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INTRODUCTION: Reactivity to daily stressors may change as a function of stressor type and age. However, prior research often excludes older adults or compares them to younger age groups (e.g., younger and middle-aged adults). Recognizing older adults as a heterogeneous population with shifting motivations, this study focused on individuals aged ≥65 years and tested age differences in associations between different types of daily stressors, affect and physical symptoms. METHODS: A total of 108 older adults aged 65-92 years (M = 73.11, SD = 5.92; 58% women) completed daily dairy questionnaires on daily stressors, positive and negative affect, and physical symptoms for 14 consecutive days. Multilevel models were employed, adjusting for sex, age, education, living situation, and day-in-study. RESULTS: Findings revealed age-dependent variations in the associations between daily stressors and affect and physical symptoms. Specifically, external stressors (e.g., finance and traffic stressors) and health stressors were more strongly associated with daily affective states and with overall physical symptoms (respectively) among older age adults. Age did not moderate associations between social stressors and affect or physical symptoms. CONCLUSION: These findings underscore the heterogeneous nature of older adults' responses to daily stressors based on stressor type and age. Specifically, the oldest-old might benefit from personalized support for dealing with challenges such as health and financial stressors.

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Episodes of solitude (being alone and without social interaction) are common in older age and can relate to decreased well-being. Identifying everyday resources that help maintain older adults' well-being in states of solitude is thus important. We investigated associations of daily solitude with subjective and physical well-being under consideration of time-savoring (i.e., attending to positive experiences and upregulating positive emotions). 108 older adults aged 65-92 years (M = 73.11, SD = 5.93; 58% women; 85% born in Switzerland) took part in an app-based daily diary study in 2022. Over 14 consecutive days, participants reported daily solitude, time-savoring, depressive mood, loneliness, and somatic symptoms in an end-of-day diary. Multilevel models revealed that participants reported higher depressive mood and loneliness, but not higher somatic symptoms on days on which they spent more time in solitude than usual. Higher-than-usual daily time-savoring was associated with lower depressive mood, loneliness, and somatic symptoms. Associations of solitude with depressive mood, loneliness, and somatic symptoms were weaker on days on which higher time-savoring than usual was reported. Findings highlight the potential of everyday time-savoring as a resource in older adults in the context of increased solitude.

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This study aimed to investigate mechanisms explaining associations between vaccination and protective health behaviors during the COVID-19 pandemic. The study used a secondary analysis of data from a longitudinal online study at four time points between April 2020 and March 2021. Two hundred and forty participants responded to questionnaires assessing adherence to multiple COVID-19 protection behaviors, COVID-19 vaccination, behavioral specific outcome expectancies and general healthy lifestyle. Statistical analyses included z statistic for differences between correlations and moderation analysis by the SPSS PROCESS macro. The correlation between initial adherence to protective behaviors prior to availability of vaccination and actual vaccination was positive, but when vaccination was available, the concurrent correlation between these behaviors was null. Healthy lifestyle and outcome expectancies moderated the association between vaccination and adherence to protection behaviors. These results were explained by a 'redundancy effect', conceptualized as beliefs that engagement in specific health behaviors justifies evading other health behaviors. The 'redundancy effect' cancelled the initial positive correlation between vaccination and protective health behaviors, produced by a 'transfer effect', based on similarities between the perceived purposes of those behaviors. Theoretical and practical implications of the findings were discussed.

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In view of the grave consequences of distress reactions to the COVID-19 pandemic, this study investigated CSE (Core Self-evaluations) - internal/external health locus of control, generalized self-efficacy and trait optimism - and intolerance of uncertainty as potential correlates of distress reactions. We conducted an online questionnaire-based cross-sectional study with 422 Israeli respondents. Pandemic-related distress was defined by perceived stress, negative and positive affect, and worries. Predictors were: health locus of control, generalized self-efficacy, trait optimism, and intolerance of uncertainty. The findings show that CSEs and intolerance of uncertainty added between 11% (to perceived stress) and 22% (to negative affect) of explained variance beyond the background variables. Specifically, higher trait optimism and generalized self-efficacy were associated with less distress, and greater intolerance of uncertainty was correlated with higher distress. In conclusion, the CSE framework is useful for explaining psychological distress during the COVID-19 pandemic. Beyond their theoretical contribution, the findings may have practical implications for increasing resilience and ameliorating distress during a pandemic.

