Three-level Multilevel Models Research Articles

Gender-Sexuality Alliance Experiences and LGBTQ+ Inclusive School Policies and Practices Predict Youth's School Belonging.

Gender-Sexuality Alliances (GSAs) and inclusive school policies and practices that affirm youth with minoritized sexual orientations or gender identities (e.g., lesbian, gay, bisexual, transgender, queer youth; LGBTQ+ youth) are two sources of support for LGBTQ+ youth that could promote school belonging. The current study tested a three-level multilevel model in which youth's GSA experiences and the degree to which their schools implemented LGBTQ+ inclusive policies and practices predicted their school belonging over a six-month period. Participants included 627 youth (87% LGBQ+ youth, 45% transgender or nonbinary youth, 48% youth of color) ages 11-22 (Mage = 15.13) in 51 GSAs. At the within-individual level, youth reported greater school belonging on occasions following months when they felt their peers and advisors were more responsive to their needs and when they had taken on more leadership in the GSA. At the between-individual level, youth who generally felt their peers were more responsive over the study period reported greater school belonging than others. At the between-GSA level, GSA members in schools that more thoroughly implemented LGBTQ+ inclusive policies and practices reported greater school belonging over the study period. These findings underscore the relevance of GSAs and inclusive policies and practices in establishing welcoming school environments.

“What’s yours is mine”: Partners’ everyday emotional experiences and cortisol in older adult couples

The existing literature consistently finds that emotional experiences and cortisol secretion are linked at the within-person level. Further, relationship partners tend to covary in emotional experience, and in cortisol secretion. However, we are only beginning to understand whether and how an individuals’ emotions are linked to their relationship partners’ cortisol secretion. In this project, we harmonized data from three intensive measurement studies originating from Canada and Germany to investigate the daily dynamics of emotions and cortisol within 321 older adult couples (age range=56–87 years). Three-level multilevel models accounted for the nested structure of the data (repeated assessments within individuals within couples). Actor-Partner Interdependence Models were used to examine the effect of own emotional experiences (actor effects) and partner emotional experiences (partner effects) on momentary and daily cortisol secretion. Adjusting for age, sex, education, comorbidities, assay version, diurnal cortisol rhythm, time spent together, medication, and time-varying behaviors that may increase cortisol secretion, results suggest that higher relationship partner’s positive emotions are linked with lower momentary cortisol and total daily cortisol. Further, this association was stronger for older participants and those who reported higher relationship satisfaction. We did not find within-couple links between negative emotions and cortisol. Overall, our results suggest that one’s relationship partner’s positive emotional experience may be a protective factor for their physiological responding, and that these more fleeting and day-to-day fluctuations may accumulate over time, contributing to overall relationship satisfaction.

부가가치모형 기반의 학교행복지수 산출 및 학생들이 행복한 학교의 특성 분석

This study aimed to calculate the School Happiness Index using a value-added model and analyze characteristics of happy schools. The value-added School Happiness Index was calculated after controlling for background characteristics and pre-happiness scores, which reflected changes in students' happiness scores compared to schools with similar backgrounds. KCYPS 2018 data was used, and a three-level multilevel growth model and school-level path analysis were applied to estimate the value-added School Happiness Index and examine related middle school characteristics. The findings revealed that peer relationships and academic enthusiasm in schools were identified as crucial school characteristics for promoting school happiness. The results of this study can contribute to increasing educational interest in student happiness in schools and serve as empirical evidence for promoting happy schools.

Genetic and subjective sensitivity, relationship dynamics, and psychological distress in couples.

Positive and negative aspects of intimate relationships influence mental health and well-being in couples. According to the environmental sensitivity framework, individuals differ in how strongly they are affected by their environment, with some individuals being more or less sensitive to both negative and positive experiences. The present study examined the longitudinal associations between positive and negative relationship dynamics, including marital satisfaction, positive bonding, and negative communication, and psychological distress as well as the extent to which individual differences in genetic and subjective measures of environmental sensitivity moderated the association between relationship dynamics and psychological distress in a sample of couples in the U.S. Army (n = 238 individuals representing 152 unique couples). Sensitivity was measured by self-report and a polygenic score derived from previous genome-wide association study results. Separate three-level multilevel models were conducted for each relationship dynamic and sensitivity variable. Only for subjective (i.e., self-reported) sensitivity did significant cross-level interactions emerge in predicting psychological distress, whereas no such interactions were found for genetic (i.e., polygenic score) sensitivity. Specifically, lower marital satisfaction and positive bonding were associated with higher psychological distress among subjectively highly sensitive individuals, and higher negative communication was associated with higher psychological distress among subjectively highly sensitive individuals. Findings suggest that both low positive and high negative relationship dynamics may have a greater effect on psychological distress among highly sensitive individuals, which may help to inform tailored intervention to meet the unique needs of couples. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

