adult participants participated in the feasibility study. Most participants rated each session and the overall program as very useful after each session (average program usefulness rating of 4.54/5). Participants also attributed a wide range of novel behaviors to this intervention and stated that they felt it changed their perspectives on ageism and/or internalized ageism. Results from this study provide a promising foundation from which to advance research on interventions that address internalized ageism - a problem that has severe consequences on the health and well-being of growing numbers of older adults globally.

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OBJECTIVES: Exposure to ageism may be internalized in older adults, and this can have severe consequences. However, little research has addressed reducing internalized ageism. Thus, Reimagine Aging, a 6-week process-based intervention to reduce internalized ageism, was designed and implemented, using education, acceptance and commitment therapy, and attributional retraining to target theoretically based mechanisms of change. METHODS: Seventy-two older adults (M = 70.4 years, SD = 6.4 years) participated in Reimagine Aging, consented to participate in this robust single-sample pilot study, and provided valid data. Participants completed questionnaires prior to, immediately following, and 2 months after the intervention. RESULTS: Participants' self-perceptions of aging (ηp2=0.37, p < .001) and perceptions of older adults (ηp2=0.27, p < .001) became significantly more positive, associated with large effect sizes. Furthermore, these positive gains were mediated by increases in psychological flexibility, mindfulness, and perceived control. DISCUSSION: This study provides initial support for this process-based intervention targeting a reduction of internalized ageism. CLINICAL IMPLICATIONS: This program has the potential to reduce the negative impact internalized ageism has on the health of older adults. Furthermore, it provides novel insights into intervention targets and tools that may be useful in achieving this reduction.

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Older adults make up the largest portion of the population of physically inactive individuals. Health challenges, and psychological barriers (e.g., maladaptive causal attributions), contribute to reduced activity engagement and low perceived control. This pilot study tested an attributional retraining (AR) intervention designed to increase control-related outcomes in a physical activity context for older adults with compromised health. Using a randomized treatment design, we examined treatment effects on a sample of older adults attending a day hospital (N = 37, M age = 80). We employed ANCOVAs, controlling for age, sex, and morbidity, to assess differences in post-treatment outcomes between AR and No-AR conditions. AR recipients (vs. No-AR) reported lower post-treatment helplessness and more perceived control over their health. Our study offers evidence for AR to increase control-related outcomes and lays the groundwork for further research into supporting older adult populations with compromised health.

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Research suggests that when dealing with personal setbacks, secondary control (SC) adjustment and acceptance beliefs can foster psychological wellbeing. However, little research has examined these beliefs, in combination, and how they impact students in their academic development. We conducted secondary analysis using an eight-month longitudinal study design over a two-semester introductory course on a sample of university students (n = 237; 64% female; M age = 19 years old). Multiple regression analyses assessed whether the students' Semester 1 adjustment and acceptance SC beliefs influenced Semester 2 learning-related emotions, perceived stress, and perceived course success, and whether Adjustment x Acceptance interactions emerged involving these outcomes. Adjustment beliefs promoted learning-related positive emotions (hope, pride), perceived course success, and reduced perceived stress; acceptance predicted higher shame and perceived stress. Students' adjustment predicted lower helplessness for students with high acceptance beliefs. These findings are discussed in light of the role that SC beliefs might play in curbing psychological distress reported by students on postsecondary campuses.

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Despite increased emphasis on educating students in science, technology, engineering, and mathematics (STEM) disciplines, nearly half of U.S. college students who enroll in these programs fail to graduate with STEM degrees. Using archival data from the Motivation and Academic Achievement Database, we tested whether a motivation intervention to reframe causal attributions for academic setbacks improved graduation rates for college students in STEM disciplines (N = 496). Results showed that the intervention increased the odds of 8-year graduation for students who were at risk of college dropout. Findings highlight the potential of theory-informed psychological interventions to increase persistence to graduation for at-risk students in STEM fields.

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OBJECTIVES: Although physical activity is recognised as a health-promoting behaviour for older adults, notable barriers exist that may reduce physical activity in this age group. Limited research has explored causal beliefs (attributions) as a barrier to physical activity. Our study assessed associations between older adults' attributions about physical activity and objective health outcomes. METHODS: We examined the role of attributions as a predictor of everyday physical activity (EPA) and subsequent mortality risk over a 10-year period (2006-2016) in a sample of older adults (Mage = 87, N = 261). RESULTS: OLS and Cox proportional hazard regression analyses revealed older adults who endorsed more internal and uncontrollable attributions for limited activity (physical incapacity) when feeling unwell had lower subsequent EPA (ß = -0.18), and higher 10-year mortality risk (HR = 1.46). Other attributions with different dimensional properties (e.g. internal and controllable) were not associated with EPA or mortality. DISCUSSION: Findings suggest that causal beliefs older adults have about their physical activity can influence their future behaviour and longevity. Psychological treatments designed to discourage maladaptive attributional thinking for older populations who face barriers to physical activity may be an important avenue for future research.

