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While numerous studies exist on the benefits of social support (both receiving and giving), little research exists on how the balance between the support that individuals regularly give versus that which they receive from others relates to physical health. In a US national sample of 6,325 adults from the National Survey of Midlife Development in the United States, participants were assessed at baseline on hours of social support given and received on a monthly basis, with all-cause mortality data collected from the National Death Index over a 23-y follow-up period. Participants who were relatively balanced in the support they gave compared to what they received had a lower risk of all-cause mortality than those who either disproportionately received support from others (e.g., received more hours of support than they gave each month) or disproportionately gave support to others (e.g., gave many more hours of support a month than they received). These findings applied to instrumental social support (e.g., help with transportation, childcare). Additionally, participants who gave a moderate amount of instrumental social support had a lower risk of all-cause mortality than those who either gave very little support or those who gave a lot of support to others. Associations were evident over and above demographic, medical, mental health, and health behavior covariates. Although results are correlational, one interpretation is that promoting a balance, in terms of the support that individuals regularly give relative to what they receive in their social relationships, may not only help to strengthen the social fabric of society but may also have potential physical health benefits.

Previous studies have indicated that high neuroticism is associated with early mortality. However, recent work suggests that people's level of neuroticism changes over long periods of time. We hypothesized that such changes in trait neuroticism affect mortality risk. Growth-curve parameters (levels and slopes) that quantified the trajectories of neuroticism change over 12 years were used to predict 18-year risk of mortality among 1,663 aging men. Proportional hazards models were used to estimate mortality risk from level and slope parameters, controlling for objective and subjective health, depression, and age. Although a parallel analysis of extraversion showed no significant effects, level and slope of neuroticism interacted in their effect on mortality. Men who had both a high average level of neuroticism and an increasing level of neuroticism over time had much lower survival than men without that combination. These findings suggest that it is not just the level of personality traits, but their direction of change, that is related to mortality.

Cigarette smoking and alcohol consumption during pregnancy can have detrimental effects on the developing fetus, including fetal alcohol syndrome and low birth weight. Surprisingly little is known about the association of personality traits with smoking and alcohol consumption in the specific subpopulation of pregnant women. This study analyzed data from a geographically diverse sample of 603 pregnant women, aged 18 years and older, who provided information regarding their smoking and drinking habits before and during pregnancy. We compared women who consumed alcohol or smoked cigarettes before pregnancy with women who quit or continued smoking or drinking during pregnancy. Associations between personality and maladaptive behaviors prior to and during pregnancy were modeled using logistic regression. The study revealed that women who scored high on openness to experience were significantly more likely to continue alcohol consumption during pregnancy (OR = 1.07, 95% CI 1.01, 1.14, p = .02). This association was maintained after adjusting for potential confounds. This study demonstrated a significant relationship between personality traits and women's likelihood of continued alcohol consumption prior to and during pregnancy. Understanding personality-based determinants of health-detrimental behavior is important in order to design interventions that aim at decreasing rates of maladaptive health behaviors among pregnant women.

Background: Using longitudinal data from the Survey of Mid-Life Development in the United States, this study examined the role of systemic inflammation in mediating the link between multimorbidity and increases in and onset of functional limitations over a 17–19 year follow-up period. Methods: Participants completed questionnaire assessments of chronic conditions and functional limitations. Interleukin-6, C-reactive protein, and fibrinogen were assayed in serum. Structural equation models were used to predict increases in and onset of functional limitations associated with baseline multimorbidity status; mediation by inflammation was also determined. Results: Multimorbidity (versus 0–1 conditions) predicted more functional limitations and greater odds of onset of limitations over time. Significant indirect effects showed that inflammation partially mediated the link between multimorbidity and changes in, but not onset of, limitations. Discussion: These results show that inflammation, a nonspecific marker of multiple disease conditions, explains in part the degree to which multimorbidity is disabling.

Poor medication adherence is associated with reduced drug effectiveness, poor health-related quality of life, increased morbidity and mortality, and increased healthcare utilization and cost. Including the patient’s voice is essential in understanding barriers to adherence. Useful patient-reported adherence measures are brief, inexpensive, non-invasive; can indicate barriers to adherence; and can be incorporated in electronic health records. The NIH Patient-Reported Outcomes Measurement Information System (PROMIS®) includes high-quality, freely available patient-reported measures covering many important constructs in patient-centered research but does not include a medication adherence measure. To fill this gap, we developed the PROMIS Medication Adherence Scale (PMAS) using the rigorous PROMIS instrument development guidelines. To develop the PMAS, we first conducted a review of the reviews, which enabled us to identify content areas relevant to medication adherence behavior. Then, we conducted qualitative research to elicit patients’ views of and experiences with medication adherence. This process identified the following important content areas to guide item writing: extent medication is taken, knowledge of medication regimen, beliefs about medication, remembering to take medication, skipping due to side effects, skipping due to feeling better, and cost of medications. Based on the results of these activities, we wrote items and aimed to retain 1– 2 items per content area. The final item set included 9 total adherence items, which were then refined through intensive comprehension and translatability review, as well as cognitive interviews. Future steps include testing the PMAS’s validity.