A Longitudinal Multilevel Analysis of the Effects of Contraceptive Failures on Unintended Pregnancies among Women in Urban Nigeria.

Unintended pregnancy is a global public health concern. However, the effect of contraceptive failure on unintended pregnancy remains unclear in Nigeria. We undertook a longitudinal analysis to examine the effect of contraceptive failure on unintended pregnancy among urban women in Nigeria. We used panel data from the Nigerian Urban Reproductive Health Initiative. The Measurement, Learning and Evaluation program conducted the surveys among a cohort of women aged 15-49 who were first interviewed at baseline in 2010/2011 and followed up at endline in 2014/2015. Analytic sample was 4140 women aged 15-49 who ever used contraceptives. We fitted three-level multilevel binary logistic regression models estimated with GLLAMM. The study established evidence that there is a significant effect of contraceptive failure on unintended pregnancy among urban women in Nigeria. The positive effect of between-person contraceptive failure indicates that respondents who experienced more contraceptive failure than the average in the sample had 5.26 times higher odds of unintended pregnancy (OR = 5.26; p-value < 0.001). Results also established a significant effect of within-person contraceptive failures among the respondents. Findings suggest there is evidence of a significant longitudinal effect of contraceptive failure on unintended pregnancy in urban Nigeria. Efforts to reduce unintended pregnancy must include interventions to address the problem of contraceptive failure among urban women in Nigeria.

DISRUPTING THE NEGATIVE AFFECT AND PAIN CONNECTION IN OLDER ADULTS: THE ROLE OF SOCIAL INTERACTIONS AND ENJOYMENT

Abstract Although it is well-established that negative affect is bi-directionally linked with pain, little research has examined their relationship in daily life among older adults. Even less is known about what social factors may help attenuate the affect-pain connection. We examined whether social interactions and reported enjoyment in daily life were associated with an attenuated link between negative affect and two important pain outcomes (pain intensity and perceived interference from pain). This was examined among a socioeconomically and racially diverse sample of 317 older adults aged 70+ (Mage = 77.45 ; 67% women; 40% Black; 13% Hispanic) who were recruited from the Bronx, NY as part of the Einstein Aging Study and who completed ecological momentary assessments five times daily for 14 days. Three-level multilevel models were estimated, controlling for mild cognitive impairment (MCI) status, gender, age, education, body mass index, and average level positive affect for models that did not include enjoyment. In given moments, higher negative affect and lower enjoyment were associated with higher pain intensity and pain interference (ps&amp;lt;.05). Moment-level negative affect and enjoyment significantly interacted to predict both higher pain intensity (p=.005) and pain interference (p&amp;lt;.0001), with patterns suggesting a buffering effect of enjoyment. In addition, a three-way interaction emerged such that during moments when no interactions occurred and negative affect was lower than a person’s average, there was a buffering effect of momentary enjoyment on pain intensity. Findings extend understanding of the affect-pain connection and the potential mitigating impact of social interactions and moments of enjoyment.

Multilevel modelling of neonatal mortality in Ghana: Does household and community levels matter?

