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Stress, even extremely traumatic stress, may pose both risks and benefits. Although combat can have lifelong negative consequences, the perception of positive benefits from military experience can mitigate the negative effects of combat on mental health. However, little research has examined the impact of trauma earlier in life on the development of positive adaptation, such as wisdom, later in life. The authors examined whether combat exposure and the perception of benefits from military experience, assessed in 1990, were associated with greater wisdom in later life, assessed in 2001 in 615 men from the Normative Aging Study men (mean age 74 years, SD = 6.8 years). A quadrilinear relationship between combat exposure and wisdom was found. Moderate levels of combat were associated with higher levels of wisdom. The perception of benefits and coping predicted wisdom. Thus, how one appraises and copes with problems may be more important in the prediction of positive adaptation than the simple occurrence of stress. [ABSTRACT FROM AUTHOR]

Self-transcendence has been hypothesized to be a critical component of wisdom (Curnow, 1999) and adaptation in later life (Tornstam, 1994). It reflects a decreasing reliance on externals for definition of the self, increasing interiority and spirituality, and a greater sense of connectedness with past and future generations. The Adult Self-Transcendence Inventory was administered to 351 individuals along with the NEO-FFI Personality Scale (McCrae & Costa, 1989). A principal axis factor analysis identified two factors: self-transcendence and alienation. The relationships between self-transcendence and neuroticism, openness to experience, extraversion, and agreeableness were significant, although modest, suggesting that self-transcendence cannot be accounted for in terms of positive personality traits alone. As expected, a multiple regression analysis indicated that self-transcendence was negatively related to neuroticism and positively related to meditation practice. The present study appears to lend support to the construct of self-transcendence. [ABSTRACT FROM AUTHOR]

The metabolic syndrome is a complex construct with interrelated factors of obesity, blood pressure, lipids, and glucose. It is a risk factor for a number of chronic diseases in late life. This study tested a model in which the relationship between stress and the metabolic syndrome was mediated by appraisal, coping, and affect. Data were collected from 518 male participants in the Normative Aging Study (X(age) = 68.17 years). The model was partially confirmed. Relationships among stress, appraisal, coping, and affect were valenced along positive and negative pathways. However, affect was not directly related to the metabolic syndrome. The metabolic syndrome was related to positive coping as operationalized by self-regulatory strategies. The results of this study suggest that the influence of coping on physical health may occur through emotional regulation. [ABSTRACT FROM AUTHOR]

Objectives: This study examined the development of wisdom within the context of difficult life events (DLEs), and the importance of individuals and their social environments in this process of growth. Social support has long been studied in adulthood, yet less is known about the ways social transactions can promote wisdom., Method: Semi-structured interviews were conducted with men (n = 14) and women (n = 36), ages 56-91 years (M = 71.71; SD = 8.8) who described a DLE and how they coped with it. The analysis was guided by constructivist grounded theory., Results: DLEs included those from childhood through later life. When personal meaning was disrupted by adversity, the social environment played a key role in facilitating new perspectives that corresponded with aspects of wisdom: self-knowledge, compassion, comfort with uncertainty, and accepting complexity., Discussion: Wisdom is often studied as an individual characteristic, but this study highlighted the relevance of a social ecological perspective to understanding how wisdom development is also facilitated through social transactions.

The valid measurement of latent constructs is crucial for psychological research. Here, we present a mixed-methods procedure for improving the precision of construct definitions, determining the content validity of items, evaluating the representativeness of items for the target construct, generating test items, and analyzing items on a theoretical basis. To illustrate the mixed-methods content-scaling-structure (CSS) procedure, we analyze the Adult Self-Transcendence Inventory, a self-report measure of wisdom (ASTI, Levenson et al., 2005). A content-validity analysis of the ASTI items was used as the basis of psychometric analyses using multidimensional item response models ( N = 1215). We found that the new procedure produced important suggestions concerning five subdimensions of the ASTI that were not identifiable using exploratory methods. The study shows that the application of the suggested procedure leads to a deeper understanding of latent constructs. It also demonstrates the advantages of theory-based item analysis.