BackgroundHealth complications from diabetes place major strain on individuals, financially and emotionally. The onset and severity of these complications are largely driven by patients’ behaviors, making psychosocial factors that influence behaviors key targets for interventions. One promising factor is sense of purpose or the degree to which a person believes their life has direction.MethodThe current study investigated whether sense of purpose predicts self-rated health, cardiovascular disease, and smoking status among adults with diabetes concurrently and prospectively. Moreover, it tested whether these associations held across multiple samples and cultures. Coordinated analysis using 12 datasets cross-sectionally and eight longitudinally (total N = 7277) estimated the degree to which sense of purpose is associated with subjective health, smoking status, and cardiovascular disease among adults with diabetes. Coordinated analysis allows for greater generalizability of results across cultures, time periods, and measurement instruments. Datasets were included if they concurrently included a measure of sense of purpose and diabetes status and at least one health measure: self-rated health, current smoking status, or heart condition status.ResultsSense of purpose was associated with higher self-rated health, smoking status, and cardiovascular disease cross-sectionally and self-rated health prospectively. Purpose was unassociated with changes in health over time.ConclusionThese results highlight the relationship of a key individual difference, sense of purpose, to the behaviors and outcomes of adults with diabetes. While more research is needed to determine the boundaries of this relationship, it seems sense of purpose may be considered in the future as a potential target for intervention.

Objectives: The current study investigated whether personality traits and facets were associated with interleukin-6, C-reactive protein, and fibrinogen, and whether physical activity mediated the relationship between personality and biomarkers of inflammation. Methods: Personality was assessed in the Midlife Development in the United States study using the Multi-Dimensional Personality Questionnaire and Midlife Development Inventory personality scale. Data were included from 960 participants (mean age = 57.86 years, standard deviation = 11.46). Personality was assessed from 2004 to 2009. Serum levels of interleukin-6, fibrinogen, and C-reactive protein were assessed in 2005–2009 as part of the Midlife Development in the United States biomarkers subproject. Results: Lower neuroticism was associated with elevated interleukin-6, and achievement was associated with lower fibrinogen. Higher physical activity was associated with lower interleukin-6 and C-reactive protein. Mediation models suggested that physical activity mediated the associations between achievement and both interleukin-6 and C-reactive protein. Discussion: Physical activity is an important factor in the Health Behavior Model of personality and explains some of the associations between personality and inflammation. These findings contribute to the fields of aging and health by linking individual difference factors to markers of inflammation, and showing that these processes may function partially through specific behaviors, in this case physical activity.

The United States (U.S.) National Institutes of Health–funded Environmental influences on Child Health Outcomes (ECHO)-wide Cohort was established to conduct high impact, transdisciplinary science to improve child health and development. The cohort is a collaborative research design in which both extant and new data are contributed by over 57,000 children across 69 cohorts. In this review article, we focus on two key challenging issues in the ECHO-wide Cohort: data collection standardization and data harmonization. Data standardization using a Common Data Model and derived analytical variables based on a team science approach should facilitate timely analyses and reduce errors due to data misuse. However, given the complexity of collaborative research designs, such as the ECHO-wide Cohort, dedicated time is needed for harmonization and derivation of analytic variables. These activities need to be done methodically and with transparency to enhance research reproducibility. Impact Many collaborative research studies require data harmonization either prior to analyses or in the analyses of compiled data. The Environmental influences on Child Health Outcomes (ECHO) Cohort pools extant data with new data collection from over 57,000 children in 69 cohorts to conduct high-impact, transdisciplinary science to improve child health and development, and to provide a national database and biorepository for use by the scientific community at-large. We describe the tools, systems, and approaches we employed to facilitate harmonized data for impactful analyses of child health outcomes.

INTRODUCTION The extent to which the Big Five personality traits and subjective well‐being (SWB) are discriminatory predictors of clinical manifestation of dementia versus dementia‐related neuropathology is unclear. METHODS Using data from eight independent studies (Ntotal= 44,531; Ndementia= 1703; baseline Mage= 49 to 81 years, 26 to 61% female; Mfollow‐up range = 3.53 to 21.00 years), Bayesian multilevel models tested whether personality traits and SWB differentially predicted neuropsychological and neuropathological characteristics of dementia. RESULTS Synthesized and individual study results indicate that high neuroticism and negative affect and low conscientiousness, extraversion, and positive affect were associated with increased risk of long‐term dementia diagnosis. There were no consistent associations with neuropathology. DISCUSSION This multistudy project provides robust, conceptually replicated and extended evidence that psychosocial factors are strong predictors of dementia diagnosis but not consistently associated with neuropathology at autopsy. Highlights N(+), C(−), E(−), PA(−), and NA(+) were associated with incident diagnosis. Results were consistent despite self‐report versus clinical diagnosis of dementia. Psychological factors were not associated with neuropathology at autopsy. Individuals with higher conscientiousness and no diagnosis had less neuropathology. High C individuals may withstand neuropathology for longer before death.

Previous studies have shown that certain personality traits such as neuroticism and conscientiousness influence dietary choices. Pregnancy is a unique period in a woman’s life during which most women are highly intrinsically and extrinsically motivated to start a diet rich in fruit and vegetables. Yet, an adequate consumption of fruits and vegetables remains a challenge for many women. The present study investigates the relationships between personality traits and fish, dairy, fruit, and vegetable intake. Data was collected from 602 pregnant women and analyzed using descriptive statistics and hierarchical regression analyses in order to examine predictive relationships between the variables of interest. The results demonstrated that high scores in openness to experience, older maternal age, higher income, and educational attainment were positively associated with increased fish, vegetable, and fruit intake. These findings have important implications for interventions that seek to improve eating behaviors of pregnant women, thereby increasing the health of their pregnancies.