BackgroundNeonatal mortality accounts for an increasing share of under-five deaths, and they are declining at a slower rate than postnatal deaths. Apparently, neonatal mortality is increasingly becoming a major public health problem in Ghana and the world over. The current study sought to analyze neonatal mortality as a function of predictor variables and to estimate and understand unobserved household and community-level residual effects on neonatal mortality to provide data driven evidence to shape informed policies and interventions aimed at reducing the neonatal mortality burden. MethodsThe current study extracted three-level complex data on 5884 children born in the five years preceding the 2014 Ghana Demographic and Health Survey. A two-level and three-level multilevel logistic models were applied to estimate unobserved household and community-level variations in neonatal mortality in the presence of set of predictor variables. Sampling weights were incorporated in both the descriptive and inferential analysis since the data used emanated from a complex survey. Model fit statistics such as AIC scores for a weighted two-level and three-level random intercept logistic models were compared. The model with the lowest AIC score was considered the most preferred model. ResultsThe household-level random intercept model suggested that the odds of neonatal mortality was higher among multiple births [OR = 3.15 (95% CI: 1.17, 8.50)], babies born to mothers who received prenatal care from non-skilled worker [OR = 5.88 (95% CI: 2.90, 11.91)], babies delivered through caesarian section [OR = 2.47 (95% CI: 1.06, 5.79)], a household with 1–4 members [OR = 10.23 (95% CI: 4.17, 25.50)], a short preceding birth interval (<24 months) [OR = 3.05 (95% CI: 1.18, 7.88)], and preceding birth interval between 24 and 47 months [OR = 2.88 (95% CI: 1.41, 5.91)]. Substantial unobserved household-level residual variations in neonatal mortality were observed. ConclusionThe findings of the current study provide an actionable information to be used by government and other stakeholders in the health sector to renew commitment to reduce neonatal mortality to an acceptable level. There is the need to intensify maternal health education by health providers to encourage pregnant women to visit antenatal clinics at least four times so they could benefit substantially from ANC services.

Dynamic relations among simultaneous alcohol and cannabis use, subjective responses, and problem drinking during naturally occurring drinking episodes

BackgroundSimultaneous alcohol and cannabis use (SAM) is associated with riskier drinking. However, little is known regarding mechanisms of risk during drinking episodes. The current study tested whether subjective responses to simultaneous vs. alcohol-only use (i.e., high arousal positive/reward, high arousal negative/aggression, low arousal positive/relaxation, low arousal negative/impairment) were mechanisms through which SAM use was associated with daily drinking. MethodsEmerging adults who co-use alcohol and cannabis (N=85) completed 21 days of ecological momentary assessment with drink-contingent reports during drinking episodes. Participants reported on their simultaneous use and current subjective effects during drink reports and past-night total drinks consumed and negative consequences experienced the next morning. Three-level multilevel models (momentary, daily, person level) tested whether SAM use predicted subjective responses, and whether subjective responses mediated associations between SAM use, heavier drinking and negative consequences. ResultsAt the momentary and day-level, SAM (vs. alcohol-only) use predicted increased high arousal positive/rewarding, low arousal positive/relaxing, and low arousal negative/impairing subjective effects. SAM use indirectly predicted heavier day-level drinking and further negative consequences through high arousal positive/rewarding response. SAM use also indirectly predicted day-level negative consequences through low arousal negative/impairing response. At the person-level, more frequent SAM use predicted higher person-average high arousal positive/rewarding and low arousal positive/relaxing responses, and high arousal positive/rewarding response mediated relation between SAM frequency and heavier drinking. ConclusionsSimultaneous use was associated with reward, relief, and impairment, and reward and impairment were mechanisms of risk between SAM use and riskier drinking. Findings may inform theory and just-in-time interventions seeking to reduce alcohol misuse.

Growing up together: Differences between siblings in the development of compliance separating within-family and between-family effects.

This study applies a within-family, age-snapshot design to investigate differences between siblings in the development of compliance during the preschool years by disaggregating situational, within-family, and between-family effects. The aim of the study was to investigate the relation between sibling differences in compliance and the within-family factors birth order and differential parenting, as well as interactions between these factors. Using observational data of 311 Dutch families (self-identified as culturally Dutch) with 2 children when each child was 3 and 4 years old (firstborns: 36.2 months old; SD = 3.6; 48% girls, second-borns (2 years later): 36.67 months old; SD = .62; 47% girls) and both parents. Three-level cross-classified multilevel models showed main effects of observed sibling noncompliance and differential verbal discipline on noncompliance. In addition, second-born children were more compliant than their firstborn siblings, but only when the firstborn was disciplined physically more often than his/her younger sibling. The results provide evidence that birth-order effects may partially be explained by differential parenting and suggest that differences between siblings cannot be fully understood without taking into account the influence of both direct and indirect sibling effects. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Alcohol-induced blackouts among college student drinkers: A multilevel analysis