Whether wisdom is a culturally-specific or universal construct is a matter of some debate (see Curnow 1999; Grossman et al. Psychological Science, 2012). This study compared similarities and differences in the factor structure of a measure of wisdom focused on self-transcendence in U.S. (n = 305, M(age) = 33.99) and Korean samples (n = 838, M(age) = 30.28), with ages ranging from 20 to 73). The Adult Self-Transcendence Inventory (ASTI; Levenson et al. International Journal of Aging and Human Development, 60, 127-143, 2005) has two factors, self-transcendence and alienation, the latter of which was included to differentiate between social withdrawals due to contemplative practices versus that due to depression. Confirmatory factor analyses found a partial scalar factorial invariance model fit the data best, indicating that the factor structure of the ASTI is largely equivalent and that the construct is comparable across the two cultures. Regression analyses showed that age and religiousness were related to self-transcendence and alienation. Education was related to self-transcendence only. The interaction between age and culture was significant on alienation; alienation was higher in mid-life Koreans but not in Americans, which may reflect either age or cohort effects. Thus, self-transcendence may be a more universal measure of wisdom than those based on pragmatics or cognitive functioning.

We examined whether the social convoy model and socioemotional selectivity theory apply in collectivistic cultures by examining the contextual factors which are hypothesized to mediate age-related differences in social support in a collectivist European country. Five hundred Spanish community-dwelling older adults (Mean age = 74.78, SD = 7.76, range = 60-93) were interviewed to examine structural aspects of their social networks. We found that age showed highly complex relationships with network size and frequency of interaction, depending on the network circle and the mediation of cultural factors. Family structure was important for social relations in the inner circle, while pubs and churches were important for peripheral relations. Surprisingly, pub attendance was the most important variable for maintenance of social support of peripheral network members. In general, the results support the applicability of the social convoy and socioemotional selectivity constructs to social support among Spanish older adults.

We examined long-term patterns of stressful life events (SLE) and their impact on mortality contrasting two theoretical models: allostatic load (linear relationship) and hormesis (inverted U relationship) in 1443 NAS men (aged 41-87 in 1985; M = 60.30, SD = 7.3) with at least two reports of SLEs over 18 years (total observations = 7,634). Using a zero-inflated Poisson growth mixture model, we identified four patterns of SLE trajectories, three showing linear decreases over time with low, medium, and high intercepts, respectively, and one an inverted U, peaking at age 70. Repeating the analysis omitting two health-related SLEs yielded only the first three linear patterns. Compared to the low-stress group, both the moderate and the high-stress groups showed excess mortality, controlling for demographics and health behavior habits, HRs = 1.42 and 1.37, ps <.01 and <.05. The relationship between stress trajectories and mortality was complex and not easily explained by either theoretical model.

We evaluated the efficacy of an emotional education program that seeks to reduce the intergenerational transmission of negative interaction patterns by increasing forgiveness and spirituality. We examined both reduction of psychological symptoms and increase in positive psychological outcomes over the course of a year, as well as the mediators of this change. At baseline, the sample consisted of 99 participants and 47 waiting list controls. Comparisons of scores from baseline (Time 1) to one week after the Hoffman Quadrinity Process (Time 2) showed large declines in negative affect (depressive symptoms) and increases in both positive outcomes (mastery, empathy, emotional intelligence, life satisfaction, forgiveness, and spiritual experience) and health and well-being. Over the course of a year, most of these gains were sustained, in comparison with the control group. Further, increases in forgiveness and spirituality mediated the effect of program participation on depressive symptoms.

Objective: To examine four issues regarding college-student drinking to cope: (1) The prevalence of drinking to cope among students in a medium-sized Midwestern state university; (2) the relationships among drinking to cope and alcohol-related outcomes; (3) the use of drinking to cope within the larger context of students' coping processes; and (4) gender differences in drinking to cope., Method: Data were drawn from a sample of 275 undergraduates (164 women, 104 men, 7 subjects of unreported gender) in a cross-sectional sample. Of the 275 students assessed, data were analyzed from the 260 who reported ever having consumed alcohol. Drinking to cope was examined both as a style and in response to a specific situation identified by the participant., Results: Drinking to cope is very common among college students and is related to much higher levels of alcohol consumption, episodes of heavy drinking, and levels of both negative and positive alcohol-related consequences. In examining the relative influence of drinking to cope and other variables on alcohol use, regression analyses indicated that positive alcohol expectancies were strongly related to alcohol use and that, even when considering other variables, situational drinking to cope remained a fairly strong predictor of most of the alcohol-use indicators. Analysis of gender differences suggested that men rely on alcohol to cope more than women do., Conclusions: Drinking to cope is a significant and highly problematic factor in college student alcohol use. Implications for interventions are discussed.