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RATIONALE AND OBJECTIVES: Whether expectations about future health are adaptive or maladaptive in late life likely depends on the extent to which they conform to or defy a future reality of declining health. Our premise was that, when adults face a downward spiral in health, it can be adaptive to realistically expect poorer future health and maladaptive to unrealistically expect good health. METHOD: This 18-year-long study of community-dwelling older Canadians (n = 132, 72-98 years) involved a baseline interview to identify those who anticipated heath would decline (pessimistic expectation) or improve/remain stable (optimistic expectation). We determined initial (baseline) health status by assessing the severity of chronic conditions. An objective within-person measure of actual health change was derived by documenting hospital admissions (HAs) over time to capture a continuum that ranged from no declines (HAs remained stable) to greater declines in health (increasing numbers of HAs). Our a priori hypotheses examined the effects of health expectations (pessimistic, optimistic) and actual health change on the outcomes of depressive symptoms and mortality. RESULTS: Support was found for our premise that it is adaptive to be realistic when forecasting future health, at least at low levels of initial chronic condition severity. Regression analyses showed that realistically pessimistic (vs. unrealistically optimistic) expectations predicted significantly fewer depressive symptoms and a lower risk of death. The results also supported our premise that it is maladaptive to be unrealistically optimistic when health subsequently declines in reality: The risk of death was 313% higher for those with optimistic expectations that were unrealistic (vs. realistic). CONCLUSION: These findings provide insights for health care professionals regarding the messages they communicate to their patients. Together, they imply that, when good health is slipping away, it seems optimal to encourage a healthy dose of realism.

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OBJECTIVES: Although forecasting a positive future can be adaptive, it may not be when expectations are unmet. Our study examined whether such inaccurate expectations about future health status (overestimation) were maladaptive for older adults who commonly experience late life declines in physical functioning. METHOD: We analyzed data from the nationally representative German Aging Survey (DEAS; 1996-2011; n = 2,539; age range 60-85 years) using multilevel growth models that assessed the influence of inaccurate health expectations on older adults' physical functioning over a 9-year period. RESULTS: Overestimating future health status predicted reduced day-to-day physical functioning when age, gender, and self-rated health were controlled. A Time × Overestimation interaction indicated that the negative effects of overestimation on physical functioning became more pronounced over the 9-year period. DISCUSSION: Results suggest that repeatedly unmet health expectations may undermine motivational resources and accelerate late life declines in physical functioning.

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Objectives: Appraising health as controllable is typically thought to be adaptive, but recent evidence suggests the paradoxical possibility that perceived control (PC) can be detrimental. We considered the premise that high PC should have a survival benefit when it is part of an adaptive mindset involving high value (importance) for health, but it might be detrimental when it is part of a mindset comprised of low health value (HV). In addition, we examined whether the survival consequences of PC and HV vary with advancing age. Method: Interviews were conducted with a heterogeneous sample of community-dwelling adults (n = 341; 72-99 years) to assess appraisals of control and value in the domain of health. Mortality data were obtained over 12 years from a provincial health registry. Results: Both age and HV moderated the PC effect on mortality. The predicted beneficial and detrimental PC effects emerged at younger ages: higher PC predicted longer survival times when health was highly valued but shorter survival times when health was less highly valued. Discussion: These findings deepen the knowledge regarding the conditions under which PC is or is not adaptive, suggesting the consequences depend on age and the extent to which health is valued.

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Although an active pursuit of health goals is typically adaptive, there may be circumstances in very late life when it is not. Our 10-year study of community-dwelling individuals (n = 220, 79-98 years-old) examined whether investing substantial effort into personal health (high selective primary control) in the absence of help-seeking strategies (low compensatory primary control) jeopardized survival for very old adults who varied in functional independence (low, high). Cox proportional hazard models showed selective primary control (SPC) predicted 10-year mortality risk for only those with low compensatory primary control (CPC) and high initial functional independence. For these individuals, each standard deviation increase in SPC predicted a 101% higher risk of death. Results are consistent with the lines-of-defense model (Heckhausen et al., 2013) and suggest that, for very old adults with little previous need for help-seeking strategies, tenacious self-reliance (high SPC, low CPC) may have life-shortening consequences. (PsycINFO Database Record

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Research has established the health benefits of psychological factors, including the way individuals appraise outcomes. Although many studies confirm that appraising outcomes as controllable is adaptive for health, a paradoxical possibility is largely ignored: Perceived control may be detrimental under some conditions. Our premise was that appraising health as controllable but at the same time ascribing little value to it might signal a dysfunctional psychological mindset that fosters a mistaken sense of invincibility. During face-to-face interviews with a representative sample of older adults (age range = 72-99), we identified individuals with such a potentially maladaptive "invincible" mindset (high perceived control and low health value) and compared them to their counterparts on several outcomes. The findings were consistent with our hypotheses. The invincibles denied future risks, they lacked the activating emotion of fear, and they visited their physicians less often over a subsequent five-year period. Moreover, in contrast to their counterparts, the invincibles did not appear strategic in their approach to seeking care: Even poor health did not prompt them to seek the counsel of a physician. The recognition that psychological appraisals are modifiable highlights the promise of remedial methods to alter maladaptive mindsets, potentially improving quality of life.

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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.

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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.