ObjectiveTo identify factors (manner of drinking, combined alcohol and other substance use, physiology) that are associated with alcohol-induced blackouts (AIBs) over and above estimated blood alcohol concentration (eBAC). MethodsStudents (N = 462, 51.7 % female, 87.7 % White, Mage = 20.1) were assessed across 6 weekends via e-surveys (80–97 % response rate). eBAC was calculated using standard number of drinks, drinking duration, sex, and weight. Three-level multilevel models (days, weeks, persons) were conducted to test for main effects, controlling for eBAC. ResultsProtective behavioral strategies (PBS) were associated with decreased odds of AIBs on the daily (OR = 0.64, 95 % CI: 0.53, 0.77), weekly (OR = 0.84, 95 % CI: 0.72, 0.98), and person-levels (OR = 0.62, 95 % CI: 0.51, 0.74). Combined cannabis with alcohol was associated with increased odds of AIBs on the weekly (OR = 2.13, 95 % CI 1.13, 4.07) and person-levels (OR = 3.56, 95 % CI 1.60, 7.93). People who more frequently played drinking games (OR = 1.41, 95 % CI: 1.12, 1.77), pregamed (OR = 1.55, 95 % CI: 1.19, 2.03), and showed higher tolerance (OR = 1.22, 95 % CI: 1.08, 1.37) showed increased risk of AIBs, over and above eBAC levels. ConclusionWe identified a number of daily-, weekly-, and person-level factors that uniquely contribute to the prediction of AIBs even at equivalent eBACs. Many of these factors were behavioral, suggesting that they may serve as malleable prevention targets for AIBs in college student drinkers.

Inequality at the Starting Line: Underrepresentation in Gifted Identification and Disparities in Early Achievement

Is underrepresentation of Black students, Latinx students, English learners (EL), and students from economically challenging communities in gifted programs due to inequality in early academic achievement or bias in the gifted identification process? Using three-level multilevel logistic models, we examine the degree to which the disparities in gifted identification are due to disparities in early achievement. Our datasets include 3rd-, 4th-, and 5th-grade achievement scores and demographic variables from all students in a 3rd-grade, 2011–2012 cohort across three states. Students who qualified for free/reduced-price lunch (FRPL), EL, and Black or Latinx students were between two to eight times less likely to be identified as gifted compared to non–free/reduced-price lunch, non-EL, and White or Asian students. However, between 50% and 100% of gifted identification disparities could be explained by student-level differences in early academic achievement, which is consistent with an opportunity gap explanation of underrepresentation.

Using Bourdieu's theory of cultural reproduction to examine English language learning: A multilevel study in three lower- and middle-income countries

This study examines the determinants of the gaps in learning outcomes of students in three lower- and middle-income countries (LMICs) – Ethiopia, India, and Vietnam. We examined the extent to which English language performance relates to Bourdieu's theory of cultural reproduction, using the Young Lives international school survey data in the three countries. We employed a three-level multilevel model, to investigate variables at the individual, classroom and school levels that may influence English language skills of students. We find that differences in English test performance are attributable to both home background and school factors in all three contexts. Within countries, we find evidence of a high degree of variation in the English test scores of students between schools, indicating the importance of schooling quality and school characteristics for the development of English language skills. We conclude that the process of cultural reproduction through schooling is different for each country, with school-level factors found to reinforce social stratification in countries that are less equitable. This study provides a robust quantitative contribution to the literature base on English language learning in LMICs, where large-scale cross-country comparisons are relatively uncommon due to a relative lack of suitable data. The results and recommendations would be of interest to education stakeholders within LMIC contexts.

DISSOCIATING RETEST EFFECTS FROM DEVELOPMENTAL CHANGE FOR PREDICTING COGNITIVE STATUS

Abstract In longitudinal designs, unadjusted retest effects can confound developmental change estimates. This study utilized a measurement burst design and three-level multilevel modeling to a) independently parameterize short-term retest and long-term developmental change and b) employ these estimates as predictors of cognitive status at long-term follow-ups. Using data from Project MIND , participants (N=304; aged 64-92 years) were assessed across biweekly sessions nested within annual bursts (spanning up to 17 total assessments over four years). Cognitive impairment no dementia (CIND) status was classified at Years 4 (the final burst assessment) and 8 (the study end date). Response time inconsistencies (RTI) were computed to index intraindividual variability across RT trials of a one-back response time (BRT) task. Three-level multilevel models simultaneously yet independently estimated BRT RTI change across weeks and years, indexing short-term retest and long-term developmental change, respectively. Individual slope estimates were extracted and utilized in multinomial logistic regression models contrasting short- vs. long-term RTI change as predictors of long-term cognitive status. Results from the three-level models indicated that retest and developmental slopes yielded non-redundant sources of variance, providing unique estimates of change that would otherwise be confounded. Further, short- and long-term RTI differentially predicted cognitive status at Years 4 and 8; failing to benefit from retest effects on the BRT task was associated with increased likelihood of cognitive impairment. This innovative approach to parameterizing retest effects can reduce systematic bias in estimates of long-term developmental change, as well as highlight the utility of retest effects as predictors of cognitive health.

