Year of Publication

2017

Degree Name

Doctor of Philosophy (PhD)

Document Type

Doctoral Dissertation

College

Arts and Sciences

Department

Psychology

First Advisor

Dr. Ruth A. Baer

Second Advisor

Dr. Suzanne C. Segerstrom

Abstract

Despite natural declines in physical and cognitive function, older adults maintain good emotion regulation abilities, leading to emotional wellbeing and resilience. This phenomenon can partially be explained by socioemotional selectivity theory (SST), which posits that when time is perceived as a limited resource, older adults focus attention on positive environmental stimuli to regulate emotions. Although this positivity effect maintains emotional wellbeing, it may disrupt information processing related to healthcare decision-making. Older adults request less information from their doctors, are less likely to ask for a second opinion, make their decisions more quickly, and devote more attention to positive medical information, compared with younger adults. These age effects are temporarily reversible when older adults are primed to reduce their emotional focus or increase the amount of information they gather. However, this leads to reductions in positive affect and may reduce self-regulatory capacities required for emotion regulation. Personal values have been studied in the context of information processing and decision-making. Emphasizing personal values increases positive affect, counteracts self-regulatory fatigue, and reduces defensiveness when processing health information. Despite the relevance of personal values to older adults, the effects of personal values have not been studied in research on healthcare decision-making and aging.

The present study employed a laboratory-based healthcare decision-making task to examine the effects of three writing tasks (control, information-gathering, and values) on the decision-making process in older adults (n=90) compared to race/gender-matched younger adults (n=90). Participants also completed self-report questionnaires on physical and psychological wellbeing, a behavioral task measuring self-regulatory strength, and neuropsychological measures.

The present study found that older adults reviewed more positive information when selecting a health plan and physician, and recalled their physician choice more positively compared to younger adults. Older adults took significantly longer and reviewed more information when selecting a health plan and physician compared to younger adults. However, there were no significant effects for writing task condition. Significant age-related differences in information processing were partially accounted for by baseline affect and future time perspective. These results offer support for the positivity effect in older adults when reviewing health-related information. Null findings associated with values-based writing task highlight experimental complexities when examining age-related differences and provide additional avenues for future research.

Digital Object Identifier (DOI)

https://doi.org/10.13023/ETD.2017.070

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