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OBJECTIVES: Pursuing health goals in very old age is a challenging task that may be undermined by conflicted goal engagement involving mismatched primary (behavior-focused) and secondary (motivation-focused) control striving. Our study explored whether one potentially detrimental combination of control strategies (low primary control/high secondary control) compromised 3-year indicators of everyday physical activity and blood oxygen saturation. METHOD: We analyzed data from a representative sample of very old adults (n = 107) using simple slope regression analyses that tested the conditional effects of control striving on everyday physical activity and blood oxygen saturation. RESULTS: We found a conflicted engagement effect wherein primary control predicted our outcomes only when secondary control was high. The lowest levels of everyday physical activity and blood oxygen saturation were found for older adults high in secondary control but low in primary control. A supplemental mediation analysis suggested everyday physical activity was the mechanism through which conflicted engagement undermined blood oxygen saturation. DISCUSSION: Employing health maintenance strategies that promote motivation-focused thinking but discourage goal-directed behaviors (conflicted engagement) may compromise physical activity and health among very old adults. Further research is needed to determine whether control-enhancing interventions promote harmonious goal engagement and better health among these high-risk individuals.

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OBJECTIVE: A positivity ratio of approximately three positive emotions to one negative emotion has been found to distinguish between flourishing and languishing (optimal vs. poor psychological health). The current study assessed 2-year shifts (2008, 2010) in positivity ratios among 295 older adults and considered whether such shifts were associated with concurrent changes in psychological health (perceived stress, depressive symptoms, and perceived control). METHOD: Based on participants' reported positive and negative emotions, we identified two positivity ratio groups who were characterized by ratios that did not change, either remaining persistently optimal (above 2.9) or persistently suboptimal, and two groups that depicted shifts in ratios that either became optimal or became suboptimal. RESULTS: Most participants (67%) remained in their initial group, but shifts between categories did occur in both directions. Ratio groups and time (2008 vs. 2010) were predictor variables in 4 × 2 generalized estimating equations that were computed for each psychological health measure. The hypothesized positivity ratio group × time interaction emerged for each psychological health measure. Ratio shifts that 'became optimal' were associated with a significant concurrent decrease in stress and an increase in perceived control; ratio shifts that 'became suboptimal' were associated with a significant increase in depression. CONCLUSION: Although older adults who began with a suboptimal positivity ratio were unlikely to experience a shift to an optimal ratio, findings are more encouraging for those who began with an optimal positivity ratio. The majority of these older adults retained optimal positivity ratios over time and appeared to flourish.

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This study examined potential discriminators of groups of older adults showing different patterns of stability or change in loneliness over 5 years: those who became lonely, overcame loneliness, were persistently lonely, and were persistently not lonely. Discriminant function analysis results showed that the persistently lonely, compared with the persistently not lonely, were more often living alone, widowed, and experiencing poorer health and perceived control. Moreover, changes in living arrangements and perceived control predicted loneliness change. In conclusion, perceiving that one is able to meet social needs is a predictor of loneliness and loneliness change and appears to be more important than people's friendships. Because the predictors were better able to predict entry into loneliness, results point to the promise of prevention approaches to loneliness interventions.

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Few studies of older individuals have directly assessed secondary control beliefs, previously defined by Morling and Evered in 2006 as a combination of psychological adjustment and acceptance. We classified older adults ( n = 223, M age = 85 years, 62% women) into three categories of secondary control beliefs: psychological adjustment only, psychological adjustment and acceptance, and neither psychological adjustment nor acceptance. Relative to individuals who emphasized beliefs about psychological adjustment only, those who emphasized a combination of secondary control beliefs (including both psychological adjustment and acceptance), reported more frequent positive emotions, greater life satisfaction, and less severe chronic conditions. Our findings have implications in both theoretical and applied contexts. Theoretically, our findings extend contemporary thinking on secondary control. In applied contexts, they suggest ways of thinking that could enhance well-being in the very old.

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OBJECTIVE: Drawing from Heckhausen and Schulz's 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 Schulz's theorized goal-opportunity congruence premise and have implications for quality-of-life interventions to assist community-dwelling older adults.

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OBJECTIVES: This study examined the longitudinal relationships between loneliness, physical activity, and mortality in older adults. This study also tested the implication of Fredrickson's Broaden and Build Theory (1998, 2001) that positive emotions (happiness) might serve to "undo" the detrimental effects of negative emotions (loneliness). METHOD: Participants (n = 228; 62% female; aged 77-96 years) took part in the Aging in Manitoba Study (2001) and the Successful Aging Study (2003). Mortality information was assessed in 2008. RESULTS: Regression analyses showed that loneliness longitudinally predicted perceived physical activity and mortality. Moreover, in support of Fredrickson's theory, happiness moderated these relationships, suggesting that happiness had the power to "undo" the detrimental effects of loneliness on activity and mortality. CONCLUSIONS: Loneliness is an independent risk factor for mortality and reduced physical activity among older adults; however, being happy may offset the negative consequences of being lonely. Future interventions could target positive emotions and loneliness as a way of ultimately enhancing the lifespan and wellspan of older adults.

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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.

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