BSS Flash Poster Session 2: The Power of Purpose and Personal Ties in Late Life

Abstract This study examined (1) the time-varying relationship between purpose in life and perceived stress reactivity, (2) the trajectory of perceived stress reactivity as it relates to both within- and between-person purpose in life, as well as (3) the predictive utility of perceived stress reactivity and its rate of change on cognitive ability and allostatic load. The sample comprised 933 participants from the Notre Dame Study of Health &amp; Well-being, a 10-year study of annual questionnaire packets and biennial daily diary bursts. Analyses included three-level multilevel models from which random effects were extracted and used to predict allostatic load and cognitive ability. Results indicated that individuals were affectively reactive to perceived stress, and that perceived stress reactivity declined over time. Considering the effects of purpose in life on these processes, there were two cross-level interaction effects indicating (1) more purposeful individuals were less stress reactive than less purposeful individuals, and (2) more purposeful individuals declined less in negative affect over time than less purposeful individuals. There was also preliminary evidence for a within-person interaction effect between yearly purpose in life and daily affective reactivity such that when individuals felt particularly purposeful, they also tended to be less stress reactive. Finally, higher perceived stress reactivity, as well as less decline in this construct, was predictive of better cognitive ability. These findings indicate purpose in life buffers against environmental and maturational effects on negative affect, and that perceived stress reactivity may indicate a different, more adaptive process than affective reactivity to experienced stressors.

PURPOSE IN LIFE, STRESS REACTIVITY, AND COGNITIVE AGING: A LONGITUDINAL INVESTIGATION

Abstract This study examined (1) the time-varying relationship between purpose in life and perceived stress reactivity, (2) the trajectory of perceived stress reactivity as it relates to both within- and between-person purpose in life, as well as (3) the predictive utility of perceived stress reactivity and its rate of change on cognitive ability and allostatic load. The sample comprised 933 participants from the Notre Dame Study of Health &amp; Well-being, a 10-year study of annual questionnaire packets and biennial daily diary bursts. Analyses included three-level multilevel models from which random effects were extracted and used to predict allostatic load and cognitive ability. Results indicated that individuals were affectively reactive to perceived stress, and that perceived stress reactivity declined over time. Considering the effects of purpose in life on these processes, there were two cross-level interaction effects indicating (1) more purposeful individuals were less stress reactive than less purposeful individuals, and (2) more purposeful individuals declined less in negative affect over time than less purposeful individuals. There was also preliminary evidence for a within-person interaction effect between yearly purpose in life and daily affective reactivity such that when individuals felt particularly purposeful, they also tended to be less stress reactive. Finally, higher perceived stress reactivity, as well as less decline in this construct, was predictive of better cognitive ability. These findings indicate purpose in life buffers against environmental and maturational effects on negative affect, and that perceived stress reactivity may indicate a different, more adaptive process than affective reactivity to experienced stressors.

How the Great Recession changed class inequality: Evidence from 23 European countries

The question of whether economic recessions increase or decrease the earnings gap between the working and upper-middle class is debated. We study this issue and examine the Great Recession period using two different analytical strategies: three-level multilevel models and multivariate analysis over time. Based on EU Statistics on Income and Living Conditions (EU-SILC) data in 23 countries from 2004 to 2017, our results under both analytical strategies provide robust evidence that, by and large, the Great Recession widened the earnings gap between the working and upper-middle class. The effect magnitude is sizable; an increase of 5 percentage points in the unemployment rate is associated with an increase in the class earnings gap of approximately 0.10 log points.