Individual differences in physical and psychological health trajectories were examined in 1,515 Normative Aging Study men. Mean age at baseline was 47.15 years (range = 28-80), and average follow up was 18.55 years (range = 8-25). Both linear and nonlinear growth curves were estimated with random-effects models and then clustered to identify patterns of change. Men whose physical health trajectories were characterized by high, increasing symptoms were higher in hostility and anxiety, were overweight, and smoked. Those whose trajectories were characterized by low symptoms were emotionally stable, educated, nonsmokers, and thin. Men with high, stable psychological trajectories had high hostility; those with low, stable trajectories had high emotional stability; those with moderate anxiety levels had nonlinear trajectories with peaks in psychological symptoms at different life stages. Personality had life-long effects on health trajectories, but these effects varied across traits and health outcomes.

Objective: We examined whether alcohol consumption and problem drinking decreased with age or if the reported declines were actually cohort and/or period effects., Method: We utilized data from the Normative Aging Study, assessing 1,267 men three times over an 18-year period (1973, 1982, 1991). Men were divided into five 9-year birth cohorts; age ranged from 46 to 72., Results: Sequential analyses using repeated measures ANOVAs showed significant age, cohort and period effects. Although there was a tendency for alcohol consumption to decline with age, this was not true for all cohorts. Men born between 1910 and 1918 increased from an average of 350 to 440 drinks per year from their fifties to their sixties. The younger cohorts tended to report both more consumption and more problems. However, period had the most consistent effect in this study. There was an increase in problems and in consumption during the 1970s but a decrease in the 1980s, with the exception of the youngest cohort (1937-1945) who reported more problems in the 1991 assessment despite lower consumption., Conclusions: Age-related change in both consumption and problems varied depending upon which cohort or time period was assessed. Thus, drinking patterns are a complex amalgam of individual aging and societal change.

The present study examined antisocial dispositions in 487 university students. Primary and secondary psychopathy scales were developed to assess a protopsychopathic interpersonal philosophy. An antisocial action scale also was developed for purposes of validation. The primary, secondary, and antisocial action scales were correlated with each other and with boredom susceptibility and disinhibition but not with experience seeking and thrill and adventure seeking. Secondary psychopathy was associated with trait anxiety. Multiple regression analysis revealed that the strongest predictors of antisocial action were disinhibition, primary psychopathy, secondary psychopathy, and sex, whereas thrill and adventure seeking was a negative predictor. This argues against a singular behavioral inhibition system mediating both antisocial and risk-taking behavior. These findings are also consistent with the view that psychopathy is a continuous dimension.

The purpose of this study was to examine whether appraisals of desirable and undesirable effects of military service mediated the effect of combat stress on posttraumatic stress disorder (PTSD) symptoms in later life in 1,287 male veterans, aged 44-91 years (M = 63.56, SD = 7.46), 40% of whom had been in combat. The men reported more desirable effects of military service (e.g., mastery, self-esteem, and coping skills) than undesirable ones; both increased linearly with combat exposure (r = .17 and .33, p < .001, respectively). Path analysis revealed that the appraisals were independent and opposite mediators, with undesirable effects increasing and desirable effects decreasing the relationship between combat exposure and PTSD, even controlling for depression and response style. Although lifelong negative consequences of combat exposure were observed, perceiving positive benefits from this stressful experience mitigated the effect.

Although retirement is generally thought to lead to a decline in social support due to a loss of social contacts with coworkers, the evidence for this is at best contradictory. This longitudinal study examined change in social support among 1,311 men, participants in the Veterans Administration Normative Aging Study, over a 3-year period. In general, long-term retirees reported the least quantitative social support, and the continuing full-time workers the most; however, change in workforce status produced no apparent effect on quantitative support over the duration of this study. In general, qualitative support showed no retirement effects. We also examined more specific patterns of coworker friendship and again found a pattern similar to that of general quantitative support. The findings support our earlier suggestion of a distinction between retirement as a transition and retirement as a state, and also support the convoy model of social support in late life and the selectivity theory of developmental adaptation to aging.