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BACKGROUND: Despite the clear benefits of vaccination, their uptake against common infectious diseases is suboptimal. In December 2020, vaccines against COVID-19 became available. PURPOSE: To determine factors that predict who will take the COVID-19 vaccine based on a conceptual model. METHODS: An online survey was administered twice: prior to public vaccination, and after vaccinations were available. Participants were 309 Israelis with initial data and 240 at follow-up. Baseline questionnaires measured intentions to be vaccinated and hypothesized predictors clustered in four categories: background, COVID-19, vaccination, and social factors. Self-reported vaccination uptake was measured at follow-up. RESULTS: Sixty-two percent of the sample reported having been vaccinated. Intentions were strongly associated with vaccination uptake and mediated the effects of other predictors on behavior. Eighty-six percent of the variance in vaccination intentions was explained by attitudes toward COVID-19 vaccination, regret for having declined vaccination, trust in vaccination, vaccination barriers, past flu vaccination, perceived social norms, and COVID-19 representations. CONCLUSIONS: Beliefs related directly to the COVID-19 vaccine explained most of the variance in intentions to vaccinate, which in turn predicted vaccination uptake.

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OBJECTIVES: To describe and explain peoples' developing threat appraisal and representations of the novel illness COVID-19 over the first months of the pandemic. The Common-Sense Model of illness perceptions provided the theoretical framework. DESIGN: A cross-sectional study with 511 respondents and a follow-up study 4 months later on 422 respondents completing an online survey measuring demographic factors, media consumption, self-assessed health, experience with the disease, health anxiety, COVID-19 threat, worries and cognitive and emotional illness representations. RESULTS: Health anxiety, media consumption, female gender, lower self-assessed health, knowing a deceased COVID-19 patient and being infected explained variance in threat appraisal. Worries represented 2 factors: psychosocial and existential. Threat appraisal and worries explained variance in illness representations. Representations of the disease worsened and started stabilizing over time. Emotional representations were exceptionally stable and explainable by threat appraisals. CONCLUSIONS: These studies revealed the initial stages of developing representations of a new disease in the context of the COVID-19 pandemic. Gaining insights into those representations is key to understanding, predicting and modifying behavioral and mental responses to the pandemic.

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BACKGROUND AND OBJECTIVES: To explore coping processes used by adults aged 60 and above (defined as high age-related risk group) in reaction to the COVID-19 threat, and the associations between these processes and state anxiety. DESIGN AND METHODS: A cross-sectional study with 498 respondents of an online survey, 72 (15%) in the high age-related risk group. Questionnaires measured: background variables, state anxiety, and COVID-19 related perceptions. RESULTS: The high age-related risk group perceived the coronavirus as more severe, their belongingness to a risk group as higher, and the behavioral recommendations as more effective compared to the low age-related risk group. The part of perceived vulnerability that is not explained by belonging to an age-related risk group (defined as residual perceived vulnerability) was lower in the high age-related risk group. Mediation analysis indicated that the high (compared to the low) age-related risk group had lower anxiety levels, and that this effect was mediated by lower residual perceived vulnerability and higher perceived disease severity levels. CONCLUSIONS: The higher age-related risk group maintains a relatively moderate level of anxiety without denying their belonging to a high risk group. This can be explained by defensive processing of COVID-19 related information and by developmental processes.

