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Optimism/Pessimism As a Mediator of Social Structural

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Optimism/Pessimism As a Mediator of Social Structural OPTIMISM/PESSIMISM AS A MEDIATOR OF SOCIAL STRUCTURAL DISPARITIES EFFECTS ON PHYSICAL HEALTH AND PSYCHOLOGICAL WELL-BEING: A LONGITUDINAL STUDY OF HOSPITALIZED ELDERS by CHRISTOPHER J. BURANT Submitted in partial fulfillment of the requirements For the degree of Doctor of Philosophy Dissertation Adviser: Dr. Kyle Kercher Department of Sociology CASE WESTERN RESERVE UNIVERSITY August, 2006 CASE WESTERN RESERVE UNIVERSITY SCHOOL OF GRADUATE STUDIES We hereby approve the thesis/dissertation of ______________________________________________________ candidate for the ________________________________degree *. (signed)_______________________________________________ (chair of the committee) ________________________________________________ ________________________________________________ ________________________________________________ ________________________________________________ ________________________________________________ (date) _______________________ *We also certify that written approval has been obtained for any proprietary material contained therein. Table of Contents List of Tables / 4 List of Figures / 5 Abstract / 9 Chapter 1: Introduction / 11 Does Hospitalization Contribute to Declining Health? / 14 Does Optimism/pessimism Play a Role in Recovery from Hospitalization? / 17 Is Optimism/pessimism a Trait or a State? / 18 Do Aspects of Social Structure Impact an Individual’s Level of Optimism and Pessimism? / 22 How is Optimism/pessimism Related to Social Structure and Human Agency? / 45 How does the Proposed Study Contribute to the Literature? / 47 Chapter 2: Literature Review of Optimism and Pessimism / 51 Optimism/Pessimism / 52 Definition of Optimism/Pessimism / 52 Measurement of Optimism/Pessimism / 54 Chapter 3: Literature Review Of Conceptual Relationships and Associated Hypotheses / 62 Consequences of Optimism and Pessimism / 62 Antecedents of Optimism and Pessimism / 69 Social Structural Disparities as an Antecedent to Physical Health and Psychological Well-Being / 74 Optimism/Pessimism as Mediator Of Social Structural Disparities Impact on Psychological Well-Being and Physical Health / 77 Causal Ordering of Physical Health and Psychological Well-Being / 81 Impact of Institutional Care Environment / 82 Summary / 89 Chapter 4: Research Design / 91 Background / 91 Proposed Study / 94 Determining the Window Eligible Data Set / 96 Measures / 99 Social Structural Disparities / 100 1 Dispositional Characteristics / 100 Psychological Well-Being / 108 Physical Health / 108 Chapter 5: Data Analytic Strategy / 111 Strategies for Longitudinal Analyses / 113 The Univariate Simplex Autoregressive Model / 115 The Bivariate Autoregressive Model / 117 The Latent Trajectory Model / 121 The Bivariate Latent Trajectory Model / 125 Combining Predictors of Longitudinal Analyses Depression and Physical Functioning / 127 Specification Search in the Development of Longitudinal Models with Predictors / 129 The Hybrid Autoregressive Latent Trajectory (ALT) Model / 134 The Bivariate Hybrid Autoregressive Latent Trajectory (ALT) Model / 135 Bivariate ALT Model with Predictors / 139 Chapter 6: Results I (Autoregressive Models) / 142 Autoregressive Model of Optimism and Pessimism / 142 Univariate Autoregressive Model of Depression / 145 Univariate Autoregressive Model of Physical Functioning / 152 Bivariate Autoregressive Models of Depression and Physical Functioning / 154 Cross Lagged Model / 154 Contemporaneous Model / 157 Summary / 161 Chapter 7: Results II ( Latent Trajectory Models and Autoregressive Latent Trajectory Models ) / 162 The Latent Trajectory Models / 162 The Univariate Latent Trajectory Model of Depression / 162 The Univariate Latent Trajectory Model of Physical Functioning / 170 The Bivariate Latent Trajectory Model of Depression and Physical Functioning / 177 The Bivariate Latent Trajectory Model of Depression and Physical Functioning with Optimism and Pessimism as Predictor / 183 The Development of the Bivariate Latent Trajectory Model with Health Disparities, Optimism and Pessimism, and Clinical Measures as Predictors / 189 Developing the Model between Disparities in Social Structures and Optimism and Pessimism / 190 Developing the Model between Disparities in Social Structures, Optimism and Pessimism, and Clinical Measures / 194 2 The Bivariate Latent Trajectory Model with Disparities in Social Structures, Optimism and Pessimism, and Clinical Measures as Predictors / 198 The Development of the Autoregressive Latent Trajectory Hybrid Model with Predictors / 211 Testing Optimism and Pessimism as Mediators of the Impact of Structural Disparities on Depression and Physical Functioning using the Autoregressive Latent Trajectory