Several prospective studies have suggested that moderate alcohol consumption may offer protection against total and coronary heart disease (CHD) mortality. These studies have been criticized for failing to control for changes in drinking and the influence of comorbidity on consumption decisions. In the present study, we examined whether rates of death from all causes and from CHD were related to overall consumption as well as variability in or problems with drinking. In 1973, a drinking questionnaire was completed by 1,823 male subjects participating in a longitudinal study who were prescreened for absence of serious or chronic disease. After 12 years of follow-up per subject (21,716 man years of follow-up in all), 159 men have died, 74 from CHD. Incidence rates of overall mortality were lowest for moderate drinkers in each of three age groups. CHD death rates for moderate drinkers were similar to those of non-drinkers except in the oldest men where rates were lower for moderate drinkers. Proportional hazards models testing several measures of consumption consistently showed moderate or regular drinkers to have lower risk of death than teetotalers. Regular drinkers had lower overall and CHD mortality than lifetime abstainers. For all-cause and CHD mortality, drinking heavily in the past, ever having tried to quit drinking and having had problems with alcohol were not related to increased risk. These results lend support to the hypothesis of the beneficial effect of moderate drinking, with respect to mortality.

We examined whether separate norms for older men are necessary for the revised Minnesota Multiphasic Personality Inventory (MMPI-2). Scores from 1,459 men in the Normative Aging Study (NAS) (age: M = 61.27, SD = 8.37) were contrasted with those from 1,138 men from the MMPI Restandardization Study (age: M = 41.71, SD = 15.32). Results showed that scores on the MMPI-2 validity, clinical, and content scales for the NAS men were highly similar to those from the MMPI-2 Restandardization sample. There were also few differences between the two groups at the item level. Within-sample analyses revealed some differences between age groups. However, the magnitudes of these differences were small and may represent the single or combined effects of cohort factors and age-related changes in physical health status rather than age-related changes in psychopathology per se. We concluded that special, age-related norms for the MMPI-2 are not needed for older men.

The stressfulness of retirement both as a transitional event experienced during the past year and as a life stage was investigated. Transitional stress was assessed using a life events approach, and stage stress using a "hassles" approach. Respondents were 1,516 male participants in the Normative Aging Study, 45% of whom were retired. Among those retiring in the past year, respondents' own and spouse's retirement were rated the least stressful from a list of 31 possible events. Only 30% found retirement stressful. Retirement hassles were also less frequently reported and were rated less stressful than the work hassles of men still in the labor force. The only consistent predictors of both transitional and stage retirement stress were poor health and family finances; personality did not predict retirement stress.

The MAC scale has been very successful in identifying alcoholics and, in studies of clinical populations, is often considered a test for predisposition to alcoholism. MacAndrew, however, holds that the MAC scale assesses a more general personality trait characterized by sociability, boldness, rebelliousness and pleasure seeking. The present study examines the distribution of MAC scale scores in a normal population and tests for correlates of high MAC scores other than alcohol-related problems (e.g., arrest history). The sample consisted of 1,117 men, participants in the Normative Aging Study (mean age = 61.6). As expected, heavier drinkers and problem drinkers reported significantly higher MAC scale scores than did lighter and nonproblem drinkers. However, arrestees without drinking problems had MAC scale scores nearly identical to those of problem drinkers without arrest histories (23.19 and 23.42, respectively). Further, 36% of the sample without problem drinking or arrest histories had MAC scale scores of 24 or above, the clinical indicator of alcoholism, and more than 32% of these had scores above 27. In the entire sample, of the 152 men who had MAC scores above 27, 71% had no problems, either with arrest or drinking. Results are interpreted as supporting MacAndrew's interpretation of the meaning of the MAC scale as a general personality measure rather than a specific alcoholism instrument.

We investigated the relationship between the personality traits of emotionality and extraversion and symptom-reporting, both cross-sectionally and longitudinally. The sample consisted of 1,034 men, initially screened for good health, who completed both the 16PF and at least two CMIs, (M = 5, range = 2-8) over an average period of 17 years (range = 2-25). Using a two-stage growth model, we obtained a predicted baseline and slope for each man for self-reported physical and psychological symptoms. Correlations revealed that emotionality was positively related to the numbers of both physical and psychological symptoms reported at baseline, while extraversion was negatively related. However, regression analyses including age and both personality variables indicated that only emotionality was associated with level of symptom-reporting. Longitudinal analyses revealed that emotionality was unrelated to physical symptom slopes and only weakly related to psychological slopes. We interpret these results as showing that, while personality and symptom-reporting are related cross-sectionally, personality does not predict changes in symptom reporting.