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OBJECTIVES: To compare the relative strengths of cognitive and emotional factors in explaining variance in adherence to recommendations for protective health behaviors against the coronavirus disease 2019 (COVID-19). DESIGN: A longitudinal (4-month) study with 422 participants who completed an online survey assessing cognitive factors: perceptions of the severity of the disease, vulnerability to it, and the effectiveness of the protective behavior recommendations against it. The emotional factors investigated were: trait health anxiety, worries, and anxiety related to COVID-19. RESULTS: Adherence and perceived behavior efficacy decreased over time, while perceived vulnerability and worries increased. Regression analyses showed a clear predictive advantage of beliefs about the efficacy of adherence to protective behaviors. CONCLUSIONS: The findings support the "cognitive approach" to explaining pandemic-related behaviors, particularly the key role of perceived efficacy of behavior recommendations. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

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OBJECTIVE: It has been suggested that self-rated health (SRH), a construct of overall subjective health, is predicted by depressive symptoms. However, depressive symptoms were also found to predict SRH. The present study aimed to simultaneously examine these alternatives as well as test the potential moderating role of age. METHODS: Data concerning self-reported measures from two consecutive waves of the Survey of Health, Aging and Retirement in Europe (SHARE) were examined by using a longitudinal cross-lagged panel analysis. RESULTS: The model that included the effects of both paths, i.e. from SRH to depressive symptoms and from depressive symptoms to SRH, demonstrated better fit than models including one or no cross-lagged paths. However, the longitudinal effect of SRH on depressive symptoms was stronger than the longitudinal effect of depressive symptoms on SRH, particularly among adults aged 65-79. The longitudinal effect of depressive symptoms on SRH was stronger among individuals aged 80 and older, compared with younger ages. CONCLUSIONS: Bidirectional effects may exist between SRH and depressive symptoms among adults aged 50 and older. Special attention should be paid to the unique effects of SRH on depressive symptoms in the years following retirement and also to depressive symptoms on SRH among the old-old.

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BACKGROUND: Based on models of cross-behavioural associations and the role of past behaviour in predicting behaviour, an association was hypothesized between healthy lifestyle behaviours prior to the COVID-19 pandemic and adherence to coronavirus protective behaviours. Self-assessed health was also examined as a potential moderator. METHODS: A cross-sectional sample (N = 463) completed online questionnaires during a COVID-19-related lockdown that measured engagement in healthy lifestyle behaviours (e.g., exercising and eating fruits and vegetables), adherence to coronavirus protective behaviours (e.g., wearing a face mask and practicing social distancing), and self-assessed health (subjective evaluation of overall health). RESULTS: As predicted, higher engagement in healthy lifestyle behaviours prior to the pandemic was significantly correlated with higher adherence to coronavirus protective behaviours (Pearson r(459) = .308, p < .001). Adherence levels were higher than engagement in healthy lifestyle behaviours, and self-assessed health was related to the latter but not to the former. Moderation was examined using model 1 in PROCESS for SPSS; as expected, the association was stronger among individuals with higher levels of self-assessed health (coefficient 95% CI [.04, .20]). CONCLUSIONS: The findings highlight cross-behavioural facilitating processes, specifically between lifestyle behaviours and adherence to recommended protective behaviours during the pandemic. They also draw attention to the need to address individuals whose poorer evaluations of their general health might prevent them from implementing their behavioural intentions.

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BACKGROUND: Self-assessed health (SAH) predicts health outcomes above and beyond medical variables. One of the explanations for this robust finding is the sensitivity of SAH to changes in multiple aspects of health, including emotional factors. We assessed the dynamic nature of SAH by longitudinally examining the associations between initial and change levels of SAH and positive affect (PA) and negative affect (NA). METHODS: Participants were 138 cardiac patients undergoing coronary angioplasty. Self-report questionnaires measured SAH, PA, and NA, one day and one month after catheterisation. RESULTS: Means of SAH and NA did not change between measurement points, but PA decreased. Cross-lagged analysis indicated that the best model for representing the data included a path from affect at hospitalisation to SAH one month later; that is, lower NA (but not PA) at hospitalisation predicted higher SAH a month later. A latent change model analysis also revealed that NA (but not PA) at hospitalisation predicted changes in SAH (but SAH did not predict changes in negative or positive affect); and that increases in positive affect and decreases in negative affect were linked to increases in SAH. CONCLUSIONS: These findings highlight the importance of NA as an indicator of SAH and SAH change, and provide further insights into the dynamics of SAH in cardiac patients.

