Well-being Paradox Research Articles

A Salutogenic Analysis of the Well-Being Paradox in Older Age

Following Antonovsky’s salutogenic perspective, we investigate to what extent the sense of coherence and psychological resources mediate the physical health-mental health relationship, assuming that these resilience factors mutually influence each other. In our questionnaire study, 387 older persons at the mean age of 73.8 years volunteered. We assessed physical health appraisals, sense of coherence components (comprehensibility, manageability, and meaningfulness), psychological resources (self-efficacy and self-esteem) and mental health (subjective well-being, depressive mood, and psychological health). We used structural equation modeling with latent variables and a bootstrapping method to test hypothesized mediation chains. We found (a) a significant direct effect of physical health on mental health, (b) two significant specific indirect effects of physical health on mental health, substantiating that the sense of coherence was a stronger mediator than psychological resources, and (c) two significant 3-path mediated effects. Physical health is profoundly associated with mental health. However, resilience factors such as the sense of coherence and psychological resources enable older people to maintain mental health when confronted with chronic physical health problems.

The age and subjective well-being paradox revisited:A multidimensional perspective

This study re-examines the much-discussed paradox that although aging is associated with declines in many life domains, overall subjective well-being does not appear to decline sharply with age. We use data from two waves of the Norwegian NorLAG study (age 40-85, n=3,750) and examine age differences in change in well-being outcomes (life satisfaction, positive affect, negative affect, and depression) and factors that may account for age variations in such change. Outcomes show stability well into older age, but negative changes in advanced age, cross-sectionally or longitudinally. Life satisfaction and negative affect are adversely related to older age longitudinally, whereas positive affect and depression are adversely related to older age in the cross-section. Results are similar for men and women. Loss of health and partner are the main causes of declining well-being in older age. Findings suggest qualifications to the “well-being paradox”, e.g.: only some dimensions of SWB remain stable, while others decline; across dimensions SWB change is more negative in old-old than in young-old age.

Ongoing Cumulative Chronic Stressors as Predictors of Well-Being in the Second Half of Life

The main aim of the present study was to examine the relationship between ongoing cumulative chronic stressors (OCCS) and well-being during the second half of life. The sample comprised 7,268 participants who had completed the Health and Retirement Study 2006 psychosocial questionnaire and the full OCCS questionnaire. OCCS were evaluated as a predictor of Subjective Well-Being and Psychological Well-Being (PWB) using two measures: the number of events and the subjective evaluation attributed to the events by the participant. Additionally, the association between OCCS and well-being was evaluated in midlife (50–64), young-old (65–79), and old-old (80–104) participants. The results showed that the participant’s age as well as the number of OCCS perceived as “very upsetting” were strong predictors of well-being. The relationship between OCCS and PWB was weaker among old-old participants than among midlife and young-old participants. Although well-being is considered a stable trait-like personality dimension in the second half of life, the study’s findings suggest that as the number of OCCS was higher, and especially as the subjective evaluations attributed to an event are more upsetting, well-being was lower. Nevertheless, this lower level of well-being is partially moderated in the PWB measures by age. Old-old participants maintain a higher general positive sense of PWB than midlife and young-old participants in what was previously termed the “well-being paradox.” Implications of the results are discussed.

The Functional Quality of Life (fQOL)-Model

Quality of life (QOL) is increasingly being suggested as a crucial outcome variable for interventions that aim to maintain or improve health and psychological resources in old age. Currently, two main approaches to measuring QOL can be distinguished: (1) the sQOL approach which measures an individual’s subjective evaluation of his or her overall life situation and QOL; (2) the oQOL approach that infers QOL of an individual from the outside, e.g., via measurement of health impairments. Both approaches, however, are problematic: In the first case, a large majority of individuals report relatively high levels of sQOL that are sometimes in stark contrast to observable impairments (known as the well-being paradox; Staudinger, 2000 ). This suggests that improving impaired resources does not necessarily lead to improved sQOL (although there may be positive effects on the autonomy of these individuals). The second approach is problematic because improved oQOL leads only to an increase in self-reported overall sQOL under very rare conditions – and one cannot assume that an increase in resources necessarily has led or will lead to higher levels of sQOL. Therefore, we propose a new, functional quality of life (fQOL) approach to determine quality of life. It combines the existing approaches by linking the subjective representations of objectively measurable resources to their functional value for pursuing individually meaningful activities and goals. From this model, fQOL-improving interventions as well as methods to evaluate the effectiveness of QOL-interventions can be derived.

Depression and QOL in patients with ALS: how do self-ratings and ratings by relatives differ?