Comparisons were made of the personality and social orientations of antisocial risk takers, defined as residents in a long-term drug-treatment facility (N = 24); adventurous risk takers, defined as rock climbers (N = 18); and prosocial risk takers, or heroes, defined as policemen and firemen decorated for bravery (N = 21). Measures included substance abuse proclivity, emotional arousability, conformity, moral reasoning, empathy, psychopathy, and sensation seeking. Discriminant analysis identified two functions that correctly classified 98.18% of the sample. Drug-unit residents had high scores on an Antisocial function, characterized by emotionality, depression, psychopathy, substance abuse proclivity, and lower scores on moral reasoning. Rock climbers had high scores on an Antistructural function, characterized by sensation seeking and moral reasoning, the latter reflecting the higher education level of the rock climbers. Neither discriminant function characterized the heroes. Thus, drug-unit residents, rock climbers, and heroes appear to represent both different psychological types and different forms of risk taking.

Cross-sectional differences between retirees and workers in the importance of coworkers as a source of support, as well as in general quantitative support (social networks and frequency of interaction) and qualitative support (confidants and the perceived reliability of support) were examined. The sample consisted of 1,513 older men (mean age = 61), participants in the Normative Aging Study. Half (56%) were working, and the rest were retired. Slightly fewer retirees than workers reported coworker friends, especially among those who were long-term retirees or who did not work at all in retirement. Whereas similar findings were seen with quantitative support, workers and retirees reported nearly identical levels of qualitative support. However, retirees almost never discussed personal problems with former coworkers. The relevance of these findings for the convoy construct is discussed.

Investigated whether emotionality, assessed in 1975, predicted the reporting of both objective stress (life events) and subjective stress (hassles) 10 years later, and how emotionality affected the relation between both objective and subjective stress and mental health. The sample consisted of 1,159 older men, participants in the Normative Aging Study. Path analysis revealed that the reporting of stress was confounded with personality: Individuals higher in emotionality reported both more life events and more hassles. Furthermore, individuals higher in emotionality exhibited slightly higher levels of symptoms under stress than did individuals lower in emotionality. Nonetheless, both stress measures contributed independent variance to the prediction of psychological symptoms, even controlling for prior levels of emotionality. Implications for the assessment of stress are discussed.

Researchers during the past decade have found little effect of retirement on physical health. However, retirement entails a number of losses, and its effect on mental health, as measured by the prevalence of psychological symptoms, is unclear. We examined psychological symptoms in a sample of 1,513 older men, participants in the Normative Aging Study, using the SCL-90-R (Derogatis, 1983). Analyses of variance indicated that retirees reported more psychological symptoms than did workers, even after controlling for physical health status. Exploratory analyses examining the circumstances of retirement found no effects for length of retirement or part-time employment, but did find effects for the timing of retirement. Both early and late retirees reported more psychological symptoms. Late workers (aged 66 and older) reported the fewest symptoms. Reasons for these findings are discussed.

In another approach to the problem of aspiration before injection of local anesthetics, a new self aspirating plunger was designed. It is composed of similar materials currently in use. Its action is simply the elastic return of a temporarily stretched diaphragm in the center of the plunger. A gentle pressure and release will cause aspiration. No harpoon is used; therefore the cartridge can be more quickly loaded and changed. No special syringe is needed.Stanley C. Harris has said, "one of the most insidious dangers in therapeutics is the complacency which develops when undesirable reactions are infrequent. With local anesthesia, this complacency is intensified by the knowledge that local anesthetics are given intravenously by intention in certain medical procedures. However, when this procedure is employed, the patient is hospitalized, in an operating room with emergency equipment and drugs instantly available."(1)Dentists are aware of the possible consequences of intravascular injection of local anesthetics and know that these can range from lack of anesthesia to an unplesant experience or to a rare lethal one.(2-3) Case histories of complications of intravascular injection appear regularly in the literature. The presence of the anesthetic in the blood can easily be demonstrated.(4)

Longitudinal changes in self-reported symptoms were investigated using the Cornell Medical Index (CMI) in a sample of 2,041 men. The average man completed 5 CMIs (range = 2-8) over 17 (range = 2-25) years. Using a two-stage growth model, we first regressed symptoms against time on study for each man. The average slope of physical symptoms showed a moderate increase over time, but the average slope of psychological symptoms showed little change. Next, individual differences in change were examined using age at entry as an explanatory variable. Age accounted for 50% of the variance in physical symptoms at entry and 7% of the variance in slopes, but explained neither baseline level nor change in psychological symptoms. Rather, a U-shaped curve described the relation between age and psychological symptom change. These results, in concert with a developmental perspective, may help reconcile conflicting findings on aging and mental health.