The role of team structures in social integration in swiss football clubs: a multilevel analysis

Sports clubs may be an ideal setting for social integration for people from different backgrounds. Using heuristic multilevel models, prior studies linked the individual characteristics of the members with social structures at the club context (e.g. club goals) to explain social integration. However, due the organisation of sport activities in teams, another social context with distinct social structures (e.g. team culture) exists within clubs that is likely relevant for social integration as well. Based on data from 1415 members in 140 teams of 42 Swiss football clubs, this study analyses social integration in the dimension of identification in a three-level multilevel model that is the first to include the team context as a level of analysis. The results revealed that teams differ considerably in the social integration of their members. Besides individual factors (e.g. education level, membership duration), a team culture of social togetherness and especially a pronounced team sociability are relevant for identification. Cross-level interactions showed that these factors play a role for members independent of their migration background. Yet, additional positive effects exist for members new to the club. Based on these results, sports club researchers should consider including the team level in multilevel analyses.

The naturalistic reinforcement of worry from positive and negative emotional contrasts: Results from a momentary assessment study within social interactions

BackgroundThe Contrast Avoidance Model (Newman & Llera, 2011) proposes that worry is reinforced by avoiding a negative contrast and increasing the likelihood of a positive contrast. ObjectiveTo determine if reinforcement of worry occurs naturalistically via contrasts in both negative and positive emotion. MethodUsing event-contingent momentary assessment we assessed social interactions, pre-interaction state worry and pre-post interaction positive and negative emotion. Participants with generalized anxiety disorder (GAD; N = 83) completed an online questionnaire after social interactions lasting at least 1 min for 8 days. Three-level multilevel models were conducted. ResultsHigher worry was concurrently associated with increased negative emotion and decreased positive emotion. Regardless of pre-interaction worry level, negative emotion decreased, and positive emotion increased from before to after interactions, suggesting that most interactions were benign or positive. At lower levels of pre-interaction worry, participants experienced increased negative emotion and decreased positive emotion from before to after interactions. At higher levels of pre-interaction worry, participants experienced decreased negative emotion and increased positive emotion from before to after interactions. ConclusionAmong persons with GAD, worrying before social interactions may be both negatively and positively reinforced; furthermore, not worrying before social interactions may be both negatively and positively punished.

Scar effects of unemployment on generalised social trust: The joint impact of individual and contextual unemployment across Europe

How does unemployment affect generalised social trust? A growing body of work has analysed the scar effects of unemployment on trust. However, this literature has not yet addressed the moderating role of contextual unemployment. In this article, we extend a theoretical framework positing that individual and contextual unemployment depress generalised social trust and formulate competing hypotheses on their interaction. We test these hypotheses relying on Rounds 4–9 (2008–2018) of the European Social Survey, for up to 29 countries and 227 regions. Results from three-level multilevel models indicate that individual and contextual unemployment are associated with lower trust, although at the macro-level this holds only for cross-sectional unemployment. At the macro-micro level, we find that lower cross-sectional unemployment rates powerfully exacerbate the individual association, while the latter becomes not significant at higher cross-sectional rates. These findings highlight that individual and contextual unemployment are central to illuminate social trust patterns.

Exploring the impact of community-based choral participation on cognitive function and well-being for persons with dementia: evidence from the Voices in Motion project

Objectives Music-based interventions are postulated to mitigate cognitive decline in individuals with dementia. However, the mechanisms underlying why music-based interventions facilitate cognitive benefits remain unknown. The present study examines whether a choral intervention can modulate patterns of cognitive change in persons with dementia and whether within-person variation in affect is associated with this change. Methods Thirty-three older adults with dementia engaged weekly in the Voices in Motion (ViM) study consisting of 3 choral seasons spanning 18-months. Performance on the Mini-Mental State Examination (MMSE) and the Positive and Negative Affect Schedule was assessed monthly within each choral season using a longitudinal intensive repeated-measures design. Three-level multilevel models were employed to disaggregate between- and within-person effects across short- (month-to-month) and long-term (season-to-season) intervals. Results ViM participants exhibited an annual MMSE decline of 1.8 units, notably less than the clinically meaningful 3.3 units indicated by non-intervention literature. Further, variability in negative affect shared a within-person time-varying association with MMSE performance; decreases in negative affect, relative to one’s personal average, were linked to corresponding improvements in cognitive function. Conclusion Engagement in the ViM choral intervention may attenuate cognitive decline for persons with dementia via a reduction of psychological comorbidities such as elevated negative affect.