Amyotrophic lateral sclerosis (ALS) is a lethal neurodegenerative disease affecting the motor nervous system and currently lacking effective means of treatment. The focus of ALS treatment therefore lies in palliative treatment from a multidisciplinary team. Published findings regarding affective components and patients' perceived quality-of-life (QoL) as well as comparative reports of family members/caregivers remain equivocal. In this study, 41 ALS patients and their relatives were enrolled in a study employing the 12-item ALS-Depression-Inventory (ADI-12) and the Munich quality-of-life dimensions list (MLDL). The ALS-functional rating scale (ALSFRS-R) was used to evaluate physical disabilities. The ADI-12 depression scale data identified nine patients with depressive disorders; the patients had satisfactory QoL outcomes on the MLDL. The results did not differ significantly between ALS patients and their relatives. Thus, in agreement with other studies, QoL and emerging depression do not automatically coincide with patients' physical impairments of the patients. This "well-being paradox" is currently not well understood, and further studies are needed to optimize the treatment of patients through the course of disease progression.

Quality of Life, Anxiety, and Oncological Factors: A Follow-Up Study of Breast Cancer Patients

The number of long-term survivors of breast cancer has increased over recent decades because of many treatment advances. Thus, long-term quality of life (QoL) and factors affecting it are of growing research interest.The authors investigated longitudinal changes in QoL and anxiety in breast cancer patients and differences in QoL and anxiety in various oncological subgroups.A group of 236 women with a primary diagnosis of breast cancer or carcinoma in-situ completed questionnaires after surgical treatment, 6 months, and 12 months post-surgery.QoL scores of breast cancer patients improved over time, but impairments in terms of anxiety, body image, and sexual functioning were still observed. Younger patients were more likely to be distressed by cancer diagnosis and treatment.Surgical modality and tumor prognostic factors, however, seemed to play a minor role in patients' subjective QoL, which is discussed in terms of the "well-being paradox."

Quality of Life, Anxiety, and Oncological Factors: A Follow-Up Study of Breast Cancer Patients

The number of long-term survivors of breast cancer has increased over recent decades because of many treatment advances. Thus, long-term quality of life (QoL) and factors affecting it are of growing research interest. The authors investigated longitudinal changes in QoL and anxiety in breast cancer patients and differences in QoL and anxiety in various oncological subgroups. A group of 236 women with a primary diagnosis of breast cancer or carcinoma in-situ completed questionnaires after surgical treatment, 6 months, and 12 months post-surgery. QoL scores of breast cancer patients improved over time, but impairments in terms of anxiety, body image, and sexual functioning were still observed. Younger patients were more likely to be distressed by cancer diagnosis and treatment. Surgical modality and tumor prognostic factors, however, seemed to play a minor role in patients' subjective QoL, which is discussed in terms of the "well-being paradox."

Delineating Terminal Change in Subjective Well-Being and Subjective Health: Brief Report

The present study investigated whether several evaluative indicators of subjective well-being (SWB) and subjective health decline as death approaches and which of them shows a stronger decline. Using three-wave longitudinal data from deceased participants of the Cross-Sectional and Longitudinal Aging Study (N = 1,360; age range 75-94 at T1= Time 1), we found a stronger decline in most evaluative indicators when plotted by distance-to-death relative to distance from birth. After controlling for background characteristics and physical and cognitive functioning, death-related decline was still found for SWB but not for subjective health. Implications are discussed regarding the well-being paradox and the yet unclear mechanisms that link evaluative indicators to the dying process.

Where is the “wellbeing dividend”? Nature, structure and consumption inequalities

Recent interest in wellbeing has important ramifications for sustainable development. This paper describes the so-called wellbeing paradox: the existence of stationary or declining levels of subjective wellbeing, despite growing income and consumption levels. This paradox suggests the existence of a “wellbeing dividend” that could flow from more sustainable societies: the potential to reduce or redistribute consumption, without compromising levels of wellbeing. Numerical analysis to support this view is presented using data on consumer expenditure and reported life satisfaction across 27 European countries. The results indicate that certain categories of consumer expenditure may already deliver negative returns to scale in terms of life satisfaction. The paper offers two different kinds of “explanation” for continued consumption growth (one based in human nature and the other in social structure) and illustrates how these “lock us in” to more unequal, less sustainable societies. Finally, the author explores some potential “solution spaces” in the search for sustainability.

Das „Zufriedenheitsparadox” in der Lebensqualitätsforschung - Wovon hängt unser Wohlbefinden ab? -

In quality-of-life research an empirical phenomenon has been observed independently in medicine and in the social sciences which is so contrary to what intuition tells us that it has been called paradoxical. In medicine it is called the "satisfaction paradox" and in the social sciences the "well-being paradox". What is meant in both cases is that objectively negative factors in one's life have relatively little effect on subjective quality of life. In the present paper examples are given of relevant research findings from both fields. An attempt is then made to explain the phenomenon, with the topic being examined not only from a methodological but also from a personality, cognition and social psychology perspective. Finally, the implications for research and clinical work are discussed.