Hybrid Model / 223 Summary / 225 Chapter 8: Discussion and Conclusions / 230 How does the proposed study contribute to the literature? / 231 The First Contribution / 231 The Second Contribution / 237 The Third Contribution / 251 Is optimism or pessimism a trait or a state? / 253 The Fourth Contribution / 255 Implications of Findings / 259 Limitations / 261 Implications for Future Research / 262 Conclusions / 264 References/ 266 Appendix A: Sociodemographic Measures / 297 Appendix B: Dispositional Characteristic Measures / 299 Appendix C: Psychological Well-Being Measures / 301 Appendix D: Physical Health Measures / 303 3 List of Tables Tables 4.1: Patient Instrument / 95 4.2 : Window eligible data set / 98 4.3: Descriptive Statistics on Measures in Figure 3.1 (Total N=910) / 101 5.1: Specification Search -Example of Summary Table of all Models / 131 5.2: Specification Search - Example of the Short List of the Best Model for Each Parameter / 132 6.1: Correlated errors in Figure 6.5 / 151 7.1: Six regression paths tested for mediation / 225 4 List of Figures Figures 1.1: Proposed Conceptual Model of Optimism\Pessimism as Mediator of Social Inequality effects on Physical Health and Psychological Well-being ("Cross-sectional Perspective") / 13 1.2: Diagram of behavioral consequences of self-focused attention, including illustration of interrupt mechanism and assessment of out come expectancy (adapted from Carver & Scheier, 1982) / 23 3.1: Proposed Auto-regressive Longitudinal Model of Optimism\Pessimism as Mediator of Social Inequality effects on Physical Health and Psychological Well- being / 67 3.2: Proposed Mediation Model of Optimism and Pessimism with Social Status Characteristics as Time Invariant Predictors of the Latent Growth Curves of Physical Health and Psychological Well-being / 88 5.1: Univariate Simplex Autoregressive Model with Autocorrelated Measurement Errors and Disturbances / 116 5.2: Bivariate Autoregressive Crosslagged Model / 118 5.3: Bivariate Autoregressive Contemporaneous Model / 120 5.4: Univariate Latent Trajectory Model (Linear) / 122 5.5: Univariate Latent Trajectory Model (Quadratic) / 123 5.6: Univariate Latent Trajectory Model (Freely Estimated Slope) / 125 5.7: Bivariate Latent Trajectory Model / 127 5.8: Specification Search - Scree Plot Example 1 / 133 5.9: Univariate Hybrid Autoregressive Latent Trajectory (ALT) Model / 135 5.10: Bivariate Crosslagged ALT Model / 136 5.11: Bivariate Crosslagged ALT Base Model with Predictors / 141 5 6.1: Initial Bivariate Autoregressive Model of Optimism and Pessimism (Standardized Parameters) / 143 6.2: Standardized Results of Bivariate Autoregressive Model of Optimism and Pessimism (Structural Components shown) with Measurement Errors Correlated (not shown) / 144 6.3: Standardized Results of the Univariate Autoregressive Model of Depression (Structural Components and Factor Loadings shown) / 147 6.4: Standardized Results for the Univariate Autoregressive Model of Depression after adding Correlations between Measurement Errors and Disturbance Terms from Modification Indices (Structural Components, Factor Loadings, and Correlations with Disturbance Terms shown) / 148 6.5: Standardized Results for the Univariate Autoregressive Model of Depression after adding Correlations between Measurement Errors and Disturbance Terms from Modification Indices; Factor Loadings Constrianed to be Equal (Structural Components, Factor Loadings, and Correlations with Disturbance Terms shown) / 149 6.6: Standardized Results fot the Univariate Autoregressive Model of Physical Functioning (Structural Components and Factor Loadings shown) / 153 6.7: Standardized Results for the Bivariate Autoregressive Crosslagged Model of Depression and Physical Functioning / 156 6.8: Standardized Results of the Bivariate Autoregressive Contemporaneous Model of Depression and Physical Functioning / 160 7.1: The Univariate Latent Trajectory Model of Depression with Intercept and Linear Slope (Standardized Parameters) / 163 7.2: The Univariate Latent Trajectory Model of Depression with Intercept, Linear Slope, and Quadratic Slope (Standardized Parameters) / 164 7.3: The Univariate Latent Trajectory Model of Depression with Intercept and Freely Estimated Slope (Standardized Parameters) / 166 7.4: The Univariate Latent Trajectory Model of Depression with Intercept and Freely Estimated Slope (Unstandardized Parameters) / 167 7.5: Line Graph of the Trajectory of Depression / 169 7.6: The Univariate Latent Trajectory Model of Physical Functioning with Intercept 6 and Linear Slope (Standardized Parameters) / 171 7.7: The Univariate Latent Trajectory Model of Physical Functioning with Intercept, Linear Slope, and Quadratic Slope (Standardized Parameters) / 172 7.8: The Univariate Latent Trajectory Model of Physical Functioning with Intercept and Freely Estimated Slope (Standardized
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