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OBJECTIVE: To achieve a comprehensive understanding of patients' adherence to medication following acute coronary syndrome (ACS), we assessed the possible moderating role played by attachment orientation on the effects of attitudes, subjective norms, and perceived behavioral control (PBC), as derived from the Theory of Planned Behavior (TPB; Ajzen, 1991), on intention and reported adherence. METHOD: A prospective longitudinal design was employed. During hospitalization, ACS male patients (N = 106) completed a set of self-report questionnaires including sociodemographic variables, attachment orientation, and measures of TPB constructs. Six months post-discharge, 90 participants completed a questionnaire measuring adherence to medication. RESULTS: Attachment orientations moderated some of the predictions of the TPB model. PBC predicted intention and reported adherence, but these associations were found to be significant only among individuals with lower, as opposed to higher, attachment anxiety. The association between attitudes and intention was stronger among individuals with higher, as opposed to lower, attachment anxiety. Only among individuals with higher attachment avoidance, subjective norms were negatively associated with intention to take medication. CONCLUSIONS: Cognitive variables appear to explain both adherence intention and behavior, but differently, depending on individuals' attachment orientations. Integrating personality and cognitive models may prove effective in understanding patients' health behaviors.

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It has been reported that allowing patients to watch the coronary angiography screen during the procedure results in psychological benefits. This study aimed to investigate the roles of illness perceptions as mediators of this outcome and to examine whether individual differences in monitoring coping style moderated these effects. The experiment compared patients who were instructed to watch the monitor screen (n = 57) with those who were not (n = 51). Questionnaires were used to measure the research variables at one day and one month after the procedure. Results showed that watching the angiography screen increased patients' personal and treatment control perceptions that mediated changes in self-assessed health, risk perceptions, negative affect, general and diet outcome expectancies, and diet and physical activity intentions. The behavior-related outcomes were moderated by monitoring coping style. These findings illustrate the significance of illness perceptions, perceived control and monitoring coping style in achieving desirable outcomes among patients undergoing coronary angiography, and reveal opportunities for interventions using medical imaging technologies.

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OBJECTIVES: Previous research suggested that illness perceptions provide the basis for illness risk perceptions through an inductive reasoning process. This study aimed to assess the direction of relationships between illness and recurrence risk perceptions over time, among cardiac patients. DESIGN: A longitudinal study was conducted among 138 patients undergoing coronary angioplasty. Self-report questionnaires measured perceived recurrence risk and illness perceptions one day and one month after catheterisation. RESULTS: Cross-lagged Panel Model Analyses revealed that higher perceptions of timeline, consequences and emotional representations of illness at hospitalisation were associated with higher recurrence risk perceptions one month later. Perceived personal control was the only illness perception with bi-directional associations: higher perceived personal control at hospitalisation was associated with higher recurrence risk perceptions one month later; and higher recurrence risk perceptions at hospitalisation was associated with lower personal control one month later. CONCLUSIONS: The findings suggest that the associations between recurrence risk and illness perceptions can only partly be explained by inductive reasoning. Halo effects and defensive processes are suggested as complementary explanations for the observed associations between risk and illness perceptions.

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AIMS: Percutaneous coronary intervention (PCI) may be perceived as a frightening experience. Some psychological factors are known correlates of recovery and rehabilitation of cardiac patients. Our objective was to investigate the emotional, cognitive and behavioral effects of patient guidance during their cardiac catheterization. METHODS: We performed a randomized trial comparing a patient group that was instructed while watching the monitor screen during their PCI (study group) and another group that was not (controls). Replies to questionnaires measuring emotional, cognitive and behavioral variables known to be associated with cardiac patients' health status, rehabilitation and quality of life were collected 1 day and 1 month after the procedure. RESULTS: The study group included 57 patients and the control group included 51 patients. Most patients (∼87%) were men at the mean age of 60. They were well matched for reasons for referral to PCI. The study group reported less pain, a more positive affect, greater self-efficacy and stronger intentions to change health-related behaviors than the control group. At 1 month following the procedure, the study group evaluated their general health as significantly better, and reported a less negative affect, less cardiac anxiety, greater functional self-efficacy and more positive outcome expectancies regarding diet, and quitting smoking than the controls. CONCLUSION: A simple adjustment in the standard PCI protocol can become a highly beneficial psychological intervention for enhancing patient outcomes.

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